Economic Costs Associated with Motorbike Accidents in Kathmandu, Nepal

Background: Road traffic accidents, considered as global tragedies, are in increasing trend however, the safety situation is very severe in developing countries incurring substantial amount of human, economic and social costs. Motorcycle crashes, the commonest form, occur mostly on economically active population. However, there is limited coverage of studies on economic burden of motorcycle crashes. This study aims to estimate the total cost and DALYs lost due to motorbike accidents among victims of Kathmandu Valley.Materials and Methods: Retrospective cross-sectional study was conducted among the patients having history of motorbike accidents within past twelve months and at least 3 months from the date of data collection. Interview was conducted using proforma among 100 victims of accidents and their care giver in case of death from November 15, 2014 to May 15, 2015. Cost estimation of motorbike accident was done based on human capital approach. Data collection tool was pretested and collected data were analyzed by SPSS and Microsoft excel. Results: Males (79%) belonging to the economically productive age group shared the highest proportion among total accidents victims. Most common reason for accidents was reported to be poor road condition (41%). Indirect cost was found to be significantly higher than direct costs highlighting its negative impact on economy of family and nation due to productivity loss. Total Disability Adjusted Life Years (DALYs) lost per person was found to be 490 years and national estimation showed large burden of motorbike accidents due to huge DALY loss.Conclusions: For low resource countries like Nepal, high economic costs of motorbike accidents can pose additional burden to the fragile health system. These accidents can be prevented, and their consequences can be alleviated. There is an urgent need for reinforcement of appropriate interventions and legislation to decrease the magnitude of it and its associated grave economic consequences so as to nib this emerging epidemic in the bud

Geographic remoteness and socioeconomic disadvantage reduce the supportiveness of food and physical activity environments in Australia

Objective An analysis of food and physical activity environments in relation to socioeconomic disadvantage was conducted in 25 communities across Queensland, Australia. Methods Physical activity and food environments were assessed in 25 Queensland communities using The Systematic Pedestrian and Cycling Environmental Scan (SPACES) and the Nutrition Environment Measurement Survey (NEMS). Spearman's correlation tested the association between physical activity and food environments and degree of remoteness and socioeconomic disadvantage of each region. Results A significant negative association was observed between the supermarket food environment and degree of remoteness and socioeconomic disadvantage. All regions have a moderately supportive environment for physical activity. Food availability and price varied in supermarkets with more remote communities having less supportive food environments. Conclusions Areas with a high degree of remoteness and socioeconomic disadvantage were more likely to experience disadvantages in the physical activity, supermarket, and restaurant food environments than metropolitan areas and socioeconomically disadvantaged areas. Implications for public health Socioeconomic disadvantage and remoteness were associated with reduced supportiveness of the built environment hindering the ability of consumers to make healthy food and physical activity choices. Improving the food and physical activity environments in these areas may assist in reducing the health inequalities experienced by these communities

Navigating pregnancy and early motherhood in prison: a thematic analysis of mothers’ experiences

BACKGROUND: Maternal imprisonment negatively impacts mothers and their children and is likely to have lifelong and intergenerational sequelae. In many jurisdictions nationally and internationally, young children (usually those less than 5 years) can reside with their mothers in prison. However, there is considerable debate regarding the impact of prison environments on incarcerated mothers and their children who are born, and/or raised in prison. Research to date on the pregnancy and mothering experiences of imprisoned mothers and their preferences for care arrangements for their babies and young children is limited. METHODS: This study was part of the Transforming Corrections to Transform Lives project, in which workshops were conducted with imprisoned mothers to understand their needs while in custody and post-release, and the kind of supports and system changes that are required to meet those needs. Incarcerated mothers (n = 75) participated in seven workshops conducted across four Queensland prisons. Themes were generated through reflexive thematic analysis. RESULTS: Three themes characterised mothers’ experiences of being pregnant and undertaking a mothering role of a young child while in prison. First, for most mothers, imprisonment adds vulnerability and isolation during pregnancy and childbirth. Second, although mothers felt that residing together with their children in prison motivated them to change for a better future, they were concerned about the potential negative impact of the prison environment on the child’s development. Lastly, most mothers voiced losing autonomy and agency to practice motherhood independently within custodial settings. Mothers expressed a need for the correctional system to be adapted, so it is better equipped to address the unique and additional needs of mothers with young children. CONCLUSION: Mothers’ experiences indicated that the correctional system and policies, which were predominantly designed for men, do not adequately address the varied and complex needs of pregnant women, mothers, and their young children. Imprisonment of pregnant women and mothers with young children should be the last resort, and they should be provided with holistic, individually tailored support, most preferably in community settings, to address their multiple intersecting needs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40352-022-00196-4

Feasibility and Effectiveness of an Intervention to Reduce Intimate Partner Violence and Psychological Distress Among Women in Nepal: Protocol for the Domestic Violence Intervention (DeVI) Cluster-Randomized Trial

BackgroundIntimate partner violence (IPV) disproportionately affects people in low-and middle-income countries (LMICs), such as Nepal. Women experiencing IPV are at higher risk of developing depression, anxiety, and posttraumatic stress disorder. The shortage of trained frontline health care providers, coupled with stigma related to IPV and mental health disorders, fuels low service uptake among women experiencing IPV. The Domestic Violence Intervention (DeVI) combines the Problem Management Plus counseling program developed by the World Health Organization with a violence prevention component. ObjectiveThis study aims to implement and evaluate the feasibility, acceptability, and effectiveness of DeVI in addressing psychological distress and enabling the secondary prevention of violence for women experiencing IPV. MethodsA parallel cluster-randomized trial will be conducted across 8 districts in Madhesh Province in Nepal, involving 24 health care facilities. The study will include women aged 18-49 years who are either nonpregnant or in their first trimester, have experienced IPV within the past 12 months, have a 12-item General Health Questionnaire (GHQ-12) score of 3 or more (indicating current mental health issues), and have lived with their husbands or in-laws for at least 6 months. A total sample size of 912 was estimated at 80% power and α<.05 statistical significance level to detect a 15% absolute risk reduction in the IPV frequency and a 50% reduction in the GHQ-12 score in the intervention arm. The health care facilities will be randomly assigned to either the intervention or the control arm in a 1:1 ratio. Women visiting the health care facilities in the intervention and control arms will be recruited into the respective arms. In total, 38 participants from each health care facility will be included in the trial to meet the desired sample size. Eligible participants allocated to either arm will be assessed at baseline and follow-up visits after 6, 17, and 52 weeks after baseline. ResultsThis study received funding in 2019. As of December 29, 2022, over 50% of eligible women had been recruited from both intervention and control sites. In total, 269 eligible women have been enrolled in the intervention arm and 309 eligible women in the control arm. The trial is currently in the recruitment phase. Data collection is expected to be completed by December 2023, after which data analysis will begin. ConclusionsIf the intervention proves effective, it will provide evidence of how nonspecialist mental health care providers can address the harmful effects of IPV in resource-constrained settings with a high burden of IPV, such as Nepal. The study findings could also contribute evidence for integrating similar services into routine health programs in LMICs to prevent IPV and manage mental health problems among women experiencing IPV. Trial RegistrationClinicalTrials.gov NCT05426863; https://clinicaltrials.gov/ct2/show/NCT05426863 International Registered Report Identifier (IRRID)DERR1-10.2196/4591

Psychosocial problems among adolescent students: An exploratory study in the central region of Nepal

Background: Recently, school has drawn attention, as one of the dominant factors for psychosocial development of students. Nepal, however has limited studies on this issue. Study sought to assess the prevalence of psychosocial problem among adolescent students and family related factors. Methods: Taking 787 adolescent students from 13 schools of Hetauda municipality, we accomplished a cross-sectional study. A set of structured questionnaire and Y-PSC (Youth-Pediatric Symptoms Checklist) was adopted. A series of univariate, bivarite and multivariate analysis were performed for statistical analysis.Results: One-fifth (17.03%) adolescent students suffered with psychosocial problem. Male (9.50%) got affected more, compared to their female counterparts (7.80%). Figure of psychosocial problem rose with rise in age group and class. Frequency of family dispute was significantly associated with psychosocial problem (95% CI: 2.27-17.23). Conclusion: Interventions on psychosocial problems need a greater start, with special emphasis on school setting, targeting adolescents and community settings, targeting parents

Additional file 2: of Interventions for domestic violence among pregnant women in low- and middle-income countries: a systematic review protocol

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