Popis: |
IntroductionThe rapid increase of COVID-19 cases since the beginning of May 2020, imposition of lockdown, and preparation activities to detect, manage and treat COVID-19 in public hospitals have impacted on the provision of non-COVID health care services resulting in increased morbidity and mortality in Nepal. This study aims to explore challenges in providing non-COVID as well as COVID-19 health care services through public hospitals in Eastern Nepal.MethodsA qualitative study with 25 key informants from three public hospitals in Eastern Nepal was conducted. Key informants were health care workers (HCWs) and managers of the hospitals. A thematic analysis was carried out to identify challenges in providing non-COVID and COVID-19 health care services.ResultsWe identified four themes: weak implementation; weak co-ordination and management; low accountability of HCWs and staff; and risk of infection and stigma as the challenges to provide COVID-19 health care services. We identified three themes: maintaining safety measures in hospitals, managing patients, and fear of infection as the challenges in provision of non-COVID health care services. Inadequate resources and HCWs, lengthy procurement process, and poor jobs specification were the main reasons for weak implementation. HCWs stated weak hospital administration while managers and focal persons complained of low accountability of HCWs and staff to manage COVID-19 health care services.ConclusionIn addition to inadequate resources; the risk of infection of COVID-19, maintaining safety measures in hospitals, ensuring clear leadership and governance, and preparing motivated and accountable HCWs and staff to get ‘work done’ are unique challenges observed in the study hospitals; and consequently need to be addressed. |