Background: Timely access and use of health services are critical for improving maternal health services. The objective of present study is to identify key factors related to antenatal care and institutional delivery services in Nepal.Methods: Data from the Nepal Demographic Health Survey 2016 was analyzed. Women who have taken four or more antenatal checkup (ANC4+), and who delivered at a health Institution were considered outcome variables. Logistic regression analysis was used to compute odds ratio. Women (15-49) having most recent birth in 5 years preceding the survey were included in the study.Results: 69.4% women had taken four or more ANC and 60.6 % had given delivery at a health institution. Age of mother at birth of child, birth order, residence, and ethnicity were significantly associated with use of maternal health service. Educated were 3.79(CI2.83-5.08) times likely to take ANC4+ and 2.71 (CI 2.05-3.57) times likely to give birth at health institution. Richest women were 2.25(CI2.83-5.08) times likely to utilize the ANC4+ service and 9.48(CI6.46-13.91) times likely to give birth at health institution. Women in Province 7 were 3.16(CI2.14-4.67) times likely to utilize ANC4+ service and 2.71(CI 1.83-4.05) times likely to give delivery in health institution compared to women in Province 6.Conclusions: Higher educated and richest women were using antenatal care and institutional delivery compared to less educated. The finding reinforces importance of empowering women with education and improving economic situation.Keywords: Antenatal care; demographic and health survey; institutional delivery; maternal health; Nepal.
Background: Healthcare workplaces are prone to the occurrence of violence of varying types and degrees. This study assessed the prevalence of violence experienced by nursing staff at a tertiary hospital in urban Nepal. Methods: A self-administered, cross-sectional survey was distributed to the entire nursing staff (N=146) currently working at a large teaching hospital in Kathmandu. The types of violence ascertained included verbal abuse, general harassment, physical assault, and sexual violence. Descriptive and logistic regression were applied to the data analysis. Results: General harassment was the second most commonly experienced; 44% reported having experienced it any time in the past; and 28% reported to have experienced it in the last 12 months. Overall, 68% of all the respondents reported having experienced any type of violence, and 47% reported having experienced it any time in the last 12 months. Compared to single nurses/respondents, married nurses were particularly more likely to experience violence. Conclusion: Development of workplace standards, orientation for all staff members, and the establishment of an effective monitoring and enforcement system are needed to minimize workplace violence at the study site, and most likely elsewhere in Nepal as well.
Background: In Nepal, the private sector has prominently emerged as a provider of health services in recent years. The objective of this paper is to assess whether public and private hospitals are competing for patients with similar socioeconomic strata, or providing services to different segments of the patient population. Methods: Data were collected prospectively from one public hospital and one private-for-profit hospital, both located in close proximity to one another in Tanahu district. A total of 384 and 389 patients presenting themselves for outpatient services available at the district public hospital and a private hospital, respectively, were systematically selected and interviewed using a survey form. The profiles of the patients were comparatively analyzed, and the reasons for using a particular hospital were assessed. Binary logistic regression was used for multivariate analysis.Results: Compared to the patients using the public hospital, patients at the private hospital were younger, possessed a higher level of education, represented indigenous and disadvantaged ethnic groups, and belonged to business or agricultural occupations. The four prominent reasons for using the private hospital were: positive perception/prior experience, followed by recommendation/word-of-mouth, timely availability of services, and trustworthiness. Among the public hospital patients, the prominent reasons were: low fee for services or having insurance, positive perception/prior experience, and trustworthiness. Conclusions: Public and private hospitals have played a complementary role in serving the health needs of different patient population segments in the study district. Keywords: Nepal; private hospital; public hospital; reasons for use; users profile.
Introduction: Occupational health hazards of teaching includes ill health, poor physical posture and confusion that plays a vital role in triggering other diseases which are associated with musculoskeletal, cardiovascular, gastrointestinal, vocal cord, skin and other health problems. Most of the teachers develop occupational health problems after being enrolled into this profession, identification of such problems should be carried out in the initial phase of the profession. Objective: To access the health status of teachers in terms of age, gender, health problem and types of health problem. To access the association between gender, years in profession and health problem. Methodology: Cross-sectional study was conducted among teachers of selected secondary level Government school of Kathmandu i.e. 50 schools. Sample size of 270 was calculated. Random sampling was used for school selection. Response rate was 95.5 % i.e. 258 samples were collected. Result: Majority of the teachers i.e. 69% were facing some kind of health problem. Respondents who were above 30 years were found to have different kinds of health problems. Significant association between teaching for more than 10 years and health problem was observed among Males (72.7%, P<0.05) and females (82.5%, P< 0.05). Conclusion: The proportion of health problem was slightly higher among male teachers than in female teachers. It is necessary to improve the work standards and quality of life of teachers, through establishment of routine health checkups and strong coordination between District Education office and District Public Health office.
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