- Bhairahwa Multiple Campus, Siddharthanagar, Nepal
- Tribhuvan University, Department of Health and Physical Education, Faculty Memberadd
- Research Scholaredit
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The government of Nepal introduced a national health insurance program in 2016 to comply with the constitution and international commitments to ensure universal health coverage by 2030. This qualitative study explores public perceptions... more
The government of Nepal introduced a national health insurance program in 2016 to comply with the constitution and international commitments to ensure universal health coverage by 2030. This qualitative study explores public perceptions and satisfaction concerning the new health insurance program. The study is guided by an interpretive worldview using both in‐depth interviews (IDIs) and focus group discussions (FGDs). Altogether, 34 (28 IDIs and 6 FGDs) events were conducted covering both self‐ and government‐sponsored health insurance enrollees in the new health insurance program. The study found that insurees had larger expectations as well as both favorable and negative perceptions of the program. Positive perceptions included that the program helped to lower the gap between the wealthy and the poor, increase coverage with fewer financial contributions, and make it easier to receive health services financially. Negative perceptions included long waiting times for registration, consultations, laboratory test results, and pharmacy visits, as well as the lack of drugs, inadequate coverage (a low ceiling), low‐quality services, and strict procedures, which combined to make insurees dissatisfied. We noticed that insurees had expectations that went beyond the program's guidelines, such as the expectation that services would be provided without queues and long waits, that additional services and coverage would be provided, and that preference would be shown for patients who lived far from hospitals. Adequate information, education, and communication‐ and process‐related interventions that address these issues may help minimize the insurees' unrealistic expectations and areas of dissatisfaction.
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Exposure to mass media plays a crucial role in behavior change or decision‐making. The study used a cross‐sectional survey design. A total of 810 households were randomly selected for data collection by using a validated interview... more
Exposure to mass media plays a crucial role in behavior change or decision‐making. The study used a cross‐sectional survey design. A total of 810 households were randomly selected for data collection by using a validated interview schedule. The study examined exposure to radio, television (TV), hoarding boards (billboards), newspapers, and brochures, pamphlets, and posters as media platform “independent variables” and enrollment in health insurance (HI) as the “dependent variable.” Data showed that 60% of the respondents had exposure to HI information with electronic (radio and TV) media and 33% had exposure via printed or displayed media. All these media were significantly associated with enrollment in HI. But exposure to HI‐related information from radio (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] = 1.39–2.61, p < 0.001), TV (aOR = 1.72, 95% CI = 1.25–2.38, p < 0.01), and hoarding board (billboard) (aOR = 1.87, 95% CI = 1.25–2.81, p < 0.01) were the significant predictor for enrollment in HI. The study findings suggest that it would be best to consider the use of these predictor communication channels when making strategic communication plans to promote HI enrollment in Nepal.
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This study was conducted from a behaviour change perspective to assess the association between the constructs of Health Belief Model and enrolment in health insurance (HI). A cross‐sectional study was conducted among 810 households in... more
This study was conducted from a behaviour change perspective to assess the association between the constructs of Health Belief Model and enrolment in health insurance (HI). A cross‐sectional study was conducted among 810 households in Kailali and Baglung districts. The study used personal interviews to collect data. Perceived susceptibility, severity of diseases, benefits of enrolment, causes of non‐enrolment, interaction with peers/neighbours, and family member's approval to enrol were independent variables and enrolment in HI served as dependent variable. More than half (52%) of the respondents evaluated themselves as not susceptible to health problems. The severity of the health problem was perceived as an economic burden. General treatment and reduction of financial load were perceived as the main benefits of enrolment. Economic status was described as the main barrier to enrol. A vast majority of the respondents had been invited to enrol, and 73% agreed to enrol. Perceived susceptibility and severity of health problems were significantly associated with HI enrolment but were not significant predictors. However, peers' requests to register in HI, discussion with relatives, and family members' approval to enrol were the most significant predictors enrolment. These factors could be incorporated into future intervention plans for increasing enrolment in HI.
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The government of Nepal introduced a national health insurance program in 2016 to comply with the constitution and international commitments to ensure universal health coverage by 2030. This qualitative study explores public perceptions... more
The government of Nepal introduced a national health insurance program in 2016 to comply with the constitution and international commitments to ensure universal health coverage by 2030. This qualitative study explores public perceptions and satisfaction concerning the new health insurance program. The study is guided by an interpretive worldview using both in‐depth interviews (IDIs) and focus group discussions (FGDs). Altogether, 34 (28 IDIs and 6 FGDs) events were conducted covering both self‐ and government‐sponsored health insurance enrollees in the new health insurance program. The study found that insurees had larger expectations as well as both favorable and negative perceptions of the program. Positive perceptions included that the program helped to lower the gap between the wealthy and the poor, increase coverage with fewer financial contributions, and make it easier to receive health services financially. Negative perceptions included long waiting times for registration, co...
The Government of Nepal (GoN) has approved the Malaria Strategic Plan with the aim of 'Malaria free Nepal by 2025'. This study aimed to determine the factors associated with the mosquito bed nets and its determinants of the... more
The Government of Nepal (GoN) has approved the Malaria Strategic Plan with the aim of 'Malaria free Nepal by 2025'. This study aimed to determine the factors associated with the mosquito bed nets and its determinants of the ownership with reference to the households' wealth status in Nepal. The study used the secondary data from the Nepal Demographic and Health Survey 2016. The households' characteristics were considered independent variables and ownership of the mosquito nets as the dependent variable. We used IBM SPSS Statistics 22 to analyse the data. The data showed that three fourths of the total households had such nets, where 80 percent were urban households as compared to 68 percent rural households, 95 percent from the Terai region of Nepal as compared to 34 percent from the mountain region, 91 percent were of middle income, as compared to 39 percent the poorest wealth status of households, 84 percent of households that had TV as compared to 66 percent of th...
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Background The majority of Nepalese people are involved in farming. However, due to limited knowledge of zoonoses and poor preventive practices on the part of livestock farmers, vulnerabilities to zoonotic diseases are very high. The main... more
Background The majority of Nepalese people are involved in farming. However, due to limited knowledge of zoonoses and poor preventive practices on the part of livestock farmers, vulnerabilities to zoonotic diseases are very high. The main objective of this study was to assess the regional variation in zoonoses-related knowledge and preventive practices of livestock farmers in different ecological regions of Nepal. Material and methods Descriptive cross-sectional quantitative research design was followed in the study. The total sample size was 380 livestock farmers from randomly selected three ecological regions of Nepal. Systematic sampling techniques were applied for data collection. Data were entered into an excel sheet and then imported into Statistical Package for Social Sciences (SPSS) software. The data were calculated using descriptive statistics. Univariate, and bivariate analyses were performed, and the result of the study was presented in the form of text and tables based ...
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Nepal is experiencing low enrolment and high dropout rates, but the causes of these issues have remained unknown. This study aimed to explore the causes of dropouts of the HIP implemented by the Health Insurance Board, Nepal. We employed... more
Nepal is experiencing low enrolment and high dropout rates, but the causes of these issues have remained unknown. This study aimed to explore the causes of dropouts of the HIP implemented by the Health Insurance Board, Nepal. We employed an exploratory qualitative research design. We purposefully selected the informants for the data collection who had previously enrolled and currently not renewed their insurance scheme. We gathered qualitative information from 16 in-depth interviews, four key informant interviews, and four focus group discussion in Palpa and Bardia Districts of Lumbini Province, Nepal. The qualitative data were analyzed using thematic analysis. We identified two major themes and nine drop-out-related sub-themes. These were: unnecessary health insurance; negligence to renew; unable to pay the contribution amount; poor cooperation between institutions as well as insurees and insurers; limited coverage and ceiling amount; rigid processes to receive health services; health professionals' behaviors; poor quality healthcare services; inadequate information. Dropout-related factors were associated with personal or individual factors and institutional or policy-related (process-related) factors. The major causes/reasons for dropout include lengthy procedures, poor quality and unsatisfactory services, a lack of knowledge on health insurance norms and procedures, and health professionals' behavior towards insurees during treatment. Information, education, and communication programs related to health insurance are still necessary to make the insurees familiar with the insurance systems and its processes. These factors could be taken into account by policymakers while planning interventions to minimize the low enrollment and high dropout.
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Public Service Announcement (PSA) is an advertisement to inform the people sponsored by the public company or the governmental agencies. There were several PSAs implemented to inform the people about health insurance (HI). Data from the... more
Public Service Announcement (PSA) is an advertisement to inform the people sponsored by the public company or the governmental agencies. There were several PSAs implemented to inform the people about health insurance (HI). Data from the Health Insurance Board showed low enrolment with high dropout in health insurance programme (HIP). It was found that the PSAs could not attract the people. Therefore, we assessed the PSAs used for the HIP and amomg them, three Radio/FM jingles, eight TV spots, hoarding board, newspapers, and brochure were evaluated using the Health Belief Model (HBM). We found the almost all PSAs have not covered the constructs of HBM. Most of the PSAs have included primarily perceived benefits and perceived susceptibility but missed to include perceived severity, perceived threats, and self-efficacy. Only benefits focused message could not attract the people. Therefore, we recommend that all PSAs need to have all the features of HBM in the PSA messages while notifyi...
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The Government of Nepal introduced the health insurance [HI] program in three districts, in 2016 and now has been expanded almost all districts. Since it was a new initiative, there was no clear evidence on people's attitude,... more
The Government of Nepal introduced the health insurance [HI] program in three districts, in 2016 and now has been expanded almost all districts. Since it was a new initiative, there was no clear evidence on people's attitude, perception, and awareness, which continues until now. This study, therefore, intended to assess the perception and attitude of household heads towards enrollment in HI. The descriptive research design was used and 810 households in Baglung and Kailali Districts of Nepal were selected randomly. The interview schedule used for data collection comprised positive and negative statements at a three-point scale as independent variables to explore the perception and attitude of people towards HI and enrollment in HI as a dependent variable. Most of the respondents agreed with the statement where attitude and perception were significantly associated with the enrollment in HI. Among the 16 statements, 13 statements were observed statistically significant. Among the...
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Junk food consumption (JFC) is increasing and it is common mostly among schoolchildren and adolescents (SCA). The consequences of JFC have become a public health concern. The study aims to explore the factors associated with the JFC among... more
Junk food consumption (JFC) is increasing and it is common mostly among schoolchildren and adolescents (SCA). The consequences of JFC have become a public health concern. The study aims to explore the factors associated with the JFC among SCA using the socioecological model (SEM). Electronic databases such as PubMed, Google Scholar, ResearchGate, and bibliographic references were used to obtain the related papers following the standard process of identification, screening, eligibility assessment, study quality assessment, and data extraction from the selected articles. Strengthening the reporting of observational studies in the epidemiological (STROBE) checklist was used to assess the quality standards of the papers. Out of the 785 papers, we synthesized the results from 22 quantitative articles based on merits. The findings of the study indicate that JFC behavior among the SCA is influenced by multilevel factors that extend from intrapersonal to public policy through interpersonal,...
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Anaemia remains one of the major health problems throughout the world and is most common in underdeveloped or developing countries like Nepal. Most of the studies have presented and analysed the situation on a particular time basis that... more
Anaemia remains one of the major health problems throughout the world and is most common in underdeveloped or developing countries like Nepal. Most of the studies have presented and analysed the situation on a particular time basis that could be by chance. The paper intended to assess the trends of anaemia prevalence amongst reproductive-age women throughout the decade using nationally representative data. The study used the data from recent three Nepal Demographic and Health Surveys (NDHS) 2006, 2011, and 2016. More than one third (36%, 35%, and 41% in NDHS 2006/2011/2016 respectively) of women of reproductive age were anaemic. Data showed inconsistent trends of anaemia prevalence among the surveys years. The situation of anaemia has not been improved. It was even worse in the latest NDHS 2016. Policymakers should reconsider, re-evaluate, and revise the intervention programmes applied to reduce anaemia.
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This study examines the effect of education and mass media on discriminatory attitudes towards people living with HIV (PLHIV) among women in Nepal. Data were drawn from the Nepal Demographic and Health Surveys 2006, 2011, and 2016 and... more
This study examines the effect of education and mass media on discriminatory attitudes towards people living with HIV (PLHIV) among women in Nepal. Data were drawn from the Nepal Demographic and Health Surveys 2006, 2011, and 2016 and covered 36,329 women of reproductive age (WRA) 15–49 years. An example of discriminatory attitude towards PLHIV is not wanting to buy fresh vegetables from a shopkeeper or vendor if an individual knew that the seller had HIV. Discriminatory attitude toward PLHIV has increased significantly over time (27.3% in 2006 to 29.7% in 2011 and 34.2% in 2016) among the WRA. Women who had no education and only primary education were 23% (aOR = 1.23, 95% CI 1.13–1.34) and 46% (aOR = 1.46, 95% CI 1.35–1.58) more likely to be affected by discriminatory attitudes, respectively, than those who had secondary or above education. Similarly, women who did not read newspapers were about five times more likely (aOR = 4.91, 95% CI 2.65–9.10) to develop a discriminatory attit...
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This study was conducted from a behaviour change perspective to assess the association between the constructs of Health Belief Model and enrolment in health insurance (HI). A cross-sectional study was conducted among 810 households in... more
This study was conducted from a behaviour change perspective to assess the association between the constructs of Health Belief Model and enrolment in health insurance (HI). A cross-sectional study was conducted among 810 households in Kailali and Baglung districts. The study used personal interviews to collect data. Perceived susceptibility, severity of diseases, benefits of enrolment, causes of non-enrolment, interaction with peers/neighbours, and family member's approval to enrol were independent variables and enrolment in HI served as dependent variable. More than half (52%) of the respondents evaluated themselves as not susceptible to health problems. The severity of the health problem was perceived as an economic burden. General treatment and reduction of financial load were perceived as the main benefits of enrolment. Economic status was described as the main barrier to enrol. A vast majority of the respondents had been invited to enrol, and 73% agreed to enrol. Perceived susceptibility and severity of health problems were significantly associated with HI enrolment but were not significant predictors. However, peers' requests to register in HI, discussion with relatives, and family members' approval to enrol were the most significant predictors enrolment. These factors could be incorporated into future intervention plans for increasing enrolment in HI.
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Regular handwashing with soap and running water is one of the effective ways to stop spreading of germs that protects us from the disease. The aim of this study is to assess the handwashing knowledge and practice among the selected school... more
Regular handwashing with soap and running water is one of the effective ways to stop spreading of germs that protects us from the disease. The aim of this study is to assess the handwashing knowledge and practice among the selected school students of Bardiya district in Nepal. To address this objective, the school-based descriptive cross-sectional design was applied. A total of 327 students including 9 to 12 grades were taken from four secondary schools using the multistage sampling technique. The validated self-administrated questionnaires were used to collect the data from the selected students. Similarly, the univariate (frequencies and percentage) and bivariate analyses (chi-square test for association) were performed to analyse the data, using the Statistical Package of Social Science (SPSS) 26 versions. Out of the total participants, 29.7% were between the ages of 15-16 years, 60.9% were male, and the majority (95.7%) were from Hindu. The study showed that 36.9% participants h...
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Young people’s sexuality is often stigmatized in South Asian societies, including Nepal, where premarital sex is not accepted socially and culturally. However, the prevalence of early sexual activities among adolescents has increased over... more
Young people’s sexuality is often stigmatized in South Asian societies, including Nepal, where premarital sex is not accepted socially and culturally. However, the prevalence of early sexual activities among adolescents has increased over time. Given this background, this paper aimed to explore the prevalence of premarital sexual behaviour among the urban high school adolescents. This study utilized a cross-sectional design and collected a total of 609 students of grade 9-12 [ages 10-19] from both community and institutional schools in the Kathmandu metropolis. A validated structured questionnaire was employed and data were analyzed using SPSS with version 24. Univariate, bivariate, and multivariate analyses were performed to interpret the results. The study showed that the mean age of the respondents was 16 years. More than half of adolescents (52.4%) ever watched pornography, amongst whom eight percent did it on a regular basis. Similarly, 14 percent of in-school adolescents ever ...
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The Government of Nepal has introduced a health insurance programme since 2016. The main essence of the program is to reduce the gap in the utilization of health services between poor and rich, to reduce the out-of pocket expenditure... more
The Government of Nepal has introduced a health insurance programme since 2016. The main essence of the program is to reduce the gap in the utilization of health services between poor and rich, to reduce the out-of pocket expenditure while receiving the healthcare services, and to protect the family from poverty due to catastrophic healthcare expenditure. Researchers review the policy, programme and existing practice Data from Health Insurance Board shows that the programme appears not so effective in many districts but it looks successful in some districts where private healthcare providers are existing as a referral hospital. It is still unanswered whether the HIP is going to boost industrialists in the name of basic rights, health equity and social justice. The paper studies socio-economic and political perspectives of healthcare and health insurance with reference to Nepal and concludes that the healthcare system needs to reform for real welfare, social justice, and citizens'...
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Animals contribute to a pivotal role in human societies. Occupational exposure to animals is barred in several ethnicities in Nepal. Limited studies have been found on zoonoses-related diseases and their knowledge, practices, and... more
Animals contribute to a pivotal role in human societies. Occupational exposure to animals is barred in several ethnicities in Nepal. Limited studies have been found on zoonoses-related diseases and their knowledge, practices, and perception regarding ethnic groups. This study aims to identify the associated factors for human closeness to animals and their host characteristics related to ethnocultural practices. A total of 20 articles were reviewed. In addition to the review, 25 people from different ethnic groups were interviewed. The ethnomedicinal practice and host characteristics of animals for various zoonoses were reviewed from published papers and database journals. There are 1415 species identified as pathogenic to humans, 61% categorized as zoonotic, and of the 175 newly emerging pathogens, 75% are listed as zoonoses. Almost all studies among ethnic groups in Nepal revealed that people interact closely with animals for several reasons, including cultural, religious, and ethn...
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The study analysed antenatal care (ANC) services usage trends related to exposure to mass media based upon data from three Nepal Demographic and Health Surveys [NDHS] conducted in 2006, 2011, and 2016. Total 12,212 women aged 15-49 having... more
The study analysed antenatal care (ANC) services usage trends related to exposure to mass media based upon data from three Nepal Demographic and Health Surveys [NDHS] conducted in 2006, 2011, and 2016. Total 12,212 women aged 15-49 having live births within five years preceding each survey included in the study. Most independent variables were found to be associated with utilisation of ANC services. For example, exposure to TV illustrated an increasing services trend. Seventy-three percent of the women had exposure to Radio followed by TV (65%), and newspaper (25%). All three media were significantly associated with ANC services in all surveys (p < 0.05). High exposure to Newspapers were (2.5 times, 95%CI: 1.93-3.19), Radio (1.3 times, 95%CI: 1.13-1.46), and TV (1.6 times, 95%CI: 1.36-1.76) more likely to result in adequate (≥4) ANC visits. Age and age at marriage; caste and educational status of women; place of residence; wealth status; and women's decision-making autonomy were significant predictors for adequate ANC visits. ANC services utilisation trends increased gradually, but not satisfactory. Most socio-demographic variables were also significant predictors for utilizing ANC services. All these predictors should be used to guide ANC services promotion policies and interventions.
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After the adoption of liberal economic policy, Nepal entered into the international work force market. Human resource moves abroad seeking for employment opportunities. The globalization of workforce on one hand benefit to the country... more
After the adoption of liberal economic policy, Nepal entered into the international work force market. Human resource moves abroad seeking for employment opportunities. The globalization of workforce on one hand benefit to the country with a huge amount of inward remittance and on the other brings different bi-products in the country. The physical and emotional effects on the left-behind children [LBC] have come on the forefront as a burning issue. Absence of parents in the family has resulted in children’s sedentary and complicated life as well. However, health-related problems such as cough or respiratory difficulties and diarrhoea have been a major concern among the LBC. The absence of guardians results in nutritional problems such as height / weight for the age. Out of the parents, mother’s migration results in severe consequences. It does not only have an effect on children’s basic immunization and breastfeeding, but also effects on personal hygiene and sanitation. However, aff...
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Novel Coronavirus Disease (COVID-19) is an infectious disease similar form of pneumonia/ SARS-CoV-2- impacting deadly globally. The main objective of this article is to analyze the studies and gather of the current information aimed at... more
Novel Coronavirus Disease (COVID-19) is an infectious disease similar form of pneumonia/ SARS-CoV-2- impacting deadly globally. The main objective of this article is to analyze the studies and gather of the current information aimed at COVID-19 and analyze the situation of Nepal. We summarized the published articles from the web pages, Journals, Google search engine. It is declared as a public health emergency. However, why COVID-19 does not register in developing counties (Nepal) rather than China, Europe and North America it is unknown. Nepal has lower experiences of the COVID-19 where only 49 death cases registered and total cases 19,237 cases throughout the country (till 08/1/2020). Nepalese health services need to maintain up than today and follow lockdown, isolation, social distance and an advance screening test kit around the country.
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INTRODUCTION: The Government of Nepal introduced a health insurance programme in three districts in 2016. However, it seems that there has not been systematic evidence on whether the current contribution amount (CCA) needed for enrolling... more
INTRODUCTION: The Government of Nepal introduced a health insurance programme in three districts in 2016. However, it seems that there has not been systematic evidence on whether the current contribution amount (CCA) needed for enrolling in health insurance (HI), is acceptable for those who are willing to enroll. This article aims to assess the respondents' willingness to pay (WTP) for HI. METHODS: A cross-sectional study was conducted with 810 randomly selected households in Baglung and Kailali districts and the data was collected using a validated schedule. The socio-demographic characteristics were considered as independent and the WTP as dependent variables respectively. Univariate, bivariate and multivariate analysis were performed. RESULTS: Of the total respondents, 74 percent expressed that they could pay nearly three times as much as the CCA. Mean differences in WTP for HI were observed in terms of districts (p<0.001), sex of the respondents (p<0.01), household hea...
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Youth are important change agents for social, political and economic issues. However, research evidence suggests that many youth, especially females, face many challenges in Nepal in reaching their social potential due to serious problems... more
Youth are important change agents for social, political and economic issues. However, research evidence suggests that many youth, especially females, face many challenges in Nepal in reaching their social potential due to serious problems with educational access and attainment. This study examines the influence of educational attainment on achieving the social potential of Nepalese female youth through a secondary analysis of data from the Nepal Demographic and Health Survey 2016. Results from this analysis show that one out of 10 female youth are illiterate and do not receive a formal education. Socio-demographic variables, such as marital status, caste, place of residence and wealth status were found to be major predictors for literacy status and educational attainment of female youth in Nepal. The findings from this study suggest that special attention should be paid to these critical variables for guiding educational and interventional planning by concerned authorities including...
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Background Most of the studies have indicated that various programmes were failing due to lack of appropriate information, education, and communication [IEC] to the target audiences. But still unanswered that which methods or means of... more
Background Most of the studies have indicated that various programmes were failing due to lack of appropriate information, education, and communication [IEC] to the target audiences. But still unanswered that which methods or means of communication could be the most powerful for changing behaviour, decision making, and or desired action. The paper aims to assess the effects of IEC on the enrollment of health insurance [HI] in Nepal.Methods A cross-sectional study, with randomly selected 810 [405 enrolled and 405 not-enrolled] households, was conducted at Baglung and Kailali districts of Nepal in 2018 using pretested structured interview tool. Background characteristics of family and respondents, and exposure to the means of communication were independent variables; and enrollment of HI was the dependent variable. Univariate, bivariate, and multivariate analyses were done to interpret the data.Results Data show that socio-demographics and exposure to HI related information were assoc...
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Most of the family planning services are being provided free of cost in Nepal however threat of service utilization appears unsatisfactory. This paper aims to assess the factors that are associated with non-use of family planning services... more
Most of the family planning services are being provided free of cost in Nepal however threat of service utilization appears unsatisfactory. This paper aims to assess the factors that are associated with non-use of family planning services among currently married women of reproductive age. The data for this paper are extracted from the Nepal Demographic and Health Survey (NDHS), 2016. Altogether 9875 currently married women of reproductive age were included in this analysis. Bivariate and multivariate analysis were performed to explore the association of socio-demographic characteristics with non-use of contraceptives. Almost a half of the sampled currently married women (47%) were non-users of contraception. Married women aged below 25 years (aOR=2.07, 95% CI 1.75-2.44) and aged 25 to 34 year (aOR=1.15, 95% CI 1.02-1.29)were more likely to not to use contraceptives compared to women aged 35 or above years. Janajati were less likely to be non-user of contraception compared to Brahmin...
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Background Intimate partner violence [IPV] is public health problem globally and most common in developing countries that affects more than one fourth of women of reproductive age [WRA]. It is more critical during pregnancy. IPV not only... more
Background Intimate partner violence [IPV] is public health problem globally and most common in developing countries that affects more than one fourth of women of reproductive age [WRA]. It is more critical during pregnancy. IPV not only affects physical and mental well-being but also leads in birth outcomes with negative consequences. Methods We use secondary data from Nepal Demographic and Health Survey 2016 to assess the association between IPV, and maternal service utilization: ANC visits and institutional delivery. Altogether 1374 WRA were randomly selected. Background characteristics of WRA and IPV were the independent variables, and ANC visits and institutional delivery were the dependent variables. Results Data show that 26 percent of WRA had faced at least one form of IPV, 68 percent had visited health facilities at least four times for ANC check-up during pregnancy, and the rate of institutional delivery was 61 percent. There were association among IPV with ANC visits and ...
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Nepal is experiencing low enrolment and high dropout rates, but the causes of these issues have remained unknown. This study aimed to explore the causes of dropouts of the HIP implemented by the Health Insurance Board, Nepal. We employed... more
Nepal is experiencing low enrolment and high dropout rates, but the causes of these issues have remained unknown. This study aimed to explore the causes of dropouts of the HIP implemented by the Health Insurance Board, Nepal. We employed an exploratory qualitative research design. We purposefully selected the informants for the data collection who had previously enrolled and currently not renewed their insurance scheme. We gathered qualitative information from 16 in-depth interviews, four key informant interviews, and four focus group discussion in Palpa and Bardia Districts of Lumbini Province, Nepal. The qualitative data were analyzed using thematic analysis. We identified two major themes and nine drop-out-related sub-themes. These were: unnecessary health insurance; negligence to renew; unable to pay the contribution amount; poor cooperation between institutions as well as insurees and insurers; limited coverage and ceiling amount; rigid processes to receive health services; health professionals' behaviors; poor quality healthcare services; inadequate information. Dropout-related factors were associated with personal or individual factors and institutional or policy-related (process-related) factors. The major causes/reasons for dropout include lengthy procedures, poor quality and unsatisfactory services, a lack of knowledge on health insurance norms and procedures, and health professionals' behavior towards insurees during treatment. Information, education, and communication programs related to health insurance are still necessary to make the insurees familiar with the insurance systems and its processes. These factors could be taken into account by policymakers while planning interventions to minimize the low enrollment and high dropout.
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The enrollment in Health Insurance (HI) is considered as a sustainable way of financing for health and preparedness for catastrophic health care cost during receiving health services. Various socio-demographic factors are still unanswered... more
The enrollment in Health Insurance (HI) is considered as a sustainable way of financing for health and preparedness for catastrophic health care cost during receiving health services. Various socio-demographic factors are still unanswered regarding their influence. A study aiming to assess the factors associated with the enrollment of HI was conducted in 2018 in two districts of Nepal namely Kailali and Baglung. The study was cross-sectional covering 810 (405 enrolled and 405 not-enrolled) randomly selected households (HH). Socio-demographic variables were considered as independent variables and enrollment in HI as dependent variable. An interview schedule was used as a tool for data collection. Univariate, bivariate and multivariate analyses were performed to analyze the data. The data show that various socio-demographic characteristics are associated with the enrollment of HI. A significant statistical difference is seen between enrollment to HI and HH headship, age group of respo...