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Bitter CC, Dornbush C, Khoyilar C, Hull C, Elsner-Boldt H, Mainali S, Rice B, Visser E. A Short-Term Medical Mission in Rural Nepal: Chief Complaints, Medications Dispensed, and Unmet Health Needs. Cureus 2021; 13:e15427. [PMID: 34249572 PMCID: PMC8254532 DOI: 10.7759/cureus.15427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Although Nepal is striving to expand primary health services for its citizens, many remote areas have limited access to basic health care. Short-term medical missions (STMMs) are one way of supplementing human resources for health in underserved areas. This article describes the chief complaints, medications dispensed, and unmet health needs during an STMM in rural Nepal. Methods This study is a retrospective analysis of data collected during an STMM that occurred in October 2017. Deidentified data from clinic intake forms were entered into an Excel spreadsheet, and formatted and cleaned. Demographics, chief complaints, medications, and unmet health needs were analyzed using descriptive statistics. Results During a two-day health camp, 443 patients were seen. The most common chief complaint was dental (33.4%) followed by musculoskeletal (28.2%) and gastrointestinal (21.2%). Medications were dispensed to 94.8% of patients, primarily analgesics, antibiotics, and ophthalmologic preparations. Of the patients, 21% had unmet health needs, including specialty care and labs or imaging that were beyond the scope of the STMM. One patient was referred urgently to a hospital for treatment of dyspnea and markedly elevated blood pressure. Conclusion While STMMs cannot replace access to primary health services, they can provide insight into acute care needs in a system that has limited surveillance. This information describing an acute care patient population should inform future development work.
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Affiliation(s)
- Cindy C Bitter
- Emergency Medicine, Saint Louis University School of Medicine, St. Louis, USA.,Emergency Medicine, Himalayan Family Healthcare Project, St. Louis, USA
| | - Carine Dornbush
- Surgery, Saint Louis University School of Medicine, St. Louis, USA
| | - Cyrus Khoyilar
- Anesthesia, Saint Louis University School of Medicine, St. Louis, USA
| | - Charlotte Hull
- Emergency Medicine, Saint Louis University School of Medicine, St. Louis, USA
| | | | | | - Brian Rice
- Emergency Medicine, Stanford University School of Medicine, Palo Alto, USA
| | - Errol Visser
- Emergency Medicine, Himalayan Family Healthcare Project, St. Louis, USA
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Lee M. Engaging female community health volunteers in maternal health services and its satisfaction among village mothers in Hill and Mountain Regions, Nepal. AIMS Public Health 2020; 7:778-791. [PMID: 33294481 PMCID: PMC7719561 DOI: 10.3934/publichealth.2020060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022] Open
Abstract
Background Female Community Health Volunteers (FCHVs) are service providers and educators for maternal health at the village level (in the hill and Terai district) in Nepal. At present, there are insufficient data and little is understood about the maternal health service (MHS) of FCHVs from Nepali mothers' perspective. Methodology The research was undertaken in three hill and mountain regions where there should be at least one FCHVs per ward, Thulo sirubari, Sano sirubari and Jalkeni in Chautara Sangachowkgadi in Nepal, during five days from 5 April to 9 April 2019. The study worked with a local partner organisation, Green Tara Nepal (GTN). The study took the form of a qualitative approach with a community-based snowball approach (seed-and-recruit approach), which consisted of interviews with six key informants and 11 village mothers who have a child aged under five. Results The study found that all participated mothers recognised FCHVs and that it was easy to contact them within walking distance. They were happy with FCHV's existence and had a close relationship between them. They were all satisfied with MHS from FCHVs. In particular, accessibility of FCHVs, frequent home visits, monthly mothers' meetings, and regular ANC were the main points of satisfaction. Moreover, NGO intervention increased their satisfaction and contributed significantly to FCHV activities. However, the lack of meeting place and sustainable incentives are challenging to implement monthly mothers' meetings. Sufficient regular refresher training for FCHVs is also required to educate them better. Furthermore, the local government's unequally distributed budget for FCHVs programmes, small incentives, and benefits for FCHVs are challenges. Conclusion This study offered various views with vivid memories into the satisfaction of FCHV's MHS among village mothers in three hill and mountain regions of Nepal. FCHVs are essential assets for MHS in rural communities. The FCHVs programme should be complemented by (1) supporting suitable meeting place of mother's meeting, (2) providing sustainable and sufficient budget for mother's meeting and FCHVs, (3) distributing the budget equally in each ward, (4) offering frequent FCHVs training to improve the MHS for village mothers.
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Affiliation(s)
- Mina Lee
- STOP-TB Partnership KOREA, Korean National Tuberculosis Association, Siem Reap, Cambodia
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Sürmeli A, Tolunay T, Yasin Y, Kusoglu H, Arcan A, Jaiswal A, Gökmen B, Acharya B, Arslan B, Baka BE, Imamoglu GS, Ökke L, Sahiner M, Yildiz P, Altinayak R, Pokharel S, Yaylaci S, Arikan S, Yolcu YU, Kurt Ö. Child health, parasites and lower socioeconomic status: Outcomes of a long-term screening, intervention and training study by health volunteers in rural Nepal. Acta Trop 2020; 202:105263. [PMID: 31711749 DOI: 10.1016/j.actatropica.2019.105263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 09/19/2019] [Accepted: 11/07/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Nepal is a developing country with limited resources for health provision due to its geographic difficulties and frequent natural disasters, such as floods and earthquakes. Children are at risk of growth retardation due to inadequate food intake and unhealthy environment. Lower back pain is common among the adults and causes limitations in daily activities. MATERIAL/METHODS A group of voluntary Turkish medical students, doctors and civil members conducted a field study, together with Nepalese doctors (MDs) and local volunteers, concerned with health-screening, intervention practices and on-site training in rural Nepal between 2013 and 2015. Physical examination of participants, together with stool examinations for parasites were done and those for whom treatment was indicated were referred to MDs who also ran a field pharmacy containing donated medications. RESULTS Totally, 1148 individuals-725 children and 423 adults-were screened between 2013 and 2015. Musculoskeletal problems and upper respiratory tract infections were primary complaints among adults and sick children, respectively. Three-quarters of 203 collected stools had ≥ 1 parasite(s). CONCLUSIONS Growth retardation in children observed during the study, the burden of intestinal parasites on Nepalese children and unavailability of effective health services for citizens in rural areas should direct local authorities to allocate greater resources for country's health infrastructure improvement and to provide a higher standard of childhood nutrition.
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Affiliation(s)
- Aral Sürmeli
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey; Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey
| | - Tuana Tolunay
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey; Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey
| | - Yesim Yasin
- ACUFoM, Department of Public Health, Istanbul, Turkey
| | - Hülya Kusoglu
- ACUFoM, Department of Infectious Diseases, Istanbul, Turkey
| | - Abdullah Arcan
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey; Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey
| | | | - Beril Gökmen
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey
| | | | - Burcu Arslan
- Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey
| | - Büsra Ecem Baka
- ACU Faculty of Health Sciences, Physical Therapy and Rehabilitation, Istanbul, Turkey
| | - Gizem Söylemez Imamoglu
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey
| | - Larissa Ökke
- Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey; ACU Faculty of Health Sciences, Physical Therapy and Rehabilitation, Istanbul, Turkey
| | - Melike Sahiner
- ACUFoM, Department of Medical Education, Istanbul, Turkey
| | - Piril Yildiz
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey; Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey
| | | | | | - Serpil Yaylaci
- ACUFoM, Department of Emergency Medicine, Istanbul, Turkey
| | - Silasu Arikan
- Medical Rescue Association of Turkey (MEDAK), Istanbul, Turkey
| | - Yagiz Ugur Yolcu
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine (ACUFoM), Kerem Aydinlar Kampüsü, Kayisdagi Cad. No: 32, Istanbul 34752, Turkey
| | - Özgür Kurt
- Acibadem LABMED Clinical Laboratories, Istanbul, Turkey; ACUFoM, Department of Medical Microbiology, Istanbul, Turkey; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Clinical Parasitology Study Group, Switzerland.
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