Search

Background: Nepal has implemented the social health security program in certain health facilities to improve access to quality health services. The aim of the study is to understand the utilization pattern of social health security schemes and community's perception of the social health security program. Method: A descriptive cross-sectional mixed-method study was conducted among 300 households of Illam district who had enrolled in the social health security scheme. A multi-stage random sampling method was used. A semi-structured questionnaire was used to collect quantitative data whereas focus group discussions (FGDs) were conducted for qualitative data. Descriptive analysis, bivariate and multivariate analysis was done. FGDs were transcribed and thematic analysis was done. Findings: The utilization rate of social health security scheme was 88.7%. Factors associated with the utilization of program included: presence of under-five children and chronic illness in households, sex and age group. Focus group discussion revealed that people were aware of social health insurance and pleased with program implemented by government. However, the hospitals under the social health insurance were not able to meet their expectations. Conclusion: Although the utilization of social health security scheme was high, people were dissatisfied with the service provided by the hospital under the social health security scheme. Therefore, the social health insurance board should closely monitor the hospitals and develop a feedback mechanism from the users. [ABSTRACT FROM AUTHOR]

Background: WHO addresses the infectious disease like Tuberculosis, and non- communicable disease like Diabetes among the top 10 causes of death worldwide, which collectively leads to increasing mortality and premature death especially in developing countries. Hence, the present study aims to assess the prevalence of diabetes and its associated risk factors among the tuberculosis patient of Morang, Eastern Nepal., Methods: A cross-sectional study was carried out among the 320 respondents undergoing tuberculosis treatment of Morang district. Respondents from eight randomly selected DOTS centers were selected purposively. The Fasting Blood Sugar and 2-h Post-Prandial Blood Sugar were assessed in the laboratory of respective DOTS center by the glucose oxidase method. An interview for socio-demographic and other variables was conducted using a pretested semi-structured questionnaire based on WHO-STEP Instrument for chronic disease and excerpt from DASS-21 was used for the variable stress., Results: The prevalence of diabetes, pre-diabetic and glucose intolerance among tuberculosis patient was 11.9, 17.2, and 17.8% respectively. Additionally, the univariate analysis reported, user of tobacco products, current alcohol consumers, family history of diabetes and stress level, to have positive association with diabetes, while the multivariate analysis reported, the current alcohol consumer as the significant predictor of diabetes among the tuberculosis patient., Conclusion: A significant portion of the respondents were diabetic, impaired glucose tolerance and pre-diabetic, which supports the fact of diabetes being comorbid with tuberculosis. Hence, it shifts the focus on the bidirectional screening of tuberculosis and diabetes.