Knowledge on Epidemic Dropsy among the Health Workers of Sunsari, Nepal

Epidemic dropsy is caused by consuming vegetable oil contaminated with argemone mexicana, grows as a weed along with mustard seeds and is similar to it in appearance. This has been seen commonly in this part of the world. The recent outbreak in India and Nepal clearly underline the need for disseminating knowledge to health workers about being prepared to tackle and control the outbreaks of epidemic dropsy. This study talks about the knowledge and perception about epidemic dropsy among the health workers in Sunsari. The knowledge about epidemic dropsy among the health workers was poor. Health education about epidemic dropsy, reasons for outbreak and control and preventive measures were given to the health workers of Sunsari district. Key Words: Epidemic Dropsy, Out Break, Nepal Health Worker

Forty years after Alma-Ata: primary health-care preparedness for chronic diseases in Mozambique, Nepal and Peru.

Background Four decades after the Alma-Ata Declaration, strengthening primary health care (PHC) remains a priority for health systems, especially in low- and middle-income countries (LMICs). Given the prominence of chronic diseases as a global health issue, PHC must include a wide range of components in order to provide adequate care. Objective To assess PHC preparedness to provide chronic care in Mozambique, Nepal and Peru, we used, as 'tracer conditions', diabetes, hypertension and a country-specific neglected tropical disease with chronic sequelae in each country. Methods By implementing a health system assessment, we collected quantitative and qualitative data from primary and secondary sources, including interviews of key informants at three health-system levels (macro, meso and micro). The World Health Organization's health-system building blocks provided the basis for content analysis. Results In total, we conducted 227 interviews. Our findings show that the ambitious policies targeting specific diseases lack the support of technical, administrative and financial resources. Data collection systems do not allow the monitoring of individual patients or provide the health system with the information it requires. Patients receive limited disease-specific information. Clinical guidelines and training are either non-existent or not adapted to local contexts. Availability of medicines and diagnostic tests at the PHC level is an issue. Although medicines available through the public health care system are affordable, some essential medicines suffer shortages or are not available to PHC providers. This need, along with a lack of clear referral procedures and available transportation, generates financial issues for individuals and affects access to health care. Conclusion PHC in these LMICs is not well prepared to provide adequate care for chronic diseases. Improving PHC to attain universal health coverage requires strengthening the identified weaknesses across health-system building blocks

High-quality health systems: time for a revolution in research and research funding.

Comment - No abstract available

Moving from formative research to co-creation of interventions: insights from a community health system project in Mozambique, Nepal and Peru.

Different methodological approaches for implementation research in global health focusing on how interventions are developed, implemented and evaluated are needed. In this paper, we detail the approach developed and implemented in the COmmunity HEalth System InnovatiON (COHESION) Project, a global health project aimed at strengthening health systems in Mozambique, Nepal and Peru. This project developed innovative formative research at policy, health system and community levels to gain a comprehensive understanding of the barriers, enablers, needs and lessons for the management of chronic disease using non-communicable and neglected tropical diseases as tracer conditions. After formative research, COHESION adopted a co-creation approach in the planning of interventions. The approach included two interactions with each type of stakeholder at policy, health system and community level in each country which aimed to develop interventions to improve the delivery of care of the tracer conditions. Diverse tools and methods were used in order to prioritise interventions based on support, resources and impact. Additionally, a COHESION score that assessed feasibility, sustainability and scaling up was used to select three potential interventions. Next steps for the COHESION Project are to further detail and develop the interventions propositioned through this process. Besides providing some useful tools and methods, this work also highlights the challenges and lessons learned from such an approach

ROAD TRAFFIC ACCIDENT CASES AT BPKIHS, DHARAN, NEPAL: ONE YEAR IN RETROSPECT

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Health Seeking Behavior and Utilization of Health Care Services in Eastern Hilly Region of Nepal

noBackground &amp; Objectives: Preventive, promotive, curative, and rehabilitative health care services depend not only in availability &amp; accessibility of it but also on awareness and attitude of the people and various inter-woven social structure that determines in making choice. The objective of this study was to explore health seeking behavior and utilization of health care services in the rural places in VDCs of Ilam district of Eastern Nepal.Materials &amp; Methods: A cross sectional study was conducted in between period of March 25th 2013 to April 10th 2013 Fikkal and Pashupatinagar VDCs in Ilam district with sample of 300 people. Data was collected using a semi-structured questionnaire.Results: One fifth of the populations were found to be seeking traditional healers’ service and 80 percent among modern treatment system were relying on private treatment facility for treating sickness. People who had lived more than 20 years in that place and who felt modern health services were costly were likely to use service of traditional healers. Similarly people suffering from chronic illness, having health facility more than 30 minutes and using stretcher or walking as means of transportation were using government health centers more compared to private services.Conclusion: Significant people still use traditional healers’ service and the government health facility utilization was low as compared to private. The people living for longer period in that place and having the concept that modern health centers are costly were primary user of traditional healing system. Health facility nearby or people who could afford for automobile travel facilities were using costly private health centers.JCMS Nepal. 2015; 11(2):8-16</p

Study of Health-Related Quality of Life and Healthcare Utilization among Type 2 Diabetic Population in an Urban Area of Eastern Nepal

Introduction. Diabetes mellitus is a major cause of morbidity and mortality and places huge burden on public health funding. Diabetes affects quality of life through associated complications, comorbidity, and disease burden. Consequently, people have frequent healthcare visits. This study assessed quality of life and healthcare utilization patterns among type 2 diabetic populations in an urban area of eastern Nepal. Methods. A cross-sectional study was conducted among 270 participants of age ≥20 years with type 2 diabetes in Itahari using a semistructured questionnaire. A D-39 questionnaire was used to assess quality of life. Five wards were selected by systematic random sampling, and the population was proportionate according to the sample size. Multiple linear regressions were conducted to identify the factors associated with quality of life and its domains. Results. The highest mean score ± SD was found in the domain anxiety and worry (57.34 ± 11.08). About 18.5% of the participants perceived extremely affected quality of life. Hypertension (55.55%) was the most common comorbidity. Age, marital status, literacy, alcohol, disease duration, comorbidity, and complications were significantly associated with overall quality of life. In last 6 months of duration, 93.7% had hospital visits. Among them, 8.1% had emergency visit and 5.9% were admitted in the hospital. Conclusion. People with diabetes in this study were more affected in the domain anxiety and worry. The frequency of healthcare access and utilization in patients with type 2 diabetes was high. The quality of life among them could be improved by taking care on healthy behavior, comorbid conditions, and complications