Health Prospect

Comprehensive reproductive health care services during COVID19 in Nepal: An ethical analysis through Reproductive Justice Framework

2022-04-24T16:55:46+00:00

Reproductive health care services are fundamental human rights of every individual, which are also stated by various international instruments. Nepal is also part of these international commitments and has reflected its commitment in the nation’s plan, strategy, and programs. Though significant efforts have been made to fulfill and improve the sexual and reproductive health care services in Nepal, women and marginalized communities are still deprived of the services. During the COVID-19 pandemic, the utilization of reproductive health services declined which is aggravating the situation and threatening to reverse the progress made so far. The article reviews the accessibility of comprehensive reproductive health services through the framework of reproductive justice during the COVID-19 in Nepal. Reproductive Justice is not only a framework for liberty for marginalized communities but also ethical guidance for policymakers and service providers.

Struggling to reply to reviewers: Some advice for novice researchers

2022-03-13T06:23:25+00:00

Peer review is key in academic publishing, and rejection (or at least being asked to resubmit your paper to the journal), is a not uncommon occurrence. However, receiving such rejection and having to reply to it can be hard for the early-career researcher.

In this paper, we first highlight the role of the peer reviewer, followed by some of the less friendly reviewers’ comments to our own submitted papers in four case studies. We conclude with several suggestions of ways to deal with less than positive reviews.

Perspectives on Smoking among Female Smokers: A Qualitative Study from Kathmandu, Nepal

2022-01-30T13:42:59+00:00

Introduction: Tobacco is one of the biggest public health threats the world has ever faced, killing nearly eight million people a year. The problem of smoking among females has not been well addressed in Nepal. The study aims is to identify reasons behind smoking initiation and maintenance from the perspective of female smokers in Nepal.
Methods: A qualitative study was conducted among female smokers aged between 18-24 years using focus group discussion and individual interviews in different hotspots for smoking in Kathmandu valley, Nepal. The purposive sampling technique was used. The female smokers who had smoked at least once in the previous seven days and continuously for the previous six months were included in the study. The interviews and discussions were recorded and transcribed before thematic analysis was conducted.
Results: Four major themes emerged from analysis -initiation of smoking, smoking behavior, reasons for smoking and beliefs about smoking. All the female smokers started smoking as teenagers, generally out of curiosity and influence from family members. They preferred to smoke in groups and some were forced to smoke by their friends and had smoked against their will until smoking became a habit. Other factors for them to smoke were stress, conflict, peer pressure, fashion and education factors. The participants regarded the sense of release and independence gained from smoking as important and perceived the health risks as slight.
Conclusion: The different perspectives on smoking identified in this study suggest that public health interventions should aim to decrease smoking levels by targeting groups rather than individuals, focusing on changing the smoking behavior of families and strengthening the non-smoking policy in public places.

Knowledge and Utilization of Family Planning Methods among people living with HIV in Kathmandu Valley

2022-02-25T17:26:51+00:00

Background: HIV is a major global health issue, targeting the immune system and making the body prone to diseases. People living with HIV mostly face societal stigma and fear of disclosure resulting in discrimination of accessing health facilities leading to multiple sex partners, increased sexual activity and less use of condoms. HIV positive women are at risk of transmitting HIV to their infants and their partners. Thus, the family planning services if provided to PLHIV can help to improve their and families health. In addition to, it reduces the risk of mother-to-child transmission (PMTCT). Family planning is seemed to be a cost effective strategy for preventing mother to child transmission of HIV (PMTCT). In Nepal, people living with HIV/AIDS were found to experience stigma and discrimination, ultimately resulting in discrimination of accessing health facilities. The purpose of this study is to explore the knowledge of family planning methods and identify factors affecting the current utilization of such methods among HIV infected men and women attending ART sites of Kathmandu Valley. The study is expected to contribute in enhancing the present understanding of PLHIV towards family planning.

Methods: The cross sectional descriptive method was used for the research. The study followed Population proportion to size method for the calculation of the respondents from four ART sites of Kathmandu Valley. Structured questionnaire used previously in similar research has been adopted with necessary question related to dual contraceptive use.

Results: The mean age group of the respondents was (39.16 ± 6.969) years. More than two third respondents (69.5%) were Hindu. 34.8% respondents were married at the less than 20 years of age. Almost three- fourth of the PLHIV (74.4%) were literate where more than three fourth (79.3%) their spouses were literate and educated. About half of the respondents (43.9%) were found to be involved in professional/ technical/ managerial. More than half of the respondent’s spouses (63.4%) were HIV positive. All the respondents (100%) respondents had disclosed their status to their partners. Neither the respondents nor their partner had desire of further child. 28% of neither respondents nor their partners had used the family planning methods before HIV diagnosis. More than half (60.4%) of the respondents had sexual intercourse prior to last 6 months. 15.9% of the respondents positively responded to use of dual protection. Only 11% either respondents or their partners had used the emergency contraceptive pill. 17.7% respondents did not use any family planning. This study revealed that almost half of the respondents (48.8%) had the good knowledge on the use of contraception.

Conclusion: The use of dual protection is much less than the half of the respondents. Therefore, counseling and health education towards motivating PLHIV on using dual FP methods to avoid the risk of HIV, STIs and unplanned pregnancy is encouraged.