Nationally representative surveys show gradual shifting of overweight and obesity towards poor and less-educated women of reproductive age in Nepal.

Overweight and obesity are considered major public health concerns all over the world. They have the potential to increase the risk of developing non-communicable diseases in reproductive age women, increasing their risk of pregnancy related complications and adverse birth outcome. This study was carried out to identify the trend of prevalence of overweight and obesity, along with their determinants, among reproductive age women (15-49 years) in Nepal. Data were taken from the nationally representative 2006, 2011 and 2016 Nepal Demographic and Health Surveys (NDHSs). Women were considered to be overweight or obese when their BMI was 23.0-27.5 kg/m2 or ≥27.5 kg/m2, respectively. Univariate, bivariate and multivariate analyses were performed, with significance taken at p<0.05. The prevalences of overweight and obesity both showed rising trends in women of reproductive age in Nepal from 2006 to 2016, particularly among those with no education, only primary education and poor women. The presence of overweight and obesity was found to be significantly associated with the sample women's age, educational status, wealth index, place of residence, ecological zone, developmental region, number of household members, marital status and ethnicity. In 2016 one in every three women of reproductive age in Nepal was either overweight or obese. As overweight and obesity have detrimental effects on women's health, the Government of Nepal, in collaboration with other government and non-government organizations, should take action to halt the rising trends in overweight and obesity in the country.

Gender differences in hypertension awareness, antihypertensive use and blood pressure control in Nepalese adults: findings from a nationwide cross-sectional survey.

The objective of this cross-sectional study was to determine the gender differences in hypertension awareness, antihypertensive use and blood pressure (BP) control among the adult Nepalese population (≥18 years) using data from the nationally representative Nepal Demographic and Health Survey 2016. A weighted sample of 13,393 adults (5620 males and 7773 females) was included in the final analysis. After conducting descriptive analyses with the selective explanatory variable, multivariable logistic regression analysis was performed to assess the association between the outcome variable and the explanatory variables. The strength of the association was expressed in adjusted odds with 95% confidence intervals. A higher proportion of women had their BP checked (87.7% females vs 73.0% males, p<0.001) and were aware of their raised BP (43.9% females vs 37.1% males, p<0.001) compared with men. Although female hypertensive individuals had a higher prevalence of antihypertensive medication use than their male counterparts (50.1% females vs 47.5% males), a higher proportion of male hypertensive participants had their BP controlled (49.2% females vs 53.5% males). Women with the poorest wealth index had a lower prevalence of antihypertensive use than their male counterparts. The odds of having their own BP measured increased with age among men but decreased with age among women. The household wealth index was positively associated with the odds of BP measurement, awareness of own BP and antihypertensive use. This study revealed that although women had a higher prevalence of hypertension awareness and antihypertensive medication use, the practice did not translate into better BP control. Inequality in antihypertensive medication use was observed among the poorest wealth quintiles. Public health programmes in Nepal should focus on reducing these inequalities. Further research is needed to learn why females have poorer control of BP, despite having higher antihypertensive medication use.

Association between the frequency of television watching and overweight and obesity among women of reproductive age in Nepal: Analysis of data from the Nepal Demographic and Health Survey 2016.

BACKGROUND: The prevalence of overweight and obesity, particularly among women, is increasing in Nepal. Previous studies in the South Asia have found television watching to be a risk factor for overweight and obesity among women of reproductive age. However, this association had not been studied in the context of Nepal. This study aims to identify the association between frequency of television watching and overweight and obesity among Nepalese women of reproductive age. METHODS: This cross-sectional study utilized the Nepal Demographic and Health Survey 2016 (NDHS 2016) data. A total weighted sample of 6,031 women were included in the final analyses. The women were 15-49 years of age and were either not pregnant or had not delivered a child within the two months prior to the survey. Body mass index (BMI) was the primary outcome of this study, which was categorized using an Asia-specific cutoff value. Normal and/or underweight was defined as a BMI <23.0 kg/m2, overweight was defined as a BMI between 23.0 kg/m2 and <27.5 kg/m2, and obesity was defined as a BMI ≥27.5 kg/m2. Frequency of watching television was the main independent variable of this study, which was divided into the following three categories: not watching television at all, watching television less than once a week, and watching television at least once a week. Multilevel ordered logistic regression was conducted to find the factors associated with overweight and obesity. A p-value <0.05 was considered significant in the final model. RESULTS: Around 35% of the participants were overweight or obese (overweight: 23.7% and obese: 11.6%). A majority of the study participants was aged between 15 and 24 years (36.5%), and resided in an urban area (63.2%), Province No. 3 (22.3%), and the Terai ecological region (49.5%). Around one-third (34.0%) of the participants received no formal education while an almost similar proportion (35.5%) completed secondary education. Approximately half of the study participants (50.6%) reported watching television at least once a week, whereas more than a quarter (28.7%) of them did not watch television at all. Women who watched television at least once a day had a higher prevalence of overweight and obesity than the other groups (p-value <0.0001). Women who watched television at least once a week were 1.3 times more likely to be overweight or obese in comparison to women who never watched television (Adjusted Odds Ratio (AOR): 1.3, 95% CI: 1.0-1.7; p-value <0.05). In the urban areas, women who watched television at least once a week were 40% more likely to be overweight or obese than those who did not watch television at all (AOR: 1.4, 95% CI: 1.1-1.7; p-value <0.01). No significant association between overweight and obesity and the frequency of viewing television was observed in the rural area. CONCLUSIONS: Watching television at least once a week is associated with overweight and obesity in women of reproductive age living in the urban areas of Nepal. Public health promotion programs should raise awareness among women regarding harmful health consequences of sedentary lifestyle due to television watching.

Prevalence and risk factors of postpartum depression within one year after birth in urban slums of Dhaka, Bangladesh.

Postpartum depression (PPD) is a serious pubic health concern and known to have the adverse effects on mother's perinatal wellbeing; and child's physical and cognitive development. There were limited literatures on PPD in Bangladesh, especially in urban slum context. The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression status. Respondent's socio-economic characteristics and other risk factors were collected with structured validated questionaire by trained interviewers. Unadjusted Prevalence Ratio (PR) and Adjusted Prevalence Ratio (APR) were estimated with Generalized Linear Model (GLM) and Generalized Estimating Equation (GEE) respectively to identify the risk factors of PPD. The prevalence of PPD was 39.4% within first 12 months following the child birth. Job involvement after child delivery (APR = 1.9, 95% CI = 1.1, 3.3), job loss due to pregnancy (APR = 1.5, 95% CI = 1.0, 2.1), history of miscarriage or still birth or child death (APR = 1.4, 95% CI = 1.0, 2.0), unintended pregnancy (APR = 1.8, 95% CI = 1.3, 2.5), management of delivery cost by borrowing, selling or mortgaging assets (APR = 1.3, 95% CI = 0.9, 1.9), depressive symptom during pregnancy (APR = 2.5, 95% CI = 1.7, 3.8) and intimate partner violence (APR = 2.0, 95% CI = 1.2, 3.3), were identified as risk factors. PPD was not associated with poverty, mother in law and any child related factors. The burden of postpartum depression was high in the urban slum of Bangladesh. Maternal mental health services should be integrated with existing maternal health services. Research is required for the innovation of effective, low cost and culturally appropriate PPD case management and preventive intervention in urban slum of Bangladesh.

Prevalence and determinants of hypertension among adult population in Nepal: Data from Nepal Demographic and Health Survey 2016.

Like other developing countries, Nepal is currently going through epidemiological transition along with rising burden of Non-communicable Diseases. However, since 2013, no study investigated the prevalence and determinants of hypertension in Nepal involving nationally representative sample. Therefore, this study aimed to find out the current prevalence of hypertension in Nepal and its determinants using the latest nationally representative data obtained from Nepal Demographic and Health Survey (NDHS) 2016. The NDHS 2016 collected data on hypertension from 13,304 men and women aged 18 years and above from 5,520 urban and 5,970 rural households covering seven administrative provinces and three ecological zones. Participants were considered as hypertensive when their systolic blood pressure was ≥140 mmHg and/or diastolic blood pressure was ≥90 mmHg and/or they reported taking antihypertensive medication. A total of 19.9% study participants were diagnosed as hypertensive of which majority were male (male-24.3%, female-16.9%), ever married (ever married-21.7%, unmarried-6.1%) and residents of urban area (urban-20.9%, rural-18.3%). Hypertension prevalence has shown growing trend with the increase of age. This prevalence was also higher among rich and overweight/obese individuals. In multivariable logistic regression analysis, older age, male gender, better education, residence at urban area and province 4 and 5 and being overweight/obese were found positive association with having hypertension. When the determinants of hypertension were stratified by sex of the participants, difference was observed in case of age group, education and place of residence. As one out of every five individuals in Nepal are hypertensive, public health initiatives are immediately required for prevention and control of hypertension to reduce mortality and morbidity associated with this progressive disease.