Browsing by Author "Joshi, Lok Raj"
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Publication Lessons Learned from the Design and Implementation of the Tuberculosis Free Nepal Initiative(Nepal Medical Association, 2025) Shrestha, Prajowl; Mishra, Gokul; Khanal, Mukti Nath; Shah, Naveen Prakash; Dahal, Deepak; Thapa, Barsha; Joshi, Lok Raj; Ghimire, Namita; Wingfield, TomAbstract Introduction: Nepal has a persistently high burden of tuberculosis. Despite implementation of multiple interventions by the National tuberculosis Program, Nepal is not on track to achieve many of WHO’s End tuberculosis Strategy targets. Method: The National tuberculosis Control Centre developed a Google Sheet with key indicators to monitor the tuberculosis -Free Initiative across municipalities. Focal points recorded real-time data, ensuring transparency. National tuberculosis Control Centre compiled, analyzed, and interpreted the data to track progress, evaluate program outcomes, and support future planning. Results: The tuberculosis-Free Initiative achieved significant results in implementing municipalities. A total of 112 END TUBERCULOSIS Committees were formed at the municipal level, with over 1,000 ward-level committees engaged in tuberculosis microplanning. More than 56% of municipalities mobilized community-led monitoring groups, and 16 municipalities conducted annual social audits. tuberculosis-Free Volunteers facilitated screening in 53 municipalities. In 2023, innovative case-finding methods contributed significantly. The sputum courier system identified 1,790 Pulmonary bacteriologically confirmed tuberculosis cases, 554 cases were diagnosed via screening camps and door-to-door visits, and 222 cases through Primary healthcare centre Outreach Clinics. Additionally, 23 patient support groups, 32 youth groups, and 32 civil society organizations were mobilized, strengthening community participation. These efforts highlight the tuberculosis-Free Initiative’s impact on enhancing case detection, community engagement, and tuberculosis control strategies. Conclusion: Developing local level ownership and accountability in the national tuberculosis response, ensuring high quality implementation through robust monitoring and evaluation, and generating and sustaining local resources, requires strong government leadership, advocacy, and capacity building. Within the implementing teams by the stakeholders, frequent initiative reviews, coaching, and mentoring support.Publication Prevalence of Abuse and its Associated Factors among Elder Population Living in Kawasoti Municipality of Nepal(Central Department of Public Health, 2024) Kafle, Bharat; Bhattarai, Preeti; Shrestha, Aman; Aryal, Umesh Raj; Joshi, Lok Raj; Amgain, Kapil; Koirala, Sagar; Sanjel, SeshanandaAbstract Background: Elder abuse is a growing public health problem. To tackle the elder issues World Health Organization, declare for the decade of healthy ageing from 2020 to 2030, where Nepal is not exception from this goal. Thus, the study aims to assess the prevalence of abuse and its associated factors among elder population living in Kawasoti Municipality. Methods: A community based cross sectional study was conducted, taking 422 elders who were 60 years and above. The face-to-face interviews were conducted from October 2018 to January 2019. The collected data were entered into EpiData 3.1 and was exported to SPSS 26 version. The logistic regression was performed to measure associated between overall abuse and its covariates. Results: The overall prevalence of elder abuse was 43.8% and caregiver neglect was the most reported form of elder abuse. Study found that nuclear family [OR=0.42, 95% CI;0.18-0.97], illiterate [OR: 2.01, 95% CI; 1.11-3.96], family members have no migrated to another country [OR=0.57, 95% CI; 0.33-0.97], health condition was bad [OR= 1.92, 95% CI; 1.15-3.21], elder who did not depend on their daily activities on family members [OR=0.25, 95% CI; 0.12-0.52], and those who had consumed tobacco [OR= 1.91, CI; 1.19-3.06] were associated with elder abuse. Conclusion: The finding suggests that good health, a nuclear family, literacy, family members not migrated to another country, and independence in daily activities strongly reduce elder abuse. To address this, it is essential to implement awareness programs, and ageing population for their economic sustainability activities, and healthy and active aging life.