title: People's perspective on access to health care services in a rural district of Nepal.
abstract: BACKGROUND
  Over the past several decades, Nepal has attempted to increase the access of health care services, however progress toward achieving high coverage of health care services in rural communities is still low. Therefore this study attempts to provide a perspective on access to basic health care services in government health facility.
  
  
  METHODS
  Descriptive cross-sectional study with quantitative and qualitative methods was designed and applied to identify the access to health care services. The study population were people who were sick within three months prior to the study where basic sampling unit was household. Total sample size was 96 through the application of simple random sampling method. Bivariate analysis with 95% confidence interval was used to identify the association of variables with access to health care services.
  
  
  RESULTS
  Among the total population, 28% of households in the study area received health care services at government health facility. The reasons for not accessing health care were insufficient drugs (61%), distance (22%), staff unavailability (19%), sickness (9%), money (7%), and facility hours (4%). Sex, ethnicity and distance were found significantly associated with access to health care services.
  
  
  CONCLUSIONS
  Less than one third of households had access to health care services in government health facility. Addressing the important factors such as drug problems, staff unavailability, long distance to health institutions and inconvenient health facility hours may help to increase access to health care services at government health facility.
authors.affiliation: Department of Community Medicine and Public Health, Tribhuvan University, Kathmandu, Nepal. paudel.rajan@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Paudel
authors.forename: T
authors.initials: T
authors.lastname: Upadhyaya
authors.forename: D P
authors.initials: DP
authors.lastname: Pahari
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers / Q000706:statistics & numerical data* / Q000600:supply & distribution; D003430:Cross-Sectional Studies; D035082:Federal Government; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009390:Nepal; D004364:Pharmaceutical Preparations / Q000592:standards / Q000600:supply & distribution; D011320:Primary Health Care / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution; D012737:Sex Factors; D012923:Social Class; D000078329:Workforce; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations