KEY FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AT TERM IN NEPAL: A CASE CONTROL STUDY

Background:Low Birth Weight (LBW) is a major public health problem in developing countries including Nepal. Nepal has a prevalence of LBW of 21%. There are various factors associated to high prevalence of LBW. This study aimed to identify specific factors associated to LBW at term in hospital settings in Nepal. Methodology: This study used a hospital based case control design. Hospital nurses interviewed mothers aged 15-45 years who had delivered a full term, single and live baby. Results: A total of 1533 respondents (511 cases and 1022 controls) were taken which is slightly more than the estimated sample size. The mean weight of newborns among case group was 2215 gm (SD:203); and among control group was 3012gm (SD:367). This study revealed that factors such as mothers under 20 years old (OR=1.436, 95% CI:1.074-1.920); height below 145cm (OR=1.504, 95% CI:1.087 -2.083); primigravida (OR=1.423, 95% CI:1.132-1.788); illiterate (OR=1.407 95% CI:1.011-1.957); <4 ANC visits (OR=1.534, 95% CI:1.202-1.957); and iron supplement <180 tabs (OR=1.434, 95% CI:1.152-1.786) were associated with LBW. However, variables like <20 years at the first pregnancy (OR=1.139, 95% CI: 0.904-1.433), disadvantaged ethnicity (OR=1.077, 95% CI: 0.861-1.347) were not associated with LBW in this study.Conclusion: Maternal height, education, number of ANC visits, and iron consumption were strong predictors for LBW in Nepal. It would benefit the country to develop effective strategies on maternal nutrition, female education, and quality ANC to overcome LBW.KEYWORDS: Low Birth Weight; Socio-demographic and antenatal care, Case control design

KEY FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AT TERM IN NEPAL: A CASE CONTROL STUDY

Background:Low Birth Weight (LBW) is a major public health problem in developing countries including Nepal. Nepal has a prevalence of LBW of 21%. There are various factors associated to high prevalence of LBW. This study aimed to identify specific factors associated to LBW at term in hospital settings in Nepal. Methodology: This study used a hospital based case control design. Hospital nurses interviewed mothers aged 15-45 years who had delivered a full term, single and live baby. Results: A total of 1533 respondents (511 cases and 1022 controls) were taken which is slightly more than the estimated sample size. The mean weight of newborns among case group was 2215 gm (SD:203); and among control group was 3012gm (SD:367). This study revealed that factors such as mothers under 20 years old (OR=1.436, 95% CI:1.074-1.920); height below 145cm (OR=1.504, 95% CI:1.087 -2.083); primigravida (OR=1.423, 95% CI:1.132-1.788); illiterate (OR=1.407 95% CI:1.011-1.957); <4 ANC visits (OR=1.534, 95% CI:1.202-1.957); and iron supplement <180 tabs (OR=1.434, 95% CI:1.152-1.786) were associated with LBW. However, variables like <20 years at the first pregnancy (OR=1.139, 95% CI: 0.904-1.433), disadvantaged ethnicity (OR=1.077, 95% CI: 0.861-1.347) were not associated with LBW in this study.Conclusion: Maternal height, education, number of ANC visits, and iron consumption were strong predictors for LBW in Nepal. It would benefit the country to develop effective strategies on maternal nutrition, female education, and quality ANC to overcome LBW.KEYWORDS: Low Birth Weight; Socio-demographic and antenatal care, Case control design

Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for Nepalese diet

<p>We developed a food frequency questionnaire (FFQ) designed to measure the dietary practices of adult Nepalese. The present study examined the validity and reproducibility of the FFQ. To evaluate the reproducibility of the FFQ, 116 subjects completed two 115-item FFQ across a four-month interval. Six 24-h dietary recalls were collected (1 each month) to assess the validity of the FFQ. Seven major food groups and 23 subgroups were clustered from the FFQ based on macronutrient composition. Spearman correlation coefficients evaluating reproducibility for all food groups were greater than 0.5, with the exceptions of oil. The correlations varied from 0.41 (oil) to 0.81 (vegetables). All crude spearman coefficients for validity were greater than 0.5 except for dairy products, pizzas/pastas and sausage/burgers. The FFQ was found to be reliable and valid for ranking the intake of food groups for Nepalese dietary intake.</p

Health system gaps in cardiovascular disease prevention and management in Nepal

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal's health systems gaps to prevent and manage CVDs. METHODS: We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts' codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. RESULTS: National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. CONCLUSION: Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.</p