Attitudes and Practices Toward Sex-Selective Abortion in an Urban District of Nepal: Findings From a Cross-Sectional Study.

Nepal, a country with deeply ingrained patriarchal values and culture, has limited evidence regarding the practices of sex selection and sex-selective abortion. This study aimed to investigate the attitudes and practices surrounding sex-selective abortion (SSA) and the factors associated with it. A cross-sectional study design was used to collect data from 320 women between the ages of 15 and 49, who had at least one child under the age of 5 and lived in the Bhaktapur district, Nepal. A total of 19.7% of the participants had undergone an abortion, with 39.6% of those being SSAs. Factors like women empowerment and preference for smaller family size are associated with women's favorable attitude toward SSA. In multivariate analysis, women who faced pressure from their families to have a son and those who were aware of Nepal's abortion laws were more likely to abort a female fetus.

Two-decade trends and factors associated with overweight and obesity among young adults in Nepal.

Overweight and obesity are global epidemics in the adult population, and also affect young people. This study estimated the long-term trend (1996-2019) of overweight and obesity among young adults aged 18 to 29 years in Nepal by sex based on the World Health Organization (WHO) and Asian cut-offs for body mass index (BMI). We also investigated the demographic factors associated with overweight and obesity in the latest survey. This study utilized data from nationwide studies, Demographic and Health Surveys (DHSs) and WHO STEPwise approach to surveillance (STEPS) surveys. The trends in overweight and obesity were studied using trend analysis and joinpoint regression. Average annual percent changes (AAPCs) and their 95% confidence intervals (CIs) were calculated for the trends. Multivariable logistic regression was used to study the factors associated with overweight and obesity. The study findings showed significant upward trends in both overweight and obesity for women with AAPCs of 10.5 (95% CI 6.4-14.7) and 15.8 (95% CI 10.9-20.8) respectively. In the 25-29 age-group, the prevalence of overweight/obesity increased among women from 2.2% to 24.7% between 1996 and 2019, and among men from 8.8% to 25.4% between 2007 and 2019. Increased odds of overweight (AOR 9.15, 95% CI 6.64-12.60), and obesity (AOR 42.09, 95% CI 10.12-175.04) were found in 2019 compared to 1996. Older age and female sex, being married and urban residence were significantly associated with overweight and obesity. In conclusion, this study showed rapid upward trends in overweight and obesity among young adults in Nepal with an accelerated trend among women; the predictors for overweight were older age, female sex and married status, and those for obesity were older age, female sex, and urban residence.

Nepalese version of Douleur Neuropathique 4 (DN4) questionnaire for detection of neuropathic pain signs and symptoms: Translation and psychometric properties.

OBJECTIVE: This study aimed to translate the DN4 questionnaire into Nepalese version and assess its psychometric properties: diagnostic accuracy, internal consistency, and test-retest reliability. METHODS: An observational study was conducted in a tertiary level teaching hospital of Kathmandu, Nepal. We included 166 patients with chronic pain visiting a pain clinic over a period of one year. The Nepalese version of the DN4 questionnaire was used for detecting signs and symptoms of neuropathic pain. The English version of the questionnaire was translated into Nepali in accordance with the standard guideline with the help of linguistic experts. The patients who met the inclusion criteria were examined and interviewed twice in an interval of two weeks. The association between the index test and the reference test was analyzed using Chi-square test. Diagnostic accuracy was assessed using sensitivity, specificity, Youden's index, and positive and negative predictive values. We calculated internal consistency using Cronbach's alpha (∝), and test-retest reliability using Cohen's kappa and Intra-class correlation coefficient (ICC). RESULTS: The study showed a significant association between the result of DN4 questionnaire and the gold standard (physician's diagnosis) (p<0.001). The sensitivity and specificity values for the DN4 questionnaire were 75% and 95.3% respectively. Similarly, positive and negative predictive values were 93.8% and 80.4% respectively. Our study showed adequate internal consistency (∝ = 0.710) and a good test-retest reliability (kappa = 0.872, ICC = 0.877). CONCLUSIONS: The Nepalese version of DN4 questionnaire is a valid and reliable tool for the identification of signs and symptoms of neuropathic pain. This can be used for screening neuropathic pain signs and symptoms in clinical as well as research settings.

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.