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

A rare case of Herlyn-Werner-Wunderlich syndrome-with pregnancy

Herlyn-Werner-Wunderlich syndrome also known as uterus didelphys with obstructing hemivaginal septum and ipsilateral renal agenesis (OHVIRA) is a very rare syndrome with only a few case reported. A female patient referred to our hospital with retention of urine revealed uterus didelphys with 8 weeks gestation sac in the left moiety and hematometra and hematocolpous in the right moiety with absent right kidney. Diagnosing this syndrome at an early stage is important to prevent the complications in these patients

Energy use efficiency of crop residue management for sustainable energy and agriculture conservation in NW India

In the Indo-Gangetic plains of South Asia, the triple challenges of diminishing farm profitability, deteriorating natural resources and energy deficits threaten conventional agricultural sustainability. This threat is intensified by the open field burning of crop residues that not only squander an indirect renewable source of energy but also impair the soil and environment quality. The crop residues can be used as organic manure by retaining the residues as mulch in the field. After a long term (5-yrs) study, it was concluded that crop residues biomass contributed maximum (∼79%) in total input energy (1,68,556 MJ ha−1) in conservation agriculture (CA) based systems, however fertilizer application (non-renewable energy source) contributed maximum (∼50%) to the total energy (40,636 MJ ha−1) in conventional tillage (CT) based maize-wheat cropping system.CA based maize systems recorded higher input energy and energy intensiveness by 23 and 57% respectively, and recorded almost 44% lower energy use efficiency and energy productivity compared to CT based maize systems. On 5 years average basis, Zero tillage based maize-wheat-mungbean with nutrient expert cropping system(ZT/MWMb + NE) utilized 351% more input energy, which resulted in25%higher output energy and 363% higher EI compared to CT/MW (40,636 MJ ha−1, 4,20,197 MJ ha−1, 39.60 MJ USD−1)

Effect of different tillage and residue management practices on crop and water productivity and economics in maize (Zea mays) based rotations

In recent years, increasing water and labor scarcity & production cost, decreasing farm profitability and climatechange- induced variability are major challenges faced by the farmers of Indo-Gangetic Plains (IGP) in South Asia. Conservation agriculture (CA) based best-bet crop management practices may increase crop productivity, profitability and conserve the natural resources. In a 2-year (2012-2014) study, we assessed the effects of six combinations of tillage and crop establishment (TCE) and residue management options on crop & water productivity, profitability and soil thermal and moisture regimes in maize (Zea mays)-wheat (Triticum aestivum L.) (MW) and maize-chickpea (Cicer arietinum L.) (MC) rotations in Western IGP of India. The treatments consisted of both crops sown on permanent raised beds with residue (PB+R) and without residue (PB-R); zero tilled flat with residue (ZT+R) and without residue (ZT-R) and conventional tilled flat with residue (CT+R) and without residue (CT-R). Overall, 2-year mean maize, wheat and chickpea grain/seed yield was found to be 17.0-23.2, 20.8-24.8 and 22-31.7% higher under CA-based PB+R/ZT+R than CT-R, but it was 5.3-10.9, 4.9-8.4 and 13.8-22.8% higher than CT+R, respectively. The yield of maize, wheat and chickpea was significantly (P<0.05) higher in CA-based PB+R and ZT+R systems compared to CT-R right from first year onwards. The MW and MC, 2-year mean system productivity (based on maize equivalent yield- MEY) was higher by 21.1-21.9 and 18.7-27.5% in CA-based systems (PB+R & ZT+R) than in the CT-R, respectively. CA-based PB+R and ZT+R practices reduced the total system water use in MW and MC rotations by 75-112 mm and 55-90 mm and resulted enhanced system water productivity (WP) compared to CT-R system. Irrespective of crop rotations and TCE practices residue management treatments enhances the soil moisture (in the range of 14.5 to 30.4% during winter and monsoon seasons) and also moderates the soil temperatures. Economic profit for MW and MC rotations was always significantly (P<0.05) higher (168-445 and 215-619 US$/ha/year) in CA-based systems than in CT-R. Findings of our study shows that MW and MC rotations under CA-based system is one of the way for improving crop productivity, WP and farm income with less risk of extreme temperature and moisture stress while sustaining the natural resources in Western IGP of India and other similar agro-ecologies of South Asia