The Madhesi Upsurge and the Contested Idea of Nepal

Jha, Kalpana

doi:10.1007/978-981-10-2926-4

Cited by 28 publications

(16 citation statements)

References 22 publications

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“…Our nding is consistent with previous literature from Nepal, which documented a higher burden of chronic disease among the Madhesi ethnic group [22,27]. Historically, the Madhesi ethnic group was considered disadvantaged in the society as they were discriminated against by the upper caste groups and had limited access to education and employment [28]. As one of the marginalized groups, these groups have a comparatively lower socioeconomic status increasing threats to their poor outcomes in health and wellbeing [29].…”

Section: Discussionsupporting

confidence: 90%

Prevalence and correlates of Multimorbidity among older adults in rural Nepal: a cross sectional study

Yadav¹,

Ghimire²,

Mistry³

et al. 2020

Preprint

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Background Multimorbidity among older adults is an increasing challenge for health systems. Compared to a single disease condition, multimorbidity lowers the quality of life and experience higher hospital admission and health care expenditure. Although multimorbidity has gained global attention, it remains a less studied area in Nepal. Our study aimed to estimate the prevalence of major chronic diseases and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioral risk factors.Methods We analyzed data of 794 Nepalese older adults recruited using a multi-stage cluster sampling approach in two rural setting of Sunsari and Morang District of Nepal. This was a cross-sectional study, conducted between January to April 2018. Socio-demographics and health conditions data [ Osteoarthritis, Cardiovascular diseases (CVD), Diabetes, Chronic Obstructive Pulmonary Diseases (COPD) ] were collected through the help of trained research assistants using a validated questionnaire. The correlates of multimorbidity were examined using mixed-effects logistic regression.Results 48.9% of the participants had at least one chronic condition, and 14% were multimorbid. The prevalence of individual conditions were osteoarthritis- 41.7%, CVD- 2.39%, diabetes- 5.29%, and COPD- 15.7%. In the adjusted model, older adults aged 70-79 years, those from underprivileged Madhesi and other ethnic groups, without a history of alcohol drinking, and those physically inactive, were significantly associated with multimorbidity.Conclusion Our study found a sizeable proportion of the older adults had multimorbidity in our studied population. This prevalence of multimorbidity and its socioeconomic and behavioural correlates, need to be addressed through multi-level preventive strategies, including clinical guidelines and the development of a multidisciplinary workforce to address the needs of the multimorbid older adults.

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Section: Discussionsupporting

confidence: 90%

Prevalence and correlates of Multimorbidity among older adults in rural Nepal: a cross sectional study

Yadav¹,

Ghimire²,

Mistry³

et al. 2020

Preprint

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“… 19 26 Historically, the Madhesi ethnic group were discriminated against by the upper caste groups and had limited access to education and employment. 34 As one of the marginalised groups, they have a comparatively lower socioeconomic status increasing their risk of poor health and well-being.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study

et al. 2021

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ObjectivesThis study’s objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors.DesignThis was a community-based cross-sectional study conducted between January and April 2018.SettingRural municipalities of Sunsari and Morang districts in eastern Nepal.Participants794 older Nepalese adults, 60 years and older, were recruited using a multistage cluster sampling approach.Primary outcome measure(s)Prevalence of four major non-communicable chronic conditions (osteoarthritis, cardiovascular disease, diabetes and chronic obstructive pulmonary disease (COPD) and multimorbidity.ResultsAlmost half (48.9%: men 45.3%; women 52.4%) of the participants had at least one of four non-communicable chronic conditions, and 14.6% (men 12.5%; women 16.8%) had two or more conditions. The prevalence of individual conditions included: osteoarthritis—41.7% (men 37.5%; women 45.9%), cardiovascular disease—2.4% (men 2.8%; women 2.0%), diabetes—5.3% (men 6.0%; women 4.6%) and COPD—15.4% (men 13.3%; women 17.5%). In the adjusted model, older adults aged 70–79 years (adjusted OR (AOR): 1.62; 95% CI: 1.04 to 2.54), those from Madhesi and other ethnic groups (AOR: 1.08; 95% CI: 1.02 to 1.72), without a history of alcohol drinking (AOR: 1.53; 95% CI: 1.18 to 2.01) and those physically inactive (AOR: 5.02; 95% CI: 1.47 to 17.17) had significantly higher odds of multimorbidity.ConclusionsThis study found one in seven study participants had multimorbidity. The prevalence of multimorbidity and associated socioeconomic and behavioural correlates need to be addressed by integrating social programmes with health prevention and management at multiple levels. Moreover, a longitudinal study is suggested to understand the temporal relationship between lifestyle predictors and multimorbidity among older Nepalese adults.

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“…Although in Nepal the CPA of 2006 appeared to be an inclusive settlement, there was a strong push back from established elites at the centre, as well as Madhesi and Tharu groups in the Tarai; the latter manifesting itself in the Madhesi andolan, a violent uprising against constitutional proposals in 2007 and 2015 (Jha, 2014(Jha, , 2017. A new constitution was finally agreed in 2015, introducing a federal governance structure and the creation of a Madhesi-led Province (Province 2) in the Eastern Tarai.…”

Section: Systems In Flux: Comparing Sri Lanka and Nepal's Post-war Tr...mentioning

confidence: 99%

Fixes and Flux: Frontier Brokers, Political Settlements and Post-War Politics in Nepal and Sri Lanka

Goodhand

Walton

2022

The Journal of Development Studies

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This article examines post-war politics in Nepal and Sri Lanka through the prism of centre-periphery relations, drawing upon and expanding political settlements analysis. We highlight two key features neglected in existing research on political settlements: first, the spatial dimensions of these settlementsparticularly the salience of frontier regions in shaping post-war orders. These 'sensitive spaces' continue as sites of struggle in the post-war period and frontier battles over the reordering of space and the delineation of rights, authority and citizenship are central to the emergence of post-war political settlements. Second, within these post-war frontiers we highlight the role of 'frontier brokers' who mediate between national and local levels of the political system. Post-war frontiers provide an opening and a demand for brokers who act as both gatekeepers and go-betweens, balancing demands from communities at the margins with the need to forge alliances and extract resources from central actors. We argue that questions of space and agency need to be foregrounded in political settlement analysis, and studying the lives of frontier brokers provides a lens for understanding shifts in political settlements and the changing relationship between the national and subnational levels of the political system at war's end.

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The Madhesi Upsurge and the Contested Idea of Nepal

Cited by 28 publications

References 22 publications

Prevalence and correlates of Multimorbidity among older adults in rural Nepal: a cross sectional study

Prevalence and correlates of Multimorbidity among older adults in rural Nepal: a cross sectional study

Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study

Fixes and Flux: Frontier Brokers, Political Settlements and Post-War Politics in Nepal and Sri Lanka

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