Suchergebnisse

Occupational health and safety (OHS) is essential for every professional especially healthcare workers who work day and night serving patients. According to the WHO, health workers should not face any kind of workplace violence during their professional activities.Attention should also be paid to the mental and psychological health of healthcare workers and their protection should be of paramount importance. OHS related policies, rules and regulations have been formulated in Nepal. According to the law, the responsibility of the OHS of the employees has to be taken by the concerned organization. In Nepal, during the COVID-19 pandemic, health workers have to take the risk of infecting themselves while providing care for the patients. This has led to the infection of thousands of health workers and we have also lost quite a few healthcare workers in the line of duty in Nepal. On one hand, there is a psychological fear of acquiring COVID-19 infection in healthcare workers despite adopting health and safety measures, while on the other hand, in case of infection they will have to pay for the treatment from their own pockets.Sometimes ICU and ventilator services are not available not only in their working hospital but also in government referral health institutions which have given rise to incidences that healthcare workers themselves have to be admitted to other hospitals for the treatment.In such a situation, not just mental but also a financial burden has been added to the healthcare workers.

Background: The Senior Citizens Acts 2063, Nepal defines the senior citizens (elderly population) as "people who are 60 years and above". Health is the most important determinant of the quality of life of people. Ill-health becomes a major obstacle for the well-being of the elderly population. This study was conducted to assess the morbidity pattern in elderly population.Methods: A community based cross-sectional study was carried out in field practice area of the Department of Community Medicine. 124 elderly population were selected by convenient sampling technique. A structured questionnaire was used to collect the data. Data was analyzed using SPSS version 20. Chi-square was used to test the association and p<0.05 was considered as significant.Results: The mean age of elderly population was 69.85 years. Majority (47.6%) of them were in the age group of 60-69 years. Males (50.8%) were more than females (49.2%). Twelve respondents (9.7%) were not suffering from any form of morbidity. Most common morbidity was muscular skeleton problem (40.8%), followed by hypertension (36.3%), diabetes (29.8.8%), psychological (23.4%) and respiratory (18.6%). Other morbidities gastrointestinal, dental, ENT, eye and genitourinary system were found in around ten percentage of elderly population Conclusions: Majority of the elderly population were suffering from non-communicable diseases. There is a need for health care services at all level with special focus on disease prevention, early detection and treatment for elderly population. This study found high prevalence of musculoskeletal, hypertension, diabetes and psychological problem and low prevalence of respiratory, gastrointestinal, dental, ENT, genitourinary and eye problem. Keywords: Changu Narayan; diabetes; hypertension; masculo skeleton; morbidity pattern; senior citizens.

Background: Provision of adequate water supply, sanitation, hygiene and waste management in schools has a number of positive effects. The study focuses on children because disease related to water; sanitation and hygiene are the leading cause of mortality and morbidity among children. Materials and Methods: This cross-sectional study comprised of 220 students. Participants involved were Government school students of grades 9-10 in Sindhupalchowk and Bhaktapur. Data consisted of hygiene and hand washing practices, knowledge about sanitation and personal hygiene characteristics. Results: This study revealed that knowledge regarding water borne disease was high among Urban school students 86.5% but knowledge regarding transmission route seemed inadequate in both urban and rural students (35% and 16% respectively). The practice on hand washing was found high (94.4%).There was significant difference in the knowledge of students regarding WASH in urban and rural settings of the school (P value<0.001). Treated water facility and hand washing facilities with water was found lacking in rural schools. Schools from the urban area had proper hand washing facilities, but there was not any soap available in both the areas. Conclusions: The knowledge and practice of Water, Sanitation and Hygiene (WASH) among secondary school students is still poor. The knowledge of WASH in secondary school students when compared to the rural areas, urban areas had better on the basis of knowledge score.Keywords: hygiene; knowledge; practice; water; sanitation.

Background: Kangaroo mother care is an effective and low cost technique which prevents neonate from hypothermia, a leading cause of preventable neonatal mortality. Knowledge and practice of Kangaroo mother care is of utmost importance in developing countries such as Nepal. Purpose of this study was to find out knowledge, attitude and practice of kangaroo mother care among health workers in tertiary health centres in Nepal.Methods: This cross sectional study was carried out in three teaching hospitals in Nepal during the period from January 2016 to April 2016. Doctors and nurses working in Paediatrics/Neonatal and Obstetrics/Gynaecology wards were surveyed using pretested questionnaire. Responses from the doctors and the nurses were compared.Results: Response rate of the survey was 65%. All of the doctors and 95.3% of the nurses who participated in the survey had knowledge about kangaroo mother care.37.7%of the doctors and 48.8% of the nurses thought that this method is only used for neonates with low birth weight (<2500grams) (p= 0.013).Three fourth of the doctors and half of the nurses agreed that KMC is practiced regularly in their ward (p = 0.016). 22.2% participants informed that main reasons for not practicing kangaroo care regularly could be lack of skill and knowledge. Conclusions: We found that general knowledge and attitude of majority of doctors and nurses towards kangaroo mother care was good, however, its practise was not uniform.

OBJECTIVE: To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. DESIGN: Delphi study. SETTING: Nepal. PARTICIPANTS: Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants then completed two rounds of ranking and a workshop. RESULTS: A total of 93 participants took part in interviews and two rounds of ranking. Participants were grouped with others sharing expertise relating to each of the five WHO 'pillars' of road safety: (1) road safety management; (2) safer roads; (3) safer vehicles; (4) safer road users and (5) effective postcrash response. Interviews yielded 1019 research suggestions across the five pillars. Two rounds of ranking within expert groups yielded consensus on the important questions for each pillar. A workshop involving all participants then led to the selection of 6 questions considered the most urgent: (1) How can implementing agencies be made more accountable? (2) How should different types of roads, and roads in different geographical locations, be designed to make them safer for all road users? (3) What vehicle fitness factors lead to road traffic crashes? (4) How can the driver licensing system be improved to ensure safer drivers? (5) What factors lead to public vehicle crashes and how can they be addressed? and (6) What factors affect emergency response services getting to the patient and then getting them to the right hospital in the best possible time? CONCLUSIONS: The application of the Delphi approach is useful to enable participants representing a range of institutions and expertise to contribute to the identification of road safety research priorities. Outcomes from this study provide Nepali researchers with a greater understanding of the necessary focus for future road safety research.

INTRODUCTION: Road traffic injuries are a major but neglected global challenge. There are high and rising rates of road traffic injuries in Nepal. Most of the studies reporting these injuries in Nepal have used quantitative methods to describe the injury burden. Little qualitative research has been conducted to describe the contexts and social processes surrounding crashes, or public perceptions of risks and potential solutions. The aim of this study was to explore the perceptions of road dangers from communities living alongside a major highway in Nepal. METHODS: In this qualitative study we recruited members of neighbourhood development committees and a mother's group to take part in focus groups exploring their views. Data were audio-recorded, transcribed, translated and analysed thematically. RESULTS: Four focus groups were conducted involving 34 participants aged 24-65. Our study findings highlight the challenges faced by people living near a major highway and their fear of getting injured on the road. Five themes that emerged were: risky behaviours of road users, infrastructure for safer behaviour, poor condition and maintenance of roads and vehicles, limited adherence and enforcement of traffic laws, and the need for road safety awareness programmes. CONCLUSION: The community groups expressed multiple concerns regarding the safety of members of their communities and lived-in fear of death and injury on the road where they lived. There is an urgent need for government agencies to understand these concerns and to take action in relating to infrastructure provision, regulation and behavioural change programmes.

BACKGROUND: Heavy goods vehicle drivers are an influential driving population in Nepal, with over 90% of goods in the country are transported by road. Due to the time spent on the road, drivers have long periods of exposure to the risk of crash involvement. The study explores the perceptions and experiences of heavy goods vehicle drivers and representatives from their professional association regarding road danger. METHODS: We conducted semi-structured interviews with fifteen heavy goods vehicle drivers regularly driving on the East-West highway of Makwanpur District, Nepal. A focus group was conducted with eleven members from a major transportation entrepreneur's association in Nepal. The focus group and interviews were audio-recorded, transcribed, translated, and analyzed using thematic analysis. RESULTS: Four themes were developed- assumptions of blame; perceptions of safety culture in the trucking industry; influence of road infrastructure; and behaviours of road users. The road and traffic environment, enforcement, and the safety culture in the heavy vehicle industry not only influenced the attitudes of the road users towards traffic safety but also legitimized and encouraged behaviours that affect safety. General and industry-related road safety improvements suggested by participants included: making provision for heavy good vehicles parking areas, separating the highway with a median strip, improving crash investigation capacity, conducting road safety awareness and training programs, strictly enforcing the speed limit and laws about driving under the influence of alcohol/drugs, and formulating strategies to create a safe, supportive working environment in the heavy vehicle industry. CONCLUSION: Heavy goods vehicle drivers and members of the professional association can provide rich information regarding the barriers and facilitators of road risk in Nepal. Their perceptions and opinions can contribute to devising interventions at individual, societal, organizational, and governmental levels, and inform ...

BACKGROUND: Injuries, the cause of an estimated 4.5 million deaths annually and many more disabilities worldwide each year, are the predictable outcome of particular circumstances. One of the most effective ways to prevent injuries is through policy and legislation. The aim of this research study was to identify and critically review all policy and legislation in Nepal that had the potential to prevent injuries. METHODS: We identified legislation and policy that met inclusion criteria through a stakeholder meeting, networks and contacts, and websites and electronic resources. Each included document was critically reviewed to identify areas of strength and opportunities for improvement. We compared the included documents against WHO's recommendations of known effective interventions. RESULTS: Sixty-two documents met the inclusion criteria for this review. Of these, 24 (38.7%) were exclusively related to road injuries, 11 (17.7%) to occupational injuries, 6 (9.7%) to injuries in the home and 5 (8.1%) to injuries at school; 30 (48.4%) documents included text related to the first response to injuries. Of 127 strategic recommendations by WHO that provided an area for policy or legislative focus, 21 (16.5%) were considered adequately met by Nepali policy and legislation, 43 (33.9%) were considered partially met and 63 (49.6%) were not met. CONCLUSION: We drew five conclusions from this critical policy review, which we have related to recommendations as follows: widening the scope of legislation and policy for injury prevention to emphasize injuries occurring at home or school; addressing the causes of injuries and promoting proven preventive measures; greater clarity on both individual and institutional roles and responsibilities; trustworthy data and quality evidence to inform decision-making; and financial investment and capacity-strengthening for injury prevention and first response. The current system of federal governance in Nepal has potential for strengthening injury prevention and first response at the ...

Injuries account for 9.2% of all deaths and 9.9% of the total disability-adjusted life years in Nepal. To date, there has not been a systematic assessment of the status of first response systems in Nepal. An online survey was cascaded through government, non-governmental organisations and academic networks to identify first response providers across Nepal. Identified organisations were invited to complete a questionnaire to explore the services, personnel, equipment, and resources in these organisations, their first aid training activities and whether the organisation evaluated their first response services and training. Of 28 organisations identified, 17 (61%) completed the questionnaire. The range of services offered varied considerably; 15 (88.2%) provided first aid training, 9 (52.9%) provided treatment at the scene and 5 (29.4%) provided full emergency medical services with assessment, treatment and transport to a health facility. Only 8 (47.1%) of providers had an ambulance, with 6 (35.3%) offering transportation without an ambulance. Of 13 first aid training providers, 7 (53.8%) evaluated skill retention and 6 (46.2%) assessed health outcomes of patients. The length of a training course varied from 1 to 16 days and costs from US$4.0 to 430.0 per participant. There was a variation among training providers in who they train, how they train, and whether they evaluate that training. No standardisation existed for either first aid training or provision of care at the scene of an injury. This survey suggests that coordination and leadership will be required to develop an effective first response system across the country.

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model.