Effect of an Educational Intervention on Dietary Diversity Practices among Public School Students.

BACKGROUND: Poor dietary diversity leading to malnutrition among children and adolescents is a serious public health problem in Nepal. Though nutrition education intervention has been effective in changing the dietary intake habits of individuals in school settings, the contextual educational intervention has not been tested in our study area. This study is aimed at assessing the effect of dietary diversity education based on the Health Belief Model among secondary level students in selected schools of Siddhicharan Municipality, Okhaldhunga. METHODS: Quasi-experimental study design was employed during the intervention study. Our study was conducted in 3 phases: Phase I, Baseline Study; Phase II, Education Package Development; and Phase III- Intervention Study (Implementation and evaluation of the package). The data was collected for getting baseline that was used to develop package, pre-intervention assessment and after intervention assessment, using a self-administered structured questionnaire based on constructs of Health Belief Model (HBM). Study participants were students from grade 7 and 8. The collected data was analyzed using SPSS version 21. RESULTS: After the education intervention, dietary diversity knowledge and practice in the intervention group increased from 16.4% to 54.2% and 32.8% to 48.6% respectively. Significant association (P<0.001) was noted between knowledge of dietary diversity with intervention in post-test. Similarly, the mean score of the Health Belief Model construct was significantly improved and showed an association (P<0.001) with nutrition education after the intervention. CONCLUSIONS: Nutrition education based on the Health Belief Model showed a positive impact on knowledge and practice of dietary diversity among school students. Hence, such education intervention should be promoted by educational institutions, the Ministry of Education, Ministry of Health and Population, NGOs and INGOs.

Newborn Service Readiness of Primary Level Health Facilities of Eastern Mountain Region of Nepal.

BACKGROUND: Newborn service readiness is facility's observed capacity to provide newborn services and a pre-requisite for quality. Newborn services are priority program of government and efforts are focused on infrastructure and supplies at peripheral health facilities. Study describes health facility readiness for newborn services in four domains of general requirements, equipment, medicines and commodities, and staffing and guidelines. METHODS: Convergent parallel mixed method using concurrent triangulation was done in public health facilities providing institutional deliveries of two randomly selected districts- Taplejung and Solukhumbu of Eastern Mountain Region of Nepal. Face to face interview and observation of facilities were done using structured questionnaire and checklist; in-depth interviews were done using interview guideline from November 2016 to January 2017. Ethical clearance was taken. Descriptive analysis and deductive thematic analysis were done. RESULTS: Mean score of newborn service readiness was 68.7±7.1 with range from 53.3 to 81.4 out of 100. Domains of general requirement, equipment, medicine and commodity, supervision, staffing and guideline were assessed. The gaps identified in general requirements were availability of uninterrupted power supply, means of communication and referral vehicle. Clean wrappers and heater for room temperature maintenance were identified during interviews to be part of the readiness. All health facilities had trained staff while retention of skill was of concern. There was felt need of enforcing adequate training coverage to suffice the need of human resources in remote. CONCLUSIONS: Efforts of improving transportation, heater for room temperature maintenance, trainings with skill retention strategy, utilization of guidelines, availability of skilled birth attendance could result increased and improved newborn service readiness.

Assesssment of Health Facilities for Implementation of Non-communicable Disease Package.

BACKGROUND: Non-communicable Diseases are an alarming public health emergency in Nepal. Owing to the risk of NCD's in Nepal, Government of Nepal has developed a Multisectoral Action Plan for Non-communicable Disease 2014-2020 and has adopted the World Health Organization Package of Essential Non-communicable Disease protocol. Prior for its implementation in Nepal, baseline study has been carried out to assess the status of health facilities in Nepal. METHODS: A descriptive cross-sectional study was carried out in Kailali and Ilam district encompassing a total of 92 health facilities. A set of structured questionnaire and interview guideline was used to obtain the data. Collected data was transferred to Microsoft Excel, cleaned and analyzed in SPSS 16.0. Descriptive analysis was performed to express the frequencies and relative frequencies Results: Of the total health facilities, 49 and 43 health facilities of Ilam and Kailali were interviewed. The hospital of Ilam consisted all the procedure, equipment and medicine for the management of NCDs whilst, health posts lacked Oxygen services. Only 592 posts were fulfilled out of 704 sanctioned post in both the districts of which only 161 were trained in management of NCDs. Atotal of 231 patients were diagnosed with NCDs before the day of study in all the health facilities of both districts. CONCLUSIONS: Study reveals the gaps in capacity of health institution and system in terms of training, supply, equipments, and diagnostics. However, training of health workers, supply of essential medicines and improvising the service delivery would supplement the effective implementation of PEN in Nepal.

Bullying Behavior and Psychosocial Health - A Cross-sectional Study among School Students of Pyuthan Municipality.

BACKGROUND: Bullying remains as pervasive phenomenon affecting children worldwide. Bullying in school has long been a matter of concern as wide range of adjustment problems including poor mental health and violent behavior in school are associated with it. The present study examined the prevalence of bullying behavior (bullies, victims and bully-victims) and their association with depression and psychosomatic symptoms. METHODS: A cross-sectional descriptive study was carried out among 8th, 9th and 10th grade students of Pyuthan Municipality, Mid-Western Nepal. A total of 405 students responded to the structured self-administered questionnaire. Data was collected from randomly selected public and private schools. Descriptive and inferential statistics were used for analysis. RESULTS: The result of this study showed higher prevalence of bully (55.8%) among students of Relatively Advantaged Janajati whereas victims (64.86%) belonged to Disadvantaged Janajatis. Students who bully were found more in grade 8 and 10 whilst the students of grade 9 were more victims. Bullying behavior prevailed more in private schools than in public schools. CONCLUSIONS: The overall prevalence of bullying behavior (either bully or victim) is 69.14%. The finding bolsters an association between bullying behavior and depression, psychosomatic symptoms and school type. Higher prevalence of bullying behavior suggested by this study portends the alarming consequences among school students. Bullying needs to be addressed fleetly. Effective interventions that reduce bullying practice in school is essential.