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Role of Prophylactics Antibiotics in Clean Head and Neck Surgery in a Tertiary Care Center of Nepal: A Prospective Comparative Study. 尼泊尔一家三级医疗中心的头颈部清洁手术中预防性抗生素的作用:前瞻性比较研究。
Q3 Medicine Pub Date : 2024-06-22 DOI: 10.33314/jnhrc.v22i01.4992
Deepak Paudel, Anil Bikram Karki, Amod Shrestha

Background: Surgical site infections are well recognized complications of any surgical procedures. In head and neck surgeries, prophylactic antibiotics are commonly used to prevent Surgical site infections, in contaminated and clean contaminated procedures. Guidelines advised against routine antibiotics use in clean surgeries, but in our setting, non-compliance is frequent, resulting excessive antibiotics use. Objective of the study was to compare the Surgical site infections rate between prophylactics antibiotics group and no antibiotics group in clean head and neck surgery.

Methods: It was a prospective comparative study conducted at a tertiary care centre of eastern Nepal. Patients were assigned to two groups, one receiving prophylactic antibiotics and another receiving no antibiotics.

Results: Out of 131 patients, 66 received prophylactic antibiotics and 65 did not. Thyroidectomy was the most common surgery. The surgical site infection rate was 6.06% in antibiotic group and 7.69% in no antibiotic group, the difference was not significant (p=0.744). The risk reduction of surgical site infection with use of antibiotics was 0.0163 and number need to treat was calculated to be 61.35 About 3% of the patients who were administered antibiotics experienced adverse drug reactions. Factors, such as gender, amount of blood loss, smoking, placement of drains had no significant impact on Surgical site infections rate.

Conclusions: Prophylactics antibiotics does not offer substantial advantages in preventing surgical site infections and are not advised for such procedures. Moreover, their use increases the financial burden and risk of adverse drug reactions to the patients.

背景:手术部位感染是公认的外科手术并发症。在头颈部手术中,预防性抗生素通常用于预防手术部位感染,包括污染手术和清洁手术。指南建议在清洁手术中不要常规使用抗生素,但在我们的环境中,经常出现不遵守指南的情况,导致抗生素使用过量。本研究旨在比较头颈部清洁手术中预防性使用抗生素组和不使用抗生素组的手术部位感染率:这是一项前瞻性比较研究,在尼泊尔东部的一家三级医疗中心进行。患者被分为两组,一组接受预防性抗生素治疗,另一组不接受抗生素治疗:在 131 名患者中,66 人接受了预防性抗生素治疗,65 人未接受治疗。甲状腺切除术是最常见的手术。使用抗生素组的手术部位感染率为 6.06%,不使用抗生素组为 7.69%,差异不显著(P=0.744)。使用抗生素可降低手术部位感染的风险为 0.0163,计算出需要治疗的人数为 61.35。约有 3% 的患者在使用抗生素后出现药物不良反应。性别、失血量、吸烟、放置引流管等因素对手术部位感染率无明显影响:预防性抗生素在预防手术部位感染方面并无实质性优势,因此不建议在此类手术中使用。此外,使用抗生素还会增加患者的经济负担和药物不良反应的风险。
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引用次数: 0
Youth Suicide in Nepal: A Growing Concern. 尼泊尔的青少年自杀问题:日益严重的问题。
Q3 Medicine Pub Date : 2024-06-22 DOI: 10.33314/jnhrc.v22i01.5179
Sudip Paudel, Alok Atreya

In Nepal, suicidal behaviour among adolescents is a growing concern, and the country has been in the grip of a major mental health disaster for many years. The issue must be addressed immediately, and there must be urgent and concerted action by state institutions, healthcare practitioners, and society. Official statistics show the increased rates of completed suicide, whereas those cases that attempted suicide and survived the event remain unaccounted for. The fortunate suicide victims, who were timely rescued, resuscitated, and survived; in the recent years as witnessed at a tertiary hospital in the western region of Nepal, depict a grim picture of suicidality among youths, particularly among teenagers and young adults. The authors recognize the urgent need to tackle and address the problem of youth suicide in the country. Keywords: Cultural factors; mental health crisis; Nepal; risk-taking behaviour; suicide prevention.

在尼泊尔,青少年自杀行为日益令人担忧,该国多年来一直处于严重的精神健康灾难之中。这个问题必须立即得到解决,国家机构、医疗从业人员和社会必须采取紧急的一致行动。官方统计数字显示,完成自杀的比率有所上升,而自杀未遂但幸存下来的病例却仍然下落不明。近年来,在尼泊尔西部地区的一家三甲医院里,一些幸运的自杀者被及时抢救、复苏并存活了下来。作者认为,尼泊尔急需处理和解决青少年自杀问题。关键词文化因素;心理健康危机;尼泊尔;冒险行为;自杀预防。
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引用次数: 0
Prevalence of Anxiety and Depressive Symptoms among Hospitalized Patients Diagnosed with COVID-19. 被诊断为 COVID-19 的住院病人中焦虑和抑郁症状的流行率。
Q3 Medicine Pub Date : 2024-06-22 DOI: 10.33314/jnhrc.v22i01.4835
Sandipa Sharma, Siddinath Gyawali, Niranjan K C, Subash Sapkota, Siddhartha Kumar Shrestha, Pujan Bataju, Rumi K C, Ram Prashad Lamichhane

Background: A series of acute, atypical respiratory diseases was identified in Wuhan, China, which was named Coronavirus disease (COVID-19) by the World Health Organization (WHO), and the disease was later declared a pandemic. This disease has psychological effects in addition to physiological symptoms. This study aims to find out the psychological impacts of disease in the form of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19.

Methods: A multicentric descriptive cross-sectional study was conducted among patients diagnosed with COVID-19 who were admitted from July 1, 2021 to August 15, 2021 in six different hospitals. Ethical approval was obtained from the Nepal Health Research Council (reference number 284). COVID-19 was diagnosed using Reverse Transcription Polymerase Chain Reaction (RT-PCR) or COVID-19 antigen test. Data were collected from the patients using proforma containing the demographic profile and two questionnaires (Hospital Anxiety and Depression scale and Global Health Questionnaire-12) translated into the Nepali language.

Results: Among 360 patients who participated in the study, 194 (53.9%) were males and 166 (46%) were females. Symptoms of anxiety and depression were seen in 161 (44.7%) and 253 (70.3%) of the participants respectively. Similarly 349 (96.9%) of them were found to have clinically significant mental distress.

Conclusions: The prevalence of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19 is significantly high compared to the general population.

背景:在中国武汉发现了一系列急性、非典型呼吸道疾病,世界卫生组织(WHO)将其命名为冠状病毒病(COVID-19),随后宣布该病为大流行病。这种疾病除了生理症状外,还会对心理产生影响。本研究旨在了解确诊为 COVID-19 的住院病人的焦虑和抑郁症状对疾病造成的心理影响:方法:对 2021 年 7 月 1 日至 2021 年 8 月 15 日期间在六家不同医院住院的确诊为 COVID-19 的患者进行多中心描述性横断面研究。研究获得了尼泊尔卫生研究委员会的伦理批准(编号 284)。COVID-19通过逆转录聚合酶链反应(RT-PCR)或COVID-19抗原检测进行诊断。使用包含人口统计学特征和两份翻译成尼泊尔语的问卷(医院焦虑抑郁量表和全球健康问卷-12)的表格收集患者数据:在参与研究的 360 名患者中,194 名(53.9%)为男性,166 名(46%)为女性。分别有 161 人(44.7%)和 253 人(70.3%)出现焦虑和抑郁症状。同样,其中 349 人(96.9%)有明显的临床精神痛苦:结论:在被诊断患有 COVID-19 的住院患者中,焦虑和抑郁症状的发生率明显高于普通人群。
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引用次数: 0
Barriers to Abortion among Women and Girls in Selected Districts of Nepal. 尼泊尔部分地区妇女和女孩堕胎的障碍。
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.4935
Parash Prasad Phuyal, Tejaswee Bhattarai, Prakash Dev Pant, Bishnu Devkota, Jivan Devkota, Madhav Prasad Dhakal, Sujan Karki, Jagadishwor Ghimire, Brittany Moore

Background: Even after two decades of legalization of abortion in Nepal, most women and girls still do not have knowledge on abortion legality and face abortion barriers. This study will explore perceived barriers to safe abortion and the factors associated with it.

Methods: A Mixed method study design was conducted in 30 wards of 20 Municipals of seven districts of Lumbini and Sudurpaschim provinces. Quantitative data was analyzed for 673 women of reproductive age of 15-49 years. For qualitative data, key informant interviews were conducted. The analysis was done on five different barriers and a composite variable was created from them.

Results: Most women and girls perceived social (34.6%), followed by family (30.6%), physical (30.6%), personal (29.5%), and health facility (14.9%) barriers to access safe abortion services. The key finding was that women and girls with knowledge on abortion legality were more likely to perceive barriers to abortion (AOR:2.31, CI:1.574-3.394). Women and girls with higher educational and economic status as well as Dalit women were less likely to perceive barriers to abortion services whereas never married women and girls perceived more barriers in accessing abortion services.

Conclusions: Women and girls perceived several barriers to access safe abortion services. Women who have better knowledge on abortion legality recognize more barriers regarding abortion. This highlights the importance of raising awareness of women and girls on abortion rights to empower them in recognizing and advocating for the removal of the obstacles that stop them from getting abortion services.

背景:即使在尼泊尔堕胎合法化二十年之后,大多数妇女和女孩仍然不了解堕胎的合法性,并面临堕胎障碍。本研究将探讨安全堕胎的认知障碍及其相关因素:在蓝毗尼省和苏都帕斯金省 7 个县 20 个市的 30 个区开展了混合方法研究。对 673 名 15-49 岁育龄妇女的定量数据进行了分析。在定性数据方面,对关键信息提供者进行了访谈。对五种不同的障碍进行了分析,并从中创建了一个综合变量:大多数妇女和女孩认为在获得安全堕胎服务方面存在社会障碍(34.6%),其次是家庭障碍(30.6%)、身体障碍(30.6%)、个人障碍(29.5%)和医疗机构障碍(14.9%)。主要发现是,了解堕胎合法性的妇女和女孩更有可能认为存在堕胎障碍(AOR:2.31,CI:1.574-3.394)。教育程度较高、经济地位较高的妇女和女孩以及贱民妇女不太可能感知到人工流产服务的障碍,而从未结过婚的妇女和女孩在获得人工流产服务方面感知到更多障碍:结论:妇女和女童在获得安全人工流产服务方面存在多种障碍。对堕胎合法性有更多了解的妇女认识到堕胎方面的更多障碍。这凸显了提高妇女和女孩对堕胎权利认识的重要性,从而增强她们的能力,使她们能够认识到并倡导消除阻止她们获得堕胎服务的障碍。
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引用次数: 0
Detection of Cervical Precancer Using Visual Inspection Method with Acetic Acid. 用醋酸目测法检测宫颈癌前病变
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.5024
Gehanath Baral, Lila Oli, Sheela Verma, Snigdha Rai, Parshuram Aryal, Suman Tiwari

Background: Cervical cancer screening is the priority activity of the government. Visual inspection with Acetic acid (VIA), Pap smear Liquid-based cytology, and HPV DNA testing are different methods of screening. VIA-based screening is the cost-effective method of screening in a resource-constrained setting like in our country as this doesn't require cyto-histological testing, can be performed by trained paramedics too, and is as accurate as a cytological test. The aim is to explore pre-cancer cervical lesions by screening women in the community by visual inspection using acetic-acid.

Methods: Community-based cross-sectional study done at a health camp setting for three months from March to June 2023. The married non-pregnant women of 30-60 years were screened. Descriptive tests as well as sub-group analysis performed by Chi-Square tests.

Results: From ten community health camps, 1255 cases were screened and screen positivity was 14.3%. Positive results were proportionately distributed to all parity by 13-19%. Half of the positive results (47.2%) were in the 34-40 age group. There were no significant differences in screen positivity by parity or vaginal discharge. Menopausal women had 7.7% screen positivity.

Conclusions: The prevalence of VIA positivity in the community was found double the previous facility-based prevalence; and there was no significant difference by parity, menopausal status, and vaginal discharge. The positivity was more in 30-45 years of age.

背景:宫颈癌筛查是政府的优先活动。醋酸目视检查(VIA)、巴氏涂片液基细胞学检查和人乳头瘤病毒 DNA 检测是不同的筛查方法。在我国这种资源有限的情况下,醋酸目测筛查是最经济有效的筛查方法,因为这种方法不需要细胞组织学检测,受过培训的医务辅助人员也可以进行,而且与细胞学检测一样准确。我们的目的是通过使用醋酸对社区妇女进行肉眼检查,来发现宫颈癌前病变:方法:在 2023 年 3 月至 6 月的三个月期间,在健康营环境中进行了基于社区的横断面研究。筛查对象为 30-60 岁的已婚未孕妇女。通过 Chi-Square 检验进行描述性检验和亚组分析:在 10 个社区健康营中,共筛查了 1255 个病例,筛查阳性率为 14.3%。阳性结果在所有奇偶数中的分布比例为 13-19%。一半的阳性结果(47.2%)出现在 34-40 岁年龄组。筛查阳性率在奇偶数或阴道分泌物方面没有明显差异。更年期妇女的筛查阳性率为 7.7%:结论:在社区中发现的 VIA 阳性率是以前在医疗机构中发现的阳性率的两倍;而且不同的奇偶数、绝经状态和阴道分泌物也没有明显差异。30-45岁的妇女阳性率更高。
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引用次数: 0
Fetomaternal Outcome of Pregnant Women at Term Undergoing Cesarean Section. 接受剖腹产手术的临产孕妇的胎儿结局
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.4599
Sonu Bharati, Ganesh Dangal, Kenusha Devi Tiwari, Sunita Maharjan, Srijana Bhandari, Aruna Karki, Hema Kumari Pradhan, Ranjana Shrestha, Kabin Bhattachan

Background: Cesarean section is one of the most common procedures performed in obstetric practice today and is a lifesaving surgery for mother and fetus. Cesarean sections are classified traditionally, as elective cesarean section or emergency cesarean. The purpose of this study is to compare the maternal and neonatal outcomes in elective and emergency cesarean section so that measures can be taken to reduce maternal and neonatal morbidity and mortality.

Methods: A descriptive study including 400 pregnant women who underwent caesarean section were included in this study. Patients were subjected to elective or emergency cesarean section as per the indication and protocol of institute. were included in the study.

Results: During the study period there were total 1080 deliveries. The average age of the women was 29.21±4.07 years. Of the 400 cesarean section cases, only 2.8% had wound infection, 3.8% had fever, 4.8% urinary tract infection (UTI) whereas no women had observed with post-partum hemorrhages (PPH) and maternal death. Regarding fetal outcome, neonatal intensive care unit (NICU) admission was observed in 16%, birth asphyxia was 2.3% poor Apgar score 2.5% and neonatal death was not observed. Rate of fever, UTI, wound infection, need of resuscitation and poor Apgar score was significantly high in emergency section than elective caesarean section whereas NICU admission was not statistically significant. The most common indication of emergency cesarean section were fetal dress and for previous LSCS.

Conclusions: Emergency cesarean was associated with increased maternal and perinatal complications than in elective cesarean section.

背景:剖腹产是当今产科最常见的手术之一,也是挽救母亲和胎儿生命的手术。传统上将剖宫产分为择期剖宫产和急诊剖宫产。本研究的目的是比较择期剖宫产和急诊剖宫产的产妇和新生儿结局,以便采取措施降低产妇和新生儿的发病率和死亡率:本研究是一项描述性研究,包括 400 名接受剖腹产手术的孕妇。研究对象包括 400 名接受剖腹产手术的孕妇,患者均根据医院的指征和方案接受择期或急诊剖腹产手术:研究期间共有 1080 例分娩。平均年龄为(29.21±4.07)岁。在 400 例剖宫产病例中,仅有 2.8%的产妇出现伤口感染,3.8%的产妇发烧,4.8%的产妇出现尿路感染(UTI),没有产妇出现产后出血(PPH)和产妇死亡。在胎儿结局方面,16%的产妇住进了新生儿重症监护室(NICU),2.3%的产妇出生时窒息,Apgar 评分较差,占 2.5%,没有发现新生儿死亡。急诊剖腹产的发热、UTI、伤口感染、复苏需求和 Apgar 评分差的发生率明显高于择期剖腹产,而新生儿重症监护室的入院率则没有统计学意义。急诊剖宫产最常见的指征是胎儿着装和既往 LSCS:结论:与择期剖宫产相比,急诊剖宫产与产妇和围产期并发症增加有关。
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引用次数: 0
Trends and Inequities in Use of Abortion Services in Nepal: A Nepal Demographic and Health Survey Data Analysis 1996-2022 A.D. 尼泊尔使用堕胎服务的趋势和不平等:公元 1996-2022 年尼泊尔人口与健康调查数据分析
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.4944
Manish Gautam, Suresh Mehata, Sujan Karki, Jagadishwor Ghimire, Sanju Maharjan, Bhogendra Raj Dotel

Background: Despite policy advances and public health initiatives in Nepal to improve access to reproductive healthcare, disparities persist in utilization of abortion services. Grounded in longitudinal data from the Nepal Demographic and Health Survey from 1996 to 2022, this study aims to shed light on evolving patterns in pregnancy outcomes and inequities in use of abortion services across ecological zones and wealth quintiles.

Methods: Utilizing six rounds of Nepal Demographic and Health Survey data, pregnancy outcomes were categorized as abortion, delivery, miscarriage, or stillbirth. Income-related inequality in the utilization of abortion services was assessed through the concentration index, ranging from -1 to 1. Trends over time were evaluated using the annual rate of change.

Results: The ARC indicated a substantial rise in induced abortion rates, surging from 0.4% in 1996 to 8.8% in 2022. In contrast, live births witnessed a decline from 92.8% to 81.2%. Significant variations were observed across ecological zones and wealth quintiles, with the Mountain zone and the Poorest group experiencing the most pronounced increases in induced abortion rates. By 2022, the concentration index reached a near-zero value, signifying a near-elimination of income-related disparities in the use of induced abortion services.

Discussion: The findings suggest that while there has been significant progress in access to and use of abortion services in Nepal, particularly post-2002 policy shifts, challenges remain. Women from lower socio-economic backgrounds continue to face barriers, indicating the need for a multi-pronged approach to address residual challenges.

Conclusions: Nepal has made remarkable strides in enhancing equitable access to and use of induced abortion services, but more needs to be done to guarantee equitable access for all women. Future efforts should focus on policy reforms, infrastructural improvements, and societal change to eliminate existing barriers to reproductive healthcare.

背景:尽管尼泊尔在改善生殖保健服务方面取得了政策进步并采取了公共卫生措施,但在人工流产服务的利用方面仍存在差异。本研究以 1996 年至 2022 年尼泊尔人口与健康调查的纵向数据为基础,旨在揭示不同生态区域和财富五等分层的妊娠结局演变模式以及堕胎服务使用的不公平现象:方法:利用六轮尼泊尔人口与健康调查数据,将妊娠结果分为堕胎、分娩、流产或死胎。结果:ARC 表明人工流产率大幅上升:ARC 表明人工流产率大幅上升,从 1996 年的 0.4% 猛增至 2022 年的 8.8%。相比之下,活产率从 92.8%下降到 81.2%。不同生态区和五等分财富组之间存在显著差异,山区和最贫困组的人工流产率上升最为明显。到 2022 年,集中指数接近零值,这表明在人工流产服务的使用方面,与收入有关的差异几乎消除:讨论:研究结果表明,虽然尼泊尔在获得和使用人工流产服务方面取得了重大进展,特别是 2002 年后的政策转变,但挑战依然存在。社会经济背景较差的妇女仍然面临障碍,这表明有必要采取多管齐下的方法来应对残余挑战:尼泊尔在促进公平获得和使用人工流产服务方面取得了长足进步,但要保证所有妇女都能公平获得人工流产服务,还需要做更多的工作。未来的努力应侧重于政策改革、基础设施改善和社会变革,以消除生殖保健方面的现有障碍。
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引用次数: 0
Awareness of Menstrual Hygiene Management Rights and Perception of Risks, Self-Efficacy, and Behavior. 对经期卫生管理权利的认识以及对风险、自我效能和行为的看法。
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.5095
Ram Naresh Yadav, Shrijana Joshi, Ji Sun Park

Background: Menstrual Hygiene Management stands as a critical health concern for girls entering reproductive age on a global scale. This transition often induces fear and anxiety due to inadequate knowledge about menstruation and a lack of resources to comprehend bodily changes. Notably, school-aged girls in marginalized communities face formidable barriers to MHM, given the insufficient facilities, supplies, and awareness in educational institutions.

Methods: A Mixed method study was conducted adopting a mixed-methods approach. It engaged 562 respondents across five local levels of Bajura district, including three municipalities (Badimalika, Budhiganga, and Tribeni) and two rural municipalities (Gaumul and Khaptad Chhedaha).

Results: The study unveiled over 90% awareness on on five out of seven MHM rights related statements and over 85% self-efficacy on 5 out of 8 statements regarding MHM among female adolescent respondents. However, their actual practices fell short of expectations, marked by the prevalence of restrictive norms and perceived risks pertinent to MHM. Notably, 27% (N=154) expressed fear of divine consequences for not adhering to menstrual customs. Malpractices were observed, including 66% using cloth during menstruation, inadequate pad changing frequencies, and some girls staying in Chhaugoth during menstruation. Despite a high awareness (97%) of menstrual rights, behavioral practices did not consistently align with this awareness.

Conclusions: The study highlights high awareness and self-efficacy in menstrual hygiene management among female adolescents, yet challenges persist due to cultural norms, perceived risks, and insufficient infrastructure, necessitating multifaceted solutions for behavioral change and access to resources.

背景:月经卫生管理是全球范围内进入育龄期女孩的一个重要健康问题。由于对月经的认识不足,以及缺乏了解身体变化的资源,这种转变往往会引发恐惧和焦虑。值得注意的是,由于教育机构的设施、用品和意识不足,边缘化社区的学龄女童在进行 MHM 方面面临着巨大的障碍:采用混合方法进行研究。巴朱拉地区五个地方的 562 名受访者参与了研究,其中包括三个市镇(巴迪马利卡、布迪甘加和特里贝尼)和两个农村市镇(高穆尔和卡普塔德切达哈):研究结果显示,女性青少年受访者对七项有关产妇保健权利的声明中的五项声明的知晓率超过 90%,对有关产妇保健的八项声明中的五项声明的自我效能感超过 85%。然而,她们的实际做法却与期望值相差甚远,这主要表现在限制性规范的普遍存在以及与产妇保健相关的风险认知上。值得注意的是,27%(N=154)的受访者表示害怕不遵守月经习俗会带来神圣的后果。还观察到一些不良习俗,包括 66% 的女孩在月经期间使用布,更换护垫的频率不足,以及一些女孩在月经期间呆在 Chhaugoth。尽管人们对月经权利的认识很高(97%),但行为习惯与这种认识并不一致:这项研究强调了女性青少年在经期卫生管理方面的高意识和自我效能,但由于文化规范、感知风险和基础设施不足,挑战依然存在,因此需要多方面的解决方案来改变行为和获取资源。
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引用次数: 0
Knowledge, Practice and Factors associated with Utilization of Cervical Cancer Screening Services. 宫颈癌筛查服务的相关知识、实践和因素。
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.4896
Nancy Bhattarai, Siddhi Laxmi Bajracharya

Background: Cervical cancer is treatable with regular screening and follow-up practices. The utilization of cervical cancer utilization services is found to be unsatisfactory in the context of Nepal. The objective of this study was to assess the factors that influence knowledge, practice, and utilization of cervical cancer screening among women in the Dhulikhel Municipality, Nepal.

Methods: A cross-sectional study was conducted on 156 married women residing in Dhulikhel Municipality. The study participants were selected using the convenience sampling method. A standard questionnaire was used to collect the information. This study examined socio-demograhic data, knowledge, practice, and factors associated with cervical cancer screening. Descriptive and inferential statistics were used to analyze the data.

Results: Only one-fifth (17.9%) of the participants had received a cervical cancer screening. Most participants possessed a sufficient level, 134 out of 85.9%, of information about cervical cancer and cervical cancer screening. Annual healthcare visits (p=0.00), participant knowledge (p=0.014), and perceived barriers (p=0.001) were statistically significant factors in the uptake of cervical cancer screening. Out of those who felt they were highly susceptible, just one-fourth, or 25%, had undergone cervical cancer screening services.

Conclusions: The number of medical visits, participants' knowledge, and perceived barriers had a significant impact on the uptake of cervical cancer screening. However, there was not found any relationship between the use of cervical cancer screening and perceived susceptibility and other socio-demographic factors.

背景:宫颈癌是可以通过定期筛查和随访治疗的。在尼泊尔,宫颈癌筛查服务的利用率并不令人满意。本研究旨在评估影响尼泊尔 Dhulikhel 市妇女对宫颈癌筛查的了解、实践和利用的因素:本研究对居住在 Dhulikhel 市的 156 名已婚妇女进行了横断面研究。研究对象采用方便抽样法选出。采用标准问卷收集信息。本研究调查了与宫颈癌筛查相关的社会人口数据、知识、实践和因素。数据分析采用了描述性和推论性统计方法:只有五分之一(17.9%)的参与者接受过宫颈癌筛查。大多数参与者对宫颈癌和宫颈癌筛查有足够的了解,在 85.9% 的参与者中有 134 人。每年的保健访问(p=0.00)、参与者的知识(p=0.014)和感知到的障碍(p=0.001)是影响接受宫颈癌筛查的重要统计因素。在那些认为自己极易患宫颈癌的人中,只有四分之一,即 25% 接受了宫颈癌筛查服务:结论:就诊次数、参与者的知识水平和感知到的障碍对接受宫颈癌筛查有重要影响。然而,没有发现宫颈癌筛查的使用与感知易感性和其他社会人口因素之间有任何关系。
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引用次数: 0
An Estimate of Abortion Incidence and Unintended Pregnancies. 人工流产发生率和意外怀孕估计。
Q3 Medicine Pub Date : 2024-06-21 DOI: 10.33314/jnhrc.v22i01.4945
Jagadishwor Ghimire, Bibek Kumar Lal, Sujan Karki, Suresh Mehata, Bhogendra Raj Dotel, Nisha Joshi, Gauri Shrestha Pradhan, Manish Gautam, Deeb Shrestha Dangol, Parash Prasad Phuyal, Kritee Lamichhane, Navaraj Bhattarai, Anna Lynam

Background: After the legalization of abortion in Nepal, there has been remarkable changes in policies and service delivery. However, even after two decades of legalization, access to and use of safe abortion services remains limited. The objective of this study is to estimate the incidence of abortion and unintended pregnancies in Nepal.

Methods: A cross sectional study was conducted in 767 health facilities using structured questionnaires to assess the availability of abortion services, and 231 key informant interviews were conducted. Information on medical abortion drugs was collected from distributors and pharmacies. Abortion estimations were segmented into categories: those performed within healthcare facilities, those conducted outside healthcare facilities, and those using other traditional methods. To estimate pregnancy outcomes, we utilized secondary data from national censuses and health surveys.

Results: The total incidence of induced abortion cases in Nepal was estimated to be 333,343 for the year 2021. Only 48 percent of abortion services were provided from the listed (legal) sites and providers. The estimates showed that total facility based induced abortion in Nepal was 176,216 in 2021, more than half were medical abortions. The highest and lowest abortion cases were in Bagmati and Karnali province respectively. The result showed that more than half of the pregnancies were unintended (53.3%).

Conclusions: Despite a relatively liberal legal environment, more than half of all abortions are extra-legal in Nepal. Unintended pregnancies are also common, resulting in induced abortion. This demands for increasing access to information and services on contraception and safe abortion among women and girls.

背景:尼泊尔在堕胎合法化之后,在政策和服务提供方面发生了显著变化。然而,即使在合法化二十年后,获得和使用安全堕胎服务的机会仍然有限。本研究旨在估算尼泊尔堕胎和意外怀孕的发生率:在 767 家医疗机构开展了一项横断面研究,使用结构化问卷评估人工流产服务的可用性,并进行了 231 次关键信息提供者访谈。从经销商和药店收集了有关药物流产的信息。人工流产估算分为三类:在医疗机构内进行的人工流产、在医疗机构外进行的人工流产以及使用其他传统方法进行的人工流产。为了估算妊娠结果,我们利用了全国人口普查和健康调查的二手数据:据估计,2021 年尼泊尔人工流产病例总数为 333 343 例。只有 48% 的人工流产服务是由列出的(合法)地点和提供者提供的。估算结果显示,2021 年尼泊尔基于医疗机构的人工流产总数为 176 216 例,其中一半以上为药物流产。最高和最低的人工流产案例分别发生在巴格马蒂省和卡纳利省。结果显示,超过一半的怀孕是意外怀孕(53.3%):结论:尽管尼泊尔的法律环境相对宽松,但一半以上的堕胎都是非法的。意外怀孕也很常见,导致人工流产。这就要求增加妇女和女孩获得有关避孕和安全堕胎的信息和服务的机会。
{"title":"An Estimate of Abortion Incidence and Unintended Pregnancies.","authors":"Jagadishwor Ghimire, Bibek Kumar Lal, Sujan Karki, Suresh Mehata, Bhogendra Raj Dotel, Nisha Joshi, Gauri Shrestha Pradhan, Manish Gautam, Deeb Shrestha Dangol, Parash Prasad Phuyal, Kritee Lamichhane, Navaraj Bhattarai, Anna Lynam","doi":"10.33314/jnhrc.v22i01.4945","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i01.4945","url":null,"abstract":"<p><strong>Background: </strong>After the legalization of abortion in Nepal, there has been remarkable changes in policies and service delivery. However, even after two decades of legalization, access to and use of safe abortion services remains limited. The objective of this study is to estimate the incidence of abortion and unintended pregnancies in Nepal.</p><p><strong>Methods: </strong>A cross sectional study was conducted in 767 health facilities using structured questionnaires to assess the availability of abortion services, and 231 key informant interviews were conducted. Information on medical abortion drugs was collected from distributors and pharmacies. Abortion estimations were segmented into categories: those performed within healthcare facilities, those conducted outside healthcare facilities, and those using other traditional methods. To estimate pregnancy outcomes, we utilized secondary data from national censuses and health surveys.</p><p><strong>Results: </strong>The total incidence of induced abortion cases in Nepal was estimated to be 333,343 for the year 2021. Only 48 percent of abortion services were provided from the listed (legal) sites and providers. The estimates showed that total facility based induced abortion in Nepal was 176,216 in 2021, more than half were medical abortions. The highest and lowest abortion cases were in Bagmati and Karnali province respectively. The result showed that more than half of the pregnancies were unintended (53.3%).</p><p><strong>Conclusions: </strong>Despite a relatively liberal legal environment, more than half of all abortions are extra-legal in Nepal. Unintended pregnancies are also common, resulting in induced abortion. This demands for increasing access to information and services on contraception and safe abortion among women and girls.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 1","pages":"50-57"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Nepal Health Research Council
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