Reproductive health rights ensure that people are able to have satisfying and safe sex life and that they have the capacity to reproduce with freedom to decide, when and how often to do so. This study aimed to assess the knowledge and practices on reproductive health rights among madhesi married women. A descriptive cross-sectional study was conducted among 384 madhesi married women of reproductive age in Sarlahi district conducted from July 2014 to December 2014. Data were entry in Epidata software and analyzed by SPSS 20 version. Of the total 384 respondents most of them (39.3%) were of age group 25-35 years from different ethnic groups. Most were simple illiterate (65.6%) and housewife (60.9%) very few of respondents were knowledge about reproductive health rights (37%) and not statistical significant relationship with level of knowledge and level of practice (χ 1 2 =2.036, p=0.154). Level of knowledge was statistically significant relationship with educational level (χ 4 2 = 43.983 p<0.001). Use of FP services have statistically significant relationship with Age group (p<0.001). The level of knowledge and level of practice on RHRs is still very low in Madhesi women.

Health insurance poses a vital role in developing countries, to attain an equitable health outcome to all citizens by ensuring universal health coverage.  This study aims to assess the factors associated with non-enrollment in National Health Insurance Scheme (NHIS) in a setting of Nepal. A cross-sectional study was conducted among 492 households (246 non-enrolled and 246 enrolled) of Kaski district, Nepal from May to August 2020. Data were gathered from face-to-face interview. Data were entered in Epi data 3.1 and analysed by using statistical package for social sciences (SPSS16).  Descriptive and inferential statistics were performed to analyze the data. The household without elderly family members were 2.06 times less likely to enroll in the scheme (AOR=2.060, CI=1.141-3.721, p<0.01). Similarly, non-enrollment increases with the decreasing wealth quintile of the family (AOR=4.312, CI=1.881-9.880, p<0.001). Families who perceived their family health status as fair was more likely to join the scheme than those as a good health status. Households who had poor or average knowledge on the scheme were almost five times more likely to non-enrollment (AOR=4.641, CI=2.841-7.582, p <0.001). Factors that determine the non-enrolment in NHIS are households had without elderly family members, poor wealth quintile, self-perceived good health status and poor knowledge on NHIS. Effective coordination from different stakeholders need to increase the health insurance coverage and increase the health literacy through the wide coverage of health communication program.

Background: Depression is a common and major public health problem among geriatric people, but it is not a normal part of aging. It is not just a low mood or feeling sad, but a serious condition that needs treatment and has serious effects on physical as well as mental health. It is one of the hidden problems of the geriatric people.Methods: A cross-sectional study was conducted among 196 elderly people from Kaski district of Nepal using geriatric depression scale to assess the level of depression. Wards of metropolitan was randomly selected and represented as urban area and ward of rural municipality were randomly selected and considered as rural areas. Data were collected by face-to-face interview among geriatric people. Data were analyzed by SPSS v.16 version. The appropriate statistical tests were applied based on the nature of the data, setting the level of significance at p<0.05.Results: Out of total 196 study participants 101 were from urban area and 95 from rural area. The overall prevalence of depression was 55.1%. In this study geriatric depression was significantly associated with: spouse status, living arrangement, satisfaction with living condition, family support, family care, abuse, relationship with son, relationship with daughter in law, work, discrimination, social isolation and loneliness and health problems.Conclusions: More than half of the elderly population had developed depressive symptoms. Immediate addressing of geriatric depression by providing health services, counseling and harmonious relationship among geriatric people and family members especially their son and daughter in law should be created by providing social support and counseling to family members.

Introduction: Cost analysis can be an important element and it help to sort out important economic issues. The economic constraint is one of the factors that hinder service utilization among rural women attending urban health although there is Maternal Incentive Scheme, households often have to pay a too large share of the indirect costs of maternity services, or do not seek care because of it. Methods: Cross sectional study design which is community based with quantitative method were used for this study to assess the indirect cost of institutional delivery under safe motherhood program in Pokhara Metropolitan from Jan 2019 to June 2019. Study population were the mothers who delivered at health facilities having safe motherhood program within the 6 months preceding the survey. Probability Proportional to size sampling method was adopted with face to face interview among the care takers of mothers. Reliability and validity was maintained by applying different strategies carefully developing tools, pretesting, double entry and validation. Data entry, management and analysis was done with Epi Data and SPSS (20 version) Software. Results: In this study majority more than half (54.4%) of the mothers were between 25-34 years. Majority of the participants were male and nearly half of the respondents were belonged to Janajatis (51.5%). More than one fourth (29.6%) of the mothers were from the highest quintile. Median expenditure for indirect cost was NRs 4900 which ranges from NRs 500 to NRs 47000. Conclusions: From the study we can conclude that existing Aama Surakshya Program can save only a few expenditure of mothers there should need to review this demand side financing scheme and also need to address the main barriers for service utilization i.e. indirect cost of institutional delivery.

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.