Knowledge on risk factors of uterine prolapse among reproductive age group women of Bajrabarahi Municipality of Lalitpur, Nepal

Background: Pelvic organ prolapse (POP) is a most common gynecological health problem contributing to maternal morbidity and mortality among women of reproductive age in developing countries. In Nepal prevalence of uterus prolapse among reproductive age women is around 17-27%. Still large numbers of rural Nepalese women are deprived of access to early diagnosis and quality treatment services related uterus prolapse. The present study was conducted with the aims to assess knowledge on risk factors on uterine prolapse among the reproductive age group of women who have at least one child below five years of age and residing at Bajrabarahi municipality of Lalitpur district.Methods: This is a cross sectional descriptive study. Total 185 individuals were randomly selected from the list of safe motherhood register book of Bajrabarahi municipality for the interview. Semi-structured questionnaire was used as tools to collect data from study participants. Data collected was entered in Epi-data and data analysis was done using SPSS 16.0 version. Bivariate analysis was done using Chi-Square test to find the association between the selected variables of the study.Results: The study results shows that out of total 46.5% of respondents have adequate knowledge and 53.5% of respondents have inadequate knowledge regarding risk factors of uterus prolapse. The study results explicitly reflects the knowledge on risk factors of uterus prolapse is significantly associated with the age of respondent (p=0.021), age at marriage of respondents (p=0.011), education status of respondents (p=0.001) and age at first child birth of respondent (p=0.001).Conclusions: Though majority of respondents have heard about uterus prolapse, very few participants have in-depth or adequate knowledge about risk factors of uterus prolapse. Still extensive efforts of government and non-government organizations are essential to improve maternal health status of rural Nepalese women

Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders

Background The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. Methods The semi-structured qualitative interviews were conducted among purposively selected participants (n = 41) from a mix of rural and urban settings in all districts (n = 8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. Results The findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. Conclusions This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population

In search of a theory of supercooled liquids

Despite the absence of consensus on a theory of the transition from supercooled liquids to glasses, the experimental observations suggest that a detail-independent theory should exist.Comment: Commentary. 3 pages 2 figure

Accelerating progress towards the Zero Hunger Goal in cross-boundary climate change hotspots

The most recent 2017 United Nations’ Sustainable Development Goals progress report highlighted the need to accelerate the pace of progress in order for the Sustainable Development Goals to be fully achieved. Responding to these concerns, the present commen tary proposes four distinct, but interrelated approaches to accelerate the Zero Hunger G oal in transboundary climate change hotspots, regions which suffer from multiple stressors and vulnerabilities, and in which prevalence of food insecurity and malnutrition often remains disproportionately high. These conceptual, programmatic and policy approaches are discussed drawing from a newly developed conceptual framework and referring to specific examples from climate change hotspots around the world

Review of gynaecological cancer among Aboriginal and/or Torres Strait Islander people in Australia

Gynaecological cancers bear a significant burden on the health of Australians. Whilst Australia has made great strides in reducing the overall gynaecological cancer burden nationally, Aboriginal and/or Torres Strait Islander women continue to experience disproportionately high rates of gynaecological cancers. This review focuses on the social, cultural, and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women. An in-depth discussion on cervical cancer, ovarian cancer, and uterine cancer are described; including the incidence, mortality, survival, and management of these diseases for Aboriginal and/or Torres Strait Islander women. It highlights both the persistent barriers and facilitators relating to Aboriginal and/or Torres Strait Islander women’s uptake of preventative measures and treatments, including their use of services and programs relating to the management of gynaecological cancers. This review summarises past and current policies and strategies implemented by the Australian Government and other cancer related peak bodies that aim to address this health issue. It recommends that critical attention be given to risk reduction, participation in cancer screening programs, and improved access to culturally appropriate, high quality primary health care and tertiary specialist services. This would address inequitable differences faced by Aboriginal and/or Torres Strait Islander people and reduce the overall burden of gynaecological cancers

Perceived fear of COVID-19 and its associated factors among Nepalese older adults in eastern Nepal : a cross-sectional study

Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal. Methods A cross-sectional study was conducted between July and September 2020 among 847 older adults (?60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear. Results The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear. Conclusion Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them

The COVID‐19 Pandemic Not Only Poses Challenges, but Also Opens Opportunities for Sustainable Transformation

The COVID-19 pandemic has impacted social, economic, and environmental systems worldwide, slowing down and reversing the progress made in achieving the Sustainable Development Goals (SDGs). SDGs belong to the 2030 Agenda to transform our world by tackling humankind's challenges to ensure well-being, economic prosperity, and environmental protection. We explore the potential impacts of the pandemic on SDGs for Nepal. We followed a knowledge co-creation process with experts from various professional backgrounds, involving five steps: online survey, online workshop, assessment of expert's opinions, review and validation, and revision and synthesis. The pandemic has negatively impacted most SDGs in the short term. Particularly, the targets of SDG 1, 4, 5, 8, 9, 10, 11, and 13 have and will continue to have weakly to moderately restricting impacts. However, a few targets of SDG 2, 3, 6, and 11 could also have weakly promoting impacts. The negative impacts have resulted from impeding factors linked to the pandemic. Many of the negative impacts may subside in the medium and long terms. The key five impeding factors are lockdowns, underemployment and unemployment, closure of institutions and facilities, diluted focus and funds for non-COVID-19-related issues, and anticipated reduction in support from development partners. The pandemic has also opened a window of opportunity for sustainable transformation, which is short-lived and narrow. These opportunities are lessons learned for planning and action, socio-economic recovery plan, use of information and communication technologies and the digital economy, reverse migration and “brain gain,” and local governments' exercising authorities

Food insecurity and dietary diversity among lactating mothers in the urban municipality in the mountains of Nepal.

BACKGROUND:Adequate nutrition is essential during the lactation period for better maternal and child health outcomes. Although food insecurity and dietary monotony (defined as less diverse diet), two important determinants of undernutrition, are endemic in the rural mountains of Nepal, insufficiently examined and assessed for risk factors in mothers during lactation, a life stage of high nutritional demand. This study aimed to assess the status and factors associated with food insecurity and dietary diversity among lactating mothers residing in the mountains of Nepal. METHODS:A community-based cross-sectional study was conducted in an urban municipality in the mountainous Bajhang District of far-western Nepal. The sampling frame and strategy led to 417 randomly selected lactating mothers. Household Food Insecurity Access Scale (HFIAS) and the tool "Minimum Dietary Diversity for Women" developed by the Food and Agriculture Organization were used to measure food insecurity and dietary diversity, respectively. Additional information on socio-demographics and risk factors were collected. Multivariable logistics regression assessed correlates of study outcomes. RESULTS:Overall, 54% of the households were food insecure, and over half (53%) of the mothers had low dietary diversity. Food insecurity status (mild food insecurity AOR = 10.12, 95% CI = 4.21-24.34; moderate food insecurity AOR = 8.17, 95% CI = 3.24-20.59, and severe food insecurity AOR = 10.56, 95% CI = 3.92-28.43) were associated with higher odds of dietary monotony. Likewise, participants with lower dietary diversity were 8.5 times more likely to be food insecure than those with higher dietary diversity (AOR = 8.48, 95% CI = 3.76-19.14). The monthly income of the family was positively associated with food insecurity. Participants' (AOR = 3.92 95%CI = 1.76-8.71) or spouses' (AOR = 2.90, 95% CI = 1.07-7.85) unemployment was associated with higher odds of being food insecure. Likewise, owning a cultivable land (AOR = 0.49, 95% CI = 0.28-0.84) and participant's unemployment status (AOR = 5.92, 95% CI = 3.02-11.63), were significantly associated with increased odds of dietary monotony. CONCLUSION:The observed food insecurity and poor dietary diversity among lactating mothers, the correlates associated with these outcomes, may help local stakeholders to identify local health needs and subgroups for targeted interventions. Socioeconomically disadvantaged mothers should be specifically targeted for relevant programs and policies

Knowledge on risk factors of uterine prolapse among reproductive age group women of Bajrabarahi Municipality of Lalitpur, Nepal

Background: Pelvic organ prolapse (POP) is a most common gynecological health problem contributing to maternal morbidity and mortality among women of reproductive age in developing countries. In Nepal prevalence of uterus prolapse among reproductive age women is around 17-27%. Still large numbers of rural Nepalese women are deprived of access to early diagnosis and quality treatment services related uterus prolapse. The present study was conducted with the aims to assess knowledge on risk factors on uterine prolapse among the reproductive age group of women who have at least one child below five years of age and residing at Bajrabarahi municipality of Lalitpur district.Methods: This is a cross sectional descriptive study. Total 185 individuals were randomly selected from the list of safe motherhood register book of Bajrabarahi municipality for the interview. Semi-structured questionnaire was used as tools to collect data from study participants. Data collected was entered in Epi-data and data analysis was done using SPSS 16.0 version. Bivariate analysis was done using Chi-Square test to find the association between the selected variables of the study.Results: The study results shows that out of total 46.5% of respondents have adequate knowledge and 53.5% of respondents have inadequate knowledge regarding risk factors of uterus prolapse. The study results explicitly reflects the knowledge on risk factors of uterus prolapse is significantly associated with the age of respondent (p=0.021), age at marriage of respondents (p=0.011), education status of respondents (p=0.001) and age at first child birth of respondent (p=0.001).Conclusions: Though majority of respondents have heard about uterus prolapse, very few participants have in-depth or adequate knowledge about risk factors of uterus prolapse. Still extensive efforts of government and non-government organizations are essential to improve maternal health status of rural Nepalese women