Journal of Health Promotion The official publication of the Health Education Association of Nepal (HEAN). en-US <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> (Prof. Shyam Krishna Maharjan, PhD) (Sioux Cumming) Mon, 23 Nov 2020 18:10:46 +0000 OJS 60 Editorial Vol.8 <p>Not available.</p> Shyam Krishna Maharjan Copyright (c) 2020 Health Education Network (HEAN) Fri, 20 Nov 2020 00:00:00 +0000 The Role of Health Promotion during the COVID-19 Pandemic <p>Not available.</p> Padam Simkhada, Preeti Mahato, Pasang Tamang, Edwin van Teijlingen, Prakash Shahi Copyright (c) 2020 Health Education Network (HEAN) Fri, 20 Nov 2020 00:00:00 +0000 Awareness of Weight and Situation of Body Mass Index and Hypertension in Nepalese Teachers <p>Teachers are the role models to their students in terms of health and wellbeing, in particularly the nutritional status and physical outlook. These present opportunities to students for observational learning. However, many teachers face health complications which are not even perceived as a threat by them to their career and life. This study was conducted to determine the awareness of weight and current status of body mass index and hypertension among the Nepalese school teachers. It also examined the association between the BMI and hypertension. Randomly selected secondary level teachers in the Bagamati province of Nepal were the respondents. A cross-sectional descriptive research was conducted. Self-administered questionnaires were used to collect data. Age-wise relationship was found with BMI and hypertension. More the age, higher was the BMI category and so was the blood pressure. Risky situation of BMI and hypertension among senior teachers could create a threat to the teachers’ wellbeing and a setting for poor observational learning to the students. Teachers need to focus on improving their lifestyle and activities to better their conditions and present healthy role modeling.</p> <p>&nbsp;</p> Bhagwan Aryal Copyright (c) 2020 Health Education Network (HEAN) Fri, 20 Nov 2020 00:00:00 +0000 Perpetrators and Common Places of Sexual Harassment Against Adolescent School Girls in Nepal <p>&nbsp;The main aim of this study was to find out the vulnerable places of sexual harassment to the girl students and the persons involved in such unwanted behaviors. It was a mixed-methods study. Altogether 773 girl respondents were selected for obtaining quantitative data from Lalitpur and Rupendehi districts in Nepal. Similarly, 10 focus group discussions, 14 Key informant interviews, and eight In-depth interviews were conducted for collecting qualitative data. The result showed that male peers/ friends, teachers, neighbors/ relatives, and strangers were involved in sexual harassment. Frequency of verbal/gestural type of sexual harassment is higher from male peers and touching/pinching and sexual abuse/assault types of sexual harassment are more common from teachers and relatives. Sexual harassment frequently happens in public transport. In society, teachers deserve great respect and trust from parents and students. They have close access to girl students. However, such trust and closeness transformed into sexual harassment whereby accelerating sexual harassment. The higher incidence of sexual harassment at public transports might be due to the proximity and anonymity, which, in turn, results in high levels of sexual harassment and abuse with very little risk of social or legal consequences. The awareness program against sexual harassment and strong laws and order are essential and the judiciary process should be simple and victim-friendly that can reduce sexual harassment to girl students by various perpetrators at different domains in society.</p> <p>&nbsp;</p> Kalpana Gyawali Copyright (c) 2020 Health Education Network (HEAN) Fri, 20 Nov 2020 00:00:00 +0000 A Review of Parental Role on Risky Sexual Behaviour of Adolescents <p>Adolescence is a phase in human life which is characterized as the growing desire for sexual intercourse. Furthermore, the lack of knowledge on sexual health during this phase may result in risky sexual practices. So, parental monitoring is essential for this group of people. On this basis, I have conducted a review on parental monitoring of risky sexual behaviour of adolescents. While reviewing, accessible and eligible resources are consulted from PubMed, Hinari, Research Gate, etc up to November 2018. This review primarily focuses on how the parents monitor the probable risky sexual practices of their adolescent children. On the basis of existing literature, this review attempts to explore the growing risky practices of sexual behaviour among children without parental guidance.</p> <p>&nbsp;</p> Sushil Sharma Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Premarital Sexual Behaviours among Secondary School Adolescents: A Cross-sectional Study in Kathmandu <p class="Default" style="text-align: justify;"><span style="font-size: 14.0pt; font-family: 'Times New Roman','serif';">Young people’s sexuality is often stigmatized in South Asian societies, including Nepal, where premarital sex is not accepted socially and culturally. However, the prevalence of early sexual activities among adolescents has increased over time. Given this background, this paper aimed to explore the prevalence of premarital sexual behaviour among the urban high school adolescents. This study utilized a cross-sectional design and collected a total of 609 students of grade 9-12 [ages 10-19] from both community and institutional schools in the Kathmandu metropolis. A validated structured questionnaire was employed and data were analyzed using SPSS with version 24. Univariate, bivariate, and multivariate analyses were performed to interpret the results. The study showed that the mean age of the respondents was 16 years. More than half of adolescents (52.4%) ever watched pornography, amongst whom eight percent did it on a regular basis. Similarly, 14 percent of in-school adolescents ever experienced premarital vaginal sexual intercourse, where the median age for the sexual debut was 16 years. Male respondents tended to be 13 times more likely to have premarital sex compared to the girls. Respondents who were exposed to pornography materials were likely to be exposed by 5.7 times higher than that who were not. Further, 48 percent respondents who ever had sex did not use condoms during their first sexual intercourse, followed by 45 percent who had multiple sex partners.The study concluded that a notable proportion of adolescents was involved in premarital sexual behaviours followed with vaginal sexual intercourse, especially among the boy students. Hence, the results of this study suggest school-based comprehensive sexuality education to minimize the risky sexual behaviour and promote the safer sexual activities among the secondary level school adolescents. </span></p> <p class="Default" style="text-align: justify;"><span style="font-size: 14.0pt; font-family: 'Times New Roman','serif';">&nbsp;</span></p> Yadu Ram Upreti, Devaraj Acharya Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Intimate Partner Violence Against Women in Kohalpur Municipality of Banke District, Nepal <p>&nbsp;Intimate partner violence (IPV) is abuse that occurs in a close relationship. The main purpose of this study is to determine the forms and risk factors associated with violence as well as the effect of demographic elements on IPV. The population of this study was all the women of the reproductive age group in Ward No. 7 of Kohalpur Municipality Banke district, Nepal. For this study 151 married women aged 15-49 years were selected from Kohalpur municipality by using. convenience sampling method. Data were collected through the interview schedule and attitude scale. The researcher has found that 33.11 percent respondents strongly agreed that they were afraid of their husbands and 53.64 percent respondents strongly agreed that their husbands physical forced to have sex. Likewise, 17.21 percent respondents pointed IPV is due to lack of education and 55.62 percent due to gambling and drinking behaviors of their husbands. Similarly, 6.62 percent respondents pointed out that it is due to fewer dowry system. IPV, a serious problem, has long-lasting effects on individuals, families and society also. So this has to be prevented. To reduce the proportion of IPV, healthy, respectful, understanding and an appropriate environment has to be promoted instead of violent relationships.</p> <p>&nbsp;</p> Bhagawoti Sharma Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Factors Associated with Early Marriage in Rural Mid-Western Nepal <p>&nbsp;Early (or child) marriage is a global public health issue influenced by a complex web of factors including socio-demographic conditions of the people. The present paper aims to examine factors associated with early marriageamong the people in rural communities of Nepal. A cross-sectional end-line study was carried out among 155 married respondents selected through cluster cum convenience sampling from six clusters of two rural districts of Mid-western Nepal. The mean age at first marriage was 18.4 years (SD=3.83). Two-third of them had an early marriage and the proportion of early marriage was remarkably higher among women than men (77.8% vs. 42.6%). The prevalence of early marriage was the most common among those of women, age-group of 35-44 years, illiterate and basic literate ones, nuclear and small families, and <em>Janajatis</em>. Sex and educational status of the respondents had a statistically significant association with their marital age (p &lt; 0.05) and were major factors associated with early marriage but other socio-demographic factors such as age, caste/ethnicity, family type, family size and source of income were notfound directlyassociated with early marriage for the sample. Future research efforts should prioritize gender-transformative interventions to recognize and confront inequitable gender norms and actions.</p> <p>&nbsp;</p> Belpatra Nath Yogi Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Menstrual Hygiene Management and Practices in Campuses <p>&nbsp;Studies on menstruation hygiene management (MHM) in education have focused mostly on adolescent school girls indicating the need to investigate this particular phenomenon in the context of higher education. In this study, I wanted to explore the experiences of female students and teachers during menstruation while they are at the campus and document them to unpack the realities of the phenomenon to persuade the campus authorities for better MHM on the campuses. Using the qualitative design, the study is aimed at exploring and probing students and teachers on their MHM practices. This research has nested the life experiences of myself and participants of purposively selected two constituent and one affiliated campuses of Tribhuvan University in the Kathmandu Valley. In-depth interviews with six teachers and focus group discussions with six groups of students were included in this study. The research revealed multiple issues during menstrual hygiene management that include lack of appropriate water sanitation and hygiene (WASH) facilities, no access to emergency absorbent during menstruation, no provision of pain killer medicines during uterine cramps (dysmenorrhea) and back-aches and no provision of dust bin for absorbent disposal. This indicates that higher education institutions in Nepal need to pay more attention to ensure dignified menstruation on campus.</p> <p>&nbsp;</p> Madhavi Gautam Ghimire Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Problems and Practice of Management on Menstruation by Adolescents Girls of Basic Schools of Chitwan, Nepal <p>Managing menstruation in a hygienic way is a challenge in most of the low and middle-income countries (LMIC) including Nepal, where normal and natural physiological process of menstruation is considered as girls’ problem which is viewed as sinful, unholy and matter of shame. This paper explores the current practice and existing difficulties that adolescents girls encounter hygienic management of menstruation (MHM) especially during school days. The study was conducted on five purposively selected community schools of Chitwan district. The study adopted Participatory Action Research (PAR) as an approach, that is encapsulated with mixed method research design. For qualitative information observation, focus group discussions (FGD) and field notes were used, whereas for quantitative data self-administrative questionnaires were used. Quantitative information was collected from 205 girls students who were present at schools on the day of data collection. The finding shows that majority of the girls (93.7%) who encounter hygienic management of menstruation were of 10-14 years old age, whereas nearly one third of them were (29%) from grade eight. Similarly, among the total 205 girls, only 79 girls have already started their menstruation; among those who have started menstruation majority (78%) had heard about menstruation form their mothers. Likewise, 35% girls used homemade cotton pads and 40.5% of them changed pad three times a day. During FGD, adolescents girls shared that lack of water and soap in toilets, stress and lack of concentration during menstruation are the major difficulties which they encounter during days of menstruation. They suggested the concerned authorities to manage pad bank, make soap and water available, and develop skills for proper disposing of used sanitary pads for MHM at schools.&nbsp;</p> Sudha Ghimire Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Multi-level Barriers for Utilization of Youth Friendly Reproductive Health Services (YFRHS) among Youths <p>&nbsp;The present study aims to examine the multi-level barriers to utilize by the youth-friendly reproductive health services (YFRHS) among the school-going youths of the Surkhet valley of Nepal. This study is based on the sequential explanatory research design under mixed-method research. The quantitative data were collected using the self- administered questionnaire from the 249 youths, aged between the 15-24 years, those selected by using random sampling. The qualitative data were collected using the Focus Group Discussions (FGDs) from the 12 participants who were selected purposively. The study confirmed that school-going youths do not have appropriate utilization of YFHS due to multi-layered barriers. However, the utilization of the service was higher among females, those the older age group, studying in the upper classes, the upper castes, and married youths. The key findings and themes are recognized as multi-layered barriers including personal-level, health system-level, community-level, and policy-level on the entire socio-ecological field. Among them, the existing health system is the foremost barrier. Multi-level interventions are, therefore, required to increase the YFRHS utilization and improve concerns for school-going-youths.</p> <p>&nbsp;</p> Shanti Prasad Khanal Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Knowledge and Use of Emergency Contraceptive Pills among Bachelor's Level Female Students of Kathmandu Valley <p>&nbsp;Emergency Contraceptive Pill (ECP) is used for preventing pregnancy after having unprotected sexual intercourse, contraceptive failure or forced sex. The use of ECP within 120 hours of sexual intercourse could prevent unwanted pregnancy and its adverse effects particularly unintended childbirth and unsafe abortion. The study, therefore, aimed to assess knowledge and use of emergency contraceptives among Bachelors level female students from Kathmandu Valley. A descriptive cross-sectional study was undertaken from August to November 2017 among 347 female students who were studying at the Bachelors's level. A random sampling technique was used to select study participants and a structured self-administered questionnaire was used to assess the knowledge and use of ECP after securing informed consent. Epi data and SPSS version 22 were used for data processing and analysis. The mean age of the female students was 21.5 years. Overall, 91.4% of the respondents had ever heard about emergency contraceptives. The main sources of information were radio or television, the internet and newspapers. About 4.6% of the undergraduate female students used ECP. Age, marital status, use of contraceptives and knowledge of ECP used within 72 hours were significantly associated with use of ECP. Although the findings of this study showed a high prevalence of knowledge among respondents, the improvement of female students’ knowledge on specific details of ECP and its advantages/disadvantages and timely utilization needs to be considered for any future awareness programmes.</p> <p>&nbsp;</p> Bhu Dev Jha Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Teachers’ and Parents’ Perceptions on Eating Behaviour of Primary School Students: A Qualitative Study <p class="Default" style="text-align: justify;"><span style="font-size: 10.0pt;">This study explores the perceptions involved in the healthy eating behaviour of 1st, 2nd, and 3rd-grade students in a primary level community school in Nepal. A total, ten observations during mid-day meal and three focus group discussions were conducted among teachers and parents. Sixty students from grade one to three, five teachers and sixteen parents took part in the study. All the participating teachers and parents were engaged in dialogue conferences during focus groups and students’ eating behaviours were observed by the teachers and parents during tiffin time throughout the study. Thematic-content analysis based on the qualitative approach was used on the collected data from the field notes during a series of participant observations and focus group discussions. It is found that the family norms and feeding culture around a child’s domestic life have an active role in establishing and promoting healthy habits that persists throughout. It is also noted that parental food habits and feeding strategies are the most dominant determinants of children eating behaviour and food choices of mid-day meal during tiffin time at the school. It is recommended that parents and teachers should expose their children and students to a range of good food choices and acting as positive role models. </span></p> <p class="Default" style="text-align: justify;"><span style="font-size: 16.0pt; font-family: 'Times New Roman','serif';">&nbsp;</span></p> Milan Acharya, Kamal Prasad Acharya Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Street Children in Nepal: Causes and Health Status <p>&nbsp;Street children refer to the children who have not reached adulthood, for whom the street has become their habitual abode and/or a source of livelihood. The reasons for their connection to the street will vary from nation to nation, city to city, and from person to person. This research envisaged to explore the causes of being street children and assess their health status of two study areas, Kathmandu and Birjung, Nepal. The research followed descriptive, exploratory and applied 'QUAN-qual', quantitative dominant mixed methods. The two: semi-structured questionnaire with 150 participants for quantitative data and Key-in-depth interviews (KIIs) with 18 participants for qualitative data were employed in this research. The research areas were purposively selected as per the researcher's pre-observation and respondents on the basis of convenience sampling. The quantitative data were analyzed using the Statical Package for the Social Science (SPSS) software version 20.0 and qualitative data were thematically analyzed using content analysis. The findings of the study depicted that the dominant causes to be street children are family-based causes. Economic, social, and other causes are second, third, and fourth respectively in the study area. Additionally, gender and alcohol consumed behavior was found significant where education level and age had no significance to determinants of the health status of street children. The overall implication of the study signifies that the attention has been shifted from treating the biological to encouraging street children to gain positive necessary health skills that are based on self-care and self-management behaviors including knowledge, beliefs, attitude, motivation, and behaviors.</p> Mohan Kumar Sharma Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000 Effect of a Pilot Programme by Capability Approach to Prevent Lifestyle-related Diseases in Kaski, Nepal <p>&nbsp;In the rural area of Nepal, lifestyle-related non-communicable diseases (NCDs) are emerging in recent days. We piloted a program model (2017-2019) to protect people from lifestyle-related diseases in a remote village of Kaski district where the health facilities are limited. This program was supported by Japan International Corporation Agency. We aimed to initiate a simple model of health monitoring to reduce the risks of lifestyle-related diseases. Health monitoring (blood pressure and body weight measurement) together with peer education regarding lifestyle-related disease was conducted by trained volunteers on regular bases. One-group pre-test–post-test research design was used to measure the impact of the program on the 104 participants with the age ranging 52±8.99 years in female and 57±7.38 years in male, sampled from the 100 households in the target village, Gairegaon. The double burden of underweight and overweight was observed in the programming community. After the program was conducted for one year, the percentage of people who is in the normal body mass index (BMI) range was significantly increased from 68.2% to 75.9% in total. Similarly, the ratio of normal blood pressure rose up significantly from 40.4% to 59.6%. This program results suggested that the community-led capability approach works effectively with locally affordable cost to change the behavior of people to reduce the risk of lifestyle-related diseases.</p> <p>&nbsp;</p> Yoko Oda Thapa, Janak Poudel, Prakash Acharya, Kenji Kimura, Rina Kawata, Maki Kanzaki, Hiroko Okugawa, Hiroko Sakai Copyright (c) 2020 Health Education Network (HEAN) Sun, 22 Nov 2020 00:00:00 +0000