Background: Adolescence is a transition period from childhood to adult life during which pubertal development and sexual maturation take place, thus making physiological development a challenge adolescents have to face. There is a substantial lacuna in the knowledge towards menstruation among adolescent girls. Menstrual hygiene and management is an issue that is insufficiently acknowledged and has not received adequate attention. Objective: This study was done to assess the knowledge and practices regarding menstruation among school going adolescents. Methods: A descriptive study was done among sixty-one female adolescents of Shree Himali Secondary School, Panchkanya, Sunsari, where data were collected from the adolescents meeting the inclusion criteria. Results: It was found that 36.1% correctly reported about menstruation where most common informant was mother (39.3%). Dysmenorrhoea was the commonest problem faced during menstruation (78.7%) followed by back pain and excessive blood loss. More than half of respondents (54.1%) used sanitary pads and frequency of changing pads twice a day was highest (50.8%). Initial reaction was of fear/apprehension at menarche by 36.1% of girls whereas 44.3% perceived it as an expectant process. Girls still faced different types of restrictions like not being allowed to visit holy places, not being allowed to cook and touch male family member etc. Conclusion: Traditional beliefs regarding menstruation still persist and menstrual hygiene among the adolescents was found to be unsatisfactory. It highlights the need of targeted interventions to raise awareness and provision of family health education package to all girls. Menstrual hygiene is an issue that needs to be addressed at all levels.Journal of Kathmandu Medical College Vol. 2, No. 3, Issue 5, Jul.-Sep., 2013 Page: 117-121DOI: http://dx.doi.org/10.3126/jkmc.v2i3.9962Uploaded date : 3/4/2014

Background Diabetes mellitus is a major public health problem which accounts for serious medical and economic consequences. Depression is an important associated condition that upsets the management and complications of diabetes. This study aimed to measure the prevalence of depression among people living with Type 2 Diabetes and to examine the factors linked with it. Methods This community based, cross-sectional study was conducted among 278 people living with type 2 diabetes in Duhabi-Bhaluwa municipality, Nepal. A face to face interview was conducted using a pre-tested semi-structured questionnaire to gain information on socio-demographic characteristics and clinical profile of the participants. Depression was assessed using the Beck Depression Inventory (BDI-II) scale. Variables were categorical and were thus, compared with Pearson’s chi-square tests and binary logistic regression models. Results The prevalence of depression in this study was 22.7%. Most people indicative of having depression were of older age, females, below secondary level education, with a smaller family size, with low family income, using insulin, without a family history of diabetes and/or having an additional illness. However, multivariate analysis showed that the only significant factors for depression were older age, education below secondary level, homemaker, smaller family size, using insulin and having an additional illness. Conclusion The prevalence of depression in this study is consistent with that reported by other communities. Factors like older age, lower education level, being a homemaker, living in a small size family, insulin use and additional illness could increase the likelihood of developing Major Depressive disorder among people with type 2 diabetes, hence, psychosocial assessment is necessary along with diabetes management plan in a primary health care setting.

Background: Understanding of risk factors and developing healthy lifestyles is a way of tackling the surging burden of chronic diseases in low-to-middle income countries such as Nepal. Health literacy (HL) has a pivotal role in prevention, adherence to treatment, self-care, and better use of health care; therefore, factors associated with HL need to be studied in the context of Nepal. Objective: This study was conducted to assess the level of HL and explore disease-specific knowledge among patients with chronic diseases. Methods: A cross-sectional study was conducted among 426 respondents with hypertension, diabetes mellitus, or chronic obstructive pulmonary disease from a tertiary care hospital and primary care clinics using face-to-face interviews. HL was measured using a translated and pretested HL questionnaire (the Europe-Asia Health Literacy Survey Questionnaire). Disease-related knowledge was assessed using a validated questionnaire. Key Results: The study found that 27% of the respondents had sufficient HL, 19% had marginal HL, and 54% had inadequate HL. Factors associated with inadequate HL included being older and female, and having lower or no education, unemployment or retired status, poverty, and having a history of smoking or a history of consuming alcohol. HL was a strong predictor of knowledge regarding hypertension (β = 0.32; p < .05), diabetes mellitus (β = 0.41; p < .05), and chronic obstructive pulmonary disease (β = 0.37; p < .05) in multiple regression analyses after adjusting for age, gender, education, marriage, family history of disease, attendance at follow-up clinics at recommended intervals, information received regarding disease at clinics, smoking, and alcohol intake. Conclusions: A sufficient level of HL was uncommon among participants in our study. People with sufficient HL knew significantly more about their diseases or conditions than those with inadequate HL. [ HLRP: Health Literacy Research and Practice . 2018;2(4):e221–e230.] Plain Language Summary: Very little is known about health literacy in Nepal. We conducted a study to learn how much people in Nepal with hypertension, diabetes, or chronic obstructive pulmonary disease knew about their condition and sought to check its association with health literacy. We found that more than one-half of the participants did not have adequate health literacy levels. Participants who were older, female, uneducated, retired from work, or poor had lower levels of health literacy. We also found that those with high levels of health literacy had better knowledge of their disease. Therefore, we recommend that in Nepal health literacy should be measured for each patient and support regarding management of his or her condition should be provided if necessary. ...

Background Nepal has implemented the social health security program in certain health facilities to improve access to quality health services. The aim of the study is to understand the utilization pattern of social health security schemes and community’s perception of the social health security program. Method A descriptive cross-sectional mixed-method study was conducted among 300 households of Illam district who had enrolled in the social health security scheme. A multi-stage random sampling method was used. A semi-structured questionnaire was used to collect quantitative data whereas focus group discussions (FGDs) were conducted for qualitative data. Descriptive analysis, bivariate and multivariate analysis was done. FGDs were transcribed and thematic analysis was done. Findings The utilization rate of social health security scheme was 88.7%. Factors associated with the utilization of program included: presence of under-five children and chronic illness in households, sex and age group. Focus group discussion revealed that people were aware of social health insurance and pleased with program implemented by government. However, the hospitals under the social health insurance were not able to meet their expectations. Conclusion Although the utilization of social health security scheme was high, people were dissatisfied with the service provided by the hospital under the social health security scheme. Therefore, the social health insurance board should closely monitor the hospitals and develop a feedback mechanism from the users.

Background: Mosquito borne diseases are major health problems in rural areas even after implementation of national Vector Borne Disease Control Programme in Nepal. The information on mosquito borne diseases related knowledge, practices and behavior of the people of rural and peri-urban areas of Nepal living in endemic areas are essential to develop behavioral change communication messages and for producing policy to prevent and control mosquito borne disease in the country. Objective: To assess knowledge, practices and behavior of the people living in rural and peri-urban areas regarding mosquito borne diseases. Methods: A cross-sectional study of 413 households was conducted from 10 th March -10 th April, 2013 in Inaruwa municipality and Duhabi village of Sunsari District. Pre-tested semi-structured questionnaire were administered by face to face interview for data collection. Results: Ninety four percent responded, malaria was caused by mosquito but only 21% responded as dengue and Japanese encephalitis was caused by mosquito. Malaria and filariasis were considered fatal disease by 40%; however 20% had no idea about Japanese encephalitis and dengue. More than 70% respondent had perception that mosquito bites at night only. Although use of bed-net was found to be higher; only 2% had knowledge on insecticide impregnated bed-nets. 31% of respondents didn't take medication during anti-filarial campaign supplied by government mainly due to side effects. It was observed that 61% respondents were unaware about the routine JE vaccination by Nepal government. Conclusion: Health education must be taken into account for communities in endemic areas to create awareness regarding prevention from mosquito borne diseases.