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1
Prindle, Peter H. "Marketing under Famine Conditions in Rural Nepal." Modern Asian Studies 23, no. 4 (October 1989): 749–64. http://dx.doi.org/10.1017/s0026749x00010192.
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Recently social scientists have demonstrated an increasing interest in famines and their sociocultural effects. However, as William Torry notes, empirical research on famines at the local community level particularly in terms of quantitative household surveys, longitudinal studies, or the junctures of relationships linking the local community with regional or national levels of organization are extremely scarce (1984: 229, 243, 245–7; 1986:13).
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Poudel, Aastha. "Pelvic Floor Dysfunction in Right Hemiplegic Female in Rural Nepal." Archives of Medical Case Reports and Case Study 5, no. 5 (June 6, 2022): 01–04. http://dx.doi.org/10.31579/2692-9392/121.
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Pelvic floor dysfunction i.e., Pelvic Organ Prolapse (POP) and Urinary incontinence (UI) is seen to be more prevalent in rural part of Nepal and majority of these conditions are seen in females of reproductive age. Pelvic floor dysfunction negatively impacts female's quality of life and if it is associated with female with disability, it increases the severity of their physical, mental, and social well-being and can hinder their full and effective participation in society. Thus, educational programs regarding sex education should be conducted focusing on vulnerable population to increase awareness, advocacy about their sexual and reproductive rights including causes and risk factors of POP and UI.
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Pigg, Stacy Leigh. "Inventing Social Categories Through Place: Social Representations and Development in Nepal." Comparative Studies in Society and History 34, no. 3 (July 1992): 491–513. http://dx.doi.org/10.1017/s0010417500017928.
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Nepal is a predominantly rural nation: Most people live in villages and make their living as subsistence farmers. The Nepalese government, assisted by international donor agencies, administers projects directed at improving the conditions of life for these rural people. Images of villages and village life accompany the promotion of development ideals. Radio Nepal has actors playing the part of villagers in didactic skits aimed at convincing rural people that they should consult doctors for their health problems or should feed oral rehydration solution to children suffering from diarrhea. Schoolbooks contain illustrations of village scenes and talk about village life as they inform children about development programs. When development policy makers plan programs, they discuss what villagers do, how they react, and what they think. Together, these images coalesce into a typical, generic village, turning all the villages of rural Nepal into the village.
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Niraula, Bhanu B. "Old Age Security and Inheritance in Nepal: Motives Versus Means." Journal of Biosocial Science 27, no. 1 (January 1995): 71–78. http://dx.doi.org/10.1017/s002193200000701x.
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SummaryThis paper documents expectations of old age support in rural Nepal. Current living arrangements of the elderly have been analysed with a focus on the ownership of land holdings. It is argued that the inter-generational transfer of property through inheritance from the older to the younger generation, especially among sons, together with the Nepali normative prescription that sons care for their aged parents, provides a mechanism for old age support. However, land is becoming a scarce resource, cultural traditions are breaking down through modernisation and the living conditions of the elderly are likely to deteriorate as this process continues.
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Singh, Rakesh, Anoop Krishna Gupta, Babita Singh, Pragyan Basnet, and S. M. Yasir Arafat. "History of psychiatry in Nepal." BJPsych International 19, no. 1 (October 13, 2021): 7–9. http://dx.doi.org/10.1192/bji.2021.51.
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The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.
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Sudmeier-Rieux, Karen, Brian G. McAdoo, Sanjaya Devkota, Purna Chandra Lal Rajbhandari, John Howell, and Shuva Sharma. "Invited perspectives: Mountain roads in Nepal at a new crossroads." Natural Hazards and Earth System Sciences 19, no. 3 (March 29, 2019): 655–60. http://dx.doi.org/10.5194/nhess-19-655-2019.
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Abstract. In Nepal and many developing countries around the world, roads are vehicles for development for communities in rural areas. By reducing travel time on foot, opportunities are opened for quicker transportation of goods and better access to employment, education, health care and markets. Roads also fuel migration and numerous social changes, both positive and negative. Poorly constructed roads in mountainous areas of Nepal have increased erosion and landslide risk as they often cut through fragile geology, destabilizing slopes and altering local hydrological conditions, with costs to lives and livelihoods. The convergence of the newly constituted decentralized Nepali government with China's Belt and Road Initiative is likely to bring more roads to rural communities. The new provincial government administrations now have the opportunity to develop policies and practices, which can realign the current trend of poorly engineered, inefficient and hazardous road construction toward a more sustainable trajectory. This commentary provides an overview of some of the obstacles along the way for a more sustainable road network in Nepal and illustrates how good governance, development and landslide risk are intertwined. The opinion presented in this brief commentary lends little hope that Nepal's current pathway of unsustainable road construction will provide the country with the much-needed sustainable road network, unless checks and balances are put in place to curb noncompliance with existing laws and policies.
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George, Susan Mary, and MC Mathews. "Ataxia Telangiectasia: Case Report from a Rural Hospital in Nepal and Current Management Recommendation." Journal of Nepal Paediatric Society 34, no. 2 (October 30, 2014): 138–40. http://dx.doi.org/10.3126/jnps.v34i2.9694.
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It is important though challenging to make accurate diagnosis of neurodegenerative conditions in children and initiate the right treatment. A 14 years old boy presented with deterioration in speech, mobility and performance of daily activities and frequent chest infections over four years. Aided ataxic gait, dysarthria, stooped posture, generalised hypotonia and weakness and ocular telangiectasia were noted. We present a case of Ataxia telangiectasia from a rural hospital in Nepal. DOI: http://dx.doi.org/10.3126/jnps.v34i2.9694 J Nepal Paediatr Soc 2014;34(2):138-140
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Shrestha, Jagat Kumar. "Rural Road Network Decision Model for Hilly Regions of Nepal." Journal of Advanced College of Engineering and Management 4 (December 31, 2018): 51–64. http://dx.doi.org/10.3126/jacem.v4i0.23178.
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Transportation cost is one of the major costs for public and private sectors in rural areas of developing countries (in order to deliver goods and services). This is due to the absence of links or to their poor physical conditions (such as road surface in a road network). To reduce the operation costs in existing links better road surfaces are needed. However, only some links can be improved or constructed to the best surface level at the same time, due to resource constraints. Hence, a careful decision about which links should be improved or constructed to achieve the minimum transportation cost is needed. This paper presents a decision support model for a rural road network that provides portfolio of suggested links for road network improvements or constructions and offers solutions for different budget levels minimizing the transportation cost in the rural road network. Mixed integer programming is used to get an optimal solution.
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Acharya, Alok, Ava Pokhrel, Amar Kumar Yadav, and Rimu Mishra. "Study of housing conditions among people of a rural community in Morang, Eastern Nepal." Journal of Nobel Medical College 6, no. 2 (April 5, 2018): 1–8. http://dx.doi.org/10.3126/jonmc.v6i2.19562.
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Background : Poor Housing condition, sanitation and hygiene is associated with adverse health conditions. This study is done to assess the housing conditions, sanitation coverage and hygiene practices among rural community in Bhaudaha VDC, eastern Nepal.Material &Methods: A cross sectional study was conducted from 22nd May 2016 to 22nd November 2016 in Bhaudaha VDC of eastern Nepal with appropriated sample size of 525 participants. A direct interview was taken with structured questionnaire. Chi square test was used to find out association of the variables.Results: Out of 525 respondents, adequate ventilation was present among 54.9% literates followed by 44.2% illiterates (p=0.01) and separate kitchen was also found among 77.2% of literates and 64.6% of illiterates (p=0.002). Among Dalit castes 74.4% had separate kitchen in their house followed by 50.7% janajatis (p<0.001). Covering of stored water was found in 75.8% Dalit and 61.2% Janajati (P=0.003). Improved sanitation was highest among other terai casts (78.1%) followed by Dalits (59.9%) and 58.2% Janajati (p=0.132).Conclusion: There is need of appropriate methods of health education to be focused on all the groups in the community for improvement in sanitation and healthy housing conditions and targeted more towards Janajati and illiterate group and further studies need to be done in different region of Nepal to understand the cause of disparities in housing and sanitation conditions among different groups.Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11 (July-December, 2017) Page: 1-8
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Yogi, Belpatra Nath. "Factors Associated with Early Marriage in Rural Mid-Western Nepal." Journal of Health Promotion 8 (November 22, 2020): 63–72. http://dx.doi.org/10.3126/jhp.v8i0.32986.
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Early (or child) marriage is a global public health issue influenced by a complex web of factors including socio-demographic conditions of the people. The present paper aims to examine factors associated with early marriageamong the people in rural communities of Nepal. A cross-sectional end-line study was carried out among 155 married respondents selected through cluster cum convenience sampling from six clusters of two rural districts of Mid-western Nepal. The mean age at first marriage was 18.4 years (SD=3.83). Two-third of them had an early marriage and the proportion of early marriage was remarkably higher among women than men (77.8% vs. 42.6%). The prevalence of early marriage was the most common among those of women, age-group of 35-44 years, illiterate and basic literate ones, nuclear and small families, and Janajatis. Sex and educational status of the respondents had a statistically significant association with their marital age (p < 0.05) and were major factors associated with early marriage but other socio-demographic factors such as age, caste/ethnicity, family type, family size and source of income were notfound directlyassociated with early marriage for the sample. Future research efforts should prioritize gender-transformative interventions to recognize and confront inequitable gender norms and actions.
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Shrestha, R., DP Shrestha, L. Lama, D. Gurung, and I. Rosdahl. "Pattern Of Skin Diseases In A Rural Village Development Community Of Nepal." Nepal Journal of Dermatology, Venereology & Leprology 12, no. 1 (January 7, 2016): 41–44. http://dx.doi.org/10.3126/njdvl.v12i1.10595.
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Introduction: Skin diseases are a common cause of morbidity in Nepal as per the health services report. There is limited information on the prevalence and pattern of skin diseases in the community. The objective of this study was to determine the pattern of skin diseases in a rural village development community of Nepal. Materials and methods: Two dermatologic health camps were conducted, during which, the villagers were examined by dermatologists. The skin diseases diagnosed were recorded in a proforma. Results: There were 433 individuals examined and 359 (male-47.9%; female-52.1%) had skin disease identified clinically (camp prevalence- 83%). The age of patients ranged from 1 to 80 years (mean-24.5; SD±15.9), with majority in the age group of 10-19 years. The most common skin disease category was eczemas (36.4%), followed by infections (28.4%), acne (22%), pigment disorders (34%) and urticaria (12.3%). Conclusion: Skin diseases were common in the community. The five most common Skin disease categories were eczemas, infections, acne and pigment disorders were the more common conditions. DOI: http://dx.doi.org/10.3126/njdvl.v12i1.10595 Nepal Journal of Dermatology, Venereology & Leprology Vol.12(1) 2014 pp.41-44
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Yadav, Uday Narayan, Tarka Bahadur Thapa, Sabuj Kanti Mistry, Saruna Ghimire, Krishna Kumar Yadav, Godfred O. Boateng, and Cathy O’Callaghan. "Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study." PLOS ONE 15, no. 11 (November 30, 2020): e0242942. http://dx.doi.org/10.1371/journal.pone.0242942.
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Background The ageing population in most low-and middle-income countries is accompanied by an increased risk of non-communicable diseases culminating in a poor quality of life (QOL). However, the factors accelerating this poor QOL have not been fully examined in Nepal. Therefore, this study examined the factors associated with the QOL of older adults residing in the rural setting of Nepal. Methods Data from a previous cross-sectional study conducted among older adults between January and April 2018 in in rural Nepal was used in this study. The analytical sample included 794 older adults aged ≥60 years, selected by a multi-stage cluster sampling approach. QOL was measured using the Older People’s Quality of Life tool; dichotomized as poor and good QOL. Other measures used included age, gender, ethnicity, religion, marital status, physical activity, and chronic diseases such as osteoarthritis, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), and depression. The factors associated with QOL were examined using mixed-effects logistic regression. Results Seven in ten respondents (70.4%) reported a poor QOL. At the bivariate level, increasing age, unemployment, intake of alcohol, lack of physical activity as well as osteoarthritis, COPD and depression were significantly associated with a lower likelihood of a good QOL. The adjusted model showed that older age (AOR = 0.50, 95% CI: 0.28–0.90), the Christian religion (AOR = 0.38, 95% CI: 0.20–0.70), and of an Indigenous (AOR: 0.25; 95% CI: 0.14–0.47), Dalit (AOR: 0.23; 95% CI: 0.10–0.56), and Madheshi (AOR: 0.29; 95% CI: 0.14–0.60) ethnic background were associated with lower odds of good QOL. However, higher income of >NRs 10,000 (AOR = 3.34, 95% CI: 1.43–3.99), daily physical activity (AOR: 3.33; 95% CI: 2.55–4.34), and the absence of osteoarthritis (AOR: 1.9; 95% CI: 1.09–3.49) and depression (AOR: 3.34; 95% CI: 2.14–5.22) were associated with higher odds of good QOL. Conclusion The findings of this study reinforce the need of improving QOL of older adults through implementing programs aimed at addressing the identified biosocial and disease conditions that catalyse poor QOL in this older population residing in rural parts of Nepal.
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Ngai, T. K. K., S. Murcott, R. R. Shrestha, B. Dangol, and M. Maharjan. "Development and dissemination of Kanchan™ Arsenic Filter in rural Nepal." Water Supply 6, no. 3 (July 1, 2006): 137–46. http://dx.doi.org/10.2166/ws.2006.807.
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In the rural Terai region of Nepal, many tubewell drinking water sources are microbially and/or arsenic contaminated and consequently, millions lack access to “safe” water. Those who drink contaminated water may suffer from preventable water-borne diseases such as diarrhoea, stunting, skin lesions, and cancer. To combat this problem, a team comprising researchers from Massachusetts Institute of Technology (MIT), together with two local partners, Environment & Public Health Organization (ENPHO), and Rural Water Supply and Sanitation Support Programme (RWSSSP), have developed an award-winning household water filter, the Kanchan™ Arsenic Filter (KAF), for simultaneous arsenic and pathogen removal. The KAF is constructed using locally available labour and materials and is optimised based on the local socio-economic conditions. The first part of this paper explains the technology development process and the technical details of this innovation. The second part of this paper describes the dissemination activities since 2004. This dissemination model not only built capacity in local people towards long-term, user-participatory safe water provision, but also made a contribution to the local economy. As of January 2006, over 25,000 people have gained access to safe water as a result of the implementation of the KAF.
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Ali Rizvi, Syed Wajahat, Sardar Mohd Akram, Humayoun Ashraf, and Mohammed Azfar Siddiqui. "Extreme Ophthalmomyiasis externa with simultaneous facial and scalp involvement." Nepalese Journal of Ophthalmology 8, no. 1 (December 12, 2016): 95–96. http://dx.doi.org/10.3126/nepjoph.v8i1.16146.
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Background: Ophthalmomyiasis is a rare entity seen mainly in immunocompromised host with neglected wounds under poor hygienic conditions. Case: We report a case of extreme ophthalmomyiasis with extensive facial and scalp involvement in an old rural inhabitant following evisceration. Conclusion: Proper wound care and personal hygiene are of paramount importance for good wound healing. Nepal J Ophthalmol 2016; 8(15): 95-96
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Piryani, R. M., and R. S. Poudel. "Necessity of strengthening neurology services in Nepal." Journal of Chitwan Medical College 5, no. 2 (August 14, 2015): 50. http://dx.doi.org/10.3126/jcmc.v5i2.13158.
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Dear Editor,Stroke, head injuries and epilepsy are common neurological problems reported worldwide including Nepal. Nepal also bears the burden of nervous system infection such as meningitis, cerebral malaria, Japanese B encephalitis. The average life expectancy of Nepalese population has increased noticeably in the last twelve years; hence it may lead to increase in age related neurological conditions such as dementia, Parkinson disease. Because of poor road condition, rapidly increasing number of two- wheelers, disorganized traffic pattern, and lack of driving discipline in Nepal, motor vehicles accidents are on rise, so the head injuries too. The accompanied person along for the ride on two- wheel vehicles are not required to wear helmet and passengers in four wheelers avoid using safety belts are at risk. Moreover, the implementation of legislation to prevent driving in drunken state is limited.Presently some of the government hospitals, private medical college teaching hospitals and corporate sector hospitals located in urban areas provide neurological services. However, a large number of patients of sub-urban and rural areas having common neurological aliments have limited access. Ignorance, illiteracy, limited resources, negative attitude, discrimination, faith on traditional healers and weak economical status may be the limiting factor to access. Establishing neurological services network with public private partnership and use of latest technology may improve care and delivery of neurological services in country. At the same time government need to 1) motivate, encourage and facilitate young doctors to get training in neurosurgery and neuromedicine, 2) invest in infrastructure development, 3) create awareness among public especially of suburban and rural areas and 4) promote research.These approaches may improve quality of care and service delivery.SincerelyDr. Rano Mal Piryani- Prof of Medicine and Medical Education, Chitwan Medical CollegeMr. Ramesh Sharma Poudel- Pharmacist, Pharmacy, Chitwan Medical College Teaching Hospital
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Bhatt, Navin, Ashmita Karki, Biplav Shrestha, Amul Singh, Lal B. Rawal, and Sanjib Kumar Sharma. "Effectiveness of an educational intervention in improving healthcare workers’ knowledge of early recognition, diagnosis and management of rheumatic fever and rheumatic heart disease in rural far-western Nepal: a pre/post-intervention study." BMJ Open 12, no. 4 (April 2022): e059942. http://dx.doi.org/10.1136/bmjopen-2021-059942.
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ObjectivesRheumatic fever (RF) and rheumatic heart disease (RHD) remain among the major heart problems among children in Nepal. Although these conditions are preventable and treatable, the lack of proper knowledge and resources to diagnose and manage these conditions in rural health centres is a key concern. This study assessed the impact of educational sessions to improve the knowledge of healthcare workers in the early recognition, diagnosis, and management of RF and RHD in rural far-western Nepal.Design, setting and participantsThis study used a pretest and post-test interventional design and was conducted among 64 healthcare workers in two primary healthcare centres and a peripheral district-level hospital in Achham district in the far-western region of Nepal. A self-administered questionnaire was used before and after the educational sessions. Data were analysed using SPSS V.21.ResultsThe overall test scores increased from 10 (SD=2.4) pre-intervention to 13.8 (SD=1.9) post-intervention (p<0.001). Similarly, participant confidence (graded 1–5) in differentiating bacterial from viral sore throat rose from 3.6 (SD=1.08) pre-intervention to 3.98 (SD=1.09) post-intervention (p<0.05). Confidence in managing RF increased from 3.9 (SD=0.88) pre-intervention to 4.30 (SD=0.8) post-intervention (p<0.001).ConclusionThe findings suggest that the investigated educational sessions are promising with respect to improving the knowledge and confidence of healthcare workers in the early recognition, diagnosis, and management of RF and RHD at the primary healthcare level. Further studies with a larger sample size and conducted in different parts of the country are warranted to assess the effectiveness and impact of scaling up such educational interventions in Nepal.
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Baral, Chhabi Ram. "Assessing the Condition of Domestic Child Workers Aftermath of Nepal Earthquake in Besisahar Municipality, Lamjung." Patan Pragya 7, no. 1 (December 31, 2020): 10–21. http://dx.doi.org/10.3126/pragya.v7i1.35256.
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Domestic Child Workers are a familiar and a serious problem throughout the world. It is also common wide-spread phenomena and emerging issue not only in urban areas but also in rural setting in Nepal. Domestic child workers are not only the problem of an individual or a family but also the common problem of the society. In this context, the main objective of this paper is to examine the major problems, health situation, and assess the working conditions of domestic child workers aftermath of April 25th, 2015 earthquake disaster in Besisahar Municipality, Lamjung, Nepal. The data and information needed for this study were obtained through the mix method with primary and secondary sources. Study finds that the education level of child domestic workers is very poor. Poverty is one of the major causes for children being engaged in domestic child worker. Based on findings the overall condition for the domestic child workers in terms of basic needs like food, shelter, clothes and health was found critical.
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Worthman, Carol M., and Catherine Panter-Brick. "Homeless street children in Nepal: Use of allostatic load to assess the burden of childhood adversity." Development and Psychopathology 20, no. 1 (2008): 233–55. http://dx.doi.org/10.1017/s0954579408000114.
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AbstractAs challenges to child well-being through economic disadvantage, family disruption, and migration or displacement escalate world wide, the need for cross-culturally robust understanding of childhood adversity proportionately increases. Toward this end, developmental risk was assessed in four contrasting groups of 107 Nepali children ages 10–14 years that represent distinctive, common conditions in which contemporary children grow up. Relative cumulative burden (allostatic load) indexed by multiple dimensions of physical and psychosocial stress was ascertained among homeless street boys and three family-based groups, from poor urban squatter settlements, urban middle class, and a remote rural village. Biomarkers of stress and vulnerability to stress included growth status, salivary cortisol, antibodies to Epstein–Barr virus, acute phase inflammatory responses (alpha1-antichymotrypsin), and cardiovascular fitness and reactivity (flex heart rate and pressor response). Individual biomarkers of risk and allostatic load differed markedly among groups, were highest in villagers, and varied by components of allostatic load. Such data suggest a need for critical appraisal of homelessness and migration as a risk factor to youth, given prevailing local conditions such as rural poverty, and represents the only multidimensional study of childhood allostatic load and developmental risk in non-Western settings.
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Nijhawan, Anisha, Guy Howard, Moti Poudel, Maria Pregnolato, Yuen Tung Eunice Lo, Anish Ghimire, Manish Baidya, Abraham Geremew, Adrian Flint, and Yohannes Mulugeta. "Assessing the Climate Resilience of Community-Managed Water Supplies in Ethiopia and Nepal." Water 14, no. 8 (April 15, 2022): 1293. http://dx.doi.org/10.3390/w14081293.
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Understanding the resilience of water supplies to climate change is becoming an urgent priority to ensure health targets are met. Addressing systemic issues and building the resilience of community-managed supplies, which serve millions of people in rural LMIC settings, will be critical to improve access to safe drinking water. The How Tough is WASH (HTIW) framework to assess resilience was applied to community-managed water supplies in Ethiopia and Nepal to assess the effectiveness of this framework in field conditions. The resilience of these water supplies was measured along six domains—the environment, infrastructure, management, institutional support, community governance and supply chains—that can affect how they respond to climate change effects. We found that the HTIW framework provided an objective measure of resilience and could be used to rank water supplies in order of priority for action. We also found that systemic issues could be identified. The tools and methods used in the framework were easy to deploy by field research teams. The water supplies studied in Ethiopia and Nepal had low to moderate resilience to climate change. Service management and institutional support were weak in both countries. The data from Ethiopia and Nepal suggests that many water supplies in rural and small-town communities are unlikely to be resilient to future climate change without increased investment and support. The use of simple frameworks such as HTIW will be important in supporting decisions around such investments by identifying priority communities and actions.
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Belbase, M., D. Joshi, A. Koki, R. Gautam, R. Sharma, and J. Adhikari. "Physical Comorbidity and Psychiatric Diagnosis in a Neuropsychiatric Clinic in Sindhuli District, Rural Nepal." Journal of Psychiatrists' Association of Nepal 2, no. 1 (September 5, 2013): 26–29. http://dx.doi.org/10.3126/jpan.v2i1.8571.
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Background: Presence of physical illness with mental health problems is very common occurrence. Contraindication of certain psychotropics with certain physical problem and some beneficial effects of other drugs in comorbid conditions is one of important aspect of studying comorbidity. Comorbidity identification and intervention helps to cure and contain mental problems in most effective way. Materials and methods: Descriptive study with convenient sampling in all the patients who consented and attended monthly neuropsychiatric satellite health camp in Sindhuli district of Nepal from the month of Shrawan to Poush 2069 (6 months) organized by Tranquility Hospital and Research Centre, Khumaltar, Kathamndu. Results: Out of the 172 subjects studied, the most common age group was 20-39 years (47.7 %) followed by 40-59 years (27.9 %). The most common neuropsychiatric diagnosis was mood spectrum disorder followed by neurotic (neurotic, stress-related and somatoform) disorders. Psychosis spectrum (schizophrenia, schizotypal and delusional disorders) was the least common. The most common physical comorbid diagnosis was migraine followed by hypertension and diabetes mellitus. Conclusions: Migraine, hypertension and diabetes mellitus are the most common comorbid physical problems in psychiatric population found in our study. DOI: http://dx.doi.org/10.3126/jpan.v2i1.8571 J Psychiatrists’ Association of Nepal Vol .2, No.1, 2013 26-29
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Singh, Jitendra Kumar, Dilaram Acharya, Salila Gautam, Mandira Adhikari, Ji-Hyuk Park, Seok-Ju Yoo, and Kwan Lee. "Socio-Demographic and Diet-Related Factors Associated with Insufficient Fruit and Vegetable Consumption among Adolescent Girls in Rural Communities of Southern Nepal." International Journal of Environmental Research and Public Health 16, no. 12 (June 17, 2019): 2145. http://dx.doi.org/10.3390/ijerph16122145.
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Sufficient fruit and vegetable (FV) consumption has been associated with reduced risks of chronic diseases and adverse health conditions. However, the determinants of insufficient of FV intake among adolescent girls in Nepal have not been determined. This study was undertaken to identify associations between socio-demographic and diet-related factors with insufficient fruit and vegetable consumption among adolescent girls living in rural communities. This community-based, cross-sectional study was conducted on 407 adolescent girls from rural communities in the Bateshwar rural municipality of Dhanusha district, Southern Nepal between 12 October, 2018 and 14 December, 2018. The study subjects responded to FV consumption and dietary factor-related questionnaires, and anthropometric measurements were taken. Data were analyzed using the univariate logistic regression followed by multivariable logistic regression analyses. Unadjusted and adjusted odds ratios with 95% confidence intervals (CI) are reported. From the 407 study subjects, 359 (88.2%) reported insufficient FV consumption. The factors significantly associated with insufficient FV consumption were education to under the 10th grade, household income in the first tercile, lack of awareness of the importance of FV consumption, the non-availability of FVs at the household level, the low level of dietary diversity, and undernutrition (BMI (body mass index) (<18.5)). The study shows almost 90% of adolescent girls consumed inadequate amounts of FV and that socio-demographic and dietary factors should be taken into account while designing preventive strategies to increase fruit and vegetable consumption to recommended levels.
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Devkota, Niranjan, Ram Kumar Phuyal, and Durga Lal Shrestha. "Cost and benefit analysis of adoption of climate change adaptation options among rural rice farmers in Nepal." Asian Journal of Agriculture and Rural Development 7, no. 7 (February 22, 2018): 136–48. http://dx.doi.org/10.18488/journal.1005/2017.7.7/1005.7.136.148.
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This paper estimates cost and benefit of adoption of climate change adaptation options available to the rural rice farmers of Nepal. Multi-stage sampling technique was used to source respondents for the study and used structured questionnaire techniques to collect data from 773 households from seven districts - 3 from Terai and 4 from Hilly region of Nepal. The result revealed that there are 13 major adaptation options rice farmers practice in order to protect themselves from climatic risk. Among the given adaptation options, the first three costly adaptation options are the alternative irrigation practice which incurred average cost of US $ 69.95 (US$ 1 = 102.84 Nepalese Rupees), followed by denser plantation of local seeds ($ 20.69) and using climate smart varieties ($ 18.06). Nearby 88% farmers practiced more than one adaptation strategies on the same farm with the aim of reducing the effect of extreme climatic conditions. Total cost and revenue revealed that per unit total cost ranges from $ 28.34 to $ 32.79 whereas per unit total revenue ranges $ 33.4 to $ 49.02. Surprisingly, it is observed that farmers who do not adopt any adaptation options are able to received highest income from per unit production.
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Rai, C., S. Thapa, J. Day, L. Bhattarai, S. McMullen, R. Jha, S. Shrestha, S. Bastola, and R. Rivera. "Conditions in rural Nepal for which depot-medroxyprogesterone acetate initiation is not recommended: implications for community-based service delivery." Contraception 60, no. 1 (July 1999): 31–37. http://dx.doi.org/10.1016/s0010-7824(99)00056-6.
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Dhungana, Raja Ram, Khem Bahadur Karki, Bihungum Bista, Achyut Raj Pandey, Meghnath Dhimal, and Mahesh K. Maskey. "Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey." BMJ Open 11, no. 7 (July 2021): e047665. http://dx.doi.org/10.1136/bmjopen-2020-047665.
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ObjectivesTo assess the prevalence, pattern and determinants of non-communicable diseases (NCDs) multimorbidity in Nepal.DesignSecondary analysis of the data from the NCD survey 2018, which was conducted between 2016 and 2018.SettingThe data belong to the nationally representative survey, that selected the study samples from throughout Nepal using multistage cluster sampling.Participants8931 participants aged 20 years and older were included in the study.Primary outcomesNCD multimorbidity (occurrence of two or more chronic conditions including hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease and cancer). Descriptive statistics, prevalence ratio and odds ratio were computed to assess pattern and determinants of multimorbidity.ResultsMean (SD) age was 46.7 years (14.9 years). The majority of the participants were women (57.8%), without formal education (53.4%) and from urban areas (51.5%). Multimorbidity was present in 13.96% (95% CI: 12.9% to 15.1%). Hypertension and diabetes coexisted in 5.7%. Age, alcohol consumption, body mass index, non-high-density lipoprotein (non-HDL) level and rural–urban setting were significantly associated with multimorbidity.ConclusionMultimorbidity was prevalent in particular groups or geographical areas in Nepal suggesting a need for coordinated and integrated NCD care approach for the management of multiplicative co-comorbid conditions.
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Yadav, Uday Narayan, Saruna Ghimire, Sabuj Kanti Mistry, Selvanaayagam Shanmuganathan, Lal B. Rawal, and Mark Harris. "Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study." BMJ Open 11, no. 2 (February 2021): e041728. http://dx.doi.org/10.1136/bmjopen-2020-041728.
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ObjectivesThis study’s objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors.DesignThis was a community-based cross-sectional study conducted between January and April 2018.SettingRural municipalities of Sunsari and Morang districts in eastern Nepal.Participants794 older Nepalese adults, 60 years and older, were recruited using a multistage cluster sampling approach.Primary outcome measure(s)Prevalence of four major non-communicable chronic conditions (osteoarthritis, cardiovascular disease, diabetes and chronic obstructive pulmonary disease (COPD) and multimorbidity.ResultsAlmost half (48.9%: men 45.3%; women 52.4%) of the participants had at least one of four non-communicable chronic conditions, and 14.6% (men 12.5%; women 16.8%) had two or more conditions. The prevalence of individual conditions included: osteoarthritis—41.7% (men 37.5%; women 45.9%), cardiovascular disease—2.4% (men 2.8%; women 2.0%), diabetes—5.3% (men 6.0%; women 4.6%) and COPD—15.4% (men 13.3%; women 17.5%). In the adjusted model, older adults aged 70–79 years (adjusted OR (AOR): 1.62; 95% CI: 1.04 to 2.54), those from Madhesi and other ethnic groups (AOR: 1.08; 95% CI: 1.02 to 1.72), without a history of alcohol drinking (AOR: 1.53; 95% CI: 1.18 to 2.01) and those physically inactive (AOR: 5.02; 95% CI: 1.47 to 17.17) had significantly higher odds of multimorbidity.ConclusionsThis study found one in seven study participants had multimorbidity. The prevalence of multimorbidity and associated socioeconomic and behavioural correlates need to be addressed by integrating social programmes with health prevention and management at multiple levels. Moreover, a longitudinal study is suggested to understand the temporal relationship between lifestyle predictors and multimorbidity among older Nepalese adults.
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Bhat, Basanta Rana. "Opportunity and Challenge of Organic Certification System in Nepal." Journal of Agriculture and Environment 10 (August 12, 2009): 144–49. http://dx.doi.org/10.3126/aej.v10i0.2139.
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The demand for organic certification is gradually increasing in Nepal although it is in early stage. Organic certification is a written assurance given by an independent third party about the production methodology and quality of products to confirm special requirements. Certification brings opportunities for protection of local resources, better market access, improvement of worker and consumer health, and eventually enhancement of living conditions of rural communities. The demanding nature of regulatory requirements makes it difficult as well as expensive for local certification initiatives in developing markets to establish themselves to offer export certification. Certification cost, limited awareness of group certification, small and medium-sized farms and inadequate understanding of how organic certification works are some of the constraints for organic certification. Certification Alliance (Cert All), a regional collaboration in certification representing national and international organic certification bodies, addresses the aforementioned challenges. The alliance has recognized the value of collaborating instead of competing. Organic Certification Nepal (OCN), a part of Cert All, offers an internationally accredited inspection and certification service to local operators at a reasonable cost. This paper highlights certification process followed by OCN and potential challenges and opportunities it will likely face.Key words: Organic Agriculture; Standards; Inspection; Certification; HarmonizationThe Journal of Agriculture and Environment Vol:10, Jun.2009 Page: 144-149
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Poudyal, Anil, Bihungum Bista, Pradip Gyanwali, Shristi Karki, Saroj Bhattarai, Sweekriti Sharma, and Meghnath Dhimal. "Prevalence and factors associated with joint pain in Nepal: findings from a countrywide cross-sectional STEPS survey." BMJ Open 11, no. 10 (October 2021): e051536. http://dx.doi.org/10.1136/bmjopen-2021-051536.
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ObjectiveThis study aims to determine the prevalence of joint pain and its association with demographic, socioeconomic and behavioural factors in Nepal.DesignThe study was a national cross-sectional population-based study.SettingWe used the most recent nationally representative population-based cross-sectional health survey, The WHO STEPwise approach to surveillance (STEPS) survey, 2019 from all seven provinces of Nepal including both urban and rural areas.ParticipantsThe participants were men and women aged 15–69 years, who were usual residents of the households for at least 6 months and have stayed the night before the survey.Primary and secondary outcome measuresPrimary outcome in this study was prevalence of joint pain. The secondary outcome measure was factors associated with joint pain in Nepal. Joint pain in our study was based on any self-reported symptoms of joint pain, stiffness and swelling lasting for more than 1 month in the past 12 months. Data were weighted to generate national estimates.ResultsThe prevalence of self-reported joint pain in Nepal was 17% (95% CI 14.3% to 20.2%) with higher prevalence for older adults, females, ever married, none/less than primary education, smoker, lowest wealth quintile, homemaker, those with sufficient physical activity and those living in the Karnali province of Nepal. In multivariable analysis self-reported joint pain was found to be associated with advanced age (adjusted OR (AOR)=2.36; 95% CI 1.56 to 3.55), sex (AOR=1.47; 95% CI 1.19 to 1.82) and sufficient physical activity (AOR=0.40; 95% CI 0.25 to 0.65).ConclusionsThe results showed a high prevalence of joint pain in Nepal. Considering the process of ageing and rapid growth in non-communicable disease, this study warrants the need for health policies directed to prevention, treatment and rehabilitation for people affected by chronic musculoskeletal conditions addressing related disabilities and loss of work in Nepal.
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Tomberge, Vica Marie Jelena, Janine Stefanie Bischof, Regula Meierhofer, Akina Shrestha, and Jennifer Inauen. "The Physical Burden of Water Carrying and Women’s Psychosocial Well-Being: Evidence from Rural Nepal." International Journal of Environmental Research and Public Health 18, no. 15 (July 26, 2021): 7908. http://dx.doi.org/10.3390/ijerph18157908.
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Many women in low-income countries carry heavy loads of drinking water for their families in difficult terrain. This can adversely affect their health and well-being. The present study is the first to investigate the physical burden of water carrying and women’s psychosocial well-being, and how this relationship is moderated by environmental and health conditions. Trained local interviewers conducted interviews with 1001 women across five rural communities in Nepal. In addition, objective measurement was used to assess the weight carried and distance from the water source. The physical burden of water carrying was calculated from weight, distance, and frequency of trips. Its association with psychosocial well-being was modeled using generalized estimating equations. Two additional models included the terrain and uterine prolapse as moderators. The physical burden of water carrying is directly related to higher emotional distress and reduced daily functioning. This correlation was exacerbated for women carrying in hilly versus flat terrain, and for those who had uterine prolapse. Our results underline the importance of adequate water access for women’s psychosocial well-being, especially for vulnerable populations such as women with impaired health (e.g., uterine prolapse) or those living in hilly terrain. The results further highlight the interconnectedness of the Sustainable Development Goal (SDG) 6: water access, SDG 3: health and well-being, and SDG 5: gender equality.
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Park, Myung-Bae, Chun-Bae Kim, Chhabi Ranabhat, Chang-Soo Kim, Sei-Jin Chang, Dong-Won Ahn, and Young-Kyoo Joo. "Influence of community satisfaction with individual happiness: comparative study in semi-urban and rural areas of Tikapur, Nepal." Global Health Promotion 25, no. 3 (July 18, 2017): 22–32. http://dx.doi.org/10.1177/1757975916672169.
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Happiness is a subjective indicator of overall living conditions and quality of life. Recently, community- and national-level investigations connecting happiness and community satisfaction were conducted. This study investigated the effects of community satisfaction on happiness in Nepal. A factor analysis was employed to examine 24 items that are used to measure community satisfaction, and a multiple regression analysis was conducted to investigate the effects of these factors on happiness. In semi-urban areas, sanitation showed a positive relationship with happiness. In rural areas, edu-medical services were negatively related to happiness, while agriculture was positively related. Gender and perceived health were closely associated with happiness in rural areas. Both happiness and satisfaction are subjective concepts, and are perceived differently depending on the socio-physical environment and personal needs. Sanitation, agriculture (food) and edu-medical services were critical factors that affected happiness; however, the results of this study cannot be generalized to high-income countries.
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White, Pamela, and Juho Haapala. "Water Security and Social Inclusion: Local Governance within the Newly Established Rural Municipalities in Nepal." New Angle: Nepal journal of social science and public policy 5, no. 1 (November 19, 2019): 99–127. http://dx.doi.org/10.53037/na.v5i1.8.
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In the Himalayan foothills of Nepal, water demand is increasing while many water sources are depleting. Local levels of government may play a role in tackling local water problems in a fair manner, or in failing to adapt to changing conditions. Nepal has recently undergone rapid changes in its institutional governance setting. Rural Municipalities (RMs) were established in mid-2017 as new, democratic, local tiers of governance. Their responsibilities include ensuring equitable access to water for all citizens, in line with the new Constitution. RMs must tackle decreasing water availability, increasing demands for domestic, agricultural and commercial uses, impacts of climate change, and the challenges of ensuring inclusive and participatory decision-making. At the same time, they are newly appointed finding their position and responsibilities after years of management by line ministries in Kathmandu. The study analyzes the current status of rural municipalities in remote areas of Sudurpashchim and Karnali Provinces in terms of their institutional capacity to implement inclusive water governance and water security in collaboration with a large donor project. It uses the OECD Principles on Water Governance (OECD 2011, 2015) as a framework. This research asks what the current water governance issues are in this setting of collaboration. The opportunities identified include the potential for more accountable policy formulation at a closer level to the community, by leaders who are more representative and accountable to their citizens and are aware of specific local water issues. On the other hand, there is a risk that policy formulation and accountability of governance could go astray. We conclude that this is a key moment to support the fledgling rural municipalities and demonstrate ways to build their capacities to secure safe water for all.
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Ekezie, Winifred, Alex Robert Jenkins, Ian Philip Hall, Catrin Evans, Rajendra Koju, Om Prakash Kurmi, and Charlotte Emma Bolton. "The burden of chronic respiratory diseases in adults in Nepal: A systematic review." Chronic Respiratory Disease 18 (January 1, 2021): 147997312199457. http://dx.doi.org/10.1177/1479973121994572.
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While chronic lung disease causes substantial global morbidity and mortality, global estimates have primarily been based on broad assumptions. Specific country data from low-income countries such as Nepal are limited. This review assessed primary evidence on chronic respiratory disease burden among adults in Nepal. A systematic search was performed in June 2019 (updated May 2020) for studies through nine databases. High levels of heterogeneity deemed a narrative synthesis appropriate. Among 27 eligible studies identified, most were low-moderate quality with cross-sectional and retrospective study design. Chronic lung diseases identified were chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and restrictive lung diseases. Studies were categorised as: (i) community-based, (ii) hospital-based and (iii) comorbidity-related and disease burden. Reported disease prevalence varied widely (COPD, 1.67–14.3%; asthma, 4.2–8.9%). The prevalence of airflow obstruction was higher among rural dwellers (15.8%) and those exposed to household air pollution from domestic biomass burning as opposed to liquid petroleum gas users (Odds Ratio: 2.06). Several comorbidities, including hypertension and diabetes mellitus added to the disease burden. The review shows limited literature on lung disease burden in Nepal. Publications varied in terms of overall quality. Good quality research studies with prospective cohorts related to respiratory conditions are required.
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Sahu, Sabin, Rajiv Ranjan Karn, Dipesh Ram, Tejsu Malla, Sanjib Chaudhary, and Sanjay Kumar Singh. "Comparative Study on Knowledge and Awareness of Common Ocular Diseases Among Rural and Urban Community in Siraha District of Nepal: The Lahan Study." Nepalese Journal of Ophthalmology 13, no. 1 (January 1, 2021): 13–21. http://dx.doi.org/10.3126/nepjoph.v13i1.28010.
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Introduction: Awareness and knowledge about the common ocular conditions can help people to seek early eye care services. The understanding and acceptance of the importance of routine eye examinations can help in timely detection and treatment of the eye diseases and thus help to reduce the burden of avoidable ocular blindness from the general population.
Objective: This study aims to assess and analyze the information related to knowledge and awareness of common ocular diseases and eye health among the rural and urban communities of the Siraha district, Nepal.
Materials and methods: A descriptive cross-sectional study was conducted between April and June 2018 in Lahan Municipality ward number 6 (urban) and Sakhuwa Nankarkatti Rural Municipality ward number 4 (rural) in Siraha district. The sample size of 975 was calculated from study population of 3247. A systematic random sampling technique was used to interview adults above 18 years of age, using a pre-tested structured questionnaire. The collected data was analyzed.
Results: Out of total 975 participants, 514 (52.7%) were from rural community in Sakhuwa Rural Municipality and 461 (47.3%) were from urban community in Lahan Municipality. The mean age was 38.38 ± 15 years. Female participants were more (63.2%) compared to male (36.8%). Overall, 58.3% were literate and 41.7% were illiterate. Rural community had more uneducated participants (48%) compared to urban community (34%). In rural community, 69% were aware about cataract, 83% had knowledge about its treatment; while in urban community 81% were aware about cataract and 86% had knowledge about its treatment. The awareness of glaucoma among the participants was poor, more so in rural cohort (15%) than the urban cohort (25%). The knowledge of glaucoma was 14% in rural and 62% in urban cohort. Awareness that diabetes can affect the eye was found to be significantly lower (p = 0.01) in rural population (25%) compared to that in urban population (41%) in this study. The knowledge about diabetic retinopathy was lower in rural community (38%) compared to urban community (49%). Awareness about Night Blindness was lesser in rural (62%) compared to urban (70%) community (p = 0.17). Awareness about refractive errors were 37% in rural compared to 60% in urban community. The major sources of information were society and eye hospital in both community.
Conclusion: The knowledge and awareness level regarding common ocular diseases was high among the community people of urban community (Lahan) in comparison to rural community (Sakhuwa Nankarkatti). Awareness and knowledge level mainly regarding glaucoma and diabetic retinopathy was very poor in both urban and rural community. There is need to conduct comprehensive awareness programs on common ocular diseases like cataract, glaucoma, diabetic retinopathy, night blindness, congenital eye disease, ocular trauma, eye donations and others in both rural and urban areas to raise the awareness level and improve attitudes and right practices reducing the burden of avoidable blindness.
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Karki, Yogendra Kumar, Punya Prasad Regmi, and Resham Bahadur Thapa. "Coffee Production in Kavre and Lalitpur Districts, Nepal." Journal of Nepal Agricultural Research Council 4 (May 6, 2018): 72–78. http://dx.doi.org/10.3126/jnarc.v4i1.19692.
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Coffee (Coffea spp) is an important and emerging cash crop having potential to provide farmers employment and income generation opportunities. This crop is well adapted to the climatic conditions of mid-hills of Nepal. Thus, majority of the farmers are attracted towards cultivation of coffee because of demands in national and international market. Coffee is now becoming integral part of farming system in rural areas. However, information on performance of coffee and farmers response has not been well documented. Therefore, we undertook the present work to analyze demography, ethnicity, household occupation, literacy status, average land holding, coffee cultivation area, livelihood and sources of income of coffee growers, production and productivity, pricing, cropping pattern of the coffee and problesm faced by them in mid hill district of Kavrepalanchowk (hereafter ‘Kavre’) and Lalitpur Districts. All the samples were taken randomly and selected from coffee producing cooperative of Kavre and Lalitpur. Our analysis showed that the male farmer dominant over female on adopting coffee cultivation in both districts with higher value in Kavre. Brahmin and Chetri ethnic communities were in majority over others in adopting the coffee cultivation. Literate farmers were more dominant over illiterates on adopting the coffee cultivation, The mean land holding was less, ranging from 0.15 to 2.30 ha for coffee cultivation, the history of coffee cultivation in Kavre showed that highest number of farmers were engaged in coffee farming from last 16 years. The mean yield of fresh cherry was 1027.20 kg/ha in Kavre, while it was 1849.36 kg/ha in Lalitpur. The study revealed that majority of the coffee plantations were between 6-10 years old. The major problems facing by coffee farmers were diseases spread, lack of irrigation facility and drying of plants. Despite of that the coffee farming was one of the rapidly emerging occupations among the farmers in both district of Nepal.
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Acharya, Chetana, Alisha Dhungana, and Chiranjeebi Shah. "Nutritional Status and Associated Factors among the Elderly People in Mandavi Rural Municipality of Pyuthan District, Nepal." Journal of Health and Allied Sciences 11, no. 1 (August 18, 2021): 72–78. http://dx.doi.org/10.37107/jhas.236.
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Introduction: The geriatric population is increasing throughout the world. With the increase in age, people suffer from various chronic diseases and conditions. Nutrition-related problems are also common in elderly people. This study was conducted to assess the nutritional status and associated factors among elderly people.
Methods: A community-based cross-sectional descriptive and quantitative study was carried out among 124 elderly people of Mandavi Rural Municipality, Pyuthan, Nepal from September 2019 to November 2019. The study population was selected using a convenient method. Data collection was carried out through a structured questionnaire using the standard tool, mini nutritional assessment (MNA). Ethical approval was taken from Nepal Health Research Council (NHRC). Chi-square test was used to identify the association between independent variables and nutritional status.
Results: More than 1/4th of the total respondents had weight loss in the last three months. More than 1/4th of the participants had neuropsychological problem and psychological stress. Out of the studied population, 22.6 % had hypertension and 8.9% had diabetes. 18.5% were smokers while 40.3% were alcohol users. 40.3% were at risk of malnutrition and 4.0% were malnourished (MNA< 17.23). Sex (p = 0.04), smoking (p = 0.014), decline in food intake (p = 0.042), psychological stress (p = 0.03) and neuropsychological problem (p = 0.01) were found significantly associated with the nutritional status (p-value <0.05).
Conclusion: A significant proportion of participants were at the risk of malnourishment. Effective intervention should be designed to promote healthy aging among elders dwelling in rural areas.
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Adhikari, Shambhu P., Pragya Shrestha, and Rubee Dev. "Feasibility and Effectiveness of Telephone-Based Telephysiotherapy for Treatment of Pain in Low-Resource Setting: A Retrospective Pre-Post Design." Pain Research and Management 2020 (May 8, 2020): 1–7. http://dx.doi.org/10.1155/2020/2741278.
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Introduction. Telephysiotherapy (TPT) is a provision of physiotherapy services at a distance, using telecommunication technology when an in-person visit is not a feasible option. The objective of this study was to investigate the effectiveness of TPT in management of pain caused due to various problems among patients living in rural areas of a developing country. Methods. This retrospective study conducted in rural areas of Nepal recruited all patients who met the eligibility criteria during a day campaign. Two physiotherapists, one for assessment and another for treatment, were involved. Based on pretraining assessment finding, evidence-based individualized physiotherapy was prescribed. Pamphlets containing pictures of the prescribed exercises and instructions in the Nepali language were distributed. The treating physiotherapist made telephone calls to every patient each week to give necessary information, correction, modification, and progression of the exercise whatever required. At the end of the second and fourth weeks, pain was assessed using the Numeric Pain Rating Scale (NPRS) through telephone calls. The data were analyzed using ANOVA with repeated measures followed by pairwise comparisons. Results. Fifteen patients having pain due to various conditions participated in the study. The NPRS demonstrated significantly decreased pain (at rest: F = 3.5, p=0.04, when worst: F = 26.4, p<0.001, during activities of daily living: F = 16.6, p<0.001, and during occupation: F = 15.6, p=0.001) across time. The result met the minimal clinically important difference of NPRS, which is 2. Conclusions. The telephone-based TPT interventions demonstrated significant reduction in pain caused by various musculoskeletal problems. It could be a feasible and effective treatment option for the patients living in rural areas. However, we recommend for large-scale trials to establish effectiveness of the intervention and for its implication into routine clinical practice.
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Hamal, Pawan Kumar, Anuj Jung Rayamajhi, Nabin Pokhrel, Rupesh Kumar Yadav, Prajjwal Raj Bhattarai, and Navindra Raj Bista. "Can Ultrasound Guided Regional Anesthesia Improve Rural Anesthesia Services and Address Safety Issues in Low Income Country? Perspective from Nepal." Journal of Nepal Health Research Council 18, no. 1 (April 20, 2020): 144–46. http://dx.doi.org/10.33314/jnhrc.v18i1.2614.
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Provision of anesthesia services in a deprived area particularly in low income countries is a major challenge all over the globe. Along with issues of manpower, logistics, services, there lies agendas of safety and accuracy while delivering the services. With rise in ultrasound use in regional anesthesia, pain and perioperative care, it is prudent that some of these issues can be addressed with proper training, mentoring and monitoring. The global idea needs to be implemented locally to reach out to huge volume of patients who are inadequately treated for the various painful conditions. A group of regional enthusiasts from Nepal takes the vision and mission in Nepalese context to address the issues. Keywords: Low income country; rural anesthesia; safety; ultrasound guided regional anesthesia
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Pokharel, Tika Ram, and Hom Bahadur Rijal. "Energy Transition toward Cleaner Energy Resources in Nepal." Sustainability 13, no. 8 (April 11, 2021): 4243. http://dx.doi.org/10.3390/su13084243.
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Energy is an important input for socioeconomic development and human well-being. The rationality of energy transitions toward cleaner energy resources is not only to improve individual living conditions, but also to enhance the economic growth of a nation. Nepal is considered to be one of the countries with a low per-capita electricity use, heavily relying on traditional energy resources such as firewood and agricultural residues. The country is rich in hydropower resources. However, various economic and socioeconomic constraints have left the significant potential for hydroelectricity untapped. This study describes the energy transition patterns in Nepal based on a literature review and field survey of household energy use in the winter. We collected data from 516 households in the Solukhumbu, Panchthar, and Jhapa districts of Nepal. The rate of per-capita electricity consumption was 330 kWh/capita/year, which is significantly lower than that of other contemporary global societies such as India 1000 and China 4900 kWh/capita/year. The increasing trend in hydroelectricity production has optimistically transformed the energy sector toward cleaner resources; this correlates with the GDP per capita. Solar home systems, mini- and micro-hydropower plants, biogas technology, and improved cook stoves have been widely used, which has lowered the health and environmental burdens in rural areas. By analysing the survey data, we found that 25% of the households only relied on traditional cooking fuel, while 67% and 8% of the households relied on mixed and commercial cooking fuels, respectively. Moreover, 77% and 48% of traditional and mixed-fuel-using households were unhappy with current cooking fuels while 40% and 66% of these households preferred to use clean cooking fuels. The share of traditional energy resources decreased from 78% to 68%, while that of commercial energy resources increased from 20% to 28% from 2014/15 to 2019/20. This study suggests that future energy policies and programs should acknowledge the reality of energy transition to achieve sustainability by establishing reliable and clean sources of energy.
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Chaudhary, Mukesh Kumar, Laxmi K. Gupta, Lokendra B. Chand, Ramesh Chaudhary, and Sabin Ranpal. "A prospective study on clinico-epidemiological profile and outcome in management of poisonous snake bite." International Journal of Basic & Clinical Pharmacology 9, no. 5 (April 23, 2020): 695. http://dx.doi.org/10.18203/2319-2003.ijbcp20201742.
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Background: Snake bite is a major health problem in Nepal. According to WHO, annual morbidity due to snake bite is 162 out of 100,000 people in Nepal. Aim of the study is to observe epidemiology, clinical features, and analysis of possible relationship between time delay in administration of anti-snake venom (ASV) and mortality. Methods: This prospective observational study analyses the data of 81 patients admitted to the Lumbini zonal hospital, Butwal, Rupandehi, Nepal with history of snake bite between April to September, 2017.Results: In this study 56% patients were female. Patients of age group (15-30) years were maximum (38.27%). The study showed that 50.61% of snake bites were occurred outside home. Most of patients (84%) were from the Terai region. Average no. of vials used per case was (28±10) vials. Most of victims of snake bite were from rural areas. In most of cases we found that prothrombin time was prolonged. It was found that most of patients 57% reach hospital before 4 hours of snake bite. The mean days of hospital stay was 6±2.86. Most of case of snake bite was unknown (62%). The mortality rate in this study was 6.17%.Conclusions: There is a great need to improve in existing health care conditions for effective management of snake bite; it requires training of the personnel engaged in the emergency health care management, development of national guidelines based on the clinical trials, improving the distribution and easy availability of antivenom.
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Lamichhane, Rajendra Prasad, Masahiro Amano, Takeshi Kadota, and Akihiko Sasaki. "An Analysis of the Socioeconomic Conditions of the Rural People based on Caste : Implications for Suitable Watershed Management in the Kaski District, Nepal." Journal of Forest Planning 6, no. 1 (2000): 25–37. http://dx.doi.org/10.20659/jfp.6.1_25.
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Bhandari, Bak, Lee, Chon, Bhattachan, Rimal, Shrestha, et al. "Assessment of Socio-Demographic Factors, Mother and Child Health Status, Water, Sanitation, and Hygienic Conditions Existing in a Hilly Rural Village of Nepal." International Journal of Environmental Research and Public Health 16, no. 20 (October 17, 2019): 3965. http://dx.doi.org/10.3390/ijerph16203965.
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In many low income developing countries, socioeconomic, environmental and demographic factors have been linked to around half of the disease related deaths that occur each year. The aim of this study is to investigate the sociodemographic factors, mother and child health status, water, sanitation, and hygienic conditions of a Nepalese community residing in a hilly rural village, and to identify factors associated with mother and child health status and the occurrence of diarrheal and febrile disease. A community-based cross-sectional survey was carried out and 315 households from the village of Narjamandap were included in this study. Factors associated with diarrhea, febrile disease, and full maternal and under-five immunizations were assessed using logistic regression. Results showed that higher education level (middle school versus primary education; Odds Ratio (OR): 0.55, p = 0.04; high school versus primary education; OR 0.21, p = 0.001) and having a toilet facility at home were significantly associated with a lower risk of developing diarrhea and febrile disease (OR 0.49, p = 0.01), while, interestingly, the use of improved water supply was associated with higher risk (OR 3.07, p = 0.005). In terms of maternal immunization, the odds of receiving a tetanus toxoid vaccination were higher in women who had regular antenatal checkups (OR 12.9, p < 0.001), and in those who developed complications during pregnancy (OR 4.54, p = 0.04); for under-five immunization, the odds of receiving full vaccination were higher among children from households that reported diarrhea (OR 2.76, p < 0.001). The findings of this study indicated that gaps still exist in the mother and child healthcare being provided, in terms of receiving antenatal checkups and basic immunizations, as evidenced by irregular antenatal checkups, incomplete and zero vaccination cases, and higher under-five deaths. Specific public health interventions to promote maternal health and the health of under-five children are suggested.
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Silwal, Ram Chandra, Akira Shibanuma, Amod Kumar Poudyal, Subaru Ikeda, and Masamine Jimba. "Difference in factors associated with continuum of care completion rate from pregnancy to postpartum period in rural Nepal: a community-based, cross-sectional study." BMJ Open 11, no. 6 (June 2021): e044928. http://dx.doi.org/10.1136/bmjopen-2020-044928.
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ObjectivesThis study aimed to investigate the continuum of care (CoC) completion rate in maternal, neonatal and child health and its associated factors among mothers in two ecological regions in Nepal.DesignThis was a community-based, cross-sectional study, for which data were collected through face-to-face interviews using a structured questionnaire. Multiple logistic regression analyses were conducted to determine the associated factors.SettingThis was carried out in two rural districts of Nepal, in different regions: one in the hills (Dhading) and another in the flatlands called Terai (Nawalparasi). The data were collected between July and December 2016.ParticipantsMothers who gave birth within a year before this study were included as participants. In total, there were 1803 participants.An outcome measureThe outcome of this study was measured by the CoC completion rate when a mother completes four antenatal check-ups, deliver at a health facility and receives postnatal care within 24 hours of delivery.ResultsThe CoC completion rates were 41% in Dhading and 28% in Nawalparasi. In Dhading, shorter travel time to a health facility and higher wealth quintiles were associated with a better CoC completion rate. In Nawalparasi, the CoC completion rate was affected by parity and decision-making for pregnancy care.ConclusionsThe CoC completion rate was low in both districts in Nepal. However, factors associated with the CoC completion rate varied by district. Differences in these factors might be reflected by geographical and socioeconomic conditions and the characteristics of household decision making in these districts.
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Giri, Krishna. "Catastrophic Household Health Expenditures and its Poverty Impact (A Case Study of Rural and Urban Area of Eastern Chitwan)." Interdisciplinary Journal of Management and Social Sciences 2, no. 1 (April 29, 2021): 90–101. http://dx.doi.org/10.3126/ijmss.v2i1.36747.
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The principle of "health as a fundamental right of the people" is enshrined in the constitution of Nepal 2072 which has guided the state’s obligation towards good health for all Nepali people. In order to ensure this constitutional obligation there is a need to provide equitable health services that factor in differences in geographical area, gender, caste and economic conditions. The study describes the field study on the catastrophic health expenditure and its impact on poverty in Ratnanagar municipality and shaktikhor village of eastern chitwan. The people in the study area are highly affected by catastrophic health expenditure. Catastrophic health expenditure is experienced by all socio- economic groups but severe impoverishment impact is experienced by poor. The impact of out-of pocket payments for health care can become catastrophic over time and can significantly affect the living standards, welfare and poverty of individuals or household.
The study is based on primary as well as secondary data. Primary data were collected from primary sources. The sources of primary data are obviously based on the information obtained from the head of the households. A household survey and group discussion techniques were used to obtain statistical data and required information.
The findings reveal that 28 percent of the total studied households are experiencing catastrophic health expenditure. 7 percent of the household are poor and 6 percent of the households fall below the poverty line because of the health expenditure. It was also found that the normalized poverty gap as 1.97 percent whiles the poverty gap after deduction of OOP is 2.65 percent (an increase by 0.68 percent). This indicates a percentage point change by 34.5 percent of the conventional poverty gap.
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Sharma, Bimala, S. Wagle, N. Shrestha, MP Bhatt, and BR Tiwari. "Factors Associated with Poor Self-rated Health in Machhapuchhre Rural Municipality of Kaski District, Nepal: A Cross-sectional Survey." Journal of Gandaki Medical College-Nepal 11, no. 02 (December 31, 2018): 34–40. http://dx.doi.org/10.3126/jgmcn.v11i02.22960.
Full textAbstract:
Introduction: Self-rated health reflects respondents’ overall perceptions of their general health status. It is a simple and reliable measure of general health status of the population.
Objective: The objective of the study was to assess prevalence and associated factors of poor self-rated health among adult population in Machhapuchhre Rural Municipality of Kaski District, Nepal.
Methods: A cross-sectional household survey was conducted among adult population at Machhapuchhre Rural Municipality. A structured questionnaire was used for the face to face interview. Household survey was conducted in July 2018. Self-rated health was measured by using a single question such as ‘In general, how would you rate your health?’ Responses were arranged along a five-point Likert-type scale: ‘excellent’, ‘good’, ‘fair’, ‘poor’ and very poor. The outcome variable was dichotomized as ‘good’ (excellent, good or fair) or ‘poor’ (poor or very poor). Chi-square test and multiple logistic regression analysis were performed; and odds ratios with corresponding 95% confidence intervals for poor self-rated health were presented.
Results: Of total respondents, 13.2% respondents reported that they perceived their health as poor. Of the total, 14.3% respondents stated themselves as overweight and 8.8% mentioned they were unhappy. The study found that illiterate respondents, respondents with smoking habit and the individuals with poor psychological conditions were more likely to perceive their health as poor. Illiteracy, current smoking, perceived overweight, unhappiness, suicidal ideation and having depressed feeling were significant factors associated with poor self-rated health in the study.
Conclusion: Education, health behavior and psychosocial health variables has important influences on self-rated health.
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Fischer, Melanie, Jana Brettin, Sigrid Roessner, Ariane Walz, Monique Fort, and Oliver Korup. "Rare flood scenarios for a rapidly growing high-mountain city: Pokhara, Nepal." Natural Hazards and Earth System Sciences 22, no. 9 (September 26, 2022): 3105–23. http://dx.doi.org/10.5194/nhess-22-3105-2022.
Full textAbstract:
Abstract. Pokhara (ca. 850 m a.s.l.), Nepal's second-largest city, lies at the foot of the Higher Himalayas and has more than tripled its population in the past 3 decades. Construction materials are in high demand in rapidly expanding built-up areas, and several informal settlements cater to unregulated sand and gravel mining in the Pokhara Valley's main river, the Seti Khola. This river is fed by the Sabche glacier below Annapurna III (7555 m a.s.l.), some 35 km upstream of the city, and traverses one of the steepest topographic gradients in the Himalayas. In May 2012 a sudden flood caused >70 fatalities and intense damage along this river and rekindled concerns about flood risk management. We estimate the flow dynamics and inundation depths of flood scenarios using the hydrodynamic model HEC-RAS (Hydrologic Engineering Center’s River Analysis System). We simulate the potential impacts of peak discharges from 1000 to 10 000 m3 s−1 on land cover based on high-resolution Maxar satellite imagery and OpenStreetMap data (buildings and road network). We also trace the dynamics of two informal settlements near Kaseri and Yamdi with high potential flood impact from RapidEye, PlanetScope, and Google Earth imagery of the past 2 decades. Our hydrodynamic simulations highlight several sites of potential hydraulic ponding that would largely affect these informal settlements and sites of sand and gravel mining. These built-up areas grew between 3- and 20-fold, thus likely raising local flood exposure well beyond changes in flood hazard. Besides these drastic local changes, about 1 % of Pokhara's built-up urban area and essential rural road network is in the highest-hazard zones highlighted by our flood simulations. Our results stress the need to adapt early-warning strategies for locally differing hydrological and geomorphic conditions in this rapidly growing urban watershed.
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Pandey, Rishikesh. "Life and Livelihoods in the ‘Forbidden Kingdom’, the Trans-Himalaya, Nepal." Dhaulagiri Journal of Sociology and Anthropology 11 (December 31, 2017): 24–59. http://dx.doi.org/10.3126/dsaj.v11i0.18822.
Full textAbstract:
Rural livelihoods in Nepal are generally based on ecosystem resources. Despite a large number of studies on the Himalayan livelihoods, representation of the Trans-Himalaya, particularly Upper-Mustang, are rare. Such a scarcity could be associated with the fact that the place was isolated from the rest of the world and mainstream Nepali societies for a long time and also used to be known as ‘forbidden kingdom.’ This paper documents livelihood situation of Upper-Mustang in reference to the data collected in 66 households, in-depth interviews taken with 22 key informants, and focus group discussions conducted in 6 locations. Household livelihood system was studied with reference to five livelihood capitals, which were transformed into Livelihood Capital Index (LCI) at first and Livelihood Sustainability Index (LSI) later. Households in the Trans-Himalaya fulfill their livelihood requirement from multiple sources such as farming and livestock ranching together with small-scale enterprises, remittance and labouring. Overall status of livelihood capital is weak that cannot satisfy households’ food and livelihood requirements. There exists inter-household variation in the status of livelihood capitals.The households with diversified livelihood options have relatively secured livelihood, although such security is relative to the households of Upper-Mustang. Considering the weak status of agro-livestock system, which is mostly associated with unfavorable geographic conditions and lack of agro-livestock service provision, the region has sound scope for tourism industries and production as well as marketing of medicinal and aromatic plants, and fruits. Therefore, there is a plenty of possibility of diversifying livelihoods, however, neither the communities are eager to do so nor the state policies are encouraging. Therefore, together with expansion and advancement of physical infrastructure, effective service delivery and provision for social welfare, government programs should be facilitative for optimum and sustainable utilization of ecosystem resources for the sustainability of household livelihood system.Dhaulagiri Journal of Sociology and Anthropology Vol.11, 2017; 24-59
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Thapa, B. J. "Climate change perception and adaptation among indigenous farmers : A study on Thamis of Dolkha." Banko Janakari 29, no. 2 (December 31, 2019): 42–48. http://dx.doi.org/10.3126/banko.v29i2.28098.
Full textAbstract:
Anthropogenic climate change is perceived as one of the most threatening global environmental issues today. A common finding in the past researches is that most of the vulnerable communities affected by the changing climate are the indigenous ones living in rural parts of the world, mostly from the developing nations. These indigenous communities have a close relation with their surrounding environments which have provided them a vast knowledge and clues about the micro-climatic conditions in their surroundings. These clues shape their perceptions and adaptation practices. This research was conducted on the indigenous Thami Community of Nepal focusing on their perceptions towards changing climate and their adaptation practices in congruence with their local and indigenous knowledge about their environment. As Thamis are mostly reliant on subsistence agricultural farming for their livelihood, this study mainly focuses on the impacts of climate change on agriculture practices of Thami Community of Dolakha district. In this study it was found that the practices of Thamis were severely affected by the changing environmental conditions. The farmers perceived changes in temperatures, precipitation and extreme weather events, and interpreted those as per their understanding of their surroundings
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Manandhar, Dev Chandra, and Siddhi Prasad Koirala. "Role of Private School on Continuing Education in the Context of COVID-19 in Nepal." International Research Journal of MMC 2, no. 1 (February 23, 2021): 41–50. http://dx.doi.org/10.3126/irjmmc.v2i1.35128.
Full textAbstract:
Government can apply learning continuity plan followed by private school during the lockdown period in the context of Covid-19 which appears as outbreak from Wuhan, China and spread rapidly all over the world. Since education is the systematic process of getting or receiving knowledge in the institutions, privatization of education is also being accepted by many countries and have brought the policy to emerge the education sector with the help of public and private schools. In the present context, when the Corona virus spread rapidly all over the world, WHO initiates to stay safe in quarantines and UNESCO suggest about closures of schools and universities. In this context, a study was conducted in 8 schools of every province of Nepal with Kathmandu valley. Schools were chosen randomly as well as mixed method was used to analyze the study. Chi-square, cross tabulation and correlation analysis was done to elaborate the data and SPSS vol-20 was used to interpret the data. In Nepal, private schools of urban area and some public schools are playing an effective role in continuing education through online learning constructing digital infrastructure. However, the majority of private schools are found less effective in online class due to geographic and socioeconomic conditions as well as they are facing electricity and internet problems to continue education in this pandemic era. So, government as well as private sector should prepare Temporary Learning Centre (TLC) and bring the Learning Continuity Plan (LCP) to urban and rural areas to continue education in the COVID -19 periods.
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Adhikari, Dewa. "A Study On Health Status Of Children Under Five Years Of Age In A Rural Village Of Eastern Part Of Nepal." Journal of Nobel Medical College 2, no. 1 (March 3, 2013): 49–54. http://dx.doi.org/10.3126/jonmc.v2i1.7676.
Full textAbstract:
Introduction: Every needy child should receive the best medical and surgical attention. In 1940, the White house Conference proposed adequate health services including medical and dental examination, immunization and early detection and treatment of diseases, vision and hearing tests, prevention and control of disease, health records and health services facilities. Objectives: To assess the health status of under five children. To know the treatment preference of the parents towards their sick children. To initiate control measures early, by allocating the health resources more efficiently and providing health awareness activities. Materials and Methods: Descriptive cross-sectional study was conducted. The entire 1-5 years age child (40children) residing in Dharan Municipality ward. No-17 at Phoklen Tapu was included. Simple random sampling technique (lottery method) was used to select the village and Census survey technique was followed to find out the 1-5 years children. The survey was conducted by investigator herself and self develop tools were used to health status of the child. Results: Most of the morbid conditions founded in the study were related to skin diseases (ring worm, boils/wound, cuts, eczema/ redness), ear infection, enlarged lymph node, Pneumonia, Diarrhoea/ vomiting, abdominal enlargement and malnutrition with different Grade. Conclusion: Majority of the parent were not having health education regarding child care. The treat their child with home remedies, by faith healer then after third time they seek sick child with health personnel. Journal of Nobel Medical College Vol. 2, No.1 Issue 3 Nov.-April 2013 Page 49-54 DOI: http://dx.doi.org/10.3126/jonmc.v2i1.7676
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Meierhofer, Regula, Carola Bänziger, Sandro Deppeler, Bal Kunwar, and Madan Bhatta. "From Water Source to Tap of Ceramic Filters—Factors That Influence Water Quality Between Collection and Consumption in Rural Households in Nepal." International Journal of Environmental Research and Public Health 15, no. 11 (November 1, 2018): 2439. http://dx.doi.org/10.3390/ijerph15112439.
Full textAbstract:
The study assessed changes in water quality between the water source and the tap of locally produced low cost ceramic water filters used by a community living in hygienically critical conditions in a remote mountainous area in Western Nepal. Data was collected from 42 rural households during two visits. The effectiveness of filter handling on its performance was assessed through microbiological analysis, structured household interviews and structured observations. Water quality decreased significantly when source water was filled into transport containers, while the use of the filters improved drinking water quality for about 40% of the households. Highly inadequate filter cleaning practices involving the use of contaminated raw water, hands (geo mean = 110 E. coli CFU/100 mL) and cleaning tools (geo mean = 80 E. coli CFU/100 mL) stained hygienic parts of the filter. The use of boiling water to disinfect the filters was significantly correlated with improved filter performance and should be further promoted. However, even disinfected filters achieved a very low average LRV for E. coli of 0.4 in the field and performed worse than during laboratory tests (LRV for E. coli of 1.5–2). Comprehensive training on adequate filter handling, as well as better filter products, are required to improve the impact of filter use.
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Visscher, Marty O., Aimee Summers, Vivek Narendran, Subarna Khatry, Jeevan Sherchand, Steven LeClerq, Joanne Katz, James Tielsch, and Luke Mullany. "Birthweight and Environmental Conditions Impact Skin Barrier Adaptation in Neonates Receiving Natural Oil Massage." Biomedicine Hub 6, no. 1 (January 18, 2021): 17–24. http://dx.doi.org/10.1159/000512274.
Full textAbstract:
<b><i>Introduction:</i></b> Skin interventions have been implemented to reduce neonatal mortality, demonstrating the skin’s role in neonatal innate immunity. We examined the impact of birthweight and environmental conditions on skin integrity in infants receiving oil massage in rural Nepal. <b><i>Methods:</i></b> In a community-based cluster randomized controlled trial, 991 premature and full-term infants were grouped by birthweight as: (1) 920–1,560 g, (2) 1,570–2,450 g, (3) 2,460–2,990 g, and (4) 3,000–4,050 g and by high or low heat index (HI). Skin integrity was measured as erythema, rash, dryness, pH, protein concentration, and transepidermal water loss (TEWL). <b><i>Results:</i></b> Skin pH was higher for the smallest (group 1) than the largest infants (group 4) and higher for group 2 than 3 and 4. Arm and leg rash differed for all 4 groups, with the least amount of rash for the smallest babies. Erythema was lower for group 1 than all others. The lower day 1 values for pH, TEWL and protein at high versus low HI remained lower over 28 days. The pH reduction was faster at high HI. Erythema (arm, leg) was more severe at high HI. Rash severity was greater at high HI for arms and legs every day. <b><i>Conclusions:</i></b> Birthweight influenced the skin response to oil massage. The smallest infants had the lowermost skin irritation, suggesting diminished ability to mount an inflammatory response. High HI may be protective for premature infants in low resource settings.