Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal

IntroductionPre-hospital emergency care is crucial for improving patient outcomes, especially in low- and middle-income countries (LMICs) where trauma is a leading cause of death. In Nepal, inadequate pre-hospital care contributes to approximately 16,600 preventable deaths annually. This study asses...

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Main Authors: Pavan Kumar Sah, Wenyi Lai, Neelam Gupta, Bimal Singh Bist, Sanjib Gautam, Khem Raj Sapkota, Bipin Koirala, Ileana Kong Zhuo, Morlai Sesay, Ying Guan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1623868/full
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author Pavan Kumar Sah
Wenyi Lai
Neelam Gupta
Bimal Singh Bist
Sanjib Gautam
Khem Raj Sapkota
Bipin Koirala
Ileana Kong Zhuo
Morlai Sesay
Ying Guan
Ying Guan
author_facet Pavan Kumar Sah
Wenyi Lai
Neelam Gupta
Bimal Singh Bist
Sanjib Gautam
Khem Raj Sapkota
Bipin Koirala
Ileana Kong Zhuo
Morlai Sesay
Ying Guan
Ying Guan
author_sort Pavan Kumar Sah
collection DOAJ
description IntroductionPre-hospital emergency care is crucial for improving patient outcomes, especially in low- and middle-income countries (LMICs) where trauma is a leading cause of death. In Nepal, inadequate pre-hospital care contributes to approximately 16,600 preventable deaths annually. This study assessed the knowledge, attitudes, and practices (KAP) of healthcare providers in pre-hospital care to identify factors influencing their preparedness.MethodsA quantitative, descriptive cross-sectional design was employed, utilizing a 35-item questionnaire based on a 5-point Likert scale. Data were collected via an online survey (Google Forms) from 517 healthcare providers (doctors, nurses, and paramedics) across 16 hubs and 76 satellite hospitals in Nepal’s seven provinces based on a systematic randomization technique. Data were described with median and interquartile range. Nonparametric analysis, rank Spearman’s rank correlation, and ordinal regression were used to analyze the data.ResultsThe study revealed that 62% of providers had good knowledge, 66% exhibited positive attitudes, but only 25% demonstrated good practice. Significant variations were observed by gender, profession, and workplace, with males, doctors, and private hospital providers scoring higher in knowledge and practice. Moderate correlations were found between knowledge, attitude, and practice (rs = 0.420–0.562, p < 0.001). Ordinal logistic regression indicated significant associations between demographic factors and KAP levels.ConclusionDespite good knowledge and positive attitudes, only 25% demonstrated good practice, indicating practical implementation of pre-hospital care remains suboptimal. Targeted training programs, simulation-based learning, and continuous professional development will be needed to bridge the gap between knowledge and practice.
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spelling doaj-art-6c625602b3564c7eacbf3f01e754d33b2025-08-20T03:32:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.16238681623868Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in NepalPavan Kumar Sah0Wenyi Lai1Neelam Gupta2Bimal Singh Bist3Sanjib Gautam4Khem Raj Sapkota5Bipin Koirala6Ileana Kong Zhuo7Morlai Sesay8Ying Guan9Ying Guan10Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, ChinaDepartment of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, ChinaDepartment of Pediatrics, Paropakar Maternity and Women's Hospital, Kathmandu, NepalDepartment of Health Education, Graduate School of Education, Tribhuvan University, Kathmandu, NepalNepal College of Information Technology, Lalitpur, NepalSchool of International Education, Southern Medical University, Guangzhou, ChinaSchool of International Education, Southern Medical University, Guangzhou, ChinaDepartment of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, ChinaDepartment of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, ChinaDepartment of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, ChinaSchool of International Education, Southern Medical University, Guangzhou, ChinaIntroductionPre-hospital emergency care is crucial for improving patient outcomes, especially in low- and middle-income countries (LMICs) where trauma is a leading cause of death. In Nepal, inadequate pre-hospital care contributes to approximately 16,600 preventable deaths annually. This study assessed the knowledge, attitudes, and practices (KAP) of healthcare providers in pre-hospital care to identify factors influencing their preparedness.MethodsA quantitative, descriptive cross-sectional design was employed, utilizing a 35-item questionnaire based on a 5-point Likert scale. Data were collected via an online survey (Google Forms) from 517 healthcare providers (doctors, nurses, and paramedics) across 16 hubs and 76 satellite hospitals in Nepal’s seven provinces based on a systematic randomization technique. Data were described with median and interquartile range. Nonparametric analysis, rank Spearman’s rank correlation, and ordinal regression were used to analyze the data.ResultsThe study revealed that 62% of providers had good knowledge, 66% exhibited positive attitudes, but only 25% demonstrated good practice. Significant variations were observed by gender, profession, and workplace, with males, doctors, and private hospital providers scoring higher in knowledge and practice. Moderate correlations were found between knowledge, attitude, and practice (rs = 0.420–0.562, p < 0.001). Ordinal logistic regression indicated significant associations between demographic factors and KAP levels.ConclusionDespite good knowledge and positive attitudes, only 25% demonstrated good practice, indicating practical implementation of pre-hospital care remains suboptimal. Targeted training programs, simulation-based learning, and continuous professional development will be needed to bridge the gap between knowledge and practice.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1623868/fullemergency medical servicesSustainable Development Goalshealthcare workerspre-hospital systemNepalKAP survey
spellingShingle Pavan Kumar Sah
Wenyi Lai
Neelam Gupta
Bimal Singh Bist
Sanjib Gautam
Khem Raj Sapkota
Bipin Koirala
Ileana Kong Zhuo
Morlai Sesay
Ying Guan
Ying Guan
Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal
Frontiers in Public Health
emergency medical services
Sustainable Development Goals
healthcare workers
pre-hospital system
Nepal
KAP survey
title Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal
title_full Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal
title_fullStr Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal
title_full_unstemmed Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal
title_short Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal
title_sort knowledge attitudes and practices of healthcare providers in pre hospital care in nepal
topic emergency medical services
Sustainable Development Goals
healthcare workers
pre-hospital system
Nepal
KAP survey
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1623868/full
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