Search

Introduction: Stillbirth has a long-lasting impact on parents and families. This study examined socio-economic predictors associated with stillbirth in Nepal for the year 2001, 2006 and 2011. Methods: The Nepalese Demographic and Health Survey (NDHS) data for the period (2001–2011) were pooled to estimate socio-economic predictors associated with stillbirths in Nepal using binomial logistic regression while taking clustering and sampling weights into account. Results: A total of 18,386 pregnancies of at least 28 weeks gestation were identified. Of these pregnancies, 335 stillbirths were reported. Stillbirth increased significantly among women that lived in the hills ecological zones (aRR 1.38, 95% CI 1.02, 1.87) or in the mountains ecological zones (aRR 1.71, 95% CI 1.10, 2.66). Women with no schooling (aRR 1.72, 95% CI 1.10, 2.69), women with primary education (aRR 1.81, 95% CI 1.11, 2.97); open defecation (aRR 1.48, 95% CI 1.00, 2.18), and those whose major occupation was agriculture (aRR 1.80, 95% CI 1.16, 2.78) are more likely to report higher stillbirth. Conclusions: Low levels of education, ecological zones and open defecation were found to be strong predictors of stillbirth. Access to antenatal care services and skilled birth attendants for women in the mountainous and hilly ecological zones of Nepal is needed to further reduce stillbirth and improved services should also focus on women with low levels of education. [ABSTRACT FROM AUTHOR]

Indigenous plant use-systems have evolved under, and constantly adapted to human and non-human impacts. In the last decades however, increasing socioeconomic and cultural transformations, including land-use change, outmigration, globalized markets, the introduction of new species, and climate change have led to a decreasing availability of indigenous resources, and are ultimately leading to a reduction of local use-knowledge. Participant observations, discussions, walks-in-the-woods, semi-structured interviews and informal meetings were carried out in 12 villages of far western Nepal between 2011 and 2015 to assess how sociocultural changes have affected the sustenance of indigenous systems and local biodiversity, when compared to studies carried out in the previous decades. Our findings show that there were no statistically significant differences in subject variable means, but differences were relatively important to plant parts-use and plant growth-forms (p = 0.183 and 0.088 respectively). Cissampelos pareira, Acorus calamus, Calotropis gigantea were found to have the greatest relative importance, whereas Ageratina adenophora, Melia azedarach, Carum carvi were most important based on use values. Among them, C. pareira and A. adenophora were introduced. The spatial distribution of species collected for medicine showed that all habitats were important for collection however, habitats close to villages were more favored. The use of non-indigenous and easily available species and more accessible habitats is becoming more prevalent as primary forests become increasingly overexploited, indigenous species become limited, and sociocultural cause of land use change expand. The utilization of indigenous and non-indigenous species and nearby habitats, although possibly affecting the quality of medicinal species, nonetheless reveals the dynamism of indigenous medicines as an adaptive asset mitigating human and non-human environmental changes. [ABSTRACT FROM AUTHOR]