Need Factors for Utilisation of Institutional Delivery Services in Nepal: an analysis from Nepal Demographic and Health Survey, 2011

Objective: This study aims to assess the role of need factors with respect to the utilisation of institutional delivery services in Nepal. Design: An analytic study was conducted using a subset of 4079 ever married women from the 2011 Nepal Demographic and Health Survey, which utilised two-stage cluster sampling. Logistic regression with complex sample analysis was performed to evaluate the effects of antenatal care visits and birth preparedness activities on facility delivery. Outcome measures: Facility delivery. Results: Overall facility delivery rate was low at 36.9% (95% CI 33.5% to 40.2%, SE 1.69). Only half (50.1%) of the women made four or more antenatal care visits while 62.9% (95% CI 59.9% to 65.8%, SE 1.51) did not indicate any of the four birth preparation activities. After adjusting for external, predisposing and enabling factors, women who made more than four antenatal care visits were five times more likely to deliver at a health facility when compared to those who paid no visit (adjusted OR 4.94, 95% CI 3.14 to 7.76). Similarly, the likelihood for facility delivery increased by 3.4-fold among women who prepared for at least two of the four activities compared to their counterparts who made no preparation (adjusted OR 3.41, 95% CI 2.01 to 5.58).Conclusions: The perceived need, as expressed by the frequency of antenatal care visits and birth preparedness activities, plays an important role in institutional delivery service utilisation for Nepali women. These findings have implications for behavioural interventions to change their intention to deliver at a health facility

Effect of biochar and plastic mulch on growth, yield, and yield attributing characteristics of spring maize (Zea mays L.)

Spring maize is an important crop to meet the growing demand for maize. Moisture stress is an important yield limiting factor during the dry spring period. Biochar and plastic mulch help in soil moisture conservation and might contribute to the growth and yield of maize. A field experiment was conducted to evaluate the effects of biochar application and plastic mulch on growth, yield, and yield attributing characteristics of spring maize (Zea mays L.) in a sandy loam soil at Rampur, Chitwan, Nepal in 2018. The experiment was laid out in a split-plot design (SPD) with three replications. The Main plots were allocated to the mulching (mulching, and no mulching) while the Subplot was to the biochar rates of 0 t/ha, 5 t/ha, 15 t/ha, and 25 t/ha. There were twenty-four plots of each plot size 4.8 × 1.5 m2. The grounded biochar passed through a 1 mm sieve and was applied in the well-prepared plots two weeks before seed sowing. The maize seeds were sown at 60 cm row to row and 25 cm plant to plant distance. There were no significant effects due to both factors on maize seed emergence, plant height, number of leaves per plant, leaf area index, root length, dry matter content, stover yield, and yield attributes. But the yield was significantly influenced by their interactions. Significantly highest grain yield (2.58 t/ha) was obtained from 25 t/ha with plastic mulch followed by plastic mulch with 15 t/ha biochar (2.06 t/ha) and the least was recorded from control plots (1.19 t/ha). From the result, it can be concluded that the application of a higher biochar rate of 25 t/ha with plastic mulch contributes to a higher yield of spring maize

Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.

BACKGROUND: The burden of maternal morbidity is high in developing countries including Nepal. This study investigated obstetric complications and rural-urban difference in cesarean delivery rate in Western Nepal. METHODS: A community-based cohort study was conducted in the Rupandehi district of Western Nepal during January-October, 2014, by interviewing 735 mothers within one month postpartum. The prevalence of obstetric complications was reported via frequency distribution, while factors associated with cesarean delivery were assessed using logistic regression analysis. RESULTS: The prevalence of adverse obstetric symptoms during antenatal, intranatal and postnatal periods were 19.7 %, 27.8 % and 21.6 %, respectively. In total, 81 (11.0 %) mothers reported having stillbirths. The cesarean delivery rate was 14.1 % overall but was four times higher in the urban (23.0 %) than in the rural areas (5.8 %). Prolonged labor (19.0 %) and heavy bleeding (16.7 %) were common among rural women. Logistic regression analysis confirmed that cesarean section was more likely for mothers residing in urban areas than in rural areas (adjusted odds ratio 3.41; 95 % confidence interval 2.01 to 5.78). CONCLUSIONS: About one in five mothers reported some adverse obstetric symptoms. Obstetric problems were more common in the rural areas, whereas cesarean delivery rate was much higher in the urban areas. Further investigations are required to determine whether these cesarean sections are medically warranted or provider induced

The supplemental use of infant formula in the context of universal breastfeeding practices in Western Nepal.

BACKGROUND: While the initiation of breastfeeding is universal in Nepal, little has been reported on formula feeding practices. This study aimed to report the prevalence of, and factors associated with, the use of infant formula as supplementary feeds in the Western region of Nepal. METHODS: A community-based cohort study was conducted to collect infant feeding information among 735 postpartum mothers using structured questionnaires. Complete formula feeding data were collected from 711 women in the first, fourth and sixth month postpartum. Factors independently associated with formula feeding were investigated using multiple logistic regression. RESULTS: All mothers were breastfeeding their infants at the time of recruitment. The prevalence of formula feeding was 7.5 % in the first month and 17 % in the sixth month. About a quarter of mothers (23.8 %) reported providing infant formula at least once during the first six months of life. Infant formula was used commonly as top-up food. Stepwise logistic regression showed that infants born to families residing in urban areas (adjusted odds ratio (aOR): 2.14; 95 % confidence interval (CI): 1.37 to 3.33), mothers with higher education (aOR: 2.08; 95 % CI: 1.14 to 3.80), and infants born by caesarean section (aOR: 1.96; 95 % CI: 1.21 to 3.18) were at greater risk of formula feeding. CONCLUSION: The current findings indicate that health workers should support mothers to initiate and continue exclusive breastfeeding particularly after caesarean deliveries. Furthermore, urban health programs in Nepal should incorporate breastfeeding programs which discourage the unnecessary use of formula feeding. The marketing of formula milk should be monitored more vigilantly especially in the aftermath of the April 2015 earthquakes or other natural disasters

Robotic Harvesting of Fruiting Vegetables: A Simulation Approach in V-REP, ROS and MATLAB

In modern agriculture, there is a high demand to move from tedious manual harvesting to a continuously automated operation. This chapter reports on designing a simulation and control platform in V-REP, ROS, and MATLAB for experimenting with sensors and manipulators in robotic harvesting of sweet pepper. The objective was to provide a completely simulated environment for improvement of visual servoing task through easy testing and debugging of control algorithms with zero damage risk to the real robot and to the actual equipment. A simulated workspace, including an exact replica of different robot manipulators, sensing mechanisms, and sweet pepper plant, and fruit system was created in V-REP. Image moment method visual servoing with eye-in-hand configuration was implemented in MATLAB, and was tested on four robotic platforms including Fanuc LR Mate 200iD, NOVABOT, multiple linear actuators, and multiple SCARA arms. Data from simulation experiments were used as inputs of the control algorithm in MATLAB, whose outputs were sent back to the simulated workspace and to the actual robots. ROS was used for exchanging data between the simulated environment and the real workspace via its publish-and-subscribe architecture. Results provided a framework for experimenting with different sensing and acting scenarios, and verified the performance functionality of the simulator

Under-utilization of antenatal care services in Timor-Leste: Results from Demographic and Health Survey 2009-2010

Background: Timor-Leste is a young country in the Asia-Pacific region with a high maternal mortality rate of 557 per 100,000 live births. As most maternal deaths can be prevented by providing quality antenatal care (ANC) and skilled assistance during childbirth, understanding the barriers to the utilization of ANC services can enhance program implementation. This study aimed to investigate the prevalence and factors associated with the under-utilization of ANC services in Timor-Leste. Methods: Timor-Leste Demographic and Health Survey (TDHS) 2009-2010 was a nationally representative multi-stage cross-sectional study involving 11,463 households and 9,828 childbirths. Information on last born child was recorded for 5,895 mother-child pairs. Factors influencing under-utilization of ANC were assessed using hierarchical logistic regression analysis. Results: Only 3311 (55.2, 95 % confidence interval (CI) 53.1 to 57.3 %) made the recommended four ANC visits, while 2584 (44.8; 95 % CI 42.7 to 46.9 %) of them reported attending three or less ANC services. Significant factors positively associated with the under-utilization of ANC were low wealth status (odds ratio (OR) 2.09; 95 % CI 1.68 to 2.60), no maternal education (OR 1.54; 95 % CI 1.30 to 1.82) or primary maternal education (OR 1.21; 95 % CI 1.04 to 1.41), no paternal education (OR 1.34; 95 % CI 1.13 to 1.60), and having a big problem in permission to visit health facility (OR 1.65; 95 % CI 1.39 to 1.96). Conclusions: Despite the apparently good progress made in re-establishing the healthcare infrastructure, 45 % of mothers remained in need of a focused intervention to increase their use of ANC services. Further prenatal care program should pay attention to women with low wealth status and those and their partners who are uneducated. Moreover, women should be encouraged to make decision on their own health

Prelacteal Feeding of Newborns in Postconflict Timor-Leste

Objectives: The aim of the present study was to investigate the prevalence of prelacteal feeding and its associated factors in Timor-Leste using updated data from the national survey. Methods: Complex sample analysis was undertaken to account for the 2-stage cluster design of the Demographic and Health Survey 2009–2010. Backward stepwise logistic regression was conducted to ascertain factors associated with the prevalence of prelacteal feeding. Results: A total of 4821 mother–infant pairs were included in the analysis. The prevalence of prelacteal feeding was 12.3% (95% confidence interval [CI] 11.1–13.5). The most popular prelacteal food was plain water (50.7%), followed by glucose/sugar water (32.5%) and milk other than breast milk (22.7%). Older mothers (35–49 years), mothers with upper socioeconomic status, those who perceived their newborns as small size, and those residing in urban areas were approximately 1.5 times more likely to give prelacteal feeds, whereas women who followed religions other than Roman Catholic had twice the risk (adjusted odds ratio 1.98; 95% CI 1.16–3.41). Conclusions: Antenatal and postnatal counselling sessions that promote exclusive breast-feeding and discourage prelacteal feeding are needed that specifically target these vulnerable subgroups of Timorese mothers

Agrobiodiversity and Its Conservation in Nepal

Nepal is a part of the world\u27s biodiversity hotspot and ranks the 49th in the world for biodiversity. Agrobiodiversity and its conservation status were studied through literature review, field survey, key informant survey and focus group discussion. Results of field implementation of some good practices and action research were also documented. Among 24,300 total species in the country, 28% are agricultural genetic resources (AGRs), termed as agrobiodiversity. Agrobiodiversity has six components (crops, forages, livestock, aquatic, insects and microorganisms) and four sub-components (domesticated, semi-domesticated, wild relatives and wild edible) in Nepal. Agrobiodiversity on each component exists at agroecosystem, species, variety/breed/biotype/race/strain, genotype and allele levels, within an altitude range from 60 to 5,000 masl. There are 12 agroecosystems supporting 1026 species under crop component, 510 under forage, 35 under livestock, 250 under the aquatic animal, 17 under aquatic plant, 3,500 under insect and 800 under microorganism. An estimated loss of agrobiodiversity is 40%, however, farmers have reported up to 100% loss of AGRs in some areas for a particular species. Conservation of agrobiodiversity has been initiated since 1986. Four strategies namely ex-situ, on-farm, in-situ and breeding have been adopted for conservation and sustainable utilization of AGRs. Eighty good practices including process, methods and actions for managing agrobiodiversity have been in practice and these practices come under five conservation components (sensitization, method and approach, accelerator, value and enabling environment). Within the country, 18,765 accessions of AGRs have been conserved in different kinds of banks. A total of 24,683 accessions of Nepalese crops, forages and microbes have been conserved in different International and foreign genebanks. Some collections are conserved as safety duplication and safety backup in different CGIARs\u27 banks and World Seed Vault, Korea. Two global databases (GENESYS and EURISCO) have maintained 19,200 Nepalese accessions. Geographical Information System, Climate Analog Tool and biotechnological tools have been applied for better managing AGRs. Many stakeholders need to further concentrate on the conservation and utilization of AGRs. Global marketing of some native AGRs is necessary for sustaining agriculture and attracting young generations as well as conserving them through use

Infant Feeding Information, Attitudes and Practices: a Longitudinal Survey in Central Nepal

Background: Infant feeding is governed by environmental as well as cultural factors. Breastfeeding knowledge and attitudes are known to be associated with breastfeeding duration. This study investigated breastfeeding information, attitudes and supplementary feeding in the central hills district of Nepal.Methods: A community-based prospective cohort study of 701 pregnant women was conducted. Information on breastfeeding attitudes, feeding practices and supplementary feeding was sought from the cohort at 4 weeks, 12 weeks and 22 weeks postpartum through repeated interviews using validated questionnaires.Results: Average duration of intended breastfeeding was 28 months (SD 7.9) and average target time to introduce solid foods was 6.1 months (SD 1.2). About 80% of women reported their husband, mother/mother-in-law preferred breastfeeding. Eleven percent of the cohort said that breastfeeding was not enjoyable. At 12 weeks and 22 weeks after birth, about a quarter (24.8%) and half (52.8%) of the infants were introduced cow/buffalo milk, respectively, while only 6.3% and 13.4% of them were given infant formula. Overall, any breastfeeding rate remained high at over 98% throughout the follow up period.Conclusions: Breastfeeding attitudes were encouraging in this population. Breastfeeding was almost universal. Use of infant formula was quite low, whereas cow or buffalo milk appeared to be popular supplementary foods