Health Service Management

Dhulikhel Hospital profile and

epidemiological study on Childhood
Pneumonia

Date: 1st Falgun, 2076

Dhulikhel Hospital

Health Service Management, 5th Batch, Group B3 1

HSM Specific Objectives:
• To prepare a hospital profile.
• To conduct epidemiological study on prioritized health problem.
• To conduct a sharing workshop and wrap up our field work on mission
hospital.

Health Service Management, 5th Batch, Group B3 2

Methodology
• Study type: Observational study
• Study site: Dhulikhel Hospital, Dhulikhel, Kavre
• Study duration: 3 weeks

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Dhulikhel Hospital

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Hospital profile
• Type: non-profit oriented, community level hospital
• Established: December 9, 1996 AD
• No. of beds: 425
• Location: Dhulikhel, Kavre

Health Service Management, 5th Batch, Group B3 5

 General Assembly

Executive Committee

Director

Administrative Director

Matron
Hospital Administrator
(Nursing, Housekeeping)
 
General Manager - Finance Director ( Chief
Physical Clinical () Coordinator - Coordinator - Director - Manager -
Administrat School of Manager Nursing Engineer-
Facility Coordinator Physiotherapy Dental Preclinical Community
or Manager medical education) Eng. Dept
Manager Sciences Programs
sciences
Human Resource Registration
Officer Cash Public Health
Engineers Dental –
Consultants General Store Officer and Academic Officer
Nursing Account
Medical Officer Overseers Program
Supervisor Physiotherapy– Outreach
Pharmacy Store
Academic centres
Sisters PG Residents
Procurement officer Program Faculties
Staff Nurse Nursing Faculties –
Bachelor level-
IT Department Academic Program
Paramedical Allied Sciences
Communication
House Keeping
Transportation

Laundry Canteen

Security
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Findings

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Input
• Physical facility
• Human resource
• Logistics
• Budget
• Recording and Reporting

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Process

• Planning, staffing, directing

• Organizing

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Output
PREVENTIVE: DIAGNOSTIC: CURATIVE:
•REHABILITATIVE
Infection Prevention
: • Lab • OPDs
•• Immunization
Physiotherapy • Imaging • OT
• Wards
• Emergencies
• DOTS and ART center
• Nutrition
• ICU/NICU

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Output
Other services:
• Pharmacies
Community Programs:
• Canteens
• Outreach centres
• Library
• MicroFinance program
• Transportation
• Laundry, CSSD
• Blood bank
• Research
• Autopsy and OCMC
• Safe Motherhood Program

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EPIDEMIOLOGICAL STUDY
• A comparative study on hospital admitted cases of Childhood
Pneumonia in pre and post-earthquake* period.

*2015 earthquake

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Rationale
• It is one of the most common cause of hospital admission in
dhulikhel hospital.
• Easy availability of data.
• Pnemonia is a common disease in the context of our country.

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OBJECTIVES
• General
▪ To conduct an epidemiological study on Childhood Pneumonia in
the patients admitted in Dhulikhel Hospital, Kavre.
• Specific
▪ To describe the magnitude of Childhood Pneumonia cases
admitted in Dhulikhel Hospital between 2014 to 2017 AD.
▪ To describe the distribution of Childhood Pnuemonia cases
admitted in Dhulikhel Hospital in terms of time, place and person.
▪ To compare the trend of Childhood Pneumonia in pre and post-
earthquake period.

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Methodology
• Study design: Cross-sectional, Descriptive, Observational study
• Study type: Quantitative
• Study site: Dhulikhel Hospital
• Population under study: All the patients under 18yrs of age admitted
in Dhulikhel Hospital with the diagnosis of Childhood Pneumonia
• Study unit: Individual
• Sample size: 536
• Study data: In-patient admission registers of paediatric IPDs in the
year 2014, 2015, 2016 and 2017
• Study duration: 14 days

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Methodology contd.
• Sources of data
• Secondary - Records from medical record section, medical ward and paediatric
ward of DH
• Variables:
• Time – month, year
• Place- district
• Person- Age, sex
• Data processing
• Manual processing
• Statistical analysis through SPSS and Excel
• Interpretation: Graphs and figures
• Validity and Reliability: All data were obtained from hospital records and
are presumed to be valid and reliable

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 Magnitude of Childhood Pneumonia in DH
sesac
fo
.on

250

200
latoT

150

100

211.00
50

169.00

0
&) &) &) &)
112.00
Time (in years)
*1 mortality in 2017
Fig: Bar diagram showing magnitude of childhood pneumonia cases in DH
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Age wise distribution of Childhood Pneumonia



 Neonate
  Post neonate
 1y - 5y
 5y - 17y



Fig: Pie chart showing age-wise distribution of childhood pneumonia cases in DH

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Gender-wise distribution





 Male
 Female

Fig: Pie chart showing gender-wise distribution of childhood pneumonia cases in DH

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 Time-wise distribution
100
sesac

90
fo

80
.on

70
latoT

60

50

40
90.00
30

20

10
56.00
0  Spring (Mar-May)  Summer  Autumn (Sep-Nov)  Winter (Dec-Feb)
 50.00 (Jun-Aug)  
46.00 47.00

38.00
Time (in years)
31.00 32.00
26.00 27.00
Fig: Bar diagram showing time-wise distribution of childhood pneumonia cases
24.00 in DH
23.00

Health Service Management, 5th Batch, Group B3 15.00

20
10.00 9.0010.00
Time-wise distribution
sesac
250
fo
.on

36.5%
latoT

200

150

100
224.00

50
164.00

0
5WJJFWYMVZFPJ &UW2FW 5TXYJFWYMVZFPJ 2F^2FW
Time (in years)
Fig: Bar diagram showing magnitude of childhood pneumonia cases in DH
Health Service Management, 5th Batch, Group B3 21
 180

160
sesac

Place-wise
140
distribution
120
fo
.on

100
latoT

80

60 155.00

40

20
108.00
0  2014  2015  2016
0F[WJ 8NSIZUFQHMT\P
7FRJHMFUU 'MFPYFUZW 8NSIMZQN
 2017
4YMJWX
79.00

48.00 Time (in years)

Fig: Bar diagram showing place-wise 29.00

distribution of childhood pneumonia cases in DH
24.00
Health Service Management,18.00
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9.00 9.00
Conclusion
Pneumonia is one of the most common cause of admission in Dhulikhel
hospital.
The infection occurs throughout the year with peak incidence during
the period from November to January.
Out of all hospital admitted cases around 2/3rd of the cases were from
kavrepalanchowk.
Childhood Pneumonia is predominant in pre-school going children with
male predominance.
Post earthquake the incidence of pneumonia increased by 36.5%

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Limitations

Data obtained from Dhulikhel hospital only  the complete picture of

the disease in the whole district could not be presented.
Five year trend analysis on childhood pneumonia could not be done
due to lack of data.

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Recommendation
Proper recording and reporting (diagnosis wise) along with storage of
the record files should be done
Qualitative studies need to be conducted in this topic to reach the root
of the disease which further helps in planning preventive, promotive
and curative aspects.
Extensive awareness programmes about the disease need to be
conducted in the community.

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Positive aspect of hospital
• As being a non profit organization the hospital has been providing
quality health services to the community people within their
affordability limits
• It’s quite refreshing to see that the hospital has been providing
various health services without compromising in the quality in very
low price
• The hygiene and cleanliness of the hospital and its premises is really
praiseworthy
• Though having limited number of staffs in the hospital it is really
appreciable and pleasant to see the good efforts of every staffs to
maintain the quality of the hospital

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It provides health care services to the people of rural areas of different
parts of Nepal through its outreach centres.

Through community development programme it helps to improve the

living standard of people as well as launch awareness programme on
different health related issues.

Health Service Management, 5th Batch, Group B3 27

Points to be looked after
Most areas of hospital runs on solar power however it would be better
if all the hospital areas had proper access to solar power.
Hospital has its own water treatment plant however certain areas of
sewage drainage is not properly covered.
Autoclave of waste management department needs to be maintained
regularly.
More number of manpower is required.

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THANK YOU
!!!

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 YOUR COMMENTS
AND QUERIES PLEASE
!!!

Health Service Management, 5th Batch, Group B3 29

 Thank You, Dhulikhel Hospital
Family for your Help, Support and
Cooperation

Health Service Management, 5th Batch, Group B3 30