Assessment of a Community-Based Nutrition Program for Women and Children in Nepal Using Demographic and Health Survey.

Undernutrition is a particularly acute problem in middle- and low-income countries. The "Suaahara" program is a 5-year community-focused program in Nepal, aimed at improving the health and nutrition of pregnant and lactating women and their children under the age of 2 years. This research contributes to evidence on the impact of the "Suaahara" program in 41 treated districts compared to 34 control districts. Using the difference-in-differences method, we found that the weight-for-height z-score and body mass index z-score of children under the age of 2 in the treated districts significantly increased by 0.223 standard deviations (SDs) and 0.236 SDs, respectively, compared with the control districts 5 years before and after the program. The number of antenatal care visits (at least four visits) and safe deliveries significantly increased for pregnant women by 10.4% and 9.1%, respectively, in the treated districts compared with the control districts. The prevalence of fever in children under 2 years of age was significantly reduced by 6.2% in the treated districts. The results show the significance of a policy evaluation with transparent indicators on public health, which is necessary for policymakers so that they can propose evidence-based policy.

Potential demand for voluntary community-based health insurance improvement in rural Lao People's Democratic Republic: A randomized conjoint experiment.

INTRODUCTION: In Lao People's Democratic Republic (PDR), community-based health insurance (CBHI) is the only voluntary insurance scheme; it typically targets self-employed people, most of whom reside in rural areas and are dependent on agricultural activities for subsistence. However, until very recently, the enrollment rate has fallen short and failed to reach a large percentage of the target group. To promote the CBHI scheme and increase demand, some supporting components should be considered for inclusion together with the health infrastructure component. OBJECTIVES: This paper provides empirical evidence that the benefit package components of hypothetical CBHI schemes have causal effects on enrollment probabilities. Furthermore, we examine the distribution of willingness to pay (WTP) in response to policy changes based on a sample of 5,800 observations. METHODS: A randomized conjoint experiment is conducted in rural villages in Savannakhet Province, Lao PDR, to elicit stated preference data. Each respondent ranks three options-two hypothetical alternatives and the CBHI status quo scheme. The levels of seven attributes-insurance coverage for medical consultations, hospitalizations, traffic accidents, pharmaceuticals and transportation; premiums; and prepaid discounts-are randomly and simultaneously assigned to the two alternatives. RESULTS: The findings suggest that the average WTP is at least as large as 10.9% of the per capita income of those who live in rural areas, which is higher than the WTP for health insurance averaged across low- and middle-income countries (LMICs) in the literature. The component of round-trip transportation insurance coverage has a significant effect on WTP distribution, particularly increasing the share of the highest bin. CONCLUSION: Therefore, the low CBHI scheme enrollment rate in Lao PDR does not necessarily imply low demand among the targeted population, as the finding from the WTP analysis illustrates potential demand for the CBHI scheme. Specifically, if transportation is addressed, enrollment is likely to significantly increase.

Effects of Nanpao, a Kampo medicine, on the decline in estrous cyclicity with advancing age in female rats, as measured by vaginal impedance methods.

The present study was designed to evaluate the time-dependent effects of Nanpao, a kampo medicine, on age-related changes in the estrous cycle of female rats, and to investigate the utility of measuring electrical impedance in the vagina (EIV) for studying transitional changes in the estrous cycle. Rats were allocated to 3 groups: control, Nanpao 30 mg/kg/day, and 100 mg/kg/day groups. EIV measurements and cytology samples were taken for 14 days at the age of 6 months before the initial treatment. After the start of the treatment, these data were collected at about monthly intervals until the age of 10 months in the same manner. Observations at the ages of 7 (weeks 2-3 of dosing) and 8 months (weeks 6-7 of dosing) showed that loss of a regular estrous cycle in the 100 mg/kg/day group was inhibited as compared to the control group. Moreover, at the ages of 9 (weeks 11-12 of dosing) and 10 months (weeks 17-18 of dosing), these effects were identified not only in the 100 mg/kg/day group, but also in the 30 mg/kg/day group. Since vaginal cytology and EIV gave almost concordant results as indicators of estrous cyclicity, we concluded that the measurement of EIV was capable of detecting time-dependent changes in the estrous cycle as well as observations of vaginal smears. A short period of Nanpao administration inhibited loss of regular estrous cycles, and the EIV method is a worthwhile approach to a more precise study of estrous cyclicity in rats exhibiting abnormal estrous cycles.

Effects of Nanpao, a kampo medicine, on peripheral blood flow and surface skin temperature in aged female rats.

The effects of long-term treatment with Nanpao, a kampo medicine, on cold constitution were evaluated in aged female rats. Five-month-old rats were administered Nanpao orally at doses of 0, 30, or 100 mg/kg/day. The peripheral blood flow and surface skin temperature in the hind paws were measured using a laser Doppler blood flow meter and infrared thermography, respectively. In animals treated with Nanpao, the peripheral blood flow increased dose-dependently compared to that in the control group. Moreover, the surface skin temperature after immersion in ice-cold water was higher in the Nanpao-treated groups than in the control group at all measurement times. These results suggest that Nanpao has the potential to improve cold constitution associated with decreased peripheral blood flow in women.

Anti-aging effects of nanpao, a kampo medicine, on reproductive functions in female rats.

The improvement effect of nanpao, a kampo medicine, on the age-related decline in reproductive function was evaluated in female rats given the test drug for a long-term period. Young rats were allocated to the cesarean section and natural delivery groups to examine reproductive performance (young rat groups). Five-month-old rats were allocated to the 3 groups (aged rat groups): 1--control and 2--nanpao-treated groups. They were given orally in a dose of 0, 30 or 100mg/kg/day of the test drug, respectively. In aged rats, the first mating experiment was initiated at week 21 of dosing to evaluate reproductive performance by natural delivery and the second mating experiment at week 31 of dosing was evaluated by cesarean section. In the first and second mating experiments, various reproductive functions decreased in aged rats as compared to the young rats. On the other hand, loss of regular estrous cycles, decreases in delivery and pregnancy rates and mean fetal weights were inhibited in the treated groups as compared to the control group. In addition, decreases in the numbers of mean live offspring and fetuses were inhibited in the 100 mg/kg/day group. In conclusion, nanpao maintained normal embryo-foetal development in female rats.