ObjectivesThe study aimed at estimating out-of-pocket (OOP) expenditure, catastrophic health expenditure (CHE) and distress financing due to hospitalisation and outpatient care among industrial workers in Eastern Nepal.MethodsWe conducted a cross-sectional study involving industrial workers employed in a large-scale industry in Eastern Nepal. Those who were hospitalised in the last 1 year or availed outpatient care within the last 30 days were administered a structured questionnaire to estimate the cost of illness. CHE was defined as expenditure more than 20% of annual household income. Distress financing was defined as borrowing money/loan or selling assets to cope with OOP expenditure on health.ResultsOf 1824 workers eligible for the study, 1405 (77%) were screened, of which 85 (6%) were hospitalised last year; 223 (16%) attended outpatient department last month. The median (IQR) OOP expenditure from hospitalisation and outpatient care was US$124 (71–282) and US$36 (19–61), respectively. Among those hospitalised, the prevalence of CHE and distress financing was found to be 13% and 42%, respectively, and due to outpatient care was 0.4% and 42%, respectively. Drugs and diagnostics account for a large share of direct costs in both public and private sectors. More than 80% sought hospitalisation and outpatient care in a private sector.ConclusionIndustrial workers face significant financial risks due to ill health compared with the general population. Poor utilisation and higher cost of care in public health facilities warrant strengthening of public sector through increased government spending. The labour act 2014 of Nepal should be strictly adhered.

Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally with 17.9 million deaths in 2016. Nepal is facing a high burden of non-communicable diseases (NCDs) with 66% of people dying from NCDs in 2018. In this study, we aim to assess the knowledge, attitudeand practice regarding CVDs among people of Pakhribas Municipality in Eastern Nepal. Methods: Observational cross-sectional study was conducted among residents of Pakhribas Municipality in eastern Nepal from 9th December to 22nd December 2018. We recruited a convenient sample of 458 permanent residents of Pakhribas municipality. A semi-structured questionnaire based on the CARRF-KL scale survey for knowledge, attitude and practice (after thorough literature review) was used to elicit the information. Descriptive and thematic analysis was done. Result: Fifty-five percent of the respondents belonged to the age group of 30-60 years. Half of the respondents were females. Janjati community was the most dominant ethnicity. One-fourth of the participants were illiterate. The knowledge was found to be average with only 51.5% realizing that family history of CVDs increases the risk of CVDs. Similarly, 46% didn’t know that coronary heart disease could be prevented. The attitude was found to be good with 90.4%, 93.6% and 90.6% respectively stating that they will exercise more, change eating habits and quit smoking if they had CVDs. Regarding practices, people visit traditional healers when they are ill and drink alcohol to fight cold despite knowing it as a risk factor for CVDs. Conclusion: The knowledge of people of Pakhribas Municipality regarding CVD was average. However, the attitude was good. Regarding the practice, people have mixed practices.

INTRODUCTION: Diabetes was considered the disease of affluent and imposes a significant burden on the health services. The modalities of diabetes therapies are different in different parts of the world. However, studies regarding public or private healthcare utilization are lacking in Nepal. Therefore, this study was designed to assess public private health care facility utilization among diabetic people in an urban area of Ithari, Nepal. MATERIALS AND METHODS: A community based cross-sectional study was conducted in Itahari, Submetropolitan of Sunsari district in the Koshi zone of Nepal from September 2017 - September 2018. The study population included 221 participants of age 25 years and above, diagnosed with type 2 Diabetes. Multi-stage proportionate random sampling method was adopted to select the participants. Chi square test was applied to find out the association and p<0.05 is considered significant. RESULTS: Out of the total (221) participants, 55.7% were aged 45-64 years with male of 50.2%. Higher proportion of participants above poverty line (79.7%) were used private healthcare facilities. Among the participants those reported less or equal to two hours waiting time, majority (90.8%) had gone to private healthcare facilities, whereas those reported more than two hours waiting time, majority (70.8%) had gone to public healthcare facilities for the treatment which was found statistically significant (p=0.0002). CONCLUSIONS: Maximum participants prefer private health care services as compared to government health services for their treatment. Therefore, additional community based studies are needed to include larger study populations in order to help healthcare providers develop proper health care programs for these patients.