Access to Basic Healthcare in Nepal

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Although we acknowledge that there is no universally accepted definition of access to health services , access to health generally means service availability i.e., having access to health care requires that there is an adequate supply of health services available, Measured traditionally using indicators such as numbers of doctor or hospital beds ,utilisation of services and barriers to access i.e., people in need may have access to services but may encounter difficulties in utilising services. Access to health services represents degree of fit between clients and the health care system where the degree of fit is influenced by barriers to service utilization, relevance, effectiveness and access providing the right service at the right time and at the right place, and equity and access which means to ensure that health care resources meet the needs of different population groups. Access has four dimensions: availability, geographic accessibility, affordability and acceptability(O’Donnell 2007).In this sense health services should be not only accessible but also affordable and acceptable as well. Access to health competes with many other issues i.e. social, environmental etc. Due to several factors countries like Nepal face a great challenge in making the health facility accessible to all part of the nation. Much of rural Nepal is located on hilly or mountainous regions. The rugged terrain and the lack of proper infrastructure makes it highly inaccessible, limiting the availability of basic health care. In many villages the only mode of transportation is by foot. This results in a delay of treatment, which can be detrimental to patients in need of immediate medical attention. Most of Nepal’s health care facilities are concentrated in urban areas. Rural health facilities often lack adequate funding and over the years, the problems and challenges related to insufficient trained health workers, limited supply of drugs and essential equipment in the health facilities, and low level of community awareness about public health and sanitation have jeopardized the health system at the district and community levels. Besides, Nepal’s health care issues are largely attributed by the fact that its political power and resources are mostly centered in its capital, Kathmandu,, resulting in the social exclusion of other parts of Nepal. The restoration of democracy in 1990 has allowed the strengthening of local institutions. The 1999 Local Self Governance Act aimed to include devolution of basic services such as health, drinking water and rural infrastructure but the program has not provided notable public health improvements. Due to a lack of political will, Nepal has failed to achieve complete decentralization, thus limiting its political, social, and physical potential. Nepal is rich in culture, but challenged by an unstable political climate, a high incidence of natural disasters and mountainous terrain. Most people live in remote villages that are difficult to reach and lack public health services. As a result of these challenges, the landlocked country faces several major health issues, such access to safe water, adequate nutrition and infectious disease prevention/treatment. These all challenges include having a much-needed-system wide approach to improving roads and other transportation and communication systems as well as strengthening the health system altogether In addition, the changing demographic picture across the world, along with the rapid shift towards urbanization, will have profound implications for the delivery of health services. Not only do changing demographics make access to health more difficult, they also add to problems, such as poor sanitation, which encourage the spread of infectious disease. This makes the lack of access to health care in these areas even more keenly felt. Another cause of inadequate access to health care is armed conflicts, a case in point can be the Maoist activity(a kind of war like...
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