Child Healthcare in Nepal: Progress and Direction

Akhtar, Radeeb

doi:10.12691/ajphr-3-2-7

Cited by 6 publications

(10 citation statements)

References 3 publications

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“…It's in the Quran." 74 Abe's dreams of establishing a worldwide Islamic caliphate are eerily similar to the current goal of ISIS, and once again, play upon American fears. Akhtar's Pulitzer Prize-winning play ends with a tragic silence and no redeemable Muslim character standing on the stage.…”

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confidence: 91%

Muslim Identity in 21st Century America: Ayad Akhtar's Works as Autobiography

Asif¹

2015

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Recipient of the 2013 Pulitzer Prize for Drama, Ayad Akhtar has been lauded as the de facto voice of the American Muslim in theatre and literature. Akhtar, A Pakistani American, claims that all of his works are inspired by his life and personal experiences; they are, he admits, a form of autobiography. In a post-9/11 world, however, where the position of Muslims in the United States has become increasingly scrutinized, Akhtar’s works purposely play upon American fears and anxiety in regard to Islam. Indeed, Akhtar’s works rely heavily on Muslim stereotypes in order to unsettle American audiences and gain artistic recognition. By doing so, Akhtar not only continues the clichéd depiction of Muslims in American media, but also upholds Stephen Spender’s theory on autobiography: that the perspective of the autobiographer, his Self, is forever forced to submit to that of society, the Other.

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confidence: 91%

Muslim Identity in 21st Century America: Ayad Akhtar's Works as Autobiography

Asif¹

2015

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“…Nepal currently ranks 110th on the United Nations Development Programme's Gender Inequality Index [1], with caste and ethnicity continuing to be major determinants of poverty, education and health outcomes [2][3][4][5]. There are signi cant inequalities in access to and utilisation of basic health services between urban and rural areas, as well as between lowland, hill and mountain zones [2,3,[5][6][7]. This presents a signi cant challenge for Nepal in terms of promoting social and economic development, meeting the Sustainable Development Goals to end preventable deaths of newborns and children under 5 years of age, and achieving universal health coverage.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, individual patient records cannot easily be investigated for health outcome correlations with gender, ethnicity and caste [7]. For the same reason, there is a signi cant data gap that prevents monitoring and evaluation of the practices of front-line health workers, such as the extent to which they comply with treatment guidelines [7,8].…”

Section: Introductionmentioning

confidence: 99%

Determinants affecting utilisation of health services and treatment for children under-5 in rural Nepali health centres: a retrospective cohort study

Shrestha¹,

Green

Baidya³

et al. 2022

Preprint

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Background: Large inequalities in child health remain in Nepal, with caste, ethnicity and sex being major determinants of deprivation and negative outcomes. The purpose of this study was to explore whether key demographics on under 5s were associated with health seeking behaviours, utilisation of health care, and treatment received.Methods: Data came from Integrated Management of Neonatal & Childhood Illness (IMNCI) records of 23 health centres across five districts. After digitising the paper records, district, ethnicity, sex, age and temperature of the child were used to predict the number of days taken to seek medical care for Acute Respiratory Infection (ARI), diarrhoea and fever. In addition to this, correct diagnosis and subsequent treatment of pneumonia was assessed against IMNCI guidelines, again using the demographic factors of interest to predict these outcomes.Results: From 116 register books spanning 23 health centres, 33,860 child patient records were considered for analysis. The median age of attendance was 16 months (Inter-Quartile Range= 9, 30), while there were more male children that attended (55.8% vs. 44.2% for females). There were statistically significant differences for the time taken to attend a health centre between different districts for ARI, diarrhoea and fever, with children in the remote Humla and Mugu districts taking significantly longer to present at a health facility after the onset of symptoms (all p<0.012). Children from underprivileged ethnic groups, Madhesi and Dalit, were less likely to be given a correct diagnosis of pneumonia (p=0.001), while males were more likely to receive a correct diagnosis than females (73% vs. 67%, p=0.001). This sex difference remained in the adjusted regression models for diagnosis of pneumonia (p=0.011) but not for treatment of pneumonia (p=0.202).Conclusions: Significant demographic differences were found based on ethnicity, sex, and district when examining health seeking behaviours for ARI, diarrhoea, and fever. Significant associations were seen for these same factors when exploring accuracy of diagnoses of pneumonia, but not for treatment. This study has emphasised the importance of a digitalised healthcare system, where inequalities can be identified without the reliance on anecdotal evidence.

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“…The common causes of maternal mortality are hemorrhage, sepsis, unsafe abortions, and labor related complications [8]; for children under five years of age, common causes include respiratory infections, malnutrition, diarrheal diseases, and intrapartum related complications [9]. Even though there has been a remarkable decline in the maternal and under-five mortality ratios since the 1990s [3,10], disparities, depending on geographical areas [11], socio-economic status, educational background, and ethnicity, still exist [3]. In addition, it has been reported that delays in vaccination timings increase the risk of mortality [2,12].…”

Section: Introductionmentioning

confidence: 99%

“…In order to reduce these disparities and make timely health care available to all, several community-based, decentralized programs have been implemented throughout the country since the mid-1990s [10,11,13]. Several initiatives have been taken on by the Government of Nepal (GoN) to scale up the existing health care services in collaboration with international organizations.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Socio-Demographic Factors, Mother and Child Health Status, Water, Sanitation, and Hygienic Conditions Existing in a Hilly Rural Village of Nepal

Bhandari

Bak

Lee

et al. 2019

IJERPH

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In many low income developing countries, socioeconomic, environmental and demographic factors have been linked to around half of the disease related deaths that occur each year. The aim of this study is to investigate the sociodemographic factors, mother and child health status, water, sanitation, and hygienic conditions of a Nepalese community residing in a hilly rural village, and to identify factors associated with mother and child health status and the occurrence of diarrheal and febrile disease. A community-based cross-sectional survey was carried out and 315 households from the village of Narjamandap were included in this study. Factors associated with diarrhea, febrile disease, and full maternal and under-five immunizations were assessed using logistic regression. Results showed that higher education level (middle school versus primary education; Odds Ratio (OR): 0.55, p = 0.04; high school versus primary education; OR 0.21, p = 0.001) and having a toilet facility at home were significantly associated with a lower risk of developing diarrhea and febrile disease (OR 0.49, p = 0.01), while, interestingly, the use of improved water supply was associated with higher risk (OR 3.07, p = 0.005). In terms of maternal immunization, the odds of receiving a tetanus toxoid vaccination were higher in women who had regular antenatal checkups (OR 12.9, p < 0.001), and in those who developed complications during pregnancy (OR 4.54, p = 0.04); for under-five immunization, the odds of receiving full vaccination were higher among children from households that reported diarrhea (OR 2.76, p < 0.001). The findings of this study indicated that gaps still exist in the mother and child healthcare being provided, in terms of receiving antenatal checkups and basic immunizations, as evidenced by irregular antenatal checkups, incomplete and zero vaccination cases, and higher under-five deaths. Specific public health interventions to promote maternal health and the health of under-five children are suggested.

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Child Healthcare in Nepal: Progress and Direction

Cited by 6 publications

References 3 publications

Muslim Identity in 21st Century America: Ayad Akhtar's Works as Autobiography

Muslim Identity in 21st Century America: Ayad Akhtar's Works as Autobiography

Determinants affecting utilisation of health services and treatment for children under-5 in rural Nepali health centres: a retrospective cohort study

Assessment of Socio-Demographic Factors, Mother and Child Health Status, Water, Sanitation, and Hygienic Conditions Existing in a Hilly Rural Village of Nepal

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