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Supportive counseling and facilitated referrals to support organizations have shown positive effects on mental health and coping with domestic and family violence. However, the reasons why and how such effects are significant remain unknown. The current paper used data from a randomized controlled trial of a psychosocial intervention implemented in Nepal among 140 abused pregnant women. The hypothesized mediating effects of self‐efficacy and social support on mental health and quality of life of abused pregnant women were tested using serial mediation analyses. Significance of parameter estimates and bias‐corrected 95% confidence intervals (CIs) for the indirect effects were generated using bootstrapping. The postintervention changes in self‐efficacy and social support were found to have significant mediating effects on the relationship between the intervention and changes in both mental health and quality of life of participants post intervention. The positive effects on outcomes were seen at follow‐up as well, though to a lesser extent. Further interventions should focus on enhancing abused women's self‐efficacy and social support to ensure their positive mental health and better lives. [ABSTRACT FROM AUTHOR]

Aim: Studies regarding the impact of adult children's migration on older parents left‐behind have focused on physical and mental health. This study assessed the relationship between migration of adult children and quality of life (QOL) of older parents left‐behind in Nepal. Methods: A cross‐sectional community‐based survey was carried out (May–July 2019) among 791 randomly selected older adults aged ≥60 years. QOL was measured using the World Health Organization Quality of Life‐abbreviated scale, and migration status was assessed into three categories: no migration, internal migration only and any international migration. A range of sociodemographic characteristics were measured for adjustment. Associations between migration of children and each domain of the QOL were examined by multilevel mixed regression. Results: Scores for QOL were; 58.8 ± 19.8 for physical, 63.7 ± 18.0 for psychological, 60.7 ± 16.2 for social, and 61.8 ± 15.0 for environmental domains. This study identified positive and null associations between the migration of children and QOL for parents, with higher scores for physical (b = 5.16, P = 0.017) and environmental (b = 3.19, P = 0.046) domains among left‐behind parents whose children migrated internally compared with parents whose children did not migrate. Conclusions: The findings differ from previous research showing poorer QOL among left‐behind older parents. Migration plays a significant role in shaping physical and environmental QOL among left‐behind parents living in rural areas with important implications for migrants, their families, researchers and social scientists. Geriatr Gerontol Int 2020; 20: 1061–1066.. [ABSTRACT FROM AUTHOR]

We describe the iterative process of developing a locally-appropriate quality of care approach and its role in emergency obstetric care (EmOC) programming in Nepal. We describe the context of maternal health issues in Nepal, the rationale for developing a quality of care approach within a model to improve EmOC, and outline the outcomes and catalytic effects of the process. The lessons learned during the development of this approach are detailed. The program developed and implemented a quality of care approach at three district hospitals in Nepal. This resulted in improvements in the structure, process and outcomes of EmOC in these institutions. The process also resulted in improved understanding of quality of care approaches on both local and national levels and the creation of a Nepalese quality of care evaluation framework for maternity services. While the theoretical concept of quality of care is difficult to translate into a concrete approach, we used a process in rural hospitals in Nepal that created highly motivated teams and improved the overall functioning of these hospitals. [ABSTRACT FROM AUTHOR]