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1
Sekine, Kazutaka, and Mellisa Roskosky. "Emergency response in water, sanitation and hygiene to control cholera in post-earthquake Nepal in 2016." Journal of Water, Sanitation and Hygiene for Development 8, no. 4 (July 16, 2018): 799–802. http://dx.doi.org/10.2166/washdev.2018.016.
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Abstract After the 2015 earthquake in Nepal that killed approximately 9,000 people, the country faced an increased risk of cholera outbreaks due to extensive destruction of water and sanitation infrastructure and massive displacement. The disaster revealed long-standing weaknesses in water and sanitation systems in the country. Anticipating a cholera outbreak in 2016, UNICEF, Johns Hopkins University, and the Group for Technical Assistance partnered to support the Government of Nepal to ensure a safe water supply and improve sanitation and hygiene. This article discusses challenges, gaps, lessons learned and recommendations that were drawn from the authors' experience in cholera prevention and control in post-earthquake Nepal. Challenges identified include lack of regular water quality testing and monitoring, inconsistent use of point-of-use water treatment products, and lack of a fast-track mechanism for rapid response. The article argues for building a resilient water and sanitation system to secure sustainable and equitable access to safe drinking water.
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Singh, Sarswoti, Nil P. Dhital, Rajan Paudel, Dipak K. Sah, Arjun Hamal, and Junu Shrestha. "Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal." Journal of Institute of Medicine Nepal 42, no. 3 (December 31, 2020): 76–81. http://dx.doi.org/10.3126/jiom.v42i3.37590.
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Introduction Childhood malnutrition is a critical public health concern in Nepal. Slums are supposed to have poor water, sanitation and hygiene practices. This study has aimed to examine association between water, sanitation and hygiene (WASH) variables and stunting among 6 to 59 months children of slums of Kathmandu metropolitan city.
MethodsDescriptive cross-sectional study design was employed where 335 households were included in the study. Data were collected using standard questionnaire and observation checklist. Weight and height of children were taken using seca digital weighing scale and wooden height board of UNICEF respectively. Anthropometric analysis was done using WHO Anthro version 3.2.2 software and other statistical analysis was conducted using SPSSversion 22 software.
ResultsThe prevalence of stunting was 23%. Four out of five household (80%) in slum used to drink water from unimproved source. Absence of handwashing station (AOR=2.109, 95% CI:1.05-3.27) and absence of water storage covering (AOR=2.46, 95% CI: 1.16–5.23) were found to be significantly contributing to stunting status.
ConclusionThis study highlights the importance of good WASH practices, and the potential of WASH interventions, to contribute for the improved childhood stunting living in urban slums in Nepal. Also, the findings recommend the need of strategies on purification of water, improvement of toilets, behaviour change and awareness related activities to improve the stunting among children.
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Yount, Kathryn M., Cari Jo Clark, Irina Bergenfeld, Zara Khan, Yuk Fai Cheong, Sadhvi Kalra, Sudhindra Sharma, et al. "Impact evaluation of the Care Tipping Point Initiative in Nepal: study protocol for a mixed-methods cluster randomised controlled trial." BMJ Open 11, no. 7 (July 2021): e042032. http://dx.doi.org/10.1136/bmjopen-2020-042032.
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IntroductionGirl child, early and forced marriage (CEFM) persists in South Asia, with long-term consequences for girls. CARE’s Tipping Point Initiative (TPI) addresses the causes of CEFM by challenging repressive gender norms and inequalities. The TPI engages different participant groups on programmatic topics and supports community dialogue to build girls’ agency, shift inequitable power relations, and change community norms sustaining CEFM.Methods/analysisThe Nepal TPI impact evaluation has an integrated, mixed-methods design. The quantitative evaluation is a three-arm, cluster randomised controlled trial (control; Tipping Point Programme (TPP); TPP+ with emphasised social norms change). Fifty-four clusters of ~200 households were selected from two districts (27:27) with probability proportional to size and randomised. A household census ascertained eligible study participants, including unmarried girls and boys 12–16 years (1242:1242) and women and men 25+ years (270:270). Baseline participation was 1134 girls, 1154 boys, 270 women and 270 men. Questionnaires covered agency; social networks/norms; and discrimination/violence. Thirty in-depth interviews, 8 key-informant interviews and 32 focus group discussions were held across eight TPP/TPP+ clusters. Guides covered gender roles/aspirations; marriage decisions; girls’ safety/mobility; collective action; perceived shifts in child marriage; and norms about girls. Monitoring involves qualitative interviews, focus groups and session/event observations over two visits. Qualitative analyses follow a modified grounded theory approach. Quantitative analyses apply intention to treat, regression-based difference-in-difference strategies to assess impacts on primary (married, marriage hazard) and secondary outcomes, targeted endline tracing and regression-based methods to address potential selection bias.Ethics/disseminationThe Nepal Social Welfare Council approved CARE Nepal to operate in the study districts. Emory (IRB00109419) and the Nepal Health Research Council (161–2019) approved the study. We follow UNICEF and CARE guidelines for ethical research involving children and gender-based violence. Study materials are here or available on request. We will share findings through clinicaltrials.gov, CARE reports/briefs and publications.Trial registration numberNCT04015856.
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Pokharel, Ridesh, Bibhor Pokharel, Rajan Bhusal, and Deepika Chapagain. "Nutrition status of children in Nepal: Analysis from the findings of Nepal Demographic Health Survey 2016." Grande Medical Journal 1, no. 2 (December 31, 2019): 122–26. http://dx.doi.org/10.3126/gmj.v1i2.27100.
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Introduction: Nutrition is simply the process of intake of food which is required according to the body need. A well balanced food with regular physical activity is a foundation for a good health. Some effects in health such as reduced immunity, increased susceptibility to disease, poor physical and mental development and reduction in productive capacity can be seen as a result of poor nutrition. The indicators of nutrition are stunting, wasting, underweight and overweight among the children.
Methods: The 2016 Nepal Demographic Health Survey (NDHS) measured the height and weight of eligible children under age 5 in sample households. Weight measurements were taken from lightweight SECA infant scales with a digital display (model no. SECA 878U), designed and supplied by the United Nations Children’s Fund (UNICEF). Height was measured with a measuring board (Shorr Boards®). Recumbent length was measured for children younger than age 24 months, and standing height was measured for older children.
Results: Overall, 36% of children under age 5 were stunted, with 12% being severely stunted (too short for their age); 10% were wasted, with 2% severely wasted (too thin for their height); and 27% were underweight, with 5% severely underweight (too thin for their age), while around 1% of the children were overweight (heavy for their height).
Conclusion: The different indicators of nutritional status among children such as stunting, wasting and underweight are decreasing. The national program and effective contribution from several non-governmental agencies is the main reason for the improvement in nutritious status.
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Panthy, Laxmi, Jagadishwor Panthi, Kapil Amgain, Pooja Thapaliya, and Jos Van Laar. "COVID-19 in Nepal: Scarcity of Personal Protective Equipment (PPE) and its Alternative." Europasian Journal of Medical Sciences 2, no. 1 (May 4, 2020): 74–80. http://dx.doi.org/10.46405/ejms.v2i1.47.
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The Coronavirus Disease (COVID-19), which was first discovered in Wuhan, China in December 2019, puts an entire world under unprecedented danger. Powerful nations such as the United States of America and European Union countries having their hardest time to get sufficient medical protective gear, ensure market operation, and eventually to save people from dying of corona infection. To date, 213 countries have been affected. World Health Organization (WHO) has confirmed 123,010 deaths and 1914,916 cases with coronavirus positive as of 15 April 2020. It has created a global public health emergency. There is no specific prophylaxis or treatment available yet. Hand washing, covering one's mouth when coughing, social distancing, self-isolation, and quarantine are preventive measures to hamper the spread of disease. Currently, Nepal has entered into the second phase of the outbreak. Health care workers (HCW) at the frontlines of the battle against COVID-19 are ill-equipped to treat coronavirus patients, due to not having adequate personal protective equipment in Nepal. Additionally, there is a shortage of PPE in the world market due to the aggressive buying of PPE globally. According to UNICEF, demand for protective gear used in response to COVID-19 has increased as high as 1000-2000 folds than of annual demand.
Conclusion: In this global scarcity, locally made PPE has become another alternate way for Nepal. Hence, some of the local garments, hospitals, and local rural municipalities have prepared and delivered to HCWs. Although these Nepal-made PPE are not as high quality as imported ones, they at least offer some protection to medical staff.
Recommendations: Following is our recommendation to the stakeholders:
Learn- from countries with the lowest mortality rate and best medical & preventive practices policies, as fast as possible.
Alternative Approaches - are necessary to decrease the risk of exposure to HCWs and are safe for patient care in this global market scarcity of PPE.
Solidarity- between richer and poorer countries is necessary.
Cooperate globally - international cooperation between governments, scientists, corporations, and health care professionals is not only needed but also necessary to end this pandemic.
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Banerjee, Subhanil, Ashok Kumar Sar, and Shilpa Pandey. "Improved yet Unsafe: An Aquatic Perspective of Indian Infant Mortality." Journal of Health Management 22, no. 1 (March 2020): 57–66. http://dx.doi.org/10.1177/0972063420908379.
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Infant mortality rate (IMR) is an important development indicator and a vital component of millennium development goals (MDGs) set by United Nations Development Programme (UNDP). According to UNDP, so far India has only fared moderately in reducing IMR (Goal 4 of MDGs). India (32) ranks 144th among 196 countries regarding IMR as per the 2017 data availed from World Development Indicators. Its adjacent countries such as Bhutan (25.6), Bangladesh (26.9) and Nepal (27.8) have fared much better regarding infant survival. Numbers within the parentheses indicate the IMR of the respective country. The United Nations Children’s Fund (UNICEF) has identified that IMR among families with better access to improved drinking water sources and toilet is much lower than those bereft of the same. This inference has been drawn from National Family Health Survey 3 data (NFHS III). The present study investigates into the aforementioned relation analysing NFHS IV data. The result depicts that contrary to UNICEF’s findings, IMR increases with better accessibility to improved water sources. Further to this, the article shows that an additional aqua-related practice together with improved drinking water sources might lead to the betterment of IMR for India.
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Yadav, Dipendra Kumar, Bhoopendra Sharma, Naveen Shrestha, Isha Karmacharya, and Saroj Yadav. "Prevalence of Risk Factors of Major NonCommunicable Diseases among Adolescents of Higher Secondary Schools of Kaski, District." Journal of Nepal Health Research Council 16, no. 3 (November 2, 2018): 307–12. http://dx.doi.org/10.3126/jnhrc.v16i3.21429.
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Background: The main aim of this study is to determine the prevalence of major Non communicable disease risk factors among higher secondary school students.Methods: A cross-sectional study was conducted among higher secondary students of grade 11 and 12 of Kaski district in Nepal. The study period was from July 2016 to June 2017. Total sample 640 higher secondary students were recruited through two-stage cluster sampling. Self-administrated questionnaire was used for the data collection tool along with other tools which were used such as UNICEF electronic weighing scale, stature meter and mechanical aneroid sphygmomanometer. Ethical approval was obtained from IRC, Pokhara University. Data were entered into EpiData software and analysis was performed with the help of the Statistical Package for Social Science (SPSS).Results: The prevalence of smoking was 6.1% which was high in male (11.9%) than female (0.6%). Alcohol consumption practice among the adolescents was 18.9%. Family history of hypertension was seen higher than family history of diabetes.The prevalence of hypertension was 11.7%.High prevalence of abnormal values of systolic and diastolic BP was found in male than female students. Overweight was seen in 6.1% students. Prevalence of obesity was almost equal in both groups.Conclusions: There is high prevalence of smoking, alcoholism among adolescents. Hypertension was more common than diabetes among adolescents.
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Yadav, Dipendra Kumar, Bhoopendra Sharma, Naveen Shrestha, Isha Karmacharya, and Saroj Yadav. "Prevalence of Risk Factors of Major Non-Communicable Diseases among Adolescents of Higher Secondary Schools of Kaski District." Journal of Nepal Health Research Council 16, no. 3 (October 30, 2018): 307–12. http://dx.doi.org/10.33314/jnhrc.v16i3.1415.
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Background: The main aim of this study is to determine the prevalence of major non communicable disease risk factors among higher secondary school students.Methods: A cross-sectional study was conducted among higher secondary students of grade 11 and 12 of Kaski district in Nepal. The study period was from July 2016 to June 2017. Total sample 640 higher secondary students were recruited through two-stage cluster sampling. Self-administrated questionnaire was used for the data collection tool along with other tools which were used such as UNICEF electronic weighing scale, stature meter and mechanical aneroid sphygmomanometer. Ethical approval was obtained from IRC, Pokhara University. Data were entered intoEpiData software and analysis was performed with the help of the Statistical Package for Social Science (SPSS).Results: The prevalence of smoking was 6.1% which was high in male (11.9%) than female (0.6%). Alcohol consumption practice among the adolescents was 18.9%. Family history of hypertension was seen higher than family history of diabetes.The prevalence of hypertension was 11.7%. High prevalence of abnormal values of systolic and diastolic BP was found in male than female students. Overweight was seen in 6.1% students. Prevalence of obesity was almost equal in both groups.Conclusions: There is high prevalence of smoking, alcoholism among adolescents. Hypertension was more common than overwieght among adolescents.Keywords: Adolescent; college students; non-communicable diseases; risk factors.
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Chattopadhyay, Nandita, and Masani Saumitra. "Developmental Outcome in Children with Malnutrition." Journal of Nepal Paediatric Society 36, no. 2 (December 31, 2016): 170–77. http://dx.doi.org/10.3126/jnps.v36i2.14619.
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Background: Developmental challenges and malnutrition are two major childhood health problems in the developing world and malnutrition is a major risk factor for poor development, which can, ultimately, lead to developmental challenges with life-long implications, affecting the individual, the family and the society at-large.Materials and Methods: We searched PUBMED & COCHRANE REVIEW databases, published documents from WHO, UNICEF, UNDP and the World Bank and citations thereof, for relevant literature on brain development and malnutrition, dietary supplementation and brain development.Results: Effect of nutrition on the developing brain has been thoroughly studied and established. Undernutrition, particularly during fetal and 1st two years of postnatal life, is a major risk factor for poor neuro-development, leading to motor, cognitive and speech delay, as well as behavioral problems and learning disabilities. Macro and micro-nutrients, like proteins, Iron, Iodine, Zinc, vitamins-B, C and D, choline and essential fatty acids are essential for proper brain development. Supplementation of pregnant and lactating mothers, infants and toddlers with multiple micronutrient, specially Iron, Iodine, Vitamins B12 and Folate and choline has been found beneficial, particularly among the vulnerable population.Conclusion: Dietary supplementation for pregnant and lactating mothers, infants and toddlers along with a congenial socio-emotional environment and cognitive stimulation from an early age can go a long way to help the child at-risk attain his developmental potential.J Nepal Paediatr Soc 2016;36(2):170-177.
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Owais, Aatekah, Sara Wuehler, James Lee, Oumar Samb, Andrew Thorne-Lyman, Joanne Katz, Kuntal Saha, and Rebecca Heidkamp. "How Can We Improve the Measurement of Iron Folic Acid Coverage Globally? Key Findings from Recent Measurement Research." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 878. http://dx.doi.org/10.1093/cdn/nzaa053_083.
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Abstract Objectives Daily Iron-Folic Acid (IFA) supplementation is recommended for all pregnant women but there is no global standard coverage indicator. The validity of common IFA consumption indicators is questionable. The WHO UNICEF Technical Expert Advisory Group for Nutrition Monitoring and partners have supported multiple efforts to identify a feasible and valid indicator of IFA coverage for reporting by World Health Assembly member states. Methods In 2019 we conducted 1) key informant interviews (KII) in 8 countries 2) an online survey among 58 nutrition professionals from 31 countries 3) cognitive interviews with postpartum women in Senegal, Bangladesh and Nepal and 4) advanced analysis of determinants of IFA data quality across four Demographic and Health Surveys (DHS). Together these methods characterized current challenges and identified ways to improve IFA coverage measurement. Results The KII and online surveys reported similar challenges. Less than half (45%) of online survey respondents were satisfied with their current methods for collecting IFA coverage data. Recommended changes include reduced recall period, adding questions about counseling, including other beneficiary groups and assessing supply issues. Cognitive interviews confirmed that women find it difficult to answer questions about numbers of pills consumed. Results from the DHS data quality analysis are forthcoming. Conclusions IFA coverage measurement is a global priority and there is clear demand for a revised indicator and guidance for collection in survey and administrative systems. While indicators of IFA delivery are more feasible there are promising ways to improve women's report of amount of IFA consumed. Funding Sources Bill & Melinda Gates Foundation.
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Upadhyay, S., A. Sharma, P. Rijal, and S. Shrestha. "Review of Paediatrics In-Patient at Nepal Medical College and Teaching Hospital." Journal of Nepal Paediatric Society 31, no. 1 (January 11, 2011): 25–29. http://dx.doi.org/10.3126/jnps.v31i1.3262.
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Introduction: This retrospective study was undertaken to analyze the disease pattern in the Pediatric ward in a Medical College. After analyzing the data, our study would emphasize on the prevention and the management modality of the most prevalent diseases in the community. Methodology: This study was carried out retrospectively for one year from January 2008 - December 2008 on the basis of age and sex and the frequency of disease according to the system involved. Results: A total number of 453 patients were admitted during the study period. There were 267(59%) male and 186(41%) female children. Less than five years age group accounted for 180(39.7%) excluding the neonate. In the study period, respiratory tract infections were the commonest cause of admission in all age group 198(43.7%), gastrointestinal including diarrhoeal diseases were 112(24.7%), enteric fever comprised of 22(5%), and other disease comprised of about 143(31.5%) of the total admissions. CNS diseases comprised of 43(9%) of which 7(16%) were meningitis and meningoencephalitis, 26(60%) of the total CNS cases were due to febrile convulsion. Respiratory diseases were found to be the major cause of morbidity in children. Conclusion: Children under five years age being the most common age group amongst all, with infection being the most predominant cause of Pediatric morbidity, the WHO/UNICEF algorithm for Integrated Management of Childhood Illness (IMCI) is specifically suited for the developing country like ours. Key words: Paediatric Inpatient; Morbidity; IMCI DOI: 10.3126/jnps.v31i1.3262J Nep Paedtr Soc 2010;31(1):25-29
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Thapa, Bijay Kumar, Kapil Kumar Pokharel, Nitendra Chaurasia, Alok Acharya, Rimu Mishra, and Ganesh Sharma. "Reality of having bed nets at home, their status and pattern of using it at night among the population of Lakhantari Village Development Committee of Nepal." Journal of College of Medical Sciences-Nepal 14, no. 1 (March 30, 2018): 39–43. http://dx.doi.org/10.3126/jcmsn.v14i1.18838.
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Background & Objectives:The use of insecticide treated nets has been advocated for the prevention of the vector borne transmitted disease (malaria) by the World Health Organization and UNICEF for more than a decade. In spite of this, there is no significant reduction in the transmission of the disease. Main objectives of study were to find out the real pattern of using it, to find out the physical integrity of the bed nets being used, and to prove the correlation in between the physical integrity of bed nets and the disease outcome. Torn bed nets with holes size more than 1.2 mm were considered as “holes” in this study.Materials & Methods:A community based cross- sectional study was carried out in Lakhantari VDC within the duration of two weeks. This VDC has been named recently as Gramthan Gaupalika one of State one. Sample size of 384 was determined by the WHO sample size calculator. Face to face interview technique was used after taking consent from individual. Confidentiality was maintained. It was ethically approved by the IRC (Institutional Review Committee) of Nobel Medical College.Results:A total of 384 household were studied. Total household had bed nets but the physical integrity of bed nets was not intact. Almost 73% of the bed nets were torn having more than four holes in them. Nearly 94% of household used bed nets only for three to four days a week. Nearly half of the Malaria was found among 22% and encephalitis in 17% of household. Conclusion:Use of bed nets do not prevent and provide guarantee from vector borne disease unless it is properly used. Torn bed nets are of almost no use unless people are using other preventive measures.
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Poudel, Durga D., Krishna Belbase, Marthe De Boevre, Sarah De Saeger, and Peetambar Dahal. "Climate Smart Dry Chain for Food and Nutrition Security in Nepal." Strategic Planning for Energy and the Environment, May 12, 2021. http://dx.doi.org/10.13052/spee1048-4236.39147.
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Global efforts to feed the burgeoning population have focused on increasing food production and access. In the meantime, FAO estimates about 1/3 food loss in the developing countries. To minimize these losses, grain storage techniques were investigated in an earthquake hit village in Kavre district of Nepal. Pesticide free moisture proof/airtight food storage bags were provided to 1,055 households using financial support from UNICEF-Nepal. Thirty-three households were identified who could store food grains for 6-month for this study. Maize and rice grains were stored in porous and in moisture-proof hermetic bags. Food grain samples were collected at the beginning and at 6-month and were analyzed for physical quality parameters, nutrients and mycotoxins. About 92% insect damage occurred in maize stored in porous bags which was prevented in triple layer hermetic Purdue Improved Cowpea Storage (PICS) bags. Insect damage in paddy remained low within 10% in both treatments. Major maize nutrient loss occurred through insect damage. The traditional practice was to use insect and mold infested maize as feed. Mycotoxins results showed that toxigenic molds develop in open storage of improperly dried grains especially maize. Fusarium-related mycotoxins associated with stunting were detected in maize samples using LC-MS/MS equipment. Mature grains should be dried sooner to processing moisture contents and packaged into moisture-proof hermetic bags (Dry Chain) to minimize postharvest loss. A clear policy implication is that use of improved low-cost Dry Chain technology should be promoted to enable quality food systems.
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Thorne-Lyman, Andrew L., Leah E. M. Bevis, Helen Kuo, Swetha Manohar, Binod Shrestha, Angela KC, Rolf D. Klemm, and Rebecca A. Heidkamp. "Season of Data Collection of Child Dietary Diversity Indicators May Affect Conclusions About Longer-Term Trends in Peru, Senegal, and Nepal." Current Developments in Nutrition 5, no. 8 (July 12, 2021). http://dx.doi.org/10.1093/cdn/nzab095.
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ABSTRACT Background The WHO-UNICEF minimum dietary diversity (MDD) indicator for children aged 6–23 mo is a global monitoring indicator used to track multi-year population-level changes in dietary quality, but the influence of seasonality on MDD estimates remains unclear. Objectives To examine how seasonality of data collection may influence population-level MDD estimates and inferences about MDD changes over multiple survey years. Methods We selected countries with 3 or more consecutive years of MDD data collection, including continuous national Demographic Health Surveys in Senegal (2012–2017; n = 12,183) and Peru (2005–2016; n = 35,272) and the Policy and Science for Health, Agriculture, and Nutrition sentinel site seasonal surveys (covering 3 seasons/y) in Nepal (2013–2016; n = 1309). The MDD prevalence (≥5 of 8 food groups) and an 8-item continuous Food Group Score (FGS) and 95% CIs were estimated by month and compared for lean and non-lean seasons using ordinary least squares regression with dummy variables for year. Results The national prevalence of MDD was higher in Peru (75.4%) than in Nepal (39.1%) or in Senegal (15.7%). Children in Peru were 1.8% (coefficient, –0.0179; 95% CI, –0.033 to –0.002) less likely to achieve MDD during the lean season. Similar seasonal magnitudes were observed in Senegal (coefficient, –0.0347; 95% CI, –0.058 to –0.011) and Nepal (coefficient, –0.0133; 95% CI, –0.107 to 0.081). The FGS was about 0.1 item lower during the lean season in all 3 countries. In comparison, MDD increased by an average rate of only 4.2 and 4.4 percentage points per 5 y in Peru and Senegal, respectively. Intakes of specific food groups were stable across months in all countries, with the provitamin A–rich food group exhibiting the most seasonality. Conclusions The magnitude of seasonal variation in MDD prevalence was smaller than expected but large relative to longer-term changes. If large-scale surveys are not conducted in the same season, biased conclusions about trends are possible.
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"EYE ON CHINA." Asia-Pacific Biotech News 19, no. 09 (September 2015): 4–16. http://dx.doi.org/10.1142/s0219030315000555.
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