Determinants of home delivery in a semi urban setting of Nepal

Aim: To study the effect of various determinants of home delivery in Nepal. Methods: Prospective descriptive study among women who after being delivered at home were admitted in Nepal Medical College Teaching Hospital (NMCTH), a tertiary care hospital situated at suburban area of Kathmandu Results: Of 114 women, majority were between the ages of 20-24 yrs. Most of the women were multipara (64%). Majority had no formal education accounting for 68.4 %. Lasheta (Lama, Sherpa, Tamang) was the most common ethnic group. Most (30.1%) of their spouses also were illiterate or had only primary level education. Majority of the husbands of the respondents were laborers (63.2%). Regarding attendance of antenatal care (ANC); at least 84 (73.7%) women had attended ANC once and half of the women had attended 4 more visits. Home delivery was planned by 67 (58.8%) women; whereas only 47 (41.2%) had chosen hospital delivery and delivered at home due to various reasons. Financial problem was the most common reason followed by ignorance and transportation problem. Among all the women, only 5.3 % were attended to by a professionally trained provider (doctor, nurse, and midwife). A disturbingly high proportion of women (87.6%) were attended by an untrained family member, friend or neighbor, and 7 % of women delivered completely unattended. Women were brought to the hospital by family member 59.6 % other than husband and 8.8 % were accompanied by neighbors/friends. Most of these women were brought with retained placenta, primary post partum hemorrhage. Conclusion: In this study area, usage of the antenatal care was high, but the opportunity to deliver at hospital was not fully utilized. This study has highlighted some of the factors affecting the choice of place of delivery among mothers in a semi urban settlement in Nepal namely mothers educational level, husband’s education and occupation, financial constraints, lack of transportation and ignorance. Majority of the deliveries took place at home and unsupervised by a skilled attendant thus aggravating the risk of the high perinatal and maternal morbidities and mortalities in the study area. Key ey words: Home delivery, determinants, antenatal care, delivery attendanc

Menopausal Health Status of the Nepalese Women

Introduction: Menopause is an unavoidable and sometimes problematic condition in which women may suffer from a number of health problems. Knowledge of the major symptoms associated with menopause helps reduce the burden and stress associated with the condition. In this context, a study was conducted to establish baseline data regarding menopausal health problems among Nepalese women. Methods: A descriptive cross-sectional study was conducted among 2000 women aged over 40 years to identify their knowledge, attitude and practice related to menopausal health problems. Data was collected by interviewing the women and doing physical examination. Analysis was done using descriptive statistics and SPSS software was used for data analysis. Results: A cohort of 2073 women (ages 40-60 years) participated in the research, among them 2000 yielded complete response. The study revealed that 820 (41%) women had reached menopause. The average age of menopause was 48.7 years. Majority of the women 1183 (59.2%) in the study did not know about menopausal health problems. Abnormal bleeding 353 (17.65%), sweating 315 (15.75%), hot flushes 299 (14.95%), joint/muscle pain 285 (14.25%) were the most common menopausal symptoms known by the women. Joint pain 736 (36.8%), hot flushes 584 (29.2%), irregular bleeding 582 (29.1%) were the most common experienced symptoms of menopause and only 586 (29.3%) consulted the health workers to alleviate menopausal symptoms. Moreover, most of the women 926 (46.3%) accepted menopause as a part of life. Conclusions: The research has tried to establish the baseline of menopausal health problems in the Nepalese women. The average age of menopause was 48.7 years. Majority did not know about menopausal health problems. Further researches with nationally representative sample are recommended to further explore the menopausal health problems of Nepalese women. Keywords: health problems; menopause; Nepal; women