Assessment of a Community-Based Nutrition Program for Women and Children in Nepal Using Demographic and Health Survey.

Undernutrition is a particularly acute problem in middle- and low-income countries. The "Suaahara" program is a 5-year community-focused program in Nepal, aimed at improving the health and nutrition of pregnant and lactating women and their children under the age of 2 years. This research contributes to evidence on the impact of the "Suaahara" program in 41 treated districts compared to 34 control districts. Using the difference-in-differences method, we found that the weight-for-height z-score and body mass index z-score of children under the age of 2 in the treated districts significantly increased by 0.223 standard deviations (SDs) and 0.236 SDs, respectively, compared with the control districts 5 years before and after the program. The number of antenatal care visits (at least four visits) and safe deliveries significantly increased for pregnant women by 10.4% and 9.1%, respectively, in the treated districts compared with the control districts. The prevalence of fever in children under 2 years of age was significantly reduced by 6.2% in the treated districts. The results show the significance of a policy evaluation with transparent indicators on public health, which is necessary for policymakers so that they can propose evidence-based policy.

Frontline healthcare workers' knowledge and perception of COVID-19 and willingness to work during the pandemic in Nepal: a nationwide cross-sectional web-based study

BackgroundThe health sectors effectiveness during a pandemic primarily depends on the availability, knowledge, skills, perceptions, and motivations of frontline healthcare workers. In this study, we aimed to investigate the contextual factors associated with the knowledge, perceptions, and the willingness of frontline healthcare workers to work during the COVID-19 pandemic in Nepal. MethodsA total of 1051 frontline health-workers from all seven Nepalese provinces were included in this web-based cross-sectional study, which was conducted in May 2020. Using a 5-point Likert scale questionnaire, we collected information on knowledge, perceptions, and the willingness of frontline healthcare workers to work during the COVID-19 pandemic. Multivariable logistic regression was applied to identify independent associations between predictors and outcome variables. ResultsOf the 1051 frontline health-workers, 17.2% were found to have inadequate knowledge on COVID-19, 63.6% reported unsatisfactory perceptions of government response, and 35.9% showed an unwillingness to work during the pandemic. Health workers at local health facilities (AOR: 0.35; 95% CI: 0.17-0.68) and those with chronic diseases were less likely to have adequate knowledge of COVID-19. Nurses (AOR: 2.10; 95% CI: 1.38-3.18), health-workers from Karnali Province (AOR: 2.62; 95% CI: 1.52-4.53), and those who had adequate knowledge of COVID-19 (AOR: 3.86; 95% CI: 2.51-6.16) were more likely to have satisfactory perception towards government response to COVID-19. In addition, laboratory-workers, health workers from Karnali province, and those with adequate knowledge (AOR: 1.81; 95% CI: 1.27-2.58) were more likely to work during the COVID-19 pandemic. ConclusionsWe concluded that frontline healthcare workers have some gaps in knowledge-related to COVID-19; about two-thirds of them had a negative perception of government response, and nearly one-third of them were unwilling to work. These observations demonstrate that prompt actions are required to improve health-worker knowledge of COVID-19, address negative perceptions to government responses, and motivate them to provide healthcare services during the pandemic.

Factors enabling women with pelvic organ prolapse to seek surgery at mobile surgical camps in two remote districts in Nepal: a qualitative study

Background: Pelvic organ prolapse (POP) is a major reproductive health problemin Nepal, though many women delay seeking treatment. To address this, theNepalese government has been providing free vaginal hysterectomies with pelvicfloor repair to women in mobile surgical camps. Studies exploring factors thatenable women to attend these camp settings are limited. This study aimed toidentify factors that affected women seeking surgical treatment for POP at mobilesurgical camps.Methods: The study used a qualitative approach. Twenty-one women with POPwere recruited in two week-long mobile surgical camps held in two remote districtsin Nepal during April and May 2013. Data were collected from individual face-toface interviews and were analysed thematically.Results: Three themes and six subthemes emerged from the analysis. The firsttheme, “health-system factors”, suggests that accessibility and affordability ofthe treatment, and the supportive role of female community health volunteersfacilitate women to seek treatment in the camp. The second theme, “factorsrelated to sociocultural norms”, reveals that reaching the end of reproductiveyears and approval by relevant influential family members empowers women totake up surgical treatment in the mobile surgical camp. Similarly, the third theme,“individual-level factors”, includes women’s experience of POP, such as worseningsymptoms and fear of development of cancer, as factors enabling women to seektreatment.Conclusion: Enablers to seeking treatment at mobile surgical camps forwomen are related to the Nepalese health system, sociocultural norms andindividual experiences of women. Each of these factors should be consideredwhen conducting mobile surgical camps, if women’s uptake of treatment is to beenhanced