Factors Influencing Dietary Diversity of Pregnant Women Attending Antenatal Care in Western Regional Hospital, Nepal: A Cross-sectional Study

Introduction: Diet during pregnancy is important to fulfill the nutritional demand of physiological changes as well as to create an environment for fetal development. In Nepal, meal diversity scores of mothers and children are low. The situation of dietary diversity among pregnant women was unknown in the Western Region of Nepal. Thus, this study was conducted to generate evidence regarding the status and determinants of dietary diversity among pregnant women. Methods: It was a cross-sectional study. Systematic random sampling was done to select 282 pregnant women of third trimester attending antenatal care in Western Regional Hospital, Nepal. The semi-structured questionnaires, 24-hour recall tool, and Household Food Insecurity Access Scale were used to collect information from participants. Univariate, bivariate and multivariate analysis was done to assess the status, association as well as strength of association between study variables respectively.   Results: The mean (±SD) Women's Dietary Diversity Score was 4.96 (±1.42). Pregnant women having education level < SLC compared to ≥ SLC were 74.7% less likely to have high dietary diversity to lowest dietary diversity (AOR: 0.253, CI: 0.103 – 0.620, p=0.003). Similarly, pregnant women having an unpaid occupation of husbands compared to paid were 74.5% less likely to have high dietary diversity to lowest dietary diversity (AOR: 0.255, CI: 0.074 – 0.876, p=0.030). Conclusions: Consumption of medium dietary diversity was predominant among pregnant women. The education of pregnant women and the occupation of her husband were the two significantly associated factors with dietary diversity. Keywords: ANC; Dietary diversity; Household Food Security; Nepal; Pregnant women DOI: https://doi.org/10.3126/jkahs.v2i3.2665

Between Emergency Responses and Rights?based Approaches: Addressing Poverty and Undernutrition in Eastern India

This article analyses poverty and undernutrition in two of India's poorest states – Orissa and West Bengal. We describe poverty and undernutrition in these two states, focusing on within?state differences. We argue that the persistence of the differences within Orissa is due to ‘structural inequalities’ in the access to and delivery of central government programmes. We then explore the preliminary evidence on West Bengal's recent efforts to improve service delivery through a programme of decentralisation. The conclusion reflects on the nature of approaches that are needed to ensure programmes work even in the most remote and deprived places

Experience of Cyberbullying among Nursing Students

Background: Personal hygiene includes cleanliness of the body and proper maintenance of personal appearance. This study aimed to identify the existing knowledge and practice of personal hygiene among lower secondary level school-going children in Morang, province one, in Eastern-Nepal. Methods: A quantitative, descriptive study was conducted in selected schools of Morang district, Eastern-Nepal comprising of 400 school children. Data was collected using a self-developed and validated structured questionnaire and observation checklist. Two schools from rural areas and two from urban areas were randomly selected and students from classes 6, 7 and 8 were also randomly selected for the study. Result: The majority of the students were in the age group 10-15 years (55% in urban areas and 50% in rural areas). Proper handwashing technique was reported by 59.5% of the students from the urban areas and 48.5% from rural areas. The majority of the students used toothpaste for brushing teeth in urban (79%) and rural areas (76%) respectively. For hand washing, 52% used soap in the urban areas whereas only 26% used soap in the rural area. Although knowledge and practice of personal hygiene were adequate, a significant gap was noted between them in the urban and rural areas (p<0.05). Conclusion: There was a significant gap between the knowledge and practice regarding the personal hygiene among the respondents both in the rural and in the urban areas. Adequate number of educational interventions has to be encompassed in the schools to increase the awareness among the students regarding this subject

Floral diversity and ecology in Kalyani area of Nadia district, West Bengal, India

An assessment of plant diversity was carried out to record different species of flowering plants (Angiosperms) in Kalyani township of Nadia district, West Bengal, India during January, 2014. All together 6 quadrats were laid down, and 30 flowering plant species belonging to 15 families were documented. Voucher specimens were preserved and digitized in departmental phyto-informatics center. Frequency and density varied greatly among the taxa, while many species were not evenly abundant in the study area. Out of total species, 11 species can be used as economic and medicinal plants. There are also some alien invasive species of diverse origin

Predictors of incompletion of immunization among children residing in the slums of Kathmandu valley, Nepal: a case-control study

Abstract Background Immunization is one of the most effective health interventions averting an estimated 2–3 million deaths every year. In Nepal, as in most low-income countries, infants are immunized with standard WHO recommended vaccines. However, 16.4 % of children did not receive complete immunization by 12 months of age in Nepal in 2011. Studies from different parts of the world showed that incomplete immunization is even higher in slums. The objective of this study was to identify the predictors of incompletion of immunization among children aged 12–23 months living in the slums of Kathmandu Valley, Nepal. Methods The unmatched case-control study was conducted in 22 randomly selected slums of Kathmandu Valley. The sampling frame was first identified by complete enumeration of entire households of the study area from which 59 incompletely immunized children as cases and 177 completely immunized children as controls were chosen randomly in 1:3 ratio. Data were collected from the primary caretakers of the children. Backward logistic regression with 95 % confidence interval and adjusted odds ratio (AOR) were applied to assess the factors independently associated with incomplete immunization. Result Twenty-six percent of the children were incompletely vaccinated. The coverage of BCG vaccine was 95.0 % while it was 80.5 % for measles vaccine. The significant predictors of incomplete immunization were the home delivery of a child, the family residing on rent, a primary caretaker with poor knowledge about the schedule of vaccination and negative perception towards vaccinating a sick child, conflicting priorities, and development of abscess following immunization. Conclusion Reduction of abscess formation rate can be a potential way to improve immunization rates. Community health volunteers should increase their follow-up on children born at home and those living in rent. Health institutions and volunteers should be influential in creating awareness about immunization, its schedule, and post-vaccination side effects

Heat stress impacts on cardiac mortality in Nepali migrant workers in Qatar

Background: Qatar is a major destination country for Nepali migrant workers (NMWs; main age range 25–35 years) in the construction trade. These 120,000+ NMWs are exposed to various occupational hazards, including excessive heat, and 3–4 workers die each week. Our study aimed to show whether heat exposure caused deaths. Methods: The worker population and mortality data of NMWs were retrieved from government institutions in Nepal. Heat exposure was assessed by monthly estimates of daily wet bulb globe temperature (WBGT), for in-shade conditions, from data collected at the Doha weather station from 2009 to 2017. Working in the sun during the middle of the day would add 2–3°C to the in-shade WBGT values. Daily deaths and their causes were obtained from the records of the Foreign Employment Promotion Board (FEPB) in Nepal, 2009–2017. Interviews with returning NMWs about their working conditions and the impacts of these conditions added information. The association between the heat variable and mortality was tested with standard statistical methods. Results: The average annual death rate for NMWs in Qatar was 150 deaths/100,000. According to interviews, the majority of NMWs were found working in high WBGT (>31°C) each working day during hot months. The major cause of these deaths was recorded as cardiovascular problems (cardiovascular disease; CVD). Unfortunately, the causes of death were poorly described, and many deaths were listed as “cardiac arrest.” We included these deaths in the broader category of “cardiovascular causes.” There was a strong correlation between average monthly afternoon heat levels (WBGT) and CVD mortality. It is likely that a large proportion of these CVD deaths during hot months were due to serious heat stroke. Global studies show that approximately 15% of deaths in the age group 25–35 years are due to CVD causes. However, in this NMW population, the figures were 22% during the cool season and 58% during the hot season. Conclusions: The increased CVD mortality during hot periods is most likely due to severe heat stress. As many as 200 of the 571 CVD deaths during 2009–2017 could have been prevented if effective heat protection had been implemented as a part of local occupational health and safety programs. There is an urgent need for protection against such heat effects among NMWs, and rising temperatures from ongoing climate change are further increasing the health risks. Cause of death records for workers dying in hot conditions should be more precise than “cardiac arrest.