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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
Correction in: Osong Public Health Res Perspect 2022;13(1):80
  • 5,297 View
  • 92 Download
  • 3 Citations
AbstractAbstract PDF

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.


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.


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).


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


Citations to this article as recorded by  
  • Correction to “Prevalence and Associated Factors of Hypertension Subtypes Among the Adult Population in Nepal: Evidence from Demographic and Health Survey Data” [Osong Public Health Res Perspect 2019;10(6):327–36]
    Rajat Das Gupta, Animesh Talukder, Shams Shabab Haider, Mohammad Rifat Haider
    Osong Public Health and Research Perspectives.2022; 13(1): 80.     CrossRef
  • Is Isolated Diastolic Hypertension an Important Phenotype?
    Cesar A. Romero, Aldo H. Tabares, Marcelo Orias
    Current Cardiology Reports.2021;[Epub]     CrossRef
  • Relationship between cigarette smoking and blood pressure in adults in Nepal: A population-based cross-sectional study
    Renqiao Lan, Max K. Bulsara, Prakash Dev Pant, Hilary Jane Wallace, Palash Chandra Banik
    PLOS Global Public Health.2021; 1(11): e0000045.     CrossRef
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
  • 2,532 View
  • 18 Download
  • 10 Citations
AbstractAbstract PDF
This study aims to determine prevalence of gender-based violence among pregnant women attending an antenatal care (ANC) clinic.
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.
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.
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.


Citations to this article as recorded by  
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    Shohreh Shafiei, Maryam Chegeni, Sima Afrashteh, Hamid Reza Shoraka, Azam Bazrafshan, Zohreh Bagherinezhad, Masumeh Ghazanfarpour, Hamid Sharifi
    Maternal and Child Health Journal.2022; 26(10): 1983.     CrossRef
  • Gendered consequences of social changes in Nepal: rich possibilities
    Radha Adhikari, Jeevan R Sharma
    European Bulletin of Himalayan Research.2022;[Epub]     CrossRef
  • Gebelikte aile içi şiddete maruz kalmanın postpartum depresyon ve maternal bağlanmaya etkisi
    Adıyaman Üniversitesi Sağlık Bilimleri Dergisi.2021; : 94.     CrossRef
  • Is there an association between fertility and domestic violence in Nepal?
    Sarah Raifman, Mahesh Puri, Jennet Arcara, Nadia Diamond-Smith
    AJOG Global Reports.2021; 1(2): 100011.     CrossRef
  • Intimate partner violence among pregnant women attending antenatal care services in the rural Gambia
    Joseph W. Jatta, Ararso Baru, Olufunmilayo I. Fawole, Oladosu A. Ojengbede, Yong-hui Dang
    PLOS ONE.2021; 16(8): e0255723.     CrossRef
  • Factors associated with contraceptive use in rural Nepal: Gender and decision-making
    Preeti K. Mahato, Zoë A. Sheppard, Edwin van Teijlingen, Nisa De Souza
    Sexual & Reproductive Healthcare.2020; 24: 100507.     CrossRef
  • Experiences and Perceptions of Abused Turkish Women Regarding Violence Against Women
    Emel Bahadir-Yilmaz, Fatma Oz
    Community Mental Health Journal.2019; 55(4): 686.     CrossRef
  • Intimate Partner Violence in Relation to Husband Characteristics and Women Empowerment: Evidence from Nepal
    Sujan Gautam, Hyoung-Sun Jeong
    International Journal of Environmental Research an.2019; 16(5): 709.     CrossRef
  • Criticality as Ideological Becoming: Developing English Teachers for Critical Pedagogy in Nepal
    Bal Krishna Sharma, Prem Phyak
    Critical Inquiry in Language Studies.2017; 14(2-3): 210.     CrossRef
  • In Bangla There Is No Word for Vagina <br>—Reflections on Language, Sexual Health, and Women’s Access to Healthcare in Resource-Limited Countries
    Annekathryn Goodman, Mithila Faruque, Rachel M. Clark
    Health.2016; 08(12): 1244.     CrossRef
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
  • 2,100 View
  • 14 Download
  • 11 Citations
AbstractAbstract PDF
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.
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.
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.
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.


Citations to this article as recorded by  
  • The magnitude of out‐of‐pocket expenditure for antenatal care in low and middle‐income countries: A systematic review and meta‐analysis
    Sajaan Praveena Gunarathne, Nuwan Darshana Wickramasinghe, Thilini Chanchala Agampodi, Indika Ruwan Prasanna, Suneth Buddhika Agampodi
    The International Journal of Health Planning and M.2023; 38(1): 179.     CrossRef
  • Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision
    Aisha Kuliya-Gwarzo, Tara Tancred, Daniel Gordon, Imelda Bates, Joanna Raven
    F1000Research.2023; 12: 288.     CrossRef
  • Protocol for systematic review and meta-analysis: magnitude, reasons, associated factors, and implications of the out-of-pocket expenditure during pregnancy
    S.P. Gunarathne, N.D. Wickramasinghe, T.C. Agampodi, R.P.I.R. Prasanna, S.B. Agampodi
    Public Health.2022; 206: 33.     CrossRef
  • Length of Hospital Stay After Cesarean Delivery and Its Determinants Among Women in Eastern Sudan
    Bahaeldin Hassan, Omer Mandar, Nadiah Alhabardi, Ishag Adam
    International Journal of Women's Health.2022; Volume 14: 731.     CrossRef
  • Free delivery care and supply-side incentives in Nepal’s poorest districts: the effect on prenatal care and neonatal tetanus vaccinations
    Sujita Pandey, Angela Daley
    Journal of Development Effectiveness.2021; 13(1): 100.     CrossRef
  • How costly is the first prenatal clinic visit? Analysis of out-of-pocket expenditure in rural Sri Lanka - a country with free maternal health care
    Sajaan Praveena Gunarathne, Nuwan Darshana Wickramasinghe, Thilini Chanchala Agampodi, Indika Ruwan Prasanna, Suneth Buddhika Agampodi
    BMC Health Services Research.2021;[Epub]     CrossRef
  • Length of stay in health facilities after childbirth and associated maternal and neonatal factors in Ethiopia: a cross-sectional study from a national survey
    Yemisrach Belete Biru, Getasew Assefa Lemelem, Nahom Solomon
    BMJ Open.2021; 11(12): e055327.     CrossRef
  • Length of stay after childbirth in India: a comparative study of public and private health institutions
    Pradeep Kumar, Preeti Dhillon
    BMC Pregnancy and Childbirth.2020;[Epub]     CrossRef
  • Hidden Costs of Hospital-Based Delivery Among Women Using Public Hospitals in Bale Zone, Southeast Ethiopia
    Melese Merga, Tilahun Fufa Debela, Tesfamichael Alaro
    Journal of Primary Care & Community Health.2019; 10: 215013271989644.     CrossRef
  • “We are called the et cetera”: experiences of the poor with health financing reforms that target them in Kenya
    Evelyn Kabia, Rahab Mbau, Robinson Oyando, Clement Oduor, Godfrey Bigogo, Sammy Khagayi, Edwine Barasa
    International Journal for Equity in Health.2019;[Epub]     CrossRef
  • The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana
    Philip Ayizem Dalinjong, Alex Y. Wang, Caroline S. E. Homer
    Health Economics Review.2017;[Epub]     CrossRef

PHRP : Osong Public Health and Research Perspectives