Pub Date : 2020-05-19DOI: 10.21203/rs.3.rs-29479/v1
Anshu Bhoosal, N. Karki, Riya Parajuli
Background HIV is a major global health issue, targeting the immune system and making the body prone to diseases. People living with HIV mostly face societal stigma and fear of disclosure resulting in discrimination of accessing health facilities leading to multiple sex partners, increased sexual activity and less use of condoms. HIV positive women are at risk of transmitting HIV to their infants and their partners. Thus, the family planning services if provided to PLHIV can help to improve their and families health. In addition to, it reduces the risk of mother-to-child transmission (PMTCT). The facts related to PLHIV with respect to pregnancy and childbearing are not available. The purpose of this study is to focus on the status of the use of family planning methods and explore factors affecting the utilization among people living with HIV and AIDS in Kathmandu valley of Nepal. The study is expected to contribute in enhancing the present understanding of PLHIV towards family planning.Methods The cross sectional descriptive method was used for the research. The study followed Population proportion to size method for the calculation of the respondents from four ART sites of Kathmandu Valley. Structured questionnaire used previously in similar research has been adopted with necessary question related to dual contraceptive use.Results The mean age group of the respondents was (39.16 ± 6.969) years. More than two third respondents (69.5%) were Hindu. 34.8% respondents were married at the less than 20 years of age. Almost three- fourth of the PLHIV (74.4%) were literate where more than three fourth (79.3%) their spouses were literate and educated. About half of the respondents (43.9%) were found to be involved in professional/ technical/ managerial. More than half of the respondent’s spouses (63.4%) were HIV positive. All the respondents (100%) respondents had disclosed their status to their partners. Neither the respondents nor their partner had fertility desire. 28% of neither respondents nor their partners had used the family planning methods before HIV diagnosis. More than half (60.4%) of the respondents had sexual intercourse prior to last 6 months. 15.9% of the respondents positively responded to use of dual protection. Only 11% either respondents or their partners had used the emergency contraceptive pill. 17.7% respondents did not use any family planning. This study revealed that almost half of the respondents (48.8%) had the good knowledge on the use of contraception.Conclusion The use of dual protection is much less than the half of the respondents. Therefore, counseling and health education towards motivating PLHIV on using dual FP methods to avoid the risk of HIV, STIs and unplanned pregnancy is encouraged.
{"title":"Knowledge and Utilization of Family Planning Methods Among People Living With Hiv In Kathmandu Valley","authors":"Anshu Bhoosal, N. Karki, Riya Parajuli","doi":"10.21203/rs.3.rs-29479/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-29479/v1","url":null,"abstract":"\u0000 Background HIV is a major global health issue, targeting the immune system and making the body prone to diseases. People living with HIV mostly face societal stigma and fear of disclosure resulting in discrimination of accessing health facilities leading to multiple sex partners, increased sexual activity and less use of condoms. HIV positive women are at risk of transmitting HIV to their infants and their partners. Thus, the family planning services if provided to PLHIV can help to improve their and families health. In addition to, it reduces the risk of mother-to-child transmission (PMTCT). The facts related to PLHIV with respect to pregnancy and childbearing are not available. The purpose of this study is to focus on the status of the use of family planning methods and explore factors affecting the utilization among people living with HIV and AIDS in Kathmandu valley of Nepal. The study is expected to contribute in enhancing the present understanding of PLHIV towards family planning.Methods The cross sectional descriptive method was used for the research. The study followed Population proportion to size method for the calculation of the respondents from four ART sites of Kathmandu Valley. Structured questionnaire used previously in similar research has been adopted with necessary question related to dual contraceptive use.Results The mean age group of the respondents was (39.16 ± 6.969) years. More than two third respondents (69.5%) were Hindu. 34.8% respondents were married at the less than 20 years of age. Almost three- fourth of the PLHIV (74.4%) were literate where more than three fourth (79.3%) their spouses were literate and educated. About half of the respondents (43.9%) were found to be involved in professional/ technical/ managerial. More than half of the respondent’s spouses (63.4%) were HIV positive. All the respondents (100%) respondents had disclosed their status to their partners. Neither the respondents nor their partner had fertility desire. 28% of neither respondents nor their partners had used the family planning methods before HIV diagnosis. More than half (60.4%) of the respondents had sexual intercourse prior to last 6 months. 15.9% of the respondents positively responded to use of dual protection. Only 11% either respondents or their partners had used the emergency contraceptive pill. 17.7% respondents did not use any family planning. This study revealed that almost half of the respondents (48.8%) had the good knowledge on the use of contraception.Conclusion The use of dual protection is much less than the half of the respondents. Therefore, counseling and health education towards motivating PLHIV on using dual FP methods to avoid the risk of HIV, STIs and unplanned pregnancy is encouraged.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134444976","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}
Pub Date : 2019-09-08DOI: 10.3126/HPROSPECT.V18I2.25525
D. Acharya, Malcolm Thomas, Rosemary Cann, P. Regmi
Sex education is taught to secondary school students in Nepal. Nevertheless, there are concerns that the school-based sexual health education is not effective and adequate to address young people’s necessities. We carried out a qualitative study comprising key informant interviews with teachers (n=8) and parents (n=6) in Makwanpur district in Nepal. Interviews were recorded, transcribed and translated into English. Thematic analysis was performed to identify patterns or themes within the qualitative data. Most participants (both teachers and parents) had thought of delivering sex education preferably from grade seven to avoid the effects of globalised mass media and the internet. The practical aspects of school sex education programme and the importance of parent-child communication were of major concerns. Comprehensive training to health teachers, an informal approach to teaching sex education and seeking outside health professionals, such as health facilitators were the frequently reported issues. There is a need to offer sexual health services along with sex education to protect young people from potential dangers of STIs including HIV infection. Particularly, health teachers should be trained properly to mitigate the social and cultural impacts, and to allow a smooth sex education discussion in the classroom. The curriculum for sex education should be relevant, engaging and developmentally suitable with clear progressive avenues for learning experience.
{"title":"Parents’ and teachers’ perspectives on children’s sexual health education: a qualitative study in Makwanpur Nepal","authors":"D. Acharya, Malcolm Thomas, Rosemary Cann, P. Regmi","doi":"10.3126/HPROSPECT.V18I2.25525","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V18I2.25525","url":null,"abstract":"Sex education is taught to secondary school students in Nepal. Nevertheless, there are concerns that the school-based sexual health education is not effective and adequate to address young people’s necessities. We carried out a qualitative study comprising key informant interviews with teachers (n=8) and parents (n=6) in Makwanpur district in Nepal. Interviews were recorded, transcribed and translated into English. Thematic analysis was performed to identify patterns or themes within the qualitative data. Most participants (both teachers and parents) had thought of delivering sex education preferably from grade seven to avoid the effects of globalised mass media and the internet. The practical aspects of school sex education programme and the importance of parent-child communication were of major concerns. Comprehensive training to health teachers, an informal approach to teaching sex education and seeking outside health professionals, such as health facilitators were the frequently reported issues. There is a need to offer sexual health services along with sex education to protect young people from potential dangers of STIs including HIV infection. Particularly, health teachers should be trained properly to mitigate the social and cultural impacts, and to allow a smooth sex education discussion in the classroom. The curriculum for sex education should be relevant, engaging and developmentally suitable with clear progressive avenues for learning experience.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114206650","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}
Pub Date : 2019-07-06DOI: 10.3126/HPROSPECT.V18I1.23858
R. S. Yadav, Shumneva Shrestha
Global health is a multidisciplinary and interdisciplinary approach of dealing transnational determinants of health. Strengthening health care institutions is vital for achieving universal health care. It also favors global health outcomes as it bridges gaps of health inequalities and saves numerous lives. In Nepal, the Institute of Medicine, Tribhuvan University is offering global health course since 2013. This paper discusses practical application of the learnings from the global health course to make commendable achievements at a primary health center. The global health course can be the foundation for transforming clinicians and public health practitioners into promising global health leaders. This will contribute to improve basic health care services, quality care, and vaccination program to improve the health of population. Therefore, global health course should be an imperative of medical education to capacitate doctors working in these settings to better understand the social determinants of disease prevention, care and rehabilitation.
{"title":"Importance of learning Global Health in strengthening Primary Health Care: an experience from Nepal","authors":"R. S. Yadav, Shumneva Shrestha","doi":"10.3126/HPROSPECT.V18I1.23858","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V18I1.23858","url":null,"abstract":"Global health is a multidisciplinary and interdisciplinary approach of dealing transnational determinants of health. Strengthening health care institutions is vital for achieving universal health care. It also favors global health outcomes as it bridges gaps of health inequalities and saves numerous lives. In Nepal, the Institute of Medicine, Tribhuvan University is offering global health course since 2013. This paper discusses practical application of the learnings from the global health course to make commendable achievements at a primary health center. The global health course can be the foundation for transforming clinicians and public health practitioners into promising global health leaders. This will contribute to improve basic health care services, quality care, and vaccination program to improve the health of population. Therefore, global health course should be an imperative of medical education to capacitate doctors working in these settings to better understand the social determinants of disease prevention, care and rehabilitation.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125023373","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}
Pub Date : 2019-05-16DOI: 10.3126/HPROSPECT.V18I1.24103
S. Selby, A. Arnaert, N. Ponzoni, S. Dunne, C. Dunne
Background: Nepal continues to struggle to increase its population access to healthcare, especially in rural and isolated villages where primary healthcare is offered through local health outposts. However, people often prefer to consult initially with traditional healers for minor issues as this is more aligned with their cultural beliefs and practices. Knowing that Nepal is undergoing healthcare reform, it would be timely to explore perceptions of health and care-seeking behaviors amongst patients living in high-altitude communities in rural Nepal for consideration in future planning and policy; which is the purpose of this qualitative study. Methods: In-person, semi-structured interviews were conducted, with the use of a translator, with 17 participants, living in two rural villages. After transcribing the interviews, themes were identified using thematic analysis. Results: People expressed the belief that they hold expertise in sustaining health due to their naturalistic lifestyle and community-focus developed within the context of a unique local culture and environment. When faced with a health problem, villagers are compelled to seek treatment from available healthcare offerings. Their care-seeking behavior and their eventual choice between Modern and Belief-based medicine is filtered through a number of considerations: the ease of its accessibility, the cost of services, their prior knowledge related to the illness, their belief system, and the severity of the medical situation. Conclusion: This study indicates that better understanding of the perceptions of the rural Nepali is crucial in advocating for sustainable and culturally-sensitive delivery of healthcare. Tweetable Abstract: Rural Nepali’s care-seeking behavior, rooted in naturalistic lifestyle and community-focus; however, contextual considerations oblige them to make choices between Modern and Belief-based medicine.
{"title":"Perception of Health and Care Seeking Behaviors of Patients Living in High-Altitude Villages of Rural Nepal","authors":"S. Selby, A. Arnaert, N. Ponzoni, S. Dunne, C. Dunne","doi":"10.3126/HPROSPECT.V18I1.24103","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V18I1.24103","url":null,"abstract":"Background: Nepal continues to struggle to increase its population access to healthcare, especially in rural and isolated villages where primary healthcare is offered through local health outposts. However, people often prefer to consult initially with traditional healers for minor issues as this is more aligned with their cultural beliefs and practices. Knowing that Nepal is undergoing healthcare reform, it would be timely to explore perceptions of health and care-seeking behaviors amongst patients living in high-altitude communities in rural Nepal for consideration in future planning and policy; which is the purpose of this qualitative study. \u0000Methods: In-person, semi-structured interviews were conducted, with the use of a translator, with 17 participants, living in two rural villages. After transcribing the interviews, themes were identified using thematic analysis. \u0000Results: People expressed the belief that they hold expertise in sustaining health due to their naturalistic lifestyle and community-focus developed within the context of a unique local culture and environment. When faced with a health problem, villagers are compelled to seek treatment from available healthcare offerings. Their care-seeking behavior and their eventual choice between Modern and Belief-based medicine is filtered through a number of considerations: the ease of its accessibility, the cost of services, their prior knowledge related to the illness, their belief system, and the severity of the medical situation. \u0000Conclusion: This study indicates that better understanding of the perceptions of the rural Nepali is crucial in advocating for sustainable and culturally-sensitive delivery of healthcare. \u0000Tweetable Abstract: Rural Nepali’s care-seeking behavior, rooted in naturalistic lifestyle and community-focus; however, contextual considerations oblige them to make choices between Modern and Belief-based medicine.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131112578","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}
Pub Date : 2019-03-25DOI: 10.3126/HPROSPECT.V18I1.19060
Sajama Nepali, Manodhara Shakya
Background: Continuing breastfeeding after three months of the postpartum period has been a challenge to mothers rather than their choice. The engagement of husbands in breastfeeding serves both as physical and mental support to their wives. This study aimed to assess the breastfeeding self-efficacy of mothers, identify their husbands’ support for breastfeeding and examine the association between breastfeeding self-efficacy of mothers and the husbands’ support for breastfeeding. Methods: This descriptive, cross sectional study recruited 110 mothers of infants, visiting Bungmati Health Post for immunization from July 2015 to November 2015. Mothers were interviewed face to face with semi structured questionnaire. Data entry and analysis was carried out using SPSS version 23. Descriptive analysis was performed on the socio-demographic characteristics, delivery characteristics, breastfeeding self-efficacy and husbands’ support scale. Bivariate analysis was used to examine the association between breastfeeding self-efficacy and husbands’ support scale and other outcomes. Results: Majority (94%) of the mothers reported to be confident on the breastfeeding self-efficacy, while 95 percent of their husbands were supportive towards breastfeeding. A significant association was seen between the breastfeeding self-efficacy and the husbands’ support scale (p<0.04). Mothers who received support from husbands were 10 times more likely to report confidence on breastfeeding than those who did not. Conclusions: The results suggested that husbands’ support increases the breastfeeding self-efficacy of mothers. Based on this finding, it is recommended that involvement of husband is crucial for encouraging mother to breastfeed child. Tweetable Abstract: Mothers who received support from their husbands were 10 times significantly more likely to breastfeed.
{"title":"Husband’s Support for Breastfeeding and Breastfeeding Efficacy of Nepalese Mothers","authors":"Sajama Nepali, Manodhara Shakya","doi":"10.3126/HPROSPECT.V18I1.19060","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V18I1.19060","url":null,"abstract":"Background: Continuing breastfeeding after three months of the postpartum period has been a challenge to mothers rather than their choice. The engagement of husbands in breastfeeding serves both as physical and mental support to their wives. This study aimed to assess the breastfeeding self-efficacy of mothers, identify their husbands’ support for breastfeeding and examine the association between breastfeeding self-efficacy of mothers and the husbands’ support for breastfeeding. \u0000Methods: This descriptive, cross sectional study recruited 110 mothers of infants, visiting Bungmati Health Post for immunization from July 2015 to November 2015. Mothers were interviewed face to face with semi structured questionnaire. Data entry and analysis was carried out using SPSS version 23. Descriptive analysis was performed on the socio-demographic characteristics, delivery characteristics, breastfeeding self-efficacy and husbands’ support scale. Bivariate analysis was used to examine the association between breastfeeding self-efficacy and husbands’ support scale and other outcomes. \u0000Results: Majority (94%) of the mothers reported to be confident on the breastfeeding self-efficacy, while 95 percent of their husbands were supportive towards breastfeeding. A significant association was seen between the breastfeeding self-efficacy and the husbands’ support scale (p<0.04). Mothers who received support from husbands were 10 times more likely to report confidence on breastfeeding than those who did not. \u0000Conclusions: The results suggested that husbands’ support increases the breastfeeding self-efficacy of mothers. Based on this finding, it is recommended that involvement of husband is crucial for encouraging mother to breastfeed child. \u0000Tweetable Abstract: Mothers who received support from their husbands were 10 times significantly more likely to breastfeed.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133424182","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}
Pub Date : 2019-03-02DOI: 10.3126/HPROSPECT.V18I1.19337
Edwin Roland van Teijlingen, P. Regmi, P. Adhikary, N. Aryal, P. Simkhada
Over the past few years the practice of disciplines collaborating in interdisciplinary or multidisciplinary research has grown in popularity and not just in the health field. In a multi-faceted discipline such as Public Health, interdisciplinary approaches are a welcome addition to the research field. Interdisciplinary research can bring new insights and understanding across disciplinary boundaries. Novel interdisciplinary research can transcend disciplinary boundaries to address sophisticated and so-called wicked problems in society. However, there are potential difficulties arising from researchers trained in different individual disciplines attempting to work together. We have highlighted some of these issues which interdisciplinary research in Public Health needs to consider and, where necessary, address before they become barriers.
{"title":"Interdisciplinary Research in Public Health: Not quite straightforward","authors":"Edwin Roland van Teijlingen, P. Regmi, P. Adhikary, N. Aryal, P. Simkhada","doi":"10.3126/HPROSPECT.V18I1.19337","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V18I1.19337","url":null,"abstract":"Over the past few years the practice of disciplines collaborating in interdisciplinary or multidisciplinary research has grown in popularity and not just in the health field. In a multi-faceted discipline such as Public Health, interdisciplinary approaches are a welcome addition to the research field. Interdisciplinary research can bring new insights and understanding across disciplinary boundaries. Novel interdisciplinary research can transcend disciplinary boundaries to address sophisticated and so-called wicked problems in society. However, there are potential difficulties arising from researchers trained in different individual disciplines attempting to work together. We have highlighted some of these issues which interdisciplinary research in Public Health needs to consider and, where necessary, address before they become barriers.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116178086","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}
Pub Date : 2019-02-25DOI: 10.3126/HPROSPECT.V18I1.22856
P. Khanal, S. Mishra
Not required (Editorial)
不需要(社论)
{"title":"Federal governance and the undying parade for universal health coverage in Nepal","authors":"P. Khanal, S. Mishra","doi":"10.3126/HPROSPECT.V18I1.22856","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V18I1.22856","url":null,"abstract":"Not required (Editorial)","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"153 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122863782","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}
Pub Date : 2018-10-08DOI: 10.3126/HPROSPECT.V17I1.21296
D. Pahari, R. Upadhyay, C. Sharma
Introduction: Depression is a major co-morbidity associated with diabetes. This study aims to assess the prevalence and determine factors associated with depression among diabetic patients visiting a diabetes center in Lalitpur, Nepal.Methods: This is a cross-sectional study of diabetic patients visiting a diabetes center in Kathmandu, Nepal. 203 diabetic patients were recruited in a period of two months. A validated and reliable Beck Depression Inventory Scale was used to identify and classify depression. Diabetes status was self-reported. Prevalence of depression, socio-demographic and diabetes related characteristics were calculated using frequency and percentages. Association was analyzed using chi-squared test. Statistical significance was determined at p<0.05. Bivariate logistic regression was performed to identify unadjusted odds ratio with 95% CI. Then, multivariate logistic regression model was designed for those variables significant at bivariate level to calculate adjusted odds ratio with 95% CI.Results: The prevalence of depression among diabetic patients was 34% (Mild - 17.7%, Moderate - 13.8% and Severe - 2.5%). Diabetic patients with secondary or above educational level were less than half likely to be affected by depression compared to patients with no formal school education [AOR:0.42]. Similarly, diabetic patients on insulin therapy were twice likely to be affected by depression compared to patients on oral hypoglycemic agents [AOR: 2.08] and patients having other comorbidity along with diabetes were also twice likely to be affected by depression [AOR:2.18]. Patients with stressful life events in the past were twelve times more likely to have depression compared to patients with no such events in the past [AOR: 12.33].Conclusion: More than one third of the diabetic patients have some degree of depression. Factors such as no schooling, being on insulin therapy, having other comorbid conditions along with diabetes and stressful life events in the past among diabetic patients kept them at higher risk of depression. These factors should be focused in program for prevention and control of depression among diabetic patients in Nepal.
{"title":"Depression among diabetic patients visiting a diabetes center in Nepal","authors":"D. Pahari, R. Upadhyay, C. Sharma","doi":"10.3126/HPROSPECT.V17I1.21296","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V17I1.21296","url":null,"abstract":"Introduction: Depression is a major co-morbidity associated with diabetes. This study aims to assess the prevalence and determine factors associated with depression among diabetic patients visiting a diabetes center in Lalitpur, Nepal.Methods: This is a cross-sectional study of diabetic patients visiting a diabetes center in Kathmandu, Nepal. 203 diabetic patients were recruited in a period of two months. A validated and reliable Beck Depression Inventory Scale was used to identify and classify depression. Diabetes status was self-reported. Prevalence of depression, socio-demographic and diabetes related characteristics were calculated using frequency and percentages. Association was analyzed using chi-squared test. Statistical significance was determined at p<0.05. Bivariate logistic regression was performed to identify unadjusted odds ratio with 95% CI. Then, multivariate logistic regression model was designed for those variables significant at bivariate level to calculate adjusted odds ratio with 95% CI.Results: The prevalence of depression among diabetic patients was 34% (Mild - 17.7%, Moderate - 13.8% and Severe - 2.5%). Diabetic patients with secondary or above educational level were less than half likely to be affected by depression compared to patients with no formal school education [AOR:0.42]. Similarly, diabetic patients on insulin therapy were twice likely to be affected by depression compared to patients on oral hypoglycemic agents [AOR: 2.08] and patients having other comorbidity along with diabetes were also twice likely to be affected by depression [AOR:2.18]. Patients with stressful life events in the past were twelve times more likely to have depression compared to patients with no such events in the past [AOR: 12.33].Conclusion: More than one third of the diabetic patients have some degree of depression. Factors such as no schooling, being on insulin therapy, having other comorbid conditions along with diabetes and stressful life events in the past among diabetic patients kept them at higher risk of depression. These factors should be focused in program for prevention and control of depression among diabetic patients in Nepal.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130581182","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}
Pub Date : 2018-09-29DOI: 10.3126/HPROSPECT.V17I1.21201
R. Joshi, Y. P. Joshi
Background: Solid waste is a by-product of human activities. It has become an alarming challenge during recent decades in many cities of Nepal. Quantity and characteristics of solid waste have changed as a result of the modification in people’s lifestyle. The purpose of this study is to characterize the composition of solid waste in Bhimdatta Municipality of Kanchanpur district, Nepal.Methods: In between July to September 2015, a total of 45 households, 15 commercial places, 15 institutions were selected randomly. Solid waste samples were collected in recommended plastic bags. The collected wastes were categorized and weighted. Direct observation of municipal solid waste collection and its disposal practices were also performed. Qualitative information was collected from focus group discussion.Results: A total of 446.7 kg of solid waste was collected and the highest proportion (66.4%) was organic in composition. In the daily production of overall solid wastes, households were ranked the first (23.3%) and followed to the hotels and lodges (20.4%). The commercial centers produced the highest amount of all types of wastes. The crude waste dumping practice in the open and vacant areas was found a threat to human health, causing ecological imbalances and also bringing land, water, and air pollution.Conclusions: The rapidly growing population in the urban region of the study area has become an urgent issue in the production of several types of solid wastes. The organic waste was generated in the highest amount and maximum proportions of solid waste were produced from commercial centers.
{"title":"A Study on Solid Waste Composition in Kanchanpur District, Nepal","authors":"R. Joshi, Y. P. Joshi","doi":"10.3126/HPROSPECT.V17I1.21201","DOIUrl":"https://doi.org/10.3126/HPROSPECT.V17I1.21201","url":null,"abstract":"Background: Solid waste is a by-product of human activities. It has become an alarming challenge during recent decades in many cities of Nepal. Quantity and characteristics of solid waste have changed as a result of the modification in people’s lifestyle. The purpose of this study is to characterize the composition of solid waste in Bhimdatta Municipality of Kanchanpur district, Nepal.Methods: In between July to September 2015, a total of 45 households, 15 commercial places, 15 institutions were selected randomly. Solid waste samples were collected in recommended plastic bags. The collected wastes were categorized and weighted. Direct observation of municipal solid waste collection and its disposal practices were also performed. Qualitative information was collected from focus group discussion.Results: A total of 446.7 kg of solid waste was collected and the highest proportion (66.4%) was organic in composition. In the daily production of overall solid wastes, households were ranked the first (23.3%) and followed to the hotels and lodges (20.4%). The commercial centers produced the highest amount of all types of wastes. The crude waste dumping practice in the open and vacant areas was found a threat to human health, causing ecological imbalances and also bringing land, water, and air pollution.Conclusions: The rapidly growing population in the urban region of the study area has become an urgent issue in the production of several types of solid wastes. The organic waste was generated in the highest amount and maximum proportions of solid waste were produced from commercial centers.","PeriodicalId":230485,"journal":{"name":"Health Prospect","volume":"171 1-2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114047340","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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