Medical abortion kit dispensing practices of community pharmacies in Pokhara Metropolitan, Nepal.

BACKGROUND: Medical abortion (MA) refers to the use of medicines to terminate the pregnancy. There is an urgent need to spread safe abortion services in the community. This study assessed the MA kit dispensing practices of community pharmacies in Pokhara Valley, Nepal. METHODS: A cross-sectional descriptive study was conducted in Pokhara Valley, Nepal from December 2017 to November 2018. Among the community pharmacies of Pokhara Valley, 115 community pharmacies were selected using a consecutive sampling method. A semi-structured questionnaire was used to collect data. MA kit and related information were requested by simulated male clients visiting the community pharmacies. The information obtained from the pharmacy workers was recorded in the data collection sheet. RESULTS: Nine brands of MA kit from eight manufacturing companies were found in practice in Pokhara Valley, out of those only five (56%) were registered in Nepal. Seven brands were sold at more than the labeled price. The pharmacy workers asked about the gestational age and confirmation of pregnancy in all the cases. Most of them counseled the clients on the frequency, duration, and direction of use. Dispensing practice and level of counseling were found to be significantly correlated (r = 0.40, p value = 0.01). CONCLUSION: Despite the awareness of the pharmacy workers on the MA kit, most of them provided limited information to the clients. Nearly half unregistered MA kits were found in practice at the community pharmacies. Thus, the Department of Drugs Administration and other concerned authorities must provide relevant training and awareness programs to the pharmacy workers of the community pharmacies for preventing the malpractice of MA kit. The Government of Nepal must restrict the illegal entry of unregistered brands and assure the standards of MA kit by regulating drug acts and policies effectively.

Use of Pesticides and Health Risk among Farmers in Sunsari District, Nepal.

BACKGROUND: An increasing widespread use of Pesticides is as an issue in the agricultural sector. Pesticides use is one of the occupational risks in farmers of low-income countries including Nepal. Objective of this study was to explore the health effects of Pesticides among agricultural farmers of Sunsari. METHODS: A community based cross sectional study was carried out in Duhabi-Bhaluwa of Sunsari District, Nepal from September 2015 to February 2016. Non-probability sampling technique was used to enroll the total 300 study participants. Data were collected by face to face interview with farmers using pre-tested semi structured questionnaire. Data were recorded by reading the original container of the Pesticides. RESULTS: Fungicides (60.3%), Herbicides (56.3%), pyrethrum (35.3%) and Organophophate (11.6%) Pesticides were commonly used by the agricultural farmers in their farms. The health problem within 48 hours after application of pesticides was reported by more than one-sixth (17%) of the farmers. Dizziness (74.5%) and headache (58.8%) were the most common health problems found among the farmers. Skin irritation (19.6%), nausea (13.7%), paraesthesia (9.8%), restlessness (5.8%), eye irritation (5.8%) and vomiting (1.9%) were also reported by pesticides handlers. Factors associated with health problems were hazardous pesticides use (AOR=26.95, CI 6.15 - 118.0), good knowledge on impacts of pesticides (AOR=3.16, CI 1.09-9.13), determination of wind direction first and spray (AOR=2.25, CI 1.08-4.67), working experience of 20-29 years on farm (AOR=3.38, CI 1.05-10.83). CONCLUSIONS: One-sixth of the farmers reported health problems. Farmers working with hazardous Pesticides were in need of special attention in terms of safe handling, determing the wind direction and spray.