Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

Acharya, Kiran; Thapa, Rajshree; Bhattarai, Navaraj; Bam, Kiran; Shrestha, Bhagawan

doi:10.1136/bmjopen-2020-040918

Cited by 22 publications

(41 citation statements)

References 25 publications

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“…This procedure involves assigning equal weights to each domain, and adjusting for the "variation in the number of indicators within each domain so that the weight of the indicator is inversely proportional to the number of indicators in the domain" where a facility obtains a total score-that is, the sum of all indicators were standardized to have a maximum score of 100. Equal weighting is the most spontaneous approach to generate a composite measurement compared with other frequently used weighting patterns [19][20][21][22]. The measurement procedure of the readiness score is displayed in the S1 Table.…”

Section: Discussionmentioning

confidence: 99%

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Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Acharya¹,

Subedi²,

Dahal

et al. 2021

PLoS ONE

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Background Achieving maternal and newborn related Sustainable Development Goals targets is challenging for Nepal, mainly due to poor quality of maternity services. In this context, we aim to assess the Basic Emergency Obstetric and Newborn Care (BEmONC) service availability and readiness in health facilities in Nepal by analyzing data from Nepal Health Facility Survey (NHFS), 2015. Methods We utilized cross-sectional data from the nationally representative NHFS, 2015. Service availability was measured by seven signal functions of BEmONC, and service readiness by the availability and functioning of supportive items categorized into three domains: staff and guidelines, diagnostic equipment, and basic medicine and commodities. We used the World Health Organization’s service availability and readiness indicators to estimate the readiness scores. We performed a multiple linear regression to identify important factors in the readiness of the health facilities to provide BEmONC services. Results The BEmONC service readiness score was significantly higher in public hospitals compared with private hospitals and peripheral public health facilities. Significant factors associated with service readiness score were the facility type (14.69 points higher in public hospitals, P<0.001), number of service delivery staff (2.49 points increase per each additional delivery staff, P<0.001), the service hours (4.89 points higher in facilities offering 24-hour services, P = 0.01) and status of periodic review of maternal and newborn deaths (4.88 points higher in facilities that conducted periodic review, P = 0.043). Conclusions These findings suggest that BEmONC services in Nepal could be improved by increasing the number of service delivery staff, expanding service hours to 24-hours a day, and conducting periodic review of maternal and newborn deaths at health facilities, mainly in the peripheral public health facilities. The private hospitals need to be encouraged for BEmONC service readiness.

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Section: Discussionmentioning

confidence: 99%

“…The location of facilities (rural/urban) was not available in the datasets. We have classified them using the global positioning system [19]. These key variables were taken from the available literature [20,21] and were used to demonstrate the availability or readiness of the health facility to provide BEmONC services.…”

Section: Measurement Of Variablesmentioning

confidence: 99%

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Acharya¹,

Subedi²,

Dahal

et al. 2021

PLoS ONE

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“…Further, expansion of HIV testing facilities is critical as only a quarter of government and 30% of private hospital currently provide HIV testing services. 23 …”

Section: Discussionmentioning

confidence: 99%

“…It is to be noted that HIV testing is free in Nepal but higher testing among participants at higher economic quintile may be related to the higher risk behaviour and involvement in risky sex behaviour among these groups. 11 HIV testing services varied by provinces 23 which is explained by the disproportionate distribution of HIV in the country. Province no.…”

Section: Open Accessmentioning

confidence: 99%

Factors associated with HIV testing and counselling services among women and men in Nepal: a cross-sectional study using data from a nationally representative survey

Bhattarai

Bam²,

Acharya³

et al. 2021

BMJ Open

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ObjectivesThis study is set up to explore the factors associated with Human Immunodeficiency Virus (HIV) testing among women and men in Nepal.Study designNepal Demographic and Health Survey, 2016 adopts a cross-sectional design.SettingNepal.ParticipantsWomen and men of age 15–49 years.Primary outcome measuresOur primary outcome was ever tested for HIV. We used multivariable analysis at a 95% level of significance to measure the effect in outcome variables.ResultsAbout one in 10 women (10.8%) and one in five men (20.5%) ever tested for HIV. Women who had media exposure at least once a week ((adjusted odds ratio (aOR)=2.8; 95% CI: 1.4 to 5.3) were more likely to get tested for HIV compared with those who had no media exposure at all. Similarly, those who had their recent delivery in the health facility (aOR=3.9; 95% CI: 2.4 to 6.3) were more likely to get tests for HIV compared with those delivered elsewhere. Likewise, among men, compared with adolescents (15–19 years), those from older age groups were more likely to get tested for HIV. Compared with no education, secondary (aOR=2.3; 95% CI: 1.4 to 3.6) and higher education (aOR=1.7; 95% CI: 1.0 to 2.8) had higher odds of getting tested for HIV. Similarly, wealth quintiles in richer and richest groups were more likely to get tested for HIV compared with the poorest quintile. Other characteristics like media exposure, paid sex and 2+ sexual partners were positively associated with being tested for HIV.ConclusionsHIV testing is not widespread and more men than women are accessing HIV services. More than two-thirds of women who delivered at health facilities never tested for HIV. It is imperative to reach out to people engaging in risky sexual behaviour, people with lower educational attainment, and those in the lower wealth quintile for achieving 95–95–95 targets by 2030.

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“…Hence, more efforts should be put into screening, education and treatment of STIs in developing countries. [42,43] Solomon Islands, Equatorial Guinea, and Uganda are almost the least developed country in the world, [44,45] which had the highest age-standardized death and DALYs rate.…”

Section: Disease Burden In Different Regionsmentioning

confidence: 99%

Global Burden of Sexually Transmitted Infections: 1990 - 2019

et al. 2021

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Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

Cited by 22 publications

References 25 publications

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

Factors associated with HIV testing and counselling services among women and men in Nepal: a cross-sectional study using data from a nationally representative survey

Global Burden of Sexually Transmitted Infections: 1990 - 2019

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