AN ANALYSIS OF SOCIO-ECONOMIC CONSEQUENCES OF CANCER IN NEPAL

This dissertation investigates the socio-economic burden of cancer patients using a primary survey in Nepal. Given the low uptake rate of cancer screening facilities in developing countries, my study covers three important issues: the need of information dissemination on cancer prevention among asymptomatic individuals, the emotional stress of cancer patients in relation to a control group of patients, and the severity of economic burden due to premature cancer related deaths measured at the national and individual levels. In developing countries with low level of information and awareness, it is difficult to communicate the importance of cancer preventative measures to the healthy population. It is only those who have a deeper understanding of the state of world and of the extent of disease adversities can truly value a cancer preventative program. With this background, Chapter 2 studies the retrospective preference of cancer patients in valuing an annual comprehensive cancer screening program. Conventional contingent valuation models and a structural equation modeling framework under mediation analysis not only determines how current health status affect preferences, but also unravel mediating linkages between different psychosocial factors of patients. For example, patients\u27 perceived chances of cancer re-occurrence may lead them to prefer screening services, but it can also leave an opposing effect on screening preferences through higher pessimism among patients. The second chapter is a case-control comparison of mental burden. I extended the mental health literature by studying the differential impact of gender and cancer sites on patients\u27 experience of emotional stress. Using propensity score matching methods, binary, and multivalued treatment effect weighting strategies, I found that cervical cancer is not only the most prevalent cancer in Nepal, but they also face the highest mental burden pointing to dysfunctional familial relationships. The objective of my third chapter is to highlight the magnitude of economic burden that low resource-setting countries face due to cancer. Mortality cost measured in the number of life years lost and the amount of productivity loss constitute the highest proportion of economic burden. Understanding the severity is important to provide insight into the need of a cancer control policy in the country

Knowledge, attitude, belief and behavior of the Bagmati River users in Kathmandu Valley, Nepal

To add to the existing state of knowledge, the present paper will list out the existence of other unidentified factors that may have a bearing on health outcomes. The relatively new branch of KABB (knowledge, attitude, belief and behavioral) studies tries to locate any differences, if they exist, in the awareness of the population about better health and behavioral practices. This paper seeks to understand the potential role being played by cultural and religious practices in explaining the inconsistency in individual’s knowledge and behavior

Differences in mental burden faced by different cancer patients: A study of Nepal

In our study we have made an attempt to hold personal interviews with randomly selected 600 cancer patients and 200 control patients from five different hospitals of Nepal. From our preliminary analysis, we found that Lung cancer and Breast cancer are the most common types of cancers faced by male and female population respectively. Cancer patients face higher economic burden and coupled with lack of health insurance leads them to rely on aggressive means of payments such as borrowing and selling of properties to finance treatment. In relation to the control group of patients, cancer patients face a significantly higher amount of disease specific mental burden. We took an in-depth analysis of cervical cancer patients in relation to breast cancer, all other female cancers, and all male cancer patients. Propensity score matching results indicate that cervical cancer patients in relation to other categories mentioned above face a significantly higher mental burden. One way of surviving through the disease is the social support that patients receive from close relatives and society. This helps in the recovery process specially of those patients who feel stigmatized and embarrassed in public and are at a higher risk of harming themselves due to the burden of cancer

Role of policy interventions in limiting emissions from vehicles in Delhi, 2020-2030

Urban India, particularly metros, is a major hotspot of air pollution with a PM2.5 concentration level ranging above the permissible limits defined by the WHO for most of the year. Unsurprisingly, special efforts have been made by the Government of India in recent years to improve air quality. Since the transport sector is a major source of air pollution in urban India, the Government of India adopted BS-VI emission standards in 2016 in principle for all major on-road vehicle categories. The rollout of Euro 6 in India began with the capital city Delhi. Furthermore, India's policymakers have been proactive in introducing clean fuel such as CNG, as well as electric vehicle and hydrogen fuel vehicles for urban transport. In this paper, we analyze the interplay between the policy shifts on transport and the level of emissions for Delhi for the next 10 years. We devised three scenarios, starting with the Optimistic Scenario (OPS), which assumes that all of the set policy targets of the Government of India will be realized as planned. A Pessimistic Scenario (PES) assumes implementation of the Optimistic Scenario with a delay of three years, and finally, the Business as Usual Scenario (BAU) assumes no policy interventions in the transport sector and a status quo to be in operation for the coming decade. We predict a significant decline in the emissions of particulate matter (PM), hydrocarbon (HC), carbon monoxide (CO), and nitrogen oxides (NOx) in the OPS/PES scenarios due to the proposed introduction of BS-VI and battery electric fuel vehicles. We find a 20.67% decrease in the overall PM emissions level in the city by 2030. By contrast, our BAU scenario predicts that emissions will increase significantly if no policy intervention is undertaken. In sum, policy interventions may lead to a substantial reduction in emissions in Delhi and thereby a longer life for Delhi inhabitants