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> The smoking behavior of women of reproductive age in Nepal <p>Smoking, the leading cause of preventable deaths worldwide, which is more detrimental to women not only increases the chances of infertility and miscarriage, but hastens the onset of menopause and causes women to be more susceptible to depression, decreased bone density, cataracts, and skin diseases. This paper investigates the smoking behavior and factors influencing smoking among women of reproductive age in Nepal. The study used secondary data from the 2016 Nepal Demographic and Health Survey. A total of 12,862 women of the reproductive age group were covered in the survey. The association between smoking and the explanatory variables was first assessed in bivariate analysis using the Chi-square test. The associations were further explored using multivariate logistic analysis. Nearly two-fifths (38%) of women were aged 15-24 years. Overall, 8% of women used tobacco products (smoking/chewing). Multivariate analysis showed that women aged 35 and above were almost seven times (aOR=6.52, CI=4.75-8.94) to be smokers than younger women. Separated/divorced/widowed women were nearly twice (aOR=1.86, CI=1.14-3.01) as likely to be smokers than their counterparts. Education is a significant predictor of smoking as women having primary (aOR=0.65, CI=0.54-0.78) and secondary/higher education (aOR=0.21, CI=0.16-0.26) were less likely to smoke than women with no education. Dalit women were nearly two times more likely to be smokers than higher caste Brahmin/Chhetri. Similarly, the richest and richer women were less likely to smoke than the poorest women. Age, education, marital status, caste/ethnicity, and wealth index were significant determinants of smoking among women. Hence, tobacco control interventions need to be focused on women of higher age groups and uneducated and poorer women. </p> Ramesh Adhikari Aakriti Wagle Min Raj Adhikari Copyright (c) 2021 2021-11-30 2021-11-30 9 01 8 18 10.3126/jhp.v9i01.40958 Ethnocultural influences for zoonoses transmission in multi-ethnic communities in Nepal <p>Animals contribute to a pivotal role in human societies. Occupational exposure to animals is barred in several ethnicities in Nepal. Limited studies have been found on zoonoses-related diseases and their knowledge, practices, and perception regarding ethnic groups. This study aims to identify the associated factors for human closeness to animals and their host characteristics related to ethnocultural practices. A total of 20 articles were reviewed. In addition to the review, 25 people from different ethnic groups were interviewed. The ethnomedicinal practice and host characteristics of animals for various zoonoses were reviewed from published papers and database journals. There are 1415 species identified as pathogenic to humans, 61% categorized as zoonotic, and of the 175 newly emerging pathogens, 75% are listed as zoonoses. Almost all studies among ethnic groups in Nepal revealed that people interact closely with animals for several reasons, including cultural, religious, and ethnomedical practices. Most of the domesticated animals are also possible hosts for the transmission of zoonoses. So, creating awareness about preventing zoonoses is crucial for the protection of the human race. These findings call for immediate action by government and policymakers to control prevalent zoonoses by commencing proactive activities among at-risk groups.</p> Kosh Bilash Bagale Ramesh Adhikari Devaraj Acharya Basant Gaire Bidhusi Pokhrel Copyright (c) 2021 2021-11-30 2021-11-30 9 01 19 31 10.3126/jhp.v9i01.40959 Experiences of the COVID-19 infected persons during isolation in Nepal <p class="Default"><span style="font-size: 11.0pt;">Isolation is the separation and restriction of movement of people diagnosed with COVID-19 positive. Isolation is one of the best measures for preventing and controlling pandemics; however, it might be stressful. This study intends to explore the perceptions of COVID-19 infected people towards the COVID-19 pandemic and their experiences at Nepal's isolation centers with the broad theoretical frame of the transactional theory of stress and coping by Lazarus &amp; Folkman (1986). This qualitative study was conducted in institutional isolation centers in Nepal's Morang, Rautahat, Sindhupalchowk, Tanahun, Banke, Surkhet, and Kailali districts. Thirty-five participants, five from every seven provinces, were selected using a purposive-convenient sampling method. Data were collected through interviews in the period of October to December 2020. The findings of the study have been presented in four different themes: personal and environmental attributes, perception of COVID-19 as a stressor, short-term outcome based on situation, and adoption of coping mechanism. There were individual differences in perceiving the COVID-19 as a stressor. Environment and available facilities acted as another source of stress. Similarly, anxiety, irritation, lack of sleep, loss of appetite resulted from stress while staying in isolation. Regarding the coping mechanism of the stress, most participants were found to use mobile phones, play games, watch movies, and talk to family members. We recommend emphasizing psychological intervention comprising meditation, outdoor games, yoga, and counseling in institutional isolation based on this study.</span></p> Sudha Ghimire Govinda Prasad Devkota Madhavi Gautam Ghimire Sushil Sharma Bhagawati Sharma Belpatra Nath Yogi Prayag Raj Joshi Khem Kumar Bhurtel Anil Kumar Mandal Copyright (c) 2021 2021-11-30 2021-11-30 9 01 32 41 10.3126/jhp.v9i01.40960 Maternal health care services in Nepal: A qualitative perspective based on the socio-ecological model <p class="Default"><span style="font-size: 11.0pt;">Nepal has a high Maternal Mortality Rates (MMR) in the South Asian region, partly due to the poor utilization of maternal and child healthcare services. The study aims to explore the influencing factors of maternal and child healthcare services among Nepalese women. Eighteen women, who had seven-days-old-children and those recently accessed maternal and child healthcare practices, were purposively selected. The face-to-face, In-depth-Interview (IDI) was applied to collect the information. The data were thematically analyzed, where Socio-Ecological Model (SEM) was applied as a theoretical framework. The study showed that the factors such as the knowledge of women, perception, and decision-making-autonomy at individual levels influenced maternal and child healthcare-seeking behaviors. Likewise, mothers-in-law and the role of husbands at intrapersonal levels, employment at institutional levels, peers and role of neighbors at community levels, and safe motherhood program at policy levels were significant factors for the utilization of maternal and child healthcare-seeking-behaviors. The negligence of women concerning pregnancy, inadequate health facilities, lack of specialist health workers with advanced equipment, and cultural taboos and beliefs were observed as score barriers for utilization of maternal and child health-seeking behaviors. The research strongly recommends that all women be aware of maternal and child healthcare and health-seeking behaviors at their initial ages. </span></p> Mohan Kumar Sharma Shanti Prasad Khanal Ramesh Adhikari Jib Acharya Copyright (c) 2021 2021-11-30 2021-11-30 9 01 42 54 10.3126/jhp.v9i01.40961 Body mass index (BMI) of vegetarian and non-vegetarian children in Nepal <p>This article builds upon a study that aimed to evaluate the BMI differences among vegetarian and non-vegetarian children of Nepal and to recommend the diet practice of growing-age children. A descriptive cross-sectional study was conducted to determine physical growth and calculate the BMI values of 1251 Koiri and Yadav children aged 6-14 years who were selected for the study. Data were analyzed based on age, sex, vegetarian and non-vegetarian children. The average BMI value wt (kg)/ht (m<sup>2</sup>) of non-vegetarian children was significantly higher than the vegetarian in both sex groups. The finding of the study clearly shows that vegetarian diet practice in children is smaller than the non-vegetarian. The study recommends that vegetarian group children required more plant source protein food for favorable growth and balanced physical growth, good health status to maintain different physical and mental disabilities, and enhance school performances. Protein requirements on vegetarian children may be fulfilled if the diet includes different varieties of plant-based protein sources in their regular meals. Therefore, the study recommends that vegetarian families regularly include protein-rich foods for the growing-age children, such as legumes, beans, different seeds and nuts, and a variety of protein sources.&nbsp;</p> Usha Acharya Jun Nakanishi Copyright (c) 2021 2021-11-30 2021-11-30 9 01 55 64 10.3126/jhp.v9i01.40962 Teachers' persuasion to modify health behaviors among students of Bagmati Province, Nepal <p>Teachers encounter many of the unhealthier behaviors of students that need their support in improving such behaviors. Teachers employ various techniques including instruction, persuasion, and demonstration. They are role models to their students because they present opportunities for observational learning. Teachers can consciously attempt to influence students to change through persuasion. This cross-sectional descriptive survey of 344 teachers in 46 secondary schools aimed to identify the type of health degrading behaviors of the students modified by the teachers and the actions taken in modifying such behaviors, particularly including health persuasion. Teachers were found to involve in the act of persuasion, however, their action was mostly moving around the 'instruction' and 'advise' as the tools for modifying the student's health deteriorating behaviors. More effective persuasive <br>techniques such as demonstrating healthy behaviors by the teachers are necessary to bring evident change.</p> Bhagwan Aryal Ram Krishna Maharjan Copyright (c) 2021 2021-11-30 2021-11-30 9 01 65 73 10.3126/jhp.v9i01.40964 Antenatal care among women in Chitwan district of Nepal: A cross-sectional study <p>Antenatal care is one of the most effective measures to reduce maternal mortality in Lower Middle-income Countries. The study aims to assess the utilization of antenatal care and related factors by breastfeeding mothers in Chitwan district of Nepal. A cross-sectional study was carried out in Bharatpur municipality in April 2020, among all women of the reproductive age group (15-49) who have had a birth child in the last 12 months before the survey date. A census sampling technique was used to select respondents. The vaccination period was two weeks. All the mothers who came to the vaccine center to vaccinate their children were the respondents of this study. The data were collected by using an interview schedule. The collected data were managed using SPSS Version 20. The study found that 84.31 percent of respondents attended more than four antenatal care utilization. The educational level of the respondents and the occupation of their partners were linked to the use of antenatal care. The number of pregnancies, the number of live births, the place of delivery, and the educational level and occupations of the birth attendees were also significantly linked to the use of antenatal care. Community mobilization and intensive use of community health workers are essential factors to improve the use of antenatal care.</p> Sharmila Pokharel Ram Krishna Maharjan Copyright (c) 2021 2021-11-30 2021-11-30 9 01 74 86 10.3126/jhp.v9i01.40968 Perceived threats towards COVID-19 pandemic among Nepali migrant workers returned from India <p>Evidence shows that the seasonal migrants returned from India have been a source of COVID-19, which helped spread it across Nepal. This cross-sectional study, guided by the Health Belief Model (HBM) model, that people's underlying believes in this case around COVID-19, is determined by a large extend their subsequent behaviors. This study aimed to examine the association between personal characteristics and perceived threats regarding COVID-19 among 384 seasonal migrants who had returned from India and were staying in a quarantine center in Surkhet, Nepal. A questionnaire was used with the help of three health workers working in the Quarantine Center. A five-point sequential grade Likert scale was constructed based on two HBM constructs, like 'perceived susceptibility' and ‘severity.' A score ≥ of 50% was designated as high, and ≤ 50% as a perceived low level of threat. Univariate and bivariate analyses were performed to interpret the data using SPSS 20 version. Generally, participants regarded the threat of COVID-19 as low. The severity of COVID-19 was thought to be greater than the vulnerability of the subjects. Gender, age, caste, education, health status, and perceived susceptibility did not correlate with perceived susceptibility. However, the participants’ demographic characteristics were associated with their perceived level of severity. Therefore, this study calls for proper risk communication to people who returned from abroad, as this is essential in promoting protective behavior during a pandemic outbreak. </p> Shanti Prasad Khanal Edwin van Teijlingen Mohan Kumar Sharma Jib Acharya Sharma Sharma Copyright (c) 2021 2021-11-30 2021-11-30 9 01 87 99 10.3126/jhp.v9i01.40970 Access and utilization of the youth-friendly sexual and reproductive health services in Nepal: What does literature show? <p>This study has attempted to assess the access and utilization of youth-friendly sexual and reproductive health services in Nepal. Different literature regarding youth-friendly sexual and reproductive health services has been reviewed using online databases. A total of 125 relevant articles were assessed for the study. The literature was categorized and analyzed with five key thematic areas: knowledge on SRH among youths, the prevalence of child marriage and teenage pregnancy, attitudes towards premarital sex, utilization of SRHs, and barriers to utilizing the SRHS. This study has found that youths do not always utilize SRHS. Various barriers exist for providing and using YFSRHs in Nepal. Nepal's adolescents and youths face problems of STIs, HIV/AIDS, early pregnancy and parenthood, difficulties accessing contraception, and safe abortion. The study has also found that many countries have single youth-friendly sexual and reproductive health policies and that utilization of SRHS is also high in those countries. Moreover, this review has also found that because of inadequate knowledge and information on SRHS, Nepalese youths are facing numerous reproductive health problems. Multiple factors contribute as barriers to utilizing the SRHS. Therefore, there is a need for a program to motivate youths to respect their right to access reproductive health information and service, ensure the availability of peer counselors in the health centers, and increase the awareness level of the community so that they can utilize the quality of SRHS.</p> Bhabani Adhikari Ramesh Adhikari Copyright (c) 2021 2021-11-30 2021-11-30 9 01 100 115 10.3126/jhp.v9i01.40971 Editorial Vol.9 (2021) <p>Not available. </p> Shyam Krishna Maharjan Copyright (c) 2021 2021-11-30 2021-11-30 9 01 10.3126/jhp.v9i01.40954 Understanding health education, health promotion and public health <p>Across the globe, there can be confusion about the difference between the concepts of health education, health promotion and, often also, public health. This confusion does not limit itself to the individual terms but also to how these terms relate to each other. Some use terms such as health education and health promotion interchangeably; others see them clearly as different concepts. In this theoretical overview paper, we have first of all outlined our understanding of these individual terms. We suggest how the five principles of health promotion as outlined by the World Health Organization (WHO, 1984) fit into Tannahill’s (2009) model of three overlapping areas: (a) health education; (b) prevention of ill health; and (c) health protection. Our schematic overview places health education within health promotion and health promotion itself in the center of the overarching disciplines of education and public health. We hope our representation helps reduce confusion among all those interested in our discipline, including students, educators, journalists, practitioners, policymakers, politicians, and researchers.</p> Kitty R. van Teijlingen Bhimsen Devkota Flora Douglas Padam Simkhada Edwin R. van Teijlingen Copyright (c) 2021 2021-11-30 2021-11-30 9 01 1 7 10.3126/jhp.v9i01.40957