Background People affected by leprosy are at increased risk of ulcers from peripheral nerve damage. This in turn can lead to visible impairments, stigmatisation and economic marginalisation. Health care providers suggest that patients should be empowered to self-manage their condition to improve outcomes and reduce reliance on services. Self-care involves carrying out personal care tasks with the aim of preventing disabilities or preventing further deterioration. Self-help, on the other hand, addresses the wider psychological, social and economic implications of leprosy and incorporates, for example, skills training and microfinance schemes. The aim of this study, known as SHERPA (Self-Help Evaluation for lepRosy and other conditions in NePAl) is to evaluate a service intervention called Integrated Mobilization of People for Active Community Transformation (IMPACT) designed to encourage both self-care and self-help in marginalised people including those affected by leprosy. Methods A mixed-method evaluation study in Province 5, Nepal comprising two parts. First, a prospective, cluster-based, non-randomised controlled study to evaluate the effectiveness of self-help groups on ulcer metrics (people affected by leprosy only) and on four generic outcome measures (all participants) - generic health status, wellbeing, social integration and household economic performance. Second, a qualitative study to examine the implementation and fidelity of the intervention. Impact This research will provide information on the effectiveness of combined self-help and self-care groups, on quality of life, social integration and economic wellbeing for people living with leprosy, disability or who are socially and economically marginalised in low- and middle- income countries.

Breast cancer has emerged as a major public health problem and early detection helps in bringing down the burden. Even thoughMammography is the best choice for screening, it is expensive and requires skilled personnel. Breast Self-Examination (BSE) is important in early detection and for mass awareness especially in resource poor countries. Nurses and midwives constitute major contributors in delivering health care and education and if these are empowered and trained they can convince women to perform BSE. Various studies conducted on nurses BSE practice show that the nurses are generally ineffective practitioners of BSE and that their frequency of BSE teaching is low. To assess the knowledge and practice of effective BSE among female nurses. A descriptive cross sectional study was conducted among 90 female nurses working in a tertiary care hospital. A self-administered questionnaire was used to assess the knowledge and practice of BSE. Written consent was taken from the participants. Data was collected on the socio demographic information, knowledge and practice of BSE. Data was analysed using SPSS version 16. : 55.6% of the nurses said that BSE should be performed once in 6 months, 18.9% felt that it should be performed monthly. 42.2% of the nurses said that BSE has no relation to menstrual cycle. 86.7% of nurses said that BSE should be performed in standing up position and the first source of information was BSE awareness programmes. 75.6% nurses practiced BSE but only 33.3% were effectively practicing BSE. 50% of the nurses said that they were confident in performing BSE. The major reasons for practicing were, early detection has a great value and fear of Breast cancer. Themajor reasons for not practicing BSE were, afraid I will find something 54.5%.The study indicates that nurses had inadequate knowledge about BSE. Practice of BSE was high but very few practiced it effectively.