Do more with less: managing public investment in federal Nepal

Nepal's success or failure hinges on how effectively the governments at all levels can deliver public services, which demands proper fiscal and investment management. Mukti Subedi and Bishal K Chalise write that the national framework for public financial management, particularly in the context of transition to federalism, is non-existent

Drivers of food choice among children and caregivers in post-earthquake Nepal

Food systems in many countries are experiencing a shift from traditional foods towards processed foods high in sugar, fat and salt, but low in dietary fiber and micronutrients. There is an urgent need to better understand drivers of changing food behavior, particularly for lower-income countries. This study analyzes drivers of food choice among children and parents in rural Nepal. It uses qualitative data collected through key informant interviews and focus group discussions with school children, parents and teachers. The study reveals substantial changes in food behavior during the past decade with increased consumption of rice, meat, and highly processed snack foods while an increased consumption of fruit and vegetables is not evident. It identifies cash availability is the main driver of increased rice, meat and snack food consumption. The second driver is the 2015 Nepal earthquake, which accelerated the transition from home-grown food to purchased food as people got habituated to eating more meat and snack foods while reconstruction tripled local wages and changed the food environment. This shows how humanitarian assistance in the wake of extreme shocks can unintentionally contribute to unhealthy eating habits. An integrated school and home garden intervention appears to contribute to healthier diets

Psychological impact of COVID-19 among health-care workers in Nepal: An analytical cross-sectional study

Context: Many psychological problems including stress, anxiety, insomnia, depression, frustration, denial, anger, and fear emerged during coronavirus disease 2019 (COVID-19) outbreak. Aims: This study was done to assess the prevalence and associated factors of depression, anxiety, stress, insomnia, and fear experienced by health-care workers (HWs) during COVID-19 in Nepal. Settings and Design: This was web-based analytical cross-sectional study conducted among health-care workers from December 27, 2020, to February 28, 2021, all over Nepal. Subjects and Methods: All the HWs including doctors, nurses, and allied health-care professional from 7 provinces were selected using convenience sampling technique. Data collection was done using the validated questionnaires. Statistical Analysis Used: Univariate and binary logistic regression analyses were performed to find the association between the different variables. Statistical significance was set at P < 0.05. Results: A total of 608 HWs completed the survey with a mean age of 30.82 ± 6.68. About 27% had symptoms of depression, 28% anxiety, 10% stress, 18% insomnia, and 49.8% fear of COVID-19. Resident doctors and health workers who had bachelor level of education and working experience <2 years were significantly associated with higher odds of experiencing depression and anxiety. Health workers working 2–5 years and with more than 5 years' experience had significantly lower odds of experiencing fear. History of tobacco use or medical condition had significantly higher odds of experiencing depression, anxiety, stress, insomnia, and fear. Conclusions: This study concluded that the prevalence of depression, anxiety, insomnia, and fear was found to be high. Resident doctors and health workers with bachelor level of education, working experience <2 years, and history of medical condition were significantly associated with experiencing adverse mental health outcomes

Sabaiko Nepali;Kaksha: Das

Grade 10 (Nepali Date: 2057), Language: Nepal

Comparative yield of tuberculosis during active case finding 2 using GeneXpert or smear microscopy for diagnostic testing 3 in Nepal : a cross sectional study

Funding: Stop TB Partnership/UNOPS – TB REACH project (grant number: 5–31); European Union, Horizon 2020 – IMPACT TB project (grant number: 733174).This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092; 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4; 95%CI = 1.12–1.72; p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally.Publisher PDFPeer reviewe

Population and conservation threats to the vulnerable Sarus crane Grus antigone in Nepal

Abstract Globally, biodiversity is declining due to habitat loss and degradation, over‐exploitation, climate change, invasive species, pollution, and infrastructure development. These threats affect the populations of large waterbird species, such as Sarus crane (Grus antigone), which inhabits agricultural–wetland ecosystems. Despite the burgeoning built‐up areas and diminishing agricultural and wetland spaces, scant research investigates the impact of these changing land uses on the globally vulnerable Sarus crane in Nepal. During the pre‐breeding season from April to June 2023, our comprehensive study meticulously scrutinized Sarus crane population status and factors associated with the occurrences and conservation challenges across 10 specific districts of Nepal. Our study documented a total of 690 individuals of Sarus cranes in five districts. The Lumbini Province has 685 individuals, occupying 11 roosting sites. Conversely, the remaining five districts have no Sarus cranes presence during this period. Wetland, farmland and built‐up areas exhibited a significantly positive influence on Sarus crane occurrences in the Lumbini Province. Additionally, we recorded 47 fatalities of Sarus cranes over the past 13 years in the Lumbini Province due to electrocution and collisions. Our study provides a baseline dataset crucial for developing conservation policies, particularly during the dry season when Sarus crane populations tend to congregate in larger flocks. The adaptation of the Sarus crane to urbanized landscapes exposes them to several anthropogenic threats in the coming days. Therefore, protecting wetlands and farmland areas and adopting transboundary conservation approaches are imperative for the long‐term conservation of the Sarus crane and its habitat