Inequalities in Childhood Immunisation in South Asia.

Identifying the inequalities associated with immunisation coverage among children is crucial. We investigated the factors associated with complete immunisation among 12- to 23-month-old children in five South Asian countries: Afghanistan, Bangladesh, India, Nepal, and Pakistan, using nationally representative data sets from the Demographic and Health Survey (DHS). Descriptive statistics, bivariate association, and logistic regression analyses were employed to identify the prevalence and the factors in each country that affect the likelihood of full childhood immunisation coverage. The complete childhood immunisation coverage varied significantly within each country in South Asia. Afghanistan had the lowest immunisation rates (42.6%), whereas Bangladesh ranked the highest in complete childhood immunisation rates, at 88.2%. Similarly, 77.1% of Indian children, 79.2% of Nepali children, and 62.2% of Pakistani children were completely immunised. Household wealth status strongly correlated with full childhood immunisation in Afghanistan, India, and Pakistan at the bivariate level. The results from the logistic regression showed that a higher maternal educational level had a statistically significant association with complete childhood immunisation in all countries compared to mothers who did not attend any school. In conclusion, the study revealed the inequalities of complete childhood immunisation within South Asia. Governments must be proactive in their endeavours to address universal and equitable vaccine coverage in collaboration with national and international stakeholders and in line with the relevant Sustainable Development Goals.

Perceived Risk Factors for Suicide among Nepalese Migrant Workers in South Korea.

(1) Background: In South Korea, far from their homeland, Nepalese migrant workers often face tremendous challenges. The most severe outcome for migrant workers is death by suicide-a major cause of premature death among migrant workers. Nevertheless, in the literature, key factors associated with suicide among Nepalese migrant workers are not specifically identified. Thus, we aimed to delineate the main suicide risk factors for this group of migrants. (2) Methods: We used qualitative research methodology (sample = 20; male =17, female = 3) and employed nominal group techniques to identify the perceived primary risk factors for suicide. (3) Results: Study participants identified and ranked eight sources of distress and perceived risks for suicide, both from home and in the host country. Perceived risks for suicide include a complex set of socio-cultural, behavioral, occupational, physical, and mental health issues as well as communication barriers. (4) Conclusions: The findings suggest the need to design tailored mental health promotion programs for migrant workers before departure from Nepal as well as after arrival as migrant workers in South Korea.

Determinants of child maltreatment in Nepal: Results from the 2014 Nepal multiple indicator cluster survey (the 2014 NMICS).

We examined the prevalence of child maltreatment as measured by the level of physical (moderate to severe) and emotional abuse and child labor, and the associated household level determinants of child maltreatment in Nepal. We used a nationally representative data set from the fifth round of the Nepal Multiple Indicator Cluster Survey (the 2014 NMICS). The main independent variables were household level characteristics. Dependent variables included child experience of moderate to severe physical abuse, emotional abuse, and child labor (domestic work and economic activities). Bivariate analyses and logistic regressions were used to examine the associations between independent and dependent variables. The results showed that nearly half of the children (49.8%) had experienced moderate physical abuse, 21.5% experienced severe physical abuse, and 77.3% experienced emotional abuse. About 27% of the children had engaged in domestic work and 46.7% in various economic activities. At bivariate level, educational level of household's head and household wealth status had shown significant statistical association with child maltreatment (p<0.001). Results from multivariate logistic regressions showed that higher education levels and higher household wealth status protected children from moderate to severe physical abuse, emotional abuse and child labor. In general, child maltreatment is a neglected social issue in Nepal and the high rates of child maltreatment calls for mass awareness programs focusing on parents, and involving all stakeholders including governments, local, and international organizations.

Factors associated with intimate partner violence against married women in Nepal.

This study was to explore the factors associated with intimate partner violence (IPV) in Nepal. A sample of 3,373 married women was taken from the 2011 Nepal Demographic and Health Survey. Multilevel logistic regression methods were used to analyze the data. The results show that 28.31% of the population experienced the IPV in the past year. The results indicate that female illiteracy, low economic status, violent family history, and a lack of decision-making autonomy were associated with IPV. Regarding family background, whether or not the husband was an alcoholic, the husband's level of education, and a higher number of children were risk factors associated with IPV. At the community level, women most at risk of IPV were those living in the Terai region, and women belonging to underprivileged castes and ethnic groups. The findings suggest the need for context-specific policy formation and the need for the creation of the certain intervention programs designed to mitigate IPV in Nepal.