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Health system gaps in cardiovascular disease prevention and management in Nepal.

Publication ,  Journal Article
Shrestha, A; Maharjan, R; Karmacharya, BM; Bajracharya, S; Jha, N; Shrestha, S; Aryal, A; Baral, PP; Bhatt, RD; Bhattarai, S; Bista, D; Oli, N ...
Published in: BMC health services research
July 2021

Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal's health systems gaps to prevent and manage CVDs.We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts' codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system.National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible.Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.

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Published In

BMC health services research

DOI

EISSN

1472-6963

ISSN

1472-6963

Publication Date

July 2021

Volume

21

Issue

1

Start / End Page

655

Related Subject Headings

  • Nepal
  • Medical Assistance
  • Humans
  • Health Policy & Services
  • Government Programs
  • Delivery of Health Care
  • Cardiovascular Diseases
  • 4206 Public health
  • 4205 Nursing
  • 4203 Health services and systems
 

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Shrestha, A., Maharjan, R., Karmacharya, B. M., Bajracharya, S., Jha, N., Shrestha, S., … Koju, R. (2021). Health system gaps in cardiovascular disease prevention and management in Nepal. BMC Health Services Research, 21(1), 655. https://doi.org/10.1186/s12913-021-06681-0
Shrestha, Archana, Rashmi Maharjan, Biraj Man Karmacharya, Swornim Bajracharya, Niharika Jha, Soniya Shrestha, Anu Aryal, et al. “Health system gaps in cardiovascular disease prevention and management in Nepal.BMC Health Services Research 21, no. 1 (July 2021): 655. https://doi.org/10.1186/s12913-021-06681-0.
Shrestha A, Maharjan R, Karmacharya BM, Bajracharya S, Jha N, Shrestha S, et al. Health system gaps in cardiovascular disease prevention and management in Nepal. BMC health services research. 2021 Jul;21(1):655.
Shrestha, Archana, et al. “Health system gaps in cardiovascular disease prevention and management in Nepal.BMC Health Services Research, vol. 21, no. 1, July 2021, p. 655. Epmc, doi:10.1186/s12913-021-06681-0.
Shrestha A, Maharjan R, Karmacharya BM, Bajracharya S, Jha N, Shrestha S, Aryal A, Baral PP, Bhatt RD, Bhattarai S, Bista D, Citrin D, Dhimal M, Fitzpatrick AL, Jha AK, Karmacharya RM, Mali S, Neupane T, Oli N, Pandit R, Parajuli SB, Pradhan PMS, Prajapati D, Pyakurel M, Pyakurel P, Rai BK, Sapkota BP, Sapkota S, Shrestha AP, Shrestha R, Sharma GN, Sharma S, Spiegelman D, Suwal PS, Thapa B, Vaidya A, Xu D, Yan LL, Koju R. Health system gaps in cardiovascular disease prevention and management in Nepal. BMC health services research. 2021 Jul;21(1):655.
Journal cover image

Published In

BMC health services research

DOI

EISSN

1472-6963

ISSN

1472-6963

Publication Date

July 2021

Volume

21

Issue

1

Start / End Page

655

Related Subject Headings

  • Nepal
  • Medical Assistance
  • Humans
  • Health Policy & Services
  • Government Programs
  • Delivery of Health Care
  • Cardiovascular Diseases
  • 4206 Public health
  • 4205 Nursing
  • 4203 Health services and systems