NepMed Repository :: Browsing by Author "Oli, N"

Browsing by Author "Oli, N"

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Determination and Evaluation of Sense of Coherence in Women in Semi-urban Nepal: A part of the Heart-health Associated Research, Dissemination, and Intervention in the Community (HARDIC) Trial
(Kathmandu University, 2021) Thapa, DR; Oli, N; Vaidya, A; Suominen, S; Ekström-Bergström, A; Areskoug Josefsson, K; Krettek, A
ABSTRACT Background Sense of coherence (SOC) is a core concept of salutogenesis which relates to individuals’ overall life orientation. Stronger SOC associates with better coping strategies, better health, and better quality of life. Although the SOC-questionnaire is validated in many cultures and languages, it has not, to date, been applied in Nepal. Objective To determine and evaluate women’s SOC before and after a health education intervention. Method This study was conducted as a part of the Heart-health Associated Research, Dissemination, and Intervention in the Community in the semi-urban Jhaukhel- Duwakot Health Demographic Surveillance Site in Nepal. Jhaukhel and Duwakot were selected as the control and intervention areas, respectively. Participants were women with children aged 1-7 years. Eight hundred and fifty-seven women before and 1,268 women after the health education intervention participated in the study. The statistical analysis was carried out with chi-square tests and one-way uni-variate ANOVA. Result Women’s total SOC mean values at baseline were 51.1-57.4 and at follow up 54.4-54.9 in the intervention and control area, respectively. At baseline, SOC was significantly weaker in the intervention area compared to the control area (p < 0.001). At follow- up three months later, SOC was significantly stronger in the intervention area than in the control area (p < 0.001). Conclusion Nepalese women had weaker SOC than women in high-income countries, but comparable to neighboring country India with similar cultural features. Empowerment of women through community participation and health education strengthened SOC. The SOC-13-questionnaire in its Nepali version is recommended to be further evaluated. KEY WORDS Health education, Health promotion, Non-communicable disease, Quality of life, Sense of coherence
Dietary Salt Intake in a Suburban Nepali Community: A Cross-sectional Study Using 24-Hour Urinary Sodium
(Kathmandu University, 2025) Bhatt, RD; Shrestha, A; Karmacharya, BM; Timalsena, D; Dhimal, MN; Pradhan, P; Oli, N; Bista, D; Pyakurel, M; Barakoti, R; Mishra, R; Risal, P
ABSTRACT Background High dietary salt intake is a recognized contributor to hypertension and cardiovascular diseases, particularly in low- and middle-income countries. Despite the high burden of hypertension in Nepal, robust estimates of salt intake using the gold standard 24- hour urinary sodium collection remain scarce, especially in suburban populations. Objective To accurately assess dietary salt intake using 24-hour urinary sodium excretion and evaluate factors influencing salt consumption in a suburban Nepali population. Method A cross-sectional study was conducted in 2023-2024 as part of the Dhulikhel Heart Study’s second phase. A total of 381 adult participants were recruited from randomly selected wards of Dhulikhel Municipality. Data on sociodemographic characteristics, dietary habits, salt-related knowledge, and anthropometry were collected. Salt intake was estimated from 24-hour urinary sodium excretion. Generalized Estimating Equations (GEE) and multivariate analyses were used to identify associated factors. Result The mean age of the participants was 49.9 ± 15.5 years and average salt consumption was 9.55 ± 3.2 g/day. The mean dietary salt intake significantly exceeded WHO recommendations, with notable variations by sex, education, and frequency of eating out. Conclusion This study highlights alarmingly high salt intake in a suburban Nepali community and underscores the need for population-specific strategies to reduce sodium consumption. Policy action, public education, and promotion of healthier dietary behaviors are essential to combat the growing burden of salt-related non- communicable diseases. KEY WORDS Blood pressure, Dietary salt intake, 24-hours urine sodium
Human Resources for Cardiovascular Disease Management in Nepal: A National Need Assessment
(Kathmandu University, 2021) Thapa, B; Sharma, S; Shrestha, A; Maharjan, R; Jha, N; Bajracharya, S; Shrestha, S; Neupane, T; Sapkota, BP; Koju, RP; Oli, N
ABSTRACT Background Human resources are the mainstay of the healthcare system. Higher numbers of health workers have better healthcare coverage and outcomes. Availability of trained human resources to address the exponential rise in cardiovascular disease in Nepal is a national concern. Objective To assess the need of human resources for cardiovascular disease management in Nepal. Method We conducted an exploratory sequential mixed-method study. We developed a task force and organized a national workshop to engage stakeholders and collect feedback on the research process. We did a desk review and conducted 24 key informant interviews. We did thematic analysis from the codes generated. Result There is no clear definition and required estimation of health workers for cardiovascular disease management. There is a shortage of health workers with 8.9 doctors, 20.8 nurses, 0.05 cardiologist/cardiac surgeon, 4.2 pharmacist, 10.2 laboratory technicians per 10,000 population. There is a comprehensive human resource plan but it does not provide details of human resources for cardiovascular disease management. There is a lack of public private collaboration for human resource management. However, there is production of human resources for cardiovascular disease management through pre-service specialized courses and in- service training. Conclusion A clear definition and estimation of health workers with stringent human resource plan for cardiovascular disease management is essential. The government can still address these gaps by establishing a well-equipped central health workforce unit and expanding collaboration with private sectors. KEY WORDS Cardiovascular diseases, Human Resource for health, National need assessment, Nepal
Research Capacity for Prevention and Control of Non-communicable Diseases and their Risk Factors in Nepal: Findings of a Needs Assessment Study
(Kathmandu University, 2022) Oli, N; Pradhan, PMS; Sagtani, RA; Shrestha, A; Jaacks, LM; Karmacharya, BM; Danaei, G; Vaidya, A
ABSTRACT Background Despite a high burden, there are limited trainings in non-communicable disease research in Nepal. Objective We conducted a needs assessment to assess existing research training capacity in academic health institutions of Nepal for the prevention and control of non- communicable diseases, identify gaps in research, and explore the feasibility of developing research training program in Nepal targeting non-communicable diseases. Method We did mixed-method research and reviewed academic institution curricula and scientific articles authored by Nepali researchers. We conducted 14 Focus Group Discussions with bachelor and masters level students of public health and community medicine; 25 In-depth Interviews with department heads and faculties, and government stakeholders. We surveyed medical and public health students on their research knowledge and skills development. Result Research methodology component was addressed differently across academic programs. One-third (33.7%) of students expressed lack of skills for analysis and interpretation of data. They felt that there is a wide scope and career-interest in non-communicable diseases research in Nepal. However, specific objectives in the curriculum and practical aspects regarding non-communicable diseases were lacking. Most of the non-communicable diseases research in Nepal are prevalence studies. Lack of funding, conflicting priorities with curative services, and inadequate training for advanced research tools were reported as major barriers. Conclusion Nepal must strengthen the whole spectrum of research capacity: epidemiological skills, research management, and fund development. Generation of a critical mass of non-communicable disease researchers must go together with improved funding from the government, non-governmental, and external funding organizations. KEY WORDS Curriculum, Need assessment, Public health, Research methodology
Study of Neighborhood Environment for Cardiovascular Health in a Squatter Area in Nepal
(Kathmandu University, 2025) Oli, N; Vaidya, A; Rijal, D; Suwal, PS; Maharjan, B
ABSTRACT Background Behavioral risk factors for cardiovascular diseases are prevalent among the urban poor in Nepal. Understanding environmental factors such as the availability of retailers selling tobacco, alcohol, and junk food, as well as neighbourhood access to and the built environment’s support for physical activity is critical for addressing the rising burden of cardiovascular disease in the community. Objective To identify aspects of the community environment that contribute to behavioral risk factors, focusing on the food supply system, built environment, walkability, and the marketing, availability, and accessibility of tobacco and alcohol. Method Spatial data were collected in the Sinamangal-Minbhawan squatter area of Kathmandu using a mixed-method approach. Geographic Information System tool, direct field observations, including spot observation and transect walk, and Market Basket Surveys were done by a trained research team during the period March-May 2022. Data were analyzed using methodological triangulation, combining interviews, observations, GPS data, and Google Earth imagery in ArcMap 10.8. Thematic analysis of market basket survey interviews involved coding transcripts for cardiovascular disease-related behaviors, with codes refined into six key themes, including sociodemographic characteristics. Result We reported a few vegetable outlets and no fruit shops. There were 84 fast-food outlets and local restaurants with junk food and soft drinks available. We observed 77 tobacco outlets with a variety of tobacco products easily available to all. There were 48 alcohol outlets in the area, which, except for four outlets, were present together with tobacco and junk food outlets. Tobacco and alcohol products were largely consumed by men of all age groups. Conclusion Community-based health programs can raise awareness about the importance of healthy behavior. Advocacy efforts to promote policies that support improved access to healthy foods, smoke-free public spaces, and safe environments for physical activity are important to provide community members with healthy choices. KEY WORDS Food supply environment, Geographic information system, Market basket survey, Spatial analysis
The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC) Trial for Nepalese Mothers regarding Diet and Physical Activity: A Process Evaluation
(Kathmandu University, 2017) Vaidya, A; Oli, N; Eiben, G; Krettek, A
ABSTRACT Background Mothers with young children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance site of Bhaktapur district have misconceptions and poor behavioural practice regarding diet and physical activity. We developed the Heart- health Associated Research, Dissemination and Intervention in the Community trial - a health promotion intervention for mothers. Objective The objective of this study was to evaluate the intervention’s feasibility, acceptability, potential for transferability and scaling up, and to determine its immediate outcome. Method Duwakot and Jhaukhel were randomly selected as the intervention and control communities, respectively. We trained 47 peer mothers from Duwakot, each of whom gave classes with 10 fellow mothers of their neighbourhood. The process evaluation was carried out on a continuous basis at different points of the intervention held from August to November 2016. Result In round one, the participation and completion rates were both > 90% for peer mothers; and 85% and 70%, respectively, for the fellow mothers. However, the participation rates fell in the round two of the intervention. On the whole, the mothers expressed satisfaction and acceptance of the course content and training modality. Immediate evaluation of the intervention showed improvement of knowledge, attitude and practice of diet and physical activity among both groups of mothers. Conclusion The successful implementation of the intervention targeting diet and physical activity clearly demonstrates the feasibility of health promotional activities in the Nepalese community for improvement of cardiovascular health. KEY WORDS Diet, health promotion, mothers, physical activity, process evaluation

Browsing by Author "Oli, N"

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