Challenges and possible improvements for healthcare teams at outreach clinics in Nepal – a qualitative study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

ABSTRACT

Background

All Nepalese citizens have the right to high-quality healthcare services free of charge. To achieve this, healthcare services for the rural population in Nepal need to be improved in terms of personnel, medicines, and medical equipment.

Objectives

To explore challenges and possible improvements healthcare personnel experience when travelling to rural parts of Nepal to provide healthcare.

Method

Data was collected from various health professionals using focus group discussions at Dhulikhel Hospital in Nepal. The data were transcribed and analysed using Systematic text condensation.

Results

Twenty-two professional healthcare personnel participated in five group discussions. Four categories emerged from the collected material: Finding ORC services being underutilised, Wanting to fulfil tasks and do a good job, Facing inadequate resources, and Seeing the need for improved organisation and cooperation. There was consensus that rural clinics are important to maintaining health for the rural population of Nepal. However, there was frustration that the rural population was not benefitting from all available healthcare services due to underutilisation.

Conclusion

Rural healthcare clinics are not utilised appropriately, according to healthcare workers at the rural outreach clinics. Potential ways of overcoming the perceived challenges of underutilising available healthcare services include financial and human resources. The rural population´s health awareness needs to be increased, and the work environment for rural healthcare workers needs to be improved. These issues need to be prioritised by the government and policymakers.

Paper Context

Main findings: Outreach clinics in Nepal are perceived as underutilised by health providers.
Added knowledge: Increased awareness among rural people on when to seek healthcare, improved work conditions for health providers and collaboration with other health facilities may strengthen the utilisation of offered care.
Global health impact for policy and action: Updated policies reflecting these Nepalese suggestions on strengthening rural healthcare may be useful and benefit other rural populations in similar settings.

Related collections

Most cited references 19

Record: found
Abstract: found
Article: not found

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

A Tong, P SAINSBURY, J. Craig (2007)

Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.

0 comments Cited 8613 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Motivation and retention of health workers in developing countries: a systematic review

Mischa Willis-Shattuck, Posy Bidwell, Steve Thomas … (2008)

Background A key constraint to achieving the MDGs is the absence of a properly trained and motivated workforce. Loss of clinical staff from low and middle-income countries is crippling already fragile health care systems. Health worker retention is critical for health system performance and a key problem is how best to motivate and retain health workers. The authors undertook a systematic review to consolidate existing evidence on the impact of financial and non-financial incentives on motivation and retention. Methods Four literature databases were searched together with Google Scholar and 'Human Resources for Health' on-line journal. Grey literature studies and informational papers were also captured. The inclusion criteria were: 1) article stated clear reasons for implementing specific motivations to improve health worker motivation and/or reduce medical migration, 2) the intervention recommended can be linked to motivation and 3) the study was conducted in a developing country and 4) the study used primary data. Results Twenty articles met the inclusion criteria. They consisted of a mixture of qualitative and quantitative studies. Seven major motivational themes were identified: financial rewards, career development, continuing education, hospital infrastructure, resource availability, hospital management and recognition/appreciation. There was some evidence to suggest that the use of initiatives to improve motivation had been effective in helping retention. There is less clear evidence on the differential response of different cadres. Conclusion While motivational factors are undoubtedly country specific, financial incentives, career development and management issues are core factors. Nevertheless, financial incentives alone are not enough to motivate health workers. It is clear that recognition is highly influential in health worker motivation and that adequate resources and appropriate infrastructure can improve morale significantly.

0 comments Cited 104 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Disease avoidance as a functional basis for stigmatization.

Megan Oaten, Richard J. Stevenson, Trevor I. Case (2011)

Stigmatization is characterized by chronic social and physical avoidance of a person(s) by other people. Infectious disease may produce an apparently similar form of isolation-disease avoidance-but on symptom remission this often abates. We propose that many forms of stigmatization reflect the activation of this disease-avoidance system, which is prone to respond to visible signs and labels that connote disease, irrespective of their accuracy. A model of this system is presented, which includes an emotional component, whereby visible disease cues directly activate disgust and contamination, motivating avoidance, and a cognitive component, whereby disease labels bring to mind disease cues, indirectly activating disgust and contamination. The unique predictions of this model are then examined, notably that people who are stigmatized evoke disgust and are contaminating. That animals too show avoidance of diseased conspecifics, and that disease-related stigma targets are avoided in most cultures, also supports this evolutionary account. The more general implications of this approach are then examined, notably how it can be used to good (e.g. improving hygiene) or bad (e.g. racial vilification) ends, by yoking particular labels with cues that connote disease and disgust. This broadening of the model allows for stigmatization of groups with little apparent connection to disease.

0 comments Cited 67 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Glob Health Action

Journal ID (iso-abbrev): Glob Health Action

Title: Global Health Action

Publisher: Taylor & Francis

ISSN (Print): 1654-9716

ISSN (Electronic): 1654-9880

Publication date (Electronic, pub): 7 August 2024

Publication date (Electronic, collection): 2024

Publication date PMC-release: 7 August 2024

Volume: 17

Issue: 1

Electronic Location Identifier: 2385177

Affiliations

[a ]Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology; , Trondheim, Norway

[b ]School of Medical Sciences, Kathmandu University; , Dhulikhel, Nepal

[c ]Nell Hodgson Woodruff School of Nursing, Emory University; , Atlanta, GA, USA

[d ]Department of Women’s and Children’s Health, Uppsala University; , Uppsala, Sweden

[e ]Department of Obstetrics and Gynecology, St Olav’s Hospital, Trondheim University Hospital; , Trondheim, Norway

[f ]Malawi Liverpool Wellcome Programme; , Blantyre, Malawi

[g ]Institute of Life Course and Medical Sciences, University of Liverpool; , Liverpool, UK

Author notes

CONTACT Ingrid Eriksen ingrer@ 123456ntnu.no Department of Public Health and Nursing, NTNU, Håkon Jarlsgate 11, Trondheim 7491, Norway

[*]

These authors contributed equally to this work.

Author information

Ingrid Eriksen https://orcid.org/0009-0000-9734-5248

Eirin Helene Rasmussen https://orcid.org/0009-0005-9576-2247

Biraj Karmacharya https://orcid.org/0000-0001-8983-0235

Seema Das https://orcid.org/0000-0001-5170-1622

Elisabeth Darj https://orcid.org/0000-0002-8311-4956

Maria Lisa Odland https://orcid.org/0000-0003-4340-7145

Article

Publisher ID: 2385177

DOI: 10.1080/16549716.2024.2385177

PMC ID: 11308952

PubMed ID: 39109605

SO-VID: 353d15c9-6a89-4da8-a5da-e892c92923cf

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

Challenges and possible improvements for healthcare teams at outreach clinics in Nepal – a qualitative study

Read this article at

ABSTRACT

Background

Objectives

Method

Results

Conclusion

Paper Context

Related collections

Tobacco Prevention & Cessation

Most cited references 19

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

Motivation and retention of health workers in developing countries: a systematic review

Disease avoidance as a functional basis for stigmatization.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 381

Most referenced authors 175