Barriers to Accessing Healthcare Services among Urban Squatter Communities in Kathmandu Valley, Nepal

A Qualitative Study of Providers' Perspectives

Authors

  • Ram Bahadur Shrestha National Academy for Medical Science
  • Prabin Shrestha National Academy for Medical Sciences

DOI:

https://doi.org/10.32674/a3h9tn12

Keywords:

Health Care Services, Barriers, Urban Squatters, Access, Healthcare Providers

Abstract

The purpose of this study was to explore the barriers to accessing healthcare services among marginalized individuals in urban squatter communities of Kathmandu Valley. A qualitative approach was used for the study. The squatter communities were divided into six clusters, and healthcare providers working in government-run local health institutions in the periphery of the urban squatters of Kathmandu Valley were approached for an interview. Thematic analysis was used to identify the barriers. Different barriers to accessing healthcare services among the squatter communities were identified, related to the supply and demand of healthcare services.

References

Adhikari, SR. (2016). [Springer Briefs in Economics] Economics of Urban Externalities. doi:10.1007/978-981-10-0545-9

Afework, MB., Mekonnen, HW., Znabu, HK., Zewditu, G., & Alessandra, NB. (2018). Demand and Supply Side Barriers that Limit the Uptake of Nutrition Services among Pregnant Women from Rural Ethiopia: An Exploratory Qualitative Study. www.mdpi.com/jurnal/nutrients

Amee, DA., Anthony, GC., Qian, D., Amber, WT., & Sherry, MW. (2020). The gender gap and

healthcare: associations between gender roles and factors affecting healthcare access in Central Malawi, June–August 2017. Archives of Public Health.

Bart J., Por I., Maryam, B., Peter, LA., & Wim, VD. (2011). Addressing access barriers to health

services: an analytical framework for selecting appropriate interventions in low-income Asian countries. Oxford University Press.

Chioma, O., Joya B., Oniyire, A., Barbara, R., Ugo, O., Bright, O., Emmanuel, U., Gbenga, I., &

Myra, B. (2021). Gender discrimination as a barrier to high quality maternal and newborn health care in Nigeria: findings from a cross-sectional quality of care assessment. BMC Health Service Research.

Dahal, G., Ghimire, N., Hassan, MA., Pokhrel, P. (2017). Nepal’s transition toward universal

health coverage: A challenging pace for implementation. International Journal of Medical science and Public Health, Vol.6, Issue 3.

Firdaus, G. (2012). Urbanization, emerging slums and increasing health problems: challenge

before the nation: an empirical study with reference to state of Uttar Pradesh in India. Journal of Environmental Research and Management Vol.3 (9). pp. 146-152

Government of Nepal. (2016). The constitution of Nepal -2016

Huls, N. (2004). Access to Health. Review digest: human right and health.

https://www.du.edu/korbel/hrhw/researchdigest/health/access.pdf

Integrated Regional Information Networks (IRIN), part of the UN Office for the Coordination of

Humanitarian Affairs (2007). A report regarding impoverished urban squatters face high risk of poor health.

Katri, A., Jani, M., Ilpo, A., Jaana, EM., Leena, K., Saastamoinen, J., Simon B., Sirpa, H., Pauline,

N. (2014). Cost-related barriers to use of health services and prescription medicines in Finland: a cross-sectional survey. European Journal of Public Health, Vol. 25, No. 3, 368–372.

Levesque, J., Harris, M., & Russell, G. (2013). Patient-centered access to health care:

conceptualizing access at the interface of health systems and populations. International Journal for Equity in Health.

Linda L. (2015). Infrastructure - the key to healthcare improvement. Future Hospital Journal

, Vol 2, No 1: 4–7.

Lisa, C., Jean, FL., Virginia, L., Mylaine, B., Kim, S., Jan, WW., Jeannie, H., & Grant R. (2016).

Barriers to accessing primary health care: comparing Australian experiences internationally. Australian Journal of Primary Health, vol 23, pp 223–228.

LUMANTI Support Group for Shelter. (2008). Status of Squatter Communities along Bagmati

River and its tributaries in Kathmandu Valley. Kathmandu Nepal.

Maija, S., Kumar, S., & Mikko, P. (2020). Barriers to accessing health care services: a qualitative

study of migrant construction workers in a southwestern Indian city. BMC Health Service Research.

Marasini, M. and Chidi, CL. (2021). Vulnerability Assessment of Squatter Settlement in Butwal

Sub-Metropolitan City, Nepal. The Third Pole: Journal of Geography, Vol. 20 - 21: 47-58, 2021

Ministry of Health and Population (MoHP), Ministry of Local Development (MoLD), Nepal.

(2010). National Urban Health Policy, Strategy and Action Plan on Primary Health Service Delivery System in the Municipalities of Nepal (2010-2014).

Ministry of Health and Population, Government of Nepal (2016). National Urban Health Policy,

Ministry of Health and Population (MoHP), Nepal. (2015). Nepal Health Sector Strategy, 2015-

Ministry of Health and Population (MoHP), Department of health Service (DHS). (2018).

Annual report.

Ministry of Health and Population (MoHP), Nepal. (2019). National health policy 2019.

Ministry of urban development, Nepal. (2016). Third United Nations Conference on Housing

and Sustainable Urban Development (Habitat III) NEPAL, National Report.

NHRC. (2022). Towards Universal Health Coverage: Addressing Financial Hardship and

Improving Access to Healthcare in Nepal (Policy brief). Kathmandu, Nepal Health Research Council

Ranabhat, S., Baskota, S., Thapa, R. (2021). Utilization of Maternal Health Services: An

Experience from Squatter Settlement in Nepal. International Journal of Health Sciences and Research; Vol.11; Issue: 10; October 202.

Shrestha, A., Poudel, D., and Khatri, D. (2020). Development, disasters and squatter settlements

in urban Nepal: A review of characteristics and challenges. Working report, South Asia Institute of Advanced Studies (SIAS).

Stefane, MK., Carole, O., John, MH., Mark AS., & Raymond, L. (2006). The importance of

human resources management in health care: a global context. Human Resources for Health. https://human-resources-health.biomedcentral

Tulane University, School of Public Health and Tropical Medicine. (2020). 10 strategies for

effective communication. https://publichealth.tulane.edu/blog/health-communication-effective-strategies/

WHO & UN-HABITA. (2010). Hidden cities: unmasking and overcoming health inequities in

urban cities. Chapter two: in an urban context.

WHO. (2017). Access to medicines: making market forces serve the poor- ten year in public

health. https://www.who.int/publications/10-year-review/chapter-medicines.pdf

WHO. (2018). Low quality healthcare is increasing the burden of illness and health costs

globally. https://www.who.int/news/item/05-07-2018-low-quality-healthcare-is-increasing-the-burden-of-illness-and-health-costs-globally

WHO. (2020). Universal Health Coverage.

https://www.who.int/health-topics/universal-health-coverage#tab=tab_1

World Health Organization: WHO. (2023, October 5). Universal health coverage (UHC).

https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)

World Health Organization, Regional Office for South-East Asia. (WHO SEAR). (2019).

Monitoring progress on universal health coverage and the health-related Sustainable Development Goals in the WHO South-East Asia Region: 2019 update. New Delhi:

World Bank. (2014). Poverty and Health.

https://www.worldbank.org/en/topic/health/brief/poverty-health

World Bank & WHO. (2017). Half the world lacks access to essential health services, 100

million still pushed into extreme poverty because of health expenses. https://www.who.int/news/item/13-12-2017

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Published

2025-08-27

Issue

Section

Special Issue on Health Disprarities