Summary Healthy lifestyle behaviors during the preconception period are important to optimize maternal and child outcomes, including weight. However, the majority of women do not have optimal preconception lifestyle behaviors. This systematic review explored enablers and barriers to women's preconception lifestyle behaviors using the Capability, Opportunity, Motivation, Behaviour (COM‐B) model and Theoretical Domains Framework (TDF). Preconception was defined as the time before conception, capturing planned and unplanned pregnancies. Medline Complete, EMBASE, PsycINFO, and CINAHL were searched for peer‐reviewed, quantitative and qualitative primary studies (English, 2006–2020) that explored enablers and barriers to lifestyle behaviors (diet, physical activity, smoking, alcohol use, supplement intake). Forty‐two studies (of 3406) were included, assessing supplement use (n = 37), diet (n = 10), smoking (n = 10), alcohol use (n = 8), and physical activity (n = 5). All three COM‐B components were identified only for diet and supplement use. Of the 14 TDF domains, 7 were identified: knowledge, beliefs about capabilities, beliefs about consequences, goals, intentions, social support, and environmental context and resources. The presence/absence of knowledge on healthy behaviors was the most commonly assessed enabler/barrier. Future studies should explore a wider range of factors influencing preconception women's capability, opportunity, and motivation to modify their lifestyle behaviors.

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The aims of this study were to explore women’s and health professionals’ perspectives of preconception care and whether expanding the role of practice nurses (PNs) to provide preconception care is acceptable. In a descriptive qualitative approach, 23 semistructured interviews and three focus groups were conducted with women (n=14), PNs (n=8), GPs (n=10) and practice managers (n=2) in the state of Victoria, Australia, between September and December 2019. An inductive process of thematic analysis identified five themes and 12 subthemes. Women and health professionals viewed preconception to be when a woman is planning a pregnancy. Women wanted personalised preconception care, and receiving this from a PN was considered to be acceptable. If the role of PNs is expanded, PNs would require training and professional recognition of their role to provide preconception care. Funding barriers were discussed by PNs, GPs and practice managers, along with potential solutions, such as Medicare item numbers and checklists to streamline consultations. Other resources in the wider community, such as schools, were identified as important aspects of a coordinated approach. Overall, expanding the role of PNs to provide preconception care was acceptable to women and health professionals to increase women’s awareness and uptake of preconception care.

Abstract. Water sources classified as "improved" may not necessarily provide safe drinking water for householders. We analyzed data from Nepal Multiple Indicator Cluster Survey 2014 to explore the extent of fecal contamination of household drinking water. Fecal contamination was detected in 81.2% (95% confidence interval [CI]: 77.9-84.2) household drinking water from improved sources and 89.6% (95% CI: 80.4-94.7) in water samples from unimproved sources. In adjusted analysis, there was no difference in odds of fecal contamination of household drinking water between improved and unimproved sources. We observed significantly lower odds of fecal contamination of drinking water in households in higher wealth quintiles, where soap and water were available for handwashing and in households employing water treatment. The extent of contamination of drinking water as observed in this study highlights the huge amount of effort required to ensure the provision of safely managed water in Nepal by 2030 as aimed in sustainable development goals.The 2011 census of Nepal suggested 85% of households had "improved" drinking water sources, an increase of 39% points from the 1990s.1 These improved water sources are expected to better protect the water from extraneous contamination compared with unimproved sources. "Improved" water sources comprise water piped to premises, public taps/standpipes, tube wells or boreholes, protected wells, protected springs, and rainwater.2 "Unimproved" sources comprise unprotected springs, unprotected wells, tanker trucks, surface waters, and bottled water. 2But water from improved sources also have varied risk of fecal contamination, particularly in a developing country scenario such as in Nepal where poor management of water sources, household water storage practices, and water-related behaviors increase the risk of contamination. 3 The recently endorsed sustainable development goals (SDGs) intend to measure the goal of "achieving universal and equitable access to safe and affordable drinking water for all by 2030" based on the percentage of population using "safely managed drinking water services." 4 This refers to water from improved sources that are located on premises, available when needed, and free of fecal and priority chemical contamination. 4 In this study, we present the extent of fecal contamination of household drinking water and associated factors in Nepal using a nationally representative survey-Nepal Multiple Indicator Cluster Survey (NMICS) 2014. 5In the NMICS 2014, the number of Escherichia coli colony forming units (CFUs) was measured in water samples using a field-based method. A 100 mL volume of water sample was filtered through a filtration membrane (0.45 μm), and the membrane was then placed over a compact dry E. coli growth media plate. In addition, 1 mL water sample was directly plated on to another media plate. Media plates were incubated in a body-belt incubator or in a phase-change incubator for 24 hours. Blank tests were conducted for quality control. For further details...

Thousands of Nepalese women were widowed as a consequence of a decade (1996-2006) long civil war in Nepal. These women are at grave risk of mental health problems due to both traumatic experiences and violation of natural order of widowhood. The present study explores the depression and anxiety among war-widows. In 2012, a cross-sectional study was designed to interview 358 war-widows using validitated Beck Depression Inventory and Beck Anxiety Inventory in four districts of Nepal - Bardiya, Surkhet, Sindhupalchowk and Kavrepalanchowk with history of high conflict intensity. The prevalence of depression and anxiety was 53% and 63% respectively. Financial stress was significantly associated with depression (2.67, 95% CI: 1.40-5.07) and anxiety (2.37, 95% CI: 1.19-4.72). High autonomy of women as compared to low autonomy, high social support as compared to low social support and literacy as opposed to illiteracy was associated with less likelihood of depression and anxiety. Our results suggest high magnitude of depression and anxiety among war-widows in Nepal. Future policy efforts should be directed at providing mental health services to identify mental health issues among conflict affected individuals with focus on education, employment and activities to promote social support and autonomy at community.