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Background: In Nepal, the private sector has prominently emerged as a provider of health services in recent years. The objective of this paper is to assess whether public and private hospitals are competing for patients with similar socioeconomic strata, or providing services to different segments of the patient population. Methods: Data were collected prospectively from one public hospital and one private-for-profit hospital, both located in close proximity to one another in Tanahu district. A total of 384 and 389 patients presenting themselves for outpatient services available at the district public hospital and a private hospital, respectively, were systematically selected and interviewed using a survey form. The profiles of the patients were comparatively analyzed, and the reasons for using a particular hospital were assessed. Binary logistic regression was used for multivariate analysis.Results: Compared to the patients using the public hospital, patients at the private hospital were younger, possessed a higher level of education, represented indigenous and disadvantaged ethnic groups, and belonged to business or agricultural occupations. The four prominent reasons for using the private hospital were: positive perception/prior experience, followed by recommendation/word-of-mouth, timely availability of services, and trustworthiness. Among the public hospital patients, the prominent reasons were: low fee for services or having insurance, positive perception/prior experience, and trustworthiness. Conclusions: Public and private hospitals have played a complementary role in serving the health needs of different patient population segments in the study district. Keywords: Nepal; private hospital; public hospital; reasons for use; users profile.

Diabetes is one of the major public health problems in Nepal. Very few studies on correlation between waist hip ratio and random blood sugar have been done in remote areas of Nepal particularly in minor ethnic groups like Thami. This study attempted to compare waist hip ratio and blood sugar level in Thami community.This cross sectional study was conducted in sub-health post of Lapilang village of Dolakha district of Nepal. A total of 243 local inhabitants from Thami Tribe participated in the study. Waist hip ratio was calculated after taking measurements of waist and hip using flexible measuring tape; and, blood glucose level was measured by glucometer.The mean age of the participants was 46.02 years; among participants 126 (51.9%) were males and 117 (48.1%) were females. Mean waist hip ratio was 0.87, mean blood sugar level was 124.5 mg%. Increase in Waist hip ratio correlated significantly with increase in random blood sugar level both in males (p=0.008) and females (p=0.007).Increase in waist hip ratio is associated with increase in random blood sugar level. Therefore, there is a need of public awareness program to reduce waist circumference thus reducing weight of people to prevent development of diabetes mellitus in long run.

In troduction: Diabetes is one of the major public health problems in Nepal. Very few studies on correlation between waist hip ratio and random blood sugar have been done in remote areas of Nepal particularly in minor ethnic groups like Thami . This study attempted to compare waist hip ratio and blood sugar level in Thami community of Nepal. Methods: This cross sectional study was conducted in sub-health post of Lapilang village of Dolakha district of Nepal. A total of 243 local inhabitants from Thami Tribe participated in the study. Waist hip ratio was calculated after taking measurements of waist and hip using flexible measuring tape; and, blood glucose level was measured by glucometer. Results: The mean age of the participants was 46.02 years; among participants 126(51.9%) were males and 117(48.1%) were females. Mean waist hip ratio was 0.87, mean blood sugar level was 124.5mg%.Increase in Waist hip ratio correlated significantly with increase in random blood sugar level both in males(p=0.008) and females(p=0.007). Conclusions: Increase in waist hip ratio is associated with increase in random blood sugar level. Therefore, there is a need of public awareness program to reduce waist circumference thus reducing weight of people to prevent development of diabetes mellitus in long run. Keywords: blood sugar level; diabetes; Thami community; waist hip ratio