Background Due to the limited number of studies in low- and middle-income countries (LMICs), this study aimed to identify the prevalence and determinants of postpartum poor maternal sleep and depression. Methods This cross-sectional study was conducted with 380 women who were 2–12 months postpartum in March and April 2017 in Ramechhap district, Nepal. Multiple logistic regression was used to identify the associated factors. Results The prevalence of poor sleep quality and depression was 28.2% and 18.7%, respectively. Poor sleep quality was associated with having an occupation (in government or business, odds ratio [OR] 6.69; in agriculture/labour, OR 15.5), a male infant (OR 2.37), home delivery (OR 2.17), mental illness during pregnancy (OR 5.87), complications after delivery (OR 5.58) and postpartum depression (OR 2.86). Meanwhile, postpartum depression was associated with having no post-natal care (OR 98.7), living in a nuclear family (OR 48.5), living in a rural area (OR 26.6), having a male infant (OR 4.61), having complications after delivery (OR 21.9), introducing complementary foods before 6 months of age (OR 4.71) and having poor sleep quality (OR 3.20). Conclusions A relatively high prevalence of depression and poor sleep quality were found. The close positive association between poor sleep quality and depression suggests the need for early identification and support for women at risk of poor sleep quality and depression in Nepal.

Introduction: This is a study of hospital managers in Nepal, measuring their reported capability to undertake management tasks and explore their views about management development.  Methods: A questionnaire was administered through hospitals. Respondents were asked to rate a series of management tasks on a scale according to how important it was, for their role and their capability to perform it. These tasks were grouped into different factors. The sample included government hospital of each district and major private or hospitals run bu non-government organizations.  Results: A total of 31 hospitals were visited in 18 districts. Information was obtained from 103 managers from different professions. In most hospitals visited, overall management was provided by the doctors. Few had undergone some training to take on management responsibilities. All types of managers, regardless of profession or type of hospital, reported a ‘competence gap’for each factor defi ned as the difference between reported importance and capability. Non-government managers consistently rated themselves as beingmore capable than government managers, but the difference was only signifi cant when it concerned managing People. The need for a separate cadre of managers was supported by 85% of respondents but a majority of doctors (57%) felt that the best people to manage hospitals were doctors.  Conclusions: Consistent with other studies from low income countries, there is an urgent need to provide different modalities of management developmentenabling hospital managers to improve their capabilities. There is widespread need of management training to be made available in Nepal.  Keywords: hospital management, management competency, management training needs.

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