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Bhopal S.S.,Newcastle upon Tyne Hospitals NHS Foundation Trust | Bhopal S.S.,Northumbria University | Halpin S.J.,St Jamess 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.

Thapa P.,Nepal Health Research Council | Aryal K.K.,Nepal Health Research Council | Dhimal M.,Nepal Health Research Council | Mehata S.,Nepal Health Sector Support Programme | And 7 more authors.
Journal of Nepal Health Research Council | Year: 2015

BACKGROUND: Oral diseases and feeding habits are inextricably linked. Significance of assessing oral health conditions among the school children therefore exists. The current study investigated the oral health condition among 5-6 years and 12-13 years children in Nawalparasi district, Nepal.METHODS: Recruiting 1,000 school children aged (5-6) and (12-13) years in Nawalparasi district, a cross-sectional study was carried out from November to December, 2014. Data assembled from standard instrument was entered in Epi-Data 3.1, cleaned in SPSS version 16.0, and analyzed in Epi Info 3.5.4.RESULTS: Of 12-13 years children, three out of ten (32.0%, 95% CI: 27.8-36.4) suffered from occasional dental discomfort and pain, and 8.1% (95% CI: 5.9-11.0) often experienced dental discomfort and pain during the last 12 months. It was 73.6% (95% CI: 69.3-77.4) who brushed teeth at least once a day, while another 20.7% (95% CI: 17.2-24.7) brushed twice a day. Among all children, 86.1% (95% CI: 82.6-89.1) used toothpaste to brush the teeth. A three-fourth (73.8%, 95% CI: 69.5-77.7) drank tea with sugar daily. Dental caries was visible on 42.2% (95% CI: 37.7-46.8) (mean DMFT score 2.3 ± 1.5). Likewise, a quarter (24.1%, 95% CI: 20.3-28.3) had gingival bleeding, 10.9% (95% CI: 8.3-14.1) questionable enamel fluorosis, 4.5% (95% CI: 2.9-6.9) dental trauma, and 1.7% (95% CI: 0.8-3.5) oral mucosal lesion. Referral for preventive/routine treatment was observed in 40.5% (95% CI: 36.145.1). Among 5-6 years old children, a remarkable proportion of dental caries (64.4%, 95% CI: 59.2-69.4 and mean DMFT score 4.4 ± 3.0) was noted. Statistics of enamel fluorosis, dental trauma, and oral mucosal lesions in this age group were: 3.1% (95% CI: 1.6-5.6), 1.7% (95% CI: 0.7-3.8), and 1.1% (95% CI: 0.4-3.0) respectively. About 40.1% (95% CI: 35.0-45.4) were referred for preventive treatment, and the rest for prompt treatment.CONCLUSIONS: Oral health of the children was poor, chiefly dental carries remained widespread. Dental hygiene awareness should be promoted in schools in active coordination and collaboration with education authorities.

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.

Bista B.,Nepal Health Research Council | Mehata S.,Nepal Health Sector Support Programme | Aryal K.K.,Nepal Health Research Council | Thapa P.,Nepal Health Research Council | And 5 more authors.
Journal of Nepal Health Research Council | Year: 2015

BACKGROUND: Globally, tobacco use is most common public health problem. Similar is the situation of Nepal where thousands of lives are lost annually. Both sexes are affected by tobacco use but women share different and unique problems. Hence, in this paper we made an attempt to understand socio-demographic predictors of tobacco use among women of Nepal.METHODS: A cross-sectional study was carried out with a sample of 2797 women (15-69 years) recruited through multistage cluster sampling technique. This study used sub-set of data of non-Communicable diseases risk factors survey 2013 of Nepal. Bivariate and multivariable regression analyses were carried out to determine predictors of tobacco use among women of Nepal.RESULTS: Among total women, 14% were having at least one form and pattern of tobacco use. Furthermore, 10 % were smoker and 4 percent were using any form of chewing tobacco user. As compared to 15-29 years women, 45-69 years age group were 5 times (OR=4.7, 95% CI =2.7-8.0) more likely to be tobacco user. Similarly, urban women were 40% (OR=0.6, 95% CI=0.38-0.95) less vulnerable than rural women. In addition, higher educated women were found to be at 1% (OR=0.01, 95% CI=0.01-0.01) less risk of being tobacco user.CONCLUSIONS: Age, area of residence, and education level were found to be significant socio-demographic predictors for tobacco use among women in Nepal. Therefore, tobacco control programme should target these groups for interventions.

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.

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