Assessment of knowledge, attitude and practice towards maternal healthcare among mothers in Illam: a cross-sectional study from Nepal.

Introduction: Healthcare during pregnancy and childbirth and after delivery is important for the survival and well-being of both the mother and the neonate. Maternal healthcare in Nepal faces challenges due to various causes. However, providing proper knowledge on maternal healthcare to mothers and promoting a positive attitude towards it can have a significant impact on maternal and child health outcomes. The objective of this study was to assess knowledge, attitude and practice towards maternal healthcare among mothers in Illam. Methods: A cross-sectional study was conducted among 197 mothers in Illam municipality who gave birth within the last 5 years. The study used face-to-face interviews with a semi-structured questionnaire to collect data. Descriptive as well as inferential statistics were used to analyze the data. Results: The total number of participants was 197. The results showed majority (48.22%) belonged to the age group of 22-29 years and the mean age of the participants was 30.2± 5.37, majority were home-makers (44.7%), mean age at marriage was 21.39±3.99 years, mean age at first pregnancy was 23.9±4.33years and mean birth spacing from last child was 70±41.28 months. Overall, we found that knowledge, attitude and practice regarding antenatal care (ANC) were 72%, 83% and 69%, respectively. Similarly, knowledge, attitude and practice regarding post-natal care (PNC) were 39%, 91%, and 43%, respectively. Conclusions: Mothers showed satisfactory knowledge on ANC but inadequate knowledge on PNC. Most had a positive attitude towards both practices. However, actual practices related to ANC and PNC were poor despite adequate knowledge and attitude.

Factors associated with self-care behaviours among people with hypertension residing in Kathmandu: a cross-sectional study.

OBJECTIVE: To determine the prevalence and associated factors of self-care behaviours among people with hypertension in the Kathmandu district of Nepal. DESIGN: Cross-sectional study. SETTING: Municipalities of Kathmandu district, Nepal. PARTICIPANTS: We enrolled 375 adults aged ≥18 years with a minimum 1-year duration of hypertension using multistage sampling. OUTCOME MEASURES: We used the Hypertension Self-care Activity Level Effects to assess self-care behaviours and collected data through face-to-face interviews. We conducted univariate and multivariable logistic regression analyses to determine the factors associated with self-care behaviours. The results were summarised as crude and adjusted ORs (AORs) with 95% CIs. RESULTS: The adherence to antihypertensive medication, Dietary Approach to Stop Hypertension (DASH) diet, physical activity, weight management, alcohol moderation, and non-smoking were 61.3%, 9.3%, 59.2%, 14.1%, 90.9%, and 72.8%, respectively. Secondary or higher education (AOR: 4.42, 95% CI: 1.11 to 17.62), Brahmin and Chhetri ethnic groups (AOR: 3.30, 95% CI: 1.26 to 8.59) and good to very good perceived health (AOR: 3.96, 95% CI: 1.60 to 9.79) were positively associated with DASH diet adherence. Males (AOR: 2.05, 95% CI: 1.19 to 3.55) had higher odds of physical activity. Brahmin and Chhetri ethnic groups (AOR: 3.44, 95% CI: 1.63 to 7.26) and secondary or higher education (AOR: 4.70, 95% CI: 1.62 to 13.63) were correlates of weight management. Secondary or higher education (AOR: 2.47, 95% CI: 1.16 to 5.29), body mass index ≥25 kg/m2 (AOR: 1.83, 95% CI: 1.04 to 3.22) and income above the poverty line (AOR: 2.24, 95% CI: 1.08 to 4.63) were positively associated with non-smoking. Furthermore, Brahmin and Chhetri ethnic groups (AOR: 4.51, 95% CI: 1.64 to 12.40), males (AOR: 0.17, 95% CI: 0.06 to 0.50) and primary education (AOR: 0.26, 95% CI: 0.08 to 0.85) were associated with alcohol moderation. CONCLUSION: The adherence to the DASH diet and weight management was particularly low. Healthcare providers and policymakers should focus on improving self-care by designing simple and affordable interventions for all patients with hypertension.

Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study.

BACKGROUND: Chronic kidney disease is an important cause of global mortality and morbidity. Data for epidemiological features of chronic kidney disease and its risk factors are limited for low-income and middle-income countries. The International Society of Nephrology's Kidney Disease Data Center (ISN-KDDC) aimed to assess the prevalence and awareness of chronic kidney disease and its risk factors, and to investigate the risk of cardiovascular disease, in countries of low and middle income. METHODS: We did a cross-sectional study in 12 countries from six world regions: Bangladesh, Bolivia, Bosnia and Herzegovina, China, Egypt, Georgia, India, Iran, Moldova, Mongolia, Nepal, and Nigeria. We analysed data from screening programmes in these countries, matching eight general and four high-risk population cohorts collected in the ISN-KDDC database. High-risk cohorts were individuals at risk of or with a diagnosis of either chronic kidney disease, hypertension, diabetes, or cardiovascular disease. Participants completed a self-report questionnaire, had their blood pressure measured, and blood and urine samples taken. We defined chronic kidney disease according to modified KDIGO (Kidney Disease: Improving Global Outcomes) criteria; risk of cardiovascular disease development was estimated with the Framingham risk score. FINDINGS: 75,058 individuals were included in the study. The prevalence of chronic kidney disease was 14·3% (95% CI 14·0-14·5) in general populations and 36·1% (34·7-37·6) in high-risk populations. Overall awareness of chronic kidney disease was low, with 409 (6%) of 6631 individuals in general populations and 150 (10%) of 1524 participants from high-risk populations aware they had chronic kidney disease. Moreover, in the general population, 5600 (44%) of 12,751 individuals with hypertension did not know they had the disorder, and 973 (31%) of 3130 people with diabetes were unaware they had that disease. The number of participants at high risk of cardiovascular disease, according to the Framingham risk score, was underestimated compared with KDIGO guidelines. For example, all individuals with chronic kidney disease should be considered at high risk of cardiovascular disease, but the Framingham risk score detects only 23% in the general population, and only 38% in high-risk cohorts. INTERPRETATION: Prevalence of chronic kidney disease was high in general and high-risk populations from countries of low and middle income. Moreover, awareness of chronic kidney disease and other non-communicable diseases was low, and a substantial number of individuals who knew they were ill did not receive treatment. Prospective programmes with repeat testing are needed to confirm the diagnosis of chronic kidney disease and its risk factors. Furthermore, in general, health-care workforces in countries of low and middle income need strengthening. FUNDING: International Society of Nephrology.