Dementia care landscape in Nepal: Understanding the context, barriers, and opportunities for the development of a national dementia care plan.

OBJECTIVE: This study was conducted to comprehensively understand the context, barriers, and opportunities for improving dementia care, treatment, and support. The objective is to guide the development of a national dementia care plan. METHODOLOGY: This document review was conducted by analyzing literature available in the public domain, including scientific publications, project documents/reports, media reports, and hospital records. Additionally, annual reports published by the Department of Health Services, national census and demographic and health survey reports, Old Age Homes, and other relevant government reports were examined. Firsthand information was gathered from relevant stakeholders based on the World Health Organization's situational analysis framework for dementia plans. This framework encompasses four domains: Policy context (national ministries, legislation, policies, strategies, plans related to dementia, mental health, aging, and disability), service delivery assessment (health and social care workforces, services, support and treatment programmes, and promotion of awareness and understanding), and epidemiological indicators (prevalence and incidence rates of dementia, risk factors). Ethical clearance was obtained from the Institutional Review Committee (IRC) of B.P. Koirala Institute of Health Sciences (IRC no.2658/023). RESULTS: Existing policies in Nepal inadequately address the needs of people with dementia and their caregivers. Concerning health services, the Government of Nepal provides financial subsidies to individuals diagnosed with dementia; however, numerous hurdles impede access to care. These obstacles include geographical and structural barriers, an inefficient public healthcare system, weak governance, financial constraints, low awareness levels, stigma, and inadequate workforce. Furthermore, the absence of robust nationally representative epidemiological studies on dementia in Nepal hampers the development of evidence-based plans and policies. Similarly, there are no interventions targeted at caregivers of people with dementia, and no initiatives for dementia prevention are in place. CONCLUSIONS: This review underscores the urgent need to formulate a comprehensive national dementia care plan to address the growing challenges. Key priority action areas include the integration of dementia care into primary healthcare services, training workforce to provide the care, increasing awareness, mitigating stigma, developing caregiver support programs, and initiating high-quality research to inform evidence-based policymaking.

Obstacles and Satisfaction to Balance Between Family Life and Medical Career Among Saudi Women Doctors.

BACKGROUND:  Besides their medical career obligations, female physicians traditionally have assumed responsibility for raising families and maintaining the household. Finding an acceptable balance between their career and family life is challenging. OBJECTIVE:  The study aimed to discover the obstacles and the relationship between the barriers/factors with the satisfaction in balancing career and family life. METHODOLOGY:  A cross-sectional study that analyzed data from Saudi female physicians. The study included 165 female physicians from the six Ministry of Health hospitals in Al-Madinah Al-Munawarah; 65 were specialists and consultants, and 100 were general practitioners and residents. The data were collected from October until the end of November 2022 through a semi-structured, self-administered questionnaire gathered by convenience sampling. The data were collected and analyzed with SAS software. RESULTS:  The study's main findings include a satisfaction rate in balancing career and family life among the studied female physicians, which was low at 15.7%. In comparison, female physicians unsatisfied with such balancing were 38.2%. The effect of family responsibilities on career choice was nearly equal, where 50.3% of the studied female physicians affected them. There was a statistically significant difference regarding the satisfaction in balancing career with family life by their specialty; female surgeons and gyn/obs physicians found a higher percentage of unsatisfaction, whereas, among family medicine physicians, the least rate of unsatisfaction was found (P-value < 0.01). At 80% of the studied physicians suggested providing childcare centers as the main solution to their difficulties and obstacles; also, 46.5% suggested taking more days off of maternity leave. Transportation difficulties, however, represented the lowest type of difficulty, 12.7%. CONCLUSION:  The present study has revealed several obstacles facing female physicians that negatively impact relationships with their families.

Public Knowledge, Attitude, and Practice Toward Herpes Zoster Vaccination in Saudi Arabia.

Introduction Herpes zoster (HZ) is a viral infection that occurs due to the reactivation of the varicella-zoster virus (VZV). Reactivation of the latent virus causes a painful dermatomal rash that is typical in HZ, which is frequently accompanied by post-herpetic neuralgia (PHN). Although HZ negatively impacts individuals' quality of life, vaccination has been shown to reduce the incidence of HZ and PHN and reduce the severity of the disease in the event of a breakthrough. Nonetheless, several studies have shown a low level of knowledge and poor practices regarding HZ and its vaccine. However, only two studies on this issue have been conducted in the Middle East. This study aimed to assess the level of knowledge, attitudes, and practices toward HZ vaccinations among the Saudi population aged 50 years and older. Methods A cross-sectional observational study was conducted from December 2022 to July 2023 involving citizens aged 50 years and older in Saudi Arabia. Data were collected using an online, validated, close-ended structured questionnaire distributed through social media. Linear regression analysis was used to assess independent predictors of knowledge regarding HZ, knowledge regarding the HZ vaccine, and attitudes toward HZ. Categorical variables were dummy-coded. Binary logistic regression was used to assess factors associated with the willingness to receive the HZ vaccine. Results A total of 368 respondents completed the questionnaire. The mean knowledge scores (%) regarding HZ and its vaccine were 28.6% and 37.1%, respectively. While 51.6% (n = 190) claimed to be aware of the HZ vaccine, only 31.6% (n = 60) had a knowledge score of 80% or higher. Multivariate analysis showed that knowledge was positively associated with female gender, prior chickenpox infection, and higher education. Only 54.4% of the respondents were willing to get the HZ vaccine, and 28.8% were willing to pay out of pocket for the HZ vaccine. Conclusion The results suggest that educational campaigns on HZ and its vaccine targeting at-risk groups are required to raise awareness and increase the public's knowledge. Additionally, healthcare personnel's recommendation of the HZ vaccine to the target population should be encouraged, as it is an important factor in vaccine acceptability.

Voluntary blood donation among female health care university students in Saudi Arabia, knowledge and status.

CONTEXT: Blood donation is an essential lifesaving procedure. There is a continuous effort to supply the high demand in hospitals. AIMS: To assess the current status, knowledge, and attitudes of female health care students in King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) regarding blood donation. SETTINGS AND DESIGN: A cross-sectional study was done with students in the female campus of KSAU-HS in Riyadh. METHODS AND MATERIAL: The sample was categorized based on the college and year of study. A self-administered questionnaire was distributed during the first semester of the 2018-2019 academic year to an estimated 20%-25% of students per batch. STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences version 22 (SPSS Inc., Chicago, IL). RESULTS: A total of 302 students completed the questionnaire with a median age of 21 years and a range of 18-30 years. Only 14.6% of the sample previously donated blood, with half of this group donating more than once. Just less than half (48.7%, n = 147) have been exposed previously to a university campaign related to blood donation. The majority (74.5%, n = 225) knew their blood type, small proportions (16.6%, n = 50) and (10.9%, n = 33) reported knowing family members or friends requiring blood products. More than half (57.6%) of the students admitted not having sufficient knowledge regarding blood donation, and the majority (75.1%) were not aware of the quantity of blood collected during a donation. Two-thirds, 31.4% and 32.1% agree and strongly agree, respectively, that blood donation is a duty that every individual should perform. Just more than half (53%) of the students strongly agreed that they are motivated to donate blood on moral or religious grounds. CONCLUSION: The proportion of prior blood donation in the sample was low. This is due, in part, to inadequate knowledge about the donation process. Given that many students felt motivated to donate, it is possible that raising awareness through educational interventions could increase donations in female health care students.