Anemia is a condition in which the number of red blood cells is not sufficient to meet the physiological need of the body. Women of reproductive age and pregnant women are at a high risk of anemia, which in turn may contribute to maternal morbidity and mortality. We aimed to describe the prevalence of anemia and the factors associated with the risk of developing anemia in women of reproductive age in Nepal. Additionally, we examined the association of women’s decision-making autonomy regarding healthcare and experience of intimate partner violence (IPV) with anemia. Data from the 2016 Nepal Demographic and Health Survey (NDHS) were used in this study. The data were adjusted for sampling weight, stratification, and cluster sampling design. A battery-operated portable HemoCue was used to measure hemoglobin and detect anemia. Using complex sample logistic regression, the association between dependent and independent variables were examined; crude and adjusted odds ratio were reported. The mean (± SD) hemoglobin concentration was 12.13 g/dL (± 1.48). Overall, about 41% (95% CI 38.6–43.0%) of women aged 15–49 years were anemic. Women in households with wells as the source of drinking water (aOR 1.93; 95% CI 1.58–2.37) were significantly associated with an increased risk of developing anemia. While women who were currently using hormonal contraceptives (aOR 0.63, 95% CI 0.52–0.76) were significantly less likely to be anemic. After adjusting for background characteristics among women who were married at the time of the survey, decision-making autonomy regarding healthcare, and experience of IPV did not have a significant association with anemia. The high prevalence of anemia suggests the need for substantial improvement in the nutritional status of women. The increased disease burden compared with the past survey highlights the needs to reconsider the existing nutritional policy in Nepal.
The purpose of this study is to assess the magnitude of intimate partner violence (IPV) and associated factors among women in Nepal. The secondary data from the Nepal Demographic and Health Survey (NDHS) 2016 was used. This study was confined to the respondents selected for the domestic violence module. The association between experience of IPV ‘ever’ and ‘in the past year’ with selected factors were examined by using Chi-square test, followed by multivariate logistic regression. Complex sample analysis procedure was adopted to adjust for multi-stage sampling design, cluster weight, and sample weight. The result revealed that 26.3% of ever-married women experienced any form of IPV at some point in their lives, while only 13.7% has experienced any form of IPV in the past year. The factors associated with both ‘lifetime’ and ‘past year’ experience of IPV includes women witnessing parental violence during their childhood, the husband being drunk frequently, women being afraid of their husband most of the times, and women whose husbands shows marital control behavior. Women’s experiencing IPV was associated more with husband related factors than with women’s empowerment indicators. Reducing IPV requires a commitment to changing the norms that promote the husband’s behavior of controlling his wives and beating her.
This study aims to identify the relationship of women’s autonomy and intimate partner violence (IPV) with maternal healthcare service utilization among married women of reproductive age in Nepal. This study used data from the 2016 Nepal Demographic and Health Survey (NDHS), which is a nationally representative sample survey. The association between outcome variables with selected factors were examined by using the Chi-square test (χ2), followed by multiple logistic regression. The sample was adjusted for multi-stage sampling design, cluster weight, and sample weight. Of the total sample, 68.4% reported attending sufficient Antenatal care (ANC) visits throughout their pregnancy, while 59.9% reported having a health facility delivery. The factors associated with both, sufficient ANC visits and institutional delivery includes ethnicity, place of residence, household wealth status, and the number of living children. Women who have access to media, and who have intended pregnancy were more likely to have sufficient ANC visits. Exposure to some forms of violence was found to be the barrier for maternal health service utilization. Attending ANC visits enables mothers to make the decision regarding skilled attendance or health facility delivery. Preventing any forms of violence need to be considered as a vital element in interventions aimed at increasing maternal health service utilization.
Background: Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). Methods: A cross-national study was performed with different sources of data, using the administrative record linkage theory. We created a new data set using data from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. Result: The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. AM was significantly higher in economically weak countries, countries with political instability, countries with traditional religion, without achievement of UHC, and Sub-Saharan Africa (p<0.01). There was high disparity of AM between countries with and without UHC (F = male: 61.89, female: 51.85, p<0.001) and between groups with low and high income (F = male: 36.33, female: 42.39, p<0.001). UHC and political stability would significantly reduce AMR by > 0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70, in relation to countries without UHC, with political instability, and low economic status. Conclusions: Disparities in AM can be reduced after the achievement of UHC and economically productive activities for those adults affected by conflict and political unrest.
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