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Abstract:
This study assessed the quality of care at
health facilities in providing sick child
care, using data from the 2015 Nepal Health
Facility Survey. The measures of quality of
care were divided into structure
(infrastructure of the facility and
availability of commodities), process
(provider’s performance), and outcomes
(client’s overall satisfaction with
services). Associations between client
satisfaction and structural and process
attributes were analyzed using multiple
regressions.
The average readiness score of health
facilities to provide sick child services was
54.9, with some variation among different
types of facilities, ecological regions, and
provinces. The score was similar between
public and private facilities. In examining
process factors, we found that the large
majority of children (86%) diagnosed with
pneumonia received correct treatment, while
less than half (44%) of those diagnosed with
diarrhea received correct treatment.
Among the structural factors, such as
frequency of services in a week, 24-hour
availability of health workers, availability
of an ORT corner and emergency transport,
toilets for clients, etc.—though important
aspects of quality of care—we found none
significantly associated with client
satisfaction. Process attributes, however,
such as waiting time less than 30 minutes and
receiving information from providers about
the child’s illness, were significantly
associated with higher client satisfaction.