COVID-19 epidemic in Nepal is escalating with new cases/admissions at hospitals in recent weeks. ... more COVID-19 epidemic in Nepal is escalating with new cases/admissions at hospitals in recent weeks. The rise in cases is contributed by importation from India and has also led to an increase in the number of local/community transmission. While long-term lockdown can have devastating consequences in population, it is high time to consider the possibilities of exit strategies. The main objective of this piece is to explore the literature to lay out the possible measures for exit from the lockdown in Nepal. We used a descriptive review approach to compare and analyze the published academic and non-academic articles related to COVID-19 and lockdown until date. Post lifting plan should be in place as a roadmap to recovery. An exit strategy can be enacted effectively only when the community complies with new normal adjustments aided with effective public health measures and restrictions. Phase-wise measures should be employed while sudden loosening of restriction might result in detrimental ...
BackgroundRapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented ... more BackgroundRapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the characteristics and drivers of the health system preparedness towards COVID-19 and its impacts on frontline health care workers (HCWs) in Nepal.MethodsSemi-structured interviews (SSIs) were conducted among 32 HCWs who were involved in clinical care of COVID-19 patients and four policymakers who were responsible for COVID-19 control and management at central and provincial level. Participants were included from all seven provinces of Nepal. All SSIs were conducted through telephone or internet based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches.ResultsBoth HCWs and policymakers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic contro...
IntroductionOver-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antim... more IntroductionOver-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antimicrobial resistance (AMR). Drawing on qualitative research methods, this article explores the characteristics of OTC sales of antibiotic in Nepal, its drivers and implications for policy.MethodsData were collected in and around three tertiary hospitals in eastern, western and central Nepal. Using pre-defined guides, a mix of semi-structured interviews and focus group discussions were conducted with dispensers at drug stores, patients attending a hospital and clinicians. Interviews were audio-recorded, translated and transcribed into English and coded using a combination of an inductive and deductive approach.ResultsDrug shops were the primary location where patients engaged with health services. Interactions were brief and transactional: symptoms were described or explicit requests for specific medicine made, and money was exchanged. There were economic incentives for clients and drug st...
ObjectivesThere is a dearth of information on transgender individuals in Nepal, particularly stud... more ObjectivesThere is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue.SettingThe study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski.Design and participantsThis qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017.ResultsOur participants were young. The majority of FGD participants had completed school-level education and 40% had be...
Background: Infectious disease outbreaks following natural disasters are reported in literature. ... more Background: Infectious disease outbreaks following natural disasters are reported in literature. Outbreaks were documented following natural disasters in many countries including Haiti. Such possibility following 2015 Nepal earthquake was a public health concern. Risk factors needed evaluation by post-disaster outbreak investigation. Hence, present study was undertaken to investigate potentials for such outbreak and to generate evidence for public health intervention.Methods: The study was conducted between April – May, 2015, with the cooperation of National Public Health Laboratory, Epidemiology and Disease Control Division, Nepal Health Research Council and the Chinese team. Rapid Response Teams visited earthquake affected districts and collected samples for analysis. Syndromic surveillance approach was followed. Samples were collected from syndromic patients under supervision. Those sick prior to earthquake or receiving treatment were excluded. Blood, stool and throat swab sample...
Journal of Manmohan Memorial Institute of Health Sciences, 2018
Not available.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page:... more Not available.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page: 1-5
Journal of Manmohan Memorial Institute of Health Sciences, 2018
Many people and departments in higher education institutions and hospitals across the globe have ... more Many people and departments in higher education institutions and hospitals across the globe have objectives that include cross-national partnership working, internationalisation, capacity-building and sharing education and research. We find such commendable ideals at a global level in the Sustainable Development Goals (SDGs) to strategic plans of individual organisations from both low and high-income countries. Using a case-study approach this paper offers insights into some of the key practical issues around global partnership working. We use two case studies of a developing partnership between two separate higher education institutions from the United Kingdom (UK) and one from Nepal. To inform and guide others interested in developing global partnerships we highlight key the reasons for, considerations about, key procedures around the development of such Nepal-UK partnerships and key challenges. Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page...
Introduction: Unintentional injury is the biggest threat to the survival of the under-five childr... more Introduction: Unintentional injury is the biggest threat to the survival of the under-five children, which impact is immeasurable to families and often entire communities. The objectives of this study were to assess the prevalence of unintentional injuries among under-five children and the factors associated with it.Material and Methods: A facility-based quantitative cross-sectional study was conducted from August 2016 to January 2017. Multistage time frame convenient sampling method was applied to collect the data from 259 mothers of under-five children in the selected district of Mid-Western Development region of Nepal. The data was collected from 10 rural health facilities and two from urban setting using a semi-structured questionnaire. An analysis was performed using SPSS ver.15.Results: The prevalence of unintentional injuries was found to be 33.20 % among the under-five children. The present study showed that ecological belt, the age of mothers, education of mothers, educatio...
The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a fu... more The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a further 2 million. One year later, a national workshop was organized with various Nepali stakeholders involved in the response to the earthquake. The workshop provided participants an opportunity to reflect on their experiences and sought to learn lessons from the disaster. One hundred and thirty-five participants took part and most had been directly involved in the earthquake response. They included representatives from the Ministry of Health, local and national government, the armed forces, non-governmental organizations, health practitioners, academics, and community representatives. Participants were divided into seven focus groups based around the following topics: water, sanitation and hygiene, hospital services, health and nutrition, education, shelter, policy and community. Facilitated group discussions were conducted in Nepalese and the key emerging themes are presented. Participa...
Journal of Manmohan Memorial Institute of Health Sciences, 2016
Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries... more Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries around the world. Economic barrier is one of the major problems in poor and marginalized population. Poor people mostly remain unaware of the treatment facilities and some find it difficult in seeking T.B treatment as they don’t trust the program and most of them don’t possess enough knowledge about the disease itself. Population residing in the remote areas of the countries can’t access the treatment facilities due to far distance of health facilities from there residence due to lack of roads and lack of transport. Thus difficult geography primarily in rural areas in the country acts as a barrier to access the health facility. TB infection faces add-on challenge with the advent of co-infection and possibility of increase in drug resistant TB. This is why detecting TB in its early stage would pose a number of advantages to the patient that would in turn help for early treatment. However...
Background: Nepal introduced Tobacco Products (Control and Regulatory) Act in 2011. This act has ... more Background: Nepal introduced Tobacco Products (Control and Regulatory) Act in 2011. This act has mandatory provision of enlarged graphical health warning in Nepali language on at least 75% area on the package of all the tobacco products. This study examined the perception of cigarette graphic health warnings and smoking habits among current smokers.Methodology: This is a cross-sectional study conducted in Butwal sub-metropolitan city in Rupandehi district of Nepal. Among 19 wards of the sub-metropolitan city, four wards were selected randomly by computer-generated codes. Enumerators purposively selected 10 shops from each ward, then recruited every third cigarette buyer from each shop to make a total of five. Smoking status was ascertained by asking if they had ever smoked in last thirty days. We approached 200 people, of whom 40 (20.0%) didn’t agree to participate and 10 (5.0%) didn’t smoke currently. Thus, information from 150 current smokers was finally included in the analysis.R...
COVID-19 epidemic in Nepal is escalating with new cases/admissions at hospitals in recent weeks. ... more COVID-19 epidemic in Nepal is escalating with new cases/admissions at hospitals in recent weeks. The rise in cases is contributed by importation from India and has also led to an increase in the number of local/community transmission. While long-term lockdown can have devastating consequences in population, it is high time to consider the possibilities of exit strategies. The main objective of this piece is to explore the literature to lay out the possible measures for exit from the lockdown in Nepal. We used a descriptive review approach to compare and analyze the published academic and non-academic articles related to COVID-19 and lockdown until date. Post lifting plan should be in place as a roadmap to recovery. An exit strategy can be enacted effectively only when the community complies with new normal adjustments aided with effective public health measures and restrictions. Phase-wise measures should be employed while sudden loosening of restriction might result in detrimental ...
BackgroundRapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented ... more BackgroundRapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the characteristics and drivers of the health system preparedness towards COVID-19 and its impacts on frontline health care workers (HCWs) in Nepal.MethodsSemi-structured interviews (SSIs) were conducted among 32 HCWs who were involved in clinical care of COVID-19 patients and four policymakers who were responsible for COVID-19 control and management at central and provincial level. Participants were included from all seven provinces of Nepal. All SSIs were conducted through telephone or internet based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches.ResultsBoth HCWs and policymakers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic contro...
IntroductionOver-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antim... more IntroductionOver-the-counter (OTC) use of antibiotics contributes to the burgeoning rise in antimicrobial resistance (AMR). Drawing on qualitative research methods, this article explores the characteristics of OTC sales of antibiotic in Nepal, its drivers and implications for policy.MethodsData were collected in and around three tertiary hospitals in eastern, western and central Nepal. Using pre-defined guides, a mix of semi-structured interviews and focus group discussions were conducted with dispensers at drug stores, patients attending a hospital and clinicians. Interviews were audio-recorded, translated and transcribed into English and coded using a combination of an inductive and deductive approach.ResultsDrug shops were the primary location where patients engaged with health services. Interactions were brief and transactional: symptoms were described or explicit requests for specific medicine made, and money was exchanged. There were economic incentives for clients and drug st...
ObjectivesThere is a dearth of information on transgender individuals in Nepal, particularly stud... more ObjectivesThere is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue.SettingThe study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski.Design and participantsThis qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017.ResultsOur participants were young. The majority of FGD participants had completed school-level education and 40% had be...
Background: Infectious disease outbreaks following natural disasters are reported in literature. ... more Background: Infectious disease outbreaks following natural disasters are reported in literature. Outbreaks were documented following natural disasters in many countries including Haiti. Such possibility following 2015 Nepal earthquake was a public health concern. Risk factors needed evaluation by post-disaster outbreak investigation. Hence, present study was undertaken to investigate potentials for such outbreak and to generate evidence for public health intervention.Methods: The study was conducted between April – May, 2015, with the cooperation of National Public Health Laboratory, Epidemiology and Disease Control Division, Nepal Health Research Council and the Chinese team. Rapid Response Teams visited earthquake affected districts and collected samples for analysis. Syndromic surveillance approach was followed. Samples were collected from syndromic patients under supervision. Those sick prior to earthquake or receiving treatment were excluded. Blood, stool and throat swab sample...
Journal of Manmohan Memorial Institute of Health Sciences, 2018
Not available.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page:... more Not available.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page: 1-5
Journal of Manmohan Memorial Institute of Health Sciences, 2018
Many people and departments in higher education institutions and hospitals across the globe have ... more Many people and departments in higher education institutions and hospitals across the globe have objectives that include cross-national partnership working, internationalisation, capacity-building and sharing education and research. We find such commendable ideals at a global level in the Sustainable Development Goals (SDGs) to strategic plans of individual organisations from both low and high-income countries. Using a case-study approach this paper offers insights into some of the key practical issues around global partnership working. We use two case studies of a developing partnership between two separate higher education institutions from the United Kingdom (UK) and one from Nepal. To inform and guide others interested in developing global partnerships we highlight key the reasons for, considerations about, key procedures around the development of such Nepal-UK partnerships and key challenges. Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page...
Introduction: Unintentional injury is the biggest threat to the survival of the under-five childr... more Introduction: Unintentional injury is the biggest threat to the survival of the under-five children, which impact is immeasurable to families and often entire communities. The objectives of this study were to assess the prevalence of unintentional injuries among under-five children and the factors associated with it.Material and Methods: A facility-based quantitative cross-sectional study was conducted from August 2016 to January 2017. Multistage time frame convenient sampling method was applied to collect the data from 259 mothers of under-five children in the selected district of Mid-Western Development region of Nepal. The data was collected from 10 rural health facilities and two from urban setting using a semi-structured questionnaire. An analysis was performed using SPSS ver.15.Results: The prevalence of unintentional injuries was found to be 33.20 % among the under-five children. The present study showed that ecological belt, the age of mothers, education of mothers, educatio...
The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a fu... more The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a further 2 million. One year later, a national workshop was organized with various Nepali stakeholders involved in the response to the earthquake. The workshop provided participants an opportunity to reflect on their experiences and sought to learn lessons from the disaster. One hundred and thirty-five participants took part and most had been directly involved in the earthquake response. They included representatives from the Ministry of Health, local and national government, the armed forces, non-governmental organizations, health practitioners, academics, and community representatives. Participants were divided into seven focus groups based around the following topics: water, sanitation and hygiene, hospital services, health and nutrition, education, shelter, policy and community. Facilitated group discussions were conducted in Nepalese and the key emerging themes are presented. Participa...
Journal of Manmohan Memorial Institute of Health Sciences, 2016
Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries... more Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries around the world. Economic barrier is one of the major problems in poor and marginalized population. Poor people mostly remain unaware of the treatment facilities and some find it difficult in seeking T.B treatment as they don’t trust the program and most of them don’t possess enough knowledge about the disease itself. Population residing in the remote areas of the countries can’t access the treatment facilities due to far distance of health facilities from there residence due to lack of roads and lack of transport. Thus difficult geography primarily in rural areas in the country acts as a barrier to access the health facility. TB infection faces add-on challenge with the advent of co-infection and possibility of increase in drug resistant TB. This is why detecting TB in its early stage would pose a number of advantages to the patient that would in turn help for early treatment. However...
Background: Nepal introduced Tobacco Products (Control and Regulatory) Act in 2011. This act has ... more Background: Nepal introduced Tobacco Products (Control and Regulatory) Act in 2011. This act has mandatory provision of enlarged graphical health warning in Nepali language on at least 75% area on the package of all the tobacco products. This study examined the perception of cigarette graphic health warnings and smoking habits among current smokers.Methodology: This is a cross-sectional study conducted in Butwal sub-metropolitan city in Rupandehi district of Nepal. Among 19 wards of the sub-metropolitan city, four wards were selected randomly by computer-generated codes. Enumerators purposively selected 10 shops from each ward, then recruited every third cigarette buyer from each shop to make a total of five. Smoking status was ascertained by asking if they had ever smoked in last thirty days. We approached 200 people, of whom 40 (20.0%) didn’t agree to participate and 10 (5.0%) didn’t smoke currently. Thus, information from 150 current smokers was finally included in the analysis.R...
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