Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.

<h4>Background</h4>Investment Case is a participatory approach that has been used over the years for better strategic actions and planning in the health sector. Based on this approach, a District Investment Case (DIC) program was launched to improve maternal, neonatal and child health se...

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Autores principales:	Janak Kumar Thapa, Doris Stöckl, Raj Kumar Sangroula, Asha Pun, Meena Thapa, Mahesh Kumar Maskey, Maria Delius
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/360e84c568ec4dd49beaa8599539caf0
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spelling	oai:doaj.org-article:360e84c568ec4dd49beaa8599539caf02021-12-02T20:13:49ZInvestment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.1932-620310.1371/journal.pone.0255231https://doaj.org/article/360e84c568ec4dd49beaa8599539caf02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255231https://doaj.org/toc/1932-6203<h4>Background</h4>Investment Case is a participatory approach that has been used over the years for better strategic actions and planning in the health sector. Based on this approach, a District Investment Case (DIC) program was launched to improve maternal, neonatal and child health services in partnership with government, non-government sectors and UNICEF Nepal. In the meantime, this study aimed to explore perceptions and experiences of local stakeholders regarding health planning and budgeting and explore the role of the DIC program in ensuring equity in access to maternal and child health services.<h4>Methods</h4>This study adopted an exploratory phenomenography design with a purposive sampling technique for data collection. Three DIC implemented districts and three comparison districts were selected and total 30 key informant interviews with district level stakeholders and six focus groups with community stakeholders were carried out. A deductive approach was used to explore the perception of local stakeholders of health planning and budgeting of the health care expenses on the local level.<h4>Results</h4>Investment Case approach helped stakeholders in planning systematically based on evidence through collaborative and participatory approach while in comparison areas previous year plan was mainly primarily considered as reference. Resource constraints and geographical difficulty were key barriers in executing the desired plan in both intervention and comparison districts. Positive changes were observed in coverage of maternal and child health services in both groups. A few participants reported no difference due to the DIC program. The participants specified the improvement in access to information, access and utilization of health services by women. This has influenced the positive health care seeking behavior.<h4>Conclusions</h4>The decentralized planning and management approach at the district level helps to ensure equity in access to maternal, newborn and child health care. However, quality evidence, inclusiveness, functional feedback and support system and local resource utilization should be the key consideration.Janak Kumar ThapaDoris StöcklRaj Kumar SangroulaAsha PunMeena ThapaMahesh Kumar MaskeyMaria DeliusPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0255231 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Janak Kumar Thapa Doris Stöckl Raj Kumar Sangroula Asha Pun Meena Thapa Mahesh Kumar Maskey Maria Delius Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.
description	<h4>Background</h4>Investment Case is a participatory approach that has been used over the years for better strategic actions and planning in the health sector. Based on this approach, a District Investment Case (DIC) program was launched to improve maternal, neonatal and child health services in partnership with government, non-government sectors and UNICEF Nepal. In the meantime, this study aimed to explore perceptions and experiences of local stakeholders regarding health planning and budgeting and explore the role of the DIC program in ensuring equity in access to maternal and child health services.<h4>Methods</h4>This study adopted an exploratory phenomenography design with a purposive sampling technique for data collection. Three DIC implemented districts and three comparison districts were selected and total 30 key informant interviews with district level stakeholders and six focus groups with community stakeholders were carried out. A deductive approach was used to explore the perception of local stakeholders of health planning and budgeting of the health care expenses on the local level.<h4>Results</h4>Investment Case approach helped stakeholders in planning systematically based on evidence through collaborative and participatory approach while in comparison areas previous year plan was mainly primarily considered as reference. Resource constraints and geographical difficulty were key barriers in executing the desired plan in both intervention and comparison districts. Positive changes were observed in coverage of maternal and child health services in both groups. A few participants reported no difference due to the DIC program. The participants specified the improvement in access to information, access and utilization of health services by women. This has influenced the positive health care seeking behavior.<h4>Conclusions</h4>The decentralized planning and management approach at the district level helps to ensure equity in access to maternal, newborn and child health care. However, quality evidence, inclusiveness, functional feedback and support system and local resource utilization should be the key consideration.
format	article
author	Janak Kumar Thapa Doris Stöckl Raj Kumar Sangroula Asha Pun Meena Thapa Mahesh Kumar Maskey Maria Delius
author_facet	Janak Kumar Thapa Doris Stöckl Raj Kumar Sangroula Asha Pun Meena Thapa Mahesh Kumar Maskey Maria Delius
author_sort	Janak Kumar Thapa
title	Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.
title_short	Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.
title_full	Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.
title_fullStr	Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.
title_full_unstemmed	Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.
title_sort	investment case approach for equitable access to maternal neonatal and child health services: stakeholders' perspective in nepal.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/360e84c568ec4dd49beaa8599539caf0
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Investment case approach for equitable access to maternal neonatal and child health services: Stakeholders' perspective in Nepal.

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