Staff perspectives of barriers to women accessing birthing services in Nepal: A qualitative study

Background: Nepal has made significant progress with regard to reducing the maternal mortality ratio but a major challenge remains the under-utilisation of skilled birth attendants who are predominantly facility based. Studies have explored women's views of the barriers to facility birth; however the voices of staff who offer services have not been studied in detail. This research explores the views of staff as to the key reasons why pregnant women do not give birth in a maternity-care facility. Methods: This mixed methods study comprised qualitative interviews and non-participant observation. The study was conducted in two small non-governmental hospitals, one semi-rural and one urban, in Kathmandu Valley. Twenty interviews were conducted with health care providers and other staff in these hospitals. The interviews were undertaken with the aid of a Nepali translator, with some interviews being held in English. Twenty-five hours of non-participant observation was conducted in both maternity hospitals . Both observation and interview data were analysed thematically. Ethical approval was granted by the Nepal Research Health Council and Bournemouth University's Ethics Committee. Results: Key themes that emerged from the analysis reflected barriers that women experience in accessing services at different conceptual levels and resembled the three phases of delay model by Thaddeus and Maine. This framework is used to present the barriers. First Phase Delays are: 1) lack of awareness that the facility/services exist; 2) women being too busy to attend; 3) poor services; 4) embarrassment; and 5) financial issues. Themes for the second Phase of Delay are: 1) birthing on the way; and 2) by-passing the facility in favour of one further away. The final Phase involved: 1) absence of an enabling environment; and 2) disrespectful care. Conclusion: This study highlights a multitude of barriers, not all of the same importance or occuring at the same time in the pregnancy journey. It is clear that staff are aware of many of the barriers for women in reaching the facility to give birth, and these fit with previous literature of women's views. However, staff had limited insight into barriers occuring within the facility itself and were more likely to suggest that this was a problem for other institutions and not theirs

Power generation potential and cost of a roof top solar PV system in Kathmandu

The paper presents a comparative study of the 3 most used solar PV module technologies in Nepal, which are Si-mono-crystalline, Si-polycrystalline and Si-amorphous. The aim of the paper is to present and discuss the recorded Global Solar Radiation, received in the Kathmandu valley by three different, Si-mono-crystalline, Si-poly-crystalline and Si-amorphous calibrated solar cell pyranometers and to propose the best-suited solar PV module technology for roof top solar PV systems inside the Kathmandu valley. Data recorded over the course of seven months, thus covering most of the seasonal meteorological conditions determining Kathmandu valley’s global solar radiation reception are presented. The results indicate that the Si-amorphous pyranometer captured 1.56% more global solar radiation than the Si-mono-crystalline and 18.4% more than Si-poly-crystalline pyranometer over the course of seven months. Among the three pyranometer technologies the maximum and minimum cell temperature was measured by the Si-mono-crystalline pyranometer. Following the technical data and discussion, an economical analysis, using the versatile software tool PVSYST V5.01is used to calculate the life cycle costs of a 1kW roof top solar PV RAPS system, with battery storage, and a 1kW roof top solar PV grid connected system with no energy storage facility, through simulations, using average recorded global solar radiation data for the KTM valley and investigated market values for each solar PV module and peripheral equipment costs

Feasibility study on Grid connected PV system in Nepal

The climatic conditions of Nepal are ideal for solar energy technology. Indeed, stand alone PV plants are used in remote areas, grid connected systems however are not yet well enough considered. The power supply system is suffering from lack of production forcing the distributor to practice regular load shedding. Therefore, using the energy production potential of grid connected PV plants could substantially contribute in making the national power supply system more diversified and independent, and more ecologically and economically sustainable. The aim of the project (October 2008 – December 2009) was to conduct a feasibility study on PV grid connected plants in the Kathmandu Valley, Nepal, and the consequent development and delivery of an educational program. Nepal benefits from extremely favorable climatic conditions for the use of PV technology with grid connected plants. A south oriented 30° tilted photovoltaic installation can produce 1700 kWh/kWp/Year. The same installation can produce 2300kWh/kWp/Year if installed on a two-axes sun tracker. The initial investment is high but is paid off by a high production and by a cost of 19.6NRs/kWh of the final energy that is by far less than the one produced by the systems at use in households during load shedding periods (inverter-batteries: 54.0NRs/kWh; genset: 55.4 NRs/kWh), or by thermal power plant (ca. 30NRs/kWh). PV energy can contribute to the reduction at all times of the year of the country’s energy production deficit

Psychosocial factors associated with occupation: A comparative study between brick kiln and grocery workers

Background: Psychosocial factors, like physical, chemical and biological factors, are also the potential hazards. But, psychological factors, such as stress, are not mentioned in every kinds of occupation.  Some important psychosocial manifestations found among the workers in previous studies were headache, depression, frustration, worry, low self-esteem, boredom and lack of sleep. Objective: This study was carried out to evaluate and psychosocial factors that are associated with occupational factor between brick kiln workers and grocery workers. Methods: An analytical cross-sectional study was conducted in Kathmandu Valley during February-March 2015 i, targeting all the brick kiln workers. Firstly, all the registered the brick kilns (106 in number) were visited to form the potential sampling frame. Multi-stage probability proportionate to size sampling was applied to select 400 brick kiln workers from 16 brick kilns who had been working there for more than two years. An equal size unmatched reference group was maintained from the grocery workers. Interviews were conducted by trained health workers. Data was entered in the Microsoft (MS) excel and was transferred into the International Business Machines (IBM) Corporation. Statistical Package for the Social Sciences (SPSS) Statistics 21 was used to perform analysis. Both descriptive and (mean, median and inter-quartile range) and inferential (Mann Whitney U test) statistics were computed. The level of significance was set at <0.05. Results: Nearly 20.0% of exposed workers were <19 years of age among which slightly above three fifth achieved primary education. Almost 40% of brick kiln workers were ever smokers. Positive factors of psychosocial and emotional functioning were lower and negative factors were higher among brick kiln workers. The parameters of relationships such as self-esteem, stress and personal agency and the parameters of emotions like emotional, somatic, chronic fear, anxiety, hopelessness, helplessness, abuse and mal-treatment were better and significantly better respectively, in the reference group than the exposed group.  However, the social factor was significantly poor among the reference group i.e. the grocery workers as observed while conducting Mann Whitney U test at p<0.05 level. Conclusion: Among most of the parameters, brick kiln workers' psychosocial functioning was significantly poorer than the grocery workers. Providing formal and/or non-formal education as well as raising awareness about the deleterious effects of the exposure to brick kiln workers  should be recommended

Respiratory symptoms and illnesses related to the concentration of airborne particulate matter among brick kiln workers in Kathmandu valley, Nepal

Abstract Background Bricks have been manufactured in Nepal for hundreds of years and are seen as a component of Nepalese sculpture and architecture. Large quantities of hazardous materials including high concentrations of particulate matter are emitted on a daily basis from brick kilns. Exposure to these hazardous materials can lead to adverse consequences on the environment and human health. This study was conducted to  estimate the prevalence of respiratory symptoms/illnesses and the magnitude of respirable and total dust exposures among Nepalese brick kiln workers. Methods Respiratory symptoms/illnesses were evaluated by questionnaire among brickfield workers (n = 400) and a referent group of grocery workers (n = 400) in Kathmandu valley. Work zones (WZs): green brick molding (GBM), green brick stacking/carrying (GBS/C), red brick loading/carrying (RBL/C), coal preparation (CP) and firemen (FM) were the similar exposure groups (SEGs) from where personal air samples and interviews were taken. Among brickfield workers, personal monitoring was conducted across SEGs for total (n = 89) and respirable (n = 72) dust during February–March 2015 and March–April 2016. Applying multi-stage probability proportionate to size sampling technique, 16 kilns and 400 brick workers for interview were selected. Proportions, means, medians and ranges were calculated for the demographics, samples and respiratory symptoms/illnesses. One-way ANOVA was applied to compare the significance differences of the level of particulate matter among SEGs. Bivariate and multivariate logistic regression analysis were performed to evaluate association between respiratory symptoms/illnesses and participants groups, and SEGs among brick kiln workers at 0.05 level. Statistical analyses were performed using IBM SPSS Statistics 21. Results Chronic cough (14.3%), phlegm (16.6%) and bronchitis (19.0%) were higher (P < 0.05) among brickfield compared with grocery workers (6.8, 5.8 and 10.8%). Mean respirable (5.888 mg/m3) and total (20.657 mg/m3) dust exposures were highest for red brick loading tasks. The prevalence of chronic cough, chronic phlegm, chronic bronchitis, wheezing and asthma were significantly higher for other WZs workers (p < 0.05) compared with CP; for GBM: 22.9, 34.6, 15.0 and 7.5%; for GBS/C: 13.5, 15.8, 10.0, 8.8 and 7.5%; for RBL/C: 11.1, 17.1, 27.4, 19.0 and 11.9%; for FM: 18.4, 12.5, 28.4, 4.9 and 0.0%; and for CP: 4.9, 6.3, 13.3, 9.3 and 4.0% respectively. Conclusion High dust exposures identified in this study may explain the increased prevalence of respiratory symptoms/illnesses among Nepalese brickfield workers, warranting action to reduce exposures

Development of PV grid-connected plants in Nepal. A feasibility study and training programme co-financed by REPIC

This project was co-funded by REPIC and SUPSI. It was achieved through the close collaboration between SUPSI and two Nepalese partner teams: the CES of the Tribhuvan University together with NSES, and Kathmandu University alongside RIDS-Nepal. The project was implemented between October 2008 and June 2010. Although connecting PV modules to the main electric grid is by far the most rational, economical and efficient way to install this technology, it appears that, like in many other developing and transition countries, PV technology has so far been applied in Nepal exclusively through standalone plants (NEA, 2008). Such plants are used in several remote areas of the country and provide very satisfactory service to the rural populations (Zahnd, McKay, & Komp, 2006). However, the urban regions of Nepal, which already have access to the national electricity grid, are so far making use of PV technology without the added advantage of a connection to the grid. As exposed in chapter four, Nepal benefits from extremely favourable climatic conditions for exploiting PV technology. Moreover, despite its extraordinary potential for the production of hydropower, a lack of investments, political instability and the increase in energy demands have brought the country in a severe energy crisis, with as much as sixteen hours of load shedding per day during spring 2009. Solutions and ways out of the energy crisis will certainly be found by diversifying the electricity sources, so as to increase the production capacity in the short and long term, with –hopefully– careful consideration for global sustainability criteria. Grid-connected PV technology could be part of the “package” of Nepal’s future electricity supply scheme, but the conditions and criteria to make it applicable in the given context are manifold and influenced by technical, institutional and economic aspects. These will be analysed in the present work in order to assess its feasibility. Although the investigation for the development of alternative energy sources is a fundamental and acknowledged issue for the energy sector in Nepal, the present study is the first to look specifically at the feasibility of grid-connected PV in the country. The reference context considered in this study is the Kathmandu Valley. In parallel to the feasibility study, a training programme was conducted for TU and KU students at various phases of the project. Moreover, both TU and KU students were directly involved in the study activities, mainly to conduct surveys with potential domestic and industry/service technology users