Road traffic accidents in Kathmandu—an hour of education yields a glimmer of hope

After the Metropolitan Traffic Police, Kathmandu initiated a “No Drinking and Driving” policy in 2011 in which a major intervention for intoxicated drivers was mandatory 1-hour class to modify drunk driving behaviors, reports show that the number of road traffic accidents in the year 2012 decreased by 23 percent from the year 2011. The injury to fatality ratio decreased by 21 percent in this period. We remain encouraged by these statistics which confirm that increased enforcement of road traffic rules, combined with behavioral change programs, can have positive changes in LMICs which suffer considerably from the global burden of trauma

Strengthening Nepal’s Female Community Health Volunteer network: a qualitative study of experiences at two years

Background: Nepal’s Female Community Health Volunteer (FCHV) program has been described as an exemplary public-sector community health worker program. However, despite its merits, the program still struggles to provide high-quality, accessible services nation-wide. Both in Nepal and globally, best practices for community health worker program implementation are not yet known: there is a dearth of empiric research, and the research that has been done has shown inconsistent results. Methods: Here we evaluate a pilot program designed to strengthen the Nepali government’s FCHV network. The program was structured with five core components: 1) improve local FCHV leadership; 2) facilitate structured weekly FCHV meetings and 3) weekly FCHV trainings at the village level; 4) implement a monitoring and evaluation system for FCHV patient encounters; and 5) provide financial compensation for FCHV work. Following twenty-four months of program implementation, a retrospective programmatic evaluation was conducted, including qualitative analysis of focus group discussions and semi-structured interviews. Results: Qualitative data analysis demonstrated that the program was well-received by program participants and community members, and suggests that the five core components of this program were valuable additions to the pre-existing FCHV network. Analysis also revealed key challenges to program implementation including geographic limitations, literacy limitations, and limitations of professional respect from healthcare workers to FCHVs. Descriptive statistics are presented for programmatic process metrics and costs throughout the first twenty four months of implementation. Conclusions: The five components of this pilot program were well-received as a mechanism for strengthening Nepal’s FCHV program. To our knowledge, this is the first study to present such data, specifically informing programmatic design and management of the FCHV program. Despite limitations in its scope, this study offers tangible steps forward for further research and community health worker program improvement, both within Nepal and globally

Road traffic accidents in Kathmandu¿an hour of education yields a glimmer of hope

Abstract After the Metropolitan Traffic Police, Kathmandu initiated a “No Drinking and Driving” policy in 2011 in which a major intervention for intoxicated drivers was mandatory 1-hour class to modify drunk driving behaviors, reports show that the number of road traffic accidents in the year 2012 decreased by 23 percent from the year 2011. The injury to fatality ratio decreased by 21 percent in this period. We remain encouraged by these statistics which confirm that increased enforcement of road traffic rules, combined with behavioral change programs, can have positive changes in LMICs which suffer considerably from the global burden of trauma

Strengthening Free Healthcare in Rural Nepal

Nepal, a mountainous country in South East Asia, still lags in increasing access to healthcare and reducing health inequity. Possible Non Government Organization based in Achham, Nepal, which is a sister organization of Possible International Non Government Organization based in New York, USA recognized the increasing health needs in the far western rural hilly parts of Nepal, where extreme poverty and illiteracy was creating a vulnerable picture especially in Achham. Possible (previously named Nyaya Health) started to operate Bayalpata Hospital in 2009 after completing more than one year of free health services in Sanfe-Bagar, Achham, in partnership with the Nepalese Ministry of Health and Population. It supports the idea that free health service has its own challenges but a public-private partnership can thrive while promote equity in health services. 
 Keywords: achham; free health care; nepal; nyaya health; possible

Strengthening Free Healthcare in Rural Nepal

Nepal, a mountainous country in South East Asia, still lags in increasing access to healthcare and reducing health inequity. Possible Non Government Organization based in Achham, Nepal, which is a sister organization of Possible International Non Government Organization based in New York, USA recognized the increasing health needs in the far western rural hilly parts of Nepal, where extreme poverty and illiteracy was creating a vulnerable picture especially in Achham. Possible (previously named Nyaya Health) started to operate Bayalpata Hospital in 2009 after completing more than one year of free health services in Sanfe-Bagar, Achham, in partnership with the Nepalese Ministry of Health and Population. It supports the idea that free health service has its own challenges but a public-private partnership can thrive while promote equity in health services. Keywords: achham; free health care; nepal; nyaya health; possible

Parenteral organophosphorus poisoning in a rural emergency department: a case report

BACKGROUND: Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world. CASE PRESENTATION: Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result. CONCLUSION: Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure

Parenteral organophosphorus poisoning in a rural emergency department: a case report

Abstract Background Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world. Case presentation Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result. Conclusion Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure

YouTube lens to attention deficit hyperactivity disorder: a social media analysis

Abstract Objective Social media has provided an online environment for patients to discuss regarding their health and seek medical information. The primary aim of our study was to analyze the quality of information shared on YouTube regarding attention deficit hyperactivity disorder (ADHD). Results More than half of the videos, 91 (57.23%) had duration of fewer than 5 min. Only 8 (5.03%) videos were rated as highly useful whereas 61 (38.36%) videos were misleading. Interestingly, there was a significant higher (1203.38 ± 395) likes in the misleading group of videos, compared to 162.13 ± 169.63 likes in the very useful group, P = 0.012. Only a small fraction of videos had very useful information on ADHD. There is a need for high-quality, evidence-based, educational videos on ADHD for patient education