Bridging the national data gap with Google earth engine and landsat imagery by developing annual land cover for Afghanistan.

The national-level land cover database is essential to sustainable landscape management, environmental protection, and food security. In Afghanistan, the existing national-level land cover data from 1972, 1993, and 2010 relied on satellite data from diverse sensors adopted three different land cover classification systems. This inconsistent land cover map across the various years leads to the challenge of assessing landscape changes that are crucial for management efforts. To address this challenge, a 19-year national-level land cover dataset from 2000 to 2018 was developed for the first time to aid policy development, settlement planning, and the monitoring of forests and agriculture across time. In the development of the 19 year span of land cover data products, a state-of-the-art remote sensing approach, employing a harmonized classification scheme was implemented through the utilization of Google Earth Engine (GEE). Publicly accessible Landsat imagery and additional geospatial covariates were integrated to produce an annual land cover database for Afghanistan. The generated dataset bridges historical data gaps and facilitates robust land cover change information. The annual land cover database is now accessible through https://rds.icimod.org/. This repository ensures that the annual land cover data is readily available to all users interested in comprehending the dynamic land cover changes happening in Afghanistan.

Perceptions of service providers, service recipients and female community health volunteers on a rural obstetric ultrasound program in rural Nepal: a qualitative study.

BACKGROUND: In rural Nepal, where women face financial and geographic barriers in accessing ultrasound scans, the government initiated a Rural Obstetric Ultrasound Program (ROUSG) to train skilled birth attendants (SBAs) in rural birthing centers and expand access to routine ultrasound scans for local pregnant women. This study explores the perceived benefits and limitations of the training and implementation of this program. METHODS: A qualitative study was conducted in 15 primary care facilities in Bhojpur and Dhading, two rural districts of Nepal. The research team conducted in-depth interviews with 15 trained SBAs and focus group discussions with 48 service recipients and 30 FCHVs to gain insight into their perceptions. All interviews and focus group discussions were recorded, reviewed, and manually coded into MS Excel. RESULTS: Overall, our findings indicated that the ROUSG program was very well received among all our study participants, though critical gaps were identified, mostly during the training of the SBAs. These included insufficient guidance or practice opportunities during training and the challenges of implementing the mobile obstetric ultrasound service. Most importantly, though, our results suggest that the implementation of the ROUSG program increased access to prenatal care, earlier identification and referrals for abnormal scans, as well as reduced pregnancy-related stress. There was also a notable anecdotal increase in antenatal care utilization and institutional deliveries, as well as high satisfaction in both service providers and recipients. CONCLUSION: Our findings highlighted that while the training component could use some strengthening with increased opportunities for supervised practice sessions and periodic refresher training after the initial 21-days, the program itself had the potential to fill crucial gaps in maternal and newborn care in rural Nepal, by expanding access not only to ROUSG services but also to other MNH services such as ANC and institutional deliveries. Our findings also support the use of ultrasound in areas with limited resources as a solution to identify potential complications at earlier stages of pregnancy and improve timely referrals, indicating the potential for reducing maternal and neonatal morbidities. This initial study supports further research into the role ROUSG can play in expanding critical MNH services in underserved areas and improving broader health outcomes through earlier identification of potential obstetric complications.

Socio-culturally adapted educational videos increase maternal and newborn health knowledge in pregnant women and female community health volunteers in Nepal's Khotang district.

OBJECTIVES: While Nepal has made significant improvements in maternal and newborn health overall, the lack of maternal and newborn health-related knowledge in the more rural parts of the country has led to significant disparities in terms of both maternal and newborn health service utilization and maternal and newborn health outcomes. This study aimed to assess whether viewing culturally adapted maternal and newborn health educational films had a positive impact on (1) the maternal and newborn health knowledge levels among pregnant women and (2) the postpartum hemorrhage-related knowledge levels among Female Community Health Volunteers in rural Nepal. METHODS: Four locations were selected for their remoteness and comparatively high number of pregnancies. A convenience sample of 101 pregnant women and 39 Female Community Health Volunteers were enrolled in the study. A pre- and post-test design was employed to assess this intervention. Paired t-tests were used to analyze the change in number of correct responses by knowledge domain for multi-film participants, producing a numeric "mean knowledge score," and McNemar's tests were used to calculate the change and significance among select questions grouped into distinct themes, domains, and points of "maternal and newborn health-related knowledge" based on the priorities outlined in Nepal's maternal and newborn health 2030 goals. RESULTS: There was a significant improvement in knowledge scores on maternal and newborn health issues after watching the educational films for both types of participants. The mean knowledge score for pregnant women improved from 10 to 15 (P < 0.001) for the Understanding Antenatal Care (ANC) film, 3 to 10 (P < 0.001) for the Warning Sign in Pregnancy film, and 6 to 14 (P < 0.001) for the Newborn Care film. For the Female Community Health Volunteers, knowledge also significantly improved (P < 0.05) in all except one category after watching the postpartum hemorrhage film. The percent that correctly answered when to administer misoprostol (80%-95%) was the only variable in which knowledge improvement was not significant (P < 0.057). CONCLUSION: Using culturally adapted educational films is an effective intervention to improve short-term maternal and newborn health-related knowledge among rural populations with low educational levels. The authors recommend additional larger-scale trials of this type of intervention in Nepal and other low- and middle-income countries to determine the impact on long-term maternal and newborn health knowledge and behaviors among rural populations.

Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call.

Nepal, a South Asian country, was in nationwide lockdown for nearly three months in 2020 with partial restrictions still in place. Much worryingly, COVID-19 induced restrictions have confined women and young girls in their home, increasing the risk of domestic violence. The available support system to respond to violence against women and girls (VAWG) has also been disrupted during this period. The figures of violence against women, and child sexual abuse are increasingly being reported during the lockdown and thereafter. To mitigate this, a response against VAWG should not be a missing agenda. This commentary focuses on the situation of VAWG during COVID-19 induced restrictions in Nepal and offers a way forward for addressing the issue.

An urgent call to address the nutritional status of women and children in Nepal during COVID-19 crises.

Due to the ongoing nationwide lockdown in Nepal, women and children face a greater risk of malnutrition and eventually leading to mortality and morbidity. To harness the progress made so far in improving the nutritional status of women and children, a focus on nutrition should be a part of the COVID-19 response plan.

Historical Development of Health Research Ethics in Nepal.

Health research in Nepal initiated with a survey in malaria in 1952. The first regulatory body for health research was Nepal Medical Research Committee formed under Ministry of Health. Ethical Review Body is the first ethical review structure. Nepal Health Research Council is now an independent body to regulate health research in Nepal. Development of research ethics in Nepal is clearly evident with the development of ethical guidelines; functioning of Ethical Review Board; expansion of institutional review committees and initiation of online submission system. However, monitoring compliance with research ethics could be a challenge for the Nepal Health Research Council.