Antecedent and Sequalae Issues of Nepalese Women Trafficked into Prostitution

Using a qualitative descriptive methodology, this study explored the experiences of Nepalese women trafficked into prostitution in India. The study found that poverty and lack of awareness about being at risk for trafficking are the major precursors for their trafficking experience. Abduction, fake marriages and the seduction of a better job were the major approaches adopted by pimps to traffic the women. The study also showed that after returning from the Indian brothel(s), they were rejected by their family and community. Such rejections occurred as family and community perceived these young women as at high risk for HIV infection. Strategies should be put in place to assist the women to reintegrate into their family and community

Developing Standard Treatment Workflows—way to universal healthcare in India

Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80–90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Unpacking drug detoxification in Nepal: in-depth interviews with participants to identify reasons for success and failure

Objective: This study conducted an in-depth exploration of the factors which helped people to detoxify from drugs and the factors which led to relapse among 20 participants from Kathmandu and Pokhara in Nepal.\ud \ud Methods: The research took a phenomenological approach using in-depth interviews for data collection and all data were analyzed using a grounded theory framework.\ud \ud Results: The study found that detoxification and rehabilitation services for drug users were mostly provided by private organizations. Some of these organizations had a comprehensive plan, trained staff and counselors. Most counselors were ex-drug users, and they functioned as mentors and role models who helped some drug users to realize that successful detoxification from drugs is possible. This approach enabled current drug users to adhere to the detoxification program. These service providers recognized that 'frustration' and lack of support are leading causes of a relapse. The best programs included activities to help the drug users to confront these frustrations. Participants who demonstrated a strong ability to manage the frustrations inherent in drug withdrawal were considered to be more able to avoid relapse after discharge.\ud \ud Conclusions: The evidence-base is lacking concerning successful detoxification and rehabilitation in Nepal. There is also no clear policy on detoxification and rehabilitation services. The Government of Nepal needs to develop guidelines for coordination, supervision, monitoring, evaluation and accreditation of organizations which provide detoxification and rehabilitation services

Antecedent and Sequalae Issues of Nepalese Women Trafficked into Prostitution

Using a qualitative descriptive methodology, this study explored the experiences of Nepalese women trafficked into prostitution in India. The study found that poverty and lack of awareness about being at risk for trafficking are the major precursors for their trafficking experience. Abduction, fake marriages and the seduction of a better job were the major approaches adopted by pimps to traffic the women. The study also showed that after returning from the Indian brothel(s), they were rejected by their family and community. Such rejections occurred as family and community perceived these young women as at high risk for HIV infection. Strategies should be put in place to assist the women to reintegrate into their family and community

Withdrawal Symptoms Hindering Harm-Minimization and Drug Detoxification Efforts: Experiences of Injecting Drug Users in Nepal

In this study, the authors explored the perception and strategies used by 20 injecting drug users (IDUs) as they regularly confront life-threatening complications stemming from their drug use. The 20 IDUs were from four urban centers of Nepal: Kathmandu Valley, Pokhara, Narayanghaat, and Hetauda. The phenomenological study was conducted, using individual in-depth interviews ranging from 1 to 2 hours in length. All data were analyzed using the analytical approaches of grounded theory. It was found that the urgency and severity of withdrawal symptoms are the major precursors, leading drug users to share unsterile syringes and needles and thereby increasing the risks of HIV transmission and other health risks. The study also found that IDUs seemed aware and worried about HIV and other health risks, prompting them to devise their own seemingly suitable strategies for harm minimization. Understanding these high-risk strategies should inform public health and intensive harm-reduction services to be considered and implemented in Nepal. Attempts should be made to keep the IDUs in touch with suitable medication-assisted therapies to overcome the withdrawal symptoms, thus minimizing the chance of sharing syringes/needles with other IDUs

Coping with HIV and dealing with the threat of impending death in Nepal

The number of people living with HIV is increasing in Nepal. While efforts have been made to measure the number of people affected by HIV and trends in the epidemic, little is known about how people with HIV perceive their disease, and how they cope on a day-to-day basis. The study also highlights the role of counselling and a variety of support systems. A grounded theory approach was used to explore the life experiences of people living with HIV in Nepal. A detailed study of 20 participants was undertaken. The participants experienced immediate and long-lasting psychosocial effects of HIV which included a prolonged 'death phobia' and heavy burdens of care. Particularly for women, the issues associated with decreasing health and fear of death was severe. A HIV positive diagnosis led some men to take fatalistic approaches, such as using drugs and alcohol to cope with HIV, whereas some women attempted suicide. Counselling and interactions between people with HIV and their HIV positive peers helped to overcome adverse psychosocial consequences and to cope with HIV

Assessment of Mental Stress among Medical Undergraduate Students of a tertiary health care centre of Bihar, India

Background: Studies done across the world reveals that psychological morbidity like stress is commonly present in medical undergraduate students. Aim: To find out the prevalence of stress among medical undergraduate students. Materials and Method: Across sectional study was conducted among 150 medical undergraduates to assess their levels of stress by using Kessler 10 (K10) psychological distress scale. Stress was categorized into none, mild, moderate and severe categories.Result: The total prevalence of stress was 62.6% and the prevalence of severe stress was 21.3%.Conclusion: Students should receive consultation on how to manage and cope up with stress. Preventive mental health services, supportive learning environment and student counseling services need to be made available and accessible to curb this morbidity

Immunization coverage among children in age group of 12-24 months in a block of Darbhanga, Bihar,India

Immunization coverage has improved over the past few decades, but the rate of progress is not satisfactory. Globally, this rate has witnessed an increasing trend, the rate of DPT-3 vaccine has increased to 85% in 2017 from 72% in 2000 and 21% in 1980. Methodology: A community-based cross-sectional study was conducted between January and March 2021 in few randomly selected villages of Bahadurpur block of Darbhanga district in Bihar,India. The study subjects are included all the children aged 12--23 months old from the Bahadurpur block of Darbhanga. In this study, Bahadurpur block of Darbhanga district was selected.List of villages under the block were listed. WHO protocol for cluster sampling was used for the current study, so 30 villages were randomly selected from the obtained list. From each village, 7 households were selected as per WHO protocol. Hence, the calculated sample size came to210 (30 × 7). Results: A total of 210 children in the concerned age group of 12-23 months were included in the survey. There was a slight male preponderance with a male female ratio of 1.69:1. Mean age of the surveyed children was 16.8 months with a standard deviation of 4.5 months. Median age was 17.5 months. Immunization card was available and presented at the time of survey among majority (97.8%) of the surveyed children. The present study revealed that 82.7% of children were fully immunized by first year of life. Rest 17.3% were partially immunized and only one female child was found to be non-immunized. Conclusion: To increase the immunization coverage, need to continuous monitoring and supervision of immunization site