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Mr. Narayan Sapkota.Cdr Original Research Arcle Sapkota N et al PREPAREDNESS FOR MITIGATING NON COMMUNICABLE DISEASES IN GAINDAKOT MUNICIPALITY, NEPAL: PERSPECTIVES OF KEY-INFORMANTS Narayan Sapkota1*, Damaru Prasad Paneru2 ABSTRACT Affiliaon Introducon 1. Hospital Manager, Chitwan Mutu Aspatal Pvt. Ltd. Non-communicable Diseases (NCDs) are the major public 2. Associate Professor, Public Health, School of Health and Allied health problem that leads to high morbidity and mortality in Sciences, Pokhara University, Nepal. the world including Nepal. Government of Nepal has launched the Mul-sectoral NCD Acon Plan in 2014 and established NCD and Injuries Poverty Commission in 2016 for the management and control of NCDs nevertheless the implementaon status and its outcomes are not idenfied ll date at the local level. A R T I C L E I N F O Objecves Received : 08 December, 2020 To explore the preparedness of the local government for the Accepted : 18 April, 2021 prevenon and control of NCDs at Gaindakot, Nawalpur, Published : 15 June, 2021 Nepal. © Authors retain copyright and grant the journal right of first Methodology publicaon with the work simultaneously licensed under Creave Commons Aribuon License CC - BY 4.0 that allows A qualitave study was conducted in the Gaindakot others to share the work with an acknowledgment of the municipality; Nawalpur to document the key informant's work's authorship and inial publicaon in this journal. perspecves on health system's preparedness to prevent the potenal impacts of NCDs. Face to face Indepth interview was performed using open-ended quesons. Interview guidelines were prepared on the basis of building blocks of health system. Informaon was processed basis on themac analysis. Result ORA 227 The study revealed that health secon has NCD preparedness structure but need to strengthening for the beer delivery of health services. The study highlights that screening DOI: hps://doi.org/10.3126/bjhs.v6i1.37567 services and the medicine for major NCDs like hypertension and diabetes were available at local level. Limited budget was allocated and health workforce was not trained for NCDs prevenon and control. There was no reporng mechanism for NCD related data from local level. * Corresponding Author Mr. Narayan Sapkota Conclusion Student, Public Health Basic medicine and screening services were provided from School of Health and Allied Sciences, Pokhara University, Nepal the local level to the selected NCDs such as hypertension Email: [email protected] and diabetes. There was no provision of reporng NCD ORCID: hps://orcid.org/0000-0002-4304-3110 related informaon and health workforce were not trained to respond NCDs. Local level health system strengthening is an urgent need to address the increasing burden of NCDs. Citaon Narayan Sapkota, Damaru Prasad Paneru. Preparedness for migang KEYWORDS non-communicable diseases in Gaindakot Municipality, Nepal: Non-communicable diseases, preparedness, health system, Perspecves of key-informants. BJHS 2021;6(1)14. 1320 - 1324. Nepal Birat Journal of Health Sciences ISSN: 2542-2758 (Print) 2542-2804 (Online) Vol. 6, No. 1, Issue 14, Jan-Apr 2021 1320 Original Research Arcle Sapkota N et al INTRODUCTION transcripts. All audio recordings were saved on password Non-communicableDiseases (NCDs) are emerging as major protected computer. public health problems throughout the world. Four major Data collecon procedure NCDs: cardiovascular diseases, chronic respiratory diseases, Indepth interview was conducted to collect informaon diabetes and cancer lead to more deaths globally than all 1 from the key informants using a semi-structured interview others disease combined. NCDs are also major cause of guide. Interview guidelines were based on the building morbidity and responsible for devastang, long term blocks of health system that was developed by the help of economic consequences for individuals and households in 2 related literature and expert guidance to assess the response Low and Middle Income Countries. According to the World of municipality. Interview guideline was tested among key Health Organizaon (WHO), the deaths aributed to NCDs informants of Devchuli municipality and necessary in Nepal has increased from 51 percent in 2010 to 66 percent 3,4 modificaon was made. Quesons for IDI were broadly in 2016. divided into eight topics with related probing quesons on: Low and middle income countries are making effort towards · Percepon related to NCDs the achieving the Sustainable Development Goals to provide · Service delivery universal coverage5 however the burden of NCDs connue 6 · Health workforce to grow That is challenging the health care system to achieve these targets. To address NCDs, LMICs need more · Informaon management resources and also need to redesigned their healthcare · Financing systems.7 In Nepal, annual healthcare investment for NCD · Governance and management is approximately US$ 16 per capita and 51 · Policy percent of disability-adjusted life years are aributed to Data analysis NCD.8 Health care pending has only focused on specialized Analysis was performed according to the building block of program including vaccine-preventable diseases, maternal health system. The informaon processing was based on and child health and infecous diseases thereby liming its themac analysis. Audiotapes of the interviews were ability to respond the growing burden of NCDs. Ministry of transcribed then the transcripts were read and generate a Health and Populaon launched the Mul-sectoral NCD 9 list of inial codes focusing on the main topics. Some codes Acon Plan in 2014 and established NCD and Injuries 8 generate main themes or sub-themes, whereas other codes Poverty Commission in 2016 naonwide roll-out of WHO's were discarded. Next, reviewing of themes was carried out. Package of Essenal Non-communicable Disease intervenon. Aer that defining and naming of themes were done. Despite this progress, available data shows that NCD services fall short of populaon's needs.10 Validity and reliability were measured in terms of trustworthiness which comprises of dependability, A comprehensive approach is required to decrease the credibility, and conformability. Trustworthiness was impact of NCDs by reducing the risk factors associated with maintained throughout the research process. The enre NCDs. Nepal has recently shied towards the federal interview was conducted in their local language (Nepali). context many changes have occurred in the geographical Respondent's responses were wrien in notes and recorded distribuon and health service delivery from central to in their own words. Dependability of the findings was periphery level. In the present context of federalizaon, the ensured by asking same set of quesons with same method present study was conducted to explore the preparedness to all respondents and all interviews was conducted by of the local government for the prevenon and control of researcher themselves. Credibility of the finding was NCDs at Gaindakot, Nawalpur, Nepal. ensured by shown the data to the respondents in order to ensure correct reflecon of their feelings. Conformability METHODOLOGY was gained through checking and rechecking of the translaon Study area and parcipants and result. All interviews were recorded; transcribed, coded Qualitave method was used to explore the preparedness and analysed by the researcher themselves. of municipality to migate NCDs by using WHO health system framework. Indepth interview was carried out RESULTS among five key informants of Gaindakot municipality. Key IDI was conducted among the key informants of Gaindakot informants were policy makers from the local government municipality. They were health workers at the health facility, and service providers of different health facilies of that public health inspector and officer at the municipal office municipality. Key informants were selected from the close and the elected leader of the municipality. The age of the coordinaon with municipality based on their posion and parcipants was 45-55 years. responsibility. Number of parcipants were allocated based on the saturaon of data. Ethical approval was obtained Percepon regarding NCDs from Nepal Health Research Council (NHRC) and permission was taken from the municipality and different schools. All parcipants perceived that the burden of non- Confidenality was assured by using numbers instead of communicable disease was in increasing trend. Except P-2 names (P1, P2 and P3 etc) and removed identy from the all the parcipants said that the risk factors were high Birat Journal of Health Sciences 1321 Vol. 6, No. 1, Issue 14, Jan-Apr 2021 ISSN: 2542-2758 (Print) 2542-2804 (Online) Original Research Arcle Sapkota N et al among adult populaon than adolescents. P-2 said that risk Among 7 staffs, 4 have already got training on NCDs and in was almost equal among adolescents and others groups. interval of 1 and half month, every staff will get training The major NCDs that were prevalent in this municipality are package (P-2) hypertension, diabetes and cancer. Parcipants said that Informaon management burden of NCDs was increased due to lack of regular physical There was no provision of reporng NCDs related data in exercise, dietary habits of eang junk foods and stressful work. roune HMIS. One parcipant (p-2) said that previously they “In past, people used to engage in agriculture, they used to used to refer hypertensive and diabetes paent to eat fruits and vegetables that culvate in their own field, Bharatpur hospital but nowadays health they used to treat they didn't engage
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