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Original Articles
Prevalence and Associated Factors of Hypertension Subtypes Among the Adult Population in Nepal: Evidence from Demographic and Health Survey Data
Rajat Das Gupta, Animesh Talukdar, Shams Shabab Haider, Mohammad Rifat Haider
Osong Public Health Res Perspect. 2019;10(6):327-336.   Published online December 31, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.6.02
Correction in: Osong Public Health Res Perspect 2022;13(1):80
  • 3,889 View
  • 87 Download
  • 3 Citations
AbstractAbstract PDF
Objectives

This study aims to determine the prevalence, and associated factors of undiagnosed hypertension [Systolic Diastolic Hypertension (SDH), Isolated Systolic Hypertension (ISH) and Isolated Diastolic Hypertension (IDH)] in the Nepalese adult population.

Methods

Nepal Demographic and Health Survey 2016 data from adults (≥ 18 years) was used in this study. The final weighted sample size was 13,393. Blood pressure (BP) was measured 3 times and the average of the second and third measurement was reported. SDH (systolic BP (SBP) ≥ 140 mmHg and diastolic BP (DBP) ≥ 90 mmHg), ISH (SBP ≥ 140 mmHg and DBP < 90 mmHg), and IDH (SBP < 140 mmHg and DBP ≥ 90 mmHg) were measured. Multilevel logistic regression analyses were conducted to find the association between the independent variables and the covariates.

Results

The prevalence of SDH, IDH and ISH were 8.1%, 7.5%, and 3.3% respectively. The odds of having SDH and ISH increased with old age. However, the odds of having IDH decreased with increasing age. Females has lower odds of having SDH and IDH compared with male participants. Individuals that had been married, resided in Province 4 (p < 0.05) or 5 (p < 0.01) were statistically significantly associated with having IDH. Being overweight or obese was statistically significantly associated with all 3 HTN subtypes (p < 0.001).

Conclusion

The necessary steps should be taken so that public health promotion programs in Nepal may prevent and control undiagnosed hypertension.

Gender-based Violence Among Pregnant Women of Syangja District, Nepal
Samjhana Gurung, Jeevan Acharya
Osong Public Health Res Perspect. 2016;7(2):101-107.   Published online April 30, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.010
  • 1,693 View
  • 17 Download
  • 8 Citations
AbstractAbstract PDF
Objectives
This study aims to determine prevalence of gender-based violence among pregnant women attending an antenatal care (ANC) clinic.
Methods
Between September 2014 and December 2014, a cross-sectional study was conducted among 202 pregnant women attending the antenatal ward of the Primary Healthcare Centre (PHC) of Syangja district, Nepal. The data were collected using semistructure questionnaires with face-to-face interviews. SPSS software (IBM Corp, Armonk, NY, USA) was used for analysis the data.
Results
The prevalence rate of gender-based violence was found to be 91.1% (184). Most of the respondents (87%) faced economic violence followed by psychological (53.8%), sexual (41.8%), and physical (4.3%) violence. Women experienced: (1) psychological violence with most complaining of angry looks followed by jealousy or anger while talking with other men, insults using abusive language and neglect; (2) economic violence with most complaining of financial hardship, denial of basic needs and an insistence on knowing where respondents were and restricting them to parents' home or friends/relatives' houses (jealousy); (3) physical violence by slapping, pushing, shaking, or throwing something at her, twisting arm or pulling hair, and punching and kicking; and (4) sexual violence by physically forcing her to have sexual intercourse without consent, and hurting or causing injury to private parts. Most (100%) of the perpetrators were found to be husbands and mothers-in-law (10.7%) who violated them rarely.
Conclusion
The prevalence of gender-based violence (GBV) among pregnant women attending the ANC clinic was greater in the Syangja district of Nepal. Women's empowerment, economic autonomy, sensitization, informal or formal training regarding GBV for men and women, and the need for large-scale population-based surveys are the major recommendations of this study.
Are Free Maternity Services Completely Free of Costs?
Jeevan Acharya
Osong Public Health Res Perspect. 2016;7(1):26-31.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.002
  • 1,385 View
  • 14 Download
  • 9 Citations
AbstractAbstract PDF
Objectives
The Government of Nepal revised free maternity health services, “Aama Surakshya Karyakram”, beginning at the start of Fiscal Year 2012/13, which specifies the services to be funded, the tariffs for reimbursement, and the system for claiming and reporting on free deliveries each month. This study was designed to investigate the amount of monetary expenditure incurred by families using apparently free maternity services.
Methods
Between August 2014 and December 2014, a hospital-based cross-sectional study was conducted at Manipal Teaching Hospital and Western Regional Hospital. Nepalese women were not involved with family finances and had very little knowledge of income or expenditures. Therefore, face-to-face interviews with 384 postpartum mothers with their husbands or the head of the family household were conducted at the time of discharge by using a pre-tested semi-structural questionnaire.
Results
The average monthly family income was 19,272.4 NRs (189.01 US$), the median duration of hospital stay was 4 days (range, 2−19 days), and the median patient expenditure was equivalent to 13% of annual family income. The average total visible cost was 3,887.07 NRs (38.1 US$). When the average total hidden cost of 27,288.5 NRs (267.6 US$) was added, then the average total maternity care expenditure was 31,175.6 NRs (305.76 US$), with an average cost per day of 7,167.5 NRs (70.29 US$). The mean patient expenditure on food and drink, clothes, transport, and medicine was equivalent to 53.07%, 9.8%. 7.3%, and 5.6% of the mean total maternity care expenditure, respectively. The earnings lost by respondent women, husbands, and heads of household were 5,963.7 NRs (58.4 US$), 7,429.3 NRs (72.9 US$), and 6,175.9 NRs (60.6 US$), respectively.
Conclusion
The free maternity service in Nepal has high out-of-pocket expenditures, and did not represent a system completely free of costs. Therefore, arrangements should be made by hospitals free of cost to provide medicine that is not included as essential during the hospital stay and at discharge time. Similarly, arrangements for liquid, food, and hot water, as well as clothes for mothers and newborns, should be made by the hospital in order to enhance hospital attendance.

PHRP : Osong Public Health and Research Perspectives