Ethnomedicine in Himalaya: a case study from Dolpa, Humla, Jumla and Mustang districts of Nepal

PubMed Central

Kunwar, Ripu M; Nepal, Bal K; Kshhetri, Hari B; Rai, Sanjeev K; Bussmann, Rainer W

2006-01-01

Traditional plant use in Nepal has been documented for millennia. The importance of plants as medicine has not diminished in any way in recent times, and traditional medicines are still the most important health care source for the vast majority of the population. This paper examines the ethnobotany and traditional use of plants extracted from the vulnerable alpine zone in the Dolpa, Humla, Jumla and Mustang districts of Nepal. The results of this ethnobotanical study indicate that a very large number of plant species is used as traditional medicines. There were 107, 59, 44 and 166 species of ethnomedicinal importance in surveyed areas of Dolpa, Humla, Jumla and Mustang district respectively. Of these, 84 common species, used at least in two districts, were selected to enumerate their ethnomedicinal properties. The 84 species belonged to 75 genera and 39 families. The commonest species in this pharmacopoeia were: Allium wallichii, Cordyceps sinensis, Dactylorhiza hatagirea, and Rheum australe. A total of 21 species were most common in three districts and 59 in two districts. The genera Aconitum, Allium, Arisaema, Berberis, Corydalis, Gentiana, Hippophae, Juniperus and Rhododendron each possessed two species with ethnomedicinal use. Labiatae was the most medicinally important family with five species used, followed by Araceae, Compositae, Liliaceae, Polygonaceae, Ranunculaceae, Scrophulariaceae and Umbelliferae, each contributing four species. PMID:16749924

Using exhumation histories to constrain Main Himalayan Thrust geometry and seismic hazard in the western Nepal Himalaya

NASA Astrophysics Data System (ADS)

Harvey, J. E.; Burbank, D.

2016-12-01

The Himalaya of western Nepal present a challenge to conventional understanding of the geometry and behavior of the Main Himalayan Thrust (MHT), a major seismogenic structure which accommodates 2 cm/yr of Indo-Asian convergence. Slip along a steeper ramp in the MHT drives long-term uplift of the Greater Himalaya along >1000 km of the central range front, resulting in a conspicuous physiographic transition known as PT2. This physiographic break is seemingly absent in western Nepal, which suggests a structural geometry and/or kinematic history distinct from areas along strike. This anomaly must be investigated to clarify how seismic hazard may differ from better-understood areas along strike. The importance of this work is heightened by the recent and catastrophic Gorkha earthquake in 2015. We present a suite of 7 relief transects comprising a mix of apatite and zircon U-Th/He and muscovite Ar-Ar cooling ages. These transects were collected across the more gradual mountain front in western Nepal in an effort to clarify where uplift and exhumation have been focused over the past 10 Ma. We invert these cooling ages using the thermo-kinematic model Pecube in order to constrain exhumation histories that best fit the measured cooling ages. Results confirm that MHT geometry and kinematic history in western Nepal are far more complex than in better-studied areas along strike. Exhumation rates in the along-strike projection of PT2 are slow ( 0.1-0.2 km/Myr) compared with rates 50 km toward the hinterland ( 1.0-1.5 km/Myr), suggesting that exhumation has been more rapid in this more northerly position for the past several Ma. Although a range of kinematic scenarios could explain the anomalous cooling histories, it is likely that a recently active midcrustal ramp in the MHT sits beneath this more northerly position. If the 2015 Gorkha earthquake initiated near the up-dip end of the MHT ramp in central Nepal, it is conceivable that similarly hazardous earthquakes could trigger

Assessment of social vulnerability to natural hazards in Nepal

NASA Astrophysics Data System (ADS)

Gautam, Dipendra

2017-12-01

This paper investigates district-wide social vulnerability to natural hazards in Nepal. Disasters such as earthquakes, floods, landslides, epidemics, and droughts are common in Nepal. Every year thousands of people are killed and huge economic and environmental losses occur in Nepal due to various natural hazards. Although natural hazards are well recognized, quantitative and qualitative social vulnerability mapping has not existed until now in Nepal. This study aims to quantify the social vulnerability on a local scale, considering all 75 districts using the available census. To perform district-level vulnerability mapping, 13 variables were selected and aggregated indexes were plotted in an ArcGIS environment. The sum of results shows that only 4 districts in Nepal have a very low social vulnerability index whereas 46 districts (61 %) are at moderate to high social vulnerability levels. Vulnerability mapping highlights the immediate need for decentralized frameworks to tackle natural hazards in district level; additionally, the results of this study can contribute to preparedness, planning and resource management, inter-district coordination, contingency planning, and public awareness efforts.

Spousal migration and human papillomavirus infection among women in rural western Nepal.

PubMed

Johnson, Derek C; Lhaki, Pema; Bhatta, Madhav P; Kempf, Mirjam-Colette; Smith, Jennifer S; Bhattarai, Pankaj; Aryal, Shilu; Chamot, Eric; Regmi, Kiran; Vermund, Sten H; Shrestha, Sadeep

2016-07-01

In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal. Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status. In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration. Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal.

PubMed

Ghimire, Prakash; Singh, Nihal; Ortega, Leonard; Rijal, Komal Raj; Adhikari, Bipin; Thakur, Garib Das; Marasini, Baburam

2017-05-23

Glucose-6-phosphate dehydrogenase (G6PD) is a rate limiting enzyme of the pentose phosphate pathway and is closely associated with the haemolytic disorders among patients receiving anti-malarial drugs, such as primaquine. G6PD deficiency (G6PDd) is an impending factor for radical treatment of malaria which affects the clearance of gametocytes from the blood and subsequent delay in the achievement of malaria elimination. The main objective of this study was to assess the prevalence of G6PD deficiency in six malaria endemic districts in Southern Nepal. A cross-sectional population based prevalence survey was conducted in six malaria endemic districts of Nepal, during April-Dec 2013. A total of 1341 blood samples were tested for G6PDd using two different rapid diagnostic test kits (Binax-Now ® and Care Start™). Equal proportions of participants from each district (n ≥ 200) were enrolled considering ethnic and demographic representation of the population groups. Out of total 1341 blood specimens collected from six districts, the overall prevalence of G6PDd was 97/1341; 7.23% on Binax Now and 81/1341; 6.0% on Care Start test. Higher prevalence was observed in male than females [Binax Now: male 10.2%; 53/521 versus female 5.4%; 44/820 (p = 0.003) and Care Start: male 8.4%; 44/521 versus female 4.5%; 37/820 (p = 0.003)]. G6PDd was higher in ethnic groups Rajbanshi (11.7%; 19/162) and Tharu (5.6%; 56/1005) (p = 0.006), major inhabitant of the endemic districts. Higher prevalence of G6PDd was found in Jhapa (22/224; 9.8%) and Morang districts (18/225; 8%) (p = 0.031). In a multivariate analysis, male were found at more risk for G6PDd than females, on Binax test (aOR = 1.97; CI 1.28-3.03; p = 0.002) and Care Start test (aOR = 1.86; CI 1.16-2.97; p = 0.009). The higher prevalence of G6PDd in certain ethnic group, gender and geographical region clearly demonstrates clustering of the cases and ascertained the risk groups within the population. This is the

Barriers to using skilled birth attendants’ services in mid- and far-western Nepal: a cross-sectional study

PubMed Central

2013-01-01

Background 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. Methods 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. Results 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. Conclusions 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

The incidence of color blindness among some school children of Pokhara, Western Nepal.

PubMed

Niroula, D R; Saha, C G

2010-03-01

The incidence of color blindness varies from race to race and different in different geographical area. Since, there is no such report about the prevalence of color blindness in the western part of Nepal, the present study had been conducted to find out the incidence of color blindness among school children of Pokhara city, western Nepal. Participant's (n=964, 474 boys, 490 girls, age group 10 to 19 years) color vision was tested by using Ishihara chart (38 plates). Among 474 boys, 18 boys were color blind with the prevalence of 3.8%. None of girls were found to be color blind. Out of 18 color blind boys, nine, six and three boys were the victims of deuteranopia, deuteranomaly and protanomaly respectively. The incidence of color blindness were more amongst the Darji (14.3%) and Newar (9.1%) ethnic groups.

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

PubMed

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

Assessment of district health system within inter-sectoral context in Nepal.

PubMed

Bhusal, C L; Singh, S P; Aryal, K K; Jha, B K; Ghimire, N; Shah, N; Khatiwada, D; Magar, A

2013-05-01

Inter-sectoral coordination has been one of the different factors in the district health system that produces efficient output which has been identified by the Alma Ata declaration as an essential component to achieve notion of 'Health for All'. This study was therefore aimed to describe the major four key functions of the health systems and to find out the situation of inter-sectoral coordination in Nepal. A mixed method with Focus Group Discussion (FGD) and In-Depth Interview with relevant personnel to collect the majority of the data was carried out from June 2012 to November 2012 from six districts selected purposively based on the health performance indicators. The major findings in relation to the key functions of district health systems showed that the overall management of the district health system happens under the leadership of chief of District Health Office of Public health office with the cooperation of all the personnel in different sections in a predetermined pattern and inter-sectoral coordination and collaboration exist only to a very limited extent. The major constraints for inter-sectoral coordination to be effective is lack of its planning and enforcement where inter-sectoral coordination could be important for both preventive and promotive health care, waste management, water supply and sanitation, health service utilization, pesticides and human health, agriculture and nutrition, air pollution. The main components in the district health system needs an immediate attention and inter-sectoral effort should be initiated from the central level and implemented in all the levels.

Alcohol Consumption during Pregnancy and Postpartum Period and its Predictors in Sindhupalchowk District, Nepal.

PubMed

Aryal, K K; Thapa, N; Mehata, S; Thapa, P; Alvik, A; Stray-Pedersen, B

2016-09-01

A substantial proportion of women in Nepal consume alcohol and homebrewed alcoholic beverages are the most common type of alcohol. Alcohol being a part of tradition and culture in Nepal and evidences suggesting even low to moderate dose of alcohol having impacts on the birth outcomes, we aimed at exploring the alcohol consumption pattern during pregnancy and postpartum period along with its predictors. We studied all pregnant and recently delivered women using quantitative methods in selected wards within selected Village Development Committees of Sindhupalchowk district in Nepal after purposively choosing the district. We present the findings on pregnancy and postpartum period drinking and its predictors as proportion and adjusted odds ratio along with 95% CI. One-third of women drank alcohol during pregnancy and 43% during postpartum period. Nearly all drinking women mostly consumed homebrewed alcoholic beverages such as jaad/chhyang/localraksi. One-third consumed it daily during pregnancy, while three-quarters consumed daily during postpartum. One-fifth of currently drinking women drank ≥5 standard drinks on average per day in the last 30 days. Illiterate or women with low level of education were three times more likely to consume alcohol during pregnancy than women with secondary level education or higher. Similarly, women who didn't know that alcohol during pregnancy affects mother and child were four and half times more likely to consume alcohol during pregnancy than those who knew about it. Also, being dalits, disadvantaged and janajatis, husband's drinking and home brewing of alcohol were strongly associated with women's drinking during pregnancy and postpartum period. A substantial proportion of women consumed alcohol during pregnancy and postpartum period with high consumption frequency. Findings suggested, increasing awareness about consequences of drinking during pregnancy and postpartum period would be helpful probably as one of the components of

Serological Assessment for Leishmania donovani Infection in Blood Donors of Sunsari District, Dharan, Nepal.

PubMed

Timilsina, Suraj; Raj Bhattarai, Narayan; Khanal, Basudha; Rijal, Suman

2016-03-01

Visceral leishmaniasis (VL) is a major vector-borne disease caused by Leishmania donovani, after replication of the parasites in macrophages, mononuclear phagocytic system. VL is endemic in 12 districts of central and eastern Terai lowlands of Nepal bordering North Bihar, India with an estimated 8 million population at risk. In addition, VL endemicity is also extending to new endemic regions like Dharan from its classical rural foci. Hence, we aimed to detect the evidence of Leishmania donovani infection in the blood samples received from blood donors of Sunsari district, Dharan, (eastern Nepal), a region endemic for human VL. Sera from 507 asymptomatic blood donors were subjected to serological screening for anti-Leishmania donovani antibodies. Direct agglutination test (DAT) was performed on the sera. Out of 507 donors, majority (78.50 %) were male. Among the donors, 472 (93.10 %) belonged to age group 18-45 years where as 35 (6.90 %) to age group >45 years. Circulating anti-Leishmania antibodies were detected in 5 (1 %) out of 507 healthy, Human Immunodeficiency Virus types 1 and 2 (HIV 1and 2), Hepatitis B Surface Antigen (HBsAg), anti- Hepatitis C Virus (anti-HCV)-negative, and Syphillis non-reactive donors. All the seropositive cases were male and belonged to the age group 18-45 years. The result suggests that there is an immediate need of screening asymptomatic blood donors for leishmania seropositivity especially in endemic areas.

Understanding three decades of land use changes and a cloudburst in Phewa Lake Watershed, Western Nepal

NASA Astrophysics Data System (ADS)

Sudmeier-Rieux, Karen; Tonini, Marj; Vulliez, Cindy; Sanjaya, Devkota; Derron, Marc-Henri; Jaboyedoff, Michel

2017-04-01

This paper details an extreme rainfall event, or cloudburst (315 mm/ 24 hours) which occurred on July 29-30, 2015 in the Phewa Lake Watershed, Western Nepal, three months after the April 25, 2015 Gorkha Earthquake. The event triggered over 170 landslides and debris flows, caused 8 deaths and considerable damage to livelihoods. The fatal debris flow started from one of the numerous rural roads, which have proliferated exponentially over the past decades. In addition to mapping landslides due to this extreme rainfall event, our study sought to document and analyze underlying natural and human land use factors that may have impacted the occurrence of landsliding (Vulliez et al submitted). To do so, our study analyzed land cover/ land use changes for the period 1979-2016 based on an interpretation of aerial photos and satellite images, combined with ground truthing. We studied how land use / land cover changes have resulted in a shift of active erosion zones from overgrazing around streams and forests to an exponential number of small failures along unplanned earthen rural roads, or "bulldozer roads". With several hundred small failures documented along roadsides (Leibundgut et al., 2016) as compared to only 14 landslides prior to 2015 extreme rainfall event - and none triggered by the 2015 earthquake - roads are thus a major driver of active erosion zones and small failures in the watershed. More effective management of the current unsustainable mode of rural road construction is required to reduce further environmental and economic impacts on vulnerable populations in Nepal. Leibundgut, G., Sudmeier-Rieux, K. Devkota, S., Jaboyedoff, M., Derron, M-H., Penna, I. Nguyen, L. (2016). Rural earthen roads impact assessment in Phewa watershed, Western region, Nepal. Geoenvironmental Disasters (2016) 3:13. DOI 10.1186/s40677-016-0047-8 Vulliez, C, Tonini, M., Sudmeier-Rieux, K. Devkota, S., Derron, M-H, Jaboyedoff, M. (submitted) Land use changes, landslides and roads in the

Economic uses of forest plant resources in western Chitwan, Nepal

PubMed Central

Dangol, Dharma R.

2012-01-01

This paper discusses economic uses of forest plant resources documented from 117 forest plots and neighboring areas of western Chitwan, Nepal. The paper lists information on the plant species (1) that provide valuable food, vegetable and medicinal products that maintain human health and general well-being of the households; (2) that are economically valuable to farmers such as high-grade fodder, useful plants for crop management (e.g., pesticide, compost, green manure); (3) that are used as piscicide (harvest fish from rivers and streams), (4) that provide materials for use in household construction (e.g. building materials, thatch) and tool making; and (5) that have aesthetic value. The access to forest resources is important for many households, especially those living in remote and poor agricultural areas such as Western Chitwan. This paper also highlights the availability of the species wherever possible based upon the field data. PMID:23066332

Community perceptions of unintentional child injuries in Makwanpur district of Nepal: a qualitative study

PubMed Central

2014-01-01

Background In Nepal, childhood unintentional injury is an emerging public health problem but it has not been prioritised on national health agenda. There is lack of literature on community perceptions about child injuries. This study has explored community perceptions about child injuries and how injuries can be prevented. Methods Focus group discussions were conducted with mothers, school students and community health volunteers from urban and rural parts of Makwanpur district in Nepal. FGDs were conducted in Nepali languages. These were recorded, transcribed and translated into English. A theoretical framework was identified and thematic analysis conducted. Results Three focus group discussions, with a total of 27 participants, took place. Participants were able to identify examples of child injuries which took place in their community but these generally related to fatal and severe injuries. Participants identified risk factors such as the child’s age, gender, behaviours and whether they had been supervised. Consequences of injuries such as physical and psychological effects, impact on household budgets and disturbance in household plans were identified. Suggestions were made about culturally appropriate prevention measures, and included; suitable supervision arrangements, separation of hazards and teaching about safety to the parents and children. Conclusion Community members in Nepal can provide useful information about childhood injuries and their prevention but this knowledge is not transferred into action. Understanding community perceptions about injuries and their prevention can contribute to the development of preventive interventions in low income settings. PMID:24886124

Nutritional status of children in two districts of the mountain region of Nepal.

PubMed

Thapa, M; Neopane, A K; Singh, U K; Aryal, N; Agrawal, K; Shrestha, B

2013-09-01

Nutritional status is a prime indicator of health. Generally, three anthropometric indicators are often used to assess nutritional status during childhood and adolescence: underweight (weight-for-age), stunting (height- for-age) and thinness (BMI-for-age). Malnutrition in children is a major public health problem in many developing countries. This study was conducted to assess nutritional status among children attending health camps in two mountainous districts in Nepal. Five hundred and seventy five children below 15 years of age attending the medical camp in Humla and Mugu districts in October 2011 were assessed for nutritional status. For children less than five years, weight for age, weight for height and height for age as per WHO classification, and for children between five to 15 years age specific values of height, weight and Body Mass Index (BMI) were calculated. In Humla district, 28.2% children were undernourished, 8.8% wasted and 22.4% stunted in less than five years. In the same age group, 31.7% children were undernourished, 9.4% wasted and 29.4% stunted in Mugu district. In the age group five to 15 years, thinness was seen in 22.4% and 29.4% children in Humla and Mugu respectively. Malnutrition (underweight, stunting, wasting and thinness) still constitutes a major health problem among Nepalese children, particularly in mountainous regions.

Application of Vertical Electrical Sounding (VES) for the assessment of Ground Water Potential at Madi Phant, Palpa District, Western Nepal

NASA Astrophysics Data System (ADS)

Khatiwada, B.; Ghimire, H.; Bhusal, U. C.; Shrestha, S. R.; Upadhyay, K.; Khanal, A.; Pandey, D.

2017-12-01

Ground Water Resources Development Board (GWRDB), Government of Nepal, is the sole authority for systematize investigation, and management of ground water in the country. This study was conducted by GWRDB to create a data base of the groundwater potential in the hilly area. The main purpose of the study was to assess the groundwater potential at the Madi Phant Valley, Lesser Himalaya Region, Plapa District, Nepal. Data were acquired from WDJD-4 and analyzed using computer aided software called IPI2win, which yield an automatic interpretation of the apparent resistivity and data were correlated with lithologs of the vertical section. The simulated results of the ten VES points conducted using Schlumberger Configuration with AB/2 varying from 2 to 400 m and MN/2 varying from 0.5 to 50m reveal the presence of 4 to 8 geo-electric layers. Results obtained from software were rechecked by plotting the apparent resistivity value on Log-Log transparent graph sheet and manually interpreted using master curves and auxiliary curves. The resistivity values of the different layers' ranges from 3 Ωm to 3700 Ωm and were statistically analyzed from Golden Software Grapher. Representative resistivity sounding curves with modeled layer obtained after inversion was used to delineate the aquifer and 1D geoelectric sections. The geoelectrical sections for the study area consists of: the topsoil, sandy silt, sand and gravel, fractured rock and the fresh basement rock. The groundwater bearing layer of fractured rock varies between depth of 8-65 meters across foothill site (Eastern Corner) of the study area and groundwater bearing layer of sand and gravel/fractured rock varies between depth of 20-100 m in the central part of the Madi Phant valley. Contour map and 3D map of bedrock and water bearing layers for the conceptual model were prepared with the help of surfer shows that the gradient of the contour is high in the surrounding parts and flat in the center of Valley.

A Distance Blended Learning Program to Upgrade the Clinical Competence of District Non-doctor Anesthesia Providers in Nepal.

PubMed

Shah, Shristi; Knoble, Stephen; Ross, Oliver; Pickering, Stephen

2017-12-01

Across Nepal, anesthesia at a district level is provided mostly by non-doctor anesthesia providers (anesthesia assistants-AAs). Nepal's Government recognized the need to sustain competence with continuous professional development and to upgrade 6-month trained working AAs to professional equivalence with the new national standard of 12-month training. As they are essential district health workers and AA clinical training sites are full, an innovative distance blended learning, competency-based, upgrade 1-year course was developed and conducted in 2014-2017 for two batches. The course content was developed over 18 months by a team of Nepali and overseas AA training experts. The 1-year course started with a refresher course, continued with tablet-based 12-month self-learning modules and clinical case logs, regular educational mentor communication, midcourse 2-week contact time in an AA training site, regular text messaging and ended with clinical examination and multiple-choice questions. Tablet content included 168 new case studies, pre- and posttests, video lectures, matching exercises and a resource library. All module work and logged clinical cases were uploaded centrally, where clinical mentors were able to review work. Clinical skills were upgraded, as needed, through direct clinical contact midway through the course. Quantitative and qualitative course assessments were included. Fourteen working AAs in first batch and eight working AAs in second batch from district, zonal and mission hospitals across Nepal were enrolled. All remained working at their hospitals throughout the course, and there were no significant tablet problems inhibiting course completion. Twenty-one AAs completed all modules successfully with time required for module completion averaging 19.2 h (range 11.2-32). One AA left the course after 3 months with a personal problem. Subjectively, AAs felt that the obstetric and pediatric modules were more difficult; lowest marks were objectively

Using thermochonology to validate a balanced cross section along the Karnali River, far-western Nepal

NASA Astrophysics Data System (ADS)

Battistella, C.; Robinson, D.; McQuarrie, N.; Ghoshal, S.

2017-12-01

Multiple valid balanced cross sections can be produced from mapped surface and subsurface data. By integrating low temperature thermochronologic data, we are better able to predict subsurface geometries. Existing valid balanced cross section for far western Nepal are few (Robinson et al., 2006) and do not incorporate thermochronologic data because the data did not exist. The data published along the Simikot cross section along the Karnali River since then include muscovite Ar, zircon U-Th/He and apatite fission track. We present new mapping and a new valid balanced cross section that takes into account the new field data as well as the limitations that thermochronologic data places on the kinematics of the cross section. Additional constrains include some new geomorphology data acquired since 2006 that indicate areas of increased vertical uplift, which indicate locations of buried ramps in the Main Himalayan thrust and guide the locations of Lesser Himalayan ramps in the balanced cross section. Future work will include flexural modeling, new low temperature thermochronometic data, and 2-D thermokinematic models from a sequentially forward modeled balanced cross sections in far western Nepal.

Genetic diversity of plasmodium vivax merozoite surface protein-3alpha (Pvmsp-3alpha) gene in Jhapa District of Nepal.

PubMed

Adhikari, Madhav; Ranjitkar, Samir; Schousboe, Mette Leth; Alifrangis, Michael; Imwong, Mallika; Bhatta, Dwij Raj; Banjara, Megha Raj

2012-03-01

In Nepal, Plasmodium vivax accounts for approximately 80-90% of the malaria cases, but limited studies have been conducted on the genetic diversity of this parasite population. This study was carried out to determine the genetic diversity of P. vivax population sampled from subjects living in an endemic area of Jhapa District by analyzing the polymorphic merozoite surface protein-3alpha (Pvmsp-3alpha) gene by using PCR-restriction fragment length polymorphism. Three distinct genotypes were obtained from 96 samples; type A: 40 (71%), type B: 7 (13%), and type C: 9 (16%) which could be categorized into 13 allelic patterns: A1-A9, B1, B2, C1 and C2. These results indicated a high genetic diversity within the studied P. vivax population. As the transmission rate of malaria is low in Nepal, the diversity is most likely due to migration of people between the malaria endemic regions, either within the country or between Nepal and India. Similar prevalence of the three genotypes of Pvmsp-3alpha between the two countries likely supports the latter explanation.

Morbidity profile and prescribing patterns among outpatients in a teaching hospital in Western Nepal

PubMed Central

Lamichhane, DC; Giri, BR; Pathak, OK; Panta, OB; Shankar, PR

2006-01-01

Background Recent studies on prescribing among outpatients in hospitals in Western Nepal are lacking. The main objectives of the study were to obtain information on the morbidity pattern among outpatients and to analyze prescribing using drug use indicators. Methods A retrospective hospital record based study from 01.01.2004 to 31.12.2004 was carried out among individuals attending the outpatient department (OPD) of the Manipal Teaching hospital, Pokhara, Western Nepal. A total of 32,017 new patients attended the OPD during the study period. Systematic random sampling (1 in every 20 patients) was done and 1600 patients selected. After excluding patients visiting the emergency department, those who got admitted and whose records were not available, 1261 cases were analyzed. The demographic details, morbidity pattern, average number of drugs prescribed, percentage of drugs prescribed by generic names and from the Essential drug list of Nepal (Essential drugs are those which satisfy the priority healthcare needs of the population), percentage of encounters with an antibiotic and an injection prescribed were noted. Results 1261 patients made 1772 visits. Upper respiratory tract infection and acid peptic disease were the most common diagnoses. The mean number of drugs was 1.99. Only 19.5% and 39.6% of drugs were prescribed by generic name and from the Essential drug list. Antibiotics and injections were prescribed in 26.4% and 0.96% of encounters. Cetrizine, vitamins, amoxicillin, the combination of paracetamol and ibuprofen and ranitidine were most commonly prescribed. Conclusions Upper respiratory tract infections and acid peptic disease were the common illnesses. Generic prescribing and use of essential drugs were low. Some of the drug combinations being used were irrational. Prescriber education may be helpful in encouraging rational prescribing. PMID:18523618

Processes of Internal and International Migration from Chitwan, Nepal.

PubMed

Bohra, Pratikshya; Massey, Douglas S

2009-01-01

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.

Processes of Internal and International Migration from Chitwan, Nepal

PubMed Central

Bohra, Pratikshya; Massey, Douglas S.

2011-01-01

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. PMID:21423821

Knowledge and Practice on Injection Safety among Primary Health Care Workers in Kaski District, Western Nepal

PubMed Central

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kc, Vikash Kumar; Jha, Nisha; Sharma, Damodar

2016-01-01

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

Technology for Climate Change Adaptation in Nepal Himalaya: Policy, Practices and Perspective

NASA Astrophysics Data System (ADS)

Gautam, K.; Panthi, J., Sr.

2016-12-01

The recent scientific findings and the periodic reports corroborated by IPCC has disclosed the climate change is unequivocal and the Himalayan region is one of the hardest hit by the change and variability in climatic system due to its sensitive ecosystem, low resilience capacity and geographical extremes. Nepal, which lies in the central Himalayan region, has developed its strategies to mitigate the impacts of climate change by developing national, regional and local plan of actions which are being implemented and some of them have already been proven. Nepal, as a party to the UNFCCC, has accomplished technology need assessment that identifies the need for new technology, equipment, knowledge and skills for reducing vulnerability to climate change. The plan has recommended an enabling framework for the diffusion of the prioritized technologies and the actions necessary to reduce or remove policy finance and technology related barriers. This paper aims to analyze the technological penetration in national level policy instruments such as NAPA, LAPA, Climate Change Policy and how those technologies have been used in actual field during the implementation of LAPA activities in western Nepal taking two administrative districts, one from low land and another from highland, as a pilot study.

Spatiotemporal analysis of dengue fever in Nepal from 2010 to 2014.

PubMed

Acharya, Bipin Kumar; Cao, ChunXiang; Lakes, Tobia; Chen, Wei; Naeem, Shahid

2016-08-22

Due to recent emergence, dengue is becoming one of the major public health problems in Nepal. The numbers of reported dengue cases in general and the area with reported dengue cases are both continuously increasing in recent years. However, spatiotemporal patterns and clusters of dengue have not been investigated yet. This study aims to fill this gap by analyzing spatiotemporal patterns based on monthly surveillance data aggregated at district. Dengue cases from 2010 to 2014 at district level were collected from the Nepal government's health and mapping agencies respectively. GeoDa software was used to map crude incidence, excess hazard and spatially smoothed incidence. Cluster analysis was performed in SaTScan software to explore spatiotemporal clusters of dengue during the above-mentioned time period. Spatiotemporal distribution of dengue fever in Nepal from 2010 to 2014 was mapped at district level in terms of crude incidence, excess risk and spatially smoothed incidence. Results show that the distribution of dengue fever was not random but clustered in space and time. Chitwan district was identified as the most likely cluster and Jhapa district was the first secondary cluster in both spatial and spatiotemporal scan. July to September of 2010 was identified as a significant temporal cluster. This study assessed and mapped for the first time the spatiotemporal pattern of dengue fever in Nepal. Two districts namely Chitwan and Jhapa were found highly affected by dengue fever. The current study also demonstrated the importance of geospatial approach in epidemiological research. The initial result on dengue patterns and risk of this study may assist institutions and policy makers to develop better preventive strategies.

Visceral leishmaniasis diagnosis and reporting delays as an obstacle to timely response actions in Nepal and India.

PubMed

Boettcher, Jan P; Siwakoti, Yubaraj; Milojkovic, Ana; Siddiqui, Niyamat A; Gurung, Chitra K; Rijal, Suman; Das, Pradeep; Kroeger, Axel; Banjara, Megha R

2015-02-06

To eliminate visceral leishmaniasis (VL) in India and Nepal, challenges of VL diagnosis, treatment and reporting need to be identified. Recent data indicate that VL is underreported and patients face delays when seeking treatment. Moreover, VL surveillance data might not reach health authorities on time. This study quantifies delays for VL diagnosis and treatment, and analyses the duration of VL reporting from district to central health authorities in India and Nepal. A cross-sectional study conducted in 12 districts of Terai region, Nepal, and 9 districts of Bihar State, India, in 2012. Patients were interviewed in hospitals or at home using a structured questionnaire, health managers were interviewed at their work place using a semi-structured questionnaire and in-depth interviews were conducted with central level health managers. Reporting formats were evaluated. Data was analyzed using two-tailed Mann-Whitney U or Fisher's exact test. 92 VL patients having experienced 103 VL episodes and 49 district health managers were interviewed. Patients waited in Nepal 30 days (CI 18-42) before seeking health care, 3.75 times longer than in Bihar (8d; CI 4-12). Conversely, the lag time from seeking health care to receiving a VL diagnosis was 3.6x longer in Bihar (90d; CI 68-113) compared to Nepal (25d; CI 13-38). The time span between diagnosis and treatment was short in both countries. VL reporting time was in Nepal 19 days for sentinel sites and 76 days for "District Public Health Offices (DPHOs)". In Bihar it was 28 days for "District Malaria Offices". In Nepal, 73% of health managers entered data into computers compared to 16% in Bihar. In both countries reporting was mainly paper based and standardized formats were rarely used. To decrease the delay between onset of symptoms and getting a proper diagnosis and treatment the approaches in the two countries vary: In Nepal health education for seeking early treatment are needed while in Bihar the use of private and non

Parent Decision-Making When Selecting Schools: The Case of Nepal

ERIC Educational Resources Information Center

Joshi, Priyadarshani

2014-01-01

This paper analyzes the parent decision-making processes underlying school selection in Nepal. The analysis is based on primary survey and focus group data collected from parent meetings in diverse local education markets in two districts of Nepal in 2011. It highlights three main arguments that are less frequently discussed in the context of…

Prioritizing and Funding Nepal's Multisector Nutrition Plan.

PubMed

Pomeroy-Stevens, Amanda; Shrestha, Madhukar B; Biradavolu, Monica; Hachhethu, Kusum; Houston, Robin; Sharma, Indu; Wun, Jolene

2016-12-01

Nepal has a long tradition of designing good multisectoral nutrition policy. However, success of policy implementation has varied. More evidence on how to successfully carry out multisector nutrition policy is needed. We tracked the influence of Nepal's multisectoral nutrition plan (MSNP) on the process of priority setting and budgeting from 2014 to 2016. This study used a mixed-method longitudinal design to track qualitative and budgetary changes related to MSNP processes nationally as well as in 3 districts. Qualitative changes in each study area were assessed through interviews, observation, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation interviews. Improved understanding of the MSNP was documented nationally and in study districts but not in VDCs. Human resources, ownership, bottom-up planning, coordination, advocacy, and sustainable structures all emerged as important factors within the enabling environment. Evidence suggests the MSNP influenced improvements in the last 3 factors. We also found notable increases in activities and financing for nutrition-allocations increased steadily between FY 2013-2014 and FY 2015-2016, and 28% of total nutrition allocations in the final year came from new or expanded MSNP-affiliated activities. Data from 3 districts highlight challenges linking local planning and budgeting to central-level structures. The MSNP appears to have strengthened the nutrition system in Nepal and increased priority and funding for nutrition. Next steps include strengthening linkages to the districts and below. Other countries can learn from the MSNP's success in increasing investment for nutrition. © The Author(s) 2016.

The Byanshi: an ethnographic note on a trading group in far western Nepal.

PubMed

Manzardo, A E; Dahal, D R; Rai, N K

1976-09-01

The Byanshi who live in the district of Darchula are among the lesser known trading groups of Nepal. The Byanshi, close to the borders of Nepal, India, and Tibet, make their living trading wool, yak tails, salt, grain, and other commodities across the Himalayas and over the border into Pithoragarh district and even down into the Terai. The Byanshi live their lives in 2 separate areas. In the summer they live in their traditional homeland in Byana panchayat in the northern section of Darchula, close to Nepal's border with China. The major settlements in the area are Tinkar and Chhangru. The entire panchayat has a population of about 2000. In the winter, when snow makes life difficult in the high mountains, the Byanshi migrate down to Khalanga panchayat. Of greater importance than agriculture is animal husbandry, which is the backbone of trade in the Himalayas. Most important is that husbandry supports trade. The Byanshi social organization is somewhat confusing. An attempt is made to explain the clan structure as simply as possible. Upon the birth of a child the women from the village bring local beer, meat, and other food to the mother. Up to the 11th day after childbirth, the new mother and child are considered to be polluted. On the 8th day after delivery a ceremony known as "malengkho kormo" is performed, where the mother and child are ritually bathed. From this point, both the mother and child may enter the hearth area of their house, but the house itself is considered polluted. On the 11th day, all villagers are invited to attend the ceremony known as "chhyosimo" which purifies the house and the people. The Byanshi practice 3 forms of marriage: marriage by capture; love marriage, a form of elopmement; and the arranged marriage. The latter is becoming most common. Death rituals have always been the most exaggerated and costly ceremonies for the Bayanshi. The religion of the Byanshi combines features of Tibetan Buddhism, hill animism, and Hinduism in a very

Intestinal Parasitic Infestation in Combatants and Their Families: A Hospital-Based Study in Mid-Western Regional Police Hospital, Nepal

PubMed Central

Paudel, Damodar; Aung, Myo Nyein; Sharma, Bindhya; Aung, Thin Nyein Nyein; Moolphate, Saiyud

2014-01-01

Objective: To find out the scenario of intestinal parasitic infestation in combatants and their families in the setting of Mid-Western Regional Police Hospital (MWRPH), Nepal. Study Design: Cross-sectional study. Methods: All 2005 patients presented with the complaint of abdominal pain, diarrhoea, frequent defecation, blood in stool, or black stool from August 2007 to February 2011 were offered a stool examination. About 10g of fresh stool was collected in a clean, dry bottle. Two slides from each specimen were examined applying light microscope in 10 and 40 uvf at Banke, Nepalgunj hospital laboratory. Result: Among 2005 patients, 928 (46.28%) were infested with either helminths and/or protozoa. 96% were single infestation. The most common infestation was Ascaris lumbricoides (48.06%) and the second was hook worm (18.97%). Most common protozoal infestations were Entamoeba histolytica (12.92%) and Giardia lamblia (9.49%). Helminthic infestations peaked in cool months and protozoal infestations were rather steady throughout the year. Conclusion: Very high parasitic infestation in least developed mid- western Nepal may need urgent public health intervention. PMID:24762341

Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio cholerae O1

PubMed Central

2014-01-01

Background Although endemic cholera causes significant morbidity and mortality each year in Nepal, lack of information about the causal bacterium often hinders cholera intervention and prevention. In 2012, diarrheal outbreaks affected three districts of Nepal with confirmed cases of mortality. This study was designed to understand the drug response patterns, source, and transmission of Vibrio cholerae associated with 2012 cholera outbreaks in Nepal. Methods V. cholerae (n = 28) isolated from 2012 diarrhea outbreaks {n = 22; Kathmandu (n = 12), Doti (n = 9), Bajhang (n = 1)}, and surface water (n = 6; Kathmandu) were tested for antimicrobial response. Virulence properties and DNA fingerprinting of the strains were determined by multi-locus genetic screening employing polymerase chain reaction, DNA sequencing, and pulsed-field gel electrophoresis (PFGE). Results All V. cholerae strains isolated from patients and surface water were confirmed to be toxigenic, belonging to serogroup O1, Ogawa serotype, biotype El Tor, and possessed classical biotype cholera toxin (CTX). Double-mismatch amplification mutation assay (DMAMA)-PCR revealed the V. cholerae strains to possess the B-7 allele of ctx subunit B. DNA sequencing of tcpA revealed a point mutation at amino acid position 64 (N → S) while the ctxAB promoter revealed four copies of the tandem heptamer repeat sequence 5'-TTTTGAT-3'. V. cholerae possessed all the ORFs of the Vibrio seventh pandemic island (VSP)-I but lacked the ORFs 498–511 of VSP-II. All strains were multidrug resistant with resistance to trimethoprim-sulfamethoxazole (SXT), nalidixic acid (NA), and streptomycin (S); all carried the SXT genetic element. DNA sequencing and deduced amino acid sequence of gyrA and parC of the NAR strains (n = 4) revealed point mutations at amino acid positions 83 (S → I), and 85 (S → L), respectively. Similar PFGE (NotI) pattern revealed the Nepalese V. cholerae to be clonal

Prevalence of diabetic retinopathy among self-reported adult diabetics in districts of Eastern Nepal in a community based study.

PubMed

Agarwal, Lalit T; Agarwal, Nisha

2017-07-01

Diabetic retinopathy (DR) is the leading cause of blindness among working age adults around the world. Each year more and more people live with this condition, which can result in life-changing complications. To determine the prevalence and risk factors of diabetic retinopathy (DR) in a large community based screening programme, in order to estimate the future burden of the disease. A cross sectional community based study was conducted between 1st January and 31st December 2014 in a purposive sample of adults with selfreported diabetes mellitus (DM) from Morang and Sunsari district of Nepal. A structured questionnaire was used to collect patient data. Ophthalmological evaluation was done and fundus was examined for grading DR using direct and indirect ophthalmoscope. Among the 698 diabetic patients, mean age was 55.02±11.8 years (ranging from 24 to 91 years). 12.3% of diabetic were not under any treatment. Only 69.3% of patients had visited eye specialist for diabetic retinopathy screening. Prevalence of DR was found to be 15.3%; 13.9% had non-proliferative DR and 1.4% had proliferative DR. Prevalence of diabetic macular edema was 2.1%. In Morang district prevalence of DR was 14.2% and in Sunsari district it was 16.2%. In the binary-logistic regression analysis, duration of diabetes was associated with significantly increased risk of DR (OR: 1.13; 95% confidence interval (CI), 1.09 to 1.17; p<0.001). History of absence of arterial hypertension decreased the risk of DR (OR: 0.56; 95% CI, 0.36 to 0.87; p=0.01). One sixth of the patients with diabetes in the Eastern region of Nepal have retinopathy. Diabetic retinopathy risk increased with duration of diabetes and decreased with history of no co-existing arterial hypertension. © NEPjOPH.

Measles deaths in Nepal: estimating the national case-fatality ratio.

PubMed

Joshi, Anand B; Luman, Elizabeth T; Nandy, Robin; Subedi, Bal K; Liyanage, Jayantha B L; Wierzba, Thomas F

2009-06-01

To estimate the case-fatality ratio (CFR) for measles in Nepal, determine the role of risk factors, such as political instability, for measles mortality, and compare the use of a nationally representative sample of outbreaks versus routine surveillance or a localized study to establish the national CFR (nCFR). This was a retrospective study of measles cases and deaths in Nepal. Through two-stage random sampling, we selected 37 districts with selection probability proportional to the number of districts in each region, and then randomly selected within each district one outbreak among all those that had occurred between 1 March and 1 September 2004. Cases were identified by interviewing a member of each and every household and tracing contacts. Bivariate analyses were performed to assess the risk factors for a high CFR and determine the time from rash onset until death. Each factor's contribution to the CFR was determined through multivariate logistic regression. From the number of measles cases and deaths found in the study we calculated the total number of measles cases and deaths for all of Nepal during the study period and in 2004. We identified 4657 measles cases and 64 deaths in the study period and area. This yielded a total of about 82 000 cases and 900 deaths for all outbreaks in 2004 and a national CFR of 1.1% (95% confidence interval, CI: 0.5-2.3). CFR ranged from 0.1% in the eastern region to 3.4% in the mid-western region and was highest in politically insecure areas, in the Ganges plains and among cases < 5 years of age. Vitamin A treatment and measles immunization were protective. Most deaths occurred during the first week of illness. To our knowledge, this is the first CFR study based on a nationally representative sample of measles outbreaks. Routine surveillance and studies of a single outbreak may not yield an accurate nCFR. Increased fatalities associated with political insecurity are a challenge for health-care service delivery. The short period

Establishing a health demographic surveillance site in Bhaktapur district, Nepal: initial experiences and findings

PubMed Central

2012-01-01

Background A health demographic surveillance system (HDSS) provides longitudinal data regarding health and demography in countries with coverage error and poor quality data on vital registration systems due to lack of public awareness, inadequate legal basis and limited use of data in health planning. The health system in Nepal, a low-income country, does not focus primarily on health registration, and does not conduct regular health data collection. This study aimed to initiate and establish the first HDSS in Nepal. Results We conducted a baseline survey in Jhaukhel and Duwakot, two villages in Bhaktapur district. The study surveyed 2,712 households comprising a total population of 13,669. The sex ratio in the study area was 101 males per 100 females and the average household size was 5. The crude birth and death rates were 9.7 and 3.9/1,000 population/year, respectively. About 11% of births occurred at home, and we found no mortality in infants and children less than 5 years of age. Various health problems were found commonly and some of them include respiratory problems (41.9%); headache, vertigo and dizziness (16.7%); bone and joint pain (14.4%); gastrointestinal problems (13.9%); heart disease, including hypertension (8.8%); accidents and injuries (2.9%); and diabetes mellitus (2.6%). The prevalence of non-communicable disease (NCD) was 4.3% (95% CI: 3.83; 4.86) among individuals older than 30 years. Age-adjusted odds ratios showed that risk factors, such as sex, ethnic group, occupation and education, associated with NCD. Conclusion Our baseline survey demonstrated that it is possible to collect accurate and reliable data in a village setting in Nepal, and this study successfully established an HDSS site. We determined that both maternal and child health are better in the surveillance site compared to the entire country. Risk factors associated with NCDs dominated morbidity and mortality patterns. PMID:22950751

Climate change and adverse health events: community perceptions from the Tanahu district of Nepal

NASA Astrophysics Data System (ADS)

Mishra, Shiva Raj; Mani Bhandari, Parash; Issa, Rita; Neupane, Dinesh; Gurung, Swadesh; Khanal, Vishnu

2015-03-01

Nepal is a country economically dependent on climate-sensitive industries. It is highly vulnerable to the environmental, social, economic and health impacts of climate change. The objective of this study is to explore community perceptions of climate variability and human health risks. In this letter, we present a cross sectional study conducted between August 2013 and July 2014 in the Tanahu district of Nepal. Our analysis is based on 258 face-to-face interviews with household heads utilizing structured questionnaires. Over half of the respondents (54.7%) had perceived a change in climate, 53.9% had perceived an increase in temperature in the summer and 49.2% had perceived an increase in rainfall during the rainy season. Half of the respondents perceived an increase in the number of diseases during the summer, 46.5% perceived an increase during the rainy season and 48.8% during winter. Only 8.9% of the respondents felt that the government was doing enough to prevent climate change and its impact on their community. Belonging to the Janajati (indigenous) ethnic group, living in a pakki, super-pakki house and belonging to poor or mid-level income were related to higher odds of perceiving climate variability. Illiterates were less likely to perceive climate variability. Respondents living in a pakki house, super-pakki, or those who were poor were more likely to perceive health risks. Illiterates were less likely to perceive health risks.

Rumblings and Rainfall, Rebels, Remittances and Roads- The complex landscape of slope failure in Nepal

NASA Astrophysics Data System (ADS)

McAdoo, Brian G.; Sudmeier, Karen; Devkota, Sanjaya

2017-04-01

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

Pattern of occurrence of leukemia at a teaching hospital in eastern region of Nepal - a six year study.

PubMed

Kulshrestha, R; Sah, S P

2009-01-01

Pattern of leukemia is known to vary widely throughout the world. The characterization of distribution patterns of different subtypes of leukemia in Nepal needs further study. We wanted to study the leukemia pattern in our institute. A retrospective study of 196 cases of leukemia, diagnosed at BPKIHS, between January 1997 to December 2002 was done. We analyzed the pattern of leukemia at BPKIHS by morphological subtype, gender, age at diagnosis, time period of diagnosis (seasonality), and geographic distribution. Morphological sub typing showed that 121 cases were of acute leukemia and 75 of chronic leukemia. Chronic myeloid leukemia constituted the single largest group comprising 35.2 % of all cases, followed by acute myeloid leukemia (28.57 %) and acute lymphoid leukemia (19.9 %). Maximum numbers of cases were from the lowlands while least number of cases were from the mountain districts. Results were compared with literature from Nepal and other countries. This is the second series of leukemia from Nepal. The data published in this study reflects the leukemia pattern in the eastern region of Nepal. The pattern and distribution of AML, CML, ALL was similar to that in the developed western countries while the lesser frequency of CLL was similar to that in Southeast Asian region.

TRADITIONAL USES OF PLANTS OF COMMONLAND HABITATS IN WESTERN CHITWAN, NEPAL

PubMed Central

Dangol, D.R.

2012-01-01

This paper is based on the flora data gathered from 138 common land plots as part of a multi-method longitudinal study of the reciprocal relations between population and environment in western Chitwan, Nepal. The paper also describes the uses and availability of different species drawing upon both field data and knowledge of indigenous and local residents in the study area. Land use in western Chitwan is changing rapidly and common land areas have been under much stress due to population increase, whereas the common land areas are valuable to local residents. Both indigenous and new migrant residents in this area use the available plant resources for different purposes which bring economic benefit to the households. Plant species provide valuable food, vegetable and medicinal products that maintain human health and general wellbeing of the household. These plants are also economically valuable to farmers with high quality forage value as well as useful for crop management (e.g., pesticide, compost, green manure). Moreover, some plant species are used as fish poison to harvest fish from rivers and streams. Likewise, the common land areas provide materials for use in house construction (e.g., thatch) and making tools with the potential and viable sites as communal grazing land. It is evident that access and utilization of common land resources are important for many households, especially those in remote and poor agricultural areas such as western Chitwan. PMID:22945971

The experiences of districts in implementing a national incentive programme to promote safe delivery in Nepal

PubMed Central

Powell-Jackson, Timothy; Morrison, Joanna; Tiwari, Suresh; Neupane, Basu Dev; Costello, Anthony M

2009-01-01

Background Nepal's Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. Methods We conducted in ten study districts a series of key informant interviews and focus group discussions with staff from health facilities and the district health office and other stakeholders involved in implementation. Manual content analysis was used to categorise data under emerging themes. Results Problems at the central level imposed severe constraints on the ability of district-level actors to implement the programme. These included bureaucratic delays in the disbursement of funds, difficulties in communicating the policy, both to implementers and the wider public and the complexity of the programme's design. However, some district implementers were able to cope with these problems, providing reasons for why uptake of the programme varied considerably between districts. Actions appeared to be influenced by the pressure to meet local needs, as well individual perceptions and acceptance of the programme. The experience also sheds light on some of the adverse effects of the programme on the wider health system. Conclusion The success of conditional cash transfer programmes in Latin America has led to a wave of enthusiasm for their adoption in other parts of the world. However, context matters and proponents of similar programmes in south Asia should give due attention to the challenges to implementation when capacity is weak and health services inadequate. PMID:19508710

The Role of Obstetric Knowledge in Utilization of Delivery Service in Nepal

ERIC Educational Resources Information Center

Karkee, Rajendra; Baral, Om Bahadur; Khanal, Vishnu; Lee, Andy H.

2014-01-01

Birth Preparedness and Complication Readiness (BP/CR) program has been promoted in Nepal to equip pregnant women with obstetric knowledge so as to motivate them to seek professional care. Using a prospective design of 701 pregnant women of more than 5 months gestation in a central hills district of Nepal, we evaluated if having obstetric knowledge…

Female community health volunteers service utilization for childhood illness- improving quality of health services only is not enough: a cross-sectional study in mid-western region, Nepal.

PubMed

Miyaguchi, Moe; Yasuoka, Junko; Poudyal, Amod Kumar; Silwal, Ram Chandra; Jimba, Masamine

2014-09-11

Female Community Health Volunteers (FCHVs) are considered service providers for major health problems at the community level in Nepal. However, few studies have been conducted about the roles of FCHVs from the users' perspective. This study sought to examine the current status of FCHV service utilization and identify the determinants of caregivers' utilization of FCHVs' health services in the mid-western region of Nepal. This cross-sectional study targeted 446 caregivers of children under five years of age and whose children had ever fallen ill in the study village development committees (VDCs) of three districts of Nepal. Caregivers were asked about their usual health practices for childhood illness, health service utilization for childhood illness, children's health condition, satisfaction with health services, and socio-demographic status. Descriptive statistics and multiple logistic regression were used for analysis. Among 446 caregivers, 66.8% had never sought care from FCHVs for their children's illnesses in their lifetime, and more than 50% of them were unaware of FCHVs' services for acute respiratory infection and diarrhea. Among 316 caregivers whose child had an illness during the last seven months, 92.3% of them (n = 293) did not take their child to FCHVs. The main reasons were the lack of medicine available from them and their incompetency in providing care. Among the 446 caregivers, those who participated in a mothers' group (n = 82) were more likely to use FCHVs' services in their lifetime (AOR = 3.23, 95% CI =1.81-5.76). Caregivers can gain benefit by using FCHV's health services, but a majority of the caregivers did not seek care from FCHVs due to its limited quality. Raising caregivers' awareness on FCHV is equally important at community level.

The role of Tamang mothers-in-law in promoting breast feeding in Makwanpur District, Nepal.

PubMed

Masvie, Hilde

2006-03-01

to systematically analyse the Nepalise grandmother's own perspective of breast feeding. a qualitative approach was used. Three focus-group discussions and eight semi-structured interviews formed the primary database. All interviews and discussions were tape recorded, and translated transcripts and field notes were analysed. Makwanpur District, rural Nepal. 31 Tamang mothers-in-law living in a household with their son's family, and taking part in child care. the data suggest that the mothers-in-law see themselves as key providers of, and decision-makers in, perinatal care practices. Traditional patterns of promotive and preventive care were identified. contrary to the widespread reports that early breast feeding is delayed in this setting, these grandmothers held colostrum in high regard, used no prelacteals and supported early initiation of breast feeding.

Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

PubMed Central

Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P.; Krettek, Alexandra

2014-01-01

Background Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps. PMID:25119066

Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study.

PubMed

Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P; Krettek, Alexandra

2014-01-01

Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

Multidisciplinary study on anthropogenic landslides in Nepal

NASA Astrophysics Data System (ADS)

Puglia, Christopher; Derron, Marc-Henri; Nicolet, Pierrick; Sudmeier-Rieux, Karen; Jaboyedoff, Michel; Devkota, Sanjay

2013-04-01

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.

Revisiting global body politics in Nepal: A reflexive analysis.

PubMed

Harcourt, Wendy

2016-01-01

Using the example of a human rights training in Nepal, the author looks at global body politics in a reflexive piece on her engagement in development practices that translate western feminist ideas on gender inequality and empowerment via UN human rights policies into non-western contexts. It firsts look at postcolonial and critical literature on feminist engagement in gender and development processes including a discussion on the concept of global body politics before examining briefly the framing of gender-based violence in Nepal. The core of the paper is a reflexive analysis and interrogation of the training in Nepal in order to bring out the tensions and contradictions around western developmental, feminist and human rights discourses. The discussion looks at how difficult it is for feminist, human rights and developmental discourses and practices to unmoor themselves from the notion of the 'expert' and those who do the rights/work/righting rights training and those who are perennially seen as requiring training. The conclusion reflects on possibilities of other epistemic practices found in intercultural dialogues.

Isolation and characterization of aerobic culturable arsenic-resistant bacteria from surfacewater and groundwater of Rautahat District, Nepal.

PubMed

Shakya, S; Pradhan, B; Smith, L; Shrestha, J; Tuladhar, S

2012-03-01

Arsenic (As) contamination of groundwater is a serious Environmental Health Management issue of drinking water sources especially in Terai region of Nepal. Many studies have reported that due to natural abundance of arsenic in the environment, various bacteria have developed different resistance mechanisms for arsenic compound. In this study, the culturable arsenic-resistant bacteria indigenous to surfacewater as well as groundwater from Rautahat District of Nepal were randomly isolated by standard plate count method on the basis of viable growth on plate count agar amended with arsenate ranging from 0, 0.5, 10, 40, 80 to 160 milligram per liter (mg/l). With respect to the morphological and biochemical tests, nine morphologically distinct potent arsenate tolerant bacteria showed relatedness with Micrococcus varians, Micrococcus roseus, Micrococcus luteus, Pseudomonas maltophilia, Pseudomonas sp., Vibrio parahaemolyticus, Bacillus cereus, Bacillus smithii 1 and Bacillus smithii 2. The isolates were capable of tolerating more than 1000 mg/l of arsenate and 749 mg/l of arsenite. Likewise, bioaccumulation capability was highest with M. roseus (85.61%) and the least with B. smithii (47.88%) indicating the potential of the organisms in arsenic resistance and most probably in bioremediation. Copyright © 2011 Elsevier Ltd. All rights reserved.

An ethnobotanical survey of medicinal plants used in Terai forest of western Nepal

PubMed Central

2012-01-01

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 authors note that

A Review of Tectonic Models and Analytical Data from Almora-Dadeldhura Klippe, Northwest India and Far Western Nepal.

NASA Astrophysics Data System (ADS)

Bosu, S.; Robinson, D.; Saha, A.

2017-12-01

Tectonic models developed from the Himalayan thrust belt constitute three models- critical taper, channel flow and wedge extrusion. Their differences are manifested in predicted minimum shortening, deformation propagation style and tectonic architecture across the thrust belt. Recent studies from isolated synformal klippen composed of Greater and Tethyan Himalayan rock within the Himalayan thrust belt disagree over the tectonic history, especially in the Almora-Dadeldhura klippe, which is the largest klippe in the thrust belt. These recent studies are limited to one transect each, and two or fewer types of analytical data to justify their models. Due to the limited spatial coverage, these studies often reflect a narrow perspective in their tectonic models; thus, combining the data from these studies provides a holistic view of the regional tectonic history. This study compiled the available data across the 350 km wide Almora-Dadeldhura klippe, using petrology, stratigraphy, metamorphic history, microstructure, U-Pb ages of intrusive granite, monazite and muscovite ages of the shear zones, and exhumation ages from apatite fission track, along with original field observations, microstructure and microtexture data from 5 different transects in northwest India and far western Nepal. The review of the compiled data suggests that the Himalayan thrust belt in northwest India and far western Nepal is a forward propagating thrust system, and that the analytical data support the critical taper model.

Profile of skin biopsies and patterns of skin cancer in a tertiary care center of Western Nepal.

PubMed

Kumar, Ajay; Shrestha, Prashanna Raj; Pun, Jenny; Thapa, Pratichya; Manandhar, Merina; Sathian, Brijesh

2015-01-01

Skin biopsy is the method to assist clinicians to make definite dermatological diagnosis which further helps in holistic management. Skin cancers are relatively rare clinical diagnosis in developing countries like Nepal, but the prevalence is on rise. To investigate the profile of skin biopsies and frequencies and pattern of skin cancers in a tertiary care centre of Western Nepal. The materials consisted of 434 biopsies (1.37%) out of 31,450 OPD visits performed in the Department of Dermatology, Manipal Teaching Hospital, Pokhara, Nepal, during the period of Dec 2011-Nov 2014. Data were collected and analyzed using SPSS-16 with reference to incidence, age, sex, race and clinical and histopathological features. The commonest disorders observed in biopsies were papulosquamous lesions, skin tuberculosis of different types, benign skin tumors, leprosy, collagen and fungal diseases. Viral diseases were rarely seen, probably due to straight forward clinical diagnosis. Dermatological malignancies accounted for 55/434 (12.67%) of biopsies. Skin disorders in general were commoner in females 280/434 (64%), including malignancies 32/55(58.2%). Mean age of patients with skin cancer was 54.5 years. Facilities for proper laboratory investigation of dermatological disorders will improve the quality of life. The most prevalent lesion in skin biopsies was papulosquamous disorders followed by skin tuberculosis of different types. Dermatological malignancy constituted 55/434 (12.67%) cases. The prevalence of skin malignancy is on rise in Nepalese society probably due to increase in life expectancy and better diagnostic services.

Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?

PubMed

Bhandari, Tulsi Ram; Kutty, V Raman; Sarma, P Sankara; Dangal, Ganesh

2017-01-01

Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives-women's autonomy-plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women's autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women's autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women's education had a strong positive association (odds ratio = 24.11, CI = 9.43-61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women's education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband's education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women's autonomy may be an important mediating factor in this pathway.

Sexual behavior and condom use among seasonal Dalit migrant laborers to India from Far West, Nepal: a qualitative study.

PubMed

Bam, Kiran; Thapa, Rajshree; Newman, Marielle Sophia; Bhatt, Lokesh Prasad; Bhatta, Shree Krishna

2013-01-01

Around 41% of Human Immunodeficiency Virus (HIV) cases in Nepal occur in seasonal migrant laborers. Dalit migrant laborers represent the largest proportion of reported HIV cases in the Far Western Region (Sudur Pashchimanchal, or Far West), Nepal. The study's objectives were to assess sexual behavior, condom use status and HIV risk perception among Dalit migrant laborers to India from Far West Region, Nepal. The study was conducted among Dalit male migrant laborers aged 15 years and above who had migrated for at least six months of the last two years to India. For the sampling the village development committees (VDCs) from Achham, Doti and Kanchanpur districts of Nepal were purposively selected. The data were collected in March and April 2011 via ten in-depth interviews and four focus group discussions and analyzed using content analysis. Poor socio-economic status, caste-related discrimination, and lack of employment opportunities push large groups of young Dalits to migrate to India for employment, where they engage in sex with female sex workers (FSWs). The participants described unmarried status, peer influence, alcohol use, low-priced sex with FSWs and unwillingness to use condoms as common factors of their migration experience. Lack of awareness on HIV/AIDS was common among study participants. Awareness of HIV/AIDS and faithful, monogamous partnerships are reported as factors influencing safer sexual behavior. Dalits are an especially vulnerable population among migrant laborers and may be over-represented in new HIV infections in Nepal. Comprehensive surveying and health promotion programs targeted to this population are urgently needed and potent methods of stopping HIV spread.

Universal institutional delivery among mothers in a remote mountain district of Nepal: what are the challenges?

PubMed

Joshi, D; Baral, S C; Giri, S; Kumar, A M V

2016-12-21

Setting: Eight village development committees of Mugu District, a remote mountainous district of Nepal that has poor maternal health indicators. Objectives: 1) To assess the proportion of mothers who delivered in health facilities (institutional delivery); 2) among mothers who delivered at home, to understand their reasons for doing so; and 3) among mothers who delivered in health facilities, to understand their challenges. Design: Cross-sectional study involving semi-structured interviews with mothers conducted in 2015. Results: Of 275 mothers, 97 (35%) had an institutional delivery. Multivariate logistic regression analysis showed that women who resided within 1 h distance from the birthing centre, had adequate mass media exposure or had only one child were more likely to deliver in hospital. Reasons for non-institutional delivery ( n = 178) were related to geographical access (49%), personal preferences (18%) and perceived poor quality care (4%). Mothers who accessed institutional delivery ( n = 97) also reported difficulties related to travel (60%), costs (28%), dysfunctional health system (18%) and unfriendly attitudes of the health-care providers (7%). Conclusion: To improve access to institutional delivery, the government should establish a 24/7 emergency ambulance network, including air ambulance. Health system issues, including unfriendly staff attitudes, urgently need to be addressed to gain the trust of the mothers.

Women's Autonomy and Its Correlates in Western Nepal: A Demographic Study.

PubMed

Bhandari, Tulsi Ram; Kutty, V Raman; Ravindran, T K Sundari

2016-01-01

Despite various efforts for enhancing women's autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women's autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women's autonomy using a recently developed women's autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women's autonomy was 23.34 ± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple's education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women's education (OR = 8.14, CI = 3.77-17.57), husband's education (OR = 2.63, CI = 1.69-4.10) and economic status of household (OR = 1.42, CI = 1.01-2.03) on women's autonomy. When we adjusted women's education for husband's education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77-17.57) to (OR = 6.32, CI = 2.77-14.46)} and was a mediator effect. The economic status of household also had mediator effect on women's autonomy through their education. Education status of women is a key predictor of women's autonomy in Kapilvastu district. Husband's education and economic status of the household are other important predictors of women's autonomy which have a mediator effect on women's autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women's autonomy.

Measuring impacts of community forestry program through repeat photography and satellite remote sensing in the Dolakha district of Nepal.

PubMed

Niraula, Rabin Raj; Gilani, Hammad; Pokharel, Bharat Kumar; Qamer, Faisal Mueen

2013-09-15

During the 1990's community-based forest management gained momentum in Nepal. This study systematically evaluates the impacts that this had on land cover change and other associated aspects during the period 1990-2010 using repeat photography and satellite imagery in combination with interviews with community members. The results of the study clearly reflect the success of community-based forest management in the Dolakha district of the mid-hills of Nepal: during the study period, the rate of conversion of sparse forest into dense forest under community-based management was found to be between 1.13% and 3.39% per year. Similarly, the rate of conversion of non-forest area into forest was found to be between 1.11% and 1.96% per year. Community-based forest management has resulted in more efficient use of forest resources, contributed to a decline in the use of slash-and-burn agricultural practices, reduced the incidence of forest fires, spurred tree plantation, and encouraged the conservation and protection of trees on both public and private land. The resulting reclamation of forest in landside areas and river banks and the overall improvement in forest cover in the area has reduced flash floods and associated landslides. Copyright © 2013 Elsevier Ltd. All rights reserved.

Applicability of citronella oil (Cymbopogon winteratus) for the prevention of mosquito-borne diseases in the rural area of Tikapur, far-western Nepal.

PubMed

Sajo, Ma Easter Joy; Song, Soon-Bong; Bajgai, Johny; Kim, Young-Je; Kim, Pan-Suk; Ahn, Dong-Won; Khanal, Narendra; Lee, Kyu-Jae

2015-01-01

Mosquito-borne diseases are a serious global problem, particularly in tropical and sub-tropical countries such as Nepal. Citronella oil is a natural mosquito repellent as well as a local fragrance in Nepal, which is accessible at very low cost because citronella plants are widely cultivated in rural areas of the Terai belt in Nepal. This study was conducted using a real-life randomized controlled pilot trial to confirm the effectiveness and applicability of locally-produced citronella oil as a mosquito repellent for the prevention of mosquito-borne diseases in Nepal. A repellency activity test was performed with 100% citronella oil (Cymbopogon winteratus) from April to May 2013 in the Tikapur Municipality of the Kailali district, Nepal. The test was divided into two trials: an indoor exposure (IE) test (N=101) and an outdoor exposure (OE) test (N=140) from 5.00 pm to 7.00 pm. Each trial contained an experimental citronella oil-applied group and a non-applied (control) group. The outcome measures were the protective effect of citronella oil against mosquitoes, the number of mosquito bites, the repellency percentage, the smell satisfaction and the irritation level. Experimental group had a significant protective effect against mosquito bites in IE (96.5%, n=57) and OE (95.7%, n=70) tests compared to the control group in IE (29.5%, n=44) and OE (28.6%, n=70) tests (experimental vs control groups, p<0.001). The repellency percentage for the OE test was 96.7%. In the smell satisfaction test (n=127), most of the participants responded with high satisfaction: 'good' (67.7%), 'very good' (16.5%), 'bad' (13.4%) and 'very bad' (2.4%). IE and OE tests showed similar satisfaction levels in each category. In the irritation level test (n=127), 87.4% and 12.6% responded with no irritation and slight irritation, respectively. There were no reports of moderate or severe irritation. The topical application of citronella oil can be employed as an easily-available, affordable and

Lower Genital Tract Trauma in A Tertiary Care Centre in Mid-Western Nepal.

PubMed

Adhikari, A K; Dutta, M; Das, C R

2017-01-01

The study of lower genital tract trauma has become important in gynaecological practice. There is paucity of reports on this clinical entity from our settings. The main aim of this study is to document injuries in female lower genital tract in Mid-Western Nepal. Sixty female patients admitted to the hospital with genital tract injuries caused by coitus or accidents were included in the study. Details of the causes of trauma clinical presentations and management were recorded. These injuries were grouped according to etiological factors. This study included 33 (55%) coital injuries and 27 (45%) non- coital injuries. Out of coital injury, 12 cases were criminal assault (rape) in age group of 4 to 18 years. Four unmarried girls had consensual sex. Non-coital injuries were due to fall from height, cattle horn injuries, straddle type of trauma, vulvar haematoma and anorectal injuries. Appropriate surgical intervention can avert morbidity and mortality.

The supplemental use of infant formula in the context of universal breastfeeding practices in Western Nepal.

PubMed

Khanal, Vishnu; Scott, Jane A; Lee, Andy H; Karkee, Rajendra; Binns, Colin W

2016-05-21

While the initiation of breastfeeding is universal in Nepal, little has been reported on formula feeding practices. This study aimed to report the prevalence of, and factors associated with, the use of infant formula as supplementary feeds in the Western region of Nepal. A community-based cohort study was conducted to collect infant feeding information among 735 postpartum mothers using structured questionnaires. Complete formula feeding data were collected from 711 women in the first, fourth and sixth month postpartum. Factors independently associated with formula feeding were investigated using multiple logistic regression. All mothers were breastfeeding their infants at the time of recruitment. The prevalence of formula feeding was 7.5 % in the first month and 17 % in the sixth month. About a quarter of mothers (23.8 %) reported providing infant formula at least once during the first six months of life. Infant formula was used commonly as top-up food. Stepwise logistic regression showed that infants born to families residing in urban areas (adjusted odds ratio (aOR): 2.14; 95 % confidence interval (CI): 1.37 to 3.33), mothers with higher education (aOR: 2.08; 95 % CI: 1.14 to 3.80), and infants born by caesarean section (aOR: 1.96; 95 % CI: 1.21 to 3.18) were at greater risk of formula feeding. The current findings indicate that health workers should support mothers to initiate and continue exclusive breastfeeding particularly after caesarean deliveries. Furthermore, urban health programs in Nepal should incorporate breastfeeding programs which discourage the unnecessary use of formula feeding. The marketing of formula milk should be monitored more vigilantly especially in the aftermath of the April 2015 earthquakes or other natural disasters.

Mobile Learning Practice in Higher Education in Nepal

ERIC Educational Resources Information Center

Parajuli, Krishna Prasad

2016-01-01

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…

Prevalence and risk factors for trachoma in Sarlahi district, Nepal.

PubMed Central

Katz, J; West, K P; Khatry, S K; LeClerq, S C; Pradhan, E K; Thapa, M D; Ram Shrestha, S; Taylor, H R

1996-01-01

AIMS: To estimate the prevalence of trachoma in preschool children in Sarlahi district, Nepal, and to identify risk factors for the disease. METHODS: A stratified random sample of 40 wards was selected for participation in a trachoma survey. Within each ward, a systematic 20% sample of children 24-76 months of age was chosen to determine the presence and severity of trachoma using the World Health Organisation grading system. RESULTS: A total of 891 children were selected and 836 (93.8%) were examined for trachoma from December 1990 to March 1991. The prevalence of active trachoma was 23.6% (21.9% follicular and 1.7% intense inflammatory). Cicatricial trachoma was not seen in this age group. The prevalence of trachoma ranged from 0 to 50% across wards with certain communities at much higher risk for trachoma than others. Three year old children had the highest prevalence of follicular (25.5%) and intense inflammatory trachoma (4.3%). Males and females had similar prevalence rates. Wards without any tube wells were at higher risk than those with one or more tube wells. Lower rates of trachoma were seen in families who lived in cement houses, had fewer people per room, more servants, more household goods, animals, and land. Hence, less access to water, crowding and lower socioeconomic status were risk factors for trachoma. CONCLUSIONS: Although follicular trachoma is prevalent, intense inflammatory trachoma is relatively rare and scarring was not observed in this preschool population. Hence, this population may not be at high risk for repeat infections leading to blindness in adulthood. PMID:9059265

Sexual Behavior and Condom Use among Seasonal Dalit Migrant Laborers to India from Far West, Nepal: A Qualitative Study

PubMed Central

Bam, Kiran; Thapa, Rajshree; Newman, Marielle Sophia; Bhatt, Lokesh Prasad; Bhatta, Shree Krishna

2013-01-01

Background Around 41% of Human Immunodeficiency Virus (HIV) cases in Nepal occur in seasonal migrant laborers. Dalit migrant laborers represent the largest proportion of reported HIV cases in the Far Western Region (Sudur Pashchimanchal, or Far West), Nepal. The study’s objectives were to assess sexual behavior, condom use status and HIV risk perception among Dalit migrant laborers to India from Far West Region, Nepal. Methods The study was conducted among Dalit male migrant laborers aged 15 years and above who had migrated for at least six months of the last two years to India. For the sampling the village development committees (VDCs) from Achham, Doti and Kanchanpur districts of Nepal were purposively selected. The data were collected in March and April 2011 via ten in-depth interviews and four focus group discussions and analyzed using content analysis. Results Poor socio-economic status, caste-related discrimination, and lack of employment opportunities push large groups of young Dalits to migrate to India for employment, where they engage in sex with female sex workers (FSWs). The participants described unmarried status, peer influence, alcohol use, low-priced sex with FSWs and unwillingness to use condoms as common factors of their migration experience. Lack of awareness on HIV/AIDS was common among study participants. Awareness of HIV/AIDS and faithful, monogamous partnerships are reported as factors influencing safer sexual behavior. Conclusions Dalits are an especially vulnerable population among migrant laborers and may be over-represented in new HIV infections in Nepal. Comprehensive surveying and health promotion programs targeted to this population are urgently needed and potent methods of stopping HIV spread. PMID:24040359

Safe delivery care practices in western Nepal: Does women’s autonomy influence the utilization of skilled care at birth?

PubMed Central

Kutty, V. Raman; Sarma, P. Sankara; Dangal, Ganesh

2017-01-01

Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives—women’s autonomy—plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women’s autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women’s autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women’s education had a strong positive association (odds ratio = 24.11, CI = 9.43–61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women’s education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband’s education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women’s autonomy may be an important mediating factor in this pathway. PMID:28771579

Equity and Discrimination among Children: Schooling Decisions in Rural Nepal.

ERIC Educational Resources Information Center

Ashby, Jacqueline A.

1985-01-01

Interviews and survey questionnaires were used to collect--from 302 randomly selected farm households in the Kahvre Palanchowk District in eastern Nepal--information regarding how families make decisions about schooling for children. The findings suggest that sociocultural and economic factors cause parents to discriminate among children according…

The spatial heterogeneity between Japanese encephalitis incidence distribution and environmental variables in Nepal.

PubMed

Impoinvil, Daniel E; Solomon, Tom; Schluter, W William; Rayamajhi, Ajit; Bichha, Ram Padarath; Shakya, Geeta; Caminade, Cyril; Baylis, Matthew

2011-01-01

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 Nepal

Support to the Safe Motherhood Programme in Nepal: an integrated approach.

PubMed

Barker, Carol E; Bird, Cherry E; Pradhan, Ajit; Shakya, Ganga

2007-11-01

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.

Outbreak Investigation of Influenza in Pajaru VDC of Jajarkot District of Nepal.

PubMed

Upadhyay, S K; Singh Pradhan, P M; Mahato, R K; Marasini, B; Upadhyaya, B; Shakya, G; Baral, G; Baral, K P

2016-09-01

An outbreak investigation study was conducted in Pajaru, one of the initially affected Village Development Committees (VDCs) of the Jajarkot district in Nepal following an outbreak of respiratory illness in early 2015. The objectives of this study were to identify the cases and magnitude of the outbreak. A cross-sectional study was carried out in mid-April 2015 covering five most affected wards of Pajaru VDC to assess the patients using standard case definition for Influenza like Illness (ILI). Throat and nasal swabs were collected and sent to the National Influenza Center (NIC) in Kathmandu for laboratory confirmation. The throat swab samples tested at NIC found Influenza A H1N1 pdm09. The attack rate was calculated to be 3% in ward number 9 and 41% in ward number 8. Wavelength of the infection was nearly two weeks in both the wards. Nearly 54% of the specimens were positive for Influenza A H1N1 pdm09. There was no ILI case fatality in the study area. Children aged 0-15 years were most affected. Majority of the patients presented with symptoms of fever, cough and sore throat. There was gradual decline in the number of cases in all five wards suggestive of development of natural immunity in the community. True severity of the outbreak was not accurately reflected as compared to media reports.

Scrub Typhus: An Emerging Neglected Tropical Disease in Nepal.

PubMed

Upadhyaya, B P; Shakya, G; Adhikari, S; Rijal, N; Acharya, J; Maharjan, L; Marasini, B R

2016-05-01

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.

Factors affecting institutional delivery in rural Chitwan district of Nepal: a community-based cross-sectional study.

PubMed

Shah, Rajani; Rehfuess, Eva A; Maskey, Mahesh K; Fischer, Rainald; Bhandari, Prem B; Delius, Maria

2015-02-13

Health facility delivery is considered a critical strategy to improve maternal health. The Government of Nepal is promoting institutional delivery through different incentive programmes and the establishment of birthing centres. This study aimed to identify the socio-demographic, socio-cultural, and health service-related factors influencing institutional delivery uptake in rural areas of Chitwan district, where high rates of institutional deliveries co-exist with a significant proportion of home deliveries. This community-based cross-sectional study was conducted in six rural Village Development Committees of Chitwan district, which are characterised by relatively low institutional delivery rates and the availability of birthing centres. The study area represents both hilly and plain areas of Chitwan. A total of 673 mothers who had given birth during a one-year-period were interviewed using a structured questionnaire. Univariate and multivariable logistic regression analysis using stepwise backward elimination was performed to identify key factors affecting institutional delivery. Adjusting for all other factors in the final model, advantaged caste/ethnicity [aOR: 1.98; 95% CI: 1.15-3.42], support for institutional delivery by the husband [aOR: 19.85; 95% CI: 8.53-46.21], the decision on place of delivery taken jointly by women and family members [aOR: 5.43; 95% CI: 2.91-10.16] or by family members alone [aOR: 4.61; 95% CI: 2.56-8.28], birth preparations [aOR: 1.75; 95% CI: 1.04-2.92], complications during the most recent pregnancy/delivery [aOR: 2.88; 95% CI: 1.67-4.98], a perception that skilled health workers are always available [aOR: 2.70; 95% CI: 1.20-6.07] and a birthing facility located within one hour's travelling distance [aOR: 2.15; 95% CI: 1.26-3.69] significantly increased the likelihood of institutional delivery. On the other hand, not knowing about the adequacy of physical facilities significantly decreased the likelihood of institutional delivery

Characterization of rabies virus from a human case in Nepal.

PubMed

Pant, G R; Horton, D L; Dahal, M; Rai, J N; Ide, S; Leech, S; Marston, D A; McElhinney, L M; Fooks, A R

2011-04-01

Rabies is endemic throughout most of Asia, with the majority of human cases transmitted by domestic dogs (Canis familiaris). Here, we report a case of rabies in a 12-year-old girl in the Lalitpur district of Nepal that might have been prevented by better public awareness and timely post-exposure prophylaxis. Molecular characterization of the virus showed 100% identity over a partial nucleoprotein gene sequence to previous isolates from Nepal belonging to the 'arctic-like' lineage of rabies virus. Sequence analysis of both partial nucleoprotein and glycoprotein genes showed differences in consensus sequence after passage in vitro but not after passage in vivo.

Health system decentralisation in Nepal: identifying the issues.

PubMed

Collins, Charles; Omar, Mayeh; Adhikari, Damodar; Dhakal, Ramji; Emmel, Nick; Dhakal, Megha Raj; Chand, Padam; Thapa, Druba; Singh, Arjun B

2007-01-01

The purpose of this paper is to describe and discuss policy analysis in Nepal and review the wide range of choices feasible in decentralisation decision making. In this paper an iterative qualitative method was developed and used in the research, which consisted of focus group interviews, key informant interviews, document analysis, including descriptive statistics, and analysis of the policy context. Participants in the research reflected the urban/rural mix of districts and the geography of Nepal. Analysis combined transcribed interviews with findings from document searches and analysis of the policy context. Coding was pre-determined during the training workshop and further codes were generated during and after the fieldwork. The paper finds that Nepal is in the process of decentralising public services from the central level to the local level, particularly to local bodies: District Development Committees (DDCs), Village Development Committees (VDCs) and Municipalities. Key contextual factors referred to are the overall structure of decentralisation, the social context of poverty and the political instability leading to a fluid political situation characterised by political tension, armed conflict, controversies and agreements while carrying out the research. The key issues identified and discussed in the paper are the policy process leading to decentralisation, the organisational structure and tension in the proposed system, the systems of resource generation, allocation, planning and management and lastly the forms of accountability, participation, public-private relations and collaborative strategies. The paper discusses the challenges faced in conducting such a policy analysis, the broad ranging and unremitting nature of the decentralisation process, and the contextual setting of the process of change.

Dengue Virus Serotypes 1 and 2 Responsible for Major Dengue Outbreaks in Nepal: Clinical, Laboratory, and Epidemiological Features

PubMed Central

Dumre, Shyam Prakash; Bhandari, Renu; Shakya, Geeta; Shrestha, Sanjaya Kumar; Cherif, Mahamoud Sama; Ghimire, Prakash; Klungthong, Chonticha; Yoon, In-Kyu; Hirayama, Kenji; Na-Bangchang, Kesara; Fernandez, Stefan

2017-01-01

Abstract. Dengue virus (DENV) is expanding toward previously nonendemic areas. DENV has recently been introduced in Nepal with limited information. We report the clinical features and serotype distribution of DENV in Nepal during the 2010 outbreaks. A total of 1,215 clinical dengue cases at two major hospitals of central and western Nepal were investigated. Demographic, clinical, and laboratory parameters were recorded. Serum specimens were tested for DENV by IgM/IgG enzyme-linked immunosorbent assays (ELISAs) and reverse transcription polymerase chain reaction (RT-PCR). We confirmed DENV infection in 403 (33%) patients from 12 districts with an estimated case fatality rate of 1.5%. DENV infection was more common in adults (87%) and urban settings (74%). We detected all four serotypes but DENV-1 and -2 were mainly responsible for major outbreaks (92%). Overall, 60% of all DENV infections were secondary and 17% were severe dengue; both being more frequent among the DENV-2 infections. Rash, bleeding, abdominal pain, hepatomegaly, elevated liver enzymes, and thrombocytopenia were significantly more common in severe dengue compared with nonsevere infections. We also confirmed the expansion of dengue to hill urban areas (DENV-1 and -2), including the capital Kathmandu (altitude, 1,300 m) though > 90% cases were from southern plains. Differential clinical and laboratory features probably help in clinical decisions. Multiple serotypes circulation and elevated secondary infections pose potential risk of severe outbreaks and deaths in the future. Therefore, a country with recent dengue introduction, like Nepal, urgently requires a systematic surveillance and appropriate control measures in place to respond to any disastrous outbreaks. PMID:29031282

Spatial and Temporal Dynamics of Flora in Forest, Grassland and Common Land Ecosystems of Western Chitwan, Nepal

PubMed Central

DANGOL, Dharma Raj; MAHARJAN, Keshav Lall

2013-01-01

This paper describes changes of species composition and population of flora in space and time in western Chitwan, Nepal. This paper also discusses on the changes in flora due to flood and human activities. To illustrate these changes, we used survey data collected from January to April of 1996, 2000, and 2007 from the Barandabhar forest, National Park forest and the forests along the Narayani River banks, grasslands of National Park and common lands of western Chitwan as a part of longitudinal study on “reciprocal relation of population and the environment”. From these data, density values were calculated to analyze spatial and temporal changes in flora species composition and population. We also noted the changes of top species in time and space in due course of time. If the species and its rank not changed, their densities (population) values of flora species changed. We found that changes in species composition, population, appearance or disappearance of flora from a particular space (research plot) were noted as a result of natural forces or human activities. PMID:25061414

Spatial and Temporal Dynamics of Flora in Forest, Grassland and Common Land Ecosystems of Western Chitwan, Nepal.

PubMed

Dangol, Dharma Raj; Maharjan, Keshav Lall

2012-06-30

This paper describes changes of species composition and population of flora in space and time in western Chitwan, Nepal. This paper also discusses on the changes in flora due to flood and human activities. To illustrate these changes, we used survey data collected from January to April of 1996, 2000, and 2007 from the Barandabhar forest, National Park forest and the forests along the Narayani River banks, grasslands of National Park and common lands of western Chitwan as a part of longitudinal study on "reciprocal relation of population and the environment". From these data, density values were calculated to analyze spatial and temporal changes in flora species composition and population. We also noted the changes of top species in time and space in due course of time. If the species and its rank not changed, their densities (population) values of flora species changed. We found that changes in species composition, population, appearance or disappearance of flora from a particular space (research plot) were noted as a result of natural forces or human activities.

An ethnobotanical analysis of parasitic plants (Parijibi) in the Nepal Himalaya.

PubMed

O'Neill, Alexander Robert; Rana, Santosh Kumar

2016-02-24

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.

Birth Spacing of Pregnant Women in Nepal: A Community-Based Study.

PubMed

Karkee, Rajendra; Lee, Andy H

2016-01-01

Optimal birth spacing has health advantages for both mother and child. In developing countries, shorter birth intervals are common and associated with social, cultural, and economic factors, as well as a lack of family planning. This study investigated the first birth interval after marriage and preceding interbirth interval in Nepal. A community-based prospective cohort study was conducted in the Kaski district of Nepal. Information on birth spacing, demographic, and obstetric characteristics was obtained from 701 pregnant women using a structured questionnaire. Logistic regression analyses were performed to ascertain factors associated with short birth spacing. About 39% of primiparous women gave their first child birth within 1 year of marriage and 23% of multiparous women had short preceding interbirth intervals (<24 months). The average birth spacing among the multiparous group was 44.9 (SD 21.8) months. Overall, short birth spacing appeared to be inversely associated with advancing maternal age. For the multiparous group, Janajati and lower caste women, and those whose newborn was female, were more likely to have short birth spacing. The preceding interbirth interval was relatively long in the Kaski district of Nepal and tended to be associated with maternal age, caste, and sex of newborn infant. Optimal birth spacing programs should target Janajati and lower caste women, along with promotion of gender equality in society.

Impact of Spiritual Behavior on Self-Reported Illness: A Cross-Sectional Study among Women in the Kailali District of Nepal.

PubMed

Ranabhat, Chhabi Lal; Kim, Chun-Bae; Park, Myung-Bae; Bajgai, Johny

2018-01-01

Different health behaviors influence health and illness. Spiritual well-being is one of the most important aspects of health promotion. The aim of this study was to identify the association between spiritual behavior in relation to meditation, worship, and physical exercise during yoga with self-reported disease/illness among women of the Kailali district of Nepal. This was a cross-sectional study with 453 randomly selected women in the Kailali district of Nepal within 1 municipality and 4 village development committees (VDC) using cluster sampling. We used a semi-structured interview to collect the data for selected respondents. Socioeconomics, lifestyle, self-care, and spiritual behavior variables were independent variables, and self-reported illness in the past year was a dependent variable. Descriptive statistics, chi square, hierarchical logistic regression for odds ratio, and 95% CI were used when appropriate. Study results showed that 89% of participants were from the rural area, 29.3% were housewives, 51.4% had no formal education, 43.2% used tobacco, 42.1% did yoga, and 16.9% engaged in regular worship. Self-reported illness was associated with safe toilet-using behavior, tobacco use, junk food consumption, yoga and regular exercise, worship, and regular sleeping habits. Comparing odds ratios and 95% CIs, the women who had safe toilet behavior and did not use tobacco were 2.48 (1.98-7.98) and 2.86 (1.74-7.34) times less likely to be ill, respectively. Likewise, women who consumed junk food; did not regularly exercise, meditate, or worship; and had irregular sleeping habits were 1.65 (1.32-4.61), 2.81(1.91-5.62), 2.56 (2.01-4.88), 4.56 (3.91-8.26), and 2.45 (2.12-5.03) times more likely to become ill, respectively. Our study concludes that spiritual behavior is effective for better health and low risk for disease occurrence. A spiritual health policy and separate curriculum for basic education and medical education should be promoted globally, and further

The Spatial Heterogeneity between Japanese Encephalitis Incidence Distribution and Environmental Variables in Nepal

PubMed Central

Impoinvil, Daniel E.; Solomon, Tom; Schluter, W. William; Rayamajhi, Ajit; Bichha, Ram Padarath; Shakya, Geeta; Caminade, Cyril; Baylis, Matthew

2011-01-01

Background 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. Methods 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. Results 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. Conclusion 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

Medicinal plants used by the Tamang community in the Makawanpur district of central Nepal

PubMed Central

2014-01-01

Background We can conserve cultural heritage and gain extensive knowledge of plant species with pharmacological potential to cure simple to life-threatening diseases by studying the use of plants in indigenous communities. Therefore, it is important to conduct ethnobotanical studies in indigenous communities and to validate the reported uses of plants by comparing ethnobotanical studies with phytochemical and pharmacological studies. Materials and methods This study was conducted in a Tamang community dwelling in the Makawanpur district of central Nepal. We used semi-structured and structured questionnaires during interviews to collect information. We compared use reports with available phytochemical and pharmacological studies for validation. Results A total of 161 plant species belonging to 86 families and 144 genera to cure 89 human ailments were documented. Although 68 plant species were cited as medicinal in previous studies, 55 different uses described by the Tamang people were not found in any of the compared studies. Traditional uses for 60 plant species were consistent with pharmacological and phytochemical studies. Conclusions The Tamang people in Makawanpur are rich in ethnopharmacological understanding. The present study highlights important medicinal plant species by validating their traditional uses. Different plant species can improve local economies through proper harvesting, adequate management and development of modern techniques to maximize their use. PMID:24410808

On the relationship between cultural values and preferences and affective health in Nepal.

PubMed

Furr, L Allen

2005-03-01

The westernization of developing countries has improved physical health and life expectancy. Modernization, however, is believed to have injurious effects on mental health. Some research suggests that the effects of modernization vary, hurting some but benefiting others. Economic disparity is usually presumed to cause the mental health problems. The purpose of this study was to determine if aspects of westernization other than economic status predicted depression scores in a sample of adults occupying similar economic stations in Nepal. Survey data were collected from 276 teachers in Nepal. The questionnaire was administered in Nepali. Statistical tests sought to determine the relationship between scores on a measure of depression and having a western cultural orientation. Bivariate and multi-variate analyses indicate that a higher western orientation was associated with lower depression scores. Non-traditional attitudes towards the Nepalese caste system and gender political equality predicted lower depression scores. Attitudes regarding gender economic equality and a preference for western music and film and English language were not associated with depression scores. Findings suggest that the relationship between modernization and psychological well-being are contextual.

Fault- and Area-Based PSHA in Nepal using OpenQuake: New Insights from the 2015 M7.8 Gorkha-Nepal Earthquake

NASA Astrophysics Data System (ADS)

Stevens, Victoria

2017-04-01

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

Women’s Autonomy and Its Correlates in Western Nepal: A Demographic Study

PubMed Central

Bhandari, Tulsi Ram; Kutty, V. Raman; Ravindran, T. K. Sundari

2016-01-01

Despite various efforts for enhancing women’s autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women’s autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women’s autonomy using a recently developed women’s autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women’s autonomy was 23.34± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple’s education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women’s education (OR = 8.14, CI = 3.77–17.57), husband’s education (OR = 2.63, CI = 1.69–4.10) and economic status of household (OR = 1.42, CI = 1.01–2.03) on women’s autonomy. When we adjusted women’s education for husband’s education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77–17.57) to (OR = 6.32, CI = 2.77–14.46)} and was a mediator effect. The economic status of household also had mediator effect on women’s autonomy through their education. Education status of women is a key predictor of women’s autonomy in Kapilvastu district. Husband’s education and economic status of the household are other important predictors of women’s autonomy which have a mediator effect on women’s autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women’s autonomy. PMID:26799217

Molecular phylogenetic identification of Fasciola flukes in Nepal.

PubMed

Shoriki, Takuya; Ichikawa-Seki, Madoka; Devkota, Bhuminand; Rana, Hari B; Devkota, Shiva P; Humagain, Sudeep K; Itagaki, Tadashi

2014-12-01

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.

Rural Agricultural Change and Fertility Transition in Nepal

ERIC Educational Resources Information Center

Bhandari, Prem; Ghimire, Dirgha

2013-01-01

Using longitudinal panel data from the Western Chitwan Valley of Nepal, this study examines the impact of the use of modern farm technologies on fertility transition--specifically, the number of births in a farm household. Previous explanations for the slow pace of fertility transition in rural agricultural settings often argued that the demand…

Adolescents' knowledge and opinions about smoking: a qualitative study from the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur District, Nepal.

PubMed

Povlsen, Lene; Aryal, Umesh Raj; Petzold, Max; Krettek, Alexandra

2016-04-09

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.

Seasonal fuel consumption, stoves, and end-uses in rural households of the far-western development region of Nepal

NASA Astrophysics Data System (ADS)

Lam, Nicholas L.; Upadhyay, Basudev; Maharjan, Shovana; Jagoe, Kirstie; Weyant, Cheryl L.; Thompson, Ryan; Uprety, Sital; Johnson, Michael A.; Bond, Tami C.

2017-12-01

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.

Malnutrition Status Among Under-5 Children in a Hill Community of Nepal.

PubMed

Gaurav, K; Poudel, I S; Bhattarai, S; Pradhan, P M S; Pokharel, P K

2014-01-01

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 <0.05) effect on stunting. More than 50% 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.

Predisposing, enabling, and need factors associated with utilization of institutional delivery services: A community-based cross-sectional study in far-western Nepal.

PubMed

Freidoony, Leila; Ranabhat, Chhabi Lal; Kim, Chun-Bae; Kim, Chang-Soo; Ahn, Dong-Won; Doh, Young Ah

2018-01-01

Use of institutional delivery services can be effective in reducing maternal and infant mortality. In Nepal, however, the majority of women deliver at home. Using Andersen's behavioral model of use of health care services, this cross-sectional study aimed to identify factors associated with use of institutional delivery services in four villages and one municipality in Kailali district, Nepal. Mothers (N = 500) who had given birth in the 5 years preceding the survey (conducted between January and February 2015) were randomly selected by cluster sampling and interviewed using a semi-structured questionnaire. Bivariate analyses and multivariate hierarchical logistic regression analyses were performed. Among the women surveyed, 65.6% had used institutional delivery services for their last delivery, a higher proportion than the national average. Primiparity, having a secondary or higher education level, living in the Durgauli village, having husbands with occupations other than agriculture or professional/technical jobs, and having attended four or more antenatal care (ANC) visits had significantly increased use of institutional deliveries. Also, belonging to the richest 20% of the community and having experienced pregnancy complications were marginally significantly associated. These findings demonstrate the need for improving mother's education, encouraging them to attend ANC visits and addressing disparities between different regions.

Epidemiology of Unintentional Child Injuries in the Makwanpur District of Nepal: A Household Survey

PubMed Central

Pant, Puspa Raj; Towner, Elizabeth; Ellis, Matthew; Manandhar, Dharma; Pilkington, Paul; Mytton, Julie

2015-01-01

Secondary sources of information indicate that the proportion of child deaths due to injuries is increasing in Nepal. This study aimed to describe the epidemiology of unintentional injuries in children, explore risk factors and estimate the burden faced by families and the community in the Makwanpur district. We conducted a household survey in Makwanpur, covering 3441 households. Injuries that occurred during the 12 months before the survey and required treatment or caused the child to be unable to take part in usual activities for three or more days were included. We identified 193 cases of non-fatal unintentional child injuries from 181 households and estimated an annual rate of non-fatal injuries of 24.6/1000 children; rates for boys were double (32.7/1000) that for girls (16.8/1000). The rates were higher among the children of age groups 1–4 years and 5–9 years. Falls were the most common cause of non-fatal child injuries followed by burns in preschool children and road traffic injuries were the most likely cause in adolescence. Mean period of disability following injury was 25 days. The rates and the mechanisms of injury vary by age and gender. Falls and burns are currently the most common mechanisms of injury amongst young children around rural homes. PMID:26633439

First isolation of dengue virus from the 2010 epidemic in Nepal.

PubMed

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

2013-09-01

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.

Pesticide poisoning in Chitwan, Nepal: a descriptive epidemiological study.

PubMed

Gyenwali, Deepak; Vaidya, Abhinav; Tiwari, Sundar; Khatiwada, Prakash; Lamsal, Daya Ram; Giri, Shrikrishana

2017-07-03

Globally, there is a growing concern over pesticides use, which has been linked to self-harm and suicide. However, there is paucity of research on the epidemiology of pesticides poisoning in Nepal. This study is aimed at assessing epidemiological features of pesticides poisoning among hospital-admitted cases in selected hospitals of Chitwan District of Nepal. A hospital-based quantitative study was carried out in four major hospitals of Chitwan District. Information on all pesticides poisoning cases between April 1 and December 31, 2015, was recorded by using a Pesticides Exposure Record (PER) form. A total of 439 acute pesticides poisoning cases from 12 districts including Chitwan and adjoining districts attended the hospitals during the 9-month-long study period. A majority of the poisoned subjects deliberately used pesticides (89.5%) for attempted suicide. The total incidence rate was 62.67/100000 population per year. Higher annual incidence rates were found among young adults (111.66/100000 population), women (77.53/100000 population) and individuals from Dalit ethnic groups (98.22/100000 population). Pesticides responsible for poisoning were mostly insecticides (58.0%) and rodenticides (20.8%). The most used chemicals were organophosphates (37.3%) and pyrethroids (36.7%). Of the total cases, 98.6% were hospitalized, with intensive care required for 41.3%. The case fatality rate among admitted cases was 3.8%. This study has indicated that young adults, females and socially disadvantaged ethnic groups are at a higher risk of pesticides poisoning. Pesticides are mostly misused intentionally as an easy means for committing suicide. It is recommended that the supply of pesticides be properly regulated to prevent easy accessibility and misuse. A population-based study is warranted to reveal the actual problem of pesticides exposure and intoxication in the community.

Community-based early warning systems for flood risk mitigation in Nepal

NASA Astrophysics Data System (ADS)

Smith, Paul J.; Brown, Sarah; Dugar, Sumit

2017-03-01

This paper focuses on the use of community-based early warning systems for flood resilience in Nepal. The first part of the work outlines the evolution and current status of these community-based systems, highlighting the limited lead times currently available for early warning. The second part of the paper focuses on the development of a robust operational flood forecasting methodology for use by the Nepal Department of Hydrology and Meteorology (DHM) to enhance early warning lead times. The methodology uses data-based physically interpretable time series models and data assimilation to generate probabilistic forecasts, which are presented in a simple visual tool. The approach is designed to work in situations of limited data availability with an emphasis on sustainability and appropriate technology. The successful application of the forecast methodology to the flood-prone Karnali River basin in western Nepal is outlined, increasing lead times from 2-3 to 7-8 h. The challenges faced in communicating probabilistic forecasts to the last mile of the existing community-based early warning systems across Nepal is discussed. The paper concludes with an assessment of the applicability of this approach in basins and countries beyond Karnali and Nepal and an overview of key lessons learnt from this initiative.

Progress Toward Measles Elimination - Nepal, 2007-2014.

PubMed

Khanal, Sudhir; Sedai, Tika Ram; Choudary, Ganga Ram; Giri, Jagat Narain; Bohara, Rajendra; Pant, Rajendra; Gautam, Mukunda; Sharapov, Umid M; Goodson, James L; Alexander, James; Dabbagh, Alya; Strebel, Peter; Perry, Robert T; Bah, Sunil; Abeysinghe, Nihal; Thapa, Arun

2016-03-04

In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR) established a goal to eliminate measles and to control rubella and congenital rubella syndrome (CRS) in SEAR by 2020. Current recommended measles elimination strategies in the region include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets minimum recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. In 2013, Nepal, one of the 11 SEAR member states, adopted a goal for national measles elimination by 2019. This report updates a previous report and summarizes progress toward measles elimination in Nepal during 2007-2014. During 2007-2014, estimated coverage with the first MCV dose (MCV1) increased from 81% to 88%. Approximately 3.9 and 9.7 million children were vaccinated in SIAs conducted in 2008 and 2014, respectively. Reported suspected measles incidence declined by 13% during 2007-2014, from 54 to 47 cases per 1 million population. However, in 2014, 81% of districts did not meet the measles case-based surveillance performance indicator target of ≥2 discarded non-measles cases per 100,000 population per year. To achieve and maintain measles elimination, additional measures are needed to strengthen routine immunization services to increase coverage with MCV1 and a recently introduced second dose of MCV (MCV2) to ≥95% in all districts, and to enhance sensitivity of measles case-based surveillance by adopting a more sensitive case definition, expanding case-based surveillance sites nationwide, and ensuring timely transport of

Health resources and Internet with reference to HealthNet Nepal.

PubMed

Pradhan, Mohan Raj

2003-01-01

Technologies with the ability to send information in a fast, efficient and cheap fashion, such as the Internet--can provide dramatic improvements in access to information, advice and care. This article discusses importance of Internet, applications of Internet in providing information services in the health field. The Internet was developed in western countries and the information flow is from North to South. But for decision making within a country, information generated within a country is needed. For this, an organization like HealthNet Nepal is developed. The article discusses the various services of HealthNet Nepal and discusses about its unique features as compared to commercial ISPs.

Innovation in Primary School Construction: Community Participation in Seti Zone, Nepal. Educational Building Report 20. A Case Study.

ERIC Educational Resources Information Center

Tamang, H. D.; Dharam, K. C.

Nepal is one of the poorest countries in the world. In 1981 the Education for Rural Development in Seti Zone Project--more commonly known as the "Seti Project"--was part of the Nepalese government's effort to develop a system of basic education in that far western region of Nepal. The early success of the project provided the impetus for…

Nutritional assessment of community-dwelling older adults in rural Nepal.

PubMed

Ghimire, Saruna; Baral, Binaya Kumar; Callahan, Karen

2017-01-01

Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal's health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool. A cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated. 111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p<0.001). The diagnostic accuracy, sensitivity and specificity of MNA were 81%, 86% and 67% respectively. Of the 242 elderly sampled, 24% were malnourished and 65% were at risk of malnutrition. Malnutrition was more prevalent among females (29%) than males (18%), and most prevalent among the marginalized Dalit ethnic group (40%). Elderly persons who were married and literate had better nutritional health than their counterparts. The MNA appears to be a valid and sensitive tool for

Survival on antiretroviral treatment among adult HIV-infected patients in Nepal: a retrospective cohort study in far-western Region, 2006–2011

PubMed Central

2013-01-01

Background Though financial and policy level efforts are made to expand antiretroviral treatment (ART) service free of cost, survival outcome of ART program has not been systematically evaluated in Nepal. This study assesses the mortality rates and determinants among adult HIV-infected patients on ART in Far-western region of Nepal. Methods This retrospective cohort study included 1024 (51.2% men) HIV-infected patients aged ≥15 years, who started ART between May 15th 2006 and May 15th 2011 in five ART sites in the Far-western region, Nepal. Follow-up time was calculated from the date of ART initiation to date of death or censoring (loss to follow-up, transferred out, or 15 November 2011). Mortality rates (per 100 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore determinants of mortality. Results The median follow-up time was 19.1 months. The crude mortality rate was 6.3 (95% confidence interval (CI) 5.3-7.6) but more than three-times higher in first 3 months after ART initiation (21.9 (95% CI 16.6- 28.8)). About 12% (83% men) of those newly initiated on ART died during follow-up. The independent determinants of mortality were male sex (hazard ratio (HR) 4.55, 95% CI 2.43-8.51), poor baseline performance scale (bedridden <50% of the day during the past month, HR 2.05, 95% CI 1.19-3.52; bedridden >50% of the day during the past month, HR 3.41, 95% CI 1.67-6.98 compared to normal activity), one standard deviation decrease in baseline bodyweight (HR 1.04, 95% CI 1.01-1.07), and poor WHO clinical stage (stage III, HR 2.96, 95% CI 1.31-6.69; stage IV, HR 3.28, 95% CI 1.30-8.29 compared to WHO clinical stage I or II). Conclusions High mortality was observed within the first 3 months of ART initiation. Patients with poor baseline clinical characteristics had higher mortality, especially men. Earlier initiation of ART through expanded testing and counselling should be encouraged in HIV-infected patients. PMID

Ethnobotanical study on traditional use of medicinal plants in South-Western Serbia, Zlatibor district.

PubMed

Savikin, Katarina; Zdunić, Gordana; Menković, Nebojša; Zivković, Jelena; Cujić, Nada; Tereščenko, Milena; Bigović, Dubravka

2013-04-19

This paper provides significant ethnobotanical information on medicinal plant uses in the Zlatibor district, South-Western Serbia. A survey was performed using questionnaires with 220 informants (mean age 47, 79% female, 21% male). In addition, the use value and the relative importance of species were determined and the informant consensus factor was calculated for the medicinal plants included in the study. Intended plants usage was compared with previous ethnobotanical literature, with reference to the neighboring areas of Zlatibor district. The informants provided data for 69 medicinal plants belonging to 36 families. Rosaceae, Lamiaceae and Asteraceae were the predominant locally used families. The species with the highest use value were Mentha piperita, Matricaria chamomilla, Hypericum perforatum and Achillea millefolium. The most frequently reported medicinal uses were ones for treating gastrointestinal ailments, respiratory problems and skin diseases. Usually, the administration was primarily oral followed by topical applications. All different plant parts were utilized, however leaves were the most exploited parts of the plants. Folk medicine in South-Western Serbia, Zlatibor district is intended mainly as a mode of primary health care in healing of minor illnesses. The results indicate a slight reduction in the ethnobotanical and medical knowledge in this area, when compared with neighboring regions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Prevalence, associated factors, awareness, treatment, and control of hypertension: Findings from a cross sectional study conducted as a part of a community based intervention trial in Surkhet, Mid-western region of Nepal

PubMed Central

Dhungana, Raja Ram; Bhandari, Pratiksha; Gurung, Yadav; Paudel, K. N.

2017-01-01

Background Hypertension is one of the leading public health problems globally. About half of the deaths from cardiovascular diseases were attributed to hypertension in 2008. Reduction of blood pressure to normal range is one of the major challenges in preventing complications and future burden of cardiovascular diseases. Therefore, this study aims to determine prevalence, awareness, treatment and control of hypertension and its associated factors in Nepal. Methods This was a community based cross-sectional study conducted as a part of a community based intervention trial in Birendranagar Municipality of Surkhet district located at the Mid-western region of Nepal. We enrolled 1159 subjects aged 30 years and above. Out of 12 wards (administrative unit), four wards were selected randomly. Three hundred participants were recruited from each selected ward. Trained enumerator collected socio-demographic, anthropometric, and clinical data using standard STEPS questionnaires. Results Out of all participants, women were 71% and mean age was 47±12.6 years. The overall prevalence of hypertension was 38.9% (95% CI: 36–41.7) while age and sex adjusted prevalence was 40.6%. The hypertension was present in 48.1% (95% CI: 45.2–50.9) of men and 35.2% (95% CI: 32.4–37.9)] of women. Male gender (OR = 1.49), older age (OR = 1.04 per year), Dalit caste (OR = 1.71), past history of cigarettes smoking (OR = 2.78), current alcohol consumption (OR = 1.75), and raised body mass index (OR = 1.17 per unit) were identified as significant factors associated with hypertension. Of total hypertensive respondents, 53.4% (95% CI: 48.7–58) were aware, 29% (95% CI: 24.8–33.1) were receiving treatment for high blood pressure, and 8.2% (95% CI: 5.6–10.7) had controlled blood pressure. The awareness, treatment, and control status were worse in younger participants. Conclusions The study revealed high prevalence with low awareness, treatment, and control of hypertension in Nepal. Gender, age

The "Iron Gate": High-Stakes Assessment at Age 16 in Nepal and England

ERIC Educational Resources Information Center

Davies, Dan

2016-01-01

In Nepal, the School Leaving Certificate (SLC) assessment taken by 16-year-olds at the end of Grade 10 of formal schooling performs a similar function to the General Certificate of Secondary Education (GCSE) examination in England in that it summarises individual, school, district and national achievement and acts as a filtering mechanism to the…

Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal.

PubMed

McMichael, Celia; Robinson, Priscilla

2016-08-01

Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation. The research was conducted during October-November 2014, two and half years following the intervention's end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of 'most significant change'. Households' handwashing/water facilities and toilets were observed. Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours. Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact. Copyright © 2016 Elsevier Ltd. All rights reserved.

Regional variation in pig farmer awareness and actions regarding Japanese encephalitis in Nepal: implications for public health education.

PubMed

Dhakal, Santosh; Joshi, Durga Datt; Ale, Anita; Sharma, Minu; Dahal, Meena; Shah, Yogendra; Pant, Dhan Kumar; Stephen, Craig

2014-01-01

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.

Marital status and abortion among young women in Rupandehi, Nepal.

PubMed

Andersen, Kathryn L; Khanal, Ram Chandra; Teixeira, Alexandra; Neupane, Shailes; Sharma, Sharad; Acre, Valerie N; Gallo, Maria F

2015-01-01

Despite liberalization of the Nepal abortion law, young women continue to experience barriers to safe abortion services. We hypothesize that marital status may differentially impact such barriers, given the societal context of Nepal. We evaluated differences in reproductive knowledge and attitudes by marital status with a probability-based, cross-sectional survey of young women in Rupandehi district, Nepal. Participants (N = 600) were surveyed in 2012 on demographics, romantic experiences, media habits, reproductive information, and abortion knowledge and attitudes. We used logistic regression to assess differences by marital status, controlling for age. Participants, who comprised never-married (54%) and ever-married women (45%), reported good access to basic reproductive health and abortion information. Social desirability bias might have prevented reporting of premarital romantic and sexual activity given that participants reported more premarital activities for their friends than for themselves. Only 45% knew that abortion was legal, and fewer ever-married women were aware of abortion legality. Never-married women expected more negative responses from having an abortion than ever-married women. Findings highlight the need for providing sexual and reproductive health care information and services to young women regardless of marital status.

Newborn survival in Nepal: a decade of change and future implications.

PubMed

Pradhan, Y V; Upreti, Shyam Raj; Pratap K C, Naresh; K C, Ashish; Khadka, Neena; Syed, Uzma; Kinney, Mary V; Adhikari, Ramesh Kant; Shrestha, Parashu Ram; Thapa, Kusum; Bhandari, Amit; Grear, Kristina; Guenther, Tanya; Wall, Stephen N

2012-07-01

Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35,000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurring in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding. Over the decade, Nepal's neonatal mortality rate reduced by 3.6% per year, which is faster than the regional average (2.0%) but slower than national annual progress for mortality of children aged 1-59 months (7.7%) and maternal mortality (7.5%). A dramatic reduction in the total fertility rate, improvements in female education and increasing change in skilled birth attendance, as well as increased coverage of community-based child health interventions, are likely to have contributed to these mortality declines. Political commitment and support for newborn survival has been generated through strategic use of global and national data and effective partnerships using primarily a selective newborn-focused approach for advocacy and planning. Nepal was the first low-income country to have a national newborn strategy, influencing similar strategies in other countries. The Community-Based Newborn Care Package is delivered through the nationally available Female Community Health Volunteers and was piloted in 10 of 75 districts, with plans to increase to 35 districts in mid-2013. Innovation and scale up, especially of community-based packages, and public health interventions and commodities appear to move relatively rapidly in Nepal compared with some other countries. Much remains to be done to achieve high rates of effective coverage of community care, and especially to improve the quality of facility-based care given the rapid

Livelihood Vulnerability Approach to Assess Climate Change Impacts to Mixed Agro-Livestock Smallholders Around the Gandaki River Basin of Nepal

NASA Astrophysics Data System (ADS)

Panthi, J., Sr.

2014-12-01

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.

Dengue virus infection in a French traveller to the hilly region of Nepal in 2015: a case report.

PubMed

Gupta, Birendra Prasad; Adhikari, Anurag; Rauniyar, Ramanuj; Kurmi, Roshan; Upadhya, Bishnu Prasad; Jha, Bimlesh Kumar; Pandey, Basudev; Das Manandhar, Krishna

2016-03-21

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.

Unplanned roads impacts assessment in Phewa Lake watershed, Western region, Nepal

NASA Astrophysics Data System (ADS)

Leibundgut, Geoffroy; Sudmeier-Rieux, Karen; Devkota, Sanjaya; Jaboyedoff, Michel; Penna, Ivanna; Adhikari, Anu; Khanal, Rajendra

2015-04-01

This work describes current research being conducted in the Phewa Lake watershed, near Pokhara in Nepal's Siwaliks/Middle hills, a moist sub-tropical zone with the highest amount of annual rainfall in Nepal (4,500 - 5,000 mm). The watershed lithology is mainly siltstone, sandstones and intensively weathered rocks, highly prone to erosion and shallow landslides (Agrawala et al., 2003). The main purpose of this study is to focus on the impact of unplanned earthen road construction in the Phewa Lake watershed as part of land use changes over 30 years in one of Nepal's most touristic regions. Over the past three decades, the road network has expanded exponentially and a majority of rural earthen roads are often funded by communities themselves, with some government subsidies. They are usually constructed using a local bulldozer contractor with no technical or geological expertise increasing erosion processes, slope instabilities risk and impacts to settlements, forests, water sources, agriculture lands, and infrastructure. Moreover, these human-induced phenomena are being compounded by increasingly intense monsoon rains, likely due to climate change (Petley, 2010). Research methods were interdisciplinary and based on a combination of remote sensing, field observations and discussions with community members. The study compared 30 year-old aerial photos with current high resolution satellite images to correlate changes in land use with erosion and slope instabilities. Secondly, most of the watershed's roads were surveyed in order to inventory and quantify slope instabilities and soil loss events. Using a failure-characteristics grid, their main features were measured (location, size, type and extension of damage areas, etc.) and a GIS data base was created. We then estimated economic impacts of these events in terms of agriculture lands losses and road maintenance, based on field observations and discussions with affected people. Field work investigations have shown that

Investigating aquifer contamination and groundwater quality in eastern Terai region of Nepal.

PubMed

Mahato, Sanjay; Mahato, Asmita; Karna, Pankaj Kumar; Balmiki, Nisha

2018-05-21

This study aims at assessing the groundwater quality of the three districts of Eastern Terai region of Nepal viz. Morang, Jhapa, Sunsari using physicochemical characteristics and statistical approach so that possible contamination of water reservoir can be understood. pH, temperature, conductivity, turbidity, color, total dissolved solids, fluorides, ammonia, nitrates, chloride, total hardness, calcium hardness, calcium, magnesium, total alkalinity, iron, manganese, arsenic have to be analyzed to know the present status of groundwater quality. Results revealed that the value of analyzed parameters were within the acceptable limits for drinking water recommended by World Health Organization except for pH, turbidity, ammonia and iron. As per Nepal Drinking Water Quality Standards, fluoride and manganese too were not complying with the permissible limit. Electrical conductivity, total dissolved solids, chloride, total hardness, calcium hardness, manganese, and total alkalinity show good positive correlation with major water quality parameters. Calcium, magnesium, total hardness, calcium hardness and total alkalinity greatly influences total dissolved solids and electrical conductivity. ANOVA, Tukey, and clustering highlight the significance of three districts. Groundwater can be considered safe, but there is always a chance of contamination through chemical wastes in the heavily industrialized area of Morang and Sunsari Industrial corridor.

Design and implementation of a patient navigation system in rural Nepal: Improving patient experience in resource-constrained settings.

PubMed

Raut, Anant; Thapa, Poshan; Citrin, David; Schwarz, Ryan; Gauchan, Bikash; Bista, Deepak; Tamrakar, Bibhu; Halliday, Scott; Maru, Duncan; Schwarz, Dan

2015-12-01

Patient navigation programs have shown to be effective across multiple settings in guiding patients through the care delivery process. Limited experience and literature exist, however, for such programs in rural and resource-constrained environments. Patients living in such settings frequently have low health literacy and substantially lower social status than their providers. They typically have limited experiences interfacing with formalized healthcare systems, and, when they do, their experience can be unpleasant and confusing. At a district hospital in rural far-western Nepal, we designed and implemented a patient navigation system that aimed to improve patients' subjective care experience. First, we hired and trained a team of patient navigators who we recruited from the local area. Their responsibility is exclusively to demonstrate compassion and to guide patients through their care process. Second, we designed visual cues throughout our hospital complex to assist in navigating patients through the buildings. Third, we incorporated the patient navigators within the management and communications systems of the hospital care team, and established standard operating procedures. We describe here our experiences and challenges in designing and implementing a patient navigator program. Such patient-centered systems may be relevant at other facilities in Nepal and globally where patient health literacy is low, patients come from backgrounds of substantial marginalization and disempowerment, and patient experience with healthcare facilities is limited. Copyright © 2015 Elsevier Inc. All rights reserved.

Serosurveillance and factors associated with the presence of antibodies against bluetongue virus in dairy cattle in two eco-zones of Nepal.

PubMed

Gaire, T N; Karki, S; Dhakal, I P; Khanal, D R; Bowen, R A

2016-12-01

Cattle play an important role in the epidemiology of bluetongue (BT) by acting as reservoir hosts. However, the status of BT virus (BTV) in dairy cattle in Nepal is unknown. The objective of this study was to estimate the prevalence of BTV antibodies in dairy cattle in two eco-zones of Nepal, and to identify the factors associated with virus exposure. The authors conducted a cross-sectional serosurvey from March 2012 through February 2013 by sampling 131 dairy cattle from seven clusters (villages) in the Chitwan district in the Terai region (southern lowlands) and the Lamjung district in the Hills region (the middle part of Nepal). Of the 131 serum samples tested, 29.3% (95% confidence interval [CI]: 21.5-37.2) were positive for BTV antibodies. Herd-level seroprevalence was 45.7% (95% CI: 30.9-61.0). Bivariate analysis indicated a positive association between seroconversion to BTV and age, and an association with breed of cattle after controlling for clustering of animals within herds. Based on this model, cattle were more likely to become seropositive as they aged. Crossbred cattle were more likely to be seropositive than those of exotic breeds (odds ratio [OR] = 4.6; 95% CI: 1.5-14.1). The results indicate widespread exposure of dairy cattle to BTV in Nepal. The authors suggest that dairy cattle should be included in the surveillance plan for BTV infection in Nepal and that it is important to educate farmers about the possible impacts of this disease. © OIE (World Organisation for Animal Health), 2016.

Determinants of farmers' choice for veterinary service providers in Nepal Mountains.

PubMed

Lamichhane, Dirga Kumar; Shrestha, Sabina

2012-08-01

This study was aimed to analyze factors that affect farmers' choice for major actors of veterinary service providers in village areas of Kaski district of Nepal, with the objective of identifying choice-specific attributes which could be addressed for improving the penetration of professional veterinary services in village areas. The information was obtained from 125 farmers using a structured questionnaire. A proportional hazard model was used for data analysis because of its ability to accommodate the attributes of both the chooser and the choice simultaneously. The results showed that village animal health workers (VAHWs) were the most preferred service providers followed by veterinarians and mid-level technicians. The farmers' age and education level had a significant but inverse relationship with the probability of choosing any of the three service providers. From our study, we found that the main choice-specific attributes with a significant impact on the choice probability was the distance to the preferred service provider. Since there was a high preference for VAHW, this suggests the possibility of poorly trained service providers dominating veterinary service market in village areas of Kaski district. Hence, the efforts put forward in the legalization of VAHW system in Nepal should first address the constraints that obstruct the accessibility of professional veterinary service providers in village areas.

Stratigraphy and structure of the western Kentucky fluorspar district

USGS Publications Warehouse

Trace, R.D.; Amos, D.H.

1984-01-01

The western Kentucky fluorspar district is part of the larger Illinois-Kentucky fluorspar district, the largest producer of fluorspar in the United States. This report is based largely on data gathered from 1960 to 1974 during the U.S. Geological Survey-Kentucky Geological Survey cooperative geologic mapping program of Kentucky. It deals chiefly with the stratigraphy and structure of the district and, to a lesser extent, with the fluorspar-zinc-lead-barite deposits. Sedimentary rocks exposed in the district range in age from Early Mississippian (Osagean) to Quaternary. Most rocks exposed at the surface are Mississippian in age; two-thirds are marine fossiliferous limestones, and the remainder are shales, siltstones, and sandstones. Osagean deep-water marine silty limestone and chert are present at the surface in the southwestern corner of the district. Meramecian marine limestone is exposed at the surface in about half the area. Chesterian marine and fluvial to fluviodeltaic clastic sedimentary rocks and marine limestone underlie about one-third of the area. The total sequence of Mississippian rocks is about 3,000 ft thick. Pennsylvanian rocks are dominantly fluvial clastic sedimentary rocks that change upward into younger fluviodeltaic strata. Pennsylvanian strata of Morrowan and Atokan age are locally thicker than 600 ft along the eastern and southeastern margin and in the major grabens of the district where they have been preserved from erosion. Cretaceous and Tertiary sediments of the Mississippi embayment truncate Paleozoic formations in and near the southwestern corner of the district and are preserved mostly as erosional outliers. The deposits are Gulfian nonmarine gravels, sands, and clays as much as 170 ft thick and upper Pliocene fluvial continental deposits as thick as 45 ft. Pleistocene loess deposits mantle the upland surface of the district, and Quaternary fluvial and fluviolacustrine deposits are common and widespread along the Ohio and Cumberland

Cumulative incidence, distribution, and determinants of catastrophic health expenditure in Nepal: results from the living standards survey.

PubMed

Ghimire, Mamata; Ayer, Rakesh; Kondo, Masahide

2018-02-14

Nepal has committed to the global community to achieve universal health coverage by 2030. Nevertheless, Nepal still has a high proportion of out-of-pocket health payment and a limited risk-pooling mechanism. Out-of-pocket payment for the healthcare services could result in catastrophic health expenditure (CHE). Evidence is required to effectively channel the efforts to lower those expenses in order to achieve universal health coverage. However, little is known about CHE and its determinants in a broad national context in Nepal. Therefore, this study was conducted to explore the cumulative incidence, distribution, and determinants of CHE in Nepal. Data were obtained from the nationally representative survey, the Nepal Living Standards Survey-third undertaken in 2010/11. Information from 5988 households was used for the analyses. Households were classified as having CHE when their out-of-pocket health payment was greater than or equal to 40% of their capacity to pay. Remaining households were classified as not having CHE. Logistic regression analyses were used to identify determinants of CHE. Based on household-weighted sample, the cumulative incidence of CHE was 10.3% per month in Nepal. This incidence was concentrated in the far-western region and households in the poorer expenditure quartiles. Multivariable logistic regression revealed that households were more likely to face CHE if they; consisted of chronically ill member(s), have a higher burden of acute illness and injuries, have elderly (≥60 years) member(s), belonged to the poor expenditure quartile, and were located in the far-western region. In contrast, households were less likely to incur CHE when their household head was educated. Having children (≤5 years) in households did not significantly affect catastrophic health expenditure. This study identified a high cumulative incidence of CHE. CHE was disproportionately concentrated in the poor households and households located in the far-western

Identifying Pathways for Improving Household Food Self-Sufficiency Outcomes in the Hills of Nepal

PubMed Central

Karki, Tika B.; Sah, Shrawan K.; Thapa, Resam B.; McDonald, Andrew J.; Davis, Adam S.

2015-01-01

Maintaining and improving household food self-sufficiency (FSS) in mountain regions is an ongoing challenge. There are many facets to the issue, including comparatively high levels of land fragmentation, challenging terrain and transportation bottlenecks, declining labor availability due to out-migration, and low technical knowledge, among others. Using a nonparametric multivariate approach, we quantified primary associations underlying current levels of FSS in the mid-hills of Nepal. A needs assessment survey was administered to 77 households in Lungaun (Baglung District), Pang (Parbat District), and Pathlekhet (Myagdi District), with a total of 80 variables covering five performance areas; resulting data were analyzed using Classification and Regression Trees. The most parsimonious statistical model for household FSS highlighted associations with agronomic management, including yields of maize and fingermillet within a relay cropping system and adoption of improved crop cultivars. Secondary analyses of the variables retained in the first model again focused primarily on crop and livestock management. It thus appears that continued emphasis on technical agricultural improvements is warranted, independent of factors such as land holding size that, in any case, are very difficult to change through development interventions. Initiatives to increase household FSS in the mid-hills of Nepal will benefit from placing a primary focus on methods of agricultural intensification to improve crop yields and effective technology transfer to increase adoption of these methods. PMID:26047508

Evaluation of community pharmacies regarding dispensing practices of antibiotics in two districts of central Nepal.

PubMed

Ansari, Mukhtar

2017-01-01

To evaluate the status of community pharmacies, their staff, and practices toward dispensing antibiotics. Cross-sectional, prospective. Community pharmacies in two districts of central Nepal, from March 2016 to May 2016. A systematic random sampling approach was adopted to sample 161 community pharmacies. Data on the registration status of pharmacies, qualification or training of dispensing staff, and the practice of dispensing antibiotics were collected using a pre-tested questionnaire. Face to face interviews were carried out by a previously trained interviewer. Data were analyzed for descriptive and inferential statistics using IBM SPSS Statistics 21. Among 161 community pharmacies, 25% were not registered and most of them were located in rural areas. It was typical (66.5%) to dispense antibiotics without prescription and most (91.4%) of the staffs involved in dispensing were non-pharmacists. Furthermore, the study revealed common practices of replacing one brand of antibiotic with other brands (66%), dispensing incomplete courses of antibiotics (73%), and not giving any advice regarding antibiotic use (39%) or completion of a full course of therapy (80%). There were significant (p < 0.001) relationships between the location of pharmacies (rural vs urban) and the qualifications of the pharmacy staff. Dispensing antibiotics without prescription and by non-pharmacists are common in this region. The study also found several issues regarding the irrational use of antibiotics. Thus, there is an urgent need to address these issues and promote the informed use of antibiotics.

Rectal bleeding and implications for surgical care in Nepal.

PubMed

Tessler, Robert; Gupta, Shailvi; Pathak, John; Ghimire, Pranita; Kingham, Thomas P; Kushner, Adam L; Amatya, Kapendra Shekhar; Nwomeh, Benedict C

2015-07-01

Because rectal bleeding is a cardinal symptom of many colorectal diseases including colorectal cancers, its presence alone could give insight into the prevalence of these conditions where direct population screening is lacking. In South Asia, which is home to over one fifth of the world's population, there is paucity of epidemiologic data on colorectal diseases, particularly in the lower-income countries such as Nepal. The aim of this study was to enumerate the prevalence of rectal bleeding in Nepal and increase understanding of colorectal diseases as a health problem in the South Asian region. A countrywide survey using the Surgeons OverSeas Assessment of Surgical Need tool was administered from May 25-June 12, 2014 in 15 of the 75 districts of Nepal, randomly selected proportional to population. In each district, three Village Development Committees were selected randomly, two rural and one urban based on the Demographic Health Survey methodology. Individuals were interviewed to determine the period and point prevalence of rectal bleeding and patterns of health-seeking behavior related to surgical care for this problem. Individuals aged >18 y were included in this analysis. A total of 1350 households and 2695 individuals were surveyed with a 97% response rate. Thirty-eight individuals (55% male) of the 1941 individuals ≥ 18 y stated they had experienced rectal bleeding (2.0%, 95% confidence interval 1.4%-2.7%), with a mean age of 45.5 (standard deviation 2.2). Of these 38 individuals, 30 stated they currently experience rectal bleeding. Health Care was sought in 18 participants with current rectal bleeding, with two major procedures performed, one an operation for an anal fistula. For those who sought health care but did not receive surgical care, reasons included no need (4), not available (6), fear and/or no trust (5), and no money for health care (1). For those with current rectal bleeding who did not seek health care, reasons included no need (1), not

Population Mobility and Spread of HIV Across the Indo-Nepal Border

PubMed Central

Nepal, Binod

2007-01-01

The article reviews information on the epidemiology of HIV/AIDS and behavioural networking to examine the role of population mobility in spreading HIV across the Indo-Nepal border. Documents were collected through a systematic search of electronic databases and web-based information resources, and the review focuses on studies about types of the virus, prevalence of HIV, and sexual and injecting networking. HIV-1 (subtype C) and HIV-2 were identified in Nepal. The prevalence of HIV was higher among male labour migrants and female sex workers (FSWs) who returned from India, especially from Mumbai, than in similar non-migrant groups. In the early 2000s, about 6–10% of Mumbai returnee men, compared to up to 4% of India returnee men and up to 3% of non-migrant men in the far-west Nepal, were identified with HIV. Likewise, when the prevalence of HIV among sex workers in Kathmandu was found to be 17% in 1999–2000, up to 44% of India returnee and 73% of Mumbai returnee FSWs were identified with the virus. These data are, however, based on small samples with questionable representativeness of the target populations and need to be interpreted cautiously. They also generate a biased impression that HIV was coming into Nepal from India. Recently, the possibility of a two-way flow of HIV across the Indo-Nepal border through injecting and sexual networking have been indicated by serological and behavioural data from a south-eastern cluster of Nepal and a north-eastern district of India. Although similar behavioural networks exist along other segments of the border, serological data are unavailable to assess whether and how extensively this phenomenon has caused the spread of HIV. Collaborative research and interventions covering both sides of the border are desirable to fully understand and address the prospect of HIV epidemics associated with cross-border population mixing. PMID:18330059

Barriers and facilitators to institutional delivery in rural areas of Chitwan district, Nepal: a qualitative study.

PubMed

Shah, Rajani; Rehfuess, Eva A; Paudel, Deepak; Maskey, Mahesh K; Delius, Maria

2018-06-20

Giving birth assisted by skilled care in a health facility plays a vital role in preventing maternal deaths. In Nepal, delivery services are free and a cash incentive is provided to women giving birth at a health facility. Nevertheless, about half of women still deliver at home. This study explores socio-cultural and health service-related barriers to and facilitators of institutional delivery. Six village development committees in hill and plain areas were selected in Chitwan district. We conducted a total of 10 focus group discussions and 12 in-depth-interviews with relevant stakeholder groups, including mothers, husbands, mothers-in-law, traditional birth attendants, female community health volunteers, health service providers and district health managers. Data were analyzed inductively using thematic analysis. Three main themes played a role in deciding the place of delivery, i.e. socio-cultural norms and values; access to birthing facilities; and perceptions regarding the quality of health services. Factors encouraging an institutional delivery included complications during labour, supportive husbands and mothers-in-law, the availability of an ambulance, having birthing centres nearby, locally sufficient financial incentives and/or material incentives, the 24-h availability of midwives and friendly health service providers. Socio-cultural barriers to institutional deliveries were deeply held beliefs about childbirth being a normal life event, the wish to be cared for by family members, greater freedom of movement at home, a warm environment, the possibility to obtain appropriate "hot" foods, and shyness of young women and their position in the family hierarchy. Accessibility and quality of health services also presented barriers, including lack of road and transportation, insufficient financial incentives, poor infrastructure and equipment at birthing centres and the young age and perceived incompetence of midwives. Despite much progress in recent years, this

Nutritional assessment of community-dwelling older adults in rural Nepal

PubMed Central

Ghimire, Saruna; Baral, Binaya Kumar; Callahan, Karen

2017-01-01

Background Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal’s health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool. Methods A cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated. Results 111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p<0.001). The diagnostic accuracy, sensitivity and specificity of MNA were 81%, 86% and 67% respectively. Of the 242 elderly sampled, 24% were malnourished and 65% were at risk of malnutrition. Malnutrition was more prevalent among females (29%) than males (18%), and most prevalent among the marginalized Dalit ethnic group (40%). Elderly persons who were married and literate had better nutritional health than their counterparts. Conclusions The MNA

Knowledge, attitude and practice towards medicines among school teachers in Lalitpur district, Nepal before and after an educational intervention

PubMed Central

2013-01-01

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 (p<0.001), attitude

Impact of mass media on the utilization of antenatal care services among women of rural community in Nepal.

PubMed

Acharya, Dilaram; Khanal, Vishnu; Singh, Jitendra Kumar; Adhikari, Mandira; Gautam, Salila

2015-08-12

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.

Linking Attitudes, Policy, and Forest Cover Change in Buffer Zone Communities of Chitwan National Park, Nepal

NASA Astrophysics Data System (ADS)

Stapp, Jared R.; Lilieholm, Robert J.; Leahy, Jessica; Upadhaya, Suraj

2016-06-01

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.

Linking Attitudes, Policy, and Forest Cover Change in Buffer Zone Communities of Chitwan National Park, Nepal.

PubMed

Stapp, Jared R; Lilieholm, Robert J; Leahy, Jessica; Upadhaya, Suraj

2016-06-01

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.

Children from the Dalit Community in Rural Nepal: A Challenge to Inclusive Education

ERIC Educational Resources Information Center

Khanal, Damodar

2015-01-01

Based on empirical research carried out in public secondary schools in the western part of Nepal, this article examines how Dalit children experience secondary-level education. Their experiences are explored using in-depth interviews with Dalit children, their parents and teachers. The findings reveal that Dalit children's inclusion is affected by…

A cluster-randomized evaluation of an intervention to increase skilled birth attendant utilization in mid- and far-western Nepal.

PubMed

Choulagai, Bishnu P; Onta, Sharad; Subedi, Narayan; Bhatta, Dharma N; Shrestha, Binjwala; Petzold, Max; Krettek, Alexandra

2017-10-01

Skilled birth attendant (SBA) utilization is low in remote and rural areas of Nepal. We designed and implemented an evaluation to assess the effectiveness of a five-component intervention that addressed previously identified barriers to SBA services in mid- and far-western Nepal. We randomly and equally allocated 36 village development committees with low SBA utilization among 1-year intervention and control groups. The eligible participants for the survey were women that had delivered a baby within the past 12 months preceding the survey. Implementation was administered by trained health volunteers, youth groups, mothers' groups and health facility management committee members. Post-intervention, we used difference-in-differences and mixed-effects regression models to assess and analyse any increase in the utilization of skilled birth care and antenatal care (ANC) services. All analyses were done by intention to treat. Our trial registration number was ISRCTN78892490 (http://www.isrctn.com/ISRCTN78892490). Interviewees included 1746 and 2098 eligible women in the intervention and control groups, respectively. The 1-year intervention was effective in increasing the use of skilled birth care services (OR = 1.57; CI 1.19-2.08); however, the intervention had no effect on the utilization of ANC services. Expanding the intervention with modifications, e.g. mobilizing more active and stable community groups, ensuring adequate human resources and improving quality of services as well as longer or repeated interventions will help achieve greater effect in increasing the utilization of SBA. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Birth outcomes across ethnic groups of women in Nepal.

PubMed

Acharya, Pratima Poudel; Alpass, Fiona

2004-01-01

This study was conducted at the Western Regional Hospital (WRH), Pokhara, Nepal. We investigated the relationship between selected socioeconomic variables, pregnancy indices, birth weight, and maternal health in women of different ethnic origins. In our cross-sectional data set, 29.8% of infants were born with a low birth weight. Our data analysis showed Indo-Aryan and lower caste ethnic groups had significantly lower weight babies than Tibeto-Burman and Newar groups. Further analysis showed that the Tibeto-Burman group received better care during pregnancy. Similarly, the Newar groups had significantly better nutritional intake than the Indo-Aryan and lower caste groups. The outcome of food restriction and antenatal care during pregnancy in specific ethnic groups has important implications for the health care delivery system. Health policymakers should target those ethnic groups and develop culturally based policies to reduce the incidence of low birth weight in Nepal.

Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal.

PubMed

He, Wen-Jun; Lai, Ying-Si; Karmacharya, Biraj M; Dai, Bo-Feng; Hao, Yuan-Tao; Xu, Dong Roman

2018-04-02

Per United Nations' Sustainable Development Goals, Nepal is aspiring to achieve universal and equitable access to safe and affordable drinking water and provide access to adequate and equitable sanitation for all by 2030. For these goals to be accomplished, it is important to understand the country's geographical heterogeneity and inequality of access to its drinking-water supply and sanitation (WSS) so that resource allocation and disease control can be optimized. We aimed 1) to estimate spatial heterogeneity of access to improved WSS among the overall Nepalese population at a high resolution; 2) to explore inequality within and between relevant Nepalese administrative levels; and 3) to identify the specific administrative areas in greatest need of policy attention. We extracted cluster-sample data on the use of the water supply and sanitation that included 10,826 surveyed households from the 2011 Nepal Demographic and Health Survey, then used a Gaussian kernel density estimation with adaptive bandwidths to estimate the distribution of access to improved WSS conditions over a grid at 1 × 1 km. The Gini coefficient was calculated for the measurement of inequality in the distribution of improved WSS; the Theil L measure and Theil T index were applied to account for the decomposition of inequality. 57% of Nepalese had access to improved sanitation (range: 18.1% in Mahottari to 100% in Kathmandu) and 92% to drinking-water (range: 41.7% in Doti to 100% in Bara). The most unequal districts in Gini coefficient among improved sanitation were Saptari, Sindhuli, Banke, Bajura and Achham (range: 0.276 to 0.316); and Sankhuwasabha, Arghakhanchi, Gulmi, Bhojpur, Kathmandu (range: 0.110 to 0.137) among improved drinking-water. Both the Theil L and Theil T showed that within-province inequality was substantially greater than between-province inequality; while within-district inequality was less than between-district inequality. The inequality of several districts was

The economic burden of HIV/AIDS on individuals and households in Nepal: a quantitative study.

PubMed

Poudel, Ak Narayan; Newlands, David; Simkhada, Padam

2017-01-24

There have been only limited studies assessing the economic burden of HIV/AIDS in terms of direct costs, and there has been no published study related to productivity costs in Nepal. Therefore, this study explores in detail the economic burden of HIV/AIDS, including direct costs and productivity costs. This paper focuses on the direct costs of seeking treatment, productivity costs, and related factors affecting direct costs, and productivity costs. This study was a cross-sectional, quantitative study. The primary data were collected through a structured face-to-face survey from 415 people living with HIV/AIDS (PLHIV). The study was conducted in six representative treatment centres of six districts of Nepal. The data analysis regarding the economic burden (direct costs and productivity costs) was performed from the household's perspective. Descriptive statistics have been used, and regression analyses were applied to examine the extent, nature and determinants of the burden of the disease, and its correlations. Average total costs due to HIV/AIDS (the sum of average total direct and average productivity costs before adjustment for coping strategies) were Nepalese Rupees (NRs) 2233 per month (US$ 30.2/month), which was 28.5% of the sample households' average monthly income. The average total direct costs for seeking HIV/AIDS treatment were NRs 1512 (US$ 20.4), and average productivity costs (before adjustment for coping strategies) were NRs 721 (US$ 9.7). The average monthly productivity losses (before adjustment for coping strategies) were 5.05 days per person. The major determinants for the direct costs were household income, occupation, health status of respondents, respondents accompanied or not, and study district. Health status of respondents, ethnicity, sexual orientation and study district were important determinants for productivity costs. The study concluded that HIV/AIDS has caused a significant economic burden for PLHIV and their families in Nepal. The

Disabled women׳s maternal and newborn health care in rural Nepal: A qualitative study

PubMed Central

Morrison, Joanna; Basnet, Machhindra; Budhathoki, Bharat; Adhikari, Dhruba; Tumbahangphe, Kirti; Manandhar, Dharma; Costello, Anthony; Groce, Nora

2014-01-01

Objective there is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal. Design we used a qualitative methodology, using semi-structured interviews. Setting rural Makwanpur District of central Nepal. Participants we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. Findings married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. Key conclusions and implications for practice integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care. PMID:24768318

Disabled women׳s maternal and newborn health care in rural Nepal: a qualitative study.

PubMed

Morrison, Joanna; Basnet, Machhindra; Budhathoki, Bharat; Adhikari, Dhruba; Tumbahangphe, Kirti; Manandhar, Dharma; Costello, Anthony; Groce, Nora

2014-11-01

there is little evidence about disabled women׳s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women׳s experiences of maternal and newborn care in rural Nepal. we used a qualitative methodology, using semi-structured interviews. rural Makwanpur District of central Nepal. we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Structure of the Red Dog District, western Brooks Range, Alaska

USGS Publications Warehouse

de Vera, Jean-Pierre P.; McClay, K. R.

2004-01-01

The Red Dog district of the western Brooks Range of northern Alaska, which includes the sediment-hosted Zn-Pb-Ag ± Ba deposits at Red Dog, Su-Lik, and Anarraaq, contains one of the world's largest reserves of zinc. This paper presents a new model for the structural development of the area and shows that understanding the structure is crucial for future exploration efforts and new mineral discoveries in the district. In the Red Dog district, a telescoped Late Devonian through Jurassic continental passive margin is exposed in a series of subhorizontally stacked, internally imbricated, and regionally folded thrust sheets. These sheets were emplaced during the Middle Jurassic to Late Cretaceous Brookian orogeny and subsequently were uplifted by late tectonic activity in the Tertiary. The thrust sheet stack comprises seven tectonostratigraphically distinct allochthonous sheets, three of which have been subject to regional and detailed structural analysis. The lowermost of these is the Endicott Mountains allochthon, which is overlain by the structurally higher Picnic Creek and Kelly River allochthons. Each individual allochthon is itself internally imbricated into a series of tectonostratigraphically coherent and distinct thrust plates and subplates. This structural style gives rise to duplex development and imbrication at a range of scales, from a few meters to tens of kilometers. The variable mechanical properties of the lithologic units of the ancient passive margin resulted in changes in structural styles and scales of structures across allochthon boundaries. Structural mapping and analysis of the district indicate a dominant northwest to west-northwest direction of regional tectonic transport. Local north to north-northeast transport of thrust sheets is interpreted to reflect the influence of underlying lateral and/or oblique ramps, which may have been controlled by inherited basin margin structures. Some thrust-sheet stacking patterns suggest out

Hydrogeochemical Investigations of Historic Mining Districts, Central Western Slope of Colorado, Including Influence on Surface-Water Quality

USGS Publications Warehouse

Nash, J. Thomas

2002-01-01

This report describes reconnaissance hydrogeochemical investigations of 22 mining districts on the Western Slope of Colorado in the Gunnison and Uncompahgre National Forests and adjacent public lands administered by the Bureau of Land Management. Sources and fates of contaminants from historic mines, mine waste, and mill tailings are interpreted from chemical analyses for 190 samples of surface waters; 185 samples of mined rocks, mill tailings, and altered rocks; and passive leach analyses of 116 samples of those mineralized materials. Short reaches of several headwater streams show relatively low level effects of historic mining; the headwaters of the Uncompahgre River are highly contaminated by mines and unmined altered rocks in the Red Mountain district. There is encouraging evidence that natural processes attenuate mine-related contamination in most districts.

Using Inexpensive Technology and Multimedia to Improve Science Education in Rural Communities of Nepal

ERIC Educational Resources Information Center

Neupane, Sujaya

2014-01-01

This article explores an ongoing project that promotes science education in rural communities of western Nepal by using affordable technology. With the advent of inexpensive technology and multimedia resources, teaching materials for science education can be accessed with a much smaller budget than was previously possible. A preliminary survey…

Factors associated with childhood ocular morbidity and blindness in three ecological regions of Nepal: Nepal pediatric ocular disease study.

PubMed

Adhikari, Srijana; Shrestha, Mohan Krishna; Adhikari, Kamala; Maharjan, Nhukesh; Shrestha, Ujjowala Devi

2014-10-23

Nepal Pediatric Ocular Diseases Study is a three year longitudinal population based study. Here we present the baseline survey report which aims to investigate various risk factors associated with childhood ocular morbidity and blindness in three ecological regions of Nepal. This baseline survey is a population based cross sectional study. The investigation was conducted in a district from each of the following regions: Terai, Hill and Mountain. The Village Development Committees (VDCs) from each district were selected by random sampling. Three Community health workers were given training on vision screening and identification of abnormal ocular signs in children. They conducted a house to house survey in their respected districts examining the children and gathering a standardized set of data variables. Children with abnormal vision or ocular signs were then further examined by pediatric ophthalmologists. A total of 10950 children aged 0-10 years (5403 from Terai, 3204 from the hills, 2343 from the mountains) were enrolled in the study. However 681 (6.2%) were non responders. The male to female ratio was 1.03. The overall prevalence of ocular morbidity was 3.7% (95% CI of 3.4%-4%) and blindness was 0.07% (95% CI of 0.02%-0.12%). Ocular morbidity was more prevalent in the mountain region whereas blindness was more prevalent in the Terai region.Children from the Terai region were more likely to suffer from congenital ocular anomalies compared to the other regions. Children whose mother smoked, drank alcohol, or was illiterate were significantly afflicted with ocular diseases (p < 0.05). In addition,a higher prevalence of ocular disease was related to children with past medical history of systemic illnesses, abnormal postnatal period or missing childhood vaccinations. Blindness was more prevalent in children who suffered from a systemic illness. Females and under-nourished children were more likely to have ocular morbidity and blindness. It was found that

Navigating Diagnoses: Understanding Mind–Body Relations, Mental Health, and Stigma in Nepal

PubMed Central

Harper, Ian

2013-01-01

Anthropologists and psychiatrists traditionally have used the salience of a mind–body dichotomy to distinguish Western from non-Western ethnopsychologies. However, despite claims of mind–body holism in non-Western cultures, mind–body divisions are prominent in non-Western groups. In this article, we discuss three issues: the ethnopsychology of mind–body dichotomies in Nepal, the relationship between mind–body dichotomies and the hierarchy of resort in a medical pluralistic context, and, lastly, the role of mind–body dichotomies in public health interventions (biomedical and psychosocial) aimed toward decreasing the stigmatization of mental illness. We assert that, by understanding mind–body relations in non-Western settings, their implications, and ways in which to reconstitute these relations in a less stigmatizing manner, medical anthropologists and mental health workers can contribute to the reduction of stigma in global mental healthcare. PMID:18784989

Pharmacotherapy of Bipolar Affective Disorder: A Hospital based Study from Sub Himalayan Valley of Nepal

PubMed Central

Sathian, Brijesh; Chakraborty, Prasanta Kumar; Banerjee, Indraneel; Roy, Bedanta; Jauhari, Akhilesh Chandra; Saha, Archana

2014-01-01

Introduction: In Bipolar disorder the mood of the patients fluctuates between depression and mania. The main objective of the study was to find out the commonest mood stabilizers used for the treatment of Bipolar affective disorders in Western Nepal in hospitalized patients in an actual clinical set up. Methods: This was a cross-sectional study which was conducted between October 2009 and September 2010 at Psychiatric ward at Manipal teaching hospital, Pokhara, Nepal, a tertiary care hospital situated in Western Nepal. The diagnosis of the disease was based on ICD-10 (Tenth revision) Classification of mental and Behavioural disorders, Diagnostic Criteria for Research. We calculated odds ratio and their 95% confidence intervals (95% CI). p< 0.05 was considered as statistically significant. Results: 62.1% of the patients were less than 40 yrs, 56.3% were male, 72.4% were unemployed and 75.9% of the patients were having monthly income <10,000/month. As far as ethnicity is concerned 37.9% of the cases were Brahmin and by occupation 29.9% of the patients were students followed by housewife 25.3%, labour 17.2%, retired 13.8% respectively. Drugs and Psychotherapy [OR 1.4, 95% (CI 0.575, 3.4017)] was prescribed in age <40 years as compared to age>40 yrs. Male patients [OR 7.22, 95% (CI 0.862, 60.499)] and [OR 2.353, 95% (CI 0.857, 6.455)] received drugs by trade names and drugs not from the national drug list of Nepal as compared to females. Monthly income <10,000/month and [OR 2.8, 95% (CI 0.742, 10.56)] tendency of receiving drugs by trade names. Among the mood elevators Sodium valproate was the commonest drug to be prescribed in 51/87(58.6%) patients followed by Lithium in 30/87 (34.5%) cases and Carbamazepine in 6/87 (6.9%) cases. Sodium valproate was prescribed at 1,000 mg/day, Lithium was prescribed at 900 mg/day in and Carbamazepine was prescribed at 800 mg/day. Conclusion: Among all the mood elevators Sodium valproate is the commonest drug prescribed for the

Medicinal plant diversity and traditional healing practices in eastern Nepal.

PubMed

Shrestha, Nawal; Shrestha, Saugat; Koju, Laxmi; Shrestha, Krishna Kumar; Wang, Zhiheng

2016-11-04

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

Are Birth-preparedness Programmes Effective? Results From a Field Trial in Siraha District, Nepal

PubMed Central

McPherson, Robert A.; Moore, Judith M.; Sharma, Meena

2006-01-01

The birth-preparedness package (BPP) promotes active preparation and decision-making for births, including pregnancy/postpartum periods, by pregnant women and their families. This paper describes a district-wide field trial of the BPP implemented through the government health system in Siraha, Nepal, during 2003–2004. The aim of the field trial was to determine the effectiveness of the BPP to positively influence planning for births, household-level behaviours that affect the health of pregnant and postpartum women and their newborns, and their use of selected health services for maternal and newborn care. Community health workers promoted desired behaviours through inter-personal counselling with individuals and groups. Content of messages included maternal and newborn-danger signs and encouraged the use of healthcare services and preparation for emergencies. Thirty-cluster baseline and endline household surveys of mothers of infants aged less than one year were used for estimating the change in key outcome indicators. Fifty-four percent of respondents (n=162) were directly exposed to BPP materials while pregnant. A composite index of seven indicators that measure knowledge of respondents, use of health services, and preparation for emergencies increased from 33% at baseline to 54% at endline (p=0.001). Five key newborn practices increased by 19 to 29 percentage points from baseline to endline (p values ranged from 0.000 to 0.06). Certain key maternal health indicators, such as skilled birth attendance and use of emergency obstetric care, did not change. The BPP can positively influence knowledge and intermediate health outcomes, such as household practices and use of some health services. The BPP can be implemented by government health services with minimal outside assistance but should be comprehensively integrated into the safe motherhood programme rather than implemented as a separate intervention. PMID:17591345

Rare Mineralogy in Alkaline Ultramafic Rocks, Western Kentucky Fluorspar District

NASA Astrophysics Data System (ADS)

Anderson, W.

2017-12-01

The alkaline ultramafic intrusive dike complex in the Western Kentucky Fluorspar District contains unusual mineralogy that was derived from mantle magma sources. Lamprophyre and peridotite petrologic types occur in the district where altered fractionated peridotites are enriched in Rare Earth Elements (REE) and some lamprophyre facies are depleted in incompatible elements. Unusual minerals in dikes, determined by petrography and X-ray diffraction, include schorlomite and andradite titanium garnets, astrophyllite, spodumene, niobium rutile, wüstite, fluoro-tetraferriphlogopite, villiaumite, molybdenite, and fluocerite, a REE-bearing fluoride fluorescent mineral. Mixing of MVT sphalerite ore fluids accompanies a mid-stage igneous alteration and intrusion event consistent with paragenetic studies. The presence of lithium in the spodumene and fluoro-tetraferriphlogopite suggests a lithium phase in the mineral fluids, and the presence of enriched REE in dikes and fluorite mineralization suggest a metasomatic event. Several of these rare minerals have never been described in the fluorspar district, and their occurrence suggests deep mantle metasomatism. Several REE-bearing fluoride minerals occur in the dikes and in other worldwide occurrences, they are usually associated with nepheline syenite and carbonatite differentiates. There is an early and late stage fluoride mineralization, which accompanied dike intrusion and was also analyzed for REE content. One fluorite group is enriched in LREE and another in MREE, which suggests a bimodal or periodic fluorite emplacement. Whole-rock elemental analysis was chondrite normalized and indicates that some of the dikes are slightly enriched in light REE and show a classic fractionation enrichment. Variations in major-element content; high titanium, niobium, and zirconium values; and high La/Yb, Zr/Y, Zr/Hf, and Nb/Ta ratios suggest metasomatized lithospheric-asthenospheric mantle-sourced intrusions. The high La/Yb ratios in some

Need of The Ministry of Health in Federal Democratic Republic of Nepal.

PubMed

Regmi, K; Upadhyay, M; Tarin, E; Chand, P B; Uprety, S R; Lekhak, S C

2017-01-01

The constitution of Nepal provides appointing a council of ministers both at federal and provincial levels without defining portfolios. There is a political agreement that MOH will be retained at the federal level. This article draws evidences around the world to meet health needs of Nepalese, the role of provincial ministry of health and coordinating structure at district/local level. The constitution emphasises on health and pronounced in 46 articles which provides guidance for the creation of federalized governance levels at federal, provincial and local levels. Retaining ministry of health at federal level without creating devolved structure at province and local levels in health sector will create difficulty in translating the spirit of the constitution and may not be effective in addressing health issues nationally and meeting global achievements like SDGs. It is suggested to establish an elaborate health system accordingly in Nepal to ensure constitutional mandate of health as a basic human right.

Age at first marriage in Nepal: differentials and determinants.

PubMed

Aryal, Tika Ram

2007-09-01

The aim of this paper is to investigate the differentials and determinants of female age at first marriage in rural Nepal. The life table technique was employed to calculate median age at marriage. The proportional hazard model was used to study the effect of various socioeconomic variables, and to identify the magnitude and significance of their effects on the timing of first marriage. The data were taken from a sample survey of Palpa and Rupandehi districts in rural Nepal. Both married and unmarried females of marriageable age were included in the survey. Median age at marriage was about 17 years for data from only married females, whereas it was about 18 years for data from married as well as unmarried females of marriageable age. Median age at marriage was about 16 years for uneducated females and 19 years for females educated up to intermediate or higher level. The analysis underestimates the median age at marriage for married females, probably due to right censoring. The risk of getting married early decreased gradually with increasing year-of-birth cohort. The risk of early marriage was higher among females of high socioeconomic status compared with those of low socioeconomic status. Females engaged in service married earlier than those engaged in household work. High socioeconomic status families are motivated, for religious and prestige reasons, to get their daughters married at an early age, preferably before menarche. Thus, education, occupation and age at menarche are the most powerful factors in deciding the timing of first marriage in Nepal.

A qualitative study about the gendered experiences of motherhood and perinatal mortality in mountain villages of Nepal: implications for improving perinatal survival.

PubMed

Paudel, Mohan; Javanparast, Sara; Dasvarma, Gouranga; Newman, Lareen

2018-05-15

We aim to examine the gendered contexts of poor perinatal survival in the remote mountain villages of Nepal. The study setting comprised two remote mountain villages from a mid-western mountain district of Nepal that ranks lowest on the Human Development Index (0.304), and is reported as having the lowest child survival rates in the country. The findings are taken from a larger study of perinatal survival in remote mountain villages of Nepal, conducted through a qualitative methodological approach within a framework of social constructionist and critical theoretical perspectives. Data were collected through in-depth interviews with 42 women and their families, plus a range of healthcare providers (nurses/auxiliary nurses, female health volunteers, support staff, Auxiliary Health Worker and a traditional healer) and other stakeholders from February to June, 2015. Data were analysed with a comprehensive coding process utilising the thematic analysis technique. The social construction of gender is one of the key factors influencing poor perinatal survival in the villages in this study. The key emerging themes from the qualitative data are: (1) Gendered social construct and vulnerability for poor perinatal survival: child marriages, son preference and repeated child bearing; (2) Pregnancy and childbirth in intra-familial dynamics of relationships and power; and (3) Perception of birth as a polluted event: birth in Gotha (cowshed) and giving birth alone. Motherhood among women of a low social position is central to women and their babies experiencing vulnerabilities related to perinatal survival in the mountain villages. Gendered constructions along the continuum from pre-pregnancy to postnatal (girl settlement, a daughter-in-law, ritual pollution about mother and child) create challenges to ensuring perinatal survival in these villages. It is imperative that policies and programmes consider such a context to develop effective working strategies for sustained reduction

Antimicrobial drug use in dermatology in a teaching hospital in western Nepal.

PubMed

Sarkar, C; Das, B; Sripathi, H

2002-05-01

Medical audit is supposed to oversee, monitor and analyse standards of medical treatment at all levels of the healthcare delivery system. This study was undertaken to monitor the prescribing of antimicrobial drugs for patients seeking treatment in the dermatology outpatient department of the Manipal Teaching Hospital in Nepal. A total of 292 dermatology prescriptions of patients attending the dermatology OPD were collected between July 2000 and June 2001. Prescriptions for antimicrobial agents were separated from the total prescriptions collected, and evaluated. There were more female patients (58.2%) than male (41.8%) in our study; most were in the 21-40 year age group. The commonest cutaneous infections were acne (15.8%) followed by fungal infections (14.8%). Of the 292 prescriptions audited, 149 contained antimicrobial agents, constituting 36% of the total number of drugs prescribed. Of 256 antimicrobials prescribed, 63% were topical and 37% systemic; 5% were generic, 29% were from the essential drug list of Nepal, and 15% were fixed-dose combinations. Most of the patients received one or two antimicrobials, 50% of which were antibacterials and 40% antifungals. Though the selection of antimicrobial drugs used in dermatology was largely rational, anomalies were observed, and these issues were discussed with clinicians in relation to various aspects of drug use. The results indicate there is scope for improving prescribing habits. A periodic audit of drug prescribing is desirable in rationalising prescribing practice.

Urban air quality of kathmandu valley "Kingdom of Nepal"

NASA Astrophysics Data System (ADS)

Sharma, C. K.

The oval shaped tectonic basin of Kathmandu valley, occupying about 656 sq.km is situated in the middle sector of Himalayan range. There are three districts in the valley, i.e. Kathmandu, Lalitpur and Bhaktapur. Out of the three, the most populated is Kathmandu city (the capital of Kingdom of Nepal) which has a population of 668,00 in an area of approximately 50 km 2. The energy consumption of the city population is about 1/3 of the total import to Nepal of gasoline, diesel, kerosene, furnace oil and cooking gas. This has resulted heavy pollution of air in the city leading to bronchitis, and throat and chest diseases. Vehicles have increased several fold in recent months and there are 100,000 in number on the road and they have 900 km of road, out of which only 25% is metalled. Most of the two and three wheelers are polluting the air by emission of gases as well as dust particulate. SO 2 has been found to go as high as 202 μg cm -3 and NO 2 to 126 μg cm -3 particularly in winter months when a thick layer of fog covers the valley up to 10 am in the morning. All the gases are mixed within the limited air below the fog and the ground. This creates the problem. Furthermore, municipal waste of 500 m 3 a day and also liquid waste dumped directly into the Bagmati river at the rate of 500,000 ℓ d -1 makes the city ugly and filthy. Unless pollution of air, water and lard are controlled in time, Nepal will lose much of its foreign exchange earnings from the tourist industry. It is found that tourist arrivals have considerably reduced in recent years and most of hotels occupancy is 50-60% in peak time. Nepal is trying to introduce a legal framework for pollution control but it will take time to become effective.

Geomorphic impacts, age and significance of two giant landslide dams in the Nepal Himalayas: Ringmo-Phoksundo (Dolpo District) and Dhampu-Chhoya (Mustang District).

NASA Astrophysics Data System (ADS)

Fort, Monique; Braucher, Regis; Bourlès, Didier; Guillou, Valery; Nath Rimal, Lila; Gribenski, Natacha; Cossart, Etienne

2014-05-01

Large catastrophic slope failures have recently retained much attention in the northern dry Himalayas (1). They play a prominent role in the denudation history of active orogens at a wide range of spatial and time scales (2), and they impact durably landforms and process evolution in upstream catchments. Their occurrence mostly results from three different potential triggers: earthquakes, post-glacial debuttressing, and permafrost melting. We focus on two examples of giant rock slope failures that occurred across and north of the Higher Himalaya of Nepal and assess their respective influence on the regional, geomorphic evolution. The Ringmo rockslide (4.5 km3) results from the collapse of a mountain wall (5148 m) cut into palaeozoic dolomites of the Tethysian Himalayas. It caused the damming of the Suli Gad River at the origin of the Phoksumdo Lake (3600 m asl). The presence of glacial till at the very base of the sequence suggests the rockslide event is post-glacial, a field assumption confirmed by cosmogenic dating. Two consistent 36Cl ages of 20,885 ±1675 argue for a single, massive event of paraglacial origin that fits well with the last chronologies available on the Last Glacial Maximum in the Nepal Himalaya. The persistence of the Phoksumdo Lake is due to its dam stability (i.e. high lime content of landslide components) and to low sediment flux from the arid, upper Suli Gad catchment. The Dhampu-Chhoya rock avalanche (about 1 km3, area extent 10 km2) was derived from the northward failure of the Kaiku ridge, uphold by north-dipping, upper crystallines of the Higher Himalaya. It dammed the Kali Gandaki River, with complex interactions with the Late Pleistocene ice tongues derived from the Dhaulagiri (8167 m) and Nilgiris (7061 m) peaks. Both the rock avalanche and glaciers controlled the existence and level of the "Marpha Lake" (lacustrine deposits up to Kagbeni). Again, consistent 10Be ages of 29,680 ± 1015 ka obtained from two large blocks (>1000 m3

Evaluating the electronic tuberculosis register surveillance system in Eden District, Western Cape, South Africa, 2015.

PubMed

Mlotshwa, Mandla; Smit, Sandra; Williams, Seymour; Reddy, Carl; Medina-Marino, Andrew

2017-01-01

Tuberculosis (TB) surveillance data are crucial to the effectiveness of National TB Control Programs. In South Africa, few surveillance system evaluations have been undertaken to provide a rigorous assessment of the platform from which the national and district health systems draws data to inform programs and policies. Evaluate the attributes of Eden District's TB surveillance system, Western Cape Province, South Africa. Data quality, sensitivity and positive predictive value were assessed using secondary data from 40,033 TB cases entered in Eden District's ETR.Net from 2007 to 2013, and 79 purposively selected TB Blue Cards (TBCs), a medical patient file and source document for data entered into ETR.Net. Simplicity, flexibility, acceptability, stability and usefulness of the ETR.Net were assessed qualitatively through interviews with TB nurses, information health officers, sub-district and district coordinators involved in the TB surveillance. TB surveillance system stakeholders report that Eden District's ETR.Net system was simple, acceptable, flexible and stable, and achieves its objective of informing TB control program, policies and activities. Data were less complete in the ETR.Net (66-100%) than in the TBCs (76-100%), and concordant for most variables except pre-treatment smear results, antiretroviral therapy (ART) and treatment outcome. The sensitivity of recorded variables in ETR.Net was 98% for gender, 97% for patient category, 93% for ART, 92% for treatment outcome and 90% for pre-treatment smear grading. Our results reveal that the system provides useful information to guide TB control program activities in Eden District. However, urgent attention is needed to address gaps in clinical recording on the TBC and data capturing into the ETR.Net system. We recommend continuous training and support of TB personnel involved with TB care, management and surveillance on TB data recording into the TBCs and ETR.Net as well as the implementation of a well

The impact of ocular trauma during the Nepal earthquake in 2015.

PubMed

Pradhan, E; Limbu, B; Thakali, S; Jain, N S; Gurung, R; Ruit, S

2017-03-28

Nepal was struck by a massive earthquake on the 25th April 2015 and major aftershock on the 12th of May 2015, resulting in widespread devastation with a death toll in the thousands. The burden of ocular trauma resulting from the recent earthquakes in Nepal has not been described thus far. The aim of this study was to determine the types of ocular injuries sustained in the earthquake in Nepal and its management in Tilganga Institute of Ophthalmology (TIO) in Gaushala, Kathmandu. This is a hospital-based retrospective study of patients presenting to TIO following repeated earthquake. Variables that were recorded included patients' presenting symptoms and time to presentation, visual acuities at presentation and at follow-up, diagnosis of ocular injury and surgery performed. There were 59 cases of earthquake victims visiting TIO, Gaushala, Kathmandu from April 2015 to July 2015, with 64 affected eyes due to 5 cases of bilateral involvement. The majority of patients were from the district Sindhupalchowk (14 cases, 23.7%), which was the epicenter of the main earthquake. The average duration between the earthquake and presentation was 13 · 9 days (range 1-120 days). Closed globe injury was most frequent (23 cases), followed by open globe injuries (8 cases). While 24 patients (38%) initially presented with a visual acuity <3/60 in their affected eye, 15 patients (23%) had a visual acuity of <3/60 on follow-up. A variety of surgical treatments were required including anterior and posterior segment repair. Immediate management of ocular trauma is critical in order to prevent blindness. Characterizing the burden of earthquake-related ocular trauma will facilitate planning for service provision in the event of a future earthquake in Nepal, or in countries, which are similarly at risk of having natural disasters.

Environmental management plan (EMP) for Melamchi water supply project, Nepal.

PubMed

Khadka, Ram B; Khanal, Anil B

2008-11-01

More than 1.5 million people live in the Kathmandu valley. The valley is facing an extreme shortage of water supply. At the same time the demand is escalating rapidly. To address this issue of scarcity of water, the government of Nepal has proposed a project of inter-basin transfer of water from Melamchi River located 40 km north-east of the Kathmandu valley. The project will cover two districts and three municipalities and will potentially have significant impacts on the environment. In accordance with the Environmental Protection Regulation of Nepal (1997), the Melamchi Water Supply Project (MWSP) has undergone an EIA during the feasibility study stage of the proposed project. The recommendations contained in the EIA were integrated into the project design for implementation in 2006. This paper summarizes the background of MWSP, the environmental concerns described in the EIA and the status of Environmental Management Plan (EMP) developed to address environmental compliance and other issues involving participation and support of the local people. This paper also provides some lessons to learn on the modalities of addressing the demands and grievances of the local people concerning environmental management.

Determinants of institutional birth among women in rural Nepal: a mixed-methods cross-sectional study.

PubMed

Maru, Sheela; Rajeev, Sindhya; Pokhrel, Richa; Poudyal, Agya; Mehta, Pooja; Bista, Deepak; Borgatta, Lynn; Maru, Duncan

2016-08-27

Encouraging institutional birth is an important component of reducing maternal mortality in low-resource settings. This study aims to identify and understand the determinants of persistently low institutional birth in rural Nepal, with the goal of informing future interventions to reduce high rates of maternal mortality. Postpartum women giving birth in the catchment area population of a district-level hospital in the Far-Western Development Region of Nepal were invited to complete a cross-sectional survey in 2012 about their recent birth experience. Quantitative and qualitative methods were used to determine the institutional birth rate, social and demographic predictors of institutional birth, and barriers to institutional birth. The institutional birth rate for the hospital's catchment area population was calculated to be 0.30 (54 home births, 23 facility births). Institutional birth was more likely as age decreased (ORs in the range of 0.20-0.28) and as income increased (ORs in the range of 1.38-1.45). Institutional birth among women who owned land was less likely (OR = 0.82 [0.71, 0.92]). Ninety percent of participants in the institutional birth group identified safety and good care as the most important factors determining location of birth, whereas 60 % of participants in the home birth group reported distance from hospital as a key determinant of location of birth. Qualitative analysis elucidated the importance of social support, financial resources, birth planning, awareness of services, perception of safety, and referral capacity in achieving an institutional birth. Age, income, and land ownership, but not patient preference, were key predictors of institutional birth. Most women believed that birth at the hospital was safer regardless of where they gave birth. Future interventions to increase rates of institutional birth should address structural barriers including differences in socioeconomic status, social support, transportation resources, and

Genotypic Characterization of Human Immunodeficiency Virus Type 1 Derived from Antiretroviral Drug-Treated Individuals Residing in Earthquake-Affected Areas in Nepal.

PubMed

Negi, Bharat Singh; Kotaki, Tomohiro; Joshi, Sunil Kumar; Bastola, Anup; Nakazawa, Minato; Kameoka, Masanori

2017-09-01

Molecular epidemiological data on human immunodeficiency virus type 1 (HIV-1) are limited in Nepal and have not been available in areas affected by the April 2015 earthquake. Therefore, we conducted a genotypic study on HIV-1 genes derived from individuals on antiretroviral therapy residing in 14 districts in Nepal highly affected by the earthquake. HIV-1 genomic fragments were amplified from 40 blood samples of HIV treatment-failure individuals, and a sequencing analysis was performed on these genes. In the 40 samples, 29 protease, 32 reverse transcriptase, 25 gag, and 21 env genes were sequenced. HIV-1 subtyping revealed that subtype C (84.2%, 32/38) was the major subtype prevalent in the region, while CRF01_AE (7.9%, 3/38) and other recombinant forms (7.9%, 3/38) were also detected. In addition, major drug resistance mutations were identified in 21.9% (7/32) of samples, indicating the possible emergence of HIV-1 drug resistance in earthquake-affected areas in Nepal.

Scientific publications in Nepal.

PubMed

Magar, A

2012-09-01

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.

New climatic classification of Nepal

NASA Astrophysics Data System (ADS)

Karki, Ramchandra; Talchabhadel, Rocky; Aalto, Juha; Baidya, Saraju Kumar

2016-08-01

Although it is evident that Nepal has an extremely wide range of climates within a short latitudinal distance, there is a lack of comprehensive research in this field. The climatic zoning in a topographically complex country like Nepal has important implications for the selection of scientific station network design and climate model verification, as well as for studies examining the effects of climate change in terms of shifting climatic boundaries and vegetation in highly sensitive environments. This study presents a new high-resolution climate map of Nepal on the basis of long-term (1981-2010) monthly precipitation data for 240 stations and mean air temperature data for 74 stations, using original and modified Köppen-Geiger climate classification systems. Climatic variables used in Köppen-Geiger system were calculated (i) at each station and (ii) interpolated to 1-km spatial resolution using kriging which accounted for latitude, longitude, and elevation. The original Köppen-Geiger scheme could not identify all five types of climate (including tropical) observed in Nepal. Hence, the original scheme was slightly modified by changing the boundary of coldest month mean air temperature value from 18 °C to 14.5 °C in order to delineate the realistic climatic condition of Nepal. With this modification, all five types of climate (including tropical) were identified. The most common dominant type of climate for Nepal is temperate with dry winter and hot summer (Cwa).

Selection and Characterization of Potential Baker's Yeast from Indigenous Resources of Nepal

PubMed Central

Timilsina, Parash Mani; Yadav, Archana; Joshi, Yogesh; Bhujel, Sahansila; Adhikari, Rojina; Neupane, Katyayanee

2017-01-01

The study aims to isolate the yeast strains that could be used effectively as baker's yeast and compare them with the commercial baker's yeast available in the market of Nepal. A total of 10 samples including locally available sources like fruits, Murcha, and a local tree “Dar” were collected from different localities of Bhaktapur, Kavre, and Syangja districts of Nepal, respectively. Following enrichment and fermentation of the samples, 26 yeast strains were isolated using selective medium Wallerstein Laboratory Nutrient Agar. From the differential tests which included morphological and microscopic observation and physiological and biochemical characterization such as nitrate reduction and lactose utilization tests, 8 strains were selected as possible Saccharomyces strain. The selected strains were further assessed for their efficient leavening ability by tests such as ethanol tolerance, osmotolerance, invertase test, and stress exclusion test. The three most potent strains ENG, MUR3B, and SUG1 isolated from grape, Murcha, and sugarcane, respectively, were used in the fermentation and baking of dough. These strains also carried a possibility of being used as industrial baker's yeast. PMID:29387490

Selection and Characterization of Potential Baker's Yeast from Indigenous Resources of Nepal.

PubMed

Karki, Tika B; Timilsina, Parash Mani; Yadav, Archana; Pandey, Gyanu Raj; Joshi, Yogesh; Bhujel, Sahansila; Adhikari, Rojina; Neupane, Katyayanee

2017-01-01

The study aims to isolate the yeast strains that could be used effectively as baker's yeast and compare them with the commercial baker's yeast available in the market of Nepal. A total of 10 samples including locally available sources like fruits, Murcha, and a local tree "Dar" were collected from different localities of Bhaktapur, Kavre, and Syangja districts of Nepal, respectively. Following enrichment and fermentation of the samples, 26 yeast strains were isolated using selective medium Wallerstein Laboratory Nutrient Agar. From the differential tests which included morphological and microscopic observation and physiological and biochemical characterization such as nitrate reduction and lactose utilization tests, 8 strains were selected as possible Saccharomyces strain. The selected strains were further assessed for their efficient leavening ability by tests such as ethanol tolerance, osmotolerance, invertase test, and stress exclusion test. The three most potent strains ENG, MUR3B, and SUG1 isolated from grape, Murcha, and sugarcane, respectively, were used in the fermentation and baking of dough. These strains also carried a possibility of being used as industrial baker's yeast.

Working Together, Staying Vital. Proceedings of the Joint Conference of the Western Australian District High Schools Administrators' Association and the National Society for the Provision of Education in Rural Australia (20th, Fremantle, Western Australia, June 2004)

ERIC Educational Resources Information Center

Boylan, Colin, Ed.; Hemmings, Brian, Ed.

2004-01-01

The 20th National Society for the Provision of Education in Rural Australia (SPERA) and Western Australia District High School Administrators' Association (WADHSAA) joint conference proceedings, based on the theme "Working Together, Staying Vital," was held in Fremantle, Perth, Western Australia, in June 2004. The proceedings contain 13…

Mothers' beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal.

PubMed

Ansari, Mukhtar; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi; Shankar, P Ravi; Koirala, Arun; Thapa, Noor Jang

2012-10-24

In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers' beliefs and barriers about diarrhea and its management. Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis. Twenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers' beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers. There were varied beliefs among the mothers

Examination of Relationships among Organizational Characteristics and Organizational Commitment of Nurses in Western and Eastern Region of Nepal.

PubMed

Joshi, A S; Namba, M; Pokharela, T

2015-01-01

The objective of this study is to identify relationships between three components of organizational commitment and organizational characteristics of nurses in the western and the eastern region of Nepal. A self-administrated questionnaire was used to collect data from 310 nurses currently working at various hospitals in the eastern and the western region of the country. The questionnaire included three sections namely 1) personal characteristics 2) organizational characteristics and 3) organizational commitments scale. Descriptive analysis and multiple regression analysis were performed to identify significance in various relationships. Out of the 240 completed questionnaires, 226 were found valid for analysis. The mean age was 27.4 years. For each depended variable affective, continuance and normative commitment, multiple regression analysis was performed with personal Characteristics and organizational characteristics as independent variables. All independent variables were found significantly related to each of the two dependent variables; affective commitment and normative commitment (R2 adjusted=0.24, p<0.01 and R2 adjusted=0.05, p<0.01 respectively). However, they were not significantly related to the continuance commitment. Both support from boss (β=0.138, p<0.05) and satisfaction with training (β=0.301, p<0.05) were found to be positive and significant with affective commitment. On the other hand, satisfaction with training (β=0.191, p<0.05) was also positive and significant with normative commitment. Since both support from boss and training program were found to be positive and significant with affective commitment, hospitals must encourage supervisors to provide more assistance to the subordinate nurses. Moreover, hospitals should develop more training programs to keep nurses motivated.

Nepal project moves ahead as grass-roots force.

PubMed

1995-06-01

A JOICFP mission to Nepal (April 2-14, 1995) performed several tasks, including the following: 1) collection of materials from nongovernmental organizations, the government, and international agencies in preparation for a National IEC Workshop (November 14-16, 1995) and a National Workshop (November 19-21, 1995) on family planning promotions; 2) arrangements for an external evaluation of the Community-based Sustainable Family Planning/Maternal and Child Health (MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA); 3) discussions regarding the production of the Nepali version of the videotape, "Rakhee and Mousse," and plans for utilization of US$11,122 of the JOICFP Voluntary Fund (JVF); 4) observation of refresher training for 135 women volunteers from 15 villages in Panchkhal, Kavre District, that was conducted by Sabatri Basnet; and 5) a meeting with the village health committee and women volunteers of the community-based, primary health care unit of Anaikiot. Coordination with the other activities of the Family Planning Association of Nepal and women volunteers to diffuse FP/MCH services and project activities has been a positive development in the project. The mission decided, based on its visits, to formulate technical support in the form of training, provision of quality service, and a referral institute for patients for the project areas of Panchkhal and Sunsari.

Depression and anxiety among war-widows of Nepal: a post-civil war cross-sectional study.

PubMed

Basnet, Syaron; Kandel, Pragya; Lamichhane, Prabhat

2018-02-01

Thousands of Nepalese women were widowed as a consequence of a decade (1996-2006) long civil war in Nepal. These women are at grave risk of mental health problems due to both traumatic experiences and violation of natural order of widowhood. The present study explores the depression and anxiety among war-widows. In 2012, a cross-sectional study was designed to interview 358 war-widows using validitated Beck Depression Inventory and Beck Anxiety Inventory in four districts of Nepal - Bardiya, Surkhet, Sindhupalchowk and Kavrepalanchowk with history of high conflict intensity. The prevalence of depression and anxiety was 53% and 63% respectively. Financial stress was significantly associated with depression (2.67, 95% CI: 1.40-5.07) and anxiety (2.37, 95% CI: 1.19-4.72). High autonomy of women as compared to low autonomy, high social support as compared to low social support and literacy as opposed to illiteracy was associated with less likelihood of depression and anxiety. Our results suggest high magnitude of depression and anxiety among war-widows in Nepal. Future policy efforts should be directed at providing mental health services to identify mental health issues among conflict affected individuals with focus on education, employment and activities to promote social support and autonomy at community.

Phenotypic and genetic characterization of Vibrio cholerae O1 clinical isolates collected through national antimicrobial resistance surveillance network in Nepal.

PubMed

Shakya, Geeta; Kim, Dong Wook; Clemens, John D; Malla, Sarala; Upadhyaya, Bishnu Prasad; Dumre, Shyam Prakash; Shrestha, Sirjana Devi; Adhikari, Shailaja; Sharma, Supriya; Rijal, Nisha; Shrestha, Sanjaya K; Mason, Carl; Kansakar, Palpasa

2012-08-01

Cholera occurs in sporadic cases and outbreaks in Nepal each year. Vibrio cholerae O1 (n = 522) isolated during 2007-2010 from diarrheal patients at 10 different hospital laboratories in Nepal were characterized. Biochemical and serologic identifications showed that all the isolates belonged to serogroup O1, El Tor biotype. Except 72 isolates of Inaba serotype isolated in the year 2007, all the remaining isolates were of Ogawa serotype. All isolates were resistant to nalidixic acid and furazolidone. Resistance to tetracycline, ciprofloxacin, erythromycin and co-trimoxazole were 21, 4, 16 and 90 % respectively. Seventy-seven of these isolates were selected for further characterization for ctxB gene and MLVA typing. Two different variants of classical type cholera toxin were observed. Ogawa strains from 2007 and 2010-Western Nepal outbreak harbored CTX-3 type cholera toxin, whereas Inaba serotypes in 2007 and the remaining Ogawa serotypes in 2008-2010 harbored CTX 3b-type toxin. MLVA analysis showed circulation of four different groups of altered V. cholerae O1 El Tor strains. Two different profiles were seen among 2007 Inaba (9, 3, 6, x, x) and Ogawa (10, 7, 6, x, x) isolates. The MLVA profile of 2008 and 2009 Ogawa isolates were similar to those of Inaba strains of 2007. Isolates from 2010 also showed three different MLVA profiles; profile 9, 3, 6, x, x in 3 isolates, 11, 7, 6, x, x among 2010 Western Nepal outbreak strains and profile 8, 3, 6, x, x among isolates from Butwal and Kathmandu.

Nutrition-sensitive agricultural interventions and gender dynamics: A qualitative study in Nepal.

PubMed

Kjeldsberg, Cecilie; Shrestha, Niva; Patel, Miti; Davis, Dale; Mundy, Gary; Cunningham, Kenda

2018-03-24

Undernutrition and low women's status persist as major development obstacles in South Asia and specifically, Nepal. Multi-sectoral approaches, including nutrition-sensitive agriculture, are potential avenues for further reductions in undernutrition. Although evidence is growing, many questions remain regarding how gender mediates the translation of agricultural production activities into nutritional benefit. In this study, we examined how gender influences the pathway from agricultural production to improved income and control of income, with a focus on five domains of empowerment: decision-making power, freedom of mobility, social support, workload and time, and self-efficacy. For this, we conducted a qualitative retrospective assessment (N = 10 FGDs) among 73 beneficiary women of a nutrition-sensitive agriculture programme implemented from 2008 to 2012 in two districts of Nepal-Baitadi and Kailali. We found that women reported increased decision-making power, new knowledge and skills, increased recognition by their family members of their new knowledge and contributions, and self-efficacy as farmers and sellers, whereas workload and time were the most consistent constraints noted. We also found that each empowerment domain operated differently at different stages of the pathway, sometimes representing barriers and at other times, opportunities and that the interconnectedness of the domains made them difficult to disentangle in practice. Finally, there were major contextual differences for some domains (e.g., freedom of mobility) between the two districts. Future policies and programmes need to include in-depth formative research to ensure that interventions address context-specific gender and social norms to maximise programmatic opportunities to achieve desired results. © 2018 John Wiley & Sons Ltd.

The household costs of visceral leishmaniasis care in south-eastern Nepal.

PubMed

Uranw, Surendra; Meheus, Filip; Baltussen, Rob; Rijal, Suman; Boelaert, Marleen

2013-01-01

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. 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. 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%). 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.

Indirect exposure to a family planning mass media campaign in Nepal.

PubMed

Boulay, Marc; Storey, J Douglas; Sood, Suruchi

2002-01-01

It is often noted that some individuals become aware of a mass media program's messages through discussions with other individuals. However, the extent to which indirect exposure occurs, and its influence on behavior, are somewhat unclear. This study examines the role of indirect exposure in extending the reach of a family planning mass media campaign in Nepal. Sociometric data, gathered from nearly all women between the ages of 15 and 49 years living in six villages in Dang District, Nepal (N = 667), assessed indirect exposure to the radio program. Indirect exposure was extensive; half of all respondents were indirectly exposed to the program's messages and the overall reach of the program increased from 50% to 75% when indirect exposure was considered. Members of community groups had higher levels of direct exposure to the radio program and more extensive and diverse social networks, allowing them to serve as a conduit for these messages into the wider community. While direct exposure to the radio program appeared to influence family planning knowledge, indirect exposure was more strongly associated with contraceptive use. These findings suggest that program evaluations that ignore indirect exposure underestimate the impact of a mass media program on behavior.

Operationalizing crop monitoring system for informed decision making related to food security in Nepal

NASA Astrophysics Data System (ADS)

Qamer, F. M.; Shah, S. N. Pd.; Murthy, M. S. R.; Baidar, T.; Dhonju, K.; Hari, B. G.

2014-11-01

In Nepal, two thirds of the total population depend on agriculture for their livelihoods and more than one third of Gross Domestic Product (GDP) comes from the agriculture sector. However, effective agriculture production across the country remains a serious challenge due to various factors, such as a high degree of spatial and temporal climate variability, irrigated and rain-fed agriculture systems, farmers' fragile social and economic fabric, and unique mountain practices. ICIMOD through SERVIR-Himalaya initiative with collaboration of Ministry of Agricultural Development (MoAD) is working on developing a comprehensive crop monitoring system which aims to provide timely information on crop growth and drought development conditions. This system analyzes historical climate and crop conditions patterns and compares this data with the current growing season to provide timely assessment of crop growth. Using remote sensing data for vegetation indices, temperature and rainfall, the system generated anomaly maps are inferred to predict the increase or shortfall in production. Comparisons can be made both spatially and in graphs and figures at district and Village Developmental Committee (VDC) levels. Timely information on possible anomaly in crop production is later used by the institutions like Ministry of Agricultural Development, Nepal and World Food Programme, Nepal to trigger appropriate management response. Future potential includes integrating data on agricultural inputs, socioeconomics, demographics, and transportation to holistically assess food security in the region served by SERVIR-Himalaya.

Demand and access to mental health services: a qualitative formative study in Nepal.

PubMed

Brenman, Natassia F; Luitel, Nagendra P; Mall, Sumaya; Jordans, Mark J D

2014-08-02

Nepal is experiencing a significant 'treatment gap' in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME's integrated care plan advocate strategic awareness raising initiatives to improve the reach

Seasonal Dietary Intakes and Socioeconomic Status among Women in the Terai of Nepal

PubMed Central

Campbell, Rebecca K.; Talegawkar, Sameera A.; Christian, Parul; LeClerq, Steven C.; Khatry, Subarna K.; Wu, Lee S.F.

2014-01-01

ABSTRACT Despite widespread nutritional deficiencies, investigations of usual diet in rural South Asia remain sparse. The present study characterizes year-round and seasonal dietary patterns of women in the Terai of Nepal by sociodemographic status, using a novel, weekly single-visit and usual food frequency questionnaire that links recall to the agricultural season. The study was conducted across seasons in 2006-2008 among 15,899 women of reproductive age in Sarlahi district. Intakes were tabulated for all foods, overall and by socioeconomic status (SES), and in and out of season, as appropriate. Foods consumed regularly [median (interquartile range) weekly frequency] were rice [13 (7-13)], potatoes [10 (5-13)], legumes [6 (2-9)], and vegetable oil [13 (13-13)]. Animal products were infrequently consumed [1 (0-2) time per week] as were fruits and vegetables, most with a median weekly intake frequency of 0. Higher SES was associated with more frequent consumption of most food-groups, including in-season fruits and vegetables. Diets of women in the Terai of Nepal lack diversity and, likely, nutrient adequacy, which may pose health risks. PMID:25076658

Learning styles of preclinical students in a medical college in western Nepal.

PubMed

Shankar, P R; Dubey, A K; Binu, V S; Subish, P; Deshpande, V Y

2006-01-01

Information on the learning styles of medical students are lacking in medical colleges in Nepal. Learning styles may be associated with student understanding and may predict success in examination. The present study was carried out to obtain information on learning styles and preferences for teaching of fourth semester medical students and note the association, if any, between respondents' personal characteristics and preferences for learning styles and types of teaching. The correlation between preferences for learning styles and types of teaching and performance in the second year university examination was also explored. The study was carried out during October 2003 at the Manipal College of Medical Sciences, Pokhara, Nepal using the Approaches and Study Skills Inventory (ASSIST) instrument. Information on the respondents' personal characteristics was collected. Respondents had to indicate their degree of agreement with a set of statements using a modified Likert-type scale. The statements were grouped into three main learning styles and two types of teaching. The median scores among different subgroups of respondents were compared using appropriate non-parametric tests (p<0.05). Ninety-two students (92%) participated; fifty-six were male. Thirty-one respondents were Nepalese, 48 were Indians. Majority were educated in English medium schools. The median scores for deep and surface learning styles were 64 and 49 respectively (maximum score=80). The scores for strategic learning was 75.5 (maximum score=100). There was no clear preference for any particular type of teaching. Indian students used more surface apathetic learning strategies compared to others. There was a negative correlation between surface learning and marks obtained in the final examination. The students mainly used deep and strategic learning styles. Differences in preference for learning styles and types of teaching were noted according the respondents' personal characteristics. This was a

Hidden voices: prevalence and risk factors for violence against women with disabilities in Nepal.

PubMed

Puri, Mahesh; Misra, Geetanjali; Hawkes, Sarah

2015-03-18

There is an increasing body of evidence on the extent and predictors of violence against women in Nepal. However, much of the published research does not yet take into account additional features of marginalization and vulnerability suffered by some women - for example, women socially excluded on account of their disability. Critical gaps exist in empirical data on the extent, risk factors, access to care, socio-economic and health consequences of violence among women with disabilities in Nepal. This paper addresses some these gaps and aims to promote evidence-informed policy and programme responses in Nepal. We conducted a cross-sectional survey of 475 women with disability aged 16 years and above in three districts in Nepal. In-depth interviews with 12 women who reported violence in the survey were also carried out. Using multivariate statistical methods we estimated the prevalence and risk factors for violence experienced both over the past 12 months and lifetime. Over the lifetime, 57.7% of women reported they had ever experienced violence, including emotional violence (55.2%); physical violence (34%); and sexual violence (21.5%). Over the preceding 12 months, 42% of women reported that they had experienced violence. Multivariate analysis showed that women with disabilities who were young, working in paid employment, and those who required permission from husbands/family to go to health centres or participate in community organizations were at increased risk of violence. Women experienced a range of negative outcomes from violence - including physical and emotional trauma. However, a majority of women did not seek care or redress from the health, justice or other sectors. Women in Nepal are at high risk of violence, often from members of their immediate family or local community. Rates of violence are higher in women with disability than among women in the general population. Tackling violence requires a comprehensive approach that addresses the root causes of

Suicidal ideation among students of a medical college in Western Nepal: a cross-sectional study.

PubMed

Menezes, Ritesh G; Subba, S H; Sathian, Brijesh; Kharoshah, Magdy A; Senthilkumaran, Subramanian; Pant, Sadip; Arun, M; Kundapur, Rashmi; Jain, Animesh; Lobo, Stany Wilfred; Ravi Shankar, P

2012-07-01

Many studies have been conducted in the developed countries to know the magnitude and factors influencing suicidal ideation among medical students, but such data are sparse in developing countries. This cross-sectional study was therefore conducted to find out the prevalence of suicidal ideation and factors influencing such ideation among students of a medical college in Western Nepal. A total of 206 students were selected using random sampling and questioned about their socio-demographic factors, other risk factors and suicidal ideation using a preformed validated questionnaire. The data were analyzed using SPSS for Windows Version 16.0 and the EPI Info 3.5.1 Windows Version. Descriptive statistics and testing of hypothesis were applied for the statistical methodology. The univariate and multivariate logistic regression methods were used to examine the association between different variables. Suicidal ideation in the last one year was present in nearly one tenth of the study population and in almost one fifth of them life-time suicidal ideation was present. Factors that were associated with suicidal ideation were primarily dissatisfaction with academic performance, being in the clinical semesters, having history of drug abuse and feeling neglected by parents. Most common reason reported for suicidal ideation was family related followed by self-related. Recognition of suicidal ideation among students and their associated factors can help in detecting it on time, making the right interventions and controlling the problem. Understanding the magnitude of the problem and their epidemiology via scientific study like this would be the first step in this process. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Exploring health facilities' experiences in implementing the free health-care policy (FHCP) in Nepal: how did organizational factors influence the implementation of the user-fee abolition policy?

PubMed

Sato, Midori; Gilson, Lucy

2015-12-01

This article presents an Asian experience of abolishing health-care user fees: Nepal's universal free health-care policy, implemented in 2008. Based on doctoral fieldwork between August 2008 and April 2009, the paper analyses primary-care facilities' and central and district health systems' experiences with the policy. It makes a unique contribution to existing evidence because it explicitly applies organizational theory within a carefully designed, rigorous, multiple case-study analysis to deepen our understanding of the organizational and 'people' factors in the successful removal of user fees. The cases were two pairs of primary-care facilities in one district, paired for comparison of the facilities' experiences with the policy in relation to its effects on health care utilization. Data collection methods included document reviews; key informant interviews at district and central levels; in-depth, semi-structured interviews and group interviews at case facilities. (Data on indicators of utilization and quality changes over time were also collected and will be published separately). Using key elements of Nadler and Tushman's 'Organizational Congruence' model, a degree-of-fit analysis tested the study's initial propositions and yielded generalizations for contexts in and outside Nepal. The study found that Nepal's key implementation challenges were similar to Africa's: insufficient or delayed inputs of drugs and compensation; insufficient workforce and the resulting reduced quality of services that hampered facilities' relationships with their clients and health providers' attitudes. However, the Nepalese case facilities with (1) good intra- and inter-facility relationships, (2) adequate staffing, (3) well-oriented providers and (4) previously trained, better-informed and skilled health management committees experienced higher utilization and better-quality indicators over time. Through its detailed analysis of Nepal's experience in removing user fees, the study

The Differential Impact of User-Fee Exemption Compared to Conditional Cash Transfers on Safe Deliveries in Nepal.

PubMed

Pradhan, Elina; Fan, Victoria Y

2017-08-01

To assess the differential impact of a copayment exemption compared to a cash incentive on increasing skilled birth attendance (i.e., birth attended by a skilled health worker) in Nepal. This study used data on 8,785 children born between July 2005 and December 2008, obtained from the nationally representative Demographic and Health Surveys, 2006 and 2011. Twenty-five districts received both the policy interventions, and the remaining 50 control districts received only the cash incentive. We employed a difference-in-differences model to compare children born in districts with both interventions to those in districts with conditional cash transfers only. Average marginal effects of the difference-in-difference coefficient on skilled birth attendance measures are estimated. Skilled birth attendance in districts with both interventions was no higher on average than in districts with only the cash incentive. In areas with adequate road networks, however, significantly higher skilled birth attendance was observed in districts with both interventions compared to those with only the cash incentive. The added incentive of the user-fee exemption did not significantly increase skilled birth attendance relative to the presence of the cash incentive. User-fee exemptions may not be effective in areas with inadequate road infrastructure. © Health Research and Educational Trust.

Monsoon Rainfall and Landslides in Nepal

NASA Astrophysics Data System (ADS)

Dahal, R. K.; Hasegawa, S.; Bhandary, N. P.; Yatabe, R.

2009-12-01

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

Factors Associated with Smokeless Tobacco Use among Pregnant Women in Rural Areas of the Southern Terai, Nepal.

PubMed

Singh, J K; Acharya, D; Kadel, R; Adhikari, S; Lombard, D; Koirala, S; Paudel, R

2017-01-01

Tobacco use among women during pregnancy leading to poor maternal and child health outcomes has been well documented. However, factors influencing use of smokeless tobacco in Nepal has not yet been well established. This study aims at exploring the factors related to smokeless tobacco use among pregnant women in rural southern Terai of Nepal. A community-based cross-sectional study was performed at 52 wards within 6 Village Development Committee in Dhanusha district of Nepal. A total of 426 expectant mothers in their second trimester were selected using a multistage cluster sampling method. Descriptive and regression analyses were done to explore the factors that influence smokeless tobacco use. In a total of 426 pregnant mothers, one in five used tobacco in any form. Among the users, 13.4% used smokeless tobacco. Pregnant mothers who were smoking tobacco (AOR 6.01; 95% CI (1.88-19.23), having alcohol consumption (AOR 3.86; 95% CI (1.23-12.08), stressed (AOR 5.04; 95% CI (1.81-14.03), non-vegetarian (AOR 3.31;(1.84-13.03), not attending regular mothers' group meetings (AOR 4.63; (1.41-15.19), and not-exposed to mass media (AOR 5.02; (1.89-13.33) were significantly associated with smokeless tobacco use. Similarly, mothers of age group 20-34 years, dalit, aadibasi and janajati, hill origin, no education and primary education were more likely to use smokeless tobacco than their counterparts. Factors such as smoking tobacco, alcohol consumption, stress, and poor education were found to be significantly associated with smokeless tobacco use among pregnant women in southern Terai of Nepal. This requires an immediate attention develop an effective strategy to prevent and control smokeless tobacco use among pregnant women in southern Terai of Nepal.

Association of water handling and child feeding practice with childhood diarrhoea in rural community of Southern Nepal.

PubMed

Acharya, Dilaram; Singh, Jitendra K; Adhikari, Mandira; Gautam, Salila; Pandey, Pragya; Dayal, Vinita

Diarrhoea is a major cause of childhood morbidity and mortality globally. While the childhood diarrhoea and its association with child feeding, and hygiene, hand washing and water treatment are studied elsewhere, the association of water handling and child feeding with childhood diarrhoea is an understudied area in Nepal. This study aimed to investigate the association of water handling and child feeding practice with childhood diarrhoea among children of one to five years of age in Southern, Nepal. A cross-sectional study was conducted in the Dhanusha district of Southern Nepal in 2013. A total of 284 mother-child pairs were selected using systemic random sampling. A four-week prevalence of childhood diarrhoea was reported using frequency distribution. The association of childhood diarrhoea with water handling and child feeding practices was ascertained using multiple logistic regressions after adjusting for potential confounders. The result of the study demonstrated that the four-week prevalence of childhood diarrhoea was 36.6%. Our finding showed that unsafe water handling practices were associated independently with childhood diarrhoea: untreated water (aOR 3.55; 95% CI: 1.13-11.10), uncovered water (aOR 2.14; 95% CI: 1.09-4.19). Similarly, partial breast feeding (aOR 4.35; 95% CI: 1.87-10.12) was also associated with higher odds of childhood diarrhoea. One third of children in Southern Nepal still had diarrhoea within the four weeks preceding the survey. As poor water handling and sub optimal infant feeding practice were major risk factors contributing to such a high burden of the disease, health promotion strategies such as promotion of safe water handling, improved hygiene and child feeding practices are recommended for the prevention of childhood diarrhoea in Southern Terai of Nepal. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Identifying acceptability and price points for purchasing micronutrient powders for children 2 to 5 years old in Nepal.

PubMed

Gunnala, Rajni; Perrine, Cria G; Subedi, Giriraj; Mebrahtu, Saba; Dahal, Pradiumna; Jefferds, Maria Elena

2017-01-01

Little is known about purchasing micronutrient powders (MNP) for children 2-5 years. We describe acceptability for purchasing and price points for MNP for children 2-5 years among caregivers living in districts where free MNP are distributed for children 6-23 months. Crosssectional surveys conducted 3 months after MNP program implementation in 2 districts; 15 months after implementation in 2 different districts. Chi square tests and logistic regression describe associations among sociodemographics and program exposure factors and acceptability of purchasing MNP among 1,261 mothers of children 6-23 months who had heard of MNP. Overall, 77.5% and 86.1% of mothers reported acceptability for purchasing MNP in the 3 and 15 month surveys, respectively. Positive pricing attitude (PPA) about paying 150 Nepali rupees for 60 sachets of MNP was reported by 66.3% and 73.4% of mothers. Acceptability for purchasing MNP in both time periods increased with higher wealth quintile and higher maternal education; PPA increased with higher maternal education. Controlling for socio-demographics, program exposure factors associated with acceptability for purchasing MNP included: lack of perceived barriers to MNP intake and health worker counselling (3 month surveys); knowledge of benefits of MNP intake and lack of perceived barriers to MNP intake (15 month surveys). Mothers reported acceptability for purchasing MNP and PPA for older children in Nepal. Differences in acceptability were found across socio-demographics and program exposures. Use of these results and further exploration into actual purchasing behaviour can inform future MNP distribution methods in Nepal.

Phlebotomus argentipes seasonal patterns in India and Nepal.

PubMed

Picado, Albert; Das, Murari Lal; Kumar, Vijay; Dinesh, Diwakar S; Rijal, Suman; Singh, Shri P; Das, Pradeep; Coosemans, Marc; Boelaert, Marleen; Davies, Clive

2010-03-01

The current control of Phebotomus argentipes (Annandale and Brunetti), the vector of Leishmania donovani (Laveran and Mesnil), on the Indian subcontinent is base on indoor residual spraying. The efficacy of this method depends, among other factors, on the timing and number of spraying rounds, which depend on the P. argentipes seasonality. To describe P. argentipes' seasonal patterns, six visceral leishmaniasis (VL) endemic villages, three in Muzaffarpur and three in Sunsari districts in India and Nepal, respectively, were selected based on accessibility and VL incidence. Ten houses per cluster with the highest P. argentipes density were monitored monthly for 15-16 mo using Center for Disease Control and Prevention light traps. Minimum and maximum temperature and rainfall data for the months January 2006 through December 2007 were collected from the nearest available weather stations. Backwards stepwise regression was used to generate the minimal adequate model for explaining the monthly variation in P. argentipes populations. The seasonality of P. argentipes is similar in India and Nepal, with two annual density peaks around May and October. Monthly P. argentipes density is positively associated with temperature and negatively associated with rainfall in both study sites. The multivariate climate model explained 57% of the monthly vectorial abundance. Vector control programs against P. argentipes (i.e., indoor residual spraying) should take into account the seasonal described here when implementing and monitoring interventions. Monitoring simple meteorological variables (i.e., temperature, rainfall) may allow prediction of VL epidemics on the Indian subcontinent.

Literacy and motivation for the prevention and control of hypertension among female community health volunteers: a qualitative study from Nepal.

PubMed

Neupane, Dinesh; Mclachlan, Craig S; Gautam, Rupesh; Mishra, Shiva Raj; Thorlund, Michael; Schlütter, Mette; Kallestrup, Per

2015-01-01

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). To assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs. 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. 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. 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.

Feminization and marginalization? Women Ayurvedic doctors and modernizing health care in Nepal.

PubMed

Cameron, Mary

2010-03-01

The important diversity of indigenous medical systems around the world suggests that gender issues, well understood for Western science, may differ in significant ways for non-Western science practices and are an important component in understanding how social dimensions of women's health care are being transformed by global biomedicine. Based on ethnographic research conducted with formally trained women Ayurvedic doctors in Nepal, I identify important features of medical knowledge and practice beneficial to women patients, and I discuss these features as potentially transformed by modernizing health care development. The article explores the indirect link between Ayurveda's feminization and its marginalization, in relation to modern biomedicine, which may evolve to become more direct and consequential for women's health in the country.

Women's empowerment in agriculture and child nutritional status in rural Nepal.

PubMed

Cunningham, Kenda; Ploubidis, George B; Menon, Purnima; Ruel, Marie; Kadiyala, Suneetha; Uauy, Ricardo; Ferguson, Elaine

2015-12-01

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, P<0·01), access to and decisions regarding credit (β=0·20, P=0·02) and autonomy in production (β=0·10, P=0·04). No indicator of women's empowerment 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.

The Household Costs of Visceral Leishmaniasis Care in South-eastern Nepal

PubMed Central

Baltussen, Rob; Rijal, Suman; Boelaert, Marleen

2013-01-01

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. PMID:23469298

Repeated glacial lake outburst flood threatening the oldest Buddhist monastery in north-western Nepal

NASA Astrophysics Data System (ADS)

Kropáček, J.; Neckel, N.; Tyrna, B.; Holzer, N.; Hovden, A.; Gourmelen, N.; Schneider, C.; Buchroithner, M.; Hochschild, V.

2015-10-01

Since 2004, Halji village, home of the oldest Buddhist Monastery in north-western Nepal, has suffered from recurrent glacial lake outburst floods (GLOFs). A sudden englacial drainage of a supraglacial lake, located at a distance of 6.5 km from the village, was identified as the source of the flood. The topography of the lake basin was mapped by combining differential Global Positioning System (DGPS) measurements with a structure-from-motion (SFM) approach using terrestrial photographs. From this model the maximum filling capacity of the lake has been estimated as 1.06 ×106 m3 with a maximum discharge of 77.8 m3 s-1, calculated using the empiric Clague-Mathews formula. A simulation of the flooded area employing a raster-based hydraulic model considering six scenarios of discharge volume and surface roughness did not result in a flooding of the village. However, both the village and the monastery are threatened by undercutting of the river bank formed by unconsolidated sediments, as it already happened in 2011. Further, the comparison of the GLOF occurrences with temperature and precipitation from the High Asia Reanalysis (HAR) data set for the period 2001-2011 suggests that the GLOF is climate-driven rather than generated by an extreme precipitation event. The calculation of geodetic mass balance and the analysis of satellite images showed a rapid thinning and retreat of Halji Glacier which will eventually lead to a decline of the lake basin. As the basin will persist for at least several years, effective mitigation measures should be considered. A further reinforcement of the gabion walls was suggested as an artificial lake drainage is not feasible given the difficult accessibility of the glacier.

Estimates of delays in diagnosis of cervical cancer in Nepal

PubMed Central

2014-01-01

Background Cervical cancer is the leading cause of cancer related deaths among women in Nepal. The long symptom to diagnosis interval means that women have advanced disease at presentation. The aim of this study was to identify, estimate and describe the extent of different delays in diagnosis of cervical cancer in Nepal. Methods A cross-sectional descriptive study was conducted in two tertiary cancer hospitals of Nepal. Face to face interview and medical records review were carried out among 110 cervical cancer patients. Total diagnostic delay was categorized into component delays: patient delay, health care providers delay, referral delay and diagnostic waiting time. Results Total 110 patients recruited in the study represented 40 districts from all three ecological regions of the country. Median total diagnostic delay was 157 days with more than three fourth (77.3%) of the patients having longer total diagnostic delay of >90 days. Out of the total diagnostic delay, median patient delay, median health care provider delay, median referral delay and median diagnostic waiting time were 68.5 days, 40 days, 5 days and 9 days respectively. Majority of the patients had experienced longer delay of each type except referral delay. Fifty seven percent of the patients had experienced longer patient delay of >60 days, 90% had suffered longer health care provider delay of >1 week, 31.8% had longer referral delay of >1 week and 66.2% had waited >1 week at diagnostic center for final diagnosis. Variation in each type of delay was observed among women with different attributes and in context of health care service delivery. Conclusions Longer delays were observed in all the diagnostic pathways except for referral delay and diagnostic waiting time. Among the delays, patient delay is of crucial importance because of its longer span, although health care provider delay is equally important. In the context of limited screening services in Nepal, the efforts should be to

Do mobile family planning clinics facilitate vasectomy use in Nepal?

PubMed

Padmadas, Sabu S; Amoako Johnson, Fiifi; Leone, Tiziana; Dahal, Govinda P

2014-06-01

Nepal has a distinct topography that makes reproductive health and family planning services difficult to access, particularly in remote mountain and hill regions where over a quarter of modern contraceptive users rely exclusively on vasectomy. A three-level random intercept logistic regression analysis was applied on data from the 2011 Nepal Demographic and Health Survey to investigate the extent of influence of mobile family planning clinics on the odds of a male or a female sterilization, adjusting for relevant characteristics including ecological differences and random effects. The analyses included a sample of 2014 sterilization users, considering responses from currently married women of reproductive ages. The odds of a male sterilization were significantly higher in a mobile clinic than those in a government hospital (odds ratio, 1.65; 95% confidence interval, 1.21-2.25). The effects remained unaltered and statistically significant after adjusting for sociodemographic and clustering effects. Random effects were highly significant, which suggest the extent of heterogeneity in vasectomy use at the community and district levels. The odds of vasectomy use in mobile clinics were significantly higher among couples residing in hill and mountain regions and among those with three or more sons or those with only daughters. Mobile clinics significantly increase the uptake of vasectomy in hard-to-reach areas of Nepal. Reproductive health interventions should consider mobile clinics as an effective strategy to improve access to male-based modern methods and enhance gender equity in family planning. Family planning interventions in hard-to-reach communities could consider mobile clinic as an effective strategy to promote male-based modern methods. Improving access to vasectomy could substantially reduce unmet need for family planning in countries experiencing rapid fertility transition. Copyright © 2014 Elsevier Inc. All rights reserved.

Chronic pain experience and pain management in persons with spinal cord injury in Nepal.

PubMed

Thapa, Sagun; Kitrungrote, Luppana; Damkliang, Jintana

2018-04-25

Chronic pain is the frequent and significantly challenging complications in persons with spinal cord injury (SCI). Socio-cultural background may lead people perceive and manage pain differently. The study aims to describe the chronic pain experience and pain management of SCI persons in Nepal. A descriptive cross sectional study was conducted among purposively selected sample of 120 SCI persons with chronic pain living in the eight districts of Bagmati Zone of Nepal. The data were collected using the International Spinal Cord Injury Pain Basic Data Set Version 2 (ISCIPBDS-2) and Open-ended Pain Management Questionnaire. The data were analyzed using descriptive statistics and content analysis method. The back (n=84), lower legs/feet (n=63) and buttocks/hips (n=51) was found as the common pain locations. In common, the onset of pain was found within the first 6 month of the injury. Overall pain intensity and pain interference were found to be at the moderate level. The SCI persons used pain medications and non-pharmacological pain management. Ibuprofen was the commonly used pain medication and commonly used non-pharmacological pain management methods included physical support (e.g. massage, exercise), relaxation (e.g. distraction, substance abuse), coping (e.g. acceptance, praying), and traditional herbs. SCI persons had chronic pain experience which interfered with their daily living. They used pain medications and non-pharmacological pain management methods based on their beliefs, knowledge, and community resources in Nepal. This study provides some evidence to help the team of rehabilitation professional to plan and help SCI persons with chronic pain. Based on these findings, chronic pain management intervention for SCI persons should be developed and supported continuously from hospital to home based community context of Nepal.

Re-emergence of dengue virus serotype 2 strains in the 2013 outbreak in Nepal

PubMed Central

Gupta, Birendra Prasad; Singh, Sneha; Kurmi, Roshan; Malla, Rajani; Sreekumar, Easwaran; Manandhar, Krishna Das

2015-01-01

Background & objectives: Epidemiological interventions and mosquito control are the available measures for dengue control. The former approach uses serotype and genetic information on the circulating virus strains. Dengue has been frequently reported from Nepal, but this information is mostly lacking. The present study was done to generate a comprehensive clinical and virological picture of a dengue outbreak in Nepal during 2013. Methods: A hospital-based study involving patients from five districts of Nepal was carried out. Demographic information, clinical details and dengue serological status were obtained. Viral RNA was characterized at the molecular level by reverse-transcription polymerase chain reaction (RT-PCR), nucleotide sequencing and phylogenetic analysis. Results: From among the 2340 laboratory-confirmed dengue cases during the study period, 198 patients consented for the study. Clinically they had fever (100%), headache (59.1%), rashes (18.2%), retro-orbital pain (30.3%), vomiting (15.1%), joint pain (28.8%) and thrombocytopenia (74.3%). Fifteen (7.5%) of them had mucosal bleeding manifestations, and the rest were uncomplicated dengue fever. The patients were mostly adults with a mean age of 45.75 ± 38.61 yr. Of the 52 acute serum samples tested, 15 were positive in RT-PCR. The causative virus was identified as DENV serotype 2 belonging to the Cosmopolitan genotype. Interpretations & conclusions: We report here the involvement of DENV serotype 2 in an outbreak in Nepal in 2013. Earlier outbreaks in the region in 2010 were attributed to serotype 1 virus. As serotype shifts are frequently associated with secondary infections and severe disease, there is a need for enhancing surveillance especially in the monsoon and post-monsoon periods to prevent large-scale, severe dengue outbreaks in the region. PMID:26905233

Prevalence and Associated Factors of Hypertension: A Community-Based Cross-Sectional Study in Municipalities of Kathmandu, Nepal

PubMed Central

Pandey, Achyut Raj; Devkota, Surya

2016-01-01

Objective. This study aimed to assess the prevalence and associated factors of hypertension in newly declared municipalities of Kathmandu, Nepal. Design, Settings, and Participants. This was a community-based cross-sectional study conducted in the municipalities of Kathmandu District, Nepal, between January and July 2015. Study participants were aged 18 to 70 years, residing permanently in the study sites. Municipalities, Wards, households, and respondents were selected randomly. Results. Of the 587 participants, 58.8% were females, mean (SD) age was 42.3 (13.5) years, 29.3% had no formal education, 35.1% were Brahmins, and 41.2% were homemakers. Prevalence of hypertension was 32.5% (95% CI: 28.7–36.3). Age, gender, education, ethnicity, occupation, smoking, alcohol consumption, physical activity, diabetes, menopausal history, and family history of cardiovascular disease (CVD) and hypertension were significantly associated with hypertension. In multivariable analysis, smoking, alcohol consumption, physical activity, body mass index, and diabetes were identified as significant explanatory variables for hypertension. Conclusion. This study demonstrated that the people living in newly established municipalities of Kathmandu, Nepal, have a high burden of hypertension as well as its associated factors. Therefore, community-based preventive approaches like lifestyle modification and early detection and treatment of hypertension might bring a substantial change in tackling the burden effectively. PMID:27293880

Fitting Community Based Newborn Care Package into the health systems of Nepal.

PubMed

Pradhan, Y V; Upreti, S R; Kc, N P; Thapa, K; Shrestha, P R; Shedain, P R; Dhakwa, J R; Aryal, D R; Aryal, S; Paudel, D C; Paudel, D; Khanal, S; Bhandari, A; Kc, A

2011-10-01

Community-based strategies for delivering effective newborn interventions are an essential step to avert newborn death, in settings where the health facilities are unable to effectively deliver the interventions and reach their population. Effective implementation of community-based interventions as a large scale program and within the existing health system depends on the appropriate design and planning, monitoring and support systems. This article provides an overview of implementation design of Community-Based Newborn Care Package (CB-NCP) program, its setup within the health system, and early results of the implementation from one of the pilot districts. The evaluation of CB-NCP in one of the pilot districts shows significant improvement in antenatal, intrapartum and post natal care. The implementation design of the CB-NCP has six different health system management functions: i) district planning and orientation, ii) training/human resource development, iii) monitoring and evaluation, iv) logistics and supply chain management, v) communication strategy, and vi) pay for performance. The CB-NCP program embraced the existing system of monitoring with some additional components for the pilot phase to test implementation feasibility, and aligns with existing safe motherhood and child health programs. Though CB-NCP interventions are proven independently in different local and global contexts, they are piloted in 10 districts as a "package" within the national health system settings of Nepal.

Assessment of Nutritional Status of Children Under Five years of age in rural Nepal.

PubMed

Chataut, J; Khanal, K

2016-01-01

Background Nutritional status of children is one of the major predictors of child survival. However, malnutrition is a major public health problem in most of the developing countries and occurs prominently among under-five children. In context of Nepal, nearly 37% children are suffering from underweight, 41% from stunting and 11% are suffering from wasting. These children are at a substantially greater risk of severe acute malnutrition and death. Objective The objective of the study was to assess the nutritional status of children under five years of age and to find the factors associated with malnutrition. Method A cross-sectional study was conducted in Dolakha and Kavre districts of Nepal for assessing the nutritional status of under-five children and associated factors. A total of 243 under five children were included from two purposively selected village development committees (VDCs) i.e. one from each district. Statistical Package for the Social Sciences (SPSS) 22 Version and ENA Software Version 2011 were used for analyzing the data. Result Out of 243 children, according to WHO based on weight for height assessment, 17 (7.0%) were wasted, in height for age analysis, 97 (39.9%) were stunted and in weight for age assessment, 46 (18.9%) were underweight. Conclusion In the study population, there is high prevalence of malnutrition, especially stunting among under-five. Taking into account weight, height, age, and mid upper arm circumference (MUAC) measurements of malnourished children more than threefifths of them were found below -2SD and nearly one-fourths below -3SD which needs intervention.

Prevalence and correlates of tobacco use amongst junior collegiates in twin cities of western Nepal: A cross-sectional, questionnaire-based survey

PubMed Central

Sreeramareddy, Chandrashekhar T; Kishore, PV; Paudel, Jagadish; Menezes, Ritesh G

2008-01-01

Background College students are vulnerable to tobacco addiction. Tobacco industries often target college students for marketing. Studies about prevalence of tobacco use and its correlates among college students in Nepal are lacking. Methods A cross-sectional survey was carried out in two cities of western Nepal during January-March, 2007. A pre-tested, anonymous, self-administered questionnaire (in Nepali) adapted from Global Youth Tobacco Survey (GYTS) and a World Bank study was administered to a representative sample of 1600 students selected from 13 junior colleges by two-stage stratified random sampling. Results Overall prevalence of 'ever users' of tobacco products was 13.9%. Prevalence among boys and girls was 20.5% and 2.9% respectively. Prevalence of 'current users' was 10.2% (cigarette smoking: 9.4%, smokeless products: 6.5%, and both forms: 5.7%). Median age at initiation of cigarette smoking and chewable tobacco was 16 and 15 years respectively. Among the current cigarette smokers, 58.7% (88/150) were smoking at least one cigarette per day. Most (67.8%) 'Current users' purchased tobacco products by themselves from stores or got them from friends. Most of them (66.7%) smoked in tea stalls or restaurants followed by other public places (13.2%). The average daily expenditure was 20 Nepalese rupees (~0.3 USD) and most (59%) students reported of having adequate money to buy tobacco products. Majority (82%) of the students were exposed to tobacco advertisements through magazines/newspapers, and advertising hoardings during a period of 30 days prior to survey. The correlates of tobacco use were: age, gender, household asset score and knowledge about health risks, family members, teachers and friends using tobacco products, and purchasing tobacco products for family members. Conclusion School/college-based interventions like counseling to promote cessation among current users and tobacco education to prevent initiation are necessary. Enforcement of legislations

Prevalence and correlates of tobacco use amongst junior collegiates in twin cities of western Nepal: a cross-sectional, questionnaire-based survey.

PubMed

Sreeramareddy, Chandrashekhar T; Kishore, Pv; Paudel, Jagadish; Menezes, Ritesh G

2008-03-26

College students are vulnerable to tobacco addiction. Tobacco industries often target college students for marketing. Studies about prevalence of tobacco use and its correlates among college students in Nepal are lacking. A cross-sectional survey was carried out in two cities of western Nepal during January-March, 2007. A pre-tested, anonymous, self-administered questionnaire (in Nepali) adapted from Global Youth Tobacco Survey (GYTS) and a World Bank study was administered to a representative sample of 1600 students selected from 13 junior colleges by two-stage stratified random sampling. Overall prevalence of 'ever users' of tobacco products was 13.9%. Prevalence among boys and girls was 20.5% and 2.9% respectively. Prevalence of 'current users' was 10.2% (cigarette smoking: 9.4%, smokeless products: 6.5%, and both forms: 5.7%). Median age at initiation of cigarette smoking and chewable tobacco was 16 and 15 years respectively. Among the current cigarette smokers, 58.7% (88/150) were smoking at least one cigarette per day. Most (67.8%) 'Current users' purchased tobacco products by themselves from stores or got them from friends. Most of them (66.7%) smoked in tea stalls or restaurants followed by other public places (13.2%). The average daily expenditure was 20 Nepalese rupees (approximately 0.3 USD) and most (59%) students reported of having adequate money to buy tobacco products. Majority (82%) of the students were exposed to tobacco advertisements through magazines/newspapers, and advertising hoardings during a period of 30 days prior to survey. The correlates of tobacco use were: age, gender, household asset score and knowledge about health risks, family members, teachers and friends using tobacco products, and purchasing tobacco products for family members. School/college-based interventions like counseling to promote cessation among current users and tobacco education to prevent initiation are necessary. Enforcement of legislations to decrease availability

A new experimental community pharmacy internship module for undergraduate pharmacy students in western Nepal: overview and reflections.

PubMed

Timsina, Sangita; K C, Bhuvan; Adhikari, Dristi; Alrasheedy, Alian A; Mohamed Ibrahim, Mohamed Izham; Kaundinnyayana, Atisammodavardhana

2017-01-01

Community pharmacies in Nepal and other South Asian countries are in a mediocre state due to poor regulation and the fact that many pharmacies are run by people with insufficient training in dispensing. This has led to the inappropriate use of medicines. The problems due to poor regulation and the mediocre state of community pharmacies in South Asia encompass both academia and clinical practice. In this paper, a 2-week community pharmacy internship programme completed by 2 graduating pharmacy students of Pokhara University (a Nepalese public university) at Sankalpa Pharmacy, Pokhara, Nepal is illustrated. During the internship, they were systematically trained on store management, pharmaceutical care, counselling skills, the use of medical devices, pharmaceutical business plans, medicine information sources, and adverse drug reaction reporting. An orientation, observations and hands-on training, case presentation, discussion, and feedback from 2 senior pharmacists were used as the training method. A proper community pharmacy internship format, good pharmacy practice standards, and a better work environment for pharmacists may improve the quality of community pharmacies.

A new experimental community pharmacy internship module for undergraduate pharmacy students in western Nepal: overview and reflections

PubMed Central

2017-01-01

Community pharmacies in Nepal and other South Asian countries are in a mediocre state due to poor regulation and the fact that many pharmacies are run by people with insufficient training in dispensing. This has led to the inappropriate use of medicines. The problems due to poor regulation and the mediocre state of community pharmacies in South Asia encompass both academia and clinical practice. In this paper, a 2-week community pharmacy internship programme completed by 2 graduating pharmacy students of Pokhara University (a Nepalese public university) at Sankalpa Pharmacy, Pokhara, Nepal is illustrated. During the internship, they were systematically trained on store management, pharmaceutical care, counselling skills, the use of medical devices, pharmaceutical business plans, medicine information sources, and adverse drug reaction reporting. An orientation, observations and hands-on training, case presentation, discussion, and feedback from 2 senior pharmacists were used as the training method. A proper community pharmacy internship format, good pharmacy practice standards, and a better work environment for pharmacists may improve the quality of community pharmacies. PMID:28811395

Identifying acceptability and price points for purchasing micronutrient powders for children 2 to 5 years old in Nepal

PubMed Central

Gunnala, Rajni; Perrine, Cria G; Subedi, Giriraj; Mebrahtu, Saba; Dahal, Pradiumna; Jefferds, Maria Elena

2017-01-01

Background and Objective Little is known about purchasing micronutrient powders (MNP) for children 2–5 years. We describe acceptability for purchasing and price points for MNP for children 2–5 years among caregivers living in districts where free MNP are distributed for children 6–23 months. Methods and Study Design Cross-sectional surveys conducted 3 months after MNP program implementation in 2 districts; 15 months after implementation in 2 different districts. Chi square tests and logistic regression describe associations among socio-demographics and program exposure factors and acceptability of purchasing MNP among 1,261 mothers of children 6–23 months who had heard of MNP. Results Overall, 77.5% and 86.1% of mothers reported acceptability for purchasing MNP in the 3 and 15 month surveys, respectively. Positive pricing attitude (PPA) about paying 150 Nepali rupees for 60 sachets of MNP was reported by 66.3% and 73.4% of mothers. Acceptability for purchasing MNP in both time periods increased with higher wealth quintile and higher maternal education; PPA increased with higher maternal education. Controlling for socio-demographics, program exposure factors associated with acceptability for purchasing MNP included: lack of perceived barriers to MNP intake and health worker counselling (3 month surveys); knowledge of benefits of MNP intake and lack of perceived barriers to MNP intake (15 month surveys). Conclusions Mothers reported acceptability for purchasing MNP and PPA for older children in Nepal. Differences in acceptability were found across socio-demographics and program exposures. Use of these results and further exploration into actual purchasing behaviour can inform future MNP distribution methods in Nepal. PMID:28049270

Smartphone tool to collect repeated 24 h dietary recall data in Nepal.

PubMed

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

2018-02-01

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.

Integration of Remote Sensing Products with Ground-Based Measurements to Understand the Dynamics of Nepal's Forests and Plantation Sites

NASA Astrophysics Data System (ADS)

Gilani, H.; Jain, A. K.

2016-12-01

This study assembles information from three sources - remote sensing, terrestrial photography and ground-based inventory data, to understand the dynamics of Nepal's tropical and sub-tropical forests and plantation sites for the period 1990-2015. Our study focuses on following three specific district areas, which have conserved forests through social and agroforestry management practices: 1. Dolakha district: This site has been selected to study the impact of community-based forest management on land cover change using repeat photography and satellite imagery, in combination with interviews with community members. The study time period is during the period 1990-2010. We determined that satellite data with ground photographs can provide transparency for long term monitoring. The initial results also suggests that community-based forest management program in the mid-hills of Nepal was successful. 2. Chitwan district: Here we use high resolution remote sensing data and optimized community field inventories to evaluate potential application and operational feasibility of community level REDD+ measuring, reporting and verification (MRV) systems. The study uses temporal dynamics of land cover transitions, tree canopy size classes and biomass over a Kayar khola watershed REDD+ study area with community forest to evaluate satellite Image segmentation for land cover, linear regression model for above ground biomass (AGB), and estimation and monitoring field data for tree crowns and AGB. We study three specific years 2002, 2009, 2012. Using integration of WorldView-2 and airborne LiDAR data for tree species level. 3. Nuwakot district: This district was selected to study the impact of establishment of tree plantation on total barren/fallow. Over the last 40 year, this area has went through a drastic changes, from barren land to forest area with tree species consisting of Dalbergia sissoo, Leucaena leucocephala, Michelia champaca, etc. In 1994, this district area was registered

Knowledge, attitude and practice regarding dengue fever among the healthy population of highland and lowland communities in central Nepal.

PubMed

Dhimal, Meghnath; Aryal, Krishna Kumar; Dhimal, Mandira Lamichhane; Gautam, Ishan; Singh, Shanker Pratap; Bhusal, Chop Lal; Kuch, Ulrich

2014-01-01

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.

Knowledge, Attitude and Practice Regarding Dengue Fever among the Healthy Population of Highland and Lowland Communities in Central Nepal

PubMed Central

Dhimal, Meghnath; Aryal, Krishna Kumar; Dhimal, Mandira Lamichhane; Gautam, Ishan; Singh, Shanker Pratap; Bhusal, Chop Lal; Kuch, Ulrich

2014-01-01

Background 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. Methods 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. Principal Findings 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). Conclusion 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. PMID:25007284

Demand and access to mental health services: a qualitative formative study in Nepal

PubMed Central

2014-01-01

Background Nepal is experiencing a significant ‘treatment gap’ in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. Methods This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. Results As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. Conclusions This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME’s integrated care plan advocate strategic

Student feedback on the use of paintings in Sparshanam, the Medical Humanities module at KIST Medical College, Nepal

PubMed Central

2011-01-01

Background Paintings have been used in Medical Humanities modules in Nepal at Manipal College of Medical Sciences and KIST Medical College. Detailed participant feedback about the paintings used, the activities carried out, problems with using paintings and the role of paintings in future modules has not been previously done. Hence the present study was carried out. Methods The present module for first year medical students was conducted from February to August 2010 at KIST Medical College, Nepal. Paintings used were by Western artists and obtained from the Literature, Arts and Medicine database. The activities undertaken by the students include answering the questions 'What do you see' and 'What do you feel' about the painting, creating a story of 100 words about the scene depicted, and interpreting the painting using role plays and poems/songs. Feedback was not obtained about the last two activities. In August 2010 we obtained detailed feedback about the paintings used. Results Seventy-eight of the 100 students (78%) participated. Thirty-four students (43.6%) were male. The most common overall comments about the use of paintings were "they helped me feel what I saw" (12 respondents), "enjoyed the sessions" (12 respondents), "some paintings were hard to interpret" (10 respondents) and "were in tune with module objectives" (10 respondents). Forty-eight (61.5%) felt the use of western paintings was appropriate. Suggestions to make annotations about paintings more useful were to make them shorter and more precise, simplify the language and properly introduce the artist. Forty-one students (52.6%) had difficulty with the exercise 'what do you feel'. Seventy-four students (94.9%) wanted paintings from Nepal to be included. Conclusions Participant response was positive and they were satisfied with use of paintings in the module. Use of more paintings from Nepal and South Asia can be considered. Further studies may be required to understand whether use of paintings

Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey.

PubMed

Shrestha, Akina; Sharma, Subodh; Gerold, Jana; Erismann, Séverine; Sagar, Sanjay; Koju, Rajendra; Schindler, Christian; Odermatt, Peter; Utzinger, Jürg; Cissé, Guéladio

2017-01-18

This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8-7.6), free and total residual chlorine (0.1-0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren's homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08-2.50; p = 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities.

Rights of the Child in Nepal.

ERIC Educational Resources Information Center

Schonveld, Ben

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the country of Nepal. The report's introductory summary asserts that although the Nepal government's passage of the Act to…

Land-Use and Socioeconomic Change, Medicinal Plant Selection and Biodiversity Resilience in Far Western Nepal

PubMed Central

Baral, Kedar; Paudel, Prashant; Acharya, Ram P.; Thapa-Magar, Khum B.; Cameron, Mary; Bussmann, Rainer W.

2016-01-01

Indigenous plant use-systems have evolved under, and constantly adapted to human and non-human impacts. In the last decades however, increasing socioeconomic and cultural transformations, including land-use change, outmigration, globalized markets, the introduction of new species, and climate change have led to a decreasing availability of indigenous resources, and are ultimately leading to a reduction of local use-knowledge. Participant observations, discussions, walks-in-the-woods, semi-structured interviews and informal meetings were carried out in 12 villages of far western Nepal between 2011 and 2015 to assess how sociocultural changes have affected the sustenance of indigenous systems and local biodiversity, when compared to studies carried out in the previous decades. Our findings show that there were no statistically significant differences in subject variable means, but differences were relatively important to plant parts-use and plant growth-forms (p = 0.183 and 0.088 respectively). Cissampelos pareira, Acorus calamus, Calotropis gigantea were found to have the greatest relative importance, whereas Ageratina adenophora, Melia azedarach, Carum carvi were most important based on use values. Among them, C. pareira and A. adenophora were introduced. The spatial distribution of species collected for medicine showed that all habitats were important for collection however, habitats close to villages were more favored. The use of non-indigenous and easily available species and more accessible habitats is becoming more prevalent as primary forests become increasingly overexploited, indigenous species become limited, and sociocultural cause of land use change expand. The utilization of indigenous and non-indigenous species and nearby habitats, although possibly affecting the quality of medicinal species, nonetheless reveals the dynamism of indigenous medicines as an adaptive asset mitigating human and non-human environmental changes. PMID:27936247

Land-Use and Socioeconomic Change, Medicinal Plant Selection and Biodiversity Resilience in Far Western Nepal.

PubMed

Kunwar, Ripu M; Baral, Kedar; Paudel, Prashant; Acharya, Ram P; Thapa-Magar, Khum B; Cameron, Mary; Bussmann, Rainer W

2016-01-01

Indigenous plant use-systems have evolved under, and constantly adapted to human and non-human impacts. In the last decades however, increasing socioeconomic and cultural transformations, including land-use change, outmigration, globalized markets, the introduction of new species, and climate change have led to a decreasing availability of indigenous resources, and are ultimately leading to a reduction of local use-knowledge. Participant observations, discussions, walks-in-the-woods, semi-structured interviews and informal meetings were carried out in 12 villages of far western Nepal between 2011 and 2015 to assess how sociocultural changes have affected the sustenance of indigenous systems and local biodiversity, when compared to studies carried out in the previous decades. Our findings show that there were no statistically significant differences in subject variable means, but differences were relatively important to plant parts-use and plant growth-forms (p = 0.183 and 0.088 respectively). Cissampelos pareira, Acorus calamus, Calotropis gigantea were found to have the greatest relative importance, whereas Ageratina adenophora, Melia azedarach, Carum carvi were most important based on use values. Among them, C. pareira and A. adenophora were introduced. The spatial distribution of species collected for medicine showed that all habitats were important for collection however, habitats close to villages were more favored. The use of non-indigenous and easily available species and more accessible habitats is becoming more prevalent as primary forests become increasingly overexploited, indigenous species become limited, and sociocultural cause of land use change expand. The utilization of indigenous and non-indigenous species and nearby habitats, although possibly affecting the quality of medicinal species, nonetheless reveals the dynamism of indigenous medicines as an adaptive asset mitigating human and non-human environmental changes.

An exemplary developing astronomy movement in Nepal

NASA Astrophysics Data System (ADS)

Neupane, Sudeep

2015-03-01

Astronomy and space science education had been given least importance by Nepalese government in the past. The modern astronomy movement is believed to have started when an official observation programme of Haley's comet was organized by Royal Nepal Academy of Science and Technology (RONAST) in 1986. Following the huge pressure from the scientific community, the Nepal government (Kingdom of Nepal at that time) established B.P. Koirala Memorial Planetarium, Observatory and Science Museum Development Board in 1992. Initiatives of the project started with observatory set up and the development of astrophysics syllabus for university students. Astrophysics is included as an elective paper in the Physics masters course. The lead astrophysicist of Nepal Dr. Binil Aryal is running a research group in Tribhuvan University since 2005 which has a significant number of international publications. The developing government initiatives and achievements will be discussed. In 2007, a group of astronomy enthusiastic students along with amateurs working independently in past established Nepal Astronomical Society (NASO), which surprisingly increased the amateur activities and inspired other amateur groups to revive. During IYA 2009, more than 80 outreach and observation events were organized solely by NASO. NASO was able to collaborate with many international programmes and projects like GHOU/GTTP, EurAstro, AWB, UNAWE, SGAC, Star Peace, TWAN etc during and beyond IYA2009. Currently Nepal is recognized as the most eventful country of outreach and astronomy education among the amateur community. The success story of the astronomy movement and the local difficulties while organizing the events will be explained.

Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case-control study.

PubMed

Pravana, Nilesh Kumar; Piryani, Suneel; Chaurasiya, Surendra Prasad; Kawan, Rasmila; Thapa, Ram Krishna; Shrestha, Sumina

2017-08-28

Malnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like Nepal. Children with severe acute malnutrition (SAM) are nine times more likely to die than children without malnutrition. The prevalence of SAM has increased in Nepal over the past 15 years; however, the determinants of SAM have not been clearly assessed in the country. To assess the determinants of SAM among children aged 6-59 months in the Bara district of Nepal. A community-based case-control study was conducted in 12 randomly selected Village Development Committees (VDCs) of the Bara district of Nepal. A random sample of 292 children aged 6-59 months (146 as cases and 146 as controls) from 12 VDCs were included in this study. The prevalence of SAM among children under the age of 5 years was 4.14%. The following factors were significantly associated with SAM: low socioeconomic status (adjusted odds ratio (AOR) 17.13, 95% CI 5.85 to 50.13); mother's age at birth <20 or >35 years (AOR 3.21, 95% CI 1.30 to 7.94); birth interval <24 months (AOR 4.09, 95% CI 1.87 to 8.97); illiterate father (AOR 3.65, 95% CI 1.62 to 8.20); bottle feeding (AOR 2.19, 95% CI 1.73 to 12.03); and not initiating complementary feeding at the age of 6 months (AOR 2.91, 95% CI 1.73 to 12.03). Mother's educational level, initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM. The mother's age at birth, birth interval, socioeconomic status, father's educational level and initiation of complementary feeding at the age of 6 months were important determinants of SAM among children. A multi-sector approach is essential to address SAM. There is a need for further studies not only focusing on SAM but also moderate acute malnutrition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

Environmental burden of diarrhoeal diseases due to unsafe water supply and poor sanitation coverage in Nepal.

PubMed

Aryal, K K; Joshi, H D; Dhimal, M; Singh, S P; Dhakal, P; Dhimal, B; Bhusal, C L

2012-05-01

Unsafe water and poor sanitation are major contributing factors of diarrhoea. Most of the water supply systems in urban and rural area of Nepal do not have basic water treatment facilities. This has resulted in frequent reports of fecal contamination in drinking water and outbreaks of waterborne diseases. The purpose of this study was to find out the burden of diarrhoeal diseases at different scenario of water supply system and sanitation status in Nepalese context. A cross-sectional study was conducted in four different districts of Nepal analyzing six different scenarios based on availability of water supply and sanitation status. Village Development Committees (VDCs) and community selection was made purposively and 360 households, 60 from each scenario were selected conveniently to achieve the required number. Within the selected household, the head of the household or any member above 18 years of age was interviewed using a structured questionnaire. Observation was done for toilet and water sources besides questionnaire method. Incidence of diarrhoea per 1000 population was found to be the highest in scenario-IV (Spring without toilet) with 204.89 followed by scenario-VI (Tube well without toilet) with 145.30, while it was less in scenario-I (Tap water with toilet) with 46.05. Accordingly, the burden of disease (YLD) was also found to be the highest in scenario-IV and the lowest in scenario-I. Most of the households didn't treat water before drinking. Hand washing practice was found to be more than 90% regardless of toilet availability. The greater risk of acquiring diarrhoeal disease and higher burden of disease in situation of unprotected water source and absence of toilet shows that these are still important contributing factors for diarrhoeal disease in Nepal. Use of sanitary toilets and protected water source are the important measures for diarrhoeal disease prevention in Nepal.

12 CFR 4.5 - District and field offices.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., northeast and southeast Iowa, central Kentucky, Michigan, Minnesota, eastern Missouri, North Dakota, Ohio..., Mississippi, Oklahoma, Tennessee, and Texas. Western District Office of the Comptroller of the Currency, 1225... and western Iowa, Kansas, western Missouri, Montana, Nebraska, Nevada, New Mexico, Oregon, South...

Low compliance with iron-folate supplementation among postpartum mothers of Nepal: an analysis of Nepal Demographic and Health Survey 2011.

PubMed

Khanal, Vishnu; Adhikari, Mandira; Karkee, Rajendra

2014-06-01

One in five maternal deaths are directly attributable to anaemia in the world. The World Health Organization recommends iron supplementation from the second trimester of pregnancy to 45 days after delivery. The aim of this study was to determine the compliance rate of iron-folate consumption and the factors associated with iron-folate consumption among post-natal mothers in Nepal. This study utilised the data of Nepal Demographic and Health Survey (NDHS) 2011. The NDHS 2011 is a cross sectional and nationally representative survey. Of the 4,148 respondents, only 20.7% consumed iron throughout the post-natal period for 45 days. Mothers who had higher and secondary education [adjusted Odd ratio (aOR) 3.101; 95% CI (2.268-4.240)]; had attended four or more antenatal care visits [aOR 9.406; 95% CI (5.552-15.938)]; lived in Far-western development region [aOR 1.822; 95% CI (1.387-2.395)]; delivered in health facility [aOR 1.335; 95% CI (1.057-1.687)]; and attended postnatal care [aOR 2.348; 95% CI (1.859-2.965)] were more likely to take iron for 45 days of postpartum. Intervention to increase the compliance with the postpartum iron-folate supplementation are required to avoid adverse pregnancy outcomes associated with poor iron status with especial focus on the mothers who delivered at homes and did not attend post-natal check up.

Distribution and habitat use of red panda in the Chitwan-Annapurna Landscape of Nepal.

PubMed

Bista, Damber; Shrestha, Saroj; Sherpa, Peema; Thapa, Gokarna Jung; Kokh, Manish; Lama, Sonam Tashi; Khanal, Kapil; Thapa, Arjun; Jnawali, Shant Raj

2017-01-01

In Nepal, the red panda (Ailurus fulgens) has been sparsely studied, although its range covers a wide area. The present study was carried out in the previously untapped Chitwan-Annapurna Landscape (CHAL) situated in central Nepal with an aim to explore current distributional status and identify key habitat use. Extensive field surveys conducted in 10 red panda range districts were used to estimate species distribution by presence-absence occupancy modeling and to predict distribution by presence-only modeling. The presence of red pandas was recorded in five districts: Rasuwa, Nuwakot, Myagdi, Baglung and Dhading. The predictive distribution model indicated that 1,904.44 km2 of potential red panda habitat is available in CHAL with the protected area covering nearly 41% of the total habitat. The habitat suitability analysis based on the probability of occurrence showed only 16.58% (A = 315.81 km2) of the total potential habitat is highly suitable. Red Panda occupancy was estimated to be around 0.0667, indicating nearly 7% (218 km2) of the total habitat is occupied with an average detection probability of 0.4482±0.377. Based on the habitat use analysis, altogether eight variables including elevation, slope, aspect, proximity to water sources, bamboo abundance, height, cover, and seasonal precipitation were observed to have significant roles in the distribution of red pandas. In addition, 25 tree species were documented from red panda sign plots out of 165 species recorded in the survey area. Most common was Betula utilis followed by Rhododendron spp. and Abies spectabilis. The extirpation of red pandas in previously reported areas indicates a need for immediate action for the long-term conservation of this species in CHAL.

School Districts Try a New Tack.

ERIC Educational Resources Information Center

Spitz, James A., Jr., Battaglia, Michael

1997-01-01

Politicians are increasingly pressuring school districts to improve instruction while holding down costs. To achieve this aim, western New York school districts are experimenting with mutual gains bargaining, an alternative negotiation process based on Roger Fisher and William Ury's 1991 book "Getting to Yes." Instead of bargaining from…

Status of intestinal parasitosis among hospital visiting patients in Deukhury Valley, Dang, Nepal.

PubMed

Khanal, L K; Rai, S K; Khanal, P R; Ghimire, G

2011-06-01

Intestinal parasitosis is highly prevalent among the general population in Nepal. This study aimed to assess the status of intestinal parasitosis among patients attending Deukhury Community Hospital, Lamahi, Dang, situated in the mid western region of Nepal. A total of 210 stool samples examined by direct smear technique were reported. The overall prevalence of intestinal parasitic infection was found to be 21.4% (M = 23.5% vs F = 19.3%). Children < 15 yrs age were infected more often as compared to > 60 yrs and 15-60 yrs aged people. Among adults, Entamoeba histolytica infection was found to be very high compared to high helminthic infection found among children. Finding showed that, the prevalence was significantly high (68.8%) among people having low socio-economic status compared to others (31.1%) (p < 0.05). Among various parasites detected, E. histolytica was the most common parasite (48.8%) followed by helminths, mainly Ascaris lumbricoides (31.1%), hookworm (13.3%), Trichuris trichiura (4.4%) and Taenia species (2.2%) respectively in the locality.

Student perception about working in rural Nepal after graduation: a study among first- and second-year medical students.

PubMed

Shankar, P Ravi; Thapa, Trilok P

2012-08-31

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. 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. 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. The majority of respondents were in favour of working in rural Nepal

Reading habits and attitude toward medical humanities of basic science students in a medical college in Western Nepal.

PubMed

Shankar, P Ravi; Dubey, Arun K; Mishra, P; Upadhyay, Dinesh K

2008-01-01

The Manipal College of Medical Sciences, Pokhara, Nepal, admits students from Nepal, India, Sri Lanka, and other countries to the undergraduate medical course. The present study sought to describe and explore reading habits of medical students during the first three semesters and obtain their views regarding inclusion of medical humanities in the course. The authors introduced a voluntary module in medical humanities to the fifth- and sixth-semester students. Gender, semester, and nationality of respondents were noted. Commonly read noncourse books (fiction and nonfiction) were noted. Student attitudes toward medical humanities were studied using a set of nine statements. A total of 165 of the 220 students (75%) participated. Indians followed by Nepalese were the most common nationalities. Romantic fiction and biography were most commonly read. The Alchemist and The Da Vinci Code were commonly read books. Students were in favor of inclusion of medical humanities in the curriculum. The median total score was 30 (maximum possible score = 45). Students read widely beyond their course. The possibility of introducing medical humanities in the curriculum should be explored.

Investigation of antimicrobial use pattern in the intensive treatment unit of a teaching hospital in western Nepal.

PubMed

Shankar, P Ravi; Partha, Praveen; Shenoy, Nagesh; Brahmadathan, K N

2003-11-01

Inappropriate use of antimicrobials is of special importance in the intensive treatment unit because of the large number of drugs prescribed, the chance for drug errors, and the likelihood of development of drug resistance. A total of 297 records of patients admitted to the intensive treatment unit of the Manipal teaching hospital, a tertiary care hospital in Pokhara, western Nepal, were studied to determine the prescribing frequency and rationality of use of antimicrobials. Patient outcome, duration of stay in the intensive treatment unit, and the age and sex distribution of the patients were also studied. Mean+/-SD drugs per patient was 3.4+/-1.8. About half (50.2%) of the patients received an antimicrobial; 84.6% of the antimicrobials were used without obtaining bacteriologic evidence of infection. The commonest organisms isolated on culture were Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus pneumoniae, and Staphylococcus aureus. A total of 28.9% of the antimicrobials were prescribed for lower respiratory tract infections on the basis of the putative site of infection; 61.9% of the antimicrobials were prescribed by the parenteral route and mainly the older generation of antimicrobials were used. In 39 of the 149 patients prescribed an antimicrobial, the use was irrational. Prescriber education to improve prescribing patterns and regular auditing of antimicrobial prescriptions to prevent their inappropriate use and unnecessary cost to the patients are required. The high percentage of inappropriate use of antimicrobials raises concerns about the development and spread of drug resistance, which must be addressed.

Mid-Late Holocene Asian monsoon variations recorded in the Lake Rara sediment, western Nepal

NASA Astrophysics Data System (ADS)

Nakamura, A.; Yokoyama, Y.; Maemoku, H.; Yagi, H.; Okamura, M.; Matsuoka, H.; Miyake, N.; Adhikari, D.; Dangol, V.; Miyairi, Y.; Obrochta, S.; Matsuzaki, H.; Ikehara, M.

2011-12-01

The Asian monsoon is an important component of the Earth's climate system to understand regional and global climate dynamics. While geological reconstructions indicate that the Asian summer monsoon intensity gradually decreased through the Holocene, a clear and coherent picture of millennial and centennial scale variability has yet to emerge (e.g., Overpeck and Cole, 2007). The Himalayas are a key location for understanding centennial to millennial scale variations in the Asian monsoon, yet few studies of the Holocene have been conducted in this sensitive area. Direct evidence for shifts in monsoonal wind strength is often limited to marine proxy records, while terrestrial reconstructions (e.g., lake levels and spleothems) focus on precipitation. Here, we present the first evidence of terrestrial summer monsoon wind strength changes from Lake Rara, western Nepal. The lake is located at 3,000m above sea level and has a maximum water depth of 168m. Lake Rara Mn/Ti data, a proxy for lake stratification, provide the first direct comparison of the Indian summer monsoon wind intensity between the terrestrial Himalayan region and the marine Arabian sea region (Gupta et al., 2003) during mid-late Holocene. Centennial to millennial scale variability found in those records are synchronous, with the weak wind intervals corresponding to drier periods of East Asian. Strong similarities between the Lake Rara monsoon record and the Dongge cave speleothems precipitation record (Wang et al., 2005) suggest that the influence of Indian summer monsoon penetrates into southeastern China, which should be taken into account when interpreting paleomonsoon reconstructions. Overpeck JT, Cole JE. 2007. Climate change - Lessons from a distant monsoon. Nature 445: 270-271. Gupta AK, Anderson DM, Overpeck JT. 2003. Abrupt changes in the Asian southwest monsoon during the Holocene and their links to the North Atlantic Ocean. Nature 421: 354-357. Wang YJ, Cheng H, Edwards RL, He YQ, Kong XG, An

Understanding Health Research Ethics in Nepal.

PubMed

Sharma, Jeevan Raj; Khatri, Rekha; Harper, Ian

2016-12-01

Unlike other countries in South Asia, in Nepal research in the health sector has a relatively recent history. Most health research activities in the country are sponsored by international collaborative assemblages of aid agencies and universities. Data from Nepal Health Research Council shows that, officially, 1,212 health research activities have been carried out between 1991 and 2014. These range from addressing immediate health problems at the country level through operational research, to evaluations and programmatic interventions that are aimed at generating evidence, to more systematic research activities that inform global scientific and policy debates. Established in 1991, the Ethical Review Board of the Nepal Health Research Council (NHRC) is the central body that has the formal regulating authority of all the health research activities in country, granted through an act of parliament. Based on research conducted between 2010 and 2013, and a workshop on research ethics that the authors conducted in July 2012 in Nepal as a part of the on-going research, this article highlights the emerging regulatory and ethical fields in this low-income country that has witnessed these increased health research activities. Issues arising reflect this particular political economy of research (what constitutes health research, where resources come from, who defines the research agenda, culture of contract research, costs of review, developing Nepal's research capacity, through to the politics of publication of data/findings) and includes questions to emerging regulatory and ethical frameworks. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

Promoting small towns for rural development: a view from Nepal.

PubMed

Bajracharya, B N

1995-06-01

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

Epidemic meningococcal disease: recommendations for travelers to Nepal.

PubMed

1985-03-08

In the Kathmandu Valley of Nepal, an epidemic of serogroup A meningococcal meningitis resulted in 875 cases and 95 deaths during the 1st 6 months of 1983. The overall annual attack rate was 103 cases/100,000 population; the case fatality ratio was 11%. The highest age-specific attack rate (223/100,000) occurred among children under age 1 year. 3 times as many cases occurred in Kathmandu during December 1983 and January 1984 as in the same period a year previously. A mass vaccination campaign was initiated on February 8, 1984, and 330,000 doses of bivalent A/C meningococcal vaccine were administered, achieving approximately 65% coverage of the target population. A marked decline in the number of meningitis cases occurred coincident with the initiation of the mass campaign. In 1985 meningococcal meningitis is occurring at a much lower rate than in 1984, but meningococcal disease among hikers now is being recognized. Over the January 1984-January 1985 period, 2 culture-confirmed and 4 clinically suspected cases of meningococcal disease were documented among tourists from western countries traveling in Nepal. Patients ranged in age from 16-40 years. 5 patients had evidence of meningococcemia; the other had meningitis alone. 2 patients died, and all became ill during or shortly after hiking outside kathmandu. 3 patients were from the US, 2 from Australia, and 1 from Switzerland. Tables present data on cases of specified notifiable diseases in the US.

Tablet e-Logbooks: Four Thousand Clinical Cases and Complications e-Logged by 14 Nondoctor Anesthesia Providers in Nepal.

PubMed

Shah, Shristi; Ross, Oliver; Pickering, Stephen; Knoble, Stephen; Rai, Indra

2017-10-01

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

Maternal and Neonatal Health Knowledge, Service Quality and Utilization: Findings from a Community Based Quasi-experimental Trial in Arghakhanchi District of Nepal.

PubMed

Shrestha, J R; Manandhar, D S; Manandhar, S R; Adhikari, D; Rai, C; Rana, H; Poudel, M; Pradhan, A

2015-01-01

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.

Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey

PubMed Central

Shrestha, Akina; Sharma, Subodh; Gerold, Jana; Erismann, Séverine; Sagar, Sanjay; Koju, Rajendra; Schindler, Christian; Odermatt, Peter; Utzinger, Jürg; Cissé, Guéladio

2017-01-01

This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8–7.6), free and total residual chlorine (0.1–0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren’s homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08–2.50; p = 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities. PMID:28106779

Increasing Science Literacy in Nepal

NASA Astrophysics Data System (ADS)

Lamsal, Jeevan

2016-07-01

Nepal, a small landlocked and one of the least developed countries in south Asia is curious with its neighbor's giant space missions. As for now, space mission is not imminent to Nepal at least for decade. Due to lack of proper education and the resources; space education is also not very effective. In the curriculum of Nepal, basic astronomy is included in the science book of middle school which consist only 5% of the total course and 10% in high school. However the total course has been mostly theoretical which has made this subject uninteresting and difficult among the students. The examinations in all education levels are practiced on the rote memorization of contents. Pokhara Astronomical Society (PAS) introduced new techniques in teaching with more practical approach. We helped students to construct bamboo telescopes and observe the night sky which brought tremendous interest in studying astronomy in middle school. Similarly in high schools we organized different kinds of webinar with renowned scientist from different parts of the world. We screened documentaries of space activities; we helped them to use online robotic telescopes by using internet. This eventually is creating more interest in students to study science and particularly astronomy in their higher studies. The use of mobile Apps and different satellite tracking website helped students determine the location of space objects and created more interest for detail study of them. We are now reaching thousands of students with different proceedings to popularize astronomy and generating interest to pursue higher education in this subject. As well as creating the scientific awareness and understanding among others who are not choosing science in their higher studies. This paper highlights the comparative study of advanced and practical approach of teaching over traditional approach. The results of survey suggest most students are interested in choosing science in their higher studies where practical

Bypassing birthing centres for child birth: a community-based study in rural Chitwan Nepal.

PubMed

Shah, Rajani

2016-10-21

Child delivery in a health facility is important to reduce maternal mortality. Bypassing nearby birthing facility to deliver at a hospital is common in developing countries including Nepal. Very little is known about the extent and determinants of bypassing the birthing centres in Nepal. This study measures the status of bypassing, characteristics of bypassers and their reasons for bypassing. A community-based cross-sectional study was carried out in six rural village development committees of Chitwan district of Nepal. Structured interviews were conducted with 263 mothers who had given birth at a health facility and whose nearest facility was a birthing centre. Descriptive statistics, univariate and multivariable logistic regression analysis were performed. More than half of the mothers had bypassed the nearer birthing centres to deliver at hospital. Living in plain area [aOR: 2.467; 95 % CI: 1.005-6.058], higher wealth index [aOR: 4.981; 95 % CI: 2.482-9.999], advantaged caste/ethnicity [aOR: 2.172; 95 % CI: 1.153-4.089], older age [aOR: 2.222; 95 % CI: 1.050-4.703] and first birth [aOR: 2.032; 95 % CI: 1.060-3.894] were associated with higher likelihood of bypassing. Among the reasons of bypassing as reported by the bypassers, lack of operation, video x-ray, and blood test facilities were the most common ones, followed by the lack of medicines/drugs and equipment, lack of skilled service provider, and inadequate physical facilities, among others. Quality of service at the birthing centres needs to be given a high consideration to increase their use as well as to ensure an equitable access to the quality care by all.

Association between socioeconomic status of mothers, food security, food safety practices and the double burden of malnutrition in the Lalitpur district, Nepal.

PubMed

Sarki, Mahesh; Robertson, Aileen; Parlesak, Alexandr

2016-01-01

The prevalence of childhood overweight and obesity is increasing in low-and middle income countries such as Nepal. At the same time, high prevalence of chronic undernutrition persists leading to a double burden of malnutrition. To identify associations between the socioeconomic status of mothers, food security, the food safety environment within the household, and prevalence of stunting and overweight of the children. Statistical analysis of socioeconomic, food safety-related and anthropometric data from 289 mother-child dyads in an urban area of the Kathmandu Valley, Nepal. According to WHO standards, 26 % of the children, aged 0-59 months, were stunted, 10 % were underweight, and 6.6 % were either overweight or obese. Significantly more boys than girls were underweight (p = 0.004) and stunted (p < 0.001). The higher education level of mothers was associated with a higher height-for-age (HAZ) score in girls, but not with HAZ in boys. Irrespective of sex, children of mothers with highest education level had significantly lower BMI-for-age scores (BAZ) than those of mothers with low education levels. None of the food safety indicators were associated with either HAZ or the BAZ. The education level of mothers seems to be relevant to help reduce the double burden of malnutrition at least in some regions of Nepal. This should be taken into consideration when designing programmes to prevent both chronic undernutrition and non-communicable diseases.

Comparison of pulmonary and extrapulmonary tuberculosis in Nepal- a hospital-based retrospective study.

PubMed

Sreeramareddy, Chandrashekhar T; Panduru, Kishore V; Verma, Sharat C; Joshi, Hari S; Bates, Michael N

2008-01-24

Studies from developed countries have reported on host-related risk factors for extra-pulmonary tuberculosis (EPTB). However, similar studies from high-burden countries like Nepal are lacking. Therefore, we carried out this study to compare demographic, life-style and clinical characteristics between EPTB and PTB patients. A retrospective analysis was carried out on 474 Tuberculosis (TB) patients diagnosed in a tertiary care hospital in western Nepal. Characteristics of demography, life-style and clinical features were obtained from medical case records. Risk factors for being an EPTB patient relative to a PTB patient were identified using logistic regression analysis. The age distribution of the TB patients had a bimodal distribution. The male to female ratio for PTB was 2.29. EPTB was more common at younger ages (< 25 years) and in females. Common sites for EPTB were lymph nodes (42.6%) and peritoneum and/or intestines (14.8%). By logistic regression analysis, age less than 25 years (OR 2.11 95% CI 1.12-3.68) and female gender (OR 1.69, 95% CI 1.12-2.56) were associated with EPTB. Smoking, use of immunosuppressive drugs/steroids, diabetes and past history of TB were more likely to be associated with PTB. Results suggest that younger age and female gender may be independent risk factors for EPTB in a high-burden country like Nepal. TB control programmes may target young and female populations for EPTB case-finding. Further studies are necessary in other high-burden countries to confirm our findings.

Comparison of pulmonary and extrapulmonary tuberculosis in Nepal- a hospital-based retrospective study

PubMed Central

Sreeramareddy, Chandrashekhar T; Panduru, Kishore V; Verma, Sharat C; Joshi, Hari S; Bates, Michael N

2008-01-01

Background Studies from developed countries have reported on host-related risk factors for extra-pulmonary tuberculosis (EPTB). However, similar studies from high-burden countries like Nepal are lacking. Therefore, we carried out this study to compare demographic, life-style and clinical characteristics between EPTB and PTB patients. Methods A retrospective analysis was carried out on 474 Tuberculosis (TB) patients diagnosed in a tertiary care hospital in western Nepal. Characteristics of demography, life-style and clinical features were obtained from medical case records. Risk factors for being an EPTB patient relative to a PTB patient were identified using logistic regression analysis. Results The age distribution of the TB patients had a bimodal distribution. The male to female ratio for PTB was 2.29. EPTB was more common at younger ages (< 25 years) and in females. Common sites for EPTB were lymph nodes (42.6%) and peritoneum and/or intestines (14.8%). By logistic regression analysis, age less than 25 years (OR 2.11 95% CI 1.12–3.68) and female gender (OR 1.69, 95% CI 1.12–2.56) were associated with EPTB. Smoking, use of immunosuppressive drugs/steroids, diabetes and past history of TB were more likely to be associated with PTB. Conclusion Results suggest that younger age and female gender may be independent risk factors for EPTB in a high-burden country like Nepal. TB control programmes may target young and female populations for EPTB case-finding. Further studies are necessary in other high-burden countries to confirm our findings. PMID:18218115

Effect of an educational intervention on knowledge and attitude regarding pharmacovigilance and consumer pharmacovigilance among community pharmacists in Lalitpur district, Nepal.

PubMed

Jha, Nisha; Rathore, Devendra Singh; Shankar, Pathiyil Ravi; Bhandary, Shital; Pandit, Rabi Bushan; Gyawali, Sudesh; Alshakka, Mohamed

2017-01-03

Pharmacovigilance activities are in a developing stage in Nepal. ADR reporting is mainly confined to healthcare professionals working in institutions recognized as regional pharmacovigilance centers. Community pharmacists could play an important role in pharmacovigilance. This study was conducted among community pharmacists in Lalitpur district to examine their knowledge and attitude about pharmacovigilance before and after an educational intervention. Knowledge and attitude was studied before, immediately after and 6 weeks following the intervention among 75 community pharmacists. Responses were analysed using descriptive and inferential statistics. A pretested questionnaire having twelve and nine statements for assessing knowledge and attitude were used. The overall scores were obtained by adding the 'knowledge' and 'attitude' scores and 'overall' scores were summarized using median and interquartile range. Wilcoxon signed-rank test for repeated samples was used to compare the differences between knowledge and attitude of the pharmacists before and after the educational program. Knowledge scores [median (interquartile range)] improved significantly between pre-test [39 (44-46)], post-test [44 (44-44)] and retention period of 6 weeks after the intervention [46 (43-46)]. Knowledge score improved immediately post-intervention among both males [44 (41-47)] and females [44 (43-45)] but the retention scores (after 6 weeks) were higher [46 (42-48)] among males. Attitude scores improved significantly among females [46 (44-48)]. The overall scores were higher among pharmacists from rural areas. Knowledge and attitude scores improved after the educational intervention. Further studies in other regions of the country are required. The national pharmacovigilance center should promote awareness about ADR reporting among community pharmacists.

Distribution and habitat use of red panda in the Chitwan-Annapurna Landscape of Nepal

PubMed Central

Sherpa, Peema; Thapa, Gokarna Jung; Kokh, Manish; Lama, Sonam Tashi; Khanal, Kapil; Thapa, Arjun; Jnawali, Shant Raj

2017-01-01

In Nepal, the red panda (Ailurus fulgens) has been sparsely studied, although its range covers a wide area. The present study was carried out in the previously untapped Chitwan-Annapurna Landscape (CHAL) situated in central Nepal with an aim to explore current distributional status and identify key habitat use. Extensive field surveys conducted in 10 red panda range districts were used to estimate species distribution by presence-absence occupancy modeling and to predict distribution by presence-only modeling. The presence of red pandas was recorded in five districts: Rasuwa, Nuwakot, Myagdi, Baglung and Dhading. The predictive distribution model indicated that 1,904.44 km2 of potential red panda habitat is available in CHAL with the protected area covering nearly 41% of the total habitat. The habitat suitability analysis based on the probability of occurrence showed only 16.58% (A = 315.81 km2) of the total potential habitat is highly suitable. Red Panda occupancy was estimated to be around 0.0667, indicating nearly 7% (218 km2) of the total habitat is occupied with an average detection probability of 0.4482±0.377. Based on the habitat use analysis, altogether eight variables including elevation, slope, aspect, proximity to water sources, bamboo abundance, height, cover, and seasonal precipitation were observed to have significant roles in the distribution of red pandas. In addition, 25 tree species were documented from red panda sign plots out of 165 species recorded in the survey area. Most common was Betula utilis followed by Rhododendron spp. and Abies spectabilis. The extirpation of red pandas in previously reported areas indicates a need for immediate action for the long-term conservation of this species in CHAL. PMID:29020020

Design and implementation of an affordable, public sector electronic medical record in rural Nepal.

PubMed

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

2017-06-23

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.

Design and implementation of an affordable, public sector electronic medical record in rural Nepal

PubMed Central

Raut, Anant; Yarbrough, Chase; Singh, Vivek; Gauchan, Bikash; Citrin, David; Verma, Varun; Hawley, Jessica; Schwarz, Dan; Harsha, Alex; Shrestha, Biplav; Schwarz, Ryan; Adhikari, Mukesh; Maru, Duncan

2018-01-01

Introduction 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. Development The 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. Application 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. Discussion Over 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. PMID:28749321

Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations.

PubMed

Fernandez, Ana; Gillespie, James A; Smith-Merry, Jennifer; Feng, Xiaoqi; Astell-Burt, Thomas; Maas, Cailin; Salvador-Carulla, Luis

2017-03-01

Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis

Detection of tectonometamorphic discontinuities within the Himalayan orogen: Structural and petrological constraints from the Rasuwa district, central Nepal Himalaya

NASA Astrophysics Data System (ADS)

Rapa, Giulia; Mosca, Pietro; Groppo, Chiara; Rolfo, Franco

2018-06-01

A detailed structural, lithological and petrological study of different transects in the Rasuwa district of central Nepal Himalaya allows the characterization of the tectonostratigraphic architecture of the area. It also facilitates constraining the P-T evolution of the different units within the Lesser (LHS) and Greater (GHS) Himalayan Sequences. Peak P-T conditions obtained for the studied metapelite samples using the pseudosection approach and the Average PT method highlight the existence of four different T/P ratio populations in different tectonometamorphic units: 80 ± 11 °C/kbar (LHS), 66 ± 7 °C/kbar (RTS), 73 ± 1 °C/kbar (Lower-GHS) and 101 ± 12 °C/kbar (Upper-GHS). Integration of structural and petrological data emphasizes the existence of three tectonometamorphic discontinuities bounding these units, characterized by top-to-the-south sense of shear: the Ramgarh Thrust, which separates the LHS (peak metamorphism at ∼600 °C, 7.5 kbar) from the overlying RTS (peak metamorphism at ∼635 °C, 10 kbar); the Main Central Thrust, which separates the RTS from the Lower-GHS (peak at 700-740 °C, 9.5-10.5 kbar with a prograde increase in both P and T in the kyanite stability field), and the Langtang Thrust, which juxtaposes the Upper-GHS (peak at 780-800 °C, 7.5-8.0 kbar with a nearly isobaric heating in the sillimanite stability field) onto the Lower-GHS. An increase in the intensity of deformation, with development of pervasive mylonitic fabrics and/or shear zones, is generally observed approaching the discontinuities from either side. Overall, data and results presented in this paper demonstrate that petrological and structural analysis combined together, are reliable methods adequate to identify tectonometamorphic discontinuities in both the LHS and GHS. Geochronological data from the literature allow the interpretation of these discontinuities as in-sequence thrusts.

Communicating awareness of light pollution with the schools in Nepal

NASA Astrophysics Data System (ADS)

Acharya, Jayanta

2015-08-01

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.

Intimate partner violence during pregnancy and use of antenatal care among rural women in southern Terai of Nepal.

PubMed

Singh, Jitendra Kumar; Evans-Lacko, Sara; Acharya, Dilaram; Kadel, Rajendra; Gautam, Salila

2018-04-01

Underutilisation of antenatal care services due to intimate partner violence during pregnancy has been well documented elsewhere, but it is understudied in Nepal. Our study aimed at exploring the impact of intimate partner violence on antenatal care service utilisation in southern Terai of Nepal. A community-based cross-sectional study was performed in 6 village development committees in Dhanusha district, Nepal. A total of 426 pregnant women in their second trimester were selected using a multistage cluster sampling method. Multivariable regression analyses were used to examine the association between exposure to intimate partner violence and selected antenatal care services, adjusting for covariates. Among 426 pregnant women, almost three out of ten women (28.9%) were exposed to intimate partner violence at some point during their pregnancy. Pregnant women who were exposed to intimate partner violence were less likely to: register for antenatal care (OR 0.31; 95% CI (0.08-0.50)), take iron and folic acid (OR 0.55; 95% CI (0.12-0.90)), report dietary diversity (middle vs low: OR 0.34; 95% CI (0.11-0.58) and high vs low: OR 0.18; 95% CI (0.08-0.37)), have rest and sleep during day time (OR 0.47; 95% CI (0.61-0.58)), and attend mother's group meetings (OR 0.29; 95% CI (0.10-0.83)). Intimate partner violence during pregnancy is associated with low utilisation of antenatal care services. Therefore, effective strategies to prevent or reduce intimate partner violence during pregnancy is needed, which may lead to improved antenatal care service utilization in Nepal with healthier mothers and children's outcome. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Molecular and phylogenetic analyses of the liver amphistome Explanatum explanatum (Creplin, 1847) Fukui, 1929 in ruminants from Bangladesh and Nepal based on nuclear ribosomal ITS2 and mitochondrial nad1 sequences.

PubMed

Mohanta, U K; Rana, H B; Devkota, B; Itagaki, T

2017-07-01

Explanatum explanatum flukes, liver amphistomes of ruminants, cause significant economic loss in the livestock industry by inducing severe liver damage. A total of 66 flukes from 26 buffaloes and 7 cattle in four different geographic areas of Bangladesh and 20 flukes from 10 buffaloes in the Chitwan district of Nepal were subjected for analysis. The sequences (442 bp) of the second internal transcribed spacer (ITS2) of ribosomal DNA and the variable fragments (657 bp) of mitochondrial nicotinamide dehydrogenase subunit 1 (nad1) of E. explanatum flukes from Bangladesh and Nepal were analysed. The aim of this study was molecular characterization of the flukes and to elucidate their origin and biogeography. In the ITS2 region, two genotypes were detected among the flukes from Bangladesh, while flukes from Nepal were of only one genotype. Phylogenetic analyses inferred from the nad1 gene revealed that at least four divergent populations (groups I-IV) are distributed in Bangladesh, whereas two divergent populations were found to be distributed in Nepal. Fst values (pairwise fixation index) suggest that Bangladeshi and Nepalese populations of group I to IV are significantly different from each other; but within groups III and IV, the populations from Bangladesh and Nepal were genetically close. This divergence in the nad1 gene indicates that each lineage of E. explanatum from diverse geography was co-adapted during the multiple domestication events of ruminants. This study, for the first time, provides molecular characterization of E. explanatum in Bangladesh and Nepal, and may provide useful information for elucidating its origin and dispersal route in Asia.

Hearing loss is associated with decreased nonverbal intelligence in rural Nepal.

PubMed

Emmett, Susan D; Schmitz, Jane; Pillion, Joseph; Wu, Lee; Khatry, Subarna K; Karna, Sureshwar L; LeClerq, Steven C; West, Keith P

2015-01-01

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 < 0.001). Subjects with bilateral hearing loss scored an average of 3.16 points lower (95% confidence interval, -5.56 to -0.75; p = 0.01) than subjects with normal hearing after controlling for socioeconomic factors. There was no difference in nonverbal 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.

Dating and Sex among Emerging Adults in Nepal

ERIC Educational Resources Information Center

Regmi, Pramod R.; van Teijlingen, Edwin R.; Simkhada, Padam; Acharya, Dev R.

2011-01-01

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.…

Understanding effects of armed conflict on health outcomes: the case of Nepal

PubMed Central

2010-01-01

Objective There is abundance of literature on adverse effects of conflict on the health of the population. In contrast to this, sporadic data in Nepal claim improvements in most of the health indicators during the decade-long armed conflict (1996-2006). However, systematic information to support or reject this claim is scant. This study reviews Nepal's key health indicators before and after the violent conflict and explores the possible factors facilitating the progress. Methods A secondary analysis has been conducted of two demographic health surveys-Nepal Family Health Survey (NFHS) 1996 and Nepal Demographic and Health Survey (NDHS) 2006; the latter was supplemented by a study carried out by the Nepal Health Research Council in 2006. Results The data show Nepal has made progress in 16 out of 19 health indicators which are part of the Millennium Development Goals whilst three indicators have remained static. Our analysis suggests a number of conflict and non-conflict factors which may have led to this success. Conclusion The lessons learnt from Nepal could be replicable elsewhere in conflict and post-conflict environments. A nationwide large-scale empirical study is needed to further assess the determinants of Nepal's success in the health sector at a time the country experienced a decade of armed conflict. PMID:21122098

Vision science literature of Nepal in the database "Web of Science".

PubMed

Risal, S; Prasad, H N

2012-01-01

Vision Science is considered to be a quite developed discipline in Nepal, with much research currently in progress. Though the results of these endeavors are published in scientific journals, formal citation analyses have not been performed on works contributed by Nepalese vision scientists. To study Nepal's contribution to vision science literature in the database "Web of Science". The primary data source of this paper was Web of Science, a citation database of Thomas Reuters. All bibliometric analyses were performed with the help of Web of Science analysis service. In the current database of vision science literature, Nepalese authors contributed 112 publications to Web of Science, 95 of which were original articles. Pokharel GP had the highest number of citations among contributing authors of Nepal. Hennig A contributed the highest number of article as a first author. The Nepal Eye Hospital contributed the highest number of articles as an institution to the field of Vision Science. Currently, only two journals from Nepal including Journal of Nepal Medical Association (JAMA) are indexed in the Web of Science database (Sieving, 2012). To evaluate the total productivity of vision science literature from Nepal, total publication counts from national journals and articles indexed in other databases such as PubMed and Scopus must also be considered. © NEPjOPH.

Implementing Nepal's national building code—A case study in patience and persistence

USGS Publications Warehouse

Arendt, Lucy; Hortacsu, Ayse; Jaiswal, Kishor; Bevington, John; Shrestha, Surya; Lanning, Forrest; Mentor-William, Garmalia; Naeem, Ghazala; Thibert, Kate

2017-01-01

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.

Climate Change and Hydrology of a Snow-fed Watershed in Western Nepal

NASA Astrophysics Data System (ADS)

Pandey, V. P.; Bharati, L.; Dhaubanjar, S.

2017-12-01

Many river basins across the globe are experiencing varying degrees of impacts from climate change. Snow-fed watersheds are expected to be affected even more. Chamelia, a tributary of Mahakali river basin, is a snow-fed river in the western Nepal with catchment area of 1,603 km2above the confluence with Mahakali River. Forest cover (40%) and rainfed agriculture (28%) covers more than two-third of the watershed. Topography varies from 505 to 7,090 m. According to the data from Department of Electricity Development (DoED) this watershed contains 14 licensed hydropower projects of varying capacities. Climate change may affect various aspects of the hydropower project, all of which are hinged around hydrology. This study simulated hydrological response of Chamelia watershed using Soil and Water Assessment Tool (SWAT) as an input for a hydro-economic model to analyze the water-energy-food nexus. The model was calibrated for the period of 2001-2007 and validated for 2008-2013 and then used to examine the streamflow response to climate change. Future climates for near-future (2020-2045), mid-future (2046-2070) and far-future (2071-2095) were considered based on CSIRO-CCAM Regional Circulation Model (RCM), derived from ACCESS1, downloaded from South Asia Cordex for RCP4.5 and RCP8.5 scenarios and then bias corrected using linear scaling method. Results, based on climate date at Station-103 showed that maximum temperature under RCP4.5 (RCP8.5) scenario for near-, mid-, and far-futures are projected to increase by 1.2°C (1.4°C), 1.5°C (2.8°C), and 2.3°C (2.6°C), respectively, from the baseline. Minimum temperature for the same scenarios and future periods, in the same order, are projected to increase by 1.1°C (1.5°C), 2.1°C (3.6°C), and 2.5°C (4.7°C), respectively, from the baseline. Precipitation in the other hand under RCP4.5 (RCP8.5) scenario for near-, mid-, and far-futures are projected to increase by 10.2% (10.4%), 7.6% (13.6%), and 3.1% (12

Nepal moves mountains with literacy.

PubMed

Hanford, H

1992-01-01

Women's literacy in Nepal is 13% compared with 38% for men. 70% of children, primarily girls, enrolled in school drop out. Many girls are never enrolled. Nepal is a country with rapid population growth, poverty, and an eroding resource base. A description is given of the effective Chili Beti, a women's literacy program operated by the Nepalese government and UNICEF. The target is girl's not enrolled in the formal school system. Classes are conveniently arranged so as not to interfere with household life in a traditional, rural society. Classes begin in November and last for 6 months at a time of day agreeable to students and parents; this avoids a conflict with field work and household chores. The program began in 1983 in a few remote areas and has expanded to include 75 districts. 5000 girls have completed the course. Attendance rates are 86%, and 25% graduate into the primary school system. The goal is to reach 1.7 million out-of-school children by the year 2000, and to expand the program to include boys as well. Success is attributed to course material which is made relevant to girls' daily lives and builds simultaneously practical knowledge and self-confidence, i.e., building latrines or halting rat infestation. Songs and group activities (planting gardens) are used to reinforce classroom presentations. A unique feature of the program is the use of the cartoon character, Kamali, who is a young village girl engaging students while gradually acquiring skills and becoming a Chili Beti teacher herself. Kamali also mobilizes her community to fight soil erosion. After a year of lessons, a secret is revealed: that Kamali is a member of the lower caste; this instills hope that changes is possible. Teachers are also role models and are selected from the local area. There is a month long teacher training program involving recruitment of girls for the program and teaching in and out of a classroom setting. The program challenges attitudes about the appropriateness of

Postpartum hemorrhage prevention in Nepal: a program assessment.

PubMed

Rajbhandari, Swaraj Pradhan; Aryal, Kamal; Sheldon, Wendy R; Ban, Bharat; Upreti, Senendra Raj; Regmi, Kiran; Aryal, Shilu; Winikoff, Beverly

2017-06-05

In 2009, the Nepal Ministry of Health and Population launched a national program for prevention of postpartum hemorrhage (PPH) during home births that features advance distribution of misoprostol to pregnant women. In the years since, the government has scaled-up the program throughout much of the country. This paper presents findings from the first large-scale assessment of the effectiveness of the advance distribution program. Data collection was carried out in nine districts and all three ecological zones. To assess knowledge, receipt and use of misoprostol, household interviews were conducted with 2070 women who had given birth within the past 12 months. To assess supply and provision of misoprostol, interviews were conducted with 270 Female Community Health Volunteers (FCHVs) and staff at 99 health facilities. Among recently delivered women, only 15% received information about misoprostol and 13% received misoprostol tablets in advance of delivery. Yet 87% who received advance misoprostol and delivered at home used it for PPH prevention. Among FCHVs, 96% were providing advance misoprostol for PPH prevention; however 81% had experienced at least one misoprostol stock out within the past year. About one-half of FCHVs were providing incomplete information about the use of misoprostol; in addition, many did not discuss side effects, how to recognize PPH or where to go if PPH occurs. Among health facilities, just one-half had sufficient misoprostol stock, while 95% had sufficient oxytocin stock, at the time of this assessment. In Nepal, women who receive advance misoprostol are both willing and able to use the medication for PPH prevention during home births. However the supply and personnel challenges identified raise questions about scalability and impact of the program over the long-term. Further assessment is needed.

Electrocardiography in people living at high altitude of Nepal

PubMed Central

Aryal, Nirmal; Weatherall, Mark; Bhatta, Yadav Kumar Deo; Mann, Stewart

2017-01-01

Objective The main objective of this study was to estimate the prevalence of coronary heart disease (CHD) of high-altitude populations in Nepal determined by an ECG recordings and a medical history. Methods We carried out a cross-sectional survey of cardiovascular disease and risk factors among people living at four different altitude levels, all above 2800 m, in the Mustang and Humla districts of Nepal. 12-lead ECGs were recorded on 485 participants. ECG recordings were categorised as definitely abnormal, borderline or normal. Results No participant had Q waves to suggest past Q-wave infarction. Overall, 5.6% (95% CI 3.7 to 8.0) of participants gave a self-report of CHD. The prevalence of abnormal (or borderline abnormal) ECG was 19.6% (95% CI 16.1 to 23.4). The main abnormalities were: right axis deviation in 5.4% (95% CI 3.5 to 7.7) and left ventricular hypertrophy by voltage criteria in 3.5% (95% CI 2.0 to 5.5). ECG abnormalities were mainly on the left side of the heart for Mustang participants (Tibetan origin) and on the right side for Humla participants (Indo-Aryans). There was a moderate association between the probability of abnormal (or borderline abnormal) ECG and altitude when adjusted for potential confounding variables in a multivariate logistic model; with an OR for association per 1000 m elevation of altitude of 2.83 (95% CI 1.07 to 7.45), p=0.03. Conclusions Electrocardiographic evidence suggests that although high-altitude populations do not have a high prevalence of CHD, abnormal ECG findings increase by altitude and risk pattern varies by ethnicity. PMID:28243317

Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda

PubMed Central

Mendenhall, Emily; De Silva, Mary J.; Hanlon, Charlotte; Petersen, Inge; Shidhaye, Rahul; Jordans, Mark; Luitel, Nagendra; Ssebunnya, Joshua; Fekadu, Abebaw; Patel, Vikram; Tomlinson, Mark; Lund, Crick

2014-01-01

Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care

Acceptability and feasibility of using non-specialist health workers to deliver mental health care: stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda.

PubMed

Mendenhall, Emily; De Silva, Mary J; Hanlon, Charlotte; Petersen, Inge; Shidhaye, Rahul; Jordans, Mark; Luitel, Nagendra; Ssebunnya, Joshua; Fekadu, Abebaw; Patel, Vikram; Tomlinson, Mark; Lund, Crick

2014-10-01

Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care

Advancement of Women in Post-Conflict Nepal

DTIC Science & Technology

2017-04-01

DANIEL K. INOUYE ASIA PACIFIC CENTER FOR SECURITY STUDIES OCCASIONAL PAPER, APRIL 2017 The Advancement of Women in Post -Conflict Nepal Lily Thapa1...in the lack of access to appropriate services and compensation, and in the way that female ex -combatants are treated and reintegrated...5,912 2,985 The Advancement of Women in Post -Conflict Nepal 2 reparation of victims of armed conflict and the provision of mechanisms for

Community development and livestock promotion in rural Nepal: effects on child growth and health.

PubMed

Miller, Laurie C; Joshi, Neena; Lohani, Mahendra; Rogers, Beatrice; Loraditch, Meghan; Houser, Robert; Singh, Padma; Mahato, Shubh

2014-09-01

More than 50% of children in Nepal are malnourished. Economic growth and poverty reduction are not always sufficient to improve the health and nutritional status of children. Heifer Nepal uses livestock training as a tool for community development and poverty alleviation but does not directly address child health and nutrition. To systematically assess the effects of Heifer activities on child health and nutrition. The study was a 2-year, longitudinal, randomized, controlled trial in six communities in Nepal (both Terai and hills), pair-matched for specific characteristics, randomly assigned to receive Heifer community development activities at baseline (intervention) or 1 year (control). At 6-month intervals over a period of 2 years, child anthropometric and comprehensive household surveys were performed. Four hundred fifteen households were enrolled containing 607 children 6 months to 5 years of age. The intervention and control communities were equivalent for baseline socioeconomic status, household size, ownership of land and animals, and child nutrition and health. At 12 months (prior to animal donations), the Terai intervention group had improved child weight (p = .04), improved child height (p = .05), and reduced sick days (p = .03), as well as increased household income (p = .004), increased ownership of animals (p = .04) and land (p = .04), and improved sanitation practices (p < .01). In all districts, longer participation in Heifer activities corresponded to more improvement in child height-for-age z-scores. Heifer interventions resulted in improved socioeconomic status and household income per family member. Children under 60 months of age in the intervention group had greater incremental improvement in height-for-age and weight-for-age z-scores than children in the control group, and longer participation in Heifer activities was associated with better growth. Poverty alleviation programs, such as Heifer, may indirectly benefit child growth.

Challenges to improving maternal health in rural Nepal.

PubMed

Thapa, S

1996-05-04

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

Administrator/Student Ratios in Large School Districts.

ERIC Educational Resources Information Center

Ornstein, Allan C.

1989-01-01

According to a survey of large school districts, the ratio of central office managers to students enrolled ranges from 1 administrator per 1,650 students to 1 administrator per 161 students. The average ratio was 1 administrator per 561 students. Western school districts appear most efficient. The ideal: 1 administrator per 1,000 to 1,200…

Teaching Field Geology in the Nepal Himalaya with a Geohazards and Intercultural Emphasis

NASA Astrophysics Data System (ADS)

Pratt-Sitaula, B. A.; Upreti, B. N.; Gajurel, A.

2017-12-01

SIT Study Abroad (School of International Training), in collaboration with Nepal's national university - Tribhuvan University, runs a seven-week summer field education called "Nepal: Geoscience in the Himalaya". The program is designed to teach core geoscience field skills as well as geohazard analysis and intercultural science collaboration. Approximately 70% of the students come from colleges across the USA and 30% come from Tribhuvan University. A key element of the learning is how to work effectively with colleagues from a different educational system and culture. The program starts with a four-day orientation in Kathmandu and then travels to the Kali Gandaki Valley of western Nepal. Everyone treks on foot while completing a geologic transect map from south to north across the main Himalayan range. More traditional field skills are learned during a detailed stratigraphic exercise. On the way back down the valley, the emphasis changes to surface processes and students complete an air photo analysis and small research project on human-earth system interactions. Once back on the road system, the students conduct both a landslide hazard analyses and an earthquake damage assessment. Throughout this time, students maintain a research ideas journal from which they develop an independent study project, which they carry out during the last two weeks of the program. The program particularly emphasizes affordable, sustainable solutions to geohazards that are appropriate for a developing country such as Nepal—a very eye-opening approach for students from the USA. The overall program mission is to promote geoscience field skill development in a societal context and more globally informed scientists, citizens, and leaders.

Defense.gov Special Report: Disaster Relief - Nepal Earthquake

Science.gov Websites

You have reached a collection of archived material. The content available is no longer being updated and may no longer be applicable as a result of changes in law, regulation and/or administration U.S. Troops Continue Aid, Relief in Nepal U.S. Troops Load Humanitarian Aid Supplies in Nepal U.S

Risk factors for early infant mortality in Sarlahi district, Nepal.

PubMed Central

Katz, Joanne; West, Keith P.; Khatry, Subarna K.; Christian, Parul; LeClerq, Steven C.; Pradhan, Elizabeth Kimbrough; Shrestha, Sharada Ram

2003-01-01

OBJECTIVES: Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS: Over the period 1994-97, 15,469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS: In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR = 1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR = 1.85, 95% CI 1.24-2.75). A larger maternal mid-upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR = 11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION: Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy. PMID:14758431

Strategic rehabilitation of the earthquake affected microhydropower plants in Nepal

NASA Astrophysics Data System (ADS)

Baidar, B.; Koirala, R.; Neopane, H. P.; Shrestha, M. V.; Thapa, B.

2016-11-01

Most people in the rural areas of Nepal rely on Micro-hydro Power Plants (MHPs) for their energy sources. With around four decade experiences in design and development of MHPs, Nepalese techno-entrepreneurs have gained wider reputation in the South Asian region and the beyond. However with the lack of competences in developing Francis turbines, majority of the MHPs are equipped with either Pelton of Cross Flow turbine, even though Francis units are suitable. With the devastating earthquake of a 7.6 magnitude that struck in the Gorkha district on Saturday, 25 April 2015, about 76 km northwest of the capital city Kathmandu, and the aftershocks followed claimed more than 8000 lives. It did not leave hydropower plants either. Many big plants have been affected and hundreds of MHPs were damaged, needing short to long term rehabilitation. The preliminary assessment of the 61 affected MHPs in the 6 earthquake affected districts shows more than 50% sites are suitable for Francis turbine. Hence the strategic rehabilitation plan has been developed in the present paper for the affected plants considering issues like geographical shift, dislocation of people and also with the focus on replacing the old turbine with Francis turbine in the suitable sites. The similar strategy can also be implemented in other developing countries with such situations.

Health Care Waste Management Practice in Health Care Institutions of Nepal.

PubMed

Joshi, H D; Acharya, T; Ayer, R; Dhakal, P; Karki, K B; Dhimal, M

2017-01-01

Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal. A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal. A structured questionnaire and observation checklist were used for data collection. The waste generation rate is found significantly correlated with bed capacity, patient flow rate and annual budget spent in the hospital. It is found significantly higher in Teaching hospital than other Health Care Institutions of Nepal. An average of 3.3 kg/day/patient of medical waste (2.0 kg/day/patient non-hazardous and 1.0 kg/day/patient hazardous waste) was generated during the study period. Further, it was found that most of the Health care wastes were not disinfected before transportation to waste disposal sites. Very limited number of Health Care Institutions had conducted Environmental Assessment. Similarly, some of the Health Care Institutions had not followed Health care waste management guideline 2009 of Nepal Government. We found poor compliance of medical waste management practice as per existing legislation of Government of Nepal. Hence, additional effort is needed for improvement of Health care waste management practice at Health Care Institutions of Nepal.

Attempts to bring the trained teachers in the schools of Nepal

NASA Astrophysics Data System (ADS)

Lamsal, Jeevan

2016-07-01

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

Disaster risk profile and existing legal framework of Nepal: floods and landslides

PubMed Central

Gaire, Surya; Castro Delgado, Rafael; Arcos González, Pedro

2015-01-01

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 improve the vulnerability of Nepal, an early warning system, mainstreaming disasters with development, research activities, community participation and awareness, and a rainfall monitoring system must all be a focus. PMID

Disaster risk profile and existing legal framework of Nepal: floods and landslides.

PubMed

Gaire, Surya; Castro Delgado, Rafael; Arcos González, Pedro

2015-01-01

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 improve the vulnerability of Nepal, an early warning system, mainstreaming disasters with development, research activities, community participation and awareness, and a rainfall monitoring system must all be a focus.

Health-sector responses to address the impacts of climate change in Nepal.

PubMed

Dhimal, Meghnath; Dhimal, Mandira Lamichhane; Pote-Shrestha, Raja Ram; Groneberg, David A; Kuch, Ulrich

2017-09-01

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.

The Maoist Insurgency in Nepal: 1996-2001

DTIC Science & Technology

2002-04-09

Indian border is 1660 kilometers long and crisscrossed with paths and local roads. The best land routes into Nepal are from the South. The Chinese...offered Mumbai and Kandla as ports for export, but this largesse is offered on the assumption of good behavior and the Indians are quick to punish too...much independence. India has been seen to subsume Sikkim, and coerce Bhutan and Nepal is determined not to be absorbed as an Indian satellite state. This

Hearing Loss is Associated with Decreased Nonverbal Intelligence in Rural Nepal

PubMed Central

Emmett, Susan D.; Schmitz, Jane; Pillion, Joseph; Wu, Lee; Khatry, Subarna K.; Karna, Sureshwar L.; LeClerq, Steven C.; West, Keith P.

2014-01-01

Objective Evaluate the association between adolescent and young adult hearing loss and nonverbal intelligence in rural Nepal Study Design Cross-sectional assessment of hearing loss among a population cohort of adolescents and young adults Setting Sarlahi District, southern Nepal Patients 764 individuals aged 14–23 years Intervention Evaluation of hearing loss, defined by WHO criteria of pure-tone average (PTA) >25 decibels (0.5, 1, 2, 4 kHz), unilaterally and bilaterally Main Outcome Measure Nonverbal intelligence, measured by the Test of Nonverbal Intelligence, 3rd Edition (TONI-3) standardized score (mean 100; standard deviation (SD) 15) Results 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 <0.001). Subjects with bilateral hearing loss scored an average of 3.16 points lower (95% CI: −5.56, −0.75; p =0.01) than subjects with normal hearing after controlling for socioeconomic factors. There was no difference in nonverbal intelligence score based on unilateral hearing loss (0.97; 95% CI: −1.67, 3.61; p =0.47). Conclusions Nonverbal intelligence is adversely affected by bilateral hearing loss, even at mild hearing loss levels. Social and economic well being appear compromised in individuals with lower nonverbal intelligence test scores. PMID:25299832

Blue sheep in the Annapurna Conservation Area, Nepal: habitat use, population biomass and their contribution to the carrying capacity of snow leopards.

PubMed

Aryal, Achyut; Brunton, Dianne; Ji, Weihong; Raubenheimer, David

2014-01-01

The Himalaya region of Nepal provides a habitat for the endangered snow leopard (Panthera uncia) and its principal prey species, the blue sheep (Pseudois nayaur). The aim of this study was to describe the habitat, the distribution and the population structure of blue sheep, and to estimate their contribution to the carrying capacity of snow leopard in the upper Mustang region of Nepal. Blue sheep were recorded at altitudes from 3209-5498 m on slopes with gradients of 16-60° and aspects of 40°NE to 140°SE. A total of 939 blue sheep were counted in the upper Mustang region, and 98 were counted in the Yak Kharka region of Manang district; however, upper Mustang had the lowest population density of blue sheep recorded within their distribution range in Nepal (0.86 blue sheep/km(2)). The results of the study show that a higher density of blue sheep is associated with greater plant species diversity. The most important species present in the blue sheep habitat were Kobresia pygmaea, Artemesia spp., Lonicera spp., Lancea tibetica, Poa spp., Astragalus spp. and Ephedra gerardiana. It is estimated that the existing blue sheep population biomass of approximately 38 925 kg in the upper Mustang region could support approximately 19 snow leopards (1.6 snow leopards/100 km(2)). © 2012 Wiley Publishing Asia Pty Ltd, ISZS and IOZ/CAS.

Association of Panton Valentine Leukocidin (PVL) genes with methicillin resistant Staphylococcus aureus (MRSA) in Western Nepal: a matter of concern for community infections (a hospital based prospective study).

PubMed

Bhatta, Dharm R; Cavaco, Lina M; Nath, Gopal; Kumar, Kush; Gaur, Abhishek; Gokhale, Shishir; Bhatta, Dwij R

2016-05-15

Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. Panton Valentine leukocidin (PVL) is considered one of the important virulence factors of S. aureus responsible for destruction of white blood cells, necrosis and apoptosis and as a marker of community acquired MRSA. This study was aimed to determine the prevalence of PVL genes among MRSA isolates and to check the reliability of PVL as marker of community acquired MRSA isolates from Western Nepal. A total of 400 strains of S. aureus were collected from clinical specimens and various units (Operation Theater, Intensive Care Units) of the hospital and 139 of these had been confirmed as MRSA by previous study. Multiplex PCR was used to detect mecA and PVL genes. Clinical data as well as antimicrobial susceptibility data was analyzed and compared among PVL positive and negative MRSA isolates. Out of 139 MRSA isolates, 79 (56.8 %) were PVL positive. The majority of the community acquired MRSA (90.4 %) were PVL positive (Positive predictive value: 94.9 % and negative predictive value: 86.6 %), while PVL was detected only in 4 (7.1 %) hospital associated MRSA strains. None of the MRSA isolates from hospital environment was found positive for the PVL genes. The majority of the PVL positive strains (75.5 %) were isolated from pus samples. Antibiotic resistance among PVL negative MRSA isolates was found higher as compared to PVL positive MRSA. Our study showed high prevalence of PVL among community acquired MRSA isolates. Absence of PVL among MRSA isolates from hospital environment indicates its poor association with hospital acquired MRSA and therefore, PVL may be used a marker for community acquired MRSA. This is first study from Nepal, to test PVL among MRSA isolates from hospital environment.

Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014.

PubMed

Shrestha, Sudeep; Thorne-Lyman, Andrew L; Manohar, Swetha; Shrestha, Binod; Neupane, Sumanta; Rajbhandary, Ruchita; Shrestha, Raman; Klemm, Rolf Dw; Nonyane, Bareng As; Adhikari, Ramesh K; Webb, Patrick; West, Keith P

2018-01-01

Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional status following the earthquake in Nepal in 2015. A multi-stage sample was drawn comprising 21 sites in 75 districts of the country, representing the mountains, hills and Terai zones, providing proportionate to zonal samples of 4286 and 4947 households and 5401 and 5474 preschool children in each year, respectively. Children 6 to 59 months of age were measured for weight and height, expressed as standardized z-scores for height-for-age (HAZ), weight-for-height (WHZ), and stunting and wasting (<-2 z for each). The household food insecurity access scale (HFIAS) was used to measure food security. Between 2013 and 2014, HAZ decreased from a mean (SD) of -1.46 (1.39) to -1.54 (1.33) z-scores, while the prevalence of stunting increased from 35.5% to 37.4% (p<0.05 for both), evident in the mountains and Terai but not hills. In both years, wasting was highest (~22%) in the Terai versus mountains or hills (~8%). More households were classified food secure in 2014 (73%) than 2013 (59%), evident in all zones. Two midyear surveys in Nepal revealed a stable nutritional situation among preschool children, reflecting a pause in the long-term decline in stunting noted in previous years. The same period saw a slight reduction in wasting and improved household food security.

Teaching English as a Foreign/Second Language in Nepal: Past and Present

ERIC Educational Resources Information Center

Bista, Krishna

2011-01-01

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…

Variable shortening on the Main Frontal Thrust in Nepal

NASA Astrophysics Data System (ADS)

Almeida, R. V.; Hubbard, J.; Lee, Y. S.; Liberty, L. M.; Paudel, L.; Shrestha, A.; Sapkota, S. N.; Joshi, G.

2017-12-01

The Main Frontal Thrust (MFT) is the youngest, most active, and southernmost thrust system in the Himalaya. It is located in the footwall of the Main Boundary thrust (MBT), deforming Miocene to Pliocene age Siwalik Group rocks. Although often considered a single, continuous fault, in reality as many as four subparallel faults, spaced 5-30 km apart, make up this fault system. Estimates of total shortening across the MFT for eastern and central Nepal vary from 15 to 40 km, based on cross-sections and surface measurements. However, when the same methods are applied, shortening does not vary significantly along strike (Hirschmiller et al., 2014), suggesting contrasting methodologies rather than a difference in interpreted along strike structural history. Based on high resolution seismic reflection imaging, we present new interpretations of total shortening recorded by the MFT system in central vs. eastern Nepal (200 km apart), together with a detailed transect of field observations in central Nepal. Our structural interpretations demonstrate that the geological shortening recorded on the MFT ranges from >20 km in central Nepal to <1 km in far eastern Nepal. Geodetic measurements show only a slight decrease in interseismic convergence from central (15±1 mm/yr) to eastern Nepal (14±1 mm/yr) and therefore cannot explain this dramatic difference (Lindsey et al., in prep). Taken at face value, these results imply that the MBT must have been much more recently active in eastern Nepal ( 70 ka) than central Nepal ( 1.4 Ma). We propose an alternative model that does not require this dramatic difference in the age of the MFT. As one end-member, it is indeed possible that the MFT may have broken forward much more recently in the east. However, it is also possible that older MFT thrust sheets have formed, and then have been consumed as the MBT passively slid south in the hanging wall of the MFT. Distinguishing between these models is important not only for understanding the

Communicating Climate Change - Weather Forecast Need Assessment and Information Dissemination Mechanism to Farmers in Nepal

NASA Astrophysics Data System (ADS)

Panthi, J., Sr.

2014-12-01

Climate Change is becoming one of the major threats to the fragile Himalayan ecosystem. It is affecting all sectors mainly fresh water, agriculture, forest, biodiversity and species. The subsistence agriculture system of Nepal is mainly rain-fed; therefore, climate change and climate extremes do have direct impacts on it. Weather extremes like droughts, floods and landslides long-lasting fog, hot and cold waves are affecting the agriculture sectors of Nepal. As human-induced climate change has already showing its impacts and it is going to be there for a long time to come, it is paramount importance to move towards the adaptation. Early warning system is an effective way for reducing the impacts of disasters. Forecasting of weather parameters (temperature, precipitation, and wind) helps farmers for their preparedness activities. With consultation with farmers and other relevant institutions, a research project was carried out, for the first time in Nepal, to identify the forecast information need to farmers and their dissemination mechanism. Community consultation workshops, key informant survey, and field observations were the techniques used for this research. Two ecological locations: Bageshwori VDC in Banke (plain) and Dhaibung VDC in Rasuwa (mountain) were taken as the pilot sites for this assessment. People in both the districts are dependent highly on agriculture and the weather extremes like hailstone, untimely rainfall; droughts are affecting their agriculture practices. They do not have confidence in the weather forecast information disseminated by the government of Nepal currently being done because it is a general forecast not done for a smaller domain and the forecast is valid only for 24 hours. The weather forecast need to the farmers in both the sites are: rainfall (intensity, duration and time), drought, and hailstone but in Banke, people wished to have the information of heat and cold waves too as they are affecting their wheat and tomato crops

Soil Bioengineering Application and Practices in Nepal

NASA Astrophysics Data System (ADS)

Dhital, Yam Prasad; Kayastha, Rijan Bhakta; Shi, Jiancheng

2013-02-01

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.

Soil bioengineering application and practices in Nepal.

PubMed

Dhital, Yam Prasad; Kayastha, Rijan Bhakta; Shi, Jiancheng

2013-02-01

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.

Communicating Astronomy With Public in Nepal

NASA Astrophysics Data System (ADS)

Bhattarai, Suresh

2015-08-01

This paper highlights the mode of communications that Nepal Astronomical Society (NASO) implemented during 2007-2014 for promoting science and technology in Nepal with astronomy as a key tool.Camparatve study between the role of old media and new media for astronomy communication will be discussed. The role of new media and Information and Communication Technology (ICT) to foster astronomy communication with the public with some case studies will be discussed in detail. Proposed model of integrating both old and old media with smooth transition between these communication channels will be presented and discuss in brief.

Public Health Responses to a Dengue Outbreak in a Fragile State: A Case Study of Nepal

PubMed Central

Griffiths, Karolina; Banjara, Megha Raj; O'Dempsey, T.; Munslow, B.; Kroeger, Axel

2013-01-01

Objectives. The number of countries reporting dengue cases is increasing worldwide. Nepal saw its first dengue outbreak in 2010, with 96% of cases reported in three districts. There are numerous policy challenges to providing an effective public health response system in a fragile state. This paper evaluates the dengue case notification, surveillance, laboratory facilities, intersectoral collaboration, and how government and community services responded to the outbreak. Methods. Qualitative data were collected through 20 in-depth interviews, with key stakeholders, and two focus-group discussions, with seven participants. Results. Limitations of case recognition included weak diagnostic facilities and private hospitals not incorporated into the case reporting system. Research on vectors was weak, with no virological surveillance. Limitations of outbreak response included poor coordination and an inadequate budget. There was good community mobilization and emergency response but no routine vector control. Conclusions. A weak state has limited response capabilities. Disease surveillance and response plans need to be country-specific and consider state response capacity and the level of endemicity. Two feasible solutions for Nepal are (1) go upwards to regional collaboration for disease and vector surveillance, laboratory assistance, and staff training; (2) go downwards to expand upon community mobilisation, ensuring that vector control is anticipatory to outbreaks. PMID:23690789

Alcohol Consumption Practices among Married Women of Reproductive Age in Nepal: A Population Based Household Survey

PubMed Central

Thapa, Narbada; Aryal, Krishna Kumar; Puri, Rupendra; Shrestha, Saraswoti; Shrestha, Sheela; Thapa, Pukar; Mehata, Suresh; Thapa, Pushpa; Banjara, Megha Raj; Stray-Pedersen, Babill

2016-01-01

Background Alcohol chemically known as ethanol, causes several health, economic and social consequences across the world. Literatures suggest potential harm of alcohol drinking by pregnant women especially to the fetus and the mother. Despite anumber of significant public health problems related to alcohol consumption, this area has been ignored in Nepal and information at the national level is limited. Thus this study aimed at finding the prevalence of alcohol consumption among married women of reproductive age. Methods A nationally representative household survey was carried out from April to August 2013 by taking 16 districts across all 15 eco administrative regions. From the selected districts, 86 village development committees and 14 municipalities were selected as primary sampling units using probability proportionate to size, followed by random selection of 3 wards from each primary sampling unit. Finally, 30 households within each ward were selected using systematic random sampling, and one married women of reproductive age from each household. A total of 9000 married women of reproductive age were interviewed using a semi-structured questionnaire, on alcohol consumption practices including environmental factors and socio demographic characteristics and were included in the analysis. Results National prevalence of alcohol consumption ever among married women of reproductive age was 24.7% (95% CI:21.7–28.0), last 12 months 17.9% (95% CI:15.3–20.7) and last 30 days (current drinking) 11.8% (95% CI:9.8–14.1). There was substantial variation among the districts ranging from 2% to 60%. Multivariable analysis suggests women with no education or within formal education, dalit and janajatis ethnicity, whose husbands drink alcohol, who brew alcohol at home and women from mountains were significantly at higher risk of consuming alcohol. Among the women who drank alcohol in last 12 months, a substantial proportion of them drank home brewed alcoholic beverages

Language Learning Strategies Profiles of EFL Learners in Nepal

ERIC Educational Resources Information Center

Dawadi, Saraswati

2017-01-01

This study investigated language learning strategies (LLS) used by English as foreign language (EFL) learners in Nepal. For this study, 370 undergraduate level students from a university in Nepal responded to a questionnaire. The quantitative software SPSS was used to analyse the data. Results indicated that students were moderate users of those…

Awareness of occupational hazards and use of safety measures among welders: a cross-sectional study from eastern Nepal

PubMed Central

Budhathoki, Shyam Sundar; Singh, Suman Bahadur; Sagtani, Reshu Agrawal; Niraula, Surya Raj; Pokharel, Paras Kumar

2014-01-01

Objective The proper use of safety measures by welders is an important way of preventing and/or reducing a variety of health hazards that they are exposed to during welding. There is a lack of knowledge about hazards and personal protective equipments (PPEs) and the use of PPE among the welders in Nepal is limited. We designed a study to assess welders’ awareness of hazards and PPE, and the use of PPE among the welders of eastern Nepal and to find a possible correlation between awareness and use of PPE among them. Materials and methods A cross-sectional study of 300 welders selected by simple random sampling from three districts of eastern Nepal was conducted using a semistructured questionnaire. Data regarding age, education level, duration of employment, awareness of hazards, safety measures and the actual use of safety measures were recorded. Results Overall, 272 (90.7%) welders were aware of at least one hazard of welding and a similar proportion of welders were aware of at least one PPE. However, only 47.7% used one or more types of PPE. Education and duration of employment were significantly associated with the awareness of hazards and of PPE and its use. The welders who reported using PPE during welding were two times more likely to have been aware of hazards (OR=2.52, 95% CI 1.09 to 5.81) and five times more likely to have been aware of PPE compared with the welders who did not report the use of PPE (OR=5.13, 95% CI 2.34 to 11.26). Conclusions The welders using PPE were those who were aware of hazards and PPE. There is a gap between being aware of hazards and PPE (90%) and use of PPE (47%) at work. Further research is needed to identify the underlying factors leading to low utilisation of PPE despite the welders of eastern Nepal being knowledgeable of it. PMID:24889850

Self-reported health problems, health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur District of Nepal.

PubMed

Kshetri, Dan B B; Smith, William C S

2011-06-01

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.

The Advancement of Women in Post-Conflict Nepal

DTIC Science & Technology

2017-04-01

DANIEL K. INOUYE ASIA PACIFIC CENTER FOR SECURITY STUDIES OCCASIONAL PAPER, APRIL 2017 The Advancement of Women in Post -Conflict Nepal Lily Thapa1...in the lack of access to appropriate services and compensation, and in the way that female ex -combatants are treated and reintegrated...5,912 2,985 The Advancement of Women in Post -Conflict Nepal 2 reparation of victims of armed conflict and the provision of mechanisms for

Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

PubMed

Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

2016-01-01

Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape.

PubMed

Schoevers, Johan; Jenkins, Louis

2015-04-21

Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape. An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel. Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7%-71.4% and 58.1%-74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital. Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

Convergence rate across the Nepal Himalaya and interseismic coupling on the Main Himalayan Thrust, implications for seismic hazard

NASA Astrophysics Data System (ADS)

Ader, T. J.; Avouac, J.; Bollinger, L.; Lyon-Caen, H.; Chanard, K. D.; Galetzka, J. E.; Genrich, J. F.; Sapkota, S. N.

2011-12-01

We use 24 continuous GPS stations installed by Caltech throughout Nepal, in addition to previously published campaign GPS points and leveling data collected along the road Birganj-Katmandu-Kodari to propose a detailed pattern of coupling on the MHT. The continuous GPS time series are processed modeling the noise on the daily positions by a combination of white and flicker noise, in order to infer secular velocities at the stations with consistent error bars. We then locate the pole of rotation of the Indian plate in the ITRF 2005 reference frame at longitude = 3.6o ± 2.6o, latitude = 51.52o ± 0.26o with an angular velocity of Ω = 0.518 ± 0.008o/Myr. The pattern of coupling on the MHT is computed with a backslip model on a fault dipping 10o to the North and whose strike roughly follows the foothills of the Himalayan chain. The model indicates that the MHT is locked from the surface to a distance of approximately 100 km along dip, corresponding to a depth of 15 to 20 km where the temperature reaches 350oC. In map view, the transition locked/creeping seems to be at the most a few tens of kilometers wide and overlaps with the belt of midcrustal microseismicity underneath the Himalayas. The convergence of the Indian plate underneath the Tibetan plateau proceeds at a rate of 18.1 ± 0.5~mm/yr in central and eastern Nepal and 19.9 ± 0.7~mm/yr in western Nepal. The moment deficit accrues at a rate of 6.7 ± 1019 Nm/yr on the MHT. This rate exceeds by far the moment released by the seismicity in the past 500 years, indicating that the risk for a large M > 8 earthquake to happen in Nepal is real.

Risk Factors for the Presence of Chikungunya and Dengue Vectors (Aedes aegypti and Aedes albopictus), Their Altitudinal Distribution and Climatic Determinants of Their Abundance in Central Nepal

PubMed Central

Dhimal, Meghnath; Gautam, Ishan; Joshi, Hari Datt; O’Hara, Robert B.; Ahrens, Bodo; Kuch, Ulrich

2015-01-01

Background The presence of the recently introduced primary dengue virus vector mosquito Aedes aegypti in Nepal, in association with the likely indigenous secondary vector Aedes albopictus, raises public health concerns. Chikungunya fever cases have also been reported in Nepal, and the virus causing this disease is also transmitted by these mosquito species. Here we report the results of a study on the risk factors for the presence of chikungunya and dengue virus vectors, their elevational ceiling of distribution, and climatic determinants of their abundance in central Nepal. Methodology/Principal Findings We collected immature stages of mosquitoes during six monthly cross-sectional surveys covering six administrative districts along an altitudinal transect in central Nepal that extended from Birgunj (80 m above sea level [asl]) to Dhunche (highest altitude sampled: 2,100 m asl). The dengue vectors Ae. aegypti and Ae. albopictus were commonly found up to 1,350 m asl in Kathmandu valley and were present but rarely found from 1,750 to 2,100 m asl in Dhunche. The lymphatic filariasis vector Culex quinquefasciatus was commonly found throughout the study transect. Physiographic region, month of collection, collection station and container type were significant predictors of the occurrence and co-occurrence of Ae. aegypti and Ae. albopictus. The climatic variables rainfall, temperature, and relative humidity were significant predictors of chikungunya and dengue virus vectors abundance. Conclusions/Significance We conclude that chikungunya and dengue virus vectors have already established their populations up to the High Mountain region of Nepal and that this may be attributed to the environmental and climate change that has been observed over the decades in Nepal. The rapid expansion of the distribution of these important disease vectors in the High Mountain region, previously considered to be non-endemic for dengue and chikungunya fever, calls for urgent actions to

A Cultural Adaptation of Dialectical Behavior Therapy in Nepal

PubMed Central

Ramaiya, Megan K.; Fiorillo, Devika; Regmi, Upasana; Robins, Clive J.; Kohrt, Brandon A.

2017-01-01

Growing evidence exists on the potential for adapting evidence-based interventions for low- and-middle-income countries (LMIC). One opportunity that has received limited attention is the adaptation of psychotherapies developed in high-income countries (HIC) based on principles from LMIC cultural groups. Dialectical behavior therapy (DBT) is one such treatment with significant potential for acceptability in South Asian settings with high suicide rates. We describe a tri-phasic approach to adapt DBT in Nepal that consists of qualitative interviews with major Nepali mental health stakeholders (Study 1), an adaptation workshop with 15 Nepali counselors (Study 2), and a small-scale treatment pilot with eligible clients in one rural district (Study 3). Due to low literacy levels, distinct conceptualizations of mind and body, and program adherence barriers, numerous adaptations were required. DBT concepts attributable to Asian belief systems were least comprehensible to clients. However, the 82% program completion rate suggests utility of a structured, skills-based treatment. This adaptation process informs future research regarding the effectiveness of culturally adapted DBT in South Asia. PMID:29056846

Evidence of West Nile virus infection in Nepal.

PubMed

Rutvisuttinunt, Wiriya; Chinnawirotpisan, Piyawan; Klungthong, Chonticha; Shrestha, Sanjaya Kumar; Thapa, Amod Bahadur; Pant, Arjun; Yingst, Samuel L; Yoon, In-Kyu; Fernandez, Stefan; Pavlin, Julie A

2014-11-27

Acute febrile illness is common among those seeking medical care and is frequently treated empirically with the underlying illness remaining undiagnosed in resource-poor countries. A febrile illness study was conducted 2009-2010 to identify known and unknown pathogens circulating in Nepal. Study methods included diagnostic testing and preliminary ELISA screening of acute and convalescent samples for diseases both known and unknown to be circulating in Nepal, including West Nile virus (WNV). The molecular assays including Polymerase Chain Reaction (PCR), Sanger sequencing and ultra deep sequencing on MiSeq Illumina Platform were conducted to further confirm the presence of WNV. The study enrolled 2,046 patients presenting undifferentiated febrile illness with unknown etiology. Sera from 14 out of 2,046 patients were tested positive for west nile virus (WNV) by nested Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Only two out of 14 cases were confirmed for the presence of WNV by sequencing and identified as WNV lineage 1 phylogentically. The two patients were adult males with fever and no neurological symptoms from Kathmandu and Bharatpur, Nepal. Two out of 2,046 serum samples contained fragments of WNV genome resembling WNV lineage 1, which is evidence of the continued spread of WNV which should be considered a possible illness cause in Nepal.

Japanese encephalitis in a French traveler to Nepal.

PubMed

Lagarde, S; Lagier, J-C; Charrel, R; Quérat, G; Vanhomwegen, J; Desprès, P; Pelletier, J; Kaphan, E

2014-02-01

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.

Level of awareness about legalization of abortion in Nepal: a study at Nepal Medical College Teaching Hospital.

PubMed

Tuladhar, H; Risal, A

2010-06-01

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.

Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal.

PubMed

Gyawali, Sudesh; Rathore, Devendra S; Kc, Bhuvan; Shankar, P Ravi

2013-01-03

Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a) to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b) to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. A descriptive cross-sectional mixed type (qualitative and quantitative) survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. The in-charges (eight males, two females) who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable) injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal training in waste management. Certain safe injection

Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal

PubMed Central

2013-01-01

Background Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a) to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b) to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. Methodology A descriptive cross-sectional mixed type (qualitative and quantitative) survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. Results The in-charges (eight males, two females) who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable) injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal training in waste management

The 2014 Karnali River Floods in Western Nepal: Making Community Based Early Warning Systems Work When Data Is Lacking

NASA Astrophysics Data System (ADS)

Dugar, S.; MacClune, K.; Venkateswaran, K.; Yadav, S.; Szoenyi, M.

2015-12-01

Implementing Community Based Flood Early Warning System (EWS) in developing countries like Nepal is challenging. Complex topography and geology combined with a sparse network of river and rainfall gauges and little predictive meteorological capacity both nationally and regionally dramatically constrain EWS options. This paper provides a synopsis of the hydrological and meteorological conditions that led to flooding in the Karnali River, West Nepal during mid-August 2014, and analyses the effectiveness of flood EWS in the region. On August 14-15, 2014, a large, slow moving weather system deposited record breaking rainfall in the foothills of the Karnali River catchment. Precipitation depths of 200 to 500 mm were recorded over a 24-hour period, which led to rapid rise of river heights. At the Chisapani river gauge station used for the existing EWS, where the Karnali River exits the Himalaya onto the Indo-Gangetic Plain, water levels rapidly exceeded the 11 meter danger level. Between 3 to 6 am, water levels rose from 11 to 16. 1 meters, well beyond the design height of 15 meters. Analysis suggests that 2014 floods may have been a one-in-1000 year event. Starting with the onset of intense rainfall, the Chisapani gauge reader was in regular communication with downstream stakeholders and communities providing them with timely information regarding rising water level. This provided people just enough time to move to safe places with their livestock and key assets. Though households still lost substantial assets, without the EWS, floodwaters would have caught communities completely unaware and damage would almost certainly have been much worse. In particular, despite the complications associated with access to the Chisapani gauge and failure of critical communication nodes during the floods, EWS was instrumental in saving lives. This study explores both the details of the flood event and performance of the early warning system, and identifies lessons learned to help

Knowledge, Attitude, and Practice on Menstrual Hygiene Management among School Adolescents.

PubMed

Yadav, Ram Naresh; Joshi, Shrijana; Poudel, Rajesh; Pandeya, Pawan

2018-01-01

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.

ADULT EDUCATION IN NEPAL.

ERIC Educational Resources Information Center

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…

Women's experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal.

PubMed

Shrestha, Binjwala; Onta, Sharad; Choulagai, Bishnu; Poudyal, Amod; Pahari, Durga Prasad; Uprety, Aruna; Petzold, Max; Krettek, Alexandra

2014-02-03

Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women's experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September-December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Study participants were 23-82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband's sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. UP adversely affects women's daily life and negatively influences their physical, mental, and social well-being. The results of our study are

Prevalence of Cutaneous Leishmaniasis in Districts of High and Low Endemicity in Mali.

PubMed

Traoré, Bourama; Oliveira, Fabiano; Faye, Ousmane; Dicko, Adama; Coulibaly, Cheick A; Sissoko, Ibrahim M; Sibiry, Samake; Sogoba, Nafomon; Sangare, Moussa Brema; Coulibaly, Yaya I; Traore, Pierre; Traore, Sekou F; Anderson, Jennifer M; Keita, Somita; Valenzuela, Jesus G; Kamhawi, Shaden; Doumbia, Seydou

2016-11-01

Historically the western sahelian dry regions of Mali are known to be highly endemic for cutaneous leishmaniasis (CL) caused by Leishmania major, while cases are rarely reported from the Southern savanna forest of the country. Here, we report baseline prevalence of CL infection in 3 ecologically distinct districts of Mali (dry sahelian, north savanna and southern savanna forest areas). We screened 195 to 250 subjects from 50 to 60 randomly selected households in each of the 6 villages (four from the western sahelian district of Diema in Kayes region, one from the central district of Kolokani and one from the southern savanna district of Kolodieba, region of Sikasso). The screening consisted of: 1] A Leishmanin Skin Test (LST) for detection of exposure to Leishmania parasites; 2] clinical examination of suspected lesions, followed by validation with PCR and 3] finger prick blood sample to determine antibody levels to sand fly saliva. LST positivity was higher in the western district of Diema (49.9%) than in Kolokani (24.9%) and was much lower in Kolondieba (2.6%). LST positivity increased with age rising from 13.8% to 88% in Diema for age groups 2-5 years and 41-65 years, respectively. All eight PCR-confirmed L. major CL cases were diagnosed in subjects below 18 years of age and all were residents of the district of Diema. Exposure to sand fly bites, measured by anti-saliva antibody titers, was comparable in individuals living in all three districts. However, antibody titers were significantly higher in LST positive individuals (P<0.0001). In conclusion, CL transmission remains active in the western region of Mali where lesions were mainly prevalent among children under 18 years old. LST positivity correlated to higher levels of antibodies to sand fly salivary proteins, suggesting their potential as a risk marker for CL acquisition in Mali.

Medical education and training in Nepal: SWOT analysis.

PubMed

Dixit, H; Marahatta, S B

2008-01-01

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.

Spine surgery in Nepal: the 2015 earthquake

PubMed Central

2015-01-01

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 2nd major earthquake of magnitude 7.3 on 12 May 2015. Past and current experiences in Nepal will be presented. PMID:27683676

First report of Lyme disease in Nepal.

PubMed

Pun, Sher Bahadur; Agrawal, Sumit; Jha, Santoshananda; Bhandari, Lila Nath; Chalise, Bimal Sharma; Mishra, Abadhesh; Shah, Rajesh

2018-03-01

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.

Anaemia and associated factors among under-fives and their mothers in Bushenyi district, Western Uganda.

PubMed

Kikafunda, Joyce K; Lukwago, Fred B; Turyashemererwa, Florence

2009-12-01

To determine the prevalence of anaemia and associated factors among under-fives and their mothers in a rural area of Western Uganda. A cross-sectional investigation using both qualitative and quantitative methods of data collection. Stratified multistage sampling methods were used to select the study sample. A haemoglobinometer was used to assess Hb levels in the blood. A rural district in Western Uganda. Children aged 6-59 months and their mothers aged 15-49 years. The overall prevalence of Fe-deficiency anaemia among children and their mothers was 26.2 % and 17.9 %, respectively. There was a significant correlation (r = 0.5, P = 0.008) between the Hb levels of the mothers and their children. Place of birth, age of the child, factors related to complementary foods, and formal education and nutrition knowledge of the mother were major factors that were significantly associated (r = 0.05, P = 0.05) with low Hb levels among the children. The most important factors that were associated with low Hb levels of the mothers were their formal education, nutrition knowledge and health status. Fe-deficiency anaemia was found to be a major problem in this cohort of children and their mothers. Dietary factors and sociodemographic factors were the major factors associated with high levels of anaemia among the children and their mothers. It is therefore recommended that rural mothers should be sensitized on best practices for prevention of anaemia among both women and children.

Creation of Nepal's First Skin Bank: Challenges and Outcomes.

PubMed

Cai, Lawrence; Long, Chao; Karki, Bishal; Nakarmi, Kiran; Iqbal, Adnan; Casertano, Michele; Anderson, Sara; Patell, James; Chang, James; Rai, Shankar Man

2017-11-01

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.

Prevalence and factors associated with childhood overweight/obesity of private school children in Nepal.

PubMed

Koirala, M; Khatri, R B; Khanal, V; Amatya, A

2015-01-01

Childhood overweight/obesity is a global health problem because of adverse health and nutrition consequences worldwide. Currently, there is a paucity of information on childhood overweight/obesity in Nepal. Therefore, the objective of this study was to assess the prevalence of, and the factors associated with, childhood overweight/obesity among primary school children. A cross-sectional study was conducted in June-December, 2013. We collected data using the structured self-administered questionnaire with parents of children aged 6-13 years in grades 1-6 studying at private schools of the Lalitpur district of Nepal. Height and weight measurements of 986 children were taken, and the corresponding body mass index (BMI)-for-age was calculated. The prevalence of childhood overweight/obesity was reported in proportion. Factors associated with childhood overweight/obesity were examined using the Chi-square tests followed by multiple logistic regression analyses. Of 986 children, 144 (14.6%) were overweight and 111 (11.3%) were obese. Overall, 255 (25.9%) children were found to be overweight/obese. Children from families, having ≤2 siblings (adjusted odds ratio (aOR)=1.958, 95% confidence interval (CI): 1.163-3.296), upper class family (aOR=3.672; 95% CI: 1.154-11.690), and advantaged ethnic group (aOR=1.561; 95% CI: 1.00-2.437) and children who were of larger birth weight (>4.0kg) had a greater likelihood of being (aOR=2.557, 95% CI: 1.222-5.349) overweight/obese. A quarter of children were found to be overweight/obese in private primary schools. Preventive interventions should focus on the advantaged ethnic groups, families with fewer siblings, and upper class families. A greater emphasis ought to be placed on formulation and implementation of policies aimed at addressing the newly emerging problems of childhood overweight/obesity in Nepal. New school health programs are to be launched and strengthened including avoidance of high energy junk food, and promoting outdoor

Incidence Rate of Acute Encephalitis Syndrome without Specific Treatment in India and Nepal

PubMed Central

Potharaju, Nagabhushana Rao

2012-01-01

Background: A performance target (PT) for the incidence rate (IR) of acute encephalitis syndrome (AES) was not defined by the World Health Organization (WHO) due to lack of data. There is no specific treatment for ~90% of the AES cases. Objectives: (1) To determine the IR of AES not having specific treatment (AESn) in two countries, India and Nepal. (2) To suggest the PT. Subjects and Methods: This was a record-based study of the entire population of India and Nepal from 1978 to 2011. The WHO definition was used for inclusion of cases. Cases that had specific treatment were excluded. IR was calculated per 100,000 population per annum. Forecast IR was generated from 2010 to 2013 using time-series analysis. Results: There were 165,461 cases from 1978 to 2011, of which 125,030 cases were from India and 40,431 were from Nepal. The mean IR of India was 0.42 (s 0.24) and that of Nepal was 5.23 (σ 3.03). IRs of 2010 and 2011 of India and that of 2011 of Nepal were closer to the mean IR rather than the forecast IR. IR of 2010 of Nepal was closer to the forecast IR. The forecast IR for India for 2012 was 0.49 (0.19-1.06), for 2013 was 0.42 (0.15-0.97) and for Nepal for both 2012 and 2013 was 5.62 (1.53-15.05). Conclusions: IRs were considerably different for India and Nepal. Using the current mean IR as PT for the next year was simple and practical. Using forecasting was complex and, less frequently, useful. PMID:23293439

Global projects and Astronomy awareness activities in Nepal

NASA Astrophysics Data System (ADS)

Gautam, Suman

2015-08-01

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.

Impact and determinants of sex preference in Nepal.

PubMed

Leone, Tiziana; Matthews, Zoë; Dalla Zuanna, Gianpiero

2003-06-01

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.

Adapting Nepal's polio eradication programme.

PubMed

Paudel, Krishna P; Hampton, Lee M; Gurung, Santosh; Bohara, Rajendra; Rai, Indra K; Anaokar, Sameer; Swift, Rachel D; Cochi, Stephen

2017-03-01

Many countries have weak disease surveillance and immunization systems. The elimination of polio creates an opportunity to use staff and assets from the polio eradication programme to control other vaccine-preventable diseases and improve disease surveillance and immunization systems. In 2003, the active surveillance system of Nepal's polio eradication programme began to report on measles and neonatal tetanus cases. Japanese encephalitis and rubella cases were added to the surveillance system in 2004. Staff from the programme aided the development and implementation of government immunization policies, helped launch vaccination campaigns, and trained government staff in reporting practices and vaccine management. Nepal eliminated indigenous polio in 2000, and controlled outbreaks caused by polio importations between 2005 and 2010. In 2014, the surveillance activities had expanded to 299 sites, with active surveillance for measles, rubella and neonatal tetanus, including weekly visits from 15 surveillance medical officers. Sentinel surveillance for Japanese encephalitis consisted of 132 sites. Since 2002, staff from the eradication programme have helped to introduce six new vaccines and helped to secure funding from Gavi, the Vaccine Alliance. Staff have also assisted in responding to other health events in the country. By expanding the activities of its polio eradication programme, Nepal has improved its surveillance and immunization systems and increased vaccination coverage of other vaccine-preventable diseases. Continued donor support, a close collaboration with the Expanded Programme on Immunization, and the retention of the polio eradication programme's skilled workforce were important for this expansion.

Sex Trafficking Related Knowledge, Awareness, and Attitudes among Adolescent Female Students in Nepal: A Cross-Sectional Study.

PubMed

Shrestha, Roman; Karki, Pramila; Suwal, Asha; Copenhaver, Michael

2015-01-01

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 the

Public health impacts of climate change in Nepal.

PubMed

Joshi, H D; Dhimal, B; Dhimal, M; Bhusal, C L

2011-04-01

Climate change is a global issue in this century which has challenged the survival of living creatures affecting the life supporting systems of the earth: atmosphere, hydrosphere and lithosphere. Scientists have reached in a consensus that climate change is happening. The anthropogenic emission of greenhouse gases is responsible for global warming and therefore climate change. Climate change may directly or indirectly affect human health through a range of pathways related to temperature and precipitation. The aim of this article is to share knowledge on how climate change can affect public health in Nepal based on scientific evidence from global studies and experience gained locally. In this review attempt has been made to critically analyze the scientific studies as well as policy documents of Nepalese Government and shed light on public health impact of climate change in the context of Nepal. Detailed scientific study is recommended to discern impact of climate change on public health problems in Nepal.

Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

PubMed

Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

2017-01-01

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.

Universal Primary Education in Nepal: Fulfilling the Right to Education

ERIC Educational Resources Information Center

Lohani, Shiva; Singh, Ram Balak; Lohani, Jeevan

2010-01-01

With the net enrollment ratio in primary education in Nepal at 94%, most children are in the school system, but the system fails to ensure that all enrolled children will continue in school cycle and complete primary education of acceptable quality. Given the system's poor internal efficiency, Nepal is not likely to achieve the MDG and EFA goals…

Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006

PubMed Central

2011-01-01

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 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 < 0.05 was considered as significant. Results Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco 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

Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006.

PubMed

Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Harsha Kumar, Hn; Sathian, Brijesh; Arokiasamy, John T

2011-12-20

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 < 0.05 was considered as significant. Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco 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

76 FR 26314 - Notice of Public Meetings, Twin Falls District Resource Advisory Council, Idaho

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... of Public Meetings, Twin Falls District Resource Advisory Council, Idaho AGENCY: Bureau of Land... (BLM) Twin Falls District Resource Advisory Council (RAC) will meet as indicated below. DATES: May 16, 2011. On May 16, 2011, the Twin Falls District RAC members will meet at the Best Western Sawtooth Inn...

Platinum potential of mafic-ultramafic massifs in the western part of the Dambuka ore district (Upper Amur Region, Russia)

NASA Astrophysics Data System (ADS)

Melnikov, A. V.; Stepanov, V. A.; Moiseenko, V. G.

2016-02-01

New data on the Pt potential of mafic-ultramafic massifs of the Khani-Maya, Uldegit, and Dzhalta complexes in the western part of the Dambuka ore district are discussed. The Khani-Maya Complex is represented by metamorphosed gabbro, gabbronorites, gabbro anorthosites, subordinate pyroxenites, hornblendites, and peridotites. The Uldegit Complex is composed of pyroxenites, hornblendites, gabbro, gabbronorites, norites, troctolites, peridotites, dunites, actinolite-tremolites, serpentinites, anthophyllites, and tremolite-plagioclase rocks. The Dzhalta Complex is formed of peridotites, gabbro, eclogitized gabbro, hornblendites, cortlandites, and pyroxenites. All these complexes differ from each other by the concentrations of Ni, Cu, Co, Au, and platinoids depending on the composition of the constituting rocks and the presence of sulfide minerals.

Population dynamics and environmental degradation in Nepal: an interpretation.

PubMed

Karki, Y B

1993-01-01

This paper examines the special problems that are faced by developing countries, specifically Nepal, which have to sustain increasing populations from a depleting natural resource base. Nepal is an example of a developing country where fertility is high and mortality is decreasing fast, resulting in a high rate of population growth. Nepal's rapid population growth has had a significant impact on natural resource depletion and consequently, environmental degradation. The case of Nepal demonstrates the difficulties confronting developing countries, which attempt practical implementation of the population policy guidelines set out in Agenda 21. Past and current population programs in this country have failed to address the population problem as multidimensional, and have failed to encourage grassroots participation. Economic stagnation and poverty encourage a large family size, and are delaying declines in fertility which subsequently leads to high land encroachment and fast depletion of natural resources like forests and water. The government needs to implement an integrated, multidimensional approach, which emphasizes literacy, education, lowering infant mortality, and providing contraceptives along with follow-ups. Finally, the greatest action must consist of fostering a higher rate of planned economic and social development that must be shown to have meaning for, and impact on the population in general.

Convergence rate across the Nepal Himalaya and interseismic coupling on the Main Himalayan Thrust: Implications for seismic hazard

NASA Astrophysics Data System (ADS)

Ader, Thomas; Avouac, Jean-Philippe; Liu-Zeng, Jing; Lyon-Caen, HéLèNe; Bollinger, Laurent; Galetzka, John; Genrich, Jeff; Thomas, Marion; Chanard, Kristel; Sapkota, Soma Nath; Rajaure, Sudhir; Shrestha, Prithvi; Ding, Lin; Flouzat, Mireille

2012-04-01

We document geodetic strain across the Nepal Himalaya using GPS times series from 30 stations in Nepal and southern Tibet, in addition to previously published campaign GPS points and leveling data and determine the pattern of interseismic coupling on the Main Himalayan Thrust fault (MHT). The noise on the daily GPS positions is modeled as a combination of white and colored noise, in order to infer secular velocities at the stations with consistent uncertainties. We then locate the pole of rotation of the Indian plate in the ITRF 2005 reference frame at longitude = - 1.34° ± 3.31°, latitude = 51.4° ± 0.3° with an angular velocity of Ω = 0.5029 ± 0.0072°/Myr. The pattern of coupling on the MHT is computed on a fault dipping 10° to the north and whose strike roughly follows the arcuate shape of the Himalaya. The model indicates that the MHT is locked from the surface to a distance of approximately 100 km down dip, corresponding to a depth of 15 to 20 km. In map view, the transition zone between the locked portion of the MHT and the portion which is creeping at the long term slip rate seems to be at the most a few tens of kilometers wide and coincides with the belt of midcrustal microseismicity underneath the Himalaya. According to a previous study based on thermokinematic modeling of thermochronological and thermobarometric data, this transition seems to happen in a zone where the temperature reaches 350°C. The convergence between India and South Tibet proceeds at a rate of 17.8 ± 0.5 mm/yr in central and eastern Nepal and 20.5 ± 1 mm/yr in western Nepal. The moment deficit due to locking of the MHT in the interseismic period accrues at a rate of 6.6 ± 0.4 × 1019 Nm/yr on the MHT underneath Nepal. For comparison, the moment released by the seismicity over the past 500 years, including 14 MW ≥ 7 earthquakes with moment magnitudes up to 8.5, amounts to only 0.9 × 1019 Nm/yr, indicating a large deficit of seismic slip over that period or very infrequent

Development of Earthquake Emergency Response Plan for Tribhuvan International Airport, Kathmandu, Nepal

DTIC Science & Technology

2013-02-01

Kathmandu, Nepal 5a. CONTRACT NUMBER W911NF-12-1-0282 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER ...In the past, big earthquakes in Nepal (see Figure 1.1) have caused a huge number of casualties and damage to structures. The Great Nepal -Bihar...UBC Earthquake Engineering Research Facility 2235 East Mall, Vancouver, BC, Canada V6T 1Z4 Phone : 604 822-6203 Fax: 604 822-6901 E-mail

HIV-AIDS in Nepal: the coming crisis.

PubMed

Seddon, D

1998-01-01

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.

Rebuilding Government Legitimacy in Post-Conflict Societies: Case Studies of Nepal and Afghanistan

DTIC Science & Technology

2015-01-01

Post-conflict Societies: Case Studies of Nepal and Afghanistan 5a. CONTRACT NUMBER FA2386-12-1-4052 5b. GRANT NUMBER Grant 12RSZ057 AOARD...on the government of different groups in the Nepal , a list of 13 local and regional groups was compiled (see Appendix E). These comprised the eight... Nepal , and email and mobile phone use is inconsistent (especially in rural areas), alternative strategies needed to be developed for finding

Using formative research to design a context-specific behaviour change strategy to improve infant and young child feeding practices and nutrition in Nepal.

PubMed

Locks, Lindsey M; Pandey, Pooja R; Osei, Akoto K; Spiro, David S; Adhikari, Debendra P; Haselow, Nancy J; Quinn, Victoria J; Nielsen, Jennifer N

2015-10-01

Global recommendations on strategies to improve infant feeding, care and nutrition are clear; however, there is limited literature that explains methods for tailoring these recommendations to the local context where programmes are implemented. This paper aims to: (1) highlight the individual, cultural and environmental factors revealed by formative research to affect infant and young child feeding and care practices in Baitadi district of Far Western Nepal; and (2) outline how both quantitative and qualitative research methods were used to design a context-specific behaviour change strategy to improve child nutrition. Quantitative data on 750 children aged 12-23 months and their families were collected via surveys administered to mothers. The participants were selected using a multistage cluster sampling technique. The survey asked about knowledge, attitude and behaviours relating to infant and young child feeding. Qualitative data on breastfeeding and complementary feeding beliefs and practices were also collected from a separate sample via focus group discussions with mothers, and key informant interviews with mothers-in-law and husbands. Key findings revealed gaps in knowledge among many informants resulting in suboptimal infant and young child feeding practices - particularly with relation to duration of exclusive breastfeeding and dietary diversity of complementary foods. The findings from this research were then incorporated into a context-specific nutrition behaviour change communication strategy. © 2013 Helen Keller International © 2013 John Wiley & Sons, Ltd.

Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey.

PubMed

Kane, J C; Luitel, N P; Jordans, M J D; Kohrt, B A; Weissbecker, I; Tol, W A

2018-06-01

Two large earthquakes in 2015 caused widespread destruction in Nepal. This study aimed to examine frequency of common mental health and psychosocial problems and their correlates following the earthquakes. A stratified multi-stage cluster sampling design was employed to randomly select 513 participants (aged 16 and above) from three earthquake-affected districts in Nepal: Kathmandu, Gorkha and Sindhupalchowk, 4 months after the second earthquake. Outcomes were selected based on qualitative preparatory research and included symptoms of depression and anxiety (Hopkins Symptom Checklist-25); post-traumatic stress disorder (PTSD Checklist-Civilian); hazardous alcohol use (AUDIT-C); symptoms indicating severe psychological distress (WHO-UNHCR Assessment Schedule of Serious Symptoms in Humanitarian Settings (WASSS)); suicidal ideation (Composite International Diagnostic Interview); perceived needs (Humanitarian Emergency Settings Perceived Needs Scale (HESPER)); and functional impairment (locally developed scale). A substantial percentage of participants scored above validated cut-off scores for depression (34.3%, 95% CI 28.4-40.4) and anxiety (33.8%, 95% CI 27.6-40.6). Hazardous alcohol use was reported by 20.4% (95% CI 17.1-24.3) and 10.9% (95% CI 8.8-13.5) reported suicidal ideation. Forty-two percent reported that 'distress' was a serious problem in their community. Anger that was out of control (symptom from the WASSS) was reported by 33.7% (95% CI 29.5-38.2). Fewer people had elevated rates of PTSD symptoms above a validated cut-off score (5.2%, 95% CI 3.9-6.8), and levels of functional impairment were also relatively low. Correlates of elevated symptom scores were female gender, lower caste and greater number of perceived needs. Residing in Gorkha and Sindhupalchowk districts and lower caste were also associated with greater perceived needs. Higher levels of impaired functioning were associated with greater odds of depression and anxiety symptoms; impaired

Women’s experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal

PubMed Central

2014-01-01

Background Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women’s experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Methods Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September–December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Results Study participants were 23–82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband’s sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. Conclusions UP adversely affects women’s daily life and negatively influences their physical, mental, and

Ethnomedicinal practices in the highlands of central Nepal: a case study of Syaphru and Langtang village in Rasuwa district.

PubMed

Shrestha, Nawal; Prasai, Deepshikha; Shrestha, Krishna Kumar; Shrestha, Saugat; Zhang, Xian-Chun

2014-09-11

The present paper documents the utilization of medicinal plants for the treatment of various human ailments in two village development committees in the Rasuwa district of central Nepal. It also evaluates the ethnopharmacological significance of the documented reports and identifies species of high indigenous priority in local therapeutics. The ethnobotanical information was collected by interviews and group discussions using standard ethnobotanical procedures. The homogeneity of informant׳s knowledge was validated by Informant consensus factor (F(IC)) and the relative importance of a plant species used as medicine in the study area was calculated with the help of use value (UV). The present study identified a total of 46 medicinal plants belonging to 26 families used for the treatment of 38 human ailments. Besides medicinal uses, the study has also documented the culinary and cultural use of 13 species of medicinal plants. The most commonly used part was root constituting about 42% of the total utilized plants. The most commonly used form of preparation was paste (31.91%). We found new usage reports for 9 medicinal plants. The F(IC) value in the present study ranged from 0.66 to 1 with 84.6% values greater than 0.8 indicating high consensus among the informants. The most preferred species was Neopicrorhiza scrophulariflora (UV=0.96) and the lowest used value was found for Lyonia ovalifolia (UV=0.32). People of Rasuwa possess rich traditional knowledge in medicinal plants utilization with strong consensus among local people on the utilization of species evident by higher F(IC) values in different ailment categories. Strong pharmacological evidence for a majority of species being currently used as medicines shows that the plants used in local therapeutics are likely to be more effective in treating different medical ailments. The bioactive compounds extracted from these medicinal plants could subsequently be used in the creation of novel drugs to treat life

Differentiated Typology of Sex Work and Implication for HIV Prevention Programs among Female Sex Workers in Nepal.

PubMed

Mishra, Shiva Raj; Neupane, Sanjeev Raj

2015-01-01

Sex work in exchange for kind and cash has long been practiced in Nepal. The HIV prevention program in Nepal is focused mainly on these two typologies of sex work. There might be more typologies of sex work beyond streets and establishments seeking research and programmatic attention. The objective of the study is to explore the differentiated typologies of sex work. This is a cross-sectional study conducted using a qualitative technique. Researchers carried out eight Focus Group Discussions with female sex workers (FSWs) (n = 50) in different places of Tanahu district. Data were analyzed using a deductive thematic analysis approach. We identified a more differentiated typology of sex work. Private contact-based sex work and the covert sex work on the cruising areas along the major highways were common. Sex work has become easier to operate with the advent of new technologies such as cell phone. With limited role of facilitation by brokers and pimps, now FSWs are better off and have longer duration of relationship with clients. Soft prostitution was common, as FSWs complemented their income through sex work. The conventional mode of peer and outreach educational approach needs to be further strengthened and modified according to the changing typology of sex work. HIV testing sites need to be further expanded to cruising areas along the highways.

Differentiated Typology of Sex Work and Implication for HIV Prevention Programs among Female Sex Workers in Nepal

PubMed Central

Mishra, Shiva Raj; Neupane, Sanjeev Raj

2015-01-01

Background: Sex work in exchange for kind and cash has long been practiced in Nepal. The HIV prevention program in Nepal is focused mainly on these two typologies of sex work. There might be more typologies of sex work beyond streets and establishments seeking research and programmatic attention. The objective of the study is to explore the differentiated typologies of sex work. Methods: This is a cross-sectional study conducted using a qualitative technique. Researchers carried out eight Focus Group Discussions with female sex workers (FSWs) (n = 50) in different places of Tanahu district. Data were analyzed using a deductive thematic analysis approach. Results: We identified a more differentiated typology of sex work. Private contact-based sex work and the covert sex work on the cruising areas along the major highways were common. Sex work has become easier to operate with the advent of new technologies such as cell phone. With limited role of facilitation by brokers and pimps, now FSWs are better off and have longer duration of relationship with clients. Soft prostitution was common, as FSWs complemented their income through sex work. Conclusion: The conventional mode of peer and outreach educational approach needs to be further strengthened and modified according to the changing typology of sex work. HIV testing sites need to be further expanded to cruising areas along the highways. PMID:25785259

Determinants of skilled birth attendants for delivery in Nepal.

PubMed

Baral, Y R; Lyons, K; Skinner, J; van Teijlingen, E R

2010-01-01

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

Determinants of Child Immunization in Nepal: The Role of Women's Empowerment

ERIC Educational Resources Information Center

Pandey, Shanta; Lee, Hae nim

2012-01-01

Background: Approximately 1.4 million or 13% of all children who die each year could be prevented with widely-available vaccines. Objective: We examined if women's empowerment improved child immunization using data on 1,056 mothers with young children from Nepal. Methods: The study utilized the 2006 Nepal Demographic and Health Survey, a…

Mineralogy and sedimentology of the Miocene Göcenoluk borate deposit, Kırka district, western Anatolia, Turkey

NASA Astrophysics Data System (ADS)

García-Veigas, Javier; Helvacı, Cahit

2013-05-01

The Miocene boratiferous district of Kırka, in western Anatolia (Turkey), is the most important Na-borate (borax) resource in the world. Two separate deposits in the Kırka district are located near the villages of Sarıkaya and Göcenoluk (Eskişehir Province). Borax is intensively exploited in open-pit mines in the Sarıkaya deposit while only small quarries of colemanite are known in the Göcenoluk deposit. Recent exploratory drilling in the Göcenoluk area intersected a thick succession of dolostones, tuffs and three borate-bearing units (Lower, Intermediate and Upper Borate Units). In them, the most abundant borate mineral is ulexite (Ca-Na-borate) passing at depth to probertite. Borax (Na-borate) is only present in the Intermediate Borate Unit. Minor amounts of colemanite (Ca-borate) and hydroboracite (Ca-Mg-borate) occur at the base, and/or top, of each mineralized unit. Pyroclastic layers within the borate units show intense alteration by alkaline, boron-bearing waters and formation of diagenetic clay minerals (smectites), zeolites (analcime) and borosilicates (searlesite). The Göcenoluk succession is interpreted as a shallow, ephemeral, alkaline lake deposit in which carbonates formed as stromatolites and travertines. Borate precipitation in the Göcenoluk area took place interstitially within muddy and carbonate sediments in a lateral progression from marginal Ca-borates towards Na-Ca-borates and rarely to Na-borates in the center of the lake. Authigenic silicate mineral distribution shows parallel changes toward the center of the lake that reflect increasing pH gradient.

HIV decline associated with changes in risk behaviours among young key populations in Nepal: analysis of population-based HIV prevalence surveys between 2001 and 2012.

PubMed

Deuba, Keshab; Ekström, Anna Mia; Tomson, Göran; Shrestha, Rachana; Marrone, Gaetano

2017-08-01

We assessed changes in HIV prevalence and risk behaviours among young key populations in Nepal. A total of 7505 participants (aged 16-24 years) from key populations who were at increased risk of HIV infection (2767 people who inject drugs (PWID); 852 men who have sex with men/transgender (MSM/TG); 2851 female sex workers (FSW) and 1035 male labour migrants) were recruited randomly over a 12-year period, 2001-2012. Local epidemic zones of Nepal (Kathmandu valley, Pokhara valley, Terai Highway and West to Far West hills) were analysed separately. We found a very strong and consistent decline in HIV prevalence over the past decade in different epidemic zones among PWID and MSM/TG in Kathmandu, the capital city, most likely due to a parallel increase in safe needle and syringe use and increased condom use. A decrease in HIV prevalence in 22 Terai highway districts, sharing an open border with India, was also consistent with increased condom use among FSW. Among male labour migrants, HIV prevalence was low throughout the period in the West to Far West hilly regions. Condom use by migrant workers involved with FSW abroad increased while their condom use with Nepalese FSW declined. Other risk determinants such as mean age at starting first injection, injection frequency, place of commercial sex solicitation, their mean age when leaving to work abroad did not change consistently across epidemic zones among the young key populations under study. In Nepal, the decline in HIV prevalence over the past decade was remarkably significant and consistent with an increase in condom use and safer use of clean needles and syringes. However, diverging trends in risk behaviours across local epidemic zones of Nepal suggest a varying degree of implementation of national HIV prevention policies. This calls for continued preventive efforts as well as surveillance to sustain the observed downward trend.

Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal.

PubMed

Budhathoki, Shyam Sundar; Bhattachan, Meika; Castro-Sánchez, Enrique; Sagtani, Reshu Agrawal; Rayamajhi, Rajan Bikram; Rai, Pramila; Sharma, Gaurav

2018-02-02

Menstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. Despite being an important issue concerning women and girls in the menstruating age group MHM is often overlooked in post-disaster responses. Further, there is limited evidence of menstrual hygiene management in humanitarian settings. This study aims to describe the experiences and perceptions of women and adolescent girls on menstrual hygiene management in post-earthquake Nepal. A mixed methods study was carried out among the earthquake affected women and adolescent girls in three villages of Sindhupalchowk district of Nepal. Data was collected using a semi-structured questionnaire that captured experiences and perceptions of respondents on menstrual hygiene management in the aftermath of the Nepal earthquake. Quantitative data were triangulated with in-depth interview regarding respondent's personal experiences of menstrual hygiene management. Menstrual hygiene was rated as the sixth highest overall need and perceived as an immediate need by 18.8% of the respondents. There were 42.8% women & girls who menstruated within first week of the earthquake. Reusable sanitary cloth were used by about 66.7% of the respondents before the earthquake and remained a popular method (76.1%) post-earthquake. None of the respondents reported receiving menstrual adsorbents as relief materials in the first month following the earthquake. Disposable pads (77.8%) were preferred by respondents as they were perceived to be clean and convenient to use. Most respondents (73.5%) felt that reusable sanitary pads were a sustainable choice. Women who were in the age group of 15-34 years (OR = 3.14; CI = (1.07-9.20), did not go to school (OR = 9.68; CI = 2.16-43.33), married (OR = 2.99; CI = 1.22-7.31) and previously used reusable sanitary cloth (OR = 5.82; CI = 2.33-14.55) were more likely to use the reusable sanitary cloth. In

Risk Factors for Podoconiosis: Kamwenge District, Western Uganda, September 2015.

PubMed

Kihembo, Christine; Masiira, Ben; Lali, William Z; Matwale, Gabriel K; Matovu, Joseph K B; Kaharuza, Frank; Ario, Alex R; Nabukenya, Immaculate; Makumbi, Issa; Musenero, Monica; Zhu, Bao-Ping; Nanyunja, Miriam

2017-06-01

AbstractPodoconiosis, a noninfectious elephantiasis, is a disabling neglected tropical disease. In August 2015, an elephantiasis case-cluster was reported in Kamwenge District, western Uganda. We investigated to identify the disease's nature and risk factors. We defined a suspected podoconiosis case as onset in a Kamwenge resident of bilateral asymmetrical lower limb swelling lasting ≥ 1 month, plus ≥ 1 of the following associated symptoms: skin itching, burning sensation, plantar edema, lymph ooze, prominent skin markings, rigid toes, or mossy papillomata. A probable case was a suspected case with negative microfilaria antigen immunochromatographic card test (ruling out filarial elephantiasis). We conducted active case-finding. In a case-control investigation, we tested the hypothesis that the disease was caused by prolonged foot skin exposure to irritant soils, using 40 probable case-persons and 80 asymptomatic village control-persons, individually matched by age and sex. We collected soil samples to characterize irritants. We identified 52 suspected (including 40 probable) cases with onset from 1980 to 2015. Prevalence rates increased with age; annual incidence (by reported onset of disease) was stable over time at 2.9/100,000. We found that 93% (37/40) of cases and 68% (54/80) of controls never wore shoes at work (Mantel-Haenszel odds ratio [OR MH ] = 7.7; 95% [confidence interval] CI = 2.0-30); 80% (32/40) of cases and 49% (39/80) of controls never wore shoes at home (OR MH = 5.2; 95% CI = 1.8-15); and 70% (27/39) of cases and 44% (35/79) of controls washed feet at day end (versus immediately after work) (OR = 11; 95% CI = 2.1-56). Soil samples were characterized as rich black-red volcanic clays. In conclusion, this reported elephantiasis is podoconiosis associated with prolonged foot exposure to volcanic soil. We recommended foot hygiene and universal use of protective shoes.

Hazardous child labor in Nepal: The case of brick kilns.

PubMed

Larmar, Stephen; O'Leary, Patrick; Chui, Cheryl; Benfer, Katherine; Zug, Sebastian; Jordan, Lucy P

2017-10-01

Hazardous child labor in Nepal is a serious concern, particularly in the brick kiln industry. Although a range of interventions have been implemented in Nepal to address hazardous child labor, there is a lack of research to both measure success and shape further development in interventions that integrate sound child protection practices to ensure the wellbeing of all children. This paper provides a review of the literature outlining interventions for children working in brick kilns in Nepal, and presents preliminary case study findings of one current intervention in the Kathmandu Valley. The paper highlights the strength of applying foundational child protection principles and advocates for the development and implementation of future programs underpinned by broad civil society principles within a child rights and protection framework. Copyright © 2017. Published by Elsevier Ltd.

Disaster response under One Health in the aftermath of Nepal earthquake, 2015.

PubMed

Asokan, G V; Vanitha, A

2017-03-01

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.

Epidemiology, Impact and Control of Rabies in Nepal: A Systematic Review

PubMed Central

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

2016-01-01

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

Epidemiology, Impact and Control of Rabies in Nepal: A Systematic Review.

PubMed

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

2016-02-01

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 populations and the true

Attitudes towards helminthic infection in the Jirel population of eastern Nepal.

PubMed

Williams-Blangero, S; Subedi, J; Upadhayay, R P; Manral, D B; Khadka, K; Jirel, S; Robinson, E S; Blangero, J

1998-08-01

Intestinal worm infections, including roundworm, hookworm, and whipworm, are major international health concerns, affecting approximately one fourth of the world's population. Many intervention schemes have been attempted to control these infections in heavily exposed populations, but success has been limited because individuals are readily reinfected upon renewed exposure. Few data are available concerning people's health beliefs about soil-transmitted helminthic infections in such populations. The purpose of this study was to assess health beliefs about common helminthiasis in a population experiencing moderate to high rates of infection. The focal population for the study was the Jirel population, a tribal group distributed across nine villages in the Jiri Region of Dolakha District, eastern Nepal. The results indicate that beliefs about the types, causes, and treatments of helminthic infections have been developed and reinforced by experience and empirical evidence. People's frequent inability to confirm the efficacy of drug therapy by observing worms in stools has led to dissatisfaction with biomedical approaches. Carefully planned education programs are required to alter prevailing attitudes and improve control of soil-transmitted helminthiasis in the region.

Review of Brucellosis in Nepal

PubMed Central

Acharya, Krishna Prasad; Niroula, Nirajan; Kaphle, Krishna

2016-01-01

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

Mapping Geohazards in the Churia Region of Nepal: An Application of Remote Sensing and Geographic Information Systems

NASA Astrophysics Data System (ADS)

Bannister, Terri

The Churia region of Nepal is experiencing serious environmental degradation due to landslides, monsoon flooding, land use changes, and gravel excavation. The objectives of this study were to quantify the temporal change of landslides as related to changes in land use/deforestation/urbanization, to quantify the temporal change and extent of river inundation in the Terai, to quantify the extent to which stone quarrying exacerbates the degradation process, and to generate a landslide hazard risk map. Gravel extraction and precipitation data, along with field work and geospatial methods, were used to map degradation by focusing on the centrally located districts of Bara, Rautahat, and Makwanpur. Landsat land use classifications were conducted on imagery from 1976, 1988, 1999, and 2015. A modified Normalized Difference Mid-Infrared (NDMIDIR) algorithm was created by incorporating slope, elevation, and land use types to identify landslide scars. A GIS model using weighted landslide variables derived from remote sensing and GIS methods to predict landslide susceptibility was created. These variables include hydrology, settlement, lithology, geology, precipitation, infrastructure, elevation, slope, aspect, land use, and previous landslides. Gravel excavation in 2007/2008 was nearly 700% higher than in 2001/2002. The Normalized Difference Vegetation Index (NDVI) results showed that the study area is losing 1.03% forest cover annually; in 1977, there was 70% forest cover, but only 32% forest cover remained in 2016. The accuracy assessment of the 2015 Landsat 8 land use classification was 79%. NDMIDIR results showed that from 1988 to 2016, the total area representing landslide scars increased from 7.26km2 to 8.73 km2. The weighted variable GIS model output map indicated that 70% of the Siwalik zone and southern Lesser Himalayan zone in the three study districts have significant risk of landslides. Landslides and flooding from heavy monsoon rain, deforestation to develop

Complementary school garden, nutrition, water, sanitation and hygiene interventions to improve children's nutrition and health status in Burkina Faso and Nepal: a study protocol.

PubMed

Erismann, Séverine; Shrestha, Akina; Diagbouga, Serge; Knoblauch, Astrid; Gerold, Jana; Herz, Ramona; Sharma, Subodh; Schindler, Christian; Odermatt, Peter; Drescher, Axel; Yang, Ray-Yu; Utzinger, Jürg; Cissé, Guéladio

2016-03-09

Malnutrition and intestinal parasitic infections are common among children in Burkina Faso and Nepal. However, specific health-related data in school-aged children in these two countries are scarce. In the frame of a larger multi-stakeholder project entitled "Vegetables go to School: Improving Nutrition through Agricultural Diversification" (VgtS), a study has been designed with the objectives to: (i) describe schoolchildren's health status in Burkina Faso and Nepal; and to (ii) provide an evidence-base for programme decisions on the relevance of complementary school garden, nutrition, water, sanitation and hygiene (WASH) interventions. The studies will be conducted in the Centre Ouest and the Plateau Central regions of Burkina Faso and the Dolakha and Ramechhap districts of Nepal. Data will be collected and combined at the level of schools, children and their households. A range of indicators will be used to examine nutritional status, intestinal parasitic infections and WASH conditions in 24 schools among 1144 children aged 8-14 years at baseline and a 1-year follow-up. The studies are designed as cluster randomised trials and the schools will be assigned to two core study arms: (i) the 'complementary school garden, nutrition and WASH intervention' arm; and the (ii) 'control' arm with no interventions. Children will be subjected to parasitological examinations using stool and urine samples and to quality-controlled anthropometric and haemoglobin measurements. Drinking water will be assessed for contamination with coliform bacteria and faecal streptococci. A questionnaire survey on nutritional and health knowledge, attitudes and practices (KAP) will be administered to children and their caregivers, also assessing socioeconomic, food-security and WASH conditions at household level. Focus group and key-informant interviews on children's nutrition and hygiene perceptions and behaviours will be conducted with their caregivers and school personnel. The studies will

Abortion: Still Unfinished Agenda in Nepal.

PubMed

Shrestha, Dirgha Raj; Regmi, Shibesh Chandra; Dangal, Ganesh

2018-03-13

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.

Involving diaspora and expatriates as human resources in the health sector in Nepal.

PubMed

Devkota, A; Devkota, B; Ghimire, J; Mahato, R K; Gupta, R P; Hada, A

2013-05-01

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.

Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

PubMed Central

Shrestha, Khadka Narayan; Homer, Caroline S. E.

2017-01-01

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

Measuring Nutrition Governance: An Analysis of Commitment, Capability, and Collaboration in Nepal.

PubMed

Webb, Patrick; Ghosh, Shibani; Shrestha, Robin; Namirembe, Grace; Gurung, Sabi; Sapkota, Diplav; Bell, Winnie Fay; Davis, Dale; Kennedy, Eileen; Neupane, Shailes; Manohar, Swetha; Baral, Kedar

2016-12-01

Global commitments to nutrition have supported calls for better evidence to support effective investments at national level. However, too little attention has so far been paid to the role of governance in achieving impacts. This article explores the ways by which the commitment and capabilities of policy implementers affect collaborative efforts for achieving nutrition goals. Over 1370 structured interviews were held with government and nongovernment officials over 3 years in 21 districts. Coded responses supported quantitative analysis of stakeholders' knowledge, attitudes, and practices regarding policy implementation. Stakeholder commitment was already high in 2013 when a new national policy was adopted, but capabilities were weak. Only one-third of interviewed respondents had any nutrition training. Rollout of training focusing on districts targeted for early implementation of multisector programming. This raised levels of nutrition training among interviewed respondents to 57% in 2015, which raised demand for technical information to support actions. Better understanding of the complexity of cross-sector work led to calls for higher budgets and more effective cross-sectoral collaboration. Nepal offers an example of effective efforts to improve nutrition governance across sectors at all levels of administration. The promotion of awareness, capacity, and new ways of working shows promise. Trainings, information sharing, and management support led to growing willingness among civil servants to engage across sectors. Structured surveys offer a viable way to track change across institutions and sectors. © The Author(s) 2016.

Assessing access to surgical care in Nepal via a cross-sectional, countrywide survey.

PubMed

Boeck, Marissa A; Nagarajan, Neeraja; Gupta, Shailvi; Varadaraj, Varshini; Groen, Reinou S; Shrestha, Sunil; Gurung, Susant; Kushner, Adam L; Nwomeh, Benedict; Swaroop, Mamta

2016-08-01

Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. Fifteen of 75 Nepali districts were selected proportionate to the population, with 1,350 households surveyed. Household heads answered questions regarding access to health facilities, and 2 household members were interviewed for medical history. Continuous and categorical variables were analyzed via Wilcoxon rank sum test and Pearson χ(2) test. Multivariable logistic regressions for independent predictors of care access were performed controlling for age, sex, location, and literacy. Of respondents with a surgical condition (n = 1,342), 650 (48.4%) accessed care and 237 (17.7%) did not. Unadjusted analyses showed greater median travel times to all facilities (P < .001) and median transport costs to secondary and tertiary centers (P < .001) for those who did not access care versus those who did. Literate respondents were more likely to access care across all facilities and access variables in adjusted models (odds ratio 1.66-1.80, P < .01). Those without transport money were less likely to access care at any facility in all analyses (P < .01). The data project that at least 2.4 million individuals lack access to needed surgical care in Nepal during their lifetimes, with those not accessing health facilities having lower literacy rates and fewer transport resources. Promoting education, outreach programs, and transportation access could lessen barriers but will require further exploration. Copyright © 2016 Elsevier Inc. All rights reserved.

The epidemiology of ocular trauma in rural Nepal

PubMed Central

Khatry, S K; Lewis, A E; Schein, O D; Thapa, M D; Pradhan, E K; Katz, J

2004-01-01

Aims: To estimate the incidence of ocular injury in rural Nepal and identify details about these injuries that predict poor visual outcome. Methods: Reports of ocular trauma were collected from 1995 through 2000 from patients presenting to the only eye care clinic in Sarlahi district, Nepal. Patients were given a standard free eye examination and interviewed about the context of their injury. Follow up examination was performed 2–4 months after the initial injury. Results: 525 cases of incident ocular injury were reported, with a mean age of 28 years. Using census data, the incidence was 0.65 per 1000 males per year, and 0.38 per 1000 females per year. The most common types of injury were lacerating and blunt, with the majority occurring at home or in the fields. Upon presentation to the clinic, 26.4% of patients had a best corrected visual acuity worse than 20/60 in the injured eye, while 9.6% had visual acuity worse than 20/400. 82% were examined at follow up: 11.2% of patients had visual acuity worse than 20/60 and 4.6% had vision worse than 20/400. A poor visual outcome was associated with increased age, care sought at a site other than the eye clinic, and severe injury. 3% of patients were referred for further care at an eye hospital at the initial visit; 7% had sought additional care in the interim between visits, with this subset representing a more severe spectrum of injuries. Conclusions: The detrimental effects of delayed care or care outside of the specialty eye clinic may reflect geographic or economic barriers to care. For optimal visual outcomes, patients who are injured in a rural setting should recognise the injury and seek early care at a specialty eye care facility. Findings from our study suggest that trained non-ophthalmologists may be able to clinically manage many eye injuries encountered in a rural setting in the “developing” world, reducing the demand for acute services of ophthalmologists in remote locations of this highly

Paleozoic sedimentary rocks in the Red Dog Zn-Pb-Ag district and vicinity, western Brooks Range, Alaska: provenance, deposition, and metallogenic significance

USGS Publications Warehouse

Slack, John F.; Dumoulin, Julie A.; Schmidt, J.M.; Young, L.E.; Rombach, Cameron

2004-01-01

The distribution and composition of Paleozoic strata in the western Brooks Range may have played a fundamental role in Zn-Pb mineralization of the Red Dog district. In our model, deposition and early lithification of biogenic chert and bedded siliceous rocks in the upper part of the Kuna Formation served as a regional hydrologic seal, acting as a cap rock to heat and hydrothermal fluids during Late Mississippian base-metal mineralization. Equally important was the iron-poor composition of black shales of the Kuna Formation (i.e., low Fe/Ti ratios), which limited synsedimentary pyrite formation in precursor sediments, resulting in significant H2S production in pore waters through the interaction of aqueous sulfate with abundant organic matter. This H2S may have been critical to the subsurface deposition of the huge quantities of Zn and Pb in the district. On the basis of this model, we propose that low Fe/Ti and S/C ratios in black shale sequences are potential basin-scale exploration guides for giant sediment-hosted, stratiform Zn-Pb-Ag deposits.

Foreign Assistance and Its Impact on Civil-Military Relations: A Case Study of Federal Democratic Republic of Nepal

DTIC Science & Technology

2014-03-01

China activities and keeping Nepal away from being too dependent in India. While assisting Kathmandu, Beijing is consciously making strategic inroads...112 Campbell, “Nepal Case Study,” 5. 113 M Humagain, “Aid Quantum : China the Rising Sun on Nepal Economic...military/library/congress/2006_hr/060407- hillen.pdf. Humagain, M. “Aid Quantum : China the Rising Sun on Nepal Economic Horizon.” Kathmandu Post

Sex Trafficking Related Knowledge, Awareness, and Attitudes among Adolescent Female Students in Nepal: A Cross-Sectional Study

PubMed Central

2015-01-01

Background 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. Methods 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. Results 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

Evaluation of a monitoring program for assessing the effects of management practices on the quantity and quality of drainwater from the Panoche Water District, western San Joaquin Valley, California

USGS Publications Warehouse

Leighton, David A.; Fio, John L.

1995-01-01

An evaluation was made of an existing monitoring program in the Panoche Water District for 1986-93. The Panoche Water District is an agricultural area located in the western San Joaquin Valley of California. Because irrigation drainage from this area has high concentrations of dissolved solids and selenium, management strategies have been developed to improve the quality of drainwater discharge. The purpose of the Panoche Water District's monitoring program is to assess the effects of water- and land-use practices on local ground water and drain flow from the district. Drainflow from the district consists of the discharge from 50 separate on-farm underground tile-drainage systems. The Panoche Water District maintains information on water deliveries, planned and actual crop types, and planned and actual acreages planted each year. In addition, the water district monitors ground-water and drainage-system discharges using a variety of data-collection methods. A total of 62 observation well sites are used to monitor ground-water level and quality. A total of 42 sites were monitored for drainflow quantity, and drain flow quality samples were collected from the outlets of each of the 50 drainage systems. However, these data were collected inconsistently and (or) intermittently during the period studied. All data obtained from the water district were compiled and stored in a geographic information system database. Water delivered for irrigation by the Panoche Water District is a mix of imported water and local ground water pumped directly into delivery canals. Although delivered water is a mix, information on the proportion of water from the two sources is not reported. Also, individual growers pump directly to their crops unknown quantities of ground water, the total of which could be greater than 60 percent of total applications during years when water district deliveries are greatly reduced (for example, the years during and following a drought). To evaluate the

Incidence and Risk Factors for Neonatal Jaundice among Newborns in Southern Nepal

PubMed Central

Scrafford, Carolyn G.; Mullany, Luke C.; Katz, Joanne; Khatry, Subarna K.; LeClerq, Steven C.; Darmstadt, Gary L.; Tielsch, James M.

2016-01-01

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-values<0.01). After multi-variable adjustment, sex, birth weight, difficulty feeding, prolonged labor, primiparity, oil massage, ambient air temperature, and ethnicity remained important factors. Among infants with difficulty feeding, exclusive breastfeeding was a risk factor for neonatal jaundice, 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

Bear-inflicted injuries - a report from Nepal.

PubMed

Atreya, Alok; Kanchan, Tanuj; Nepal, Samata; Acharya, Jenash

2016-06-01

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.

Private Firms Run Two Mich. Districts

ERIC Educational Resources Information Center

Ash, Katie

2013-01-01

Educators and policy observers are keeping a close eye on two controversial experiments in private management of public schools now unfolding in the western Michigan city of Muskegon Heights and in the Detroit-area community of Highland Park. Citing chronic budget woes in the communities' low-performing school districts, Gov. Rick Snyder of…

Stigma and HIV risk among Metis in Nepal

PubMed Central

Wilson, Erin; Pant, Sunil Babu; Comfort, Megan; Ekstrand, Maria

2011-01-01

Similar to other parts of Asia, the HIV epidemic in Nepal is concentrated among a small number of groups, including transgender people, or Metis. This study was conducted to explore the social context of stigma among Metis in Nepal to better understand their risk for HIV. Fourteen in-depth interviews were conducted with Metis in Kathmandu, Nepal. We found that stigma from families leading to rural-urban migration exposed Metis to discrimination from law enforcement, employers and sexual partners, which influenced their risk for HIV. Specific HIV-related risks identified were rape by law enforcement officers, inconsistent condom use and high reported numbers of sexual partners. These data point to an immediate need to work with law enforcement to reduce violence targeting Metis. HIV prevention, housing and employment outreach to Metis in rural areas and those who migrate to urban areas is also needed. Finally, there is a need for more research to determine the prevalence of HIV among Metis, to explore risk within sexual networks and to better understand of the relationship between Metis and their families in order to develop future programmes and interventions. PMID:21058085

Sexual health knowledge, sexual relationships and condom use among male trekking guides in Nepal: a qualitative study.

PubMed

Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R; Bhatta, Prakash

2010-01-01

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.

Barriers to Utilization of Antenatal Care Services in Eastern Nepal.

PubMed

Deo, Krishna Kumar; Paudel, Yuba Raj; Khatri, Resham Bahadur; Bhaskar, Ravi Kumar; Paudel, Rajan; Mehata, Suresh; Wagle, Rajendra Raj

2015-01-01

World Health Organization recommends at least four pregnancy check-ups for normal pregnancies. Ministry of Health and Population Nepal has introduced various strategies to promote prenatal care and institutional delivery to reduce maternal and child deaths. However, maternal health service utilization is low in some selected socio-economic and ethnic groups. Hence, this study aims to assess barriers to the recommended four antenatal care (4ANC) visits in eastern Nepal. A cross-sectional quantitative study was conducted in Sunsari district. A total of 372 randomly selected women who delivered in the last year preceding the survey were interviewed using a semi-structured questionnaire. Bivariate and multivariate logistic regression analysis was carried out to identify barriers associated with 4ANC visits. More than two-third women (69%) attended at least 4ANC visits. The study revealed that women exposed to media had higher chance of receiving four or more ANC visits with an adjusted odds ratio (aOR = 3.5, 95% CI: 1.2-10.1) in comparison to women who did not. Women from an advantaged ethnic group had more chance of having 4ANC visits than respondents from a disadvantaged ethnic group (aOR = 2.4, 95% CI: 2.1-6.9). Similarly, women having a higher level of autonomy were nearly three times more likely (aOR = 2.9, 95% CI: 1.5-5.6) and richer women were twice (aOR = 2.3, 95% CI: 1.1-5.3) as likely to have at least 4ANC visits compared to women who had a lower level of autonomy and were economically poor. Being from disadvantaged ethnicity, lower women's autonomy, poor knowledge of maternal health service and incentive upon completion of ANC, less media exposure related to maternal health service, and lower wealth rank were significantly associated with fewer than the recommended 4ANC visits. Thus, maternal health programs need to address such socio-cultural barriers for effective health care utilization.

77 FR 26001 - Southwest Power Pool; Western Area Power Administration; Basin Electric Cooperative; Heartland...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-60-000] Southwest Power Pool; Western Area Power Administration; Basin Electric Cooperative; Heartland Consumers Power District... 385.207, Southwest Power Pool (SPP), Western Area Power Administration (Western), Basin Electric Power...

Study of Annual Mass Balance (2011-2013) of Rikha Samba Glacier, Hidden Valley, Mustang, Nepal

NASA Astrophysics Data System (ADS)

Gurung, S.; Bhattrai, B. C.; Kayastha, R. B.; Stumm, D.; Joshi, S.; Mool, P. K.

2016-12-01

lthough Himalayan glaciers are of particular interest interms of future water supplies, regional climate changes, and sea-level rises, little is known about them due to lack of reliable and consistent data. There is a need for monitoring these glaciers to bridge this knowledge gap and to provide field measurements necessary to calibrate and validate the results from different remote sensing operations. Therefore, glaciological observations have been carried out by the Cryosphere Monitoring Project (CMP) since September 2011 on Rikha Samba Glacier in Hidden valley, Mustang district in western Nepal in order to study its annual mass balance. This paper presents the first results of that study. There are 10 glaciers in Hidden Valley, named G1, G2, G3, up to G10. Of these, G5 is the Rikha Samba Glacier, which has the largest area (5.37 km2) in this valley and the highest and lowest altitudes (6,476 and 5,392 m a.s.l., respectively). The glacier mass balance discussed in this paper was calculated using the glaciological method and the equilibrium line altitude (ELA).The glacier showed a negative annual point mass balance along the longitudinal profile of its lower part from September 10, 2011 to October 3, 2012. Stake measurements from October 4, 2012 to September 30, 2013 indicated a negative areal average of annual mass balance -0.088±0.019 m w.e. for the whole glacier. Based on these observations, the ELA of the Rikha Samba Glacier is estimated at 5,800 m a.s.l. in 2013. This negative balance may be due to rising air temperatures in the region, which have been incrementally rising since 1980 accompanied by little or no significant increase in precipitation in that period. The negative mass balance confirms the general shrinking trend of the glacier.

An assessment study of maternal mortality ratio databank in five districts of North Western Frontier Province Pakistan.

PubMed

Farooq, Nasir; Jadoon, Huma; Masood, Tayyeb Imran; Wazir, M Saleem; Farooq, Umer; Lodhi, Mohammad Saqib

2006-01-01

Maternal mortality ratio is an indicator to measure the summary of information about mother and child health. It is estimated that about 500 maternal deaths occur per 100,000 live births each year in Pakistan. It is a well known fact that all health statistics coming out of the developing countries are calculated "guesstimates" some are perhaps more close to the real figures than the others. There is a dire need to help generate information that can be used by health professionals, health care planners and managers to save women's lives by improving the quality of care provided to turn away maternal mortality. The maternal mortality ratio for Pakistan as well as for NWFP is projected as 533/100,000 live births for the year 1990-91 produced by National Institute of Population Studies, Pakistan. This was a retrospective cross-sectional quantitative study for the period (2001-2002) conducted in five districts of (NWFP) North Western Frontier Province, Pakistan. National HMIS data opened the maternal mortality ratio for; Haripur as 0.168 and 0.173, Mansehra 00 and 00, Battagram 00 and 00, Swat 0.051. and 0.524 and Swabi 00 and 0.968 per/1000 live births, respectively. The small part exercise outcome (the study) endorsed more shadowy side of the actual maternal mortality ratio for the same period in the same districts. In our country there is a urgent need to institute an efficient mode of operation to get accurate maternal mortality database. Verbal Autopsy method is cost effective and feasible approach for implementation in a country like Pakistan.

Leadership Development Institute: A California Community College Multi-College District Case Study

ERIC Educational Resources Information Center

Leon, Bianca R.

2016-01-01

The purpose of this study is to examine a community college district Grow Your Own (GYO) leadership program in the Western United States, the Multi College Leadership Development Institute (MCLDI). The MCLDI was developed in-house for a multi-campus community college district and offered to interested employees at all position levels with the…

Exploring migration intention of nursing students in Nepal: A mixed-methods study.

PubMed

Poudel, Chandra; Ramjan, Lucie; Everett, Bronwyn; Salamonson, Yenna

2018-03-01

The objective of this study was to assess the migration intention of students enrolled in pre-registration nursing programs in Nepal, and to explore factors influencing this intention. Using an embedded mixed methods design, 799 nursing students were surveyed, followed by 12 semi-structured face-to-face interviews. The result showed that the majority (92.5%) expressed some intention to migrate, with three quarters of these listed furthering their study abroad as the primary reason. In the multiple regression analysis, those with lower professional identity, and those who reported nursing was not their first choice were likely to express migration intention. Interview data identified low salaries, unemployment, poor working conditions, insufficient postgraduate education, and a lack of professional autonomy in Nepal as reasons for their intention to migrate. Increasing opportunities for nurses to undertake postgraduate education in Nepal, promoting a positive image of nursing, and facilitating a supportive learning environment during undergraduate nursing education could help address the potential loss of nurses from Nepal. Copyright © 2017 Elsevier Ltd. All rights reserved.

Determinants of choice of market-oriented indigenous Horo cattle production in Dano district of western Showa, Ethiopia.

PubMed

Alemayehu, Befikadu; Bogale, Ayalneh; Wollny, Clemens; Tesfahun, Girma

2010-12-01

Based on a survey data collected from 150 farming households in Dano district of western Showa of Ethiopia, this paper analyzes determinants of smallholders' choice for market oriented indigenous Horo cattle production and tries to suggest policy alternatives for sustainable use of animal genetic resource in the study area. Descriptive statistics and binary logistic model were employed to analyze the data. Eight explanatory variables including age of the household head, size of the grazing land, total size of cultivated land, farmer's experience in indigenous cattle production, farmer's attitude towards productivity of local breed, off-farm income, fattening practice, and availability of information and training of the head of the household regarding conservation, management and sustainable use indigenous cattle were found to be statistically significant variables to explain farmers' choice for market oriented indigenous cattle production activities. Besides, possible policy implications were made in order to improve conservation, management and sustainable use of market oriented indigenous cattle genetic resources.

Fecal contamination of drinking water in Kericho District, Western Kenya: role of source and household water handling and hygiene practices.

PubMed

Too, Johana Kiplagat; Kipkemboi Sang, Willy; Ng'ang'a, Zipporah; Ngayo, Musa Otieno

2016-08-01

Inadequate protection of water sources, and poor household hygienic and handling practices have exacerbated fecal water contamination in Kenya. This study evaluated the rate and correlates of thermotolerant coliform (TTC) household water contamination in Kericho District, Western Kenya. Culture and multiplex polymerase chain reaction (PCR) techniques were used to characterize TTCs. The disk diffusion method was used for antibiotic susceptibility profiling of pathogenic Escherichia coli. Out of the 103 households surveyed, 48 (46.6%) had TTC contaminated drinking water (TTC levels of >10 cfu/100 mL). Five of these households were contaminated with pathogenic E. coli, including 40% enteroaggregative E. coli, 40% enterotoxigenic E. coli, and 20% enteropathogenic E. coli. All these pathogenic E. coli strains were multidrug resistant to sulfamethoxazole/trimethoprim, ampicillin, tetracycline and ampicillin/sulbactam. Rural household locality, drinking water hand contact, water storage container cleaning practice, hand washing before water withdrawal, water source total coliforms <10 cfu/100 mL, temperature, and free chlorine levels were associated with TTC contamination of household drinking water. Significant proportions of household drinking water in Kericho District are contaminated with TTCs including with pathogenic multidrug-resistant E. coli. Source and household hygiene and practices contribute significantly to drinking water contamination.

Impact of livestock hygiene education programs on mastitis in smallholder water buffalo (Bubalus bubalis) in Chitwan, Nepal.

PubMed

Ng, Linda; Jost, Christine; Robyn, Misha; Dhakal, I P; Bett, Bernard; Dhakal, Pramod; Khadka, Rupak

2010-09-01

A project implemented from 2003 to 2005 trained women in Chitwan District, Nepal, in hygienic dairy production using a process of social mobilization. The aim of this research was to assess if the prevalence of mastitis in water buffalo in the households of women who were trained was lower one year after training than in untrained households, if the training influenced knowledge and practices for the prevention or control of mastitis, and if these practices and knowledge were associated with a lower prevalence of mastitis. A total of 202 households from Eastern and Western Chitwan District were included in the study. Of these, 60 households had participated in the project and 142 had not. Milk samples were collected from 129 households (33 project households and 96 non-project households). Clinical mastitis was determined using visual inspection of udders and detection of macroscopic clots and flakes in milk. The California Mastitis Test was used to diagnose sub-clinical mastitis from milk samples, and the IDEXX SNAP test to identify the presence of tetracycline residues. The prevalence of mastitis in trained households (39.4%) was 43.78% of that in untrained households (60.4%), lower but not significantly so (p=0.08, 95% CI 0.17-1.12). Thirteen indicators of knowledge or practice for the control or prevention of mastitis were more likely to occur in trained households, four significantly so (not consuming milk from sick buffalo (p=0.001), using soap to wash hands before milking (p=0.001), discarding milk after antibiotic usage (p=0.01), and choosing appropriate flooring for their livestock (p=0.03)). Trained households that discarded milk from sick buffalo were 2.96 times more likely to have at least one animal with mastitis in the household (p=0.03, 95% CI 1.15-7.65). Trained households that knew to wash buffalos' teats after milking were less likely (OR 0.25) to have mastitis in their herd (p=0.02, 95% CI 0.08-0.80). Of the 138 buffalos tested, only one tested

Characterization of extensively drug-resistant Mycobacterium tuberculosis in Nepal.

PubMed

Poudel, Ajay; Maharjan, Bhagwan; Nakajima, Chie; Fukushima, Yukari; Pandey, Basu D; Beneke, Antje; Suzuki, Yasuhiko

2013-01-01

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.

Development of leadership self-efficacy and collective efficacy: adolescent girls across castes as peer educators in Nepal.

PubMed

Posner, J; Kayastha, P; Davis, D; Limoges, J; O'Donnell, C; Yue, K

2009-01-01

Adolescent girls in Nepal face enormous social barriers to accessing education and health services due to exclusionary socio-religious traditions and years of conflict. The programme and study reported here address two issues that a national assembly of in-school and out-of-school adolescent girls, who had completed a basic life skills class, and, in the case of unschooled girls, an intensive literacy course, identified as important to their well-being - menstrual restrictions and HIV awareness and prevention. Local non-governmental organizations developed a peer education programme in three districts of Nepal that paired girls from different castes and different educational levels. The programme sought to increase peer educators' (PE) leadership and collective efficacy for informing peers and adults in their communities about the effects that these issues have on women and girls. In total, 504 girls were selected and trained as PEs. They conducted targeted discussion sessions with other girls and organised mass awareness events, reaching 20,000 people. Examination of the effects of participating in the programme on key outcome measures showed that leadership self-efficacy, which was a central theoretical construct for the programme, provided a strong predictor of both increased HIV knowledge and of practicing fewer menstrual restrictions at endline. The project demonstrated that girls from different caste and educational backgrounds are able to work together to change individual behaviour and to address socio-cultural norms that affect their lives and well-being within their communities.

Does Private School Competition Improve Public School Performance? The Case of Nepal

ERIC Educational Resources Information Center

Thapa, Amrit

2013-01-01

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…

Determinants of child maltreatment in Nepal: Results from the 2014 Nepal multiple indicator cluster survey (the 2014 NMICS).

PubMed

Atteraya, Madhu Sudhan; Ebrahim, Nasser B; Gnawali, Shreejana

2018-02-01

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 (p<0.001). Results from multivariate logistic regressions showed that higher education levels and higher household wealth status protected children from moderate to severe physical abuse, emotional abuse and child 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.

Pharmacy workforce to prevent and manage non-communicable diseases in developing nations: The case of Nepal.

PubMed

Khanal, Saval; Nissen, Lisa; Veerman, Lennert; Hollingworth, Samantha

2016-01-01

Non-communicable diseases (NCDs, e.g. cardiovascular diseases, cancer, chronic respiratory diseases and diabetes mellitus) are the main causes of mortality and morbidity in developing countries, including Nepal. Nearly half of the deaths in Nepal are caused by NCDs. Nepal lacks adequate human resources to prevent and manage NCDs, but the skills and expertise of pharmacists in Nepal are underused. There is evidence from many countries that pharmacists can contribute substantially to the prevention and management NCD. We aim to describe the opportunities and challenges for pharmacists to prevent and manage NCDs in Nepal. Pharmacists can contribute by screening and monitoring NCDs; counseling on lifestyle; providing medication therapy management services; promoting public health; and providing other pharmaceutical services. Challenges to the implementation of some of these activities in the current context include inadequate training of pharmacists in NCD prevention and management, the cost of pharmaceutical services to patients and government, and the existing health care service delivery model. There is a need for health services research to determine how pharmacists can be best used to prevent and manage NCDs in Nepal. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of disasters on child stunting in Nepal

PubMed Central

Gaire, Surya; Delbiso, Tefera Darge; Pandey, Srijana; Guha-Sapir, Debarati

2016-01-01

Background Stunting is a major public health problem that results from inadequate nutritional intake over a long period of time. Disasters have major implications in poor and vulnerable children. The aim of this study was, therefore, to assess the impact of disasters on child stunting in Nepal. Method A sample consisting of 2,111 children aged 6–59 months was obtained from the 2011 Nepal Demographic and Health Survey. We used bivariate and multivariate analyses to examine moderate and severe stunting against disaster, controlling for all possible confounders. Result Out of the total study sample, 43% were stunted (17.1% severely and 25.9% moderately). The final model, after adjusting for confounders, showed that epidemics have no impact on child stunting (adjusted odds ratio [OR] =1.14, 95% confidence interval [CI]: 0.66, 1.97 and adjusted OR =1.04, 95% CI: 0.66, 1.65 for severe and moderate stunting, respectively). Floods have impact on child stunting (adjusted OR =0.57, 95% CI: 0.31, 0.96 and adjusted OR =0.66, 95% CI: 0.41, 0.94 for severe and moderate stunting, respectively). However, children aged 6–11 months, nonvaccinated children, children of working women, children who live in mountainous areas, and children from the poorest households were more likely to be moderately stunted. Similarly, children aged 36–47 months, Dalit and other ethnic groups, children from rural settings, and children from the poorest households were more likely to be severely stunted. Conclusion This article illustrates the need to rethink about child stunting in Nepal. This study suggests need for further research, integration of disaster data in the Nepal Demography Health Survey, educational interventions, public awareness, promotion of vaccination, and equity in health service delivery. PMID:27354834

Effects of abortion legalization in Nepal, 2001-2010.

PubMed

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

2013-01-01

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

Girls' and Women's Education in Nepal.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

The impact of enlightened policies and incentives designed to increase girls' enrollment and achievement in education has been marginal in Nepal. Ministry of Education (MOE) goals aimed at increasing girls' participation include increasing the enrollment rate, opening early childhood development centers, promoting recruitment of at least one…

A first telecoupling analysis of multi-species poaching trade in Nepal: When outside demands seek and distribute a local resource in times of globalization

NASA Astrophysics Data System (ADS)

Regmi, G. R.; Lama, R. P.; Puri, G.; Huettmann, F.

2016-12-01

Asia remains one of the last wilderness resources in the world. It's widely praised for those resources and they are in a global appreciation and demand. Considering open borders, many of them virtually uncontrollable in Asia, and globalization in full swing, precious local resources become available to a global audience without much constraint though. Nepal and its unique biodiversity presents us with one of such cases while hard data remain elusive. Here we present a first telecoupling analysis based on poaching and crime statistics presented in the public print national daily newspapers (Kantipur and Gorkhapatra) in Nepal. This review highlights a few high-profile species (timber: Sal Shorea robusta , Sissoo Dalbergia sissoo, Pine Pinus species; aromatic and medicinal plants: Red Sandal Wood Santalum album, Orchid Orchid species, Paris Paris polyphylla, Jatamashi Nardostachys grandiflora, Kutki Picrorhyza scrophulariiflora and wildlife: Royal Bengal Tiger Panthera tigris tigris, Rhino Rhinoceros unicornis, Pangolin Manis species, Common Leopard Panthera pardus, Red Panda Ailurus fulgens, Snow Leopard Panthera uncia) in Nepal, traded out directly and illegally to India and China. We provide a wider perspective regarding sending, receiving and spill-over agents. Arguably, the western world as the spill-over agent set up a globalization framework that allows for items, virtually any items, to be shipped across borders, e.g. done on foot, by car or plane. It further allows to create and satisfy a demand by the receiver (=nations in wider Asia), and a system that circumvents the legal structure in the sending location (=Nepal and its biodiversity hotspots and wilderness). We extend the traditional telecoupling analysis with a flow analysis of money, remittance payments and banking networks. This research describes for the first time such a system which is by now essentially found worldwide, how it operates, what devastating impacts it leaves behind on landscapes, and

Enhancing Community Based Early Warning Systems in Nepal with Flood Forecasting Using Local and Global Models

NASA Astrophysics Data System (ADS)

Dugar, Sumit; Smith, Paul; Parajuli, Binod; Khanal, Sonu; Brown, Sarah; Gautam, Dilip; Bhandari, Dinanath; Gurung, Gehendra; Shakya, Puja; Kharbuja, RamGopal; Uprety, Madhab

2017-04-01

Operationalising effective Flood Early Warning Systems (EWS) in developing countries like Nepal poses numerous challenges, with complex topography and geology, sparse network of river and rainfall gauging stations and diverse socio-economic conditions. Despite these challenges, simple real-time monitoring based EWSs have been in place for the past decade. A key constraint of these simple systems is the very limited lead time for response - as little as 2-3 hours, especially for rivers originating from steep mountainous catchments. Efforts to increase lead time for early warning are focusing on imbedding forecasts into the existing early warning systems. In 2016, the Nepal Department of Hydrology and Meteorology (DHM) piloted an operational Probabilistic Flood Forecasting Model in major river basins across Nepal. This comprised a low data approach to forecast water levels, developed jointly through a research/practitioner partnership with Lancaster University and WaterNumbers (UK) and the International NGO Practical Action. Using Data-Based Mechanistic Modelling (DBM) techniques, the model assimilated rainfall and water levels to generate localised hourly flood predictions, which are presented as probabilistic forecasts, increasing lead times from 2-3 hours to 7-8 hours. The Nepal DHM has simultaneously started utilizing forecasts from the Global Flood Awareness System (GLoFAS) that provides streamflow predictions at the global scale based upon distributed hydrological simulations using numerical ensemble weather forecasts from the ECMWF (European Centre for Medium-Range Weather Forecasts). The aforementioned global and local models have already affected the approach to early warning in Nepal, being operational during the 2016 monsoon in the West Rapti basin in Western Nepal. On 24 July 2016, GLoFAS hydrological forecasts for the West Rapti indicated a sharp rise in river discharge above 1500 m3/sec (equivalent to the river warning level at 5 meters) with 53

Challenging gender roles through STEM education in Nepal

NASA Astrophysics Data System (ADS)

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.

Crossing the roof of the world: Trade in medicinal plants from Nepal to China.

PubMed

He, Jun; Yang, Bin; Dong, Min; Wang, Yunshang

2018-04-26

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

Prevalence of intestinal parasitosis among school children in Baglung districts of Western Nepal.

PubMed

Shrestha, A; Narayan, K C; Sharma, R

2012-01-01

This study was carried out to estimate the prevalence of intestinal parasites among school-going children of the Baglung municipality from December 2010 to January 2011. To find out prevalence of parasitosis among school aged children and to make necessary recommendations for preventive measures. A total of 260 stool samples were collected. A structured questionnaire was used to collect data on predisposing factors. Nails were observed without prior information to the subjects so as to find their hygienic practice. The stool samples were examined by direct wet mount and formal ether concentration technique. The total prevalence of the intestinal parasitosis was found to be 21.05%. The prevalence for individual parasites was as follows: Entamoeba histolytica (9.23%), Giardia lamblia (5.76%), Trichuris trichuria (5%), Ancylostoma duodenale (2.65%) and Ascaris lumbricoides (2.3%). Nail hygiene and level of education were significantly associated with intestinal parasitosis. The gender and age of the children, sanitary habits including toilet use, hand washing practice, and the use of the antihelminthic drug (albendazole) were not significantly associated with intestinal parasitosis. Higher prevalence was seen in boys, children belonging to age group 10-14 years, lower secondary students, among those who reported gastrointestinal problems within last six months, children from agriculture-based families and children with untrimmed nail. Major contributors for the prevalence of parasites were found to be poor personal hygiene and educational level of the children. Health education and mass treatment are recommended as a preventive measures.

Service user and care giver involvement in mental health system strengthening in Nepal: a qualitative study on barriers and facilitating factors.

PubMed

Gurung, Dristy; Upadhyaya, Nawaraj; Magar, Jananee; Giri, Nir Prakash; Hanlon, Charlotte; Jordans, Mark J D

2017-01-01

Service user and caregiver involvement has become an increasingly common strategy to enhance mental health outcomes, and has been incorporated in the mental healthpolicies of many developed nations. However, this practice is non-existent or fragmented in low and middle income countries (LMICs). Instances of service user and caregiver involvement have been rising slowly in a few LMICs, but are rarely described in the literature. Very little is known about the context of user and caregiver participation in mental health system strengthening processes in a low-income, disaster- and conflict-affected state such as Nepal. This study explores (a) the extent and experiences of service user and caregiver involvement in policy making, service planning, monitoring, and research in Nepal; (b) perceived barriers to such involvement; and (c) possible strategies to overcome barriers. Key Informant Interviews (n = 24) were conducted with service users and caregivers who were either affiliated to a mental health organization or receiving menta health care integrated within primary care. Purposive sampling was employed. Data collection was carried out in 2014 in Chitwan and Kathmandu districts of Nepal. Data analysis was carried out in NVivo10 using a framework approach. The involvement of service users affiliated to mental health organizations in policy development was reported to be 'tokenistic'. Involvement of caregivers was non-existent. Perceived barriers to greater involvement included lack of awareness, stigma and discrimination, poor economic conditions, the centralized health system, and lack of strong leadership and unity among user organizations. Increased focus on reducing public as well as self-stigma, improved policy frameworks and initiatives, and decentralization of care are some strategies that may facilitate service user and caregiver involvement. The study highlighted need for user and caregiver networks free from competing interests and priorities. Improved

Strong sustainability in Nepal: A structural economics approach

NASA Astrophysics Data System (ADS)

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

High diversity of multidrug-resistant Mycobacterium tuberculosis Central Asian Strain isolates in Nepal.

PubMed

Shah, Yogendra; Maharjan, Bhagwan; Thapa, Jeewan; Poudel, Ajay; Diab, Hassan Mahmoud; Pandey, Basu Dev; Solo, Eddie S; Isoda, Norikazu; Suzuki, Yasuhiko; Nakajima, Chie

2017-10-01

Tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB) poses a major public health problem in Nepal. Although it has been reported as one of the dominant genotypes of MTB in Nepal, little information on the Central Asian Strain (CAS) family is available, especially isolates related to multidrug resistance (MDR) cases. This study aimed to elucidate the genetic and epidemiological characteristics of MDR CAS isolates in Nepal. A total of 145 MDR CAS isolates collected in Nepal from 2008 to 2013 were characterized by spoligotyping, mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) analysis, and drug resistance-associated gene sequencing. Spoligotyping analysis showed CAS1_Delhi SIT26 as predominant (60/145, 41.4%). However, by combining spoligotyping and MIRU-VNTR typing, it was possible to successfully discriminate all 145 isolates into 116 different types including 18 clusters with 47 isolates (clustering rate 32.4%). About a half of these clustered isolates shared the same genetic and geographical characteristics with other isolates in each cluster, and some of them shared rare point mutations in rpoB that are thought to be associated with rifampicin resistance. Although the data obtained show little evidence that large outbreaks of MDR-TB caused by the CAS family have occurred in Nepal, they strongly suggest several MDR-MTB transmission cases. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Climatic conditions and child height: Sex-specific vulnerability and the protective effects of sanitation and food markets in Nepal.

PubMed

Mulmi, Prajula; Block, Steven A; Shively, Gerald E; Masters, William A

2016-12-01

Environmental conditions in early life are known to have impacts on later health outcomes, but causal mechanisms and potential remedies have been difficult to discern. This paper uses the Nepal Demographic and Health Surveys of 2006 and 2011, combined with earlier NASA satellite observations of variation in the Normalized Difference Vegetation Index (NDVI) at each child's location and time of birth to identify the trimesters of gestation and periods of infancy when climate variation is linked to attained height later in life. We find significant differences by sex: males are most affected by conditions in their second trimester of gestation, and females in the first three months after birth. Each 100-point difference in NDVI at those times is associated with a difference in height-for-age z-score (HAZ) measured at age 12-59 months of 0.088 for boys and 0.054 for girls, an effect size similar to that of moving within the distribution of household wealth by close to one quintile for boys and one decile for girls. The entire seasonal change in NDVI from peak to trough is approximately 200-300 points during the 2000-2011 study period, implying a seasonal effect on HAZ similar to one to three quintiles of household wealth. This effect is observed only in households without toilets; in households with toilets, there is no seasonal fluctuation, implying protection against climatic conditions that facilitate disease transmission. We also use data from the Nepal Living Standards Surveys on district-level agricultural production and marketing, and find a climate effect on child growth only in districts where households' food consumption derives primarily from their own production. Robustness tests find no evidence of selection effects, and placebo regression results reveal no significant artefactual correlations. The timing and sex-specificity of climatic effects are consistent with previous studies, while the protective effects of household sanitation and food markets are

Preferred Source and Perceived Need of More Information about Dental Implants by the Undergraduate Dental Students of Nepal: All Nepal Survey.

PubMed

Sharma, Arati; Shrestha, Bidhan; Chaudhari, Bijay Kumar; Suwal, Pramita; Singh, Raj Kumar; Niraula, Surya Raj; Parajuli, Prakash Kumar

2018-01-01

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.

Preferred Source and Perceived Need of More Information about Dental Implants by the Undergraduate Dental Students of Nepal: All Nepal Survey

PubMed Central

Shrestha, Bidhan; Chaudhari, Bijay Kumar; Singh, Raj Kumar; Niraula, Surya Raj; Parajuli, Prakash Kumar

2018-01-01

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. PMID:29713346

Public and Private School Performance in Nepal: An Analysis Using the SLC Examination

ERIC Educational Resources Information Center

Thapa, Amrit

2015-01-01

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…

IAU Project and Research Activity in Nepal

NASA Astrophysics Data System (ADS)

Gautam, Suman

2015-08-01

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.

Abortion Incidence and Unintended Pregnancy in Nepal.

PubMed

Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie

2016-12-01

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.

Abortion Incidence and Unintended Pregnancy in Nepal

PubMed Central

Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie

2017-01-01

CONTEXT 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. METHODS 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. RESULTS 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. CONCLUSIONS 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. PMID:28825899

Emigration from Nepal: some major issues.

PubMed

Singh, M L

1997-07-01

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.

Molecular Epidemiology of Helicobacter pylori Infection in Nepal: Specific Ancestor Root

PubMed Central

Miftahussurur, Muhammad; Sharma, Rabi Prakash; Shrestha, Pradeep Krishna; Suzuki, Rumiko; Uchida, Tomohisa; Yamaoka, Yoshio

2015-01-01

Prevalence of Helicobacter pylori infection in Nepal, a low-risk country for gastric cancer, is debatable. To our knowledge, no studies have examined H. pylori virulence factors in Nepal. We determined the prevalence of H. pylori infection by using three different tests, and the genotypes of virulence factors were determined by PCR followed by sequencing. Multilocus sequence typing was used to analyze the population structure of the Nepalese strains. The prevalence of H. pylori infection in dyspeptic patients was 38.4% (56/146), and was significantly related with source of drinking water. In total, 51 strains were isolated and all were cagA-positive. Western-type-cagA (94.1%), cagA pre-EPIYA type with no deletion (92.2%), vacA s1a (74.5%), and m1c (54.9%) were the predominant genotypes. Antral mucosal atrophy levels were significantly higher in patients infected with vacA s1 than in those infected with s2 genotypes (P = 0.03). Several Nepalese strains were H. pylori recombinants with genetic features of South Asian and East Asian genotypes. These included all East-Asian-type-cagA strains, with significantly lesser activity and inflammation in the corpus than the strains of the specific South Asian genotype (P = 0.03 and P = 0.005, respectively). Although the population structure confirmed that most Nepalese strains belonged to the hpAsia2 population, some strains shared hpEurope- and Nepalese-specific components. Nepalese patients infected with strains belonging to hpEurope showed higher inflammation in the antrum than strains from the Nepalese specific population (P = 0.05). These results support that ancestor roots of Kathmandu`s people not only connected with India alone. PMID:26226153

Expansion of Safe Abortion Services in Nepal Through Auxiliary Nurse‐Midwife Provision of Medical Abortion, 2011‐2013

PubMed Central

Basnett, Indira; Shrestha, Dirgha Raj; Shrestha, Meena Kumari; Shah, Mukta; Aryal, Shilu

2016-01-01

Introduction The termination of unwanted pregnancies up to 12 weeks’ gestation became legal in Nepal in 2002. Many interventions have taken place to expand access to comprehensive abortion care services. However, comprehensive abortion care services remain out of reach for women in rural and remote areas. This article describes a training and support strategy to train auxiliary nurse‐midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal. Methods This was a descriptive program evaluation. Sites and trainees were selected using standardized assessment tools to determine minimum facility requirements and willingness to provide medical abortion after training. Training was evaluated via posttests and observational checklists. Service statistics were collected through the government's facility logbook for safe abortion services (HMIS‐11). Results By the end of June 2014, medical abortion service had been expanded to 25 districts through 463 listed ANMs at 290 listed primary‐level facilities and served 25,187 women. Providers report a high level of confidence in their medical abortion skills and considerable clinical knowledge and capacity in medical abortion. Discussion The Nepali experience demonstrates that safe induced abortion care can be provided by ANMs, even in remote primary‐level health facilities. Post‐training support for providers is critical in helping ANMs handle potential barriers to medical abortion service provision and build lasting capacity in medical abortion. PMID:26860072

Molecular Epidemiology and Antigenic Characterization of Seasonal Influenza Viruses Circulating in Nepal.

PubMed

Upadhyay, B P; Ghimire, P; Tashiro, M; Banjara, M R

2017-01-01

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.

Psychotropic drugs in Nepal: perceptions on use and supply chain management.

PubMed

Upadhaya, Nawaraj; Jordans, Mark J D; Gurung, Dristy; Pokhrel, Ruja; Adhikari, Ramesh P; Komproe, Ivan H

2018-01-24

Psychotropic drugs play an important role in the treatment of mental, neurological and substance use disorders. Despite the advancement of the use of psycho-pharmaceuticals in the developed countries, the psychotropic drug production and supply chain management in low- and middle- income countries are still poorly developed. This study aims to explore the perceptions of stakeholders involved in all stages of the psychotropic drug supply chain about the need, quality, availability and effectiveness of psychotropic drugs, as well as barriers to their supply chain management. The study was conducted among 65 respondents from the Kathmandu, Chitwan and Pyuthan districts, grouped into four categories: producers, promoters and distributors (N = 22), policy makers and government actors (N = 8), service providers (N = 21) and service users/family members (N = 14). The respondents reported that psychotropic drugs, despite having side effects, are 1) needed, 2) available in major regional centers and 3) are effective for treating mental health problems. The stigma associated with mental illness, however, forces patients and family members to hide their use of psychotropic drugs. The study found that the process of psychotropic drug supply chain management is similar to other general drugs, with the exceptions of strict pre-approval process, quantity restriction (for production and import), and mandatory record keeping. Despite these regulatory provisions, respondents believed that the misuse of psychotropic drugs is widespread and companies are providing incentives to prescribers and retailers to retain their brand in the market. The production and supply chain management of psychotropic drugs is influenced by the vested interests of pharmaceutical companies, prescribers and pharmacists. In the context of the government of Nepal's policy of integrating mental health into primary health care and increased consumption of psychotropic drugs in Nepal, there is a

Factors Associated with Underweight among Children of Former-Kamaiyas in Nepal

PubMed Central

Khatri, Resham B.; Mishra, Shiva R.; Khanal, Vishnu; Choulagai, Bishnu

2015-01-01

Background: Bonded labor was a tradition in Nepal since the 16th century. In 2002, the Government of Nepal freed Kamaiyas and gave the newly freed individuals support for basic living. Many children of former-Kamaiyas live below subsistence level and are vulnerable to undernutrition. The aim of this study was to identify the factors associated with underweight among the children of former-Kamaiyas. Methods: We conducted the community based cross-sectional study from June to December, 2012. Face-to-face interviews were conducted using semi-structured questionnaires with randomly selected mothers of 280 children under 5 years of age from former-Kamaiya families residing in Banke district. We also measured the weight and height of the children. Undernutrition was defined according to the World Health Organization child growth standards. Factors associated with underweight were examined using a Chi-square test followed by multiple logistic regression. Results: Out of 280 children, 116 (41.4%) were underweight (≤2 SD weight-for-age), 156 (55.7%) were stunted (≤2 SD height-for-age), and 52 (18.6%) were wasted (≤2 SD weight-for-height). Females were more likely to be underweight than males [adjusted odds ratio (aOR) = 1.696, 95% confidence interval (CI) = 1.026–2.804]. Children were less likely to be underweight if they were having daily bath (aOR = 0.532; 95% CI = 0.314–0.899) or if their mothers were ≥24 years of age (aOR = 0.440; 95% CI = 0.266–0.727). Conclusion: The proportion of underweight, stunting, and wasting was more than the national average among the children of former-Kamaiyas. Female children were more likely to be underweight whereas children who were being bathed daily and with mothers whose age was ≥24 years were less likely to be underweight. PMID:25688344

Flood Induced Disasters and Stakeholder Involvement to Implement Integrated Food Management in Nepal

NASA Astrophysics Data System (ADS)

Gautam, N. P.

2016-12-01

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.

Ecological and socio-demographic differences in maternal care services in Nepal

PubMed Central

Singh, Rajvir

2015-01-01

Background. Nepal is set to achieve MDG-5 goals by end of 2015. However, maternal health parameters will remain way below those of developed countries. This study was conducted to assess the factors contributing to utilization of ANC and safe delivery services with the aim of furthering overall maternal health parameters in Nepal. Material and Methods. Using survey data from the Nepal Demographic and Health Survey 2011, socio-economic and demographic factors associated with the utilization of ANC and safe delivery services among women aged 15–49 years who gave births during the last three years preceding the survey are examined. Data was segregated into three ecological zones: Mountain, Hill and Terai zones for univariate analyses. Data from all three zones was then pooled for univariate and multivariate logistic regression analyses of Antenatal Care and Safe Delivery services in Nepal. Results and Conclusion. The analyses show that rural place of residence is at a disadvantage in receiving ANC (OR, 0.8; 95% CI [0.7–0.9]) and ensuring safe delivery (OR, 0.6; 95% CI [0.5–0.7]). Woman’s education, husband’s education and wealth quintile are significant factors in ensuring ANC and safe delivery services. Further, the analyses show that Budh/Muslim/Kirat/Christians are at a significant disadvantage in ensuring safe delivery (OR, 0.8; 95% CI [0.7–0.9]) as compared with Hindus. Though ecological zones lost their significance in receiving ANC, women in the Terai region are at a significant advantage in ensuring safe delivery (OR, 1.7; 95% CI [1.2–2.1]). Recommendation. Segregated targets should be set for the different ecological zones for further improvement in maternal mortality rates in Nepal. PMID:26355429

Simulating the Snow Water Equivalent and its changing pattern over Nepal

NASA Astrophysics Data System (ADS)

Niroula, S.; Joseph, J.; Ghosh, S.

2016-12-01

Snow fall in the Himalayan region is one of the primary sources of fresh water, which accounts around 10% of total precipitation of Nepal. Snow water is an intricate variable in terms of its global and regional estimates whose complexity is favored by spatial variability linked with rugged topography. The study is primarily focused on simulation of Snow Water Equivalent (SWE) by the use of a macroscale hydrologic model, Variable Infiltration Capacity (VIC). As whole Nepal including its Himalayas lies under the catchment of Ganga River in India, contributing at least 40% of annual discharge of Ganges, this model was run in the entire watershed that covers part of Tibet and Bangladesh as well. Meteorological inputs for 29 years (1979-2007) are drawn from ERA-INTERIM and APHRODITE dataset for horizontal resolution of 0.25 degrees. The analysis was performed to study temporal variability of SWE in the Himalayan region of Nepal. The model was calibrated by observed stream flows of the tributaries of the Gandaki River in Nepal which ultimately feeds river Ganga. Further, the simulated SWE is used to estimate stream flow in this river basin. Since Nepal has a greater snow cover accumulation in monsoon season than in winter at high altitudes, seasonality fluctuations in SWE affecting the stream flows are known. The model provided fair estimates of SWE and stream flow as per statistical analysis. Stream flows are known to be sensitive to the changes in snow water that can bring a negative impact on power generation in a country which has huge hydroelectric potential. In addition, our results on simulated SWE in second largest snow-fed catchment of the country will be helpful for reservoir management, flood forecasting and other water resource management issues. Keywords: Hydrology, Snow Water Equivalent, Variable Infiltration Capacity, Gandaki River Basin, Stream Flow

Determinants and promotion of oral hygiene behaviour in the Caribbean and Nepal.

PubMed

Buunk-Werkhoven, Yvonne A B; Dijkstra, Arie; Bink, Pim; van Zanten, Sarah; van der Schans, Cees P

2011-10-01

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 expected social outcomes of having healthy teeth (ESO) were investigated. The main effects of the predictors as well as their interactions with region (Caribbean vs. Nepal) were examined. The interaction term contributed significantly to the amount of explained variance. In the Caribbean, OHB was determined by Attitude and Social Norms, and in Nepal by Perceived Behaviour Control and ESO. On the basis of these findings, quite different oral health care interventions are called for in developing and underdeveloped countries. © 2011 FDI World Dental Federation.

Productivity of public hospitals in Nepal: a data envelopment analysis

PubMed Central

Ashton, Toni

2017-01-01

Objectives Public hospitals in Nepal account for a major share of the total health budget. Therefore, questions are often asked about the performance of these hospitals. Existing measures of performance are limited to historical ratio analyses without any benchmarks. The objective of this study is to explore the trends in inputs, outputs and productivity changes in Nepalese public hospitals from 2011–2012 to 2013–2014. Setting and participants The study was conducted among 32 Nepalese public hospitals (23 district level and 9 higher level) for the three fiscal years from 2011–2012 to 2013–2014. Outcome measures First, basic ratio analyses were conducted for the input and output measures over the study years. Then, Malmquist productivity change scores were obtained using data envelopment analysis. Aggregated as well as separate analyses were conducted for district level and higher level hospitals. Results Real expenditures of the sampled hospitals declined over the 3-year period from an average of US$ 371 000 in year 1 to US$ 368 730 in year 2 and US$ 328680 in year 3. The average aggregated hospital outputs increased marginally from 8276 in 2011–2012 to 8613 in 2013–2014. The total factor productivity of the study hospitals declined by 6.9% annually from 2011–2012 to 2013–2014. Of the total 32 hospitals, productivity increased in only 12 (37.5%) hospitals and declined in the remaining 20 hospitals. The total factor productivity loss was influenced by a decline in technology change, despite an increase in efficiency. Conclusions In general, productivity of the study hospitals declined over the study period. Availability and accessibility of accurate, detailed and consistent measures of hospital inputs and outputs is a major challenge for this type of analysis. PMID:28729314

Productivity of public hospitals in Nepal: a data envelopment analysis.

PubMed

Silwal, Pushkar Raj; Ashton, Toni

2017-07-20

Public hospitals in Nepal account for a major share of the total health budget. Therefore, questions are often asked about the performance of these hospitals. Existing measures of performance are limited to historical ratio analyses without any benchmarks. The objective of this study is to explore the trends in inputs, outputs and productivity changes in Nepalese public hospitals from 2011-2012 to 2013-2014. The study was conducted among 32 Nepalese public hospitals (23 district level and 9 higher level) for the three fiscal years from 2011-2012 to 2013-2014. First, basic ratio analyses were conducted for the input and output measures over the study years. Then, Malmquist productivity change scores were obtained using data envelopment analysis. Aggregated as well as separate analyses were conducted for district level and higher level hospitals. Real expenditures of the sampled hospitals declined over the 3-year period from an average of US$ 371 000 in year 1 to US$ 368 730 in year 2 and US$ 328680 in year 3. The average aggregated hospital outputs increased marginally from 8276 in 2011-2012 to 8613 in 2013-2014. The total factor productivity of the study hospitals declined by 6.9% annually from 2011-2012 to 2013-2014. Of the total 32 hospitals, productivity increased in only 12 (37.5%) hospitals and declined in the remaining 20 hospitals. The total factor productivity loss was influenced by a decline in technology change, despite an increase in efficiency. In general, productivity of the study hospitals declined over the study period. Availability and accessibility of accurate, detailed and consistent measures of hospital inputs and outputs is a major challenge for this type of analysis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surveillance of Influenza A Virus and Its Subtypes in Migratory Wild Birds of Nepal

PubMed Central

Sharma, Ajay; Bhatta, Tarka; Adhikari, Pratikshya; Sherchan, Adarsh Man; Shrestha, Bishwo; Bista, Manisha; Rajbhandari, Rajesh; Oberoi, Mohinder; Bisht, Khadak; Hero, Jean-Marc; Dissanayake, Ravi; Dhakal, Maheshwar; Hughes, Jane; Debnath, Nitish

2015-01-01

Nepal boarders India and China and all three countries lie within the Central Asian Flyway for migratory birds. Novel influenza A H7N9 caused human fatalities in China in 2013. Subclinical infections of influenza A H7N9 in birds and the potential for virus dispersal by migratory birds prompted this study to assess avian H7N9 viral intrusion into Nepal. Surveillance of influenza A virus in migratory birds was implemented in early 2014 with assistance from the Food and Agricultural Organization (FAO). Of 1811 environmental fecal samples collected from seven wetland migratory bird roosting areas, influenza A H9N2 was found in one sample from a ruddy shelduck in Koshi Tappu Wildlife Reserve located in southern Nepal. Avian H7N9 and other highly pathogenic avian influenza viruses were not detected. This study provides baseline data on the status of avian influenza virus in migratory bird populations in Nepal. PMID:26176773

Save the Children Nonformal Education and Early Childhood Development Activities in Rural Nepal.

ERIC Educational Resources Information Center

Reinhold, Amy Jo

In 1981, Save the Children (SC) opened an office in Nepal to support projects related to health, education, income generation, and resource management. Statistics show that between 7 and 8 million of Nepal's 19 million people live below the poverty line, and almost 2 out of 3 adolescent girls do not attend school, placing the overall female…

Epidemic of Hysteria in a School of Rural Eastern Nepal: A Case Report

ERIC Educational Resources Information Center

Shakya, Rabi

2005-01-01

Introduction: The headmaster of a school (NRMV) in rural eastern Nepal, pleaded for help from the public health Department of Psychiatry, BKIHS, Dharan, Nepal, to prevent closure of his school as guardians of many students refused to send their children to his school, which was supposedly haunted by evil spirits. The author, along with his staff,…

Analysis of changes in crop farming in the Dudh Koshi (Nepal) driven by climate changes

NASA Astrophysics Data System (ADS)

Gianinetto, Marco; Polinelli, Francesco; Frassy, Federico; Aiello, Martina; Rota Nodari, Francesco; Soncini, Andrea; Bocchiola, Daniele

2017-10-01

Nepal is one of the poorest nations of the world and the Koshi Basin includes some of the poorest regions of this country. It's farming system is subsistence agriculture, mainly rainfed, with crop productivity among the lowest in South Asia. Nepal is also severely impacted by climate changes, such as retreat of glaciers, rise in temperature, erratic rainfalls and increase in frequency of extreme weather. This paper describes the spatio-temporal evolution of cultivated land in Dudh Koshi during the last four decades (1970s-2010s), by mapping the farming of its four main cereals in the districts of Solukhumbu, Okhaldunga and Kothang from space. The analysis of satellite time series showed a 10% of increment in farmland from 1970s to 1990s, and about 60% in the following twenty years. With a shift of cropping to higher altitudes. Data belonging to of the second twenty years are strongly correlated with the population growth observed in the same period (0.97

The Genesis of August 2017 Nepal Floods

NASA Astrophysics Data System (ADS)

Uprety, M.; Dugar, S.; Gautam, D.; Budimir, M.; Parajuli, B.; Kharbuja, R. G.

2017-12-01

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

Social care and support for elderly men and women in an urban and a rural area of Nepal.

PubMed

Kshetri, Dan Bahadur Baidwar; Smith, Cairns S; Khadka, Mira

2012-09-01

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.

No time to worship the serpent deities: women, economic change, and religion in north-western Nepal.

PubMed

Saul, R

1999-03-01

This paper explores the changing relationships between lay women, and the spiritual realm, in two ethnic Tibetan communities, Kag and Dzong, in northwestern Nepal. The study tackles how economic and social change has affected women's spiritual roles within the household and the community, and how these roles, in turn, have influenced the course of such change. In Kag, the introduction of tourism changed women's way of life. They became income-generating members of the community as lodge-owners. With new responsibilities to manage, Kag women eventually neglected their traditional social and spiritual obligations, much to the dismay of the older generation. On the other hand, women in Dzong still consider full social and physical participation in village life important despite the added obligations. They maintain spiritual harmony within the village. Dzongba women do not seem to feel the same conflicts as Kagpa women. The negative impact of Kag women's neglect of traditional social and spiritual responsibilities should be weighed against the possible benefits to women, household, and economy.

Cytomorphological studies in some members of tribe Paniceae (Poaceae) from district Kangra of Himachal Pradesh (Western Himalayas).

PubMed

Kaur, H; Kumari, S; Gupta, R C

2013-01-01

The present paper deals with cytological studies on the population basis of 21 species belonging to 9 genera of tribe Paniceae of family Poaceae from cytologically unexplored area of Western Himalayas i.e. district Kangra of Himachal Pradesh for the assessment of genetic diversity of grass flora. On world-wide basis, the chromosome counts have been made for the first time for three species such as Brachiaria remota (n = 16), Digitaria granularis (n = 36) and Isachne albens (n = 5). Similarly, on India basis, altogether new records are made for two species such as Echinochloa cruspavonis (n = 27) and Paspalum distichum (2n = 50). A comparison of the different euploid cytotypes studied at present for Digitaria adscendens, D. setigera and Oplismenus compositus revealed significant variations in their morphology, depicting increase in some of the characters of polyploid cytotypes. The course of meiosis has been observed to be normal in all the studied populations with high pollen fertility except for two species such as Paspalum dilatatum and P. distichum marked with abnormal meiosis and reduced pollen fertility.

Using remote sensing environmental data to forecast malaria incidence at a rural district hospital in Western Kenya.

PubMed

Sewe, Maquins Odhiambo; Tozan, Yesim; Ahlm, Clas; Rocklöv, Joacim

2017-06-01

Malaria surveillance data provide opportunity to develop forecasting models. Seasonal variability in environmental factors correlate with malaria transmission, thus the identification of transmission patterns is useful in developing prediction models. However, with changing seasonal transmission patterns, either due to interventions or shifting weather seasons, traditional modelling approaches may not yield adequate predictive skill. Two statistical models,a general additive model (GAM) and GAMBOOST model with boosted regression were contrasted by assessing their predictive accuracy in forecasting malaria admissions at lead times of one to three months. Monthly admission data for children under five years with confirmed malaria at the Siaya district hospital in Western Kenya for the period 2003 to 2013 were used together with satellite derived data on rainfall, average temperature and evapotranspiration(ET). There was a total of 8,476 confirmed malaria admissions. The peak of malaria season changed and malaria admissions reduced overtime. The GAMBOOST model at 1-month lead time had the highest predictive skill during both the training and test periods and thus can be utilized in a malaria early warning system.

Molecular characterization of multidrug-resistant Mycobacterium tuberculosis isolated in Nepal.

PubMed

Poudel, Ajay; Nakajima, Chie; Fukushima, Yukari; Suzuki, Haruka; Pandey, Basu Dev; Maharjan, Bhagwan; Suzuki, Yasuhiko

2012-06-01

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.

Politicians in apron: case study of rebel health services in Nepal.

PubMed

Devkota, Bhimsen; van Teijlingen, Edwin R

2009-10-01

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.

Factors associated with the introduction of prelacteal feeds in Nepal: findings from the Nepal Demographic and Health Survey 2011

PubMed Central

2013-01-01

Background A prelacteal feed is any food except mother’s milk provided to a newborn before initiating breastfeeding. Prelacteal feeding is a major barrier to exclusive breastfeeding. It is a prevalent practice in Nepal. Little is known about the factors associated with providing prelacteal feeds to the Nepalese newborn. This study explored the factors associated with providing prelacteal feeds to children under three years in Nepal using the Nepal Demographic and Health Survey (NDHS) 2011. Methods This study utilised the NDHS 2011 child dataset which is a nationally representative study. The rates of providing prelacteal feeds were reported as a proportion. Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multiple logistic regression were used to analyse the factors associated with providing prelacteal feeds. Results A sample of 3948 mothers were included in the study. A total of 841 [26.5% (95% CI: 23.1%–30.3%)] weighted proportion) of mothers reported of providing prelacteal feeds to their newborn infants. Plain water (n = 75), sugar/glucose (n = 35), gripe water (n = 3), sugar/salt solution (n = 3), fruit juice (n = 3), infant formula (n = 96), tea (n = 3) and other milk other than breast milk (n = 556) were some of the types of prelacteal feeds reported. The multiple regression analysis showed that the mothers who had no education, were not working, were from the middle wealth quintile, who had not attended four antenatal care visits, were first time mothers and who were from the Terai/Plain region were more likely to provide prelacteal feeds. Conclusions Given that one in four infants were provided with prelacteal feeds, there is a need to implement breastfeeding promotion programs to increase the practice of exclusive breastfeeding and reduce prelacteal feeding practices. Breastfeeding counseling at antenatal clinics and peer support for exclusive

Physiotherapy practice patterns in Intensive Care Units of Nepal: A multicenter survey

PubMed Central

Baidya, Sumana; Acharya, Ranjeeta S.; Coppieters, Michel W.

2016-01-01

Context: As physiotherapy (PT) is a young profession in Nepal, there is a dearth of insight into the common practices of physiotherapists in critical care. Aims: To identify the availability of PT services in Intensive Care Units (ICUs) and articulate the common practices by physiotherapists in ICUs of Nepal. Settings and Design: All tertiary care hospitals across Nepal with ICU facility via an exploratory cross-sectional survey. Subjects and Methods: An existing questionnaire was distributed to all the physiotherapists currently working in ICUs of Nepal with 2 years of experience. The survey was sent via E-mail or given in person to 86 physiotherapists. Statistical Analysis Used: Descriptive and inferential statistics according to nature of data. Results: The response rate was 60% (n = 52). In the majority of hospitals (68%), PT service was provided only after a physician consultation, and few hospitals (13%) had established hospital criteria for PT in ICUs. Private hospitals (57.1%) were providing PT service in weekends compared to government hospitals (32.1%) (P = 0.17). The likelihood of routine PT involvement varied significantly with the clinical scenarios (highest 71.2% status cerebrovascular accident, lowest 3.8% myocardial infarction, P < 0.001). The most preferred PT treatment was chest PT (53.8%) and positioning (21.2%) while least preferred was therapeutic exercise (3.8%) irrespective of clinical scenarios. Conclusions: There is a lack of regular PT service during weekends in ICUs of Nepal. Most of the cases are treated by physiotherapists only after physician's referral. The preferred intervention seems to be limited only to chest PT and physiotherapists are not practicing therapeutic exercise and functional mobility training to a great extent. PMID:27076708

Dryland Salinity in the North Stirling Land Conservation District, Western Australia: Simulation and Management Options

NASA Astrophysics Data System (ADS)

Gomboso, J.; Ghassemi, F.; Appleyard, S. J.

1997-01-01

The North Stirling Land Conservation District consists of approximately 100,000 hectares north of the Stirling Range National Park, Western Australia. Clearing of land for agriculture occurred in the 1960's and early 1970's. The groundwater is highly saline, and, since clearing, the water table has risen by as much as 12 m; it is now generally less than 3 m below ground level throughout the area. The rise in groundwater levels following clearing and the use of crops and pastures requiring low water use have caused dramatic secondary salinisation over a short period of time. Groundwater flow was simulated with models of steady-state and transient groundwater flow. By incorporating economic simulations with the calibrated transient hydrogeological model, estimates of the expected gross margin losses were made. Three salinity-management strategies were simulated. Results indicate that 1) under the `do-nothing' strategy, future gross margins are expected to decline; 2) under the agronomic strategy, the rate of water-table rise would be reduced and foregone agricultural production losses would be less than the `do-nothing' strategy; and 3) under the agroforestry strategy, the water table is expected to decline in the long term, which would increase future agricultural production levels and, hence, profitability.

Outbreak of pandemic influenza A/H1N1 2009 in Nepal.

PubMed

Adhikari, Bal Ram; Shakya, Geeta; Upadhyay, Bishnu Prasad; Prakash Kc, Khagendra; Shrestha, Sirjana Devi; Dhungana, Guna Raj

2011-03-23

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.

Analysis of Health Sector Budget of Nepal.

PubMed

Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K

2014-01-01

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.

Collection and trade of wild-harvested orchids in Nepal.

PubMed

Subedi, Abishkar; Kunwar, Bimal; Choi, Young; Dai, Yuntao; van Andel, Tinde; Chaudhary, Ram P; de Boer, Hugo J; Gravendeel, Barbara

2013-08-31

Wild orchids are illegally harvested and traded in Nepal for use in local traditional medicine, horticulture, and international trade. This study aims to: 1) identify the diversity of species of wild orchids in trade in Nepal; 2) study the chain of commercialization from collector to client and/or export; 3) map traditional knowledge and medicinal use of orchids; and 4) integrate the collected data to propose a more sustainable approach to orchid conservation in Nepal. Trade, species diversity, and traditional use of wild-harvested orchids were documented during field surveys of markets and through interviews. Trade volumes and approximate income were estimated based on surveys and current market prices. Orchid material samples were identified to species level using a combination of morphology and DNA barcoding. Orchid trade is a long tradition, and illegal export to China, India and Hong Kong is rife. Estimates show that 9.4 tons of wild orchids were illegally traded from the study sites during 2008/2009. A total of 60 species of wild orchids were reported to be used in traditional medicinal practices to cure at least 38 different ailments, including energizers, aphrodisiacs and treatments of burnt skin, fractured or dislocated bones, headaches, fever and wounds. DNA barcoding successfully identified orchid material to species level that remained sterile after culturing. Collection of wild orchids was found to be widespread in Nepal, but illegal trade is threatening many species in the wild. Establishment of small-scale sustainable orchid breeding enterprises could be a valuable alternative for the production of medicinal orchids for local communities. Critically endangered species should be placed on CITES Appendix I to provide extra protection to those species. DNA barcoding is an effective method for species identification and monitoring of illegal cross-border trade.

Collection and trade of wild-harvested orchids in Nepal

PubMed Central

2013-01-01

Background Wild orchids are illegally harvested and traded in Nepal for use in local traditional medicine, horticulture, and international trade. This study aims to: 1) identify the diversity of species of wild orchids in trade in Nepal; 2) study the chain of commercialization from collector to client and/or export; 3) map traditional knowledge and medicinal use of orchids; and 4) integrate the collected data to propose a more sustainable approach to orchid conservation in Nepal. Methods Trade, species diversity, and traditional use of wild-harvested orchids were documented during field surveys of markets and through interviews. Trade volumes and approximate income were estimated based on surveys and current market prices. Orchid material samples were identified to species level using a combination of morphology and DNA barcoding. Results Orchid trade is a long tradition, and illegal export to China, India and Hong Kong is rife. Estimates show that 9.4 tons of wild orchids were illegally traded from the study sites during 2008/2009. A total of 60 species of wild orchids were reported to be used in traditional medicinal practices to cure at least 38 different ailments, including energizers, aphrodisiacs and treatments of burnt skin, fractured or dislocated bones, headaches, fever and wounds. DNA barcoding successfully identified orchid material to species level that remained sterile after culturing. Conclusions Collection of wild orchids was found to be widespread in Nepal, but illegal trade is threatening many species in the wild. Establishment of small-scale sustainable orchid breeding enterprises could be a valuable alternative for the production of medicinal orchids for local communities. Critically endangered species should be placed on CITES Appendix I to provide extra protection to those species. DNA barcoding is an effective method for species identification and monitoring of illegal cross-border trade. PMID:24004516

National health insurance policy in Nepal: challenges for implementation.

PubMed

Mishra, Shiva Raj; Khanal, Pratik; Karki, Deepak Kumar; Kallestrup, Per; Enemark, Ulrika

2015-01-01

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.

Uterine prolapse prevention in Eastern Nepal: the perspectives of women and health care professionals.

PubMed

Radl, Christina M; Rajwar, Ranjita; Aro, Arja R

2012-01-01

Uterine prolapse is a major reproductive health issue in Nepal. There is a wide range of literature available on the causes and risk factors of uterine prolapse and on the ways to prevent and treat it. There is still a lack of published evidence on what prevention and treatment services are working well or the attitudes toward them. This paper presents the findings of a qualitative study on primary and secondary prevention of uterine prolapse in Eastern Nepal. The study involved eight focus group discussions with 71 women in six villages of the eastern districts of Siraha and Saptari and 14 qualitative interviews with health professionals from the local to central level. The group discussions and interviews covered the awareness levels of uterine prolapse and its prevention and treatment, as well as participants' opinions on and experiences with the services offered. It was found that patriarchy, gender discrimination, and cultural traditions such as early marriage and pregnancy make it difficult for people to discontinue uterine prolapse risk behaviors. Women are aware of risk factors, prevention, and treatment, but are powerless to change their situations. Health professionals and women are fond of surgery as treatment, but opinions on the use of ring pessaries and pelvic floor muscle training are split. The main recommendation that can be drawn from this study is that research on the effectiveness of early treatments, such as ring pessaries and exercise, should be conducted. Furthermore, the involvement of other target groups (husbands, adolescents, and mothers-in-law) needs to be increased in order to make it easier for women to adapt low-risk behaviors. Finally, uterine prolapse prevention should be better integrated in national reproductive health services. Enforcing transparency, monitoring systems, and collaborations are important factors that should be considered as well.

Uterine prolapse prevention in Eastern Nepal: the perspectives of women and health care professionals

PubMed Central

Radl, Christina M; Rajwar, Ranjita; Aro, Arja R

2012-01-01

Uterine prolapse is a major reproductive health issue in Nepal. There is a wide range of literature available on the causes and risk factors of uterine prolapse and on the ways to prevent and treat it. There is still a lack of published evidence on what prevention and treatment services are working well or the attitudes toward them. This paper presents the findings of a qualitative study on primary and secondary prevention of uterine prolapse in Eastern Nepal. Method The study involved eight focus group discussions with 71 women in six villages of the eastern districts of Siraha and Saptari and 14 qualitative interviews with health professionals from the local to central level. The group discussions and interviews covered the awareness levels of uterine prolapse and its prevention and treatment, as well as participants’ opinions on and experiences with the services offered. Results It was found that patriarchy, gender discrimination, and cultural traditions such as early marriage and pregnancy make it difficult for people to discontinue uterine prolapse risk behaviors. Women are aware of risk factors, prevention, and treatment, but are powerless to change their situations. Health professionals and women are fond of surgery as treatment, but opinions on the use of ring pessaries and pelvic floor muscle training are split. Conclusion The main recommendation that can be drawn from this study is that research on the effectiveness of early treatments, such as ring pessaries and exercise, should be conducted. Furthermore, the involvement of other target groups (husbands, adolescents, and mothers-in-law) needs to be increased in order to make it easier for women to adapt low-risk behaviors. Finally, uterine prolapse prevention should be better integrated in national reproductive health services. Enforcing transparency, monitoring systems, and collaborations are important factors that should be considered as well. PMID:22927768

Response of the Laprak Landslide to the 2015 Nepal Earthquake and Implications for the Utility of Simple Infinite Slope Models in Regional Landslide Hazard Assessment

NASA Astrophysics Data System (ADS)

Haneberg, W. C.; Gurung, N.

2016-12-01

The village of Laprak, located in the Gorkha District of western Nepal, was built on a large colluvium landslide about 10 km from the epicenter of the 25 April 2015 M 7.8 Nepal earthquake. Recent episodic movement began during a wet period in 1999 and continued in at least 2002, 2006, and 2007, destroying 24 homes, removing 23 hectares of land from agricultural production, and claiming 1 life. Reconnaissance mapping, soil sampling and testing, and slope stability analyses undertaken before the 2015 earthquake suggested that the hillside should be stable under dry conditions, unstable to marginally stable under static wet conditions, and wholly unstable under wet seismic conditions. Most of the buildings in Laprak, which were predominantly of dry fitted stone masonry, were destroyed by Intensity IX shaking during the 2015 earthquake. Interpretation of remotely sensed imagery and published photographs shows new landslide features; hence, some downslope movement occurred but the landslide did not mobilize into a long run-out flow. Monte Carlo simulations based upon a pseudostatic infinite slope model and constrained by reasonable distributions of soil shear strength, pore pressure, and slope angle from earlier work and seismic coefficients based upon the observed Intensity IX shaking (and inferred PGA) yield high probabilities of failure for steep portions of the slope above and below the village but moderate probabilities of failure for the more gentle portion of the slope upon which most of the village was constructed. In retrospect, the seismic coefficient selected for the pre-earthquake analysis proved to be remarkably prescient. Similar results were obtained using a first-order, second-moment (FOSM) approach that is convenient for GIS based regional analyses. Predictions of permanent displacement made using a variety of published empirical formulae based upon sliding block analyses range from about 10 cm to about 200 cm, also broadly consistent with the observed

Prevalence of molecular markers of anti-malarial drug resistance in Plasmodium vivax and Plasmodium falciparum in two districts of Nepal

PubMed Central

2011-01-01

Background Sulphadoxine-pyrimethamine (SP) and chloroquine (CQ) have been used in treatment of falciparum and vivax malaria in Nepal. Recently, resistance to both drugs have necessitated a change towards artemisinin combination therapy (ACT) against Plasmodium falciparum in highly endemic areas. However, SP is still used against P. falciparum infections in low endemic areas while CQ is used in suspected cases in areas with lack of diagnostic facilities. This study examines the prevalence of molecular markers of CQ and SP resistance in P. falciparum and Plasmodium vivax to determine if high levels of in vivo resistance are reflected at molecular level as well. Methods Finger prick blood samples (n = 189) were collected from malaria positive patients from two high endemic districts and analysed for single nucleotide polymorphisms (SNPs) in the resistance related genes of P. falciparum and P. vivax for CQ (Pfcrt, Pfmdr1, Pvmdr1) and SP (Pfdhfr, Pfdhps, Pvdhfr), using various PCR-based methods. Results and discussion Positive P. vivax and P. falciparum infections were identified by PCR in 92 and 41 samples respectively. However, some of these were negative in subsequent PCRs. Based on a few P. falciparum samples, the molecular level of CQ resistance in P. falciparum was high since nearly all parasites had the Pfcrt mutant haplotypes CVIET (55%) or SVMNT (42%), though frequency of the Pfmdr1 wild type haplotype was relatively low (35%). Molecular level of SP resistance in P. falciparum was found to be high. The most prevalent Pfdhfr haplotype was double mutant CNRNI (91%), while frequency of Pfdhps double mutant SGEAA and AGEAA were 38% and 33% respectively. Combined, the frequency of quadruple mutations (CNRNI-SGEAA/AGEAA) was 63%. Based on P. vivax samples, low CQ and SP resistance were most likely due to low prevalence of Pvmdr1 Y976F mutation (5%) and absence of triple/quadruple mutations in Pvdhfr. Conclusions Based on the limited number of samples, prevalence of

Overview of Integrated Child Development Services Programme in India: Some Policy Implications for Nepal.

ERIC Educational Resources Information Center

Shrestha, Kishor

This paper presents an overview of the Integrated Child Development Services (ICDS) program in India, discusses the context of Early Childhood Education (ECE) in Nepal, analyzes the best practices of the ICDS, and draws some policy implications for improving ECE in Nepal. The ICDS program is an integrated child development program with the…

Primary Education and Dropout in Nepal

ERIC Educational Resources Information Center

Devkota, Shree Prasad; Bagale, Shiba

2015-01-01

This article tries to highlight the dropout rate of primary education of Nepal. The main essence of the article is to explore the situation of dropout of primary education. There are several programs and policies to reduce the dropout, out of the school children and so on but still there are several issues that are left behind. Educational budget…

Illness recognition, decision-making, and care-seeking for maternal and newborn complications: a qualitative study in Sarlahi District, Nepal.

PubMed

Lama, Tsering P; Khatry, Subarna K; Katz, Joanne; LeClerq, Steven C; Mullany, Luke C

2017-12-21

Identification of maternal and newborn illness and the decision-making and subsequent care-seeking patterns are poorly understood in Nepal. We aimed to characterize the process and factors influencing recognition of complications, the decision-making process, and care-seeking behavior among families and communities who experienced a maternal complication, death, neonatal illness, or death in a rural setting of Nepal. Thirty-two event narratives (six maternal/newborn deaths each and 10 maternal/newborn illnesses each) were collected using in-depth interviews and small group interviews. We purposively sampled across specific illness and complication definitions, using data collected prospectively from a cohort of women and newborns followed from pregnancy through the first 28 days postpartum. The event narratives were coded and analyzed for common themes corresponding to three main domains of illness recognition, decision-making, and care-seeking; detailed event timelines were created for each. While signs were typically recognized early, delays in perceiving the severity of illness compromised prompt care-seeking in both maternal and newborn cases. Further, care was often sought initially from informal health providers such as traditional birth attendants, traditional healers, and village doctors. Key decision-makers were usually female family members; husbands played limited roles in decisions related to care-seeking, with broader family involvement in decision-making for newborns. Barriers to seeking care at any type of health facility included transport problems, lack of money, night-time illness events, low perceived severity, and distance to facility. Facility care was often sought only after referral or following treatment failure from an informal provider and private facilities were sought for newborn care. Respondents characterized government facility-based care as low quality and reported staff rudeness and drug type and/or supply stock shortages. Delaying

Nepal: a potentially explosive situation.

PubMed

Gurung, A

1993-01-01

90% of Nepal's population is engaged in agriculture; the rural children lack all modern amenities and facilities, and boys are given preference over girls, who do not attend school. In urban populations, girls and boys are treated equally; however, 150,000 children, aged 7 to 16 years, work in carpet factories in unhygienic conditions. 52.71% are illiterate; 47.29% are dropouts. Others work as domestic servants, dishwashers in restaurants, or ragpickers. Many fortunate children do attend schools, which are numerous and filled to capacity. But thousands of Nepalese girls are sold to brothels in Bombay, Calcutta, and other parts of India; upon their return home, they bring human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) with them, as do thousands of male adult migrant workers. A government agency, AIDS Prevention and Control Programme, and about 50 nongovernmental organizations (NGOs) are collaborating to help persons who are infected with HIV or suffering from AIDS. Caritas works with two of the NGOs on a mass education program, prevention, and rehabilitation of HIV-positive women. Although government statistics indicate there are 133 identified cases of HIV in Nepal, the World Health Organization estimates the number of people there who are infected with HIV to be 10,000.

Revisiting the 1993 historical extreme precipitation and damaging flood event in Central Nepal

NASA Astrophysics Data System (ADS)

Marahatta, S.; Adhikari, L.; Pokharel, B.

2017-12-01

Nepal is ranked the fourth most climate-vulnerable country in the world and it is prone to different weather-related hazards including droughts, floods, and landslides [Wang et al., 2013; Gillies et al., 2013]. Although extremely vulnerable to extreme weather events, there are no extreme weather warning system established to inform public in Nepal. Nepal has witnessed frequent drought and flood events, however, the extreme precipitation that occurred on 19-20 July 1993 created a devastating flood and landslide making it the worst weather disaster in the history of Nepal. During the second week of July, Nepal and northern India experienced abnormal dry condition due to the shifting of the monsoon trough to central India. The dry weather changed to wet when monsoon trough moved northward towards foothills of the Himalayas. Around the same period, a low pressure center was located over the south-central Nepal. The surface low was supported by the mid-, upper-level shortwave and cyclonic vorticity. A meso-scale convective system created record breaking one day rainfall (540 mm) in the region. The torrential rain impacted the major hydropower reservoir, Bagmati barrage in Karmaiya and triggered many landslides and flash floods. The region had the largest hydropower (Kulekhani hydropower, 92 MW) of the country at that time and the storm event deposited extremely large amount of sediments that reduced one-fourth (4.8 million m3) of reservoir dead storage (12 million m3). The 1-in-1000 years flood damaged the newly constructed barrage and took more than 700 lives. Major highways were damaged cutting off supply of daily needed goods, including food and gas, in the capital city, Kathmandu, for more than a month. In this presentation, the meteorological conditions of the extreme event will be diagnosed and the impact of the sedimentation due to the flood on Kulekhani reservoir and hydropower generation will be discussed.

Status of chemistry lab safety in Nepal.

PubMed

Kandel, Krishna Prasad; Neupane, Bhanu Bhakta; Giri, Basant

2017-01-01

Chemistry labs can become a dangerous environment for students as the lab exercises involve hazardous chemicals, glassware, and equipment. Approximately one hundred thousand students take chemistry laboratory classes annually in Nepal. We conducted a survey on chemical lab safety issues across Nepal. In this paper, we assess the safety policy and equipment, protocols and procedures followed, and waste disposal in chemistry teaching labs. Significant population of the respondents believed that there is no monitoring of the lab safety in their lab (p<0.001). Even though many labs do not allow food and beverages inside lab and have first aid kits, they lack some basic safety equipment. There is no institutional mechanism to dispose lab waste and chemical waste is disposed haphazardly. Majority of the respondents believed that the safety training should be a part of educational training (p = 0.001) and they would benefit from short course and/or workshop on lab safety (p<0.001).

Status of chemistry lab safety in Nepal

PubMed Central

Kandel, Krishna Prasad; Neupane, Bhanu Bhakta

2017-01-01

Chemistry labs can become a dangerous environment for students as the lab exercises involve hazardous chemicals, glassware, and equipment. Approximately one hundred thousand students take chemistry laboratory classes annually in Nepal. We conducted a survey on chemical lab safety issues across Nepal. In this paper, we assess the safety policy and equipment, protocols and procedures followed, and waste disposal in chemistry teaching labs. Significant population of the respondents believed that there is no monitoring of the lab safety in their lab (p<0.001). Even though many labs do not allow food and beverages inside lab and have first aid kits, they lack some basic safety equipment. There is no institutional mechanism to dispose lab waste and chemical waste is disposed haphazardly. Majority of the respondents believed that the safety training should be a part of educational training (p = 0.001) and they would benefit from short course and/or workshop on lab safety (p<0.001). PMID:28644869

What adaptation to research is needed following crises: a comparative, qualitative study of the health workforce in Sierra Leone and Nepal.

PubMed

Raven, Joanna; Baral, Sushil; Wurie, Haja; Witter, Sophie; Samai, Mohamed; Paudel, Pravin; Subedi, Hom Nath; Martineau, Tim; Elsey, Helen; Theobald, Sally

2018-02-07

Health workers are critical to the performance of health systems; yet, evidence about their coping strategies and support needs during and post crisis is lacking. There is very limited discussion about how research teams should respond when unexpected crises occur during on-going research. This paper critically presents the approaches and findings of two health systems research projects that explored and evaluated health worker performance and were adapted during crises, and provides lessons learnt on re-orientating research when the unexpected occurs. Health systems research was adapted post crisis to assess health workers' experiences and coping strategies. Qualitative in-depth interviews were conducted with 14 health workers in a heavily affected earthquake district in Nepal and 25 frontline health workers in four districts in Ebola-affected Sierra Leone. All data were transcribed and analysed using the framework approach, which included developing coding frameworks for each study, applying the frameworks, developing charts and describing the themes. A second layer of analysis included analysis across the two contexts, whereas a third layer involved the research teams reflecting on the approaches used to adapt the research during these crises and what was learned as individuals and research teams. In Sierra Leone, health workers were heavily stigmatised by the epidemic, leading to a breakdown of trust. Coping strategies included finding renewed purpose in continuing to serve their community, peer and family support (in some cases), and religion. In Nepal, individual determination, a sense of responsibility to the community and professional duty compelled staff to stay or return to their workplace. The research teams had trusting relationships with policy-makers and practitioners, which brought credibility and legitimacy to the change of research direction as well as the relationships to maximise the opportunity for findings to inform practice. In both contexts

Paying for hospital-based care of Kala-azar in Nepal: assessing catastrophic, impoverishment and economic consequences.

PubMed

Adhikari, Shiva R; Maskay, Nephil M; Sharma, Bishnu P

2009-03-01

Households obtaining health care services in developing countries incur substantial costs, despite services generally being provided free of charge by public health institutions. This constitutes an economic burden on low-income households, and contributes to deepening their level of poverty. In addition to the economic burden of obtaining health care, the method of financing these payments has implications for the distribution of household assets. This effect on resource-poor households is amplified since they have decreased access to health insurance. Recent literature, however, ignores the importance of the method of financing health care payments. This paper looks at the case of Nepal and highlights the impact on households of paying for hospital-based care of Kala-azar (KA) by analysing the catastrophic, impoverishment and economic consequences of their coping strategies. The paper utilizes micro-data on a random selection of 50% of the KA-affected households of Siraha and Saptari districts of Nepal. The empirical results suggest that direct costs of hospital-based treatment of KA are catastrophic since they consume 17% of annual household income. This expenditure causes more than 20% of KA-affected households to fall below the poverty line, with the remaining households being pushed into the category of marginal poor; the poverty gap ratio is more than 90%. Further, KA incidence can have prolonged and severe economic consequences for the household economy due to the mechanisms of informal sector financing to which households resort. A heavy burden of loan repayments can lead households on a downward spiral that eventually becomes a poverty trap. In other words, the method of financing health care payments is an important ingredient in understanding the economic burden of disease.

Traditional uses of medicinal plants in gastrointestinal disorders in Nepal.

PubMed

Rokaya, Maan B; Uprety, Yadav; Poudel, Ram C; Timsina, Binu; Münzbergová, Zuzana; Asselin, Hugo; Tiwari, Achyut; Shrestha, Shyam S; Sigdel, Shalik R

2014-12-02

Gastrointestinal disorders cause morbidity and can lead to mortality, especially in the developing world where sanitation is deficient. A large part of the human population relies on medicinal plants for treating various diseases, including gastrointestinal disorders. The present review summarizes the traditional uses of medicinal plants of Nepal used to treat gastrointestinal disorders, and evaluates their bio-efficacy based on a review of the available phytochemical and pharmacological literature. We searched different electronic databases and libraries for the literature on medicinal plants used in Nepal to treat gastrointestinal disorders. For each species, we also searched the literature for information on conservation status, as well as for phytochemical and pharmacological studies in support of the ethnobotanical information. We used principal component analysis to explore the relation among disorders and plant families, plant life forms, plant parts and preparation modes. We also performed permutation tests to determine if botanical families were used more often than expected considering their availability in the Nepali flora. We documented a total of 947 species belonging to 158 families and 586 genera used to treat gastrointestinal disorders in Nepal. Diarrhea was the disorder treated by the highest number of species (348), followed by stomachache (340) and dysentery (307). Among the reported species, five were endemic to Nepal, whereas 16 orchid species were protected under CITES Appendices II and III. The randomization test showed that species belonging to 14 families were used less often than expected, whereas plants belonging to 25 families were used more often than expected. The PCA scatter plot showed distinct groups of gastrointestinal disorders treated with similar plant life forms, plant parts, and/or preparation modes. We found 763 phytochemical studies on 324 species and 654 pharmacological studies on 269 species. We showed the diversity and

Effect of the 2015 earthquake on pediatric inpatient pattern at a tertiary care hospital in Nepal.

PubMed

Giri, Bishnu Rath; Chapagain, Ram Hari; Sharma, Samana; Shrestha, Sandeep; Ghimire, Sunita; Shankar, P Ravi

2018-02-05

Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7.8 magnitude Nepal earthquake on 25th April 2015. The admitted children were grouped based on direct effect of earthquake on their family (house damaged or family member injured or dead) and on whether their place of residence was located in an earthquake affected district. Most common diagnoses were identified and their distribution between the aforementioned groups analyzed to examine differences, if any, in disease occurrence or presentation. The fifteen weeks study duration was divided into three parts of five weeks each, to study trends in illness presentation. Variables were compared among various groups using appropriate statistical tests (p < 0.05). A total of 1057 patients were admitted. The proportion of patients requiring admission for pneumonia, acute gastroenteritis and acute or poststreptococcal glomerulonephritis (AGN/PSGN) was significantly higher among children belonging to earthquake affected districts. Proportion of patients with any infective condition was also significantly higher in this group. Acute gastroenteritis and any infective condition were significantly higher among children from substantially affected families. The proportion of AGN/PSGN among admitted patients increased in successive time categories among patients from affected districts and from substantially affected families. Urinary Tract Infection, bronchiolitis, tuberculosis, pleural effusion, protein energy malnutrition/failure to thrive, nephrotic syndrome, meningitis/meningoencephalitis, epilepsy or seizure disorders, leukemia

Extent of Fecal Contamination of Household Drinking Water in Nepal: Further Analysis of Nepal Multiple Indicator Cluster Survey 2014

PubMed Central

Kandel, Pragya; Kunwar, Ritu; Lamichhane, Prabhat; Karki, Surendra

2017-01-01

Water sources classified as “improved” may not necessarily provide safe drinking water for householders. We analyzed data from Nepal Multiple Indicator Cluster Survey 2014 to explore the extent of fecal contamination of household drinking water. Fecal contamination was detected in 81.2% (95% confidence interval [CI]: 77.9–84.2) household drinking water from improved sources and 89.6% (95% CI: 80.4–94.7) in water samples from unimproved sources. In adjusted analysis, there was no difference in odds of fecal contamination of household drinking water between improved and unimproved sources. We observed significantly lower odds of fecal contamination of drinking water in households in higher wealth quintiles, where soap and water were available for handwashing and in households employing water treatment. The extent of contamination of drinking water as observed in this study highlights the huge amount of effort required to ensure the provision of safely managed water in Nepal by 2030 as aimed in sustainable development goals. PMID:27821687

Phylogenetic evidence for the ancient Himalayan wolf: towards a clarification of its taxonomic status based on genetic sampling from western Nepal

PubMed Central

Kaden, Jennifer; Joshi, Jyoti; Bhattarai, Susmita; Kusi, Naresh; Sillero-Zubiri, Claudio; Macdonald, David W.

2017-01-01

Wolves in the Himalayan region form a monophyletic lineage distinct from the present-day Holarctic grey wolf Canis lupus spp. (Linnaeus 1758) found across Eurasia and North America. Here, we analyse phylogenetic relationships and the geographic distribution of mitochondrial DNA haplotypes of the contemporary Himalayan wolf (proposed in previous studies as Canis himalayensis) found in Central Asia. We combine genetic data from a living Himalayan wolf population collected in northwestern Nepal in this study with already published genetic data, and confirm the Himalayan wolf lineage based on mitochondrial genomic data (508 bp cytochrome b and 242 bp D-loop), and X- and Y-linked zinc-finger protein gene (ZFX and ZFY) sequences. We then compare the genetic profile of the Himalayan wolf lineage found in northwestern Nepal with canid reference sequences from around the globe with maximum likelihood and Bayesian phylogeny building methods to demonstrate that the Himalayan wolf forms a distinct monophyletic clade supported by posterior probabilities/bootstrap for D-loop of greater than 0.92/85 and cytochrome b greater than 0.99/93. The Himalayan wolf shows a unique Y-chromosome (ZFY) haplotype, and shares an X-chromosome haplotype (ZFX) with the newly postulated African wolf. Our results imply that the Himalayan wolf distribution range extends from the Himalayan range north across the Tibetan Plateau up to the Qinghai Lakes region in Qinghai Province in the People's Republic of China. Based on its phylogenetic distinction and its older age of divergence relative to the Holarctic grey wolf, the Himalayan wolf merits formal classification as a distinct taxon of special conservation concern. PMID:28680672

Nepal: Vocational Educator's Role in Elementary Education

ERIC Educational Resources Information Center

Stitt, Thomas R.

1974-01-01

The innovative vocational education program of the elementary grades in the developing country of Nepal focuses on "self-help" within the "practical arts" (agriculture, trade and industrial, and home science fields) and emphasizes application of subject matter to students' daily lives, integration of skills into the curriculum,…

Women physicists in Nepal

NASA Astrophysics Data System (ADS)

Shrestha, Nilam; Shrestha, Sanju

2015-12-01

Nepal is one of the least developed countries in the world, and education has been a major focus of the government. Half of the population is female, and providing education to women has been one of the biggest challenges to the government. Encouraging science education for girls, with a focus on physics, is even more of a Herculean task. Enrollment of girls in higher education is just over 25%. Data from 2002 to mid-2014 shows that the number of women in physics is increasing gradually, although their numbers are still very low.

An Overture for eCAM: Science, Technology and Innovation Initiation for Prosperous, Healthy Nepal.

PubMed

Kaphle, Krishna; Bhuju, Dinesh Raj; Jha, Pramod Kr; Bhattarai, Hom Nath

2011-01-01

Nepal the "Shangri-La" in the lap of the Himalayas is gearing up for modern times as it starts rebuilding after a decade of senseless violence and destruction. The nation one of the poorest in the global development index is rich in natural resources and biodiversity. Reports of medicinal plants far exceeding those recorded and reported so far are encouraging and at the same time concerns for medicinal plants under threat as a result of overexploitation are emerging from Nepal. The harsh mountain terrains, lack of industrialization and harnessing potentiality of its areas of strength; water; natural resources and tourism make it poor in per capita income which averages ~ 300 US$, with half the population living under >1$ a day. Nepal is beginning to realize that the way ahead is only possible through the path of Science and Technology (ST). Nepal Academy of Science and Technology formerly known as Royal Academy of Science and Technology organized the fifth national conference held every 4 years that took place in the capital Kathmandu during November 10-12, 2008. The ST initiation event saw the participation of ~ 1400 people representing over 150 organizations from the country and experts from abroad. The theme for the fifth national meet was "Science, Technology and Innovation for Prosperous Nepal". Complementary and Alternative Medicine (CAM) was an important theme in the event as the realization for the need of ST research focused in CAM for harnessing the chemo diversity potential was univocally approved.

Education Management and Performance after Rural Education Finance Reform: Evidence from Western China

ERIC Educational Resources Information Center

Liu, Mingxing; Murphy, Rachel; Tao, Ran; An, Xuehui

2009-01-01

Based on a survey of rural school districts in Western China, this essay explores the effects of fiscal centralisation on the relationship between local governance and school district management, most particularly on how managerial power is distributed in the rural education sector. The essay also examines some of the possible effects that changes…

PLANT DIVERSITY OF WESTERN CHITWAN FLORISTIC APPROACH

PubMed Central

Dangol, D. R.; Shivakoti, G. P.

2012-01-01

This paper identifies and documents the plant biodiversity of western Chitwan, Nepal. Specifically, our attention was focussed on the plants of forests, grasslands and common lands based on our “Reciprocal Relation of Population and Environment Study Project” conducted during January-April 1996. This species-diversity of trees, shrubs and herbaceous flora was recorded from 117, 117, and 1049 sampling quadrats of 10×10, 3×3 and 1×1 m2, respectively. The flora of our study plots contains 236 species that belong to 191 genera and 66 families. Of 236 species of plants, 119, 113, 59, 35 and 119 species were recorded from Tikauli forest, National Park forest, forests along the Narayani river, grasslands of National Park and common lands of the western Chitwan, respectively. Dicotyledons represent 184 (77.97%) species of the total flora species followed by monocotyledons (46 spp., 19.49%) and ferns (6 spp., 2.54%), respectively. The five largest families are Leguminosae (38 spp.), Poaceae (27 spp.), Asteraceae (22 spp.), Rubiaceae (10 spp.), and Scrophulariaceae (9 spp.). Hedyotis, Grewia and Lindernia, each with 4 spp., are the most speciose genera in the flora. PMID:22899874

The Himalayas of Nepal, a natural laboratory for the search and measurement of CO2 discharge

NASA Astrophysics Data System (ADS)

Girault, Frédéric; Koirala, Bharat P.; Bhattarai, Mukunda; Rajaure, Sudhir; Richon, Patrick; Perrier, Frédéric

2010-05-01

: the presence of a hot spring with high δ13C, of H2S smell, of hot spots in thermal images, of a geological contact, of self-potential anomalies (Byrdina et al., Journal of Geophysical Research, 2009) or of large radon-222 flux. Preliminary results about the failures or successes of the various methods will be given in the Trisuli and Langtang valleys (Central Nepal), in the Kali Gandaki valley (Western Nepal) and in the Thuli Bheri valley (Lower Dolpo, Far Western Nepal). These various sites also offer an opportunity to test the optimal estimation of total CO2 flux, using the least amount of experimental measurements. Preliminary results complemented by simulations will also be given on the total CO2 flux. In parallel, monitoring methods are being studied in the Syabru-Bensi pilot site. First, CO2 flux has been studied as a function of time using repeated measurements. Furthermore, the high radon content of the geological CO2 allows cost-effective monitoring using BARASOL probes. More than two years of data are already available and give hints on the use of radon to follow CO2 discharge as a function of time. These first results show how experimental studies carried out in natural discharge zones provide a rich laboratory to test the methodological approaches useful for CO2 leakage and monitoring.

Feasibility study of a family- and school-based intervention for child behavior problems in Nepal.

PubMed

Adhikari, Ramesh P; Upadhaya, Nawaraj; Satinsky, Emily N; Burkey, Matthew D; Kohrt, Brandon A; Jordans, Mark J D

2018-01-01

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 < 0.001, CI [5.57, 9.35]. Similarly, children's ECBI Intensity scores were significantly lower at follow-up (M = 9.9, SD = 8.5) than at baseline (M = 14.8, SD = 7.7), p < 0.005, 95% CI [1.76, 8.14]. The intervention also significantly improved children's daily functioning. Parents and teachers involved in the intervention found it acceptable and feasible for delivery to their children and students. Parents and teachers reported improved 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.

Hydrological system dynamics of glaciated Karnali River Basin Nepal Himalaya using J2000 Hydrological model

NASA Astrophysics Data System (ADS)

Khatiwada, K. R.; Nepal, S.; Panthi, J., Sr.; Shrestha, M.

2015-12-01

Hydrological modelling plays an important role in understanding hydrological processes of a catchment. In the context of climate change, the understanding of hydrological characteristic of the catchment is very vital to understand how the climate change will affect the hydrological regime. This research facilitates in better understanding of the hydrological system dynamics of a himalayan mountainous catchment in western Nepal. The Karnali River, longest river flowing inside Nepal, is one of the three major basins of Nepal, having the area of 45269 sq. km. is unique. The basin has steep topography and high mountains to the northern side. The 40% of the basin is dominated by forest land while other land cover are: grass land, bare rocky land etc. About 2% of the areas in basin is covered by permanent glacier apart from that about 12% of basin has the snow and ice cover. There are 34 meteorological stations distributed across the basin. A process oriented distributed J2000 hydrologial model has been applied to understand the hydrological system dynamics. The model application provides distributed output of various hydrological components. The J2000 model applies Hydrological Response Unit (HRU) as a modelling entity. With 6861 HRU and 1010 reaches, the model was calibrated (1981-1999) and validated (2000-2004) at a daily scale using split-sample test. The model is able to capture the overall hydrological dynamics well. The rising limbs and recession limbs are simulated equally and with satisfactory ground water conditions. Based on the graphical and statistical evaluation of the model performance the model is able to simulate hydrological processes fairly well. Calibration shows that Nash Sutcliffe efficiency is 0.91, coefficient of determination is 0.92 Initial observation shows that during the pre-monsoon season(March to May) the glacial runoff is 25% of the total discharge while in the monsoon(June to September) season it is only 13%. The surface runoff

Options for developing modernized geodetic datum for Nepal following the April 25, 2015 Mw7.8 Gorkha earthquake

NASA Astrophysics Data System (ADS)

Pearson, Chris; Manandhar, Niraj; Denys, Paul

2017-09-01

Along with the damage to buildings and infrastructure, the April 25, 2015 Mw7.8 Gorkha earthquake caused significant deformation over a large area of eastern Nepal with displacements of over 2 m recorded in the vicinity of Kathmandu. Nepal currently uses a classical datum developed in 1984 by the Royal (UK) Engineers in collaboration with the Nepal Survey Department. It has served Nepal well; however, the recent earthquakes have provided an impetus for developing a semi-dynamic datum that will be based on ITRF2014 and have the capacity to correct for tectonic deformation. In the scenario we present here, the datum would be based on ITRF2014 with a reference epoch set some time after the end of the current sequence of earthquakes. The deformation model contains a grid of the secular velocity field combined with models of the Gorkha Earthquake and the May 12 Mw7.3 aftershock. We have developed a preliminary velocity field by collating GPS derived crustal velocities from four previous studies for Nepal and adjacent parts of China and India and aligning them to the ITRF. Patches for the co-seismic part of the deformation for the Gorkha earthquake and the May 12, 2015 Mw 7.2 aftershock are based on published dislocation models. High order control would be a CORS network based around the existing Nepal GPS Array. Coordinates for existing lower order control would be determined by readjusting existing survey measurements and these would be combined with a series of new control stations spread throughout Nepal.

Paraveterinary service use in Nepal's Himalaya.

PubMed

Marshall, Edith S; Sischo, William M

2010-06-01

The involvement of paraveterinarians in animal-health delivery can reduce costs and allow expanded service delivery. Our objectives were to describe use of public paraveterinary services offered by junior technicians (JT) in two regions of Nepal, to identify factors associated with JT service use, and to characterize factors that limit JT service use. We used a survey of livestock owners in the Khumbu and Lower Mustang regions of Nepal's Himalaya to examine JT service use. Of 118 questionnaires completed between May 30, 1997 and July 8, 1997, 81 were analyzed for use of JT services to treat livestock: bovids, equids, and small ruminants. Five factors were associated with owners' use of JT services: living <30 min walk from a JT post (OR=12.2); having a positive opinion about JT services (OR=23.6); animals not having disease events that either impaired mobility or affected production or reproduction (OR=5.6), animals died related to a reported disease event (OR=3.2), and the owners' sex (with women being more likely to report use of JT services than men; OR=5.3). (c) 2010 Elsevier B.V. All rights reserved.

From Zero Energy Buildings to Zero Energy Districts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Polly, Ben; Kutscher, Chuck; Macumber, Dan

Some U.S. cities are planning advanced districts that have goals for zero energy, water, waste, and/or greenhouse gas emissions. From an energy perspective, zero energy districts present unique opportunities to cost-effectively achieve high levels of energy efficiency and renewable energy penetration across a collection of buildings that may be infeasible at the individual building scale. These high levels of performance are accomplished through district energy systems that harness renewable and wasted energy at large scales and flexible building loads that coordinate with variable renewable energy supply. Unfortunately, stakeholders face a lack of documented processes, tools, and best practices to assistmore » them in achieving zero energy districts. The National Renewable Energy Laboratory (NREL) is partnering on two new district projects in Denver: the National Western Center and the Sun Valley Neighborhood. We are working closely with project stakeholders in their zero energy master planning efforts to develop the resources needed to resolve barriers and create replicable processes to support future zero energy district efforts across the United States. Initial results of these efforts include the identification and description of key zero energy district design principles (maximizing building efficiency, solar potential, renewable thermal energy, and load control), economic drivers, and master planning principles. The work has also resulted in NREL making initial enhancements to the U.S. Department of Energy's open source building energy modeling platform (OpenStudio and EnergyPlus) with the long-term goal of supporting the design and optimization of energy districts.« less

Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements.

PubMed

Shrestha, Mina; Moles, Rebekah; Ranjit, Eurek; Chaar, Betty

2018-01-01

Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines "the Basel Statements". We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors' prescriptions, which were heavily influenced by pharmaceutical companies' marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal. Adoption and

Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements

PubMed Central

Ranjit, Eurek

2018-01-01

Background Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines “the Basel Statements”. Method We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Results Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors’ prescriptions, which were heavily influenced by pharmaceutical companies’ marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Conclusions Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in

Exploring the Nature and Reasons for Sexual Violence within Marriage among Young Women in Nepal

ERIC Educational Resources Information Center

Puri, Mahesh; Shah, Iqbal; Tamang, Jyotsna

2010-01-01

Sexual violence within marriage (SVWM) is a major public health and human right issue and yet remains a much neglected research area, especially in Nepal. An exploratory study using free listing, in-depth case histories and causal flow analysis was conducted among two major ethnic groups in Nepal. Descriptive data collected from free listing…

Reproductive status of western mosquitofish inhabiting selenium- contaminated waters in the Grassland Water District, Merced County, California

USGS Publications Warehouse

Saiki, M.K.; Martin, B.A.; May, T.W.

2004-01-01

This study was implemented to determine if western mosquitofish (Gambusia affinis) populations in the Grassland Water District suffer from impaired reproduction because of seleniferous inflows of agricultural drainwater from the Grassland Bypass Project. During June to July 2001, laboratory trials with pregnant female fish collected from two seleniferous treatment sites exposed to selenium-laden drainwater and two nonseleniferous reference sites yielded fry that averaged >96% survival at birth. In addition, none of the newborn fry exhibited evidence of teratogenesis, a typical consequence of selenium toxicity. Chemical analysis of postpartum female fish and their newborn fry indicated that mosquitofish from seleniferous sites accumulated relatively high body burdens of selenium (3.96 to 17.5 μg selenium/g in postpartum female fish and 5.35 to 29.2 μg selenium/g in their fry), whereas those from nonseleniferous sites contained lower body burdens (0.40 to 2.72 μg selenium/g in postpartum female fish and 0.61 to 4.68 μg selenium/g in their fry). Collectively, these results strongly suggest that mosquitofish inhabiting selenium-contaminated waters are not experiencing adverse reproductive effects at current levels of selenium exposure.

Effects of Abortion Legalization in Nepal, 2001–2010

PubMed Central

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.

2013-01-01

Background 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. Methods 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). Results 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). Conclusion 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

Clinic Attendance for Antiretroviral Pills Pick-Up among HIV-Positive People in Nepal: Roles of Perceived Family Support and Associated Factors.

PubMed

Ayer, Rakesh; Kikuchi, Kimiyo; Ghimire, Mamata; Shibanuma, Akira; Pant, Madhab Raj; Poudel, Krishna C; Jimba, Masamine

2016-01-01

HIV-positive people's clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal. A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance. Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92), participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82), and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99). In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93), when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44), good (AOR = 0.14, 95% CI = 0.04, 0.46), and fair (AOR = 0.21, 95% CI = 0.06, 0.70). HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings. Service providers should also consider

Clinic Attendance for Antiretroviral Pills Pick-Up among HIV-Positive People in Nepal: Roles of Perceived Family Support and Associated Factors

PubMed Central

Kikuchi, Kimiyo; Ghimire, Mamata; Shibanuma, Akira; Pant, Madhab Raj; Poudel, Krishna C.; Jimba, Masamine

2016-01-01

Introduction HIV-positive people’s clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal. Methods A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance. Results Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92), participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82), and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99). In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93), when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44), good (AOR = 0.14, 95% CI = 0.04, 0.46), and fair (AOR = 0.21, 95% CI = 0.06, 0.70). Conclusion HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings

Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade.

PubMed

Sharma, Abhishek; Mishra, Shiva Raj; Kaplan, Warren A

2017-08-22

Nepal was struck by devastating earthquakes in April-May 2015, followed by the India-Nepal border blockade later that year. We used the United Nations Commodity Trade Statistics (UN Comtrade) database to analyse exports of various health commodities from India to Nepal from January 2011-September 2016. We used time-series regressions of trading volume vs. unit price to ask how well Nepal's trading history with India prior to the earthquake and blockade was able to predict unit prices of health commodities imported into Nepal during and after the earthquake and the blockade. Regression residuals were used to quantify the extent to which the blockade impacted the price of healthcare commodities crossing into Nepal. During the blockade period (September 2015-early February 2016), the volume of all retail medicines traded across the India-Nepal border was reduced by 46.5% compared to same months in 2014-2015. For medical dressings, large volumes were exported from India to Nepal during and shortly after the earthquakes (May-June 2015), but decreased soon thereafter. During the earthquake, the difference between observed and predicted values of unit price (residuals) for all commodities show no statistical outliers. However, during the border blockade, Nepal paid USD 22.3 million more for retail medicines than one would have predicted based on its prior trading history with India, enough to provide healthcare to nearly half of Kathmandu's citizens for 1 year. The India-Nepal blockade was a geopolitical natural experiment demonstrating how a land-locked country is vulnerable to the vagaries of its primary trading partner. Although short-lived, the blockade had an immediate impact on traded medicine volumes and prices, and provided a large opportunity cost with implications for public health.

Human Trafficking in Nepal: Post-Earthquake Risk and Response.

PubMed

Gyawali, Bishal; Keeling, June; Kallestrup, Per

2017-04-01

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).

Free-Roaming Dogs in Nepal: Demographics, Health and Public Knowledge, Attitudes and Practices.

PubMed

Massei, G; Fooks, A R; Horton, D L; Callaby, R; Sharma, K; Dhakal, I P; Dahal, U

2017-02-01

In Nepal, most dogs are free to roam and may transmit diseases to humans and animals. These dogs often suffer from malnutrition and lack basic health care. Minimal information is available about their demographics and about public attitudes concerning dogs and diseases. We carried out a study in Chitwan District (central Nepal), to collect baseline data on free-roaming owned dog demographics, assess knowledge, attitudes and practices of dog owners concerning dogs and rabies, evaluate rabies vaccination coverage and anthelmintic treatment of dogs, measure dogs' response to rabies vaccination and assess dog health through body condition scores and parasites. We conducted household interviews with owners of free-roaming female dogs (n = 60) and administered dogs with rabies vaccination and anthelmintics. Dog owners regularly fed free-roaming dogs but provided minimal health care; 42% of respondents did not claim ownership of the dog for which they provided care. We collected skin, faecal and blood samples for parasite identification and for measuring rabies virus-specific antibodies. Ninety-two per cent of dog owners were aware of the routes of rabies virus transmission, but only 35% described the correct post-exposure prophylaxis (PEP) following a dog bite. Twenty-seven per cent of the dogs had measurable rabies virus-specific antibody titres and 14% had received anthelmintics in the previous year. Following rabies vaccination, 97% of dogs maintained an adequate antibody titre for ≥6 months. Most dogs appeared healthy, although haemoprotozoans, endoparasites and ectoparasites were identified in 12%, 73% and 40% of the dogs, respectively. Poor skin condition and parasite load were associated. Seventy-four per cent of the females had litters in 1 year (mean litter size = 4.5). Births occurred between September and February; we estimated 60% mortality in puppies. We concluded that vaccination coverage, PEP awareness and anthelmintic treatment should be

Promotion and prelacteal feeding of breastmilk substitutes among mothers in Kathmandu Valley, Nepal.

PubMed

Pries, Alissa M; Huffman, Sandra L; Adhikary, Indu; Upreti, Senendra Raj; Dhungel, Shrid; Champeny, Mary; Zehner, Elizabeth

2016-04-01

In 1992, Nepal passed the Mother's Milk Substitutes (Control of Sale and Distribution) Act in order to regulate the sale, distribution and promotion of substitutes for breastmilk within Nepal, in an effort to protect and promote breastfeeding. Helen Keller International, in collaboration with Nepal's Ministry of Health and Population's Child Health Division, implemented a study to assess mothers' exposure to promotions for and utilization of breastmilk substitutes in Kathmandu Valley, Nepal. A health facility-based, cross-sectional survey was conducted among 304 mothers being discharged after delivery. Prelacteal feeding of breastmilk substitutes is prevalent (55.9% of mothers, n = 170). Reported recommendations during antenatal checks and after delivery from health professionals to use breastmilk substitutes were prevalent, occurring among 47.4% (n = 144) of mothers; rates of these recommendations were significantly higher for mothers that delivered in private health facilities, as compared with public (67.7% vs. 38.0%, P < 0.001). Mothers that received a recommendation to use a breastmilk substitute from a health worker were 16.7 times more likely to provide a prelacteal feed of a breastmilk substitute, as compared with mothers that did not receive a recommendation (P < 0.001). Few mothers reported observation of commercial advertisements for breastmilk substitutes inside a health facility (reported by 3.6% of mothers). No mothers reported receiving a sample of a breastmilk substitute, bottle or teat from a health professional. More information is needed to determine why there is such a high rate of health worker recommendations for breastmilk substitute use in the first few days after delivery. While utilization of breastmilk substitutes is low among mothers of young children in Nepal, prelacteal feeding of breastmilk substitutes is highly prevalent in Kathmandu Valley. Reported recommendations from health professionals to use breastmilk

Nepali Private Schools and Tolerated Illegality: A Foucauldian Analysis of Privatisation of Education in Nepal

ERIC Educational Resources Information Center

Sharma Poudyal, Chandra

2017-01-01

The Education Act 1971 is the main policy document under which schools in Nepal are operated. With the change in political regime, this policy has been amended as per the ideology of the incoming regime. Although private schools started to show their influence in Nepal in the late 1980s, excessive growth of private schools began with the…

Participatory health development in rural Nepal: clarifying the process of community empowerment.

PubMed

Purdey, A F; Adhikari, G B; Robinson, S A; Cox, P W

1994-01-01

Community-based participatory development empowers villagers to develop community cohesion and confidence, increase their ability to identify, analyze, and priorize their own needs, and organize the resources to meet these needs. An important first step in the process involves establishing a cohesive and functional community group. The authors believe that this is best accomplished through villagers' critical examination of their experiences with development including their understanding of reasons for success or failure, and the gradual emergence of a model of working together that acknowledges and builds on participation and collective expertise. This approach to development is demonstrating encouraging results in a rural area of western Nepal in a university affiliated Canadian/Nepali Health Development Project. This paper describes two mini-projects to illustrate the evolution of group formation through reflection, analysis, and action, and identifies outcomes that could serve as indicators of community empowerment. The paper also presents a generic model of empowerment, and offers lessons learned by the project through the application of the empowerment process to sustainable health development.

Women's autonomy in household decision-making: a demographic study in Nepal.

PubMed

Acharya, Dev R; Bell, Jacqueline S; Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R

2010-07-15

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 < 0.01), however their more schooling (SLC and above) shows non-significance with other outcome measures. Interestingly, rich women are less likely to have autonomy to 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

A study of injuries and violence related articles in Nepal.

PubMed

Joshi, S K; Shrestha, S

2009-01-01

Nepal lacks sufficient data on injury and violence. Studies have been done in different regions but there is not a nationwide study on this topic. So, we have designed this systematic review to get a cumulative picture of injury and violence status in Nepal. We searched Medline database, Google scholar database and also all the national medical journals for relevant studies on injuries and violence. Our eligibility criteria included studies done in Nepal, evaluating the incidence of different forms of injuries, and their causes and effects. We excluded case reports, editorials and reviews. All together, we had 23 studies. We made cumulative analysis wherever possible. All the studies were descriptive. In overall, the incidence of injuries was twice as common in male as in female with the ratio of 2.1:1. The economically active population between 20-50 years of age was mostly involved in injuries. Road traffic injuries were the most common form of injuries, most of which (42.5%) involved motorcycles. Pedestrians (48.6%) were the most vulnerable group of population. Falls (48.9%) were the most common cause of neuro traumatic accidents. Our systematic review suggests that injuries and violence pose a big problem; road traffic accidents make the most part of it.

Nepal: Quest for Survival.

DTIC Science & Technology

1983-05-02

thesis prqso;i d to hbe faculty.of the U.S. Army Co𔃾d erjkpr .",ta ff- -C9iegs in -~ f~4fM11ment -of the c’i eq~ttkmVAts, for the N, degree er of Mi...REOTAT May 2, 1983 HQ TRADOC, ATTN: ATCS- D IS. NUMBER OF PAGES Ft. Monroe, VA 23651 117 MCLMORIW AGENCY NAME & ADDRESSIt .nffrent from Comfroiiind...concludes with an examination of the three components of Nepal’s current strategy in her quest for survival. Accession r,.- NTIS Gi ., DTIC T&B[ Unariou

Present and Future of Dengue Fever in Nepal: Mapping Climatic Suitability by Ecological Niche Model

PubMed Central

Cao, Chunxiang; Xu, Min; Pandit, Shreejana

2018-01-01

Both the number of cases of dengue fever and the areas of outbreaks within Nepal have increased significantly in recent years. Further expansion and range shift is expected in the future due to global climate change and other associated factors. However, due to limited spatially-explicit research in Nepal, there is poor understanding about the present spatial distribution patterns of dengue risk areas and the potential range shift due to future climate change. In this context, it is crucial to assess and map dengue fever risk areas in Nepal. Here, we used reported dengue cases and a set of bioclimatic variables on the MaxEnt ecological niche modeling approach to model the climatic niche and map present and future (2050s and 2070s) climatically suitable areas under different representative concentration pathways (RCP2.6, RCP6.0 and RCP8.5). Simulation-based estimates suggest that climatically suitable areas for dengue fever are presently distributed throughout the lowland Tarai from east to west and in river valleys at lower elevations. Under the different climate change scenarios, these areas will be slightly shifted towards higher elevation with varied magnitude and spatial patterns. Population exposed to climatically suitable areas of dengue fever in Nepal is anticipated to further increase in both 2050s and 2070s on all the assumed emission scenarios. These findings could be instrumental to plan and execute the strategic interventions for controlling dengue fever in Nepal. PMID:29360797

Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011

PubMed Central

Pradhan, Rina; Wynter, Karen; Fisher, Jane

2018-01-01

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy. PMID:29385771

The Discourse of Crisis in Public Meetings: Case Study of a School District's Multimillion Dollar Error

ERIC Educational Resources Information Center

Tracy, Karen

2007-01-01

School districts are both big businesses and a form of local governance that is part of American democracy. When a crisis makes a district's democratic face relevant, the organization will experience a dilemma that does not occur in business-only organizations. This study examines the public meetings of a school board in the western United States…

Base of principal aquifer for parts of the North Platte, South Platte, and Twin Platte Natural Resources Districts, western Nebraska

USGS Publications Warehouse

Hobza, Christopher M.; Abraham, Jared D.; Cannia, James C.; Johnson, Michaela R.; Sibray, Steven S.

2014-01-01

Water resources in the North and South Platte River valleys of Nebraska, including the valley of Lodgepole Creek, are critical to the social and economic health of the area, and for the recovery of threatened and endangered species in the Platte River Basin. Groundwater and surface water are heavily used resources, and uses are regulated in the study area. Irrigation is the dominant water use and, in most instances, is supplied by both groundwater and surface-water sources. The U.S. Geological Survey and its partners have collaborated to use airborne geophysical surveys for areas of the North and South Platte River valleys including the valley of Lodgepole Creek in western Nebraska. The objective of the surveys was to map the aquifers and underlying bedrock topography of selected areas to help improve the understanding of groundwater–surface-water relations to guide water-management decisions. This project was a cooperative study involving the North Platte Natural Resources District, the South Platte Natural Resources District, the Twin Platte Natural Resources District, the Conservation and Survey Division of the University of Nebraska-Lincoln, and the Nebraska Environmental Trust. This report presents the interpreted base-of-aquifer surface for part of the area consisting of the North Platte Natural Resources District, the South Platte Natural Resources District, and the Twin Platte Natural Resources District. The interpretations presented herein build on work done by previous researchers from 2008 to 2009 by incorporating additional airborne electromagnetic survey data collected in 2010 and additional test holes from separate, related studies. To make the airborne electromagnetic data useful, numerical inversion was used to convert the measured data into a depth-dependent subsurface resistivity model. An interpretation of the elevation and configuration of the base of aquifer was completed in a geographic information system that provided x, y, and z

Assessing the Groundwater Concentrations and Geographical Distribution of Arsenic in Nepal

NASA Astrophysics Data System (ADS)

Ma, J.; Liu, F.

2015-12-01

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

The Prevalence of Diabetic Retinopathy Among Known Diabetic Population in Nepal.

PubMed

Mishra, S K; Pant, B P; Subedi, P

2016-01-01

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

Extent of Fecal Contamination of Household Drinking Water in Nepal: Further Analysis of Nepal Multiple Indicator Cluster Survey 2014.

PubMed

Kandel, Pragya; Kunwar, Ritu; Lamichhane, Prabhat; Karki, Surendra

2017-02-08

Water sources classified as "improved" may not necessarily provide safe drinking water for householders. We analyzed data from Nepal Multiple Indicator Cluster Survey 2014 to explore the extent of fecal contamination of household drinking water. Fecal contamination was detected in 81.2% (95% confidence interval [CI]: 77.9-84.2) household drinking water from improved sources and 89.6% (95% CI: 80.4-94.7) in water samples from unimproved sources. In adjusted analysis, there was no difference in odds of fecal contamination of household drinking water between improved and unimproved sources. We observed significantly lower odds of fecal contamination of drinking water in households in higher wealth quintiles, where soap and water were available for handwashing and in households employing water treatment. The extent of contamination of drinking water as observed in this study highlights the huge amount of effort required to ensure the provision of safely managed water in Nepal by 2030 as aimed in sustainable development goals. © The American Society of Tropical Medicine and Hygiene.

Emergency mapping and information management during Nepal Earthquake 2015 - Challenges and lesson learned

NASA Astrophysics Data System (ADS)

Joshi, G.; Gurung, D. R.

2016-12-01

A powerful 7.8 magnitude earthquake struck Nepal at 06:11 UTC on 25 April 2015. Several subsequent aftershocks were deadliest earthquake in recent history of Nepal. In total about 9000 people died and 22,300 people were injured, and lives of eight million people, almost one-third of the population of Nepal was effected. The event lead to massive campaigned to gather data and information on damage and loss using remote sensing, field inspection, and community survey. Information on distribution of relief materials is other important domain of information necessary for equitable relief distribution. Pre and post-earthquake high resolution satellite images helped in damage area assessment and mapping. Many national and international agencies became active to generate and fill the information vacuum. The challenges included data access bottleneck due to lack of good IT infrastructure; inconsistent products due to absence of standard mapping guidelines; dissemination challenges due to absence of Standard Operating Protocols and single information gateway. These challenges were negating opportunities offered by improved earth observation data availability, increasing engagement of volunteers for emergency mapping, and centralized emergency coordination practice. This paper highlights critical practical challenges encountered during emergency mapping and information management during the earthquake in Nepal. There is greater need to address such challenges to effectively use technological leverages that recent advancement in space science, IT and mapping domain provides.

Culture and Internal Security of Nepal

DTIC Science & Technology

2012-06-08

in the villages would not even give milk to the dalits because of the belief that blood would come instead of milk leading to the death of the...buffalo and cow . 14 Political Culture For generations, Nepal was ruled under a highly centralized, authoritarian and personalized political system...languages from flourishing. The cow , simrik (red color), danphe (lophophorus), and laliguras (rhododendron) which are typical symbols of the Hindi

Prevalence, antibiogram and risk factors of thermophilic campylobacter spp. in dressed porcine carcass of Chitwan, Nepal

PubMed Central