Is prevention of acute pesticide poisoning effective and efficient, with Locally Adapted Personal Protective Equipment? A randomized crossover study among farmers in Chitwan, Nepal.

PubMed

Varma, Anshu; Neupane, Dinesh; Ellekilde Bonde, Jens Peter; Jørs, Erik

2016-07-26

Farmers' risk of pesticide poisoning can be reduced with personal protective equipment but in low-income countries farmers' use of such equipment is limited. To examine the effectiveness and efficiency of Locally Adapted Personal Protective Equipment to reduce organophosphate exposure among farmers. In a crossover study, 45 male farmers from Chitwan, Nepal, were randomly allocated to work as usual applying organophosphate pesticides wearing Locally Adapted Personal Protective Equipment or Daily Practice Clothing. For seven days before each experiment, each farmer abstained from using pesticides. Before and after organophosphate application, an interview surveys and blood tests were carried out, and analyzed with paired t-test, frequencies and percentages. The difference between follow-up mean for acute organophosphate poisoning symptoms in the two groups was 0.13 [95% CI -0.22;0.49] and for plasma cholinesterase (U/ml) -0.03 [95% CI -0.11;0.06]. The difference between follow-up mean minus baseline mean for acute organophosphate poisoning symptoms in the two groups was 0.29 [95% CI -0.26;0.84] and for plasma cholinesterase (U/ml) -0.01 [95% CI --0.08;0.06]. Wearing the Locally Adapted Personal Protective Equipment versus Daily Practice Clothing gave the following results, respectively: comfort 75.6% versus 100%, sense of heat 64.4% versus 31.3%, other problems 44.4% versus 33.3%, likeability 95.6% versus 77.8%. We cannot support the expectation that our farmers in Chitwan, Nepal working with Locally Adapted Personal Protective Equipment would have fewer acute organophosphate poisoning symptoms, higher plasma cholinesterase (U/mL) and find it more efficient to work with the equipment than farmers working with their Daily Practice Clothing. Based on the farmers' working behavior, compounds used, intensity and exposure duration we conclude that Locally Adapted Personal Protective Equipment does not provide additional protection during usual work practices. However, our

HIV epidemic in Far-Western Nepal: effect of seasonal labor migration to India

PubMed Central

2011-01-01

Background Because of limited work opportunities in Nepal and the open-border provision between Nepal and India, a seasonal labor migration of males from Far-Western Nepal to India is common. Unsafe sexual activities of these migrants in India, such as frequent visits to brothels, lead to a high HIV prevalence among them and to a potential transmission upon their return home to Nepal. The present study aims to evaluate the role of such seasonal labor-migration to India on HIV transmission in Far-Western Nepal and to assess prevention programs. Methods An HIV epidemic model was developed for a population in Far-Western Nepal. The model was fitted to the data to estimate the back and forth mobility rates of labor-migrants to India, the HIV prevalence among migrants and the HIV transmission rate in Far-Western Nepal. HIV prevalence, new infections, disease deaths and HIV infections recruited from India were calculated. Prevention programs targeting the general population and the migrants were evaluated. Results Without any intervention programs, Far-Western Nepal will have about 7,000 HIV infected individuals returning from India by 2015, and 12,000 labor-migrants living with HIV in India. An increase of condom use among the general population from 39% to 80% will reduce new HIV infections due to sexual activity in Far-Western Nepal from 239 to 77. However, such a program loses its effectiveness due to the recruitment of HIV infections via returning migrants from India. The reduction of prevalence among migrants from 2.2% to 1.1% can bring general prevalence down to 0.4% with only 3,500 recruitments of HIV infections from India. Conclusion Recruitment of HIV infections from India via seasonal labor-migrants is the key factor contributing to the HIV epidemic in Far-Western Nepal. Prevention programs focused on the general population are ineffective. Our finding highlights the urgency of developing prevention programs which reduce the prevalence of HIV among migrants

Subject preferences of first- and second-year medical students for their future specialization at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal - a questionnaire-based study.

PubMed

Jha, Rajesh K; Paudel, Keshab R; Shah, Dev K; Sah, Ajit K; Basnet, Sangharshila; Sah, Phoolgen; Adhikari, Sandeep

2015-01-01

The selection of a discipline for future specialization may be an important factor for the medical students' future career, and it is influenced by multiple factors. The interest of students in the early stages can be improved in subjects related to public health or of academic importance, as per need. A questionnaire-based study was conducted among 265 first- and second-year medical students of Chitwan Medical College, Nepal to find out their subject of preference for postgraduation and the factors affecting their selection along with their interesting basic science subject. Only the responses from 232 completely filled questionnaires were analyzed. The preference of the students for clinical surgical (50.9%), clinical medical (45.3%), and basic medical (3.9%) sciences for postgraduation were in descending order. The most preferred specialty among male students was clinical surgical sciences (56.3%), and among female students, it was clinical medical sciences (53.6%). Although all the students responded to their preferred specialty, only 178 students specified the subject of their interest. General surgery (23.4%), pediatrics (23.4%), and anatomy (2.4%) were the most favored subjects for postgraduation among clinical surgical, clinical medical, and basic medical sciences specialties, respectively. More common reasons for selection of specific subject for future career were found to be: personal interests, good income, intellectual challenge, and others. Many students preferred clinical surgical sciences for their future specialization. Among the reasons for the selection of the specialty for postgraduation, no significant reason could be elicited from the present study.

Assessment of Drought Scenario in Western Nepal

NASA Astrophysics Data System (ADS)

Pandey, V. P.; Khatiwada, K. R.

2017-12-01

Drought is a frequent phenomenon in relatively drier western Nepal. Lack of hydro-climatic information with wider spatial coverage is hindering effective assessment of the drought events. Furthermore, drought assessment is not getting adequate attention in Nepal. This study aims to develop drought scenario for Western Nepal by evaluating various types of drought indices in Karnali River Basin (area = 4,6150 km2) and recommend the most suited set of indices for data-poor regions. On the climatic data at ten stations, drought indices were calculated from following seven selected indices: Standardized Precipitation Index (SPI), Standardized Precipitation Evapotranspiration Index (SPEI), Palmer Drought Severity Index (PDSI), (self-calibrating) Palmer Drought Severity Index (scPDSI), Reconnaissance Drought Index (RDI), Standardized Streamflow Index (SSFI), and Palmer Hydrological Drought Index (PHDI). Initial results reflect that the basin is affected by severe meteorological drought. Most of the indices show the extreme dryness scenario during the years 1984-85, 1992-93, 1995, 2000, 20002, 2008-09, and 2012. The results from the stations with long-term temperature and precipitation data sets showed a higher (up to 0.9) correlation between SPI and RDI than for SPEI and other Palmer Drought Indices, which ranged from 0.6 to 0.8 only. This suggests ability of SPI to represent magnitude and duration of the drought events fairly well in the study basin, and therefore, has potential to represent drought dynamics in data-poor regions. Keywords: Drought; Karnali River Basin; Nepal Himalaya

Subject preferences of first- and second-year medical students for their future specialization at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal – a questionnaire-based study

PubMed Central

Jha, Rajesh K; Paudel, Keshab R; Shah, Dev K; Sah, Ajit K; Basnet, Sangharshila; Sah, Phoolgen; Adhikari, Sandeep

2015-01-01

Introduction The selection of a discipline for future specialization may be an important factor for the medical students’ future career, and it is influenced by multiple factors. The interest of students in the early stages can be improved in subjects related to public health or of academic importance, as per need. Methods A questionnaire-based study was conducted among 265 first- and second-year medical students of Chitwan Medical College, Nepal to find out their subject of preference for postgraduation and the factors affecting their selection along with their interesting basic science subject. Only the responses from 232 completely filled questionnaires were analyzed. Results The preference of the students for clinical surgical (50.9%), clinical medical (45.3%), and basic medical (3.9%) sciences for postgraduation were in descending order. The most preferred specialty among male students was clinical surgical sciences (56.3%), and among female students, it was clinical medical sciences (53.6%). Although all the students responded to their preferred specialty, only 178 students specified the subject of their interest. General surgery (23.4%), pediatrics (23.4%), and anatomy (2.4%) were the most favored subjects for postgraduation among clinical surgical, clinical medical, and basic medical sciences specialties, respectively. More common reasons for selection of specific subject for future career were found to be: personal interests, good income, intellectual challenge, and others. Conclusion Many students preferred clinical surgical sciences for their future specialization. Among the reasons for the selection of the specialty for postgraduation, no significant reason could be elicited from the present study. PMID:26635491

What Caused the Winter Drought in Western Nepal during Recent Years?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, S-Y; Yoon, Jin-Ho; Gillies, R.

Western Nepal has experienced consecutive and worsened winter drought conditions since 2000 culminating in a severe drought episode during 2008-2009. In this study, the meteorological conditons and a historical pespective of the winter droughts in western Nepal were analyzed using respectively instumental records and a paleoclimatic drought index. Althought decadal-scale drought conditions were found to be recurrent in the paleoclimate record, the severity of the recent decadal drought (since 2000) clearly stands out in the 700 years of record and, this is suggestive of potential anthropogenic influences in the recent decades. Meteorological diagnosis using atmospheric reanalysis in the recent decadesmore » revealed that (1) winter drought in western Nepal is linked to the Arctic Oscillation and its decadal variability, which initiates a tropospheric short-wave train across the Europe, Eurasia and South Asia, and that (2) the persistent warming of the Indian Ocean likely contributes to the suppression of rainfall through enhanced local Hadley circultion. It is therefore conceivable that the recent spells of decadal drought in Nepal drought are symptomatic of both natural variability and anthropogenic influences.« less

Lake deposits record evidence of large post-1505 AD earthquakes in western Nepal

NASA Astrophysics Data System (ADS)

Ghazoui, Z.; Bertrand, S.; Vanneste, K.; Yokoyama, Y.; Van Der Beek, P.; Nomade, J.; Gajurel, A.

2016-12-01

According to historical records, the last large earthquake that ruptured the Main Frontal Thrust (MFT) in western Nepal occurred in 1505 AD. Since then, no evidence of other large earthquakes has been found in historical records or geological archives. In view of the catastrophic consequences to millions of inhabitants of Nepal and northern India, intense efforts currently focus on improving our understanding of past earthquake activity and complement the historical data on Himalayan earthquakes. Here we report a new record, based on earthquake-triggered turbidites in lakes. We use lake sediment records from Lake Rara, western Nepal, to reconstruct the occurrence of seismic events. The sediment cores were studied using a multi-proxy approach combining radiocarbon and 210Pb chronologies, physical properties (X-ray computerized axial tomography scan, Geotek multi-sensor core logger), high-resolution grain size, inorganic geochemistry (major elements by ITRAX XRF core scanning) and bulk organic geochemistry (C, N concentrations and stable isotopes). We identified several sequences of dense and layered fine sand mainly composed of mica, which we interpret as earthquake-triggered turbidites. Our results suggest the presence of a synchronous event between the two lake sites correlated with the well-known 1505 AD earthquake. In addition, our sediment records reveal five earthquake-triggered turbidites younger than the 1505 AD event. By comparison with historical archives, we relate one of those to the 1833 AD MFT rupture. The others may reflect successive ruptures of the Western Nepal Fault System. Our study sheds light on events that have not been recorded in historical chronicles. Those five MMI>7 earthquakes permit addressing the problem of missing slip on the MFT in western Nepal and reevaluating the risk of a large earthquake affecting western Nepal and North India.

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.

The quandary of local people—Park relations in Nepal's Royal Chitwan National Park

NASA Astrophysics Data System (ADS)

Nepal, Sanjay K.; Weber, Karl E.

1995-11-01

This paper analyzes five major causes of park-people conflicts that have occurred in Nepal's Royal Chitwan National Park. The causes include illegal transactions of forest products from the park, livestock grazing in the park, illegal hunting and fishing, crop damage, and threats to human and animal life caused by wild animals from the park. The conflicts indicate a reciprocal relationship between the park and local people. They reflect the attitudes of local people and representatives of the park authority whose priorities and objectives largely diverge. The results show that people settled adjacent to the park are heavily dependent on its resources. Even in places where some, albeit few alternative sources exist, local people continue to trespass the park boundary as these sources are inadequate to ensure the fulfillment of local people's resource needs. Illegal transactions of resources continue throughout the year; however, they are less intense during summer due to flooding caused by the Rapti River, which forms the park boundary towards the northern section where this study is conducted. The frequency of local people's visits to the park is mainly determined by their age, distance between homesteads and park, and volume of crop loss caused by wild animals. Crop damage is the function of size of landholding, distance, and frequency of crop raid. Local people claim that they have no intention of letting their livestock graze in the park; however, the dense vegetation of the park attracts livestock grazing on riverbanks just outside the open park boundary. Many head of livestock are killed by carnivores of the park. Human casualties are mainly caused by sloth bear ( Melursus ursinus), tiger ( Panthera tigris), wild pig ( Sug scrofa), and rhinoceros ( Rhinoceros unicornis). There had been some earlier attempts to reconcile the conflicts by offering local people different kinds of compensations; however, these were unsuccessful measures. An integrated approach is

Spatial assessment of attitudes toward tigers in Nepal.

PubMed

Carter, Neil H; Riley, Shawn J; Shortridge, Ashton; Shrestha, Binoj K; Liu, Jianguo

2014-03-01

In many regions around the world, wildlife impacts on people (e.g., crop raiding, attacks on people) engender negative attitudes toward wildlife. Negative attitudes predict behaviors that undermine wildlife management and conservation efforts (e.g., by exacerbating retaliatory killing of wildlife). Our study (1) evaluated attitudes of local people toward the globally endangered tiger (Panthera tigris) in Nepal's Chitwan National Park; and (2) modeled and mapped spatial clusters of attitudes toward tigers. Factors characterizing a person's position in society (i.e., socioeconomic and cultural factors) influenced attitudes toward tigers more than past experiences with tigers (e.g., livestock attacks). A spatial cluster of negative attitudes toward tigers was associated with concentrations of people with less formal education, people from marginalized ethnic groups, and tiger attacks on people. Our study provides insights and descriptions of techniques to improve attitudes toward wildlife in Chitwan and many regions around the world with similar conservation challenges.

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

Linking Livelihoods and Conservation: An Examination of Local Residents' Perceived Linkages Between Conservation and Livelihood Benefits Around Nepal's Chitwan National Park

NASA Astrophysics Data System (ADS)

Nepal, Sanjay; Spiteri, Arian

2011-05-01

This paper investigates local recognition of the link between incentive-based program (IBP) benefits and conservation, and how perceptions of benefits and linkage influence attitudes in communities surrounding Chitwan National Park, Nepal. A survey of 189 households conducted between October and December 2004 examined local residents' perceived benefits, their attitudes toward park management, and perception of linkages between conservation and livelihoods. Linkage perceptions were measured by a scale compared with a respondent's recognition of benefits to determine whether IBPs establish a connection between benefits and livelihoods. An attitude scale was also created to compare attitudes toward park management with perceptions of benefits and linkage to determine if IBPs led to positive attitudes, and if the recognition of a direct tie between livelihoods and natural resources made attitudes more favorable. Research results indicate that as acknowledgement of benefit increases, so does the perception of linkage between the resource and livelihoods. Similarly, when perceived benefit increases, so too does attitude towards management. Positive attitude towards park management is influenced more by perception of livelihood dependence on resources than on benefits received from the park. However, overwhelming positive support voiced for conservation did not coincide with conduct. In spite of the positive attitudes and high perception of linkage, people did not necessarily behave in a way compatible with conservation. This suggests that while benefits alone can lead to positive attitudes, without clear linkages to conservation, the IBP may lose persuasion when alternative options—conflicting with conservation objectives—arise promising to provide greater economic benefit.

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

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.

Fine-scale spatio-temporal variation in tiger Panthera tigris diet: Effect of study duration and extent on estimates of tiger diet in Chitwan National Park, Nepal

USGS Publications Warehouse

Kapfer, Paul M.; Streby, Henry M.; Gurung, B.; Simcharoen, A.; McDougal, C.C.; Smith, J.L.D.

2011-01-01

Attempts to conserve declining tiger Panthera tigris populations and distributions have experienced limited success. The poaching of tiger prey is a key threat to tiger persistence; a clear understanding of tiger diet is a prerequisite to conserve dwindling populations. We used unpublished data on tiger diet in combination with two previously published studies to examine fine-scale spatio-temporal changes in tiger diet relative to prey abundance in Chitwan National Park, Nepal, and aggregated data from the three studies to examine the effect that study duration and the size of the study area have on estimates of tiger diet. Our results correspond with those of previous studies: in all three studies, tiger diet was dominated by members of Cervidae; small to medium-sized prey was important in one study. Tiger diet was unrelated to prey abundance, and the aggregation of studies indicates that increasing study duration and study area size both result in increased dietary diversity in terms of prey categories consumed, and increasing study duration changed which prey species contributed most to tiger diet. Based on our results, we suggest that managers focus their efforts on minimizing the poaching of all tiger prey, and that future studies of tiger diet be of long duration and large spatial extent to improve our understanding of spatio-temporal variation in estimates of tiger diet. ?? 2011 Wildlife Biology, NKV.

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.

An Assessment of Monsoon Triggered Landslides in Western Nepal

NASA Astrophysics Data System (ADS)

Sudan Acharya, Madhu

2010-05-01

Due to heavy monsoon rain, rugged topography and very young mountains, frequent slope failures and soil erosion are very common in Nepal but in most of cases the natural slopes are disturbed by men to construct a road through it and the situation further aggravated by the Monsoon rain. Summer usually tests the disaster response capacity of Nepal, when the monsoons trigger water induced disasters. This year Nepal's Western regions were most severely affected by floods and landslides. Every year, sadly, it is the same story of mostly poor people living in remote villages succumbing to landslides and flooding and those who survive facing hardships brought on by the disaster. The tail end of the monsoon in October has triggered flood and landslides in Nepal which affected a total of 14 districts in the mid and far-west regions, of which Kailali, Bardiya, Banke, Dadeldhura, Accham and Kanchapur district are most affected. The affected areas are geographically scattered and remote, and are therefore difficult to access. In this year (2009), flood and landslides have claimed 62 lives, affecting more than 152,000 individuals from 27,000 families. More than 4,000 families are displaced and are taking shelter in schools, open space and forest areas with no protection from the external elements. In the above context the prevention and mitigation measures for landslides is a great challenge for Nepal. Nepal has been investing its huge amount of resources to stabilize landslides and roadside slope failures, still then it has become unmanageable during Monsoon time. Considering the above facts, an assessment of landslides which were occurred during the Monsoon (July-October 2009), along Khodpe - Jhota - Chainpur road in far western region of Nepal has been carried out based on the field observation of various landslides. The paper presents the causes and mechanisms of failures of different landslides which are mostly triggered by Monsoon rain. It also suggests some low cost

Patterns of change: the dynamics of medicinal plant trade in far-western Nepal.

PubMed

Pyakurel, Dipesh; Sharma, Indira Bhattarai; Smith-Hall, Carsten

2018-06-06

Combined quantitative and qualitative environmental product trade studies, undertaken in the same location over time, are instrumental in identifying plant species with commercial demand and explaining what drives temporal changes. Yet such dynamic studies are rare, including for Himalayan medicinal plants that have been large-scale traded for millennia. To (i) investigate changes in medicinal plant trade in the past 17 years, and (ii) identify the main factors driving changes, using a study of Darchula District in far-western Nepal. Medicinal plant production network data were collected from March to August 2016, for the fiscal year 2014-15, for Darchula District in far-western Nepal through 167 quantitative (58 harvesters, 38 sub-local traders, 25 local traders, 25 central wholesalers, and 21 regional wholesalers), 61 qualitative (15 sub-local traders, 19 local traders, 15 central wholesalers, and 12 regional wholesalers) interviews, and four focus group discussions. Results were compared to previously unpublished similar data for Darchula District for the year 1997-98, using quantitative and qualitative interviews with 10 local traders, 20 central wholesalers, and 53 regional wholesalers. Data analysis was guided by an analytical framework derived from Global Production Network theory. Quantitative data were used to estimate changes in 12 indicators while the qualitative information allowed identification of the factors driving observed changes in the indicators. The volume of medicinal plants traded from Darchula District in the fiscal year 2014-15 was 401 t with a harvester value of USD 5.5 million, representing a 2.3 fold increase in volume and 17.2 fold increase in value compared to 1997-98. Trade in the two observation years comprised 30 air-dried plant products (from 28 identified species as well as lichens and a mineral substance); 12 products were traded in both periods, while seven disappeared, and 11 new products entered the trade. The number of

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

PREVALENCE OF LYMPHATIC FILARIASIS, MALARIA AND SOIL TRANSMITTED HELMINTHIASIS IN A COMMUNITY OF BARDIYA DISTRICT, WESTERN NEPAL.

PubMed

Ranjitkar, Samir; Alifrangis, Michael; Adhikari, Madhav; Olsen, Annette; Simonsen, Paul E; Meyrowitsch, Dan Wolf

2014-11-01

Lymphatic filariasis (LF), malaria and soil transmitted helminthiasis (STH) cause major health problems in Nepal, but in spite of this very few stud- ies have been carried out on these parasitic infections in Nepal. A cross sectional survey of all three categories of parasitic infections was carried out in Deuda- kala Village of Bardiya District, western Nepal. A total of 510 individuals aged 5 years and above were examined from finger prick blood for circulating filarial antigen (CFA), malaria antigen using a rapid diagnostic test (RDT), and malaria DNA using a PCR-based assay. In addition, 317 individuals were examined for soil-transmitted helminth (STH) eggs by the Kato-Katz technique. Prevalence of LF, malaria (antigen) and STH infection was 25.1%, 0.6% and 18.3%, respectively. PCR analysis did not detect any additional malaria cases. The prevalence of LF and STH infections differ significantly among different age groups and ethnic communities. The high prevalence of LF in the community studied indicates an immediate need for implementing a mass drug administration program for its control in this particular geographical area of Nepal.

Explaining Religious Differentials in Family Size Preferences: Evidence from Nepal in 1996

PubMed Central

Pearce, Lisa D.; Brauner-Otto, Sarah; Ji, Yingchun

2015-01-01

This paper presents an examination of how religio-ethnic identity, individual religiosity, and family members’ religiosity are related to preferred family size in Nepal. Analyses of survey data from the Chitwan Valley Family Study show that socioeconomic characteristics and individual experiences can suppress, as well as largely account for, religio-ethnic differences in fertility preferences. These religio-ethnic differentials are associated with variance in particularized religious theologies or general value orientations (like son preference) across groups. In addition, individual and family religiosity are both positively associated with preferred family size, seemingly because of their association with religious beliefs that are likely to shape fertility strategies. These findings suggest improvements in how we conceptualize and empirically measure supra-individual religious influence in a variety of settings and for a range of demographically interesting outcomes. PMID:25685878

Explaining religious differentials in family-size preference: Evidence from Nepal in 1996.

PubMed

Pearce, Lisa D; Brauner-Otto, Sarah R; Ji, Yingchun

2015-01-01

We examine how religio-ethnic identity, individual religiosity, and family members' religiosity were related to preferred family size in Nepal in 1996. Analyses of survey data from the Chitwan Valley Family Study show that socio-economic characteristics and individual experiences can suppress, as well as largely account for, religio-ethnic differences in fertility preference. These religio-ethnic differentials are associated with variance in particularized theologies or general value orientations (like son preference) across groups. In addition, individual and family religiosity are both positively associated with preferred family size, seemingly because of their association with religious beliefs—beliefs that are likely to shape fertility strategies. These findings suggest the need for improvements in how we conceptualize and measure supra-individual religious influence in a variety of settings and for a range of demographically interesting outcomes.

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.

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

Factors Determining Availability, Utilization and Retention of Child Health Card in Western Nepal.

PubMed

Paudel, K P; Bajracharya, D C; Karki, K; K C, A

2016-05-01

The immunization card is revised with addition of general information about child health and is later called as child health card. This card is a tool used by Health Management Information System in Nepal. It is important for tracking the records of immunization. Aim is to identify the factors determining the availability, utilization and retention of the child health card in Western Nepal. A cross sectional study was conducted among mothers having children < 24 months old from Gorkha (Western Hill) and Nawalparasi (Western Terai) districts. The sample size for the study was 600 and systematic random sampling was used to select the mothers having less than 24 months old children. Data entry and analysis was done by using SPSS. Qualitative data was analyzed by making matrix. The average age of respondents was 24 years. The majority of respondents have gained higher level education. Retention of the card was found to be 82.2%. 90.3% retention was seen among 0-12 months children age group whereas it was 74 % among12 to 24 months age group. The reasons for less retention were torn by the child/played by child (54.6%) followed by lack of proper place,unaware about importance and poor quality of card.The new child health cards were insufficient, compelling use of both new and old cards which created problem in consistency. Regarding utilization of child health card, it was found to be used for birth registration and for further studies in abroad. The areas of utilization of child health card should be broadened so that the retention of card can be increased. The main reasons for less retention of the card are torn by children and lack of the proper place.

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

PubMed

Choulagai, Bishnu; Onta, Sharad; Subedi, Narayan; Mehata, Suresh; Bhandari, Gajananda P; Poudyal, Amod; Shrestha, Binjwala; Mathai, Matthews; Petzold, Max; Krettek, Alexandra

2013-12-23

Skilled birth attendants (SBAs) provide important interventions that improve maternal and neonatal health and reduce maternal and neonatal mortality. However, utilization and coverage of services by SBAs remain poor, especially in rural and remote areas of Nepal. This study examined the characteristics associated with utilization of SBA services in mid- and far-western Nepal. This cross-sectional study examined three rural and remote districts of mid- and far-western Nepal (i.e., Kanchanpur, Dailekh and Bajhang), representing three ecological zones (southern plains [Tarai], hill and mountain, respectively) with low utilization of services by SBAs. Enumerators assisted a total of 2,481 women. All respondents had delivered a baby within the past 12 months. We used bivariate and multivariate analyses to assess the association between antenatal and delivery care visits and the women's background characteristics. Fifty-seven percent of study participants had completed at least four antenatal care visits and 48% delivered their babies with the assistance of SBAs. Knowing the danger signs of pregnancy and delivery (e.g., premature labor, prolonged labor, breech delivery, postpartum hemorrhage, severe headache) associated positively with four or more antenatal care visits (OR = 1.71; 95% CI: 1.41-2.07). Living less than 30 min from a health facility associated positively with increased use of both antenatal care (OR = 1.44; 95% CI: 1.18-1.77) and delivery services (OR = 1.25; CI: 1.03-1.52). Four or more antenatal care visits was a determining factor for the utilization of SBAs. Less than half of the women in our study delivered babies with the aid of SBAs, indicating a need to increase utilization of such services in rural and remote areas of Nepal. Distance from health facilities and inadequate transportation pose major barriers to the utilization of SBAs. Providing women with transportation funds before they go to a facility for delivery and managing transportation

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.

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

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

Mass Media and Rural Out-Migration in the Context of Social Change: Evidence from Nepal

PubMed Central

Piotrowski, Martin

2011-01-01

This work examines the influence of mass media on rural out-migration using historical and contemporary data from a setting experiencing massive social and economic development in the last half-century. Data come from the Chitwan Valley Family Study, an ongoing study of an agrarian region in rural Nepal. Media are hypothesized to affect migration by inducing attitudinal and behavioral changes similar to those of other determinants of migration. As their influence differs from other determinants in important ways, media represent a unique form of influence that should be taken into account. I find that movie and television exposure are significant determinants of out-migration in historical contexts, although television exposure was important in more contemporary contexts. Differences in these effects probably indicate the timing of the spread of each type of media and changing preferences among media consumers. PMID:23894210

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

Provider perspectives on the enabling environment required for skilled birth attendance: a qualitative study in western Nepal.

PubMed

Morgan, Alison; Jimenez Soto, Eliana; Bhandari, Gajananda; Kermode, Michelle

2014-12-01

In Nepal, where difficult geography and an under-resourced health system contribute to poor health care access, the government has increased the number of trained skilled birth attendants (SBAs) and posted them in newly constructed birthing centres attached to peripheral health facilities that are available to women 24 h a day. This study describes their views on their enabling environment. Qualitative methods included semi-structured interviews with 22 SBAs within Palpa district, a hill district in the Western Region of Nepal; a focus group discussion with ten SBA trainees, and in-depth interviews with five key informants. Participants identified the essential components of an enabling environment as: relevant training; ongoing professional support; adequate infrastructure, equipment and drugs; and timely referral pathways. All SBAs who practised alone felt unable to manage obstetric complications because quality management of life-threatening complications requires the attention of more than one SBA. Maternal health guidelines should account for the provision of an enabling environment in addition to the deployment of SBAs. In Nepal, referral systems require strengthening, and the policy of posting SBAs alone, in remote clinics, needs to be reconsidered to achieve the goal of reducing maternal deaths through timely management of obstetric complications. © 2014 John Wiley & Sons Ltd.

Ecological and economic analysis of poaching of the greater one-horned rhinoceros (Rhinoceros unicornis) in Nepal.

PubMed

Poudyal, Mahesh; Rothley, Kristina; Knowler, Duncan

2009-10-01

Nepal's greater one-horned rhinoceros (Rhinoceros unicornis) faces serious threats from poaching. Poaching of these rhinos is a complex problem, influenced by such diverse factors as the price of rhino horn on the international market, local socioeconomic factors, and the population dynamics of the species. Few studies have attempted to address this complexity. In this study, we model the poaching and population dynamics of the one-horned rhinoceros within an integrated framework of ecological, socioeconomic, political, and legal dimensions. The poaching model for rhinos in Royal Chitwan National Park (RCNP) in Nepal is combined with the population model for the species within a simulation framework and explored under various alternative policy scenarios with differing external socioeconomic and political conditions as well as internal policy response. We predict that, under the current (2003-2005) rhino conservation strategy, poaching would continue to be a major threat to the rhino population in RCNP. Furthermore, the internal policy response must begin to consider external factors such as socioeconomic conditions within the park buffer zone to be more effective in the long run. Finally, we find that, for long-run control, antipoaching policies should be directed at increasing the opportunity costs of poaching by creating better alternative economic opportunities, and at antipoaching enforcement.

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.

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.

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.

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

High altitude organic gold: The production network for Ophiocordyceps sinensis from far-western Nepal.

PubMed

Pouliot, Mariève; Pyakurel, Dipesh; Smith-Hall, Carsten

2018-05-23

Ophiocordyceps sinensis (Berk.) G.H.Sung, J.M.Sung, Hywel-Jones & Spatafora, a high altitude Himalayan fungus-caterpillar product found in alpine meadows in China, Bhutan, Nepal, and India, has been used in the Traditional Chinese Medicine system for over 2000 years. Heightened demand in China over the past 15 years, coupled with limited production, has led to a price hike and increased economic importance of harvests to rural households throughout the species' range. There is, however, limited knowledge on the actors and profit distribution in the O. sinensis production network, especially from the distribution areas on the southern flanks of the Himalayas. Filling in this knowledge gap is essential to the identification and design of public interventions. To describe and quantify the O. sinensis production network originating from Darchula District in far-western Nepal. Data was collected, for fiscal year 2014-15, in spring and summer 2016 using standardized collector (n=56) and trader (n=45) questionnaires in Darchula District, and central wholesaler (n=9) questionnaires in cities of Nepal. All questionnaires contained quantitative and qualitative components focusing on key elements of the production network, i.e. value creation, enhancement, and capture; and network and territorial embeddedness. Trade is sustained and significant even at the margins of the distributional range, with 384.1 kg of O. sinensis harvested in and traded from Darchula District in 2014-15, having a collector value of approximately USD 4.7 million and constituting the dominant household-level source of income for collectors. The functioning production network is characterised by conflicts in relation to value creation, a high share of value capture by collectors, limited value enhancement, and a high degree of network and territorial embeddedness. O. sinensis income is of major economic importance for rural households at the margin of its distribution range in Nepal. Production

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

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.

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.

Veterinary Research Manpower Development for Defense

DTIC Science & Technology

2008-09-01

Geographic Risk Factors for Disease Transmission between Livestock and Elephants in Chitwan, Nepal Philip Gerwin V’11 Dr. Mann The Role of...loss for the farmer, but also has negative impact on livelihoods. Using the Rose Bengal Agglutination Test, this study tested 163 goats to determine...and Mycobacterium avium in captive elephants in Nepal Trainee: Tierra Wilson Mentors: Dr. Gretchen Kaufman, Dr. Jean Mukherjee and Dr. Donna

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.

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.

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.

Spatio-temporal patterns of attacks on human and economic losses from wildlife in Chitwan National Park, Nepal.

PubMed

Lamichhane, Babu Ram; Persoon, Gerard A; Leirs, Herwig; Poudel, Shashank; Subedi, Naresh; Pokheral, Chiranjibi Prasad; Bhattarai, Santosh; Thapaliya, Bishnu Prasad; de Iongh, Hans H

2018-01-01

Wildlife attacks on humans and economic losses often result in reduced support of local communities for wildlife conservation. Information on spatial and temporal patterns of such losses in the highly affected areas contribute in designing and implementing effective mitigation measures. We analyzed the loss of humans, livestock and property caused by wildlife during 1998 to 2016, using victim family's reports to Chitwan National Park authorities and Buffer Zone User Committees. A total of 4,014 incidents were recorded including attacks on humans, livestock depredation, property damage and crop raiding caused by 12 wildlife species. In total >400,000 US dollar was paid to the victim families as a relief over the whole period. Most of the attacks on humans were caused by rhino, sloth bear, tiger, elephant, wild boar and leopard. A significantly higher number of conflict incidents caused by rhino and elephant were observed during full moon periods. An increase in the wildlife population did not coincide with an equal rise in conflict incidents reported. Underprivileged ethnic communities were attacked by wildlife more frequently than expected. Number of attacks on humans by carnivores and herbivores did not differ significantly. An insignificant decreasing trend of wildlife attacks on humans and livestock was observed with significant variation over the years. Tiger and leopard caused >90% of livestock depredation. Tigers killed both large (cattle and buffalo) and medium sized (goat, sheep, pig) livestock but leopard mostly killed medium sized livestock. Most (87%) of the livestock killing during 2012-2016 occurred within the stall but close (<500m) to the forest edge. Both the percentage of households with livestock and average holding has decreased over the years in buffer zone. Decreased forest dependency as well as conflict mitigation measures (electric and mesh wire fences) have contributed to keep the conflict incidents in control. Strengthening mitigation

Community Social Context and Individualistic Attitudes toward Marriage

ERIC Educational Resources Information Center

Barber, Jennifer S.

2004-01-01

I develop a theoretical framework explaining how community social context affects attitude formation via nonfamily institutions and related behaviors. Empirical tests of the framework use data from a study of the Chitwan Valley in rural Nepal. The analyses focus on attitudes toward seven aspects of marriage: child marriage, arranged marriage,…

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

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.

Spatio-temporal patterns of attacks on human and economic losses from wildlife in Chitwan National Park, Nepal

PubMed Central

Persoon, Gerard A.; Leirs, Herwig; Poudel, Shashank; Subedi, Naresh; Pokheral, Chiranjibi Prasad; Bhattarai, Santosh; Thapaliya, Bishnu Prasad; de Iongh, Hans H.

2018-01-01

Wildlife attacks on humans and economic losses often result in reduced support of local communities for wildlife conservation. Information on spatial and temporal patterns of such losses in the highly affected areas contribute in designing and implementing effective mitigation measures. We analyzed the loss of humans, livestock and property caused by wildlife during 1998 to 2016, using victim family’s reports to Chitwan National Park authorities and Buffer Zone User Committees. A total of 4,014 incidents were recorded including attacks on humans, livestock depredation, property damage and crop raiding caused by 12 wildlife species. In total >400,000 US dollar was paid to the victim families as a relief over the whole period. Most of the attacks on humans were caused by rhino, sloth bear, tiger, elephant, wild boar and leopard. A significantly higher number of conflict incidents caused by rhino and elephant were observed during full moon periods. An increase in the wildlife population did not coincide with an equal rise in conflict incidents reported. Underprivileged ethnic communities were attacked by wildlife more frequently than expected. Number of attacks on humans by carnivores and herbivores did not differ significantly. An insignificant decreasing trend of wildlife attacks on humans and livestock was observed with significant variation over the years. Tiger and leopard caused >90% of livestock depredation. Tigers killed both large (cattle and buffalo) and medium sized (goat, sheep, pig) livestock but leopard mostly killed medium sized livestock. Most (87%) of the livestock killing during 2012–2016 occurred within the stall but close (<500m) to the forest edge. Both the percentage of households with livestock and average holding has decreased over the years in buffer zone. Decreased forest dependency as well as conflict mitigation measures (electric and mesh wire fences) have contributed to keep the conflict incidents in control. Strengthening mitigation

Bacteriological assessment of stethoscopes used by healthcare workers in a tertiary care centre of Nepal.

PubMed

Thapa, Sangita; Sapkota, Lokendra Bahadur

2017-07-28

Stethoscope is a medical device universally used by health care workers. Stethoscope may transmit pathogens among patients and health care workers if it is not disinfected. The objective of this study was to, determine the level of stethoscope contamination used by health care workers, survey the practices of disinfecting the stethoscope, identify various microorganisms and assess their role as potential pathogens and determine the effectiveness of 70% ethanol as a disinfecting agent. This was a cross-sectional study conducted in the department of Microbiology, Chitwan Medical College, Bharatpur, Nepal. Stethoscopes of 122 health care workers from different departments were included in this study. Out of a total 122 diaphragms, 88 (72.1%) were colonized. Only 71 (58.1%) bells and 152 earpieces (66.2%) were contaminated. Micrococcus and coagulase negative staphylococci were predominantly isolated species. The contamination was lowest among stethoscopes cleaned after touching every patient (11.5%) and the difference is statistically significant (P < 0.0001). Significantly lower level of contamination (13.6%) were found on stethoscopes cleaned everyday (P < 0.0001). Only 8.5% stethoscope showed growth with decreased number of colonies after disinfecting the stethoscopes with 70% ethanol. Thus, demonstrating the effectiveness of disinfection.

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

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.

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.

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…

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

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

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.

Public perceptions of snakes and snakebite management: implications for conservation and human health in southern Nepal.

PubMed

Pandey, Deb Prasad; Subedi Pandey, Gita; Devkota, Kamal; Goode, Matt

2016-06-02

Venomous snakebite and its effects are a source of fear for people living in southern Nepal. As a result, people have developed a negative attitude towards snakes, which can lead to human-snake conflicts that result in killing of snakes. Attempting to kill snakes increases the risk of snakebite, and actual killing of snakes contributes to loss of biodiversity. Currently, snake populations in southern Nepal are thought to be declining, but more research is needed to evaluate the conservation status of snakes. Therefore, we assessed attitudes, knowledge, and awareness of snakes and snakebite by Chitwan National Park's (CNP) buffer zone (BZ) inhabitants in an effort to better understand challenges to snake conservation and snakebite management. The results of this study have the potential to promote biodiversity conservation and increase human health in southern Nepal and beyond. We carried out face-to-face interviews of 150 randomly selected CNP BZ inhabitants, adopting a cross-sectional mixed research design and structured and semi-structured questionnaires from January-February 2013. Results indicated that 43 % of respondents disliked snakes, 49 % would exterminate all venomous snakes, and 86 % feared snakes. Farmers were the most negative and teachers were the most ambivalent towards snakes. Respondents were generally unable to identify different snake species, and were almost completely unaware of the need of conserve snakes and how to prevent snakebites. Belief in a snake god, and the ability of snakes to absorb poisonous gases from the atmosphere were among many superstitions that appeared to predispose negativity towards snakes of BZ residents. People with predisposed negativity towards snakes were not proponents of snake conservation. Fear, negativity, ambivalence towards, and ignorance about, snakes and the need for snake conservation were strong indicators of the propensity to harm or kill snakes. It seems that if wanton killing of snakes continues

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

Hepatitis E virus seroepidemiology: a post-earthquake study among blood donors in Nepal.

PubMed

Shrestha, Ashish C; Flower, Robert L P; Seed, Clive R; Rajkarnikar, Manita; Shrestha, Shrawan K; Thapa, Uru; Hoad, Veronica C; Faddy, Helen M

2016-11-25

As one of the causative agents of viral hepatitis, hepatitis E virus (HEV) has gained public health attention globally. HEV epidemics occur in developing countries, associated with faecal contamination of water and poor sanitation. In industrialised nations, HEV infections are associated with travel to countries endemic for HEV, however, autochthonous infections, mainly through zoonotic transmission, are increasingly being reported. HEV can also be transmitted by blood transfusion. Nepal has experienced a number of HEV outbreaks, and recent earthquakes resulted in predictions raising the risk of an HEV outbreak to very high. This study aimed to measure HEV exposure in Nepalese blood donors after large earthquakes. Samples (n = 1,845) were collected from blood donors from Kathmandu, Chitwan, Bhaktapur and Kavre. Demographic details, including age and sex along with possible risk factors associated with HEV exposure were collected via a study-specific questionnaire. Samples were tested for HEV IgM, IgG and antigen. The proportion of donors positive for HEV IgM or IgG was calculated overall, and for each of the variables studied. Chi square and regression analyses were performed to identify factors associated with HEV exposure. Of the donors residing in earthquake affected regions (Kathmandu, Bhaktapur and Kavre), 3.2% (54/1,686; 95% CI 2.7-4.0%) were HEV IgM positive and two donors were positive for HEV antigen. Overall, 41.9% (773/1,845; 95% CI 39.7-44.2%) of donors were HEV IgG positive, with regional variation observed. Higher HEV IgG and IgM prevalence was observed in donors who reported eating pork, likely an indicator of zoonotic transmission. Previous exposure to HEV in Nepalese blood donors is relatively high. Detection of recent markers of HEV infection in healthy donors suggests recent asymptomatic HEV infection and therefore transfusion-transmission in vulnerable patients is a risk in Nepal. Surprisingly, this study did not provide evidence of a large

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

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

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

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…

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.

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.

Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal.

PubMed

Bhandari, Parash Mani; Neupane, Dipika; Rijal, Shristi; Thapa, Kiran; Mishra, Shiva Raj; Poudyal, Amod Kumar

2017-03-21

Evidence on the burden of depression, internet addiction and poor sleep quality in undergraduate students from Nepal is virtually non-existent. While the interaction between sleep quality, internet addiction and depressive symptoms is frequently assessed in studies, it is not well explored if sleep quality or internet addiction statistically mediates the association between the other two variables. We enrolled 984 students from 27 undergraduate campuses of Chitwan and Kathmandu, Nepal. We assessed sleep quality, internet addiction and depressive symptoms in these students using Pittsburgh Sleep Quality Index, Young's Internet Addiction Test and Patient Health Questionnaire-9 respectively. We included responses from 937 students in the data analysis after removing questionnaires with five percent or more fields missing. Via bootstrap approach, we assessed the mediating role of internet addiction in the association between sleep quality and depressive symptoms, and that of sleep quality in the association between internet addiction and depressive symptoms. Overall, 35.4%, 35.4% and 21.2% of students scored above validated cutoff scores for poor sleep quality, internet addiction and depression respectively. Poorer sleep quality was associated with having lower age, not being alcohol user, being a Hindu, being sexually active and having failed in previous year's board examination. Higher internet addiction was associated with having lower age, being sexually inactive and having failed in previous year's board examination. Depressive symptoms were higher for students having higher age, being sexually inactive, having failed in previous year's board examination and lower years of study. Internet addiction statistically mediated 16.5% of the indirect effect of sleep quality on depressive symptoms. Sleep quality, on the other hand, statistically mediated 30.9% of the indirect effect of internet addiction on depressive symptoms. In the current study, a great proportion of

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…

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

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

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.

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.

Predictors of Marital Dissolution During a Period of Rapid Social Change: Evidence From South Asia.

PubMed

Jennings, Elyse A

2016-10-01

Few studies have examined the causes and consequences of marital dissolution in non-Western settings. This article explores the fundamental factors that may predict marital dissolution in a mainly agrarian setting in South Asia, where collectivism has historically been valued over individualism and where life is centered on the family. Using event history analyses with retrospective life history data from the Chitwan Valley Family Study conducted in rural Nepal, I explore the possible predictors of marital dissolution. Results suggest that couples in which wives married at older ages and chose their spouse in conjunction with their parents face lower risk of marital dissolution, while wives' work increases the risk. Moreover, couples married for longer durations and couples who have more children face lower risks of marital dissolution. The influences of many of these factors have changed over the last few decades, pointing toward the important role of changing social context on marital trajectories.

Predictors of Marital Dissolution During a Period of Rapid Social Change: Evidence From South Asia

PubMed Central

Jennings, Elyse A.

2016-01-01

Few studies have examined the causes and consequences of marital dissolution in non-Western settings. This article explores the fundamental factors that may predict marital dissolution in a mainly agrarian setting in South Asia, where collectivism has historically been valued over individualism and where life is centered on the family. Using event history analyses with retrospective life history data from the Chitwan Valley Family Study, conducted in rural Nepal, I explore the possible predictors of marital dissolution. Results suggest that couples in which wives married at older ages and chose their spouse in conjunction with their parents face lower risk of marital dissolution, while wives’ work increases the risk. Moreover, couples married for longer durations and couples who have more children face lower risks of marital dissolution. The influences of many of these factors have changed over the last few decades, pointing toward the important role of changing social context on marital trajectories. PMID:27624319

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).

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.

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.

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.

Reduced vision and refractive errors, results from a school vision screening program in Kanchanpur District of far western Nepal.

PubMed

Awasthi, S; Pant, B P; Dhakal, H P

2010-01-01

At present there is no data available on reduced vision and refractive errors in school children of far western Nepal. So, school screening records were used to obtain data useful for planning of refractive services. Data are provided from school screening conducted by Geta Eye Hospital during February/March 2008. The cases with complete data sets on visual acuity, refractive error and age were included and analyzed using computer software. Of 1165 children (mean age 11.6 ± 2.5 years) examined, 98.8% (n = 1151) had uncorrected visual acuity of 6/9 and better in at least one eye whereas 1.2% (n = 14) had acuity 6/12 and worse in both eyes. Among them, either eye of 9 children improved to 6/9 and better with correction. However, visual acuity was 6/12 and worse in both eyes of 5 children even after correction. There were 24 children with refractive errors (myopia, 1.54%; n = 18 and hypermetropia, 0.51%; n = 6) in at least one eye. The spherical equivalent refraction was not significantly different with age and gender. The incidence of reduced vision and refractive errors among school children of this semi rural district were low.

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

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

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.

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

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

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.

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.

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.

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

Impact of the spread of mass education on married women's experience with domestic violence.

PubMed

Ghimire, Dirgha J; Axinn, William G; Smith-Greenaway, Emily

2015-11-01

This paper investigates the association between mass education and married women's experience with domestic violence in rural Nepal. Previous research on domestic violence in South Asian societies emphasizes patriarchal ideology and the widespread subordinate status of women within their communities and families. The recent spread of mass education is likely to shift these gendered dynamics, thereby lowering women's likelihood of experiencing domestic violence. Using data from 1775 currently married women from the Chitwan Valley Family Study in Nepal, we provide a thorough analysis of how the spread of mass education is associated with domestic violence among married women. The results show that women's childhood access to school, their parents' schooling, their own schooling, and their husbands' schooling are each associated with their lower likelihood of experiencing domestic violence. Indeed, husbands' education has a particularly strong, inverse association with women's likelihood of experiencing domestic violence. These associations suggest that the proliferation of mass education will lead to a marked decline in women's experience with domestic violence in Nepal. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of the Spread of Mass Education on Married Women’s Experience with Domestic Violence

PubMed Central

Ghimire, Dirgha J.; Axinn, William G.; Smith-Greenaway, Emily

2015-01-01

This paper investigates the association between mass education and married women’s experience with domestic violence in rural Nepal. Previous research on domestic violence in South Asian societies emphasizes patriarchal ideology and the widespread subordinate status of women within their communities and families. The recent spread of mass education is likely to shift these gendered dynamics, thereby lowering women’s likelihood of experiencing domestic violence. Using data from 1,775 currently married women from the Chitwan Valley Family Study in Nepal, we provide a thorough analysis of how the spread of mass education is associated with domestic violence among married women. The results show that women’s childhood access to school, their parents’ schooling, their own schooling, and their husbands’ schooling are each associated with their lower likelihood of experiencing domestic violence. Indeed, husbands’ education has a particularly strong, inverse association with women’s likelihood of experiencing domestic violence. These associations suggest that the proliferation of mass education will lead to a marked decline in women’s experience with domestic violence in Nepal. PMID:26463551

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…

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

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.

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

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.

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.

Learning approach among health sciences students in a medical college in Nepal: a cross-sectional study.

PubMed

Shah, Dev Kumar; Yadav, Ram Lochan; Sharma, Deepak; Yadav, Prakash Kumar; Sapkota, Niraj Khatri; Jha, Rajesh Kumar; Islam, Md Nazrul

2016-01-01

Many factors shape the quality of learning. The intrinsically motivated students adopt a deep approach to learning, while students who fear failure in assessments adopt a surface approach to learning. In the area of health science education in Nepal, there is still a lack of studies on learning approach that can be used to transform the students to become better learners and improve the effectiveness of teaching. Therefore, we aimed to explore the learning approaches among medical, dental, and nursing students of Chitwan Medical College, Nepal using Biggs's Revised Two-Factor Study Process Questionnaire (R-SPQ-2F) after testing its reliability. R-SPQ-2F containing 20 items represented two main scales of learning approaches, deep and surface, with four subscales: deep motive, deep strategy, surface motive, and surface strategy. Each subscale had five items and each item was rated on a 5-point Likert scale. The data were analyzed using Student's t-test and analysis of variance. Reliability of the administered questionnaire was checked using Cronbach's alpha. The Cronbach's alpha value (0.6) for 20 items of R-SPQ-2F was found to be acceptable for its use. The participants predominantly had a deep approach to learning regardless of their age and sex (deep: 32.62±6.33 versus surface: 25.14±6.81, P<0.001). The level of deep approach among medical students (33.26±6.40) was significantly higher than among dental (31.71±6.51) and nursing (31.36±4.72) students. In comparison to first-year students, deep approach among second-year medical (34.63±6.51 to 31.73±5.93; P<0.001) and dental (33.47±6.73 to 29.09±5.62; P=0.002) students was found to be significantly decreased. On the other hand, surface approach significantly increased (25.55±8.19 to 29.34±6.25; P=0.023) among second-year dental students compared to first-year dental students. Medical students were found to adopt a deeper approach to learning than dental and nursing students. However, irrespective of

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.

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.

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.

Social norms and women's risk of intimate partner violence in Nepal.

PubMed

Clark, Cari Jo; Ferguson, Gemma; Shrestha, Binita; Shrestha, Prabin Nanicha; Oakes, J Michael; Gupta, Jhumka; McGhee, Susi; Cheong, Yuk Fai; Yount, Kathryn M

2018-04-01

Social norms increasingly are the focus of intimate partner violence (IPV) prevention strategies but are among the least examined contextual factors in quantitative violence research. This study assesses the within-community, between-community, and contextual effect of a new measure of social norms (PVNS: Partner Violence Norms Scale) on women's risk of IPV. Data come from baseline surveys collected from 1435 female, married, reproductive-age participants, residing in 72 wards in three districts (Chitwan, Kapilvastu, Nawalparasi) in Nepal who were enrolled in a cluster randomized trial testing the impact of a social behavioral change communication intervention designed to prevent IPV. Results of unconditional multilevel logistic regression models indicated that there was cluster-level variability in the 12-month prevalence of physical (ICC = 0.07) and sexual (ICC = 0.05) IPV. Mean PVNS scores also varied across wards. When modeled simultaneously, PVNS scores aggregated to the ward-level and at the individual-level were associated with higher odds of physical (OR ind  = 1.12, CI = 1.04, 1.20; OR ward  = 1.40, CI = 1.15, 1.72) and sexual (OR ind  = 1.15, CI = 1.08, 1.24; OR ward  = 1.47, CI = 1.24, 1.74) IPV. The contextual effect was significant in the physical (0.23, se = 0.11, t = 2.12) and sexual (0.24, se = 0.09, t = 2.64) IPV models, suggesting that the ward-level association was larger than that at the individual-level. Adjustment for covariates slightly attenuated the ward-level association and eliminated the contextual association, suggesting that individual perceptions and the collective community phenomena were equally strong predictors of women's risk of IPV and should be taken into consideration when planning interventions. PVNS is a promising measure of social norms underpinning women's risk of IPV and warrants further psychometric testing. Copyright © 2018 The Authors. Published by Elsevier Ltd

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.

Nonfamily Experience and Receipt of Personal Care in a Rapidly Changing Context

PubMed Central

Yarger, Jennifer; Brauner-Otto, Sarah R.

2013-01-01

Scholars and policy makers have expressed concern that social and economic changes occurring throughout Asia are threatening the well-being of older adults by undercutting their systems of family support. Using a sample of 1,654 men and women aged 45 and older from the Chitwan Valley Family Study in Nepal, we evaluated the relationship between individuals’ nonfamily experiences, such as education, travel, and nonfamily living, and their likelihood of receiving personal care in older adulthood. Overall, we found that among individuals in poor health, those who had received more education, traveled to the capital city, or lived away from their families were less likely to have received personal care in the previous two weeks than adults who had not had these experiences. Our findings provide evidence that although familial connections remain strong in Nepal, experiences in new nonfamily social contexts are tied to lower levels of care receipt. PMID:24999289

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.

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

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

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

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.

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.

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

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.

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

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

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

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.

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

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

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

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

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.

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.

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.

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…

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.

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

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.

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.

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.

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.

Dental caries prevalence, oral health knowledge and practice among indigenous Chepang school children of Nepal.

PubMed

Prasai Dixit, Lonim; Shakya, Ajay; Shrestha, Manash; Shrestha, Ayush

2013-05-14

Chepang communities are one of the most deprived ethnic communities in Nepal. According to the National Pathfinder Survey, dental caries is a highly prevalent childhood disease in Nepal. There is no data concerning the prevalence of caries along with knowledge, attitude and oral hygiene practices among Chepang schoolchildren. The objectives of this study were to 1) record the prevalence of dental caries 2) report experience of dental pain 3) evaluate knowledge, attitude and preventive practices on oral health of primary Chepang schoolchildren. A cross sectional epidemiological study was conducted in 5 government Primary schools of remote Chandibhanjyang Village Development Committee (VDC) in Chitwan district. Ethical approval was taken from the Institutional Review Board within the Research Department of the Institute of Medicine (IOM) Tribhuvan University. Consent was obtained from parents for conducting clinical examination and administrating questionnaire. Permission was taken from the school principal in all schools. Data was collected using a pretested questionnaire on 131 schoolchildren aged 8-16-year- olds attending Grade 3-5. Clinical examination was conducted on 361 school children aged 5-16 -year-olds attending grade 1-5. Criteria set by the World Health Organization (1997) was used for caries diagnosis. The questionnaires, originally constructed in English and translated into Nepali were administered to the schoolchildren by the researchers. SPSS 11software was used for data analysis. Caries prevalence for 5-6 -year-old was above the goals recommended by WHO and Federation of Dentistry international (FDI) of less than 50% caries free children. Caries prevalence in 5-6-year-olds was 52% and 12-13-year-olds was 41%. The mean dmft/DMFT score of 5-6 -year-olds and 12 -13-year -olds was 1.59, 0.31 and 0.52, 0.84 respectively. The DMFT scores increased with age and the d/D component constituted almost the entire dmft/DMFT index. About 31% of 8-16-year

Numerical Modeling of Persistent Winter Fog over the Indo-Gangetic Plains

NASA Astrophysics Data System (ADS)

Ghimire, S.; Adhikary, B.; Praveen, P. S.; Panday, A. K.

2017-12-01

Every winter the Indo-Gangetic Plains (IGP) in northern South Asia; bounded by the great Himalayas in the north, are periodically covered by dense and persistent fog that severely impacts day-to-day activities of several hundred million people. The fog can stretch over several hundred kilometers and last several days in many locations. Despite the fog's high impact, there are very limited in-situ observations available to characterize persistent fog episodes. Also, there has been very little success to date in accurately predicting the fog occurrence and extent over a larger area such as IGP. This study will present insights into the performance of the Weather Research and Forecasting (WRF) model simulating persistent winter fog prediction in the IGP region, compared to satellite observations and in-situ measurements. Since fog is not a prognostic variable in WRF, the study presents results based on multi-rule diagnostic algorithms published in peer reviewed journals. In addition, fog episodes were analyzed using the Air Force Weather Agency (AFWA) diagnostics package available for WRF. On a regional scale, MODIS data onboard the TERRA and AQUA satellites are used to evaluate model performance skills. At a local scale, the model is evaluated at two sites in the southern Nepal, Lumbini and Chitwan, located in the IGP. Lumbini and Chitwan observatories have Luftt and Biral weather sensors which allow monitoring presence of fog, visibility range and surface meteorology. In addition, for Chitwan, data from DMT Fog Monitor (FM 120) and Luftt CHM 15K Ceilometer were used to compare model performance for liquid-water content and planetary boundary layer during foggy and non-foggy days.

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.

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…

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

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

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 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

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.

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.

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.

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.

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

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

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.

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…

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.

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…

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.

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.

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

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

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

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…

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.

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.

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

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

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.

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

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.

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

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.

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

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

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.

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.

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.

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.

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…

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

Injection practice in Kaski district, Western Nepal: a community perspective.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, Pathiyil Ravi; Kumar, Vikash K C; Maskey, Manisha; Jha, Nisha

2015-04-29

Previous studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1) quantify injection usage, 2) identify injection providers, 3) explore differences, if any, in injection usage and injection providers, and 4) study and compare people's knowledge and perception about injections between the urban and rural areas of Kaski district. A descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions (FGDs). A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held. In 218 households (36.33%) [99 in urban and 119 in rural] one or more members received at least one injection. During the three month recall period, 258 subjects (10.44%) reported receiving injection(s) with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers (34.8%), staff of medical dispensaries (37.7%), physicians (25.2%), and traditional healers (2.3%) were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever (p < 0.001). People preferred injections due to injections being perceived by them as being powerful, fast-acting, and longer lasting than oral pills. More than 82% of respondents were aware of, and named, at least one disease transmitted by using unsterile syringes during injection administration or when syringes are shared between people. Less preference for injections and high awareness about the association between

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 hyperendemic focus of Taenia solium transmission in the Banke District of Nepal.

PubMed

Sah, Keshav; Poudel, Ishab; Subedi, Suyog; Singh, Dinesh Kumar; Cocker, Jo; Kushwaha, Peetambar; Colston, Angela; Donadeu, Meritxell; Lightowlers, Marshall W

2017-12-01

Neurocysticercosis is a major cause of epilepsy in countries where Taenia solium is endemic and the parasite is a major cause of food-borne disease globally. Pigs are the natural intermediate host involved in transmission of the parasite. T. solium is known to be endemic in Nepal, however there is limited reliable data about the prevalence of the disease in Nepal. The aim of this study was to determine accurately the prevalence of porcine cysticercosis in slaughter age pigs in an area of Nepal where pigs are known to be free-roaming. Pigs were obtained from the Udaypur Village Development Committee (VDC) and Hirminiya & Betahani VDC of the Banke district in Nepal. One hundred and ten animals of slaughter age (approximately 8-16 months old) were purchased, slaughtered and the heart, liver, brain and half the body skeletal musculature were sliced using hand knives and the number and viability of T. solium cysts determined. Thirty two of the 110 animals were found to harbour T. solium cysticerci (29%), of which 30 (27%) were found to have viable cysticerci (93% of the infected animals). This is one of the highest prevalences of porcine cysticercosis that has been reported to date from the results of necropsy on randomly selected animals. This study highlights a high rate of transmission of T. solium in the Banke District of Nepal. It encourages further investigation of human and porcine cysticercosis in Nepal, as well as implementation of efforts to reduce transmission of the parasite and the associated human disease. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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.

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

Emergence of Primary Teeth in Children of Sunsari District of Eastern Nepal

PubMed Central

Gupta, Anita; Hiremath, SS; Singh, SK; Poudyal, S; Niraula, SR; Baral, DD; Singh, RK

2007-01-01

This study assessed the timing and eruption sequence of primary teeth in children of Sunsari district of Eastern Nepal and compared the eruption pattern of males & females between various, ethnic groups. Method This cross-sectional study, included 501 subjects, aged 3 months to 60 months selected by simple random sampling method. The determinant variables such as age, gender, ethnicity, and eruption of teeth were recorded. Results This study provides a model data on emergence of primary teeth and number of deciduous teeth in these children. This is a first study of its kind in Nepal. The findings of this study will help as a reference data for optimal use in clinical, academic, and research activities, especially for children of Eastern Nepal. PMID:18523631

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

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

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

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.

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

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.

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…

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.

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

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.

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

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

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.

Determinants of Marital Quality in an Arranged Marriage Society

PubMed Central

Allendorf, Keera

2013-01-01

Drawing on a uniquely large number of items on marital quality, this study explores the determinants of marital quality in Chitwan Valley, Nepal. Marital quality is measured with five dimensions identified through exploratory factor analysis, including satisfaction, communication, togetherness, problems, and disagreements. Gender, education, and spouse choice emerge as the most important determinants of these dimensions of marital quality. Specifically, men, those with more schooling, and those who participated in the choice of their spouse have higher levels of marital quality. By contrast, caste, occupation, age at marriage, marital duration, and number of children have little to no association with marital quality. While gender, education, and spouse choice emerge as key determinants of marital quality in this context, the majority of variation in marital quality remains unexplained. PMID:23146598

Changing Attitudes Toward Care of Aging Parents: The Influence of Education, International Travel, and Gender.

PubMed

Compernolle, Ellen

Population aging is a key public health issue facing many nations, and is particularly pronounced in many Asian countries. At the same time, attitudes toward filial obligation are also rapidly changing, with a decreasing sense that children are responsible for caring for elderly parents. This investigation blends the family versus nonfamily mode of social organization framework with a life course perspective to provide insight into the processes of ideational change regarding filial responsibility, highlighting the influence of education and international travel. Using data from a longitudinal study in Nepal-the Chitwan Valley Family Study-results demonstrate that education and international travel are associated with a decrease in attitudes toward filial obligation. However, findings further reveal that the impact of education and international travel vary both across the life course and by gender.

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,…

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

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.

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

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.

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.

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

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.

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.

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…

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.

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.

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

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.

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

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

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

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.

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.

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.

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,…

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

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.

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.

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.

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

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.

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.

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

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

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…

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.

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

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.

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).

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.

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

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

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

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…

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.

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

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

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.

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

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

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.

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.

Uneven Terrain: Educational Policy and Equity in Nepal

ERIC Educational Resources Information Center

Shields, Robin; Rappleye, Jeremy

2008-01-01

This paper investigates the relationship between educational policy, equity, and national development in Nepal. It argues that current inequities in educational opportunities and outcomes are largely attributable to persistent inequities and biases in the educational policy framework. We begin by surveying the complex, multifaceted reality of…

China, India, and Nepal as seen from Gemini 11

NASA Image and Video Library

1966-09-14

S66-54839 (14 Sept. 1966) --- China, India, and Nepal, looking east, as seen from the Gemini-11 spacecraft during its 37th revolution of Earth. The Great Himalaya Mountain Range is clearly visible. Photo credit: NASA

Feasibility Study of Low-Cost Image-Based Heritage Documentation in Nepal

NASA Astrophysics Data System (ADS)

Dhonju, H. K.; Xiao, W.; Sarhosis, V.; Mills, J. P.; Wilkinson, S.; Wang, Z.; Thapa, L.; Panday, U. S.

2017-02-01

Cultural heritage structural documentation is of great importance in terms of historical preservation, tourism, educational and spiritual values. Cultural heritage across the world, and in Nepal in particular, is at risk from various natural hazards (e.g. earthquakes, flooding, rainfall etc), poor maintenance and preservation, and even human destruction. This paper evaluates the feasibility of low-cost photogrammetric modelling cultural heritage sites, and explores the practicality of using photogrammetry in Nepal. The full pipeline of 3D modelling for heritage documentation and conservation, including visualisation, reconstruction, and structure analysis, is proposed. In addition, crowdsourcing is discussed as a method of data collection of growing prominence.

Obesity prevalence in Nepal: public health challenges in a low-income nation during an alarming worldwide trend.

PubMed

Vaidya, Abhinav; Shakya, Suraj; Krettek, Alexandra

2010-06-01

The future toll of the obesity epidemic will likely hit hardest in low- and middle-income countries. Ongoing urbanization promotes risk factors including sedentary lifestyle and fat- and sugar-laden diets. Low-income countries like Nepal experience a double disease burden: infectious diseases as well as rising incidence of noncommunicable diseases (e.g., cardiovascular disease and diabetes mellitus) frequently characterized by obesity. Nepal currently directs efforts towards curing disease but pays little attention to preventive actions. This article highlights obesity prevalence in Nepal, delineates the challenges identified by our pilot study (including low health literacy rates), and suggests strategies to overcome this trend.

Women and citizenship post‐trafficking: the case of Nepal

PubMed Central

Richardson, Diane; Laurie, Nina; Poudel, Meena; Townsend, Janet

2016-01-01

Abstract This article analyses the relationship between gender, sexuality and citizenship embedded in models of citizenship in the Global South, specifically in South Asia, and the meanings associated with having – or not having – citizenship. It does this through an examination of women's access to citizenship in Nepal in the context of the construction of the emergent nation state in the ‘new’ Nepal ‘post‐conflict’. Our analysis explores gendered and sexualized constructions of citizenship in this context through a specific focus on women who have experienced trafficking, and are beginning to organize around rights to sustainable livelihoods and actively lobby for changes in citizenship rules which discriminate against women. Building from this, in the final section we consider important implications of this analysis of post‐trafficking experiences for debates about gender, sexuality and citizenship more broadly. PMID:27642193

Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal

PubMed Central

Sharma, Bimala; Nam, Eun Woo

2018-01-01

This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15–49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents who reported ever having had sexual intercourse; 9843 females and 3017 males were included. Condom use was assessed by asking if respondents used condoms in their most recent sexual intercourse. Chi-square test and multivariate logistic regression analysis were performed using Complex Sample Analysis Procedure to adjust for sample weight and multistage sampling design. Overall, 7.6% of total, and 16.3% of males and 6.2% of females reported using condoms in their last sexual intercourse. Living in Far-Western region, age and wealth quintile were positively associated with condom use in both males and females. Being unmarried was the most important predictor of condom use among males. Higher education was associated with increased likelihood of condom use in females. However, mobility, having multiple sexual partners, and HIV knowledge were not significant correlates of condom use in both sexes. A big difference was observed in the variance accounted for males and females; indicating use of condoms is poorly predicted by the variables included in the study among females. Condom use was more associated with sociodemographic factors than with sexual behavior and HIV knowledge. PMID:29547564

Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal Demographic and Health Survey 2011

PubMed Central

2014-01-01

Background Postnatal care is essential to save the life of the mother and newborn. Knowledge on the determinants of postnatal care assists the policy makers to design, justify and implement appropriate interventions. The current study aimed to analyse the factors associated with utilisation of postnatal care services by mothers in Nepal based on the data from Nepal Demographic and Health Survey (NDHS) 2011. Methods This study utilised the data from NDHS 2011. The association between utilisation of at least one postnatal care visit (within 6 weeks of delivery) and immediate postnatal care (within 24 hours of delivery) with selected factors was examined by using Chi-square test (χ2), followed by multiple logistic regression. Result Of the 4079 mothers, 43.2% reported attending postnatal care within the first six weeks of birth, while 40.9% reported attending immediate postnatal care. Mothers who were from urban areas, from rich families, who were educated, whose partners were educated, who delivered in a health facility, who had attended a four or more antenatal visits, and whose delivery was attended by a skilled attendant were more likely to report attending at least one postnatal care visit. On the other hand, mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to have attended at least one postnatal care visit. Similarly, mothers who were from the urban areas, from rich families, who were educated, whose partners were educated, who had attended four or more antenatal visits, who delivered in a health facility and had delivered in the presence of a skilled birth attendant were more likely to report attending immediate postnatal care. Mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to attend immediate postnatal care. Conclusion The majority of postnatal mothers in Nepal did not seek postnatal care. Increasing utilisation of the

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

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.

Recent Emergence and Spread of an Arctic-Related Phylogenetic Lineage of Rabies Virus in Nepal

PubMed Central

Pant, Ganesh R.; Lavenir, Rachel; Wong, Frank Y. K.; Certoma, Andrea; Larrous, Florence; Bhatta, Dwij R.; Bourhy, Hervé

2013-01-01

Rabies is a zoonotic disease that is endemic in many parts of the developing world, especially in Africa and Asia. However its epidemiology remains largely unappreciated in much of these regions, such as in Nepal, where limited information is available about the spatiotemporal dynamics of the main etiological agent, the rabies virus (RABV). In this study, we describe for the first time the phylogenetic diversity and evolution of RABV circulating in Nepal, as well as their geographical relationships within the broader region. A total of 24 new isolates obtained from Nepal and collected from 2003 to 2011 were full-length sequenced for both the nucleoprotein and the glycoprotein genes, and analysed using neighbour-joining and maximum-likelihood phylogenetic methods with representative viruses from all over the world, including new related RABV strains from neighbouring or more distant countries (Afghanistan, Greenland, Iran, Russia and USA). Despite Nepal's limited land surface and its particular geographical position within the Indian subcontinent, our study revealed the presence of a surprising wide genetic diversity of RABV, with the co-existence of three different phylogenetic groups: an Indian subcontinent clade and two different Arctic-like sub-clades within the Arctic-related clade. This observation suggests at least two independent episodes of rabies introduction from neighbouring countries. In addition, specific phylogenetic and temporal evolution analysis of viruses within the Arctic-related clade has identified a new recently emerged RABV lineage we named as the Arctic-like 3 (AL-3) sub-clade that is already widely spread in Nepal. PMID:24278494

Implementation of the Arsenic Biosand Filter in Nepal

NASA Astrophysics Data System (ADS)

Murcott, S.; Ngai, T.; Shrestha, R.; Pokharel, K.; Walewijk, S.

2004-05-01

A low-cost, household-scale drinking water filter, the Arsenic Biosand Filter (ABF), appropriate for rural Nepal, was developed by researchers at Massachusetts Institute of Technology and two local partners (ENPHO and RWSSSP) to simultaneously remove arsenic and pathogens from tubewell water. The project implementation site is the Terai region of southern Nepal, where about 90% of people receive water from tubewells and where about 25+% and 40+% of tubewells are contaminated with arsenic (naturally-occurring) and coliforms (from human and animal sources) respectively, causing severe health consequences such as cancers and gastrointestinal illnesses. Despite growing recognition of the immediacy of the arsenic crisis in this region, many previous arsenic technology projects have failed. This is because many of the available technologies have serious drawbacks, including complex production methods, high maintenance, high costs, insufficient filtration rate, and/or reliance on materials unavailable in remote villages. In addition, most technologies treat arsenic and pathogens independently, resulting in complicated treatment operations. Implementation deficiencies including ineffective technology transfer, confusing NGO responsibilities, organizational non-sustainability, lack of user education and contribution, and inadequate long-term maintenance and monitoring capacity are other major problems. The ABF design is optimized based on the socio-economic conditions of rural Terai and is constructed using locally available labor and materials. It was the only arsenic remediation technology to win the prestigious World Bank Development Marketplace Competition in 2003. Funding from this prize will provide start-up capital to pilot a technology transfer network. In 2004, the team has established an in-country technology dissemination and implementation center and is building local capacity in arsenic-affected villages towards long-term, self-reliant, user-participatory safe

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

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.

Study on the refractive errors of school going children of Pokhara city in Nepal.

PubMed

Niroula, D R; Saha, C G

Refractive errors are the one of the most common visual disorders found worldwide in school going children and also it is one of the causes of blindness. It can easily be prevented, if timely proper measures are taken. In Kathmandu valley and Mechi Zone of Nepal, the distribution of refractive errors was found to be very high. No records are available from the Western part of Nepal. Considering the importance of the refractive errors the present study had been undertaken in Pokhara city. 964 subjects (474 boys, 490 girls) were selected between age groups 10 to 19 years from 6 schools representing different region of Pokhara. After Preliminary examination: on acuity of vision with Snellen's and Jaeger's charts, the subjects were referred to the Manipal Teaching Hospital, Pokhara for confirmation of the refractive errors. Sixty two schools children (6.43%), out of 964 had refractive errors. The myopia was found to be most common (4.05%). The refractive errors were found more in Private school children (9.29%) than Government school children (4.23%), which is statistically significant (P < 0.05). More boys (7.59%) were found to have suffered from refractive errors than girls (5.31%). Further, children with vegetarian diet (10.52%) had greater number of refractive errors than non-vegetarian diet children (6.17%). In the present study, percentage distribution of myopia was found to be higher (4.05%) than the hyperopia (1.24%) and astigmatism (1.14%). Interestingly, in the present study the refractive errors were found significantly higher in Private schools children than Government schools because the children who read in Private schools have higher socioeconomic status; spend more time in home work, watching Television and Computer as compared to government schools children. These near activities of the eyes causes stress on eyes of the children and might be one of the causes of developing myopia.

Obesity Prevalence in Nepal: Public Health Challenges in a Low-Income Nation during an Alarming Worldwide Trend

PubMed Central

Vaidya, Abhinav; Shakya, Suraj; Krettek, Alexandra

2010-01-01

The future toll of the obesity epidemic will likely hit hardest in low- and middle-income countries. Ongoing urbanization promotes risk factors including sedentary lifestyle and fat- and sugar-laden diets. Low-income countries like Nepal experience a double disease burden: infectious diseases as well as rising incidence of noncommunicable diseases (e.g., cardiovascular disease and diabetes mellitus) frequently characterized by obesity. Nepal currently directs efforts towards curing disease but pays little attention to preventive actions. This article highlights obesity prevalence in Nepal, delineates the challenges identified by our pilot study (including low health literacy rates), and suggests strategies to overcome this trend. PMID:20644698

Overview of Nepal's energy sources and environment

NASA Astrophysics Data System (ADS)

Sharma, C. K.

In the Kathmandu Valley, Nepal faces environmental problems of most industrialized countries whereas it has problems similar to the least developed countries, in the hills. Types and quantity of energy use have a close link with the environmental degradation in Nepal Himalaya. Over dependence on the forest to meet the energy demand in the hills has aggravated the environmental problems. Lack of forest cover on the hills, the intense monsoon rain, the fragile geology and steep terrain are contributing to the acceleration of landslides, soil erosion and temperature rise. The rise of average minimum temperature is causing glaciers to retreat and thereby the development of large bodies of glacial lake. Glacial lake outbursts of 1981 in Kodari and of 1985 in Namche bazar area caused extensive damage on infrastructures down stream. Heavy use of commercial fuel (hydrocarbons) in the bowl shaped Kathmandu valley is causing air and water pollution and an increase in the average minimum temperature. Extensive development of hydropower, biogas plants and massive reforestation on naked hills and efficient use of imported hydrocarbons are the solution to existing energy and environmental problems.

Environmental variability and child growth in Nepal.

PubMed

Shively, Gerald; Sununtnasuk, Celeste; Brown, Molly

2015-09-01

Data from the 2011 Nepal Demographic Health Survey are combined with satellite remotely sensed Normalized Difference Vegetation Index (NDVI) data to evaluate whether interannual variability in weather is associated with child health. For stunting, we focus on children older than 24 months of age. NDVI anomaly averages during cropping months are evaluated during the year before birth, the year of birth, and the second year after birth. For wasting, we assess children under 59 months of age and relate growth to NDVI averages for the current and most recent growing periods. Correlations between short-run indicators of child growth and intensity of green vegetation are generally positive. Regressions that control for a range of child-, mother- and household-specific characteristics produce mixed evidence regarding the role of NDVI anomalies during critical periods in a child's early life and the subsequent probability of stunting and wasting. Overall findings suggest that the relationship between environmental conditions and child growth are heterogeneous across the landscape in Nepal and, in many cases, highly non-linear and sensitive to departures from normality. Copyright © 2015 Elsevier Ltd. All rights reserved.

Man-animal relationships in Central Nepal

PubMed Central

2010-01-01

Background Nepal is small in size but rich in bio-cultural diversity. The rugged terrain of the country is home to a number of unique assemblages of fauna, some of which are endemic. Not only faunal resources the country also harbors some very ancient populations whose interrelationship with these diverse faunal resources is very intimate and thus demands scientific study. Animals play important role in both material and spiritual spheres of their life. There are more than hundred groups of such populations in the country and the group Tamang is one of these. The present paper studies Tamang-animal relationships in central Nepal. There is a growing trend of scientific ethnozoological studies all across the globe, but this field is yet in its infancy in Nepal. The country is losing important fauna as well as ancient human cultures at the advent of development processes. As a result, ethnozoological knowledge is also teetering on the brink of extinction. Methods Ethnozoological data were collected by applying different participatory approaches techniques such as semi-structured interviews, participatory rural appraisal, key informant interviews and focus group discussions. Quantitative data were obtained by employing a household level questionnaire survey. Data were collected from the period of September 2004 to August 2005. Most of the animals were identified up to the species level with the help of standard taxonomic keys. Results The Tamang community treasures knowledge on various uses of 41 genera belonging to 28 families. Out of total number of animals, 14.6% belong to the Invertebrate group and the rest to the Vertebrate group. Of the total uses 58% fall in the food and medicinal use category, 16% in the magico-religious use category, 18% in the category of omen indication, and 2% each in the categories such as weather forecasting, trophy, ethnomusical and taboos. Conclusions The Tamang maintain strong ties with animals both at a material as well as spiritual

Anomalous soil radon fluctuations - signal of earthquakes in Nepal and eastern India regions

NASA Astrophysics Data System (ADS)

Deb, Argha; Gazi, Mahasin; Barman, Chiranjib

2016-12-01

The present paper deals with pre-seismic soil radon-222 recorded at two different locations 200 m apart, at Jadavpur University main campus, Kolkata, India. Solid state nuclear track detector method is used for detection of the radioactive radon gas. Two simultaneous 4-month long time series data have been analysed. Anomalous fluctuations in the radon datasets have been observed prior to recent earthquakes in Nepal and eastern India during the monitoring period, mainly, the massive 25th April 7.8 M Nepal earthquake. The simultaneous measurements assist in identifying seismogenic radon precursor efficiently.

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.

Epidemiology of burn injuries in Nepal: a systemic review.

PubMed

Tripathee, Sanjib; Basnet, Surendra Jung

2017-01-01

Burn is a global public health problem associated with significant morbidity and mortality, mostly in low- and middle-income countries. Southeast-Asian countries share a big burden of burn injuries, and Nepal is not an exception. We performed a systemic review to examine the epidemiological characteristics of burn injures in Nepal. Relevant epidemiological studies were identified through systemic search in PubMed, EMBASE, and Google Scholar. Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Eight studies were included in our systemic review. Most of the burn victims belong to the working age group between 15-60 years old. Flame burns were found to be the most common cause of burn injury followed by scald burns, whereas scald burns were the most common cause of burn injury among the pediatric population. Most patients sustained less severe burn injuries, with home being the most common place of burn injury. The average hospital stay among the burn victims ranged from 13 to 60 days. Mortality among the burn victims ranged from 4.5 to 23.5%, with highest mortality among the flame burn patients. Developed nations have significantly reduced the burn incidence through effective intervention program. Although, burn injuries are the leading cause of morbidity and mortality in Nepal, effective intervention programs are lacking due to the limited epidemiological data related to burn injuries. Further large scale research is imperative to investigate the problem and assess the effectiveness of an intervention program.

Genetic characterization of rhesus macaques (Macaca mulatta) in Nepal.

PubMed

Kyes, Randall C; Jones-Engel, Lisa; Chalise, Mukesh K; Engel, Gregory; Heidrich, John; Grant, Richard; Bajimaya, Shyam S; McDonough, John; Smith, David Glenn; Ferguson, Betsy

2006-05-01

Indian-origin rhesus macaques (Macaca mulatta) have long served as an animal model for the study of human disease and behavior. Given the current shortage of Indian-origin rhesus, many researchers have turned to rhesus macaques from China as a substitute. However, a number of studies have identified marked genetic differences between the Chinese and Indian animals. We investigated the genetic characteristics of a third rhesus population, the rhesus macaques of Nepal. Twenty-one rhesus macaques at the Swoyambhu Temple in Kathmandu, Nepal, were compared with more than 300 Indian- and Chinese-origin rhesus macaques. The sequence analyses of two mitochondrial DNA (mtDNA) loci, from the HVS I and 12 S rRNA regions, showed that the Nepali animals were more similar to Indian-origin than to Chinese-origin animals. The distribution of alleles at 24 short tandem repeat (STR) loci distributed across 17 chromosomes also showed greater similarity between the Nepali and Indian-origin animals. Finally, an analysis of seven major histocompatibility complex (MHC) alleles showed that the Nepali animals expressed Class I alleles that are common to Indian-origin animals, including Mamu-A*01. All of these analyses also revealed a low level of genetic diversity within this Nepali rhesus sample. We conclude that the rhesus macaques of Nepal more closely resemble rhesus macaques of Indian origin than those of Chinese origin. As such, the Nepali rhesus may offer an additional resource option for researchers who wish to maintain research protocols with animals that possess key genetic features characteristic of Indian-origin rhesus macaques. 2005 Wiley-Liss, Inc.

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.

Socio-economic predictors of stillbirths in Nepal (2001-2011)

PubMed Central

Ghimire, Pramesh Raj; Agho, Kingsley Emwinyore; Renzaho, Andre; Christou, Aliki; Nisha, Monjura Khatun; Dibley, Michael; Raynes-Greenow, Camille

2017-01-01

Introduction Stillbirth has a long-lasting impact on parents and families. This study examined socio-economic predictors associated with stillbirth in Nepal for the year 2001, 2006 and 2011. Methods The Nepalese Demographic and Health Survey (NDHS) data for the period (2001–2011) were pooled to estimate socio-economic predictors associated with stillbirths in Nepal using binomial logistic regression while taking clustering and sampling weights into account. Results A total of 18,386 pregnancies of at least 28 weeks gestation were identified. Of these pregnancies, 335 stillbirths were reported. Stillbirth increased significantly among women that lived in the hills ecological zones (aRR 1.38, 95% CI 1.02, 1.87) or in the mountains ecological zones (aRR 1.71, 95% CI 1.10, 2.66). Women with no schooling (aRR 1.72, 95% CI 1.10, 2.69), women with primary education (aRR 1.81, 95% CI 1.11, 2.97); open defecation (aRR 1.48, 95% CI 1.00, 2.18), and those whose major occupation was agriculture (aRR 1.80, 95% CI 1.16, 2.78) are more likely to report higher stillbirth. Conclusions Low levels of education, ecological zones and open defecation were found to be strong predictors of stillbirth. Access to antenatal care services and skilled birth attendants for women in the mountainous and hilly ecological zones of Nepal is needed to further reduce stillbirth and improved services should also focus on women with low levels of education. PMID:28704548

Tobacco Chewing and Associated Factors Among Youth of Western Nepal: A Cross-sectional Study

PubMed Central

Subba, SH; Binu, VS; Menezes, RG; Ninan, J; Rana, MS

2011-01-01

Background: Smokeless tobacco is found to be as addictive and harmful as smoking but have not been explored into, especially among youth. Objectives: This study was conducted to find the prevalence of tobacco chewing among college students in Nepal and the factors that have influence over their use. Study design: A cross-sectional study with a self-administered questionnaire. Materials and Methods: Five colleges of different streams in Pokhara city were selected for the study. A total of 816 students participated. The study was conducted during the period of May 2006–February 2007, using a semi-structured, self-administered questionnaire. Results: Overall prevalence of ever tobacco chewing was 21.3% (males 30.2% and females 10.9%) among the youth with average age of initiation 15.7 years. Pan masala and gutka were used by 63.6% and frequency of use varied widely and only 5.7% said they were daily users. Reasons cited for chewing were most commonly ‘just like it’ or ‘friends chew’. Multiple logistic regression analysis showed age, ever smoking status, being ever alcoholic, and having friends or family members who chewed were significantly associated with students’ tobacco chewing. Almost one-tenth of the students believed they were addicted to chewing tobacco and 42.5% of them had tried to quit the habit. Conclusion: The study shows a high prevalence of tobacco chewing by Nepali youth. Important factors that influenced the habit were having chewer friends, their own smoking and alcohol status and having family members who chewed. It is pertinent to consider these when formulating cessation and prevention programs PMID:21976798

Social Change and the Relationships between Education and Employment.

PubMed

Yabiku, Scott T; Schlabach, Sarah

2009-08-01

The relationships between education and employment have long been of interest to social scientists. During the transition from a completely agricultural economy to one that is developing nonfarm opportunities, however, the relationships between education and employment may dramatically change. We examine how two components of education-schooling enrollment and attainment-affect the transition to employment for men and women in the Chitwan Valley of Nepal. Using discrete-time event history models, we find that school enrollment tends to delay employment, while school attainment accelerates employment. We also test how these effects may have changed across successive cohorts. Over time, the effects of enrollment have become stronger, while the effects of attainment appear to have weakened. These shifts in the nature of education may be related to increasing conflict between student and employee roles, as well as changes in the types and availability of employment.

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…

Abortion law in Nepal: the road to reform.

PubMed

Thapa, Shyam

2004-11-01

In 2002 Nepal's parliament passed a liberal abortion law, after nearly three decades of reform efforts. This paper reviews the history of the movement for reform and the combination of factors that contributed to its success. These include sustained advocacy for reform; the dissemination of knowledge, information and evidence; adoption of the reform agenda by the public sector and its leadership in involving other stakeholders; the existence of work for safe motherhood as the context in which the initiative could gain support; an active women's rights movement and support from international and multilateral organisations; sustained involvement of local NGOs, civil society and professional organisations; the involvement of journalists and the media; the absence of significant opposition; courageous government officials and an enabling democratic political system. The overriding rationale for reforming the abortion law in Nepal has been to ensure safe motherhood and women's rights. The first government abortion services officially began in March 2004 at the Maternity Hospital in Kathmandu; services will be expanded gradually to other public and private hospitals and private clinics in the coming years.

Managing the injury burden in Nepal.

PubMed

Karmacharya, P C; Singh, G K; Singh, M P; Gautam, V G; Par, Andrew; Banskota, A K; Bajracharya, A; Shreshtha, A B; Mahara, Deepak

2008-10-01

Nepal loses about 530,000 disability adjusted life years (DALYs) per year to injury, predominantly due to falls. It takes 30,000 Nepali rupees (NR), or approximately US$430 at 70 rupees per $US saved per DALY to achieve primary prevention and 6000 NR per DALY if we invest in hospitals, versus 1000 NR invested in prehospital care, because simpler less expensive actions performed early have a greater impact on outcome than more complex measures later. A system for prehospital services was planned for medical emergencies at a national level meeting at the Medical University of Nepal to promote healthcare to victims in inaccessible regions by empowered or enlightened citizens. Feasible actions for common emergencies were defined and a tutorial required to help the majority of such victims was created and packaged. The knowledge and attitude component of the tutorial will be delivered through a web site to citizens motivated to learn and help with emergencies. The knowledge will be tested through a net-based Multiple Choice Questions (MCQ) test. Practical training in medical triage skills will be provided to those who qualify for the test at the University or its designated affiliates. A mobile phone-based information system will be created and used to make these enlightened citizens available to the victim at the site/time of the emergency.

Women physicists in Nepal

NASA Astrophysics Data System (ADS)

Shrestha, Nilam; Shrestha, Sanju

2013-03-01

Women constitute more than half of the total population of Nepal but are far behind men in all aspects of life. There is a wide gender gap socially, economically, and politically. Data for 1960 through 2001 show that the proportion of female students varied at the postgraduate level and there was no woman with a PhD degree. From 2002 through mid-2010 the number of female students increased gradually at both the MSc and in PhD levels, due to study opportunities abroad. We expect that this trend will continue, with significant improvement in furthering the education of women as a whole, and will lead to an increase in women physicists in the country.

The influence of neighbors' family size preference on progression to high parity births in rural Nepal.

PubMed

Jennings, Elyse A; Barber, Jennifer S

2013-03-01

Large families can have a negative impact on the health and well-being of women, children, and their communities. Seventy-three percent of the individuals in our rural Nepalese sample report that two children is their ideal number, yet about half of the married women continue childbearing after their second child. Using longitudinal data from the Chitwan Valley Family Study, we explore the influence of women's and neighbors' family size preferences on women's progression to high parity births, comparing this influence across two cohorts. We find that neighbors' family size preferences influence women's fertility, that older cohorts of women are more influenced by their neighbors' preferences than are younger cohorts of women, and that the influence of neighbors' preferences is independent of women's own preferences. © 2013 The Population Council, Inc.

Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011.

PubMed

Shahabuddin, Asm; De Brouwere, Vincent; Adhikari, Ramesh; Delamou, Alexandre; Bardají, Azucena; Delvaux, Therese

2017-04-13

To identify the determinants of institutional delivery among young married women in Nepal. Nepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15-24 years). Place of delivery. The rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery. Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal. © 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.

Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011

PubMed Central

Shahabuddin, ASM; De Brouwere, Vincent; Adhikari, Ramesh; Delamou, Alexandre; Bardaj, Azucena; Delvaux, Therese

2017-01-01

Objectives To identify the determinants of institutional delivery among young married women in Nepal. Design Nepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15–24 years). Outcome measure Place of delivery. Results The rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery. Conclusions Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal. PMID:28408543

Medical Humanities in Nepal: Present Scenario.

PubMed

Dhakal, Ajaya Kumar; Shankar, P Ravi; Dhakal, Sanjaya; Shrestha, Devendra; Piryani, Rano Mal

2014-01-01

Humanities have an essential role in medical education. The current gap between the humanities and medicine has to be bridged and there should be continuous and vigorous debate about the theory and practice of medical humanities. Medical humanities is a relatively new concept even in developed countries, and is at infancy stage in developing countries. In Nepal, modules on medical humanities have been initiated in certain medical schools by enthusiastic faculties and it requires further debates for inclusion in curriculum.

First molecular identification and characterization of classical swine fever virus isolates from Nepal.

PubMed

Postel, Alexander; Jha, Vijay C; Schmeiser, Stefanie; Becher, Paul

2013-01-01

Classical swine fever (CSF) is a major constraint to pig production worldwide, and in many developing countries, the epidemiological status is unknown. Here, for the first time, molecular identification and characterization of CSFV isolates from two recent outbreaks in Nepal are presented. Analysis of full-length E2-encoding sequences revealed that these isolates belonged to CSFV subgenotype 2.2 and had highest genetic similarity to isolates from India. Hence, for CSFV, Nepal and India should be regarded as one epidemiological unit. Both Nepalese isolates exhibited significant sequence differences, excluding a direct epidemiological connection and suggesting that CSFV is endemic in that country.

Child maltreatment in Nepal: prevalence and associated factors.

PubMed

Kandel, P; Kunwar, R; Karki, S; Kandel, D; Lamichhane, P

2017-10-01

Child maltreatment is a global public health problem. There is limited information about this problem in low-income countries. We aimed to document the prevalence and factors associated with physical punishment of children less than 14 years of age in Nepal. Population-based cross-sectional study. We conducted an in-depth analysis using data from the Nepal Multiple Indicator Cluster Survey, a nationally representative multi-stage-stratified cluster sampling survey. Data were collected from 13,000 households in 520 sample enumeration areas. We assessed prevalence of physical punishment and different child violence related acts on 5081 children aged 3-14 years for whom complete information on all acts and attitude towards violence was available. Logistic regression was used to investigate the association between physical punishment of child and factors such as household and maternal demographics. Our results suggested violence is common across Nepal, with data showing one in every second child is physically punished. One in every third (33%) of children were spanked, hit or slapped on the bottom, 25% were hit or slapped on the face and approximately 3% were beaten up hard. Odds of facing physical punishment were higher among children aged 3-5 years (odds ratio [OR] 2.9, 95% confidence interval [CI]: 2.0-4.3), aged 6-8 years (OR 2.8, 95% CI: 2.2-3.7), engaged in child labour activities (OR 1.4, 95% CI: 1.1-1.7), with mother that accepted wife beating by husband is justified (OR 1.2, 95% CI: 1.1-1.4), whose father is currently abroad (OR 1.5, 95% CI: 1.2-1.9) and whose father is away from home but in the same country (OR 1.60, 95% CI: 1.1-2.3). The risk was also higher among children living in households that believe physical punishment of children is necessary (OR 3.5, 95% CI: 2.9-4.3) and from lower caste/indigenous (dalit/janajati) ethnicity (OR 1.3, 95% CI: 1.1-1.7). Those less likely to experience physical punishment included female children (OR 0.7, 95% CI: 0

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

Molecular and Clinical Epidemiology of Salmonella Paratyphi A Isolated from Patients with Bacteremia in Nepal.

PubMed

Sherchan, Jatan Bahadur; Morita, Masatomo; Matono, Takashi; Izumiya, Hidemasa; Ohnishi, Makoto; Sherchand, Jeevan B; Tandukar, Sarmila; Laghu, Ujjwal; Nagamatsu, Maki; Kato, Yasuyuki; Ohmagari, Norio; Hayakawa, Kayoko

2017-12-01

Little is known about the epidemiology of typhoid and paratyphoid fever in Nepal. We aimed to elucidate the molecular and clinical epidemiology of Salmonella Paratyphi A in Nepal. Isolates were collected from 23 cases of bacteremia due to S. Paratyphi A between December 2014 and October 2015. Thirteen patients (57%) were male, and the median age was 21 years. None of the patients had an underlying chronic disease. All S. Paratyphi A isolates were sensitive to ampicillin, trimethoprim/sulfamethoxazole, ceftriaxone, and chloramphenicol. All isolates were resistant to nalidixic acid and were categorized as intermediately susceptible to levofloxacin. Phylogenetic analysis revealed close relatedness among the isolates, including several clonal groups, suggesting local spread. Patients with bacteremia due to S. Paratyphi A in Kathmandu, Nepal, were relatively young and nondebilitated. Improving control of S . Paratyphi infections should focus on effective infection control measures and selection of empirical therapy based on current resistance patterns.

Importance of Health and Social Care Research into Gender and Sexual Minority Populations in Nepal.

PubMed

Regmi, Pramod R; van Teijlingen, Edwin

2015-11-01

Despite progressive legislative developments and increased visibility of sexual and gender minority populations in the general population, mass media often report that this population face a wide range of discrimination and inequalities. LGBT (lesbian, gay, and bisexual, and transgender) populations have not been considered as priority research populations in Nepal. Research in other geographical settings has shown an increased risk of poor mental health, violence, and suicide and higher rates of smoking, as well as alcohol and drugs use among LGBT populations. They are also risk for lifestyle-related illness such as cancer, diabetes, and heart diseases. Currently, in Nepal, there is a lack of understanding of health and well-being, social exclusion, stigma, and discrimination as experienced by these populations. Good-quality public health research can help design and implement targeted interventions to the sexual and gender minority populations of Nepal. © 2015 APJPH.

Knowledge, Attitude and Practice of Self-Medication Among Basic Science Undergraduate Medical Students in a Medical School in Western Nepal.

PubMed

Gyawali, Sudesh; Shankar, P Ravi; Poudel, Phanindra Prasad; Saha, Archana

2015-12-01

Studies have shown self-medication to be common among medical students. These studies are however, few in Nepal. The present study assessed knowledge, attitude, and practice of self-medication among second and fourth semesters' undergraduate medical students and studied differences in knowledge and attitude (if any) among different subgroups of the respondents. A cross-sectional survey was conducted using a questionnaire among basic science medical students of Manipal College of Medical Sciences, Nepal. Semester of study, gender, age, nationality, and the profession of their parents were noted. Students' knowledge and attitude about self-medication was studied by noting their degree of agreement with a set of 40 statements using a Likert-type scale. The average scores and frequency of occurrence of particular behaviors among different categories of respondents were compared using appropriate statistical tests. Two hundred and seventy-six of the 295 (93.6%) students participated. The mean (SD) knowledge, attitude, and total scores were 74.54 (6.92), 67.18 (5.68), and 141.73 (10.76) with maximum possible scores 100, 100 and 200, respectively. There was no significant difference in scores according to respondents' gender, age, and the profession of their parents. However, the mean knowledge, attitude and total scores were significantly different among students of different nationalities. Mean scores of fourth semester students were significantly higher compared to second semester students. There were differences in knowledge and total scores among students of different nationalities. Eighty two percent of respondents had self-medicated during the one year period preceding the study; 149 respondents (54%) shared that previous experience with the medicine was one of the information sources for self-medication. Prevalence of self-medication among respondents according to semester of study, gender, age, and profession of the parents was not significantly different. The

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.

Design for sustainable development--household drinking water filter for arsenic and pathogen treatment in Nepal.

PubMed

Ngai, Tommy K K; Shrestha, Roshan R; Dangol, Bipin; Maharjan, Makhan; Murcott, Susan E

2007-10-01

In the last 20 years, the widespread adoption of shallow tubewells in Nepal Terai region enabled substantial improvement in access to water, but recent national water quality testing showed that 3% of these sources contain arsenic above the Nepali interim guideline of 50 microg/L, and up to 60% contain unsafe microbial contamination. To combat this crisis, MIT, ENPHO and CAWST together researched, developed and implemented a household water treatment technology by applying an iterative, learning development framework. A pilot study comparing 3 technologies against technical, social, and economic criteria showed that the Kanchan Arsenic Filter (KAF) is the most promising technology for Nepal. A two-year technical and social evaluation of over 1000 KAFs deployed in rural villages of Nepal determined that the KAF typically removes 85-90% arsenic, 90-95% iron, 80-95% turbidity, and 85-99% total coliforms. Then 83% of the households continued to use the filter after 1 year, mainly motivated by the clean appearance, improved taste, and reduced odour of the filtered water, as compared to the original water source. Although over 5,000 filters have been implemented in Nepal by January 2007, further research rooted in sustainable development is necessary to understand the technology diffusion and scale-up process, in order to expand access to safe water in the country and beyond.

Addressing the needs of people with disability in Nepal: The urgent need.

PubMed

Paudel, Yuba Raj; Dariang, Maureen; Keeling, Stephen J; Mehata, Suresh

2016-04-01

Health planners and policy makers often overlook the needs of people with disability (PWDs) in less developed countries such as Nepal. The aftermath of conflict and earthquake has further escalated the need of people with disability in Nepal. While the country is preparing for the implementation of a national health sector strategy for the next five years and when the health system is being restructured, we believe that this is the right time to address needs of people with disability by strengthening the health system and operationalizing community based rehabilitation. Furthermore, there is a need of a standard database and monitoring system to regularly assess social inclusion of people with disability. Copyright © 2016 Elsevier Inc. All rights reserved.

Language Planning in Nepal, Taiwan and Sweden. Multilingual Matters.

ERIC Educational Resources Information Center

Baldauf, Richard B., Jr., Ed.; Kaplan, Robert B., Ed.

This edited volume covers the language situation in Nepal, Taiwan, and Sweden, explaining the linguistic diversity, the place of minorities and their languages, the historical and political contexts, and the current language situation, including language-in-education planning, the role of the media, the role of religion, and the roles of…

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

First Insights into the Phylogenetic Diversity of Mycobacterium tuberculosis in Nepal

PubMed Central

Malla, Bijaya; Stucki, David; Borrell, Sonia; Feldmann, Julia; Maharjan, Bhagwan; Shrestha, Bhawana

2012-01-01

Background Tuberculosis (TB) is a major public health problem in Nepal. Strain variation in Mycobacterium tuberculosis may influence the outcome of TB infection and disease. To date, the phylogenetic diversity of M. tuberculosis in Nepal is unknown. Methods and Findings We analyzed 261 M. tuberculosis isolates recovered from pulmonary TB patients recruited between August 2009 and August 2010 in Nepal. M. tuberculosis lineages were determined by single nucleotide polymorphisms (SNP) typing and spoligotyping. Drug resistance was determined by sequencing the hot spot regions of the relevant target genes. Overall, 164 (62.8%) TB patients were new, and 97 (37.2%) were previously treated. Any drug resistance was detected in 50 (19.2%) isolates, and 16 (6.1%) were multidrug-resistant. The most frequent M. tuberculosis lineage was Lineage 3 (CAS/Delhi) with 106 isolates (40.6%), followed by Lineage 2 (East-Asian lineage, includes Beijing genotype) with 84 isolates (32.2%), Lineage 4 (Euro-American lineage) with 41 (15.7%) isolates, and Lineage 1 (Indo-Oceanic lineage) with 30 isolates (11.5%). Based on spoligotyping, we found 45 different spoligotyping patterns that were previously described. The Beijing (83 isolates, 31.8%) and CAS spoligotype (52, 19.9%) were the dominant spoligotypes. A total of 36 (13.8%) isolates could not be assigned to any known spoligotyping pattern. Lineage 2 was associated with female sex (adjusted odds ratio [aOR] 2.58, 95% confidence interval [95% CI] 1.42–4.67, p = 0.002), and any drug resistance (aOR 2.79; 95% CI 1.43–5.45; p = 0.002). We found no evidence for an association of Lineage 2 with age or BCG vaccination status. Conclusions We found a large genetic diversity of M. tuberculosis in Nepal with representation of all four major lineages. Lineages 3 and 2 were dominating. Lineage 2 was associated with clinical characteristics. This study fills an important gap on the map of the M. tuberculosis genetic diversity in the Asian

Retrospective Descriptive Study of Cerebral Palsy in Nepal

ERIC Educational Resources Information Center

Thapa, Ritesh

2016-01-01

There is very little data pertaining to cerebral palsy (CP) from Nepal. In this retrospective study it was observed that dyskinetic CP was seen in 29% and the sex ratio of males to females was two in the study population of children with CP. Both of these are much higher than data from developed countries. Hence, further randomized cross-sectional…

Symptom Recognition to Diagnosis of Autism in Nepal

ERIC Educational Resources Information Center

Shrestha, Merina; Shrestha, Rena

2014-01-01

Awareness and knowledge about autism is almost non-existent in Nepal. Children who eventually get the diagnosis often miss their opportunity for early intervention. The current study shows that medical help was seeked at mean age of 27.9 + 14.5 months and most of them were for delayed language and the first preference for parents were…

Where midwives are not yet recognised: a feasibility study of professional midwives in Nepal.

PubMed

Bogren, Malin Upper; van Teijlingen, Edwin; Berg, Marie

2013-10-01

the professional midwife is a key person for promoting maternal and family health. Not all countries have yet reached the professional standard for midwives set by the International Confederation of Midwives (ICM) and Nepal is one of these countries. This study explores the feasibility to establish a professional midwifery cadre in Nepal that meets the global standards of competencies, and to define a strategy to reach this. a mixed-methods study comprised (1) policy-review (2) interviews and (3) observations. An assessment tool was designed for data collection and analysis using variables from three sources: ICM's Global Standards, the skilled birth attendant programme in Nepal, and JHPIEGO's site assessment tool for maternal health and new-born programmes. Data were collected in a desk review of education and policy documents, interviews with stakeholders, and site assessment of five higher education institutions and their hospital-based maternity departments. The analysis resulted in a recommended strategy. six levels of education of nurse staff providing midwifery care were identified; all regulated under the Nepal Nursing Council. No legislation was in place authorising midwifery as an autonomous profession. A post-basic midwifery programme on first cycle-bachelor level was under development. A well-organised midwifery association was established consisting of nurses providing maternal health care. Four university colleges offering higher education for nurses and clinicians had a capability to run a midwifery programme and the fifth had a genuine interest in starting a midwifery programme at bachelor level. The proposed strategy includes four strategic objectives and interventions in relation to four components identified by UNFPA: Legislation and regulation; Training and education; Deployment and utilisation; and Professional associations. the study has delivered a proposed strategy for the Government of Nepal for effective management of the midwifery

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

Slope Stability Analysis of Mountainous/Hilly regions of Nepal: A case study of Bhotekoshi Hydropower site

NASA Astrophysics Data System (ADS)

Acharya, A.; Gautam, S.; Kafle, K. R.

2017-12-01

Nepal is a mountainous, developing country that straddles the boundary between the Indian and Himalayan tectonic plates. In Nepal, landslides represent a major constraint on development, causing high levels of economic loss and substantial number of fatalities each year. There is a general consensus that the impacts of landslides in mountainous countries such as Nepal are increasing with time due to unstable slopes. The present study deals with the field investigation of slope stability in mountainous/hilly region of Nepal. Among the natural hazards that occur in regularly in Nepal, flood and landslides due to unstable slopes are by far the serious ones. They claim many human lives every year and cause other damages such as destruction and blockage of highway, destruction of hydropower, losses of livestock, crops and agricultural land. Slope Mass Rating system and stereographic projection has been carried out for analysis of slope stability using standard formats and parameters. It has been found that there are few major discontinuities that play the role for the rock/soil slides around the area. The major discontinuities are 235°/67°. These joint sets play the main role to the plane as well as wedge failures around the area. The rock mass rating of the slope has been found to be 27 and the slope mass rating has been found to be 37.8. The obtained slope mass rating value lies on IV class (Bad) that represents unstable slope having planner or big wedge failure and needs to be corrective measures in the slope. From stereographic projection, wedge failure of the slope has been seen according to the conditions of slope failure.

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

Plant proteomics in India and Nepal: current status and challenges ahead.

PubMed

Deswal, Renu; Gupta, Ravi; Dogra, Vivek; Singh, Raksha; Abat, Jasmeet Kaur; Sarkar, Abhijit; Mishra, Yogesh; Rai, Vandana; Sreenivasulu, Yelam; Amalraj, Ramesh Sundar; Raorane, Manish; Chaudhary, Ram Prasad; Kohli, Ajay; Giri, Ashok Prabhakar; Chakraborty, Niranjan; Zargar, Sajad Majeed; Agrawal, Vishwanath Prasad; Agrawal, Ganesh Kumar; Job, Dominique; Renaut, Jenny; Rakwal, Randeep

2013-10-01

Plant proteomics has made tremendous contributions in understanding the complex processes of plant biology. Here, its current status in India and Nepal is discussed. Gel-based proteomics is predominantly utilized on crops and non-crops to analyze majorly abiotic (49 %) and biotic (18 %) stress, development (11 %) and post-translational modifications (7 %). Rice is the most explored system (36 %) with major focus on abiotic mainly dehydration (36 %) stress. In spite of expensive proteomics setup and scarcity of trained workforce, output in form of publications is encouraging. To boost plant proteomics in India and Nepal, researchers have discussed ground level issues among themselves and with the International Plant Proteomics Organization (INPPO) to act in priority on concerns like food security. Active collaboration may help in translating this knowledge to fruitful applications.

Hydrothermal Alkalinity in Central Nepal Rivers

NASA Astrophysics Data System (ADS)

Evans, M. J.; Derry, L. A.

2002-12-01

Numerous hot springs flow along the base of the Himalayan front, at or near the Main Central Thrust, in the Narayani drainage of central Nepal. The springs are found in a narrow zone characterized by rapid uplift and high incision rates. In this zone, hot rocks are brought to the near-surface where they interact with meteoric waters to produce the hydrothermal system. Water-rock interaction produces springs with high solute loads (TDS up to 8000 mg/L.) The springs drive significant chemical anomalies (e.g. Cl, Na, K and Ge) in the rivers that flow through the hydrothermal zone In order to quantify the impact the springs have on the river chemistry, the spring discharge must be estimated. Direct measurement of the spring discharge is difficult, as the springs often flow within the stream bed itself or are inaccessible. We take advantage of the wide disparity in stream vs. hydrothermal [Ge] to calculate spring discharge by chemical mass balance. The hot springs have [Ge] up to 684 nmol/kg and Ge/Si ratios from 200 to 1000 μmol/mol while river waters have [Ge] near 0.15 nmol/kg and Ge/Si ratios near 0.5 μmol/mol, typical of non-polluted rivers. The discharge calculated from the Ge mass balance for individual springs ranges from 0.03 x 106 to 5.6 x 106 m3/yr, and accounts for a small percentage of the total river discharge (0.03% to 1.9%). The hot spring discharge for all of central Nepal is around 1.5x108 m3/yr, 0.5% of the Narayani river discharge. Distinguishing between silicate and carbonate sources is important to assessing the role of weathering on atmospheric CO2 levels and the relative contributions of silicate and carbonate alkalinity in central Nepal rivers are still not well resolved. The hot springs derive up to 100% of their alkalinity from silicate sources. Using the discharge estimates for the springs, we find that the sum of the silicate alkalinity fluxes from all the spring systems is 2.8 x 108 mol/yr. This implies that the hot springs deliver around

Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal.

PubMed

Pandey, Srijana; Karki, Supendra

2014-01-01

The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

Complete nucleotide sequence of a monopartite Begomovirus and associated satellites infecting Carica papaya in Nepal.

PubMed

Shahid, M S; Yoshida, S; Khatri-Chhetri, G B; Briddon, R W; Natsuaki, K T

2013-06-01

Carica papaya (papaya) is a fruit crop that is cultivated mostly in kitchen gardens throughout Nepal. Leaf samples of C. papaya plants with leaf curling, vein darkening, vein thickening, and a reduction in leaf size were collected from a garden in Darai village, Rampur, Nepal in 2010. Full-length clones of a monopartite Begomovirus, a betasatellite and an alphasatellite were isolated. The complete nucleotide sequence of the Begomovirus showed the arrangement of genes typical of Old World begomoviruses with the highest nucleotide sequence identity (>99 %) to an isolate of Ageratum yellow vein virus (AYVV), confirming it as an isolate of AYVV. The complete nucleotide sequence of betasatellite showed greater than 89 % nucleotide sequence identity to an isolate of Tomato leaf curl Java betasatellite originating from Indonesian. The sequence of the alphasatellite displayed 92 % nucleotide sequence identity to Sida yellow vein China alphasatellite. This is the first identification of these components in Nepal and the first time they have been identified in papaya.

Comparative Policy Brief: Status of Intellectual Disabilities in Nepal

ERIC Educational Resources Information Center

Crishna, Brinda; Prajapati, Surya Bhakta

2008-01-01

In Nepal, the estimates of the prevalence of disabilities vary, and there is sparse information specifically about people with intellectual disabilities (ID). Existing data suggest higher rates of prevalence of ID in the more remote northern area due to use of non-iodized salt, lack of health facilities, and extreme poverty. Superstitious beliefs…

Situation Report--Argentina, France, Gambia, Grenada, Hungary, Nepal, and Paraguay.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in seven foreign countries are presented in these situation reports. Countries included are Argentina, France, Gambia, Grenada, Hungary, Nepal, and Paraguay. Information is provided, where appropriate and available, under two topics, general background and family planning situation. General…

Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti : Variability in Injuries Encountered and Collaboration with Local Available Resources Drive Optimal Response.

PubMed

Bar-On, Elhanan; Blumberg, Nehemia; Joshi, Amit; Gam, Arnon; Peyser, Amos; Lee, Evgeny; Kashichawa, Shree Krishna; Morose, Alexander; Schein, Ophir; Lehavi, Amit; Kreiss, Yitshak; Bader, Tarif

2016-09-01

Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different-independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events. The purpose of this study was to analyze these differences and their implications for preparation and planning of future deployments. Data were obtained from IDF records and analyzed using SPSS™ software. 1686 patients were treated in Nepal versus 1111 in Haiti. The caseload in Nepal included significantly less earthquake-related injuries (26 vs. 66 %) with 28 % of them sustaining fractures versus 47 % in Haiti. Femoral fractures accounted for 7.9 % of fractures in Nepal versus 26.4 % in Haiti with foot fractures accounting for 23.8 and 6.4 %, respectively. The rate of open fracture was similar at 29.4 % in Nepal and 27.5 % in Haiti. 18.1 % of injured patients in Nepal underwent surgery, and 32.9 % of which was skeletal compared to 32 % surgical cases (58.8 % skeletal) in Haiti. 74.2 % of patients in Nepal and 34.3 % in Haiti were treated for pathology unrelated to the earthquake. The reasons for the variability in activities between the two hospitals include the magnitude of the disaster, the functionality of the local medical system which was relatively preserved in Nepal and destroyed in Haiti and the mode of operation which was independent in Haiti and collaborative with a functioning local hospital in Nepal. Emergency medical teams (EMTs) may encounter variable caseloads despite similar disaster scenarios. Advance knowledge of the magnitude of the disaster, the functionality of the local medical system, and the collaborative possibilities will help in planning

Injection practices in Nepal: health policymakers’ perceptions

PubMed Central

2014-01-01

Background The unnecessary and unsafe use of injections is common in developing countries like Nepal. Policymakers have an important role in promoting rational and safe injection use. Hence, the present study was carried out to explore the perception of health policymakers regarding safe injection practice in Nepal. Methods An exploratory qualitative study design was used in this study. Key policymakers from both the central and regional level were selected using purposive sampling. A semi-structured questionnaire advocated by the World Health Organization (WHO) was used after modifying the context. Interviews were conducted to clarify doubts and obtain additional information. The data was analyzed manually using deductive content analysis technique. Results In total, eleven policymakers participated. All unanimously agreed that injection safety is a problem and seven participants reported that injections are overused. They shared the opinion that injections are administered by various providers, including formal and informal health providers, and also quacks. Almost half the respondents reported that the National Drug Policy discourages injection overuse, while others reported that the policy contains no provisions regarding injection overuse. Most policymakers stated that only single-use disposable injection equipment is used to provide injection, while others thought that sterilizable glass syringe is also used. More than half of the participants believed that the quality of injection equipment available in the Nepalese market is not regulated by any government institution. Almost two-third of the policymakers stated that syringes and needles are not reused, while the rest thought syringes might be reused without sterilization in some parts of the country. Almost half of the respondents stated that illegal commercialization of used syringes exists in Nepal. Almost all respondents thought that health care institutions have a waste management plan, while more than

Injection practices in Nepal: health policymakers' perceptions.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, Pathiyil Ravi; Maskey, Manisha; Vikash, Kumar K C

2014-06-24

The unnecessary and unsafe use of injections is common in developing countries like Nepal. Policymakers have an important role in promoting rational and safe injection use. Hence, the present study was carried out to explore the perception of health policymakers regarding safe injection practice in Nepal. An exploratory qualitative study design was used in this study. Key policymakers from both the central and regional level were selected using purposive sampling. A semi-structured questionnaire advocated by the World Health Organization (WHO) was used after modifying the context. Interviews were conducted to clarify doubts and obtain additional information. The data was analyzed manually using deductive content analysis technique. In total, eleven policymakers participated. All unanimously agreed that injection safety is a problem and seven participants reported that injections are overused. They shared the opinion that injections are administered by various providers, including formal and informal health providers, and also quacks. Almost half the respondents reported that the National Drug Policy discourages injection overuse, while others reported that the policy contains no provisions regarding injection overuse. Most policymakers stated that only single-use disposable injection equipment is used to provide injection, while others thought that sterilizable glass syringe is also used. More than half of the participants believed that the quality of injection equipment available in the Nepalese market is not regulated by any government institution. Almost two-third of the policymakers stated that syringes and needles are not reused, while the rest thought syringes might be reused without sterilization in some parts of the country. Almost half of the respondents stated that illegal commercialization of used syringes exists in Nepal. Almost all respondents thought that health care institutions have a waste management plan, while more than half of them opined that

Sexual coercion of married women in Nepal

PubMed Central

2010-01-01

Background Sexual coercion is an important public health issue due to its negative association with social and health outcomes. The paper aims to examine the prevalence of sexual coercion perpetrated by husbands on their wives in Nepal and to identify the characteristics associated with this phenomenon. Methods The data used in this paper comes from a cross-sectional survey on "Domestic Violence in Nepal" carried out in 2009. A total of 1,536 married women were interviewed and associations between sexual coercion and the explanatory variables were assessed via bivariate analysis using Chi-square tests. Logistic regression was then applied to assess the net effect of several independent variables on sexual coercion. Results Overall, about three in five women (58%) had experienced some form of sexual coercion by their husbands. Logistic regression analysis found that the literacy status of women, decision-making power regarding their own health care, husband-wife age differences, alcohol consumption by the husband, and male patriarchal control all had significant associations with women's experience of sexual coercion. Literate women had 28% less chance (adjusted odds ratio (aOR) = 0.72) of experiencing sexual coercion by their husbands than did illiterate women. Women who made decisions jointly with their husbands with regard to their own health care were 36% less likely (aOR = 0.64) to experience sexual coercion than those whose health care was decided upon by their mothers/fathers-in-law. On the other hand, women whose husbands were 5 or more years older than they were more likely to report sexual coercion (aOR = 1.33) than were their counterparts, as were women whose husbands consumed alcohol (aOR = 1.27). Furthermore, women who experienced higher levels of patriarchal control from their husbands were also more likely to experience sexual coercion by their husbands (aOR = 7.2) compared to those who did not face such control. Conclusion The study indicates that

Prevalence and patterns of hazardous and harmful alcohol consumption assessed using the AUDIT among Bhutanese refugees in Nepal.

PubMed

Luitel, Nagendra P; Jordans, Mark; Murphy, Adrianna; Roberts, Bayard; McCambridge, Jim

2013-01-01

This study sought to ascertain the prevalence of hazardous and harmful alcohol consumption among Bhutanese refugees in Nepal and to identify predictors of elevated risk in order to better understand intervention need. Hazardous and harmful alcohol consumption was assessed using the Alcohol Use Disorder Identification Test (AUDIT) administered in a face-to-face interview in a census of two camps comprising ∼8000 refugees. Approximately 1/5 men and 1/14 women drank alcohol and prevalence of hazardous drinking among current drinkers was high and comparable to that seen in Western countries with longstanding alcohol cultures. Harmful drinking was particularly associated with the use of other substances including tobacco. Assessment of the alcohol-related needs of Bhutanese refugees has permitted the design of interventions. This study adds to the small international literature on substance use in forced migration populations, about which there is growing concern.

[Nepal earthquake: nursing missions in Paris and Kathmandu].

PubMed

Poux, Chrystel; Sergent, Jean-Louis

2016-01-01

A violent earthquake hit Nepal on 25th April 2015, injuring and killing thousands. A nurse manager and a nurse, both working in anaesthesia and reservists in the French Health Emergency Preparedness and Response Organisation, describe their mission: one working in the crisis centre in Paris, the other on the ground, providing assistance to French victims. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Action Learning in ActionAid Nepal: A Case Study

ERIC Educational Resources Information Center

Lustig, Patricia; Rai, Deep Ranjani

2009-01-01

This article describes an example of how action learning was used as a framework for an organisational intervention to fundamentally change the organisational culture over a period of time. It also identifies our learning over that period of time and what worked well (and not so well) in an International Non-Governmental Organisation in Nepal.

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue

PubMed Central

Colombini, Manuela; Mayhew, Susannah H; Hawkins, Ben; Bista, Meera; Joshi, Sunil Kumar; Schei, Berit; Watts, Charlotte

2016-01-01

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women’s groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country’s new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model. PMID:26412857

Climate Change and Spatiotemporal Distributions of Vector-Borne Diseases in Nepal--A Systematic Synthesis of Literature.

PubMed

Dhimal, Meghnath; Ahrens, Bodo; Kuch, Ulrich

2015-01-01

Despite its largely mountainous terrain for which this Himalayan country is a popular tourist destination, Nepal is now endemic for five major vector-borne diseases (VBDs), namely malaria, lymphatic filariasis, Japanese encephalitis, visceral leishmaniasis and dengue fever. There is increasing evidence about the impacts of climate change on VBDs especially in tropical highlands and temperate regions. Our aim is to explore whether the observed spatiotemporal distributions of VBDs in Nepal can be related to climate change. A systematic literature search was performed and summarized information on climate change and the spatiotemporal distribution of VBDs in Nepal from the published literature until December 2014 following providing items for systematic review and meta-analysis (PRISMA) guidelines. We found 12 studies that analysed the trend of climatic data and are relevant for the study of VBDs, 38 studies that dealt with the spatial and temporal distribution of disease vectors and disease transmission. Among 38 studies, only eight studies assessed the association of VBDs with climatic variables. Our review highlights a pronounced warming in the mountains and an expansion of autochthonous cases of VBDs to non-endemic areas including mountain regions (i.e., at least 2,000 m above sea level). Furthermore, significant relationships between climatic variables and VBDs and their vectors are found in short-term studies. Taking into account the weak health care systems and difficult geographic terrain of Nepal, increasing trade and movements of people, a lack of vector control interventions, observed relationships between climatic variables and VBDs and their vectors and the establishment of relevant disease vectors already at least 2,000 m above sea level, we conclude that climate change can intensify the risk of VBD epidemics in the mountain regions of Nepal if other non-climatic drivers of VBDs remain constant.

Catastrophic household expenditure on health in Nepal: a cross-sectional survey.

PubMed

Saito, Eiko; Gilmour, Stuart; Rahman, Md Mizanur; Gautam, Ghan Shyam; Shrestha, Pradeep Krishna; Shibuya, Kenji

2014-10-01

To determine the incidence of - and illnesses commonly associated with - catastrophic household expenditure on health in Nepal. We did a cross-sectional population-based survey in five municipalities of Kathmandu Valley between November 2011 and January 2012. For each household surveyed, out-of-pocket spending on health in the previous 30 days that exceeded 10% of the household's total expenditure over the same period was considered to be catastrophic. We estimated the incidence and intensity of catastrophic health expenditure. We identified the illnesses most commonly associated with such expenditure using a Poisson regression model and assessed the distribution of expenditure by economic quintile of households using the concentration index. Overall, 284 of the 1997 households studied in Kathmandu, i.e. 13.8% after adjustment by sampling weight, reported catastrophic health expenditure in the 30 days before the survey. After adjusting for confounders, this expenditure was found to be associated with injuries, particularly those resulting from road traffic accidents. Catastrophic expenditure by households in the poorest quintile were associated with at least one episode of diabetes, asthma or heart disease. In an urban area of Nepal, catastrophic household expenditure on health was mostly associated with injuries and noncommunicable diseases such as diabetes and asthma. Throughout Nepal, interventions for the control and management of noncommunicable diseases and the prevention of road traffic accidents should be promoted. A phased introduction of health insurance should also reduce the incidence of catastrophic household expenditure.

Ambiguous Loss in a Non-Western Context: Families of the Disappeared in Postconflict Nepal

ERIC Educational Resources Information Center

Robins, Simon

2010-01-01

Ambiguous loss has become a standard theory for understanding the impact of situations where the presence of a family member is subject to ambiguity. A number of studies of ambiguous loss have been made in a range of situations of ambiguity, but almost all have been firmly located within a Western cultural context. Here, ambiguous loss is explored…

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…

Molecular characterization of Mycobacterium orygis isolates from wild animals of Nepal.

PubMed

Thapa, Jeewan; Nakajima, Chie; Maharjan, Bhagwan; Poudell, Ajay; Suzuki, Yasuhiko

2015-08-01

Mycobacterium orygis, a new member of the Mycobacterium tuberculosis complex, was isolated from a captive spotted deer (Axis axis) and a blue bull (Boselaphus tragocamelus) in Nepal. Analyses by spoligotyping, mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) typing, region of difference and single nucleotide polymorphism of genes gyrB, mmpL6, TbD1, PPE55 and Rv2042c confirmed the isolates as M. orygis. Moreover, analyses by spoligotyping (SIT587) as well as MIRU-VNTR showed that the isolates shared a similar pattern with many reported isolates. From previous and the present studies, it can be inferred that South Asia is one of the endemic regions for M. orygis. Further investigation including a larger sample size and different host interaction will help to understand the ecology and epidemiology of M. orygis in Nepal.

Repeated catastrophic valley infill following medieval earthquakes in the Nepal Himalaya.

PubMed

Schwanghart, Wolfgang; Bernhardt, Anne; Stolle, Amelie; Hoelzmann, Philipp; Adhikari, Basanta R; Andermann, Christoff; Tofelde, Stefanie; Merchel, Silke; Rugel, Georg; Fort, Monique; Korup, Oliver

2016-01-08

Geomorphic footprints of past large Himalayan earthquakes are elusive, although they are urgently needed for gauging and predicting recovery times of seismically perturbed mountain landscapes. We present evidence of catastrophic valley infill following at least three medieval earthquakes in the Nepal Himalaya. Radiocarbon dates from peat beds, plant macrofossils, and humic silts in fine-grained tributary sediments near Pokhara, Nepal's second-largest city, match the timing of nearby M > 8 earthquakes in ~1100, 1255, and 1344 C.E. The upstream dip of tributary valley fills and x-ray fluorescence spectrometry of their provenance rule out local sources. Instead, geomorphic and sedimentary evidence is consistent with catastrophic fluvial aggradation and debris flows that had plugged several tributaries with tens of meters of calcareous sediment from a Higher Himalayan source >60 kilometers away. Copyright © 2016, American Association for the Advancement of Science.

Hand-touch method for detection of neonatal hypothermia in Nepal.

PubMed

Tuitui, Roshani Laxmi; Suwal, Satya Narayan; Shrestha, Sarala

2011-06-01

Neonatal hypothermia is the fourth leading causes of neonatal death in Nepal. Thus, it is the caregivers' responsibility to identify the hypothermia by using valid and less time consuming method like hand-touch method. Therefore, we examined the diagnostic validity of hand-touch method against low-reading mercury (LRM) thermometer for detecting neonatal hypothermia. We assessed neonate's temperature first by hand-touch method, then by LRM thermometer and tympanic thermometer among 100 full-term neonates, delivered within 24 h in Maternity Ward of Tribhuvan University Teaching Hospital, Nepal. We used World Health Organization (1997) criteria for classification of neonatal hypothermia. The sensitivity and specificity of the hand-touch method for detection of neonatal hypothermia were 95.6% and 70.1% against LRM thermometer and 76.6% and 83% against the tympanic thermometer, respectively. Touching method is practical and therefore has a good diagnostic validity; it can be introduced in essential newborn care package after giving adequate training to caregivers.

A community practitioner abroad: listening to women in Dailekh, Nepal.

PubMed

Nixon, Catherine

2015-07-01

Nepal is one of the poorest countries in the world, and has a strongly patriarchal culture. This study reports on methods used to explore women's opportunities in decision-making roles in Dailekh, Nepal. Action-based research was used to support women to identify barriers and to enable them to find solutions which could increase meaningful, practical and genuine representation. Participants were women in nominal positions of leadership in the community and subsequently also men in leadership roles. Focus groups and interviews enabled data to be collected and analysed using participatory and 'rich picture' tools. A five-stage framework approach was used to analyse data. A major theme of 'power' emerged comprised of supporting themes; 'place in society 'formal power,' informal power and 'voice'. These outcomes formed the basis for identifying viable action plans generated by the participants of both genders to promote meaningful involvement of women in community decision making. Women were clear that involving men and women in the actions was key to increasing success.

Qualitative research and its place in health research in Nepal.

PubMed

van Teijlingen, E; Simkhada, B; Porter, M; Simkhada, P; Pitchforth, E; Bhatta, P

2011-01-01

There has been a steady growth in recent decades in Nepal in health and health services research, much of it based on quantitative research methods. Over the same period international medical journals such as The Lancet, the British Medical Journal (BMJ), The Journal of the American Medical Association (JAMA) and the Journal of Family Planning and Reproductive Health Care and many more have published methods papers outlining and promoting qualitative methods. This paper argues in favour of more high-quality qualitative research in Nepal, either on its own or as part of a mixed-methods approach, to help strengthen the country's research capacity. After outlining the reasons for using qualitative methods, we discuss the strengths and weaknesses of the three main approaches: (a) observation; (b) in-depth interviews; and (c) focus groups. We also discuss issues around sampling, analysis, presentation of findings, reflexivity of the qualitative researcher and theory building, and highlight some misconceptions about qualitative research and mistakes commonly made.

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal

PubMed Central

2014-01-01

Background Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. Methods A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Results Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The ‘Current Index of Medical Specialties’ was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Conclusions Community pharmacies in Pokhara offer a wide range

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Adhikari, Kishor; Shankar, Pathiyil Ravi; K C, Vikash Kumar; Basnet, Suyog

2014-04-28

Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The 'Current Index of Medical Specialties' was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Community pharmacies in Pokhara offer a wide range of services including, but not limited to

Comparing Paper and Tablet Modes of Retrospective Activity Space Data Collection.

PubMed

Yabiku, Scott T; Glick, Jennifer E; Wentz, Elizabeth A; Ghimire, Dirgha; Zhao, Qunshan

2017-01-01

Individual actions are both constrained and facilitated by the social context in which individuals are embedded. But research to test specific hypotheses about the role of space on human behaviors and well-being is limited by the difficulty of collecting accurate and personally relevant social context data. We report on a project in Chitwan, Nepal, that directly addresses challenges to collect accurate activity space data. We test if a computer assisted interviewing (CAI) tablet-based approach to collecting activity space data was more accurate than a paper map-based approach; we also examine which subgroups of respondents provided more accurate data with the tablet mode compared to paper. Results show that the tablet approach yielded more accurate data when comparing respondent-indicated locations to the known locations as verified by on-the-ground staff. In addition, the accuracy of the data provided by older and less healthy respondents benefited more from the tablet mode.

Comparing Paper and Tablet Modes of Retrospective Activity Space Data Collection*

PubMed Central

Yabiku, Scott T.; Glick, Jennifer E.; Wentz, Elizabeth A.; Ghimire, Dirgha; Zhao, Qunshan

2018-01-01

Individual actions are both constrained and facilitated by the social context in which individuals are embedded. But research to test specific hypotheses about the role of space on human behaviors and well-being is limited by the difficulty of collecting accurate and personally relevant social context data. We report on a project in Chitwan, Nepal, that directly addresses challenges to collect accurate activity space data. We test if a computer assisted interviewing (CAI) tablet-based approach to collecting activity space data was more accurate than a paper map-based approach; we also examine which subgroups of respondents provided more accurate data with the tablet mode compared to paper. Results show that the tablet approach yielded more accurate data when comparing respondent-indicated locations to the known locations as verified by on-the-ground staff. In addition, the accuracy of the data provided by older and less healthy respondents benefited more from the tablet mode. PMID:29623133

Differentiation, Development, (Dis)Integration: Education in Nepal's "People's War"

ERIC Educational Resources Information Center

Shields, Robin; Rappleye, Jeremy

2008-01-01

A violent conflict between Maoist insurgents and the national government has engulfed Nepal for most of the last decade, a situation that has been complicated by deep-seated instability at the highest levels of the government itself. Even with the declaration of a ceasefire in 2006, violence endures in pockets of lawless banditry and unrest at the…

Unsafe abortion after legalisation in Nepal: a cross-sectional study of women presenting to hospitals.

PubMed

Rocca, C H; Puri, M; Dulal, B; Bajracharya, L; Harper, C C; Blum, M; Henderson, J T

2013-08-01

To investigate abortion practices of Nepali women requiring postabortion care. Cross-sectional study. Four tertiary-care hospitals in urban and rural Nepal. A total of 527 women presenting with complications from induced abortion in 2010. Women completed questionnaires on their awareness of the legal status of abortion and their abortion-seeking experiences. The method of induction and whether the abortion was obtained from an uncertified source was documented. Multivariable logistic regression was used to identify associated factors. Induction method; uncertified abortion source. In all, 234 (44%) women were aware that abortion was legal in Nepal. Medically induced abortion was used by 359 (68%) women and, of these, 343 (89%) took unsafe, ineffective or unknown substances. Compared with women undergoing surgical abortion, women who had medical abortion were more likely to have obtained information from pharmacists (161/359, 45% versus 11/168, 7%, adjusted odds ratio [aOR] 8.1, 95% confidence interval 4.1-16.0) and to have informed no one about the abortion (28/359, 8% versus 3/168, 2%, aOR 5.5, 95% CI 1.1-26.9). Overall, 291 (81%) medical abortions and 50 (30%) surgical abortions were obtained from uncertified sources; these women were less likely to know that abortion was legal (122/341, 36% versus 112/186, 60%, aOR 0.4, 95% CI 0.2-0.7) and more likely to choose a method because it was available nearby (209/341, 61% versus 62/186, 33%, aOR 2.5, 95% CI 1.5-4.3), compared with women accessing certified sources. Among women presenting to hospitals in Nepal with complications following induced abortion of pregnancy, the majority had undergone medically induced abortions using unknown substances acquired from uncertified sources. Women using medications and those accessing uncertified providers were less aware that abortion is now legal in Nepal. These findings highlight the need for continued improvements in the provision and awareness of abortion services in Nepal

Household Wealth and Neurocognitive Development Disparities among School-aged Children in Nepal

PubMed Central

Patel, Shivani A; Murray-Kolb, Laura E; LeClerq, Steven C; Khatry, Subarna K; Tielsch, James M; Katz, Joanne; Christian, Parul

2013-01-01

Background Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal. Methods We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home environment, and schooling pattern. Results We observed a positive gradient in child neurocognitive performance by household wealth. After adjusting for child and household control factors, disparities between children in the highest and lowest wealth quintiles persisted in intellectual and motor function, but not executive function. No statistically significant wealth-based differentials in outcomes remained after accounting for nutritional status, home environment, and schooling patterns. The largest differences in neurocognitive development were associated with schooling pattern. Conclusions Household wealth patterns child neurocognitive development in rural Nepal, likely through its influence on nutritional status, the home environment, and schooling. In the current context, improving early and regular schooling in this setting is critical to addressing wealth-based disparities in outcomes. PMID:24118003

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.

Determinants of anemia among women and children in Nepal and Pakistan: An analysis of recent national survey data.

PubMed

Harding, Kassandra L; Aguayo, Victor M; Namirembe, Grace; Webb, Patrick

2017-08-31

Anemia remains one of the most intractable public health challenges in South Asia. This paper analyzes individual-level and household-level determinants of anemia among children and women in Nepal and Pakistan. Applying multivariate modified Poisson models to recent national survey data, we find that the prevalence of anemia was significantly higher among women from the poorest households in Pakistan (adjusted prevalence ratio [95% CI]: 1.10 [1.04-1.17]), women lacking sanitation facilities in Nepal (1.22 [1.12-1.33]), and among undernourished women (BMI < 18.5 kg/m 2 ) in both countries (Nepal: 1.10 [1.00-1.21] and Pakistan: 1.07 [1.02-1.13]). Similarly, children in both countries were more likely to be anemic if stunted (Nepal: 1.19 [1.09-1.30] and Pakistan: 1.10 [1.07-1.14]) and having an anemic mother (Nepal: 1.31 [1.20-1.42] and Pakistan: 1.21 [1.17-1.26]). Policies and programs need to target vulnerable and hard-to-reach subpopulations who continue to bear a disproportionate burden of anemia. Covariates of poverty underpin rates of anemia among children and their mothers, but income growth alone will not suffice to resolve such deeply entrenched problems. Greater understanding of the relative role of various diet, health, sanitation, and educational factors by local context should guide investments to resolve anemia in tandem with stunting and maternal underweight. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Chigger mites (Acari: Trombiculidae) from Makalu region in Nepal Himalaya, with a description of three new species.

PubMed

Daniel, M; Stekol'nikov, A A

2009-07-01

Three new species of chigger mites, Neotrombicula kounickyi sp. n., Leptotrombidium angkamii sp. n., and Doloisia vlastae sp. n., are described from two species of small mammals collected in the Barun Glacier Valley, Makalu region, Nepal Himalaya. Two species, Trombiculindus mehtai Fernandes et Kulkarni, 2003 and Cheladonta ikaoensis (Sasa et al., 1951) are recorded for the first time in Nepal. Data on altitude distribution of chiggers and their host preferences are given.

Glacial Lake Outburst Flood Risk in Nepal and Their Mitigation Practices in Nepal

NASA Astrophysics Data System (ADS)

Gurung, S.

2017-12-01

Glacial lakes in Nepal face a huge risk of Glacial Lake Outburst Flood (GLOF) due to the ongoing effects of climate change leading to considerable amount of snow and glacier melt thus weakening the natural barriers holding these high altitude glacial lakes. Nepal is at an ever growing risk every year and always waiting for an inevitable natural disaster. Since GLOF can cause extreme huge loss of human lives and physical properties, it has now become very important to design a proper mechanism which helps in reducing hazards from such events. There is little we can do to stop natural disasters, but we can implement pro-active control measures to minimize the loss. Early Warning System is the provision of timely and effective information, which allows individuals exposed to hazards to take action, avoid or reduce risk to life and property and prepare for effective response. The basic idea behind Early Warning System is that, the earlier and more accurately we are able to predict potential risks associated with natural hazards especially flood, the more likely we will be able to manage and mitigate the disasters' impact on society, economies and environment. We are currently focused on the development of early warning system for Imja Glacial Lake. The objective of developing early warning system for Imja GLOF is to help reduce economic losses and mitigate the number of injuries or deaths by providing information that allows individuals and communities downstream of Imja Lake to protect their lives and properties by using the latest and most advanced technology available. We have installed one Automatic Weather Station near the left lateral moraine of Imja Lake to study the effects of different meteorological parameters so as to predict occurrence of any GLOF event. The sensor includes pluviometer, pyranometer, temperature and humidity sensor, wind sensor, Snowdepth sensor. Two radar level sensors are installed at the outlet of Imja Lake and downstream of Imja river

Modeling the intraurban variation in nitrogen dioxide in urban areas in Kathmandu Valley, Nepal.

PubMed

Gurung, Anobha; Levy, Jonathan I; Bell, Michelle L

2017-05-01

With growing urbanization, traffic has become one of the main sources of air pollution in Nepal. Understanding the impact of air pollution on health requires estimation of exposure. Land use regression (LUR) modeling is widely used to investigate intraurban variation in air pollution for Western cities, but LUR models are relatively scarce in developing countries. In this study, we developed LUR models to characterize intraurban variation of nitrogen dioxide (NO 2 ) in urban areas of Kathmandu Valley, Nepal, one of the fastest urbanizing areas in South Asia. Over the study area, 135 monitoring sites were selected using stratified random sampling based on building density and road density along with purposeful sampling. In 2014, four sampling campaigns were performed, one per season, for two weeks each. NO 2 was measured using duplicate Palmes tubes at 135 sites, with additional information on nitric oxide (NO), NO 2 , and nitrogen oxide (NOx) concentrations derived from Ogawa badges at 28 sites. Geographical variables (e.g., road network, land use, built area) were used as predictor variables in LUR modeling, considering buffers 25-400m around each monitoring site. Annual average NO 2 by site ranged from 5.7 to 120ppb for the study area, with higher concentrations in the Village Development Committees (VDCs) of Kathmandu and Lalitpur than in Kirtipur, Thimi, and Bhaktapur, and with variability present within each VDC. In the final LUR model, length of major road, built area, and industrial area were positively associated with NO 2 concentration while normalized difference vegetation index (NDVI) was negatively associated with NO 2 concentration (R 2 =0.51). Cross-validation of the results confirmed the reliability of the model. The combination of passive NO 2 sampling and LUR modeling techniques allowed for characterization of nitrogen dioxide patterns in a developing country setting, demonstrating spatial variability and high pollution levels. Copyright © 2017

Innovative Product Development Partnership Reduced Neonatal Mortality In Nepal Through Improved Umbilical Cord Care.

PubMed

Oyloe, Peter; Khanal, Leela; Hodgins, Stephen; Pradhan, Sabita T; Dawson, Penny

2017-11-01

Approximately 40 percent of all newborn deaths in Nepal are attributable to neonatal infections. A randomized controlled trial conducted in Nepal in the period 2002-05 on the application of a solution of the disinfectant chlorhexidine to umbilical cord stumps of newborns showed a reduced risk of infections and death. In response to these results, the Government of Nepal and various partners mobilized to deliver this simple, low-cost intervention on a national scale. We describe the design, development, and maturation of a partnership among the government, technical assistance agencies, and a local pharmaceutical company to create a suitable, commercially available gel product to reduce newborn infections. Essential contributors to the partnership's effectiveness included having a for-profit pharmaceutical company as a fully engaged partner; having responsive, flexible relationships among the partners that evolved over time; and paying attention to competition within the private sector. A less formalized arrangement among partners allowed them to build trust in each other over time. Government stewardship of the program throughout the scale-up process ensured that policy and systems integration were aligned as the program matured.

Assessment of existing and potential landslide hazards resulting from the April 25, 2015 Gorkha, Nepal earthquake sequence

USGS Publications Warehouse

Collins, Brian D.; Jibson, Randall W.

2015-07-28

This report provides a detailed account of assessments performed in May and June 2015 and focuses on valley-blocking landslides because they have the potential to pose considerable hazard to many villages in Nepal. First, we provide a seismological background of Nepal and then detail the methods used for both external and in-country data collection and interpretation. Our results consist of an overview of landsliding extent, a characterization of all valley-blocking landslides identified during our work, and a description of video resources that provide high resolution coverage of approximately 1,000 kilometers (km) of river valleys and surrounding terrain affected by the Gorkha earthquake sequence. This is followed by a description of site-specific landslide-hazard assessments conducted while in Nepal and includes detailed descriptions of five noteworthy case studies. Finally, we assess the expectation for additional landslide hazards during the 2015 summer monsoon season.

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.

Fatal and non-fatal injuries due to intentional explosions in Nepal, 2008-2011: analysis of surveillance data

PubMed Central

2013-01-01

Background Nepal is one of the post-conflict countries affected by violence from explosive devices. We undertook this study to assess the magnitude of injuries due to intentional explosions in Nepal during 2008-2011 and to describe time trends and epidemiologic patterns for these events. Methods We analyzed surveillance data on fatal and non-fatal injuries due to intentional explosions in Nepal that occurred between 1 January 2008 and 31 December 2011. The case definition included casualties injured or killed by explosive devices knowingly activated by an individual or a group of individuals with the intent to harm, hurt or terrorize. Data were collected through media-based and active community-based surveillance. Results Analysis included 437 casualties injured or killed in 131 intentional explosion incidents. A decrease in the number of incidents and casualties between January 2008 and June 2009 was followed by a pronounced increase between July 2010 and June 2011. Eighty-four (19.2%) casualties were among females and 40 (9.2%) were among children under 18 years of age. Fifty-nine (45.3%) incidents involved one casualty, 47 (35.9%) involved 2 to 4 casualties, and 6 involved more than 10 casualties. The overall case-fatality ratio was 7.8%. The highest numbers of incidents occurred in streets or at crossroads, in victims’ homes, and in shops or markets. Incidents on buses and near stadiums claimed the highest numbers of casualties per incident. Socket, sutali, and pressure cooker bombs caused the highest numbers of incidents. Conclusions Intentional explosion incidents still pose a threat to the civilian population of Nepal. Most incidents are caused by small homemade explosive devices and occur in public places, and males aged 20 to 39 account for a plurality of casualties. Stakeholders addressing the explosive device problem in Nepal should continue to use surveillance data to plan interventions. PMID:23514664

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.

Climate Change and Spatiotemporal Distributions of Vector-Borne Diseases in Nepal – A Systematic Synthesis of Literature

PubMed Central

Dhimal, Meghnath; Ahrens, Bodo; Kuch, Ulrich

2015-01-01

Background Despite its largely mountainous terrain for which this Himalayan country is a popular tourist destination, Nepal is now endemic for five major vector-borne diseases (VBDs), namely malaria, lymphatic filariasis, Japanese encephalitis, visceral leishmaniasis and dengue fever. There is increasing evidence about the impacts of climate change on VBDs especially in tropical highlands and temperate regions. Our aim is to explore whether the observed spatiotemporal distributions of VBDs in Nepal can be related to climate change. Methodology A systematic literature search was performed and summarized information on climate change and the spatiotemporal distribution of VBDs in Nepal from the published literature until December2014 following providing items for systematic review and meta-analysis (PRISMA) guidelines. Principal Findings We found 12 studies that analysed the trend of climatic data and are relevant for the study of VBDs, 38 studies that dealt with the spatial and temporal distribution of disease vectors and disease transmission. Among 38 studies, only eight studies assessed the association of VBDs with climatic variables. Our review highlights a pronounced warming in the mountains and an expansion of autochthonous cases of VBDs to non-endemic areas including mountain regions (i.e., at least 2,000 m above sea level). Furthermore, significant relationships between climatic variables and VBDs and their vectors are found in short-term studies. Conclusion Taking into account the weak health care systems and difficult geographic terrain of Nepal, increasing trade and movements of people, a lack of vector control interventions, observed relationships between climatic variables and VBDs and their vectors and the establishment of relevant disease vectors already at least 2,000 m above sea level, we conclude that climate change can intensify the risk of VBD epidemics in the mountain regions of Nepal if other non-climatic drivers of VBDs remain constant. PMID

The 2015 Nepal Earthquake(s): Lessons Learned From the Disability and Rehabilitation Sector's Preparation for, and Response to, Natural Disasters.

PubMed

Landry, Michel D; Sheppard, Phillip S; Leung, Kit; Retis, Chiara; Salvador, Edwin C; Raman, Sudha R

2016-11-01

The frequency of natural disasters appears to be mounting at an alarming rate, and the degree to which people are surviving such traumatic events also is increasing. Postdisaster survival often triggers increases in population and individual disability-related outcomes in the form of impairments, activity limitations, and participation restrictions, all of which have an important impact on the individual, his or her family, and their community. The increase in postdisaster disability-related outcomes has provided a rationale for the increased role of the disability and rehabilitation sector's involvement in emergency response, including physical therapists. A recent major earthquake that has drawn the world's attention occurred in the spring of 2015 in Nepal. The response of the local and international communities was large and significant, and although the collection of complex health and disability issues have yet to be fully resolved, there has been a series of important lessons learned from the 2015 Nepal earthquake(s). This perspective article outlines lessons learned from Nepal that can be applied to future disasters to reduce overall disability-related outcomes and more fully integrate rehabilitation in preparation and planning. First, information is presented on disasters in general, and then information is presented that focuses on the earthquake(s) in Nepal. Next, field experience in Nepal before, during, and after the earthquake is described, and actions that can and should be adopted prior to disasters as part of disability preparedness planning are examined. Then, the emerging roles of rehabilitation providers such as physical therapists during the immediate and postdisaster recovery phases are discussed. Finally, approaches are suggested that can be adopted to "build back better" for, and with, people with disabilities in postdisaster settings such as Nepal. © 2016 American Physical Therapy Association.

Fatality rates of the M w ~8.2, 1934, Bihar-Nepal earthquake and comparison with the April 2015 Gorkha earthquake

NASA Astrophysics Data System (ADS)

Sapkota, Soma Nath; Bollinger, Laurent; Perrier, Frédéric

2016-03-01

Large Himalayan earthquakes expose rapidly growing populations of millions of people to high levels of seismic hazards, in particular in northeast India and Nepal. Calibrating vulnerability models specific to this region of the world is therefore crucial to the development of reliable mitigation measures. Here, we reevaluate the >15,700 casualties (8500 in Nepal and 7200 in India) from the M w ~8.2, 1934, Bihar-Nepal earthquake and calculate the fatality rates for this earthquake using an estimation of the population derived from two census held in 1921 and 1942. Values reach 0.7-1 % in the epicentral region, located in eastern Nepal, and 2-5 % in the urban areas of the Kathmandu valley. Assuming a constant vulnerability, we obtain, if the same earthquake would have repeated in 2011, fatalities of 33,000 in Nepal and 50,000 in India. Fast-growing population in India indeed must unavoidably lead to increased levels of casualty compared with Nepal, where the population growth is smaller. Aside from that probably robust fact, extrapolations have to be taken with great caution. Among other effects, building and life vulnerability could depend on population concentration and evolution of construction methods. Indeed, fatalities of the April 25, 2015, M w 7.8 Gorkha earthquake indicated on average a reduction in building vulnerability in urban areas, while rural areas remained highly vulnerable. While effective scaling laws, function of the building stock, seem to describe these differences adequately, vulnerability in the case of an M w >8.2 earthquake remains largely unknown. Further research should be carried out urgently so that better prevention strategies can be implemented and building codes reevaluated on, adequately combining detailed ancient and modern data.

Land Clearing on the Himalayan Lower Slopes, Nepal

NASA Technical Reports Server (NTRS)

1989-01-01

This view of the Himalayan Mountain Range, Nepal (28.5N, 82.5E) shows a portion of the mountains and lower valleys filled with smoke from fires set among the subtropical temperate rainforests and alpine slope forests. Some valleys are entirely filled with smoke palls and over fifty individual point sources of burning can be delineated in this scene. These pristine forests are threatened by intensive agriculture and land clearing processes.

Nepal: Political Developments and Bilateral Relations with the United States

DTIC Science & Technology

2008-10-23

between two Asian giants — India and China — has severely constrained its foreign policy and trade options. Although Nepal has sought to maintain...friendly relations with both neighbors, its cultural, linguistic, religious and economic ties with India historically have been much closer than those...10 U.S. Foreign Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 India

Menstruation and Education in Nepal. NBER Working Paper No. 14853

ERIC Educational Resources Information Center

Oster, Emily; Thornton, Rebecca

2009-01-01

This paper presents the results from a randomized evaluation that distributed menstrual cups (menstrual sanitary products) to adolescent girls in rural Nepal. Girls in the study were randomly allocated a menstrual cup for use during their monthly period and were followed for fifteen months to measure the effects of having modern sanitary products…

Effects of Variety and Postharvest Handling Practices on Microbial Population at Different Stages of the Value Chain of Fresh Tomato (Solanum lycopersicum) in Western Terai of Nepal.

PubMed

Khadka, Ram B; Marasini, Madan; Rawal, Ranjana; Gautam, Durga M; Acedo, Antonio L

2017-01-01

Background . Fresh vegetables such as tomato should have low microbial population for safe consumption and long storage life. The aerobic bacterial count (ABC) and coliform bacterial count (CBC), yeast, and mold population are the most widely used microbial indicators in fresh vegetables which should be lower than 4 log CFU g -1 for safe consumption. The stages of the supply chain, postharvest handling methods, and crop varieties had significant effects on microbial population. ABC, CBC, yeast, and mold population were significantly highest ( P < 0.05) at retail market (5.59, 4.38, 2.60, and 3.14 log CFU g -1 , resp.), followed by wholesale market (4.72, 4.71, 2.43, and 2.44 log CFU g -1 , resp.), and were least at farm gate (3.89, 3.63, 2.38, and 2.03 log CFU g -1 , resp.). Improved postharvest practices (washing in clean water and grading and packaging in clean plastic crate) helped to reduce ABC, CBC, and mold population by 2.51, 32.70, and 29.86 percentage as compared to the conventional method (no washing and no grading and packaging in mud plastered bamboo baskets). Among varieties, Pusa ruby had the lowest microbial load of 2.58, 4.53, 0.96, and 1.77 log CFU g -1 for ABC, CBC, yeast, and mold count, respectively. Significantly negative correlation ( P < 0.05) was observed between fruit pH & ABC and pH & mold count. Although the microbial quality of fresh tomato is safe in the local market of western Terai of Nepal both in conventional and in improved practices however still it is essential to follow improved postharvest handling practices in production and marketing of newly introduced tomato cultivars (high-pH cultivars) for ensuring the safe availability of fresh tomato in the market.

Effects of Variety and Postharvest Handling Practices on Microbial Population at Different Stages of the Value Chain of Fresh Tomato (Solanum lycopersicum) in Western Terai of Nepal

PubMed Central

Marasini, Madan; Rawal, Ranjana; Gautam, Durga M.; Acedo, Antonio L.

2017-01-01

Background. Fresh vegetables such as tomato should have low microbial population for safe consumption and long storage life. The aerobic bacterial count (ABC) and coliform bacterial count (CBC), yeast, and mold population are the most widely used microbial indicators in fresh vegetables which should be lower than 4 log CFU g−1 for safe consumption. The stages of the supply chain, postharvest handling methods, and crop varieties had significant effects on microbial population. ABC, CBC, yeast, and mold population were significantly highest (P < 0.05) at retail market (5.59, 4.38, 2.60, and 3.14 log CFU g−1, resp.), followed by wholesale market (4.72, 4.71, 2.43, and 2.44 log CFU g−1, resp.), and were least at farm gate (3.89, 3.63, 2.38, and 2.03 log CFU g−1, resp.). Improved postharvest practices (washing in clean water and grading and packaging in clean plastic crate) helped to reduce ABC, CBC, and mold population by 2.51, 32.70, and 29.86 percentage as compared to the conventional method (no washing and no grading and packaging in mud plastered bamboo baskets). Among varieties, Pusa ruby had the lowest microbial load of 2.58, 4.53, 0.96, and 1.77 log CFU g−1 for ABC, CBC, yeast, and mold count, respectively. Significantly negative correlation (P < 0.05) was observed between fruit pH & ABC and pH & mold count. Although the microbial quality of fresh tomato is safe in the local market of western Terai of Nepal both in conventional and in improved practices however still it is essential to follow improved postharvest handling practices in production and marketing of newly introduced tomato cultivars (high-pH cultivars) for ensuring the safe availability of fresh tomato in the market. PMID:29124068

Analysis of health sector gender equality and social inclusion strategy 2009 of Nepal.

PubMed

Mahara, G B; Dhital, S R

2014-01-01

The policy on gender equality and social inclusion (GESI) in health sector of Nepal is formulated in 2009 targeting toward poor, vulnerable, marginalized social and ethnic groups. Gender inequality and social discrimination are a social problem that affect on individual health finally. The main objective of this paper is to critically analysis and evaluates the Government's strategy on health sector gender equality and social inclusion in Nepal. We collected published and unpublished information assessing the public health, policy analysis and research needs from different sources. A different policy approaches for the analysis and evaluation of GESI strategies is applied in this paper. Universal education, community participation, individual, group and mass communication approaches, and social capital are the key aspects of effective implementation of policy at target levels.

Modeling of the strong ground motion of 25th April 2015 Nepal earthquake using modified semi-empirical technique

NASA Astrophysics Data System (ADS)

Lal, Sohan; Joshi, A.; Sandeep; Tomer, Monu; Kumar, Parveen; Kuo, Chun-Hsiang; Lin, Che-Min; Wen, Kuo-Liang; Sharma, M. L.

2018-05-01

On 25th April, 2015 a hazardous earthquake of moment magnitude 7.9 occurred in Nepal. Accelerographs were used to record the Nepal earthquake which is installed in the Kumaon region in the Himalayan state of Uttrakhand. The distance of the recorded stations in the Kumaon region from the epicenter of the earthquake is about 420-515 km. Modified semi-empirical technique of modeling finite faults has been used in this paper to simulate strong earthquake at these stations. Source parameters of the Nepal aftershock have been also calculated using the Brune model in the present study which are used in the modeling of the Nepal main shock. The obtained value of the seismic moment and stress drop is 8.26 × 1025 dyn cm and 10.48 bar, respectively, for the aftershock from the Brune model .The simulated earthquake time series were compared with the observed records of the earthquake. The comparison of full waveform and its response spectra has been made to finalize the rupture parameters and its location. The rupture of the earthquake was propagated in the NE-SW direction from the hypocenter with the rupture velocity 3.0 km/s from a distance of 80 km from Kathmandu in NW direction at a depth of 12 km as per compared results.

Household wealth and neurocognitive development disparities among school-aged children in Nepal.

PubMed

Patel, Shivani A; Murray-Kolb, Laura E; LeClerq, Steven C; Khatry, Subarna K; Tielsch, James M; Katz, Joanne; Christian, Parul

2013-11-01

Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal. We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home environment, and schooling pattern. We observed a positive gradient in child neurocognitive performance by household wealth. After adjusting for child and household control factors, disparities between children in the highest and lowest wealth quintiles persisted in intellectual and motor function, but not executive function. No statistically significant wealth-based differentials in outcomes remained after accounting for nutritional status, home environment, and schooling patterns. The largest differences in neurocognitive development were associated with schooling pattern. Household wealth patterns child neurocognitive development in rural Nepal, likely through its influence on nutritional status, the home environment, and schooling. In the current context, improving early and regular schooling in this setting is critical to addressing wealth-based disparities in outcomes. © 2013 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.

A review of conservation legislation in Nepal: Past progress and future needs

NASA Astrophysics Data System (ADS)

Heinen, Joel T.; Kattel, Bijaya

1992-11-01

Nepal is considered a leader among developing nations with regard to conservation legislation and programs; it was among the first Asian nations to develop national conservation legislation, sign CITES, and develop a national conservation strategy. We review the history of modern conservation law in Nepal from the Rana period (early 1950s) to the present. The early legislation focused mainly on strict preservation of areas and species; this phase culminated in the National Parks and Wildlife Conservation Act of 1973. Subsequent legislation has evolved more in the direction of an integrated, holistic approach to conservation and is beginning to incorporate the participation of local people; subsequent amendments to the 1973 act allowed greater rights to rural villagers, and the designation of conservation areas in addition to the more strictly defined protected areas (national parks, wildlife reserves, etc.). Our review of conservation legislation suggests that Nepal has had many successes to date; the country has a protected area system covering over 10% of its land area, and many target species are recovering in parks and reserves. There are also some causes of concern, including staff shortages, financial constraints within the Department of National Parks and Wildlife Conservation, and the fact that there is little legal infrastructure outside of protected areas to enforce conservation laws; further, some aspects of hunting regulations are in need of revision. Primary needs include a comprehensive review of these policies and a nationalized strategy to ameliorate the shortcomings.

Spatial-Temporal Analysis of Social Media Data Related to Nepal Earthquake 2015

NASA Astrophysics Data System (ADS)

Thapa, L.

2016-06-01

Social Medias these days have become the instant communication platform to share anything; from personal feelings to the matter of public concern, these are the easiest and aphoristic way to deliver information among the mass. With the development of Web 2.0 technologies, more and more emphasis has been given to user input in the web; the concept of Geoweb is being visualized and in the recent years, social media like Twitter, Flicker are among the popular Location Based Social Medias with locational functionality enabled in them. Nepal faced devastating earthquake on 25 April, 2015 resulting in the loss of thousands of lives, destruction in the historical-archaeological sites and properties. Instant help was offered by many countries around the globe and even lots of NGOs, INGOs and people started the rescue operations immediately; concerned authorities and people used different communication medium like Frequency Modulation Stations, Television, and Social Medias over the World Wide Web to gather information associated with the Quake and to ease the rescue activities. They also initiated campaign in the Social Media to raise the funds and support the victims. Even the social medias like Facebook, Twitter, themselves announced the helping campaign to rebuild Nepal. In such scenario, this paper features the analysis of Twitter data containing hashtag related to Nepal Earthquake 2015 together with their temporal characteristics, when were the message generated, where were these from and how these spread spatially over the internet?

The Burden of Parasitic Zoonoses in Nepal: A Systematic Review

PubMed Central

Devleesschauwer, Brecht; Ale, Anita; Torgerson, Paul; Praet, Nicolas; Maertens de Noordhout, Charline; Pandey, Basu Dev; Pun, Sher Bahadur; Lake, Rob; Vercruysse, Jozef; Joshi, Durga Datt; Havelaar, Arie H.; Duchateau, Luc; Dorny, Pierre; Speybroeck, Niko

2014-01-01

Background Parasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding. Methodology We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs. Principal Findings Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI): 5450–27,694] and 9255 DALYs [95% CrI: 6135–13,292], respectively), followed by cystic echinococcosis (251 DALYs [95% CrI: 105–458]). Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur. Conclusions/Significance In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this

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.

The 2015 Nepal earthquake disaster: lessons learned one year on.

PubMed

Hall, M L; Lee, A C K; Cartwright, C; Marahatta, S; Karki, J; Simkhada, P

2017-04-01

The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a further 2 million. One year later, a national workshop was organized with various Nepali stakeholders involved in the response to the earthquake. The workshop provided participants an opportunity to reflect on their experiences and sought to learn lessons from the disaster. One hundred and thirty-five participants took part and most had been directly involved in the earthquake response. They included representatives from the Ministry of Health, local and national government, the armed forces, non-governmental organizations, health practitioners, academics, and community representatives. Participants were divided into seven focus groups based around the following topics: water, sanitation and hygiene, hospital services, health and nutrition, education, shelter, policy and community. Facilitated group discussions were conducted in Nepalese and the key emerging themes are presented. Participants described a range of issues encountered, some specific to their area of expertize but also more general issues. These included logistics and supply chain challenges, leadership and coordination difficulties, impacts of the media as well as cultural beliefs on population behaviour post-disaster. Lessons identified included the need for community involvement at all stages of disaster response and preparedness, as well as the development of local leadership capabilities and community resilience. A 'disconnect' between disaster management policy and responses was observed, which may result in ineffective, poorly planned disaster response. Finding time and opportunity to reflect on and identify lessons from disaster response can be difficult but are fundamental to improving future disaster preparedness. The Nepal Earthquake National Workshop offered participants the space to do this. It garnered an overwhelming sense of wanting to do things better, of the need for a Nepal-centric approach

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue.

PubMed

Colombini, Manuela; Mayhew, Susannah H; Hawkins, Ben; Bista, Meera; Joshi, Sunil Kumar; Schei, Berit; Watts, Charlotte

2016-05-01

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions

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

Synoptic Conditions and Moisture Sources Actuating Extreme Precipitation in Nepal

NASA Astrophysics Data System (ADS)

Bohlinger, Patrik; Sorteberg, Asgeir; Sodemann, Harald

2017-12-01

Despite the vast literature on heavy-precipitation events in South Asia, synoptic conditions and moisture sources related to extreme precipitation in Nepal have not been addressed systematically. We investigate two types of synoptic conditions—low-pressure systems and midlevel troughs—and moisture sources related to extreme precipitation events. To account for the high spatial variability in rainfall, we cluster station-based daily precipitation measurements resulting in three well-separated geographic regions: west, central, and east Nepal. For each region, composite analysis of extreme events shows that atmospheric circulation is directed against the Himalayas during an extreme event. The direction of the flow is regulated by midtropospheric troughs and low-pressure systems traveling toward the respective region. Extreme precipitation events feature anomalous high abundance of total column moisture. Quantitative Lagrangian moisture source diagnostic reveals that the largest direct contribution stems from land (approximately 75%), where, in particular, over the Indo-Gangetic Plain moisture uptake was increased. Precipitation events occurring in this region before the extreme event likely provided additional moisture.

Negotiating geophysical hazards in Nepal: An interdisciplinary approach

NASA Astrophysics Data System (ADS)

Oven, Katie; Petley, Dave; Rosser, Nick; Dunn, Chris; Rigg, Jonathan

2010-05-01

It is widely accepted that the impact of natural hazards reflects not only the nature of geophysical processes but also the social conditions that prevail. The need for collaborative research to address these complex interactions between the natural and human systems is well recognised, however moving from theory to practice presents a number of significant challenges. How researchers frame problems; develop their research questions; select the methodologies to explore these questions; and privilege certain knowledges over others, can be seen to vary between physical and social science. Drawing on a case study examining the vulnerability of rural communities to landslides in the Upper Bhote Koshi Valley, Central Nepal, this paper explores how these barriers can be overcome and the benefits of undertaking interdisciplinary research within the natural hazards field. This research investigates the different framings of landslide risk and vulnerability from different stakeholder and disciplinary perspectives. Specifically, we ask: 1. Who is vulnerable to landslide hazard? 2. Why do people occupy landslide prone areas? 3. How do ‘at risk' rural communities perceive and respond to landslide hazard and risk? The findings, based on a series of participatory methodologies, challenge a number of assumptions made regarding landslide vulnerability in mountain communities. Within the Upper Bhote Koshi Valley clear transitions in settlement patterns, rural livelihoods and thus the occupation of landslide prone areas have been seen over time. For the majority of households, their decision to occupy these areas is driven by the economic and social benefits associated with the Arniko Highway which runs through the valley, linking Nepal with Tibet. Landslide vulnerability therefore emerges not just from societal marginalisation but also from situations of relative prosperity. The findings suggest that occupants of landslide prone areas have a good understanding of landslide hazard

Human resources for refraction services in Central Nepal.

PubMed

Kandel, Himal; Murthy, G V S; Bascaran, Covadonga

2015-07-01

Uncorrected refractive error is a public health problem globally and in Nepal. Planning of refraction services is hampered by a paucity of data. This study was conducted to determine availability and distribution of human resources for refraction, their efficiency, the type and extent of their training; the current service provision of refraction services and the unmet need in human resources for refraction in Central Nepal. This was a descriptive cross-sectional study. All refraction facilities in the Central Region were identified through an Internet search and interviews of key informants from the professional bodies and parent organisations of primary eye centres. A stratified simple random sampling technique was used to select 50 per cent of refraction facilities. The selected facilities were visited for primary data collection. Face-to-face interviews were conducted with the managers and the refractionists available in the facilities using a semi-structured questionnaire. Data was collected in 29 centres. All the managers (n=29; response rate 100 per cent) and 50 refractionists (Response rate 65.8 per cent) were interviewed. Optometrists and ophthalmic assistants were the main providers of refraction services (n=70, 92.11 per cent). They were unevenly distributed across the region, highly concentrated around urban areas. The median number of refractions per refractionist per year was 3,600 (IQR: 2,400 - 6,000). Interviewed refractionists stated that clients' knowledge, attitude and practice related factors such as lack of awareness of the need for refraction services and/or availability of existing services were the major barriers to the output of refraction services. The total number of refractions carried out in the Central Region per year was 653,176. An additional 170 refractionists would be needed to meet the unmet need of 1,323,234 refractions. The study findings demand a major effort to develop appropriately trained personnel when planning

Current status of brown bears in the Manasalu Conservation Area, Nepal

USGS Publications Warehouse

Aryal, Achyut; Sathyakumar, S.; Schwartz, Charles C.

2010-01-01

Although brown bears (Ursus arctos) are rare in the Himalayan region, populations have been documented in alpine habitats of Pakistan and India. Brown bears were once known to exist in both Nepal and Bhutan, but current information on their numbers and distributions was lacking. We document the presence of brown bears in the Manasalu Conservation Area (MCA) in Nepal using field surveys and interviews with local people. We were able to confirm the existence of a remnant population based on finding bear scat and locations where bears excavated for Himalayan marmots (Marmota himalayana). Based on interviews with local people, it appeared that the presence of brown bears in the area is relatively recent and likely a result of immigration of bears from the Tibetan Autonomous Region. Interviews with local herders also indicated that livestock losses from brown bear predation amounted to approximately 318,000 Nepali rupees (US $4,240) from February 2006 through July 2008.

Molecular characterization of Mycobacterium tuberculosis isolates from elephants of Nepal.

PubMed

Paudel, Sarad; Mikota, Susan K; Nakajima, Chie; Gairhe, Kamal P; Maharjan, Bhagwan; Thapa, Jeewan; Poudel, Ajay; Shimozuru, Michito; Suzuki, Yasuhiko; Tsubota, Toshio

2014-05-01

Mycobacterium tuberculosis was cultured from the lung tissues of 3 captive elephants in Nepal that died with extensive lung lesions. Spoligotyping, TbD1 detection and multi-locus variable number of tandem repeat analysis (MLVA) results suggested 3 isolates belonged to a specific lineage of Indo-Oceanic clade, EAI5 SIT 138. One of the elephant isolates had a new synonymous single nucleotide polymorphism (SNP) T231C in the gyrA sequence, and the same SNP was also found in human isolates in Nepal. MLVA results and transfer history of the elephants suggested that 2 of them might be infected with M. tuberculosis from the same source. These findings indicated the source of M. tuberculosis infection of those elephants were local residents, presumably their handlers. Further investigation including detailed genotyping of elephant and human isolates is needed to clarify the infection route and eventually prevent the transmission of tuberculosis to susceptible hosts. Copyright © 2014 Elsevier Ltd. All rights reserved.

Enhancing NGO capacity in HIV / AIDS materials development: experiences from Nepal.

PubMed

Frey, M; Pyakuryal, N

1995-07-01

With the goal of improving the communication skills of Nepali nongovernmental organizations (NGO) involved in HIV/AIDS prevention programs and activities, Save the Children, US (SC/US) invited 12 leading NGOs in HIV/AIDS prevention to attend an information, education, and communication (IEC) workshop at the end of 1993 addressing the principles of materials development and how the groups could coordinate their activities and improve the quality of materials developed. The Nepal NGO HIV/AIDS IEC Coordination Committee resulted. 17 organizations now comprise the committee which has reviewed and commented upon 60 draft educational materials developed by member organizations and other NGOs working in more remote areas of the country. The committee has proved to be a good forum for improving materials development and distribution in Nepal and for providing technical assistance to the NGO community. NGO communication skills have increased markedly. The group has also facilitated the transfer of technical skills, coordination, and resource allocation.

Downscaling GLOF Hazards: An in-depth look at the Nepal Himalaya

NASA Astrophysics Data System (ADS)

Rounce, D.; McKinney, D. C.; Lala, J.

2016-12-01

The Nepal Himalaya house a large number of glacial lakes that pose a flood hazard to downstream communities and infrastructure. The modeling of the entire process chain of these glacial lake outburst floods (GLOFs) has been advancing rapidly in recent years. The most common cause of failure is mass movement entering the glacial lake, which triggers a tsunami-like wave that breaches the terminal moraine and causes the ensuing downstream flood. Unfortunately, modeling the avalanche, the breach of the moraine, and the downstream flood requires a large amount of site-specific information and can be very labor-intensive. Therefore, these detailed models need to be paired with large-scale hazard assessments that identify the glacial lakes that are the biggest threat and the triggering events that threaten these lakes. This study discusses the merger of a large-scale, remotely-based hazard assessment with more detailed GLOF models to show how GLOF hazard modeling can be downscaled in the Nepal Himalaya.

Evaluation of impact of earthquake on agriculture in Nepal based on remote sensing

NASA Astrophysics Data System (ADS)

Sekiyama, Ayako; Shimada, Sawahiko; Okazawa, Hiromu; Mihara, Machito; Kuo, Kuang Ting

2016-07-01

The big earthquake happening on April, 2015 killed over than 8000 people in Nepal. The effect of earthquake not only affected safety of local people but also agricultural field. Agricultural economy dominates income of local people. Therefore, restoration of agricultural areas are required for improving life of local people. However, lack of information about agricultural areas is main problem for local government to assess and restore damaged agricultural areas. Remote sensing was applied for accessing damaged agricultural field due to its advantages in observing responds of environment without temporal and spatial restriction. Accordingly, the objective of the study is to evaluate impact of earthquake on agriculture in Nepal based on remote sensing. The experimental procedure includes conducting the impact of earthquake on changes of total agricultural area, and analysis of response of greenness affected by earthquake in agricultural land. For conducting agricultural land changes, land use map was first created and classified into four categories: road, city, forest, and agricultural land. Changes before and after earthquake in total area of agricultural land were analyzed by GIS. Moreover, vegetation index was used as indicator for evaluating greenness responds in agricultural land and computed based on high-resolution satellite imagery such as World view-3. Finally, the conclusion of the study and suggestions will be made and provided for helping local government in Nepal restore agricultural areas.

Predictors of healthcare seeking delays among children with chronic musculoskeletal disorders in Nepal.

PubMed

LeBrun, Drake G; Talwar, Divya; Pham, Tuyetnhi A; Banskota, Bibek; Spiegel, David A

2017-12-01

Healthcare seeking behaviors among children with musculoskeletal disorders are poorly understood. We sought to analyze healthcare seeking delays among children with chronic musculoskeletal conditions in Nepal and identify predictors of clinically significant delays. A cross-sectional study was conducted at a large pediatric musculoskeletal rehabilitation center in Nepal. Baseline sociodemographic data and healthcare seeking behaviors were assessed via interviews with 75 randomly selected caregivers. Delays of at least 3 months between disease recognition and presentation to a health worker were considered clinically significant. Predictors of significant delay were assessed via multivariable logistic regression. Clubfoot was the most common condition seen in the study sample (N = 33; 37%). Mean and median presentation delays were 33 months and 14 months, respectively. Sixty-seven percent of children were delayed at least 3 months and 40% were delayed at least 2 years. Caregiver occupation in agriculture or unskilled labor was associated with an increased risk of delayed presentation (adjusted OR = 4.05; 95% CI: 1.36-12.09). Children with chronic musculoskeletal disorders in Nepal face significant delays in accessing healthcare. This poses a major clinical problem as the delayed diagnosis and treatment of childhood musculoskeletal disorders can complicate management options and decrease long-term quality of life. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Challenges constraining insulin access in Nepal-a country with no local insulin production.

PubMed

Sharma, Abhishek; Bhandari, Parash Mani; Neupane, Dipika; Kaplan, Warren A; Mishra, Shiva Raj

2018-05-01

Nepal is facing an increasing burden of diabetes and relies almost entirely on insulin imported through India. We employed a modified version of the WHO/Health Action International standard survey to assess insulin availability and prices, along with qualitative interviews with insulin retailers (pharmacists) and wholesalers in the Kathmandu Valley, Nepal. The mean availability of the two human insulins listed on the 2011 Nepal Essential Medicine List were 14.3% and 42.85% in the surveyed private- and public-sector pharmacies, respectively, compared with the WHO target of 80% availability. The median consumer price of human insulin cartridges, analogue insulin cartridges and pens was, respectively, 2.1, 4.6 and 5.3 times that of human insulin vials (US$5.54). The insulin cartridges made in India were less expensive (p<0.001) than those made elsewhere. The lowest-paid worker would need to spend between 3 and 17 days' wages to purchase a monthly insulin supply out of pocket. Insulin access is limited in Kathmandu owing to low availability and the highly unaffordable price. Insulin access could improve with the government exploring additional suppliers, pooling insulin tenders, auditing insulin utilization and developing independent prescribing guidelines. Furthermore, there is a need to educate physicians and develop a consensus statement on insulin initiation to curb the growing analogue use and promote rational use.

Vulnerability and impacts of climate change on forest and freshwater wetland ecosystems in Nepal: A review.

PubMed

Lamsal, Pramod; Kumar, Lalit; Atreya, Kishor; Pant, Krishna Prasad

2017-12-01

Climate change (CC) threatens ecosystems in both developed and developing countries. As the impacts of CC are pervasive, global, and mostly irreversible, it is gaining worldwide attention. Here we review vulnerability and impacts of CC on forest and freshwater wetland ecosystems. We particularly look at investigations undertaken at different geographic regions in order to identify existing knowledge gaps and possible implications from such vulnerability in the context of Nepal along with available adaptation programs and national-level policy supports. Different categories of impacts which are attributed to disrupting structure, function, and habitat of both forest and wetland ecosystems are identified and discussed. We show that though still unaccounted, many facets of forest and freshwater wetland ecosystems of Nepal are vulnerable and likely to be impacted by CC in the near future. Provisioning ecosystem services and landscape-level ecosystem conservation are anticipated to be highly threatened with future CC. Finally, the need for prioritizing CC research in Nepal is highlighted to close the existing knowledge gap along with the implementation of adaptation measures based on existing location specific traditional socio-ecological system.

World Bank in Nepal's Education: Three Decades of Neoliberal Reform

ERIC Educational Resources Information Center

Regmi, Kapil Dev

2017-01-01

This paper critically analyses key educational policy documents produced by the World Bank mainly from the mid-1980s to 2010 with regard to implementing major educational projects in Nepal. Using critical policy sociology as a methodological tool, the paper explores how a small Himalayan nation with per capita income of about US$730 (2014) plunged…

Literacy, Power, and Agency: Love Letters and Development in Nepal

ERIC Educational Resources Information Center

Ahearn, Laura M.

2004-01-01

In this paper, a case study of women's incipient literacy in Junigau, Nepal, I argue that literacy can be both a catalyst for social change and a result of numerous other types of social transformation. The increase in female literacy rates in Junigau in the 1990s made possible the emergence of new courtship practices involving love letters and…

Corporal Punishment in Private Schools: The Case of Kathmandu, Nepal

ERIC Educational Resources Information Center

Khanal, Jeevan; Park, Sae-Hoon

2016-01-01

The purpose of this study was to elaborate the situation of corporal punishment which is being practiced in Nepalese schools going against new policies that promote the non-violence teaching. It was based on original qualitative study of one private school of Kathmandu (the capital city of Nepal) having more than 2000 students and 100 teachers.…

Political violence and mental health: a multi-disciplinary review of the literature on Nepal.

PubMed

Tol, Wietse A; Kohrt, Brandon A; Jordans, Mark J D; Thapa, Suraj B; Pettigrew, Judith; Upadhaya, Nawaraj; de Jong, Joop T V M

2010-01-01

Implementation of current international consensus guidelines regarding mental health and psychosocial support in emergencies requires the consideration of findings from both the medical and social sciences. This paper presents a multi-disciplinary review of reported findings regarding the relations between political violence, mental health and psychosocial wellbeing in Nepal. A systematic search of six databases resulted in the identification of 572 studies, of which 44 were included in the review. These studies investigated the influence of political violence on contextual variables that shape mental health and psychosocial wellbeing, and examined psychological distress and mental disorders in the context of political violence. The majority of studies addressed the mental health of Bhutanese refugees in Nepal and the impact of the Maoist People's War. Based upon these results from Nepal, we discuss a number of issues of concern to international researchers and practitioners and present policy and research recommendations. Specifically, we consider (a) the need for longitudinal multi-disciplinary research into protective and risk factors, including agency, of psychological distress and mental disorders in situations of political violence, (b) the continuing controversy regarding the PTSD construct, and (c) the lack of robust findings regarding the effectiveness of mental health and psychosocial support.

Human rights violations among sexual and gender minorities in Kathmandu, Nepal: a qualitative investigation.

PubMed

Singh, Sonal; Pant, Sunil Babu; Dhakal, Suben; Pokhrel, Subash; Mullany, Luke C

2012-05-16

Nepal has experienced sporadic reports of human rights violations among sexual and gender minorities. Our objective was to identify a range of human rights that are enshrined in international law and/or are commonly reported by sexual and gender minority participants in Kathmandu, to be nonprotected or violated. In September 2009 three focus group discussions were conducted by trained interviewers among a convenience sample of sexual and gender minority participants in Kathmandu Nepal. The modified Delphi technique was utilized to elicit and rank participant-generated definitions of human rights and their subsequent violations. Data was analyzed independently and cross checked by another investigator. Participants (n = 29) reported experiencing a range of human rights violations at home, work, educational, health care settings and in public places. Lack of adequate legal protection, physical and mental abuse and torture were commonly reported. Access to adequate legal protection and improvements in the family and healthcare environment were ranked as the most important priority areas. Sexual and gender minorities in Nepal experienced a range of human rights violations. Future efforts should enroll a larger and more systematic sample of participants to determine frequency, timing, and/or intensity of exposure to rights violations, and estimate the population-based impact of these rights violations on specific health outcomes.

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

Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study from Nepal.

PubMed

Shrestha, Archana; Pyakurel, Prajjwal; Shrestha, Abha; Gautam, Rabin; Manandhar, Nisha; Rhodes, Elizabeth; Tamrakar, Dipesh; Karmacharya, Biraj Man; Malik, Vasanti; Mattei, Josiemer; Spiegelman, Donna

2017-01-01

Worksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate healthy food choices. The study explored perceptions about healthy eating as well as potential facilitators and barriers to healthy eating among employees in a wire manufacturing factory in Nepal. We conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method. Most employees defined healthy eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to healthy eating included unavailability of healthy foods, difficulty in changing eating habits, the preference for fried foods in Nepali culture and the high costs of some healthy foods. The most commonly reported facilitator of healthy eating was the availability of affordable healthy food options in worksite cafeterias. Availability of healthy food options at an affordable price could lead to healthier food choices in the worksite.

Assessment of impacts of climate change on gender in the context of Nepal

NASA Astrophysics Data System (ADS)

Paudel, R.; Acharya, A.

2016-12-01

Climate change and its impact on gender in the context of Nepal has not been clearly understood due to lack of proper scientific research in terms of gender and climate change. Climate induced disasters such as droughts, floods, GLOFs, and landslides affect men and women differently. This study is conducted to analyze the scenario of gender equality, and impacts of climate change on gender in Nepal. This study also identifies gender based adaptation approaches through the use of observed climate data, and projected and modeled demographic data such as Adolescent Fertility Rate, Labor Force Participation Rate, and Maternal Mortality Ratio. The major tasks of this project include the calculation of Gender Inequality Index (GII), trend analysis and correlation between GII and temperature, that helps to evaluate the women vulnerability and identify the gender based adaptation interventions in Nepal. The required data on gender and temperature are obtained from World Bank and Department of Hydrology and Meteorology, Nepal. GII is calculated for almost 26 years starting from the year 1990 by utilizing a tool "Calculating the Indices using Excel" provided through the UNDP. The Reproductive Health Index (RHI), Empowerment Index (EI), and Labor Market Index (LMI) that are required to determine GII are also calculated through the use of same tool. The trend analysis shows that GII follows a decreasing trend indicating higher gender equality. The correlation analysis shows the temperature positively correlated with RHI (r=0.64), EI Female (r=0.61), and EI Male (r=0.73). In case of LMI, temperature is positively correlated with female (r=0.14) and negatively correlated with male (r=-0.57). The analysis depicts negative correlation (r=-0.68) between climate change and GII. This research will provide some valuable insights in the research relating to gender and climate change that could help gender advocates and policymakers in developing further plans for women empowerment.

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

Spatial analysis of the regional variation of reproductive tract infections and spousal migration correlates in Nepal.

PubMed

Johnson, Derek C; Lhaki, Pema; Buehler Cherry, Charlotte; Kempf, Mirjam-Colette; Chamot, Eric; Vermund, Sten H; Shrestha, Sadeep

2017-05-30

Nepal has a diverse geographic landscape that could potentially create clustered subpopulations with regional socio-cultures that could result in differential health outcomes. With an alarming rise in married male populations migrating for work, it is possible that these migrants are engaged in risky sexual behaviour, putting their wives at risk for infectious disease outcomes, including reproductive tract infections (RTI), when they return home. The prevalence of male migration varies by geographic region in Nepal and this variation could potentially contribute to different RTI rates. Using a cross-sectional dataset (the 2011 Nepal Demographic and Health Survey) including 9607 married women, we investigated geospatial and socio-cultural factors associated with the symptoms of RTIs with a focus on the husbands' migration status. Choropleth maps were created to illustrate areas with high percentages of RTIs that correlated with migration patterns. Overall, 31.9% of the husbands were migrating for work. After adjusting for wealth, contraception use, age at first marriage, urban/rural status and husband's education, women whose husbands had been absent for a year or more in Nepal's Mid-West region (OR 1.93 95%, CI 1.02-3.67) or Far-West region (OR 2.89 95%, CI 1.24-6.73) were more likely to report RTI-like symptoms than others. Our results suggest a potential association between husbands' migration status and Nepali women reporting RTI symptoms by geographic regions. However, further research is needed to put this outcome on a stronger footing with respect to this under-studied population, specifically in the context of geographical variation.

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.

April 25, 2015, Gorkha Earthquake, Nepal and Sequence of Aftershocks: Key Lessons

NASA Astrophysics Data System (ADS)

Guragain, R.; Dixit, A. M.; Shrestha, S. N.

2015-12-01

The Gorkha Earthquake of M7.8 hit Nepal on April 25, 2015 at 11:56 am local time. The epicenter of this earthquake was Barpak, Gorkha, 80 km northwest of Kathmandu Valley. The main shock was followed by hundreds of aftershocks including M6.6 and M6.7 within 48 hours and M7.3 on May 12, 2015. According to the Government of Nepal, a total of 8,686 people lost their lives, 16,808 people injured, over 500,000 buildings completely collapsed and more than 250,000 building partially damaged. The National Society for Earthquake Technology - Nepal (NSET), a not-for-profit civil society organization that has been focused on earthquake risk reduction in Nepal for past 21 years, conducted various activities to support people and the government in responding to the earthquake disaster. The activities included: i) assisting people and critical facility institutions to conduct rapid visual building damage assessment including the training; ii) information campaign to provide proper information regarding earthquake safety; iii) support rescue organizations on search and rescue operations; and iv) provide technical support to common people on repair, retrofit of damaged houses. NSET is also involved in carrying out studies related to earthquake damage, geotechnical problems, and causes of building damages. Additionally, NSET has done post-earthquake detail damage assessment of buildings throughout the affected areas. Prior to the earthquake, NSET has been working with several institutions to improve seismic performance of school buildings, private residential houses, and other critical structures. Such activities implemented during the past decade have shown the effectiveness of risk reduction. Retrofitted school buildings performed very well during the earthquake. Preparedness activities implemented at community levels have helped communities to respond immediately and save lives. Higher level of earthquake awareness achieved including safe behavior, better understanding of

Local irrigation management institutions mediate changes driven by external policy and market pressures in Nepal and Thailand.

PubMed

Bastakoti, Ram C; Shivakoti, Ganesh P; Lebel, Louis

2010-09-01

This article assesses the role of local institutions in managing irrigation water use. Fifty irrigation systems in each country were studied in Nepal and Thailand to compare the influence of local institutions on performance of irrigation systems amid changes in external policy and market pressures. Nepal's new irrigation policy after the re-instatement of multiparty democracy in 1990 emphasized participatory irrigation management transferring the management responsibility from state authorities to water users. The water user associations of traditional farmer-managed irrigation systems were formally recognized by requiring registration with related state authorities. In Thailand also government policies encouraged people's participation in irrigation management. Today water users are directly involved in management of even some large irrigation systems at the level of tertiary canals. Traditional communal irrigation systems in northern Thailand received support for system infrastructure improvement but have faced increased interference from government. In Thailand market development supported diversification in farming practices resulting in increased areas under high water-demanding commercial crops in the dry season. In contrast, the command areas of most irrigation systems in Nepal include cereal-based subsistence farming with only one-third having commercial farming. Cropping intensities are higher in Nepal than in Thailand reflecting, in part, differences in availability of land and management. In both countries local institutions play an important role in maintaining the performance of irrigation systems as external drivers and local contexts change. Local institutions have provided alternative options for irrigation water use by mediating external pressures.

Nepal’s Strategic Future: Following India, or China, or Middle Road

DTIC Science & Technology

2010-12-10

Statements The policies of the Nepalese, Indian, and Chinese governments, official speeches and statements, and statistics account for a large portion......vividly portrays Nepal as a country of extraordinary contrasts, which has been constantly buffeted throughout history by China and India. He further

Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal.

PubMed

Ghimire, Laxmi; Smith, W Cairns S; van Teijlingen, Edwin R; Dahal, Rashmi; Luitel, Nagendra P

2011-09-26

Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs) and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. This paper is based on a qualitative study of Female Sex Workers (FSWs) in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients' resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO) to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work.

Adherence and Non-Adherence to Treatments: Focus on Pharmacy Practice in Nepal

PubMed Central

Bastakoti, Suresh; Khanal, Saval; Dahal, Bibek; Pun, Nirmala Tilija

2013-01-01

Nepal is one of the developing countries having many limitations in providing the quality health services to its population. In many countries, improvement in patients’ adherence to the pharmacotherapy had been one of major outcome of quality pharmaceutical services. Till date, very less thing has been done in this area in Nepal; so it seems mandatory to improve the patient adherence to the treatment plans. Adherence to the medical therapy can be explained by the extent of the behavioral coincidence to the medication and non-medication regimen by a patient whereas compliance and concordance are two different models of patient adherence to the therapy. Compliance model suggests that patients have been brought responsible for being unable to follow ‘doctor’s order and concordance tempts to measure the degree of agreement between patient and his or her clinician about the nature of illness and the best possible therapy for the welfare of the patient. Non-adherence to the therapy may lead to different problems as consequences of non-adherence in four different level- individual, institutional, societal and national levels. Although some programs like, “Direct Observation Treatment, Short-course (DOTS) for tuberculosis, implementation of antiretroviral treatment schedules for HIV patients and pediatric vaccination models,” are the examples of attention towards the cases of noncompliance in Nepal. It has long been faced its limitations in the forms of either untrained manpower or lack of good documentation of patients’ adherence to therapy or high illiteracy rate or unaffordibility of patients to their treatment or lack of pharmaceutical care services. PMID:23730670

Allele frequency distribution for 21 autosomal STR loci in Nepal.

PubMed

Kraaijenbrink, T; van Driem, G L; Opgenort, J R M L; Tuladhar, N M; de Knijff, P

2007-05-24

The allele frequency distributions of 21 autosomal loci contained in the AmpFlSTR Identifiler, the Powerplex 16 and the FFFL multiplex PCR kits, was studied in 953 unrelated individuals from Nepal. Several new alleles (i.e. not yet reported in the NIST Short Tandem Repeat DNA Internet DataBase [http://www.cstl.nist.gov/biotech/strbase/]) have been detected in the process.

Severe Hailstorm in Nepal: A case study

NASA Astrophysics Data System (ADS)

Aryal, D.

2017-12-01

During the pre-monsoon months (March-May) in Nepal, severe thunder and hailstorms cause significant property and agricultural damage in addition to loss of life from lightening. Forecasting thunderstorm severity remains a challenge even in wealthy, developed countries that have modern meteorological data gathering infrastructure, such as Doppler Radar. This study attempts to isolate the specific and unique characteristics of a hailstorm that not only might explain its severity, but also suggest forecasting techniquees for future forecasting in Nepal. The primary data sources for this investigation included Infrared Satellite images, which illustrated the sequences of convective activity, and original archived ESRL India and China upper air data, which was used for synoptic and mesoscale analyses. On May 3, 2001 between the hours of 1100pm and midnight, a severe thunderstorm accompanied by hail stones estimated at 1kg, devastated the village of Thori (Southern border to India). 800 thatched houses were destroyed, over 500 farm animals were killed and more than 200 hectares of crops lost. Many inhabitants were injured, but luckily only one death. Thori hailstorm had its origins in a topographically induced lee-side convergence area in the deserts of Pakistan on May 2, 2001, from where it propagated eastwards into India and evolved into an eastward travelling Mesoscale Convective System reaching Thori near midnight on May 3. Atmospheric instability over the Gangetic Plains, fuelled by a very active surface heat low, cold temperatures and dynamic lifting mechanisms aloft, created a synoptic and mesoscale environment capable of generating a dangerous thunderstorm.

Municipal solid waste generation in Kathmandu, Nepal.

PubMed

Dangi, Mohan B; Pretz, Christopher R; Urynowicz, Michael A; Gerow, Kenneth G; Reddy, J M

2011-01-01

Waste stream characteristics must be understood to tackle waste management problems in Kathmandu Metropolitan City (KMC), Nepal. Three-stage stratified cluster sampling was used to evaluate solid waste data collected from 336 households in KMC. This information was combined with data collected regarding waste from restaurants, hotels, schools and streets. The study found that 497.3 g capita(-1) day(-1) of solid waste was generated from households and 48.5, 113.3 and 26.1 kg facility(-1) day(-1) of waste was generated from restaurants, hotels and schools, respectively. Street litter measured 69.3 metric tons day(-1). The average municipal solid waste generation rate was 523.8 metric tons day(-1) or 0.66 kg capita(-1) day(-1) as compared to the 320 metric tons day(-1) reported by the city. The coefficient of correlation between the number of people and the amount of waste produced was 0.94. Key household waste constituents included 71% organic wastes, 12% plastics, 7.5% paper and paper products, 5% dirt and construction debris and 1% hazardous wastes. Although the waste composition varied depending on the source, the composition analysis of waste from restaurants, hotels, schools and streets showed a high percentage of organic wastes. These numbers suggest a greater potential for recovery of organic wastes via composting and there is an opportunity for recycling. Because there is no previous inquiry of this scale in reporting comprehensive municipal solid waste generation in Nepal, this study can be treated as a baseline for other Nepalese municipalities. Copyright © 2010 Elsevier Ltd. All rights reserved.

Forest conservation in Nepal: encouraging women's participation.

PubMed

Molnar, A

1987-01-01

The deforestation in Nepal is upsetting the delicate ecological balance and effecting the lives of many of the people, especially the hill women, who use these resources in their household. The deforestation increases erosion, causing landslides, and raises the silt in rivers, changing their course and flooding the southern plains. The majority of Nepal's population is rural and they depend on agriculture for their livelihood. It is estimated that 95% of the wood taken in deforestation is used for fuel primarily used in cooking. The farmers developed a complicated system of land preparation and terracing, but this has not stopped erosion on the steeper slopes. Since women are the ones who get the wood for fuel and other products they must become an integral part of any conservation plan. With the Nationalization Act of 1957, the forest land became the property of the government and therefore managed under the Ministry of Forests through the department officers. Later legislation involved the communities in replanting and longterm care and transfer of tracts for protection and management. In addition nurseries were created for seedlings and the improved wood burning stoves were distributed. Women were not initially involved in these programs because of their traditional role, but through training programs involving local communities, the importance of women in forestry conservation was recognized. Women were first employed in nursery labor and then as supervisors and now more are involved in project activities and forestry staff. They have been most helpful in training others in using the new fuel-efficient stoves.

Earlier Initiation and Use of a Greater Number of Iron-Folic Acid Supplements during Pregnancy Prevents Early Neonatal Deaths in Nepal and Pakistan

PubMed Central

Nisar, Yasir Bin; Dibley, Michael J.

2014-01-01

Introduction Early neonatal deaths account for 75% of neonatal deaths globally. Antenatal iron-folic acid (IFA) supplementation has significantly reduced the risk of early neonatal deaths in China and Indonesia. We investigated the impact of antenatal IFA supplements on the risk of early neonatal deaths in Nepal and Pakistan during the last decade. Methods Data from the most recent singleton live-births of 8,186 from two Nepal Demographic and Health Surveys (DHS) and 13,034 from two Pakistan DHS were selected for the current study. The primary outcome was early neonatal deaths and the main study variable was antenatal IFA supplementation. Analyses used multivariate Cox proportional regression, adjusted for the cluster sampling design and for 18 potential confounders. Findings The adjusted risk of early neonatal deaths was significantly reduced by 51% (aHR = 0.49, 95% CI = 0.32–0.75) in Nepal and 23% (aHR = 0.77, 95% CI = 0.59–0.99) in Pakistan with any use of IFA compared to none. When IFA supplementation started at or before the 5th month of pregnancy, the adjusted risk of early neonatal mortality was significantly reduced by 53% in Nepal, and 28% in Pakistan, compared to no IFA. When >90 IFA supplements were used and started at or before 5th months, the adjusted risk of early neonatal deaths was significantly reduced by 57% in Nepal, and 45% in Pakistan. In Nepal 4,600 and in Pakistan 75,000 early neonatal deaths could be prevented annually if all pregnant women used >90 IFA supplements and started at or before the 5th month of pregnancy. Conclusions Any use of IFA supplements was significantly associated with reduced risk of early neonatal deaths in Nepal and Pakistan. The greatest mortality sparing effect of IFA on early neonatal deaths in both countries was with early initiation and use of a greater number of supplements. PMID:25398011

Nepal and Papua Airborne Gravity Surveys

NASA Astrophysics Data System (ADS)

Olesen, A. V.; Forsberg, R.; Kasenda, F.; Einarsson, I.; Manandhar, N.

2011-12-01

Airborne gravimetry offers a fast and economic way to cover vast areas and it allows access to otherwise difficult accessible areas like mountains, jungles and the near coastal zone. It has the potential to deliver high resolution and bias free data that may bridge the spectral gap between global satellite gravity models and the high resolution gravity information embedded in digital terrain models. DTU Space has for more than a decade done airborne gravity surveys in many parts of the world. Most surveys were done with a LaCoste & Romberg S-meter updated for airborne use. This instrument has proven to deliver near bias free data when properly processed. A Chekan AM gravimeter was recently added to the airborne gravity mapping system and will potentially enhance the spatial resolution and the robustness of the system. This paper will focus on results from two recent surveys over Nepal, flown in December 2010, and over Papua (eastern Indonesia), flown in May and June 2011. Both surveys were flown with the new double gravimeter setup and initial assessment of system performance indicates improved spatial resolution compared to the single gravimeter system. Comparison to EGM08 and to the most recent GOCE models highlights the impact of the new airborne gravity data in both cases. A newly computed geoid model for Nepal based on the airborne data allows for a more precise definition of the height of Mt. Everest in a global height system. This geoid model suggests that the height of Mt. Everest should be increased by approximately 1 meter. The paper will also briefly discuss system setup and will highlight a few essential processing steps that ensure that bias problems are minimized and spatial resolution enhanced.

The potential of health literacy to address the health related UN sustainable development goal 3 (SDG3) in Nepal: a rapid review.

PubMed

Budhathoki, Shyam Sundar; Pokharel, Paras K; Good, Suvajee; Limbu, Sajani; Bhattachan, Meika; Osborne, Richard H

2017-03-27

Health literacy has been linked to health outcomes across population groups around the world. Nepal, a low income country, experiences the double burden of highly prevalent communicable as well as non-communicable diseases. The World Health Organization (WHO) has positioned health literacy as a key mechanism to meet the health-related Sustainable Development Goal (SDG3). However, there is little known about the status of health literacy in developing countries such as Nepal. This paper aims to review the potential of health literacy to address SDG3 in Nepal. A rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on barriers to health care engagements in Nepal published in English language between January 2000 and December 2015. Barriers for healthcare engagement included knowledge and education as strong factors, followed by culture, gender roles, quality of service and cost of services. These barriers influence the Nepalese community to access and engage with services, and make and enact healthcare decisions, not only at the individual level but at the family level. These factors are directly linked to health literacy. Health literacy is a pivotal determinant of understanding, accessing and using health information and health services, it is important that the health literacy needs of the people be addressed. Locally identified and developed health literacy interventions may provide opportunities for systematic improvements in health to address impediments to healthcare in Nepal. Further research on health literacy and implementation of health literacy interventions may help reduce inequalities and increase the responsiveness of health systems which could potentially facilitate Nepal to meet the sustainable development goals. While there is currently little in place for health literacy to impact on the SDG3, this paper generates insights into health literacy's potential role.

Prachanda: The Mastermind Behind the Maoist Insurgency in Nepal

DTIC Science & Technology

2010-12-01

2007, p.126). The split in CPN (Unity Centre) in 1994 gave birth to the Communist Party of Nepal (Maoist), led by Prachanda. In 1992 CPN (Unity...Pushpa Kamal Dahal after his English teacher, Raj Krishna Kandel, thought that Chabilal deserved a more appropriate name—Pushpa Kamal ( Lotus ) (Roy, 2008...and many development projects emerged in the country. However, these developments only benefited those who were already well off and the society who

Water soluble ions in aerosols (TSP) : Characteristics, sources and seasonal variation over the central Himalayas, Nepal

NASA Astrophysics Data System (ADS)

Tripathee, Lekhendra; Kang, Shichang; Zhang, Qianggong; Rupakheti, Dipesh

2016-04-01

Atmspheric pollutants transported from South Asia could have adverse impact on the Himalayan ecosystems. Investigation of aerosol chemistry in the Himalayan region in Nepal has been limited on a temporal and spatial scale to date. Therefore, the water-soluble ionic composition of aerosol using TSP sampler was investigated for a year period from April 2013 to March 2014 at four sites Bode, Dhunche, Lumbini and Jomsom characterized as an urban, rural, semi-urban and remote sites in Nepal. During the study period, the highest concentration of major cation was Ca2+ with an average concentration of 8.91, 2.17, 7.85 and 6.42 μg m-3 and the highest concentration of major anion was SO42- with an average of 10.96, 4.06, 6.85 and 3.30 μg m-3 at Bode, Dhunche, Lumbini and Jomsom respectively. The soluble ions showed the decrease in concentrations from urban to the rural site. Correlations and PCA analysis suggested that that SO42-, NO3- and NH4+ were derived from the anthropogenic sources where as the Ca2+ and Mg2+ were from crustal sources. Our results also suggest that the largest acid neutralizing agent at our sampling sites in the central Himalayas are Ca2+ followed by NH4+. Seasonal variations of soluble ions in aerosols showed higher concentrations during pre-monsoon and winter (dry-periods) due to limited precipitation amount and lower concentrations during the monsoon which can be explained by the dilution effect, higher the precipitation lower the concentration. K+ which is regarded as the tracer of biomss burning had a significant peaks during pre-monsoon season when the forest fires are active around the regions. In general, the results of this study suggests that the atmospheric chemistry is influenced by natural and anthropogenic sources. Thus, soluble ionic concentrations in aerosols from central Himalayas, Nepal can provide a useful database to assess atmospheric environment and its impacts on human health and ecosystem in the southern side of central

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.

Nepal Medical Council: The past and the future.

PubMed

Dixit, Hemang

2009-01-01

The Nepal Medical Council (NMC) has been technically in operation for forty six years though in reality it is much less. The initial years were spent in establishing it. It is only in the last fifteen years or so that there has been much interest in it's functioning. The objective of the NMC is to protect the public and also to oversee the medical education being conducted within the country. A brief account of the NMC from its date of establishment till the present is given here.

Rational for Conducting PTSD Research and Challenges of Recruiting and Training Volunteers to Screen and Treat PTSD among the Nepal 2015 Earthquake Survivors.

PubMed

Jha, A; Shakya, S

2015-01-01

Post-traumatic Stress Disorder (PTSD) is common psychiatric morbidity among earthquake survivors, and if untreated people suffer from it for years. Government of Nepal and NGOs provided various short-term mental health services to the victims of the 2015 earthquake in Nepal, but there was no plan or provision for long-term mental health problems. The prevalence of PTSD following natural disasters depends on various local factors requiring understanding and further investigation before identifying affordable evidence based interventions. This paper discusses the need for PTSD research among the survivors of the 2015 earthquake in Nepal, and describes the challenges and difficulties of recruiting and training PTSD volunteers.

Variations in the Phytophthora infestans Population in Nepal as Revealed by Nuclear and Mitochondrial DNA Polymorphisms.

PubMed

Ghimire, S R; Hyde, K D; Hodgkiss, I J; Shaw, D S; Liew, E C Y

2003-02-01

ABSTRACT Phytophthora infestans isolates collected from potato and tomato crops from various parts of Nepal during the 1999 and 2000 crop seasons were characterized for nuclear and mitochondrial DNA polymorphisms using restriction fragment length polymorphism markers. The nuclear DNA probe RG57 detected 11 multilocus genotypes among 280 isolates. Three genotypes were detected 21 times or more, constituting 94% of the total population, whereas frequencies of other genotypes ranged from 0.004 to 0.014. The overall genotypic diversity as estimated by the Gleason index was 1.78. Most of the overall diversity was present at the highest level (i.e., interregional, 46%), indicating limited gene flow among regions. Cluster analysis of multilocus genotypes derived from RG57 and mating type data for Nepalese isolates and representative isolates worldwide showed Nepalese isolates grouping into four clusters. Characterization of 67 isolates for mitochondrial DNA polymorphisms revealed the presence of two mt-haplotypes, Ia and Ib with the proportions of 0.88 and 0.12, respectively. Polymorphisms in nuclear and mitochondrial DNA revealed a moderate level of diversity in this population. Genotype NP3 had an identical RG57 fingerprint to US1 and had mt-haplotype Ib, confirming the presence of an old population in Nepal. Most of the genotypes had a different RG57 fingerprint than that of US1 and mt-haplotype Ia, the common characteristics of new populations. The presence of a new population at high proportions in Nepal was consistent with the global trend of mt-haplotype distribution, and suggests the displacement of old populations. This study indicates at least three possible introductions of P. infestans to Nepal.

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.

Human rights violations among sexual and gender minorities in Kathmandu, Nepal: a qualitative investigation

PubMed Central

2012-01-01

Background Nepal has experienced sporadic reports of human rights violations among sexual and gender minorities. Our objective was to identify a range of human rights that are enshrined in international law and/or are commonly reported by sexual and gender minority participants in Kathmandu, to be nonprotected or violated. Methods In September 2009 three focus group discussions were conducted by trained interviewers among a convenience sample of sexual and gender minority participants in Kathmandu Nepal. The modified Delphi technique was utilized to elicit and rank participant-generated definitions of human rights and their subsequent violations. Data was analyzed independently and cross checked by another investigator. Results Participants (n = 29) reported experiencing a range of human rights violations at home, work, educational, health care settings and in public places. Lack of adequate legal protection, physical and mental abuse and torture were commonly reported. Access to adequate legal protection and improvements in the family and healthcare environment were ranked as the most important priority areas. Conclusions Sexual and gender minorities in Nepal experienced a range of human rights violations. Future efforts should enroll a larger and more systematic sample of participants to determine frequency, timing, and/or intensity of exposure to rights violations, and estimate the population-based impact of these rights violations on specific health outcomes PMID:22591775

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

Three-dimensional body-wave model of Nepal using finite difference tomography

NASA Astrophysics Data System (ADS)

Ho, T. M.; Priestley, K.; Roecker, S. W.

2017-12-01

The processes occurring during continent-continent collision are still poorly understood. Ascertaining the seismic properties of the crust and uppermost mantle in such settings provides insight into continental rheology and geodynamics. The most active present-day continent-continent collision is that of India with Eurasia which has created the Himalayas and the Tibetan Plateau. Nepal provides an ideal laboratory for imaging the crustal processes resulting from the Indo-Eurasia collision. We build body wave models using local body wave arrivals picked at stations in Nepal deployed by the Department of Mining and Geology of Nepal. We use the tomographic inversion method of Roecker et al. [2006], the key feature of which is that the travel times are generated using a finite difference solution to the eikonal equation. The advantage of this technique is increased accuracy in the highly heterogeneous medium expected for the Himalayas. Travel times are calculated on a 3D Cartesian grid with a grid spacing of 6 km and intragrid times are estimated by trilinear interpolation. The gridded area spans a region of 80-90o longitude and 25-30o latitude. For a starting velocity model, we use IASP91. Inversion is performed using the LSQR algorithm. Since the damping parameter can have a significant effect on the final solution, we tested a range of damping parameters to fully explore its effect. Much of the seismicity is clustered to the West of Kathmandu at depths < 30 km. Small areas of strong fast wavespeeds exist in the centre of the region in the upper 30 km of the crust. At depths of 40-50 km, large areas of slow wavespeeds are present which track along the plate boundary.

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

Understanding Parents' and Professionals' Knowledge and Awareness of Autism in Nepal

ERIC Educational Resources Information Center

Heys, Michelle; Alexander, Amy; Medeiros, Emilie; Tumbahangphe, Kirti M.; Gibbons, Felicity; Shrestha, Rita; Manandhar, Mangala; Wickenden, Mary; Shrestha, Merina; Costello, Anthony; Manandhar, Dharma; Pellicano, Elizabeth

2017-01-01

Autism is a global phenomenon. Yet, there is a dearth of knowledge of how it is understood and its impact in low-income countries. We examined parents' and professionals' understanding of autism in one low-income country, Nepal. We conducted focus groups and semi-structured interviews with parents of autistic and non-autistic children and…

Intergenerational Occupational Mobility in Rural Economy: Evidence from Nepal and Vietnam

ERIC Educational Resources Information Center

Emran, M. Shahe; Shilpi, Forhad

2011-01-01

This paper presents evidence on intergenerational occupational mobility from agriculture to the nonfarm sector using survey data from Nepal and Vietnam. In the absence of credible instruments, the degree of selection on observables is used as a guide to the degree of selection on unobservables, a la Altonji et al. (2005) to address the unobserved…

Teaching and Learning Issues in Mathematics in the Context of Nepal

ERIC Educational Resources Information Center

Panthi, Ram Krishna; Belbase, Shashidhar

2017-01-01

In this paper, we discussed major issues of mathematics teaching and learning in Nepal. The issues coming from theories such as social and radical constructivism suggest that teachers are not trained to use such approach in teaching mathematics, and there is a lack of teaching aids and materials and technological tools. The issues related to…

"Empowering" the "Local" through Education? Exploring Community-Managed Schooling in Nepal

ERIC Educational Resources Information Center

Carney, Stephen; Bista, Min; Agergaard, Jytte

2007-01-01

This article attempts to unpack the policy vision and discourse driving community management of schooling in Nepal and to consider the ways in which these policies are being experienced by bureaucrats, teachers, parents and children. The focus is on the World Bank funded Community School Support Project (CSSP) launched by the Government of Nepal…

Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study from Nepal

PubMed Central

Shrestha, Archana; Pyakurel, Prajjwal; Shrestha, Abha; Gautam, Rabin; Manandhar, Nisha; Rhodes, Elizabeth; Tamrakar, Dipesh; Karmacharya, Biraj Man; Malik, Vasanti; Mattei, Josiemer; Spiegelman, Donna

2017-01-01

Objective Worksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate healthy food choices. The study explored perceptions about healthy eating as well as potential facilitators and barriers to healthy eating among employees in a wire manufacturing factory in Nepal. Methods and materials We conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method. Results Most employees defined healthy eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to healthy eating included unavailability of healthy foods, difficulty in changing eating habits, the preference for fried foods in Nepali culture and the high costs of some healthy foods. The most commonly reported facilitator of healthy eating was the availability of affordable healthy food options in worksite cafeterias. Conclusion Availability of healthy food options at an affordable price could lead to healthier food choices in the worksite. PMID:29225703

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.

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.

Genetic analysis of Asian measles virus strains--new endemic genotype in Nepal.

PubMed

Truong, A T; Mulders, M N; Gautam, D C; Ammerlaan, W; de Swart, R L; King, C C; Osterhaus, A D; Muller, C P

2001-07-01

In many parts of Asia measles virus (MV) continues to be endemic. However, little is known about the genetic characteristics of viruses circulating on this continent. This study reports the molecular epidemiological analysis based on the entire nucleocapsid (N) and hemagglutinin (H) genes of the first isolates from Nepal and Taiwan, as well as of recent MV strains from India, Indonesia, and China. Four isolates collected in various regions in Nepal during 1999 belonged to a new genotype, tentatively called D8. Another Nepalese isolate and one from India belonged to genotype D4. The diversity of the Nepalese strains indicated that measles continues to be endemic in this country. The isolate from Taiwan grouped with D3 viruses and one Chinese strain isolated in The Netherlands was assigned to the previously described clade H, known to be endemic in Mainland China. Molecular characterization emerges as an important tool for monitoring virus endemicity and vaccination efforts.

Conducting correlation seminars in basic sciences at KIST Medical College, Nepal

PubMed Central

2011-01-01

KIST Medical College is a new medical school in Lalitpur, Nepal. In Nepal, six basic science subjects are taught together in an integrated organ system-based manner with early clinical exposure and community medicine. Correlation seminars are conducted at the end of covering each organ system. The topics are decided by the core academic group (consisting of members from each basic science department, the Department of Community Medicine, the academic director, and the clinical and program coordinators) considering the public health importance of the condition and its ability to include learning objectives from a maximum number of subjects. The learning objectives are decided by individual departments and finalized after the meeting of the core group. There are two student coordinators for each seminar and an evaluation group evaluates each seminar and presenter. Correlation seminars help students revise the organ system covered and understand its clinical importance, promote teamwork and organization, and supports active learning. Correlation seminars should be considered as a learning modality by other medical schools. PMID:22066033

Suicide in Nepal: a modified psychological autopsy investigation from randomly selected police cases between 2013 and 2015.

PubMed

Hagaman, Ashley K; Khadka, S; Lohani, S; Kohrt, B

2017-12-01

Yearly, 600,000 people complete suicide in low- and middle-income countries, accounting for 75% of the world's burden of suicide mortality. The highest regional rates are in South and East Asia. Nepal has one of the highest suicide rates in the world; however, few investigations exploring patterns surrounding both male and female suicides exist. This study used psychological autopsies to identify common factors, precipitating events, and warning signs in a diverse sample. Randomly sampled from 302 police case reports over 24 months, psychological autopsies were conducted for 39 completed suicide cases in one urban and one rural region of Nepal. In the total police sample (n = 302), 57.0% of deaths were male. Over 40% of deaths were 25 years or younger, including 65% of rural and 50.8% of female suicide deaths. We estimate the crude urban and rural suicide rates to be 16.1 and 22.8 per 100,000, respectively. Within our psychological autopsy sample, 38.5% met criteria for depression and only 23.1% informants believed that the deceased had thoughts of self-harm or suicide before death. Important warning signs include recent geographic migration, alcohol abuse, and family history of suicide. Suicide prevention strategies in Nepal should account for the lack of awareness about suicide risk among family members and early age of suicide completion, especially in rural and female populations. Given the low rates of ideation disclosure to friends and family, educating the general public about other signs of suicide may help prevention efforts in Nepal.

The Maoist Insurgency in Nepal, 1996-2001: Implicating for U.S. Counterinsurgency Doctrine

DTIC Science & Technology

2008-06-13

Nepal, where insurgents adapted Maoist strategy to the conditions of their country , illustrates the difficulty of formulating a counterinsurgency...Ethnic and linguistic divisions separate the country into three distinct cultural areas with approximately 32 languages.5 The Communist Party of

Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal

PubMed Central

2011-01-01

Background Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs) and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. Methods This paper is based on a qualitative study of Female Sex Workers (FSWs) in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. Results The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients' resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. Conclusion This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO) to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work. PMID:21943102

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.

Nepal [Population education in countries of the region].

PubMed

Rongong, R K

1982-06-01

In 1979 the Ministry of Education and Culture in Nepal, in collaboration with Unesco and the UN Fund for Population Activities (UNFPA), organized a National Planning and Development Meeting in Population Education. The objectives were to understand the concept and nature of population education and population education programs in Asia, to review the existing programs of population education initiated by various agencies in Nepal, and to develop guidelines for the formulation of a national population education program, both in school and out of school. All of these objectives were realized. Subsequently, a population education project was formulated for UNFPA funding, with the help of the Unesco Regional Team on Population Education. The primary goal of the project is to gear the entire system--formal and nonformal--to the realization of the potential role of education in the development efforts of the country and the interrelationships between the population situation and different aspects of quality of life at the micro and macro levels. The long range objectives of the program are as follows: develop in the target audience an insight into the interrelationships between population growth and the process of social and economic development at the individual, family, society, national, and international levels; develop desirable attitudes and behavior in the teachers, students, and the community at large towards population issues so that they may make rational decisions about their family size and the quality of life that they would like to have; and institutionalize population education in the formal education system, including university, and the nonformal education program of the Ministry of Education. In a 1981 population education curriculum development workshop, 2 further objectives were added: develop in learners a knowledge and understanding of basic concepts, processes, and measures; and develop among learners an awareness of the attitudes, beliefs, and

Traditional herbal medicine in Far-west Nepal: a pharmacological appraisal

PubMed Central

2010-01-01

Background Plant species have long been used as principal ingredients of traditional medicine in far-west Nepal. The medicinal plants with ethnomedicinal values are currently being screened for their therapeutic potential but their data and information are inadequately compared and analyzed with the Ayurveda and the phytochemical findings. Methods The present study evaluated ethnomedicinal plants and their uses following literature review, comparison, field observations, and analysis. Comparison was made against earlier standard literature of medicinal plants and ethnomedicine of the same area, the common uses of the Ayurveda and the latest common phytochemical findings. The field study for primary data collection was carried out from 2006-2008. Results The herbal medicine in far-west Nepal is the basis of treatment of most illness through traditional knowledge. The medicine is made available via ancient, natural health care practices such as tribal lore, home herbal remedy, and the Baidhya, Ayurveda and Amchi systems. The traditional herbal medicine has not only survived but also thrived in the trans-cultural environment with its intermixture of ethnic traditions and beliefs. The present assessment showed that traditional herbal medicine has flourished in rural areas where modern medicine is parsimoniously accessed because of the high cost and long travel time to health center. Of the 48 Nepalese medicinal plants assessed in the present communication, about half of the species showed affinity with the common uses of the Ayurveda, earlier studies and the latest phytochemical findings. The folk uses of Acacia catechu for cold and cough, Aconitum spicatum as an analgesic, Aesculus indica for joint pain, Andrographis paniculata for fever, Anisomeles indica for urinary affections, Azadirachta indica for fever, Euphorbia hirta for asthma, Taxus wallichiana for tumor control, and Tinospora sinensis for diabetes are consistent with the latest pharmacological findings

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

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.

Comparison of cortisol and thyroid hormones between tuberculosis-suspect and healthy elephants of Nepal.

PubMed

Paudel, Sarad; Brown, Janine L; Thapaliya, Sharada; Dhakal, Ishwari P; Mikota, Susan K; Gairhe, Kamal P; Shimozuru, Michito; Tsubota, Toshio

2016-12-01

We compared cortisol and thyroid hormone (T3 and T4) concentrations between tuberculosis (TB)-suspected (n=10) and healthy (n=10) elephants of Nepal. Whole blood was collected from captive elephants throughout Nepal, and TB testing was performed using the ElephantTB STAT-PAK ® and DPP VetTB ® serological assays that detect antibodies against Mycobacterium tuberculosis and M. bovis in elephant serum. Cortisol, T3 and T4 were quantified by competitive enzyme immunoassays, and the results showed no significant differences in hormone concentrations between TB-suspect and healthy elephants. These preliminary data suggest neither adrenal nor thyroid function is altered by TB disease status. However, more elephants, including those positively diagnosed for TB by trunk wash cultures, need to be evaluated over time to confirm results.

Using Community Radio in a Rural Women's Post-Literacy Programme in Nepal

ERIC Educational Resources Information Center

Nagaoka, Chizuko; Karki, Manohar

2014-01-01

This paper examines the literacy and post-literacy needs of rural women in Nepal, describes a pilot study in using community radio to supplement a classroom-based post-literacy programme for these women, analyses the findings of this intervention and considers the implications for similar programmes in other settings.

English Medium Instruction (EMI) as Linguistic Capital in Nepal: Promises and Realities

ERIC Educational Resources Information Center

Sah, Pramod Kumar; Li, Guofang

2018-01-01

This article reports on a critical qualitative case study of an EMI-based, underresourced public school in Nepal through Bourdieu's lens of linguistic capital. As the data analysis revealed, parents, students, and teachers regarded EMI as a privileged form of linguistic capital for developing advanced English skills, enhancing educational…

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.

Knowledge of diabetes mellitus among pregnant women in three districts of Nepal.

PubMed

Shrestha, S; Thapa, P; Saleh, F; Thapa, N; Stray, B Pedersen; Khanom, K

2013-09-01

Diabetes mellitus is an emerging health problem in developing world with the consumption of energy dense diet and inactive lifestyle. The problem of diabetes is further expanded due to ignorance and lack of knowledge. The aim of the study was to assess the knowledge of diabetes among pregnant women in three districts of Nepal. A community based cross-sectional study was conducted in three districts in mountain, hilly and plain areas of Nepal. A total of 590 pregnant women were interviewed during the period of July 2009 to June 2010. A knowledge score system was applied. Poor score was <40%, average (40-60%) and good (>60%) of the total score. Statistical software SPSS 11.5 was used for data entry, data management and analysis. Out of 590 pregnant women, only 41% had heard about diabetes mellitus. Majority of the participants (75%) from age group >30 years had not heard about diabetes. Among the 241 with some knowledge, the knowledge score median percent(range) on the meaning, symptoms, risk factors, treatment, prevention, complications and overall knowledge were 50%(0-100), 25% (0-75), 20% (0-60), 20% (0-100), 25% (0-100), 20% (0-60) and 26% (0- 58) respectively. According to defined category, majority of those who ever heard about diabetes had poor knowledge (95%). Knowledge among literate women (p=.001), women residing in Kailali district (plain region) (p=.003) and those with positive family history of diabetes (p=.003) was found to be significant. As large proportions of Nepalese pregnant women do not have any knowledge or have poor knowledge regarding diabetes, extensive health education and health promotion programs are urgently recommended to prevent diabetes in Nepal.

Tobacco use among married women in Nepal: the role of women's empowerment.

PubMed

Pandey, Shanta; Lin, Yuan

2013-04-01

This study documented the prevalence and correlates of tobacco use among women of reproductive age in Nepal using nationally representative data. We utilized the 2006 Nepal Demographic and Health Survey that interviewed 10,793 women and 4,397 men. We analyzed the couple's data or households (N = 2,600) in which both husband and wife were interviewed. We examined the effects of women's empowerment-measured by education, employment, intra-household decisions, and age-on their tobacco use controlling for other individual and household characteristics. Women's empowerment had mixed effects on tobacco use. While women's education was inversely associated with their tobacco use, their age, employment and ability to make intra-household mobility decisions were positively associated with smoking. Women with primary and beyond primary education were 48 and 92 % less likely to smoke compared to women with no education, respectively. Tobacco use among women increased dramatically with age from 8 % in teen years to 42 % in their forties. A 1 year increase in age increased the odds of tobacco use by 6 %. Women whose husbands smoked were twice as likely to smoke. Nepal should not only restrict tobacco use in public places by implementing its Tobacco Control and Regulatory Act of 2010 but also focus on encouraging smoke-free homes by increasing awareness about the health consequences of tobacco use and secondhand smoke among populations most likely to smoke that include nearly all men, employed women, women with low levels of education, women whose spouses smoke and those who are 30 and above in age. Additionally, a long term goal should be to ensure at least 5th grade of education for all girls.

Criticality as Ideological Becoming: Developing English Teachers for Critical Pedagogy in Nepal

ERIC Educational Resources Information Center

Sharma, Bal Krishna; Phyak, Prem

2017-01-01

This article presents a discussion of how criticality is constructed and implemented for English as a foreign language (EFL) teacher development in Nepal. The authors draw on Freire's (1970) notion of conscientization to discuss how Nepali EFL teachers develop critical awareness in incorporating local sociopolitical issues in their lessons.…

Intimate Partner Violence among General and Urban Poor Populations in Kathmandu, Nepal

ERIC Educational Resources Information Center

Oshiro, Azusa; Poudyal, Amod K.; Poudel, Krishna C.; Jimba, Masamine; Hokama, Tomiko

2011-01-01

Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants…

Transforming Foreign Language Grammar Classes through Teacher Training: An Experience from Nepal

ERIC Educational Resources Information Center

Poudel, Kamal Kumar

2018-01-01

In Nepal, unlike elsewhere, local studies have almost continually suggested that there has not been adequate reflection of the teacher training output in the real classroom situation. English teachers commonly blame on the unfavourable environment as the main obstacle to the successful classroom application of their knowledge and skills needed for…

Engineering geological aspect of Gorkha Earthquake 2015, Nepal

NASA Astrophysics Data System (ADS)

Adhikari, Basanta Raj; Andermann, Christoff; Cook, Kristen

2016-04-01

Strong shaking by earthquake causes massif landsliding with severe effects on infrastructure and human lives. The distribution of landslides and other hazards are depending on the combination of earthquake and local characteristics which influence the dynamic response of hillslopes. The Himalayas are one of the most active mountain belts with several kilometers of relief and is very prone to catastrophic mass failure. Strong and shallow earthquakes are very common and cause wide spread collapse of hillslopes, increasing the background landslide rate by several magnitude. The Himalaya is facing many small and large earthquakes in the past i.e. earthquakes i.e. Bihar-Nepal earthquake 1934 (Ms 8.2); Large Kangra earthquake of 1905 (Ms 7.8); Gorkha earthquake 2015 (Mw 7.8). The Mw 7.9 Gorkha earthquake has occurred on and around the main Himalayan Thrust with a hypocentral depth of 15 km (GEER 2015) followed by Mw 7.3 aftershock in Kodari causing 8700+ deaths and leaving hundreds of thousands of homeless. Most of the 3000 aftershocks located by National Seismological Center (NSC) within the first 45 days following the Gorkha Earthquake are concentrated in a narrow 40 km-wide band at midcrustal to shallow depth along the strike of the southern slope of the high Himalaya (Adhikari et al. 2015) and the ground shaking was substantially lower in the short-period range than would be expected for and earthquake of this magnitude (Moss et al. 2015). The effect of this earthquake is very unique in affected areas by showing topographic effect, liquefaction and land subsidence. More than 5000 landslides were triggered by this earthquake (Earthquake without Frontiers, 2015). Most of the landslides are shallow and occurred in weathered bedrock and appear to have mobilized primarily as raveling failures, rock slides and rock falls. Majority of landslides are limited to a zone which runs east-west, approximately parallel the lesser and higher Himalaya. There are numerous cracks in

Developing an Index to Measure Health System Performance: Measurement for Districts of Nepal.

PubMed

Kandel, N; Fric, A; Lamichhane, J

2014-01-01

Various frameworks for measuring health system performance have been proposed and discussed. The scope of using performance indicators are broad, ranging from examining national health system to individual patients at various levels of health system. Development of innovative and easy index is essential to measure multidimensionality of health systems. We used indicators, which also serve as proxy to the set of activities, whose primary goal is to maintain and improve health. We used eleven indicators of MDGs, which represent all dimensions of health to develop index. These indicators are computed with similar methodology that of human development index. We used published data of Nepal for computation of the index for districts of Nepal as an illustration. To validate our finding, we compared the indices of these districts with other development indices of Nepal. An index for each district has been computed from eleven indicators. Then indices are compared with that of human development index, socio-economic and infrastructure development indices and findings has shown the similarity on distribution of districts. Categories of low and high performing districts on health system performance are also having low and high human development, socio-economic, and infrastructure indices respectively. This methodology of computing index from various indicators could assist policy makers and program managers to prioritize activities based on their performance. Validation of the findings with that of other development indicators show that this can be one of the tools, which can assist on assessing health system performance for policy makers, program managers and others.

Overweight and its associated risk factors among urban school adolescents in Nepal: a cross-sectional study

PubMed Central

Baral, Kedar Prasad; Pradhan, Bandana; Poudyal, Amod Kumar

2016-01-01

Objectives The prevalence of non-communicable diseases is increasing in Nepal. Overweight and obesity are the major risk factors of many non-communicable diseases. Adolescence is a critical phase for development of overweight and obesity. Risk factors associated with overweight and obesity are not well understood in Nepal. The objective of the study was to identify the factors associated with overweight and obesity among adolescent students. Setting A cross-sectional descriptive study was carried out on higher secondary school students in the Lalitpur sub-metropolitan city, Nepal. Participants A random sample of 360 students aged 16–19 years from eight schools was included in the study. Results The prevalence of overweight among adolescent students was 12.2% (95% CI 8.9 to 15.5). Factors associated with being overweight included being male (adjusted OR (AOR) 2.64, 95% CI 1.18 to 4.88), studying in private school (AOR 2.10, 95% CI 1.03 to 4.28), high socioeconomic status family (AOR 4.77, 95% CI 1.36 to 16.72), watching television for more than 2 h per day (AOR 8.86, 95% CI 3.90 to 20.11), and consuming fruit four times or less per week (AOR 3.13, 95% CI 1.39 to 7.01). There was no statistically significant association between adolescent overweight and age, ethnicity, mother's education level, mother's occupation, number of siblings or family type. Conclusions Socioeconomic status, watching television for a longer time and consuming less fruit are major risk factors for overweight among adolescents in Nepal. Interventions are needed to increase awareness about the risk factors of adolescent overweight and obesity to decrease prevalence of overweight-associated non-communicable diseases. PMID:27207624