Search

Introduction: Intimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15–49. Methods: We conducted a secondary data analysis of the Nepal Demographic and Health Survey (NDHS) 2022. The study examines the lifetime prevalence of IPV. IPV was measured in three domains: experience of physical violence, emotional violence, and sexual violence. Weighted univariate and multivariable logistic regression analysis were applied to determine factors associated with IPV. The results of logistic regression were presented as crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% confidence interval (CI). Results: Of 3853 women, 27.2% had experienced any form of IPV. The lifetime prevalence of physical violence, emotional violence, and sexual violence were 23.2%, 12.8%, and 7.1%, respectively. Higher odds of physical violence were reported among women aged 35–49 years (AOR: 2.13, 95% CI: 1.58–2.87), women without formal education (AOR: 1.51, 95% CI: 1.10–2.06), and women who justified wife-beating (AOR: 1.23, 95% CI: 1.00–1.52). Women from poor households (AOR: 1.61, 95% CI: 1.12–2.35) and women with uneducated partners (AOR: 1.66, 95% CI: 1.08–2.58) were at higher risk of experiencing sexual violence. Women with unemployed husbands reported a higher risk of physical violence (AOR: 2.72, 95% CI: 1.45–5.06) and emotional violence (AOR: 1.61, 95% CI: 1.12–2.35). Conclusion: Almost one in three currently partnered women experienced some form of IPV in their lifetime. Various sociodemographic, partner-related, and women's empowerment-related factors were associated with experiencing IPV. Acknowledging and addressing these factors is essential to mitigating the high rates of IPV among reproductive aged women. [ABSTRACT FROM AUTHOR]

Background: Improvements in standard precaution related to infection prevention and control (IPC) at the national and local-level health facilities (HFs) are critical to ensuring patient's safety, preventing healthcare-associated infections (HAIs), mitigating Antimicrobial Resistance (AMR), protecting health workers, and improving trust in HFs. This study aimed to assess HF's readiness to implement standard precautions for IPC in Nepal. Methods: This study conducted a secondary analysis of the nationally-representative Nepal Health Facility Survey (NHFS) 2021 data and used the Service Availability and Readiness Assessment (SARA) Manual from the World Health Organization (WHO) to examine the HF's readiness to implement standard precautions for IPC. The readiness score for IPC was calculated for eight service delivery domains based on the availability of eight tracer items: guidelines for standard precautions, latex gloves, soap and running water or alcohol-based hand rub, single use of standard disposal or auto-disable syringes, disinfectant, safe final disposal of sharps, safe final disposal of infectious wastes, and appropriate storage of infectious waste. We used simple and multiple linear regression and quantile regression models to examine the association of HF's readiness with their characteristics. Results were presented as beta (β) coefficients and 95% confidence interval (95% CI). Results: The overall readiness scores of all HFs, federal/provincial hospitals, local HFs, and private hospitals were 59.9±15.6, 67.1±14.4, 59.6±15.6, and 62.6±15.5, respectively. Across all eight health service delivery domains, the HFs' readiness for tuberculosis services was the lowest (57.8±20.0) and highest for delivery and newborn care services (67.1±15.6). The HFs performing quality assurance activities (β = 3.68; 95%CI: 1.84, 5.51), reviewing clients' opinions (β = 6.66; 95%CI: 2.54, 10.77), and HFs with a monthly meeting (β = 3.28; 95%CI: 1.08, 5.49) had higher readiness scores. The HFs from Bagmati, Gandaki, Lumbini, Karnali and Sudurpaschim had readiness scores higher by 7.80 (95%CI: 5.24, 10.36), 7.73 (95%CI: 4.83, 10.62), 4.76 (95%CI: 2.00, 7.52), 9.40 (95%CI: 6.11, 12.68), and 3.77 (95%CI: 0.81, 6.74) compared to Koshi. Conclusion: The readiness of HFs to implement standard precautions was higher in HFs with quality assurance activities, monthly HF meetings, and mechanisms for reviewing clients' opinions. Emphasizing quality assurance activities, implementing client feedback mechanisms, and promoting effective management practices in HFs with poor readiness can help to enhance IPC efforts. [ABSTRACT FROM AUTHOR]

Introduction: Family planning (FP) is crucial for improving maternal and newborn health outcomes, promoting gender equality, and reducing poverty. Unmet FP needs persist globally, especially in South Asia and Sub-Saharan Africa leading to unintended pregnancies, unsafe abortions, and maternal fatalities. This study aims to identify the determinants of unmet needs for FP from a nationally representative survey. Methods: We analyzed the data of 11,180 currently married women from nationally representative Nepal Health Demographic Survey 2022. We conducted weighted analysis in R statistical software to account complex survey design and non-response rate. We conducted univariate and multivariable binary and multinomial logistic regression to assess association of unmet need for FP with independent variables including place of residence, province, ecological belt, ethnicity, religion, current age, participant's and husband's education, occupation, wealth quintile, parity, desire for child, and media exposure. Results: The total unmet FP need was 20.8% (95%CI: 19.7, 21.9) accounting 13.4% (95%CI: 12.5, 14.4) for unmet need for limiting and 7.4% (95%CI: 6.8, 8.0) for unmet for spacing. Lower odds of total unmet need for FP were present in 20–34 years and 35–49 years compared to <20 years, women belonging to Madhesi ethnic group (AOR: 0.78; 95%CI: 0.64, 0.95) compared to Brahmin/Chhetri, women from richest (AOR: 0.69; 95%CI: 0.56, 0.84), richer (AOR: 0.82; 95%CI: 0.68, 0.97) and middle wealth quintile (AOR: 0.82; 95%CI:0.70, 0.98) groups compared poorest wealth quintile group and women belonging to rural area (AOR: 0.89; 95%CI: 0.80, 0.99) compared to urban area. Higher odds of unmet need for FP were present among women with basic (AOR: 1.34; 95%CI: 1.17, 1.54), and secondary level (AOR: 1.32; 95%CI: 1.12, 1.56) education compared to women without education, among women from Madhesh (AOR: 1.56; 95%CI: 1.22, 1.98), Gandaki (AOR: 2.11; 95%CI: 1.66, 2.68), Lumbini (AOR: 1.97; 95%CI: 1.61, 2.42) and Sudurpashchim province (AOR: 1.64; 95%CI: 1.27, 2.10) compared to Koshi province and among women whose husband education was basic level (AOR:1.37; 95%CI: 1.15, 1.63), or secondary level (AOR: 1.32; 95%CI: 1.09, 1.60) education. Conclusion: Nepal faces relatively high unmet FP needs across various socio-demographic strata. Addressing these needs requires targeted interventions focusing on age, ethnicity, religion, education, and socio-economic factors to ensure universal access to FP services. [ABSTRACT FROM AUTHOR]

Background: Nepal has made incremental progress in improving coverage of maternal health services leading to improved health outcomes. Government and other health sector stakeholders have consistently considered dissemination of educational messages on maternal health through mass media. However, in Nepal's context, the media's influence on the uptake of maternal health services is less known. This study examines the links between media exposure and maternal health service use in Nepal. Method: Our analysis is based on the nationally representative Nepal Demographic and Health Survey (NDHS) 2022 data. We analyzed data from 1933 women aged 15–49 who had given birth in the two years preceding the survey. Weight analysis was performed to account for complex survey design. We presented categorical variables as frequency, percentage, and corresponding 95% Confidence Interval (CI). Univariable and multivariable logistic regression assessed the association between media exposure and maternal health service use, and the results are presented as crude (COR) and adjusted odds ratios (AOR) along with 95% CI. Results: Women exposed to internet use had 1.59 times [AOR = 1.59, 95% CI = 1.16, 2.19], and those exposed to radio and television health programs had 1.73 times [AOR = 1.73, 95% CI = 1.17, 2.56] higher odds of having four or more Antenatal Care (ANC) visits. Similarly, women exposed to mass media had 1.32 times [AOR = 1.32, 95% CI = 1.00, 1.74] and those exposed to health programs had 1.50 times [AOR = 1.50, 95% CI = 1.02, 2.21] higher odds of having an institutional delivery. However, mass media exposure, internet use, and health program exposure were not significantly associated with increased postnatal care of mother and newborn. Conclusion: Exposure to health programs and internet use are positively associated with four or more ANC visits. Exposure to mass media and health programs are positively associated with increased institutional delivery. Our findings imply that well-designed campaigns and awareness programs delivered through mass media platforms play a vital role in enhancing the uptake of maternal health services. [ABSTRACT FROM AUTHOR]

Nepal's imminent graduation from the Least Developed Country (LDC) status marks a significant milestone in its development trajectory, highlighting substantial progress in economic, social, and human development indicators. This transition necessitates a strategic approach to capitalize on newfound opportunities while mitigating associated challenges. Drawing on insights from socio-economic indicators and economic evolution data, this paper assesses Nepal's readiness for graduation and outlines key priorities for its post-LDC journey. Emphasizing sustainable development aligned with the Sustainable Development Goals (SDGs), the paper advocates for in-country resource mobilization, system strengthening with a localization focus, human capital development, market access facilitation, resilience building, and promotion of foreign direct investment. By leveraging international support, prioritizing strategic initiatives, and fostering conducive environments for growth and investment, Nepal can navigate the transition effectively and pave the way for inclusive, resilient, and sustainable development. [ABSTRACT FROM AUTHOR]

Anaemia in pregnancy is a persistent health problem in Nepal and could be reduced through nutrition counselling and strengthened iron folic acid supplementation programmes. We analysed 24-hour diet recall data from 846 pregnant women in rural plains Nepal, using linear programming to identify the potential for optimised food-based strategies to increase iron adequacy. We then conducted qualitative research to analyse how anaemia was defined and recognised, how families used food-based strategies to address anaemia, and the acceptability of optimised food-based strategies. We did 16 interviews of recently pregnant mothers, three focus group discussions with fathers, three focus group discussions with mothers-in-law and four interviews with key informants. Dietary analyses showed optimised diets did not achieve 100 % of recommended iron intakes, but iron intakes could be doubled by increasing intakes of green leaves, egg and meat. Families sought to address anaemia through food-based strategies but were often unable to because of the perceived expense of providing an 'energy-giving' diet. Some foods were avoided because of religious or cultural taboos, or because they were low status and could evoke social consequences if eaten. There is a need for counselling to offer affordable ways for families to optimise iron adequacy. The participation of communities in tailoring advice to ensure cultural relevance and alignment with local norms is necessary to enable its effectiveness. [ABSTRACT FROM AUTHOR]

This study explores the perceived roles of children in antimicrobial resistance (AMR) in two sites across Nepal. AMR is a global challenge and underpinned by many complex behavioural drivers including how antimicrobial medicines are sourced and used. Because of this social dynamic, several research groups are using community engagement (CE) approaches to understand AMR at community level. However, most data negate the importance of children in behaviours linked to, and potentially driving AMR. In this study, authors apply secondary analysis methods to 10 transcripts representing the views of 23 adults engaged in an AMR-focused film-making project. By focusing on participants' reference to children, we reveal that antimicrobial usage and adherence to health providers' messages can be influenced by the age of the patient. Secondly that children are involved in some of the behaviours which are known to drive antimicrobial resistance such as purchasing over-the-counter antibiotic drugs. Finally, community members discuss that, with careful creation of resources, AMR could be meaningfully presented in educational settings with a view to children acting as agents of change around AMR-driving behaviours. Findings suggest that age-inclusive community engagement projects could be effective in tackling AMR at community level in Nepal and other low resource settings. [ABSTRACT FROM AUTHOR]