Nepal Health Sector Support Programme

Kathmandu, Nepal

Nepal Health Sector Support Programme

Kathmandu, Nepal
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Mirzoev T.,University of Leeds | Green A.,University of Leeds | Gerein N.,Nepal Health Sector Support Programme | Pearson S.,University of Leeds | And 6 more authors.
Evidence and Policy | Year: 2013

This paper explores the role of evidence in maternal health policy processes in Vietnam, India and China. Both formal and informal types of evidence were used; and differences were found between the stages of policy processes. Evidence used mostly covered easily quantifiable issues and clearly identifiable technical solutions. Different policy actors were involved; actors' evidence preferences were affected by their power, agendas, values and perceived characteristics of robust evidence. To enhance evidence role there is a need to: develop culture of evidence-informed policies; value different evidence types; ensure evidence use throughout policy processes; recognise and manage actors' agendas; and develop context-specific strategies. © Policy Press 2013.


PubMed | Khan Research Laboratories, Nepal Health Sector Support Programme and Kathmandu University
Type: Journal Article | Journal: Disability and health journal | Year: 2016

Health planners and policy makers often overlook the needs of people with disability (PWDs) in less developed countries such as Nepal. The aftermath of conflict and earthquake has further escalated the need of people with disability in Nepal. While the country is preparing for the implementation of a national health sector strategy for the next five years and when the health system is being restructured, we believe that this is the right time to address needs of people with disability by strengthening the health system and operationalizing community based rehabilitation. Furthermore, there is a need of a standard database and monitoring system to regularly assess social inclusion of people with disability.


Mehata S.,Nepal Health Sector Support Programme | Paudel Y.R.,Karuna Foundation Nepal | Mehta R.,Kist Medical College | Dariang M.,Nepal Health Sector Support Programme | And 2 more authors.
BioMed Research International | Year: 2014

Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal. © 2014 Suresh Mehata et al.


Mehata S.,Nepal Health Sector Support Programme | Paudel Y.R.,Karuna Foundation Nepal | Dotel B.R.,Ministry of Health and Population | Singh D.R.,Ministry of Health and Population | And 2 more authors.
BioMed Research International | Year: 2014

This paper explores inequalities in the use of modern family planning methods among married women of reproductive age (MWRA) in rural Nepal. Data from the 2012 Nepal Household Survey (HHS) were utilized, which employed a stratified, three-stage cluster design to obtain a representative sample of 9,016 households from rural Nepal. Within the sampled households, one woman of reproductive age was randomly selected to answer the survey questions related to reproductive health. Only four out of every ten rural MWRA were using a modern family planning method. Short-acting and permanent methods were most commonly used, and long-acting reversible contraceptives were the least likely to be used. Muslims were less likely to use family planning compared to other caste/ethnic groups. Usage was also lower among younger women (likely to be trying to delay or space births) than older women (likely to be trying to limit their family size). Less educated women were more likely to use permanent methods and less likely to use short-term methods. To increase the CPR, which has currently stalled, and continue to reduce the TFR, Nepal needs more focused efforts to increase family planning uptake in rural areas. The significant inequalities suggest that at-risk groups need additional targeting by demand and supply side interventions. © 2014 Suresh Mehata et al.


PubMed | Nepal Health Sector Support Programme, Ministry of Health and Population, Options Consultancy Services Ltd and Karuna Foundation Nepal
Type: | Journal: BioMed research international | Year: 2014

This paper explores inequalities in the use of modern family planning methods among married women of reproductive age (MWRA) in rural Nepal. Data from the 2012 Nepal Household Survey (HHS) were utilized, which employed a stratified, three-stage cluster design to obtain a representative sample of 9,016 households from rural Nepal. Within the sampled households, one woman of reproductive age was randomly selected to answer the survey questions related to reproductive health. Only four out of every ten rural MWRA were using a modern family planning method. Short-acting and permanent methods were most commonly used, and long-acting reversible contraceptives were the least likely to be used. Muslims were less likely to use family planning compared to other caste/ethnic groups. Usage was also lower among younger women (likely to be trying to delay or space births) than older women (likely to be trying to limit their family size). Less educated women were more likely to use permanent methods and less likely to use short-term methods. To increase the CPR, which has currently stalled, and continue to reduce the TFR, Nepal needs more focused efforts to increase family planning uptake in rural areas. The significant inequalities suggest that at-risk groups need additional targeting by demand and supply side interventions.


PubMed | Nepal Health Sector Support Programme, World Health Organization, International Union Against Tuberculosis and Lung Disease, Médecins Sans Frontières and Mid Western Regional Hospital
Type: Journal Article | Journal: Public health action | Year: 2015

This study assessed the characteristics of beneficiaries of a government-led policy of exemption for payment being provided in a regional hospital in Nepal. In January and February 2012, 9547 patients sought services at the out-patient clinic, the majority (83%) of whom were from the same district although this was a referral hospital for 15 districts. Only 10.8% received exemption from payment; 66% of the individuals aged >60 years and eligible for exemption were missed. These shortcomings highlight intrinsic weaknesses in the current implementing mechanisms for payment exemption, which may not be providing financial protection. This hampers efforts towards achieving universal health coverage.


PubMed | Nepal Health Sector Support Programme, Kist Medical College, Options Consultancy Services Ltd and Karuna Foundation Nepal
Type: | Journal: BioMed research international | Year: 2014

Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal.


Bhopal S.S.,Newcastle Upon Tyne Hospitals NHS Foundation Trust | Bhopal S.S.,Northumbria University | Halpin S.J.,St James's Hospital | Gerein N.,Nepal Health Sector Support Programme
Maternal and Child Health Journal | Year: 2013

Giving birth remains a dangerous endeavour for many of the world's women. Progress to improve this has been slow in sub-Saharan Africa. The second delay, where transport infrastructure is key in allowing a woman to reach care, has been a relatively neglected field of study. Six eRanger motorbike ambulances, specifically engineered for use on poor roads in resource-poor situations were provided in 2006 as part of an emergency referral system in rural Sierra Leone. The aim of this study was to evaluate the implementation of this referral system in terms of its use, acceptability and accessibility. Data were collected from usage records, and a series of semi-structured interviews and focus groups conducted to provide deeper understanding of the service. A total of 130 records of patients being transported to a health facility were found, 1/3 of which were for obstetric cases. The ambulance is being used regularly to transport patients to a health care facility. It is well known to the communities, is acceptable and accessible, and is valued by those it serves. District-wide traditional birth attendant training and the sensitisation activities provided a foundation for the introduction of the ambulance service, creating a high level of awareness of the service and its importance, particularly for women in labour. Motorbike ambulances are suited to remote areas and can function on poor roads inaccessible to other vehicles. © 2012 Springer Science+Business Media, LLC.


Paudel Y.R.,Khan Research Laboratories | Dariang M.,Nepal Health Sector Support Programme | Keeling S.J.,Khan Research Laboratories | Keeling S.J.,Nepal Health Sector Support Programme | Mehata S.,Nepal Health Sector Support Programme
Disability and Health Journal | Year: 2016

Health planners and policy makers often overlook the needs of people with disability (PWDs) in less developed countries such as Nepal. The aftermath of conflict and earthquake has further escalated the need of people with disability in Nepal. While the country is preparing for the implementation of a national health sector strategy for the next five years and when the health system is being restructured, we believe that this is the right time to address needs of people with disability by strengthening the health system and operationalizing community based rehabilitation. Furthermore, there is a need of a standard database and monitoring system to regularly assess social inclusion of people with disability. © 2016 Elsevier Inc. All rights reserved.


Pandey A.R.,Nepal Health Research Council | Karki K.B.,Nepal Health Research Council | Mehata S.,Nepal Health Sector Support Programme | Aryal K.K.,Nepal Health Research Council | And 5 more authors.
Journal of Nepal Health Research Council | Year: 2015

BACKGROUND: Despite being preventable disease, diabetes and hypertension fall among top 10 leading causes of death globally. Diabetes and hypertension are independent risk factor for cardiovascular disease, and the risk is markedly increased by their co-occurrence.This study attempted to find out the prevalence of comorbid diabetes and hypertension in Nepal.METHODS: A cross-sectional survey was conducted among 4,200 Nepalese adults selected through multistage cluster sampling.Out of 4,200 respondents of larger study, this article includes the analysis of 3,772respondents who granted permission for physical and biochemical measurement. Nepali version of WHO NCD STEPS instrument version 2.2 was used for data collection. In order to obtain national estimates sample weight was used. Chi-square test and multivariable binary logistic regression were used to assess the association of socio-economic predictors with comorbid conditions after adjusting effect of clusters and strata.RESULTS: The overall prevalence of comorbid diabetes and hypertension was found to be 2% in Nepal.Considering age group 15 to 29 years as reference, people in age group 45-69 and 30 to 44 years were found to have 33 folds (AOR=33.06, 95%CI=5.90-185.35) and 6 folds(AOR=6.36, 95%CI=1.08-37.43) higher odds of developing comorbid condition of diabetes and hypertension.CONCLUSIONS: Prevalence of comorbid diabetes and hypertension seem to be high in people of 45-69 years of age. Age and level of education seem to be associated with comorbid diabetes and hypertension.

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