Health Service Utilization and Its Determinants among Senior Citizens in the Semiurban Area of Western Nepal: A Cross-Sectional Study.

Background: Senior citizens are usually infected by multiple chronic conditions and other health problems. Health needs and demand for healthcare services increase with age. However, healthcare services and facilities and their utilization are limited, particularly in developing countries. Aims: To identify the utilization of health services among senior citizens and their contributing factors. Methods: A cross-sectional analytic study was conducted among 293 senior citizens of the Kushma municipality, Nepal, from June to December 2019. A structured questionnaire was used as a data collection tool using a multistage sampling technique. Face-to-face interviews were conducted to collect data on the interview schedule. Reliability and validity were maintained by applying different strategies and carefully developing tools, pretesting, double entry, and validation. Data entry, management, and analysis were performed using Epi Data and SPSS software. Research ethics were maintained. Descriptive and inferential statistical tests were performed to infer the findings. Results: Study participants had a mean age (±SD) of 70.08 (±7.6) years and had various preexisting chronic diseases such as hypertension (46%), gastritis (41.9%), arthritis (34.3%), and asthma (28.7%). Only eight out of ten senior citizens had used health services in the past year. Factors such as age, ethnicity, residency, household income, family support, the presence of chronic diseases, and being under medication were found to have statistically significant associations with the utilization of health services among senior citizens with a p value less than 0.05 and 95% confidence interval. Conclusions: A remarkable proportion of older people reported using health services in the last year. However, a substantial proportion did not utilize health services that require further interventions to enable them. Efforts are required to promote the health and well-being of Nepal's growing elderly population, including potential enhancements to rural healthcare infrastructure by policymakers.

Social and mental health impact of COVID-19 pandemic among health professionals of Gandaki Province, Nepal: A mixed method study.

BACKGROUND: The frontline health workers are the key players in the fight against the COVID-19 pandemic, however, several incidences of attacks, stigmatization, and discrimination towards them have been reported throughout the world during the peak of infection. The social impact experienced by health professionals can alter their efficiency and also lead to mental distress. This study aimed to examine the extent of social impact experienced by health professionals currently working in Gandaki Province, Nepal along with the factors associated with their depression status. METHODS: This was a mixed-method study where a cross-sectional online survey was executed among 418 health professionals followed by in-depth interviews with 14 health professionals of Gandaki Province. The bivariate analysis and multivariate logistic regression were performed to identify the factors associated with depression at 5% level of significance. The information collected from the in-depth interviews was clustered into themes by the researchers. RESULTS: Out of 418 health professionals, 304 (72.7%) expressed that COVID-19 has impacted their family relationships, whereas 293 (70.1%) expressed that it impacted their relationships with friends and relatives, and 282 (68.1%) expressed it impacted their relationships with community people. The prevalence of depression among health professionals was noted at 39.0%. Being a female (aOR:1.425,95% CI:1.220-2.410), job dissatisfaction (aOR:1.826, 95% CI:1.105-3.016), COVID-19 impact on family relation (aOR:2.080, 95% CI:1.081-4.002), COVID-19 impact on relationship with friends and relatives (aOR:3.765, 95% CI:1.989-7.177), being badly treated (aOR:2.169, 95% CI:1.303-3.610) and experiencing moderate (aOR:1.655, 95% CI:1.036-2.645) and severe fear (aOR:2.395, 95% CI:1.116-5.137) of COVID-19 were found to the independent predictors of depression. It was noted that the pandemic has an effect on the social relations of health professionals in multiple ways. CONCLUSION: This study noted that there is a significant impact of COVID-19 on health professionals in terms of their social and mental health aspects. The social impact experienced by health professionals is an important predictor of their mental health. The mental health and well-being of these vital workforces can be enhanced by focusing on the social aspect during the pandemic.

Health literacy and associated factors among undergraduate health sciences students in western Nepal: a cross-sectional study.

Despite the importance of health literacy for health promotion, Nepalese undergraduate students are largely unaware of its importance. The present study assessed the health literacy levels of undergraduate health sciences students and explored various sociodemographic, clinical and health information-related factors associated with health literacy at Pokhara University in the Kaski district of western Nepal. A cross-sectional web-based observational study was conducted among 406 undergraduate students university students from five faculties at the School of Health and Allied Sciences affiliated with Pokhara University. Data on sociodemographic information, clinical characteristics and sources of health information were collected. Health literacy was assessed using the 44-item measure that captures the concept of health literacy across nine distinct domains. Associated factors were examined using a one-way analysis of variance followed by stepwise backward multiple linear regression analysis at the level of significance of 0.05. The mean score for the health literacy questionnaire was 3.13 ± 0.26. Outcomes of multivariable analyses demonstrated various factors associated with health literacy scores, including age (ß = 0.10; p = 0.001), physical exercise (ß = -0.13; p < 0.001), monthly household income (ß = 0.05; p = 0.029) and routine health checkup (ß = -0.14; p < 0.001). The study showed that there is a need to understand and address sociodemographic factors and clinical factors, including age, physical exercise, monthly household income and routine health checkups to improve health literacy levels among undergraduate students in western Nepal. More research, including longitudinal studies, is needed to better understand factors that influence health literacy among undergraduate students in Nepal.