Tobacco Use during Pregnancy and Its Associated Factors in a Mountain District of Eastern Nepal: A Cross-Sectional Questionnaire Survey

BackgroundTobacco using among women is more prevalent in Nepal as compared to other South-East Asian countries. The effect of its use is seen not only on the pregnant women, but also health of the growing fetus is compromised. Currently, little is known about the tobacco use among women especially during pregnancy in Nepal. This study explored the tobacco use prevalence and its associated factors during pregnancy.Materials and methodsA cross-sectional study was conducted in Sankhuwasabha, a mountain district of eastern Nepal. Representative sample of 436 women of reproductive age group with infant were selected by stratified simple random sampling. Data were collected by face-to-face interviews of selected participants. Data were analyzed with SPSS version 16.0. Binary logistic regression was used to analyze the relationship among variables.ResultsThe study revealed that the prevalence of tobacco use during pregnancy was 17.2%. Only one fifth of the research participants were asked to quit tobacco by health workers during last pregnancy. Multivariable analyses revealed that illiteracy (AOR: 2.31, CI: 1.18–4.52), more than two parity (AOR: 2.45, CI: 1.19–5.07), alcohol use during last pregnancy (AOR: 3.99, CI: 1.65–9.68), and having tobacco user within family (AOR: 2.05, CI: 1.11–3.78) are more likely to use tobacco during pregnancy.ConclusionTobacco use during pregnancy was widely prevalent. Tobacco-focused interventions are required for antenatal women to promote cessation among user and prevent initiation with focus on overcoming problems like illiteracy, high parity, alcohol use, and having other tobacco user family members in family

The potential of health literacy to address the health related UN sustainable development goal 3 (SDG3) in Nepal: a rapid review

BackgroundHealth literacy has been linked to health outcomes across population groups around the world. Nepal, a low income country, experiences the double burden of highly prevalent communicable as well as non-communicable diseases. The World Health Organization (WHO) has positioned health literacy as a key mechanism to meet the health-related Sustainable Development Goal (SDG3). However, there is little known about the status of health literacy in developing countries such as Nepal. This paper aims to review the potential of health literacy to address SDG3 in Nepal.MethodsA rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on barriers to health care engagements in Nepal published in English language between January 2000 and December 2015.ResultsBarriers for healthcare engagement included knowledge and education as strong factors, followed by culture, gender roles, quality of service and cost of services. These barriers influence the Nepalese community to access and engage with services, and make and enact healthcare decisions, not only at the individual level but at the family level. These factors are directly linked to health literacy. Health literacy is a pivotal determinant of understanding, accessing and using health information and health services, it is important that the health literacy needs of the people be addressed.ConclusionLocally identified and developed health literacy interventions may provide opportunities for systematic improvements in health to address impediments to healthcare in Nepal. Further research on health literacy and implementation of health literacy interventions may help reduce inequalities and increase the responsiveness of health systems which could potentially facilitate Nepal to meet the sustainable development goals. While there is currently little in place for health literacy to impact on the SDG3, this paper generates insights into health literacy&rsquo;s potential role.<br /

Reusable sanitary towels: promoting menstrual hygiene in post-earthquake Nepal.

It is a normal human tendency to 'run for your life' when an earthquake occurs. Adolescent girls and women of reproductive age leave their homes with only the clothes they are wearing to save their own and their families' lives. Immediate disaster relief aid with its (unintentional) lack of gender sensitivity has little or no materials for the appropriate management of menstrual hygiene. The biological needs of disaster-affected women will not change despite the dire need for basic food, shelter and security. Timely identification and preparation beforehand with appropriate and culturally sensitive techniques and locally available materials that are reusable can help introduce sustainable and acceptable means of managing menstrual hygiene in a crisis. The use of reusable sanitary towels is well accepted for menstrual hygiene management in non-disaster situations and is appropriate in post-earthquake relief in Nepal

Women’s Perception of Quality of Maternity Services: A Longitudinal Survey in Nepal

Background: In the context of maternity service, the mother’s assessment of quality is central because emotional, cultural and respectful supports are vital during labour and the delivery process. This study compared client-perceived quality of maternity services between birth centres, public and private hospitals in a central hills district of Nepal. Methods: A cohort of 701 pregnant women of 5 months or more gestational age were recruited and interviewed, followed by another interview within 45 days of delivery. Perception of quality was measured by a 20-item scale with three sub-scales: health facility, health care delivery, and interpersonal aspects. Perceived quality scores were analysed by ANOVA with post-hoc comparisons and multiple linear regression.Results: Within the health facility sub-scale, birth centre was rated lowest on items ‘adequacy of medical equipment’, ‘health staff suited to women’s health’ and ‘adequacy of health staff’, whereas public hospital was rated the lowest with respect to ‘adequacy of room’, ‘adequacy of water’, ‘environment clean’, ‘privacy’ and ‘adequacy of information’. Mean scores of total quality and sub-scales health facility and health care delivery for women attending private hospital were higher (p < 0.001) than those using birth centre or public hospital. Mean score of the sub-scale interpersonal aspects for public hospital users was lower (p < 0.001) than those delivered at private hospital and birth centre. However, perception on interpersonal aspects by women using public hospital improved significantly after delivery (p< 0.001). Conclusions: Overall, perception of quality differed significantly by types of health facility used for delivery. They rated lowest the supplies and equipment in birth centres and the amenities and interpersonal aspects in the public hospital. Accordingly, attention to these aspects is needed to improve the quality

Psychosocial problems among adolescent students: An exploratory study in the central region of Nepal

Background: Recently, school has drawn attention, as one of the dominant factors for psychosocial development of students. Nepal, however has limited studies on this issue. Study sought to assess the prevalence of psychosocial problem among adolescent students and family related factors. Methods: Taking 787 adolescent students from 13 schools of Hetauda municipality, we accomplished a cross-sectional study. A set of structured questionnaire and Y-PSC (Youth-Pediatric Symptoms Checklist) was adopted. A series of univariate, bivarite and multivariate analysis were performed for statistical analysis.Results: One-fifth (17.03%) adolescent students suffered with psychosocial problem. Male (9.50%) got affected more, compared to their female counterparts (7.80%). Figure of psychosocial problem rose with rise in age group and class. Frequency of family dispute was significantly associated with psychosocial problem (95% CI: 2.27-17.23). Conclusion: Interventions on psychosocial problems need a greater start, with special emphasis on school setting, targeting adolescents and community settings, targeting parents

Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review

OBJECTIVES: There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students' motivation to practise in rural areas of low-income and middle-income countries following graduation. DESIGN: A systematic review was conducted to identify influences on medical students' motivation to work in rural areas in low-income and middle-income countries. Papers reporting influences on motivation were included, and content analysis was conducted to select the articles. Articles not published in English were excluded from this review. RESULTS: A rural background (ie, being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training and rural location of medical school motivate medical students to work in rural areas. Perceived lack of infrastructure, high workload, poor hospital management and isolation are among the health facility factors that demotivate medical students for medical practice in rural areas. CONCLUSIONS: Medical school selection criteria focusing on a rural background factor and medical education curriculum focusing on rural area are more relevant factors in low-income and middle-income countries. The factors identified in this review may assist the planners, medical educators and policymakers in low-income and middle-income countries in designing relevant interventions to positively influence rural choices where the shortage of rural physicians is an ongoing and increasing concern

Adjusted odds ratio of predictors of PHTN based on final model (Model II).

Adjusted odds ratio of predictors of PHTN based on final model (Model II).</p

Univariable and multivariable regression analysis of predictors of prehypertension (n = 749).

Univariable and multivariable regression analysis of predictors of prehypertension (n = 749).</p

Correlation of anthropometric measures with blood pressure (n = 749).

Correlation of anthropometric measures with blood pressure (n = 749).</p