Psychological morbidity in Nepali cross-border migrants in India: a community based cross-sectional study.

BACKGROUND: Since Nepali cross-border migrants can freely enter, work and stay in India, they are largely undocumented. The majority is involved in semi-skilled or unskilled jobs with limited labour rights and social security, a fact which predisposes them to psychological distress. We aimed to assess the prevalence of and factors associated with psychological morbidity among Nepali migrants upon their return from India. METHODS: A community based cross-sectional study was conducted in six districts of Nepal between September 2017 and February 2018. A total of 751 participants who had worked at least six months in India and returned to Nepal were interviewed from 24 randomly selected clusters. The General Health Questionnaire (GHQ)-12 was used to measure the psychological morbidity. Data were analysed using Poisson regression analysis. RESULTS: The majority was younger than 35 years (64.1%), male (96.7%), married (81.8%), had at least a primary education (66.6%), and belonged to Dalit, Janajati and religious minorities (53.7%). The prevalence of psychological morbidity was 13.5% (CI: 11.2-16.1%). Participants aged 45 years and above (adjusted prevalence ratio (aPR) = 2.74), from the Terai (aPR = 3.29), a religious minority (aPR = 3.64), who received no sick leave (aPR = 2.4), with existing health problems (aPR = 2.0) and having difficulty in accessing health care (aPR = 1.88) were more likely than others to exhibit a psychological morbidity. CONCLUSION: This study demonstrated that psychological morbidity was prevalent in the study participants and varied significantly with individual characteristics, work conditions and health. Multifaceted approaches including psychological counselling for returnees and protection of labour and health rights in the workplace are recommended to help reduce psychological morbidity.

Human-wildlife conflict at high altitude: A case from Gaurishankar conservation area, Nepal.

Human-wildlife conflict studies of high-altitude areas are rare due to budget constraints and the challenging nature of research in these remote environments. This study investigates the prevalence and increasing trend of human-wildlife conflict (HWC) in the mountainous Gaurishankar Conservation Area (GCA) of Nepal, with a specific focus on leopard (Panthera pardus) and Himalayan black bear (Ursus thibetanus laniger). The study analyzes a decade of HWC reports and identifies goats as the livestock most targeted by leopards. The Dolakha district of GCA received the highest number of reports, highlighting the need for mitigation measures in the area. In GCA, livestock attacks accounted for 85% of compensation, with the remaining 15% for human injuries. We estimate that the number of reported wildlife attacks grew on average by 33% per year, with an additional increase of 57 reports per year following the implementation of a new compensation policy during BS 2076 (2019 AD). While bear attacks showed no significant change post-rule alteration, leopard attack reports surged from 1 to 60 annually, indicating improved compensation may have resulted in increased leopard-attack reporting rates. The findings emphasize the economic impact of HWC on local communities and suggest strategies such as increasing prey populations, promoting community education and awareness, enhancing alternative livelihood options, developing community-based insurance programs, and implementing secure enclosures (corrals) to minimize conflicts and foster harmonious coexistence. This research addresses a knowledge gap in HWC in high-altitude conservation areas like the GCA, providing valuable insights for conservation stakeholders and contributing to biodiversity conservation and the well-being of humans and wildlife.

Non-exploitative human disturbance provides shelter for prey from predator.

Human activities can influence behaviors of predators and prey, as well as predator-prey interactions. Using camera trap data, we investigated whether or to what extent human activities influenced behaviors of predators (tigers and leopards) and prey (sambar deer, spotted deer, wild boar, and barking deer), and predator-prey interactions in the Barandabhar Corridor Forest (BCF), Chitwan District, Nepal. A multispecies occupancy model revealed that the presence of humans altered the conditional occupancy of both prey and predator species. Specifically, the conditional occupancy probability of prey was substantially higher (ψ = 0.91, CI = 0.89-0.92) when humans were present than when humans were absent (ψ = 0.68, CI = 0.54-0.79). The diel activity pattern of most prey species overlapped strongly with humans, whereas predators were generally more active when humans were absent. Finally, the spatiotemporal overlap analysis revealed that human-prey interactions (i.e., the probability that both humans and prey species being present on the same grid at the same hourly period) was ~3 times higher (10.5%, CI = 10.4%-10.6%) compared to spatiotemporal overlap between humans and predators (3.1%, CI = 3.0%-3.2%). Our findings are consistent with the human shield hypothesis and suggest that ungulate prey species may reduce predation risk by using areas with high human activities.

Caste Exclusion and Health Discrimination in South Asia: A Systematic Review.

The caste system is social stratification system that has been used over the last 3 millennia. This review aims to investigate caste-based inequity in health care utilization in South Asia, particularly focusing those at the bottom of the caste hierarchy, commonly known as Dalit communities. A systematic methodology was followed; key databases (including CINAHL, Medline, SocINDEX, PubMed, Nepjol, JSTOR, and ASSIA) were searched for relevant articles published before October 2019, using comprehensive search strategy in accordance with the PRISMA guidelines. In total 15,109 papers were found, and from these, nine selected papers were included in the review. The papers focused on studies in both India (n = 7) and Nepal (n = 2) and utilized a range of methods including qualitative (n = 2), quantitative (n = 3), and mixed methods (n = 4) approaches. The review identified four main themes: stigma, poverty, cultures and beliefs, and health care. Caste-based inequity impacts upon all aspects of an individual's well-being including violence and everyday life risks. Caste also impacts upon individuals' opportunities to access education, employment, and health care. Dalits appear to experience this more significantly due to both poverty and their caste status, which increases their vulnerability to health risks.

Rising Rates of Caesarean Section in Urban Nepal.

The rising rate of caesarean section in urban Nepal is alarming as the lack of access for women in rural areas to emergency obstetric care, putting lives at risk. The latter is referred to as 'Too little too late'. At the same time, the sharp rise in caesarean section rates in cities presents the other extreme: "Too much too soon". The overuse of caesarean section causes harm, unnecessary costs, and misuse of health resources. Availability of private hospitals and increasing hospital childbirth may contribute to the rising rate of caesarean section. This article highlights the rising rate of caesarean section in urban Nepal. Keywords: Caesarean section; emergency obstetric care; Nepal.

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.