Maternal Decision-Making Input and Health-Seeking Behaviors Between Pregnancy and the Child's Second Birthday: A Cross-Sectional Study in Nepal.

OBJECTIVES: Maternal health-seeking behaviors are critical to improving maternal and child health in low-income countries. This study investigates associations between maternal decision-making input and their health-seeking behaviors in the first 1000-day period between pregnancy and a child's second birthday in Nepal. METHODS: We used data from a cross-sectional survey conducted in 2018 in 16 districts of Nepal. Among the 3648 households surveyed, 1910 mothers of a child 0 to 24 months with complete data were included for analyses. Logistic regression was used to examine associations between decision-making input and the utilization of antenatal, delivery and postnatal care services, and attendance at health mothers' group (HMG) meetings. We also used negative binomial regression to assess the relationship between her decision-making input and participation in growth monitoring and promotion (GMP) in the 6 months prior to the survey. For each relationship examined, we adjusted for clustering, as well as potentially confounding factors at individual and household levels. RESULTS: After adjusting for confounders, maternal decision-making input had a small but positive and significant association with receiving at least 4 antenatal care visits (OR = 1.09, 95% CI 1.02, 1.17), attendance at GMP in the 6 months prior to the survey (IRR = 1.02, 95% CI 1.00, 1.04), and HMG attendance (OR = 1.10, 95% CI 1.03, 1.17), but not with receiving at least 3 postnatal care visits or delivering in a health institution. CONCLUSIONS FOR PRACTICE: Our findings indicated that empowering women and mothers in household decision-making might warrant greater attention when developing future policies and programs in Nepal.

Intimate partner violence and nutritional status among nepalese women: an investigation of associations.

BACKGROUND: Malnutrition among women in Nepal persists as a major public health burden. Global literature suggests that domestic violence may have a negative impact on women's nutritional status. The contribution of intimate partner violence (IPV) to increased stress levels, poor self-care including the consumption of less food and, in turn, malnutrition has been documented. However, there is little empirical evidence on IPV and its relationship with women's nutritional status in Nepal and thus, this paper assesses these associations. METHODS: We used data on non-pregnant married women (n = 3293) from the 2016 Nepal Demographic and Health Survey (NDHS). The primary exposure variable was whether the women had ever experienced physical, sexual, or emotional violence or controlling behaviours by a current or former partner, based on her responses to the NDHS domestic violence questions. The primary outcome variables were three indicators of malnutrition: under-weight (BMI < 18.5), over-weight (BMI > 25), and anemia (Hb < 11.0 g dL). We used logistic and multinomial regression models, adjusted for potential socio-demographic and economic confounders, as well as clustering, to examine associations between IPV exposure and malnutrition. RESULTS: Approximately 44% of women had experienced at least one of the four types of IPV. Among them, around 16, 25%. and 44% were underweight, overweight, or anemic, respectively, compared to 13, 29, and 35% of women never exposed to IPV. We did not find any associations between underweight and any of the four types of IPV. Overweight was associated with physical violence (adjusted RRR = 0.67, P < 0.01, CI = 0.50-0.88) and severe physical violence (adjusted RRR = 0.53, P < 0.05, CI = 0.32-0.88) Controlling behaviors were associated with anemia (adjusted RRR = 1.31, P < 0.01, CI = 1.11-1.54). CONCLUSIONS: Among married Nepalese women, physical violence appears to be a risk factor for one's weight and controlling behaviors for one's anemia status. Additional, rigorous, mixed-methods research is needed to understand the reporting of IPV and what relationships do or do not exist between IPV experience and nutrition both in Nepal and in other settings.

Perception of tourists regarding the smoke-free policy at Suvarnabhumi International Airport, Bangkok, Thailand.

This study was conducted during February-March 2012 to determine the perception and support regarding smoke-free policy among tourists at Suvarnabhumi International Airport, Bangkok, Thailand. In this cross-sectional study, 200 tourists (n = 200) were enrolled by convenience sampling and interviewed by structured questionnaire. Descriptive statistics, chi-square, and multinomial logistic regression were adopted in the study. Results revealed that half (50%) of the tourists were current smokers and 55% had visited Thailand twice or more. Three quarter (76%) of tourists indicated that they would visit Thailand again even if it had a 100% smoke-free regulation. Almost all (99%) of the tourists had supported for the smoke-free policy (partial ban and total ban), and current smokers had higher percentage of support than non-smokers. Two factors, current smoking status and knowledge level, were significantly associated with perception level. After analysis with Multinomial Logistic Regression, it was found that perception, country group, and presence of designated smoking room (DSR) were associated with smoke-free policy. Recommendation is that, at institution level effective monitoring system is needed at the airport. At policy level, the recommendation is that effective comprehensive policy needed to be emphasized to ensure smoke-free airport environment.