Utilisation of Postnatal Care among Rural Women in Nepal

Background: Postnatal care is uncommon in Nepal, and where it is available the quality is often poor. Adequate utilisation of postnatal care can help reduce mortality and morbidity among mothers and their babies. Therefore, our study assessed the utilisation of postnatal care at a rural community level. Methods: A descriptive, cross-sectional study was carried out in two neighbouring villages in early 2006. A total of 150 women who had delivered in the previous 24 months were asked to participate in the study using a semi-structured questionnaire. Results: The proportion of women who had received postnatal care after delivery was low (34%). Less than one in five women (19%) received care within 48 hours of giving birth. Women in one village had less access to postnatal care than women in the neighbouring one. Lack of awareness was the main barrier to the utilisation of postnatal care. The woman's own occupation and ethnicity, the number of pregnancies and children and the husband's socio-economic status, occupation and education were significantly associated with the utilisation of postnatal care. Multivariate analysis showed that wealth as reflected in occupation and having attended antenatal are important factors associated with the uptake of postnatal care. In addition, women experiencing health problems appear strongly motivated to seek postnatal care. Conclusion: The postnatal care has a low uptake and is often regarded as inadequate in Nepal. This is an important message to both service providers and health-policy makers. Therefore, there is an urgent need to assess the actual quality of postnatal care provided. Also there appears to be a need for awareness-raising programmes highlighting the availability of current postnatal care where this is of sufficient quality

Let us conserve and exchange seeds: celebrating traditional crop diversity of the Nepali lowlands

A seed fair is an activity to create awareness about and appreciate local crop diversity, exchange seed and related knowledge, and celebrate farmers’ efforts to conserve agrobiodiversity. It takes considerable time and effort to organize a seed fair. This brief describes the seed fair organized at the Agyauli Community Seedbank, Nawalparasi in the southern region of Nepal. About 30 members of 10 community seedbanks from the terai (the southern lowland) region of Nepal came together for this. Apart from exchanging seeds of traditional crop varieties, they also shared stories about the socio-cultural, religious, spiritual, nutritional and medicinal values of their varieties. The recent formal registration of the Community Seed Banks Association of Nepal (CSBAN) was also celebrated

Comparison of the physical, chemical and electrical properties of ALD Al2O3 on c- and m-plane GaN

This study compares the physical, chemical and electrical properties of Al[subscript 2]O[subscript 3] thin films deposited on gallium polar c- and nonpolar m -plane GaN substrates by atomic layer deposition (ALD). Correlations were sought between the film's structure, composition, and electrical properties. The thickness of the Al[subscript 2]O[subscript 3] films was 19.2 nm as determined from a Si witness sample by spectroscopic ellipsometry. The gate dielectric was slightly aluminum-rich (Al:O=1:1.3) as measured from X-ray photoelectron spectroscopy (XPS) depth profile, and the oxide-semiconductor interface carbon concentration was lower on c -plane GaN. The oxide's surface morphology was similar on both substrates, but was smoothest on c -plane GaN as determined by atomic force microscopy (AFM). Circular capacitors (50-300 μm diameter) with Ni/Au (20/100 nm) metal contacts on top of the oxide were created by standard photolithography and e-beam evaporation methods to form metal-oxide-semiconductor capacitors (MOSCAPs). The alumina deposited on c -plane GaN showed less hysteresis (0.15 V) than on m -plane GaN (0.24 V) in capacitance-voltage (CV) characteristics, consistent with its better quality of this dielectric as evidenced by negligible carbon contamination and smooth oxide surface. These results demonstrate the promising potential of ALD Al[subscript 2]O[subscript 3] on c -plane GaN, but further optimization of ALD is required to realize the best properties of Al[subscript 2]O[subscript 3] on m -plane GaN

Effect of GaN surface treatment on Al2O3/n-GaN MOS capacitors

Citation: Hossain, T., Wei, D., Edgar, J. H., Garces, N. Y., Nepal, N., Hite, J. K., . . . Meyer H.M, III. (2015). Effect of GaN surface treatment on Al2O3/n-GaN MOS capacitors. Journal of Vacuum Science and Technology B: Nanotechnology and Microelectronics, 33(6). doi:10.1116/1.4931793The surface preparation for depositing Al2O3 for fabricating Au/Ni/Al2O3/n-GaN (0001) metal oxide semiconductor (MOS) capacitors was optimized as a step toward realization of high performance GaN MOSFETs. The GaN surface treatments studied included cleaning with piranha (H2O2:H2SO4 = 1:5), (NH4)2S, and 30% HF etches. By several metrics, the MOS capacitor with the piranha-etched GaN had the best characteristics. It had the lowest capacitance–voltage hysteresis, the smoothest Al2O3 surface as determined by atomic force microscopy (0.2 nm surface roughness), the lowest carbon concentration (∼0.78%) at the Al2O3/n-GaN interface (from x-ray photoelectron spectroscopy), and the lowest oxide-trap charge (QT = 1.6 × 1011 cm−2eV−1). Its interface trap density (Dit = 3.7 × 1012 cm−2eV−1), as measured with photon-assisted capacitance– voltage method, was the lowest from conduction band-edge to midgap

Initiation of Breastfeeding and Factors Associated with Prelacteal Feeds in Central Nepal

Background: Prelacteal feeds and delayed initiation of breastfeeding may lead to undernutrition of the infant but are still prevalent in many countries.Objective: A prospective cohort community-based study was conducted in central Nepal to ascertain the rate of early breastfeeding initiation and factors associated with the introduction of prelacteal feeds.Methods: Breastfeeding information was collected from 639 women who recently gave birth in the Kaski district of central Nepal. Backward stepwise logistic regression analysis was performed to determine factors associated with the use of prelacteal feeds.Results: The incidence of prelacteal feeds was 9.1%, with infant formula being the most common prelacteal food. Approximately 67% and 90% of mothers breastfed within 1 hour and 4 hours of delivery, respectively. Women who reside in urban areas (odds ratio [OR] = 2.68; 95% confidence interval [CI], 1.35-5.39), first-time mothers (OR = 2.15; 95% CI,1.15-4.02), and those who underwent cesarean section (OR = 10.10; 95% CI, 5.47-18.67) were more likely to give prelacteal feeds to their infants.Conclusion: The early initiation of breastfeeding with colostrum as the first feed was common in the study area. The introduction of prelacteal feeds was associated with urban residency, first-time motherhood, and cesarean delivery

The history of disaster incidents and impact in Nepal 1900-2005: ecological, geographical, and development perspectives

The people of Nepal today are exposed to perennial local disaster events and profound vulnerability to disaster. The combined efforts of government, donors, UN agencies, NGOs, and Nepalese communities are needed to avert the impacts of disaster events. Much more can be done immediately to reduce the impacts by reviewing the scope and distribution of past disaster events. This article provides an overview of Nepal’s disaster vulnerability through an analysis of the record of disaster events that occurred from 1900 to 2005. The data were generated from historical archives and divided into incidents at the district, subnational, and national levels. Statistical and Geographical Information System (GIS) analyses were carried out to generate district level disaster vulnerability maps. It is concluded that small-scale, local disasters have a greater cumulative impact in terms of casualties than large-scale, national disasters

Care for perinatal illness in rural Nepal: a descriptive study with cross-sectional and qualitative components

BACKGROUND: Maternal, perinatal and neonatal mortality rates remain high in rural areas of developing countries. Most deliveries take place at home and care-seeking behaviour is often delayed. We report on a combined quantitative and qualitative study of care seeking obstacles and practices relating to perinatal illness in rural Makwanpur district, Nepal, with particular emphasis on consultation strategies. METHODS: The analysis included a survey of 8798 women who reported a birth in the previous two years [of whom 3557 reported illness in their pregnancy], on 30 case studies of perinatal morbidity and mortality, and on 43 focus group discussions with mothers, other family members and health workers. RESULTS: Early pregnancy was often concealed, preparation for birth was minimal and trained attendance at birth was uncommon. Family members were favoured attendants, particularly mothers-in-law. The most common recalled maternal complications were prolonged labour, postpartum haemorrhage and retained placenta. Neonatal death, though less definable, was often associated with cessation of suckling and shortness of breath. Many home-based care practices for maternal and neonatal illness were described. Self-medication was common. There were delays in recognising and acting on danger signs, and in seeking care beyond the household, in which the cultural requirement for maternal seclusion, and the perceived expense of care, played a part. Of the 760 women who sought care at a government facility, 70% took more than 12 hours from the decision to seek help to actual consultation. Consultation was primarily with traditional healers, who were key actors in the ascription of causation. Use of the government primary health care system was limited: the most common source of allopathic care was the district hospital. CONCLUSIONS: Major obstacles to seeking care were: a limited capacity to recognise danger signs; the need to watch and wait; and an overwhelming preference to treat illness within the community. Safer motherhood and newborn care programmes in rural communities, must address both community and health facility care to have an impact on morbidity and mortality. The roles of community actors such as mothers-in-law, husbands, local healers and pharmacies, and increased access to properly trained birth attendants need to be addressed if delays in reaching health facilities are to be shortened

Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal Demographic and Health Survey 2011

Background: Postnatal care is essential to save the life of the mother and newborn. Knowledge on the determinants of postnatal care assists the policy makers to design, justify and implement appropriate interventions. The current study aimed to analyse the factors associated with utilisation of postnatal care services by mothers in Nepal based on the data from Nepal Demographic and Health Survey (NDHS) 2011. Methods: This study utilised the data from NDHS 2011. The association between utilisation of at least one postnatal care visit (within 6 weeks of delivery) and immediate postnatal care (within 24 hours of delivery) with selected factors was examined by using Chi-square test (?2), followed by multiple logistic regression.Result: Of the 4079 mothers, 43.2% reported attending postnatal care within the first six weeks of birth, while 40.9% reported attending immediate postnatal care. Mothers who were from urban areas, from rich families, who were educated, whose partners were educated, who delivered in a health facility, who had attended a four or more antenatal visits, and whose delivery was attended by a skilled attendant were more likely to report attending at least one postnatal care visit. On the other hand, mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to have attended at least one postnatal care visit. Similarly, mothers who were from the urban areas, from rich families, who were educated, whose partners were educated, who had attended four or more antenatal visits, who delivered in a health facility and had delivered in the presence of a skilled birth attendant were more likely to report attending immediate postnatal care. Mothers who reported agricultural occupation, and whose partners performed agricultural occupation were less likely to attend immediate postnatal care. Conclusion: The majority of postnatal mothers in Nepal did not seek postnatal care. Increasing utilisation of the recommended four or more antenatal visits, delivery at health facility and increasing awareness and access to services through community-based programs especially for the rural, poor, and less educated mothers may increase postnatal care attendance in Nepal