Perceived risk and associated factors of healthcare waste in selected hospitals of Kathmandu, Nepal.

BACKGROUND: Healthcare waste management is the subject of a neglected issue in many developing countries. Health care facilities are facing a major challenge in handling healthcare wastes and reducing their potential risks to human health and the environment. Insufficient understanding of the risk associated with healthcare waste by health workforce can contribute to poor waste management practices. The main aim of this study is to assess risk perception towards healthcare waste among hospital attendants and to identify associated factors. METHODOLOGY: We carried out a cross-sectional hospital-based study among 120 attendants of a private and public hospital in Kathmandu, Nepal. We used two-stage random sampling for the selection of hospital and participants. We conducted a face-to-face interview with the participants using semi-structured questionnaires. Based on the mean score, we classified risk perception as good and poor. Bivariate and multivariate analysis was carried out to determine associates of risk perception towards healthcare waste. RESULTS: Approximately 51.0% of hospital attendants had poor risk perception of healthcare waste. Nearly half of the participants (49.2%) had inadequate knowledge and 43.0% had a negative attitude. Factors such as healthcare waste management training (p = 0.028), housekeeping department (p = 0.036) and attitude (p = 0.001) were associated with risk perception of healthcare waste. CONCLUSION: Hospital attendants had a poor understanding of risk perception of healthcare waste. Periodic training on healthcare waste management and edification on the risk associated with healthcare waste is essential to boost awareness among all healthcare workers. Communication on behavioral improvements for appropriate waste management must be prioritized to change the perception of health workers.

Risk perception towards healthcare waste among community people in Kathmandu, Nepal.

BACKGROUND: Healthcare waste management is a serious issue in context of developing countries. Better assessment of both risks and effects of exposure would permit improvements in the management of healthcare waste. However, there is not yet clear understanding of risks, and as consequences, inadequate management practices are often implemented. OBJECTIVES: This study primarily aims to assess risk perception towards healthcare waste and secondly to assess knowledge, attitude and identify the factors associated with risk perception. RESULTS: A cross-sectional community based study was carried out among 270 respondents selected through multistage sampling technique. Face-to-face interview was conducted using semi-structured questionnaires. Risk perception was classified as good and poor based on mean score. Bivariate and multivariate analyses were carried out to determine the associates of risk perception. More than half, 52% of the sampled population had a poor risk perception towards healthcare waste. More than a quarter 26.3% had inadequate knowledge and forty percent (40%) had a negative attitude towards health care waste management. Having knowledge (OR = 3.31; CI = 1.67-6.58) was a strong predictor of risk perception towards healthcare waste. The perception of risk towards healthcare waste among community people was poor. This highlights the need for extensive awareness programs. Promoting knowledge on healthcare waste is a way to change the perception in Nepal. Community engaged research approach is needed to address environmental health concerns among public residents.

Emotional and Behavioral Problems among Adolescents in Pokhara City in Nepal.

BACKGROUND: Adolescents are highly vulnerable to psychiatric disorders, which often have serious negative consequences for their academic achievement and potential social life. The aim of the study is to estimate the prevalence of emotional and behavioral problems among adolescents. METHODS: A descriptive cross-sectional study design was adopted to identify the emotional and behavioral problems among adolescents using cluster sampling technique. Assessment was done on students of grade 7-11 from two schools in city in Nepal using self-administered questionnaire, Youth Self-Report (YSR-11/18) 2001, developed by Achenbach System of Empirical Based Assessment and self developed socio-demographic questionnaires. Data was coded and analyzed using SPSS (20). Descriptive statistic and inferential statistic (Chi square, Fisher Exact and Odds ratio-OR) were used to analyze data. RESULTS: Altogether 330 adolescents were enrolled in study with mean age 14.3 yrs (range 11-18, male-152, female-178). Prevalence of EBPs was 30.0% (Male-38.8% female-22.5%). Internalizing problems (35.8%) were more common than externalizing (18.5%). Occurrence of EBPs was significantly associated with Sex (OR= 2.2 p=0.001), type of family (OR=1.8 p=0.035) and types of school (private: public OR=2.1 p=0.004). Among narrow band scales most common problems were social (17.6%), thought (15.5%), somatic (13%), anxious depression (12.1%) and aggression(10.3%). There was significant association between sex with EBPs on narrow band scales, male adolescents were more likely to have thought-problem (OR=3.7 p=<0.001, rule-breaking problem (OR=8.5, p=0.02), aggressive behavior (OR=3.7 p=0.001) while female were more likely to have social problems (OR=2.6 p=0.002). CONCLUSIONS: Emotional and behavioural are a serious mental health concern among adolescents. An intervention strategy (School-based mental health service) maybe required to understand their problems and provide appropriate counseling.