Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey

# Background Despite significant progress in Nepal's health indicators over the past three decades, regional disparities in public health centre (PHC) provision and accessibility remain severe. It has been reported that rural dwellers prefer and place more trust in outreach centres (ORCs) run...

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Main Authors: Hocheol Lee, Hyeyeon Jo, Biraj Man Karmacharya, Bimala Sharma, Pramita Shrestha, Prajwal Satyal, Eun Woo Nam
Format: Article
Language:English
Published: Inishmore Laser Scientific Publishing Ltd 2023-05-01
Series:Journal of Global Health Reports
Online Access:https://doi.org/10.29392/001c.75143
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author Hocheol Lee
Hyeyeon Jo
Biraj Man Karmacharya
Bimala Sharma
Pramita Shrestha
Prajwal Satyal
Eun Woo Nam
author_facet Hocheol Lee
Hyeyeon Jo
Biraj Man Karmacharya
Bimala Sharma
Pramita Shrestha
Prajwal Satyal
Eun Woo Nam
author_sort Hocheol Lee
collection DOAJ
description # Background Despite significant progress in Nepal's health indicators over the past three decades, regional disparities in public health centre (PHC) provision and accessibility remain severe. It has been reported that rural dwellers prefer and place more trust in outreach centres (ORCs) run by the Dhulikhel Hospital. However, the reasons behind this remain unclear. We aimed to examine the determinants of Nepalese rural dwellers’ choice of first-contact health facility. # Methods This was a cross-sectional survey among 1,098 adult rural dwellers in Nepal. The study sample was first divided into PHC and ORC groups, and intergroup differences were tested using Pearson chi-square test and independent sample t-test. Then, binary logistic regression was performed to analyse first-contact health facility decision-making. # Results Sex, education level, importance of health care satisfaction, importance of free health care, diagnosis of hypertension, diagnosis of diabetes, insurance coverage, savings, community-level cooperation, and distance to the health facility were significant factors affecting the choice of the first-contact health facility. Most significantly, people who were unconcerned about receiving free health care were 19.417 times more likely to use ORCs. Additionally, it was observed that rural dwellers perceived ORCs as providing higher quality health care. # Conclusions The government must promote cooperation between PHCs and ORCs, as it is essential to understand consumer demand, supply-side issues, and institutional aspects of health care in rural areas to achieve universal access to health care.
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spelling doaj-art-e53f844f193a4000bdd77cfc73effb332025-08-20T02:40:10ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232023-05-01710.29392/001c.75143Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional surveyHocheol LeeHyeyeon JoBiraj Man KarmacharyaBimala SharmaPramita ShresthaPrajwal SatyalEun Woo Nam# Background Despite significant progress in Nepal's health indicators over the past three decades, regional disparities in public health centre (PHC) provision and accessibility remain severe. It has been reported that rural dwellers prefer and place more trust in outreach centres (ORCs) run by the Dhulikhel Hospital. However, the reasons behind this remain unclear. We aimed to examine the determinants of Nepalese rural dwellers’ choice of first-contact health facility. # Methods This was a cross-sectional survey among 1,098 adult rural dwellers in Nepal. The study sample was first divided into PHC and ORC groups, and intergroup differences were tested using Pearson chi-square test and independent sample t-test. Then, binary logistic regression was performed to analyse first-contact health facility decision-making. # Results Sex, education level, importance of health care satisfaction, importance of free health care, diagnosis of hypertension, diagnosis of diabetes, insurance coverage, savings, community-level cooperation, and distance to the health facility were significant factors affecting the choice of the first-contact health facility. Most significantly, people who were unconcerned about receiving free health care were 19.417 times more likely to use ORCs. Additionally, it was observed that rural dwellers perceived ORCs as providing higher quality health care. # Conclusions The government must promote cooperation between PHCs and ORCs, as it is essential to understand consumer demand, supply-side issues, and institutional aspects of health care in rural areas to achieve universal access to health care.https://doi.org/10.29392/001c.75143
spellingShingle Hocheol Lee
Hyeyeon Jo
Biraj Man Karmacharya
Bimala Sharma
Pramita Shrestha
Prajwal Satyal
Eun Woo Nam
Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey
Journal of Global Health Reports
title Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey
title_full Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey
title_fullStr Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey
title_full_unstemmed Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey
title_short Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey
title_sort factors affecting nepalese rural dwellers choice of first contact health facility a cross sectional survey
url https://doi.org/10.29392/001c.75143
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