Aim: To understand how maternal and neonatal near-miss reviews could be implemented and scaled-up in rural communities through the existing district health system in Nepal.Methods: Mixed methods with a modified time series evaluation design were used. The World Health Organization maternal and neonatal near-miss criteria used in multicountry surveys were adapted and used to define maternal and neonatal near-miss cases.Results: The World Health Organization near-miss criteria were mainly applicable at the district hospital setting, but further adaptations were needed for community-level birthing centres, as organ dysfunction and critical intervention criteria were not found appropriate. In birthing centres, disease-based criteria were applicable for maternal near-miss review, and danger and clinical sign-based and condition at birth criteria were applicable for neonatal near-miss review. Primary barriers to implementation were attrition of trained staff due to the frequent transfer of healthcare providers, and time constraints of district hospital medical doctors for case-by-case reviews as they were often busy in hospital and in their private clinics. Conclusion: Adapted maternal and neonatal near-miss review process implementation inNepal is feasible through the existing government health system. Abbreviations CEONC, Comprehensive emergency obstetric and neonatal care; DHO, District Health Office; FCHV, Female community health volunteer; FGD, Focus group discussion; FHD, Family Health Division; IDI, In-depth interview; MNC, Maternal and newborn care; MNH, Maternal and newborn health; MNNR, Maternal and neonatal near-miss review; MNR, Maternal near-miss review; MPDR, Maternal and perinatal death review; MPDSR, Maternal and perinatal death surveillance and response; QoC, Quality of care; SBA, Skilled birth attendant; TAG, Technical advisory group; WHO, World Health Organization. Key notesIn rural areas, disease-based criteria were appropriate for maternal near-miss reviews; while for neonatal near-miss reviews, the most relevant set of criteria were the danger/clinical signs and conditions at birth criteria. Attrition of trained staff due to the frequent transfers was a primary barrier. Key recommendations include exploring integration with the existing maternal and perinatal death surveillance and response system.

Unsafe sexual behavior is common among the HIV infected. This exposes them to the risks of unintended pregnancy, HIV transmission to uninfected partners and super-infection. Studies on the use of family planning measures among People Living with HIV (PLHIV) are scarce in Nepal. The aim of this study was to explore the knowledge and practice of family planning (FP) in PLHIV. A cross sectional survey was conducted during July–December 2012 in Kaski district of Nepal. A total of 120 PLHIVs were recruited using snowball sampling from three HIV clinics within the Pokhara sub-metropolitan city area. This study found that nine in ten PLHIV had heard about family planning. Two thirds of respondents were using at least one FP method. The majority (65.8%) used condoms and had received FP counseling (67.5%). Less than one percent used condoms in addition to another contraceptive. Being single, being female and having received the counselling sessions were associated with the use of FP. The individuals who received FP counseling were more likely [OR 4.522; 95% CI (1.410–14.504)] to use FP. Females were more likely [OR 4.808; 95% CI (1.396–16.556)] to use FP than males. The individuals who were single/de-facto widowed were more likely [OR 7.330; 95% CI (2.064–26.028)] to use FP than the married individuals. Our findings suggest that there is a need to focus on FP counseling if the HIV prevention program is to increase FP use among the PLHIV population. Use of dual contraceptives need to be promoted through counseling sessions and other health promotion programs focusing in HIV prevention.

No abstract

Purpose This study aims to examine the challenges posed by COVID-19 restrictions for audit processes in India and explore the perceptions of the profession on how technology was leveraged to conduct audits during this period. The opinions of auditors on future changes in post-COVID-19 audit practices and processes are also explored. Design/methodology/approach Semi-structured interviews were conducted with senior auditors working in various audit firms in major business centers in India and subjected to content and thematic analysis using the institutional theory perspective. Findings The auditing profession used technology to respond to COVID-19-imposed disruptions of established audit process and practices while maintaining the legitimacy of audit reports. The findings indicate that auditors now seem to strongly support the integration of emerging technologies into their auditing practices post-COVID to ensure data accuracy and transparency. The interviewees displayed keen interest in continuing remote and in-person audits to maintain audit quality in the future. The experience of COVID-19 appears to have forced the auditing profession to overcome their reluctance to adopt technologies that were previously used by only Big 4 and large audit companies. Practical implications The results will be of particular interest to various stakeholders concerned with aspects of the acceptance of technology-assisted audit reports such as legitimacy, required infrastructure, cost involvement and resistance to change. The findings will also assist professional bodies and policymakers in both developed and developing economies in devising useful strategies to promote technology-aided auditing during and after COVID-19. Limitations posed by inadequate infrastructure and resistance to changes must be overcomed before implementation of technology-aided audits. Originality/value As COVID-19 pandemic is a recent phenomenon, to the best of the authors’ knowledge, this study is one of the first few studies that have examined the use of technology to facilitate audits during the COVID-19 period, more specifically from a developing economy perspective.

The chapter is aimed at analyzing the collective perception of the accounting community of Vietnam towards the adoption of International Financial Reporting Standards (IFRS). This perception is premised on the twin issues of legitimacy and isomorphism. A broad sample survey of 728 persons out of 3000 accountants, auditors and academics was undertaken with a detailed questionnaire sent to each. With a net response rate of 24 per cent from this community, there emerged a definite influence of coercive, mimetic and normative isomorphisms as well as legitimacy motives. The study provides practical implications for the policymakers of Vietnam for the transformation of the accounting profession in the country and the strategic planning towards full mandatory IFRS adoption by 2020.