Background: Junk food consumption and its consequences has become a major public health concern globally because of its deteriorating health consequences and surging prevalence. Though its adverse health consequences are widely prevalent in all age groups, children and adolescents are more at risk. It may lead to obesity and act as a risk factor for different non-communicable diseases (NCD's) like heart diseases, cardiovascular disease, cancer, hypertension, diabetes, etc. This study was carried out to explore the junk food consumption and its associated factors among adolescent students.Methods: A cross-sectional study was conducted among 538 adolescent students of Kaski district, Nepal. We used a stratified proportionate sampling technique to recruit the participants. A self-administered questionnaire was used for data collection. Descriptive and bivariate statistical analysis was performed. The odds ratio was computed to test the association.Results: The study found that more than half of the participants (60.30%) consumed junk foods over the last 30 days, more prevalent among public school participants (65.1%) followed by participants of private school (56.3%). More than half of the participants consumed salty snacks (58.7%) followed by sweets (57.5%). The time of consumption was found to be higher together with friends (83.9%). Similarly, it was consumed more while the participants were on a trip (70.1%). Consumption of junk foods was significantly associated with public school (OR: 1.44, CI = 1.01–2.06), single family (OR: 1.46, CI = 1.01–2.10), living with parents (OR: 1.64, CI = 1.03–2.63), while on travel (OR: 1.99, CI = 1.33–2.98), while reading (OR: 2.01, CI = 1.16–3.47), at home (OR: 2.20, CI = 1.53–3.16), at school (OR: 2.86, CI = 1.98–4.12), friends' influence (OR: 2.01, CI = 1.37–2.94), and junk food availability at home (OR: 1.92, CI = 1.33–2.76).Conclusion: Consumption of junk foods among adolescent students was remarkably high in both public school and private school adolescents. Regardless of adequate knowledge on harmful consequences of junk foods, school-going adolescents are consuming junk foods due to its easy availability and ready-to-use packaging. The government of Nepal should strictly standardize and regulate advertising policies and extravagant health claims advertised by junk food manufacturers. An appropriate intervention targeted to adolescents to improve food behaviors is recommended.

Background: Undernutrition increases the risk of progression from Tuberculosis (TB) infection to active TB disease and further leads to weight loss. Proper diet and nutrition play significant roles in treating TB patients. Active TB needs high energy requirement. The main aim of this study is to assess the dietary intake and nutritional status of TB patients in Pokhara city of Nepal.Methods: A cross-sectional descriptive study was carried out among 133 TB patients taking anti-tubercular drug. Data were collected using sequential sampling method. Data were collected from 4th October to 7th November, 2016.Results: This study revealed that about one-fifth of TB patients did not consume sufficient amount of calories as per RDA. More than one-third of patients were underweight during the time of registration and this is reduced to 21.8 percent in the present situation. Mean BMI was 20.99 kg/m2 (SD ± 5.81). Similarly, the mean BMI among Pulmonary TB (PTB) is 19.82 and 22.52 kg/m2 in Extra PTB. Working conditions and food intake frequency were significantly associated with calorie intake. This study found that the amount of calories, food frequency per day, types of TB, and nutritional status during registration were found to be associated with recent nutritional status. The statistical difference between mean BMI at registration and recent BMI and mean weight at registration and recent weight.Conclusion: Nutritional status has improved comparatively from the time of registration to the time of study. Proper nutritional counseling should be given to TB patients along with nutritional support to severely malnourished patients, and nutritional assessment of TB patients should be done periodically.

The average per capita annual cost of a pilot community health worker (CHW) program in rural Nepal is US$3.05. n Personnel costs, the largest cost driver, contribute 74% of the total implementation costs and are affected by the number of households covered, population distribution, geographical terrain, and supervision structure.

Background Timely tracking of health outcomes is difficult in low- and middle-income countries without comprehensive vital registration systems. Community health workers (CHWs) are increasingly collecting vital events data while delivering routine care in low-resource settings. It is necessary, however, to assess whether routine programmatic data collected by CHWs are sufficiently reliable for timely monitoring and evaluation of health interventions. To study this, we assessed the consistency of vital events data recorded by CHWs using two methodologies—routine data collected while delivering an integrated maternal and child health intervention, and data from a birth history census approach at the same site in rural Nepal. Methods We linked individual records from routine programmatic data from June 2017 to May 2018 with those from census data, both collected by CHWs at the same site using a mobile platform. We categorized each vital event over a one-year period as ‘recorded by both methods,’ ‘census alone,’ or ‘programmatic alone.’ We further assessed whether vital events data recorded by both methods were classified consistently. Results From June 2017 to May 2018, we identified a total of 713 unique births collectively from the census (birth history) and programmatic maternal ‘post-delivery’ data. Three-fourths of these births (n = 526) were identified by both. There was high consistency in birth location classification among the 526 births identified by both methods. Upon including additional programmatic ‘child registry’ data, we identified 746 total births, of which 572 births were identified by both census and programmatic methods. Programmatic data (maternal ‘post-delivery’ and ‘child registry’ combined) captured more births than census data (723 vs. 595). Both methods consistently classified most infants as ‘living,’ while infant deaths and stillbirths were largely classified inconsistently or recorded by only one method. Programmatic data identified five infant deaths and five stillbirths not recorded in census data. Conclusions Our findings suggest that data collected by CHWs from routinely tracking pregnancies, births, and deaths are promising for timely program monitoring and evaluation. Despite some limitations, programmatic data may be more sensitive in detecting vital events than cross-sectional census surveys asking women to recall these events.

Skilled care during pregnancy, childbirth, and postpartum is essential to prevent adverse maternal health outcomes, yet utilization of care remains low in many resource-limited countries, including Nepal. Community health workers (CHWs) can mitigate health system challenges and geographical barriers to achieving universal health coverage. Gaps remain, however, in understanding whether evidence-based interventions delivered by CHWs, closely aligned with WHO recommendations, are effective in Nepal’s context. We conducted a type II hybrid effectiveness-implementation, mixed-methods study in two rural districts in Nepal to evaluate the effectiveness and the implementation of an evidence-based integrated maternal and child health intervention delivered by CHWs, using a mobile application. The intervention was implemented stepwise over four years (2014–2018), with 65 CHWs enrolling 30,785 families. We performed a mixed-effects Poisson regression to assess institutional birth rate (IBR) pre-and post-intervention. We used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to evaluate the implementation during and after the study completion. There was an average 30% increase in IBR post-intervention, adjusting for confounding variables (p<0.0001). Study enrollment showed 35% of families identified as dalit, janjati, or other castes. About 78–89% of postpartum women received at least one CHW-counseled home visit within 60 days of childbirth. Ten (53% of planned) municipalities adopted the intervention during the study period. Implementation fidelity, measured by median counseled home visits, improved with intervention time. The intervention was institutionalized beyond the study period and expanded to four additional hubs, albeit with adjustments in management and supervision. Mechanisms of intervention impact include increased knowledge, timely referrals, and longitudinal CHW interaction. Full-time, supervised, and trained CHWs delivering evidence-based integrated care appears to be effective in improving maternal healthcare in rural Nepal. This study contributes to the growing body of evidence on the role of community health workers in achieving universal health coverage.

In Nepal, female community health volunteers are considered as front-line health service providers in a rejuvenated concept of primary health care by acting as a bridge between the health care delivery system and the community. A cross-sectional descriptive study was conducted in the Kaski District of Nepal with the objective to assess the knowledge and case management status of female community health volunteers on Respiratory Tract Infection. Two hundred FCHVs who completed CB-IMCI training were randomly selected.Ninety-nine percent of FCHVs correctly defined ARI; 38.4% of participants defined ARI's signs and symptoms correctly. Twentyseven percent of participants identified chest in-drawing as a danger sign of ARI. 96.5% FCHVs knew about the organ affected by ARI and practice of ARI treatment. More than two-thirds of participants knew the respiratory rate cut off point and the Cotrimoxazole dosage for infants and children. Regarding ARI case management practice, 53.32% of FCHVs referred patients to a health facility, and 20.5% recommended home care and treatment. Neither the correct nor wrong responses about knowledge of ARI were significantly associated with education level or years of service.It is concluded that the knowledge that FCHVs have about ARI in general is good, but some components of ARI knowledge are low. Supportive supervision, capacity building training, and commodities management are the factors that have the potential to improve health workers' motivation for better application of their knowledge and skills.

Globally, financing healthcare is one of the biggest challenges and it becomes a life or death issue in poor countries. Nepal is strongly committed to universal health coverage and Sustainable Development Goals. Existing public health services are inadequate to cater to the growing demands of quality health care and Public Private Partnership (PPP) evolved as newer arrangement for robust healthcare system, improved healthcare quality and enhance cost-effectiveness. Nepal has successfully utilized the PPP model in multiple sectors, however there is limited experience in healthcare. Strengthening PPP models in healthcare  could be the pathway for Nepal toward SDG’s and UHC achievement.

Introduction: Globally, iron deficiency anaemia is considered as a risk factor for maternal morbidity and mortality. It is estimated to cause 591,000 perinatal deaths and 115,000 maternal deaths annually. The World Health Organisation recommends iron supplementation to first trimester to 45 days after delivery. The Government of Nepal is supplementing Iron and Folic Acid (IFA) to pregnant and postpartum women to reduce the burden of disease and deaths, however Nepal reports low compliance and coverage. We sought to determine compliance of IFA and associated factors among postnatal mothers in Kathmandu valley. Methods: This was a cross-sectional study involving 132 mothers attending the immunisation clinic. Face to face interview was done using structured questionnaire consisting of sociodemographic information, IFA, maternal knowledge and compliance practices. Statistical analysis was done using SPSS version 23. Results: We found 68.9% compliance of iron and folic acid among the respondents. The mean age of the respondents was 27.53 ± 4.6 years (Mean ± SD). Significant association was observed between the compliance of the IFA with education,age,employment status of women and family type (p < 0.00). No significant association was observed in between the compliance of IFA and religion (p = 0.93) and delivery related complications (p = 0.143). Similarly, delivery type showed significant association with the compliance of IFA (p < 0.00). Conclusions: This study concludes that mothers from Kathmandu had better compliance and coverage of IFA than provincial as well as the national average. Private pharmacy is an important service provider for urban women.