Study on Thermal Environment and Adaptive Thermal Comfort of the Occupants in Temporary Shelters in Nepal after Massive Earthquake

東京都市大学2019年度（令和元年度

The range and shape of thermal comfort and resilience

The adaptive approach to thermal comfort shows that there is not a single comfortable temperature. A wide range of the temperatures which occur in indoor environments can be found acceptable to building occupants depending on their individual experiences and circumstances. This paper extends the approach introduced in a recent paper [1] to learn the lessons which can be drawn by looking in detail at the relationship between indoor and outdoor temperatures in buildings. By reviewing the records of indoor and outdoor temperatures from field surveys in a variety of climates and cultures, the paper explores the limits to the acceptable indoor temperature range, and its relationship to the concurrent outdoor temperature. In doing this the paper builds on past findings adding some related lessons derived from surveys from many parts of the world – especially Japan, Pakistan, Nepal and Europe. The ways in which the shape of a cloud can be interrogated are explored as well as the effect of emergencies on the range of acceptable temperatures in buildings

Child Trafficking and Associated Factors in Earthquake Affected Area of Nepal

Background: Recruitment, transportation, transfers, harboring, and/or receipt kidnapping of under 18 yrs child for the purpose of slavery, forced labor and exploitation is Child Trafficking. To assess the knowledge about child trafficking and factors associated with child trafficking in Gorkha district of Nepal Methods: Cross sectional study conducted to determine the knowledge and factors related to child trafficking in Gorkha district. Two urban municipalities selected purposively and other three rural municipalities were randomly selected.  Out of 160,772 households, total 300 households for survey was calculated by using Yamane formula (n) = N/ (1+Ne2). Wards of the municipalities were Primary Sampling Unit. Based on Population Proportionate Sampling technique; required number of households of each Wards was identified.  In Wards, households for survey were selected by using simple random method.  Head of the selected household were the respondent for household survey. Ten Key Informant Interviews were done with policemen, teachers, social workers, community leaders, stakeholders and six Focus Group Discussions were done with Youths (15-25 yrs), Parents and Social worker/teacher/community leader groups. Results: Remarkable proportions of respondents have correct knowledge about the child trafficking. Near relatives, unknown person, pears group, parents/family members and neighbor were common traffickers. During and after disaster is the most vulnerable time/event for child trafficking. False marriage, assuring lucrative job, asking for adoption and proposing good education were tricks of traffickers for child trafficking.  Homeless children, children travelling without parents, socially isolated children, children travelling at night, unprotected girl child like orphan, separated from family or without parent are most vulnerable for child Trafficking. Conclusions: Family, social groups, government officials and stakeholders should jointly initiate for anti child trafficking movement. School teacher and management committee should also take initiation to make fully aware to school going children about different dimension/aspect of Child Right and Child Trafficking

Community mobilisation and health management committee strengthening to increase birth attendance by trained health workers in rural Makwanpur, Nepal: study protocol for a cluster randomised controlled trial

Background: Birth attendance by trained health workers is low in rural Nepal. Local participation in improving health services and increased interaction between health systems and communities may stimulate demand for health services. Significant increases in birth attendance by trained health workers may be affected through community mobilisation by local women's groups and health management committee strengthening. We will test the effect of community mobilisation through women's groups, and health management committee strengthening, on institutional deliveries and home deliveries attended by trained health workers in Makwanpur District. Design: Cluster randomised controlled trial involving 43 village development committee clusters. 21 clusters will receive the intervention and 22 clusters will serve as control areas. In intervention areas, Female Community Health Volunteers are supported in convening monthly women's groups. The groups work through an action research cycle in which they consider barriers to institutional delivery, plan and implement strategies to address these barriers with their communities, and evaluate their progress. Health management committees participate in three-day workshops that use appreciative inquiry methods to explore and plan ways to improve maternal and newborn health services. Follow-up meetings are conducted every three months to review progress. Primary outcomes are institutional deliveries and home deliveries conducted by trained health workers. Secondary outcome measures include uptake of antenatal and postnatal care, neonatal mortality and stillbirth rates, and maternal morbidity

The quality of skilled birth attendants in Nepal: High aspirations and ground realities.

BackgroundWhile Nepal's maternal mortality ratio (MMR) has improved overall, the proportion of maternal deaths occurring in health facilities and attended to by skilled birth attendants (SBAs), has nearly doubled over 12 years. Although there are numerous socioeconomic, environmental and other factors at play, one possible explanation for this discrepancy between utilization of skilled maternal care services and birth outcomes lies in the quality of care being provided by SBAs. The objective of this study is to determine how competent SBAs are after training, across multiple settings and facility types in Nepal.MethodsWe used a quantitative cross-sectional analysis to evaluate a sample of 511 SBAs, all female, from 276 sub-health posts (SHP), health posts (HP), primary healthcare centers (PHC), and district and regional hospitals in the mountain, hill, and terai districts of Nepal. Any SBA actively employed by one of these health facilities was included. SBAs who had received less than three months of training were excluded. Outcomes were measured using SBAs' scores on a standardized knowledge assessment, clinical skills assessment, and monthly delivery volume, particularly as it compared with the WHO's recommendation for minimum monthly volume to maintain competence.ResultsSBAs on average exhibit a deficiency of both knowledge and clinical skills, failing to meet even the 80-percent standard that is required to pass training (knowledge: 75%, standard deviation 12%; clinical skills: 48%, standard deviation 15%). Moreover, SBAs are conducting very few deliveries, with only 7 percent (38/511) meeting the minimal volume recommended to maintain competence by the WHO, and a substantial fraction (70/511, 14%) performing an average of no monthly deliveries at all.ConclusionsTaken together, our findings suggest that while countries like Nepal have made important investments in SBA programs, these healthcare workers are failing to receive either effective training or sufficient practice to stay clinically competent and knowledgeable in the field. This could in part explain why institutional deliveries have generally failed to deliver better outcomes for pregnant women and their babies