Browsing by Author "Paudel, Pratiksha"
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Publication Dietary Diversity and its Associated Factors among Children Aged 6-59 Months in Madhyapur Thimi Municipality, Nepal(Central Department of Public Health, 2025) Thapa, Abhishek; Baral, Dipesh; Dahal, Pragati; Kharel, Jiban; Dangal, Archana; Baral, Swastika; Thapa, Rupa; Paudel, Pratiksha; Khadka, RenuBackground: Minimum dietary diversity for children (MDD-C) is a benchmark developed by the World Health Organization (WHO) to assess diet diversity in infants and young children worldwide. The lack of such diet diversity among growing children, which often leads to malnutrition, has been considered a significant public health concern in Nepal. This study is to assess the dietary diversity and associated factors among children aged 6-59 months in wards 2 and 3 of Madhyapur Thimi Municipality. Methods: A cross-sectional descriptive study was carried out by measuring the research variables in 2023 among the residents of wards number 2 (Jatigaal) and 3 (Kaushaltar) of Madhyapur Thimi Municipality. The survey was created and administered by the researchers themselves. The sample size of the study was 385. The survey includes a structured questionnaire to assess dietary diversity and associated factors among children aged 6-59 months. The association between the factors was measured by using Fisher’s Exact test. Results: 73.5% of the study population fulfilled the minimum requirement of dietary diversity. Factors such as the mother’s educational status (p=0.002), mother’s ethnicity (p=0.015), monthly expenditure on food (p=0.001), awareness of communicable diseases (p=0.001), feeding times a day (p=0.001), personal hygiene practices status (p=0.004), and awareness of junk foods (p=0.001) showed a significant association with MDD-C. Conclusion: Increasing mothers’ awareness about junk food, communicable diseases, and the importance of their hygiene practices via formal or informal education campaigns is necessary to increase the proportion of children meeting the MDD-C benchmark and prevent malnutrition.Publication Piloting Implementation Design and Preliminary Readiness for Universal Suicide Risk Screening Program in Emergency Department of a Tertiary Care Centre, Nepal: A Mixed Method Study(Nepal Medical Association, 2024) Shrestha,Anmol Purna; Shrestha, Roshana; Shakya, Renu; Paudel, Pratiksha; Sorenson, Madeleine; Gurung, Amrita; Bajracharya, Riya; Risal, Ajay; Vijayakumar, Lakshmi; Hagaman, AshleyAbstract Introduction: Nearly three quarters of the suicides occur in developing world, however few evidenced-based health systems strategies exist to detect and prevent suicide in these contexts. This pilot study evaluates the feasibility of implementing a universal suicide risk screening program in a Nepalese emergency department. Methods: This study reports the preliminary training phases of a pilot implementation trial in the emergency department to evaluate the program. The approval was obtained from the Nepal Health Research Council (Approval no. 447/2021 P), and the Kathmandu University School of Medical Sciences Institutional Ethical Review Board (Approval no. 237/2021) and Yale University IRB (Protocol ID 2000029480). Implementation assessments included suicide screening acceptability, appropriateness, confidence, system priority, and myth knowledge of staff. Implementation strategies were selected, decolonized, and preliminarily trained followed by phased supportive coaching to initiate the screening package. We designed the implementation package through co-design staff focus groups and embedded ethnography. Results: Co-design focus groups (n=8) occurred with staff and leadership. We trained 26 (76.47%) the staff on the Nepali suicide screening tool followed by supported phased initial screening over two months. Implementation assessments demonstrated increased scores on appropriateness, confidence, system priority, and myth knowledge. The implementation package included key strategies to be deployed over six months. The embedded ethnographic observations revealed barriers to effective implementation, such as anticipated stigma, reluctance to engage families, and distrust in referral processes. Conclusions: The pilot study demonstrated that training improves staff appropriateness, confidence, system priority, and myth knowledge. Despite initial barriers, co-designed strategies and phased coaching facilitates screening uptake, highlighting the program's potential for sustainable implementation.