Parental knowledge and communication with their adolescent on sexual and reproductive health issues in Nepal.

BACKGROUND: Parental knowledge about sexual and reproductive health issues and adequate communication with their adolescent on these issues are crucial in promoting adolescent sexual and reproductive health. Although there are evidence on adolescent perceptions of their sexual health issues, research on parental perspectives of adolescent sexual health and parent-adolescent communication about sexual health issues in Nepal remains unexplored. Therefore, this study aimed to assess parental knowledge and communication practice about sexual and reproductive health with their adolescent children in Lalitpur Metropolitan City of Nepal. METHODS: A community-based cross-sectional study was conducted between January and March 2019 among randomly selected 308 parents of adolescents (aged 10-19 years) residing in Lalitpur Metropolitan City of Nepal. Face-to-face interviews using structured questionnaires were conducted to collect the data. The collected data were entered into EpiData software v3.1, and data analysis was performed using IBM SPSS Statistics for Windows Version 21.0 (IBM Corp. Armonk, NY, USA). The statistical significance was considered at a p-value <0.05 and a 95% confidence interval (CI). RESULTS: Of 308 parents, one-third of parents were found to have correct knowledge about safe abortion, menstrual hygiene and management, modern contraceptives, prevention of sexually transmitted infections, wet dreams among male adolescents, abstaining from sexual intercourse during the fertile period, and the possibility of a male adolescent to impregnate a girl. In addition, only 40.9% of parents were found to have communicated with their adolescent children about sexual and reproductive health issues. Parents who have knowledge about puberty (aOR = 2.2, 95% CI: 1.2-3.9), belong to Bharamin/Chhetri ethnic group (aOR = 1.2, 95% CI: 1.1-2.2), self-employed (aOR: 2.4, 95% CI: 1.3-4.0), having two or more adolescent children (aOR = 2.0, 95% CI: 1.1-3.6), and whose adolescent children were staying in school hostel (aOR = 1.7, 95% CI:1.0-3.0) were more likely to have parental communication about sexual and reproductive health with their adolescent children. CONCLUSIONS: Most parents do not communicate with their adolescent children on sexual health topics, although they feel sexual health education is essential to adolescents. The majority of parents were found inadequately aware of adolescent sexual health issues. It is crucial to have contextual interventions that would encourage parent-adolescent communication on sexual health matters in an integrated way to promote adolescent sexual and reproductive health.

Food insecurity during COVID-19 pandemic: A genuine concern for people from disadvantaged community and low-income families in Province 2 of Nepal.

BACKGROUND: Food insecurity is a serious social and public health problem which is exacerbated by the COVID-19 pandemic especially in resource-poor countries such as Nepal. However, there is a paucity of evidence at local levels. This study aims to explore food insecurity among people from the disadvantaged community and low-income families during the COVID-19 pandemic in Province-2 of Nepal. METHODS: The semi-structured qualitative interviews were conducted virtually among purposively selected participants (n = 41) from both urban and rural areas in eight districts of Province 2 in Nepal. All the interviews were conducted in the local language between July and August 2020. The data analysis was performed using thematic network analysis in Nvivo 12 Pro software. RESULTS: The results of this study are grouped into four global themes: i) Impact of COVID-19 on food security; ii) Food insecurity and coping strategies during the COVID-19 pandemic, iii) Food relief and emergency support during the COVID-19 pandemic, and iv) Impact of COVID-19 and food insecurity on health and wellbeing. Most participants in the study expressed that families from low socioeconomic backgrounds and disadvantaged communities such as those working on daily wages and who rely on remittance had experienced increased food insecurity during the COVID-19 pandemic. Participants used different forms of coping strategies to meet their food requirements during the pandemic. Community members experienced favouritism, nepotism, and partiality from local politicians and authorities during the distribution of food relief. The food insecurity among low-income and disadvantaged families has affected their health and wellbeing making them increasingly vulnerable to the COVID-19 infection. CONCLUSION: Food insecurity among low-income and disadvantaged families was found to be a serious problem during the COVID-19 pandemic. The study suggests that the relief support plan and policies should be focused on the implementation of immediate sustainable food security strategies to prevent hunger, malnutrition, and mental health problems among the most vulnerable groups in the community.

Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders.

BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. METHODS: The semi-structured qualitative interviews were conducted among purposively selected participants (n = 41) from a mix of rural and urban settings in all districts (n = 8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. RESULTS: The findings of this research are categorized into four global themes: i) Community and stakeholders' perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. CONCLUSIONS: This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population.

Conducting Qualitative Interviews using Virtual Communication Tools amid COVID-19 Pandemic: A Learning Opportunity for Future Research.

The COVID-19 pandemic has threatened the health and wellbeing of the global citizens which has led to a significant change in attitude, lifestyle, and behavior of people from diverse professions, including academics and researchers. Doctoral students and funded researchers with the time limit to their research project have experienced stress and anxiety due to the struggle of negotiating and managing the timeline to complete the fieldwork for their research. In the current circumstances, an increasing number of researchers are looking for alternative methods to conduct the fieldwork and complete the data collection. In this context, the aim of this viewpoint is to provide reflections on the challenges and opportunities experienced by the authors while conducting qualitative research fieldwork during the COVID-19 pandemic.

'Medicine doesn't cure my worries': Understanding the drivers of mental distress in older Nepalese women living in the UK.

The mental health of migrant communities is an important public health concern. A growing body of literature suggests that social and cultural determinants of health significantly contribute to the mental health and wellbeing of older migrants in their host countries. Despite the increasing population of older Nepalese migrants in the UK, there is little research exploring the mental health needs of this community. This article explores older Nepalese women's experiences of drivers of mental distress in London. Data was collected using in-depth interviews with 20 older Nepalese women living in the London Borough of Greenwich. Grounded thematic analysis of women's narratives identified six overarching factors contributing to their emotional distress that pose potential risks to their mental health: absence of family, language barriers, housing problems, physical illness, lack of appropriate support, fears of death, and inadequate financial resources. In many cases, the impact of these factors was experienced in combination rather than isolation, often influenced by cultural dynamics. Findings highlight that re-settlement in the absence of family is at the heart of emotional challenges for older Nepalese women. The paper concludes with a series of recommendations for supporting processes of settlement to mitigate this risk among older Nepalese women in the UK.