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The article explores how Nepalese public schools' traditional hierarchy-dominated educational culture shapes teachers' professional growth and sense of identity. Through the narrative inquiry approach, I explored teachers 'professional identity development using Gee's (2000) identity framework. The data revealed that hierarchy and power relations between the teachers and the social context fundamentally shaped teacher identity development. However, the study further showed that professional hierarchy was not uni-layered, the power was not one-directional, and the domination was not permanent but rather dynamic. Factors like academic qualifications, job status, technological skills, and social status made the hierarchy complex. More interestingly, hierarchical relationships did not always undermine teacher empowerment but confidence in some cases. For example, when a teacher in a marginalized position due to some factors such as poor health condition was viewed as a role model or capable of success despite challenges, they achieved high value from their colleagues.

This article examines the role of gender difference in a qualitative interview from the theoretical lenses of the sociocultural perspective of teachers' identity in a localized context of Ph.D. field research. The study blends the researcher's critical reflections during interviewing female teachers in exploring their teacher identity and existing literature on gender differences in a qualitative interview. In addition, a research diary is used as the data source to unpack the complexity of gender dynamics in a qualitative interview. To add to the discussion of gender difference in a qualitative interview, we argued that gender difference between the interviewer and the interviewee mediates and shapes the data collection in a qualitative interview. Thus, to understand the role of gender difference in a qualitative interview, it is necessary to do a comprehensive analysis of the complex dynamics of gender matching, the cultural background of the interviewee, and possible power relations between the researcher and participants. This study contributes to the dynamics in interviewing women by a man outside the Western cultural setting, particularly during a field research experience by a Ph.D. scholar.

Studies on Psychological Sense of School Membership (PSSM) have been widespread globally for three decades. However, it has not been discussed in the context of Nepali schools' education. A positive sense of belongingness to schools among the students is essential to foster their good academic achievement as well as their mental health. Furthermore, it also increases students' motivation and peer adjustment. This study uncovers the sense of school belongingness of grade eight students in community schools in Nepal employing a descriptive survey design under quantitative research. The five points PSSM scale, a valid and widely used measurement scale, has been used to examine the students' perceptions about their school membership. Four major concepts have emerged from the data analysis: sense of attachment with school, sense of acceptance, sense of school ownership, and sense of respect and honor. Results revealed that students lack a strong sense of membership towards their school although they have feelings of attachment with their school. While students have a strong perceived sense of school ownership, they feel of being a weaker relationship with their teachers. Therefore, the study has immediate application to create awareness about the psychological sense of school membership among students and PSSM into academic discourse so that the Ministry of Education can initiate the necessary measures for improved students' learning.

Aim/Purpose: This study explores how online writing groups facilitate the academic identity development of doctoral scholars. Background: Academic institutions around the world, and especially in developing societies, are demanding increasing amounts of research and publications from their doctoral scholars. The current study used an online writing group to facilitate writing skills development, which bolstered the academic identity development of participating scholars. Academic identity is defined as the becoming and being of an academic scholar, with writing skills as a means of acquiring and performing the status and skills of a scholar. It is reflected in the confidence, contribution, and relationship carried out in writing as a member of the academic community. Methodology: This study utilizes narrative inquiry as a research methodology to capture the experiences of six doctoral scholars from two universities in Nepal. We explore the academic identity of doctoral scholars from a sociocultural perspective, employing unstructured interviews, meeting notes, and entry and exit surveys of the online writing group. Contribution This article shows how online writing groups offer unique and impactful opportunities for networking, collaboration, and problem-solving, which can significantly enhance their writing abilities and prospects of publication, thereby fostering their intellectual agency and academic identity. Findings: This study reports three findings of the value of online writing groups: addressing gaps in formal education, community as a form of accountability, and virtual community as a platform for identity development. On the final finding of identity development, we identify and discuss four themes from data analysis: growth of self-image as scholars, strengthening of commitment to scholarship, identification of venues for expanding the scope of publication, and enhancement of digital skills. The informal and collaborative nature of online writing support facilitated socially constructivist learning, which was highly conducive to the development of academic identity among emerging scholars. Recommendations for Practitioners: It is recommended that institutions implement and encourage online writing support programs as an effective means of addressing gaps in doctoral education. While this program can fill gaps in the low-resource contexts of developing countries, it can bolster formal mentoring in any context. Recommendations for Researchers: Further research should use large-scale or longitudinal studies to explore how informal, especially online writing support and collaboration, accelerate research and writing skills, scholarly productivity, and overall academic identity formation of doctoral scholars. Impact on Society: As societies around the world accelerate their demand for doctoral degrees and also require research and publications for degree completion, new and creative approaches utilizing emerging technologies could help to fill gaps in curriculum and support systems for their doctoral scholars. Future Research: Future research could expand the scope and take a longitudinal approach for more fine-grained data and developing broader perspectives.

The COVID-19 pandemic has affected higher education institutions (HEIs) worldwide and reshaped the existing educational system. Due to travel constraints and physical separation, there has been a global shift toward distance learning, and Nepal is no exception. This research intends to assess the practicality of online education by evaluating learners' experiences amidst COVID-19. A cross-sectional study was directed among HEIs students in Nepal using self-structured questionnaires. Our study revealed that 64.6% of the respondents were unsatisfied with online classes. More than half of the respondents (53.4%) use cell phones for online studies. Online education was reported to be unappealing to 28.8% of respondents. Variables such as age group (p = 0.05), enjoying class (p < 0.001), hours spent for an online class in a day (p = 0.05), and period for educational work using an electronic device (p = 0.1) were found significant with satisfaction level using both bivariate test and inferential test of univariate binary logistics regression. The challenges and opportunities encountered among students and faculties are highlighted along with the recommendations for fortifying communication in online-based teaching/learning.

This small scale ethnographic study is carried out in a public school of Kaski district in order to explore pedagogical practices from the perspectives of primary teachers as a course requirement of M Phil in Education Studies from Graduate School of Education, Tribhuvan University. Interview with three primary teachers was taken along with classroom observation. Data are analyzed qualitatively based on interview transcription, classroom observation record and researcher's field note. The study explored pedagogical practices in two broad global themes (1) shifting from traditional to constructivist teaching, (2) multiple school transition and curriculum. This article argue that primary teachers are in self-transition from traditional teaching to constructivist approach which is remarkable paradigm shifting on primary teachers' understanding of pedagogical practices. Similarly, multiple school transition and hangover of English as Medium of Instruction are major policy related challenges in order to renovate the existing teaching practices at primary level.

The purpose of this study was to explore how academic leaders of Nepali universities are experiencing entrepreneurship, changing contexts of higher education, and entrepreneurial activities to cope up with those changing contexts in order to lead universities. This inquiry is based on interpretive paradigm, which includes a multi-method approach. Five universities of Nepal were the researcher's living territories, where he interacted with nine participants in order to generate their narrative stories and experiences. The researcher explored and derived meanings from their stories and experiences, and in doing so, the researcher went through the process of coding, synthesizing, developing themes, analyzing, and interpreting meanings merging signature literature and theories of leadership and entrepreneurship. Through this enquiry, the researcher learned that entrepreneurship has multilayered meanings rooted in academic culture and society which could be understood being a part of the process. The researcher also learned that entrepreneurship is a process of dreaming and tracking a big picture, advocacy of change, elaboration of cognition, crossing the point of no return, a journey of togetherness, and tactful management of conflicts. The researcher also learned that changes in higher education in Nepal could be grouped under demand and supply market change. Within demand market, access, policy and awareness of parents and students are observed to have changed whereas within supply market, institutional providers, technology, pedagogy, curriculum and evaluation are found to have changed in higher education in Nepal. Apart from these, the researcher also learned that academic leaders of Nepali higher education have performed entrepreneurial activities like value added new programs, research and technological activities, fundraising activities, plan giving activities, retail sales and services, and real estate activities creating different values in order to cope up with those changing contexts in higher education. When the researcher examined the experiences and stories of the participants from leadership standpoint, he concludes that a vignette of entrepreneurship, changing context in higher education, and performance of entrepreneurial activities, have a nexus of dynamism in higher education.

This article aims to explore the policy provisions and practices of the local curriculum in primary level schools. Data are generated from teachers, head teachers, resource persons, and Assistant District Education Officer by using interview and focus group discussion. In addition, document analysis is done to locate the existing implementation status of local curriculum. The study revealed that the provision of local curriculum exists only on policy that lacks implementation in most primary schools. The popular trend of teaching English language is replacing the local curriculum. Teachers and head teachers are not well-informed and not acquainted with the developing guidelines of local curriculum. Similarly, they are perceived as lacking of technical knowledge in designing curricula. Therefore, there is a serious gap between the policy intention and its execution.This has created dilemma in practicing the local curriculum at primary level education in Nepal.

The 2022 Monkeypox Disease (MPOX) outbreak was declared a pandemic after detecting multiple human-to-human monkeypox cases in 'non-endemic' nations. The index case of MPOX has been reported in Nepal. Also, the disease burden in neighboring countries and international travel and tourism could increase the MPOX burden in Nepal. This study recruited 443 study participants between August 25 and September 10, 2022, using the snowball technique and using descriptive statistics to assess the awareness and knowledge of MPOX. Approximately 82% (n=361) of the study participants were young adults aged between 18-29 years and were undergoing or holders of tertiary education degrees (72.2%, n=320). Our findings showed that 76.5% (n=339/443) of the respondents were aware of the 2022 MPOX outbreak and obtained information about the disease from their local radio and television stations (20.6%, n = 70), as well as from other sources such as social media platforms (70.5%, n=239), and other internet sources (61.6%, n=209). The mean knowledge score of the respondents was 3.95±1.26, with a range of 0.5 to 7. Approximately three-quarters (72.3%, n=245) of the study participants were graded to have a good knowledge of the MPOX. Of the listed symptoms, study participants correctly identified high fever (62.2%, n=339), rashes (51.0%, n=173), swollen lymph nodes (34.5%, n=117), and sores around the mouth, vagina, and anus (26.8%, n=91). A higher number of participants were aware that vaccination could confer protection against the disease (70.8%, n=240). However, less than one third of the participants (30%, n=102) were aware that safe sex practices can be a preventive strategy against the disease. Finally, none of the sociodemographic variables were associated with increased knowledge of MPOX among the study participants. The knowledge of MPOX among the study population was above average. We advocate that public enlightenment campaigns in Nepal should address wrong perceptions of MPOX. [ABSTRACT FROM AUTHOR]

This study explores how young Bhutanese-Nepali refugee women experience racism within and outside of school settings. Using data collected from a 16-month community-based culturally responsive leadership project, we document how everyday racial othering impacts the youth's already fragile sense of identity and belonging. We explore how racial othering is produced through the denigration of language use, body image and community cultural practices. The research highlights the challenges of responding to anti-immigrant racism when negotiating spaces such as schools, workplaces, and peer culture. The findings illustrate how Bhutanese young women learned to walk away, resorted to talk-back and learned to cope with racism, and are negatively impacted by the verbal violence they encountered. Our research findings indicate how anti-Asian racial othering produces harm, leading the young women to have low self-esteem, self-doubt and anxiety. The young women's experiences reveal how racism impedes the desire and the ability to claim citizenship. The study calls for the need to recognize how immigrant/refugee experiences of being violated and aggrieved are often silenced or unrecognized and calls for the broader need for schools to engage with the struggles faced by young immigrant/refugee women.

This case report documents the first confirmed outbreak of African swine fever (ASF) in a wild boar (Sus scrofa) in Nepal. The case was identified in a wild boar carcass found in Shuklaphanta National Park in February 2023. Post‐mortem findings, including splenomegaly, haemorrhagic lymph nodes and congested organs, were suggestive of ASF, which was confirmed by real‐time PCR. Epidemiological evidence indicates potential transmission from nearby ASF‐infected domestic pigs. This case underscores the critical need for rigorous biosecurity protocols, comprehensive surveillance and targeted wildlife management strategies to prevent further transmission between domestic pig and wild boar populations. [ABSTRACT FROM AUTHOR]

Purpose: Emergency medicine can save lives and in 2018 the World Health Assembly passed resolution 72.16 ensuring the role of emergency care in all health systems. With a continued global shortage of emergency physicians, with many low-medium-income countries (LMIC) still to develop emergency medicine as a speciality, the role of emergency nurses is critical to deliver the WHO Emergency Care System Framework (WHO, 2018). Emergency medicine doctors play a critical role in collaborating with nurses, in emergency medicine where nurses are often the first clinicians are often the first clinicians to interact with patients in emergency care settings, making up the majority of health-care professionals in LMIC (Mamalelala, 2024). Yet emergency nursing has yet to become established in Nepal, where nurses are often recruited to emergency departments, without having received any training in emergency or critical care treatment and management. The purpose of this paper is to outline a collaborative leadership approach to co-design an airway, breathing, circulation, disability, exposure (ABCDE) structured approach to an emergency nursing training module designed for nurses to feel empowered in the emergency department and to report on its findings. Design/methodology/approach: This study draws upon mixed methodology research, enrolling 30 nurses (n = 30) from an emergency department in a tertiary hospital in Nepal through three stages of the project: Stage 1: training module co-design, collaborative leadership exploring the rationale for a training module and core features of design based on the ABCDE of emergency medicine; Stage 2: quantitative data were collected to assess baseline pre- and post-intervention knowledge and follow-up knowledge assessment at 30 and 45 days; Stage 3: qualitative data were collected with 24/30 (80%) nurses to evaluate the impact and application of the nurses ABCDE learning 7 months post-training. The qualitative survey was undertaken using online Google Forms. Findings: Nurses were fully engaged in the co-design and collaboration of the development of an ABCDE training module which was delivered over 3 h. Full engagement was secured from all nurses in the department, and there were statistically significant advances in ABCDE emergency knowledge from the baseline, however, this knowledge began to decrease at 30 and 45 days. A follow-up qualitative survey was distributed to nurses seven months after training with an 80% return rate, which reported a range of examples of how nurses were continuing to apply their learning in practice. Originality/value: This training module for emergency nurses was designed collaboratively from the "bottom up" in a tertiary hospital in Nepal, recognising the need to develop emergency nursing in the emergency department. The data revealed promising findings, while knowledge decreased from the post-training questionnaire, qualitative evidence revealed significant changes in practice, with the greatest reported change in the management of the airway. While this training module has made a difference in the quality of care provided, there is a need for a country-wide strategy in this area otherwise it is likely that such an initiative will only be developed by hospitals at a local level (Lecky, 2014). Education and training initiatives for nurses that focus on an evidence-based approach to clinical practice can bridge the workforce gap in the short term, however, the Government of Nepal must decide on establishing a recognised post-graduate sub-specialty in emergency nursing, the duration of training, who should be trained and what curriculum should be followed (Lecky, 2014). [ABSTRACT FROM AUTHOR]

Background: Multimorbidity is rising in low-and middle-income countries such as Nepal, yet the research has not gained pace in this field. We aimed to systematically review the existing multimorbidity literature in Nepal and estimate the prevalence and map its risk factors and consequences. Methods: We reviewed data collated from PubMed, Embase and CINAHL by including original studies that reported prevalence of multimorbidity in Nepal. The quality of included studies was assessed using the Appraisal Tool for Cross-sectional Studies. The summary of the review is presented both qualitatively as well as through meta-analysis to give pooled prevalence. We prospectively registered in PROSPERO (CRD42024499598). Results: We identified 423 studies out of which seven were included in this review. All studies were conducted in a community setting except one which was hospital based. The prevalence reported across various studies ranged from 13.96% to 70.1%. The pooled prevalence of multimorbidity was observed to be 25.05% (95% CI: 16.99 to 34.09). The number of conditions used to assess multimorbidity ranged from four to nine. The major risk factors identified were increasing age, urban residence, and lower literacy rates. Conclusion: A wide variance in the prevalence of multimorbidity was observed. Moreover, multimorbidity assessment tool/conditions considered for assessing multimorbidity were heterogeneous. [ABSTRACT FROM AUTHOR]

Simple Summary: Escherichia coli in raw milk poses economic losses and health risks due to antimicrobial resistance. In Siddarthanagar Municipality, Rupandehi, Nepal, 29.4% of buffalo milk samples were contaminated with E. coli. High resistance was observed against ceftriaxone and ceftazidime (100%), cotrimoxazole (86.7%), and amikacin (80%). Additionally, 86.7% of isolates were multidrug resistant. Although associations with risk factors lacked statistical significance, udder wash with antiseptics reduced E. coli contamination in milk, and detergent use during utensil washing showed promising trends. Farmer awareness of milk pasteurization and implementing food safety practices are crucial. Escherichia coli in untreated milk leads to economic losses from subclinical mastitis and reduced milk production, while also posing a public health risk due to the emergence of antimicrobial resistant strains, particularly associated with consuming unpasteurized milk and dairy products. This study aimed to determine the prevalence and antimicrobial resistance (AMR) of E. coli isolated from buffalo milk in Siddarthanagar Municipality of Rupandehi district, Nepal. A total of 102 milk samples were collected from lactating buffaloes. The isolation and identification of E. coli were carried out using enrichment media, selective media, and biochemical tests. Antimicrobial susceptibility testing was carried out using the Kirby–Bauer disk diffusion method on Mueller–Hinton agar (Merck), according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Resistance was tested against gentamicin, amikacin, ciprofloxacin, enrofloxacin, ceftriaxone, ceftazidime, cotrimoxazole, and chloramphenicol. In addition to this, farmers were administered a questionnaire consisting of both open- and close-ended questions to identify various animal-related and management-related risk factors associated with the prevalence of E. coli. The prevalence of E. coli in our study was 29.4% (n = 30/102). Ceftriaxone and ceftazidime showed 100% resistance, while cotrimoxazole and amikacin showed 86.7% and 80% resistance, respectively. Furthermore, 86.7% of E. coli isolates were multidrug resistant (MDR). Despite suggestive trends, associations between E. coli prevalence and risk factors lacked statistical significance, necessitating further research. While some antibiotics exhibited effectiveness, many faced resistance, highlighting the need for prudent antimicrobial usage and increased awareness among farmers. Raising awareness about milk pasteurization and implementing food safety practices is essential for ensuring farmers and public health. [ABSTRACT FROM AUTHOR]

An updated checklist of the hoverflies including distribution and seasonal occurence data of known species in Nepal is presented. The list is based on all available published literature on taxonomy, biodiversity, ecology, and biological aspects of the syrphid fauna of Nepal up to 2023. A total of 205 species from three subfamilies and 63 genera are known to occur in Nepal. Among the three subfamilies, Eristalinae shares maximum species (111 species, 54%), followed by Syrphinae (90 species, 44%), and Microdontinae (four species, 2%). is presented. Among these, 48 (23%) species are recorded in Nepal only. The distribution of known hoverfly species in the country is not uniform, with the Bagmati (82 species) and Koshi (75 species) provinces having the greatest number of species, while the Madhesh (four species) and Lumbini (one species) provinces having the lowest records. The highest number of species are recorded in May (51 species), followed by July (50 species) and June (48 species). Winter season records are relatively low, and distribution data are still incomplete for some sites. Based on the present review, comprehensive and systematic sampling across the entire country is necessary for further exploration of Nepal's hoverfly fauna. [ABSTRACT FROM AUTHOR]

Guthi, deeply rooted in the social, cultural, and economic fabric of Nepal, has traditionally managed temples, shrines, festivals, and heritage sites since the Lichchhavi era (400–750). Since 1960, however, this system has been challenged by government land reforms, which have impacted its influence on sustainable heritage conservation. Nevertheless, there is compelling evidence that land nationalization and the guthi's declining authority have harmed local heritage conservation. Nevertheless, the guthi system has endured, serving as an important informal means of heritage conservation and highlighting the adaptability of traditional institutions. These community-based trusts, originally established for social and religious purposes, have played a pivotal role in preserving cultural heritage for future generations. This article aims to demonstrate the central role of the guthi as the cornerstone of Nepal's efforts to conserve and manage both tangible and intangible cultural treasures. Using observational techniques, case studies, and a qualitative approach, it explores the historical evolution of heritage conservation through the lens of the guthi, taking into account subjective, valued, and constructed realities. This paper concludes by urging policymakers to recognize the significant contribution of indigenous systems such as the guthi system in achieving the backbone of sustainable heritage conservation and management. [ABSTRACT FROM AUTHOR]

Health literacy (HL) is crucial in achieving the Sustainable Development Goal of reducing one-third of premature mortality by 2030 from Non-Communicable Diseases (NCDs) and improving Universal Health Coverage. Low health literacy is linked to poor health outcomes, and evidence shows that levels of limited HL are high, even among highly educated individuals. This study aims to assess HL levels and related factors among patients with NCDs at Tribhuvan University Teaching Hospital (TUTH) in Nepal. A cross-sectional survey was conducted at TUTH among 303 patients with NCDs with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease, Diabetes Mellitus, Hypertension, Epilepsy, Asthma and Cancer who came for follow-up from December 2022 to February 2023. Data was collected via face-to-face interviews by the trained enumerators using a structured Health Literacy Questionnaire (HLQ) containing 44 items (divided into nine domains). Multivariate logistic regression analysis was performed using SPSS version 26, with statistical significance at 0.05, to determine the associated factors of HL. The mean ±SD age of the respondents was 47.4±16.18 years. More than half of the respondents were female (56.1%). The patients had higher HL in all HL domains except 'Navigating the healthcare system'. Educational status was significantly associated with six out of nine HL domains. Co-morbidity, attendance at health-related seminars, regular physical activity, and social connectedness were associated with at least one of the domains of HL. This study identified the important factors of HL, such as socio-demographic and medical factors among patients with NCDs. This highlights the need for a comprehensive approach to address identified gaps in HL, considering its multifaceted and composite nature and promoting interventions to improve HL in high-risk populations. [ABSTRACT FROM AUTHOR]

Measuring the impact of land use regulation on the land market involves identifying and classifying relevant impact factors related to the land market. The objective of this study was to identify land market impact factors in the context of the introduction of land use regulation in Nepal. Through a combination of desktop review and the incorporation of stakeholder perspectives, the paper presents a new approach for determining land market impact factors due to land use regulation where both generic and country issues are considered. A desktop review was carried out to identify a preliminary set of impact factors, which were reclassified through intuitive analysis based on the degree of thematic closeness. Perspective-based impact factors were identified through the qualitative analysis of primary data collected through semi-structured interviews with the Nepalese land market stakeholders. These independently derived impact factors were compared with the desktop literature review impact factors, resulting in 14 land market impact factors across four dimensions, including transaction cost, valuation, mortgage availability, taxation, and compensation across the economic dimension; lot size, subdivision restrictions, and coordination across the institutional dimension; awareness, expectation, and proximity across the social dimension; and risk reduction, quality of residential land, and suitability of zoning classification across the environmental dimension. There was significant overlap and commonality across factors identified from both the literature review and semi-structured interviews. The land market impact factors determined in this study may be adapted and generalized across other countries and could be utilized to better understand the impacts of land policy decisions on urban planning and development. Further research is recommended on the process to operationalize the use of these factors to quantify the impact of land use regulation on different land markets. [ABSTRACT FROM AUTHOR]

This research aimed to assess the influence of various chemical and organic fertilizers on the vegetative and reproductive characteristics of the 'New Kuroda' variety of carrots (Daucus carota). The study included the recommended dose (RD) of NPK (80:60:60 kg ha-1), individual components of N (80 kg ha-1), P (60 kg ha-1), and K (60 kg ha-1), as well as organic sources such as goat manure (15 tons ha-1), Farmyard manure (FYM) (20 tons ha-1), and a control group without any fertilizer. Growth and reproductive traits were measured at 45, 55, 65, 75, and 85 days after sowing. The results indicated that the recommended NPK dose consistently outperformed other fertilizer sources, enhancing both vegetative and reproductive parameters. The highest yield of 10.94 tons ha-1 was achieved with NPK fertilizer, whereas organic sources such as goat manure demonstrated the second-highest growth and development traits. The control group exhibited the lowest growth and development parameters. These results show that these fertilizer sources considerably influence the vegetative and reproductive development of the 'New Kuroda' carrot variety. The outcomes indicate how various fertilizer sources may significantly improve the vegetative and reproductive growth of the 'New Kuroda' carrot; the recommended dosage of NPK in conjunction with the supply of goat manure stands out as an appropriate technique for producing carrots. This illustrates how applying a balanced dosage of these fertilizers may lead to increased carrot yield. [ABSTRACT FROM AUTHOR]

Background: The Government of Nepal initiated a family-based National Health Insurance Program (NHIP) in April 2016, aiming to ensure universal health coverage (UHC) by enhancing access to and utilization of quality health services. However, NHIP, in its initial years of implementation, encountered challenges such as low population coverage, a high dropout rate, and concerns among the insured regarding the quality of healthcare services. There is a dearth of information regarding user satisfaction with the NHIP in Nepal. This study aimed to assess user satisfaction with NHIP at the household level in Nepal. Methods: We conducted a cross-sectional study among 347 households in the Ilam district using a multi-stage random sampling method. Face-to-face interviews were conducted with household heads enrolled in NHIP. A semi-structured questionnaire was used to collect the data. The multivariable logistic regression analysis was done to identify the predictors of satisfaction level. Results: Overall, 53.6% of the insured were satisfied with the NHIP, while 31.1% had comprehensive knowledge about the NHIP. Factors such as gender (AOR: 1.80, 95% CI: 1.08–3.00), distance to the first point of contact (AOR: 2.15, 95% CI: 1.24–3.74), waiting time (AOR: 2.02, 95% CI: 1.20–3.42), availability of diagnostic services (AOR: 1.90, 95% CI: 1.05–3.45), availability of prescribed medicine (AOR: 3.90, 95% CI: 1.97–7.69), perceived service quality (AOR: 2.20, 95% CI: 1.15–4.20), and the behavior of service providers (AOR: 3.48, 95% CI: 1.04–11.63) were significantly associated with user satisfaction. Conclusion: The satisfaction level among NHIP users was deemed moderate. This study highlighted several factors, such as gender, distance to the first point of contact, waiting time, availability of diagnostic services and prescribed medicine, perceived service quality, and the behavior of service providers, as key determinants impacting user satisfaction. Recognizing the pivotal role of user satisfaction, health insurance stakeholders must prioritize it to ensure higher retention rates and coverage within NHIP. [ABSTRACT FROM AUTHOR]

Background. Breast cancer ranks as the second most prevalent malignancy among women in Nepal. This cancer has a high likelihood of cure, if detected early. Therefore, it is imperative to emphasize awareness and screening for breast cancer in Nepal. It indeed underscores the importance of clinical breast examination. The study aims to find the disease burden, association of abnormal breast condition with sociodemographic variables, and the need for change in the breast cancer screening protocol. Methods. A cross-sectional study was conducted from July to September 2023 on 100 female participants who were older than 18 years. Data were collected through face-to-face interviews using a structured questionnaire. The chi-square test was used to compare nominal variables while the independent sample t-test and the paired sample t-test were used to compare nominal and continuous variables. Results. The findings of the study showed that 19% of all participants complained about abnormal breast, out of which 31.7% reported lumps, 26.31% reported discharge , another 26.31% reported pain, and the remaining 15.7% reported soreness. The upper outer quadrant and lower inner quadrant each individually accounted for 33.33% of the abnormal findings. The complaints of the participants in our study were significantly correlated with age at marriage, number of pregnancies, and use of contraception. Conclusion. Our study revealed considerable abnormal breast findings. This warrants the need for the change in breast cancer screening protocols which lead to early diagnosis and higher curability. [ABSTRACT FROM AUTHOR]

The increased human population increases the demand for food. Traditional farming leads to inefficiencies and difficulty in fertilizer usage, crop selection, and insect detection. This research project eliminates all these problems by developing an advanced farming web application to evaluate crop production efficiency. This research evaluates the soil nutrients needed by different plants and thereby generates a recommendation system to recommend the most suitable crop based on sensor values, thus reducing risk, nutritional imbalance and environmental pollution. It consists of an NPK sensor with a combination of machine learning models to monitor soil health and increase yields, reduce costs and match fertilizer supply with demand. It also helps to analyze various insects and provides descriptions of insects and recommends solutions to those insects in Nepali language helping farmers. The integration of ML and DL models such as random forest for fertilizer prediction, light GBM (Gradient Boosting Machine) for crop prediction and Conv2D for the classification of insects will help to maximize the production yield. [ABSTRACT FROM AUTHOR]

The sustainability of environmental management initiatives, such as watershed management programs, relies on the presence of effective institutions at the watershed level. However, there needs to be more empirical evidence from evaluating the effectiveness of watershed-level institutions. Therefore, this study presents a pioneering effort to evaluate the effectiveness of Nepal's first watershed conservation committee at the watershed scale, focusing on the case of the Khageri Khola watershed in Central Nepal. The study involved conducting a household survey, key informant interviews, focus group discussions, and field observations to collect and analyze the data. Descriptive analysis, index value calculation, and chi-square statistics were then employed to summarize the results regarding local respondents' perceptions of twelve institutional characteristics, their rationalities, and their association with socio-demographic variables. The results reveal that the watershed conservation committee was perceived as performing well in managing the watershed. Specifically, good interaction, appropriate scale, technical, environmental, social, organizational, and government rationality were perceived as highly effective, with an average index value of less than 0.36. In contrast, clarity of objectives and economic rationality showed moderate effectiveness, with an average index value ranging from 0.36 to 0.65. However, the results suggested that adaptiveness, compliance capacity, and financial rationality merit increased attention, intending to improve their performance. Further, the results showed the association of socio-demographics with respondents' perceptions of various indicators of institutional characteristics and their rationalities. Therefore, the study provides valuable insights for policymakers, researchers, and development practitioners charged with designing sustainable and effective programs and institutions. To enhance the effectiveness and sustainability of watershed management programs, we recommend establishing a policy-guided institutional mechanism at the watershed scale. This mechanism should be based on various institutional characteristics and rationalities and should consider the extant variability in the socio-demographic and topographic characteristics of the watershed. [ABSTRACT FROM AUTHOR]

The Ramaroshan Lake Complex (RLC) in Sudurpaschim Province, Nepal, is a Himalayan lake cluster that holds significant ecological, economic, religious, and esthetic importance. This study aimed to provide a comprehensive characterization of the hydrochemical properties of water within the RLC and assess its suitability for irrigation purposes. A total of 38 water samples were collected from seven different lakes of the complex. The physicochemical parameters and major ions were then analyzed. The water samples from the RLC were alkaline, and based on total hardness, they ranged from soft to moderately hard categories. The presence of major ions included the following: Ca2+ > Na+ > Mg2+ > K+ > Fe3+ > NH4+ and HCO3− > Cl− > SO42− > NO3− > PO43−. The alkaline earth metals (Ca2+ and Mg2+) dominated the alkali metals (Na+ and K+) and weak acids (HCO3−) dominated the strong acids (Cl− and SO42−). The dominant hydrochemical facies of the lake water was a Ca-HCO3 type indicating a calcium carbonate type of lithology. Carbonate rock weathering was the most dominant process in influencing the hydrochemistry of the water. A high ratio of (Ca2++ Mg2+)/Tz+ and a lower ratio of (Na+ + K+)/Tz+ revealed the dominance of Ca2+ and Mg2+ resulting from carbonate weathering, with little contribution from silicate weathering. Different irrigation indices revealed the suitability of the RLC water for irrigation. The insights derived from this study are pivotal in safeguarding water quality and bolstering sustainability efforts. The study also furnishes foundational data crucial to an array of stakeholders including researchers and policymakers and significantly contributes to advancing water management strategies and fostering ecosystem conservation in the Himalayan freshwater lakes, particularly in the face of the overarching challenge posed by global climate change. [ABSTRACT FROM AUTHOR]

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Landslides are the major problems of mountainous areas of Nepal basically due to its fragile geomorphology, intense rainfall, improper land management practices and rapid construction of hilly roads without applying necessary stabilization measures. There are huge loss of life and property, decline in ecosystem productivity and functionality and sedimentation on downstream areas due to frequent landslides. Multiple spatial factors like land use land cover, topography, road, drainage, geological setting and climatic factors like rainfall are found more associated with landslide occurrence and determine landslide susceptibility of the area. Understanding of landslide phenomenon and associated factors are crucial for adopting appropriate prevention, control and rehabilitation measures. This study was carried out in Singati sub-watershed of Sunkoshi River Basin with objectives to understand landslide hazards, associated factors and activities performed to minimize possible hazards with best strategy of minimizing hazards. Landslide assessments were made through identification and digitization of landslides using temporal Google image and field investigation. Where landslide hazard assessment and preparation of factor map was done by using GIS software and field observed data were analyzed and dimension of landslides were calculated. Along with, People perceptions on major effects of landslides on livelihood assets, were explore from associated household's questionnaire survey (n=60) using purposive sampling. And most causative factor of landslide on the perception of local people was calculated using nonparametric test (Friedman). From the field survey, a total of 46 landslides were surveys in different location of the study area. The total area of the landslide was found to be 4.77 km2. From the comparison matrix analysis using Friedman test, the study identified the main responsible factor for the occurrence of landslide are rural road, construction, slope factor rainfall and land use. The road factor up to 200 m area and 200–500 m distance from road covered the highest percentage of landslide hazard. Southeastern aspect with the slope class 30°–45° had the highest susceptibility to landslide. Dense forest was found to be more effected by landslide in comparison to other land use due to the construction of road in sloppy area inside the forest. Comparison the effects of landslide before and after the road construction about 80 percent of the respondent had the positive response on it. [ABSTRACT FROM AUTHOR]

Simple Summary: Our study found that 81.50% of respondents were aware that rabies is a zoonotic disease, and 42.10% had satisfactory knowledge of rabies. Knowledge levels were associated with gender, education, and income. Interestingly, some individuals relied on traditional medicine and healers for the immediate first aid and treatment of animal bites. Additionally, a few pet owners had not vaccinated their pets. These findings underscore the need for targeted educational interventions to improve rabies awareness and the potential of effective awareness campaigns to save lives. In many developing countries, where rabies is prevalent among dog populations, humans are at risk of contracting the disease. Recent reports from Nepal suggest that around 30,000 cases of pet and more than 100 human rabies cases occur each year, with the highest risk being in the Terai, although these numbers may be underestimated. Knowledge and practices related to rabies prevention are crucial in combating the disease. However, there is not enough data on the understanding and preventive measures of rabies among the local population in Nepal. Therefore, this study aimed to evaluate the knowledge and practices regarding rabies prevention among the people of Bharatpur-12, Chitwan, Nepal. The study, conducted in February 2022, involved a cross-sectional survey of 271 respondents selected through systematic random sampling. A semi-structured questionnaire was used for one-on-one interviews. Among the surveyed respondents, a significant proportion (81.50%; n = 221/271) correctly understood rabies is zoonotic disease. Furthermore, 73.10% (n = 198/271) could correctly identify the animals susceptible to rabies, while 39.9% (n = 108/271) knew the causative agent. Additionally, 46.5% accurately listed the modes of transmission, and a majority (86.70%; n = 235/271) recognized the signs and symptoms of rabies in animals and humans. Overall, 42.06% (n = 114/271) of the respondents demonstrated satisfactory knowledge. Out of the 271 respondents, 22.9% (n = 62) owned pets, and 39.11% (n = 106) reported incidents of animal bites within their families, with dog bites being the most commonly mentioned (92.46%; n = 98/106). The majority (81.14%; n = 86/106) sought treatment on the same day as the incident occurred. About half of them (50%; n = 53/106) cleaned the wound with soap and water, while a small percentage (5.66%; n = 6/106) relied on traditional medicine as immediate first aid after an animal bite. The level of knowledge was found to be associated with gender (p = 0.04), educational status (p = 0.05), and family monthly income (p = 0.007). These findings highlight the importance of educating the community in Nepal about rabies control and prevention measures and underscore the need for targeted educational interventions to improve rabies awareness and the potential of effective awareness campaigns to save lives. Raising awareness about health-seeking behavior and community members' role in controlling, preventing, and eliminating rabies is crucial. [ABSTRACT FROM AUTHOR]

Background: Strategic action plans around newborn health evaluation are needed, to address the high neonatal mortality rate in Nepal. Surveillance systems, like Newborn Metabolic Screening (NBS), could reveal unrecognized drivers of neonatal death. NBS is not routinely performed in Nepal. Our objective was to determine the feasibility of establishing NBS, and its acceptability among healthcare providers and parents, in Nepal. Methods: This prospective cohort study was conducted between November 2021 and May 2022 in term/late preterm infants born at Paropakar Maternity Hospital, Kathmandu, screening for 6 disorders that can be confirmed and managed locally. Staff were trained on dried-blood spot collection and transport protocols, performance metrics were established, and assays were performed at an accredited laboratory in Bangalore, India. Surveys were developed to determine acceptability among health-care providers and parents. Results: Of 835 parents approached for the study, 825 (98.8%) consented. Parental surveys showed that 92% considered "no cost" option most important in choosing to participate in the study. Samples were transported to laboratories in Kathmandu and Bangalore in 36 ± 24 h, and 4.75 ± 1 days, which exceeded expected metrics of 24 and 48 h, respectively. Results were communicated to parents by 9.5 ± 2 days, which was within the expected metric window of 14 days. Abnormalities were reported in 13 infants and included 5 hemoglobinopathy traits (4 Hb E and 1 Hb D), 3 congenital hypothyroidism, 2 glucose-6-phosphate dehydrogenase deficiency, 1 congenital adrenal hyperplasia, 1 elevated acylcarnitine, and 1 biotinidase deficiency. Healthcare providers surveyed (n = 116) showed that 67% reported a moderate understanding of NBS; all indicated that screening would be beneficial. Most cited early diagnosis and treatment, as well as, providing risk to future pregnancies as significant benefits. 90% thought screening should be routinely performed. Conclusions: We demonstrate that it is feasible to introduce NBS in Nepal. Transport metrics were longer than expected due to COVID pandemic travel restrictions; however, it was possible to deliver results to families within 2 weeks of birth. Parents overwhelmingly considered "no cost" option as the most important in choosing to screen. A government-sponsored program will be a key factor in establishing NBS in Nepal. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to assess the prevalence of dental caries, tobacco usage, and associated risk factors for dental caries in patients who visited a government hospital in Western, Nepal. Methods: This analytical cross-sectional study was conducted from January to April 2022. Patients above 18 years visiting the dental OPD of a government hospital, and who had provided informed consent were enrolled in the study using a convenience sampling technique. As the study also involved an illiterate population, in that case, informed consent was obtained from their respective legal guardian as well. A pretested standardized, close-ended questionnaire was administered by researchers to gather information regarding the associated risk factors and oral hygiene practices. Clinical examination was done for dental caries according to the criteria by the World Health Organization (WHO) using the "DMFT" index (WHO modification 1987). Bivariate and multivariable logistic regression was done and the odds ratio and p-value was calculated. For all tests, statistical significance was set at p < 0.05. Results: A total of 219 participants completed the study with a mean age of 31.73 ± 12.46. The prevalence of dental caries and tobacco was found to be 80.36% and 5.02% respectively. Participants without health insurance had 2.35 times higher odds of dental caries (95% CI: 1.03–5.36). Not rinsing the mouth after eating sweets was associated with 3.07 times higher odds of dental caries (95% CI: 1.31–7.18). Those who hadn't visited a dentist in the past 12 months had lower odds (0.42; 95% CI: 0.18–0.94). Eating fresh fruit daily showed statistically higher odds (2.70; 95% CI: 1.04–6.99) of dental caries. Non-tobacco users had higher odds (14.19; 2.55–78.99) of dental caries. Conclusion: Dental caries is highly prevalent, while tobacco usage is relatively low. Factors associated with dental caries included lack of health insurance coverage, consumption of fruits once daily, recent dental visits within the past year, not rinsing the mouth with water after consuming sweets, and non-tobacco users. [ABSTRACT FROM AUTHOR]

Globally, biodiversity is declining due to habitat loss and degradation, over‐exploitation, climate change, invasive species, pollution, and infrastructure development. These threats affect the populations of large waterbird species, such as Sarus crane (Grus antigone), which inhabits agricultural–wetland ecosystems. Despite the burgeoning built‐up areas and diminishing agricultural and wetland spaces, scant research investigates the impact of these changing land uses on the globally vulnerable Sarus crane in Nepal. During the pre‐breeding season from April to June 2023, our comprehensive study meticulously scrutinized Sarus crane population status and factors associated with the occurrences and conservation challenges across 10 specific districts of Nepal. Our study documented a total of 690 individuals of Sarus cranes in five districts. The Lumbini Province has 685 individuals, occupying 11 roosting sites. Conversely, the remaining five districts have no Sarus cranes presence during this period. Wetland, farmland and built‐up areas exhibited a significantly positive influence on Sarus crane occurrences in the Lumbini Province. Additionally, we recorded 47 fatalities of Sarus cranes over the past 13 years in the Lumbini Province due to electrocution and collisions. Our study provides a baseline dataset crucial for developing conservation policies, particularly during the dry season when Sarus crane populations tend to congregate in larger flocks. The adaptation of the Sarus crane to urbanized landscapes exposes them to several anthropogenic threats in the coming days. Therefore, protecting wetlands and farmland areas and adopting transboundary conservation approaches are imperative for the long‐term conservation of the Sarus crane and its habitat. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to assess oral hygiene practices, oral health status and barriers to utilization of oral health care services among pregnant mothers attending two family health care clinics in Sunsari, Nepal. Methods: A cross‐sectional study was conducted among 139 women using a purposive sampling technique. The data collection was done using a pretested standard semi‐structured questionnaire. Face‐to‐face interviews of the participants were done by a single investigator in the local language (Nepali). The examination was done using a mouth mirror and CPI probe for periodontal status, loss of attachment and dentition status, and treatment needs. Results: The majority of pregnant mothers brushed their teeth once a day or less than once a day (n = 106, 76.3%) and self‐reported perceived oral health status was poor/fair (n = 93, 66.9%). The prevalence of dental caries was found to be 69.8%. Bleeding on probing was present in all participants. DMFT, presence of bleeding on probing and increased periodontal pocket was significantly high among women who had self‐reported their oral health problems in comparison to those who had not reported any problem. The most common barriers reported by the participants were a lack of knowledge of dental checkups and a lack of perceived need for dental care during pregnancy. Conclusions: There was a high prevalence of dental caries and periodontal disease. Lack of knowledge and perceived need for dental care were the major barriers found in this study. Hence, this directs towards the utmost need for improvement in awareness level as well as oral hygiene practices. [ABSTRACT FROM AUTHOR]

Biological invasion is triggered by human development activities such as the construction and expansion of road networks. Road verges serve as important habitats and corridors for the distribution of invasive alien plant species (IAPS) between geographically distant habitats. However, the trajectory of plant invasion and the data regarding the impact of roads on IAPS distribution are relatively poor in Nepal. Here, we surveyed two road types (main roads and feeder road) in the Middle Mountain region of central Nepal in order to investigate how different road types are driving the dispersal of IAPS along road verges and the adjacent natural habitats. Systematic sampling was conducted at ca 2.5 km intervals along the roads. At each sampling site, paired plots (25 m × 4 m) were sampled: one adjacent to and along the road, and another 20 m away and parallel to it in the interior habitat. Our results revealed that the main road verges had a higher cover (33%) and a larger number of IAPS (14 species) than the feeder road (25%; 10 species). The IAPS cover and richness were significantly higher along verges than in the adjacent interior habitats for both road types, indicating that roads are contributing as corridors for the dispersal of IAPS in the Middle Mountain areas of central Nepal. Further, elevation, tree canopy, and disturbances (grazing/mowing/trampling) were found to be the key factors that determine spatial distribution of IAPS along road verges. We emphasize that regular monitoring of vegetation along the road verges can help with the early detection and control of potential IAPS in the region before they become problematic. [ABSTRACT FROM AUTHOR]

Background: Participatory policy analysis (PPA) as a method in health policy and system research remains underexplored. Using our experiences of conducting PPA workshops in Nepal to explore the impact of the country's move to federalism on its health system, we reflect on the method's strengths and challenges. We provide an account of the study context, the design and implementation of the workshops, and our reflections on the approach's strengths and challenges. Findings on the impact of federalism on the health system are beyond the scope of this manuscript. Main body: We conducted PPA workshops with a wide range of health system stakeholders (political, administrative and service-level workforce) at the local and provincial levels in Nepal. The workshops consisted of three activities: river of life, brainstorming and prioritization, and problem-tree analysis. Our experiences show that PPA workshops can be a valuable approach to explore health policy and system issues – especially in a context of widespread systemic change which impacts all stakeholders within the health system. Effective engagement of stakeholders and activities that encourage both individual- and system-level reflections and discussions not only help in generating rich qualitative data, but can also address gaps in participants' understanding of practical, technical and political aspects of the health system, aid policy dissemination of research findings, and assist in identifying short- and long-term practice and policy issues that need to be addressed for better health system performance and outcomes. Conducting PPA workshops is, however, challenging for a number of reasons, including the influence of gatekeepers and power dynamics between stakeholders/participants. The role and skills of researchers/facilitators in navigating such challenges are vital for success. Although the long-term impact of such workshops needs further research, our study shows the usefulness of PPA workshops for researchers, for participants and for the wider health system. Conclusions: PPA workshops can effectively generate and synthesize health policy and system evidence through collaborative engagement of health system stakeholders with varied roles. When designed with careful consideration for context and stakeholders' needs, it has great potential as a method in health policy and systems research. [ABSTRACT FROM AUTHOR]

This study explores the role of internal locus of control in shaping the entrepreneurial intentions of women micro-entrepreneurs in Nepal, with a particular focus on the mediating effect of family support. Entrepreneurship is a vital component for economic development, especially in developing countries like Nepal, where women's participation in micro-enterprises significantly contributes to household income and community welfare. To achieve the stated objective, the data were collected from the primary source through structured questionnaire under convenience sampling technique from 322 women micro-entrepreneurs of Bharatpur Metropolitan City, Chitwan. The data were analyzed using Process Macro 4 at 95 percent confidence interval using the 5,000 bootstrapping samples. The findings reveal that women with a strong internal locus of control exhibit higher entrepreneurial intentions. Moreover, the presence of robust family support significantly enhances this relationship, providing emotional, financial, and logistical backing that enables women to pursue and sustain entrepreneurial activities. The findings of this study validated the set hypotheses that internal locus of control significantly affect the entrepreneurial intention and family support partially mediated them. These insights underscore the importance of fostering both individual psychological traits and supportive family environments to enhance women's entrepreneurial engagement. The study concludes with policy recommendations aimed at empowering women micro-entrepreneurs through targeted training programs and initiatives to strengthen family support systems. [ABSTRACT FROM AUTHOR]

Avian influenza (AI) outbreaks pose severe challenges to low and middle-income countries such as Nepal, Nigeria, Bangladesh, Ghana, South Africa, and Indonesia, leading to profound economic crises with far-reaching consequences. The multifaceted impacts of AI outbreaks on low-income economies shed light on the intricate relationship between disease control and financial stability. By reviewing the implications for the poultry industry, trade restrictions, food security, public health, government legislation, and socio-economic vulnerabilities, we provide a comprehensive overview of the economic ramifications of AI outbreaks. AI outbreaks cause substantial disruptions in the poultry industry, resulting in significant financial losses for farmers and related businesses. The poultry sector contributes 4%, 1.4-1.6%, 6-8%, and 14% to the national GDPs of Nepal, Bangladesh, Nigeria, and Ghana respectively. Imposing trade restrictions on affected regions also hampers international trade, reducing revenue and foreign exchange earnings. This, in turn, affects food security as poultry products serve as vital sources of protein and nutrition in low and middle-income countries. Moreover, AI outbreaks adversely impact environmental sustainability by culling infected birds. [ABSTRACT FROM AUTHOR]

Landslide disasters in Nepal are widely reported to have increased in the last decade, but there has been limited on trends in landslide occurrence in Nepal from 2011 to 2020. This study presents the spatio-temporal distribution and trends of landslide disasters in the Nepal Himalayas and identifies landslide-prone areas. Landslide disaster data was collected to assess annual variations, investigate the relation between rainfall and landslides, describe the landslide distribution pattern, conduct statistical analysis, and predict landslide causes and triggering factors. The dataset suggests that the overall trend in landslide disasters in Nepal from 2011 to 2020 is increasing, with a high level of variability in the number of landslide disasters from year to year, depending on several factors. Results show that landslide events were clustered in space and time, with 93.26% of total landslides occurring in the rainy season. The average density of landslide disasters in 2011 was 0.85 events per 1000 km2 and increased to 3.34 in 2020. The effect of earthquake preconditioning was observed as the landslide disaster rate has been elevated since the 2015 Gorkha earthquake with systematic shifting of locations over time. Power-law relationships fit well for the cumulative frequency distribution of daily landslide disasters and the probability density of time interval between landslides. The gap between landslide events was observed as 1–170 days. Moreover, trend analysis has shown an increasing trend of landslide disasters both seasonally and annually. [ABSTRACT FROM AUTHOR]

Introduction: Children below the age of 15 years account for the majority of acquired immunodeficiency syndrome (AIDS)-related deaths in Nepal. Antiretroviral therapy (ART) improves health and prolongs lives of people with human immunodeficiency virus (HIV). Poor adherence to ART provides clue to a sub-therapeutic level of antiretroviral drug, which can facilitate multi-drug resistance of similar regimen, leading to treatment failure and death. The objective of this study was to determine the level of adherence to ART and its associated factors among HIV-infected children aged 0-14 years in Pokhara Academy of Health Sciences (PoAHS), Pokhara, Nepal. Material and methods: This cross-sectional study was conducted between September 15th, 2020 and February 15th, 2021, and included 57 HIV-infected children. Caregivers of the children were questioned with a pre-tested, semi-structured questionnaire, which was later translated verbally to Nepali. Trained doctors took the interviews. Acquired data was entered using SPSS version 17 software for analysis. Level of significance was set at p < 0.05. Results: Caregiver's forgetfulness was the main reason for missing ART doses (60%; 6/10). Other reasons were side effects of drug-related fear (30%; 3/10), followed by transportation problems (10%; 1/10). Older children (range, 11-14 years) adhered more to ART than younger ones (aged 0-5 and 6-10 years), with COR = 4.80 and 1.16, and 95% CI: 0.81-28.15% and 0.19-6.88%, respectively. Caregivers who knew their HIV status had their children more adherent to ART than those with unknown HIV status (COR = 27.94, 95% CI: 1.23-634.62%). A significant proportion of children in ART unit of PoAHS (17.54%; 10/57) missed ART doses within the previous week. Conclusions: The level of non-adherence to antiretroviral therapy in children was found to be 17.54%. Caregiver's forgetfulness, side effects of drug-related fear, and transportation problems were the most common causes of non-adherence. Encouraging caregivers to know their HIV status, providing medicines via nearby ART clinics with coordination of community-based support, and using clues as a reminder to provide the child with drugs at the same time of the day, increase ART adherence in pediatric HIV-positive patients. [ABSTRACT FROM AUTHOR]

On 3 November 2023, a moment magnitude (MW) 5.7 (Local Magnitude, ML6.4) earthquake struck the western region of Nepal, one of the most powerful seismic events since 1505 in the region. Even though the earthquake was of moderate magnitude, it caused significant damage to several masonry buildings and caused slope failures in some regions. The field reconnaissance carried out on 6–9 November by the study team, following the earthquake, conducted the first-hand preliminary damage assessment in the three most affected districts—Jajarkot; West Rukum; and Salyan. This study covers the observed typical structural failures and geotechnical case studies from the field study. To have a robust background understanding, this paper examines the seismotectonic setting and regional seismic activity in the region. The observations of earthquake damage suggest that most of the affected buildings were made of stone or brick masonry without seismic consideration, while most of the reinforced concrete (RC) buildings remained intact. Case histories of damaged buildings, the patterns, and the failure mechanisms are discussed briefly in this paper. Significant damage to Khalanga Durbar, a historical monument in Jajarkot, was also observed. Medium- to large-scale landslides and rockfalls were recorded along the highway. The motorable bridge in the Bheri River suffered from broken bolts, rotational movement at the expansion joint, and damage to the stoppers. The damage observations suggest that, despite the existence of building codes, their non-implementation could have contributed to the heavy impact in the region. This study highlights that the local population faces a potential threat of subsequent disasters arising from earthquakes and earthquake-induced landslides. This underscores the necessity for proactive measures in preparedness for future disasters. [ABSTRACT FROM AUTHOR]

Nawalparasi East district is one of the high cucumber growing areas in Nepal and is considered a pocket area for cucumbers. The study was conducted in two rural municipalities (Hupsekot and Madhyabindu) and two municipalities (Gaidakot and Kawasoti) in the district from February to July 2023 AD. The research aimed to study the production and marketing of cucumbers in the district by assessing the production cost, examining market price behavior and channels, and identifying cucumber cultivation's production and market-related problems. A questionnaire for producers and a different questionnaire for traders was designed. A sample of 120 farmers was selected from the list of cucumber farmers and 25 traders were selected from major markets. Socio-demographic and farm characteristics were identified through statistical means. Likewise, financial analysis like cost breakdown, gross revenue, BC ratio, and market analysis like price behavior were examined. Also, major problems faced by cucumber-growing farmers were ranked. SWOT analysis was also carried out through FDG (Focus Group Discussion) and KIIs (Key Informant Interviews). The cost of production was broken down into various parameters in which the land lease cost shared the highest percentage of cost i.e., 23.99% of the cost of cucumber production. The total cost of producing cucumber was observed to be NRs. 298087.62 per hectare. A good return with a BC ratio of 3.03 was also found. The study also revealed insect pests and diseases to be important production problems. Likewise, problems like price fluctuation, unawareness of farmers towards price, and middleman intervention were important marketing issues. 37.18% of producer's share and NRs. 59.43 of price spread showed a lag in the marketing of cucumbers that needs to be fixed to reach maximum profitability. [ABSTRACT FROM AUTHOR]

Salmonella is one of the pathogenic microbe responsible in food borne diseases. In developing countries like Nepal, Salmonellosis is one of the leading food-borne disease. The present study was conducted with an objective to enumerate coliform and to find the prevalence of Salmonella species in chicken meat along with their antimicrobial susceptible profile. A total of 30 chicken meat samples were collected and examined following the standard techniques and procedures at the Med Micro Lab from January 2020 to April 2020. The study was performed following the conventional methods for the detection of Salmonella spp. Biochemical methods were implied for the detection of isolates and Antibiotic Susceptibility Test were performed by modified Kirby Bauer disc diffusion test [1]. Out of the 30 samples, 12(40%) sample showed positive for Salmonella spp. Salmonella spp 2(16.67%) were found to be resistant to Ciprofloxacin, Chloramphenicol 1 (0.33%), Cotrimoxazole 2(16.66%), Nalidixic acid 7 (58.33%) Ampicillin 3 (25%) and Ceftriaxone (0%). Salmonella was found to be 100% sensitive towards Ceftriaxone. The highest resistance was observed towards Nalidixic acid (58.33%) followed by Ampicillin (25%) and Cotrimoxazole (16.67%). Finally, the result of the study recommended that the use of standardized procedures in slaughtering and handling of chicken meat, provision of training on best practice of handling of meat for handlers and raising the level of awareness of people about the healthy consumption of chicken meat should be increased. [ABSTRACT FROM AUTHOR]

Quantifying the extent of change in climatic and hydrological variables in the past and the future is essential for climate change-resilient development, especially in the climate change sensitive region of Nepal. This paper analyzed future climatic trends and extremes, historical hydrological extremes and their linkage with historical precipitation extremes, and discussed the impacts of climate change on various sectors in the less-studied Small and Medium-sized Eastern River Basins (SMERB) of Nepal. Applying an ensemble of five Coupled Model Intercomparison Project phase 6 (CMIP6) global climate models (GCMs), we evaluated 10 precipitation and 13 temperature extreme indices using Climpact2 for the historical (1979–2020), near-future (2021–2045), mid-future (2046–2070) and far-future (2071–2100) under two Shared Socioeconomic Pathway (SSP), SSP245 and SSP585. Hydrological extreme indices were assessed using Indicators of Hydrologic Alteration tool. Projected climate revealed significant increase (9–73%) in annual and seasonal rainfall except winter; frequent intense rainfall extremes but prolonged dry spells; significant increasing minimum and maximum temperature trends (0.4–5 °C); rise in extreme heat events; increasing minimum and maximum discharge extreme trends in most hydrological stations; as well as strong association between maximum 1 day precipitation (Rx1day) and 1 day max flow for all stations. Growing dry periods but intense rainfall in few wet days, coupled with warming pattern all-over SMERB with frequent extreme events indicate high risk for future climate-related disasters. The harsher climate will potentially have damaging implications, especially in climate-induced disasters, food security, and water and sanitation infrastructure. [ABSTRACT FROM AUTHOR]

In this study, wavelet analysis and traditional cross-correlation analysis (TCA) have been employed to explore the temporal characteristics of the Air Quality Index (AQI) (PM2.5) and its relationships with meteorological factors, air temperature, and rainfall in the capital city of Nepal, Kathmandu, during 2017 - 2020. The temporal variation of monthly averaged (AQI) (PM2.5) revealed that the air quality was unhealthy in winter, improved in summer, and subsequently became unhealthy again in autumn and spring. We also noticed that the lowest AQI (PM2.5) was recorded in 2020, which is due to the COVID-19 pandemic lockdown. By analyzing the time-frequency relationship of (AQI) (PM2.5) with air temperature and rainfall, using Cross Wavelet Transform (XWT), we observed the interannual, seasonal, and monthly common periodicity between them. The coherency of XWT is then tested by using Wavelet Transform Coherence (WTC), which showed a negative correlation of AQI (PM2.5) with rainfall and air temperature, while an anomaly was seen among AQI (PM2.5) and temperature as they were positively associated for a few months in 2017, 2018, and 2020. Moreover, the results of cross-correlation and multiresolution analysis (MRA) are consistent with wavelet analysis, indicating the driving effect of air temperature and rainfall on (AQI) (PM2.5). [ABSTRACT FROM AUTHOR]

This paper examines the effectiveness of migration policies in dealing with the challenges that Nepalese migrants faced during this pandemic from a disaster justice perspective. Like in other periods of natural or human-made crises, the Nepal Government brought new policies and programmes to help the victims in their reintegration. In this context, this paper examines what policies and programmes worked and what did not work based on the findings of a large survey conducted among migrants and qualitative information collected during the implementation of a programme on reintegration. The paper highlights that understanding the social vulnerability of migrants is critical to devising policies that could benefit them in such disasters. It demonstrates that socially vulnerable groups are not only disproportionately affected by disasters and are less capable of resilience and recovery; they are also not supported well by public institutions like the government. This situation makes such migrants further vulnerable to poverty, physical exploitation and psychological stresses, which calls for policies and programmes that support them in preparedness and, in the event of a disaster, long-term recovery until they become resilient. This study shows that local governments are in a better position to target the 'socially vulnerable' and to implement reintegration programmes. [ABSTRACT FROM AUTHOR]

Background: Globally, the majority of strokes affect people residing in lower-and lower-middle-income countries (LMICs), but translating evidence-based knowledge into clinical practice in regions with limited healthcare resources remains challenging. As an LMIC in South Asia, stroke care has remained a healthcare problem previously unaddressed at a national scale in Nepal. The Nepal Stroke Project (NSP) aims to improve acute stroke care in the tertiary healthcare sector of Nepal. We hereby describe the methods applied and analyze the barriers and facilitators of the NSP after 18 months. Methods: The NSP follows a four-tier strategy: (1) quality improvement by training healthcare professionals in tertiary care centers; (2) implementation of in-hospital stroke surveillance and quality monitoring system; (3) raising public awareness of strokes; and (4) collaborating with political stakeholders to facilitate public funding for stroke care. We performed a qualitative, iterative analysis of observational data to analyze the output indicators and identify best practices. Results: Both offline and online initiatives were undertaken to address quality improvement and public awareness. More than 1,000 healthcare professionals across nine tertiary care hospitals attended 26 stroke-related workshops conducted by Nepalese and international stroke experts. Monthly webinars were organized, and chat groups were made for better networking and cross-institutional case sharing. Social media-based public awareness campaigns reached more than 3 million individuals. Moreover, live events and other mass media campaigns were instituted. For quality monitoring, the Registry of Stroke Care Quality (RES-Q) was introduced. Collaboration with stakeholders (both national and international) has been initiated. Discussion: We identified six actions thatmay support the development of tertiary care centers into essential stroke centers in a resource-limited setting. We believe that our experiences will contribute to the body of knowledge on translating evidence into practice in LMICs, although the impact of our resultsmust be verified with process indicators of stroke care. [ABSTRACT FROM AUTHOR]

Introduction: Nepal's move to a federal system was a major constitutional and political change, with significant devolution of power and resources from the central government to seven newly created provinces and 753 local governments. Nepal's health system is in the process of adapting to federalism, which is a challenging, yet potentially rewarding, task. This research is a part of broader study that aims to explore the opportunities and challenges facing Nepal's health system as it adapts to federalisation. Methods: This exploratory qualitative study was conducted across the three tiers of government (federal, provincial, and local) in Nepal. We employed two methods: key informant interviews and participatory policy analysis workshops, to offer an in-depth understanding of stakeholders' practical learnings, experiences, and opinions. Participants included policymakers, health service providers, local elected members, and other local stakeholders. All interviews were audio-recorded, transcribed, translated into English, and analysed thematically using the six WHO (World Health Organization) health system building blocks as a theoretical framework. Results: Participants noted both opportunities and challenges around each building block. Identified opportunities were: (a) tailored local health policies and plans, (b) improved health governance at the municipality level, (c) improved health infrastructure and service capacity, (d) improved outreach services, (e) increased resources (health budgets, staffing, and supplies), and (f) improved real-time data reporting from health facilities. At the same time, several challenges were identified including: (a) poor coordination between the tiers of government, (b) delayed release of funds, (c) maldistribution of staff, (d) problems over procurement, and (e) limited monitoring and supervision of the quality of service delivery and data reporting. Conclusion: Our findings suggest that since federalisation, Nepal's health system performance is improving, although much remains to be accomplished. For Nepal to succeed in its federalisation process, understanding the challenges and opportunities is vital to improving each level of the health system in terms of (a) leadership and governance, (b) service delivery, (c) health financing, (d) health workforce, (e) access to essential medicines and technologies and (f) health information system. [ABSTRACT FROM AUTHOR]