Mental Health in low-and middle income countries (LMICs): Going beyond the need for funding

Despite being globally recognised as an important public health issue, mental health is still less prioritised as a disease burden in many Low-and Middle-Income Countries (LMICs). More than 70% of the global mental health burden occurs in these countries. We discussed mental health issues in LMICs under themes such as abuse and mental illness, cultural influence on mental health, need for dignity in care, meeting financial and workforce gaps and the need for national health policy for the mental health sector. We highlighted that although mental health education and health care services in most LMICs are poorly resourced; there is an urgent need to address issues beyond funding that contribute to poor mental health. In order to meet the increasing challenge of mental health illness in LMICs, there is a need for effort to address cultural and professional challenges that contribute to poor mental health among individuals. We have a notion that mental health should be integrated into primary health care in LMICs. Creating awareness on the impact of some cultural attitudes/practices will encourage better uptake of mental health services and increase the ease when discussing mental health issues in these countries which can contribute to reducing the poor mental health in LMICs

Tharu community's perception on climate changes and their adaptive initiations to withstand its impacts in Western Terai of Nepal

This paper brings out perceptions and observations of Tharu communities (Rana and Chaudhary), inhabitants of Shakarpur VDC of Kanchanpur and Gadariya VDCs of Kailali on climate change and its impacts on their livelihood strategies over the years. In addition, the paper explores some initiatives taken by the local communities to minimize its effects and impacts. Focus Group Discussions (FGD) were organized to collect and analyze vulnerability contexts on climate change and its impact on various sectors like, agriculture, forest, livestock, biodiversity, infrastructure, human casualties and water sources. Similarly, information on available service providers and their contribution was garnered through secondary sources. Local communities are facing these changes over the time and adapting strategies as per their own traditional knowledge, skills and information. Most of these strategies are biodiversity friendly, economically viable and socially acceptable. However, these innovative steps should be shared for larger scale dissemination after validating with scientific review and justifications

Shrinkage of Nepal's second largest lake (Phewa Tal) due to watershed degradation and increased sediment influx

Phewa Lake is an environmental and socio-economic asset to Nepal and the city of Pokhara. However, the lake area has decreased in recent decades due to sediment influx. The rate of this decline and the areal evolution of Phewa Lake due to artificial damming and sedimentation is disputed in the literature due to the lack of a historical time series. In this paper, we present an analysis of the lake's evolution from 1926 to 2018 and model the 50-year trajectory of shrinkage. The area of Phewa Lake expanded from 2.44 ± 1.02 km2 in 1926 to a maximum of 4.61 ± 0.07 km2 in 1961. However, the lake area change was poorly constrained prior to a 1957-1958 map. The contemporary lake area was 4.02 ± 0.07 km2 in April 2018, and expands seasonally by ~0.18 km2 due to the summer monsoon. We found no evidence to support a lake area of 10 km2 in 1956-1957, despite frequent reporting of this value in the literature. Based on the rate of areal decline and sediment influx, we estimate the lake will lose 80% of its storage capacity in the next 110-347 years, which will affect recreational use, agricultural irrigation, fishing, and a one-megawatt hydroelectric power facility. Mitigation of lake shrinkage will require addressing landslide activity and sediment transport in the watershed, as well as urban expansion along the shores

The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study.

Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey was carried out in the Nawalparasi district. Study areas were purposively chosen; however, participants were randomly selected. Nepali versions of the 12-item General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), and Connor-Davidson Resilience Scale (CD-RISC) were used. Mental ill-health risk was prevalent in 3.1% of the participants as determined by GHQ. BDI identified mild or moderate depression in 6.5% of the participants with no one having severe depression. In bivariate analysis, a high frequency of communication with the husband was associated with lower mental ill-health risk and depression, as well as increasing resilience. Reduced return intervals of husbands and a high frequency of remittance were also associated with a low GHQ score. In a multiple regression model, adjusting for potential confounding variables, participants who communicated with their husbands at least once a day had a greater mean CD-RISC score (i.e., high resilience against mental ill-health risk) compared to those who did so at least once a week; a mean difference of 3.6 (95% CI 0.4 to 6.9), P = 0.03. To conclude, a low mental ill-health risk was found in the female spouses of migrants

Experts warn Nepal Government not to reduce local Public Health spending

The health system in Nepal is currently undergoing some very interesting radical reforms. The new Constitution in 2015 brought a complete restructuring of the country’s political system, creating a Federal Republic with seven Provinces. This change involves a significant devolution of power and resources from central to local level in many sectors including the health sector. This editorial warns of the risk of moving away the political focus from Public Health in a centralised political syste