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Abstract：
OBJECTIVE: We assessed the availability and readiness of health facilities to provide cervical cancer screening services in Nepal.
METHODS: Cross-sectional study.
METHODS: We used secondary data from a nationally representative 2021 Nepal Health Facility Survey, specifically focusing on the facilities offering cervical cancer screening services.
METHODS: We defined the readiness of health facilities to provide cervical cancer screening services using the standard WHO service availability and readiness assessment manual.
RESULTS: The overall readiness score was 59.1% (95% CI 55.4% to 62.8%), with more equipment and diagnostic tests available than staff and guidelines. Public hospitals (67.4%, 95% CI 63.0% to 71.7%) had the highest readiness levels. Compared with urban areas, health facilities in rural areas had lower readiness. The Sudurpashchim, Bagmati and Gandaki provinces had higher readiness levels (69.1%, 95% CI 57.7% to 80.5%; 60.1%, 95% CI 53.4% to 66.8%; and 62.5%, 95% CI 56.5% to 68.5%, respectively). Around 17% of facilities had trained providers and specific guidelines to follow while providing cervical cancer screening services. The basic healthcare centres (BHCCs) had lower readiness than private hospitals. Facility types, province and staff management meetings had heterogeneous associations with three conditional quantile scores.
CONCLUSIONS: The availability of cervical cancer screening services is limited in Nepal, necessitating urgent action to expand coverage. Our findings suggest that efforts should focus on improving the readiness of existing facilities by providing training to healthcare workers and increasing access to guidelines. BHCCs and healthcare facilities in rural areas and Karnali province should be given priority to enhance their readiness.
METHODS: Cross-sectional study.
METHODS: We used secondary data from a nationally representative 2021 Nepal Health Facility Survey, specifically focusing on the facilities offering cervical cancer screening services.
METHODS: We defined the readiness of health facilities to provide cervical cancer screening services using the standard WHO service availability and readiness assessment manual.
RESULTS: The overall readiness score was 59.1% (95% CI 55.4% to 62.8%), with more equipment and diagnostic tests available than staff and guidelines. Public hospitals (67.4%, 95% CI 63.0% to 71.7%) had the highest readiness levels. Compared with urban areas, health facilities in rural areas had lower readiness. The Sudurpashchim, Bagmati and Gandaki provinces had higher readiness levels (69.1%, 95% CI 57.7% to 80.5%; 60.1%, 95% CI 53.4% to 66.8%; and 62.5%, 95% CI 56.5% to 68.5%, respectively). Around 17% of facilities had trained providers and specific guidelines to follow while providing cervical cancer screening services. The basic healthcare centres (BHCCs) had lower readiness than private hospitals. Facility types, province and staff management meetings had heterogeneous associations with three conditional quantile scores.
CONCLUSIONS: The availability of cervical cancer screening services is limited in Nepal, necessitating urgent action to expand coverage. Our findings suggest that efforts should focus on improving the readiness of existing facilities by providing training to healthcare workers and increasing access to guidelines. BHCCs and healthcare facilities in rural areas and Karnali province should be given priority to enhance their readiness.
摘要：
目的：我们评估了尼泊尔提供宫颈癌筛查服务的医疗机构的可用性和准备情况。
方法：横断面研究。
方法：我们使用了具有全国代表性的2021年尼泊尔医疗机构调查的次要数据，特别关注提供宫颈癌筛查服务的设施。
方法：我们使用标准的世卫组织服务可用性和准备评估手册定义了医疗机构提供宫颈癌筛查服务的准备情况。
结果：总体准备评分为59.1%（95%CI为55.4%至62.8%），有更多的设备和诊断测试比工作人员和指导方针。公立医院（67.4%，95%CI63.0%至71.7%)的准备水平最高。与城市地区相比，农村地区的卫生设施准备程度较低。Sudurpashchim,巴格马蒂省和甘达基省的战备水平较高(69.1%，95%CI57.7%至80.5%；60.1%，95%CI53.4%至66.8%；62.5%，95%CI56.5%至68.5%，分别)。大约17％的设施在提供宫颈癌筛查服务时，有受过培训的提供者和特定指南。基本医疗中心（BHCC）的准备率低于私立医院。设施类型,省和员工管理会议具有三个条件分位数分数的异质关联。
结论：尼泊尔的宫颈癌筛查服务有限，需要采取紧急行动扩大覆盖面。我们的研究结果表明，努力应该通过向医护人员提供培训和增加获得指南的机会来提高现有设施的准备程度。应优先考虑农村地区和卡纳利省的BHCC和医疗保健设施，以加强其准备工作。
方法：横断面研究。
方法：我们使用了具有全国代表性的2021年尼泊尔医疗机构调查的次要数据，特别关注提供宫颈癌筛查服务的设施。
方法：我们使用标准的世卫组织服务可用性和准备评估手册定义了医疗机构提供宫颈癌筛查服务的准备情况。
结果：总体准备评分为59.1%（95%CI为55.4%至62.8%），有更多的设备和诊断测试比工作人员和指导方针。公立医院（67.4%，95%CI63.0%至71.7%)的准备水平最高。与城市地区相比，农村地区的卫生设施准备程度较低。Sudurpashchim,巴格马蒂省和甘达基省的战备水平较高(69.1%，95%CI57.7%至80.5%；60.1%，95%CI53.4%至66.8%；62.5%，95%CI56.5%至68.5%，分别)。大约17％的设施在提供宫颈癌筛查服务时，有受过培训的提供者和特定指南。基本医疗中心（BHCC）的准备率低于私立医院。设施类型,省和员工管理会议具有三个条件分位数分数的异质关联。
结论：尼泊尔的宫颈癌筛查服务有限，需要采取紧急行动扩大覆盖面。我们的研究结果表明，努力应该通过向医护人员提供培训和增加获得指南的机会来提高现有设施的准备程度。应优先考虑农村地区和卡纳利省的BHCC和医疗保健设施，以加强其准备工作。
