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The policy document of Nepal has spelled out commitment to involving civil society organisations (CSOs) in improving human resources for health (HRH). However, lack of empirical evidences, it is very hard to figure out exact situation about the roles and engagement of CSOs in HRH management.A cross-sectional descriptive study was conducted using both quantitative and qualitative methods. Out of 404 sample health institutions, 747 health workforce from 375 health institutions were interviewed (10% non-response rate) using the probability proportionate to size method as per World Health Organization (WHO) guidelines.Nearly 75% respondents had opined that the political parties were supporting the health institutions in the grassroots. It was found that the support from the CSO was better in Hill (54.9%) compared to Terai (46.9%) and Mountain (46.7%). The support was significantly different between rural (CI: 0.5063-0.591) and urban (CI: 0.3055-0.4363) (p0.05, CI 95%). Mean index score of effectiveness of CSOs was found highest in Hills (0.3036) followed by Mountains (0.2669) and Terai (0.2589). Effectiveness of CSOs was found positively correlated with feeling of security by health workers and social prestige.The roles of civil society in HRH management still need to be recognized and well documented ensuring their active participation in formulation and implementation of policies, strategies and planning related to HRH for effective and quality healthcare services in Nepal.

This study analyzed daily patterns and dynamics of PM2.5 concentrations in the Kathmandu Valley during three winters. The PM2.5 data showed a daily repetitive cycle which represents influence of local air flow and dispersion and accumulation of air pollutants in the valley. Two concentration peaks were observed in the morning and in the evening periods, and they fell down during the daytime and the nighttime periods. This indicates local emission sources as major contributors in the valley. The more pronounced morning peak compared to the evening peak showed that the upslope wind in the morning helped to move the polluted inversion layer downward, subsequently adding to freshly emitted pollutants and causing a sharp pollutant concentration rise in the morning. Katabatic wind and rise of temperature in the basin during the day helped the pollutant upflow and dilution, resulting in a sharp PM2.5 concentration decline. Through the afternoon, the decrease in air temperature followed by decrease in wind speed caused to lower PM2.5 peaks in the evening. Also, higher morning peaks of PM2.5 concentrations compared to the evening indicated pollution from the previous day is added to the fresh emission. The valley had increased PM2.5 from the beginning of October which continued till the first week of February. The increase in PM2.5 peak fit the logistic equation y = [k/(1 + exp (p - qx)] + a sin(bx) where k, p, q, a, and b are constants. © 2009.

Distribution and skill mix of health workforce has always been a challenge in rural Nepal. Workforce surpluses or shortages and inappropriate skill mix, decrease productivity and efficiency, deplete scarce resources and squander worker capabilities. This study was aimed at generating evidences on the current distribution and skill mix of health workforce in Nepal.A cross-sectional study was conducted using both qualitative and quantitative methods.Fifteen districts representing three eco-developmental regions of Nepal were selected using multi-stage cluster sampling method. Out of 404 sampled health institutions, 747 health workers from 375 health institutions were interviewed. Observation was carried out in 256 health facilities.Currently, the vacant positions are mostly of doctors 74(38%) technicians 28 (21%) nurses 50 (10%) and paramedics 26 (6%)with respect to sanctioned positions. Variations of fulfilled positions occurred in all three ecological belts, with the Hill belt having the highest proportion of vacant posts 116 (16%).On the basis of types of health facilities, ayurvedic centres have the highest fulfilled positions 55 (95%) and the lowest in primary healthcare centres (PHCCs) 162 (81%). Proper skill mix was observed in 6 (43%) of hospitals and 3(18%) of PHCCs.Only 132 (17.7%) of health workers have taken part in orientation on non-communicable diseases (NCDs) despite the increasing trend of NCDs.There is scarcity of health workforce with appropriate skills, particularly in rural Nepal. Sanctioned positions and categories of health workers need to be revised on the basis of population growth and epidemiological shifts.

In Nepal, the relationship of health worker and patient or community people is now deteriorating and the security and safety of health worker is becoming emerging issues. The poor relationship between community people and health worker is hampering the health service especially in rural setting. This study was aimed at finding the security perception and situation of health workforce in Nepal.A cross-sectional descriptive study was conducted using both quantitative and qualitative methods. Out of 404 sample health institutions, 747 health workforce from 375 health institutions were interviewed (10% non-response rate) using the probability proportionate to size method as per World Health Organization (WHO) guidelines.Nearly 168 (23%) of health workers felt some level of insecurity at their workplace. Mostly, doctors felt insecure at their workplace 24 (30%) and argued with service users , 26 (32.50%). Feeling of security was highest in central region 160 (83.30%). Nationwide, 121 (16%) of health workers faced some level of arguments with service users, which was highest in Tarai 64 (18.08%). Of the total harassment, both gender based and sexual harassment was higher among female health workers [20 (62.5%) and 13 (56.5%) respectively]. Only, 230 (30.7%) of health workers who suffered from workplace accidents got compensation and treatment.Higher proportions of health workers feel insecurity at workplace whereas provision of compensation was minimal. There is a need of strict implementation of Security of the Health Workers and Health Organizations Act, 2066 (2009) for effective health service delivery.