Introduction: Globally, tobacco kills more than seven million people per year. In Nepal, more than fifty different types of tobacco products, both in smoke and smokeless forms, are available. Pictorial health warning labels (PHWLs) on tobacco products provide an effective way to aware both literates and illiterates about the health effects of tobacco use. This study aimed to assess the perceived effectiveness of pictorial health warning labels of tobacco products and associated factors among smokers and quitters. Methods: The study design was community-based cross-sectional analytical with the quantitative method. We interviewed 389 adults (111 Quitters and 278 Smokers) of Kaski district. The sample was taken from both rural and urban areas based on existing household proportion. Ethical approval was taken from NHRC. We entered data in EpiData and analyzed in SPSS softwares. The perceived effectiveness scores of PHWLs were calculated (alpha ranges from 0.91 to 0.96) and compared among different groups using the Wilcoxon rank-sum test and Kruskal-Wallis test with the Dunn’s multiple comparisons. The perceived effectiveness score of PHWLs were correlated with discrete covariates using Spearman rank correlation. Results: Nearly one-third of the participants (32.7%) had bought a single piece of tobacco product, which is not allowed in Nepal. Nearly sixteen percentage of the participants were moderate to high level of nicotine dependent. Only twelve percent of participants wanted to quit or already quitted as s/he saw the PHWLs. Scores of Premature birth was statistically significant (p=0.031) on smoking status. Martial status, ethnicity, any family member use tobacco, age at first exposure psychological response, behavioral response and message credibility were statistically significant for the perceived effectiveness of PHWLs among smokers. Whereas place of resident, education status, age, psychological response, behavioral response, self efficacy and message credibility were statistically significant at p<0.05 for the perceived effectiveness of PHWLs among quitters. Conclusions: This study concluded that premature type of PHWL was more effective than other type of PHWLs. The interventional program along with social and behavior change communication should be focused on the psychological, behavioral related and geographical setting. Further research is suggested to carryout the interventional study addressing behavioral and psychological factors.

Introduction: Care seeking behavior is a process of taking actions in the pursuit of health gain and obtaining treatment. Various factors influence mothers to choose public or private health care facilities for neonatal health and illness, which may help policy makers to achieve the Universal Health Coverage (UHC). Objective: The study aimed to find out the factors associated with maternal care-seeking behaviors of their neonates’ health and illness. Methodology: A cross-sectional study was carried out among 248 mothers having neonates up to six months with the history of illness during their neonatal period, selected by applying 30 cluster sampling strategy. We entered data and then analyzed in SPSS with chi-square test and logistic regression methods. Results: Majority of ill neonates (68%) were sought out in public health facilities in Jumla. A few (6%) were taken to private facilities whereas more than one-fourth (28%) were either sought out nowhere or treated at home traditionally. Proportion of fever and acute respiratory infections (ARI) among neonates was almost half (46.4%) and one-fifth (19%), respectively. Multivariate logistics regression showed that mothers with primary education and above had an odds of 25 (95% CI, 1.44-333.0) , with a self-decision had an odds of 11.29 (95% CI, 2.26-56.00), and walking distance of ≤30 minutes to health facility had an odds of 104.2 (95% CI, 3.80-2821.4), for seeking out the remedy in public health facilities for their neonates. Conclusions: The study concluded that more than half neonates were ill from different diseases and more than two-thirds of them were taken to public health facilities to seek out for remedy. Maternal education having at least primary level, with a self-decision, and less distance to health facilities were the probable factors of choosing public health facilities for seeking out the remedy for a neonatal illness. Nonetheless, further studies with larger sample size and stronger designs are warranted for a firmer conclusion.