Shankar, P R
In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may be suitable for use in Nepal. Original research articles, reviews, magazine articles and project reports dealing with Nepal and other developing countries during the period 1995 to 2010 were sourced via Google, Google Scholar and Pubmed. Full text access was obtained via WHO's HINARI database. The health workforce in Nepal is unevenly distributed resulting in doctor shortages in rural areas. The recent introduction of mandatory rural service for scholarship students was aimed to reduce the loss of medical graduates to developed nations. High tuition fees in private medical schools and low Government wages prevent recent graduates from taking up rural positions, and those who do face many challenges. Potential corrective strategies include community-based medical education, selecting rural-background medical students, and providing a partial or complete tuition fee waiver for medical students who commit to rural service. Traditional healers and paramedical staff can also be trained for and authorized to provide rural health care. A range of strategies developed elsewhere could be used in Nepal, especially community-oriented medical education that involves rural doctors in training medical students. The reimbursement of tuition fees, assistance with relocation, and provision of opportunities for academic and professional advancement for rural doctors should also be considered. Government investment in improving working conditions in rural Nepal would assist rural communities to attract and retain doctors.
Pitambar Acharya; Benjamin Welsh
After reviewing the state of early and forced child marriage (ECM) globally and nationally within Nepal, this research assessed the determinants, consequences and preventive measures of ECM in rural municipalities in Nepal today. This mixed method surveyed 167 households taking 15 % sample from the clusters of three wards of Badhaiyatal Rural Municipality in Bardiya and Dullu Municipality in Dailekh of Western Nepal. Besides household survey, six Focus Group Discussions (FGDs), 16 Key Informa...
Thorsen, Rikke Stamp; Pouliot, Mariève
Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610
Gurung, Anup; Kumar Ghimeray, Amal; Hassan, Sedky H.A.
Utilization of renewable energy technologies remains one of the major energy policies throughout the world. These technologies are proven to be successful for electrifying rural communities, especially in developing countries. Realizing the benefits of renewable energy sources, the Government of Nepal has initiated the production and distribution of renewable energy technologies in recent years, mainly to electrify rural communities. Although these technologies are suitable for providing electricity in isolated and remote rural areas, their implementation programs have not been successful as expected. This review provides broad-spectrum view about the energy situation in Nepal and highlights the current policies and subsidies for the optimal utilization of renewable energy resources in isolated and poor rural communities. In addition, major promotional barriers for their implementation in Nepal have been discussed. - Highlights: ► Nepal has enormous potential of renewable energy sources. ► Till date only small fraction of renewable energy sources has been exploited. ► However, renewable energy technologies seem to be promising options for rural electrification.
Full Text Available Background: Safe motherhood is a priority program in Nepal, aiming to restrain maternal deaths. Meanwhile, knowledge, practices, accessibility, and service quality are considered keys to improve service utilization. This study was conducted to identify knowledge and practices of maternal health care among mothers having < 1-year-old child in the Mid-western Development Region, Nepal. Materials and Methods: A community-based cross-sectional study was conducted during January-April 2011 in rural, Mid-western Development Region, Nepal. Three Village Development Committees (VDC from Bardiya (plain and two VDCs from each of the Salyan and Pyuthan (hill and Jumla (mountain districts were selected randomly. Hence, there were 81 clusters (1VDC = 9 clusters and 7-8 participants were selected randomly from each cluster. Data were collected by interview using structured questionnaire and Focus Group Discussion Guideline (18 FGDs, analyzed by SPSS (16.0. CD recorded qualitative data were transcribed and narrated. Percent mean and standard deviation were calculated. Results: Three quarters of the participants had correct knowledge regarding minimum numbers of antenatal visits to be done by a pregnant woman (WHO guideline. Nearly two-fifth participants knew schedule of antenatal care (ANC visits. Almost 60% had done ≥ 4 ANC visits during last pregnancy. Majority visited Sub Health Post/Health Post/Primary Health Care Centre for ANC Checkup. About 90% had taken Iron and folic acid tablets. About 57% were home deliveries (last childbirth, 40% deliveries were assisted by relatives/husband, and only 32% did postnatal health checkup. Conclusions: There were gaps in the knowledge and practices for health care during pregnancy, childbirth and in the postpartum period. A high rate of home deliveries with the low postnatal service utilization was prevalent. Intensive awareness progam and behavioral change interventions, regular pregnancy monitoring may promote the
Rajesh N Gongal
Full Text Available Introduction: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where the Mid-Level Health Workers (MHWs are the major service providers. Their views on providing palliative care are most important in determining how the service is organized and developed.Aim: This study aims to ascertain the perceptions of MHWs about palliative care in their local community, to inform service development.Methods: A> qualitative descriptive design, using focus group discussions, was used to collect data from a rural district of Makwanpur, 1 of the 75 districts of Nepal. Twenty-eight MHWs participated in four focus group discussions. The data were analyzed using content analysis.Result: Four themes emerged from the discussion: (i suffering of patients and families inflicted by life-threatening illness, (ii helplessness and frustration felt when caring for such patients, (iii sociocultural issues at the end of life, and (iv improving care for patients with palliative care needs.Conclusion: MHWs practicing in rural areas reported the suffering of patients inflicted with life-limiting illness and their family due to poverty, poor access, lack of resources, social discrimination, and lack of knowledge and skills of the health workers. While there are clear frustrations with the limited resources, there is a willingness to learn among the health workers and provide care in the community.
Thatte, N; Mullany, L C; Khatry, S K; Katz, J; Tielsch, J M; Darmstadt, G L
Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications and newborn care. Antenatal care included advice about nutrition and tetanus toxoid (TT) immunisation, but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs, though hand-washing practices differed by training status. There was no standard practice to identify maternal complications, such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing, and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival.
Full Text Available Dengue fever (DF is the most rapidly spreading mosquito-borne viral disease in the world. In this decade it has expanded to new countries and from urban to rural areas. Nepal was regarded DF free until 2004. Since then dengue virus (DENV has rapidly expanded its range even in mountain regions of Nepal, and major outbreaks occurred in 2006 and 2010. However, no data on the local knowledge, attitude and practice (KAP of DF in Nepal exist although such information is required for prevention and control measures.We conducted a community based cross-sectional survey in five districts of central Nepal between September 2011 and February 2012. We collected information on the socio-demographic characteristics of the participants and their knowledge, attitude and practice regarding DF using a structured questionnaire. We then statistically compared highland and lowland communities to identify possible causes of observed differences.Out of 589 individuals interviewed, 77% had heard of DF. Only 12% of the sample had good knowledge of DF. Those living in the lowlands were five times more likely to possess good knowledge than highlanders (P<0.001. Despite low knowledge levels, 83% of the people had good attitude and 37% reported good practice. We found a significantly positive correlation among knowledge, attitude and practice (P<0.001. Among the socio-demographic variables, the education level of the participants was an independent predictor of practice level (P<0.05, and education level and interaction between the sex and age group of the participants were independent predictors of attitude level (P<0.05.Despite the rapid expansion of DENV in Nepal, the knowledge of people about DF was very low. Therefore, massive awareness programmes are urgently required to protect the health of people from DF and to limit its further spread in this country.
Full Text Available Abstract Background The Federal Democratic Republic of Nepal is a developing country in South Asia with a population of 29.8 million. In September 2011, there were 18 medical schools with 14 being in the private sector. KIST Medical College is a private school in Lalitpur district. The present study was conducted to obtain information on student perceptions about working in rural Nepal after graduation. Methods The study was conducted among first- and second-year undergraduate medical students using a semi-structured questionnaire developed by the authors using inputs from the literature and their experiences of teaching medical students. Year of study, gender, method of financing of medical education, place of family residence and occupation of parents were noted. Participant responses were analysed, grouped together and the number of respondents stating a particular response was noted. Results Of the 200 students, 185 (92.5% participated with 95 being from the first year and 90 from the second. Most students were self-financing and from urban areas. Regarding the question of working in rural Nepal after graduation, 134 (72.4% said they will work after their undergraduate course. Students preferred to work in the government or nongovernmental sector. Student felt doctors are reluctant to serve in rural Nepal due to inadequate facilities, low salary, less security, problems with their professional development, less equipment in health centres, decreased contact with family and difficulties in communicating with an illiterate, rural population. About 43% of respondents felt medical education does not adequately prepare them for rural service. Repeated rural exposure, postings in rural hospitals and health centres, and training students to diagnose and treat illness with less technology were suggested. The median monthly salary expected was 60 000 Nepalese rupees (US$ 820 and was significantly higher among first-year students. Conclusions The
This thesis argues that Farmer Field Schools in Nepal contributed to agriculture and rural development and to gendered empowerment. The Nepalese government, but also NGOs involved in FFS applied a rather technocratic approach towards development (Li, 1999) and assumed that will well-defined
Lee, Anne C; Mullany, Luke C; Tielsch, James M; Katz, Joanne; Khatry, Subarna K; Leclerq, Steven C; Adhikari, Ramesh K; Darmstadt, Gary L
To assess stillbirth rates and antepartum risk factors in rural Nepal. Data were collected prospectively during a cluster-randomized, community-based trial in Sarlahi, Nepal, from 2002 to 2006. Multivariate regression modeling was performed to calculate adjusted relative risk estimates. Among 24531 births, the stillbirth rate was 35.4 per 1000 births (term stillbirth rate 21.2 per 1000 births). Most births occurred at home without a skilled birth attendant. The majority (69%) of intrapartum maternal deaths resulted in stillbirth. The adjusted RR (aRR) of stillbirth was 2.74 among nulliparas and 1.47 among mothers with history of a child death. Mothers above the age of 30 years carried a 1.59-fold higher risk for stillbirth than mothers who were 20-24 years old. The stillbirth risk was lower among households where the father had any formal education (aRR 0.70). Land ownership (aRR 0.85) and Pahadi ethnicity (aRR 0.67; reference: Madhesi ethnicity) were associated with significantly lower risks of stillbirth. Stillbirth rates were high in rural Nepal, with the majority of stillbirths occurring at full-term gestation. Nulliparity, history of prior child loss, maternal age above 30 years, Madhesi ethnicity, and socioeconomic disadvantage were significant risk factors for stillbirth. Clinicaltrials.govNCT00 109616. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Srinivasan, Chittur S; Zanello, Giacomo; Shankar, Bhavani
The persistence of rural-urban disparities in child nutrition outcomes in developing countries alongside rapid urbanisation and increasing incidence of child malnutrition in urban areas raises an important health policy question - whether fundamentally different nutrition policies and interventions are required in rural and urban areas. Addressing this question requires an enhanced understanding of the main drivers of rural-urban disparities in child nutrition outcomes especially for the vulnerable segments of the population. This study applies recently developed statistical methods to quantify the contribution of different socio-economic determinants to rural-urban differences in child nutrition outcomes in two South Asian countries - Bangladesh and Nepal. Using DHS data sets for Bangladesh and Nepal, we apply quantile regression-based counterfactual decomposition methods to quantify the contribution of (1) the differences in levels of socio-economic determinants (covariate effects) and (2) the differences in the strength of association between socio-economic determinants and child nutrition outcomes (co-efficient effects) to the observed rural-urban disparities in child HAZ scores. The methodology employed in the study allows the covariate and coefficient effects to vary across entire distribution of child nutrition outcomes. This is particularly useful in providing specific insights into factors influencing rural-urban disparities at the lower tails of child HAZ score distributions. It also helps assess the importance of individual determinants and how they vary across the distribution of HAZ scores. There are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Differences in the levels of a limited number of socio-economic characteristics - maternal education, spouse's education and the wealth index (incorporating household asset ownership and access to drinking water and sanitation) contribute a
Cunningham, Kenda; Ploubidis, George B; Menon, Purnima; Ruel, Marie; Kadiyala, Suneetha; Uauy, Ricardo; Ferguson, Elaine
To examine the association between women's empowerment in agriculture and nutritional status among children under 2 years of age in rural Nepal. Cross-sectional survey of 4080 households conducted in 2012. Data collected included: child and maternal anthropometric measurements; child age and sex; maternal age, education, occupation and empowerment in agriculture; and household size, number of children, religion, caste and agro-ecological zone. Associations between the Women's Empowerment in Agriculture Index (WEAI)'s Five Domains of Empowerment (5DE) sub-index and its ten component indicators and child length-for-age Z-scores (LAZ) and weight-for-length Z-scores (WLZ) were estimated, using ordinary least-squares regression models, with and without adjustments for key child, maternal and household level covariates. Two hundred and forty rural communities across sixteen districts of Nepal. Children under 24 months of age and their mothers (n 1787). The overall WEAI 5DE was positively associated with LAZ (β=0·20, P=0·04). Three component indicators were also positively associated with LAZ: satisfaction with leisure time (β=0·27, Pempowerment in agriculture was associated with WLZ. Women's empowerment in agriculture, as measured by the WEAI 5DE and three of its ten component indicators, was significantly associated with LAZ, highlighting the potential role of women's empowerment in improving child nutrition in Nepal. Additional studies are needed to determine whether interventions to improve women's empowerment will improve child nutrition.
Bajracharya, B N
Two small villages in Nepal are the subjects of case studies that illustrate the role of small towns in provision of services, employment, and market operations. Some general findings are that small towns act as service centers for distribution of basic essential goods such as food grains, salt, kerosene, and fabric for hill and mountain areas. The role of small towns as market centers and in the provision of employment is limited. In resource-poor areas small towns are less diversified. Towns with agricultural surpluses are more developed. Small hill towns satisfy consumption rather than production needs. The growth of rural areas and towns in rural areas in Nepal is dependent on arable land and levels of production in hill areas. Limited land and low levels of production have an adverse impact. Movement of people, goods, and services is limited by difficult terrain and lack of access to good roads. Variability in access to off-farm jobs and services available in small towns varies with ethnicity and place of residence. The best development strategy for small towns in Nepal is market-oriented territorial development, which retains surpluses in the local area and integrates markets in the larger economy. The strategy would decentralize planning into small territorial units that include both small towns and groups of villages, provide institutional support for the rural poor, expand off-farm employment, and include investment in region-serving functions. Subsistence agriculture needs to include diversification of high value cash crops based on local comparative advantage suitable for hill climate and terrain. Small farmers must produce both cash and subsistence crops. Government should provide market space and paved areas, weighing facilities, and overnight storage facilities. Products would be processed at the village level. Subdistricts must be established according to spatial and social linkages between villages and the service center and coordinated at the
M S Paudel; Anjana Kafle; Bishal Khatri Chhetri; Sahadev Prasad Dhungana; Anuj Poudel; Shamsuddhin .
Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. Tubercular Pleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. Pleural effusion occurs in approximately 5% of patients with TB. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal. Methods: A retrospe...
Dhakal, Sulochana; van Teijlingen, Edwin; Raja, Edwin Amalraj; Dhakal, Keshar Bahadur
In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p home. Results of univariate analysis showed that women from Brahmin-Chhetri ethnicity, women with higher education or who were more skilled, whose husbands had higher education and more skilled jobs, had first or second childbirth, and having adverse previous obstetric history were associated with institutional delivery while women with higher education and having an adverse history of pregnancy outcome predicted the uptake of skilled delivery care in Nepal. The main perceived problems to access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified
Acharya, Dilaram; Khanal, Vishnu; Singh, Jitendra Kumar; Adhikari, Mandira; Gautam, Salila
Antenatal care has several benefits for expecting mothers and birth outcomes; yet many mothers do not utilise this service in Nepal. Mass media may play an important role in increasing the use of antenatal care and other maternal health services. However, the effect of mass media on increasing health service utilisation has remained an under studied area in Nepal. The aim of this study was to investigate the impact of mass media on the utilisation of antenatal care services in rural Nepal. A community-based cross-sectional study was conducted in Sinurjoda Village Development Committee of Dhanusha District, Nepal. A total of 205 mothers of children aged under 1 year were selected using systematic random sampling. Logistic regression was employed to examine the association between selected antenatal care services and mass media exposure after adjusting for other independent variables. A majority of mothers were exposed to mass media. Radio was accessible to most (60.0%) of the participants followed by television (43.41%). Mothers exposed to mass media were more likely to attending antenatal visits [Odds ratio (OR) 6.28; 95% CI (1.01-38.99)], taking rest and sleep during pregnancy [OR 2.65; 95% CI (1.13-6.26)], and receiving TT immunization [OR 5.12; 95% CI (1.23-21.24)] than their non-exposed counterparts. The study reported a positive influence of mass media on the utilisation of antenatal care services in Nepal. Therefore, further emphasis should be given to increase awareness of women of rural Nepal through mass media to improve utilisation of antenatal care services in Nepal.
Resham Bahadur Khatri
Full Text Available Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers.We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis.Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center.The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.
Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E
Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.
Chhetri, Bir Bahadur Khanal; Larsen, Helle Overgaard; Smith-Hall, Carsten
This paper investigates the economic importance of environmental income to rural households in Nepal and how environmental income influences poverty and inequality measures. Qualitative contextual information was collected from two village development committees in middle Gorkha District followed...
Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kc, Vikash Kumar; Jha, Nisha; Sharma, Damodar
Background Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. Methods The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. Results All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. Conclusion The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed. PMID:27540325
NEUPANE, Pramila; THAPA, Rajesh Bahadur; SAPKOTA, Jeet Bahadur
Due to globalization and internationalization of education, the importance of English language has been growing consistently. Like many other countries around the globe, English is taught as a compulsory subject from the primary level in Nepal. Despite continuous public and private efforts, achievement in English education is not satisfactory, especially in rural areas, due to numerous socio-cultural and other factors. Thus, this article explores some important determinants of English achieve...
Dhungana, Adhish; Nanthamongkolchai, Sutham; Pitikultang, Supachai
Background: Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. Materials and Methods: This is a community based cross-sectional survey research conducted in rural area o...
Shrestha, S; Thapa, P; Saleh, F; Thapa, N; Stray, B Pedersen; Khanom, K
Diabetes mellitus is an emerging health problem in developing world with the consumption of energy dense diet and inactive lifestyle. The problem of diabetes is further expanded due to ignorance and lack of knowledge. The aim of the study was to assess the knowledge of diabetes among pregnant women in three districts of Nepal. A community based cross-sectional study was conducted in three districts in mountain, hilly and plain areas of Nepal. A total of 590 pregnant women were interviewed during the period of July 2009 to June 2010. A knowledge score system was applied. Poor score was 60%) of the total score. Statistical software SPSS 11.5 was used for data entry, data management and analysis. Out of 590 pregnant women, only 41% had heard about diabetes mellitus. Majority of the participants (75%) from age group >30 years had not heard about diabetes. Among the 241 with some knowledge, the knowledge score median percent(range) on the meaning, symptoms, risk factors, treatment, prevention, complications and overall knowledge were 50%(0-100), 25% (0-75), 20% (0-60), 20% (0-100), 25% (0-100), 20% (0-60) and 26% (0- 58) respectively. According to defined category, majority of those who ever heard about diabetes had poor knowledge (95%). Knowledge among literate women (p=.001), women residing in Kailali district (plain region) (p=.003) and those with positive family history of diabetes (p=.003) was found to be significant. As large proportions of Nepalese pregnant women do not have any knowledge or have poor knowledge regarding diabetes, extensive health education and health promotion programs are urgently recommended to prevent diabetes in Nepal.
Shrestha, Khadka Narayan; Homer, Caroline S. E.
Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987
Derek C Johnson
Full Text Available Nepal has one of the highest cervical cancer rates in South Asia. Only a few studies in populations from urban areas have investigated type specific distribution of human papillomavirus (HPV in Nepali women. Data on high-risk HPV (HR-HPV types are not currently available for rural populations in Nepal. We aimed to assess the distribution of HR- HPV among rural Nepali women while assessing self-collected and clinician-collected cervico-vaginal specimens as sample collection methods for HPV screening.Study participants were recruited during a health camp conducted by Nepal Fertility Care Center in Achham District of rural far western Nepal. Women of reproductive age completed a socio-demographic and clinical questionnaire, and provided two specimens; one cervical-vaginal specimen using a self-collection method and another cervical specimen collected by health camp auxiliary nurse midwives during a pelvic examination. All samples were tested for 14 different HR-HPV mRNA and also specific for HPV16/18/45 mRNA.Of 261 women with both clinician- and self-collected cervical samples, 25 tested positive for HR-HPV, resulting in an overall HR-HPV prevalence of 9.6% (95% confidence Interval [CI]: 6.3-13.8. The overall Kappa value assessing agreement between clinician- and self-collected tests was 0.62 (95% CI: 0.43-0.81, indicating a "good" level of agreement. Abnormal cytology was reported for 8 women. One woman identified with squamous cell carcinoma (SCC, and 7 women with high grade squamous intraepithelial lesions (HSIL. Seven of the 8 women tested positive for HR-HPV (87.5% in clinician-collected samples and 6 in self-collected samples (75.0%.This is the first study to assess HR-HPV among rural Nepali women. Self-collected sampling methods should be the subject of additional research in Nepal for screening HR-HPV, associated with pre-cancer lesions and cancer, in women in rural areas with limited access to health services.
Suvedi, Murari; Ghimire, Raju; Kaplowitz, Michael
Purpose: This paper examines the factors affecting farmers' participation in extension programs and adoption of improved seed varieties in the hills of rural Nepal. Methodology/approach: Cross-sectional farm-level data were collected during July and August 2014. A sample of 198 farm households was selected for interviewing by using a multistage,…
Full Text Available High concentrations of household air pollution (HAP due to biomass fuel usage with unvented, insufficient combustion devices are thought to be an important health risk factor in South Asia population. To better characterize the indoor concentrations of particulate matter (PM2.5 and carbon monoxide (CO, and to understand their impact on health in rural southern Nepal, this study analyzed daily monitoring data collected with DataRAM pDR-1000 and LASCAR CO data logger in 2980 households using traditional biomass cookstove indoor through the Nepal Cookstove Intervention Trial-Phase I between March 2010 and October 2011. Daily average PM2.5 and CO concentrations collected in area near stove were 1,376 (95% CI, 1,331-1,423 μg/m3 and 10.9 (10.5-11.3 parts per million (ppm among households with traditional cookstoves. The 95th percentile, hours above 100μg/m3 for PM2.5 or 6ppm for CO, and hours above 1000μg/m3 for PM2.5 or 9ppm for CO were also reported. An algorithm was developed to differentiate stove-influenced (SI periods from non-stove-influenced (non-SI periods in monitoring data. Average stove-influenced concentrations were 3,469 (3,350-3,588 μg/m3 for PM2.5 and 21.8 (21.1-22.6 ppm for CO. Dry season significantly increased PM2.5 concentration in all metrics; wood was the cleanest fuel for PM2.5 and CO, while adding dung into the fuel increased concentrations of both pollutants. For studies in rural southern Nepal, CO concentration is not a viable surrogate for PM2.5 concentrations based on the low correlation between these measures. In sum, this study filled a gap in knowledge on HAP in rural Nepal using traditional cookstoves and revealed very high concentrations in these households.
Mar 22, 2012 ... Research focus To assess the vulnerability of rural communities in Nepal's diverse ... In 2010, the Institute for Social and Environmental Transition-Nepal ... Through continuous interaction with each community, the team ...
Charlery, Lindy Callen; Qaim, Matin; Smith-Hall, Carsten
contributes to the literature by empirically analysing the effects of rural road construction on household income and income inequality in Nepal. Using a quasi-experimental design, a difference-in-difference approach is developed and employed to analyse household (n = 177) data before and after road...... construction. We find that the new road had a significantly positive impact on mean household income of USD 235 (28%). Contrary to expectations, we do not find an increase in income inequality. Compared to the counterfactual site, it appears that the road has rather contributed to decreasing income inequality....... The poorest households gained most from the road construction, making it a pro-poor development intervention....
Full Text Available Emilia Berin,1,* Micaela Sundell,1,* Chanda Karki,2 Jan Brynhildsen,1 Mats Hammar1 1Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; 2Department of Obstetrics and Gynecology, Kathmandu Medical College, Kathmandu, Nepal *These authors contributed equally to this work Objective: To map the knowledge about and attitudes toward birth control methods among women in Kathmandu, Nepal, and to compare the results between women seeking an induced abortion and a control group. Method: This was a cross-sectional cohort study with matched controls. Women aged 15–49 years seeking medical care at the Department of Gynecology and Obstetrics at Kathmandu Medical College were included and interviewed. A case was defined as a woman who sought an elective medical or surgical abortion. A control was defined as a woman who sought medical care at the outpatient department or had already been admitted to the ward for reasons other than elective abortion. A questionnaire developed for the study – dealing with different demographic characteristics as well as knowledge about and attitudes toward contraceptives – was filled out based on the interview. Results: A total of 153 women were included: 64 women seeking an abortion and 89 controls. Women seeking an abortion had been pregnant more times than the control group and were more likely to have been informed about contraceptives. Women with higher education were less likely to seek an abortion than women with lower education. There was no significant difference in knowledge about and attitudes toward contraceptives between cases and controls. The women considered highest possible effectiveness to be the most important feature when deciding on a birth control method. Conclusion: Women seeking abortion in Kathmandu had shorter education and a history of more pregnancies and deliveries than women in the control group. Education and counseling on sex
Acharya, J.; Van Teijlingen, Edwin; Murphy, Jane; Hind, Martin
bstract Undernutrition remains a key public health burden in Nepal. This study aimed to measure knowledge, attitudes, and beliefs about nutritious food amongst mothers of 3 – 5 year olds from rural and urban areas. A cross-sectional mixed-methods approach comprised a quantitative survey and qualitative focus groups. The community-based survey included 524 mothers of children who are no longer breastfed. Open-ended and structured questions investigated knowledge, beliefs and attitudes about nu...
Full Text Available Background: Healthy population is indispensable for national development. Adequate food intake by people is the key determinant to keep up their health. Malnutrition nevertheless remains pervasive in developing countries, undermining people’s health, productivity, and often their survival. Food insecurity and hunger remain persistent in Nepal. Prevalence of low calories intake by rural family is widespread throughout the country population. Mainly marginalized communities, ethnic group with poor economic status, traditional societies and lower cast people are exposed to food defi cit. Objective: to investigate the prevalence of low calories intake by rural families and its associated determinants in Palpa district. Materials and methods: The cross-sectional study was designed to achieve objective of the research. A random sample of 339 families was selected from rural areas (DUMRE, DAMKADA, GORKHEKOT and TELGHA villages of this district. Data were analyzed by using the SPSS software for Windows (version 16.0. Results: The existence of inadequate food calorie intake among rural families was most common. Most of them were malnourished. Conclusion: low calorie intake by ethnic group was considerably higher than other groups in community.
Maharjan, Keshav Lall; Joshi, Niraj Prakash
For the purpose of this study, sample was selected through stratified random sampling from Baitadi district, which falls in rural Far-western Hills of Nepal. Both income and consumption measure of poverty revealed that problem of poverty is more severe in Melauli, which is relatively remote village devoid of transportation, communication, market, and other developmental services. Education, occupation, gender of household head, and family size are found to be the most important factors that a...
Emmett, Susan D; Schmitz, Jane; Pillion, Joseph; Wu, Lee; Khatry, Subarna K; Karna, Sureshwar L; LeClerq, Steven C; West, Keith P
To evaluate the association between adolescent and young-adult hearing loss and nonverbal intelligence in rural Nepal. Cross-sectional assessment of hearing loss among a population cohort of adolescents and young adults. Sarlahi District, southern Nepal. Seven hundred sixty-four individuals aged 14 to 23 years. Evaluation of hearing loss, defined by World Health Organization criteria of pure-tone average greater than 25 decibels (0.5, 1, 2, 4 kHz), unilaterally and bilaterally. Nonverbal intelligence, as measured by the Test of Nonverbal Intelligence, 3rd Edition standardized score (mean, 100; standard deviation, 15). Nonverbal intelligence scores differed between participants with normal hearing and those with bilateral (p = 0.04) but not unilateral (p = 0.74) hearing loss. Demographic and socioeconomic factors including male sex; higher caste; literacy; education level; occupation reported as student; and ownership of a bicycle, watch, and latrine were strongly associated with higher nonverbal intelligence scores (all p intelligence score based on unilateral hearing loss (0.97; 95% confidence interval, -1.67 to 3.61; p = 0.47). Nonverbal intelligence is adversely affected by bilateral hearing loss even at mild hearing loss levels. Socio economic well-being appears compromised in individuals with lower nonverbal intelligence test scores.
Gerger, Aa; Gullberg, M
Local management of rural power supply is being evaluated in a joint research project conducted by Tanzania Electric Supply Company Limited (TANESCO) and Stockholm Environment Institute (SEI) on new approaches to management and organization of rural electrification. The study is based on literature, and on data from eight visited local organizations for management of power supply in Bolivia (4), India (1) and Nepal (3). Common for these countries is that the national, rural electrification programmes have encountered difficulties. Governments have failed to generate enough funds from existing power supply systems to cover the cost for a continued rural electrification. In cases where large private companies exist, they have had few incentives for expanding into rural areas since it is often not profit making. A third category may be defined as local initiators to power supply, private or co-operative. In all these countries, locally managed power supply systems have developed as a complement to governmental and other large scale programmes. The national policies pertaining to rural power supply in general and local management thereof in particular are described for each country. From the study, it appears that local management of rural power supply is a feasible approach in developing countries. Local management of rural power supply can slightly lower the costs of electrification, and it may help accelerate the pace of load development in newly electrified areas. For successful local organizations though, the most significant factor appears to be local peoples` willingness to develop their own area. Important though, is that proper financial and technical assistance is provided the local organizations. Crucial for sound external assistance is that the national rural electrification policies are clear and consistent. 53 refs, 1 fig, 11 tabs
Scott, Anna; Englund, Janet; Chu, Helen; Tielsch, James; Tielsch, James; Khatry, Subarna; Leclerq, Steven C; Shrestha, Laxman; Kuypers, Jane; Steinhoff, Mark C; Katz, Joanne
Abstract Background Incidence of respiratory syncytial virus (RSV) and rhinovirus (RHV) varies throughout the year. We aim to quantify the relationship between weather variables (temperature, humidity, precipitation, and aerosol concentration) and disease incidence in order to quantify how outbreaks of RSV and RHV are related to seasonal or sub-seasonal meteorology, and if these relationships can predict viral outbreaks of RSV and RHV. Methods Health data were collected in a community-based, prospective randomized trial of maternal influenza immunization of pregnant women and their infants conducted in rural Nepal from 2011–2014. Adult illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia, with infant illness defined similarly but without fever requirement. Cases were identified through longitudinal household-based weekly surveillance. Temperature, humidity, precipitation, and fine particulate matter (PM 2.5) data come from reanalysis data products NCEP, Era-Interim, and Merra-2, which are produced by assimilating historical in-situ and satellite-based observations into a weather model. Results RSV exhibits a relationship with temperature after removing the seasonal cycle (r = -0.16, N = 208, P = 0.02), and RHV exhibits a strong relationship to daily temperature (r =-0.14, N =208, P = 0.05). When lagging meteorology by up to 15 weeks, correlations with disease count and weather improve (RSV: r_max = 0.45, P < 0.05; RHV: r_max = 0.15, P = 0.05). We use an SIR model forced by lagged meteorological variables to predict RSV and RHV, suggesting that disease burden can be predicted at lead times of weeks to months. Conclusion Meteorological variables are associated with RSV and RHV incidence in rural Nepal and can be used to drive predictive models with a lead time of several months. Disclosures J. Englund, Gilead: Consultant and Investigator, Research support Chimerix: Investigator, Research support Alios: Investigator
Baland, Jean-Marie; Bardhan, Pranab; Das, Sanghamitra; Mookherjee, Dilip; Sarkar, Rinki
We investigate determinants of household firewood collection in rural Nepal, using 1995-96 and 2002-3 World Bank Living Standards Measurement Survey (LSMS) data. We incorporate village fixed effects, endogenous censoring, measurement error in living standards and heterogeneous effects of different household assets. We find no evidence in favor of the poverty-environment hypothesis. The evidence for the environmental Kuznets curve depends on the precise measure of living standards and time period studied. Firewood collections fall with a transition to modern occupations and rise with increasing population and household division. The local interhousehold collection externality is negligible, indicating that policy interventions are justified only by ecological considerations or nonlocal spillovers.
Raut, Anant; Yarbrough, Chase; Singh, Vivek; Gauchan, Bikash; Citrin, David; Verma, Varun; Hawley, Jessica; Schwarz, Dan; Harsha Bangura, Alex; Shrestha, Biplav; Schwarz, Ryan; Adhikari, Mukesh; Maru, Duncan
Globally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility.DevelopmentThe electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives. For these purposes, we adapted Bahmni, a product built with open-source components for patient tracking, clinical protocols, pharmacy, laboratory, imaging, financial management, and supply logistics. In close partnership with government officials, we deployed the system in February of 2015, added on additional functionality, and iteratively improved the system over the following year. This experience enabled us then to deploy the system at an additional district-level hospital in a different part of the country in under four weeks. We discuss the implementation challenges and the strategies we pursued to build an electronic medical record for the public sector in rural Nepal.DiscussionOver the course of 18 months, we were able to develop, deploy and iterate upon the electronic medical record, and then deploy the refined product at an additional facility within only four weeks. Our experience suggests the feasibility of an integrated electronic medical record for public sector care delivery even in settings of rural poverty.
Oven, Katie; Petley, Dave; Rosser, Nick; Dunn, Chris; Rigg, Jonathan
It is widely accepted that the impact of natural hazards reflects not only the nature of geophysical processes but also the social conditions that prevail. The need for collaborative research to address these complex interactions between the natural and human systems is well recognised, however moving from theory to practice presents a number of significant challenges. How researchers frame problems; develop their research questions; select the methodologies to explore these questions; and privilege certain knowledges over others, can be seen to vary between physical and social science. Drawing on a case study examining the vulnerability of rural communities to landslides in the Upper Bhote Koshi Valley, Central Nepal, this paper explores how these barriers can be overcome and the benefits of undertaking interdisciplinary research within the natural hazards field. This research investigates the different framings of landslide risk and vulnerability from different stakeholder and disciplinary perspectives. Specifically, we ask: 1. Who is vulnerable to landslide hazard? 2. Why do people occupy landslide prone areas? 3. How do ‘at risk' rural communities perceive and respond to landslide hazard and risk? The findings, based on a series of participatory methodologies, challenge a number of assumptions made regarding landslide vulnerability in mountain communities. Within the Upper Bhote Koshi Valley clear transitions in settlement patterns, rural livelihoods and thus the occupation of landslide prone areas have been seen over time. For the majority of households, their decision to occupy these areas is driven by the economic and social benefits associated with the Arniko Highway which runs through the valley, linking Nepal with Tibet. Landslide vulnerability therefore emerges not just from societal marginalisation but also from situations of relative prosperity. The findings suggest that occupants of landslide prone areas have a good understanding of landslide hazard
Thapa, Lekhjung; Sharma, Nooma; Poudel, Ramesh Sharma; Bhandari, Tirtha Raj; Bhagat, Riwaz; Shrestha, Ashis; Shrestha, Shakti; Khatiwada, Dipendra; Caplan, Louis R
Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP) of high school students with respect to stroke from Nepal. A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression. Among 1360 participants, 71.1% had heard or read about stroke; 30.2% knew someone with stroke. 39.3% identified brain as the organ affected. Sudden onset limb/s weakness/numbness (72%) and hypertension (74%) were common warning symptom and risk factor identified. 88.9% would take stroke patients to a hospital. Almost half participants (55.5%) felt ayurvedic treatment be effective. 44.8% felt stroke as a hindrance to a happy life and 86.3% believed that family care was helpful for early recovery. Students who identified at least one risk factor were 3.924 times ( P school Nepalese students regarding stroke was satisfactory, and the students having knowledge about the risk factors and warning symptoms were more likely to take stroke patients to a hospital. However, a few misconceptions persisted.
Huntington, Ian; Shrestha, Suvash; Reich, Nicholas G; Hagopian, Amy
The number of medical students trained in Nepal each year has increased nearly fifty-fold in the last 15 years, primarily through the creation of private medical schools. It is unknown where this expanding cohort of new physicians will ultimately practice. We distributed an anonymous survey to students in their last 2 years of medical school at four medical schools in Nepal to examine two dimensions of career intention: the intention to practice in Nepal and the intention to practice in rural areas. Eighty-five per cent of the eligible study population participated, for a total of 469 medical students. Of these, 88% thought it was likely they would practice in Nepal and 88% thought it likely they would practice in urban areas. Those students who indicated a greater likelihood of practicing abroad came from families with higher incomes, were more likely to think earning a good salary was very important to their decision to become a physician, and were less likely to think they could earn a good salary in Nepal. Students whose tuition was paid by the government were no more likely to indicate an intention to practice in Nepal than students paying their own tuition at private medical schools. Students who indicated a greater likelihood of practicing in rural areas were more likely to be male, to have gone to a government secondary school, to have been born in a village, or to have received a scholarship from the Ministry of Education that requires rural service. Based on our findings, we suggest the following policy changes: (1) medical schools consider selecting for students from rural backgrounds or government secondary schools who are more likely to intend to practice in rural areas, and (2) increase the number of post-graduate positions--weighted toward rural health needs--to retain students in Nepal.
Uranw, S.; Meheus, F.; Baltussen, R.M.; Rijal, S.; Boelaert, M.
BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined
Full Text Available Abstract Background Sexual violence within marriage is a public health and human rights issue; yet it remains a much neglected research area, especially in Nepal. This paper represents one of the first attempts to quantify the extent of sexual violence and its determinants among young married women in Nepal. Methods A cross-sectional survey was conducted among 1,296 married women aged 15–24 years in four major ethnic groups in rural Nepal. The survey data were used to estimate the prevalence and identify determinants of sexual violence. The relative importance of different correlates of sexual violence in the past 12 months at the individual, household and community levels were examined by using a multi-level multivariate statistical approach. Results Of the young women surveyed 46% had experienced sexual violence at some point and 31% had experienced sexual violence in the past 12 months. Women’s autonomy was found to be particularly protective against sexual violence both at the individual and community level. Women’s educational level was not found to be protective, while the educational level of the husband was found to be highly protective. Conclusions The high prevalence of sexual violence against young women by husbands found in this study is a matter for serious concern and underscores the need for a comprehensive response by policymakers.
Shrestha, Dirgha Raj; Regmi, Shibesh Chandra; Dangal, Ganesh
Unsafe abortion is affecting a lot, in health, socio-economic and health care cost of many countries. Despite invention of simple technology and scientifically approved safe abortion methods, women and girls are still using unsafe abortion practices. Since 2002, Nepal has achieved remarkable progress in developing policies, guidelines, task shifting, training human resources and increasing access to services. However, more than half of abortion in Nepal are performed clandestinely by untrained or unapproved providers or induced by pregnant woman herself. Knowledge on legalization and availability of safe abortion service among women is still very poor. Stigma on abortion still persists among community people, service providers, managers, and policy makers. Access to safe abortion, especially in remote and rural areas, is still far behind as compared to their peers from urban areas. The existing law is not revised in the spirit of current Constitution of Nepal and rights-based approach. The existence of abortion stigma and the shifting of the government structure from unitary system to federalism in absence of a complete clarity on how the safe abortion service gets integrated into the local government structure might create challenge to sustain existing developments. There is, therefore, a need for all stakeholders to make a lot of efforts and allocate adequate resources to sustain current achievements and ensure improvements in creating a supportive social environment for women and girls so that they will be able to make informed decisions and access to safe abortion service in any circumstances.
Dev Raj Dahal
Full Text Available Social science informs about the ideals and trains experts to deal with the complex social realities. It has a public purpose rooted in what we call dharma (professional and institutional responsibility as opposed to the arrogance of reason, self-will and self-rationalization intrinsic to contemporary rational choice and modernity. Learning has a synergy - establishing connection between the world of social science theories and the drama of social life. A lack of mutual learning between Nepal's traditional faith intellectuals and modern reason-based social scientists has created a big hiatus and contradiction. The academic life of social scientists in Nepal is completely outside of spiritual, moral and ethical influence experienced by ordinary public. The spiritual blindness of modern social scientists has thus opened multiple gaps between their worldview and those of the citizens on various frontiers--theoretical knowledge and practical experience, technical understanding and composite knowledge and secularity of social science and the vitality of the Hindu-Buddhist scriptures in the popular mind, culture, behavior and practices. This has reinforced a division between the system of knowledge of social scientists and the life-world of people. The proponents of new social movements in Nepal, such as women, Dalits, Janajatis, Madhesis, youths and marginalized population are seeking a structural shift in reason-based knowledge to both reason and feeling in social science knowledge discovery. This movement can open the "captive mind" to social learning of contextual knowledge, conduct research with the citizens, provide inputs to the policy makers and reverse their linear, structure-bound, rationalist and disciplinary thinking into the one that represents what the Nepal mandala, the Nepali space, is really like and how to improve it for the better. The renewal and indigenization of qualitative social science research is important to overcome the
Kunwar, Ripu M; Bussmann, Rainer W
Indigenous knowledge has become recognized worldwide not only because of its intrinsic value but also because it has a potential instrumental value to science and conservation. In Nepal, the indigenous knowledge of useful and medicinal plants has roots in the remote past. The present study reviews the indigenous knowledge and use of plant resources of the Nepal Himalayas along the altitudinal and longitudinal gradient. A total of 264 studies focusing on ethnobotany, ethnomedicine and diversity of medicinal and aromatic plants, carried out between 1979 and 2006 were consulted for the present analysis. In order to cross check and verify the data, seven districts of west Nepal were visited in four field campaigns. In contrast to an average of 21-28% ethnobotanically/ethnomedicinally important plants reported for Nepal, the present study found that up to about 55% of the flora of the study region had medicinal value. This indicates a vast amount of undocumented knowledge about important plant species that needs to be explored and documented. The richness of medicinal plants decreased with increasing altitude but the percentage of plants used as medicine steadily increased with increasing altitude. This was due to preferences given to herbal remedies in high altitude areas and a combination of having no alternative choices, poverty and trust in the effectiveness of folklore herbal remedies. Indigenous knowledge systems are culturally valued and scientifically important. Strengthening the wise use and conservation of indigenous knowledge of useful plants may benefit and improve the living standard of poor people.
Westendorp, A.M.B.; Visser, L.E.
This article is the outcome of an empirical study of technical training of women and men through Farmer Field Schools in rural Nepal during the last decade. When the Farmer Field Schools started in Nepal as part of the FAO Integrated Pest Management project in 1997, this was also the year that the
Amatya, B; Shrestha, N
Under-nutrition is a condition in which there is inadequate consumption, poor absorption or excessive loss of nutrients. Nepal still faces high chronic as well as acute under-nutrition in children. The following study was conducted a Sanskrit school in rural Baglung to find the prevalence of malnutrition among the children which could reflect the nutritional status of the community. Out of 60 students admitted to the school, only 43 were present at the time when we collected our data. Weight was measured with a standard weighing scale and standing height with a measuring tape attached to the wall. Data were filled up in proforma, entered in Microsoft Excel 2013 and were analyzed and indicators calculated with SPSS version 20 using WHO Child Growth Reference data for 5-19 years and macros. Stunting (Z score Sanskrit school where the study was conducted.
Full Text Available Background: Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP of high school students with respect to stroke from Nepal. Materials and Methods: A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression. Results: Among 1360 participants, 71.1% had heard or read about stroke; 30.2% knew someone with stroke. 39.3% identified brain as the organ affected. Sudden onset limb/s weakness/numbness (72% and hypertension (74% were common warning symptom and risk factor identified. 88.9% would take stroke patients to a hospital. Almost half participants (55.5% felt ayurvedic treatment be effective. 44.8% felt stroke as a hindrance to a happy life and 86.3% believed that family care was helpful for early recovery. Students who identified at least one risk factor were 3.924 times (P < 0.001, confidence interval [CI] = 1.867–8.247 or those who identified at least one warning symptom were 2.833 times (P ≤ 0.023, CI = 1.156–6.944 more likely to take stroke patients to a hospital. Conclusion: KAP of high school Nepalese students regarding stroke was satisfactory, and the students having knowledge about the risk factors and warning symptoms were more likely to take stroke patients to a hospital. However, a few misconceptions persisted.
Agha, Sohail; Karim, Ali Mehryar; Balal, Asma; Sosler, Steve
This study evaluates the impact of a nurse and paramedic reproductive health franchise in rural Nepal on client satisfaction and utilization of services. A quasi-experimental study design, with baseline and follow-up measurements on nonequivalent control groups, was used to assess the effects of the intervention. The study collected data from exit interviews with male and female clients at clinics and from household interviews with married women. Our assessment covers the project's performance for about a year of actual implementation. Client satisfaction with the quality of services increased across a range of indicators at intervention clinics but not at control clinics. Overall satisfaction with services also increased only at intervention clinics but not at control clinics. Consistent with these changes, loyalty increased among clients of franchised clinics. The analysis showed a positive relationship between client satisfaction and loyalty. Although the project's implementation was examined over a relatively short period of time, there appears to have been a net positive effect of the intervention on obtaining family planning products from medical stores/pharmacies. The study shows that franchising reproductive health services increases a provider's interest in delivering better quality services in rural areas of a developing country.
Pathiyil Ravi Shankar
Full Text Available BackgroundDiarrhoea, a common disease, is one of the majordeterminants of childhood morbidity and mortality in Nepal.MethodThis cross-sectional survey used a self-designed and pretestedstructured questionnaire to gather data on mothers’knowledge about childhood diarrhoea. The study wasconducted in the Morang district of Nepal from June toAugust 2010. Data was analysed using descriptive andinferential statistics. Testing for significant difference andcorrelation of mothers' knowledge about diarrhoea withdemographic factors were performed by using Kruskal-Wallis test and Spearman’s rank correlation at an alpha levelof 0.05.ResultsMothers had some basic knowledge about the prevention ofdiarrhoea, and fluids/foods which can or cannot be givenduring bouts of diarrhoea. Knowledge about signs ofdehydration was poor. None of the mothers were able tomention all the steps for correct and complete preparationof oral rehydration salt (ORS and salt-sugar-water (SSWsolutions. Only 8.5% of the mothers stated that the purposeof giving ORS solution during diarrhoea is to prevent thechild from getting dehydrated.ConclusionKnowledge about signs of dehydration and themanagement approaches of diarrhoea at home was poor.Thus, there is a need for public health educationalinterventions.
Tiwari, I P
This study examines the impact of migration on rural employment and income in the Western Development Region of Nepal. Data were obtained from interviews conducted among a sample population among villages in the mountain zone of the north, to the Terai in the south. The study area boundaries are irregular in order to ensure adequate spatial, topographic, and socioeconomic representation. The sample included 1387 hill people, 1248 mountain people, and 96 Terai people. Only 15.8% of the sample had access roads to villages in hill areas. 51% had access to roads in the Terai. There is no history of occupational mobility, but settlements changed over time as an adjustment to conditions. Pioneer models of development that aimed to increase economic opportunity included planned settlements. Presently, migration is comprised of rural to rural, rural to urban, and urban to urban. Rural to rural migration is primarily short distances, while long distances accompany hill to Terai moves. 37.0% of immigrants in hill areas migrate between hill districts. About 33% of hill valley settlers were first generation in-migrants, of which about 60% were migrants from hill settlements. Over 60% of the Terai plains' immigrants were from hill districts. The largest short distance movements were from higher to lower elevations, followed by horizontal movements. Permanent emigration has declined in recent years. At least one member from 34.9% of households was a temporary emigrant seeking employment. 41.5% of households had at least one employee in the Eastern Pokhara Valley. Many hill emigrants travel to foreign countries. Migrants were better educated and more involved in agriculture and salaried jobs. Analysis of variance findings indicates that rural temporary migrants came from households with smaller landholdings and larger family size. Findings support the Todaro hypothesis and findings of House and Rempel (1980) in Kenya, that reflect the benefits from migration.
Neupane, Dinesh; Dawson, Penny; Houston, Robin
and in many other developing countries. This is a cohort study to evaluate the risk of deaths among LBW infants who received FCHV follow up visit for home-based care compared to those who did not receive in Rural Nepal. Methods A cohort study design was used with data from the Morang Innovative Neonatal...
Full Text Available Background: Nurses are important health care professionals and should have wide knowledge about common diseases especially infectious diseases like dengue. Dengue is associated with shock and can lead to death. Aim: To assess the knowledge of nurses regarding dengue fever and to study the association between the demographic variables. Setting and design: A cross sectional study was conducted at the College of Medical Sciences-Teaching Hospital, Nepal among the nurses during December, 2010. Study tool: Semi structured question was prepared to assess the knowledge of nurses in which there was objective question and Yes or No type questionnaire. Statistical analysis: The filled questionnaires were collected and data were entered in Microsoft excel sheet and analyzed as per study objectives. Descriptive statistic was used to calculate the median (IQR and non parametric tests (Kruskal Wallis test and Mann Whitney test to compare the total scores with demographic profile of the subjects. Results: Of the study members 89% were from Proficiency Certificate level (PCL background and the mean (IQR age of the respondents was 21 years (20-22.75. Overall score of the nurses was 11 (9-13 with a maximum possible score of 17. There were no association between the respondents knowledge scores with age (p=0.14; educational qualifications (p=0.86; duration of experience (p=0.59; ward (p=0.28. Conclusion: The study findings report a low knowledge among the nursing practitioners on dengue fever and its complications and their knowledge did not have any association with their demographic variables. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 7-13 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9667
Tika Ram Gautam
Full Text Available Current trends of migration in Nepal imply that the extensive out-migration of young people from rural areas, to foreign and internal urban centres, coincides with a rise in the problem of older couples in rural areas. This article examines the impact of migration on living condition and internal feelings of old age couples by drawing on the results of sociological and demographic field studies in Kandebash Village Development Committee (VDC comprising multiethnic communities of western Nepal. The methodology for identifying older people is, social survey followed by direct interview with semi-structured questionnaire, examining variations by socio-economic strata and family structures. Comparative analysis indicates considerable heterogeneity in past and present migration patterns, both within and between countries. Economically higher status families are commonly able to reinforce their position by making better use of emigration opportunities. These families are migrating permanently to urban centers within country. Migrants from economically middle and lower status families are continuing temporary migration to foreign countries. Temporary migration, both within and between countries, is making old age couples alone in rural villages. The migrants' financial and material contributions are a nominal support. The old age lonely couples are facing many problems such as feeling loneliness, helplessness, frustration, increased household and social burdening.Key words: Migration, emigration, immigration, old age couple, rural migration, NepalDOI = 10.3126/dsaj.v2i0.1361Dhaulagiri Journal of Sociology and Anthropology Vol.2 pp.145-160
Henryson, Jessica; Haakansson, Teresa
Photovoltaic (PV) technology is a clean and environmentally friendly technology that does not require any fuels. The high reliability of operation and little need for maintenance makes it ideally suited for rural areas. Today PV systems are used in Nepal to power telecommunications centres, navigational aids, in pumping systems for irrigation and drinking water, and for household electrification. A solar home system consists of a PV module, a battery, a charge controller and 3-4 fluorescent light bulbs with fixture. The system provides power for lighting and operation of household appliances for several hours. The success of donor supported programs have shown that solar home systems can be a practical solution for many rural households. In 1996 the Government of Nepal launched a subsidy program for solar home systems, which dramatically has increased the demand for solar home systems among rural customers. This report includes a survey of 52 households with solar home systems in two villages. The field-study shows that the villagers are very happy with their systems and the technical performance of the systems in both villages is satisfactory. The study also shows the positive impact electricity has on education, health, income generation and quality of life. The beneficiaries of introducing electricity in remote areas are the children and the women 39 refs, 18 tabs. Examination paper
Link, Cynthia F
This study analyzes longitudinal data from couples in rural Nepal to investigate the influence of spousal communication about family planning on their subsequent contraceptive use. The study expands current understanding of the communication-contraception link by (a) exploiting monthly panel data to conduct an event history analysis, (b) incorporating both wives' and husbands' perceptions of communication, and (c) distinguishing effects of spousal communication on the use of four contraceptive methods. The findings provide new evidence of a strong positive impact of spousal communication on contraceptive use, even when controlling for confounding variables. Wives' reports of communication are substantial explanatory factors in couples' initiation of all contraceptive methods examined. Husbands' reports of communication predict couples'subsequent use of male-controlled methods. This analysis advances our understanding of how marital dynamics--as well as husbands' perceptions of these dynamics--influence fertility behavior, and should encourage policies to promote greater integration of men into family planning programs.
Choulagai, Bishnu; Onta, Sharad; Subedi, Narayan; Mehata, Suresh; Bhandari, Gajananda P; Poudyal, Amod; Shrestha, Binjwala; Mathai, Matthews; Petzold, Max; Krettek, Alexandra
Skilled birth attendants (SBAs) provide important interventions that improve maternal and neonatal health and reduce maternal and neonatal mortality. However, utilization and coverage of services by SBAs remain poor, especially in rural and remote areas of Nepal. This study examined the characteristics associated with utilization of SBA services in mid- and far-western Nepal. This cross-sectional study examined three rural and remote districts of mid- and far-western Nepal (i.e., Kanchanpur, Dailekh and Bajhang), representing three ecological zones (southern plains [Tarai], hill and mountain, respectively) with low utilization of services by SBAs. Enumerators assisted a total of 2,481 women. All respondents had delivered a baby within the past 12 months. We used bivariate and multivariate analyses to assess the association between antenatal and delivery care visits and the women's background characteristics. Fifty-seven percent of study participants had completed at least four antenatal care visits and 48% delivered their babies with the assistance of SBAs. Knowing the danger signs of pregnancy and delivery (e.g., premature labor, prolonged labor, breech delivery, postpartum hemorrhage, severe headache) associated positively with four or more antenatal care visits (OR = 1.71; 95% CI: 1.41-2.07). Living less than 30 min from a health facility associated positively with increased use of both antenatal care (OR = 1.44; 95% CI: 1.18-1.77) and delivery services (OR = 1.25; CI: 1.03-1.52). Four or more antenatal care visits was a determining factor for the utilization of SBAs. Less than half of the women in our study delivered babies with the aid of SBAs, indicating a need to increase utilization of such services in rural and remote areas of Nepal. Distance from health facilities and inadequate transportation pose major barriers to the utilization of SBAs. Providing women with transportation funds before they go to a facility for delivery and managing transportation
Morey, Edward R; Sharma, Vijaya R; Mills, Anne
A logit model is used to estimate provider choice from six types by malaria patients in rural Nepal. Patient characteristics that influence choice include travel costs, income category, household size, gender, and severity of malaria. Income effects are introduced by assuming the marginal utility of money is a step function of expenditures on the numeraire. This method of incorporating income effects is ideally suited for situations when exact income data is not available. Significant provider characteristics include wait time for treatment and wait time for laboratory results. Household willingness to pay (wtp) is estimated for increasing the number of providers and for providing more sites with blood testing capabilities. Wtp estimates vary significantly across households and allow one to assess how much different households would benefit or lose under different government proposals.
Bohra, Pratikshya; Massey, Douglas S
In this study we examine which factors predict internal and international migration from Chitwan, a flat valley located in the South-Central region of Nepal, seeking to measure the effect of theoretically specified variables such as human capital, social capital, physical capital, and neighborhood socioeconomic conditions while controlling for demographic variables. We use data from the Chitwan Valley Family Study (CVFS) to estimate a series of discrete time event history models of first and repeat migration to three competing destinations: other locations within Chitwan, other districts within Nepal, and places outside of Nepal. Results support hypotheses derived from neoclassical economics, the theory of new economics of migration, social capital theory, and cumulative causation theory. Our results underscore the need for a synthetic theoretical model that incorporates factors operating at the individual, household, and community levels. The use of multiple explanatory models yields a clearer picture of the forces driving internal and international migration from rural districts in developing nations such as Nepal.
Fleming, Matthew; King, Caroline; Rajeev, Sindhya; Baruwal, Ashma; Schwarz, Dan; Schwarz, Ryan; Khadka, Nirajan; Pande, Sami; Khanal, Sumesh; Acharya, Bibhav; Benton, Adia; Rogers, Selwyn O; Panizales, Maria; Gyorki, David; McGee, Heather; Shaye, David; Maru, Duncan
Patients in isolated rural communities typically lack access to surgical care. It is not feasible for most rural first-level hospitals to provide a full suite of surgical specialty services. Comprehensive surgical care thus depends on referral systems. There is minimal literature, however, on the functioning of such systems. We undertook a prospective case study of the referral and care coordination process for cardiac, orthopedic, plastic, gynecologic, and general surgical conditions at a district hospital in rural Nepal from 2012 to 2014. We assessed the referral process using the World Health Organization's Health Systems Framework. We followed the initial 292 patients referred for surgical services in the program. 152 patients (52%) received surgery and four (1%) suffered a complication (three deaths and one patient reported complication). The three most common types of surgery performed were: orthopedics (43%), general (32%), and plastics (10%). The average direct and indirect cost per patient referred, including food, transportation, lodging, medications, diagnostic examinations, treatments, and human resources was US$840, which was over 1.5 times the local district's per capita income. We identified and mapped challenges according to the World Health Organization's Health Systems Framework. Given the requirement of intensive human capital, poor quality control of surgical services, and the overall costs of the program, hospital leadership decided to terminate the referral coordination program and continue to build local surgical capacity. The results of our case study provide some context into the challenges of rural surgical referral systems. The high relative costs to the system and challenges in accountability rendered the program untenable for the implementing organization.
Chandra Bahadur Adhikar; Trond Bjorndal
In the present socio-economic structure of Nepal, land is the main source of income and consumption for the majority of Nepalese. This study analyses the economic relationship between access to land and poverty in Nepal by establishing the link between land and consumption as well as land and income. A generalised additive model (GAM) and ordinary least squares (OLS) demonstrate that greater access to land increases income and consumption of the household and thereby reduces poverty. The sign...
Full Text Available Abstract Background Wild edible plants (WEP provide staple and supplement foods, as well as cash income to local communities, thus favouring food security. However, WEP are largely ignored in land use planning and implementation, economic development, and biodiversity conservation. Moreover, WEP-related traditional knowledge is rapidly eroding. Therefore, we designed this study to fulfill a part of the knowledge gap by providing data on diversity, traditional knowledge, economic potential, and conservation value of WEP from Nepal. Methods The information was collected through focus group discussions and key informant interviews. Percentage of general utility of the plants among the study communities was evaluated using the Chi-square (χ2 test of homogeneity. High priority species were identified after consultation with the local stakeholders followed by scoring based on defined criteria. Pairwise ranking was used to assess ethnoecological knowledge to identify the threats to WEP. Results We documented 81 species belonging to Angiosperms (74, Pteridophytes (5, and Fungi (2. Most of the species were used as fruits (44 species followed by vegetables (36. Almost half of the species (47% were also used for purposes other than food. From the species with market value (37% of the total, 10 were identified as high priority species. Pairwise ranking revealed that WEP are threatened mostly by habitat destruction, land-use change and over-harvesting. Some of these plants are crop wild relatives and could thus be used for crop improvement. Interestingly, our study also revealed that young people who spend most of the time in the forest as herdsmen are particularly knowledgeable of wild fruit plants. Conclusion We provide empirical evidence from a relatively large area of Nepal about diversity and status of WEP, as well as methodological insights about the proper knowledge holders to consult. Regarding the unique and important knowledge they have on WEP
Full Text Available Abstract Background Nepal is small in size but rich in bio-cultural diversity. The rugged terrain of the country is home to a number of unique assemblages of fauna, some of which are endemic. Not only faunal resources the country also harbors some very ancient populations whose interrelationship with these diverse faunal resources is very intimate and thus demands scientific study. Animals play important role in both material and spiritual spheres of their life. There are more than hundred groups of such populations in the country and the group Tamang is one of these. The present paper studies Tamang-animal relationships in central Nepal. There is a growing trend of scientific ethnozoological studies all across the globe, but this field is yet in its infancy in Nepal. The country is losing important fauna as well as ancient human cultures at the advent of development processes. As a result, ethnozoological knowledge is also teetering on the brink of extinction. Methods Ethnozoological data were collected by applying different participatory approaches techniques such as semi-structured interviews, participatory rural appraisal, key informant interviews and focus group discussions. Quantitative data were obtained by employing a household level questionnaire survey. Data were collected from the period of September 2004 to August 2005. Most of the animals were identified up to the species level with the help of standard taxonomic keys. Results The Tamang community treasures knowledge on various uses of 41 genera belonging to 28 families. Out of total number of animals, 14.6% belong to the Invertebrate group and the rest to the Vertebrate group. Of the total uses 58% fall in the food and medicinal use category, 16% in the magico-religious use category, 18% in the category of omen indication, and 2% each in the categories such as weather forecasting, trophy, ethnomusical and taboos. Conclusions The Tamang maintain strong ties with animals both at a
Full Text Available Sex trafficking has been a long-standing concern in Nepal. Very little has been achieved, however, in terms of actual reduction in the number of victims despite numerous anti-sex trafficking programs. This situation may be attributable to a lack of empirical evidence upon which to formulate anti-sexual trafficking interventions. This study aimed to assess sex trafficking-related knowledge, awareness and attitudes, and factors associated with sex trafficking awareness and attitudes towards the victims of sex trafficking and/or anti-sex trafficking campaigns among adolescent female students in Nepal.A cross-sectional study was conducted between August-September 2013 among 292 adolescent female students (>10 years old using systematic random sampling from three high schools in Sindhupalchowk district, Nepal. As an initial step, descriptive analyses were employed to characterize the data and multivariate logistic regression analyses were used to explore factors associated with sex trafficking awareness and related attitudes.Seventy-six percent of sampled students reported that they were aware of sex trafficking and 94.6% indicated media (i.e., radio or television as the primary sources of their knowledge. Fifty-one percent mentioned relatives/friends as mediators of sex trafficking, 60.4% reported promise for better jobs as the primary attraction behind sex trafficking, and 48.6% mentioned adolescent females as the most vulnerable group for sex trafficking. Over half (56.8% of the respondents had positive attitudes towards the victims of sex trafficking and/or anti-sex trafficking campaigns. Age (OR = 3.38, 95% CI:2.51-4.55, parents' occupation (OR = 3.89, 95% CI:1.58-9.58, and having a radio/TV at home (OR = 6.67, 95% CI:3.99-9.54 were significantly associated with awareness, whereas being younger (OR = 0.67, 95% CI:0.55-0.79 and having joint-family (OR = 2.67, 95% CI:1.49-4.80 were significantly associated with having a positive attitudes towards
Rijal, K.; Bansal, N.K.; Grover, P.D.
This article presents the methodological guidelines used to assess rural energy resources with an example of its application in three villages each from different physiographic zones of Nepal. Existing energy demand patterns of villages are compared with estimated resource availability, and rural energy planning issues are discussed. Economics and financial supply price of primary energy resources are compared, which provides insight into defective energy planning and policy formulation and implication in the context of rural areas of Nepal. Though aware of the formidable consequences, the rural populace continues to exhaust the forest as they are unable to find financially cheaper alternatives. Appropriate policy measures need to be devised by the government to promote the use of economically cost-effective renewable energy resources so as to change the present energy usage pattern to diminish the environmental impact caused by over exploitation of forest resources beyond their regenerative capacity
O'Neill, Alexander Robert; Rana, Santosh Kumar
Indigenous biocultural knowledge is a vital part of Nepalese environmental management strategies; however, much of it may soon be lost given Nepal's rapidly changing socio-ecological climate. This is particularly true for knowledge surrounding parasitic and mycoheterotrophic plant species, which are well represented throughout the Central-Eastern Himalayas but lack a collated record. Our study addresses this disparity by analyzing parasitic and mycoheterotrophic plant species diversity in Nepal as well as the ethnobotanical knowledge that surrounds them. Botanical texts, online databases, and herbarium records were reviewed to create an authoritative compendium of parasitic and mycoheterotrophic plant species native or naturalized to the Nepal Central-Eastern Himalaya. Semi-structured interviews were then conducted with 141 informants to better understand the biocultural context of these species, emphasizing ethnobotanical uses, in 12 districts of Central-Eastern Nepal. Nepal is a hotspot of botanical diversity, housing 15 families and 29 genera of plants that exhibit parasitic or mycoheterotrophic habit. Over 150 of the known 4500 parasitic plant species (~3 %) and 28 of the 160 mycoheterotrophic species (~18 %) are native or naturalized to Nepal; 13 of our surveyed parasitic species are endemic. Of all species documented, approximately 17 % of parasitic and 7 % of mycoheterotrophic plants have ethnobotanical uses as medicine (41 %), fodder (23 %), food (17 %), ritual objects (11 %), or material (8 %). Parasitic and mycoheterotrophic plant species exhibit high diversity in the Nepal Central-Eastern Himalaya and are the fodder for biocultural relationships that may help inform future environmental management projects in the region.
It is important to understand gender difference on pesticide use knowledge, attitude and practices for identifying pesticide risks by gender and to recommend more gender-sensitive programs. However, very few studies have been conducted so far in Nepal. This study, thus, interviewed a total of 325 males and 109 females during 2005 to assess gender differences on pesticide use knowledge, attitude and practices. More than 50% females had never been to school and only <8% individuals were found trained in Integrated Pest Management (IPM). Almost all males and females did not smoke, drink and eat during pesticides application and also believed that pesticides are harmful to human health, livestock, plant diversity and their environment. However, there were gender differences on household decision on pesticides to be used (p<0.001), care of wind direction during spraying (p=0.032), prior knowledge on safety measures (p=0.016), reading and understanding of pesticides labels (p<0.001), awareness of the labels (p<0.001) and protective covers. Almost all respondents were aware of negative impacts of pesticide use on human health and environment irrespective of gender; however, females were at higher risk due to lower level of pesticide use safety and awareness. It is strongly recommended to initiate gender-sensitive educational and awareness activities, especially on pesticide use practices and safety precautions
Parajuli, Krishna Prasad
During the 15 years of this current century, mobile technology has become a leading technology in the support of educational outcomes. This study investigated the mobile learning practices among undergraduates in higher education in the semi-urban and rural areas of the Gorkha district of Nepal. The objectives were to explore the availability of…
Knowledge Access in Rural Inter-connected Areas Network (KariaNet) - Phase II ... the existing network to include two thematic networks on food security and rural ... Woman conquering male business in Yemen : Waleya's micro-enterprise.
Tiwari, H.B.; Bhandari, K.P.
Renewable energy Technology (RET) becomes the mainstream option for rural Nepal to access modern source of energy. It focuses on the trend of RET applications consisting of biogas technology, solar thermal, micro and Pico hydropower, biomass technology bio fuel technology, wind power technology etc. The RET's which provide both electricity based as well as non electricity based services, have been shown to most immediately meet the needs of a cleaner indoor environment, better quality lightning for education and income generating, activities, alternative cooking fuels and agro processing as well as rural industries. Improved cooking stoves and much more beneficial than other technologies. Wind energy utilization is still not popular. Solar thermal to generate thermal energy to cook, warm and dry, biogas for lighting and cooking services. Micro hydropower for electric as well as mechanical use and solar PV mainly for domestic lighting may become choice. The most important Renewable Energy Technology (RET's) in Nepal are related to Pico hydropower and micro-hydropower, biomass energy (biogas, briquettes, gasifies, improved cooking stoves, bio-fuels etc.) solar photovoltaic energy, solar PV water pumping, solar thermal energy (solar heater, solar dryers, solar cookers etc.) and wind energy (such as wind generators, wind mills etc.). One renowned Non-governmental organization has been established in the Jhapa and Mornag Bhutanese refugee camp. Two families from all the seven camps in Nepal received one solar cooker, one hay box and two cooking posts to each family. Under this programme, a total of 6,850 solar cookers, 12600 hay boxes and 25,200 cooking pots have been distributed 2009. The number of beneficiaries from this program has reached 85,000. Before the distribution of the cookers and the utensils, the instruction and orientation training for the maintenance and repair and operation method was improved. The refugees were divided in 315 groups of 40
Full Text Available Nepal belongs to one of the least developed countries around the world with HDI 157 out of 187 countries (UNDP 2013. Even though poverty in Nepal has reduced to 24.8% in the latest census, the livelihoods of the poorest people living in the remote communities are still vulnerable. Two third of the population still depends on the subsistence agriculture. Similarly, due to lack of job opportunities, youth migration is escalating and Nepal is facing one of the most critical phases of development in its history (Snellinger 2009. Inadequate infrastructure and poor road connectivity are other constraints for the development (World Bank 2011. It follows that, poor access to electricity is another challenge despite the country’s enormous potential for hydroelectricity. Similarly, Nepal has huge prospective for tourism due to its unique natural resources (Bhandari 2004. Nonetheless, Nepal has not benefited optimally from the tourism sector for its self-sustained development. Recently Government of Nepal (2011 has announced diverse policies for accelerating development through proper utilization of local resources. This paper critically evaluates the crucial policies such as Agriculture Development Strategy, National Cooperatives Policy, National Youth Policy, and Micro-hydro for Rural Development, and Tourism for Development. The paper discusses each of these policies’ background; critically analyse the likelihood as well as challenges for fast-tracking development; and finally offers some recommendations based discussion and analysis.
Ragupathy, Subramanyam; Dhivya, Shanmughanandhan; Patel, Kirit; Sritharan, Abiran; Sambandan, Kathirvelu; Gartaula, Hom; Sathishkumar, Ramalingam; Khadka, Kamal; Nirmala, Balasubramanian C; Kumari, A Nirmala; Newmaster, Steven G
Despite the extensive use of small millet landraces as an important source of nutrition for people living in semi-arid regions, they are presently marginalized and their diversity and distribution are threatened at a global scale. Local farmers have developed ancient breeding programs entrenched in traditional knowledge (TK) that has sustained rural cultures for thousands of years. The convention on biological diversity seeks fair and equitable sharing of genetic resources arising from local knowledge and requires signatory nations to provide appropriate policy and legal framework to farmers' rights over plant genetic resources and associated TK. DNA barcoding employed in this study is proposed as a model for conservation of genetic diversity and an essential step towards documenting and protecting farmers' rights and TK. Our study focuses on 32 landraces of small millets that are still used by indigenous farmers located in the rain fed areas of rural India and Nepal. Traditional knowledge of traits and utility was gathered using participatory methods and semi-structured interviews with key informants. DNA was extracted and sequenced (rbcL, trnH-psbA and ITS2) from 160 samples. Both multivariate analysis of traits and phylogenetic analyses were used to assess diversity among small millet landraces. Our research revealed considerable variation in traits and DNA sequences among the 32 small millet landraces. We utilized a tiered approach using ITS2 DNA barcode to make 100 % accurate landrace (32 landraces) and species (six species) assignments for all 160 blind samples in our study. We have also recorded precious TK of nutritional value, ecological and agricultural traits used by local farmers for each of these traditional landraces. This research demonstrates the potential of DNA barcoding as a reliable identification tool and for use in evaluating and conserving genetic diversity of small millets. We suggest ways in which DNA barcodes could be used in the
Knowledge Access in Rural Inter-connected Areas Network (KariaNet) - Phase II ... poor by sharing innovations, best practices and indigenous knowledge using ... A third thematic network - on knowledge management strategies - will play an ...
Hagaman, Ashley K; Khadka, S; Lohani, S; Kohrt, B
Yearly, 600,000 people complete suicide in low- and middle-income countries, accounting for 75% of the world's burden of suicide mortality. The highest regional rates are in South and East Asia. Nepal has one of the highest suicide rates in the world; however, few investigations exploring patterns surrounding both male and female suicides exist. This study used psychological autopsies to identify common factors, precipitating events, and warning signs in a diverse sample. Randomly sampled from 302 police case reports over 24 months, psychological autopsies were conducted for 39 completed suicide cases in one urban and one rural region of Nepal. In the total police sample (n = 302), 57.0% of deaths were male. Over 40% of deaths were 25 years or younger, including 65% of rural and 50.8% of female suicide deaths. We estimate the crude urban and rural suicide rates to be 16.1 and 22.8 per 100,000, respectively. Within our psychological autopsy sample, 38.5% met criteria for depression and only 23.1% informants believed that the deceased had thoughts of self-harm or suicide before death. Important warning signs include recent geographic migration, alcohol abuse, and family history of suicide. Suicide prevention strategies in Nepal should account for the lack of awareness about suicide risk among family members and early age of suicide completion, especially in rural and female populations. Given the low rates of ideation disclosure to friends and family, educating the general public about other signs of suicide may help prevention efforts in Nepal.
Burkey, Matthew D; Ghimire, Lajina; Adhikari, Ramesh Prasad; Wissow, Lawrence S; Jordans, Mark J D; Kohrt, Brandon A
Commonly used paradigms for studying child psychopathology emphasize individual-level factors and often neglect the role of context in shaping risk and protective factors among children, families, and communities. To address this gap, we evaluated influences of ecocultural contextual factors on definitions, development of, and responses to child behavior problems and examined how contextual knowledge can inform culturally responsive interventions. We drew on Super and Harkness' "developmental niche" framework to evaluate the influences of physical and social settings, childcare customs and practices, and parental ethnotheories on the definitions, development of, and responses to child behavior problems in a community in rural Nepal. Data were collected between February and October 2014 through in-depth interviews with a purposive sampling strategy targeting parents (N = 10), teachers (N = 6), and community leaders (N = 8) familiar with child-rearing. Results were supplemented by focus group discussions with children (N = 9) and teachers (N = 8), pile-sort interviews with mothers (N = 8) of school-aged children, and direct observations in homes, schools, and community spaces. Behavior problems were largely defined in light of parents' socialization goals and role expectations for children. Certain physical settings and times were seen to carry greater risk for problematic behavior when children were unsupervised. Parents and other adults attempted to mitigate behavior problems by supervising them and their social interactions, providing for their physical needs, educating them, and through a shared verbal reminding strategy (samjhaune). The findings of our study illustrate the transactional nature of behavior problem development that involves context-specific goals, roles, and concerns that are likely to affect adults' interpretations and responses to children's behavior. Ultimately, employing a developmental niche framework will elucidate setting
Newlands, David; Simkhada, Padam
Thousands of people are infected with HIV/AIDS in Nepal and most of them are adults of working age. Therefore, HIV/AIDS is a big burden in Nepal. This review was conducted to find the existing knowledge gap about the economic burden of HIV/AIDS at the household level in Nepal, the extent of economic burden exerted by the disease, and to provide policy recommendations. It is concluded that there was a considerable knowledge gap about the issue, and the economic burden exerted by HIV/AIDS was big enough to push the affected households into poverty. It is suggested that more studies need to be conducted to fill the knowledge gap. Similarly, Government of Nepal and other organisations working in the field of HIV/AIDS need to provide economic supports (e.g.- support for travel costs) to the HIV positive people and need to increase the awareness level among general population for reducing stigma and discrimination, and reducing economic burden on them. PMID:26913211
Chakraborty, Nirali M; Murphy, Caitlin; Paudel, Mahesh; Sharma, Sriju
Nepal has high unmet need for family planning and low use of intrauterine devices (IUDs). While clients' attitudes toward the IUD are known in a variety of contexts, little is known about providers' knowledge and perceptions of the IUD in developing countries. Nepal's liberal IUD service provision policies allow the opportunity to explore provider knowledge and perceptions across cadres and sectors. This research contributes to an understanding of providers' IUD perceptions in low-resource environments, and increases evidence for IUD task-sharing and private sector involvement. A questionnaire was administered to 345 nurses and auxiliary nurse midwives (ANMs) affiliated with the private Mahila Swastha Sewa (MSS) franchise, public sector, or private non-franchise sector. All providers had been trained in TCu 380A IUD insertion and removal. The questionnaire captured providers' IUD experience, knowledge, and perceived barriers to recommendation. Descriptive, multivariate linear, and multinomial logistic regression was conducted, comparing providers between cadre and sector. On average, providers answered 21.5 of 35 questions correctly, for a score of 61.4%. Providers scored the lowest on IUD medical eligibility, answering 5.9 of 14 questions correctly. Over 50% of providers were able to name the four side effects most frequently associated with the IUD; however, one-third of all providers found at least one of these side effects unacceptable. Adjusted results show that cadre does not significantly impact provider's IUD knowledge scores or side effect perceptions. Public sector affiliation was associated with higher knowledge scores regarding personal characteristic eligibility and more negative perceptions of two normal IUD side effects. IUD knowledge is significantly associated with provider's recent training and employment at multiple facilities, and side effect perceptions are significantly associated with client volume, range of family planning methods, and
Shankar Adhikari; Himlal Baral; Craig Nitschke
Rural mountain communities in developing countries are considered particularly vulnerable to environmental change, including climate change. Forests and agriculture provide numerous ecosystem goods and services (EGS) to local communities and can help people adapt to the impacts of climate change. There is however poor documentation on the role of EGS in people’s livelihood and adaptation practices. This study in the rural Panchase Mountain Ecological Region of Nepal identifies practices being...
A unique family survey was conducted in Nepal to investigate the economic consequences of having a first-born girl. Women get more children, but we find no causal effect of number of children on economic outcomes. But independently of the number of children there is a positive effect on boys' education of having a first born sister, who presumably takes care of household work so the boys can focus on school. This indicates a stronger son-preference in Nepal than what is found in studies from ...
Ma, J.; Liu, F.
Arsenic 33As, one of the major groundwater contaminants, occurs in both natural and anthropogenic forms. Arsenic inhibits cellular respiration and the production of ATP in human body. Prolonged intake of non-lethal quantities of arsenic can cause cancer and diseases in vital organs such as the heart, liver, skin, and kidney. Each year, millions of people in the rural areas of Bangladesh, India, and other developing countries in South Asia are exposed to arsenic-poisoned groundwater. According to the World Health Organization, arsenic levels in drinking water should not exceed 10 parts per billion; however, the levels of arsenic found in groundwater in the heavily contaminated regions are often more than ten times of the recommended limit. Nepal is one of these regions. In most of the rural areas in Nepal, there is no infrastructure to produce clean filtered water, and wells thus became the major source. However, most of these wells were dug without testing for groundwater safety, because the test commands resources that the rural communities do not have access to. This is also limited data published on Nepal's groundwater contaminant levels. The scarcity of information prohibits the international community from recognizing the severity of arsenic poisoning in Nepal and coming up with the most efficient measures to help. With this project, we will present a method to determine groundwater safety by analyzing geologic data and using remote sensing. The original source of arsenic is the arsenic-bearing minerals in the sediments. Some geological formations have higher arsenic levels than others due to their depositional environments. Therefore, by using existing geologic data from Nepal and countries with similar types of arsenic contamination, we hope to determine correlations between areas where there are reports of high concentrations of arsenic in groundwater to the environmental factors that may cause a particular concentration of arsenic. Furthermore, with deeper
Shrestha, Anita; Bhattarai, Dipesh; Thapa, Barsha; Basel, Prem; Wagle, Rajendra Raj
Infection control remains a key challenge for Tuberculosis (TB) control program with an increased risk of TB transmission among health care workers (HCWs), especially in settings with inadequate TB infection control measures. Poor knowledge among HCWs and inadequate infection control practices may lead to the increased risk of nosocomial TB transmission. An institution-based cross-sectional survey was conducted in 28 health facilities providing TB services in the Kathmandu Valley, Nepal. A total of 190 HCWs were assessed for the knowledge, attitudes and practices on TB infection control using a structured questionnaire. The level of knowledge on TB infection control among almost half (45.8%) of the HCWs was poor, and was much poorer among administration and lower level staff. The knowledge level was significantly associated with educational status, and TB training and/or orientation received. The majority (73.2%) of HCWs had positive attitude towards TB infection control. Sixty-five percent of HCWs were found to be concerned about being infected with TB. Use of respirators among the HCWs was limited and triage of TB suspects was also lacking. Overall knowledge and practices of HCWs on TB infection control were not satisfactory. Effective infection control measures including regular skill-based training and/or orientation for all categories of HCWs can improve infection control practices in health facilities.
Full Text Available Community healthcare workers (CHW are an important component of rural healthcare service delivery to remote rural communities in developing countries. The field of mHealth proposes that mobile technologies will have a beneficial impact on rural healthcare development. Current analyses advance the proposition that the utilization of mobile technologies leads to the shifting of space and time (Ling & Campbell, 2009. The current research examined the potential for a sustainable mHealth system for CHW in Achham, Nepal. The community aspect of mobile usage was overlaid with a spatio-temporal lens to examine the information and communication needs and practices of stakeholders within the healthcare infrastructure. Fieldwork was conducted in conjunction with Nyaya Health, at the Bayalpata Hospital, in Accham, Nepal. Qualitative research methods, focus group discussions, and in-depth interviews included 57 respondents. The findings revealed that limited relevance and information-sharing, limited access due to individual ownership and low income, and ineffective training programs were key barriers to the delivery of rural healthcare services. The spatio-temporal perspective, particularly community communicative practices, revealed technological mHealth design solutions to alleviate the problems identified. The potential shifts in power relationships by using mobile technologies and hybrid fixed wireless technologies provide opportunities for further theoretical investigation.
Knowledge Access in Rural Inter-connected Areas Network (KariaNet) - Phase II ... and indigenous knowledge using information and communication technologies (ICTs) ... for research proposals on the aforementioned topics, action-research projects, ... Evaluating knowledge-sharing methods to improve land utilization and ...
Glover, Todd A.; Nugent, Gwen C.; Chumney, Frances L.; Ihlo, Tanya; Shapiro, Edward S.; Guard, Kirra; Koziol, Natalie; Bovaird, Jim
Teachers Speak was a national survey study designed to investigate the characteristics of rural elementary school teachers' existing professional development; differences in professional development practices between rural and non-rural settings; and the potential influence of professional development characteristics on rural teachers' knowledge,…
Malatzky, Christina; Bourke, Lisa
To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.
Shrestha, S. [Asia Network for Small Scale Bioresources, Kathmandu (Nepal)
Solar Cooker is a device that uses only sunlight to cook food and pasteurise water. Solar cooker can be used along with other cooking devices to save cost, fuel and the time spent in gathering fuelwood. Solar cooking enables individual families to do without commercially sold fuel and help save money. In Nepal, supply of energy is one of the major problems for both urban and rural households. Increase in population, high migration, expensive fuel bills, environmental degradation, and unsafe drinking water have resulted in the keen interest from people of Nepal in the use of solar energy. The increasing number of tourists and trekkers are now one of the major sources of income and many people are engaged in running hotels, lodges, and restaurants. This has also increased the fuel demand. This paper highlights the current energy situation of Nepal, the technical details of solar parabolic cooker (SK-14), its uses throughout Nepal, strategies adopted by various organisations for its promotion. A lot of effort have been made by various organisations, educational, governmental and health related institutions in order to introduce solar cooking programs in villages of Nepal. The parameters, which have influenced the adoption of this technology in Nepal are also mentioned. Various awareness programs and the government subsidy program are playing considerable role in dissemination of such technologies. The promotion activities with the objective of mass awareness have long term effect and sustainable rather than instant business. Continued efforts to create awareness, development of models as well as proper promotion and dissemination are required. (au)
Stapp, Jared R.; Lilieholm, Robert J.; Leahy, Jessica; Upadhaya, Suraj
Deforestation in Nepal threatens the functioning of complex social-ecological systems, including rural populations that depend on forests for subsistence, as well as Nepal's biodiversity and other ecosystem services. Nepal's forests are particularly important to the nation's poorest inhabitants, as many depend upon them for daily survival. Two-thirds of Nepal's population relies on forests for sustenance, and these pressures are likely to increase in the future. This, coupled with high population densities and growth rates, highlights the importance of studying the relationship between human communities, forest cover trends through time, and forest management institutions. Here, we used surveys to explore how household attitudes associated with conservation-related behaviors in two rural communities—one that has experienced significant forest loss, and the other forest gain—compare with forest cover trends as indicated by satellite-derived forest-loss and -regeneration estimates between 2005 and 2013. Results found a significant difference in attitudes in the two areas, perhaps contributing to and reacting from current forest conditions. In both study sites, participation in community forestry strengthened support for conservation, forest conservation-related attitudes aligned with forest cover trends, and a negative relationship was found between economic status and having supportive forest conservation-related attitudes. In addition, on average, respondents were not satisfied with their district forest officers and did not feel that the current political climate in Nepal supported sustainable forestry. These findings are important as Nepal's Master Plan for the Forestry Sector has expired and the country is in the process of structuring a new Forestry Sector Strategy.
Stapp, Jared R; Lilieholm, Robert J; Leahy, Jessica; Upadhaya, Suraj
Deforestation in Nepal threatens the functioning of complex social-ecological systems, including rural populations that depend on forests for subsistence, as well as Nepal's biodiversity and other ecosystem services. Nepal's forests are particularly important to the nation's poorest inhabitants, as many depend upon them for daily survival. Two-thirds of Nepal's population relies on forests for sustenance, and these pressures are likely to increase in the future. This, coupled with high population densities and growth rates, highlights the importance of studying the relationship between human communities, forest cover trends through time, and forest management institutions. Here, we used surveys to explore how household attitudes associated with conservation-related behaviors in two rural communities-one that has experienced significant forest loss, and the other forest gain-compare with forest cover trends as indicated by satellite-derived forest-loss and -regeneration estimates between 2005 and 2013. Results found a significant difference in attitudes in the two areas, perhaps contributing to and reacting from current forest conditions. In both study sites, participation in community forestry strengthened support for conservation, forest conservation-related attitudes aligned with forest cover trends, and a negative relationship was found between economic status and having supportive forest conservation-related attitudes. In addition, on average, respondents were not satisfied with their district forest officers and did not feel that the current political climate in Nepal supported sustainable forestry. These findings are important as Nepal's Master Plan for the Forestry Sector has expired and the country is in the process of structuring a new Forestry Sector Strategy.
Oct 25, 2010 ... With new-found financial security, more families are able to provide education for their children, unlike many rural communities in Nepal. And the role of women in decision-making has been strengthened. ... In the early 1990s, the global news media became entranced by a ... Careers · Contact Us · Site map.
Stark, C; Innes, A; Szymczynska, P; Forrest, L; Proctor, K
Rural Scotland has an ageing population. There has been an increase in the number of people with dementia and as the proportion of people aged over 75 years continues to rise, this will increase still further. The Scottish Government has produced a dementia strategy and implementing this will be a challenge for rural Scotland. Transferring academic knowledge into practice is challenging. A Knowledge Transfer Partnership was formed between NHS Highland and the University of Stirling. A literature review was undertaken of the rural dementia literature; local services were surveyed and described; and interviews were undertaken with people with dementia and carers. Work was conducted on training, diagnostic service provision and local policy. Throughout the project, a collaborative approach was used, which aimed at the joint production of knowledge. Involving University staff in local service development had a substantial impact. Reviewing existing research knowledge and setting it in the context of local services, and of experience of service use, allowed the relevant priorities to be identified. As well as identifying training needs and providing training, the work influenced local decisions on diagnostic service design and standards, and on policy. This embedded engagement model appeared to produce more rapid change than traditional models of use of academic knowledge.
Chalise, S.; Maraseni, T.; Maroulis, J.
There are growing concerns, especially from farmers in rural mid-east Nepal, about main-streaming locally-led climate adaptation strategies. Using a bottom-up approach, we analysed the bio-physical and socio-economic impacts on Nepalese agriculture from three focus group discussions and a survey of
Thapa, Shyam; Sharma, Sharad K
In Nepal, following the liberalization of the abortion law, expansion and scaling up of services proceeded in parallel with efforts to create awareness of the legalization status of abortion and provide women with information about where services are available. This article assesses the effectiveness of these programmatic interventions in the early years of the country's abortion program. Data from a 2006 national survey are analyzed with 2 outcome measures-awareness of the legal status of abortion and knowledge of places to obtain abortion services among women ages 15 to 44 years. The variations in the outcomes are analyzed by ecological-development subregion, residence, education, household wealth quintile, age, and number of living children. Bivariate and multivariate logistic regression techniques are used. Overall 32.3% (95% confidence interval = 31.4% to 33.2%) of the respondents were aware of the legal status of abortion and 56.5% (95% confidence interval = 55.5% to 57.4%) knew of a place where they could obtain an abortion. Both outcome measures showed considerable variations by the covariates. Women with secondary or higher level of education had the highest odds ratio of being aware of the law and having knowledge of a source for abortion services. Ecological-development subregions showed the second highest levels of odds ratios. Significant disparities among the population subgroups existed in the diffusion of awareness of the legal status of abortion and having knowledge of a place for abortion services in Nepal. The results point to which population subgroups to focus on and also serve as a baseline for assessing future progress in the diffusion process. © 2012 APJPH.
Oster, Emily; Thornton, Rebecca
This paper presents the results from a randomized evaluation that distributed menstrual cups (menstrual sanitary products) to adolescent girls in rural Nepal. Girls in the study were randomly allocated a menstrual cup for use during their monthly period and were followed for fifteen months to measure the effects of having modern sanitary products…
Kovacs, Peter [Danish Energy Management, DEM for Renewable Energy Project, REP, Dhobighat, Lalitpur (Nepal); Shrestha, Niraj; Shakya, Prajwal Raj [Renewable Energy Project, REP, Dhobighat, Lalitpur (Nepal); Pokharel, Govind [Alternative Energy Promotion Centre (AEPC), Lalitpur (Nepal)
The Renewable Energy Project (REP) is a joint effort of the European Union and the Government of Nepal. Main objectives of the project are to create renewable energy infrastructure and services for the benefit of rural people in remote districts of Nepal. The REP will provide solar energy systems for public services in remote districts, as well as for income generating activities e.g. agro business and tourism. The REP focuses on the installation of institutional PV systems with a total capacity of 0.850 MWp. Concurrently, a number of solar thermal systems are being provided to community organizations (COs) in rural areas of Nepal. The priority applications for the solar thermal part are solar tunnel dryers for small industries drying vegetables. fruits and herbs, solar water heaters for community centers in trekking areas and large scale solar cookers in schools. The paper describes the Renewable Energy Project's implementation program for solar thermal technology and in particular the implications on design and usefulness of the solar tunnel dryer from on-site feasibility studies carried out by the project team. REP provides a framework for a sustainable implementation of these systems by carrying out the whole process from dissemination of information to demand collection, feasibility studies, design, procurement, commissioning and user training. Hand over of ownership will take place once the equipment is installed and successfully commissioned. Monitoring during the first year of operation should conclude the project. REP is co-funded by the European Union and the Government of Nepal. (orig.)
Atteraya, Madhu; Kimm, HeeJin; Song, In Han
Caste- and ethnicity-based inequalities are major obstacles to achieving health equity. The authors investigated whether there is any association between caste- and ethnicity-based inequalities and HIV-related knowledge within caste and ethnic populations. They used the 2011 Nepal Demographic and Health Survey, a nationally represented cross-sectional study data set. The study sample consisted of 11,273 women between 15 and 49 years of age. Univariate and logistic regression models were used to examine the relationship between caste- and ethnicity-based inequalities and HIV-related knowledge. The study sample was divided into high Hindu caste (47.9 percent), "untouchable" caste (18.4 percent), and indigenous populations (33.7 percent). Within the study sample, the high-caste population was found to have the greatest knowledge of the means by which HIV is prevented and transmitted. After controlling for socioeconomic and demographic characteristics, untouchables were the least knowledgeable. The odds ratio for incomplete knowledge about transmission among indigenous populations was 1.27 times higher than that for high Hindu castes, but there was no significant difference in knowledge of preventive measures. The findings suggest the existence of a prevailing HIV knowledge gap. This in turn suggests that appropriate steps need to be implemented to convey complete knowledge to underprivileged populations.
Adventure tourism is one of the key factors of the Nepalese tourism industry. The main aim of this bachelor’s thesis was to clarify the current situation and challenges for developing adventure tourism in Nepal and to evaluate the importance of appropriate marketing strategies. The thesis also focuses on promoting adventure tourism activities and rural tourism destinations. The objective of the thesis was to explore Dhorpatan Hunting Reserve as an adventure tourism destination at internationa...
... for their children, unlike many rural communities in Nepal. And the role of women in decision-making has been strengthened. Women take part alongside the men in all activities, from cleaning and repairing the fish cages to participating in meetings of farmers'' associations, attending workshops, and marketing the catch.
Morrison, J; Colbourn, T; Budhathoki, B; Sen, A; Adhikari, D; Bamjan, J; Pathak, S; Basnet, A; Trani, J F; Costello, A; Manandhar, D; Groce, N
There is strong evidence that participatory approaches to health and participatory women's groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women's participation in women's groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world's population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women's groups is particularly important. We used a mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability. We found no significant differences in the percentage of women that had ever attended at least one of our women's groups, between non-disabled and disabled women. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence and attendance in many groups prevented women from attending groups. Our findings are particularly significant because disabled people's participation in broader community groups, not focused on disability, has been little studied. We conclude that women's groups are an important way to reach disabled women in resource poor communities. We recommend that disabled persons organizations help to increase awareness of disability issues among organizations running community groups to further increase their effectiveness in reaching disabled women. © The Author 2015. Published by Oxford University Press.
Full Text Available Puja Sharma Dhital,1 Sarojini Sharma,2 Pratik Poudel,3 Pankaj Raj Dhital4 1Adult Health Nursing, Nepal Polytechnic Institute, College of Nursing, 2Adult Health Nursing, BP Koirala Memorial Cancer Hospital, 3Department of Radiology, College of Medical Sciences, Bharatpur, 4Department of Agricultural Extension and Rural Sociology, Agriculture and Forestry University, Rampur, Nepal Abstract: Fifty nurses working in BP Koirala Memorial Cancer Hospital, Bharatpur, were selected by probability simple random sampling technique for determining the knowledge level about postexposure prophylaxis (PEP of HIV among nurses during 2014. A descriptive design, semistructured self-administered questionnaire was used for the study. The study showed that 48% of respondents had knowledge on the meaning of PEP, only 39.39% respondents were aware of the first aid management getting needle prick injury, 60% were aware of the best time to start PEP of HIV and 56% respondents had knowledge about the time schedule of HIV test after exposure. Although the respondents answered most of the questions correctly, they had knowledge deficit in certain areas. The respondents’ knowledge in this regard needs to be improved with time-to-time awareness program and periodic training, which ultimately helps to decrease the transmission of disease and reduces mortality and morbidity. Keywords: needle prick injury, transmission, PEP, HIV
Kimber Haddix McKay
Full Text Available This paper analyzes the socio-cultural dimensions of obstacles facing solar photovoltaic projects in two villages in rural Nepal. The study was conducted in Humla District, Nepal, one of the most remote and impoverished regions of the country. There are no roads in the district, homes lack running water and villagers’ health suffers from high levels of indoor air pollution from open cooking/heating fires and the smoky torches traditionally burned for light. The introduction of solar energy is important to these villagers, as it removes one major source of indoor air pollution from homes and provides brighter light than the traditional torches. Solar energy is preferable in many villages in the region due to the lack of suitable streams or rivers for micro-hydroelectric projects. In the villages under study in this paper, in-home solar electricity is a novel and recent innovation, and was installed within the last three years in two different geo-spatial styles, depending upon the configuration of homes in the village. In some villages, houses are grouped together, while in others households are widely dispersed. In the former, solar photovoltaic systems were installed in a “cluster” fashion with multiple homes utilizing power from a central battery store under the control of the householder storing the battery bank. In villages with widely spaced households, a single home system was used so that each home had a separate solar photovoltaic array, wiring system and battery bank. It became clear that the cluster system was the sensible choice due to the geographic layout of certain villages, but this put people into management groups that did not always work well due to caste or other differences. This paper describes the two systems and their management and usage costs and benefits from the perspective of the villagers themselves.
Background Few studies regarding Knowledge, Attitude and Practice (KAP) towards medicines among school teachers have been carried out in Nepal. Obtaining baseline KAP is important to note deficiencies and plan appropriate interventions. School teachers have to know about medicines as they can be an important source of information about rational and safe use of medicines. The department of Clinical Pharmacology, KIST Medical College, Lalitpur, conducted a study regarding KAP of school teachers about medicines before and after an educational intervention from April 2011 to December 2011. Methods The study was done in selected schools of Lalitpur district. Teachers were selected on a voluntary basis after obtaining written informed consent. Gender, ethnic or caste group, native place, age, educational qualifications, subject taught were noted. An educational intervention using a combination of methods like presentations, brainstorming sessions, interactive discussions using posters and distribution of information leaflets about the use of medicines was conducted. The KAP and overall scores among subgroups according to gender, age, level of education, subject, ethnicity, type of school (primary vs. secondary and government vs. private school) were studied. KAP and overall scores before and after the intervention was compared using Wilcoxon signed ranks test as the scores were not normally distributed. Results A total of 393 teachers participated before and after the intervention. The median (interquartile range) knowledge, attitude and practice scores before the intervention were 63 (10), 23 (5) and 270 (48) respectively while the overall score was 356. The median knowledge, attitude and practice scores after the intervention were 71 (10), 28 (5) and 270 (48) respectively while the overall score increased to 369. Maximum possible score of knowledge, attitude and practice were 100, 40 and 320 respectively. Scores improved significantly for knowledge (pattitude
In the remote village of Martadi, in Bajura district of western Nepal, the total fertility rate is 7. 20% of newborns die before they reach age 1. Temporary migration, mainly to India, is common due to the inability of the rugged and rocky terrain to supply enough food. The existence of temporary migration and a high frequency of remarriage suggest a high rate of sexually transmitted diseases. The relatively new hospital is very much under used (e.g., only 35 patients in 1995). The office in Kolti that supplies vaccines to Martadi has gone at least six months without receiving any new child immunization drugs, despite the presence of an air service. During and after delivery, no one, not even family members or traditional birth attendants, can touch a woman, who is confined to a cow-shed to deliver and care for her child and herself alone. Yet sick animals receive care. A new mother also is required to bathe herself, often requiring a walk of many hours. Women often identify access to water as their top priority. Pregnant or postpartum women are forbidden from eating green vegetables because of the belief that they cause diarrhea. Sanitation is better now in Martadi than in the past. Diarrhea and vomiting were once very prevalent. The international organization, CARE, along with the Ministry of Local Development operate the Remote Area Basic Needs Project, which revolves around community organization, agroforestry, rural infrastructure, and primary health care. The project has helped villagers construct low-cost toilets. It provides training in basic hygiene. Households have kitchen-gardens. Many families are now eating green vegetables regularly. Fruit trees are being introduced. Villagers recognize the value of child immunization. Some small-scale drinking water systems are operating. Villagers are trained in repair and management of these systems. About 33% of women aged 15-49 want no more children. A first-ever outreach program for female sterilization services
A time-allocation study conducted over a 1-year period among rural women in Nepal indicated that these women are able to perform rigorous subsistence labor during pregnancy and motherhood through cultural practices that facilitate a combining of economic and childcare duties. The fieldwork was conducted in 1982-83 in the predominately Tamang village of Salme. A total of 7678 hours of minute-by-minute observation were collected on Tamang women and their male kin from 43 households. The sample included 19 nonpregnant, nonlactating women and 24 pregnant or lactating mothers. Among the Tamang, agriculture is the responsibility of women, and nonpregnant and pregnant/lactating women devoted similar numbers of hours a day (5-8 hours, depending on the season) to working fields. In addition, there were no significant differences in the amount of time nonpregnant and pregnant/lactating women devoted to animal husbandry, mountain work, and travel. The Tamang women did not ease their workloads in the final weeks of pregnancy--a finding that is consistent with a practice of not making allowances in economic activity level for age, sex, physical fitness, or maternal status due to severe labor shortage and the tight time schedule inherent to agricultural production. On the other hand, there was evidence of behavioral flexibility to cope with the demands of women's dual roles. Mothers of infants take their babies to the fields with them and breastfeed during their rest periods. The use of mobile cattle shelters minimizes the amount of time that is spent away from children. Older children care for younger siblings--a phenomenon facilitated by the long interbirth intervals among the Tamang--and contractual exchanges take place among families. The health risk of this arrangement seems greatest for older children who are left behind during periods of intense agricultural activity and are often deprived of adequate nutrition.
Tuladhar, H; Risal, A
World Health Organization (WHO) estimates that about 25.0% of all pregnancies worldwide end in induced abortion, approximately 50 million each year. More than half of these abortions are performed under unsafe conditions resulting in high maternal mortality ratio specially in developing countries like Nepal. Abortion was legalized under specified conditions in March 2002 in Nepal. But still a large proportion of population are unaware of the legalization and the conditions under which it is permitted. Legal reform alone cannot reduce abortion related deaths in our country. This study was undertaken with the main objective to study the level of awareness about legalization of abortion in women attending gyne out patients department of Nepal Medical College Teaching Hospital (NMCTH), which will give a baseline knowledge for further dissemination and advocacy about abortion law. Total 200 women participated in the study. Overall 133 (66.5%) women said they were aware of legalization of abortion in Nepal. Women of age group 20-34 years, urban residents, service holders, Brahmin/Chhetri caste and with higher education were more aware about it. Majority (92.0%) of the women received information from the media. Detail knowledge about legal conditions under which abortion can be performed specially in second trimester was found to be poor. Large proportion (71.0%) of the women were still unaware of the availability of comprehensive abortion care services at our hospital, which is being provided since last seven years. Public education and advocacy campaigns are crucial to create awareness about the new legislation and availability of services. Unless the advocacy and awareness campaign reaches women, they are not likely to benefit from the legal reform and services.
Devkota, Bhimsen; van Teijlingen, Edwin R
This article presents the findings of a systematic review on the health consequences of Nepal's armed conflict waged by the Maoists and the development and trajectory of their health workers. Nepal's decade-long violent conflict resulted in more than 13,000 deaths, the destruction of more than 1000 health posts and poor health services delivery. At present, most of the former rebel health workers live in remote/rural areas and some are running health centers. The review found that the Maoists had trained more than 2000 health workers, who can be categorized into 4 levels. However, there is little evidence on their competencies and career motivation. The Maoists demand restructuring of the Nepalese health sector and the integration of their health workforce into the national health system. However, there has been no national discussion in Nepal of what kind of health reform and integration model is appropriate for a sustainable peace and improved service delivery.
Shiva Raj Mishra
Full Text Available Unsafe sexual behavior is common among the HIV infected. This exposes them to the risks of unintended pregnancy, HIV transmission to uninfected partners and super-infection. Studies on the use of family planning measures among People Living with HIV (PLHIV are scarce in Nepal. The aim of this study was to explore the knowledge and practice of family planning (FP in PLHIV. A cross sectional survey was conducted during July-December 2012 in Kaski district of Nepal. A total of 120 PLHIVs were recruited using snowball sampling from three HIV clinics within the Pokhara sub-metropolitan city area. This study found that nine in ten PLHIV had heard about family planning. Two thirds of respondents were using at least one FP method. The majority (65.8% used condoms and had received FP counseling (67.5%. Less than one percent used condoms in addition to another contraceptive. Being single, being female and having received the counselling sessions were associated with the use of FP. The individuals who received FP counseling were more likely [OR 4.522; 95% CI (1.410-14.504] to use FP. Females were more likely [OR 4.808; 95% CI (1.396-16.556] to use FP than males. The individuals who were single/de-facto widowed were more likely [OR 7.330; 95% CI (2.064-26.028] to use FP than the married individuals. Our findings suggest that there is a need to focus on FP counseling if the HIV prevention program is to increase FP use among the PLHIV population. Use of dual contraceptives need to be promoted through counseling sessions and other health promotion programs focusing in HIV prevention.
Gaurav, K; Poudel, I S; Bhattarai, S; Pradhan, P M S; Pokharel, P K
Malnutrition, especially under nutrition puts children at increased risk of morbidity and mortality and remains a serious barrier in child growth, development and survival. This is a major public health problem among under- 5 children in Nepal particularly in rural areas. To assess the burden and contributing factors for malnutrition in hill community of Ilam district in eastern Nepal. A cross sectional study was conducted in rural hill communities of Ilam district, Nepal with a sample of 240 under- 5 children. Anthropometric measurements were used as per WHO guidelines to asses three nutritional status: Underweight, Stunting, and Wasting using descriptive statistics and chi square test was applied using SPSS 12.0 to assess social and predisposing factors. Seventeen percent of under- 5 children were moderately and 10.4 % were severely underweight. Similarly, 22.9%, and 17.5% were found to be moderately and severely stunted respectively. Less than 10% were found to be moderately and severely wasted. Older age group of children, education level of mother, not exclusive breast feeding practice had significant (p children were affected with stunting, underweight and wasting at the same time. Significant proportion of under - 5 children were malnourished in the communities of the hilly areas. The study unveiled the importance of literacy and exclusive breast feeding for the prevention of malnutrition in under- 5 children.
Gyawali, Bishal; Keeling, June; Kallestrup, Per
As Nepal mourns the 1-year commemoration of the April 2015 earthquake and its aftershocks that killed more than 8500 people and left thousands injured and displaced, other more hidden repercussions of the resultant chaotic environment need attention: the increased risk of human trafficking. Considering that natural disasters provide a milieu for this illicit trade, there is a need for a robust response from stakeholders such as donors, civil society organizations, and government organizations against human trafficking following disasters such as the Nepal earthquake. Responsibility to prevent and fight trafficking should be explicitly included in the mandate of relief and rehabilitation mechanisms set up at the national level to coordinate the disaster relief response, serving to support populations in both rural and urban areas. (Disaster Med Public Health Preparedness. 2017;11:153-154).
Kshetri, Dan Bahadur Baidwar; Smith, Cairns S; Khadka, Mira
This study has aimed to describe the care and support for urban and rural elderly people of Bhaktapur district, Nepal. Efforts were made to identify the feeling of some features of general well-beings associated to mental health, person responsible for care and support, capability to perform daily routine activities, sources of finance and ownership to the property. More than half of the respondents were found having single or multiple features of loneliness, anxiety, depression and insomnia. The rate of point prevalence loneliness was found higher in the above 80 years of age, urban respondents. Almost 9 in 10 respondents were capable themselves to dress, walk and maintain personal hygiene and majority of them were assisted by spouse, son/daughter-in-laws. Family support was common sources of income and ownership to the property was absolutely high.
Parajuli, Ranjan; Pokharel, Govind Raj; Østergaard, Poul Alberg
Nepal is heavily dependent on the traditional energy sources and imported fossil fuel, which has an adverse impact on the environment and economy. Renewable energy technologies promoted in the country are regarded as a means of satisfying rural energy needs of the country for operating different...... using petro-diesel, jatropha-based biodiesel and solar photovoltaic pumps. The technical system design consists of system sizing of prime mover (engine, solar panel and pumps) and estimation of reservoir capacity, which are based on the annual aggregate water demand modelling. With these investigations......, incentives on the investments, which have effects on the cost of pumped water. Likewise, in case of biodiesel-based system, different yield rate of jatropha plants is also considered in estimating the cost of producing biodiesel. It is found that for operating a biodiesel-based pumping system for the study...
Nepal, a developing country of the south-asian region has bigger problem of children not completing the full cycle of basic education. In other words, large number of children dropout of schools, especially in the primary and secondary level of schooling. Especially, the situation is worse for those of the backward and socially disadvantaged populations and of the rural and the remote areas. Being in this frame, this study focused on the reasons of dropout of children from schools and the pos...
Tiwari Pandey, N.
This research investigated the complex relationship between population and environment with a focus on women’s role in fertility and the food resource environment. The research was carried out in a Gurung community in Lamjung district, in mid-hill Nepal. The household was taken as the unit of
Rebane, Kaja L.; Barham, Bradford L.
Solar home systems (SHSs) are a promising electrification option for many households in the developing world. In most countries SHSs are at an early stage of dissemination, and thus face a hurdle common to many emerging alternative energy technologies: many people do not know enough about them to decide whether to adopt one or not. This study uses survey data collected in Nicaragua to investigate characteristics that predict the knowledge and adoption of SHSs among the rural population. First, a series of probit models is used to model the determinants of four measures of SHS knowledge. Next, a biprobit model with sample selection is employed to investigate the factors that predict SHS adoption, conditional on having sufficient knowledge to make an adoption decision. Comparison of the biprobit formulation to a standard probit model of adoption affirms its value. This study identifies multiple determinants of SHS knowledge and adoption, offers several practical recommendations to project planners, and provides an analytical framework for future work in this policy-relevant area. - Research highlights: → Solar home systems (SHSs) are a promising rural electrification option in the developing world. → As with many emerging renewable energy technologies, lack of knowledge may limit SHS adoption. → We use probit models to investigate the determinants of SHS knowledge in rural Nicaragua. → We also employ a biprobit model linking the determinants of knowledge and adoption. → We find that in analyzing SHS adoption, accounting for sample selection based on knowledge is key.
Povlsen, Lene; Aryal, Umesh Raj; Petzold, Max; Krettek, Alexandra
The use of tobacco products among adolescents in Southeast Asia represents a major public health burden. Two out of ten adolescents attending school are tobacco users and several factors influence them to initiate tobacco use. Most studies related to tobacco use are quantitative, whereas qualitative studies exploring adolescents' smoking behavior and their views, knowledge and experiences are scarce. To gain a deep understanding of Nepalese adolescents' knowledge and opinions about smoking and reasons for smoking initiation. Adolescents from four secondary schools in the Bhaktapur district, Nepal. Eight focus-group discussions were conducted with 71 adolescents aged 13-16 years and from grades 8-10. Data were analyzed using manifest qualitative content analysis. The participants knew that smoking represents health risks as well as socio-economic risks, but few described the addictive nature of tobacco and health risks related to passive smoking. Most participants related smoking initiation to the smoking behavior of peers and family members, but easy accessibility to cigarettes, ineffective rules and regulations, and exposure to passive smoking also created environments for smoking. Some expressed confidence to resist peer pressure and refuse to start smoking, but also expressed the need for prevention strategies in schools and for governmental initiatives, such as more strict implementation of tobacco control and regulations to prevent and reduce smoking. Curbing the tobacco epidemic in Nepal requires healthy public policies and multifaceted interventions to address the knowledge gap on health consequences associated with smoking among adolescents, teachers and parents/adults.
van Teijlingen Edwin R
Full Text Available Abstract Background Antenatal care (ANC has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law's role in (a her daughter-in-law's ANC uptake; and (b the decision-making process about using ANC services in Nepal. Methods In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC, 10 husbands and 10 mothers-in-law in two different (urban and rural communities. Results Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Conclusion Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members
Simkhada, Bibha; Porter, Maureen A; van Teijlingen, Edwin R
Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law's role in (a) her daughter-in-law's ANC uptake; and (b) the decision-making process about using ANC services in Nepal. In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two different (urban and rural) communities. Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members, particularly mothers-in-law where they control access to family
Shahabuddin, ASM; De Brouwere, Vincent; Adhikari, Ramesh; Delamou, Alexandre; Bardaj, Azucena; Delvaux, Therese
Objectives To identify the determinants of institutional delivery among young married women in Nepal. Design Nepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15–24 years). Outcome measure Place of delivery. Results The rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery. Conclusions Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal. PMID:28408543
Mustafa, R.; Hashmi, H.A.
To assess the knowledge, attitude regarding family planning and the practice of contraceptives among rural women. One-hundred women between the ages 15-45, living with their husbands and coming from rural area (villages) were interviewed. Women who were pregnant, had a child younger than 2 years, or had any medical disorder were excluded. Their knowledge, attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. The other variables used were the age of women, parity and educational status. Descriptive analysis was conducted to obtain percentages. Out of 100 interviewed women with mean age of 29.7 years, 81(81%) had some knowledge about family planning methods. The media provided information of contraceptives in 52 out of 81 (64%) women. Regarding the usage of contraceptive methods, only 53 (53%) of the respondents were using some sort of contraception. Barrier method (condoms) was in practice by 18 (33.9%) and 12 (22.6%) of women had already undergone tubal ligation. The women using injectables and intrauterine contraceptive devices were 10 (18.8%) and 7 (13.2%) respectively. Six were using oral contraceptive pills (11.3%). Positive attitude towards contraception was shown by 76 (76%) of them, while 41(41%) stated their husbands positive attitude towards contraception. In the present study, there was a low contraceptive use among women of rural origin despite good knowledge. Motivation of couples through media and health personnel can help to achieve positive attitude of husbands for effective use of contraceptives. (author)
Mohammed, Kahee A; Subramaniam, Divya S; Geneus, Christian J; Henderson, Emmett R; Dean, Caress A; Subramaniam, Dipti P; Burroughs, Thomas E
Rural residents of the United States have higher HPV-associated cancer incidence and mortality, and suboptimal HPV vaccine uptake compared to urban residents. This study aimed to assess differences in knowledge and awareness of HPV, the HPV vaccine, and HPV-associated cancers among rural and urban residents. We analyzed data from the Health Information National Trends Survey 2013-2017 on 10,147 respondents ages ≥18 years. Multivariable logistic regression analyses compared urban/rural differences in knowledge and awareness of HPV, associated cancers, and HPV vaccine. Models were adjusted for sex, age, race/ethnicity, education, household income, census region, health insurance, regular provider, internet use, and personal history of cancer. Overall, 67.2% and 65.8% of urban residents were aware of HPV and HPV vaccine, respectively, compared to only 55.8% and 58.6% of rural residents. Adjusted models illustrated that compared to urban residents, rural residents were less likely to be aware of HPV (OR = 0.68, 95% CI = 0.53-0.86) and HPV vaccine (OR = 0.78, 95% CI = 0.63-0.97). Among those who were aware of HPV, rural residents were less likely to know that HPV causes cervical cancer (OR = 0.62, 95% CI = 0.46-0.84) and that HPV can be transmitted through sexual contact (OR = 0.72, 95% CI = 0.56-0.94). No significant differences between rural and urban residents were noted for knowledge that HPV is transmitted sexually and that it causes oral, anal, and penile cancers. This study highlights significant rural health disparities in knowledge and awareness of HPV and the HPV vaccine compared to urban counterparts. Copyright © 2018 Elsevier Inc. All rights reserved.
Giri, Aditi; Khatiwada, Prashant; Shrestha, Bikram; Chettri, Radheshyam Khatri
Almost 50% of the Nepali health budget is made up of international aid. International Non-Governmental Organizations working in the field of health are able to channel their funds directly to grass root level. During a 2010 conference, the Secretary of Population stated that the government has full knowledge and control over all funds and projects coming to Nepal. However, there are no documents to support this. The study aims to assess government and partner perceptions on whether Government of Nepal currently has full knowledge of contributions of international aid organizations and International Non-Governmental Organizations to health in Nepal and to assess if the government is able to control all foreign contributions to fit the objectives of Second Long Term Health Plan (1997-2017). A qualitative study was performed along with available literature review. Judgmental and snowball sampling led to 26 in depth interviews with key informants from the government, External Development Partners and International Non-Governmental Organizations. Results were triangulated based on source of data. Representatives of the Department of Health Services declined to be interviewed. Data collection was done until researchers felt data saturation had been reached with each group of key informants. While Ministry of Health and Population leads the sector wide approach that aims to integrate all donor and International Non-Governmental Organization contributions to health and direct them to the government's priority areas, questions were raised around its capacity to do so. Similarly, informants questioned the extent to which Social Welfare Council was able to control all International Non-Governmental Organizations contributions. Political tumult, corruption in the government, lack of human resources in the government, lack of coordination between government bodies, convoluted bureaucracy, and unreliability of donor and International Non-Governmental Organization contributions
Full Text Available prime rural and development knowledge and solutions resource site for Africa and the developing world. This should ultimately facilitate the development of projects and programmes that transform rural spaces, cultures and people from poverty...
Swanoski Michael T
Full Text Available Abstract Background Understanding the signs and symptoms of heart attacks and strokes are important not only in saving lives, but also in preserving quality of life. Findings from recent research have yielded that the prevalence of cardiovascular disease risk factors are higher in rural populations, suggesting that adults living in rural locales may be at higher risk for heart attack and/or stroke. Knowledge of heart attack and stroke symptomology as well as calling 911 for a suspected heart attack or stroke are essential first steps in seeking care. This study sought to examine the knowledge of heart attack and stroke symptoms among rural adults in comparison to non-rural adults living in the U.S. Methods Using multivariate techniques, a cross-sectional analysis of an amalgamated multi-year Behavioral Risk Factor Surveillance Survey (BRFSS database was performed. The dependent variable for this analysis was low heart attack and stroke knowledge score. The covariates for the analysis were: age, sex, race/ethnicity, annual household income, attained education, health insurance status, having a health care provider (HCP, timing of last routine medical check-up, medical care deferment because of cost, self-defined health status and geographic locale. Results The weighted n for this study overall was 103,262,115 U.S. adults > =18 years of age. Approximately 22.0% of these respondents were U.S. adults living in rural locales. Logistic regression analysis revealed that those U.S. adults who had low composite heart attack and stroke knowledge scores were more likely to be rural (OR = 1.218 95%CI 1.216-1.219 rather than non-rural residents. Furthermore, those with low scores were more likely to be: male (OR = 1.353 95%CI 1.352-1.354, >65 years of age (OR = 1.369 95%CI 1.368-1.371, African American (OR = 1.892 95%CI 1.889-1.894, not educated beyond high school (OR = 1.400 955CI 1.399-1.402, uninsured (OR = 1.308 95%CI 1
Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R; Bhatta, Prakash
People in Nepal generally hold fairly traditional views about sex and sexual health, whilst Western tourists often have a more liberal approach towards sex and relationships. There is evidence that significant sexual interaction occurs between male trekking guides and female travellers and/or local female sex workers in Nepal. This qualitative study explored trekking guides' sexual health knowledge, sexual relationships and condom use with female trekkers and local female sex workers. A total of 21 in-depth interviews were conducted with male trekking guides. Most reported having had sexual relationships with female trekkers and local female sex workers. Explanations for intercourse with female trekkers included: financial support; getting future trekkers through word-of-mouth advertising from the women they have had sex with; and opportunities for emigration. Interestingly, sexual intercourse is reported as more likely to be initiated by female trekkers than by guides, and more so by older women. In contrast, the main reasons for having sex with local female sex workers included: romantic love or sexual excitement and novelty. Awareness regarding sexual health was high among guides, but several factors discouraged the regular use of condoms. Further research with female tourists would help understand the motivations and reasons for their sexual behaviour.
Shrestha Keshab P
Full Text Available Abstract Background Plant species have long been used as principal ingredients of traditional medicine in far-west Nepal. The medicinal plants with ethnomedicinal values are currently being screened for their therapeutic potential but their data and information are inadequately compared and analyzed with the Ayurveda and the phytochemical findings. Methods The present study evaluated ethnomedicinal plants and their uses following literature review, comparison, field observations, and analysis. Comparison was made against earlier standard literature of medicinal plants and ethnomedicine of the same area, the common uses of the Ayurveda and the latest common phytochemical findings. The field study for primary data collection was carried out from 2006-2008. Results The herbal medicine in far-west Nepal is the basis of treatment of most illness through traditional knowledge. The medicine is made available via ancient, natural health care practices such as tribal lore, home herbal remedy, and the Baidhya, Ayurveda and Amchi systems. The traditional herbal medicine has not only survived but also thrived in the trans-cultural environment with its intermixture of ethnic traditions and beliefs. The present assessment showed that traditional herbal medicine has flourished in rural areas where modern medicine is parsimoniously accessed because of the high cost and long travel time to health center. Of the 48 Nepalese medicinal plants assessed in the present communication, about half of the species showed affinity with the common uses of the Ayurveda, earlier studies and the latest phytochemical findings. The folk uses of Acacia catechu for cold and cough, Aconitum spicatum as an analgesic, Aesculus indica for joint pain, Andrographis paniculata for fever, Anisomeles indica for urinary affections, Azadirachta indica for fever, Euphorbia hirta for asthma, Taxus wallichiana for tumor control, and Tinospora sinensis for diabetes are consistent with the latest
Pun, Sher Bahadur; Agrawal, Sumit; Jha, Santoshananda; Bhandari, Lila Nath; Chalise, Bimal Sharma; Mishra, Abadhesh; Shah, Rajesh
Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi and is widely reported in the USA, Central Europe, South East Asia and Latin America. Until recently, no scientific report regarding Lyme disease in Nepal had been published. A 32-year-old, previously healthy female visited the hospital with a history of joint pains, fatigue, neck stiffness, tingling sensation and headache. She was initially treated for typhoid fever, brucellosis and malaria, but did not show significant improvement. Doxycycline was prescribed empirically for 3 weeks for the treatment of suspected tick-borne illness. A two-tiered immunoglobulin laboratory testing confirmed Borrelia burgdorferi . She developed post-treatment Lyme disease syndrome after completion of antibiotic therapy. To the best of our knowledge, this is the first report of Lyme disease in Nepal and probably the first documented case of post-treatment Lyme disease syndrome in Asia. Lyme disease might have been overlooked in Nepal and, therefore, patients having clinical signs and symptoms similar to Lyme disease should not be disregarded in differential diagnosis.
Marta Regina Cezar-Vaz
Full Text Available OBJECTIVETo identify the exposure of rural workers to the sun's ultraviolet radiation and pesticides; to identify previous cases of skin cancer; and to implement clinical and communicative nursing actions among rural workers with a previous diagnosis of skin cancer.METHODObservational-exploratory study conducted with rural workers exposed to ultraviolet radiation and pesticides in a rural area in the extreme south of Brazil. A clinical judgment and risk communication model properly adapted was used to develop interventions among workers with a previous history of skin cancer.RESULTSA total of 123 (97.7% workers were identified under conditions of exposure to the sun's ultraviolet radiation and pesticides; seven (5.4% were identified with a previous diagnosis of skin cancer; four (57.1% of these presented potential skin cancer lesions.CONCLUSIONThis study's results enabled clarifying the combination of clinical knowledge and risk communication regarding skin cancer to rural workers.
Winschiers-Theophilus, Heike; Rodil, Kasper; Zaman, Tariq
In this paper we explore the opportunities of mobile technologies in three of our own development endeavors with rural communities, promoting the preservation of indigenous knowledge. We reflect upon and recognize the fact that the representation of indigenous knowledge will be transformed within...
Curran, Janet A; Murphy, Andrea L; Sinclair, Douglas; McGrath, Patrick
Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual
Full Text Available Background: Sanitation refers to create and maintain hygienic conditions, through services such as garbage collection and its proper disposal, wastewater disposal, consumption of safe drinking water, housing condition and its surrounding, an act or process of making sanitary, the promotion of hygiene and prevention of disease. Human being is a social animal and being a part of society, factors affecting the society also affect human and his surroundings. The study is concerned to demographic variables and environmental practices in rural communities. Objectives: To find out environmental situation and observe an impact of demographic variables on environmental factors. Materials and methods: A cross-sectional study was followed to conduct the study in palpa district of Nepal at 2012. Three hundred thirty nine households were selected through simple random procedure. Semi-structure interview schedule was used to collect information. Data were analyzed using software SPSS for windows version 16.0. Results: Most of the families were faithful to ethnic group. Practices of refuse and excreta disposable had unsatisfactory where percentages of throwing refuse and open field defecation was 39.2 and 9.1 respectively. 77.6% households were consumed tap water. Most of the households (53.4% did not have proper drainage system around their houses. Conclusion: Family type and caste of households were strongly associated with practice related to excreta disposal, drainage system and refuse disposable. Improper sanitation could be main threat to public health promotion and disease prevention in study areas.
Technology, like society, is heterogeneous. It mirrors the context in which it operates. Micro hydro development in Nepal is a rural energy strategy, which relies on technology and innovation and takes place in a specific social context. In designing this energy strategy, both technology and its
Jordans, Mark J. D.; Komproe, Ivan H.; Tol, Wietse A.; Kohrt, Brandon A.; Luitel, Nagendra P.; Macy, Robert D.; de Jong, Joop T. V. M.
Background: In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal. Methods: A cluster…
Full Text Available INDIGENOUS KNOWLEDGE SYSTEMS (IKS) IN IMPROVING RURAL ACCESSIBILITY AND MOBILITY (IN SUPPORT OF THE COMPREHENSIVE RURAL DEVELOPMENT PROGRAMME IN SOUTH AFRICA) CHARLES NHEMACHENA1, JAMES CHAKWIZIRA2, SIPHO DUBE1, GOODHOPE MAPONYA1, REMINA RASHOPOLA3... of Environmental Sciences, Private Bag X5050, Thohoyandou, 0950 3 Department of Rural Development and Land Reform, PO Box X833, Pretoria 0001 ABSTRACT This study discusses opportunities and challenges for integrating local knowledge in improving...
Full Text Available Despite growing international consensus that the use of the policy instrument REDD+ (Reducing Emissions from Deforestation and forest Degradation in developing countries could be an effective way to reduce carbon emissions from the forestry sector and support bio-diversity with livelihood benefits, there are a range of unresolved issues, including potential implications for rural livelihoods. This paper presents results from recent research that examines social equity and livelihood implications of the piloting of REDD+ through Nepal’s community forestry system, within selected villages in the Gorkha district of Nepal. The research reveals the varying experiences of households, closely correlated to the socio-economic attributes of the households. Despite the ‘no harm and equitable’ policy, this research indicates that not everyone is experiencing the anticipated benefits of REDD+. Although poorer, women-headed and marginalized households are targeted in some ways (e.g. seed grants, the support is limited, and inadequately compensates the loss they have experienced in other ways (e.g. limited access to forests. Households bundling by caste may not necessarily address equity, but is likely to increase intra-caste marginalization.
Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva
The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.
Thus, the article argues that the indigenous knowledge systems constitute an ontology on its own terms with both theoretical and practical (utilitarian) properties. The argument is that the indigenous knowledge systems reside in the rural areas (sites) and are available as tools for regional transformation processes.
Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus FC; Simkhada, Padam; Smith, William CS; Ayres, Jon G
Background Half of the world’s population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. Methods A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor...
Background: Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths. Objectives: To compare maternal knowledge about immunization, use of growth chart and childhood health-seeking behavior in rural and urban areas. Methods: A cross-sectional comparative study done in ...
Full Text Available Aim: The prevalence of epilepsy is higher in Nepal. This study was conducted to analyze the clinical manifestations of neurocysticercosis (NCC among seizure patients admitted to our center. Methods: We retrospectively studied all the NCC patients admitted to Neurology Department, Bir Hospital, Kathmandu, Nepal from April 2012 to February 2014. Computer tomography/magnetic resonance imaging (CT/MRI head, clinical profile, lab investigations and exclusion of other causes were the basis of the NCC diagnosis. Chi-square and Student′s t-test were used for comparison of variables. Results: Out of 131 seizure patients admitted, 21 patients were diagnosed with NCC (mean age: 33.95 ± 16.41; male: 15 (71.4%, female: 6 (28.6%. Generalized tonic clonic seizure was the most common seizure type in NCC patients (18 patients; 85.7%, two of them had status epilepticus during presentation in Emergency Department. Three patients had focal seizure, one with epilepsia partialis continua. Neuroimaging showed multiple NCC lesions in 8 (38.1% and a single NCC lesion in 13 (61.9% patients. Seven of them (33.3% sought traditional healers before being presented to our center. Eight patients (38.1% were treated with antiepileptics in local health-post without neuroimaging studies done. Calcified stage of NCC was the most frequent CT/MRI findings (12 patients; 57.1%. Phenytoin was preferred both by physicians and patients due to its low cost. Conclusion: NCC is a common finding among seizure patients in Nepal. Poor economic status, illiteracy and underdeveloped rural society are the major challenges in prevention and treatment of NCC.
Suresh Kumar Ghimire
Full Text Available The importance accorded to ethnoecological knowledge for suggesting new paths in scientific research, understanding ecological processes, and designing sustainable management of natural resources has grown in recent years. However, variation in knowledge and practices, both within and across cultures, has not been given much attention in resource management nor in developing scientific understanding of the ecological status of key resources. In this paper, we discuss the heterogeneity and complexity of local ecological knowledge in relation to its practical and institutional context with respect to management of Himalayan medicinal plants. We show factors affecting this variation, and discuss how knowledge is put into action. We assessed variation in knowledge relating to the diversity of medicinal plant species, their distribution, medicinal uses, biological traits, ecology, and management within and between two culturally different social groups living in villages located in the Shey-Phoksundo National Park and its buffer zone in northwestern Nepal. Heterogeneity in levels of knowledge and in practices both within and between these groups corresponds to differences in level of specialization in relation to medicinal plants, to socio-cultural and institutional contexts, and to extra-local factors that govern people's activities. We argue that understanding the heterogeneity of knowledge and practices within a given area is crucial to design management practices that build on the intricate links between knowledge, practices, and institutional context. It is also important to develop ecological studies that will best inform management.
Harris-Fry, Helen; Beard, B James; Harrisson, Tom; Paudel, Puskar; Shrestha, Niva; Jha, Sonali; Shrestha, Bhim P; Manandhar, Dharma S; Costello, Anthony; Saville, Naomi M
To outline the development of a smartphone-based tool to collect thrice-repeated 24 h dietary recall data in rural Nepal, and to describe energy intakes, common errors and researchers' experiences using the tool. We designed a novel tool to collect multi-pass 24 h dietary recalls in rural Nepal by combining the use of a CommCare questionnaire on smartphones, a paper form, a QR (quick response)-coded list of foods and a photographic atlas of portion sizes. Twenty interviewers collected dietary data on three non-consecutive days per respondent, with three respondents per household. Intakes were converted into nutrients using databases on nutritional composition of foods, recipes and portion sizes. Dhanusha and Mahottari districts, Nepal. Pregnant women, their mothers-in-law and male household heads. Energy intakes assessed in 150 households; data corrections and our experiences reported from 805 households and 6765 individual recalls. Dietary intake estimates gave plausible values, with male household heads appearing to have higher energy intakes (median (25th-75th centile): 12 079 (9293-14 108) kJ/d) than female members (8979 (7234-11 042) kJ/d for pregnant women). Manual editing of data was required when interviewers mistook portions for food codes and for coding items not on the food list. Smartphones enabled quick monitoring of data and interviewer performance, but we initially faced technical challenges with CommCare forms crashing. With sufficient time dedicated to development and pre-testing, this novel smartphone-based tool provides a useful method to collect data. Future work is needed to further validate this tool and adapt it for other contexts.
Adams, Vincanne; Craig, Sienna; Samen, Arlene; Bhatta, Surya
Purpose This report from the field details the ways that one small maternal child health NGO, which began its work in Tibet and now works in the mountain communities of Nepal, has established a model for integrated healthcare delivery and support it calls the "network of safety." Description It discusses some of the challenges faced both by the NGO and by the rural mountain communities with whom it partners, as well as with the government of Nepal. Conclusion This report describes and analyzes successful efforts to reduce maternal and infant mortality in a culturally astute, durable, and integrated way, as well as examples of innovation and success experienced by enacting the network of safety model.
Knowledge of outcome of pregnancy and labour among rural pregnant ... and poverty for the teen mother and the child, and has serious consequences for society. ... little or no time for appropriate screening and management of risk factors.
Full Text Available The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S. The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S. The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant ( P < 0.005. In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant ( P < 0.005. The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness.
Full Text Available Abstract Background The serious long-term complications of sexually transmitted infections (STI in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. Methods A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15–49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. Results Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p Conclusion The low levels of STI knowledge found among women of reproductive age in a rural district of Vietnam indicate an urgent need of health education interventions, of which, young and unmarried women should be specifically targeted.
It is vital for all healthcare systems to have a sufficient number of suitably trained health professionals including nurses at all levels of health services to deliver effective healthcare. An ethnographic, qualitative method was chosen for this study, which included open-ended, in-depth interviews with a range of stakeholders including student nurses, qualified nurses, nurse managers and lecturers, and the human resource co-ordinator in the Ministry of Health and Population. Available records and policy documents were also analysed. Study findings suggest that there is a severe mal-distribution of the nursing workforce in rural and urban healthcare centres in Nepal. Although there is an oversupply of newly qualified nurses in hospitals in Kathmandu, the staffing situation outside the valley is undesirable. Additionally, the turnover of junior nursing staff remains high in major urban hospitals. Most qualified nurses aspire to work in developed countries, such as the UK, North America, Australia and New Zealand. Between 2000 and 2008, as many as 3000 nurses have left Nepal for jobs in the developed west. There is no effective management strategy in place to retain a nursing workforce, particularly in rural Nepal. This article concludes by proposing some suggestions for a nursing workforce retention policy to address this critical issue. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.
Barker, Carol E; Bird, Cherry E; Pradhan, Ajit; Shakya, Ganga
Evidence gathered from 1997 to 2006 indicates progress in reducing maternal mortality in Nepal, but public health services are still constrained by resource and staff shortages, especially in rural areas. The five-year Support to the Safe Motherhood Programme builds on the experience of the Nepal Safer Motherhood Project (1997-2004). It is working with the Government of Nepal to build capacity to institute a minimum package of essential maternity services, linking evidence-based policy development with health system strengthening. It has supported long-term planning, working towards skilled attendance at every birth, safe blood supplies, staff training, building management capacity, improving monitoring systems and use of process indicators, promoting dialogue between women and providers on quality of care, and increasing equity and access at district level. An incentives scheme finances transport costs to a health facility for all pregnant women and incentives to health workers attending deliveries, with free services and subsidies to facilities in the poorest 25 districts. Despite bureaucracy, frequent transfer of key government staff and political instability, there has been progress in policy development, and public health sector expenditure has increased. For the future, a human resources strategy with career paths that encourage skilled staff to stay in the government service is key.
Shiva Raj Mishra
Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.
Marjadi, Brahmaputra; McLaws, Mary-Louise
Understanding the constructs of knowledge behind clinical practices in low-resource rural health care settings with limited laboratory facilities and surveillance programs may help in designing resource-appropriate infection prevention and control education. Multiple qualitative methods of direct observations, individual and group focus discussions, and document analysis were used to examine health care workers' knowledge of infection prevention and control practices in intravenous therapy, antibiotic therapy, instrument reprocessing, and hand hygiene in 10 rural Indonesian health care facilities. Awareness of health care-associated infections was low. Protocols were in the main based on verbal instructions handed down through the ranks of health care workers. The evidence-based knowledge gained across professional training was overridden by empiricism, nonscientific modifications, and organizational and societal cultures when resources were restricted or patients demanded inappropriate therapies. This phenomenon remained undetected by accreditation systems and clinical educators. Rural Indonesian health care workers would benefit from a formal introduction to evidence-based practice that would deconstruct individual protocols that include nonscientific knowledge. To achieve levels of acceptable patient safety, protocols would have to be both evidence-based and resource-appropriate. Copyright 2010 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
Full Text Available Abstract Background Maternal, perinatal and neonatal mortality rates remain high in rural areas of developing countries. Most deliveries take place at home and care-seeking behaviour is often delayed. We report on a combined quantitative and qualitative study of care seeking obstacles and practices relating to perinatal illness in rural Makwanpur district, Nepal, with particular emphasis on consultation strategies. Methods The analysis included a survey of 8798 women who reported a birth in the previous two years [of whom 3557 reported illness in their pregnancy], on 30 case studies of perinatal morbidity and mortality, and on 43 focus group discussions with mothers, other family members and health workers. Results Early pregnancy was often concealed, preparation for birth was minimal and trained attendance at birth was uncommon. Family members were favoured attendants, particularly mothers-in-law. The most common recalled maternal complications were prolonged labour, postpartum haemorrhage and retained placenta. Neonatal death, though less definable, was often associated with cessation of suckling and shortness of breath. Many home-based care practices for maternal and neonatal illness were described. Self-medication was common. There were delays in recognising and acting on danger signs, and in seeking care beyond the household, in which the cultural requirement for maternal seclusion, and the perceived expense of care, played a part. Of the 760 women who sought care at a government facility, 70% took more than 12 hours from the decision to seek help to actual consultation. Consultation was primarily with traditional healers, who were key actors in the ascription of causation. Use of the government primary health care system was limited: the most common source of allopathic care was the district hospital. Conclusions Major obstacles to seeking care were: a limited capacity to recognise danger signs; the need to watch and wait; and an
Soneja, Sutyajeet I.; Tielsch, James M.; Khatry, Subarna K.; Zaitchik, Benjamin; Curriero, Frank C.; Breysse, Patrick N.
Alternative stoves are an intervention option to reduce household air pollution. The amount of air pollution exiting homes when alternative stoves are utilized is not known. In this paper, particulate matter exfiltration estimates are presented for four types of alternative stoves within a village-like home, which was built to reflect the use of local materials and common size, in rural Nepal. Four alternative stoves with chimneys were examined, which included an alternative mud brick stove, original Envirofit G3355 model, manufacture altered Envirofit G3355, and locally altered Envirofit G3355. Multiple linear regression was utilized to determine estimates of PM2.5 exfiltration. Overall exfiltration fraction average (converted to a percent) for the four stoves were: alternative mud brick stove with chimney 56%, original Envirofit G3355 model with chimney 87%, manufacture altered Envirofit G3355 model with chimney 69%, and locally altered Envirofit G3355 model with chimney 69%. Alternative cookstoves resulted in higher overall average exfiltration due to direct and indirect ventilation relative to traditional, mud-based stoves. This contrast emphasizes the need for an improved understanding of the climate and health implications that are believed to come from implementing alternative stoves on a large scale and the resultant shift of exposure burden from indoors to outdoors.
Tanvir H. Dewan
Full Text Available Bangladesh and Nepal lie between the Himalayas and low-lying coasts of the Bay of Bengal and are traversed by hundreds of rivers and tributaries. Historical data shows that, since 1970, the scale, intensity and duration of floods have increased in Bangladesh and Nepal, causing grave human suffering; disruptions in normal life and activity, damages of infrastructure, crops and agricultural land with severe impacts on the economy. Bangladesh is affected by torrential rain, glacier melt, upstream water flow and tidal surges. In 1988, Bangladesh experienced one of the most severe floods of the twentieth century which aroused significant concern internationally and triggered the Bangladesh Action Plan for Flood Control. The Government of Bangladesh (GOB has so far constructed a number of flood shelters and carried out 482 water and flood control projects involving flood protection embankments, drainage channels, sluice gates and regulators on different rivers and canals. These also provided safety measures against inundation by tidal waves, storm-surges and flooding. The Terai region of Nepal is highly prone to hydrological risks including torrential rain, floods, glaciers resulting in erosion and landslides. The Government of Nepal (GON has implemented different mitigation measures mainly early warning awareness, rescue measure, relief, and post-flood rehabilitation programs etc. Disaster Management Bureaus of both the countries have already conducted many trainings, workshops and seminars to disseminate scientific knowledge and coping up practices to disaster managers and to create public awareness. Besides the contemporary approaches to mitigating flood effects, people of these countries have coped with floods through generations relying on traditional/indigenous knowledge and other local adaptation practices. It is crucial that along with scientific process, indigenous, traditional and conventional practices are to be integrated for a national
Puglia, Christopher; Derron, Marc-Henri; Nicolet, Pierrick; Sudmeier-Rieux, Karen; Jaboyedoff, Michel; Devkota, Sanjay
Nepal is a country in which shallow landslide is a frequent phenomenon. Monsoon is the main triggering factor but anthropogenic influence is often significant too. Indeed, many infrastructures, such as roads or water pipes, are not built in a rigorous way because of a lack of funds and knowledge. In the present study we examine the technical, social and economic issues of landslide management for two sites in Nepal. The first site is located in Sanusiruwari VDC (Sindhupalchock district, central Nepal) and the second one in Namadi VDC (Ramecchap district, central Nepal). Both sites are affected by landslides induced by the construction of hydropower plants. These landslides may threaten the viability of the hydropower plants. At both sites the problems are quite similar, but the first site project is a private one and the second one is a public one implemented by the United Nations Development Programme (UNDP). For both sites, bioengineering methods using Vetiver (Vetyveria zizanioides) plantations is the main stabilization measure. To follow the progression of both landslides, fieldwork observations were conducted before and after the 2012 rainy season, including photogrammetric and distancemeter acquisitions. Main issues were discussed with communities and stakeholders of the hydropower projects through interviews and participatory risk mapping. Main issues include: lack of communication between the project managers and communities leading to conflict and the lack of maintenance of the bio-engineering sites, leading to less effective Vetiver growth and slope stabilization. Comparing the landslide management (technical, social and economic) of the two projects allows to point out some specific issues within an integrated risk perspective.
Dulal, R K
Nepal has entered from its unitary system into a new "Federal Democratic Republic State". The current constitution presents basic health care services as a fundamental right. The Ministry for Health and Population has been providing resources to meet health demands, but managers are wrestling to meet these demands. Persistent disparities between rural and urban and across regions resulted inferior health outcomes, e.g., life expectancy in an urban district like Bhaktapur is 71 years, whereas in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past systems prompted people to seek a different model. Ultimately, all political parties except one have agreed on federalism. The exact number of federal states that are going to be created is unknown. In federalism, all federated states have to assume certain relationships between the locality, the region, and the nation that apply not only in politics but in health care too. Managing changes in health care organization during the transitional period and after restructuring the unitary Nepal into federal states should be carefully planned. In case, if new system also fails to deliver necessary health care services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be ignored. In order to outline a structure and give life to a health care system under federalism, health care professionals need to engage themselves seriously.
Dhungana, Adhish; Nanthamongkolchai, Sutham; Pitikultang, Supachai
Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire. More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization. There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents' intention may change over time. The national family planning program also needs to identify the key factors in
Dugar, Sumit; Dahal, Vaskar
The foothills of Nepalese Himalayas located in the neotectonic mountain environment are among some of the most unstable and geomorphologically dynamic landscapes in the world. Young fold mountains in this region are characterized by complex tectonics that influence the occurrence of earthquakes, while climatic processes such as intense orographic rainfall often dictate the occurrence of floods and landslides. Development of linear infrastructures, such as roads, in mountainous terrain characterized by high relief and orogeny is considerably challenging where the complexity of landscape in steep and irregular topography, difficult ground conditions and weak geology, presents engineers and planners with numerous difficulties to construct and maintain mountain roads. Whilst application of engineering geology, geomorphic interpretation of terrain in terms of physiography and hydrology, and identification of geo-hazards along the road corridor is critical for long term operation of mountain roads, low-cost arterial roads in the Himalayan foothills generally fail to incorporate standard road slope engineering structures. This research provides unique insights on policy and governance issues in developing mountainous countries such as Nepal, where achieving a sound balance between sustainability and affordability is a major challenge for road construction. Road development in Nepal is a complex issue where socio-economic and political factors influence the budget allocation for road construction in rural hilly areas. Moreover, most mountain roads are constructed without any geological or geo-technical site investigations due to rampant corruption and lack of adequate engineering supervision. Despite having good examples of rural road construction practices such as the Dharan-Dhankuta Road in Eastern Nepal where comprehensive terrain-evaluation methods and geo-technical surveys led to an improved understanding of road construction, learnings from this project have not
Andrea Karin Barrueto
Full Text Available Agricultural innovations are important, especially as climatic conditions around the world have been subject to increasing change over the past decades. Through innovation, farmers can adapt to the changing conditions and secure their livelihoods. In Nepal, 75% of the population depends upon agriculture, which is impacted by climate change, migration, and feminisation. In this context, it is important to understand what drives a household to start agricultural innovation to increase its economic benefits and resilience in the face of multiple pressures. We sought a comprehensive understanding of these drivers by investigating the determinants of rural innovation, using macadamia and walnut trees as examples of novel, potentially commercialised cash crops. After conducting an in-depth household survey that divided farmers into those who cultivate nuts and those who do not, we analysed the socio-economic and cultural characteristics of each category using statistical tests and a multiple logistic regression. Our results show that the individual variables of ethnicity, wealth and “years of experience with fruit trees” correlate significantly with nut cultivation. The results of the multiple regression suggest that “years of experience with tree cultivation” and “having an income through fruit trees” most influence nut cultivation. Overall, we conclude that nut cultivation is an accepted and promising cash crop mostly grown by wealthier households, and that, for poor, landless, or female-headed households to benefit, alternative business models and new policies must be explored and developed. We further suggest that this is also true for other nut or other cash crop trees that have gained recent attention in Nepal such as almond, hazelnut, or pecan farming.
Inoue, Yasuteru; Honda, Shoji; Watanabe, Masaki; Ando, Yukio
The number of elderly people is dramatically increasing, and this trend is especially pronounced in rural populations. The aim of the present study was to verify the effectiveness of stroke education in a rural area. The stroke educational flyers were distributed for 3 weeks at the point of purchase within supermarkets. Questionnaires were used to determine knowledge about stroke and appropriate emergent action on identifying stroke. A total of 882 people responded to the questionnaires before (n = 409) and 3 months after (n = 473) the campaign. Of these, 686 (77.8%) were aged 65 years or older. The percentages of correct answers for hemiplegia and one-sided numbness (P point-of-purchase stroke campaign using educational flyers could meaningfully affect stroke knowledge among elderly persons in a rural community. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Sapkota, Bhim Prasad; Amatya, Archana
Nepal is experiencing a public health issue similar to the rest of the world, i.e., the geographical maldistribution of physicians. Although there is some documentation about the reasons physicians elect to leave Nepal to work abroad, very little is known about the salient factors that influence the choice of an urban versus rural practice setting for those physicians who do not migrate. In recent years, around 1000 medical students became doctors within Nepal, but their distribution in rural locations is not adequate. The purpose of this study was to explore what factors influence the choice of urban or rural location for the future clinical practice of Nepalese medical students in the final year of their program A cross-sectional descriptive study design was used for this study involving Nepalese medical students in their final year of study and currently doing an internship in a medical college. The sample consisted of 393 medical students from four medical colleges in Nepal that were selected randomly. An anonymous self-administered questionnaire was used for data collection. To determine the association with rural location choice for their future practice setting, a comparison was done that involved demographic, socio-economic, and educational factors. Data were entered in EpiData and analyzed by using SPSS version 16. Among the 393 respondents, two thirds were male (66.9%) and more than half were below 25 years of age. Almost all (93%) respondents were single and about two thirds (63.4%) were of Brahmin and Chhetri ethnic origin. About two thirds (64.1%) of the respondents were born in a rural setting, and 58.8% and 53.3% had a place of rearing and permanent address in a rural location, respectively. The predictors of future rural location choice for their clinical practice (based on the bivariate analysis) included: (a) Rural (versus urban) place of birth, place of rearing, and permanent address (b) Source of family income (service, business, and agriculture
Full Text Available Background & Objectives: The use of dental implants in partially or completely edentulous patients has proved effective and an accepted treatment modality with predictable long-term success. Dental implants are becoming a popular choice for replacing the missing teeth because of increased awareness about implants both in dentists and patients. The objective of the study was to assess the basic knowledge and education about dental implants among general dental practitioners (GDPs of Nepal.Materials & Methods: A cross sectional questionnaire was carried out among 110 GDPs which consist of twenty questions that were divided into three categories; first with some basic knowledge in implant dentistry, second with clinical knowledge of dental implants and third with dental implant education and training.Results: Out of 110 GDPs, 72.7% had basic knowledge about implant dentistry and 65.5% were not aware about advance surgical procedures like sinus lift and guided bone regeneration. All the GDPs were positive regarding more training and education in dental implants and 95.5% of them would like to incorporate dental implant treatment in their practice in future. Conclusion: GDPs should have adequate knowledge and training of dental implants which can be incorporated at undergraduate or post doctoral level so that they are skilled to provide quality dental implant therapy to their patients confidently.
Tripathee, Lekhendra; Kang, Shichang; Zhang, Qianggong; Rupakheti, Dipesh
Atmspheric pollutants transported from South Asia could have adverse impact on the Himalayan ecosystems. Investigation of aerosol chemistry in the Himalayan region in Nepal has been limited on a temporal and spatial scale to date. Therefore, the water-soluble ionic composition of aerosol using TSP sampler was investigated for a year period from April 2013 to March 2014 at four sites Bode, Dhunche, Lumbini and Jomsom characterized as an urban, rural, semi-urban and remote sites in Nepal. During the study period, the highest concentration of major cation was Ca2+ with an average concentration of 8.91, 2.17, 7.85 and 6.42 μg m-3 and the highest concentration of major anion was SO42- with an average of 10.96, 4.06, 6.85 and 3.30 μg m-3 at Bode, Dhunche, Lumbini and Jomsom respectively. The soluble ions showed the decrease in concentrations from urban to the rural site. Correlations and PCA analysis suggested that that SO42-, NO3- and NH4+ were derived from the anthropogenic sources where as the Ca2+ and Mg2+ were from crustal sources. Our results also suggest that the largest acid neutralizing agent at our sampling sites in the central Himalayas are Ca2+ followed by NH4+. Seasonal variations of soluble ions in aerosols showed higher concentrations during pre-monsoon and winter (dry-periods) due to limited precipitation amount and lower concentrations during the monsoon which can be explained by the dilution effect, higher the precipitation lower the concentration. K+ which is regarded as the tracer of biomss burning had a significant peaks during pre-monsoon season when the forest fires are active around the regions. In general, the results of this study suggests that the atmospheric chemistry is influenced by natural and anthropogenic sources. Thus, soluble ionic concentrations in aerosols from central Himalayas, Nepal can provide a useful database to assess atmospheric environment and its impacts on human health and ecosystem in the southern side of central
D.M. Dror (David); M. Majumdar (Manabi); P. Panda (Pradeep); D. John (Dominik); R. Koren (Ruth)
textabstractThis paper reports on two voluntary, contributory, contextualised, community-based health insurance (CBHI) schemes, launched in Dhading and Banke (Nepal) in 2011. The implementation followed a four-stage process: initiating (baseline survey), involving (awareness generation and engaging
Shrestha, Merina; Shrestha, Rena
Awareness and knowledge about autism is almost non-existent in Nepal. Children who eventually get the diagnosis often miss their opportunity for early intervention. The current study shows that medical help was seeked at mean age of 27.9 + 14.5 months and most of them were for delayed language and the first preference for parents were…
Morrison, Joanna; Batura, Neha; Thapa, Rita; Basnyat, Regina; Skordis-Worrall, Jolene
A global shortage of health workers in rural areas increases the salience of motivating and supporting existing health workers. Understandings of motivation may vary in different settings, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool, previously used in Kenya, and explored its validity and reliability to measure the motivation of auxiliary nurse midwives (ANM) and staff nurses (SN) in rural Nepal. Qualitative and quantitative methods were used to assess the content validity, the construct validity, the internal consistency and the reliability of the tool. We translated the tool into Nepali and it was administered to 137 ANMs and SNs in three districts. We collected qualitative data from 78 nursing personnel and district- and central-level stakeholders using interviews and focus group discussions. We calculated motivation scores for ANMs and SNs using the quantitative data and conducted statistical tests for validity and reliability. Motivation scores were compared with qualitative data. Descriptive exploratory analysis compared mean motivation scores by ANM and SN sociodemographic characteristics. The concept of self-efficacy was added to the tool before data collection. Motivation was revealed through conscientiousness. Teamwork and the exertion of extra effort were not adequately captured by the tool, but important in illustrating motivation. The statement on punctuality was problematic in quantitative analysis, and attendance was more expressive of motivation. The calculated motivation scores usually reflected ANM and SN interview data, with some variation in other stakeholder responses. The tool scored within acceptable limits in validity and reliability testing and was able to distinguish motivation of nursing personnel with different sociodemographic characteristics. We found that with minor modifications, the tool provided valid and internally consistent measures of motivation among ANMs
Devkota, Surendra R.
This dissertation analyzes the sustainability of the economy of Nepal. The main empirical question addressed is whether the Tenth Plan of Nepal (2002--2007) will meet its projected economic output goal and achieve its primary goal of reducing poverty. To this end, economic growth scenarios are examined in terms of availability of energy demand and supply, and income disparity among different households. The structure of the Nepali economy is examined using a Leontief input-output table, a Ghosian supply-side input-output table, and a social accounting matrix for the year 1999. Based on the input-output analysis of energy demand and supply for the 10th Plan, it is unlikely that energy requirements of the projected output will be met, unless some extra sources of energy are developed. Households need to switch their energy use from fuel wood/biomass to other alternatives. In order to meet the target of the Plan vis-a-vis energy demand or supply, a few policy measures are urgently needed, though some of these options require many years to develop. Household income inequality and distribution is examined through the SAM multipliers; namely aggregate, transfer, open-loop, and closed-loop multipliers. The investment-income multiplier scenarios for the 10th Plan indicate that the nominal income of households may increase due to the increased investment, which will not necessarily improve the bottom deciles households, particularly socio-economically deprived households. Economic growth in Nepal during the past fifty years demonstrates that the modernization model is unsuccessful. Economic growth occurred at some centers at the cost of periphery. A huge regional disparity has developed between hills and plains, east and west, city and rural areas. Nepal's persistent poverty indicates a failure of modernization theory. The Tenth Plan would be another continuation of a failed legacy, unless social and natural endowments are considered for sustainability. Nepal could be an
Full Text Available The study was set to determine whether knowledge and attitudes toward organ dona-tion differ according to geographical location. Self-administered questionnaires were employed to collect data such as demographic characteristics, basic knowledge, attitudes and source of information about organ donation from subjects in rural and urban areas. The questionnaires were distributed randomly to 1,000 individuals in both areas during 2008. The data were analyzed in a descriptive fashion. Despite similarities in knowledge and attitudes of respondents in both areas, rural res-pondents were less likely to have information about organ donation, to report willingness to donate organs, and to have knowledge about "brain death" or the "organ donation card" than their counter-parts in urban areas. The study identified that the principle respondents′ source of information about organ donation was the television. More than 90% of respondents in rural and urban areas reported that the contribution of health care providers in providing them with knowledge about organ dona-tion and transplantation was "none" or "little". Respondents identified several reasons, which may influence their decisions to donate organs. In conclusion, the deficit in knowledge and attitudes of rural respondents about organ donation may be justified by the lack of information about this signi-ficant issue. Accordingly, health facilities, local mass media and educational institutions should provide intensive educational programs to encourage the public donate organs.
Oct 31, 2007 ... Knowledge Systems and Natural Resources is a unique collection of case studies from Nepal. ... and students of social and political sciences and natural resource management. ... Nepal and founding Editor of the Journal of Forest and Livelihood. ... Ideas from the global climate change hotspot research.
Karmacharya, P C; Singh, G K; Singh, M P; Gautam, V G; Par, Andrew; Banskota, A K; Bajracharya, A; Shreshtha, A B; Mahara, Deepak
Nepal loses about 530,000 disability adjusted life years (DALYs) per year to injury, predominantly due to falls. It takes 30,000 Nepali rupees (NR), or approximately US$430 at 70 rupees per $US saved per DALY to achieve primary prevention and 6000 NR per DALY if we invest in hospitals, versus 1000 NR invested in prehospital care, because simpler less expensive actions performed early have a greater impact on outcome than more complex measures later. A system for prehospital services was planned for medical emergencies at a national level meeting at the Medical University of Nepal to promote healthcare to victims in inaccessible regions by empowered or enlightened citizens. Feasible actions for common emergencies were defined and a tutorial required to help the majority of such victims was created and packaged. The knowledge and attitude component of the tutorial will be delivered through a web site to citizens motivated to learn and help with emergencies. The knowledge will be tested through a net-based Multiple Choice Questions (MCQ) test. Practical training in medical triage skills will be provided to those who qualify for the test at the University or its designated affiliates. A mobile phone-based information system will be created and used to make these enlightened citizens available to the victim at the site/time of the emergency.
Lloyd, Ellen M.
Several researchers have pointed out the failures of current schooling to adequately prepare students in science and called for radical reform in science education to address the problem. One dominant critique of science education is that several groups of students are not well served by current school science practices and discourses. Rural students represent one of these underserved populations. Yet, there is little in the literature that speaks specifically to reforming the science education of rural students. Utilizing action research as a methodology, this study was designed to learn more about the unique knowledge and life experiences of rural students, and how these unique knowledge, skills and interests could suggest new ways to improve science education in rural schools. Informed by this ultimate goal, I created an after school science club where the participating high school students engaged in solving a local watershed problem, while explicitly bringing to bear their unique backgrounds, local knowledge and life experiences from living in a rural area of Upstate New York. Using Funds of Knowledge as the theoretical framework, this after-school club served as the context to investigate the following research questions: (1) What science-related funds of knowledge do rural high school students have? (2) How were these funds of knowledge capitalized on to support science learning in an after-school setting?
Pandey, Basu D; Nabeshima, Takeshi; Pandey, Kishor; Rajendra, Saroj P; Shah, Yogendra; Adhikari, Bal R; Gupta, Govinda; Gautam, Ishan; Tun, Mya M N; Uchida, Reo; Shrestha, Mahendra; Kurane, Ichiro; Morita, Kouichi
Dengue is an emerging disease in Nepal and was first observed as an outbreak in nine lowland districts in 2006. In 2010, however, a large epidemic of dengue occurred with 4,529 suspected and 917 serologically-confirmed cases and five deaths reported in government hospitals in Nepal. The collection of demographic information was performed along with an entomological survey and clinical evaluation of the patients. A total of 280 serum samples were collected from suspected dengue patients. These samples were subjected to routine laboratory investigations and IgM-capture ELISA for dengue serological identification, and 160 acute serum samples were used for virus isolation, RT-PCR, sequencing and phylogenetic analysis. The results showed that affected patients were predominately adults, and that 10% of the cases were classified as dengue haemorrhagic fever/ dengue shock syndrome. The genetic characterization of dengue viruses isolated from patients in four major outbreak areas of Nepal suggests that the DENV-1 strain was responsible for the 2010 epidemic. Entomological studies identified Aedes aegypti in all epidemic areas. All viruses belonged to a monophyletic single clade which is phylogenetically close to Indian viruses. The dengue epidemic started in the lowlands and expanded to the highland areas. To our knowledge, this is the first dengue isolation and genetic characterization reported from Nepal.
Panthi, J., Sr.
Climate change vulnerability depends upon various factors and differs between places, sectors and communities. People in developing countries whose subsistence livelihood depends upon agriculture and livestock are identified as particularly vulnerable. Nepal, where the majority of people are in a mixed agro-livestock system, is identified as the world's fourth most vulnerable country to climate change. However, there are few studies on how vulnerable mixed agro-livestock smallholders are and how their vulnerability differs across different ecological regions. This study aims to test two vulnerability assessment indices, livelihood vulnerability index (LVI) and IPCC vulnerability index (VI-IPCC), around the Gandaki river basin of Nepal. A total of 543 households practicing mixed agro-livestock were surveyed from three districts (Dhading, Syangja and Kapilvastu) representing the mountain, mid-hill and lowland altitudinal belts respectively. Data on socio-demographics, livelihoods, social networks, health, food and water security, natural disasters and climate variability were collected. Both indices differed across the three districts, with mixed agro-livestock smallholders of Dhading district found to be the most vulnerable and that of Syangja least vulnerable. This vulnerability index approach may be used to monitor rural vulnerability and/or evaluate potential program/policy effectiveness in poor countries like Nepal. The present findings are intended to help in designing intervention strategies to reduce vulnerability of mixed agro-livestock smallholders and other rural people in developing countries to climate change.
Hayat, Humera; Khan, Parwez Sajad; Imtiyaz, Bhat; Hayat, Gazala; Hayat, Rehana
Human fertility is determined by many factors such as customs, morals and habits of social groups with regard to marital obligation of life. Acceptance of family planning methods varies within and between societies and there are many factors which are responsible for such variation at community, family and individual level. Socioeconomic environment, culture and education are few of them that play a vital role. Jammu and Kashmir state in general and Kashmir valley in particular is a Muslim-dominated population with traditionally a conservative society. Apart from family customs and influence of the elders, religious background has always been behind the passive resistance, or at the best indifference towards contraception. This study makes an attempt to assess the knowledge, attitude and practice of contraception in rural Kashmir. To assess the knowledge, attitude and practice of contraception in rural Kashmir. Community-based Cross-Sectional study. December 2006 to May 2008. 1900 currently married women in the age group of 15-49 years of age. Rural households. 1900 currently married women, aged 15-49 years, selected by multi-stage random sampling technique from three districts of Kashmir valley who were interviewed at home using a pretested oral questionnaire. The assessment of various socioeconomic and other variables made as per the available standard procedures and scales. Percentage, Chi square test and Bivariate analysis. Knowledge of the contraceptive methods was fairly good especially for terminal methods i.e. female sterilization (97.7 %). Main source of information on contraception was obtained from mass media (60.4 %). Contraceptive practice was significantly related to number of living children, literacy, socioeconomic status and type of family. What is needed is to promote and stress contraceptive methods and their advantages using mass media approach and to explore more and more participation of private sector.
Lan, Pham Thi; Lundborg, Cecilia Stålsby; Mogren, Ingrid; Phuc, Ho Dang; Chuc, Nguyen Thi Kim
The serious long-term complications of sexually transmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15-49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p married vs. 76% unmarried, p married vs. 14% unmarried, p unmarried women and women who lived in the highlands or mountainous areas demonstrated very low levels of STI knowledge (regression coefficients -1.3 and -2.5, respectively, p unmarried women should be specifically targeted.
Rokaya, Maan B; Uprety, Yadav; Poudel, Ram C; Timsina, Binu; Münzbergová, Zuzana; Asselin, Hugo; Tiwari, Achyut; Shrestha, Shyam S; Sigdel, Shalik R
importance of medicinal plants used to treat gastrointestinal disorders in the traditional health care system of Nepal. As such disorders are still causing several deaths each year, it is of the utmost importance to conduct phytochemical and pharmacological studies on the most promising species. It is also crucial to increase access to traditional medicine, especially in rural areas. Threatened species need special attention for traditional herbal medicine to be exploited sustainably. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
This Bachelor’s thesis is based on the tourism and community based tourism in Nepal. The purpose of selecting tourism as a main topic is to find out the future scope of CBT in Nepal. Despite having small size, Nepal holds many attractive and adventurous tourist destinations. Nepal is famous from its cultural and traditional diversity, natural beauty, trekking trails, moun-taineering and warm and welcoming hospitality. Tourism in Nepal is undoubtedly the most important source for the econo...
Hansen, Annette Skovsted
, as a Danida fellow. Today, the older sister works in Nepal and the younger in Seattle, where they still make use of their personal networks including connections to their fellow alumni of technical assistance courses. Inspired by work on social remittances in combination with network theory , I argue......Technical Assistance courses have many functions apart from disseminating knowledge and information, one such function is to engender networks. During the course period, participants meet and establish contact and some of these contacts remain connections between alumni for many years after...... the courses are finished. The alumni networks depend on the uses they are put to by the individual alumni and the support they get from alumni and host countries. The United Nations initiated technical assistance courses in the late 1940s in order to train nationals from developing countries as a means...
This study examines the relationship between male labour out-migration and the process of sociocultural transformation in the places of origin. Taking an example from Nepal, it shows that male labour out-migration has increased women’s participation in agriculture, more significantly so in
Background There is a large burden of psychological distress in low and middle-income countries, and culturally relevant interventions must be developed to address it. This requires an understanding of how distress is experienced. We conducted a qualitative grounded theory study to understand how mothers experience and manage distress in Dhanusha, a low-resource setting in rural Nepal. We also explored how distressed mothers interact with their families and the wider community. Methods Participants were identified during a cluster-randomised controlled trial in which mothers were screened for psychological distress using the 12-item General Health Questionnaire (GHQ-12). We conducted 22 semi-structured interviews with distressed mothers (GHQ-12 score ≥5) and one with a traditional healer (dhami), as well as 12 focus group discussions with community members. Data were analysed using grounded theory methods and a model was developed to explain psychological distress in this setting. Results We found that distress was termed tension by participants and mainly described in terms of physical symptoms. Key perceived causes of distress were poor health, lack of sons, and fertility problems. Tension developed in a context of limited autonomy for women and perceived duty towards the family. Distressed mothers discussed several strategies to alleviate tension, including seeking treatment for perceived physical health problems and tension from doctors or dhamis, having repeated pregnancies until a son was delivered, manipulating social circumstances in the household, and deciding to accept their fate. Their ability to implement these strategies depended on whether they were able to negotiate with their in-laws or husbands for resources. Conclusions Vulnerability, as a consequence of gender and social disadvantage, manifests as psychological distress among mothers in Dhanusha. Screening tools incorporating physical symptoms of tension should be envisaged, along with
Rani, Padmaja K; Raman, Rajiv; Subramani, Sarvanan; Perumal, Gnanamoorthy; Kumaramanickavel, Govindasamy; Sharma, Tarun
Diabetes mellitus, particularly type II, is a major public health concern worldwide. While the occurrence of diabetic retinopathy cannot be prevented, with the provision of knowledge to sufferers, sight-threatening complications can be minimized. To report the results of a KAP (Knowledge, Attitude and Practice) study among a rural population in two areas: diabetes mellitus (DM) and diabetic retinopathy (DR). The level of knowledge was evaluated for both DM and DR; however, the influence of knowledge on practices and attitude was evaluated in only the DR group. In rural areas, 145 awareness meetings on DM and DR were conducted attended 28 347 individuals. Using systematic random sampling, the data were collected from every 14th individual. In total, 1938 individuals from a rural population were numbered for gaining their responses to the KAP questionnaire. Univariate and multiple regression analyses were performed to identify independent risk factors related to the knowledge of the disease and influence of this knowledge on attitude and practice. Of 1938 individuals, 966 (49.9%) had knowledge of DM and 718 (37.1%) had knowledge of DR. Knowledge about DM was more in women (OR=1.93; 95% CI: 1.55-2.39), in subjects who followed the Christian faith (OR=1.48; 95% CI: 1.07-2.04) and in those who belonged to the upper socioeconomic strata (OR=2.60; 95% CI: 1.84-3.67). The knowledge of DR was significantly higher among subjects who spoke the Malayalam language (OR=3.80; 95% CI: 2.03-7.13), who followed the Christian faith (OR=1.73; 95% CI: 1.27-2.35), and in those who belonged to the upper socioeconomic strata (OR=1.85; 95% CI: 1.32-2.58). Compared with those who had no knowledge of DR (n = 1220), significant percentages of individuals with knowledge (n = 718) had the right attitude - to go for regular eye examinations - (65.9% vs 93.3%) (pawareness models to educate rural populations on DM and DR.
Rural communities face a dilemma in their efforts to keep pace with knowledge developments. Their remoteness makes access to knowledge of the outside world difficult, time-consuming, and costly. At the same time, the fact that there is access of a sort can mean that local knowledge becomes lost or discarded as somehow inferior. The pervasiveness…
Prasai Dixit, Lonim; Shakya, Ajay; Shrestha, Manash; Shrestha, Ayush
Chepang communities are one of the most deprived ethnic communities in Nepal. According to the National Pathfinder Survey, dental caries is a highly prevalent childhood disease in Nepal. There is no data concerning the prevalence of caries along with knowledge, attitude and oral hygiene practices among Chepang schoolchildren. The objectives of this study were to 1) record the prevalence of dental caries 2) report experience of dental pain 3) evaluate knowledge, attitude and preventive practices on oral health of primary Chepang schoolchildren. A cross sectional epidemiological study was conducted in 5 government Primary schools of remote Chandibhanjyang Village Development Committee (VDC) in Chitwan district. Ethical approval was taken from the Institutional Review Board within the Research Department of the Institute of Medicine (IOM) Tribhuvan University. Consent was obtained from parents for conducting clinical examination and administrating questionnaire. Permission was taken from the school principal in all schools. Data was collected using a pretested questionnaire on 131 schoolchildren aged 8-16-year- olds attending Grade 3-5. Clinical examination was conducted on 361 school children aged 5-16 -year-olds attending grade 1-5. Criteria set by the World Health Organization (1997) was used for caries diagnosis. The questionnaires, originally constructed in English and translated into Nepali were administered to the schoolchildren by the researchers. SPSS 11software was used for data analysis. Caries prevalence for 5-6 -year-old was above the goals recommended by WHO and Federation of Dentistry international (FDI) of less than 50% caries free children. Caries prevalence in 5-6-year-olds was 52% and 12-13-year-olds was 41%. The mean dmft/DMFT score of 5-6 -year-olds and 12 -13-year -olds was 1.59, 0.31 and 0.52, 0.84 respectively. The DMFT scores increased with age and the d/D component constituted almost the entire dmft/DMFT index. About 31% of 8-16-year
Scientific publications have become a mainstay of communication among readers, academicians, researchers and scientists worldwide. Although, its existence dates back to 17 th century in the West, Nepal is still struggling to take few steps towards improving its local science for last 50 years. Since the start of the first medical journal in 1963, the challenges remains as it were decades back regarding role of authors, peer reviewers, editors and even publishers in Nepal. Although, there has been some development in terms of the number of articles being published and appearances of the journals, yet there is a long way to go. This article analyzes the past and present scenario, and future perspective for scientific publications in Nepal.
Access to modern energy services derived from renewable sources is a prerequisite, not only for economic growth, rural development and sustainable development, but also for energy security and climate change mitigation. The least developed countries (LDCs) primarily use traditional biomass and have little access to commercial energy sources. They are more vulnerable to problems relating to energy security, air pollution, and the need for hard-cash currency to import fossil fuels. This thesis evaluates sugarcane-molasses bioethanol, a renewable energy source with the potential to be used as a transport fuel in Nepal. Sustainability aspects of molasses-based ethanol have been analyzed. Two important indicators for sustainability, viz. net energy and greenhouse gas (GHG) balances have been used to assess the appropriateness of bioethanol in the life cycle assessment (LCA) framework. This thesis has found that the production of bioethanol is energy-efficient in terms of the fossil fuel inputs required to produce it. Life cycle greenhouse gas (GHG) emissions from production and combustion are also lower than those of gasoline. The impacts of important physical and market parameters, such as sugar cane productivity, the use of fertilizers, energy consumption in different processes, and price have been observed in evaluating the sustainability aspects of bioethanol production. The production potential of bioethanol has been assessed. Concerns relating to the fuel vs. food debate, energy security, and air pollution have also been discussed. The thesis concludes that the major sustainability indicators for molasses ethanol in Nepal are in line with the goals of sustainable development. Thus, Nepal could be a good example for other LDCs when favorable governmental policy, institutional set-ups, and developmental cooperation from donor partners are in place to strengthen the development of renewable energy technologies
Yan, Y W; Yan, J; Zhang, G P; Gao, Z L; Jian, H X
Abuse of the injection services, namely unnecessary injections and unsafe injections, exists extensively in developing countries. Unsafe injection practices contribute to the transmission of blood-borne pathogens. The aims of this study were to survey the prevalence of injections and knowledge of injection safety among the rural residents in Jingzhou district, Hubei, China and to provide scientific data for developing a health educational programme. A retrospective cross-sectional study was conducted in 12 villages, which were selected from the Jingzhou district by the random sampling method. 50 rural residents were interviewed per village using a questionnaire. Among the 595 residents studied, 192 had received at least one injection in the past three months, with an injection prevalence of 32.3 percent and an average of 0.93 injections. 90.3 percent of the rural residents knew that unsafe injections could transmit the following blood-borne pathogens: human immunodeficiency virus (74.4 percent), hepatitis B virus (55.8 percent) and hepatitis C virus (22.9 percent). Logistic regression analysis showed that the residents' age, educational level and residential area were important factors in influencing their knowledge about injection safety. The results indicated that the injection prevalence was high among rural residents in the study area, and their knowledge regarding injection safety should be further improved.
Rodrigo dos Santos Crepalde
Full Text Available ABSTRACT: The treatment given to traditional knowledge by school science tends to devalue it, subjecting it to naive, common sense, and even mythological vision. As a way of promoting dialogue and exchange between different cultures, which populate the classroom, interculturallity assumes that science education should be considered as the acquisition of yet another culture, without overcoming the validity of the others. This article presents a concrete case of teaching and learning of the physical sciences as an example of promoting the recognition of traditional knowledge about the Moon in a context of intercultural rural science teacher education. They are discussed representative excerpts of written productions of undergraduate rural education, major in natural sciences, conducted in the discipline of Introduction to Physics that aimed to argue about how scientific and traditional knowledge are related to the Moon and its implications for science teaching. It is noted that traditional knowledge is strongly intertwined with the social practices of communities of these graduates, pointing out the necessary inclusion of this knowledge in the intercultural rural science teacher education that stimulates the exchange and mutual enrichment.
Full Text Available Abstract Background Bharatpur Eye Hospital in Chitwan District, a primarily agrarian setting in south-central Nepal, reduced the number of diagnostic screening and treatment (DST camps by one half (151 to 75 in an attempt to increase both the efficiency of its outreach program and the number of people that go directly to the hospital for service. The Hospital evaluated the two program models in terms of program costs, cataract surgical utilization, hospital direct payment and patient equity. Methods The study is a prospective, before and after, study of the impact of an alternate outreach model on cataract service utilization patterns and cost per outreach camp and cost per cataract surgery at Bharatpur Eye Hospital, comparing the service years July 2006 to June 2007, with July 2007 to June 2008. Study findings were based on routinely gathered hospital and outreach administrative data. Results The total cost of the DST camps decreased by approximately US$2000. The cost per camp increased from US$52 to $78 and the cost per cataract surgery decreased from US$ 3.80 to $3.20. The number of patients who went directly to the hospital, and paid for cataract surgery, increased from 432 (17% to 623 (25%. The total number of cataract surgical procedures at Bharatpur Eye Hospital remained very similar between the two service years (2501 and 2449, respectively. The presenting visual acuity and sex of the two cataract surgical populations were very similar (favouring women, 53 and 55% in the two years, respectively. A shift toward younger men and women occurred with a 245 (64% increase in people age 50-59 years, and shift away from people age 70 years and older with a 236 (22% reduction. The age and sex distribution of the direct paying patients were very similar in the two years. Conclusion The new, more concentrated, more rural DST model of service delivery reduced overall outreach program costs, cost per cataract surgery transported, while increasing
Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie
Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15-49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted.
Meilby, Henrik; Smith-Hall, Carsten; Byg, Anja
community managed forests in Nepal, using data from 240 permanent sample plots and a structured household survey conducted in 2006 and 2009 (n = 507 and 558, respectively). We find that analyses of sustainability need to recognize the complexity of forest stand utilization, and that there is considerable...... scope, by altering how existing local forest management rules are implemented, for increasing rural household forest incomes while keeping harvesting levels sustainable....
McAdoo, Brian G.; Sudmeier, Karen; Devkota, Sanjaya
During the first monsoon season following the deadly 2015 Gorkha earthquake, 27 people were killed during two events in Nepal's Western Region due to debris flows triggered by a 24-hour, 315 mm cloudburst (Devkota et al. 2015). Both events were linked with roads: the first was caused by an accumulation of water on a newly constructed road above a steep, deforested slope, the second wiped out a major road and destroyed 10 houses. These deadly landslides were not triggered solely by extreme rainfall, but rather a complex combination of earthquakes, intensified rainfall associated with climate change and an explosion of unplanned rural road construction fueled by an increase in foreign investment, remittances and decentralisation of budgets and power from the central government to local villages. This complexity is explored through a trend data analysis on the number of landslides, landslide fatalities, rainfall intensity, and the road network in Nepal between 1980-2014 (McAdoo et al, submitted). Of most concern are the poorly constructed roads in Nepal's Middle Hill districts ( 1000-3000 m above sea level, humid, subtropical) as they are proliferating at an unprecedented pace without proper alignment, drainage, grading or maintenance. They are occurring in areas which frequently receive up to 4,000-5,000 mm of precipitation per year, causing considerable loss in lives, livelihoods and investment. Landslide fatalities increased from 88 on average for the period 1982-1995 to 130 deaths per year for the period 2007-2014 (Desinventar, 2016). Contrary to numerous studies which show a strong link between rainfall and landslides, our trend analysis demonstrates a decoupling of climate and the geomorphic drivers, pointing to other factors, namely the exponential road construction trend to explain the increase in landslide fatalities. Nepal has some of the oldest manuals and well-trained cadres in low-cost green engineering practices, yet these are rarely applied. To reverse
Full Text Available Rabies is highly prevalent in India. It is almost always fatal but preventable by timely administration of vaccine and proper wound care. Rural population have high disease burden. This may be partly due to lack of knowledge regarding the disease. Objectives- To identify the knowledge, attitude & practice of rural people attending in a rural hospital for animal bite management. Materials and Methods- Cross sectional observational study with 119 patients (period prevalence in February 2013. Results- Dogs were the main biting animal (87.4%. Children were the main victim(47.9%. 21% (25 of the respondent said that animal bite may lead to rabies. Neighbors were the main source of knowledge (38.7%. Mean duration of delay in presenting to hospital was 5.02 days. Roughly one third applied soap water to clean the wound. Attitude and practice was significantly associated with knowledge and attitude respectively (p<0.05. Conclusion- Rural population lack enough knowledge on rabies. Targeted group approach like educating mother and children may help improving health care utilization correctly.
Buunk-Werkhoven, Yvonne; Dijkstra, Arie; Bink, Pim; van Zanten, Sarah; van der Schans, Cees
The purpose of this study was to identify predictors of oral hygiene behaviour (OHB) based on the Theory of Planned Behaviour (TPB) among dental care seekers in two cultural different regions: the Caribbean (Aruba/Bonaire) and Nepal. In addition, measures of oral health knowledge (OHK) and the
Devleesschauwer, Brecht; Aryal, Arjun; Sharma, Barun Kumar; Ale, Anita; Declercq, Anne; Depraz, Stephanie; Gaire, Tara Nath; Gongal, Gyanendra; Karki, Surendra; Pandey, Basu Dev; Pun, Sher Bahadur; Duchateau, Luc; Dorny, Pierre; Speybroeck, Niko
Background Rabies is a vaccine-preventable viral zoonosis belonging to the group of neglected tropical diseases. Exposure to a rabid animal may result in a fatal acute encephalitis if effective post-exposure prophylaxis is not provided. Rabies occurs worldwide, but its burden is disproportionately high in developing countries, including Nepal. We aimed to summarize current knowledge on the epidemiology, impact and control of rabies in Nepal. Methods We performed a systematic review of international and national scientific literature and searched grey literature through the World Health Organization Digital Library and the library of the National Zoonoses and Food Hygiene Research Centre, Nepal, and through searching Google and Google Scholar. Further data on animal and human rabies were obtained from the relevant Nepalese government agencies. Finally, we surveyed the archives of a Nepalese daily to obtain qualitative information on rabies in Nepal. Findings So far, only little original research has been conducted on the epidemiology and impact of rabies in Nepal. Per year, rabies is reported to kill about 100 livestock and 10–100 humans, while about 1,000 livestock and 35,000 humans are reported to receive rabies post-exposure prophylaxis. However, these estimates are very likely to be serious underestimations of the true rabies burden. Significant progress has been made in the production of cell culture-based anti-rabies vaccine and rabies immunoglobulin, but availability and supply remain a matter of concern, especially in remote areas. Different state and non-state actors have initiated rabies control activities over the years, but efforts typically remained focalized, of short duration and not harmonized. Communication and coordination between veterinary and human health authorities is limited at present, further complicating rabies control in Nepal. Important research gaps include the reporting biases for both human and animal rabies, the ecology of stray
Full Text Available Rabies is a vaccine-preventable viral zoonosis belonging to the group of neglected tropical diseases. Exposure to a rabid animal may result in a fatal acute encephalitis if effective post-exposure prophylaxis is not provided. Rabies occurs worldwide, but its burden is disproportionately high in developing countries, including Nepal. We aimed to summarize current knowledge on the epidemiology, impact and control of rabies in Nepal.We performed a systematic review of international and national scientific literature and searched grey literature through the World Health Organization Digital Library and the library of the National Zoonoses and Food Hygiene Research Centre, Nepal, and through searching Google and Google Scholar. Further data on animal and human rabies were obtained from the relevant Nepalese government agencies. Finally, we surveyed the archives of a Nepalese daily to obtain qualitative information on rabies in Nepal.So far, only little original research has been conducted on the epidemiology and impact of rabies in Nepal. Per year, rabies is reported to kill about 100 livestock and 10-100 humans, while about 1,000 livestock and 35,000 humans are reported to receive rabies post-exposure prophylaxis. However, these estimates are very likely to be serious underestimations of the true rabies burden. Significant progress has been made in the production of cell culture-based anti-rabies vaccine and rabies immunoglobulin, but availability and supply remain a matter of concern, especially in remote areas. Different state and non-state actors have initiated rabies control activities over the years, but efforts typically remained focalized, of short duration and not harmonized. Communication and coordination between veterinary and human health authorities is limited at present, further complicating rabies control in Nepal. Important research gaps include the reporting biases for both human and animal rabies, the ecology of stray dog
Full Text Available A cross-sectional study on S6 females was conducted in the rural and urban areas of Lucknow district of Uttar Pradesh to assess the knowledge of females about exclusive breast-feeding. Knowledge from adolescent girls, married and lactating women was assessed by a pretested questionnaire for biosocial correlates (such as marital status,educational status, medium of education, working status, socio-economics status and family size, sources of information, time of initation of breast-feeding and the best method of feeding a baby <4 months of age. Only 9.8% in urban and 13.3% in rural areas had complete knowledge of Exclusive breast-feeding. Educated females had more knowledge in both urban and rural areas of initiating breast-feeding within 1 hr of delivery as compared to un-educated females. The study highlights the needs for continuing medical education and for including knowledge about Exclusive breast-feeding in school curriculum of adolescent girls.
Sathian, Brijesh; Babu, M G Ramesh; van Teijlingen, Edwin R; Banerjee, Indrajit; Roy, Bedanta; Subramanya, Supram Hosuru; Rajesh, Elayedath; Devkota, Suresh
The Human Papillomavirus (HPV) is strongly associated with cervical and other cancers. In women, cervical cancer is the third most common cancer. HPV infection can be largely prevented through vaccination of (adolescent) girls. At the same time, Nepal is a low-income country experiencing a cultural change in attitudes towards sex and sexual behaviour. However, in the adolescent population knowledge about HPV, factors associated with an increased risk of HPV and the existence of the vaccination is often low. This was a cross-sectional study with female students enrolled in health and non-health science courses in Pokhara, Nepal. The questionnaire included demographic details, knowledge and attitude questions related to HPV, associated risk behaviour and its vaccination. Descriptive statistics, including Chi-Square test, were used to identify statistically significant relationships. Ethical approval was granted by the relevant authority in Nepal. Hindu religion (75.0 %; 95% CI: 70.9, 78.6) and Newari caste (75.5%; CI: 61.1, 86.7) were more aware about HPV, HPV vaccination. Hindus religion (55.6%; 95% CI: 51.2, 60.0) and Dalit caste (61.6%, 95% CI: 53.3, 69.4) more willing to be vaccinated than other religions and other castes, respectively. Not unsurprisingly, students on health-related courses had a greater awareness of HPV, HPV vaccination and were more willing to be vaccinated than students on other courses. Similar patterns of association arose for knowledge related to those sexually active at an early age; HPV risk and multiple sex partners; and fact that condoms cannot fully prevent the transmission of HPV. Knowledge about the link between HPV and (a) early sexual initiation, (b) having multiple sexual partners, and (c) the limited protection of condoms and other birth control measures was poor in our study compared to similar research conducted in other parts of the world. One key implication is the need for education campaigns in Nepal to educate young women
Babu, M G Ramesh; van Teijlingen, Edwin R.; Banerjee, Indrajit; Roy, Bedanta; Subramanya, Supram Hosuru; Rajesh, Elayedath; Devkota, Suresh
Background: The Human Papillomavirus (HPV) is strongly associated with cervical and other cancers. In women, cervical cancer is the third most common cancer. HPV infection can be largely prevented through vaccination of (adolescent) girls. At the same time, Nepal is a low-income country experiencing a cultural change in attitudes towards sex and sexual behaviour. However, in the adolescent population knowledge about HPV, factors associated with an increased risk of HPV and the existence of the vaccination is often low. Materials and Methods: This was a cross-sectional study with female students enrolled in health and non-health science courses in Pokhara, Nepal. The questionnaire included demographic details, knowledge and attitude questions related to HPV, associated risk behaviour and its vaccination. Descriptive statistics, including Chi-Square test, were used to identify statistically significant relationships. Ethical approval was granted by the relevant authority in Nepal. Results: Hindu religion (75.0 %; 95% CI: 70.9, 78.6) and Newari caste (75.5%; CI: 61.1, 86.7) were more aware about HPV, HPV vaccination. Hindus religion (55.6%; 95% CI: 51.2, 60.0) and Dalit caste (61.6%, 95% CI: 53.3, 69.4) more willing to be vaccinated than other religions and other castes, respectively. Not unsurprisingly, students on health-related courses had a greater awareness of HPV, HPV vaccination and were more willing to be vaccinated than students on other courses. Similar patterns of association arose for knowledge related to those sexually active at an early age; HPV risk and multiple sex partners; and fact that condoms cannot fully prevent the transmission of HPV. Conclusion: Knowledge about the link between HPV and (a) early sexual initiation, (b) having multiple sexual partners, and (c) the limited protection of condoms and other birth control measures was poor in our study compared to similar research conducted in other parts of the world. One key implication is the need
Jhalendra P. Rijal
Full Text Available Farmers’ knowledge on pesticides and their safe use are critical for implementing effective pest management program. A household survey was conducted using the semi-structured questionnaire to evaluate vegetable growers’ knowledge on pesticide safety and pest management practices in Nepal. Results indicated that chemical pesticides were the primary choice of over 80% growers for pest management. Notably, 90% growers were aware of adverse effects of pesticides on human health and to the environment. Over 84% growers used at least one form of personal protection equipment (PPE during pesticide spray or handling, although the quality and appropriateness of the PPE warrants further investigation. Nearly 17% growers received at least one short-term training on integrated pest management (IPM; however, all of them neither knew the harmful effects of pesticide residues nor practiced proper pesticide disposal methods. Over 90% of growers rely on local pesticide retailers (i.e., Agro-vets for technical know-how about pesticide selection, handling, and use. This study highlighted a need for immediate implementation of strict pesticide use regulations and recommended educational programs for pest control professionals, growers, and pesticide retailers.
Heinen, Joel T.; Kattel, Bijaya
Nepal is considered a leader among developing nations with regard to conservation legislation and programs; it was among the first Asian nations to develop national conservation legislation, sign CITES, and develop a national conservation strategy. We review the history of modern conservation law in Nepal from the Rana period (early 1950s) to the present. The early legislation focused mainly on strict preservation of areas and species; this phase culminated in the National Parks and Wildlife Conservation Act of 1973. Subsequent legislation has evolved more in the direction of an integrated, holistic approach to conservation and is beginning to incorporate the participation of local people; subsequent amendments to the 1973 act allowed greater rights to rural villagers, and the designation of conservation areas in addition to the more strictly defined protected areas (national parks, wildlife reserves, etc.). Our review of conservation legislation suggests that Nepal has had many successes to date; the country has a protected area system covering over 10% of its land area, and many target species are recovering in parks and reserves. There are also some causes of concern, including staff shortages, financial constraints within the Department of National Parks and Wildlife Conservation, and the fact that there is little legal infrastructure outside of protected areas to enforce conservation laws; further, some aspects of hunting regulations are in need of revision. Primary needs include a comprehensive review of these policies and a nationalized strategy to ameliorate the shortcomings.
Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, Pathiyil Ravi; Kumar, Vikash K C; Maskey, Manisha; Jha, Nisha
Previous studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1) quantify injection usage, 2) identify injection providers, 3) explore differences, if any, in injection usage and injection providers, and 4) study and compare people's knowledge and perception about injections between the urban and rural areas of Kaski district. A descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions (FGDs). A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held. In 218 households (36.33%) [99 in urban and 119 in rural] one or more members received at least one injection. During the three month recall period, 258 subjects (10.44%) reported receiving injection(s) with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers (34.8%), staff of medical dispensaries (37.7%), physicians (25.2%), and traditional healers (2.3%) were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever (p injections due to injections being perceived by them as being powerful, fast-acting, and longer lasting than oral pills. More than 82% of respondents were aware of, and named, at least one disease transmitted by using unsterile syringes during injection administration or when syringes are shared between people. Less preference for injections and high awareness about the association between injections and injection
Uprety, Y.; Shrestha, U. B.; Rokaya, Maan Bahadur; Shrestha, S.; Chaudhary, R. P.; Thakali, A.; Cockfield, G.; Asselin, H.
Roč. 9, č. 7 (2017), s. 649-661 ISSN 1756-5529 R&D Projects: GA MŠk(CZ) LO1415 Institutional support: RVO:86652079 Keywords : climate change * local communities * Himalaya * Nepal * traditional knowledge Subject RIV: EH - Ecology, Behaviour OBOR OECD: Environmental sciences (social aspects to be 5.7) Impact factor: 2.051, year: 2016
Full Text Available Sustainable Development Goals (SDGs comprise of 17 goals and 169 targets. All SDGs are interlinked to produce synergetic eff ects and emphasize health in all policies. Among the 17 Goals, Goal 3 has a central focus on health, which is underpinned by 13 targets. The other 16 goals are also directly or indirectly related to health and will contribute to achieving the associated targets for Goal 3. The ambitious SDG agenda and their progress can be tracked by measuring numerous goals, targets, and indicators. The main objective of this paper is to provide an overview about how health- related SDGs and their targets and indicators are being tracked in the national context of Nepal. Adequate investment in research for knowledge generation, capacity building and innovation, and continous research communication among policy makers, researchers and external development partners will contribute to tracking the progress of SDGs in Nepal.
Ikwegbue, Joseph N; Ross, Andrew; Ogbonnaya, Harbor
Medical male circumcision (MMC) is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC. This study employs quantitative data to expand insight into rural Zulu women's knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons. A hospital-based antenatal clinic in rural KwaZulu-Natal. Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively. The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital. Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.
Yadoo, Annabel; Gormally, Alexandra; Cruickshank, Heather
Low-carbon off-grid electrification for rural areas is becoming increasingly popular in the United Kingdom. However, many developing countries have been electrifying their rural areas in this way for decades. Case study fieldwork in Nepal and findings from United Kingdom based research will be used to examine how developed nations can learn from the experience of developing countries with regard to the institutional environment and delivery approach adopted in renewable energy off-grid rural electrification. A clearer institutional framework and more direct external assistance during project development are advised. External coordinators should also engage the community in a mobilization process a priori to help alleviate internal conflicts of interest that could later impede a project. - Highlights: → Development of community renewable energy projects in the UK is commended. → The UK can benefit from the experience of successful programmes in Nepal. → A clearer institutional framework and more direct external assistance is required. → External coordinators should engage the community in a mobilization process.
Silwal Ram C
Full Text Available Abstract Background The challenge of delivering multiple, complex messages to promote maternal and newborn health in the terai region of Nepal was addressed through training Female Community Health Volunteers (FCHVs to counsel pregnant women and their families using a flipchart and a pictorial booklet that was distributed to clients. The booklet consists of illustrated messages presented on postcard-sized laminated cards that are joined by a ring. Pregnant women were encouraged to discuss booklet content with their families. Methods We examined use of the booklet and factors affecting adoption of practices through semi-structured interviews with district and community-level government health personnel, staff from the Nepal Family Health Program, FCHVs, recently delivered women and their husbands and mothers-in-law. Results The booklet is shared among household members, promotes discussion, and is referred to when questions arise or during emergencies. Booklet cards on danger signs and nutritious foods are particularly well-received. Cards on family planning and certain aspects of birth preparedness generate less interest. Husbands and mothers-in-law control decision-making for maternal and newborn care-seeking and related household-level behaviors. Conclusions Interpersonal peer communication through trusted community-level volunteers is an acceptable primary strategy in Nepal for promotion of household-level behaviors. The content and number of messages should be simplified or streamlined before being scaled-up to minimize intervention complexity and redundant communication.
Poudel, Kamal Kumar
In Nepal, unlike elsewhere, local studies have almost continually suggested that there has not been adequate reflection of the teacher training output in the real classroom situation. English teachers commonly blame on the unfavourable environment as the main obstacle to the successful classroom application of their knowledge and skills needed for…
Dahal, R. K.; Hasegawa, S.; Bhandary, N. P.; Yatabe, R.
A large number of human settlements on the Nepal Himalayas are situated either on old landslide mass or on landslide-prone areas. As a result, a great number of people are affected by large- and small-scale landslides all over the Himalayas especially during monsoon periods. In Nepal, only in the half monsoon period (June 10 to August 15), 70, 50 and 68 people were killed from landslides in 2007, 2008 and 2009, respectively. In this context, this paper highlights monsoon rainfall and their implications in the Nepal Himalaya. In Nepal, monsoon is major source of rainfall in summer and approximately 80% of the annual total rainfall occurs from June to September. The measured values of mean annual precipitation in Nepal range from a low of approximately 250 mm at area north of the Himalaya to many areas exceeding 6,000 mm. The mean annual rainfall varying between 1500 mm and 2500 mm predominate over most of the country. In Nepal, the daily distribution of precipitation during rainy season is also uneven. Sometime 10% of the total annual precipitation can occur in a single day. Similarly, 50% total annual rainfall also can occur within 10 days of monsoon. This type of uneven distribution plays an important role in triggering many landslides in Nepal. When spatial distribution of landslides was evaluated from record of more than 650 landslides, it is found that more landslides events were concentrated at central Nepal in the area of high mean annual rainfall. When monsoon rainfall and landslide relationship was taken into consideration, it was noticed that a considerable number of landslides were triggered in the Himalaya by continuous rainfall of 3 to 90 days. It has been noticed that continuous rainfall of few days (5 days or 7 days or 10 days) are usually responsible for landsliding in the Nepal Himalaya. Monsoon rains usually fall with interruptions of 2-3 days and are generally characterized by low intensity and long duration. Thus, there is a strong role of
Full Text Available Investing in human capital and social infrastructure represents the most important concern for the greatentrepreneurs in Romania, aiming to use the complete potential of women and men. The studies in this paper wereperformed in 2012 on a sample of 207 rural entrepreneurs, men and women, where there were pursued withmanagement experts, their knowledge of the values, behavior and entrepreneurial motivations, about managementknowledge and experience about mutual perceptions of business people. The information obtained was processedand stored electronically in order to improve the deficiencies found in rural areas, and to identify their trends in thelabor market. Differences between regions of training, knowledge, perception, adaptation and acceptance ofentrepreneurship training through courses made this research to be beneficial in order to take appropriatemeasures to increase the effectiveness of entrepreneurship in rural SW Oltenia.
Gram, Lu; Morrison, Joanna; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma; Costello, Anthony; Saville, Naomi; Skordis-Worrall, Jolene
Despite the rising popularity of indicators of women's empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen's notion of agency freedom in rural Nepal. Analysis of think-aloud interviews ( n = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample ( n = 511) suggested two positively correlated factors ( r = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample ( n = 509) revealed good fit (Root Mean Square Error of Approximation 0.05-0.08, Comparative Fit Index 0.91-0.99). In conclusion, we caution against uncritical use of agency-based quantification of women's empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom.
Full Text Available Background: The prevalence of hypertension is increasing in Nepal. Thus, there is a need for a programme to improve primary healthcare. One possibility is to assign prevention, diagnosis, and treatment of hypertension to female community health volunteers (FCHVs. Objective: To assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs. Design: Five focus group discussions (FGDs were conducted with a total of 69 FCHVs in Lekhnath municipality, Kaski district, Nepal. Seven themes were developed on the basis of data collection: 1 knowledge about hypertension; 2 risk factors of hypertension; 3 prevention and control of hypertension; 4 access to treatment for hypertension in the community; 5 learning about blood pressure measurement; 6 ability to raise blood pressure awareness in the community; 7 possible challenges for their future involvement. Data were analysed using the thematic analysis approach. Results: FCHVs have some knowledge about diagnosis, risk factors, and complications of hypertension. General unanimity was observed in the understanding that hypertension and risk factors needed to be addressed. The willingness of FCHVs to contribute to prevention, control, and management was strong, and they were confident that with some basic training they could obtain skills in hypertension management. Conclusions: Despite limited knowledge about hypertension, FCHVs expressed willingness and readiness to be trained in hypertension management. This study supports the possibility of involving FCHVs in prevention and control of hypertension in Nepal.
Sukums, Felix; Mensah, Nathan; Mpembeni, Rose; Kaltschmidt, Jens; Haefeli, Walter E; Blank, Antje
The QUALMAT (Quality of Maternal and Prenatal Care: Bridging the Know-do Gap) project has introduced an electronic clinical decision support system (CDSS) for pre-natal and maternal care services in rural primary health facilities in Burkina Faso, Ghana, and Tanzania. To report an assessment of health providers' computer knowledge, experience, and attitudes prior to the implementation of the QUALMAT electronic CDSS. A cross-sectional study was conducted with providers in 24 QUALMAT project sites. Information was collected using structured questionnaires. Chi-squared tests and one-way ANOVA describe the association between computer knowledge, attitudes, and other factors. Semi-structured interviews and focus groups were conducted to gain further insights. A total of 108 providers responded, 63% were from Tanzania and 37% from Ghana. The mean age was 37.6 years, and 79% were female. Only 40% had ever used computers, and 29% had prior computer training. About 80% were computer illiterate or beginners. Educational level, age, and years of work experience were significantly associated with computer knowledge (pworkplace. Given the low levels of computer knowledge among rural health workers in Africa, it is important to provide adequate training and support to ensure the successful uptake of electronic CDSSs in these settings. The positive attitudes to computers found in this study underscore that also rural care providers are ready to use such technology.
Bossavie, Laurent; Denisova, Anastasiya
This descriptive study investigates internal and external labor migration by Nepalese youth. External labor migration is separated into the flow to India, which is unregulated, and the flow to other countries, which typically takes the form of temporary contract migration to countries with bilateral labor agreements with Nepal (referred to in Nepal as foreign employment). The study finds t...
Menda Teodora - Adriana
Full Text Available Currently in Romania, the information sources available to farmers are limited and belong mostly to the public sector. The knowledge provided is relevant but insufficient in order to meet the needs of the Romanian farmers, especially since they are not oriented towards the market, as the main segment of interest. This paper has the intention to emphasize the need to introduce ICT as the main tool in supporting the decision making process and in resolving the specific issues faced by this sector In analyzing the current situation regarding this matter, in order to propose ways to resolve the problems encountered in achieving knowledge transfer, until now, were addressed issues such as: the evolution of the knowledge transfer concept, development milestones and actions that marked the RDI sector as the main producer of information, the main supporters of the farmers in their information actions (World Bank, IFAD, means, procedures and techniques used for transmitting knowledge (extension; consultancy. But what is most important is making all this resulted information available for the farmers, fact which can only be accomplished, in our opinion, by introducing and implementing ICT in the rural areas. The main method of research is the statistical data analysis of the data regarding the components involved in the knowledge transfer process and the current status of implementation of ICT in the rural areas. Among the expected results are included identifying the main restrictive factors in achieving knowledge transfer in rural and the main implications that implementing ICT would have on farmers' market position. Introducing ICT in the rural area is, in our opinion the best way to transform information, as a research result, into knowledge, becoming this way a real input for the farmer In practice, this will lead to lower production costs, lower prices for inputs, increased revenues by increasing the production’s prices and, not least, increased
Neupane, Maniraj; Basnyat, Buddha; Fischer, Rainald; Froeschl, Guenter; Wolbers, Marcel; Rehfuess, Eva A
Background More than two fifths of the world's population cook with solid fuels and are exposed to household air pollution (HAP). As of now, no studies have assessed whether switching to alternative fuels like biogas could impact cardiovascular health among cooks previously exposed to solid fuel use. Methods We conducted a propensity score matched cross-sectional study to explore if the sustained use of biogas fuel for at least ten years impacts blood pressure among adult female cooks of rural Nepal. We recruited one primary cook ≥30 years of age from each biogas (219 cooks) and firewood (300 cooks) using household and measured their systolic (SBP) and diastolic blood pressure (DBP). Household characteristics, kitchen ventilation and 24-h kitchen carbon monoxide were assessed. We matched cooks by age, body mass index and socio-economic status score using propensity scores and investigated the effect of biogas use through multivariate regression models in two age groups, 30–50 years and >50 years to account for any post-menopausal changes. Results We found substantially reduced 24-h kitchen carbon monoxide levels among biogas-using households. After matching and adjustment for smoking, kitchen characteristics, ventilation status and additional fuel use, the use of biogas was associated with 9.8 mmHg lower SBP [95% confidence interval (CI), −20.4 to 0.8] and 6.5 mmHg lower DBP (95% CI, −12.2 to −0.8) compared to firewood users among women >50 years of age. In this age group, biogas use was also associated with 68% reduced odds [Odds ratio 0.32 (95% CI, 0.14 to 0.71)] of developing hypertension. These effects, however, were not identified in younger women aged 30–50 years. Conclusions Sustained use of biogas for cooking may protect against cardiovascular disease by lowering the risk of high blood pressure, especially DBP, among older female cooks. These findings need to be confirmed in longitudinal or experimental studies. PMID:25460655
Neupane, Maniraj; Basnyat, Buddha; Fischer, Rainald; Froeschl, Guenter; Wolbers, Marcel; Rehfuess, Eva A
More than two fifths of the world's population cook with solid fuels and are exposed to household air pollution (HAP). As of now, no studies have assessed whether switching to alternative fuels like biogas could impact cardiovascular health among cooks previously exposed to solid fuel use. We conducted a propensity score matched cross-sectional study to explore if the sustained use of biogas fuel for at least ten years impacts blood pressure among adult female cooks of rural Nepal. We recruited one primary cook ≥ 30 years of age from each biogas (219 cooks) and firewood (300 cooks) using household and measured their systolic (SBP) and diastolic blood pressure (DBP). Household characteristics, kitchen ventilation and 24-h kitchen carbon monoxide were assessed. We matched cooks by age, body mass index and socio-economic status score using propensity scores and investigated the effect of biogas use through multivariate regression models in two age groups, 30-50 years and >50 years to account for any post-menopausal changes. We found substantially reduced 24-h kitchen carbon monoxide levels among biogas-using households. After matching and adjustment for smoking, kitchen characteristics, ventilation status and additional fuel use, the use of biogas was associated with 9.8 mmHg lower SBP [95% confidence interval (CI), -20.4 to 0.8] and 6.5 mmHg lower DBP (95% CI, -12.2 to -0.8) compared to firewood users among women >50 years of age. In this age group, biogas use was also associated with 68% reduced odds [Odds ratio 0.32 (95% CI, 0.14 to 0.71)] of developing hypertension. These effects, however, were not identified in younger women aged 30-50 years. Sustained use of biogas for cooking may protect against cardiovascular disease by lowering the risk of high blood pressure, especially DBP, among older female cooks. These findings need to be confirmed in longitudinal or experimental studies. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Nepal has recently ratified Kyoto Protocol, which considers justifiable use of resources to limit or reduce the emission of gases that contribute to green house gas inventory in the atmosphere. Nepal's per capita green gas (GHG) emission from energy use is insignificant. However, it is important for Nepal to adopt environmentally friendly energy options based on local resources like hydropower and biomass. Nepal can benefit from the provisions of clean development mechanism (CDM) under the Kyoto Protocol of the United Nations Framework Convention on Climate Change (UNFCC) or carbon funds being promoted by various organizations in order to obtain funding for new projects that reduce GHG emissions (ER). Funding can be generated through Carbon trading in international market as well. In this paper, the country's current contribution to GHG due to energy consumption is evaluated. Options for promoting more sustainable and environmentally friendly projects have also been discussed
British Army states that they have selected 310 recruits from Nepal, among which 230 will go to the British Army and the remaining 80 will join the...Workers’ Union 12. All Nepal Hotel and Restaurant Workers’ Union 13. All Nepal Carpet Workers’ Union 14. All Nepal Meter Tempo Workers’ Union 15
Yadoo, Annabel; Cruickshank, Heather
The electricity sectors of many developing countries underwent substantial reforms during the 1980s and 1990s, driven by global agendas of privatization and liberalization. However, rural electrification offered little by way of market incentives for profit-seeking private companies and was often neglected. As a consequence, delivery models for rural electrification need to change. This paper will review the experiences of various rural electrification delivery models that have been established in developing countries, including concessionary models, dealership approaches and the strengthening of small and medium-sized energy businesses. It will use examples from the USA, Bangladesh and Nepal, together with a detailed case study of a Nepali rural electric cooperative, to explore the role that local cooperatives can play in extending electricity access. It is shown that although there is no magic bullet solution to deliver rural electrification, if offered appropriate financial and institutional support, socially orientated cooperative businesses can be a willing, efficient and effective means of extending and managing rural electricity services. It is expected that this paper will be of particular value to policy-makers, donors, project planners and implementers currently working in the field of rural electrification.
Prakash Prasad Sapkota
Full Text Available This study is carried out to explore the socio-cultural condition, knowledge and changing pattern for their environmental adaptation of Magar inhabitant at Bukini Tityang V.D.C. of western Nepal. There are 73 households of 450 population. The major subsistence activity of the local people is agriculture and animal husbandry. The economic condition of the majority of families is medium. Expenditure of the families has been increasing in high rate which raised question about cohesive bond of social structure. Out of total population, 76.67% are literate that is greater than national level. Young literate people do not have their applied knowledge in agricultural production and are also not attracted as well as interested about it. Most of the people are aware of the health and sanitation. Due to migration from different places co-dominance has occurred between different clans. This phenomenon is not only in cultural activity but also in physical structure of the children. There are 86 plant species used to heal the human and domestic animal diseases, 17 species for fodder, 14 species for making agricultural equipment, 25 species as wild fruits and 23 species for different rituals and ceremonies. The elder Magars are rich in indigenous knowledge while the younger are not. If older generation dies their knowledge will be vanished. The effect of modernization and acculturation leads towards the increasing rate of dependency about fooding, clothing and recreation activity which directly change the behavior of the local people.Key Words: Ethnic group, Indigenous knowledge, ethno-ecology; Magar, Baglung, NepalDOI = 10.3126/dsaj.v2i0.1366Dhaulagiri Journal of Sociology and Anthropology Vol.2 pp.227-252
Rodil, Kasper; Winschiers-Theophilus, Heike; Bidwell, Nicola J.
Current views of sustainable development recognize the importance of accepting the Indigenous Knowledge (IK) of rural people. However, there is an increasing technological gap between Elder IK holders and the younger generation and a persistent incompatibility between IK and the values, logics an...
In 2002 Nepal's parliament passed a liberal abortion law, after nearly three decades of reform efforts. This paper reviews the history of the movement for reform and the combination of factors that contributed to its success. These include sustained advocacy for reform; the dissemination of knowledge, information and evidence; adoption of the reform agenda by the public sector and its leadership in involving other stakeholders; the existence of work for safe motherhood as the context in which the initiative could gain support; an active women's rights movement and support from international and multilateral organisations; sustained involvement of local NGOs, civil society and professional organisations; the involvement of journalists and the media; the absence of significant opposition; courageous government officials and an enabling democratic political system. The overriding rationale for reforming the abortion law in Nepal has been to ensure safe motherhood and women's rights. The first government abortion services officially began in March 2004 at the Maternity Hospital in Kathmandu; services will be expanded gradually to other public and private hospitals and private clinics in the coming years.
Akpan, M U; Ikpeme, E E; Utuk, E-Oe
Knowledge and attitude of school teachers with regard to seizure disorder has an important impact on continuation of schooling of children with seizure disorder. Though school teachers in both rural and urban settings are exposed to the same training, their perception of seizure disorder could be influenced by the environment in which they reside. To determine the knowledge and attitudes of school teachers towards children with seizure disorder, and the influence of urban residence on perception of seizure disorder by the teachers. A self-administered questionnaire on knowledge and attitudes to seizure disorder were filled by school teachers drawn from both urban and rural settings in Akwa-Ibom State, Nigeria. One-hundred and thirty-two urban school teachers and an equal number of their rural counterparts completed the questionnaire. There were significantly more female teachers in the urban schools whereas the rural schools were dominated by male teachers with male to female ratio of 1:5.6 and 1.2:1, respectively. Majority of the urban (60.6%) and rural (57.6%) school teachers were National Certificate of Education holders. Thirty-eight (28.8%) of urban respondents versus eight (6.1%) of rural respondents thought seizure disorder was caused by evil spirits whereas 60 (45.5%) urban respondents compared to 80 (60.6%) of rural respondents felt seizure disorder was infectious. Majority of the respondents from both urban and rural schools (68.2% and 63.6% respectively) believed that the foam from the mouth of a convulsing child with seizure disorder is the infecting agent. However, 62.1% of urban respondents as well as 45.5% of rural respondents would advise that children with seizure disorder be admitted into special schools. There was no significant difference in the mean overall knowledge and attitudes of school teachers to seizure disorder in the two settings ( P = 0.33 for knowledge and 0.28 for attitudes). Teachers' high level of education however, had a positive
Subedi, Yagya Prasad; Marais, Debbi; Newlands, David
Nutrition transition is rapid in developing countries, but Nepalese transition is relatively unknown. This study aimed to describe nutrition transition in Nepal over the past 40 years by identifying the shifts in the Nepalese diets and nutritional status and the underlying shifts associated with this. Popkin's framework was used to identify shifts in Nepalese diet and the inter-relationship of diet with epidemiological, demographic and economic shifts. The current study used quantitative methodology including secondary data analysis based on food balance sheets, economic surveys and the government databases. The Nepalese diet is shifting away from agricultural staple based foods to modern processed foods with higher total energy, total fat, and sugar. The prevalence of overweight/obesity and diet related non-communicable diseases are increasing. Urbanisation is rapid and nutrition transition already advanced in urban area. The Nepalese economic structure has also changed shifting away from agricultural food supply system towards modern processing based food supply system. These changes in the Nepalese diet are triggered by income and urbanisation. The trade liberalisation has made processed foods, edible oil and sugar easily available at supermarkets and fast food outlets. It is clear that Nepal has now entered into the fourth stage of nutrition transition according to Popkin's framework. As a result, overweight, obesity and the prevalence of many noncommunicable diseases are all rapidly growing. A further study is recommended to identify whether urban versus rural, rich versus poor and educated versus uneducated families are experiencing the transition in similar way.
Krishna Prasad Parajuli
Full Text Available During the 15 years of this current century, mobile technology has become a leading technology in the support of educational outcomes. This study investigated the mobile learning practices among undergraduates in higher education in the semi-urban and rural areas of the Gorkha district of Nepal. The objectives were to explore the availability of mobile technology for learning; its costs; learning trends, institutional policies, and attitudes towards mobile learning. These factors were explored to identify implications for pedagogical practice. The study adopted a mixed methods design, in which the quantitative data were collected by using a questionnaire with a sample of 161 undergraduates from six campuses. The qualitative data were collected from 19 purposively selected respondents by the way of semi-structured interviews. The result indicated that virtually all undergraduates possessed their mobile phones and used them informally for learning both inside and outside of their classes. The majority of the students had positive attitudes towards mobile learning. However, many were not satisfied with the effectiveness of their practices or with the level of institutional support for using mobile devices to support their learning. Although comprehensive mobile learning is not widespread in Nepal, enriching conventional learning by the incremental use of mobile devices is possible in Nepalese institutes of higher education. I conclude that teachers and institutions should provide guidance to students about the effective uses of mobile technology because successful use of technology in learning largely depends on appropriate pedagogy and teacher support.
Full Text Available The movement of rural households from remote uplands to valley floors and to semiurban and urban areas (internal migration is a common phenomenon in the middle mountain districts of Nepal. Understanding the causes and effects of internal migration is critical to the development and implementation of policies that promote land use planning and sustainable resource management. Using geospatial information technologies and social research methods, we investigated the causes and effects of internal migration on land use and land cover patterns in a western mountain district of Nepal between 1998 and 2013. The results show a decreasing number of households at high elevations (above 1400 m, where an increase in forest cover has been observed with a consequent decrease in agricultural land and shrub- or grassland. At lower elevations (below 1400 m, forest cover has remained constant over the last 25 years, and the agricultural land area has increased but has become geometrically complex to meet the diverse needs and living requirements of the growing population. Our findings indicate that internal migration plays an important role in shaping land use and land cover change in the middle mountains of Nepal and largely determines the resource management, utilization, and distribution patterns within a small geographic unit. Therefore, land use planning must take an integrated and interdisciplinary approach rather than considering social, environmental, and demographic information in isolation.
Full Text Available BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. METHODS: Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. RESULTS: The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days. Direct and indirect costs (income losses represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71% or taking a loan (56%. CONCLUSIONS: The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control.
Dhital, Rolina; Subedi, Madhusudan; Prasai, Neeti; Shrestha, Karun; Malla, Milan; Upadhyay, Shambhu
Background Medical education can play important role in cultivating the willingness among the medical students to work in underprivileged areas after their graduation. Experiential learning through early exposure to primary health care centers could help students better understand the opportunities and challenges of such settings. However, the information on the real experiences and reflections of medical students on the rural primary health care settings from low-income countries like Nepal ...
Ayodeji M. Adebayo
Full Text Available Introduction. The morbidity and mortality from malaria are still unacceptably high in the developing countries, especially among the vulnerable groups like pregnant women and under-five children, despite all control efforts. The knowledge about the preventive measures of malaria is an important preceding factor for the acceptance and use of malaria preventive measures like Insecticide Treated Nets (ITN by community members. Therefore, this study assessed the knowledge of malaria prevention among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria.Methodology. This is part of a larger malaria prevention study in rural Southwest Nigeria. A descriptive cross-sectional survey was conducted among pregnant women and caregivers of under-five children in Igbo-Ora, a rural town in Southwest Nigeria using a semi-structured, interviewer-administered questionnaire. Information was obtained on knowledge of malaria prevention, and overall composite scores were computed for knowledge of malaria prevention and ITN use. Data were analyzed using SPSS version 16. Associations between variables were tested using a Chi-square with the level of statistical significance set at 5%.Results. Of the 631 respondents, 84.9% were caregivers of under-five children and 67.7% were married. Mean age was 27.7 ± 6.3 years with 53.4% aged between 20 and 29 years. Majority (91.1% had at least primary school education and 60.2% were traders. Overall, 57.7% had poor knowledge of malaria prevention. A good proportion (83.5% were aware of the use of ITN for malaria prevention while 30.6% had poor knowledge of its use. Respondents who were younger (<30 years, had at least primary education and earn <10,000/per month had significantly poor knowledge of ITN use in malaria prevention. Majority (60.0% respondents had poor attitude regarding use of ITNs.Conclusion. This study showed that the knowledge of malaria prevention is still low among under
The 2015 Gorkha-Nepal M7.8 earthquake (hereafter known simply as the Gorkha earthquake) highlights the seismic risk in Nepal, allows better characterization of the geometry of the Main Himalayan Thrust (MHT), and enables comparison of recorded ground-motions with predicted ground-motions. These new data, together with recent paleoseismic studies and geodetic-based coupling models, allow for good parameterization of the fault characteristics. Other faults in Nepal remain less well studied. Unlike previous PSHA studies in Nepal that are exclusively area-based, we use a mix of faults and areas to describe six seismic sources in Nepal. For each source, the Gutenberg-Richter a and b values are found, and the maximum magnitude earthquake estimated, using a combination of earthquake catalogs, moment conservation principals and similarities to other tectonic regions. The MHT and Karakoram fault are described as fault sources, whereas four other sources - normal faulting in N-S trending grabens of northern Nepal, strike-slip faulting in both eastern and western Nepal, and background seismicity - are described as area sources. We use OpenQuake (http://openquake.org/) to carry out the analysis, and peak ground acceleration (PGA) at 2 and 10% chance in 50 years is found for Nepal, along with hazard curves at various locations. We compare this PSHA model with previous area-based models of Nepal. The Main Himalayan Thrust is the principal seismic hazard in Nepal so we study the effects of changing several parameters associated with this fault. We compare ground shaking predicted from various fault geometries suggested from the Gorkha earthquake with each other, and with a simple model of a flat fault. We also show the results from incorporating a coupling model based on geodetic data and microseismicity, which limits the down-dip extent of rupture. There have been no ground-motion prediction equations (GMPEs) developed specifically for Nepal, so we compare the results of
Gartaula, H.N.; Niehof, A.; Visser, L.E.
This paper presents the results of a survey of the livelihoods of people living in the eastern part of the subtropical plains of Nepal, known as the terai. Both qualitative and quantitative approaches were used in the survey and further data were obtained through focus group discussions, in-depth
Lwin, Moh Moh; Sudhinaraset, May; San, Aung Kyaw; Aung, Tin
Since 2008 the Sun Primary Health (SPH) franchise programme has networked and branded community health workers in rural Myanmar to provide high quality malaria information and treatment. The purpose of this paper is to compare the malaria knowledge level and health practices of individuals in SPH intervention areas to individuals without SPH intervention This study uses data from a cross-sectional household survey of 1,040 individuals living in eight rural townships to compare the knowledge level of individuals in SPH intervention areas to individuals without SPH intervention. This study found that the presence of a SPH provider in the community is associated with increased malaria knowledge and higher likelihood of going to trained providers for fevers. Furthermore, the study found a dose-response, where the longer the duration of the programme in a community, the greater the community knowledge level. The study suggests that community health workers might have significant impact on malaria-related mortality and morbidity in rural Myanmar.
Sady, Hany; Al-Mekhlafi, Hesham M; Atroosh, Wahib M; Al-Delaimy, Ahmed K; Nasr, Nabil A; Dawaki, Salwa; Al-Areeqi, Mona A; Ithoi, Init; Abdulsalam, Awatif M; Chua, Kek Heng; Surin, Johari
Schistosomiasis is highly prevalent in Yemen, with an estimated 3 million cases, particularly among rural communities. This community-based study aims to evaluate the knowledge, attitude and practices (KAP) on schistosomiasis among rural communities in Yemen. A cross-sectional study was carried out among 250 households from ten rural districts in Yemen. Overall, 400 children were screened for urogenital and intestinal schistosomiasis. Moreover, parents were interviewed using a pre-tested questionnaire to collect information about the demographic and socioeconomic information and their KAP concerning schistosomiasis. A total of 127 (31.8%) children were found to be excreting schistosome eggs in either their urine or faeces (22.5% S. haematobium and 8.0% S. mansoni). Although 92.4% of the respondents had heard about schistosomiasis, 49.8%, 68.0% and 47.2% had knowledge concerning the transmission, signs and symptoms, and prevention, respectively. In addition, 77.1% considered schistosomiasis as harmful while 48.5% believed that schistosomiasis could be prevented, albeit their practices to prevent infections were still inadequate. Significant associations between the KAP and age, education, employment status and household monthly income were reported (P Yemen was inadequate, and that this could be a challenging obstacle to the elimination of schistosomiasis in these communities. Besides the current mass drug administration, school and community-based health education regarding schistosomiasis is imperative among these communities to significantly reduce the transmission and morbidity of schistosomiasis.
Shroyer, Josh; Stewart, Craig
The purpose of this study was to determine the knowledge and opinions on concussions of high school coaches from a geographically large yet rural state in the northern Rocky Mountains of the United States. Few medical issues in sport are more important, or have had as much publicity recently, as concussions. The exposure gleaned from tragic health…
Gram, Lu; Morrison, Joanna; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma; Costello, Anthony; Saville, Naomi; Skordis-Worrall, Jolene
Abstract Despite the rising popularity of indicators of women’s empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen’s notion of agency freedom in rural Nepal. Analysis of think-aloud interviews (n = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample (n = 511) suggested two positively correlated factors (r = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample (n = 509) revealed good fit (Root Mean Square Error of Approximation 0.05–0.08, Comparative Fit Index 0.91–0.99). In conclusion, we caution against uncritical use of agency-based quantification of women’s empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom. PMID:28303173
Full Text Available This article explores the politicisation of environmental knowledge on rural Australia, in an analysis of discourse on the lived experience of drought. It draws on research conducted in dryland farm communities in the Mallee wheat-belt of Victoria – where rural histories have presented spirited sagas of community perseverance in ‘battling’ a harsh climate – during a period of marked shift in public awareness of climate change (2004-07. Indeed climate change projections have intensified debate over rural futures in Australia, where droughts have played a powerful role in the mythologizing of rural battlers and landscapes, and where drought discourse has been dominated by the language of war. Cultural engagement with climate is, however, under constant renegotiation, as rural cultural research is apt to reveal.
Close, Kristin; Karel, Michele; White, Michelle
Prevention of adverse perinatal outcome using the Helping Babies Breathe (HBB) neonatal resuscitation algorithm can reduce perinatal mortality in low income settings. Mercy Ships is a non-governmental organisation providing free healthcare education in sub-Saharan Africa and in an attempt to reach more rural areas of Madagascar with our neonatal resuscitation training we designed a novel approach in collaboration with US Peace Corps Volunteers (PCV). PCVs work in rural areas and contribute to locally determined public health initiatives. We used a model of knowledge translation and implementation to train non-medical PCVs in HBB who would then train rural healthcare workers. Bulb suction and a self-inflating bag were donated to each health centre. We evaluated knowledge translation and behaviour change at 4 months using the Kirkpatrick model of evaluation. Ten PCVs received training and then trained 42 healthcare workers in 10 rural health centres serving a combined population of over 1 million. Both PCVs and rural healthcare workers showed significant increases in knowledge and skills (p patient outcome. Our novel method of training, including the provision of essential equipment, may be another tool in the armamentarium of those seeking to disseminate good practice to the most rural areas.
Kshetri, Dan B B; Smith, William C S
The study aimed to identify the felt common health problems, utilisation of health services and unmet needs of urban and rural elderly people of Bhaktapur district, Nepal. It was a cross sectional population study of people aged 60 years or more where 204 respondents were interviewed in 2009. The common felt problems were pain and swelling of joints (65.7%), indigestion (63.7%), excessive tiredness (38.2%) and hypertension (35.8%). Pain and swelling of joints (72.5%) and back pain (40.4%) were higher in rural elderly population whereas indigestion (67.6%) and hypertension (37.85%) were higher in urban population. Pain and swelling of joints (66.7%) and indigestion (69.6%) were higher in males, and hypertension (50.0%), back pain (38.2%) and chronic bronchitis/asthma (39.2%) were higher in females. The unmet needs varied between different health problems. In general women had more unmet needs than men, where 80 unmet needs were identified for the 102 men compared with 105 for the 102 women, and these unmet needs increased dramatically with age. This approach yields new insights into the health care needs of the elderly and will be helpful to health care planners.
Full Text Available This text aims to describe a methodological proposal to identify, classify, and organize the faunistic knowledge of students of rural schools. The research was conducted with twenty sixth graders from a rural school in the Department of Cundinamarca, Colombia. Through five types of activities, they expressed, in different ways, their knowledge about the animals of the region. The information collected was organized, categorized, and systematized in tables; these tables resulted from the analysis of the information the students provided. It is a possibility of school work that favors the recognition and valuation of the traditional and ancestral knowledge, and its incorporation to the dynamics of the teaching and learning of the Natural Sciences as a way to create “bridges” between that knowledge and the scholarly scientific knowledge. It is a proposal that, among other things, favors the development of more positive attitudes toward science itself, motivates students to ask questions, to recognize the importance of the cultural context, and to recognize themselves as part of a biocultural system.
Acharya, Dev R; Bell, Jacqueline S; Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R
How socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal. This study aims to explore the links between women's household position and their autonomy in decision making. We used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257). The data consists of women's four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives. A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making. Women's autonomy in decision making is positively associated with their age, employment and number of living children. Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure. There is a mixed variation in women's autonomy in the development region across all outcome measures. Western women are more likely to make decision in own health care (1.2-1.6), while they are less likely to purchase daily household needs (0.6-0.9). Women's increased education is positively associated with autonomy in own health care decision making (p make decision in own healthcare. Women from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making. Women's autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum. A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources. This will lead the women to be more autonomous in decision making in the due course.
Given the present pace of educational globalization, educators--especially in rural schools--will benefit from an awareness of traditional knowledge as a significant contributor to sustainability. Many countries operate through a system whereby major decision making, especially in such areas as education and health, emanate from state levels of…
Shrestha, Nawal; Shrestha, Saugat; Koju, Laxmi; Shrestha, Krishna Kumar; Wang, Zhiheng
The rich floral and ethnic composition of eastern Nepal and the widespread utilization of locally available medicinal plants offer remarkable opportunity for ethnomedicinal research. The present paper aims to explore medicinal plant diversity and use in the remote villages of eastern Nepal. It also aims to evaluate ethnopharmacological significance of the documented use reports and identify species of high indigenous priority. The study was undertaken in four villages located in the Sankhuwasabha district in eastern Nepal. Ethnomedicinal information was collected through structured interviews. The homogeneity of informant's knowledge and the relative importance of documented medicinal plants were validated by informant consensus factor and use value, respectively. Species preference for treatment of particular diseases was evaluated through fidelity level. We reported medicinal properties of 48 species belonging to 33 families and 40 genera, for the treatment of 37 human ailments. The uses of 10 medicinal plants were previously undocumented. The informant consensus factor (F IC ) ranged between 0.38 and 1 with about 50% of values greater than 0.80 and over 75% of values greater than 0.70, indicating moderate to high consensus among the informants on the use of medicinal plants in the region. Swertia chirayita was the most preferred species with significantly high use values, followed by Paris polyphylla and Neopicrorhiza scrophulariiflora. The remote villages in eastern Nepal possess rich floral and cultural diversity with strong consensus among informants on utilization of plants for local healthcare. The direct pharmacological evidence for medicinal properties of most species indicates high reliability of documented information. Careful and systematic screening of compounds isolated from these plants could possibly provide good opportunity for the discovery of novel medicines to treat life-threatening human diseases. We recommend prioritization of medicinal
He, Jun; Yang, Bin; Dong, Min; Wang, Yunshang
Trade in medicinal and aromatic plants (MAPs) between Nepal and China has taken place for centuries along the Tibetan border. While there is anecdotal evidence that economic development in China over the past decades, coupled with regional infrastructure development and increasing market integration, has substantially changed this trade, there are no current published studies investigating this, e.g. in terms of species and market structure. This knowledge gap impedes the development of public interventions, e.g. in support of sustainable trade. The primary objective of this study is to provide the first informative insights into the Nepal-China trade in MAPs, with particular emphasis on the value chain in Tibet. Data was collected from December 2015 to August 2016 in Nepal and Tibet. The data collection included standardized questionnaires to understand and map the value chain of MAPs, including the actors involved and key governance issues. Data was collected from Katmandu-based MAPs wholesalers exporting from Nepal to China, (n = 6) and with regional wholesalers (n = 40) based in Tibet. The questionnaires contained quantitative and qualitative components focusing on key elements of the MAPs value chain, e.g. the traded species and their values. This was augmented with qualitative interviews with Lhasa-based processors (n = 4) and government officials (n = 12) working in border controls, customs, and/or drug administration. We also collected official statistics on the Nepal-China MAPs trade and conducted a workshop in Lhasa with traders and government officials to discuss the nature of the Nepal-China MAPs trade. The Nepal-China MAPs trade boomed after 2011 when the value of traded plants increased more than nine-fold. This rapid increase reflected both a broader species composition and higher unit prices in response to increasing demand from China. The trade expansion was also driven by increasing demand in China and facilitated by improved
Joseph N. Ikwegbue
Full Text Available Background: Medical male circumcision (MMC is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC. Aim: This study employs quantitative data to expand insight into rural Zulu women’s knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons. Setting: A hospital-based antenatal clinic in rural KwaZulu-Natal. Methods: Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively. Results: The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital. Conclusion: Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.
Prajapati, R; Baral, B; Karki, K B; Neupane, M
In Nepal, the relationship of health worker and patient or community people is now deteriorating and the security and safety of health worker is becoming emerging issues. The poor relationship between community people and health worker is hampering the health service especially in rural setting. This study was aimed at finding the security perception and situation of health workforce in Nepal. A cross-sectional descriptive study was conducted using both quantitative and qualitative methods. Out of 404 sample health institutions, 747 health workforce from 375 health institutions were interviewed (workplace. Mostly, doctors felt insecure at their workplace 24 (30%) and argued with service users , 26 (32.50%). Feeling of security was highest in central region 160 (83.30%). Nationwide, 121 (16%) of health workers faced some level of arguments with service users, which was highest in Tarai 64 (18.08%). Of the total harassment, both gender based and sexual harassment was higher among female health workers [20 (62.5%) and 13 (56.5%) respectively]. Only, 230 (30.7%) of health workers who suffered from workplace accidents got compensation and treatment. Higher proportions of health workers feel insecurity at workplace whereas provision of compensation was minimal. There is a need of strict implementation of Security of the Health Workers and Health Organizations Act, 2066 (2009) for effective health service delivery.
Knowledge Shared: Participatory Evaluation in Development Cooperation ... El Salvador, Ghana, India, Indonesia, Kenya, Mexico, Nepal, and St Vincent, the book is a ... Linking research to urban planning at the ICLEI World Congress 2018.
Bolarinwa, Oladimeji Akeem; Ameen, Hafsat Abolore; Durowade, Kabir Adekunle; Akande, Tanimola Makanjuola
Lack of access to information and knowledge about mother and child health was identified as a major contributor to poor maternal and child health in Nigeria. The Partnership for Maternal, Newborn and Child Health (PMNCH) has recognized mapping the knowledge management of Maternal Newborn and Child Health (MNCH) as one of the major strategies to be deployed in improving the health of these vulnerable groups. The main aim of this study is to map the knowledge management resources of Maternal, Newborn and Child Health (MNCH) in rural and urban settings of Ilorin West LGA of Kwara state Nigeria. It is a descriptive cross-sectional study with a comparative analysis of findings from urban and rural settings. Epi-mapping was used to carve out the LGA and map responses. The p-value of less than 0.05 was considered significant at 95% confidence level. The study showed that traditional leader was responsible for more than half of the traditional way of obtaining information by rural (66.7%) and urban (56.2%) respondents while documentation accounts for the main MNCH knowledge preservation for the rural (40.6%) and the urban (50%) dwellers. Traditional leaders (32.2%) and elders (46.7%) were the main people responsible for dissemination of knowledge in rural areas whereas elders (35.9%) and Parents (19.9%) were the main people responsible in urban areas. It was concluded that traditional and family institutions are important in the knowledge management of MNCH in both rural and urban settings of Nigeria.
Lunze, Karsten; Dawkins, Rosie; Tapia, Abeezer; Anand, Sidharth; Chu, Michael; Bloom, David E
In Nepal, hypothermia is a major risk factor for newborn survival, but the country's public health care sector has insufficient capacity to improve newborn survival given the burden imposed by distance to health facilities and cost. Low-cost technology to provide newborn thermal care in resource-limited environments exists, but lacks effective distribution channels. This study aims to develop a private sector distribution model for dedicated newborn thermal care technology to ensure equitable access to thermal protection and ultimately improve newborn health in Nepal. We conducted a document analysis of newborn health policy in Nepal and a scoping literature review of approaches to newborn hypothermia in the region, followed by qualitative interviews with key stakeholders of newborn health in Nepal. Current solutions addressing newborn hypothermia range from high-technology, high-cost incubators to low-cost behavioral interventions such as skin-to-skin care. However, none of these interventions are currently implemented at scale. A distribution model that provides incentives for community health volunteers and existing public health services in Nepal can deliver existing low-cost infant warmers to disadvantaged mothers where and when needed. Newborn technology can serve as an adjunct to skin-to-skin care and potentially create demand for newborn care practices. Harnessing market forces could promote public health by raising awareness of newborn challenges, such as newborn hypothermia, and triggering demand for appropriate health technology and related health promotion behaviors. Market approaches to promoting public health have been somewhat neglected, especially in economically disadvantaged and vulnerable populations, and deserve greater attention in Nepal and other settings with limited public health service delivery capacity.
Martinotti, Giovanni; Lupi, Matteo; Carlucci, Leonardo; Cinosi, Eduardo; Santacroce, Rita; Acciavatti, Tiziano; Chillemi, Eleonora; Bonifaci, Ludovica; Janiri, Luigi; Di Giannantonio, Massimo
Novel psychoactive substances (NPS) are new psychotropic drugs, not scheduled under the International Conventions on Psychotropic Substances, but which may pose a relevant public health threat. In this study, we investigated knowledge and use of NPS in a sample of Italian youth in urban and rural areas. Between December 2012 and October 2013, we administered a questionnaire to a sample of 3011 healthy subjects (44.7% men; 55.3% women), aged between 16 and 24 years and recruited in urban, intermediate and rural areas of Italy. Of the global sample, 53.3% declared to have some knowledge on NPS, with a higher knowledge in urban areas. Mephedrone (26%), desomorphine (22.6%) and methamphetamine (21.7%) were the most commonly known drugs. NPS use was reported by 4.7% of the sample, without significant differences between urban and rural areas; mephedrone (3.3%), synthetic cannabinoids (1.2%) and Salvia divinorum (0.3%) consumption has been identified. NPS use was also predictive of binge-drinking behaviours (χ(2) (4) = 929.58, p < .001). Urban areas may represent a focal point for preventive strategies, given the presence of higher levels of NPS knowledge. Moreover, the association between binge-drinking habits and NPS use was really strong. This issue should not be underestimated because of its medical, psychopathological and social consequences. Copyright © 2015 John Wiley & Sons, Ltd.
Munro, Michelle L; Lori, Jody R; Boyd, Carol J; Andreatta, Pamela
With a large number of births occurring outside the formal health system, it is difficult to determine the number of pregnant women in rural regions of Liberia. The exponential growth of mobile phone use in developing countries provides a potential avenue for data collection on maternal and child health in such rural, remote regions. A pre-, post-, and one-year posttest design was used to collect data on knowledge and skill retention for 7 essential items required for mobile phone use among traditional birth attendants (TBAs) trained in a short message service (SMS) texting data collection protocol (N = 99) in rural Liberia. Sixty-three participants (63.6% retention) completed the one-year posttest and displayed evidence of statistically significant knowledge and skill retention in 6 of the 7 tasks (P < .005), including the ability to: 1) turn on the phone, 2) use the mobile phone to make a call, 3) recognize that they have coverage, 4) recognize that the mobile phone is charged, 5) create a SMS text message without help, and 6) send a SMS text message without help. The TBAs continued to have difficulty with more complex tasks such as adding minutes to a phone. The mobile phone data-collection protocol proved feasible with TBAs demonstrating knowledge retention in a one-year posttest; however, clinical significance needs further investigation. The protocol increased communication and collaboration among TBAs, certified midwives, and clinic staff. © 2014 by the American College of Nurse-Midwives.
Yadav, Ram Naresh; Joshi, Shrijana; Poudel, Rajesh; Pandeya, Pawan
Menstrual hygiene management remains a taboo in many communities in Nepal. Cultural beliefs about menstruation such as food taboos and untouchability have negative impact on dignity, health and education of adolescent girls. The objective of the study was to assess the current knowledge, attitude and practice of school adolescents on menstrual hygiene management in Doti District in Far-Western Nepal. This cross-sectional study was carried out from October to December 2016 at seven village development committees in Doti district, Nepal. This study was done among 276 students from grade seven and eight of 11 schools. Self-administered structured questionnaire was used to obtain information from school students. Descriptive analysis was done to analyse the knowledge, attitude and practice of school adolescents on menstrual hygiene management. 67.4% respondents had fair knowledge and 26.4% respondents had good knowledge on menstrual hygiene management. However, out of 141 female adolescent respondents, only 56 (40%) were engaged in good menstrual hygiene practices. Around half of the respondents had positive attitude towards menstrual hygiene management related issues. Although knowledge on menstrual hygiene management among school adolescents is fair, still attitude and practice need to improve. Findings indicate the need of behavior change communication campaigns along with frequent reinforcement of school health education programs.
Mohamed, Mohamed M G; Shwaib, Hussam M; Fahim, Monica M; Ahmed, Elhamy A; Omer, Mawadda K; Monier, Islam A; Balla, Siham A
Ebola hemorrhagic fever (EHF) is an emerging threat to public health. The last epidemic in West Africa had a great effect on the affected communities. Timely and effective interventions were necessary in addition to community participation to control the epidemic. The knowledge, attitude and practices of vulnerable communities remain unknown, particularly in Sudan. The aim of this study was to explore the knowledge, attitude and practices of rural residents in Sudan regarding Ebola hemorrhagic fever. We conducted a cross sectional, community-based large-scale study in Al Gaziera state in rural Sudan in eight localities. In total, 1500 random adult participants were selected. The participants were assessed by a predesigned pretested questionnaire regarding their knowledge, attitude and practices regarding Ebola. Their sources of information were determined, and we assessed demographic factors as predictors of knowledge. We found poor knowledge, a fair attitude and suboptimal practices among the participants. The main sources of information were the press and media. Education was the only predictor of knowledge regarding Ebola. A lack of knowledge and suboptimal preventive practices mandates orientation and education programs to raise public awareness. Health care providers are advised to engage more in educating the community. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
Aduragbemi O Banke-Thomas
Full Text Available Obstetric fistula is a sequela of complicated labour, which, if untreated, leaves women handicapped and socially excluded. In Burkina Faso, incidence of obstetric fistula is 6/10,000 cases amongst gynaecological patients, with more patients affected in rural areas. This study aims to evaluate knowledge on obstetric fistula among young women in a health district of Burkina Faso, comparing rural and urban communities. This cross-sectional study employed multi-stage sampling to include 121 women aged 18-20 years residing in urban and rural communities of Boromo health district. Descriptive statistics and multiple logistic regression analysis were used to compare differences between the groups and to identify predictors of observed knowledge levels. Rural women were more likely to be married (p<0.000 and had higher propensity to teenage pregnancy (p=0.006. The survey showed overall poor obstetric fistula awareness (36%. Rural residents were less likely to have adequate preventive knowledge than urban residents [OR=0.35 (95%-CI, 0.16-0.79]. This effect was only slightly explained by lack of education [OR=0.41 (95%-CI, 0.18-0.93] and only slightly underestimated due to previous pregnancy [OR=0.27 (95%-CI, 0.09-0.79]. Media were the most popular source of awareness amongst urban young women in contrast to their rural counterparts (68% vs. 23%. Most rural young women became 'aware' through word-of-mouth (68% vs. 14%. All participants agreed that the hospital was safer for emergency obstetric care, but only 11.0% believed they could face pregnancy complications that would require emergency treatment. There is urgent need to increase emphasis on neglected health messages such as the risks of obstetric fistula. In this respect, obstetric fistula prevention programs need to be adapted to local contexts, whether urban or rural, and multi-sectoral efforts need to be exerted to maximise use of other sectoral resources and platforms, including existing routine
Full Text Available Background: Socio-cultural factors have a bearing on women's attitude towards menstruation. Health care providers should be aware of how women react to menstruation while providing health care. Aims & Objectives: To elicit menstrual awareness and knowledge of the rural adolescent girls and assess how this awareness, knowledge and demographics influence their menstrual attitude. Methodology: A community based descriptive cross-sectional study was undertaken among 245 adolescent school going girls in a rural area. Adolescent Menstrual Attitude Questionnaire (AMAQ was used as a data collection device. Data were compared by using SPSS (ver. 20.0 at the level of 0.05. Results: At menarche, 59.9% adolescents were aware of menstruation and in 3/4th of them, mothers were the source of information. There was a statistically significant effect of menstrual awareness (yes or no and menstrual knowledge (nil, partial and complete on the combined dependent variables (F(6,238=9.0, p= 0.000, Wilk’s Lambda=0.81, partial eta square=0.29 and F(6,237=8.01, p= 0.000, Wilk’s Lambda=0.69, partial eta square=0.20 respectively. Older adolescents had favorable attitude towards menstruation in three significant dimensions i.e. living with menarche, openness and acceptance. Significant effect of mother’s educational level was observed on five dimensions of menstrual attitude. Conclusion: Menstrual attitude is significantly affected by menstrual awareness and knowledge. Demographics too contributed in bringing positive attitude. There is a need to plan menstrual health education programme for adolescent girls and their mothers.
Full Text Available Background: Socio-cultural factors have a bearing on women's attitude towards menstruation. Health care providers should be aware of how women react to menstruation while providing health care. Aims & Objectives: To elicit menstrual awareness and knowledge of the rural adolescent girls and assess how this awareness, knowledge and demographics influence their menstrual attitude. Methodology: A community based descriptive cross-sectional study was undertaken among 245 adolescent school going girls in a rural area. Adolescent Menstrual Attitude Questionnaire (AMAQ was used as a data collection device. Data were compared by using SPSS (ver. 20.0 at the level of 0.05. Results: At menarche, 59.9% adolescents were aware of menstruation and in 3/4th of them, mothers were the source of information. There was a statistically significant effect of menstrual awareness (yes or no and menstrual knowledge (nil, partial and complete on the combined dependent variables (F(6,238=9.0, p= 0.000, Wilk’s Lambda=0.81, partial eta square=0.29 and F(6,237=8.01, p= 0.000, Wilk’s Lambda=0.69, partial eta square=0.20 respectively. Older adolescents had favorable attitude towards menstruation in three significant dimensions i.e. living with menarche, openness and acceptance. Significant effect of mother’s educational level was observed on five dimensions of menstrual attitude. Conclusion: Menstrual attitude is significantly affected by menstrual awareness and knowledge. Demographics too contributed in bringing positive attitude. There is a need to plan menstrual health education programme for adolescent girls and their mothers.
Mishra, S K; Pant, B P; Subedi, P
Background The worldwide prevalence of diabetic retinopathy (DR) was found to be 34.6%. WHO estimates that DR is responsible for 4.8% of the 37 million cases of blindness throughout the world. In a study undertaken in urban population in Nepal, M.D. Bhattarai found the prevalence of diabetes among people aged 20 years and above to be 14.6% and the prevalence among people aged 40 years and above to be 19%. Studies on DR, to our knowledge, have mostly been hospital based in Nepal. Little information is available about prevalence of DR at the community level in Nepal. Objective To investigate the prevalence of diabetic retinopathy and associated risk factors among known diabetic population of Nepal. Method A descriptive cross sectional study was conducted among individuals aged 30 and more using cluster sampling method. The study sites were Kathmandu metropolitan city and Birgunj sub-metropolitan city. A sample size of 5400 was calculated assuming 5% prevalence rate with 95% confidence level, 5% worst acceptable level and 1.5 cluster sampling design effect. Study participants were interviewed, anthropometric measurements and fundus photograph was taken from participants with diabetes. Fundus photographs were used to grade retinopathy. Result Around 12% of the respondents were diabetic, mean age 55.43±11.86 years, of which slightly more than half were females (50.2%). Among these diabetic respondents 9.9% had some forms of diabetic retinopathy, mean age 54.08±10.34 years, 56.7% were male. When severe grade of retinopathy in any eye was considered as overall grade of retinopathy for the individual, prevalence of Non-proliferative Diabetic Retinopathy, Proliferative Diabetic Retinopathy and complete vision loss was found to be 9.1%, 0.5% and 0.3%. Prevalence of Diabetic Macular Edema was 5.5%. Duration of diabetes, family history of diabetes and blood pressure at the day of survey was found to be associated with having any retinopathy. Conclusion Diabetic retinopathy
Sudmeier-Rieux, Karen; Dubois, Jerome; Jaboyedoff, Michel
This paper describes a methodology for assessing and quantifying vulnerability and resilience of mountain communities in Eastern Nepal increasingly affected by landslides and flooding. We are interested in improving our understanding of the complex interactions between land use, landslides and multiple dimensions of risk, vulnerability and resilience to better target risk management strategies. Our approach is based on assessing underlying social, ecological and physical factors that cause vulnerability and on the other hand, those resources and capacities that increase resilience. Increasing resilience to disasters is frequently used by NGOs, governments and donors as the main goal of disaster risk reduction policies and practices. If we are to increase resilience to disasters, we need better guidance and tools for defining, assessing and monitoring its parameters. To do so, we are establishing a methodology for quantifying and mapping an index of resilience to compare resilience factors between households and communities based on interdisciplinary research methods: remote sensing, GIS, qualitative and quantitative risk assessments, participatory risk mapping, household questionnaires and focus groups discussions. Our study applied this methodology to several communities in Eastern Nepal where small, frequent landslides are greatly affecting rural lives and livelihoods. These landslides are not captured by headlines or official statistics but are examples of cumulative, hidden disasters, which are impacting everyday life and rural poverty in the Himalayas. Based on experience, marginalized populations are often aware of the physical risks and the limitations of their land. However, they continue to live in dangerous places out of necessity and for the economic or infrastructure opportunities offered. We compare two communities in Nepal, both affected by landslides but with different land use, migration patterns, education levels, social networks, risk reduction
Full Text Available Abstract Background Nepal Himalayas have been known as a rich source for valuable medicinal plants since Vedic periods. Present work is the documentation of indigenous knowledge on plant utilization as natural remedy by the inhabitants of terai forest in Western Nepal. Methods Study was conducted during 2010–2011 following standard ethnobotanical methods. Data about medicinal uses of plants were collected by questionnaire, personal interview and group discussion with pre identified informants. Voucher specimens were collected with the help of informants, processed into herbarium following standard methods, identified with the help of pertinent floras and taxonomic experts, and submitted in Department of Botany, Butwal Multiple Campus, Tribhuvan University, Nepal for future references. Results During the present study 66 medicinal plant species belonging to 37 families and 60 genera has been documented. These plants were used to treat various diseases and ailments grouped under 11 disease categories, with the highest number of species (41 being used for gastro-intestinal disorders, followed by dermatological disorders (34. In the study area the informants’ consensus about usages of medicinal plants ranges from 0.93 to 0.97 with an average value of 0.94. Herbs (53% were the primary source of medicine, followed by trees (23%. Curcuma longa (84% and Azadirachta indica (76% are the most frequently and popularly used medicinal plant species in the study area. Acacia catechu, Bacopa monnieri, Bombax ceiba, Drymaria diandra, Rauvolfia serpentina, and Tribulus terrestris are threatened species which needs to be conserved for future use. Conclusions The high degree of consensus among the informants suggests that current use and knowledge are still strong, and thus the preservation of today's knowledge shows good foresight in acting before much has been lost. The connections between plant use and conservation are also important ones, especially as the
Full Text Available The Himalaya region of Nepal encompasses significant habitats for several endangered species, among them the brown bear (Ursus arctos pruinosus. However, owing to the remoteness of the region and a dearth of research, knowledge on the conservation status, habitat and population size of this species is lacking. Our aim in this paper is to report a habitat survey designed to assess the distribution and habitat characteristics of the brown bear in the Nepalese Himalaya, and to summarize a conservation action plan for the species devised at a pair of recent workshops held in Nepal. Results of our survey showed that brown bear were potentially distributed between 3800 m and 5500 m in the high mountainous region of Nepal, across an area of 4037 km2 between the eastern border of Shey Phoksundo National Park (SPNP and the Manasalu Conservation Area (MCA. Of that area, 2066 km2 lie inside the protected area (350 km2 in the MCA; 1716 km2 in the Annapurna Conservation Area and 48% (1917 km2 lies outside the protected area in the Dolpa district. Furthermore, 37% of brown bear habitat also forms a potential habitat for blue sheep (or bharal, Pseudois nayaur, and 17% of these habitats is used by livestock, suggesting a significant potential for resource competition. Several plant species continue to be uprooted by local people for fuel wood. Based on the results of our field survey combined with consultations with local communities and scientists, we propose that government and non-government organizations should implement a three-stage program of conservation activities for the brown bear. This program should: (a Detail research activities in and outside the protected area of Nepal; (b support livelihood and conservation awareness at local and national levels; and (c strengthen local capacity and reduce human-wildlife conflict in the region.
Full Text Available Purpose: This study was conducted to find the epidemiological characteristics of maxillofacial trauma in the Western region of Nepal. Materials and Methods: All the trauma patients attending the Department of Oral and Maxillofacial surgery in 4 years period at a tertiary center in Western Nepal were included in the study. The incidence, prevalence, age and sex distribution, etiologies and types as well as seasonal and daily variation of maxillofacial trauma were studied. Results: Maxillofacial trauma with male (71.55% predominance was seen. Road traffic accidents (RTA, 46.5% were the most common cause, and 41.65% of fracture cases due to RTA were under the influence of alcohol. Accidents were more common on the rural roads (38.9%, and majorities (43.3% were due to motorcycle accidents. They were more common on Friday (36.7% and in winter seasons (51.2%. The mandible fractures (65.85% were more common than midface fractures (53.58% and 19.44% of the fractures were combined fractures. Parasymphysis in mandible (32.16% and zygoma (39.09% in midface were the most common type of fracture. Conclusion: The increased incidence of maxillofacial trauma following RTA under the influence of alcohol noted in this study reveals the need for formulating preventive measures in the Western region of Nepal. Need to aware people to avoid drink and drive proper traffic management, prevention of carrying excessive passengers, especially on the rooftop of vehicles on the highway and disposal of out of date vehicles and timely maintenance of faulty roads is a must.
Shrestha, J R; Manandhar, D S; Manandhar, S R; Adhikari, D; Rai, C; Rana, H; Poudel, M; Pradhan, A
As part of the Partnership for Maternal and Newborn Health Project (PMNH), HealthRight International collaborated with Mother and Infant Research Activities (MIRA) to conduct operations research in Arghakhanchi district of Nepal to explore the intervention impact of strengthening health facility, improving community facility linkages along with Community Based Newborn Care Program (CB-NCP) on Maternal Neonatal Care (MNC) service quality, utilization, knowledge and care seeking behavior. This was a quasi-experimental study. Siddahara, Pokharathok, Subarnakhal,Narpani Health Posts (HPs) and Thada Primary Health Care Center(PHCC)in Electoral Constituency-2 were selected as intervention sites and Arghatosh, ,Argha, Khana, Hansapur HPs and Balkot PHCC in Electoral Constituency-1 were chosen as controls. The intervention started in February 2011 and was evaluated in August 2013. To compare MNC knowledge and practice in the community, mothers of children aged 0-23 months were selected from the corresponding Village Development Committees(VDCs) by a two stage cluster sampling design during both baseline (July 2010) and endline (August, 2013) assessments. The difference in difference analysis was used to understand the intervention impact. Local resource mobilization for MNC, knowledge about MNC and service utilization increased in intervention sites. Though there were improvements, many effects were not significant. Extensive trainings followed by reviews and quality monitoring visits increased the knowledge, improved skills and fostered motivation of health facility workers for better MNC service delivery. MNC indicators showed an upsurge in numbers due to the synergistic effects of many interventions.
Alam, Nurul; Roy, Swapan Kumar; Ahmed, Tahmeed; Ahmed, A M Shamsir
This study estimated the levels and differentials in nutritional status and dietary intake and relevant knowledge of adolescent girls in rural Bangladesh using data from the Baseline Survey 2004 of the National Nutrition Programme. A stratified two-stage random cluster-sampling was used for selecting 4,993 unmarried adolescent girls aged 13-18 years in 708 rural clusters. Female interviewers visited girls at home to record their education, occupation, dietary knowledge, seven-day food-frequency, intake of iron and folic acid, morbidity, weight, and height. They inquired mothers about age of their daughters and possessions of durable assets to divide households into asset quintiles. Results revealed that 26% of the girls were thin, with body mass index (BMI)-for-age 95th percentile), and 32% stunted (height-for-age knowledge was low. More than half could not name the main food sources of energy and protein, and 36% were not aware of the importance of taking extra nutrients during adolescence for growth spurt. The use of iron supplement was 21% in nutrition-intervention areas compared to 8% in non-intervention areas. Factors associated with the increased use of iron supplements were related to awareness of the girls about extra nutrients and their access to mass media and education. Community-based adolescent-friendly health and nutrition education and services and economic development may improve the overall health and nutritional knowledge and status of adolescents.
Nepal is also highly polluted by the lights and other dusts partials, but lacks the formal education of light pollutions and effect of light for astronomy observations. When we get Sky Quality Meter (SQM) last year (2014) we have installed it in Kathmandu.This paper will highlight about installation SQM in Nepal, measurement of brightness of the night sky in magnitudes per square arc second. Research work of light pollution of Kathmandu will be more in focus. Highlight of the Astronomy programs by different Schools in Nepal along with the background of coverage of Astronomy education in the syllables of different education level. The various procedure , technique and idea used in providing the space education through different activities and program to school studentsThe paper will also deal with the Importance of light and use of artificial light. Beside it will also highlight the possibility of development of various observatories in Nepal because of its tremendous topography increasing the Astro tourism in Nepal.Hence the paper would focus on the light pollution of the city like Kathmandu and light system in Nepal and Astronomy education to its implementation along with its outreach to Nepalese society.
Shah, Shristi; Ross, Oliver; Pickering, Stephen; Knoble, Stephen; Rai, Indra
To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course. The course is based on self-completion on a tablet loaded with new learning modules, a resource library, and a case logbook. Continuous educational mentoring was provided by anesthesiologists by phone and email. The logbook included preanesthesia assessment and interventions, American Society of Anesthesiologists (ASA) grading, types of cases and anesthesia given, monitors used, complications, outcomes and free text remarks. Cases were uploaded monthly to a database, and mentors reviewed all logbook entries. The 14 nondoctor anesthesia providers were widely distributed across the country in district, zonal, community, and mission hospitals, and had different levels of clinical experience and caseloads. Logbooks and uploads were regularly completed without difficulty; 1% cases were entered incompletely with no case details provided. A total of 4143 cases were recorded. Annual caseload per nondoctor anesthesia provider ranged from 50 to 788, the majority of which were under spinal anesthesia; 34% of the total cases were cesarean deliveries, of which 99% received spinal anesthesia. Fifty gastrointestinal laparotomies (1% total) were recorded. Ninety-one percent of cases were ASA I, 0.8% ASA III/IV. Pulse oximetry was used in 98% of cases. Complications were recorded in 6% of cases; the most common were circulation problems (69%) including hypotension and occasional bradycardia after spinal anesthesia. Airway complications
Gurung, J.D.; Lama, K.; Khadkha, M.
Metadata only record The political conflicts between Maoist groups and the government increase women's work load as they are left behind alone and without forest programs. This case study examines the incorporation of gender interests into a forestry project (Hills Leasehold Forestry and Forage Development Project (HLFFDP)) in Nepal. As a result of which we could observe changes in attitudes in both rural women, and staff of the Department of Forest (DOF). Traditionally, religion, ethnicit...
Molineri, Ana I; Signorini, Marcelo L; Tarabla, Héctor D
The aim of this study was to evaluate the level of awareness of zoonoses among rural workers and their potential associations with socio-demographic factors. A cross-sectional study was performed by holding personal interviews (N=110, n=94) using a structured questionnaire. The statistical analysis included the χ(2) test, the Student's t test and Pearson and Spearman correlations. The highest level of awareness was found for trichinosis, rabies and scabies. Species transmitting brucellosis, tuberculosis and anthrax were well known, but not their modes of transmission. The least known diseases were toxocariasis and hydatidosis, followed by leptospirosis and toxoplasmosis. Significant associations were found (p<0.001) between the knowledge of transmitting species and the modes of transmission. Senior male owners, married, and living in urban areas showed the highest overall knowledge of zoonoses. Awareness of zoonoses among rural workers is inadequate. Veterinarians in conjunction with risk insurers may play a key role in providing information to people at risk. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.
Full Text Available Rural mountain communities in developing countries are considered particularly vulnerable to environmental change, including climate change. Forests and agriculture provide numerous ecosystem goods and services (EGS to local communities and can help people adapt to the impacts of climate change. There is however poor documentation on the role of EGS in people’s livelihood and adaptation practices. This study in the rural Panchase Mountain Ecological Region of Nepal identifies practices being used to adapt to a changing environment through key informant interviews and focus group discussions. At the household level, livelihood diversification, changes in cropping patterns and farming practices, use of multipurpose plant species and income-generation activities were identified as adaptation strategies. Among major strategies at the community level were community forestry-based climate adaptation plans of action for forest and water resource management. Landscape-level adaptation strategies were large-scale collaborative projects and programs, such as Ecosystem-based Adaptation and Chitwan Annapurna Landscape conservation; which had implications at both the local and landscape-level. A proper blending and integration of adaptation strategies from individual households through to the community and to the landscape level is needed for implementing effective adaptation in the region.
Regmi, Pramod R.; van Teijlingen, Edwin R.; Simkhada, Padam; Acharya, Dev R.
Social and cultural changes in Nepal, including better communication facilities and transport, more urbanization and a rising age at which people marry, have created more opportunities for young people for "dating." Our qualitative study explores whether the existence of dating cultures influences young people's sexual behavior in Nepal.…
Arendt, Lucy; Hortacsu, Ayse; Jaiswal, Kishor; Bevington, John; Shrestha, Surya; Lanning, Forrest; Mentor-William, Garmalia; Naeem, Ghazala; Thibert, Kate
The April 2015 Gorkha Nepal earthquake revealed the relative effectiveness of the Nepal Standard, or national building code (NBC), and irregular compliance with it in different parts of Nepal. Much of the damage to more than half a million Nepal's residential structures may be attributed to the prevalence of owner-built or owner-supervised construction and the lack of owner and builder responsiveness to seismic risk and training in the appropriate means of complying with the NBC. To explain these circumstances, we review the protracted implementation of the NBC and the role played by one organization, the National Society for Earthquake Technology-Nepal (NSET), in the NBC's implementation. We also share observations on building code compliance made by individuals in Nepal participating in workshops led by the Earthquake Engineering Research Institute's 2014 class of Housner Fellows.
Dillee Prasad Paudel
Full Text Available Background: Infant feeding is a major determinant of survival, future nutrition and health status of children. Breast-feeding is an unequalled way of providing ideal food for the healthy growth and development of infants. It is also an integral part of the reproductive process with important implications for the health of mothers. Exclusive breast feeding (EBF is superior to non-exclusive breast-feeding with a protective effect against both morbidity and mortality. This study was aimed to explore the breast feeding practice and affecting factors in Bhaktapur, Nepal. Materials and Methods: Community based cross-sectional study was carried out from February to May 2007 in a rural area of Bhaktapur, Nepal. Total 333 lactating mothers having a child less than 6 months were interviewed using pretested questionnaire with her written consent. Analysis was performed in Statistical Pakage of Social Science-13 version applying appropriate statistics. Results were presented in tabular and narrative forms. Results: Among 333 mothers (mean age ± standard deviation 24.68 ± 4.16 years, majority (76.6% were 20-30 years. Almost 83.0% were Hindus, 25.8% illiterate, 62.8% house-wives and 53.5% from joint family with low economic status. About 48.0% had a baby of 2-4 months, 86.0% avoided pre-lacteal feeding, 87.1% fed colostrums, 27.9% fed the first milk within half an hour and 55.0% practiced exclusive breast-feeding for 6 months. Child′s age, education, religion, occupation, family type and knowledge level were significant (P < 0.05 factors affecting to breast feeding. Conclusion: Despite the high proportion of women initiated breast-feeding early after birth, the prevalence of EBF for 6 months was very low and a large portion had poor practice of breast feeding. Education, relationship of mother with a family member and level of knowledge were found most significant factors. Appropriate measures such as public awareness and effective counseling will support
Ederson de Sousa Martins
Full Text Available The knowledge about plants with melitophile potential is highlighted in the research field, this way; these pieces of information are collected in the rural areas. Thus, ethnobotany, which studies the relation between human groups and plants, is fundamental, because it brings information about the species visited by bees as well as beekeepers and meliponiculturers, helping with environmental protection, especially native tree species and different bee groups. The objective of this study was to conduct an ethnobotanical survey about the knowledge the residents of two rural communities in the city of Sigrefredo Pacheco, state of Piauí, about melitophile plants. The study was conducted through interviews in every house (41 of the two communities, totalizing 69 interviewees. 31 species were cited, and the family Leguminosae was highlighted.the most cited species were: Croton blanchetianus Baill. (25 and Hyptis suaveolens (L. Poit. (25, in which the native species stood out (77,4%. It is possible to observe that the younger portion had the smaller participation and about gender, it is noticeable that men presented a major number of citation addressing plants than women. The study concludes that the knowledge of melitophile plants is present among the residents of the communities, that they know the profitable practices to the conservation of the melitophile flora, though; they are not overspread in the community. It is necessary to know more and more the knowledge about apicultural flora in rural communities, in order to rescue and value this knowledge, as well as local conservation measures.
Introduction ... 3 Cochylidae ... 5 Tortricidae, Olethreutinae, Laspeyresiini ... 10 Tortricinae, Tortricini ... 48 Polyorthini ... 67 Sparganothidini ... 69 Ceracini ... 70 Archipini ... 71 Cnephasiini ... 128 Chlidanotinae ... 132 Appendix 1. Matsumuraeses species from Nepal, treated elsewhere ...
Full Text Available Objective: There is no treatment for asbestos–related diseases, but they can be prevented. One of the first interventions is to improve the knowledge level of people in order to protect people from asbestos and asbestos–related diseases. The present study was conducted to develop a questionnaire for measuring the knowledge and awareness level of asbestos and also assess its validity and reliability in a rural population that is exposed to asbestos environmentally. Methods: A questionnaire, interviewer–administered, that included 37 items was employed on a convenient sample consisting of adult persons who attended a tertiary teaching hospital in Eskişehir where asbestos exposure is widespread in its rural areas. After assessment of validity and reliability of the results, the questionnaire was refined to 19 items and one subscale. Results: A total of 760 participants were included in this study. The mean age of participants was 53.2±15.1 years and 51.6% of them were male. The discrimination and difficulty indices of the asbestos knowledge and awareness questionnaire ranged between 20.0–60.5% and 0.39–0.98, respectively. Cronbach’s alpha coefficient was 0.951 for overall items. The median (min–max and mean (SD score of the study population were 30 (19–56 and 33.9 (11.9, respectively. The score increased correspondingly with greater knowledge levels. Conclusion: This questionnaire is a practical and easy tool to apply with acceptable reliability and validity on high-risk adults in rural areas with environmental asbestos exposure.
Zhang, Wenchao; Wang, Wei; Lin, Junfen; Zhang, Ying; Shang, Xiaopeng; Wang, Xin; Huang, Meilin; Liu, Shike; Ma, Wei
(1) The objective of this study was to assess the risk perceptions, attitudes, knowledge, and behaviors related to typhoon among rural residents in Zhejiang province of China. A cross-sectional study was conducted among rural residents in Zhejiang province, China. Information was collected from 659 participants using a structured questionnaire. Univariate analysis and multivariable analysis were used to analyze the data. Participants were most concerned about property damage, followed by thei...
Full Text Available Japanese encephalitis (JE is a mosquito-borne zoonotic disease that has pigs as the major amplifying hosts. It is the most important cause of viral encephalitis in people in Nepal and is spreading in its geographic distribution in that country. Pig farming is increasing in Nepal due to reducing cultural biases against pigs and government programs to support pig farming for poverty alleviation. Major strategies for JE prevention and control include education, vector control, and immunization of people and pigs. This study used a survey of 400 pig farmers in 4 areas of Nepal with different JE and pig farming histories to explore regional variations in farmer awareness and actions towards JE, the association of awareness and actions with farm and farmer variables, and the implications of these associations for public health education. Exposure to JE risk factors was common across pig farms and pig farming districts but there were significant district level differences in knowledge and practices related to on-farm JE risk reduction. Social factors such as literacy, gender, and cultural practices were associated with farmer attitudes, knowledge and practices for JE control. JE vaccine uptake was almost non-existent and mosquito control steps were inconsistently applied across all 4 districts. Income was not a determining factor of the differences, but all farmers were very poor. The low uptake of vaccine and lack of infrastructure or financial capacity to house pigs indoors or away from people suggest that farmer personal protection should be a priority target for education in Nepal. This study re-enforces the need to attack root causes of people's personal disease prevention behaviours and take into account local variation in needs and capacities when designing health or agriculture education programs.
Jammeh, Sulayman S S; Liu, Chieh-Yu; Cheng, Su-Fen; Lee-Hsieh, Jane
Family planning services have been free of charge and available in all the health facilities in the Gambia since 1975 yet contraceptive prevalence is only 17.5% and even 6% in some areas. Since the last census in 2003, there existed no available data on married couples' contraception status. To explore married couples' family planning knowledge, attitudes, and practices in rural and urban Gambia and to analyze what factors may affect such knowledge, attitudes and practices. Quantitative cross-sectional study design was used. Through convenience sampling, 176 men and 235 women representing a total of 176 couples participated. A structured questionnaire was used for data collection. The mean scores of the married couples family planning knowledge, attitudes, and practices were 19.00 ± 6.11(ranging from 0 to 64), 6.90 ± 3.08 (0 to 14) and 4.69 ± 3.3 (0 to 19) respectively. Urban residents had higher scores on family planning practice than rural residents (pfamily planning knowledge, attitude and practice in Gambia", as well as suggesting broader health intervention programs in health education and promotion.
Full Text Available Occurrence of Scotophilus kuhlii was speculated throughout the southern plain (Tarai of Nepal. However, there was no record of voucher specimen of the species from Nepal. We collected a specimen from the Tikulia tole, Pakali Village Development Committee, Sunsari District of southeastern Nepal and deposited at Central Department of Zoology (CDZ Museum, Tribhuvan University, Kathmandu. The specimen was identified as S. kuhlii based on measurement of external body, cranial, dental parts and detail description of the species. This is the first specific locality record of the species from Nepal that confirms its presence in the country.
The paper attempts to answer some important questions around the inflationary process in Nepal, particularly the transmission of inflation from India. Because the Nepali currency is pegged to the Indian rupee and the two countries share an open border, price developments in Nepal would be expected to mirror to those in India. The results show that inflation in India and inflation in Nepal tend to converge in the long run. Our estimates indicate that the passthrough of inflation from India to ...
Swami, Viren; Loo, Phik-Wern; Furnham, Adrian
This study examined knowledge and beliefs about depression among Malaysian Malays varying in socioeconomic status. A total of 153 urban and 189 rural participants completed a questionnaire in which they had to identify two cases of depression and rate a series of items about the causes and best treatments for depression. Results showed that urban participants were more likely to use psychiatric labels ('depression') for the two vignettes, whereas rural participants tended to use more generic terms ('emotional stress'). Principal components analysis (PCA) showed that beliefs about the causes of depression factored into five components, of which stressful life events was most strongly endorsed by both groups. PCA of treatment items revealed four stable components, of which religious factors were most strongly endorsed. There were also a number of significant between-group differences in the endorsement of these factors (eta(p) (2) = .03-.11), with rural participants generally rating supernatural and religious factors more strongly than urban Malays. These results are discussed in relation to mental health literacy programmes in Malaysia.
To develop space activities and to industrialize astronomy, base of space education in the high schools must be very effective. This paper highlights the present scenario of space education and discusses the syllabus of astronomy in the different education level of Nepal. Astronomy is included in the curriculum of science book of middle school and high school which contains very few contents of solar system, constellations, galaxy, black holes and formation of stars. There is no any degree for higher studies in astronomy as a separate department in any university of Nepal. This paper also highlights the space activities and national level programs conducting in Nepal to support astronomy education. With the rise of many astronomical clubs and societies in the different regions of Nepal, astronomy education has been more effective in the recent time. Series of Galileo Teacher's Training Program in the different parts of Nepal being organized by Global Hands on Universe in cooperation with local astronomy clubs will be discuss in brief. The attempts to bring more trained and skilled teachers in the classroom by the government and non-government agencies are now gradually increasing. The competition of private schools and their capacity building workshops to their teachers to attract more students is also playing active role to shape the school education effective. The challenges, prospects and the practice of effective astronomy education prevailing in Nepal will be discuss. Key Words: Nepal, Astronomy Education, GTTP, Trained Teachers
Dhimal, Meghnath; Dhimal, Mandira Lamichhane; Pote-Shrestha, Raja Ram; Groneberg, David A; Kuch, Ulrich
Nepal is highly vulnerable to global climate change, despite its negligible emission of global greenhouse gases. The vulnerable climate-sensitive sectors identified in Nepal's National Adaptation Programme of Action (NAPA) to Climate Change 2010 include agriculture, forestry, water, energy, public health, urbanization and infrastructure, and climate-induced disasters. In addition, analyses carried out as part of the NAPA process have indicated that the impacts of climate change in Nepal are not gender neutral. Vector-borne diseases, diarrhoeal diseases including cholera, malnutrition, cardiorespiratory diseases, psychological stress, and health effects and injuries related to extreme weather are major climate-sensitive health risks in the country. In recent years, research has been done in Nepal in order to understand the changing epidemiology of diseases and generate evidence for decision-making. Based on this evidence, the experience of programme managers, and regular surveillance data, the Government of Nepal has mainstreamed issues related to climate change in development plans, policies and programmes. In particular, the Government of Nepal has addressed climate-sensitive health risks. In addition to the NAPA report, several policy documents have been launched, including the Climate Change Policy 2011; the Nepal Health Sector Programme - Implementation Plan II (NHSP-IP 2) 2010-2015; the National Health Policy 2014; the National Health Sector Strategy 2015-2020 and its implementation plan (2016-2021); and the Health National Adaptation Plan (H-NAP): climate change and health strategy and action plan (2016-2020). However, the translation of these policies and plans of action into tangible action on the ground is still in its infancy in Nepal. Despite this, the health sector's response to addressing the impact of climate change in Nepal may be taken as a good example for other low- and middle-income countries.
Islam, Fakir M Amirul; Chakrabarti, Rahul; Dirani, Mohamed; Islam, M Tauhidul; Ormsby, Gail; Wahab, Mohamed; Critchley, Christine; Finger, Robert P
To assess the Knowledge, Attitudes and Practice (KAP) amongst the general community regarding type 2 diabetes mellitus (DM) in rural Bangladesh. Data was collected using cluster random sampling from 3104 adults residing in a rural district in Bangladesh. Participants underwent a KAP questionnaire survey regarding assessing diabetes, socio-demographic and medical history. Descriptive, Chi-square and regression analyses were performed. Participants were aged between 30 and 89 years (M = 51, SD= 11.8) and 65.5% were female. The prevalence of diabetes was found to be 8.3%. The majority (93%) reported to have heard of diabetes, yet only 4% knew what a glucose tolerance test was. Only 50% reported that they knew physical inactivity was a risk factor. Age, gender, level of education and socio-economic status (SES) were significantly associated with KAP. A lower proportion (41%) of older participants (aged ≥65 years) reported that they knew that dietary modifications assist in diabetes control compared to those aged less than 35 years (69%), plevel of education compared to no schooling (β = 0.726, 95% CI = 0.596, 0.857) reported significantly more knowledge, after multivariate adjustments for covariates. Participants aged under 35 years, (odds ratio (OR)= 1.73, 95% CI = 1.22-2.43) had significantly higher positive attitudes towards treatments of diabetes compared to those aged ≥65 years. Of the 99 people with known diabetes, more than 50% (n = 52) never had their blood sugar levels checked since diagnosis. Knowledge of diabetes and its risk factors is very limited in rural Bangladesh, even in persons diagnosed with type 2 DM. The development of public health programmes to increase knowledge of diabetes and its complications is required to assist people living in rural Bangladesh to control and management of diabetes.
In this paper, the author reviews the history of English language teaching English as a second or foreign language in schools and colleges in Nepal. Teaching English language and literature in Nepal is of about a half a decade, starting from the mid of twentieth century. English learners in Nepal do not have enough exposure to various techniques…
Singh, Dilli Bahadur
Nepal could harness less than 1% of its 83000 MW hydropower potential. Pancheshwar Multipurpose Project (6720 MW) is a bi-national project on Mahakali River bordering between Nepal and India. The earnings from: electricity (NRs. 34.55 billion/year); irrigation (NRs. 5.55 billion/year), fish farming (NRs. 8.65 billion/year), carbon trading (NRs. 4.42 billion/year) and many billions from other sources e.g. eco-tourism, industry, horticulture, herbiculture, floriculture, sericulture, rafting and water sports, educational and vocational training and other industrial/commercial activities can catapult the socioeconomic horizon of Nepal. Hence, PMP should be jointly developed in the earliest and build confidence for the further hydropower development.
Devkota, Hridaya Raj; Murray, Emily; Kett, Maria; Groce, Nora
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth. The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes. Mean ATDP score among healthcare providers (78.52; SD = 14.75), was low compared to the normative score of 100 or higher. Nurses/auxiliary nurse midwives obtained the highest mean score (85.59, SD = 13.45), followed by general clinical health workers (Mean score = 82.64, SD 15.10). The lowest score was obtained by Female Community Health Volunteers (FCHV) (Score = 73.75, SD = 13.40) (P women with disabilities. The mean score difference between those who received disability training and who did not was also found statistically insignificant (P > 0.05). This may reflect the small number of individuals
Dhital, Yam Prasad; Kayastha, Rijan Bhakta; Shi, Jiancheng
The small mountainous country Nepal is situated in the central part of the Himalayas. Its climate varies from tropical in the south to arctic in the north; and natural vegetation follows the pattern of climate and altitude. Water-induced disaster problems including soil erosion, debris flow, landslides and flooding are common due to the unstable landscape. Soil erosion is the most important driving force for the degradation of upland and mountain ecosystems. Soil bioengineering has been used in Nepal for nearly 30 years to deal with erosion problems on slopes, in high way construction and riverbank stabilization. The main soil bioengineering techniques used in Nepal are brush layering, palisades, live check dams, fascines and vegetative stone pitching. This study is based on the geology, climate and vegetation of Nepal and briefly summarizes the application of soil bioengineering on slopes and stream banks, with especial attention to the role of vegetation on slope and stream bank stabilization. Furthermore, this paper addresses the role of community participation and responsibility for successful application of vegetation-based techniques in management, maintenance and utility aspects for the future. In recent years, soil bioengineering techniques are extensively used due to their cost-effectiveness, using locally available materials and low-cost labour in comparison to more elaborate civil engineering works. However, scientific implementation and record-keeping and evaluation of the work are indeed essential.
Dhital, Yam Prasad; Kayastha, Rijan Bhakta; Shi, Jiancheng
The small mountainous country Nepal is situated in the central part of the Himalayas. Its climate varies from tropical in the south to arctic in the north; and natural vegetation follows the pattern of climate and altitude. Water-induced disaster problems including soil erosion, debris flow, landslides and flooding are common due to the unstable landscape. Soil erosion is the most important driving force for the degradation of upland and mountain ecosystems. Soil bioengineering has been used in Nepal for nearly 30 years to deal with erosion problems on slopes, in high way construction and riverbank stabilization. The main soil bioengineering techniques used in Nepal are brush layering, palisades, live check dams, fascines and vegetative stone pitching. This study is based on the geology, climate and vegetation of Nepal and briefly summarizes the application of soil bioengineering on slopes and stream banks, with especial attention to the role of vegetation on slope and stream bank stabilization. Furthermore, this paper addresses the role of community participation and responsibility for successful application of vegetation-based techniques in management, maintenance and utility aspects for the future. In recent years, soil bioengineering techniques are extensively used due to their cost-effectiveness, using locally available materials and low-cost labour in comparison to more elaborate civil engineering works. However, scientific implementation and record-keeping and evaluation of the work are indeed essential.
Adhikari, Ramesh P; Upadhaya, Nawaraj; Satinsky, Emily N; Burkey, Matthew D; Kohrt, Brandon A; Jordans, Mark J D
This study evaluates the feasibility, acceptability, and outcomes of a combined school- and family-based intervention, delivered by psychosocial counselors, for children with behavior problems in rural Nepal. Forty-one children participated at baseline. Two students moved to another district, meaning 39 children, ages 6-15, participated at both baseline and follow-up. Pre-post evaluation was used to assess behavioral changes over a 4-month follow-up period (n = 39). The primary outcome measure was the Disruptive Behavior International Scale-Nepal version (DBIS-N). The secondary outcome scales included the Child Functional Impairment Scale and the Eyberg Child Behavior Inventory (ECBI). Twelve key informant interviews were conducted with community stakeholders, including teachers, parents, and community members, to assess stakeholders' perceptions of the intervention. The study found that children's behavior problems as assessed on the DBIS-N were significantly lower at follow-up (M = 13.0, SD = 6.4) than at baseline (M = 20.5, SD = 3.8), p behaviors among children and the implementation of new behavior management techniques both at home and in the classroom. Significant change in child outcome measures in this uncontrolled evaluation, alongside qualitative findings suggesting feasibility and acceptability, support moving toward a controlled trial to determine effectiveness.
Ozumba, B C; Obi, S N; Ijioma, N N
The contraceptive information and services offered to single women in most developing countries is compromised by stigma attached to premarital sex. This study was to ascertain the knowledge, attitude and practice of contraception among single women in a rural and urban community in southeast Nigeria, using a cross-sectional survey of 279 and 295 single women in Ngwo (rural) and Enugu (urban) community. The mean age of the population was 21.3 years. Contraceptive awareness was more among the urban than rural respondents (90.2% vs 34.1%). The major sources of contraceptive knowledge were mass media (68%) and peer groups (86.3%) for the urban and rural respondents, respectively. Most respondents in both groups had positive attitude towards contraception. More urban than rural respondents (68.3% vs 12.5%) began sexual activity during adolescence and the level of contraceptive use during first coitus were 48.4% and 13.7%, respectively. Of the currently sexually active respondents, 32.5% (rural) and 59.7% (urban) were using a form of modern contraception. Condoms, followed by oral pills were the most popular contraceptive method because they can easily procure them over the counter. Poor contraceptive information, highly critical behavior of family planning providers towards unmarried women seeking contraception and attitude of male partners militate against contraceptive practice. There is need to promote information and education on contraception among single women, their male partners and family planning providers.
With voices for women's education coming from around the globe, it is a real setback when girls are unable to attend schools during their menstruation or periods, a process they encounter every month. The absence of Nepalese rural female students from schools during their periods does not only have the biological aspect to it but incorporates a…
Upadhyaya, B P; Shakya, G; Adhikari, S; Rijal, N; Acharya, J; Maharjan, L; Marasini, B R
Scrub typhus is a neglected tropical disease and is under reported from Nepal. The objective of this study was to investigate the sero-epidemiology of scrub typhus in patients suffering from acute febrile illness. A total of 434 specimens collected from July to November 2015 at National Public Health Laboratory (NPHL) were investigated for detection of immunoglobulin M (IgM) antibody to Orientiatsutsugamushi.The Scrub Typhus Detect TM kit (InBios, USA) was used to detect the antibodies to O.tsutsugamushi in human serum. Randomly selected 10% positive specimens were used for confirmation by dot- enzyme-linked immunosorbent assay and indirect immunofluorescence assay. Of the total, 175 (40.3%) were positive for IgM antibodies to O. tsutsugamushi. Positive results of scrub typhus were highest among female in 11-20 year followed by males in 41-50 years age group. The IgM antibodies to O. tsutusugamushi were positive in specimens of various geographical regions including 30 districts of Nepal. Positive cases were found in various ecological regions of Nepal. Scrub typhus is one of the neglected tropical diseases in Nepal. Patients with acute febrile illness should be investigated for scrub typhus with high priority. There is an urgent need of reliable and affordable diagnostic tests at all level of health facilities of Nepal. Surveillance and public health awareness about the disease transmission and preventive measures needs to be initiated.
*Table of Contents* Sustainable Aquaculture Fertilization, soil and water quality management in small-scale ponds part II:Soil and water quality management S. Adhikari Fisheries and aquaculture activities in Nepal Tek Gurung Peter Edwards writes on rural aquaculture: A knowledge-base for rural aquaculture Farmers as Scientists: Commercialization of giant freshwater prawn culture in India M.C. Nandeesha Aquaculture in reservoir fed canal based irrigation systems of I...
the spread of disease in Kathmandu. In 1988, when the building of a dam flooded homes and farmland in ... diseases that spread from animals to humans. The research led to the coun- try's first Animal Slaughtering and ... online teaching for mental-health nursing. □ Privacy and new technologies in Asia. Funding for Nepal: ...
Triantafillou, Peter; Sassene, Michel
Today, centres and programmes for the rehabilitation of torture victims are found all over the world. In Nepal, one of the world's poorest countries, the Centre for Victims of Torture (CVICT) has since 1990 provided advanced psychosocial rehabilitation programmes. These and similar psychosocial i....... On both a discursive and a technical-practical level, the psychosocial therapy offered by the CVICT is trying to make torture victims align their personal desires and freedom with the political objectives of turning Nepal into a liberal democracy....
Forsberg, René; Olesen, Arne Vestergaard; Einarsson, Indriði
An airborne gravity survey of Nepal was carried out December 2010 in a cooperation between DTU-Space, Nepal Survey Department, and NGA, USA. The entire country was flown with survey lines spaced 6 nm with a King Air aircraft, with a varying flight altitude from 4 to 10 km. The survey operations...... as well as recent GPS-heights of Mt. Everest. The new airborne data also provide an independent validation of GOCE gravity field results at the local ~100 km resolution scale....
Karkee, Rajendra; Binns, Colin W; Lee, Andy H
There are several barriers for pregnant women to deliver in a health care facility. This prospective cohort study investigated factors affecting facility delivery and reasons for unplanned place of delivery after implementation of the safer mother programme in Nepal. Baseline interviews using a validated questionnaire were conducted on a sample of 700 pregnant women representative of the Kaski district in central Nepal. Follow-up interviews of the cohort were then conducted within 45 days postpartum. Stepwise logistic regression analysis was performed to determine factors associated with the facility delivery outcome. Of the 644 pregnant women whose delivery location had been identified, 547 (85%) gave birth in a health care facility. Women were more likely to deliver in a health facility if they were educated especially with higher secondary or above qualification (adjusted odds ratio (OR) 12.39, 95% confidence interval (CI) 5.09 to 30.17), attended 4 or more antenatal care visits (OR 2.15, 95% CI 1.25 to 3.69), and lived within 30 minutes to the facility (OR 11.61, 95% CI 5.77 to 24.04). For the 97 women who delivered at home, 72 (74.2%) were unplanned, mainly due to quick precipitation of labour making it impossible to reach a health facility. It appeared that facility delivery occurs more frequent among educated women and those who live nearby, even though maternity services are now freely available in Nepal. Because of the difficult terrain and transportation problem in rural areas, interventions that make maternity service physically accessible during antenatal period are needed to increase the utilisation of health facility for child birth.
Full Text Available Naugad is a remote rural municipality in the mountains of far west Nepal with poor accessibility and limited economic opportunities, especially for women and marginalized communities. Promotion of the natural resource-based value chain for allo (the Himalayan nettle, Girardinia diversifolia was identified as an innovative livelihood strategy by the local community. Value chain development started in 2014. The project was designed to focus on women and include participation by the private sector. This paper analyzes the impact of the project, especially on women's lives, using primary and secondary data. A community-owned enterprise was established with private-sector support from the South Asian Association of Regional Cooperation's Business Association of Home Based Workers (SABAH Nepal. The enterprise now has 82 members (69 of them women, with 150 households benefiting directly and indirectly. SABAH Nepal provided training in sustainable harvesting and processing techniques and promotes the products in high-end international markets. A buyback guarantee scheme provides security to local artisans. The quality and range of allo products have increased markedly, as has the share in benefits for local people. Skills training and visits to trade fairs have helped women build their capacity and take a leading role in the value chain process. The community-owned enterprise members have earned up to NPR 4000 per month from sewing, more than the local rate for day labor and sufficient to cover general household expenses. More than 25 women entrepreneurs have started microbusinesses related to allo. Allo has become an important economic asset, transforming the lives of mountain women in this village area. The approach has potential for scaling up across the subtropical to temperate areas of the Himalayan region in Bhutan, China, India, Myanmar, and Nepal.
Full Text Available Cereal crops have played major roles in addressing food security issues in Nepal. In recent years there have been fluctuations in crop production and demands situations due to various reasons. Thus, the present study aims to analyze the dynamics of major cereals productivity in Nepal from 1995 to 2014. Focus group discussions were done in mid-hills and tarai of Nepal in 2015. Percentage change, compound growth rate, annual rate of change, coefficient of variation, instability index were calculated to analyze results. The result shows that the area, production and productivity of major cereals had an increasing trend over the study period. The major factors contributing on productivity increase in cereal crops were irrigation facilities, use of improved and hybrid seeds, chemical fertilizer and better technical knowhow among the farmers. For effective adoption of research outputs to improve the productivity emphasis should also be given on promotion of public private partnership (PPP in research and development.
Williams, Patrick Bassey; Sallar, Anthony M
We assessed the differences and similarities in knowledge, attitude, beliefs, myths, and misconceptions; and the various high-risk behavioral factors that influence the rate of infectivity of human immunodeficiency virus (HIV)/AIDS among African American men in urban and rural communities of Mississippi. A cross-sectional sample survey was conducted on 466 African American men in 2 sites between 2005 and 2007. With the main outcome variables of knowledge, attitude/feelings, behavior/practices, and potentials for behavior change, we administered a 64-item, ethnically sensitive, gender-specific instrument to the subjects via a person-to-person interview. Of the 466 respondents (urban, 33%; rural, 67%), 70%, 14.4%, and 16.6%, respectively, were heterosexual, bisexual, and men who have sex with men (MSM). The number of the respondents' sexual partners in the previous 12 months were: 1 to 2 (54%), 3 to 4 (25.7%), and 5 or more (20.2%). Statistically significant differences were observed between the 2 populations on HIV knowledge (p sexually transmitted infection testing history (p sexual partners (p = .038), unprotected sexual intercourse with drug users (p sexual limits prior to intercourse (p = .027). Although the level of HIV/AIDS knowledge and education were lower among urban than rural respondents, subjects' negative overall beliefs, attitude/feelings, behavior and potentials for behavioral change did not differ significantly among the African American men in the 2 communities.
The effects of invasion by Mikania micrantha in the buffer zone of Chitwan National Park (CNP) of Nepal are well documented; however the studies were confined to appraising the perception of household and did not assess the changes in livelihood activities after the invasion. This study presents the effects of invasion of M. micrantha on the livelihood of buffer zone of the Chitwan National Park; hence addressing the gap in information and shows the complex effect of M. micrantha on rural livelihood. The study used a questionnaire survey to 170 households in the CNP of Nepal. The results indicate that the invasion of M. micrantha have negative effects on the community livelihood in the study area. Basic forest products such as fodder and fuel wood have become scarce as a result of reduction in the native plants. Also the spread of M. micrantha is creating impassable copse that destroy wildlife abode and jungle paths resulting into animals to shift their habitat to core area thereby reducing tourism revenues. Therefore, the study concludes that invasion of M. micrantha directly or indirectly is modifying the rural household livelihoods and a quick action is stipulated. Hence, a higher level body like the Ministry of Forestry or Department of National Park and Wildlife Conservation needs to take care of issues related to alien species. Correspondingly, it is also very important that people are aware and educated about alien species and their effects.
K. C., C., Biswas
The study focuses on exploring problems of franchising in Nepal. Its main objective is to discover obstacles franchisees encounter when bringing a franchise to Nepal and recommendations that are beneficial to their success. The thesis considers the topic both from the franchiser’s and the franchisee’s perspectives. In the literature review, the main concepts presented are franchising, franchiser, franchisee, international franchise, types of franchise systems and franchise agreements, pr...
Frazier, Barbara J.; Niehm, Linda S.; Stoel, Leslie
The Rural Entrepreneurship Teaching Unit (RETU) is designed to acquaint university retailing and hospitality majors with rural entrepreneurship opportunities. The unit is an outcome of a federal grant focused on the contribution of the local retail sector to rural community resilience. The RETU integrates knowledge regarding rural development,…
Shoriki, Takuya; Ichikawa-Seki, Madoka; Devkota, Bhuminand; Rana, Hari B; Devkota, Shiva P; Humagain, Sudeep K; Itagaki, Tadashi
Eighty-one Fasciola flukes collected from 8 districts in Nepal were analyzed for their species identification on the basis of their spermatogenic status and nuclear ribosomal internal transcribed spacer 1 (ITS1) and for their phylogenetic relation with Fasciola flukes from other Asian countries on the basis of the mitochondrial NADH dehydrogenase subunit 1 (nad1) gene. Sixty-one flukes (75.3%) were aspermic Fasciola sp., and 20 flukes (24.7%) were identified as Fasciola gigantica. All of the aspermic flukes displayed the Fh/Fg type in ITS1, which was predominant in aspermic Fasciola sp. from China, and most (60 flukes) displayed the Fsp-ND1-N1 haplotype in the nad1, which had an identical nucleotide sequence to the major haplotype (Fg-C2) of the aspermic flukes from China. These results suggest that aspermic Fasciola sp. was introduced into Nepal from China. Furthermore, the results of the diversity indices, neutrality indices, and median-joining network analysis with reference haplotypes from Asian countries suggest that aspermic Fasciola sp. rapidly expanded its distribution. In contrasts, F. gigantica displayed 10 nad1 haplotypes, which showed higher population diversity indices than the haplotypes of aspermic flukes, indicating that the F. gigantica population was clearly distributed in Nepal earlier than the aspermic Fasciola population. Although the F. gigantica haplotypes from Nepal formed a star-like phylogeny consisting of a main founder haplotype (Fg-ND1-N1), together with some F. gigantica haplotypes from Myanmar and Thailand, the Nepal population differed genetically from F. gigantica populations of neighboring countries as each country had distinct founder haplotype(s). Copyright © 2014 Elsevier Inc. All rights reserved.
Marcílio Souza Carneiro
Isolated communities in the urban environment still use medicinal plants, but such knowledge is not always passed on to new generations. In this scenario, we propose a study with students, teachers, and community residents from Córrego da Ema, Amontada, Ceará, Brazil, aiming to know the wisdom of medicinal plants in a small rural community in the Brazilian semi-arid region. We interviewed the medicinal plant connoisseurs, named as local experts, by using the “snow ball” method. We applied questionnaires to investigate Elementary School students’ knowledge on medicinal plants (pre-tour. These actions provided a basis for planning guided-tours, activities aimed at 51 students, which we carried out along with the 10 experts and 2 local school teachers, whose results (post-tour were assessed by using the same pre-tour questionnaire. Most local experts were women (80%, their families had many people and low education level, factors that contribute to using medicinal plants. Experts cited 35 medicinal plant species. Students cited 24 pre-tour plant species and 28 post-tour plant species. Students increased their knowledge, as there was also a post-tour increase in therapeutic indications and preparation methods, as mentioned. The school played an important role in appreciating this intangible heritage, because it enabled actions involving formal and informal education.
Lagarde, S; Lagier, J-C; Charrel, R; Quérat, G; Vanhomwegen, J; Desprès, P; Pelletier, J; Kaphan, E
Japanese encephalitis is frequent in Asia, with a severe prognosis, but rare in travelers. Culex mosquitoes transmit Japanese encephalitis virus. Risk factors are destination, duration of stay, summer and fall seasons, outdoor activities, and type of accommodation. We report the case of a French traveler to Nepal with neutralization-based serological confirmed Japanese encephalitis. He presented classical clinical (viral syndrome before an encephalitis status with behavioral disorder, global hypotonia, mutism, movement disorders, seizure, and coma), radiological (lesions of thalami, cortico-spinal tracts, and brainstem) and biological features (lymphocytic meningitis). Nowadays, the presence of Japanese encephalitis virus in Nepal, including mountain areas, is established but Japanese encephalitis remains rare in travelers returning from this area and neurologist physicians need to become familiar with this. We recommend vaccination for travelers spending a long period of time in Nepal and having at-risk outdoor activities.
Gupta, Birendra Prasad; Adhikari, Anurag; Rauniyar, Ramanuj; Kurmi, Roshan; Upadhya, Bishnu Prasad; Jha, Bimlesh Kumar; Pandey, Basudev; Das Manandhar, Krishna
Dengue viral infections are known to pose a significant risk during travel to tropical regions, but it is surprising to find dengue transmission in the hilly region of Nepal, which is over 1800mtr above sea level. A 43-year-old Caucasian female traveler from France presented with fever and abdominal pain following a diarrheal illness while visiting the central hilly region of Nepal. Over the course of 9 days, she developed fever, body aches, and joint pain, with hemorrhagic manifestation. She was hospitalized in India and treated with supportive care, with daily monitoring of her platelets. An assessment by enzyme-linked immunosorbent assay showed that she was positive for dengue non-structural protein 1. Upon her return to France, dengue virus was confirmed by reverse transcriptase-polymerase chain reaction. The district where this dengue case was reported is in the hilly region of Nepal, neighboring the capital city Kathmandu. To the best of our knowledge, there has previously been no dengue cases reported from the district. This study is important because it aims to establish a potential region of dengue virus circulation not only in the tropics, but also in the subtropics as well, which in Nepal may exceed elevations of 1800mtr. This recent case report has raised alarm among concerned health personnel, researchers, and organizations that this infectious disease is now on the way to becoming established in a temperate climate.
Rutt, Rebecca Leigh; Chhetri, Bir Bahadur Khanal; Pokharel, Ridish
these functions, the plans must be informed by accurate information about the forest and be actively used by local communities. Based on studies in Nepal, this paper seeks to further our understanding of the role of so-called scientific planning in community-level management through time series analyses of remote......, community-level managers appear well-informed about forest condition and their practices contribute to sustainable forest development. We suggest the need to further scrutinize the regime of scientific management planning as its practical relevance appears questionable....... sensing images, detailed forest inventories and interviews with community forest managers and public forest authorities. Results indicate that technical forest management plans have been elaborated haphazardly and that local communities base their management on other sources of knowledge. Further...
Lam, Nicholas L.; Upadhyay, Basudev; Maharjan, Shovana; Jagoe, Kirstie; Weyant, Cheryl L.; Thompson, Ryan; Uprety, Sital; Johnson, Michael A.; Bond, Tami C.
Understanding how fuels and stoves are used to meet a diversity of household needs is an important step in addressing the factors leading to continued reliance on polluting devices, and thereby improving household energy programs. In Nepal and many other countries dependent on solid fuel, efforts to mitigate the impacts of residential solid fuel use have emphasized cooking while focusing less on other solid fuel dependent end-uses. We employed a four-season fuel assessment in a cohort of 110 households residing in two elevation regions of the Far-Western Development Region (Province 7) of Nepal. Household interviews and direct fuel weights were used to assess seasonality in fuel consumption and its association with stoves that met cooking and non-cooking needs. Per-capita fuel consumption in winter was twice that of other measured seasons, on average. This winter increase was attributed to greater prevalence of use and fuel consumption by supplemental stoves, not the main cooking stove. End-use profiles showed that fuel was used in supplemental stoves to meet the majority of non-meal needs in the home, notably water heating and preparation of animal food. This emphasis on fuels, stoves, and the satisfaction of energy needs—rather than just stoves or fuels—leads to a better understanding of the factors leading to device and fuel choice within households.
HELY, ARNOLD S.M.
IN THIS REPORT ON ADULT EDUCATION IN NEPAL, THE GEOGRAPHIC, ETHNIC, ECONOMIC, EDUCATIONAL, AND POLITICAL FACTORS AFFECTING SOCIAL, EDUCATIONAL, AND ECONOMIC DEVELOPMENT ARE DISCUSSED. THE EXTENT OF PROGRESS IN NATIONAL EDUCATION (INCLUDING LITERACY CAMPAIGNS) SINCE 1951 PROVIDES BACKGROUND FOR A DESCRIPTION OF THE ADMINISTRATIVE ORGANIZATION AND…
In Nepal, maize ranks second after rice both in area and production. In recent years, maize area and production has shown a steady increase, but productivity has been low (2.46 t/ha). The major maize producing regions in Nepal are mid hill (72.85%), terai (17.36%) and high hill (9.79%) respectively. A literature review was carried out to explore major maize diseases and their management in Nepal. The omnipresent incidence of diseases at the pre harvest stage has been an important bottleneck ...
Purpose: In this paper, the knowledge dynamics of the farmer-rural extensionist' interface were explored from extensionists' perspective with the aim of understanding the matchmaking processes between supply and demand of extension services at the micro-level. Design/methodology/approach: Forty semi-structured interviews were conducted with…
Full Text Available Background: Unwanted pregnancy is still a major problem in the modern world despite the widely available contraception services. This study was conducted to determine the knowledge and attitude of married women in the reproductive age group regarding emergency contraception in selected rural areas of Udupi district, India. Material and Methods: The study group comprised of 350 married women in the reproductive age group residing in rural areas of Udupi district, India. A structured questionnaire and an attitude scale were used to assess the knowledge and the attitude. Results: Majority, 69.1% of the married women belonged to Hindu religion, 46.9% had an educational qualification of 10th standard and below. About 13.1% of the married women had undergone abortion. Nearly 96.9% of the married women had heard about emergency contraceptives and only 2% of the married women had used emergency contraceptive pills. About 63.7% out of 339 married women had got information about emergency contraceptive pills from health personnel and about 77.7% from television. Majority 84% had poor knowledge on emergency contraception. About 99.7% had favourable attitude on the use of emergency contraceptives. There was a significant association between knowledge scores and selected variable like education, knowledge and the attitude scores had a correlation. Conclusion: The study identifies the knowledge and attitude of the rural married women regarding emergency contraception, hence to help them to plan future pregnancies and prevent any unwanted or unintended pregnancies.
Opinnäytetyön tavoitteena oli selvittää, kuinka suunnitellaan ja toteutetaan Nepal-ruokakulttuuriprojekti. Projektin toimeksiantajana oli Vantaan ammattiopisto Varia. Projektin johtamisen kirjallisuus oli teoriaosassa pohjana Nepal-ruokakulttuuriprojektin suun-nitelmassa sekä projektin vaiheissa. Projektin johtamisen kirjallisuuden avulla kuvattiin pro-jektinsuunnitelma ja projektin eri vaiheet. Empiirisenä aineiston hankintamenetelmänä käytettiin teemahaastattelua ja kyselyä. Suomi-v...
Olyazadeh, Roya; Jaboyedoff, Michel; Sudmeier-Rieux, Karen; Derron, Marc-Henri; Devkota, Sanjaya
One of the crucial components of post disaster management is the efficient mapping of impacted areas. Here we present a tool designed to map landslides and affected objects after the earthquakes of 2015 in Nepal as well as for intense rainfall impact. Because internet is not available in many rural areas of Nepal, we developed an offline-online prototype based on Open-Source WebGIS technologies to make data on hazard impacts, including damaged infrastructure, landslides or flooding events available to authorities and the general public. This mobile application was designed as a low-cost, rapid and participatory method for recording impacts from hazard events. It is possible to record such events offline and upload them through a server, where internet connection is available. This application allows user authentication, image capturing, and information collation such as geolocation, event description, interactive mapping and finally storing all the data in the server for further analysis and visualisation. This application can be accessed by a mobile phone (Android) or a tablet as a hybrid version for both offline and online versions. The offline version has an interactive-offline map function which allows users to upload satellites image in order to improve ground truthing interpretation. After geolocation, the user can start mapping and then save recorded data into Geojson-TXT files that can be easily uploaded to the server whenever internet is available. This prototype was tested specifically for a rapid assessment of landslides and relevant land use characteristics such as roads, forest area, rivers in the Phewa Lake watershed near Pokhara, Nepal where a large number landslides were activated or reactivated after the 2015 monsoon season. More than 60 landslides were recorded during two days of field trip. Besides, it is possible to use this application for any other kind of hazard event like flood, avalanche, etc. Keywords: Offline, Online, Open source, Web
Ndour, C T; Ba, O; Manga, N M; Fortes, M L; Nyamwasa, D; Sow, P S
Malaria remains a major public health problem in Sub-Saharian Africa, in terms of morbidity and mortality rate. To assess the knowledge and behaviour of population regarding the transmission, the treatment and the prevention of malaria, we conducted a cluster sample household survey in Gossas, a rural District in Senegal, from May 2nd to May 6th 2005. A questionnaire that focused on socioeconomic conditions, beliefs, knowledge about and behavior toward antimalarial medication and the prevention means used was given to 480 household owners. Overall, 107 pregnant women and 1,201 children aged less than 5 years old lived within these household. More than a half of the household owners (51%) were illiterate and 25.2% ignored how malaria is transmitted. Fever was the most common symptom suggesting malaria (61%). In 46.1% of febrile cases, people did not seek for treatment from a physician. Home treatment of febrile episodes was based on paracetamol or aspirin (84%), chloroquine (13%) and cotrimoxazole (2.9%). Overall, the proportion of insecticide treated nets users were 22.7%. This percentage was 14.9% and 11.4% for pregnant women and children younger than 5 years old, respectively. People having radio sets, regular access to television, and people aware of the transmission route of malaria were more likely to use bed nets. In most cases, organic material burning was used as repellent against mosquitoes. The low prevalence of bed net use was most often explained by participants' limited accessibility to and by the high cost of insecticide-treated nets. Knowledge about malaria prevention and treatment is low in the rural district of Gossas. The rate of insecticide-treated-bed nets use in vulnerable people is very low, far from the Abuja meeting objective. A sensibilization program and a social marketing plan for insecticide-treated-bed nets could improve this situation.
Wall, Caleb; Evers, Hans-Dieter
Knowledge loss is not a remote phenomenon, unique to one knowledge system. Rather we argue that the loss of knowledge is an issue for other knowledge systems as well. Knowledge loss is certainly a concern for anthropologists working on indigenous knowledge, fearful of ‘losing’ indigenous knowledge entirely as a result of modernisation (cf. Cox, 2000). Equally, staff movements within the corporate world probably lead to a large amount of knowledge displacement, yet staff (and thus knowledge) r...
Global growth is picking up and the growth in the South Asia region continues to remain strong. A recovery in industrial activity has coincided with a pickup in global trade, after two years of marked weakness. Growth in South Asia remains strong, with regional output projected to grow by 6.8 percent in 2017 and an average of 7.2 percent in 2018–19. Economic activity in Nepal, which reboun...
Fakir M Amirul Islam
Full Text Available To assess the Knowledge, Attitudes and Practice (KAP amongst the general community regarding type 2 diabetes mellitus (DM in rural Bangladesh.Data was collected using cluster random sampling from 3104 adults residing in a rural district in Bangladesh. Participants underwent a KAP questionnaire survey regarding assessing diabetes, socio-demographic and medical history. Descriptive, Chi-square and regression analyses were performed.Participants were aged between 30 and 89 years (M = 51, SD= 11.8 and 65.5% were female. The prevalence of diabetes was found to be 8.3%. The majority (93% reported to have heard of diabetes, yet only 4% knew what a glucose tolerance test was. Only 50% reported that they knew physical inactivity was a risk factor. Age, gender, level of education and socio-economic status (SES were significantly associated with KAP. A lower proportion (41% of older participants (aged ≥65 years reported that they knew that dietary modifications assist in diabetes control compared to those aged less than 35 years (69%, p<0.001. Males (β = 0.393, 95% CI = 0.142-0.643, and any level of education compared to no schooling (β = 0.726, 95% CI = 0.596, 0.857 reported significantly more knowledge, after multivariate adjustments for covariates. Participants aged under 35 years, (odds ratio (OR= 1.73, 95% CI = 1.22-2.43 had significantly higher positive attitudes towards treatments of diabetes compared to those aged ≥65 years. Of the 99 people with known diabetes, more than 50% (n = 52 never had their blood sugar levels checked since diagnosis.Knowledge of diabetes and its risk factors is very limited in rural Bangladesh, even in persons diagnosed with type 2 DM. The development of public health programmes to increase knowledge of diabetes and its complications is required to assist people living in rural Bangladesh to control and management of diabetes.
Purpose: To assess diarrhea-related knowledge, attitude and practice through successive educational interventions. Methods: This was an interventional study conducted at nine different locations of Morang district, Nepal from March 2010 to January 2011. Multistage random sampling approach was adopted to sample 630 ...
Dixit, H; Marahatta, S B
To analyse the impact of the medical colleges that have been set up within the last two decades by production of the doctors and the effect on the health of the people. SWOT (strength, weakness, opportunities and threats) analysis of medical education in Nepal has been done by reviewing medical manpower produced by the different institutions in the undergraduate and postgraduate (PG) categories, their registration with the Nepal Medical Council in terms of the existing health scenario of the country. Shows severe shortage of basic sciences teachers. In the clinical areas ophthalmic manpower and services provided are exemplary. There are shortages and shortcomings in all areas if standard health care is to be provided to the Nepalese. There is a long way to go to provide the expected educational and medical services to foreigners prepared to pay more to avail of this in Nepal.
Sutterlin, Chester E
At noon on Saturday, 25 April 2015, a 7.8 magnitude earthquake struck Nepal. It was centered in the Himalaya northwest of Kathmandu, the capital of over 1 million people. The violent tremors were felt as far away as New Delhi, India 1,000 km from the epicenter, but the worst of its destructive force was experienced in the heavily populated Kathmandu valley and in the remote mountainous villages of the Himalaya. Ancient temples crumbled; poorly constructed buildings collapsed; men, women, and children were trapped and injured, sometimes fatally. Avalanches killed mountain climbers, Sherpa guides, and porters at Everest base camp (EBC). The death toll to date exceeds 8,600 with as many as 20,000 injured. Spinal Health International (SHI), a nonprofit volunteer organization, has been active in Nepal in past years and responded to requests by Nepali spine surgeons for assistance with traumatic spine injury victims following the earthquake. SHI volunteers were present during the 2(nd) major earthquake of magnitude 7.3 on 12 May 2015. Past and current experiences in Nepal will be presented.
Shrestha, Kamal K.
Subsequent to 9/11, concerned countries and UN agencies have taken especial interest in the security of highly radioactive sources throughout the world. The IAEA Nuclear Security Plan (2006-2009) consequently made as a result of UN Security Council Resolution 1540 is binding to all States. The Global Threat Reduction Initiative (GTRI) of the US and the Global Threat Reduction Programme (GTRP) of UK have assisted the four hospitals in Nepal having more than 1,000 Curies of radioactivity in their Cobalt-60 sources used for teletherapy. The physical upgrade of the security of the nuclear materials has also been launched in Nepal for prevention of theft with malicious intention or threats. In this presentation, the radioisotopes in Nepal that comes under different categories according to TECDOC-1355 of IAEA will be described. Problems and issues regarding the security and protection of radioactive sources at hospitals, academic and research institutions that could be prevalent in many developing counties too will be discussed by taking a case study of one of the cancer hospitals in Kathmandu valley. (author)
Jensen, Kasper L; Winschiers-Theophilus, Heike; Rodil, Kasper
As part of a long-term research and co-design project we are creating a 3D visualization interface for an indigenous knowledge (IK) management system with rural dwellers of the Herero tribe in Namibia. Evaluations of earlier prototypes and theories on cultural differences in perception led us...
H.P. Versteegh (Hendt); A. Bakia (Affuenti); H.M. Koopman (Hendrik); V. Kraaij (Vivian); F.G. Versteegh (Florens)
textabstractIntroduction: HIV/AIDS, the most important health problem in Africa, is the leading cause of death on the continent. Ignorance on HIV/AIDS status will hamper treatment and prevention. To investigate the level of HIV/AIDS knowledge among men in a rural area, we performed a questionnaire
Cai, Lawrence; Long, Chao; Karki, Bishal; Nakarmi, Kiran; Iqbal, Adnan; Casertano, Michele; Anderson, Sara; Patell, James; Chang, James; Rai, Shankar Man
In Nepal, burn trauma causes more than 55,000 injuries each year. Burn-related mortality is high in Nepal, in part due to lack of allograft, leading to high infection rates. To address this challenge, our collaboration between Kirtipur Hospital, America Nepal Medical Foundation, Stanford University, and ReSurge International established Nepal's first skin bank. We identified 3 major tasks to create a sustainable skin banking program: 1) identify and acquire the equipment and personnel needed to collect, process, store, and graft cadaveric skin for burn injuries; 2) develop safe donation protocols and documentation tools that remain feasible for low-resource settings; and 3) develop a long-term awareness program to educate the Nepali people on skin donation, a previously foreign concept. Kirtipur Hospital acquired the necessary equipment and materials for the skin bank through a combination of local and international fundraising efforts. Existing U.S. skin banking protocols were adapted for the Nepali setting and piloted on potential patients, donors, and physicians. For the first time in the hospital's history, patients with > 40% total body surface area burns were successfully treated with extensive allografts. It is feasible to create a skin bank in a country with no tradition of allograft skin use. Long-term sustainability now depends on spreading awareness and education in the Kathmandu Valley to overcome religious and cultural barriers that have hindered donor recruitment. Our low-cost and high-impact skin bank provides a model to expand this system to other hospitals both within Nepal and beyond.
Full Text Available Surya Gaire, Rafael Castro Delgado, Pedro Arcos González Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Campus del Cristo, Oviedo, Asturias, SpainAbstract: Nepal has a complicated geophysical structure that is prone to various kinds of disasters. Nepal ranks the most disaster-prone country in the world and has experienced several natural calamities, causing high property and life losses. Disasters are caused by natural processes, but may be increased by human activities. The overall objective of this paper is to analyze the disaster risk profile and existing legal framework of Nepal. The paper is based on secondary data sources. Major causative factors for floods and landslides are heavy and continuous rainfall, outburst floods, infrastructure failure, and deforestation. Historical data of natural disasters in Nepal show that water-induced disasters have killed hundreds of people and affected thousands every year. Likewise, properties worth millions of US dollars have been damaged. There is an increasing trend toward landslides and floods, which will likely continue to rise if proper intervention is not taken. A positive correlation between water-induced disasters and deaths has been observed. Nepal has a poor Index for Risk Management (INFORM. There are fluctuations in the recording of death data caused by flood and landslides. The Government of Nepal focuses more on the response phase than on the preparedness phase of disasters. The existing disaster management act seems to be weak and outdated. There is a gap in current legal procedure, so the country is in dire need of a comprehensive legal framework. The new proposed act seems to take a much broader approach to disaster management. With a long-term vision of managing disaster risk in the country, the Government of Nepal has begun the Nepal Risk Reduction Consortium (NRRC in collaboration with development and humanitarian partners. In order to
Leone, Tiziana; Matthews, Zoë; Dalla Zuanna, Gianpiero
Gender discrimination and son preference are key demographic features of South Asia and are well documented for India. However, gender bias and sex preference in Nepal have received little attention. 1996 Nepal Demographic and Health Survey data on ever-married women aged 15-49 who did not desire any more children were used to investigate levels of gender bias and sex preference. The level of contraceptive use and the total fertility rate in the absence of sex preference were estimated, and logistic regression was performed to analyze the association between socioeconomic and demographic variables and stopping childbearing after the birth of a son. Commonly used indicators of gender bias, such as sex ratio at birth and sex-specific immunization rates, do not suggest a high level of gender discrimination in Nepal. However, sex preference decreases contraceptive use by 24% and increases the total fertility rate by more than 6%. Women's contraceptive use, exposure to the media, parity, last birth interval, educational level and religion are linked to stopping childbearing after the birth of a boy, as is the ethnic makeup of the local area. The level of sex preference in Nepal is substantial. Sex preference is an important barrier to the increase of contraceptive use and decline of fertility in the country; its impact will be greater as desired family size declines.
Modern astronomy is a crowning achievement of human civilization which inspires teenagers to choose career in science and technology and is a stable of adult education. It is a unique and cost effective tool for furthering sustainable global development because of its technological, scientific and cultural dimensions which allow us to reach with the large portion of the community interact with children and inspire with our wonderful cosmos.Using astronomy to stimulate quality and inspiring education for disadvantaged children is an important goal of Nepal Astronomical Society (NASO) since its inception. NASO is carrying out various awareness activities on its own and in collaboration with national and international organizations like Central Department of Physics Tribhuvan University (TU), International astronomical Union (IAU), Department of Physics Prithvi Narayan Campus Pokhara, Nepal academy of science and technology (NAST), Global Hands on Universe (GHOU), EU- UNAWE and Pokhara Astronomical Society (PAS) to disseminate those activities for the school children and teachers in Nepal. Our experiences working with kids, students, teachers and public in the field of universe Awareness Activities for the school children to minimize the abstruse concept of astronomy through some practical approach and the project like Astronomy for the visually impaired students, Galileo Teacher Training program and International School for young astronomers (ISYA) outskirts will be explained which is believed to play vital role in promoting astronomy and space science activities in Nepal.
Govind KC; Tika B. Karki; Jiban Shrestha; Buddhi B. Achhami
Food and nutritional securities are the major threats coupled with declining factor productivity and climate change effects in Nepal. Maize being the principal food crops of the majority of the hill people and source of animal feed for ever growing livestock industries in Terai of Nepal. Despite the many efforts made to increase the maize productivity in the country, the results are not much encouraging. Many of the maize based technologies developed and recommended for the farmers to date ar...
This paper examines the impact of dividends on stock price in the context of Nepal. A majority of earlier studies conducted in developed countries show that dividend has a strong effect than retained earnings. The study examines whether this is consistent in the context of Nepal (or not) and the implication particularly to the banking and non-banking sector. To achieve the objective of the study, a descriptive and analytical research design has been administered. The secondary data are used t...
Naz, Sabrina; Page, Andrew; Agho, Kingsley Emwinyore
Objectives Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among young children in low and lower-middle income countries. This study examines for the first time trends in the association between HAP from cooking fuel and under-five mortality and measures the potential impact of interventions to reduce HAP using Nepal Demographic and Health Survey datasets (2001-2011). Methods A total of 17,780 living children across four age-groups (neonatal 0-28 days, post-neonatal 1-11 months, child 12-59 months and under-five 0-59 months) were included and multi-level logistic regression models were used for analyses. Population attributable fractions of key risk factors and potential impact fractions assessing the impact of previous interventions to reduce exposure prevalence were also calculated. Results Use of cooking fuel was associated with total under-five mortality (OR 2.19, 95% CI 1.37-3.51, P = 0.001) in Nepal, with stronger associations evident for sub-group analyses of neonatal mortality (OR 2.67, 95% CI 1.47-4.82, P = 0.001). Higher association was found in rural areas and for households without a separate kitchen using polluting fuel for cooking, and in women who had never breastfed for all age-groups of children. PIF estimates, assuming a 63% of reduction of HAP based on previously published interventions in Nepal, suggested that a burden of 40% of neonatal and 33% of under-five mortality cases associated with an indoor kitchen using polluting fuel could be avoidable. Conclusion Improved infrastructure and behavioral interventions could help reduce the pollution from cooking fuel in the household resulting in further reduction in under-five mortality in Nepal.
Scrafford, Carolyn G.; Mullany, Luke C.; Katz, Joanne; Khatry, Subarna K.; LeClerq, Steven C.; Darmstadt, Gary L.; Tielsch, James M.
Objective To quantify the incidence of and risk factors for neonatal jaundice among infants referred for care from a rural, low-resource, population-based cohort in southern Nepal. Methods Study participants were 18,985 newborn infants born in Sarlahi District in Southern Nepal from May 2003 through January 2006 who participated in a cluster-randomized, placebo-controlled, community-based trial to evaluate the effect of newborn chlorhexidine cleansing on neonatal mortality and morbidity. Jaundice was assessed based on visual assessment of the infant by a study worker and referral for care. Adjusted relative risks (RR) were estimated to identify risk factors for referral for neonatal jaundice using Poisson regression. Results The incidence of referral for neonatal jaundice was 29.3 per 1,000 live births (95% Confidence Interval: 26.9, 31.7). Male sex, high birth weight, breastfeeding patterns, warm air temperature, primiparity, skilled birth attendance, place of delivery, prolonged labor, oil massage, paternal education, and ethnicity were significant risk factors (p-valuesjaundice, whereas exclusive breastfeeding was protective among infants with no report of difficulty feeding. Conclusions Several known risk factors for neonatal jaundice in a low-resource setting were confirmed in this study. Unique observed associations of jaundice with ambient air temperature and oil massage may be explained by the opportunity for phototherapy based on the cultural practices of this study population. Future research should investigate the role of an infant’s difficulty in feeding as a potential modifier in the association between exclusive breastfeeding and jaundice. PMID:24112359
Lamichhane, Prabhat; Harken, Tabetha; Puri, Mahesh; Darney, Philip D; Blum, Maya; Harper, Cynthia C; Henderson, Jillian T
Sex-selective abortion is expressly prohibited in Nepal, but limited evidence suggests that it occurs nevertheless. Providers' perspectives on sex-selective abortion were examined as part of a larger study on legal abortion in the public sector in Nepal. In-depth interviews were conducted with health care providers and administrators providing abortion services at four major hospitals (n = 35), two in the Kathmandu Valley and two in outlying rural areas. A grounded theory approach was used to code interview transcripts and to identify themes in the data. Most providers were aware of the ban on sex-selective abortion and, despite overall positive views of abortion legalization, saw sex selection as an increasing problem. Greater availability of abortion and ultrasonography, along with the high value placed on sons, were seen as contributing factors. Providers wanted to perform abortions for legal indications, but described challenges identifying sex-selection cases. Providers also believed that illegal sex-selective procedures contribute to serious abortion complications. Sex-selective abortion complicates the provision of legal abortion services. In addition to the difficulty of determining which patients are seeking abortion for sex selection, health workers are aware of the pressures women face to bear sons and know they may seek unsafe services elsewhere when unable to obtain abortions in public hospitals. Legislative, advocacy, and social efforts aimed at promoting gender equality and women's human rights are needed to reduce the cultural and economic pressures for sex-selective abortion, because providers alone cannot prevent the practice. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Full Text Available This paper reviews recent literature concerning effects of climate change on agriculture and its agricultural adaptation strategies, climate change impacts on Chepang communities and their maize farming. Climate change is perhaps the most serious environmental threat to agricultural productivity. Change in temperature and precipitation specially has greater influence on crop growth and productivity and most of these effect are found to be adverse. Climate change has been great global threat with global temperature rise by 0.83 °C and global sea level rise by 0.19 m. Poor countries of the world are more vulnerable to changing climate due to different technological, institutional and resource constraints. In context of Nepal, practices like tree plantation, lowering numbers of livestock, shifting to off farm activities, sloping agricultural land technology (SALT and shifting cultivation are most common coping strategies. Chepang, one of the most backward indigenous ethnic groups of Nepal are also found to perceive change in the climate. Perception and adaptation strategies followed by different farmers of world including Chepang is mainly found to be effected by household head’s age, size of farm, family size, assessment to credit, information and extension service, training received and transportation. Maize is second most important crop in Nepal in which increase in temperature is favorable in Mountain and its yield is negatively influenced by increase in summer rain and maximum temperature. Local knowledge of indigenous people provides new insights into the phenomenon that has not yet been scientifically researched. So, government should combine this perceptive with scientific climate scenario and should conduct activities in term of adoption strategies and policies to insist targeted and marginalized farmers.
Marcílio Souza Carneiro
Full Text Available Isolated communities in the urban environment still use medicinal plants, but such knowledge is not always passed on to new generations. In this scenario, we propose a study with students, teachers, and community residents from Córrego da Ema, Amontada, Ceará, Brazil, aiming to know the wisdom of medicinal plants in a small rural community in the Brazilian semi-arid region. We interviewed the medicinal plant connoisseurs, named as local experts, by using the “snow ball” method. We applied questionnaires to investigate Elementary School students’ knowledge on medicinal plants (pre-tour. These actions provided a basis for planning guided-tours, activities aimed at 51 students, which we carried out along with the 10 experts and 2 local school teachers, whose results (post-tour were assessed by using the same pre-tour questionnaire. Most local experts were women (80%, their families had many people and low education level, factors that contribute to using medicinal plants. Experts cited 35 medicinal plant species. Students cited 24 pre-tour plant species and 28 post-tour plant species. Students increased their knowledge, as there was also a post-tour increase in therapeutic indications and preparation methods, as mentioned. The school played an important role in appreciating this intangible heritage, because it enabled actions involving formal and informal education.
Pan, Ning; Cai, Li; Xu, Caijuan; Guan, Han; Jin, Yu
Despite the growing number of rural-urban migrant children in China, follow-up observation on the oral health of migrant children is still scarce. This study described the changes of oral health knowledge, behaviors and parental practices in migrant children over a period of one year. Possible factors affecting changes were also investigated. The study used purposive sampling to select five private schools of migrant children in Guangzhou. A total of 1900 students in Grades 3 and 4 were recruited. A self-administered questionnaire was used in November 2011 to understand their basic situations, including oral health knowledge, behaviors and parental practices. A final survey was conducted in April 2013 to detect any changes. The mean accuracy of oral health knowledge was 53.17% and 59.42% in 2011 and 2013, respectively (p oral hygiene, dietary habits and parental practices increased at the follow-up evaluation (p oral health knowledge were more likely to achieve significantly positive changes in score of knowledge (p oral hygiene (beta estimate = 0.68, p parental practices in the baseline survey were more likely to obtain beneficial changes. No significant associations between demographic characteristics and changes of oral health knowledge and behaviors (p > 0.05) were observed. Oral health knowledge, behaviors and parental practices among migrant children significantly improved at the follow-up assessment. However, the overall situation was still poor. Positive and effective health education and prevention programs tailored to rural-urban migrant children with varying levels of oral health knowledge, behaviors and parental practices will be needed.
Sreeramareddy Chandrashekhar T; Ramakrishnareddy N; Harsha Kumar HN; Sathian Brijesh; Arokiasamy John T
Abstract Background Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use. Methods A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to ...
Full Text Available Objective: To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level. Methods: A prospective study was performed to compute the burden of road traffic accidents by quantification of disability-adjusted life years (DALYs using the Global Burden of Disease Study method on the basis of 1-year data from nine hospitals in Nepal and the Department of Forensic Medicine and cross-checked with the Nepal Traffic Directorate. Multiple methods were applied to the extrapolated population metrics of the burden of road traffic accidents in Nepal. Results: The total number of years of life lived in disability, years of life lost, and DALYs in Nepal were 38,848±194, 119,935±1464, and 158,783±1658 (95% confidence interval respectively. The number of years lost because of morbidity and death was similar in Kathmandu Valley. Most (75% of the DALYs resulted from years of life lost in Nepal. Males accounted for 73% of DALYs. Almost half (44% of the DALYs were contributed by the group aged 15–29 years. Conclusion: This study is the first to calculate the burden of road traffic accidents in Nepal using Nepal’s own data. Nepal needs to develop and enhance its own system to identify significant public health issues so as to set national priorities for prevention of road traffic accidents.
Kandel, Himal; Murthy, G V S; Bascaran, Covadonga
Uncorrected refractive error is a public health problem globally and in Nepal. Planning of refraction services is hampered by a paucity of data. This study was conducted to determine availability and distribution of human resources for refraction, their efficiency, the type and extent of their training; the current service provision of refraction services and the unmet need in human resources for refraction in Central Nepal. This was a descriptive cross-sectional study. All refraction facilities in the Central Region were identified through an Internet search and interviews of key informants from the professional bodies and parent organisations of primary eye centres. A stratified simple random sampling technique was used to select 50 per cent of refraction facilities. The selected facilities were visited for primary data collection. Face-to-face interviews were conducted with the managers and the refractionists available in the facilities using a semi-structured questionnaire. Data was collected in 29 centres. All the managers (n=29; response rate 100 per cent) and 50 refractionists (Response rate 65.8 per cent) were interviewed. Optometrists and ophthalmic assistants were the main providers of refraction services (n=70, 92.11 per cent). They were unevenly distributed across the region, highly concentrated around urban areas. The median number of refractions per refractionist per year was 3,600 (IQR: 2,400 - 6,000). Interviewed refractionists stated that clients' knowledge, attitude and practice related factors such as lack of awareness of the need for refraction services and/or availability of existing services were the major barriers to the output of refraction services. The total number of refractions carried out in the Central Region per year was 653,176. An additional 170 refractionists would be needed to meet the unmet need of 1,323,234 refractions. The study findings demand a major effort to develop appropriately trained personnel when planning
Yogendra Kumar Karki
Full Text Available Coffee (Coffea spp is an important and emerging cash crop having potential to provide farmers employment and income generation opportunities. This crop is well adapted to the climatic conditions of mid-hills of Nepal. Thus, majority of the farmers are attracted towards cultivation of coffee because of demands in national and international market. Coffee is now becoming integral part of farming system in rural areas. However, information on performance of coffee and farmers response has not been well documented. Therefore, we undertook the present work to analyze demography, ethnicity, household occupation, literacy status, average land holding, coffee cultivation area, livelihood and sources of income of coffee growers, production and productivity, pricing, cropping pattern of the coffee and problesm faced by them in mid hill district of Kavrepalanchowk (hereafter ‘Kavre’ and Lalitpur Districts. All the samples were taken randomly and selected from coffee producing cooperative of Kavre and Lalitpur. Our analysis showed that the male farmer dominant over female on adopting coffee cultivation in both districts with higher value in Kavre. Brahmin and Chetri ethnic communities were in majority over others in adopting the coffee cultivation. Literate farmers were more dominant over illiterates on adopting the coffee cultivation, The mean land holding was less, ranging from 0.15 to 2.30 ha for coffee cultivation, the history of coffee cultivation in Kavre showed that highest number of farmers were engaged in coffee farming from last 16 years. The mean yield of fresh cherry was 1027.20 kg/ha in Kavre, while it was 1849.36 kg/ha in Lalitpur. The study revealed that majority of the coffee plantations were between 6-10 years old. The major problems facing by coffee farmers were diseases spread, lack of irrigation facility and drying of plants. Despite of that the coffee farming was one of the rapidly emerging occupations among the farmers in both
Associated with the unification of Nepal under the ‘Gorkha’ kingdom, and popularly projected in both national myth and globalized tourist imagery, the ‘Gurkhas’ in the British army have been an important national symbol. The history of the ‘Gurkhas’ is multifaceted and also includes chapters abou...... of the ‘Gurkhas’ are discussed in relation to post-conflict identity politics in Nepal......., the ‘symbolic value’ of the ‘Gurkha’ tradition being loaded with notions of bravery and pride has been challenged by competing notions of (post)colonialism and mercenary practice. Hence, the discussion about the ‘Gurkha’ tradition is also a debate about national identities in the changing Nepal. This debate...
Wasti, Sharada Prasad; Simkhada, Padam; Randall, Julian; Van Teijlingen, Edwin
This paper explores some of the key issues and challenges of government HIV/AIDS prevention and treatment programme in Nepal. Providing HIV/AIDS prevention and treatment services in Nepal is associated with a number of issues and challenges which are shaped mostly on cultural and managerial issues from grass root to policy level.\\ud Numerous efforts have been done and going on by Nepal government and non-government organization but still HIV\\ud prevention and treatment service is not able to ...
Sharma, Arati; Shrestha, Bidhan; Chaudhari, Bijay Kumar; Suwal, Pramita; Singh, Raj Kumar; Niraula, Surya Raj; Parajuli, Prakash Kumar
Objectives. This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. Materials and Methods. It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey. Data collection was done th...
Full Text Available Health services research generates useful knowledge. Promotion of implementation of this knowledge in medical practice is essential. Prior to initiation of a major study on rural emergency departments (EDs, we deployed two knowledge transfer strategies designed to generate interest and engagement from potential knowledge users. The objective of this paper was to review: 1 a combined project launch and media press release strategy, and 2 a pre-study survey designed to survey potential knowledge users' opinions on the proposed study variables.We evaluated the impact of the project launch (presentation at two conferences hosted by key stakeholders and media press release via a survey of participants/stakeholders and by calculating the number of media interview requests and reports generated. We used a pre-study survey to collect potential key stakeholder' opinions on the study variables.Twenty-one of Quebec's 26 rural EDs participated in the pre-study survey (81% participation rate. The press release about the study generated 51 press articles and 20 media request for interviews, and contributed to public awareness of a major rural research initiative. In the pre-study survey, thirteen participants (46% mentioned prior knowledge of the research project. Results from the pre-study survey revealed that all of the potential study variables were considered to be relevant for inclusion in the research project. Respondents also proposed additional variables of interest, including factors promoting retention of human resources.The present study demonstrated the potential utility of a two-pronged knowledge transfer strategy, including a combined formal launch and press release, and a pre-study survey designed to ensure that the included variables were of interest to participants and stakeholders.
Chang, Esther; Daly, John; Bell, Pamela; Brown, Tracey; Allan, Jan; Hancock, Karen
Australian nurses (n=202) participated in mental health continuing education delivered via distance methods and regional workshops in rural areas. The majority increased content knowledge and thought audio- and videotapes were effective despite technical difficulties; 90% felt the experiential learning workshops and distance modules integrated…
Bekalu, Mesfin Awoke; Eggermont, Steven
Despite the widespread utilization of the mass media in HIV/AIDS prevention, little is known about the knowledge gap that results from disparities in mass media use. This study examined the relationship between HIV/AIDS-related mass media use and HIV/AIDS-related knowledge among urban and rural residents of northwestern Ethiopia. A hierarchical regression analysis indicated that HIV/AIDS-related mass media use has both sequestering and mainstreaming effects in certain segments of the study population, although it was not a significant predictor of HIV/AIDS-related knowledge in the total population. The knowledge gaps between individuals with high and low education and between individuals who experience high and low levels of interpersonal communication about HIV/AIDS narrowed as HIV/AIDS-related media use increased, but the gap between urban and rural residents widened. The widening gap could be explained by differences in perceptions of information salience and several theoretical assumptions. Current mass media information campaigns, which are often prepared and broadcast from urban centers, may not only fail to improve the HIV/AIDS knowledge of the rural populace but also put rural populations at a disadvantage relative to their urban counterparts. Communication interventions informed by socioecological models might be helpful to redress and/or narrow the widening knowledge gap between urban and rural residents. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Full Text Available The objective of this review is to provide a comprehensive outlook on existing evidence related to breast cancer in Nepal and provide a way forward. Different key words were used to search the articles in MEDLINE, Google Scholar and Google. In addition, grey literatures were searched and experts on related fields were contacted. We also looked into the references of each searched articles. BC cases are on the rise since 1990. It is more common among urban women aged 41‐50. Majority of women presented self‐detected mass at an advanced stage. Most common type of cancer was Invasive ductal carcinoma. Quality of life among BC patients was above average. History of BC treatment goes back to 1992 where first radiation therapy was started. Treatment services are being provided in seven major hospitals along and some private hospitals. BP Koirala memorial hospital is the first specialized cancer hospital in Nepal catering all kind of cancer treatment in Nepal. Different NGOs, government and cancer hospitals are working on prevention of BC in Nepal. Nepal has invested much in detection, diagnosis and treatment of breast cancer. It is high time when the resources should be diverted to primary prevention and early detection along with awareness creation.
He, Na; Zhang, Jinling; Yao, Jinjian; Tian, Xiuhong; Zhao, Genming; Jiang, Qingwu; Detels, Roger
A study of knowledge, attitudes and practices (KAP) of voluntary HIV counseling and testing (VCT) among rural migrants was conducted in Shanghai, China. An anonymous questionnaire was administered face-to-face. Among 2,690 participants, 78% reported having had lifetime sexual intercourse with 41.3% of singles reporting sexual intercourse, 9.2%…
Amélia C. Tuler
Full Text Available São José da Figueira is a rural community which economy is based on small-sized family-owned agricultural and dairy farms. Rural communities often possess medicinal plant knowledge because not only does the rural lifestyle promote this but also because these communities coexist with a wide variety of plants. The aim of this study was to survey the knowledge of the community on plants and their medicinal uses. For data collection, semi-structured interviews and guided tours were carried out. Data were analyzed through the Major Use Agreement. All of the 34 informants were women. Plants were the first choice for use for primary health care by 75% of the interviewees. Of the total of 165 species identified, most species are exotic (45%, obtained by collection in home gardens (88%, and of herbaceous habits (65.7%. Leaves were the plant parts most often used (52%. Decoction was the most widely used form of preparation (41%, and oral intake was cited most often (66.4%. Leonurus sibiricusshowed the highest value of Major Use Agreement (77.3%, in agreement with its popular use to treat diarrhea. The information obtained in this study showed that women in the community have extensive knowledge regarding medicinal plants. The home garden is a space where useful medicinal plants are maintained, and is the main location where these plants are gathered.
Carney, Stephen; Rappleye, Jeremy
The article discusses various reports published within the issue, including papers on various aspects of Nepal's education policy dynamic, a study on young people's experiences of education, especially the faith in schooling as a means to social and economic betterment, and a more radical critique...... of modernity and its relation to education in the South....
Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin
on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. DESIGN: A comprehensive review of available evidence and data sources on prevalence, risk factors, cost......, complications, treatment, and management of diabetes mellitus type 2 in Nepal was conducted through an online database search for articles published in English between January 2000 and November 2015. Additionally, we performed a manual search of articles and reference lists of published articles for additional...... references. RESULTS: Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities...
The number of officially reported cases of HIV infection and of AIDS in Nepal remains low in comparison with numbers in many other Asian countries. But Nepal's open border with India (where HIV infection rates are rapidly rising) and the high level of physical mobility within Nepal and abroad, associated with widespread labor migration and encouraged by the recent development of road transport, means that there is a real danger of a rapid spread of HIV within Nepal. The major means of infection is through heterosexual encounters involving male clients and female sex workers, but other sections of the population are also at risk from infection. Media attention has focused on female sex workers, particularly those who have worked in India, but the issue is far broader than this. Social and economic factors forcing or encouraging young men and women to seek employment away from home underlie the widespread growth of ¿the sex industry¿ and the ¿trafficking¿ of girls and young women. The state's capacity to respond effectively is limited, in part through lack of resources; international agencies are supporting local nongovernmental organizations in a variety of activities designed to ¿educate¿ and to ¿support¿ those at risk; but in the last analysis, it is the local communities from which young men and women migrate and to which they return that are obliged to find ways of coping. Sometimes these communities are supportive of the victims, sometimes not. The spread of HIV-AIDS is not just a ¿health¿ issue, but an issue of economic and social development, of gender relations and of human rights.
Hannah D. Rees
Full Text Available Background In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15–44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women’s beliefs about a potential HPV immunization campaign. Given beliefs’ influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women’s beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. Methods Our sequential explanatory mixed-methods study consisted of two phases: (1 a close-ended questionnaire, followed by (2 a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18–49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19–46. Results The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical
Rees, Hannah D; Lombardo, Alexandra R; Tangoren, Caroline G; Meyers, Sara J; Muppala, Vishnu R; Niccolai, Linda M
In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15-44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women's beliefs about a potential HPV immunization campaign. Given beliefs' influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women's beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. Our sequential explanatory mixed-methods study consisted of two phases: (1) a close-ended questionnaire, followed by (2) a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18-49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19-46. The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical cancer screening arose from interviews and built on
Bhandari, Shiva; Banjara, Megha Raj
Micronutrient deficiency is a global challenge to health as in Nepal. In Nepal, the targeted beneficiaries are less aware about importance of micronutrients (MNs), which has resulted in low intake of foods rich in MNs. Micronutrient deficiencies (MNDs) have huge impact on health of vulnerable population like women and children and have jeopardized the national economy and prosperity of developing countries including Nepal. However, less attention has been paid towards MNDs, which can be prevented. Therefore, this study aims to draw attention of the concerned authorities and researchers to combat against MNDs in Nepal. This study showed that different types of MNDs with higher prevalence exist in Nepal. The major causes of MNDs were poor diet, diseases and infestations, and poor health caring practices. The results of MNDs were unwanted child and maternal mortality, impairments of lives, and reduction in productivity and intellectual capacity. School health and nutrition education and supplementation and fortification of essential MNs proved to be effective while dietary diversification and economic growth and poverty eradication seemed promising. Control and prevention of MNDs can help to achieve Millennium Development Goals as well, so studies in this sector should be emphasized.
Khanal, Vishnu; Gavidia, Tania; Adhikari, Mandira; Mishra, Shiva Raj; Karkee, Rajendra
Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving 'optimum thermal care' among home born newborns of Nepal. Data from the Nepal Demographic and Health Surveys (NDHS) 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9%)) newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976)), attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017)), and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323)) were likely to receive optimum thermal care. The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal.
Full Text Available INTRODUCTION: Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving 'optimum thermal care' among home born newborns of Nepal. METHODS: Data from the Nepal Demographic and Health Surveys (NDHS 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. RESULTS: A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9% newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976, attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017, and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323 were likely to receive optimum thermal care. CONCLUSION: The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal.
Aung, Myo Nyein; Lorga, Thaworn; Srikrajang, Janthila; Promtingkran, Nongluk; Kreuangchai, Suchart; Tonpanya, Wilawan; Vivarakanon, Phatchanan; Jaiin, Puangpet; Praipaksin, Nara; Payaprom, Apiradee
Hypertension is currently a global health concern. Rural and minority populations are increasingly exposed to risk factors as a result of urbanization, leading to hypertension and cardiovascular disease. We conducted a survey in the rural Karen community in Thasongyang District, Tak Province, Thailand, with the aims of determining: the distribution of blood pressure across different age groups; the prevalence of hypertension and other risk factors for cardiovascular diseases (CVDs), including diabetes, smoking, sedentary lifestyle, and excess alcohol use; knowledge and awareness of hypertension as a disease; and knowledge and awareness of risk factors for hypertension among the population at risk. This was a community-based, cross-sectional survey of 298 rural Karen residents. A set of questionnaires assessing lifestyle-related health risk behaviors and awareness and knowledge of hypertension were used. Blood pressure, fasting plasma glucose, weight, height, and waist circumference were measured. Median systolic and diastolic blood pressures were 110 (range 100-120) mmHg and 70 (range 60-80) mmHg, respectively. High blood pressure was observed in more than 27% of the population, with 15% being hypertensive and 12% being prehypertensive. Multinomial logistic regression analysis showed that people in the Karen community who were aware of hypertension were less likely to be current smokers (odds ratio [OR] 0.53, confidence interval [CI] 0.29-0.97) and those with primary school education were more likely to be aware of hypertension than those who did not have a primary school education (OR 6.5, CI 1.9-22.24). Overall, our survey showed that less than half of the Karen community had such knowledge and awareness. It is urgently necessary to promote knowledge, awareness, and health literacy among the ethnic Karen tribes to prevent hypertension and associated CVDs.
Full Text Available Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life. Keywords: rehabilitation; spinal injury.
Access to affordable, reliable and clean energy is fundamental for poverty reduction and sustainable development; without it, the Millennium Development Goals cannot be achieved. Electrification, along with access to modern cooking fuels and mechanical power, is a catalyst for improvements in the fields of poverty reduction, food security, health, education and gender equality. Nevertheless, 1.3 billion people still lack access to electricity, over 95 per cent living in sub-Saharan Africa or developing Asia and 84 per cent of them living in rural areas. There are many different ways to electrify rural areas, not only with regard to the different technologies used, but also to the types of delivery models applied. Common rural electrification technologies include grid extension, community mini-grids, stand-alone household systems, multifunctional platforms, and central charging stations with battery banks. This report will focus on the delivery models used for community mini-grids, as there is evidence to show that mini-grids can be one of the cheaper forms of electrification (on a per unit basis, calculated over the system's lifetime) and also potentially offer a 24 hour AC service that can power a wide range of appliances.
Edgar O. Vazquez-Plass; Joseph M. Wunderle
Peopleâs knowledge of birds and the opinions and perceptions about specific issues related to the conservation of birds were quantified in rural and urban communities in northeastern Puerto Rico. Data were collected using questionnaires in interviews with 131 citizens haphazardly selected within the study site. Our results indicate that urban residents had a...
Poitras, Julien; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Tanguay, Alain; Simard-Racine, Geneviève
Introduction Health services research generates useful knowledge. Promotion of implementation of this knowledge in medical practice is essential. Prior to initiation of a major study on rural emergency departments (EDs), we deployed two knowledge transfer strategies designed to generate interest and engagement from potential knowledge users. The objective of this paper was to review: 1) a combined project launch and media press release strategy, and 2) a pre-study survey designed to survey potential knowledge users’ opinions on the proposed study variables. Materials and Methods We evaluated the impact of the project launch (presentation at two conferences hosted by key stakeholders) and media press release via a survey of participants/stakeholders and by calculating the number of media interview requests and reports generated. We used a pre-study survey to collect potential key stakeholder’ opinions on the study variables. Results Twenty-one of Quebec’s 26 rural EDs participated in the pre-study survey (81% participation rate). The press release about the study generated 51 press articles and 20 media request for interviews, and contributed to public awareness of a major rural research initiative. In the pre-study survey, thirteen participants (46%) mentioned prior knowledge of the research project. Results from the pre-study survey revealed that all of the potential study variables were considered to be relevant for inclusion in the research project. Respondents also proposed additional variables of interest, including factors promoting retention of human resources. Conclusions The present study demonstrated the potential utility of a two-pronged knowledge transfer strategy, including a combined formal launch and press release, and a pre-study survey designed to ensure that the included variables were of interest to participants and stakeholders. PMID:25849328
Narayan Prasad Parajuli
Full Text Available Shigellosis is an acute infectious disease characterized as severe bloody diarrhea (dysentery and is accountable for a significant burden of morbidity and mortality especially in children under the age of 5 years. Antimicrobial therapy is required in the cases of severe dysentery associated with Shigella. However, emergence of multidrug resistant (MDR strains of Shigella spp. over the last two decades has restricted the use of common therapeutic antimicrobials. In MDR strains, the third-generation cephalosporins have been used for the treatment, but, unfortunately, emerging reports of enzyme mediated β-lactam resistance among Shigella isolates from various parts of the world have greatly compromised the therapy of pediatric dysentery. In Nepal, drug resistant strains of Shigella spp. have been reported, but MDR and extended spectrum β-lactamase (ESBL producing strains were previously unknown. Here, we report two Shigella flexneri isolates harboring ESBL genotype-CTX-M associated with acute dysentery in two siblings which were presented and treated in a tertiary care teaching hospital of Kathmandu, Nepal.
Atteraya, Madhu Sudhan; Ebrahim, Nasser B; Gnawali, Shreejana
We examined the prevalence of child maltreatment as measured by the level of physical (moderate to severe) and emotional abuse and child labor, and the associated household level determinants of child maltreatment in Nepal. We used a nationally representative data set from the fifth round of the Nepal Multiple Indicator Cluster Survey (the 2014 NMICS). The main independent variables were household level characteristics. Dependent variables included child experience of moderate to severe physical abuse, emotional abuse, and child labor (domestic work and economic activities). Bivariate analyses and logistic regressions were used to examine the associations between independent and dependent variables. The results showed that nearly half of the children (49.8%) had experienced moderate physical abuse, 21.5% experienced severe physical abuse, and 77.3% experienced emotional abuse. About 27% of the children had engaged in domestic work and 46.7% in various economic activities. At bivariate level, educational level of household's head and household wealth status had shown significant statistical association with child maltreatment (pchild labor. In general, child maltreatment is a neglected social issue in Nepal and the high rates of child maltreatment calls for mass awareness programs focusing on parents, and involving all stakeholders including governments, local, and international organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background Women living in every country, irrespective of its development status, have been facing the problem of unintended pregnancy. Unintended pregnancy is an important public health issue in both developing and developed countries because of its negative association with the social and health outcomes for both mothers and children. This study aims to determine the prevalence and the factors influencing unintended pregnancy among currently pregnant married women in Nepal. Methods This paper reports on data drawn from Nepal Demographic and Health Survey (NDHS which is a nationally representative survey. The analysis is restricted to currently pregnant married women at the time of survey. Association between unintended pregnancy and the explanatory variables was assessed in bivariate analysis using Chi-square tests. Logistic regression was used to assess the net effect of several independent variables on unintended pregnancy. Results More than two-fifth of the currently pregnant women (41% reported that their current pregnancy was unintended. The results indicate that age of women, age at first marriage, ideal number of children, religion, exposure to radio and knowledge of family planning methods were key predictors of unintended pregnancy. Experience of unintended pregnancy augments with women's age (odds ratio, 1.11. Similarly, increase in the women's age at first marriage reduces the likelihood of unintended pregnancy (odds ratio, 0.93. Those who were exposed to the radio were less likely (odds ratio, 0.63 to have unintended pregnancy compared to those who were not. Furthermore, those women who had higher level of knowledge about family planning methods were less likely to experience unintended pregnancy (odds ratio, 0.60 compared to those having lower level of knowledge. Conclusion One of the important factors contributing to high level of maternal and infant mortality is unintended pregnancy. Programs should aim to reduce
Mutiso, Victoria N.; Musyimi, Christine W.; Nayak, Sameera S.; Musau, Abednego M.; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K.; Pike, Kathleen; Ndetei, David M.
Background: The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. Aims: This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Methods:
Monyeki, K.D.; Kemper, H.C.G.; Amusa, L.O.; Motshwane, M.
Background: Tobacco products use is the leading cause of chronic diseases morbidity and mortality. This study explores an exposure to tobacco advertisements factors and knowledge, an association with snuff/pipe usage and cigarette smoking among Ellisras rural children aged between 11 to 18
Assan, Abraham; Takian, Amirhossein; Hanafi-Bojd, Ahmad Ali; Rahimiforoushani, Abbas; Nematolahi, Shahrzad
Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.
Baral, Y R; Lyons, K; Skinner, J; van Teijlingen, E R
This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women's role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women's involvement in decision making; and women's autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women's role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery
This article is a reflection about whether new public management (NPM) styles of reforms seen in other developing countries are also seen in Nepal, and to substantiate these facts with the available evidence and findings. The author saw the emergence of NPM ideas in Western industrialized countries like the United Kingdom and New Zealand. Now it exists in several developing countries of Africa and Asia; but it is very hard to generalize the degree and scope of NPM elements' existence. In Southeast Asia, there is still a mix of the old bureaucratic system with new NPM-oriented reform initiatives. Series of administrative reforms, donor conditionality, and the reestablishment of democracy in the country after 1991 have influenced an orientation toward an efficient, people-oriented, mixed-economy model with increasing partnership of private agencies and nongovernmental organizations in Nepal. The political movement of the last 15 years in the country has strongly called for a new, efficient, and performance-oriented administration and management culture in the country. There are several initiatives already introduced (public-private partnership, decentralization, good governance, accountability/public auditing, performance-based outcome/results-oriented financing and reporting systems). However, to take this momentum up, it still requires strong willingness of political leaders and senior administrators. At the moment, peace and stability of turmoil, political stability, state-of-the-art management skills, and supportive organizational culture are the fundamental requirements for increasing the realization of, and sustaining the NPM-oriented reforms in Nepal.
Full Text Available The main aim of the study was to determine knowledge and use of modem contractive methods among reproductive age group rural women in Zambia. The study is a descriptive cross-sectional study of 105 randomly selected rural women. Data was collected using semi-structured interview schedule and analyzed using EPI Info version 6 statistical packages. The findings revealed that 63% of the respondents were within the age group 21-35 years, 65% were married and 64% were peasant farmers. 90% of the respondents had heard about modem contraceptives and their main source of information was the Health worker (62%. 76% of the respondents stated that modem contraceptive methods could be obtained from public health facilities. 56% of the respondents were currently using modem contraceptive methods and 46% were not using modem contraceptive methods. Reasons for non use of contraceptive methods were religious beliefs (50%, partner disapproval (30% and side effects (20%. The results showed a relationship between educational level and use of contraceptives (Chi-square 7.83, df = 3, P < 0.05 and spouse approval or support of contractive methods and use of contraceptive (Chisquare 5.9, df = 2, P < 0.05. Therefore, efforts to promote modem contraceptive use among the rural women should be intensified to overcome barriers to contraceptive use and should involve men.
Saied, Khaled G; Al-Taiar, Abdullah; Altaire, Abdulrahman; Alqadsi, Ala; Alariqi, Enas F; Hassaan, Maha
In recent years there have been several reports of outbreaks of dengue fever (DF) in Yemen. This study aimed to describe the prevailing knowledge, attitude and preventive practices regarding DF, and to investigate the factors associated with poor preventive practices in rural areas of Yemen. A population-based, cross-sectional study was conducted on 804 randomly selected heads of household. A pretested, structured questionnaire was administered through face-to-face interviews. Logistic regression was used to investigate factors independently associated with poor practice. Out of 804 participants, 753 (93.7%) were aware of the symptoms of DF and 671 (83.4%) knew that DF was transmitted by mosquito bites. Only 420 (52.2%) knew that direct person-to-person transmission was not possible. Furthermore, 205 (25.5%) thought that someone with DF should be avoided and 460 (57.2%) thought the elimination of breeding sites was the responsibility of health authorities. Poor knowledge of DF and a low level of education were significantly associated with poor preventive practices. In rural areas of Yemen, people have a vague understanding of DF transmission and a negative attitude towards preventative practices. Efforts should be made to correct misconceptions about transmission of the disease and to highlight the importance of community participation in control activities. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Nepal está saliendo de un conflicto y debatiendo el calendario electoral. Los rebeldes maoístas han depuesto las armas y se han unido a la coalición gubernamental. Pero, ¿tendrán las elecciones algún tipo de credibilidad si un gran número de desplazados no puede votar? ¿Qué puede aprender Nepal de las experiencias en otros lugares?.
Aibana, Omowunmi; Franke, Molly; Teng, Jessica; Hilaire, Johanne; Raymond, Max; Ivers, Louise C.
Background Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti. Methodology/Principal Findings We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May–June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52–2.40), preventive methods (OR 1.83; 95% CI 1.46–2.30), and water treatment modalities (OR 2.75; 95% CI 2.16–3.50). Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28–2.05). Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03–1.64). Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14–1.89). Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35–4.51). Conclusion An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti. PMID:24278498
Full Text Available Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti.We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811. An OCV campaign occurred from May-June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥ 3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52-2.40, preventive methods (OR 1.83; 95% CI 1.46-2.30, and water treatment modalities (OR 2.75; 95% CI 2.16-3.50. Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28-2.05. Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03-1.64. Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14-1.89. Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35-4.51.An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti.
Gewa, Constance A; Chepkemboi, Joan
Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers' knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers' knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. In addition to knowledge levels, mothers' beliefs play an important role in mothers' decisions to practice exclusive breastfeeding. Mother's beliefs on the impact of exclusive breastfeeding on the mother's health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.
The purpose of the study was to enhance contraceptive acceptance among currently-married women of reproductive age (CMWRA) through empowerment training of female community health volunteers (FCHVs). Seventeen FCHVs, who were working in Kakani Village Development Committee in the hills of central Nepal, attended an empowerment training that used participatory action research and reinforcement mechanisms. Following the training, the FCHVs were expected to empower the CMWRA to increase their contraceptive use. The impact of the intervention was assessed in a sample of 241 CMWRA, who were neither pregnant nor using contraceptives at the time of selection, by interviewing them before and six months after the intervention. The implementation of the intervention significantly increased the proportion of CMWRA knowing at least one contraceptive method (chi2(ldr)=71 .7, p=0.001). The use of modern contraceptives among the CMWRA from none before the intervention increased to 52.3% six months following the intervention. Satisfaction of the CMWRA with services provided by the FCHVs also significantly increased. The study concludes that empowerment training of FCHVs using participatory action research and peer reinforcement help increase the acceptance of contraceptives among CMWRA.
Wang, S-Y (Simon); Yoon, Jin-Ho; Gillies, R.; Cho, Changrae
Western Nepal has experienced consecutive and worsened winter drought conditions since 2000 culminating in a severe drought episode during 2008-2009. In this study, the meteorological conditons and a historical pespective of the winter droughts in western Nepal were analyzed using respectively instumental records and a paleoclimatic drought index. Althought decadal-scale drought conditions were found to be recurrent in the paleoclimate record, the severity of the recent decadal drought (since 2000) clearly stands out in the 700 years of record and, this is suggestive of potential anthropogenic influences in the recent decades. Meteorological diagnosis using atmospheric reanalysis in the recent decades revealed that (1) winter drought in western Nepal is linked to the Arctic Oscillation and its decadal variability, which initiates a tropospheric short-wave train across the Europe, Eurasia and South Asia, and that (2) the persistent warming of the Indian Ocean likely contributes to the suppression of rainfall through enhanced local Hadley circultion. It is therefore conceivable that the recent spells of decadal drought in Nepal drought are symptomatic of both natural variability and anthropogenic influences.
Dorah U. Ramathuba
Full Text Available Objectives: The study assessed the knowledge, attitudes and breast cancer screening practices amongst women aged 30–65 years residing in a rural South African community. Method: A quantitative, descriptive cross-sectional design was used and a systematic sampling technique was employed to select 150 participants. The questionnaire was pretested for validity and consistency. Ethical considerations were adhered to in protecting the rights of participants. Thereafter, data were collected and analysed descriptively using the Predictive Analytics Software program. Results: Findings revealed that the level of knowledge about breast cancer of women in Makwarani Community was relatively low. The attitude toward breast cancer was negative whereas the majority of women had never performed breast cancer diagnostic methods. Conclusion: Health education on breast cancer screening practices is lacking and the knowledge deficit can contribute negatively to early detection of breast cancer and compound late detection. Based on the findings, community-based intervention was recommended in order to bridge the knowledge gap
This thesis deals with agricultural intensification in Nepal. The initial focus of the study was the System of Rice Intensification (SRI), as introduced in Nepal from 2001. The multiple factors affecting SRI adoption, modification and dissemination together with the option to apply SRI in
Sapkota, Diksha; Bhattarai, Sailesh; Baral, Dharanidhar; Pokharel, Paras K
Violence against women is a global public health problem occurring in multitude of contexts and domestic violence is considered to be the most pervasive one. Poor enforcement of policies, limitation of researches and expertise in this field largely accounts for persistence of this problem and nature of domestic violence and its associated factors are poorly understood. This research aimed to estimate the magnitude of different forms of domestic violence and identify its associated factors. Community based cross sectional study was conducted among 355 married women of reproductive age group of Kusheshwor, Sindhuli, Nepal. The questionnaire adapted from the World Health Organization Multi-Country Study was used for the face to face interviews. Occurrence of current domestic violence was used as outcome variable in logistic regression. Descriptive and multivariate analysis were performed in order to assess the magnitude of domestic violence and to identify its associated factors respectively. Self-reported lifetime prevalence of physical violence was 29.6% and past year prevalence was 15.2%, while corresponding figures for sexual violence were 6.8 and 2.3%, and for psychological violence were 31.0 and 18.3%. Lifetime domestic violence was 38.6% while in past 12 months, prevalence was 23.1%. Furthermore, 12.4% of women were experiencing all forms of violence concurrently. Women with controlling husband and having poor mental health were found to be at higher risk of domestic violence. Domestic violence is still rampant in our society with several forms of violence occurring together. In a country like Nepal, differentials power in relationship and poor mental health was found to be positively associated with violent episodes. This study highlights the infringement of women rights which can be the cause for serious public health consequences.
Asokan, G V; Vanitha, A
Until now, an estimate quotes that 1100 healthcare facilities were damaged and over 100,000 livestock lost in the two earthquakes that occurred in April and May of 2015 in Nepal. Threats of infectious diseases, mostly zoonoses, could affect Nepal's economy, trade, and tourism, and reaching the targets of the United Nations Millennium Development Goals. Historically, outbreaks of infectious diseases, including zoonoses, were largely associated with the aftereffects of the earthquakes. It has been documented that zoonoses constitute 61% of all known infectious diseases. Therefore, the purpose of this communication was to examine the infectious disease outbreaks after earthquakes around the world and explore the risk assessment of the zoonoses threats reported in Nepal and highlight adopting One Health. Our summaries on reported zoonoses in Nepal have shown that parasitic zoonoses were predominant, but other infectious disease outbreaks can occur. The fragile public health infrastructure and inadequately trained public health personnel can accelerate the transmission of infections, mostly zoonoses, in the post impact phase of the earthquake in Nepal. Therefore, we believe that with the support of aid agencies, veterinarians and health professionals can team up to resolve the crisis under One Health. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Chelule, Paul K; Mokgatle, Mathildah M; Zungu, Lindiwe I; Chaponda, Armelia
Fermented foods have positive health effects in adults and children if consumed regularly. However, lack of knowledge and perceptions to-wards fermented foods may limit their usage. This study aimed to assess the caregivers' awareness and usage of fermented foods for feeding children in peri-urban/rural communities of Gauteng Province. A qualitative exploratory study was conducted in June, 2012, in a peri-urban/rural community to assess the awareness and use of fermented foods by child caregivers attending a local antenatal clinic through focus group discussions. Thirty three caregivers participated in the study; however 29 indicated their demographic profiles. Four major themes that emerged from the analysis included knowledge on fermented foods, perceived benefits of fermentation, varied views about fermentation and feeding practices. Fermented foods that caregivers, their families and community members consume include ting, fat cakes, dumplings, sorghum beer and mageu. Findings also showed that children consumed fermented foods in form of soft ting porridge; and yoghurt, marketed as Activia and Danone commercial brands. Also, caregivers were not comfortable feeding their children with fermented foods, indicating their limited knowledge on the nutri-tional value of these foods. It is critical to promote caregivers' knowledge and use of fermented foods for feeding infants and young children in South African rural communities.
Acharya, Krishna Prasad; Niroula, Nirajan; Kaphle, Krishna
OBJECTIVES The aim of this paper is to evaluate the current status of the disease, the mechanism of infection, and pathogenesis, its zoonotic potential, diagnostic advances, treatment regimens, and the preventive measures that can be adopted in managing human brucellosis in under-developed countries such as Nepal. METHODS We performed a systematic review of all the available literture through Google Scholar, PubMed, Gideon Informatics, World Health Organization and other legitimate sources. Other secondary informations were collected from the government agencies such as department of livestock services and Ministry of Health. The obtained information was then re-analysed and summarized. RESULTS Few publications have addressed brucellosis in Nepal and most of those publications have focused on bovine brucellosis with sparse information available on brucellosis in humans and small ruminants. Brucella abortus is the most predominant causative agent followed by B. suis. B. abortus is predominant in cattle accounting for a substantial portion of bovine abortion in the country. Lack of awareness, unhealthy food habit, traditional husbandry practices, and a lack of surveillance and immunization have been the major factors in maintaining a vicious cycle of propagation of the disease in human and animals. Unfortunately, nothing has been done to identify the species of Brucella at the biovar level. CONCLUSIONS Although brucellosis has been reported to be endemic in Nepal, neither the distribution nor the economic and public health impact of this disease is well characterized. Robust and well-designed nationwide survey is warranted to assess the prevalence and distribution of disease in livestock and humans. Such data would facilitate the design of appropriate control programmes. PMID:27703129
Seidel, Allison K; Schetzina, Karen E; Freeman, Sherry C; Coulter, Meredith M; Colgrove, Nicole J
Breast-feeding rates in rural and southeastern regions of the United States are lower than national rates and Healthy People 2020 targets. The objectives of this study were to understand current breast-feeding knowledge, attitudes, and beliefs among rural southern Appalachian adolescents and to explore whether a high school educational intervention designed to address the five tenets (knowledge, attitudes, intentions, perceived behavioral control, and subjective norms) of the theory of planned behavior may be effective in increasing future rates of breast-feeding in this population. An educational session including an interactive game was developed and administered to occupational health science students during a single class period in two county high schools. A presurvey and a postsurvey administered 2 weeks after the intervention were completed by students. Pre- and postsurveys were analyzed using paired t tests and Cohen d and potential differences based on sex and grade were explored. Both pre- and postsurveys were completed by 107 students (78%). Knowledge, attitudes about breast-feeding benefits, subjective norms, and intentions significantly improved following the intervention. Baseline knowledge and attitudes about breast-feeding benefits for mothers were low and demonstrated the greatest improvement. Offering breast-feeding education based on the theory of planned behavior in a single high school class session was effective in improving student knowledge, attitudes, and beliefs about breast-feeding and intention to breast-feed.
Shekhar, Shashank; Sharma, Chanderdeep; Thakur, Sita; Raina, Nidhi
Assessment of the nursing staff knowledge, attitude and practices about cervical cancer screening in a tertiary care teaching institute of rural India. A cross sectional, descriptive, interview- based survey was conducted with a pretested questionnaire among 262 staff nurses of a tertiary care teaching and research institute. In this study 77% respondents knew that Pap smear is used for detection of cervical cancer, but less than half knew that Pap smear can detect even precancerous lesions of cervix. Only 23.4% knew human papilloma virus infection as a risk factor. Only 26.7% of the respondents were judged as having adequate knowledge based on scores allotted for questions evaluating knowledge about cervical cancer and screening. Only 17 (7%) of the staff nurses had themselves been screened by Pap smear, while 85% had never taken a Pap smear of a patient. Adequate knowledge of cervical cancer and screening, higher parity and age >30 years were significantly associated with self screening for cervical cancer. Most nurses held a view that Pap test is a doctor procedure, and nearly 90% of nurses had never referred a patient for Pap testing. The majority of nursing staff in rural India may have inadequate knowledge about cervical cancer screening, and their attitude and practices towards cervical cancer screening could not be termed positive.
Full Text Available In Nepal, maize ranks second after rice both in area and production. In recent years, maize area and production has shown a steady increase, but productivity has been low (2.46 t/ha. The major maize producing regions in Nepal are mid hill (72.85%, terai (17.36% and high hill (9.79% respectively. A literature review was carried out to explore major maize diseases and their management in Nepal. The omnipresent incidence of diseases at the pre harvest stage has been an important bottleneck in increasing production. Till now, a total of 78 (75 fungal and 3 bacterial species are pathogenic to maize crop in Nepal. The major and economically important maize diseases reported are Gray leaf spot, Northern leaf blight, Southern leaf Blight, Banded leaf and sheath blight, Ear rot, Stalk rot, Head smut, Common rust, Downy mildew and Brown spot. Information on bacterial and virus diseases, nematodes and yield loss assessment is also given. Description of the major maize diseases, their causal organisms, distribution, time and intensity of disease incidence, symptoms, survival, spreads, environmental factors for disease development, yield losses and various disease management strategies corresponded to important maize diseases of Nepal are gathered and compiled thoroughly from the available publications. Concerted efforts of NARC commodity programs, divisions, ARS and RARS involving research on maize pathology and their important outcomes are mentioned. The use of disease management methods focused on host resistance has also been highlighted.
Devkota, A; Devkota, B; Ghimire, J; Mahato, R K; Gupta, R P; Hada, A
Health professional mobility has increased in the recent years and is one of the public health concerns in the developing countries including Nepal. On the other hand, we can't ignore a positive shift of Nepali diaspora coming back to Nepal for some work related projects. The objective of this study was thus to estimate the number of Nepalese Diaspora and foreign expatriate those are coming to Nepal and explore the ways and process of their engagement in the health sector of Nepal. Mixed method was used. In total, 13 Key Informant Interviews were conducted at the central level along with record review from professional councils. Nepalese Diasporas mainly come through Diaspora Volunteering Organizations, Non Resident Nepali Association and personal connections to the place of their origin. Nepalese Diasporas have supported as health specialists, health camps and project organizers, trainer and hospital promoters, supplier of equipment including ambulances etc. The Nepalese Diasporas are unrecorded with professional organizations such as NMC and NHPC. As such the real status and results of support from Nepalese Diaspora are not known. Overall, 5,120 foreign medical professionals have served to Nepal through NMC followed by 739 nursing professionals through NNC and 189 paramedical staff through NHPC as of 2012. Systematic information on number and characteristics of the Nepalese Diaspora and their role in the health sector of Nepal is limited. The health professional bodies have some record systems but they lack uniformity and systematic process.
The author visited Nepal from October, 1980, to February, 1981, investigated the geomorphology and upper Quaternary geology in Central Nepal, and collected a number of samples for radiocarbon dating. After returning to his university, he dated ten samples by himself. In Nepal, radiocarbon age has been scarcely reported as yet, besides in Kathmandu valley. Therefore, the author's ten data of the age are very important for the late Quaternary chronological study of Nepal Himalayas. In this paper, the author describes sampling localities and horizons, dating results and their geomorphological significance. These ten samples included Pokhara valley, Marsyandi Kohla, Modi Khola, Madi Khola and Muktinath samples. Some conclusion was derived as for the geomorphological development in central Nepal: The last Himalayan glacial age had already ended before 9,000 yr BP (years before A.D. 1950); In the Midland region, from 4,300 to 600 yr BP, some large-scale mudflows broke out nearly contemporaneously in the upper valleys, and they flowed down torrentially and catastrophically to deposit in the middle course of rivers. But the cause of vast quantity of material suddenly brought down from the Great Himalayas has been still left unexplained. The conclusion like this also was able to be applied to the middle Marsyandi Khola and the Pokhara valley. The wide-spread schema that the river was aggraded in the glacial age and degraded in the interglacial age may not be applicable to the rivers in the Midland region of Nepal Himalayas. (Wakatsuki, Y.)
Neni, Selamat Widiasmoro; Latif, Ahmad Zubaidi Abdul; Wong, Sok Yee; Lua, Pei Lin
This study was carried out to gauge the preliminary insight regarding epilepsy among the rural society. The purposes of this study were: (1) to determine general level of awareness, knowledge and attitudes (AKA) towards epilepsy among rural communities, (2) to compare the AKA level based on socio-demographic characteristics and (3) to investigate rural cohort's perception of the best epilepsy treatment, preference for epilepsy information delivery and preference for mode of transportation to seek medical treatment. This prospective, cross sectional study included a sample of 615 rural residents enrolled via cluster sampling in East Coast region of Peninsular Malaysia (mean age=41.6+/-18.02, female=56.6%, married=65.5%, Malay=94.0%, monthly income 0.05). However, respondents with higher education significantly possessed better attitudes and higher Total AKA level compared to those with lower education level (p<0.001). Employed respondents reported significantly more favourable attitudes than unemployed respondents (p=0.011). Additionally, higher income rural cohorts possessed both significantly better attitudes and better AKA. These rural communities perceived modern medicine as the best epilepsy treatment (56.60%), preferred to obtain direct epilepsy-related information from health personnel (60.4%) and chose to use their own car to seek medical treatment in hospital (76.30%). The outcomes of this preliminary study signified the need to devise a dedicated epilepsy education program for implementation among rural residents. Increased AKA level in the society could enhance the people's acceptance, reduce stigmatisation and improve health-related quality of life (HRQoL) for epilepsy patients and their family. Copyright 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Vijay Pd. Jayshwal
Full Text Available This paper aims to investigate issues in relation of constitutional doctrine which had potential debate among the jurists of Nepal for the issues of time extension. The paper will also argue some weaknesses in the constituent assembly and their role expected by the people of Nepal. This paper will discuss about the evolution of constitution in Nepal, its features, the principle of Constitutionalism embodied in Nepalese constitution. This paper will further argue about the legitimacy of Doctrine of Necessity and its application in Nepal. In last, this paper will show the possibility of constitutional uncertainty by newly elected constituent assembly. Penulisan ini dalam rangka mengkaji doktrin konstitusional yang tengah ramai diperdebatkan oleh para ahli hukum di Nepal, khususnya berkaitan dengan isu mengenai perpanjangan waktu. Melalui tulisan ini, terdapat temuan yang menunjukkan beberapa kelemahan yang ada dalam majelis konstituate Nepal di samping peran-perannya sebagaimana yang diharapkan oleh rakyat Nepal. Tulisan ini membahas pula mengenai evolusi konstitusi Nepal sebagaimana diwujudkan dalam prinsip-prinsip konstitusionalism yang dianut oleh Konstitusi Nepal. Lebih lanjut, berkaitan dengan legitimasi dari Doctrin of Necessity dan penerapannya di Nepal. Pada akhirnya, tulisan ini akan memberikan gambaran mengenai kemungkinan ketidakpastian secara konstitusional berkaitan dengan kondisi majelis konstituante yang baru saja terpilih.
The Nepal Contraceptive Retail Sales (CRS) Project, 5 years after lauching product sales in June 1978, incorporated as a private, nonprofit company under Nepalese management. The transition was finalized in August 1983. The Company will work through a cooperative agreement with USAID/Kathmandu to complement the national family planning goals as the program continues to provide comtraceptives through retail channels at subsidized prices. Company objectives include: increase contraceptive sales by at least 15% per year; make CRS cost effective and move towards self sufficiency; and explore the possibility of marketing noncontraceptive health products to improve primary health care. After only5 years the program can point to some impressive successes. The number of retial shops selling family planning products increased from 100 in 1978 to over 8000, extending CRS product availability to 66 of the country's 75 districts. Retail sales have climbed dramatically in the 5-year period, from Rs 46,817 in 1978 to Rs 271,039 in 1982. Sales in terms of couple year protection CYP) have grown to 24,451 CYP(1982), a 36% increase over 1980 CYP. Since the beginning of the CRS marketing program, total distribution of contraceptives--through both CRS and the Family Planning Maternal and Child Haelth (FP/MCH) Project--has been increasing. While the FP/MCH program remains the largest distributor,contribution of CRS Products is increasing, indicating that CRS is creating new product acceptors. CRS market share in 1982 was 43% for condoms and 16% for oral contraceptives (OCs). CRS markets 5 products which are subsidized in order to be affordable to consumers as well as attractive to sellers. The initial products launched in June 1978 were Gulaf standard dose OCs and Dhaal lubricated colored condoms. A less expensive lubricates, plain Suki-Dhaal condom was introduced in June 1980 in an attempt to reach poorer rural populations, but rural distribution costs are excessive and Suki
Full Text Available Context: There is a shortage of voluntary blood donors in developing countries which are, therefore, more dependent on replacement donors. Aim: To study the knowledge, attitude, and practices regarding voluntary blood donation in a rural block in Vellore, South India. Settings and Designs: A cross-sectional survey in randomly selected villages of a rural block in Vellore, South India. Materials and Methods: Knowledge, attitude, and practices were assessed using a pilot-tested, semi-structured, interviewer-administered questionnaire on randomly chosen rural adults aged between 18 and 60 years. Results: Of the 104 individuals interviewed, 90% were aware of voluntary blood donation, the main source of this awareness being television. Nearly, two-thirds of the participants felt they would fall sick by donating blood and that women and manual laborers were not capable of blood donation. Among the interviewed, 70.3% were of the opinion that blood can purchased with money. Only 44% were willing to donate blood on a voluntary basis. Perceived weakness and a misconception on the apparent lack of blood were the major reasons for unwillingness to donate blood. There was a significant association between willingness to donate blood and educational status as well as occupation, with the less educated and manual laborers unwilling to donate blood on a voluntary basis (odds ratio [OR] = 3.758, confidence interval [CI] = 1.54–9.156; OR = 5.333, CI = 1.429–19.90, respectively. Conclusions: The study found that although awareness on voluntary blood donation among individuals in the rural community was widespread, hesitancy to donate blood in real life situation was high. Since voluntary unpaid donors are the best candidates for blood donation, community being the best available source, education, and motivation of the community should play a greater role in increasing voluntary blood donation.
Constance A. Gewa
Full Text Available Abstract Background Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers’ knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers’ knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. Methods A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. Results Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. Conclusion In addition to knowledge levels, mothers’ beliefs play an important role in mothers’ decisions to practice exclusive breastfeeding. Mother’s beliefs on the impact of exclusive breastfeeding on the mother’s health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.
Havryliuk, Tatiana; Acharya, Bhuwan; Caruso, Emily; Cushing, Tracy
We surveyed Nepali porters and guides as well as English- and non-English-speaking trekkers on their knowledge of altitude illness and its treatment during trekking expeditions to the Annapurna region of Nepal. From March 15 to April 15, 2014, Nepali porters and visiting trekkers were surveyed regarding their ability to recognize and treat altitude illness in Manang, Nepal (3540 m). Their personal use of medications and home remedies and presence of acute mountain sickness (AMS) symptoms were also assessed. 504 subjects were surveyed, including 108 Nepalis. Overall incidence of AMS symptoms was 16%, 5% among Nepalis, and 21% among trekkers. Subjects recognized that headache (88%) was one of the symptoms of AMS, however many reported not knowing the symptoms of high altitude pulmonary edema (40%) or high altitude cerebral edema (42%). 58% of subjects reported carrying and 16% reported taking acetazolamide, while only 2 (0.4%) respondents took dexamethasone. The majority of subjects reported that they would be able to recognize (67%) and treat (62%) altitude illness. Trekkers reported a higher incidence of AMS symptoms than Nepalis. Although most respondents recognized symptoms of AMS, both Nepalis and trekkers lacked knowledge regarding more serious presentations of altitude illness, thus both groups were overconfident in their ability to recognize and treat altitude illness.
Sanquini, A.; Thapaliya, S. M.; Wood, M. M.; Hilley, G. E.
Motivating people in rapidly urbanizing areas to take protective actions against natural disasters faces the challenge that these people often do not know what actions to take, do not believe that such actions are effective, and/or believe that the disaster will not happen to them within their lifetimes. Thus, finding demonstrated ways of motivating people to take protective action likely constitutes a grand challenge for natural disaster risk reduction and resiliency, because it may be one of the largest, lowest-cost sources of potential risk reduction in these situations. We developed a theory-based documentary film (hereafter, intervention) targeted at motivating retrofits of local school buildings, and tested its effectiveness in Kathmandu, Nepal, using a matched-pair clustered randomized controlled trial. The intervention features Nepalese who have strengthened their school buildings as role models to others at schools still in need of seismic work. It was tested at 16 Kathmandu Valley schools from November 2014 through March 2015. Schools were matched into 8 pairs, then randomly assigned to see either the intervention film or an attention placebo control film on an unrelated topic. Testing was completed just five weeks before the M 7.8 Gorkha earthquake struck central Nepal. When compared to the control schools, the schools whose community members saw the retrofit intervention film increased their knowledge of specific actions to take in support of earthquake-resistant construction, belief in the feasibility of making buildings earthquake-resistant, willingness to support seismic strengthening of the local school building, and likelihood to recommend to others that they build earthquake-resistant homes, which have all been shown to be precursors to taking self-protective action. This suggests that employing a mass-media intervention featuring community members who have already taken the desired action increases factors that may accelerate adoption of risk
Lorga, Thaworn; Srithong, Kannapatch; Manokulanan, Pratumpan; Aung, Thin Nyein Nyein; Aung, Myo Nyein
The public knowledge of diabetes is important for prevention of disease. This study aimed to evaluate knowledge of diabetes, risk factors, and the common warning signs of diabetes and complications among community participants in a rural Karen ethnic community. Participants were asked to answer a questionnaire regarding their knowledge of diabetes. Fasting blood glucose testing, blood pressure measurement, and body mass index (BMI) assessment were provided to the participants. The study was conducted at Thasongyang district, Tak province, Thailand. A total of 299 Karen rural residents were included in the study. The median age was 45 years and median fasting blood glucose was 88 mg/dL. The response rate to the questionnaires was 91.97%. Half of the participants knew diabetes is a noncommunicable disease needing lifelong treatment. Overall, one-third of the community participants could correctly answer the knowledge assessment questions regarding risk factors and common features of diabetes. whereas the other two-thirds either gave a wrong answer or were "not sure". Female participants had poorer diabetes knowledge than the males. The public knowledge of diabetes, as represented by this sample of the Karen ethic community, is alarmingly low. There is significant gender difference in knowledge level. Culturally tailored and gender-sensitive diabetes health education interventions are urgently needed in this minority ethnic community.
Desjardins, Anne E; Busman, Mark; Manandhar, Gyanu; Jarosz, Andrew M; Manandhar, Hira K; Proctor, Robert H
The fungus Fusarium graminearum (sexual stage Gibberella zeae) causes ear rot of maize (Zea mays) and contamination with the 8-ketotrichothecenes nivalenol (1) or 4-deoxynivalenol (2), depending on diversity of the fungal population for the 4-oxygenase gene (TRI13). To determine the importance of 1 and 2 in maize ear rot, a survey of naturally contaminated maize in Nepal was combined with experiments in the field and in a plant growth room. In the survey, 1 contamination was 4-fold more frequent than 2 contamination and 1-producers (TRI13) were isolated more than twice as frequently as 2-producers (Psi TRI13). In maize ear rot experiments, genetically diverse 1-producers and 2-producers caused ear rot and trichothecene contamination. Among strains with the same genetic background, however, 1-producers caused less ear rot and trichothecene contamination than did 2-producers. The high frequency of 1 contamination and the high virulence of many 1-producers are of concern because maize is a staple food of rural populations in Nepal and because 1 has proven to be more toxic than 2 to animals.
Atreya, Alok; Kanchan, Tanuj; Nepal, Samata; Acharya, Jenash
Upper Mustang in the Northern Himalayan range of Nepal is the home of brown bears (Ursusarctos). Low-plant biomass as a result of scanty rainfall in Upper Mustang is a reason for habitat overlap of humans and wild animals. Humans who enter into the wild to collect firewood and graze cattle are liable to wild animal attacks. Such attacks, especially by brown bears, are readily identified by the type of injuries. These are more commonly confined to head and neck regions. Cutting, gnawing and tearing by sharp teeth and claws produces specific pattern of injuries, which are devastating but seldom fatal. This article reports a rare case of brown bear injury inflicted upon a man from the Upper Mustang region in Nepal. © The Author(s) 2016.
Islar, Mine; Brogaard, Sara; Lemberg-Pedersen, Martin
The energy justice framework serves as an important decision-making tool in order to understand how different principles of justice can inform energy systems and policies. The realization of the urgency of providing modern energy technology and services particularly to rural areas has prompted both the Nepalese government and development institutions to focus on community-run renewable energy facilities. It is argued that off-grid and micro-scale energy development offers an alternative path to fossil-fuel use and top-down resource management as they democratize the grid and increase marginalized communities' access to renewable energy, education and health care. However, Nepal's energy development is also heavily influenced by demands from the fast-growing economies of neighboring countries such as China and India. As a result, this article evaluates the Nepalese national energy policies by applying the key aspects of the energy justice framework and showing the feasibility constraints due to geopolitical and biophysical factors to the implementation of energy just policies in this developing country context. The empirical evidence is derived from interviews during a one-month fieldwork in the Lalitpur and Katmandu districts of Nepal, site-visits, discourse analysis of expert statements, government policies and newspaper articles as well literature review on peer-review articles. - Highlights: • Energy justice framework can be used as a decision-making tool. • Energy transitions need to be understood from multiple perspectives. • Justice principles may face geopolitical, biophysical and ethical feasibility constraints. • The implementation of energy justice principles requires attention to the problem of agency.
Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin
references. Results Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities, and lack...... on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. Design A comprehensive review of available evidence and data sources on prevalence, risk factors, cost...
Science Education and Research. India ... to look after the welfare of women has been established especially after the World Women ... there was limited number of schools for educating .... knowledge about informal sector associations, rural.
Bastakoti, B.P. [University of Reading (United Kingdom). International and Rural Development Department
The provision of energy in rural households and communities has several implications and uses. The field experience drawn in this paper shows the efforts and approaches employed to make the optimum use of the electric energy through enterprise creation. If rural electrification is left to grow without any directional inputs, experience has shown that, beyond obvious use for lighting, radios and basic home-appliances, uses which might bring economic development to an area, are slow to emerge. To be of development benefit to an area, electricity should be employed in enterprises which employ local people, and add value to local resources. However, contrary to the conventional ideology, the empirical observation from this field experience in one of the hill districts of Nepal demonstrates the positive effect of a rural-electrification programme with various innovative approaches, practical tariff policies and varieties of motivational and entrepreneurship development mechanisms. These strategic approaches with supportive institutional mechanisms have proven conducive for fostering the growth of local enterprises, thus creating employment and resource harnessing. Complementary service mechanisms and policy coordination is a necessary precondition for an effective use of power in the rural community rather than the rhetoric policy of rural electrification in isolation. Electrification in isolation, without any promotional or supportive mechanisms, still creates pitfalls. (author)
Badri Prasad Bastakoti [University of Reading (United Kingdom). International and Rural Development Dept.
The provision of energy in rural households and communities has several implication and uses. The field experience drawn in this paper shows the efforts and approaches employed to make the optimum use of the electric energy through enterprise creation. If rural electrification is left to grow without any directional inputs, experience has shown that, beyond obvious use for lighting, radios and basic home-appliances, uses which might bring economic development to an area, are slow to emerge. To be of development benefit to an area, electricity should be employed in enterprises which employ local people, and add value to local resources. However, contrary to the conventional ideology, the empirical observation from this field experience in one of the hill districts of Nepal demonstrates the positive effect of a rural-electrification programme with various innovative approaches, practical tariff policies and varieties of motivational and entrepreneurship development mechanisms. These strategic approaches with supportive institutional mechanisms have proven conducive for fostering the growth of local enterprises, thus creating employment and resource harnessing. Complementary service mechanisms and policy coordination is a necessary precondition for an effective use of power in the rural community rather than the rhetoric policy of rural electrification in isolation. Electrification in isolation, without any promotional or supportive mechanisms, still creates pitfalls. (author)
Tanvir H. Dewan
Bangladesh and Nepal lie between the Himalayas and low-lying coasts of the Bay of Bengal and are traversed by hundreds of rivers and tributaries. Historical data shows that, since 1970, the scale, intensity and duration of floods have increased in Bangladesh and Nepal, causing grave human suffering; disruptions in normal life and activity, damages of infrastructure, crops and agricultural land with severe impacts on the economy. Bangladesh is affected by torrential rain, glacier melt, upstrea...
Sanghai, Megha Sanghai
This exploratory research aims to study the role of marketing and its relevance in small and medium sized family businesses in Nepal by comparing it to the combined review of authors and academicians in the field of SME/ entrepreneurial marketing. Although marketing is a key factor in the survival and development of business ventures, SMEs in Nepal cannot do conventional marketing because of the limitations of resources which are inherent to Nepalese SMEs and also because business owner/ mana...
Silk Road not only served as a major trade route between India and China, but was also credited for the expansion of Buddhism in this region. India...endowed with legendary fighters of world fame.36 Nepal is the melting pot where two important religions, Hinduism and Buddhism are being practiced...It is believed that Hinduism exists since 1200 BC37 and Buddhism since 520 BC.38 Buddha was born in Nepal, enlightened in India, and Buddhism spread
Thapa, Subash; Paudel, Ishwari Sharma; Bhattarai, Sailesh
Information related to contraception discontinuation, especially in the context of Nepal is very limited. A nested case-control study was carried out to determine the factors affecting discontinuation of intrauterine contraceptive devices (IUCDs). A total of 115 cases (IUCD discontinuers) and 115...
You are wonderful, thank you! On 25 April 2015, Nepal and neighboring countries suffered a violent earthquake, which killed thousands. On 28 April CERN Staff Association and CERN Management appealed to your generosity to help those affected, and opened an account to be able to receive your donations. We are now pleased to announce that the amount raised is CHF 34'800, and was donated to the NGO Live to Love of His Holiness the Gyalwang Drukpa. We thank everyone who contributed to this important cause.
Monyeki, Kotsedi D; Kemper, Han C G; Amusa, Lateef O; Motshwane, Marcus
Tobacco products use is the leading cause of chronic diseases morbidity and mortality. This study explores an exposure to tobacco advertisements factors and knowledge, an association with snuff/pipe usage and cigarette smoking among Ellisras rural children aged between 11 to 18 years. A total of 1654 subjects (854 boys and 800 girls) who were part of the Ellisras Longitudinal Study completed the questionnaire. A significant (p advertising tobacco products among the Ellisras rural boys (17% boys and 12.8% for girls, p advertisements of tobacco products on the TV screens, videos or movies. Exposure to tobacco products advertisements was high among Ellisras rural children. Though tobacco products legislation exists in South Africa, efforts should be taken by the health professionals to emphasize the danger of using tobacco products even among the illiterate. Teachers and parents should refrain from advertising tobacco products at schools and at homes.
Full Text Available Nepal is one of the top twenty countries where potato contributes substantially for the human diet. Enhancing adoption of improved potato varieties could impact on farmer’s income, household food and nutritional security. As such, using a multistage sampling procedure, a study was conducted to assess the determinants of improved potato varieties adoption in Nepal covering 180 samples in four districts, two in hills and two in Tarai region. The study revealed that; Kavre and Bardiya districts in the hills and Tarai, respectively, were dominated by improved potato varieties adoption. On the other hand, Dhankuta and Jhapa in the hills and Tarai, respectively, were dominated by local potato varieties adoption. The informal seed sources followed by agro-vet and market were the major sources for improved varietal adoption. Farmers’ accesses to training and formal seed sources were important factor determining improved potato varietal adoption. However, households with larger farm size were less likely to allocate more area for improved potato varieties as many of farmers were reluctant to take potato cultivation as agri-business and still follow subsistence farming. Potato R&D programs, therefore, need to strengthen formal seed system to enhance access to quality potato seeds and build producer’s capacity through regular training and exposer visits in order to improve adoption of improved potato varieties in Nepal.
Porto, S. M. C.
Full Text Available The significant role that traditional rural buildings have with regard to environmental conservation and rural development is widely acknowledged by the scientific community. These buildings must be protected from inappropriate building interventions that may stem from their rather superficial knowledge. Therefore, this study was directed towards overcoming such a limitation by developing a method based on traditional rural buildings’ characterization. In particular, the study aimed at the characterization of building materials and techniques used for the construction of a number of building components that make up the external envelope of traditional rural buildings. The application of the method to a homogeneous area of the Etna Regional Park (Italy highlighted the need to improve the technical norms of the park’s Territorial Coordination Plan to respect the building characteristics of the traditional rural buildings located in the protected area.La comunidad científica le atribuye a las construcciones rurales tradicionales un papel fundamental en términos de conservación del medioambiente y de evolución rural. Dichos edificios deben ser protegidos contra obras inapropiadas debidas a un conocimiento más bien superficial. Por lo tanto, el objetivo de este estudio fue el de eliminar dichas limitaciones desarrollando un método basado en la caracterización de las construcciones rurales tradicionales, que puede ser aplicado para mejorar el conocimiento de estas últimas. En particular, el susodicho estudio tiene la finalidad de caracterizar los materiales y las técnicas constructivas a emplear para la construcción de algunos componentes del envoltorio externo de las construcciones rurales tradicionales. La aplicación del método propuesto a una zona homogénea del Parque Regional del Etna (Italia puso de relieve la necesidad de mejorar las normas técnicas del Plan de Coordinación Territorial del parque para respetar las caracter
Full Text Available Myo Nyein Aung,1,2 Thaworn Lorga,2 Janthila Srikrajang,2 Nongluk Promtingkran,2 Suchart Kreuangchai,2 Wilawan Tonpanya,2 Phatchanan Vivarakanon,2 Puangpet Jaiin,2 Nara Praipaksin,3 Apiradee Payaprom41Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 2Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 3Baan Rekati Health Station, Thasongyang, Thailand; 4Thasongyang Hospital, ThailandBackground: Hypertension is currently a global health concern. Rural and minority populations are increasingly exposed to risk factors as a result of urbanization, leading to hypertension and cardiovascular disease. We conducted a survey in the rural Karen community in Thasongyang District, Tak Province, Thailand, with the aims of determining: the distribution of blood pressure across different age groups; the prevalence of hypertension and other risk factors for cardiovascular diseases (CVDs, including diabetes, smoking, sedentary lifestyle, and excess alcohol use; knowledge and awareness of hypertension as a disease; and knowledge and awareness of risk factors for hypertension among the population at risk.Methods: This was a community-based, cross-sectional survey of 298 rural Karen residents. A set of questionnaires assessing lifestyle-related health risk behaviors and awareness and knowledge of hypertension were used. Blood pressure, fasting plasma glucose, weight, height, and waist circumference were measured.Results: Median systolic and diastolic blood pressures were 110 (range 100–120 mmHg and 70 (range 60–80 mmHg, respectively. High blood pressure was observed in more than 27% of the population, with 15% being hypertensive and 12% being prehypertensive. Multinomial logistic regression analysis showed that people in the Karen community who were aware of hypertension were less likely to be current smokers (odds ratio [OR] 0.53, confidence interval [CI] 0.29–0.97 and those with primary
Full Text Available Ram Lochan Yadav,1 Rano Mal Piryani,2 Gopendra Prasad Deo,3 Dev Kumar Shah,1 Laxmi Kumari Yadav,4 Md Nazrul Islam1 1Department of Physiology, Chitwan Medical College, Bharatpur, Nepal; 2Department of Internal Medicine and Health Professional Educational Research Center (HPERC, Chitwan Medical College, Bharatpur, Nepal; 3Department of Anaesthesiology and Critical Care, Chitwan Medical College, Bharatpur, Nepal; 4Department of Microbiology, Chitwan Medical College, Bharatpur, Nepal Background: Problem-based learning (PBL was introduced into Basic Medical Sciences early in the 1980s at Tribhuvan University (TU, Nepal, followed by other universities where didactic lecture method was still followed as the main teaching strategy. Despite gaining its popularity worldwide as integrated teaching learning method, PBL is not given importance in Nepal. This study aimed to assess the attitude and perceptions of undergraduate medical students regarding learning outcomes of PBL and to know their views about role and qualities of effective tutors for its successful implementation.Methods: This descriptive study was based on a self-administered questionnaire. The first part of the questionnaire measured students’ perception and attitude toward benefits of PBL and the second part measured students’ perception about role of PBL tutor. Bachelor of Medicine and Bachelor of Surgery (MBBS first year (2014/2015 academic year students at Chitwan Medical College, TU, were asked to express their opinions about the importance of learning outcomes by rating each statement on a five-point Likert scale and the responses were combined into three categorical variables: “agree” (strongly agree plus agree, “neutral”, and “disagree” (strongly disagree plus disagree. Data were analyzed using SPSS version 21.0.Results: Approximately 85.5% participants agreed that PBL is an interesting method of teaching learning. Most of them (86.7% accepted that PBL is an
Paul K Chelule
Full Text Available Background: Fermented foods have positive health effects in adults and children if consumed regularly. However, lack of knowledge and perceptions to-wards fermented foods may limit their usage. This study aimed to assess the caregivers’ awareness and usage of fermented foods for feeding children in peri-urban/rural communities of Gauteng Province. Methods: A qualitative exploratory study was conducted in June, 2012, in a peri-urban/rural community to assess the awareness and use of fermented foods by child caregivers attending a local antenatal clinic through focus group discussions. Results: Thirty three caregivers participated in the study; however 29 indicated their demographic profiles. Four major themes that emerged from the analysis included knowledge on fermented foods, perceived benefits of fermentation, varied views about fermentation and feeding practices. Fermented foods that caregivers, their families and community members consume include ting, fat cakes, dumplings, sorghum beer and mageu. Findings also showed that children consumed fermented foods in form of soft ting porridge; and yoghurt, marketed as Activia and Danone commercial brands. Also, caregivers were not comfortable feeding their children with fermented foods, indicating their limited knowledge on the nutritional value of these foods. Conclusion: It is critical to promote caregivers’ knowledge and use of fermented foods for feeding infants and young children in South African rural communities.
Chelule, Paul K; Mokgatle, Mathildah M; Zungu, Lindiwe I; Chaponda, Armelia
Background: Fermented foods have positive health effects in adults and children if consumed regularly. However, lack of knowledge and perceptions towards fermented foods may limit their usage. This study aimed to assess the caregivers’ awareness and usage of fermented foods for feeding children in peri-urban/rural communities of Gauteng Province. Methods: A qualitative exploratory study was conducted in June, 2012, in a peri-urban/rural community to assess the awareness and use of fermented foods by child caregivers attending a local antenatal clinic through focus group discussions. Results: Thirty three caregivers participated in the study; however 29 indicated their demographic profiles. Four major themes that emerged from the analysis included knowledge on fermented foods, perceived benefits of fermentation, varied views about fermentation and feeding practices. Fermented foods that caregivers, their families and community members consume include ting, fat cakes, dumplings, sorghum beer and mageu. Findings also showed that children consumed fermented foods in form of soft ting porridge; and yoghurt, marketed as Activia and Danone commercial brands. Also, caregivers were not comfortable feeding their children with fermented foods, indicating their limited knowledge on the nutritional value of these foods. Conclusion: It is critical to promote caregivers’ knowledge and use of fermented foods for feeding infants and young children in South African rural communities. PMID:25097837
Poudel, Ajay; Maharjan, Bhagwan; Nakajima, Chie; Fukushima, Yukari; Pandey, Basu D; Beneke, Antje; Suzuki, Yasuhiko
The emergence of extensively drug-resistant tuberculosis (XDR-TB) has raised public health concern for global control of TB. Although molecular characterization of drug resistance-associated mutations in multidrug-resistant isolates in Nepal has been made, mutations in XDR isolates and their genotypes have not been reported previously. In this study, we identified and characterized 13 XDR Mycobacterium tuberculosis isolates from clinical isolates in Nepal. The most prevalent mutations involved in rifampicin, isoniazid, ofloxacin, and kanamycin/capreomycin resistance were Ser531Leu in rpoB gene (92.3%), Ser315Thr in katG gene (92.3%), Asp94Gly in gyrA gene (53.9%) and A1400G in rrs gene (61.5%), respectively. Spoligotyping and multilocus sequence typing revealed that 69% belonged to Beijing family, especially modern types. Further typing with 26-loci variable number of tandem repeats suggested the current spread of XDR M. tuberculosis. Our result highlights the need to reinforce the TB policy in Nepal with regard to control and detection strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.
Dhonathã Santo Rigo
Full Text Available Inadequate occupation of rural areas and the intense exploitation of natural resources characterized by conflicting land use, as well as the divestiture process educational and productive rural population which is subjected, deepens social problems already identified at the end of the last century. The paper aims to study the complex reality of the rural municipality of Derrubadas, as an effort to build knowledge and analysis, identifying the landscaping design in the diversity of natural and social factors present, relatively homogeneous areas and the aspects socioenvironmental gifts in one of them. In the study we used methodological procedures and techniques for qualitative and quantitative approaches. Was done using the analysis of secondary data, reading the landscape, interviewing qualified informants and the community involved, besides the construction of thematic maps using the software spring and physical-chemical analysis of water samples. As a result, is observed the uneven occupation of rural areas of the county, with a large concentration of its population in vulnerable rural areas , low in suitability for agricultural use, limited in terms of production and land. For the community studied, retirement and welfare benefit (family bag are present in income of 75% of the families interviewed. The result of water analysis, virtually all sources remained outside the potability standards established by the Ministry of Health, particularly the presence of total and fecal coliforms. These results are strongly related to social conditions encountered in the community, where 42% of households do not have an indoor bathroom and 50% of the houses, waste products are designed the-sky-opened. Allied to this variable, the lack of environmental planning of areas, mainly springs region, contributing to worsening levels of contamination found and highlights the environmental problems of such a community.
Suwal, Juhee V.
Full Text Available EnglishMaternal mortality has been recognised as a public health problem in the developing countries. The situation concerning maternal mortality in Nepal remained unexplored and vague until the early 1990s. By using 1996 Nepal Family Health Survey, this study discusses the maternal mortality situation in Nepal and analyses the differentials in maternal mortality by place of residence,region, ethnic and religious groups, age at death, and parity. Almost 28 percent of deaths of women in reproductive age was accountable to maternal causes.Logistic regression analysis shows ‘ethnicity,’ ‘age of women,’ and ‘number of births’ as strong predictors of maternal mortality. A number of policy recommendations are suggested to help lower maternal mortality.FrenchLa mortalité liée à la maternité est un des phénomènes de santé qui a étéidentifié dans les pays en voie de développement. La situation de la mortalitéliée à la maternité au Népal est restée inexplorée et assez vague jusqu’au débutdes années 1990. En utilisant les données du Nepal Family Health Survey de1996, cet article examine la situation de la mortalité liée à la maternité au Népalet analyse les différentiels des taux de mortalité par lieu de résidence, région,groupe ethnique et religieux, âge au décès, et parité. Presque 28 pourcent desdécès de femmes en âge de procréer sont liés à la maternité. L’analyse derégression logique démontre que « l’ethnicité », « l’âge des femmes », et le« nombre de naissances » sont de forts prédicteurs du taux des mortalités liées àla maternité.
Using data from the survey of the Ministry of Education, Nepal-2005 for school leaving certificate (SLC) exam, this paper attempts to estimate the impact of private school competition on public school performance for the case of Nepal. The study uses the number of private schools in the neighborhood as a measure of competition. The identification…
Jillian T Henderson
Full Text Available Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion.We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001-2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001-2003, early implementation (2004-2006, and later implementation (2007-2010.23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85. Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75.Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women's health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve
Henderson, Jillian T; Puri, Mahesh; Blum, Maya; Harper, Cynthia C; Rana, Ashma; Gurung, Geeta; Pradhan, Neelam; Regmi, Kiran; Malla, Kasturi; Sharma, Sudha; Grossman, Daniel; Bajracharya, Lata; Satyal, Indira; Acharya, Shridhar; Lamichhane, Prabhat; Darney, Philip D
Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion. We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001-2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001-2003), early implementation (2004-2006), and later implementation (2007-2010). 23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75). Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women's health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve access. Other
Following the violent earthquake in Nepal and neighbouring countries, a collection of money to help the victims was organized at CERN. A sum of 34 800 CHF was collected, and transferred to the NGO Live to Love. On July 22, the NGO sent a letter to CERN thanking for the support (see below). You can also find more information concerning this NGO and how they use their funds on our website: http://staff-association.web.cern.ch/sites/staff-association.web.cern.ch/files/Docs/Live_to_Love.pdf
Chandrashekhar T Sreeramareddy
Full Text Available BACKGROUND: Inequalities in progress towards achievement of Millennium Development Goal four (MDG-4 reflect unequal access to child health services. OBJECTIVE: To examine the time trends, socio-economic and regional inequalities of under-five mortality rate (U5MR in Nepal. METHODS: We analyzed the data from complete birth histories of four Nepal Demographic and Health Surveys (NDHS done in the years 1996, 2001, 2006 and 2011. For each livebirth, we computed survival period from birth until either fifth birthday or the survey date. Using direct methods i.e. by constructing life tables, we calculated yearly U5MRs from 1991 to 2010. Projections were made for the years 2011 to 2015. For each NDHS, U5MRs were calculated according to child's sex, mother's education, household wealth index, rural/urban residence, development regions and ecological zones. Inequalities were calculated as rate difference, rate ratio, population attributable risk and hazard ratio. RESULTS: Yearly U5MR (per 1000 live births had decreased from 157.3 (95% CIs 178.0-138.9 in 1991 to 43.2 (95% CIs 59.1-31.5 in 2010 i.e. 114.1 reduction in absolute risk. Projected U5MR for the year 2015 was 54.33. U5MRs had decreased in absolute terms in all sub groups but relative inequalities had reduced for gender and rural/urban residence only. Wide inequalities existed by wealth and education and increased between 1996 and 2011. For lowest wealth quintile (as compared to highest quintile hazard ratio (HR increased from 1.37 (95% CIs 1.27, 1.49 to 2.54 ( 95% CIs 2.25, 2.86 and for mothers having no education (as compared to higher education HR increased from 2.55 (95% CIs 1.95, 3.33 to 3.75 (95% CIs 3.17, 4.44. Changes in regional inequities were marginal and irregular. CONCLUSIONS: Nepal is most likely to achieve MDG-4 but eductional and wealth inequalities may widen further. National health policies should address to reduce inequalities in U5MR through 'inclusive policies'.
Baidya Nath Mahto
Full Text Available Pest Risk Analysis (PRA is the process of evaluation for biological and economic evidences in order to determine whether a pest should be regulated under phyto-sanitary measures. The present mini review highlights the potential potato pathogen list recorded in Nepal harmful for potato production and productivity. At global scale altogether 135 potential quarantine pests (PQP for potato has been recorded, while in Nepal only 92 PQP were recorded. Out of those 52, 13 and 27 were fungi, bacteria and viruses respectively. Among the 92 PQP, 34, 30 and 13 were considered at high, medium and lower risk type pathogens for potato. There was no information available on other 15 PQP.
Sah, Keshav; Poudel, Ishab; Subedi, Suyog; Singh, Dinesh Kumar; Cocker, Jo; Kushwaha, Peetambar; Colston, Angela; Donadeu, Meritxell; Lightowlers, Marshall W
Neurocysticercosis is a major cause of epilepsy in countries where Taenia solium is endemic and the parasite is a major cause of food-borne disease globally. Pigs are the natural intermediate host involved in transmission of the parasite. T. solium is known to be endemic in Nepal, however there is limited reliable data about the prevalence of the disease in Nepal. The aim of this study was to determine accurately the prevalence of porcine cysticercosis in slaughter age pigs in an area of Nepal where pigs are known to be free-roaming. Pigs were obtained from the Udaypur Village Development Committee (VDC) and Hirminiya & Betahani VDC of the Banke district in Nepal. One hundred and ten animals of slaughter age (approximately 8-16 months old) were purchased, slaughtered and the heart, liver, brain and half the body skeletal musculature were sliced using hand knives and the number and viability of T. solium cysts determined. Thirty two of the 110 animals were found to harbour T. solium cysticerci (29%), of which 30 (27%) were found to have viable cysticerci (93% of the infected animals). This is one of the highest prevalences of porcine cysticercosis that has been reported to date from the results of necropsy on randomly selected animals. This study highlights a high rate of transmission of T. solium in the Banke District of Nepal. It encourages further investigation of human and porcine cysticercosis in Nepal, as well as implementation of efforts to reduce transmission of the parasite and the associated human disease. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Ahmed, M.; Fatmi, Z.; Ali, S.; Ahmed, S.; Ara, N.
Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge, attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have been reported only in urban areas of Pakistan. This survey was conducted for the first time in a rural area of Sindh, Pakistan. This survey was conducted in January 2007 at Thatta, a rural district of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors of district Thatta, who were practicing in private setups for at least last one year. Before TB-DOTS training PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis and management through DOTS. Survey data was analysed through SPSS version 11.05 software. On average, five TB suspects per month were seen by each PP. Only 14% of PPs advised sputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used different combination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over 40% PPs did not prescribe TB treatment regimen according to TB-DOTS category. Majority PPs (85%) did not follow the treatment through sputum microscopy and instead relied on clinical improvement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show compliance to the TB treatment and none of PPs were following the retrieval of default cases. A gross lack of PPs knowledge and right practice regarding TB diagnosis and management through DOTS was identified and needed to be addressed through providing DOTS training. (author)
Singh, R. P.; Ahmad, R.
A comparison of recent observed ground motion parameters of recent Gorkha Nepal earthquake of 25 April 2015 (Mw 7.8) with the predicted ground motion parameters using exitsing attenuation relation of the Himalayan region will be presented. The recent earthquake took about 8000 lives and destroyed thousands of poor quality of buildings and the earthquake was felt by millions of people living in Nepal, China, India, Bangladesh, and Bhutan. The knowledge of ground parameters are very important in developing seismic code of seismic prone regions like Himalaya for better design of buildings. The ground parameters recorded in recent earthquake event and aftershocks are compared with attenuation relations for the Himalayan region, the predicted ground motion parameters show good correlation with the observed ground parameters. The results will be of great use to Civil engineers in updating existing building codes in the Himlayan and surrounding regions and also for the evaluation of seismic hazards. The results clearly show that the attenuation relation developed for the Himalayan region should be only used, other attenuation relations based on other regions fail to provide good estimate of observed ground motion parameters.
Full Text Available “Our Common Future” harmonized development policies around a new sustainable development (SD paradigm, and experts also emphasize the importance of a democratic and equitable approach to define and achieve sustainable development. However, SD targets and indicators are often defined by a suite of experts or a few stakeholder groups, far removed from on-the-ground conditions. The most common expert-led development framework, the United Nations’ Millennium Development Goals (MDGs, promoted one set of targets and indicators for all developing countries. While progress towards these targets was routinely reported at the national scale, these targets may not reflect context-specific sustainable development. We evaluated the relevance and comprehensiveness of MDG 7 (environmental sustainability for Nepal. Although Nepal has met most of the MDG 7 (e.g., forest cover, protected areas coverage, water and sanitation, on closer inspection these indicators do not provide adequate context for ensuring that these targets provide the intended levels of development. Simple forest cover and protected area indicators belie the dearth of ecological conservation on the ground, and water and sanitation indicators do not reflect the inequality of access based on poverty and regions. While the Millennium Development Goals align with broad sustainability concerns in Nepal, these indicators do not reveal its true development conditions.
Wallenius, Todd J.
Science, Technology, Engineering, Mathematics (STEM) education programs are currently being introduced and expanded across "developing" nations. STEM programs often conflict with hegemonic gender norms, for example by targeting girls and women in male dominated societies. However, given the cultural complexity of STEM for girls, implementing educators are rarely asked their point of view on programs from abroad. This study explored the perceptions of educators in Nepal who participated in the Girls Get STEM Skills (GGSS) program, a program funded through the U.S. Department of State for 2015/2016. The 8-month program reached 254 girls across three government schools and included the donation of 30 laptops. In August, 2016, the researcher conducted one-on-one interviews and focus groups with 18 participants at GGSS school sites in Pokhara, Nepal. Qualitative data was gathered on educators' perceptions of teacher roles, Nepal as a developing nation, gender imbalance in STEM, and the GGSS curriculum. The study argues that educators viewed educational topics through the lens of bikas, the Nepali word for development. This suggests that the principal impact of STEM programs--as part of larger development initiatives--may be the creation and reinforcement of new social meanings rather than the tangible impacts of the projects themselves.
Full Text Available Food and nutritional securities are the major threats coupled with declining factor productivity and climate change effects in Nepal. Maize being the principal food crops of the majority of the hill people and source of animal feed for ever growing livestock industries in Terai of Nepal. Despite the many efforts made to increase the maize productivity in the country, the results are not much encouraging. Many of the maize based technologies developed and recommended for the farmers to date are not fully adopted. Therefore, problem is either on technology development or on dissemination or on both. Considering the above facts, some of the innovative and modern approaches of plant breeding and crop management technologies to increase the maize yield need to be developed and disseminated. There is a need for location-specific maize production technologies, especially for lowland winter maize, marginal upland maize production system, and resource poor farmers. Research efforts can be targeted to address both yield potential and on-farm yields by reducing the impacts of abiotic and biotic constraints. Therefore, in order to streamline the future direction of maize research in Nepal, an attempt has been made in this article to highlight the present status and future prospects with few key pathways.
The Buffer Zone (BZ) concept has been introduced in Nepal as a key component of the national biodiversity conservation strategy to mitigate the impacts of protected areas on local communities, and thereby reduce adverse impacts of local people on protected areas. Unlike traditional Buffer Zone programmes which are mostly limited to creating a protective layer and/or distributing economic benefits to local people, the Buffer Zone management approach in Nepal integrates livelihoods and conserva...
Rajesh Kumar Rai
Full Text Available Community forestry in Nepal is considered an exemplary forest management regime. However, the economics behind managing a community forest is not fully studied. This study examines whether the benefits generated from community forest management justify the contributions of forest users. The study is based on a survey of community forest users in Chitwan, Nepal. A household level benefit-cost analysis was performed to quantify and compare the costs and benefits from community forest management. Only direct benefits were included in the analysis. The study shows that older forest user groups derive more benefits to households compared to more recently established ones. The extent of timber harvesting also substantially influences the size of the household benefits. In addition, redistribution of benefits at the household level, in terms of income generating activities and payment for involvement in forest management activities, also enhances household benefits. Sensitivity analysis suggests that the current practice of community forest management enhances the welfare of rural households in this subsistence community. However, this finding is sensitive to assumptions regarding the opportunity cost of time. The study also found that the household costs of community forest management depend upon two factors – the area of community forest and the size of the forest area relative to the number of households.
Full Text Available Globally, puerperal sepsis accounts for an estimated 8-12% of maternal deaths, but evidence is lacking on the extent to which clean delivery practices could improve maternal survival. We used data from the control arms of four cluster-randomised controlled trials conducted in rural India, Bangladesh and Nepal, to examine associations between clean delivery kit use and hand washing by the birth attendant with maternal mortality among home deliveries.We tested associations between clean delivery practices and maternal deaths, using a pooled dataset for 40,602 home births across sites in the three countries. Cross-sectional data were analysed by fitting logistic regression models with and without multiple imputation, and confounders were selected a priori using causal directed acyclic graphs. The robustness of estimates was investigated through sensitivity analyses.Hand washing was associated with a 49% reduction in the odds of maternal mortality after adjusting for confounding factors (adjusted odds ratio (AOR 0.51, 95% CI 0.28-0.93. The sensitivity analysis testing the missing at random assumption for the multiple imputation, as well as the sensitivity analysis accounting for possible misclassification bias in the use of clean delivery practices, indicated that the association between hand washing and maternal death had been over estimated. Clean delivery kit use was not associated with a maternal death (AOR 1.26, 95% CI 0.62-2.56.Our evidence suggests that hand washing in delivery is critical for maternal survival among home deliveries in rural South Asia, although the exact magnitude of this effect is uncertain due to inherent biases associated with observational data from low resource settings. Our findings indicating kit use does not improve maternal survival, suggests that the soap is not being used in all instances that kit use is being reported.
Lorga, Thaworn; Aung, Myo Nyein; Naunboonruang, Prissana; Junlapeeya, Piyatida; Payaprom, Apiradee
The double burden of communicable and noncommunicable diseases (NCD) is an increasing trend in low- and-middle income developing countries. Rural and minority populations are underserved and likely to be affected severely by these burdens. Knowledge among young people could provide immunity to such diseases within a community in the long term. In this study we aimed to assess the knowledge of several highly prevalent NCDs (diabetes, hypertension, and chronic obstructive pulmonary disease [COPD]) and several highly incident communicable diseases (malaria and diarrheal diseases) among Karen high school students in a rural district in far northwest of Thailand. The aim of the study is to explore information for devising life-course health education that will be strategically based in schools. A cross-sectional survey approved by the ethics committee of Boromarajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand was conducted in Thasongyang, Tak province, from September 2011 to January 2012. Questionnaires for assessing knowledge regarding diabetes, hypertension, COPD, malaria, and diarrheal diseases were delivered to all 457 Karen high school students attending Thasongyang high school. A total of 371 students returned the questionnaires. Experts' validation and split-half reliability assessment was applied to the instrument. Students' main sources of health information were their teachers (62%), health care workers (60%), television (59%), and parents (54%). Familial risk factors of diabetes and hypertension were not known to more than two thirds of the students. Except obesity and physical inactivity, lifestyle-related risk factors were also not known to the students. Though living in a malaria-endemic area, many of the Karen students had poor knowledge about preventive behaviors. Half of the students could not give a correct answer about the malaria and hygienic practice, which might normally be traditionally relayed messages. Health education and
Full Text Available Objectives. This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. Materials and Methods. It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey. Data collection was done through a cross-sectional questionnaire survey during the academic schedule of the colleges, supervised and monitored by the investigators themselves. The collected data were coded and entered in Microsoft excel 2013, and statistical analysis was done by SPSS 20 version. Result. A majority of the respondents agreed that they were not provided with sufficient information about implant treatment procedures during their BDS program (65.3%, would like more to be provided in the curriculum (95.1%, and would like to get additional reliable information from dental consultants and specialists (40.7% and training on it from fellowship programs conducted by universities (39.2%. Significant association was seen between the responses and academic levels. Conclusion. Undergraduate dental students of Nepal want more information about dental implants through various means.
Sharma, Arati; Shrestha, Bidhan; Chaudhari, Bijay Kumar; Suwal, Pramita; Singh, Raj Kumar; Niraula, Surya Raj; Parajuli, Prakash Kumar
This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey. Data collection was done through a cross-sectional questionnaire survey during the academic schedule of the colleges, supervised and monitored by the investigators themselves. The collected data were coded and entered in Microsoft excel 2013, and statistical analysis was done by SPSS 20 version. A majority of the respondents agreed that they were not provided with sufficient information about implant treatment procedures during their BDS program (65.3%), would like more to be provided in the curriculum (95.1%), and would like to get additional reliable information from dental consultants and specialists (40.7%) and training on it from fellowship programs conducted by universities (39.2%). Significant association was seen between the responses and academic levels. Undergraduate dental students of Nepal want more information about dental implants through various means.
Panday, A. K.; Prinn, R. G.; Regmi, R. P.
The Kathmandu Valley is a bowl-shaped basin in the Nepal Himalaya, with a rapidly growing city surrounded by rice fields and steep terraced and forested mountain slopes. The valley's air quality is influenced by urban and rural emissions, nocturnal pooling of cold air, slope winds, and a daily exchange of air through mountain passes. To understand these processes and to inform air pollution policy in Nepal, we have carried out the most comprehensive study of air pollution in Nepal to date. During the 9-month dry season of 2004-2005, we carried out continuous measurements every minute of carbon monoxide, ozone, PM10, wind speed, wind direction, solar radiation, temperature, and humidity on the eastern edge of Kathmandu city, at a site that daily received air from both the city and rural areas. We recorded the diurnal cycle of the vertical temperature structure and stability with temperature loggers on towers and mountains. A sodar measured the mixed layer height and upper-level winds. 24-hour simultaneous bag sampling campaigns on mountain peaks, passes, the rural valley, and within the city provided glimpses of the spatial patterns of the diurnal cycle of CO -- a useful tracer of anthropogenic emissions. We measured winds on mountain passes and ozone on mountain peaks. At our main measurement site we found a daily-recurring pattern of CO and PM10, with an afternoon low showing rural background levels, even though the arriving air had traversed the city. This was followed by an evening peak starting at sunset, a second low late at night, and a morning peak enhanced by re-circulation. Pollutants emitted in the valley only traveled out of the valley between the late morning and sunset. During winter months, rush hour was outside of this period, enhancing the morning and evening peaks. Within the city, ozone dropped to zero at night. At mid-day we observed an ozone peak enhanced by photochemical production when the air mass that had been stagnant over the city swept
It has been well documented that young people are more likely to engage in high-risk sexual activity. Appropriate understanding of safe sex, sexual practices, and related behaviors must recognize the importance of socioeconomic and cultural factors in prevention efforts related to HIV and other sexual transmitted infections (STIs). To examine and summarize the opportunities and challenges of sexual health services among young people in Nepal. Review of literature--assessing knowledge, attitudes, and understanding of sex, sexual health, and related sexual risk behaviors, among young people (15-24), in line with the current sociocultural and health service practices. Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science, Cochrane database, and Google were searched. Similarly, documents published at the WHO, United Nations Population Fund, United Nations Development Program, and at national/local level--Ministry of Health, National Center for AIDS, and STD Control were also assessed to access the relevant reports and articles. Published and gray articles were also reviewed. This study contends growing expansion of communication and transportation networks, urbanization, and urban in-migration is creating a different sociocultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage opens a window of opportunity for premarital and unsafe sexual activity among young people and this creates risks of unwanted pregnancy, STIs/HIV and AIDS. Socioeconomic, demographic, and cultural factors have been identified as encouraging factors for risk-taking behaviors among young people. Understanding safer sex and responsible sexual/reproductive behavior is important. Effective and appropriate interventions on sexual and reproductive health education directed at young people and the whole family, including fathers, could have significant effect on reducing risk and related risk
Using data from the survey of the Ministry of Education, Nepal-2005 for School Leaving Certificate Exam, this paper analyzes public and private school performance in Nepal. The ordinary least square estimates suggest that private school students perform better than public school students. However, the problem of self-selection bias arises, as…
The second half of the twentieth century has witnessed a tremendous development in the field of astronomy and space exploration. The large telescope both on the land and in the orbit, using the whole range of the electromagnetic spectra from radio waves to gamma rays are extending their range of exploration, right to the edge of the observable universe, and making astounding discoveries in the process. Many large international telescope facilities and global plans are accessible to all astronomers throughout the world, providing an inexpensive entry to cutting- edge international research for developing countries.Nepal is a mountainous country it has a wide range of climatic and altitude variations which varies from an elevation of 200 meter to ≥ 4000 meter. The average temperature varies from ≥ 25 o C to ≤ 0 to 5oC. Because of these diverse weather and climatic variation there is the potential for the establishment of sophisticated observatory/ data centre and link with each other. So, the future possible opportunity of astronomy in Nepal will be discussed. Besides Education and Research activities conducted in Tribhuvan University, Nepal under the support of International Astronomical Union (IAU) will also be highlighted. The importance brought by those two workshops conducted on data simulation supported by IAU under TF1 will also be discussed which is believed to play a vital role for the promotion and development of astronomy and astrophysics in developing countries.
Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Harsha Kumar, Hn; Sathian, Brijesh; Arokiasamy, John T
Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use. A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas. Prevalence of
Singh, M L
This study examined emigration from Nepal during 1952-91. Data were obtained from census records decennially. Records indicate that the volume of emigration amounted to about 2.39% of total population in 1952-53, and 3.58% in 1991. The level of emigration rose from 198,120 persons to 658,290. Emigrants are persons who were absent from their home for more than 6 months due to tourism, pilgrimage, business trips, studies, employment, or permanent migration. Most emigrants return home after several months or years. A recent survey finds that 14.1% returned after more than 5 years. The Nepal model of migration is different from conventional or Marxist models. For example, landlessness or near landlessness are not the primary reasons for migration. The recent emigration to Arab countries is driven by the desire for better income. Emigrants pay handsomely to go abroad for work (Rs. 85,000). Nepalese emigrate to Australia and the US for a better income and a better life. The proportion of female emigrants was 6.23% of total emigrants to Arab countries, and 16.2% to India. 31% of emigrants were females who emigrated to North America, and 29% emigrated to European countries. Emigrants to Arab countries were likely to return home. Emigrants to North America and Europe were likely to be permanent migrants. The author prefers Mellassoux's (1981) model that says that Nepal is losing manpower during their most productive years. Remittances do not offset the loss. Government costs are incurred for supporting education abroad, benefits in old age and for youth, and the spread of sexually transmitted diseases.
Wang, Dongxu; Stewart, Donald; Chang, Chun
Purpose: The purpose of this paper is to examine the effectiveness of a holistic school-based nutrition programme using the health-promoting school (HPS) approach, on teachers' knowledge, attitudes and behaviour in relation to nutrition in rural China. Design/methodology/approach: A cluster-randomised intervention trial design was employed. Two…
Upadhyay, B P; Ghimire, P; Tashiro, M; Banjara, M R
Influenza is one of the public health burdens in Nepal and its epidemiology is not clearly understood. The objective of this study was to explore the molecular epidemiology and the antigenic characteristics of the circulating influenza viruses in Nepal. A total of 1495 throat swab specimens were collected from January to December, 2014. Real time PCR assay was used for identification of influenza virus types and subtypes. Ten percent of the positive specimens were randomly selected and inoculated onto Madin-Darby Canine Kidney Epithelial cells (MDCK) for influenza virus isolation. All viruses were characterized by the hemagglutination inhibition (HI) assay. Influenza viruses were detected in 421/1495 (28.2%) specimens. Among positive cases, influenza A virus was detected in 301/421 (71.5%); of which 120 (39.9%) were influenza A/H1N1 pdm09 and 181 (60.1%) were influenza A/H3 subtype. Influenza B viruses were detected in 119/421 (28.3%) specimens. Influenza A/H1N1 pdm09, A/H3 and B viruses isolated in Nepal were antigenically similar to the vaccine strain influenza A/California/07/2009(H1N1pdm09), A/Texas/50/2012(H3N2), A/New York/39/2012(H3N2) and B/Massachusetts/2/2012, respectively. Influenza viruses were reported year-round in different geographical regions of Nepal which was similar to other tropical countries. The circulating influenza virus type and subtypes of Nepal were similar to vaccine candidate virus which could be prevented by currently used influenza vaccine.
Bhatt, Chhavi Raj; Shrestha, Shanta Lall; Khanal, Tara; Ween, Borgny
Nepal was accepted as a member of the IAEA in 2007. Nepal is one of the world's least developed countries and is defined in Health Level IV. The population counted 26.4 millions in 2007. The health care sector increases with new hospitals and clinics, however, Nepal has no radiation protection authority or radiation protection regulation in the country until now. The radiation producing equipment in the health sector includes conventional X-ray and dental X-ray equipment, fluoroscopes, mammography, CT, catheterization laboratory equipment, nuclear medicine facilities, a few linear accelerators, Co 60 teletherapy and High Dose Rate brachytherapy sources. The situation regarding dosimetry service for radiation workers is unclear. A survey has been carried out to give an overview of the situation. The data collection of the survey was performed by phone call interviews with responsible staff at the different hospitals and clinics. Data about different occupationally exposed staff, use of personal radiation monitoring and type of dosimetry system were collected. In addition, it was asked if dosimetry reports were compiled in files or databases for further follow-up of staff, if needed. The survey shows that less of 25% of the procedures performed on the surveyed hospitals and clinics are performed by staff with personnel radiation monitoring. Radiation monitoring service for exposed staff is not compulsory or standardized, since there is no radiation protection authority. Nepal has taken a step forward regarding radiation protection, with the IAEA membership, although there are still major problems that have to be solved. An evaluation of the existing practice of staff dosimetry can be the first helpful step for further work in building a national radiation protection authority. (author)
Daniel E Impoinvil
Full Text Available To identify potential environmental drivers of Japanese Encephalitis virus (JE transmission in Nepal, we conducted an ecological study to determine the spatial association between 2005 Nepal JE incidence, and climate, agricultural, and land-cover variables at district level.District-level data on JE cases were examined using Local Indicators of Spatial Association (LISA analysis to identify spatial clusters from 2004 to 2008 and 2005 data was used to fit a spatial lag regression model with climate, agriculture and land-cover variables.Prior to 2006, there was a single large cluster of JE cases located in the Far-West and Mid-West terai regions of Nepal. After 2005, the distribution of JE cases in Nepal shifted with clusters found in the central hill areas. JE incidence during the 2005 epidemic had a stronger association with May mean monthly temperature and April mean monthly total precipitation compared to mean annual temperature and precipitation. A parsimonious spatial lag regression model revealed, 1 a significant negative relationship between JE incidence and April precipitation, 2 a significant positive relationship between JE incidence and percentage of irrigated land 3 a non-significant negative relationship between JE incidence and percentage of grassland cover, and 4 a unimodal non-significant relationship between JE Incidence and pig-to-human ratio.JE cases clustered in the terai prior to 2006 where it seemed to shift to the Kathmandu region in subsequent years. The spatial pattern of JE cases during the 2005 epidemic in Nepal was significantly associated with low precipitation and the percentage of irrigated land. Despite the availability of an effective vaccine, it is still important to understand environmental drivers of JEV transmission since the enzootic cycle of JEV transmission is not likely to be totally interrupted. Understanding the spatial dynamics of JE risk factors may be useful in providing important information to the
Gautam, N. P.
Nepal, a landlocked country in South Asia covers an area of 147, 181 square kilometers. Its elevation ranges from 61m as the lowest to 8848m, the highest peak Everest in the world. More than 80% of the annual rainfall occurs in the monsoon season from June to September. Thus, due to the intense rainfall that occurs within a short period, monsoon acts as the biggest cause for the occurrence of different disastrous events including flood. Beyond it, Nepal lies at the center and southern edge of Hindu-Kush Himalayan (HKH) region, which is the youngest geological formation in the world. Hence, floods and landslides are common in this region. In Nepal, from the records of 1971-2010, floods and landslides are the second biggest cause for casualties after epidemics. Hawaii based Center of Excellence in disaster management and humanitarian assistance in 2015 has declared Nepal as 30th vulnerable country from the aspect of floods. According to WMO definition, integrated flood management (IFM) is a process of promoting an integrated rather than a fragmented approach to flood management, integrating land and water resource development in a river basin within the context of integrated water resources management (IWRM), with the aim of maximizing the net benefits from flood plains while minimizing loss of life from flooding. That is the reason why the IFM is one of the important countermeasures to be implemented in Nepal to reduce the adverse effects of floods. This study emphasizes on the existing conditions along with the challenges of IFM with respect to stakeholder involvement in the context of Nepal. It can be assured that all the highlighted issues coming out from this study will be highly valuable to policy makers, implementing agencies along with scientific and local communities to enhance IFM works in the nation for the benefits of societies.
Pandey, Basu D.; Nabeshima, Takeshi; Pandey, Kishor; Rajendra, Saroj P.; Shah, Yogendra; Adhikari, Bal R.; Gupta, Govinda; Gautam, Ishan; Tun, Mya M. N.; Uchida, Reo; Shrestha, Mahendra; Kurane, Ichiro; Morita, Kouichi
Denguei is an emerging disease in Nepal and was first observed as an outbreak in nine lowland districts in 2006. In 2010, however, a large epidemic of dengue occurred with 4,529 suspected and 917 serologicallyconfirmed cases and five deaths reported in government hospitals in Nepal. The collection of demographic information was performed along with an entomological survey and clinical evaluation of the patients. A total of 280 serum samples were collected from suspected dengue patients. These...
Full Text Available Background Adolescent girls often lack knowledge regarding reproductive health including menstruation hygiene which can be due to socio-cultural barriers in which they grow up. Objectives: To explore the knowledge, practices and sources of information regarding menstruation and hygiene among adolescent girls in Udupi taluk, India. Methods: An epidemiologic study was undertaken using cross-sectional study method among 550 school-going adolescent girls aged13-16 years. A total of 270 were from urban and 280 from the rural area. Stratified cluster sampling was adopted to select the schools and simple random sampling technique to select the participants. Data was collected using a pre-tested questionnaire and analyzed using SPSS version 15.Results Around 34% participants were aware about menstruation prior to menarche, and mothers were the main source of information among both groups. Overall, 70.4% of adolescent girls were using sanitary napkins as menstrual absorbent, while 25.6% were using both cloth and sanitary napkins. Almost half of the rural participants dried the absorbent inside their homes. Conclusions: There is a need to equip the adolescent girls with knowledge regarding safe, hygienic practices to enable them to lead a healthy reproductive life.
Full Text Available About 35 percent of the total demand for medicines in Nepal is covered by Nepali Pharmaceutical companies, and such companies are moving ahead for producing different kinds of medicines. The Government of Nepal, Department of Drug Administration (DDA has formulated different regulations and guidelines to ensure ethical practices in the medical sector of Nepal. Ethical Promotion of Medicine-2007 was developed and released to encourage the improvement of health care through the rational use of medicine and discourage unethical practices. It is distressing that the guidelines have not been implemented properly due to the conflict of interests among concerned stakeholders. The cost of medicine has been very expensive and poor people have always suffered. Key Words: Bonus; Ethical Guideline; Unethical Practices; Pharmaceutical Regulation; Conflict of Interest DOI: 10.3126/dsaj.v3i0.2783 Dhaulagiri Journal of Sociology and Anthropology Vol.3 2009 123-142
Full Text Available Tulsi Ram Bhandari, Prabhakaran Sankara Sarma, Vellappillil Raman Kutty Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India Background: Despite a decade-long armed conflict in Nepal, the country made progress in reducing maternal mortality and is on its way to achieve the Millennium Development Goal Five. This study aimed to assess the degree of the utilization of maternal health care services during and after the armed conflict in Nepal.Methods: This study is based on Nepal Demographic and Health Survey data 2006 and 2011. The units of analysis were women who had given birth to at least one child in the past 5 years preceding the survey. First, we compared the utilization of maternal health care services of 2006 with that of 2011. Second, we merged the two data sets and applied logistic regression to distinguish whether the utilization of maternal health care services had improved after the peace process 2006 was underway.Results: In 2011, 85% of the women sought antenatal care at least once. Skilled health workers for delivery care assisted 36.1% of the women, and 46% of the women attended postnatal care visit at least once. These figures were 70%, 18.7%, and 16%, respectively, in 2006. Similarly, women were more likely to utilize antenatal care at least once (odds ratio [OR] =2.18, confidence interval [CI] =1.95–2.43, skilled care at birth (OR =2.58, CI =2.36–2.81, and postnatal care at least once (OR =4.13, CI =3.75–4.50 in 2011.Conclusion: The utilization of maternal health care services tended to increase continuously during both the armed conflict and the post-conflict period in Nepal. However, the increasing proportion of the utilization was higher after the Comprehensive Peace Process Agreement 2006. Keywords: antenatal care, armed conflict, Nepal, post-conflict, postnatal care, skilled care at birth
Sabeena, Sasidharanpillai; Bhat, Parvati V; Kamath, Veena; Aswathyraj, Sushama; Arunkumar, Govindakarnavar
Cervical cancer is one of the commonest cancers among women all over the world. The association of cervical cancer with human papilloma virus (HPV) is well established. Knowledge about the causal relationship between HPV and cervical cancer is important to make appropriate, evidence-based health care choices. In this context we conducted a community based study among women about the knowledge, attitude and practice about HPV infections and their health effects. A cross sectional interview based house to house survey was conducted with a validated data collection tool covering sociodemographic factors, knowledge, attitude and practice about HPV and its health effects, among 1020 women from a rural village, Perdoor, in Udupi district, Karnataka, India in 2013-14. The mean age of participants was 38.9 years (SD=12.6). Study participants showed a high literacy rate (85.7%). Only 2.4% of sexually exposed women had undergone Pap smear testing. Partners of 4.4%women had undergone circumcision and they belonged to the Muslim community. Male condom usage was reported by 26 women (2.6%). However, none of the participants had heard of HPV and its health effects. This community based study found complete ignorance about HPV among rural South Indian women in spite of a high literacy level.
Full Text Available The Millennium Development Goals (MDGs are international objectives on poverty reduction adopted by the world community and provide the broad context for this revolution in thinking and practice. The MDGs place a central focus on public health, in recognition of the fact that improvements in public health are vital not only in their own right but also to break the poverty trap of the world's poorest economies. Nepal has been committed to achieving the MDGs since it endorsed the Millennium Declaration. As we have at present just passed the midway through the 15 years to MDGs deadline of 2015, this article reviews the status of Nepal in achieving the MDGs, the challenges it faces and whether it can achieve the MDGs by 2015. Key words: development, goals, health, millennium, Nepal
Rukundo, Annamaria; Muwonge, Mathias M; Mugisha, Danny; Aturwanaho, Dickens; Kasangaki, Arabat; Bbosa, Godfrey S
HIV/AIDS has remained a challenge in Uganda among adolescent despite the ABC strategy used globally to prevent HIV infection. The study assessed the knowledge, attitudes and perceptions of secondary school teenagers towards HIV transmission and prevention in rural and urban schools of central Uganda. A cross sectional study using self-administered questionnaires and structured interviews was used to collect data from adolescents in secondary schools in Kampala and Buikwe districts. Eight schools were randomly selected with 4 schools in each district. A total of 245 students from schools were recruited in the study with 120 and 125 students from urban Kampala and rural Buikwe district schools respectively. Data were analyzed using SPSS version 11. The results were expressed as percentages in a 2 × 2 tables. The mean age of the participants was 15.9 ± 2.5 years. Results showed that 95.1% participants had knowledge on HIV/AIDS in both urban and rural schools and 27.4% knew all the modes of HIV transmission. About 83.7% knew the ABC strategy for HIV prevention and 37.6% would talk about HIV/AIDS mainly with friends. For HIV cure, 62.0% of study participants reported non-cure and 24.9% were not sure. The remaining 13.1% of the study participants in both urban and rural schools reported that HIV can be cured. And the modes of curing HIV that were mentioned by participants included spiritual healing, transmitting it to others through sexual intercourse and that antiretroviral (ARVs) drugs can cure it as well as that it can be cured abroad. About 65.7% of participants reported recognition of one with HIV/ AIDS and by having red lips, being sickly; weight loss, skin rash and being very rich were mentioned. About 39.2% of the study participants mentioned that they cannot get infected with HIV and can't contract HIV at all and 18.4% believed that chances of getting HIV infection were high. On perception and attitude on condoms and their use, participants reported that it is
Full Text Available BACKGROUND: In the northwest of Ethiopia, at the South Gondar region, there was a visceral leishmaniasis (VL outbreak in 2005, making the disease a public health concern for the regional health authorities ever since. The knowledge on how the population perceives the disease is essential in order to propose successful control strategies. METHODOLOGY/PRINCIPAL FINDINGS: Two surveys on VL knowledge, attitudes and practices were conducted at the beginning (May 2009 and at the end (February 2011 of a VL longitudinal study carried out in rural communities of Libo Kemkem and Fogera, two districts of the Amhara Regional State. Results showed that VL global knowledge was very low in the area, and that it improved substantially in the period studied. Specifically, from 2009 to 2011, the frequency of proper knowledge regarding VL signs and symptoms increased from 47% to 71% (p<0.0001, knowledge of VL causes increased from 8% to 25% (p<0.0001, and knowledge on VL protection measures from 16% to 55% (p<0.0001. Moreover, the improvement observed in VL knowledge was more marked among the families with no previous history of VL case. Finally, in 2011 more than 90% of the households owned at least an impregnated bed net and had been sprayed, and attitudes towards these and other protective measures were very positive (over 94% acceptance for all of them. CONCLUSIONS/SIGNIFICANCE: In 2009 the level of knowledge regarding VL was very low among the rural population of this area, although it improved substantially in the study period, probably due to the contribution of many actors in the area. VL patients and relatives should be appropriately informed and trained as they may act as successful health community agents. VL risk behavioural patterns are subject to change as attitudes towards protective measures were very positive overall.
Kohrt, Brandon A; Speckman, Rebecca A; Kunz, Richard D; Baldwin, Jennifer L; Upadhaya, Nawaraj; Acharya, Nanda Raj; Sharma, Vidya Dev; Nepal, Mahendra K; Worthman, Carol M
The causes of ethnic and caste-based disparities in mental health are poorly understood. The study aimed to identify mediators underlying caste-based disparities in mental health in Nepal. A mixed methods ethnographic and epidemiological study of 307 adults (Dalit/Nepali, n=75; high caste Brahman and Chhetri, n=232) was assessed with Nepali versions of Beck Depression (BDI) and Anxiety (BAI) Inventories. One-third (33.7%) of participants were classified as depressed: Dalit/Nepali 50.0%, high caste 28.4%. One quarter (27.7%) of participants were classified as anxious: Dalit/Nepali 50.7%, high caste 20.3%. Ethnographic research identified four potential mediators: Stressful life events, owning few livestock, no household income, and lack of social support. The direct effect of caste was 1.08 (95% CI -1.10-3.27) on depression score and 4.76 (95% CI 2.33-7.19) on anxiety score. All four variables had significant indirect (mediation) effects on anxiety, and all but social support had significant indirect effects on depression. Caste-based disparities in mental health in rural Nepal are statistically mediated by poverty, lack of social support, and stressful life events. Interventions should target these areas to alleviate the excess mental health burden born by Dalit/Nepali women and men.
Full Text Available Context: Dengue is the most common disease among all the arthropod-borne viral diseases. There is no specific treatment or vaccine available for dengue. The sole method of prevention and control is the knowledge attitude and practices (KAP for the same. Although, dengue is considered an urban- and semi-urban disease, in recent years, due to water storage practices and large-scale development activities in rural areas, dengue has become endemic in rural areas of India as well. Aims: To assess the KAP regarding dengue. Settings and Design: Urban and rural field practice area of a Tertiary Care Teaching Hospital in Pune, India. Materials and Methods: A pre-tested, semi-structured questionnaire was used to study the knowledge, attitude, and practices regarding dengue. Stratified random sampling technique was used. A modified B. G. Prasad criterion was used for socio-economic classification. Statistical Analysis Used: KAP represented as proportion (%. Chi-square test was used as a test of significance. P value < 0.05 was considered as statistically significant. Results: 68.4% in urban areas and 40.4% in rural area knew that dengue is transmitted by mosquito. 62.6% in urban areas and 48% in rural areas respectively stated fever as a symptom of dengue. The use of anti-adult mosquito measures was 48.05% and 51.42% in urban and rural area respectively Conclusions: There is a definite need to increase the information education communication activities for dengue in the study area.
Participation,” in Nepal: Quest for Participatory Democracy , ed. L. R. Baral (New Delhi: Adroit, 2006), 1. 68 Ibid, 3. 69 Ibid, 10. 70 Yanyong Innanchai...Political Participation.” In Nepal: Quest for Participatory Democracy , edited by L. R. Baral, 1–15. New Delhi: Adroit, 2006. . “The Nepali...with an emphasis on the current period. Since its first experience with democracy in 1950, the king intenupted Nepal ’s pw-suit of consolidation until
The title of my Thesis is "Farmers' Laws and Irrigation: Water Rights and Dispute Management in the Hills of Nepal". This is based on a research I conducted in the Thulotar Kulo irrigation system in Nepal, during 1997 and 1998. Thulotar Kulo is a farmer-managed irrigation
Uprety, M.; Dugar, S.; Gautam, D.; Budimir, M.; Parajuli, B.; Kharbuja, R. G.
The 2017 monsoon in Nepal was normal until mid-August 2017 when a low pressure system that formed parallel to the foothills of the Churia range brought significant amount of rain in the southern Terai belt. Rivers from East to West swelled as many of them crossed the pre-defined warning thresholds, and rainfall depths in excess of 200 mm to 600 mm were recorded in over a dozen meteorological stations across the country between 11th and 13th of August. The West Rapti River recorded water level of approximately 9 meters while the adjacent Babai River crossed 10 meters and smaller rivers such as Riu Khola and Kankai rose up to 4.8 meters and 5.5 meters respectively, well above danger levels for consecutive days. Early warning systems established in the aforementioned rivers were critical to saving lives and livelihoods. However the severity of flash floods from intermittent streams that originate from the Churia range caught people unaware and led to massive water logging and devastation across Eastern and Central Nepal that claimed 96 lives and displaced more than 14.060 families. The Department of Hydrology and Meteorology with help from telecom operators sent more than 6 million SMS messages to communities residing along the floodplains. These messages provided them with critical information on when to evacuate their homes and move to safer grounds, yet the shear spatial scale and extend of floods meant that communities struggled to find refuge on higher ground. Whilst the Global Flood Awareness System (GLoFAS) indicated with medium probability that major rivers across Nepal might swell in mid-August and the 3 day rainfall forecasts from the Numerical Weather Prediction (NWP) consistently indicated heavy precipitation in the southern Terai belt, yet no significant early actions were taken in response to this information. Despite the availability of forecast information on streamflow prediction and rainfall, there was limited pre-emptive actions and now it is
Perkins, Arland Early
The purpose of this study was to determine what sources of professional knowledge are available to principals in 1 rural East Tennessee school district. Qualitative research methods were applied to gain an understanding of what sources of knowledge are used by school principals in 1 rural East Tennessee school district and the barriers they face…
Flávia dos Santos Silva
Full Text Available Human beings have accumulated rich experience with natural resources over time, but such knowledge can be strongly influenced by several factors, such as age, sex and occupation. This study focuses on the influence of these factors on knowledge of medicinal plants in a rural community in northeastern Brazil. Data were collected through semi-structured interviews with 102 people, with the number of plants and uses cited studied for quantitative analysis. Through this research, it was possible to show that the social variables studied (age, sex and informants occupation have contributed to the formation of different patterns of knowledge regarding medicinal resources. The results indicate that awareness of this dynamic is necessary for the proper implementation of projects where the goal is the sustainable use of natural resources (because it indicates the different levels of knowledge within a community, for studies intended to discover new drugs (because it indicates the peculiarities of certain groups, and for biodiversity conservation strategies.
Full Text Available Objective: Regardless of three decades of implementation of family planning program in Nepal, need offamily planning services is largely unmet. Systematic studies, evaluating the impact of family program onseveral ethnic groups of Nepal has not been carried out in large scale. This study sheds light on theinvestigation of, whether the use of contraceptives varies among different ethnic groups in Nepal andwhat are the predictors of contraceptive variance in ethnic groups in Nepal.Materials and methods: The study is based on data collected from Nepal Demographic Health Survey(NDHS 2006. Multilevel logistic regression analyses of 10793 married women of reproductive agenested within 264 clusters from the surveys were considered as the sample size. Individual, household,and program variables were set and a multilevel logistic regression model was fitted to analyze thevariables, using GLLAMM command in STATA-9.Results: Multilevel logistic regression analysis indicated that Muslims, Dalits and Terai madheshi womenwere significantly less likely to use modern contraceptives compared to the Brahmins and Chhetries(Higher Castes. Women who were exposed to family planning information in radio were more likely touse modern contraceptives than women not exposed to radio information (OR=1.22, P> 0.01. An odd ofusing contraceptives by Newar was (OR 1.09, P>0.05, the highest among all ethnic groups. Exposure ofwomen to family planning messages through health facilities, family planning workers, and means ofcommunication, increased the odds of using modern contraceptives. However, impact of the familyplanning information on contraceptive use varied among ethnicity.Conclusion: Special attention need to be paid, in particular to the ethnicity, while formulating familyplanning policies in Nepal, for better success rate of family planning intervention programs.
Poudel, Ajay; Nakajima, Chie; Fukushima, Yukari; Suzuki, Haruka; Pandey, Basu Dev; Maharjan, Bhagwan; Suzuki, Yasuhiko
Despite the fact that Nepal is one of the first countries globally to introduce multidrug-resistant tuberculosis (MDR-TB) case management, the number of MDR-TB cases is continuing to rise in Nepal. Rapid molecular tests applicable in this setting to identify resistant organisms would be an effective tool in reversing this trend. To develop such tools, information about the frequency and distribution of mutations that are associated with phenotypic drug resistance in Mycobacterium tuberculosis is required. In the present study, we investigated the prevalence of mutations in rpoB and katG genes and the inhA promoter region in 158 M. tuberculosis isolates (109 phenotypically MDR and 49 non-MDR isolates collected in Nepal) by DNA sequencing. Mutations affecting the 81-bp rifampin (RIF) resistance-determining region (RRDR) of rpoB were identified in 106 of 109 (97.3%) RIF-resistant isolates. Codons 531, 526, and 516 were the most commonly affected, at percentages of 58.7, 15.6, and 15.6%, respectively. Of 113 isoniazid (INH)-resistant isolates, 99 (87.6%) had mutations in the katG gene, with Ser315Thr being the most prevalent (81.4%) substitution. Mutations in the inhA promoter region were detected in 14 (12.4%) INH-resistant isolates. The results from this study provide an overview of the current situation of RIF and INH resistance in M. tuberculosis in Nepal and can serve as a basis for developing or improving rapid molecular tests to monitor drug-resistant strains in this country.
Prem Lal Chauhan
Full Text Available Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the knowledge, awareness, and utilization pattern of services under JSY among the beneficiaries in rural area of Shimla, Himachal Pradesh, India. Materials and Methods: This cross-sectional study was conducted among the 78 JSY beneficiaries residing in the rural field practice area of Indira Gandhi Medical College Shimla, Himachal Pradesh, India. These beneficiaries were interviewed with pretested, predesigned, semi-structured close ended questionnaire by house-to-house visits, after obtaining informed consent. Results: Majority of the JSY beneficiaries (50; 64% were in the age group of 20–25 years and 43 (55.1% of them heard about the JSY scheme before the present pregnancy. Anganwadi workers 78 (100% and female health workers (62; 79.5% were the main sources of information. More than half of the study participants (44; 56% had good knowledge about the scheme and 42 (53.85% registered their name in health institution during thefirst trimester of last pregnancy. Forty-four (56.4% beneficiaries had undergone three antenatal checkups and only 11 (14.1% of them received three postnatal (PN visits. All the beneficiaries received the JSY incentives 1-week the following delivery. Conclusions: Awareness regarding the JSY scheme, early antenatal registration, minimum three antenatal care visits, and three PN visits is still low among rural women which needs strengthening through intensification of IEC activities.
Adhikari, Bal Ram; Shakya, Geeta; Upadhyay, Bishnu Prasad; Prakash Kc, Khagendra; Shrestha, Sirjana Devi; Dhungana, Guna Raj
The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1) 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Out of 609 collected samples, 302 (49.6%) were Universal Influenza A positive. Among the influenza A positive samples, 172(28.3%) were positive for Pandemic influenza A/H1N1 and 130 (21.3%) were Seasonal influenza A. Most of the pandemic cases (53%) were found among young people with ≤ 20 years. Case Fatality Ratio for Pandemic influenza A/H1N1 in Nepal was 1.74%. Upon Molecular characterization, all the isolated pandemic influenza A/H1N1 2009 virus found in Nepal were antigenically and genetically related to the novel influenza A/CALIFORNIA/07/2009-LIKE (H1N1)v type. The Pandemic 2009 influenza virus found in Nepal were antigenically and genetically related to the novel A/CALIFORNIA/07/2009-LIKE (H1N1)v type.
Full Text Available Abstract Background The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Results Out of 609 collected samples, 302 (49.6% were Universal Influenza A positive. Among the influenza A positive samples, 172(28.3% were positive for Pandemic influenza A/H1N1 and 130 (21.3% were Seasonal influenza A. Most of the pandemic cases (53% were found among young people with ≤ 20 years. Case Fatality Ratio for Pandemic influenza A/H1N1 in Nepal was 1.74%. Upon Molecular characterization, all the isolated pandemic influenza A/H1N1 2009 virus found in Nepal were antigenically and genetically related to the novel influenza A/CALIFORNIA/07/2009-LIKE (H1N1v type. Conclusion The Pandemic 2009 influenza virus found in Nepal were antigenically and genetically related to the novel A/CALIFORNIA/07/2009-LIKE (H1N1v type.
Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K
Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.
Pandey, Deb Prasad; Subedi Pandey, Gita; Devkota, Kamal; Goode, Matt
Venomous snakebite and its effects are a source of fear for people living in souther