NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.
Recent Publications
Association Between Minimum Service Standards and Patient Satisfaction in Outpatient Departments of Nepal’s Government Hospitals
(Nepal Health Research Council, 2026) Pathak, Janardan; Knoble, Abigail; Shah, Md Kashim; Bhandari, Rabindra; Amatya, Archana; Rajbhandari, Ruma
Abstract:
Background: Nepal’s Minimum Service Standards (MSS) tool assesses structural readiness of government hospitals but its relationship to patient satisfaction is unknown. We evaluated how well MSS scores correspond to outpatient satisfaction and patient reported gaps in the quality of services.
Methods: A cross-sectional mixed-methods study utilized 839 patient satisfaction surveys conducted from July 2021 to May 2024 across 57 government hospitals, then linked responses to retrospective hospital-level MSS scores. Overall satisfaction was modeled with an ordinal mixed-effects logistic regression with hospital-level random intercepts. For qualitative insights, six hospitals were purposely sampled for six focus group discussions with OPD staff and six interviews with hospital leaders. Transcripts underwent thematic content analysis, and quantitative and qualitative findings were triangulated.
Results: Each 1% rise in OPD MSS score increased satisfaction odds by 3% (OR?1.03, 95?%?CI?1.02–1.05; p?
Evaluation of Access and Coverage of Integrated Management of Acute Malnutrition Program
(Nepal Health Research Council, 2026) Nepali, Sujay; Maharjan, Roshna; Timalsina, Ashish; Nigussie, Melkamnesh Alemu; Singh, Phulgendra Prasad; Katwal, Manisha
Abstract:
Background: Wasting remains a critical public health concern in Nepal, with many children unable to access timely treatment despite national efforts. Evidence on program coverage is lacking in Syangja district. The objective of this study is to identify the underlying factors supporting and hindering the program and to estimate its coverage.
Methods: The Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) approach was implemented in three stages using a mixed-method design. Stage I involved qualitative data collection through key informant interviews (KII), Focus Group Discussions (FGD), and direct observations (DO) in seventeen different locations. Stage II tested a hypothesis about proximity and coverage via small-area surveys using active and door-to-door case finding. Due to inconclusive results, Stage III was not executed. Quantitative data from DHIS-2 and IMAM registers were analyzed for trends and performance indicators, while qualitative data were thematically analyzed and triangulated across participants, types and methods. A Barriers, Boosters, and Questions (BBQ) scoring exercise informed prior coverage estimation.
Results: Twelve boosters and twenty-five barriers affecting program access and coverage were identified. Boosters included strong family support, motivated frontline workers, and local government initiatives. Barriers involved stigma, logistical challenges, inconsistent protocol adherence, limited training, and stockouts. The estimated prior coverage was 34.3%. Hypothesis testing on distance-related coverage was inconclusive, halting progression to a wide-area survey. Additional qualitative investigation confirmed gaps in health worker capacity, community engagement, and IMAM protocol compliance.
Conclusions: The IMAM program in Syangja district faces systemic and community-level challenges. To improve coverage, targeted interventions are needed to strengthen service delivery, enhance staff capacity, ensure supply availability, and increase community awareness and engagement.
Keywords: Access; barriers; boosters; coverage.
Maternal Health Outcomes in Nepalese Women After Mitral Valve Replacement
(Nepal Health Research Council, 2026) Joshi, Dikshya; Shrestha, Anushruti; Bajracharya, Smriti Mahaju; Sharma, Apurb
Abstract:
Background: The effects of anticoagulation on maternal health in patients with prosthetic valves remain understudied. Our study aims to assess maternal health post-mitral valve replacement (MVR), pregnancy-related complications, maternal mortality, coagulation issues, and fetal and neonatal outcomes post-MVR.
Methods: This exploratory retrospective study, conducted from 2017-2020, included female patients of reproductive age who underwent MVR. Eligible participants were identified from hospital records, and pregnancy-related maternal outcomes were ascertained through review of medical records and a single cross-sectional telephone follow-up conducted between June and August 2023. Data on childbirth, abortion, anticoagulation management, and related complications were collected. Descriptive statistics were used for analysis.
Results: Of 474 female patients of childbearing age who underwent MVR, 380 responded to our survey. Of these, 18 cases (4.73%) involved pregnancy post-MVR. All pregnant patients were on anticoagulant therapy during pregnancy, with no maternal deaths reported. However, one patient experienced heart failure post-delivery. Bleeding was the most common complication, occurring in 5/18 pregnancies (27.7%). Seven pregnancies resulted in live births (38.8%), with one low birth weight infant. There were no congenital anomalies, but there was one intrauterine fetal death at 7 months and 2 spontaneous abortions. Seven pregnancies were electively terminated, though the reasons were not studied. One pregnancy was ongoing at the time of the study. All but one delivery occurred under medical supervision, with most patients following a warfarin-to-heparin regimen.
Conclusions: In this cohort, 4.73% of women experienced pregnancies post-MVR, with anticoagulation posing significant challenges. The low rate of maternal and fetal complications suggests a need for further research, particularly regarding the high rate of elective terminations.
Keywords: Maternal health; Nepalese women; outcomes.
Alcohol Drinking Behaviours among Bus Drivers and Staffs of Banke District, Nepal
(Nepal Health Research Council, 2026) B C, Raymond; Neupane, Sushhama; Khadka, Reeone; Bhatta, Narayan; Bhatta, Samir; Bhatta, Chetan
Abstract:
Background: Alcohol consumption is a significant public health concern worldwide, contributing substantially to disease burden and fatalities, especially among drivers. In Nepal, alcohol use is culturally accepted and widely prevalent, with evidence suggesting high consumption rates among bus drivers. This study aims to investigate alcohol consumption and drinking behaviours among bus drivers and staff’s in the Banke district of Nepal.
Methods: A cross-sectional survey was conducted among 195 drivers and staff of public passenger vehicles categorized as “Kha” in Banke district, Nepal. Systematic sampling was employed to select participants. Data were collected using a semi-structured questionnaire adapted from the Nepal STEPS Survey 2019.
Results: The study found that 64.6% of participants had ever consumed alcohol, with drivers reporting a higher prevalence (74.4%) compared to other staff (56.9%). Peer pressure (56.9%) was the most common reason for drinking, followed by family influence (20.8%) and curiosity (18.6%). A significant association was found between alcohol consumption and occupation (p = 0.0177), with drivers more likely to consume alcohol. No significant associations were found with age, marital status, education, or ethnicity.
Conclusions: The findings highlight the high prevalence of alcohol consumption among public vehicle operators, driven by peer pressure and influence from family members. The study emphasizes the critical need for public health interventions to prevent alcohol-related harm in Nepal, such as educational campaigns, stricter enforcement of drunken driving laws, and workplace-based activities.
Keywords: Alcohol consumption; Nepal; occupational group; transportation.
Effect of Sleep on Cardiorespiratory Fitness of Apparently Healthy Young Adults Authors
(Nepal Health Research Council, 2026) Kandel, Sabita; Mahotra, Narayan B; Shrestha, Lava; Bajimaya, Mahesh Man; Aryal, Vibina
Abstract
Background: Sleep dysfunction affects overall health of a person. Exact effect of sleep on cardiorespiratory fitness is less researched area. This study aimed to explore the effect of sleep on cardiorespiratory fitness by examining the difference in VO2 max between normal and poor sleep categories and examine the correlation between PSQI score with VO2 max of young medical students.
Methods: A cross-sectional analytical study was conducted in Clinical Physiology Department, Maharajgunj Medical Campus from March 2023 to September 2024. Participants were categorised into normal and poor sleep categories on the basis of PSQI scores. Participants from both groups performed Queen’s college step test. Heart rate was monitored post exercise to calculate VO2 max. Independent samples t-test was used to compare the VO2 max between the categories. Pearson’s correlation test was used to examine correlation of PSQI score with VO2 max.
Results: A total of 64 participants enrolled in the study out of which 45 were males and 19 were females. Mean PSQI score in male participants was 5.53 ± 2.76 and in female participants was 5.52 ± 3.44. The mean VO2 max in normal sleep category was 42.50 ± 8.61 mL/kg/min and mean VO2 max in poor sleep category was 41.89 ± 7.97 mL/kg/min. There was no significant difference in VO2 max between the two groups (p=0.77). Also, no correlation was found between PSQI score and VO2 max (r=0.029, p=0.591).
Conclusions: Significant impact of sleep quality on cardiorespiratory fitness assessed by VO2 max could not be established in apparently healthy young adults.
Keywords: Cardiorespiratory fitness; Nepal; queen’s college step test; sleep; VO2 max.
Author Biography
Sabita Kandel, Department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal