Health facility readiness to provide integrated Family Planning, Maternal and Child Health (FPMCH) services in Nepal: Evidence from the comprehensive health facility survey

Abstract

Introduction This study aimed to build the emergent body of evidence of family planning and maternal and child health (FPMCH) service integration benefits that can be useful in reaching the target of sustainable development goals (SDGs). Methods We utilized data from the 2015 Nepal Health Facility Survey and used the World Health Organization service readiness manual for defining the service readiness indicator score of all services related to FPMCH integration. Composite readiness index for all services including family planning, antenatal care service, delivery and newborn service readiness index, and curative child care service readiness index was considered for the integration of all services (i.e. readiness for FPMCH). Multivariable linear regression models were fitted to examine the association between covariates and readiness score to provide integrated services. Results The mean readiness score of integrated services in health facilities in Nepal was 52.1%. The services in private hospitals and peripheral health facilities had significantly lower readiness scores of integrated services compared to government hospitals. Compared to Province 3(Province 3 holds the national capital), Province 2 had significantly lower and Province 7 had significantly higher readiness scores. There is a marginally significantly higher readiness score of integrated services in the facilities where management meetings are held compared to where management meetings are never conducted. Interestingly, health facilities where external supervision occurred in the last 4 months had better service readiness of integrated services compared with those facilities with no external supervision. Similarly, the facilities that performed the routine quality assurance activities and facilities having a system for collecting opinion and being reviewed had a higher integrated services readiness score than their counterparts. Conclusion This study found a scope of improvement in management practices in the health sector of Nepal especially for supportive supervision, quality assurance (QA) activities, monthly management meetings, and a system of collecting and reviewing opinions from the clients. Strengthening management practices especially, promoting supportive supervision and adhering to QA protocols may improve HF readiness to implement integrated FPMCH in Nepal. Being low readiness, there is an urgent need for policy reform to improve the integrated service readiness, particularly in Province 2.

Revisiting swimming against tide; inequalities in child malnutrition in Nepal

“…Nutrition-sensitive interventions targeting underlying determinants of malnutrition, such as poverty, integrating nutrition counseling into maternal and child health and family planning programs, and evaluating the cost-effectiveness of social safety net programs are crucial [62,75,76,82,88]. The study emphasized that despite successful progress in improving average nutritional status, pro-poor aspects of nutritional transition need more attention for child stunting [9,32,33,89].…”

Identifying determinants of spatial agglomeration of healthcare resources by using spatial econometric methods: a longitudinal study in China

“…To increase the agglomeration of healthcare resources, the government should consider the negative effect of MMR in one province and a spatial spillover effect in its adjacent provinces. For example, the government can place a high priority on maternal and child health (MCH) services and integrate vertical programs (e.g., family planning) related to MCH and alleviate the medical burden of individual residents ( 39 ). In addition, considering the positive spillover effect of MMR on the agglomeration of the beds and health workforce, the government should also construct and strengthen interprovincial cooperation in health planning and jointly formulate health development strategies to reduce MMR.…”

Readiness of rural health facilities to provide immediate postpartum care in Uganda

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