Prevalence of Internet Addiction and Associated Psychological Co-morbidities among College Students in Bhutan.

INTRODUCTION: Globally 3.5 billion people have access to internet and most of them are young adults and adolescents. In South Asia, Bhutan has the highest proportion of population with internet access at 37% in 2016. Many studies in Asia have reported significantly high level of internet addiction among college going students. In this light, this study was designed to estimate the prevalence of internet addiction and other co-morbidities. METHODS: This cross sectional study included 823 first year and final year students aged 18-24 from six colleges in Bhutan. A self-administered questionnaire consisting of three parts was utilized for data collection. The data was entered and validated in Epidata and analyzed using STATA/IC 14. RESULTS: The prevalence of moderate and severe internet addiction was 282 (34.3%) and 10 (1%) respectively. Positive correlations between internet addiction and psychological well-being (r= 0.331 95% CI: 0.269, 0.390), between Internet Addiction score and years of internet usage (r=0.104 95% CI: 0.036, 0.171), age and years of using internet (r= 0.8 95% CI: 0.012, 0.148) were observed. The commonest mode of internet use was martphone 714 (86.8%). The use of computer laboratory (aPR 0.80, 95%CI: 0.66, 0.96) and internet use for news and educational purposes (aPR 0.76, 95%CI: 0.64, 0.9) showed protective effects. CONCLUSIONS: The prevalence of internet addiction is high among the college going students in Bhutan. This warrants timely interventions to address the problems of internet addiction.

Factors associated with delivery at home in Bhutan: findings from the National Health Survey 2012

Background Despite Bhutan’s remarkable progress in the area of maternal and child health duringthe era of the Millennium Development Goals, a large proportion of pregnant women are still deliveringat home with no skilled attendant. Limited empirical studies have been carried out to understand thefactors associated with delivery at home in Bhutan.Methods This cross-sectional analytical study used secondary data collected in the nationallyrepresentative National Health Survey 2012. The survey included a total of 2213 women aged15–49 years who had a live birth in the 2 years preceding the survey and were selected usingmultistage stratified cluster sampling. Weighted analysis was done to evaluate determinants for theplace of delivery. Unadjusted and adjusted prevalence ratios with 95% confidence intervals (CIs) werecalculated to assess the possible association of factors with home delivery.Results Out of 2213 women aged 15–49 years who had a live birth in the 2 years preceding thesurvey, 73.7% had an institutional delivery. Coverage of institutional delivery ranged from 49.4% inZhemgang district to 96.1% in Paro district. Women in the poorest wealth quintile were 7.35 timesmore likely to have a birth at home compared to women in the richest quintile (adjusted prevalenceratio [aPR]: 7.35, 95% CI: 2.59–20.9). The older mothers aged 30–49 years were 0.79 times(aPR: 0.79, 95% CI: 0.70–0.88) less likely to have a home delivery than mothers aged 15–19 years.Women who had fewer than four antenatal care visits were 1.50 times (aPR: 1.50, 95% CI: 1.35–1.66)more likely to give birth at home compared to those who had four or more visits. The mothers givingbirth for a third or more time were 1.88 times (aPR: 1.88, 95% CI: 1.60–2.22) more likely to give birthat home compared to those giving birth for the first time. Women living in rural areas were 2.87 times(aPR: 2.87, 95% CI: 1.42–5.77) more likely to deliver at home compared to those living in urban areasand women living in the eastern region of the country were 1.35 times (aPR: 1.35, 95% CI: 1.17–1.55)more likely to have a home delivery compared to those living in the western region.Conclusion Lower socioeconomic status, rural location, eastern location, non-first birth, and havingfewer than four antenatal visits were significant factors associated with home delivery. These findingsshould inform further research and policy to build on Bhutan’s progress in promoting institutionaldelivery as the key strategy towards improving maternal and child health and achieving the relevanttargets of Sustainable Development Goal 3.