Pramod R Regmi

Women's autonomy in household decision-making: a demographic study in Nepal

BackgroundHow socio-demographic factors influence womens autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal. This study aims to explore the links between womens household position and their autonomy in decision making.MethodsWe used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257). The data consists of womens four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives. A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making.ResultsWomens autonomy in decision making is positively associated with their age, employment and number of living children. Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure. There is a mixed variation in womens autonomy in the development region across all outcome measures. Western women are more likely to make decision in own health care (1.2-1.6), while they are less likely to purchase daily household needs (0.6-0.9). Womens increased education is positively associated with autonomy in own health care decision making (p < 0.01), however their more schooling (SLC and above) shows non-significance with other outcome measures. Interestingly, rich women are less likely to have autonomy to make decision in own healthcare.ConclusionsWomen from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making. Womens autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum. A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources. This will lead the women to be more autonomous in decision making in the due course.

Dating and Sex Among Emerging Adults in Nepal

Social and cultural changes in Nepal, including better communication facilities and transport, more urbanization and a rising age at which people marry, have created more opportunities for young people for “dating.” Our qualitative study explores whether the existence of dating cultures influences young people’s sexual behavior in Nepal. Focus group discussions with a total of 75 participants and 31 in-depth individual interviews were conducted among young people in Nepal. Most urban and rural young people liked the dating culture. Although it is a new kind of culture in Nepalese society, it is gaining popularity. The mass media were regarded as encouraging and creating an environment for dating. Most participants believed that dating culture encourages premarital and extramarital sexual behavior. The authors underpin their findings by linking it to the “emerging adulthood” framework. In terms of public health, they recommend that dating practice should be discussed in formal and informal education to promote safer sex.

Violence against women living with HIV: a cross sectional study in Nepal.

Background: Violence against Women (VAW) and Human Immunodeficiency Virus (HIV) both constitute major public health issues and there is an increasing evidence of their intersection. Data are sparse on the intersection of VAW and HIV in South Asia region. We aimed to identify different forms and magnitude of violence incurred by women living with HIV, and analyse causes and consequences. Methods: A cross-sectional study was conducted among 43 HIV positive women in three districts of Nepal, in the period of March-May 2008. Data was collected through semi-structured interview questionnaire. Results: The vast majority of the participants (93.02%) had suffered from at least one form of the violence. The prevalence of violence rose up sharply after being diagnosed with HIV positive than before (93.02% vs.53.5%). Forty-five percent of the participants reported their husbands being main perpetrator of violence. Self-humiliation and health and treatment problem were the major consequences of violence as reported by 90% and 77.5% of the participants respectively. Conclusion: Violence was observed to be highly prevalent among women living with HIV in Nepal. Further larger and nationally representative researches are imperative to better understand the cross-section between VAW and HIV. Our finding recommends to prioritizing programs on social aspects of HIV such as violence.

Injury and Mortality in Young Nepalese Migrant Workers A Call for Public Health Action

Approximately 3.5 million Nepalese are working as migrant workers in the Gulf countries, Malaysia, and India. Every year there are more than 1000 deaths and many hundreds cases of injuries among Nepalese workers in these countries excluding India. A postmortem examination of migrant workers is not carried out in most of these countries, and those with work-related injuries are often sent back to home. Uninsured migrant workers also do not have easy access to health care services in host countries due to the high medical and hospital fees. Greater efforts are needed to protect the health and well-being, labor rights, and human rights of migrant workers from Nepal and other South-Asian nations. There is a need to enforce universal labor laws in these countries and to develop accurate records of mortality and morbidity and their causes.

Stipulating citizen's fundamental right to healthcare: Inference from the Constitution of Federal Republic of Nepal 2015

Nepal has a great opportunity to learn from, and collaborate with, non-governmental development partners and private sectors, and from other governments and organizations around the world, but we must move promptly.

Mental health in BME groups with diabetes: an overlooked issue?

A recent commentary in The Lancet emphasised the effect of mental health on diabetes. We would particularly like to highlight the mental health issues of black and minority ethnic (BME) populations with diabetes in the UK, owing to the considerably higher prevalence of diabetes and mental illness among BME populations compared with the national average.

Importance of Health and Social Care Research into Gender and Sexual Minority Populations in Nepal

Despite progressive legislative developments and increased visibility of sexual and gender minority populations in the general population, mass media often report that this population face a wide range of discrimination and inequalities. LGBT (lesbian, gay, and bisexual, and transgender) populations have not been considered as priority research populations in Nepal. Research in other geographical settings has shown an increased risk of poor mental health, violence, and suicide and higher rates of smoking, as well as alcohol and drugs use among LGBT populations. They are also risk for lifestyle-related illness such as cancer, diabetes, and heart diseases. Currently, in Nepal, there is a lack of understanding of health and well-being, social exclusion, stigma, and discrimination as experienced by these populations. Good-quality public health research can help design and implement targeted interventions to the sexual and gender minority populations of Nepal.

Guide to the design and application of online questionnaire surveys

Collecting research data through traditional approaches (face-to-face, postal or telephone survey) can be costly and time consuming. The emerging data collection approach based on internet/e-based technologies (e.g. online platforms and email), is a relatively cost effective survey alternative. These novel data collection strategies can collect large amounts of data from participants in a short time frame. Similarly, they also seem to be feasible and effective in collecting data on sensitive issues or with samples they are generally hard to reach, for example, men who have sex with men (MSM) or migrants. As a significant proportion of the population currently in the world are digitally connected, the shift from postal (paper-pencil) or telephone towards online survey use in research is in the interests of researchers in academia as well as in the commercial world. However, compared to designing and executing paper version of the questionnaire, there is limited literature to help a starting researcher with the design and a use of online questionnaires. This short paper highlights issues around: a) methodological aspect of online questionnaire survey; b) online survey planning and management; and c) ethical concerns that may arise while using this option. We believe that this paper will be useful for researchers who want to gain knowledge or apply this approach in their research.

Effect of economic and security challenges on the Nigerian health sector

The call on the Federal Government of Nigeria to declare a state of emergency in the Nigerian health sector by its federal lawmakers has come at a time when the health sector of the country is unfortunately in a dysfunctional state. This has been furthered by the fact that the Nigerian economy has suffered set back in recent times, particularly with the official announcement of having entered an economic recession by Finance minister for the federal government in July 2016, after annual inflation increased to 17.1% highest in the last decade [1]. This came following the steep fall in the price of crude oil from

Implication of Air pollution on health effects in Nepal: Lessons from global research

115 in 2014 to currently