Injection practices in Nepal: health policymakers’ perceptions

BACKGROUND: The unnecessary and unsafe use of injections is common in developing countries like Nepal. Policymakers have an important role in promoting rational and safe injection use. Hence, the present study was carried out to explore the perception of health policymakers regarding safe injection practice in Nepal. METHODS: An exploratory qualitative study design was used in this study. Key policymakers from both the central and regional level were selected using purposive sampling. A semi-structured questionnaire advocated by the World Health Organization (WHO) was used after modifying the context. Interviews were conducted to clarify doubts and obtain additional information. The data was analyzed manually using deductive content analysis technique. RESULTS: In total, eleven policymakers participated. All unanimously agreed that injection safety is a problem and seven participants reported that injections are overused. They shared the opinion that injections are administered by various providers, including formal and informal health providers, and also quacks. Almost half the respondents reported that the National Drug Policy discourages injection overuse, while others reported that the policy contains no provisions regarding injection overuse. Most policymakers stated that only single-use disposable injection equipment is used to provide injection, while others thought that sterilizable glass syringe is also used. More than half of the participants believed that the quality of injection equipment available in the Nepalese market is not regulated by any government institution. Almost two-third of the policymakers stated that syringes and needles are not reused, while the rest thought syringes might be reused without sterilization in some parts of the country. Almost half of the respondents stated that illegal commercialization of used syringes exists in Nepal. Almost all respondents thought that health care institutions have a waste management plan, while more than half of them opined that such plans are limited to tertiary care hospitals located in the capital. CONCLUSIONS: The result of this study revealed a divergence of views among policymakers, even among those in the same ministry. Though there has been some effort from the government to increase the safety of injection practices, greater efforts are required, especially with regard to standardization of policies and procedures related to injection practice

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal

BACKGROUND: Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. METHODS: A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. RESULTS: Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The ‘Current Index of Medical Specialties’ was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. CONCLUSIONS: Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections

Factors Affecting the Utilization of Postnatal Care Services in Eastern Nepal

Background: The importance of providing care to mothers after childbirth is critical for lowering maternal illness and death rates. This research aimed to analyze the factors influencing the use of postnatal services among mothers with having at least one living child three years preceding the survey in the Sunsari district of Eastern Nepal. Materials and Methods: A cross-sectional study was conducted within a community setting, involving 401 ever-married women of reproductive age group. The studyperformed bivariate and multivariate logistic regression analyses to identify factors associated with the utilization of postnatal care services. Results: Among 401 women studied, 52% had Postnatal Care (PNC) visits. Among those who utilized PNC services, the majority (96%) had partial utilization, while only 4.3% had complete PNC.PNC visits are more frequent among the wealthy, migrants, and upper castes, as well as those exposed to media, aware of health services, and perceiving higher service quality and awareness at health facilities. Conclusion: Both the coverage and complete utilization of PNC attendance were low. Increasing focus on mothers from poorer households, pockets of the native population, individuals needing behavioural modification, and those with poor awareness about available services may enhance the overall usage of complete PNC

Knowledge and Attitude of Organ Donation among University Students in Pokhara

Donation of the tissue or organ of human body from a living or dead person to a living recipient in need of transplantation is organ donation. In the field of modern medicine organ transplantation is one of the greatest scientific advances and remains the most challenging and complex. It saves thousands of life. The main objective of the study was to explore the knowledge and attitude of organ donation. A descriptive cross- sectional study using self- administered questionnaire tool was conducted among 154 Bachelor level students who were selected by using non probability consecutive sampling technique. The obtained data was entered on SPSS 20 version program and analyzed and interpreted by using descriptive statistics (Frequency, percentage, mean, median, and standard deviation) and inferential statistics (chi square).The study found that 57.1 percent had moderate knowledge on organ donation and more than half (69.5%) had neutral attitude on organ donation. Knowledge on organ donation was poor. There was significant association (0.014) between ethnicity and knowledge level. The study concluded that there was moderate level of knowledge and neutral level of attitude on organ donation among bachelor level students and there was no significant association of socio-demographic variables and level of knowledge except ethnicity. It therefore suggests awareness programs on organ donation for college students to promote and upgrade their knowledge and attitude about organ donation.</jats:p

Gender perspective on climate change adaption strategies in livestock farming in Gandaki Province, Nepal

Background: Climate change has a significant impact on livestock farming around the globe. Farmers have adopted different strategies to mitigate the adverse impact of climate change. Females in developing countries are more vulnerable to climate change impacts and have lower adaptive capacity and they bear additional roles and responsibilities in livestock rearing as compared to their male counterparts. Aim: The main aim of this study is to examine the gender perspective on climate change adoption strategies in livestock farming in Gandaki province, Nepal. Methods: A multi-stage random sampling technique was employed to select 1,158 households from five districts in Gandaki province, western Nepal. A household head or household member who was 45 years or older resided in that area for at least 15 years and owned at least one primary livestock at the time of the survey was selected as the ultimate respondent from each selected household. Both structured and unstructured questionnaires were prepared. A structured questionnaire was used for the household survey, while a checklist (guideline) was prepared for focus group discussions (FGDs). Data were collected through face-to-face interviews, and both descriptive and inferential statistics were used for data analysis. Results: The results revealed that buffalo was the primary livestock among farmers. More than half of farmers, both men and women were aware of the impact of climate change on livestock. While this study did not fine significant gender-based differences in adaptation strategies, the odds of adoption are higher among males than females. Jobs other than agriculture and livestock, as well as access to credit, emerged as key determining factors associated with adaptation strategies among farmers in Gandaki Province. Conclusion: There is no significant gender-based difference in adaptation strategies; however, employment outside agriculture and livestock, along with access to credit, are the key determining factors associated with adaptation strategies. [Open Vet J 2024; 14(12.000): 3363-3374

Perception towards Online Classes during COVID-19 among Nursing Students of a Medical College of Kaski District, Nepal

Introduction: Online learning is a virtual learning system that integrates internet connection with teaching and learning process. This system has become a solution for the continuity of teaching and learning process in Nepal during Covid-19 pandemic. Thus the main objective of this study was to assess the perception of nursing students towards online classes during Covid-19 pandemic. Methods: A cross-sectional study was carried out among 133 nursing students studying at Gandaki Medical College of Nepal. Data were collected through online survey using a semi-structured questionnaire from 15 to 21, September, 2020 and were analyzed using Statistical Package for Social Science (SPSS) version 16 employing descriptive and inferential statistical method. Results: The result showed that mobile was the most commonly (51.9%) used gadget for attending online class. One third of the students (35.3%) had no access to static internet and 4.5% of them did not have internet at their home. Majority of the students (91.7%) felt that online classes should be continued during this pandemic. Nearly two third of the respondents (63.2%) were satisfied from the online classes. Overall, 54.1% had negative perception towards online classes. There is statistically significant association of perception with residence (p = 0.033), type of nursing programme (p = 0.027), family income (p = 0.022), education level of father (p = 0.029) and mother (p = 0.004). Conclusion: Online learning method is a solution taken by higher education in Nepal during the Covid-19 outbreak. Based on the survey result, almost half of the respondents had negative perception towards online learning. However, majority felt that online classes should be continued during this pandemic. Therefore, it is recommended to foster face to face interaction between students and teachers and to promote learning environment at home for online learning.</jats:p

Determinants of Households’ Adaptation Practices against Climate Change Impact on Off-farm Activities in Western Hill of Nepal

Climate change is one of the serious concerns which have a substantial impact in all areas of human civilization. Among these areas, agriculture is the worst hit sector. This study aims to analyze the determinants of households’ adaptation practices against climate change impact on off-farm activities in western hill of Nepal. It utilizes the data collected from six village development committees from three districts (Lamjung, Tanahu and Kaski) of western hill of Nepal. Out of 245793 Households 556 households were chosen for the survey. A systematic random sampling technique was used to select the respondents. Data was collected using pre-tested structured questionnaire through face to face interview with household head or a household member having age 45 years and above with residing in that locality since last 15 years. Binary logistic regression analysis has been carried out. Household size is only the matter for determining the households' adaptation practices for shifting to non-agricultural activities which is also the matter for temporary migration to another places. Education is the determining factor for changing the food consumption habit and temporary migration. Agriculture skill is the common determining factor for change in food consumption habit and shifting to non-agricultural activities. Sex and marital status are the major determining factors only for shifting to non-agricultural employment. Age is the significant predictor of temporary migration. Caste is also the major determining factor for changing the food consumption habit and temporary migration respectively.</jats:p