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Introduction: Corona virus disease (COVID-19) is an infectious disease caused by a newly discovered corona virus. Healthcare workers are at risk of developing psychological distress and other mental health related symptoms. This study was intended to evaluate the prevalence and predictors of depression, anxiety, stress, and fear during COVID-19 pandemic among healthcare workers of Nepal. Methods: A cross-sectional survey was conducted between June and July 2020 with 167 healthcare workers. Mental health outcome, specially, fear was estimated using fear of COVID-19 scale (FCV-19S) whereas depression, anxiety and stress were assessed using DASS-21 survey questionnaire. Statistical analysis used: Chi-square test was performed to observe the association between mental health outcomes variables among health workers and the significance level was considered to be a p-value less than 0.05. Results: There were 15.0%, 24.0%, and 5.4% of the respondents who had severe and extremely severe level of depression, anxiety, and stress respectively and 44.3% of the respondents had fear during COVID-19 pandemic. The gender and job position were statistically significant with depression. The gender, job position, and respondents who had any health problems were statistically significant with anxiety. The respondents who had any health problems were statistically significant with stress. The gender, education, and job position were statistically significant with fear. Conclusion: During the COVID-19 outbreak, the frontline healthcare workers have experienced a varying level of depression, anxiety, stress, and fear. Specific counseling, support system, training on handling COVID-19 patient, and assigning normal working hour as government protocol to all healthcare workers are needed to enhance their psychological wellbeing and strengthen the healthcare systems capacity during pandemic.

Introduction: Exclusive breastfeeding (EBF) for up to six months has several benefits for children in reducing their morbidity and mortality. The objective of this study was to find out the prevalence of EBF practice and its influencing factors. Methods: A cross-sectional survey was conducted with 362 breastfeeding mothers attending selected health facilities in the Kathmandu district. Data were collected using structured questionnaires through a face-to-face interview. The knowledge, attitudes, self-efficacy and social support of breastfeeding were assessed by Iowa Infant Feeding Attitude Scale (IIFAS), Breastfeeding Self-efficacy Scale Short Form (BSES-SF) and Exclusive Breastfeeding Social Support Scale (EBSSS) scales respectively. Data were analyzed using descriptive and inferential statistics, through SPSS. Results: The prevalence of EBF practices for the six months was 64.1%. The higher proportion (99.2%) of the respondents had high self-efficacy for breastfeeding, 95.3% of the respondents had positive attitudes toward EBF, and 89.8% had high social support for EBF practices. The determinant of the Iowa Infant Feeding Attitude Scale was being a Hindu religion (aOR 6.1, 95% CI, 2.23-16.58). The determinants of the exclusive breastfeeding social support scale were being a mother who did colostrum feeding (aOR 11.8, 95% CI, 2.29-61.14), had institutional delivery (aOR 7.4, 95% CI, 2.21-24.54), and had school level education (aOR 3.6, 95% CI, 1.54-8.53). The determinants of EBF practices were of being an unemployed mother (aOR 2.7, 95%CI, 1.40-5.07) and mothers aged 26 year-old and below (aOR 1.7, 95%CI, 1.08-2.64). Conclusion: Findings reveal that high level of knowledge, attitude, self-efficacy and social support towards exclusive breastfeeding, but the prevalence of EBF practice is still low, so it should be promoted by having targeted intervention programs for mothers who are at-risk groups. Breastfeeding awareness programs should be integrated into the existing immunization clinics and give information to mothers about its long-term benefits.