Journal of Health Promotion The official publication of the Health Education Association of Nepal (HEAN). Health Education Association of Nepal (HEAN) en-US Journal of Health Promotion 2631-2441 <p>© Health Education Network (HEAN)</p><p>Authors are required to transfer their copyright to the Health Education Association of Nepal (HEAN).</p><p>The materials of this publication may be reproduced, reviewed and translated acknowledging the source "Journal of Health Promotion".</p> Editorial Vol.7 <p>Not available.</p> Shyam Krishna Maharjan ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 10.3126/jhp.v7i0.25488 Child Marriage in Nepal: Stakeholders’ Perspective <p>This study is about child marriage in Nepal from stakeholder’s perspective. It includes school going girls, women, teachers, health post staffs and local politicians as stakeholders and intends to find the situation, effects and perfectives of stakeholders on child marriage in Nepalese context. It comprises both qualitative and quantitative aspects followed by interview schedule and FGDs as tools. Fathers, relatives and friends were responsible for the incidence of early marriage in study site. Regarding effects, problems to become self dependent and deprivation of opportunity are the major effects that respondents had to face in their life. Workload in the families seems another effect to be faced followed by health problems to be experienced. Bleeding during pregnancy, low count of RBC, weakness, postpartum complications were seen in mothers during and after child births. Teenage mothers being more likely to experience complications during pregnancy and less likely to be emotionally, physically and psychologically prepared to deal with pregnancy related challenges, which often leads to maternal illness and consequently death was seen as the main conclusion of this study.</p> Kamal Gautam ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 1 6 10.3126/jhp.v7i0.25489 Factors Associated with Non-Use of Contraceptives among Married Women in Nepal <p>Most of the family planning services are being provided free of cost in Nepal however threat of service utilization appears unsatisfactory. This paper aims to assess the factors that are associated with non-use of family planning services among currently married women of reproductive age. The data for this paper are extracted from the Nepal Demographic and Health Survey (NDHS), 2016. Altogether 9875 currently married women of reproductive age were included in this analysis. Bivariate and multivariate analysis were performed to explore the association of socio-demographic characteristics with non-use of contraceptives. Almost a half of the sampled currently married women (47%) were non-users of contraception. Married women aged below 25 years (aOR=2.07, 95% CI 1.75-2.44) and aged 25 to 34 year (aOR=1.15, 95% CI 1.02-1.29)were more likely to not to use contraceptives compared to women aged 35 or above years. Janajati were less likely to be non-user of contraception compared to Brahmin/Chhetri (aOR=0.73, 95% CI 0.64-0.83). Muslim women were less likely to use contraception (aOR= 2.45, 95% CI 1.9-3.2) compared to Hindu women. Likewise, women who did not work currently were more likely to not use contraceptives compared to currently working women (aOR=1.47, 95% CI 1.32-1.63).Similarly, poor women were less likely to not use contraception compared to rich women (aOR=1.15, 95% CI 1.01-1.32).Similarly, women who had no autonomy were more likely to be non-user of contraceptive (aOR=1.16, 95%CI 1.01-1.32) than those how had high autonomy. Women who had not heard family planning message from TV in last few months were more likely to not use contraceptives (aOR=1.16, 95%CI 1.02-1.31) than those who had heard after controlling other socio-economic variables. Women aged less than 25 years, Muslim women, currently not working and having poor wealth status, having no autonomy in household decision making, who did not watch FP message in TV were more likely to not use contraceptive methods compared to their counter parts. Thus, family-planning-related interventions need to be more focused among younger aged women, women having no or less autonomy in decision making, poor and jobless women and Muslim women. Furthermore, women empowerment initiatives (employment opportunities) tied up with family planning programs would be beneficial to increase contraceptive uptake among married women of reproductive age.</p> Ramesh Adhikari Devaraj Acharya Chhabi Lal Ranabhat Ranju KC ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 7 18 10.3126/jhp.v7i0.25490 Risky Sexual Behaviours of Gender and Sexual Minorities <p>The article aims to explore the experiences on the risky sexual behaviours of the gender and sexual minorities in Surkhet district. It is a narrative study based on interview data. Thirty seven sexual minorities selected through snowball sampling were interviewed and the data were analyzed using thematic framework approach. The gender and sexual minority’s involve in sexual activity before their maturation at the age below 20. They have multiple sexual partners and have active sex life preferring anal and oral sexes the most. Many of them do not use condom in every sexual contact, do not visit health institutions for regular check-up, and do not test for HIV and other STDs which make them more vulnerable to diseases and poor health. They have made their sexual behaviors at more risk by their sexual involvement with drug users and their monetary involvement in sex. There is diversity in sexual orientations and behaviours among them. So an extensive and in-depth study in this issue is urgently required for the fuller understanding of socio-demographic influence on risky sexual behaviours of sexual minorities.</p> Belpatra Nath Yogi ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 19 28 10.3126/jhp.v7i0.25491 Universal Particulars towards Maternal Health Circumstance <p>Maternal health is a crucial health problem in developing countries, especially in low resource settings, rural and poor communities. The main aim of this paper is to critically evaluate and explore the situation of maternal health care in Nepal. After reviewing the literature, I found that there are several direct and indirect causes as well as affecting factors in regarding maternal death in developing and least developed countries. In developing countries, women have been facing different problems during pregnancy and delivery period. Knowledge of maternal health and assessable health facilities are most essential in rural areas to save mothers from preventable maternal death.</p> Sushil Sharma ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 27 34 10.3126/jhp.v7i0.25492 Perceived Discrimination and Problems Faced by Gender and Sexual Minorities in Kathmandu <p>Equality and freedom from discrimination are fundamental human right regardless of sexual orientation, gender identity. Despite a society that is moving forward in acceptance of differences, many young people still maintain uncomfortable and confused attitudes towards on-heterosexual lifestyles. Thus, this study was conducted to assess the perceived discrimination and problems faced by gender and sexual minorities in Kathmandu. Descriptive cross-sectional design and purposive sampling method was utilized to select sample. The study was conducted on Gender and sexual Minorities Forum Nepal, blue diamond society in Kathmandu from 17th July to 20 August 2018. Semi-structured self administered questionnaire was used to collect data, followed by some qualitative interview with selected participants. Among 112 respondents, almost half were gay, one third were transgender women and few were transgender men, lesbians and bisexuals. In work place more than half (69.1%) were verbally harassed, almost half (45.7%) were denied from job; one third (34.6%) were physically tortured. Majority of the respondents (80.5%) were verbally harassed in educational institutes, most of the respondents (91.7%) in public bathroom and public places, (84.6%) by police, almost half of all (49.4%) were physically tortured and (33.3%) were bullied in school. More than half (62.3%) were denied for house rent. Majority of the respondents (36.5%) accepted discrimination as a fact of life. Despite many supportive laws and provisions, LGBT people still face societal discrimination in Nepal. Thus, its humanitarian that sexual minorities are also a part of society and they have equal right to have dignified life.</p> Sudha Ghimire Gyanu Maharjan Binita Maharjan ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 35 42 10.3126/jhp.v7i0.25493 Premarital Sexual Behaviour and its Impact on Health among Adolescents <p>More than two-thirds of young people in developed nations have sexual intercourse while still in their teens. The most vulnerable group of premarital sexual behaviour are youths and adolescents. The aim of the study is to assess factors affecting premarital sex behaviours among adolescents and its impact on health. This study is based on the review of secondary information published by the relevant organization and authors in Nepal and beyond. Study materials were primarily identified searching through Electronic databases and Software bases. Age group of 10-19 called as adolescents during the period, there is drastic development in physical, cognitive, social and emotional development. There are multidimensional factors that leads to premarital sexual behaviour. Parent relationship withtheir children and family environment, societal environment, cultural and traditional rules and values, economic condition, school environment, peer's relationship, love and affairs, communications (mobiles, internet-pone movies etc.) and rules and regulation are the risk factors that affect in premarital sexual behaviour of the adolescents. Sex after marriage is fruitful but having a premarital sex with mutual understanding with full protection is not a big issue. Unwanted pregnancy, teenage pregnancy, abortion, STIs, HIV/AIDS, regrets, guilt, loss of self-respect, depression, loss of family support, substance abuse and even suicidal death&nbsp; are the health impact of premarital sexual behaviour among adolescents.</p> Ram Bahadur Shrestha ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 43 52 10.3126/jhp.v7i0.25496 Assessment of Healthcare Utilization among Women Experiencing Childbirth in Suburban Nepal <p>The postnatal period (birth to 6 weeks of age) is a high-risk period for mothers and their newborns. Despite significant improvements in the Nepalese healthcare system over the last decade, there is still a high incidence of maternal and neonatal deaths during the postnatal period. These factors, in addition to existing socioeconomic barriers, discourage many women from returning to these facilities for postnatal care. This study therefore, aims to determine the extent of healthcare utilization among women with recent childbirth experience in the Mahalaxmi municipality in the Lalitpur district of Nepal. This study is descriptive cross-sectional needs assessment utilizing a pre-tested survey instrument administered to ninety-eight women who were randomly selected from the semi-urban Mahalaxmi municipality. All the respondents reported that they received ante-natal care during their pregnancy. A majority of the women reported that they received perinatal care from physicians. The results of the study showed that although there was a significantly high utilization of ante-natal and perinatal care among women with recent childbirth experience, most of the women were unaware of the availability or necessity of postnatal care, despite the accessibility of physicians and healthcare facilities.</p> Shelly Xu Cyril Blavo D.O. Sujan Babu Marahatta Mayur Banjara Rakchya Amatya Patrick Hardigan Nadia Anderson ##submission.copyrightStatement## 2019-09-06 2019-09-06 7 53 64 10.3126/jhp.v7i0.25497 Water Supply, Sanitation and Hygiene Situation in Nepal: A Review <p>Federal Democratic Republic of Nepal is a landlocked country located in South Asia. Nepal has made its considerable efforts to improve the water supply and sanitation (WASH) situation in the country by formulating and enforcing a number of WASH policies, guidelines and acts for the last two decades. But WASH situation of Nepal has not been well documented so far. Aim of this article is to describe the situation of water supply, sanitation and hygiene (WASH) in Nepal by analyzing secondary data and information obtained from published and unpublished literature. About 97 of the total population have access to basics anitation facilities and 87 percent access to basic water supply facility. Sanitation coverage is95 percent in six Provinces and below 90 percent in Province no. 2 of Nepal. The momentum of sanitation coverage was accelerated immediately after internalization and implementation of the Sanitation and Hygiene Master Plan in 2011 and Nepal reaches at close to the elimination of open defecation. The gap between rich and poor in accessing to and using toilet facility has been narrowing down due to the nationwide sanitation campaigns. But there is disparity in accessing and using piped water between rich and poor. Only 25 percent of water supply systems are well functioning and 68 percent can supply water to water taps throughout year. One-fourth of the existing toilet facility across the country are poorly constructed that needs to be upgraded. The government should make consolidated and integrated efforts to reduce existing inequity in the WASH sector and enhance the sustainability of water supply and sanitation services.</p> Chitra Bahadur Budhathoki ##submission.copyrightStatement## 2019-09-08 2019-09-08 7 65 76 10.3126/jhp.v7i0.25513 Surviving Research between Two Guns: Lessons Learnt from Nepal <p>Nepal’s decade long violent conflict (1996-2005) between the Nepal Communist Party (Maoist) and the Government of Nepal resulted to over 14000 deaths and thousands others became disabled and lost their properties. During this violent war, the Maoists developed their own health cadres mainly to treat the combatants and the community people under their control areas to some extent. This paper is based on author’s personal account of field experiences while conducting PhD research using mixed methods study comprising in-depth interviews and self-administrated questionnaire on the former Maoist health workers in Nepal. This study suggests a few dilemmas the first author confronted with while under taking this research. First and foremost is the risk involved to both the researcher and the participants in the absence of trust and security on both sides of the conflict. Secondly, the sources of information could easily be biased either deliberately (as propaganda) or more subtly based on respondents’ perspectives. The issues of accessing the research participants, relationships, complicity, representation and being rejected by a contact are pertinent issues when carrying out independent research. Thirdly, maintaining ethics and keeping a right balance between research, humanity and sense of justice is also the dilemma that might have affected the research findings derived from dangerous environments. Fourthly, lack of precise methods that are valid and reliable to investigate certain dynamics of conflict in the politically violent and crisis environment could be equally contested. Fifthly, undertaking cross disciplinary research on a conflict-related topic during wartime by a researcher with background in allied field is even more challenging. The researcher need to have both an in depth knowledge of conflict theories as well as being able to apply these to another discipline which can be cumbersome. This article presents a personal account of a Rotary fellow who conducted his public health research among the Maoists combatant health workers of Nepal. It presents his lived experiences that could be important in carrying out appropriate and credible research during violent conflict elsewhere in future.</p> Bhimsen Devkota Edwin van Teijlingen ##submission.copyrightStatement## 2019-09-08 2019-09-08 7 77 82 10.3126/jhp.v7i0.25517 Role of Health Literacy on Menstrual Hygiene Practice among the Girl Students <p>The main aim of this study was to find out the role of health literacy on menstruation hygiene practice of campus girls. The population of this study were girls studying health and physical education in Surkhet Campus and HA/Staff Nurse in SEDA Campus. Surkhet was selected by proportional stratified sampling. This study followed descriptive and cross-sectional design. The study used two tools Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Self Administrated Questionnaire for collecting data. It was found that health literacy among girls of study area is not satisfactory. The findings indicate that 53.93 percent respondents have adequate health literacy. Adequate health literacy level of girls of HA/Staff nurse, aged 16-18 years and 19-21 years and Chhetri and Janajati had adequate health literary. The findings support that higher proportions of the adequate health literate respondents have good menstruation hygiene practice than inadequate health literate respondents. Finally, the results indicated that health literacy among the girls is inadequate, that calls more concern to the matter of health literacy in educational programs.</p> Shanti Prasad Khanal ##submission.copyrightStatement## 2019-09-08 2019-09-08 7 83 90 10.3126/jhp.v7i0.25518 Food Consumption Habits and Nutritional Status of Women and Infants <p>This paper attempts to find-out the existing knowledge of nutrition on food consumptions and dietary practices of women and infants. I have used the systematic review of the Hinari database which were published from 2012 April to 2018.These data show that women and infant food consumption behaviour and nutrition status is directly related to family food consumptions. Research shows that low cobalamin and folic acid was found in women before they conceive and folate deficiency was uncommon on food consumptions. Low intakes of iron are consistent with a high prevalence of an aemia seen in the six to twenty-four months of children. Food beliefs and practices tend to reduce women’s consumption of micronutrient-rich foods, such as dietary restrictions during menstruation, pregnancy and lactation. The research shows that are overlapping with these beliefs and practices on intra household allocation of food. The poor dietary practice among pregnant women which ranges from 39.3 percent to 66.1 percent have limited nutritional knowledge and wrong perception towards dietary behaviour. It was also found that basis underweight is greater in rural areas (31 percent) than in urban areas (23 percent). Those children whose mothers are illiterate are more than twice as likely to be underweight than the children whose mothers have at least basic education.</p> Tanka Maya Pokharel ##submission.copyrightStatement## 2019-09-08 2019-09-08 7 91 98 10.3126/jhp.v7i0.25519 Risk of Zoonoses among Livestock Farmers in Nepal <p>In Nepal most of the people are engaged in agriculture and livestock farming but having low knowledge and poor practices are making them prone to zoo noses threats. The aim of this study is to identify the risk of common zoo noses and existing knowledge, practices among livestock farmer in Nepal and all over the world. The study was conducted based on literature review. Literature search from Google Scholar, Pub Med and Hinari databases was used for the study. The study shows that farmers have low knowledge and risky practices related to zoo noses. Sixty-five percent (n=40) of pork handlers were not following safety. Thirty six percent cattle farmers used to dispose placenta, 39.65% of them aborted foetus. Similarly, 23.25% farmers gave intra uterine medication with bare hands and 30% were sleeping in animal shed (n=250). African and South East Asian countries are facing more burden of zoo noses. Due to global warming and climate change, different zoo noses are emerging and re-emerging presentation in the world. Different research findings suggest that "One Health Approach" might help to fight against the zoo noses all over the world.</p> Ramesh Adhikari Kosh Bilash Bagale ##submission.copyrightStatement## 2019-09-08 2019-09-08 7 99 110 10.3126/jhp.v7i0.25520