Browsing by Author "Prasad, RR"
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Publication Community intervention to improve knowledge and practices on commonly used drugs(Kathmandu University, 2010) Kafle, KK; Karkee, SB; Shrestha, N; Prasad, RR; Bhuju, GB; Das, PL; Chataut, BDAbstract Background: World Health Organisation (WHO) estimates that about half of all medicines are inappropriately prescribed, dispensed and sold and about half of all patients fail to take their medicines properly. Objective: The overall objective of the study was improving use of medicines in the community by creating awareness among different target groups. Materials and methods: It was a pre-post comparison of intervention implemented at the community level in purposively selected Bhaktapur District of Kathmandu Valley, Nepal. The study was conducted in the private schools of the study district. Twelve schools were randomly selected. Thereafter, students from 6-9 grades were listed from the selected schools. Then 15% of the total students in each grade were randomly selected to get six students from each grade of the each school, totaling 288 students. The households of the selected students served as the sample households for the study. Thus, there were 288 households sampled for the study. The intervention and the targeted intermediary groups consisted of a. training of schools teachers b. training of journalists c. interactive discussions of trained school teachers with school children using key messages and c. communication of key messages through the local F.M. radio, newspaper/ magazine. Results: There was a significant increase in correct knowledge on action of antibiotics and excellent knowledge on the methods of administration of antibiotics of households after the intervention. Similarly, there was a significant increase in knowledge on cough as a disease and a significant decrease in the use of cough medicines after intervention. There was also a significant increase in excellent knowledge on the sources of vitamins and a significant decrease in the use of vitamin/tonics after the intervention. Conclusion: The participation of intermediary groups eg. school teachers, journalists and school children in the implementation of intervention were successful. The groups have fulfilled the commitments in implementing the plan of action. The key messages have effectively reached the households, and the knowledge and practices of the community members in drug use have improved. Key words: Community intervention, Use of common drugs, Knowledge and practicePublication Essential Drugs Concept : its application in Nepal(Institute of Medicine, 1998) Thapa, BB; Prasad, RR; Shrestha, BM; Bhuju, GB; Rajbhandari, VAbstract Essential drugs are those that satisfy the healthcare needs of the majority of the population; they should therefore be available at all times in adequate amount and in the appropriate dosage forms. Various factors need to be considered for the selection of such drugs, though the model list published by WHO serves as valuable guidelines. National List of Essential Drugs, Nepal (EDL) was published in 1986, which was first revised in 1992 and then in 1997. Implementation of it helps to provide health care to a large population in relatively less resources. We have made an effort in this paper to analyze the situation after implementing EDL in Nepal and suggest the ways and means for more effective implementation so that the goal of 'health for all' could be achieved. Keywords: Essential drugs, NepalPublication Evaluation of a successful intervention for sustainability and effects in post research phase(Kathmandu University, 2006) Kafle, KK; Karkee, SB; Prasad, RR; Bhuju, GB; Shrestha, N; Das, PL; Shrestha, ADIntroduction: Promoting appropriate use of drugs is an essential element in achieving quality of health and medical cares for patients and the community, and also to minimize financial burden. Objective: The objective of this paper is to assess the successful intervention for sustainability and effects in post research phase. To address these problems, a variety of educational, managerial and regulatory strategies to improve prescribing have been tried in Nepal. When training is combined with a managerial intervention i.e. peer-group discussion, it results into improved changes in prescribing practices of paramedics in several practices. Methodology: A prospective, three-way design study consisting of small group training, small group training followed by peer-group discussion and control was conducted in three regions of Nepal including one hill and two terai (plains) districts from each region. The study included all health post from the sampled districts, making 80 health posts the study population. Results: The study revealed the effectiveness of the peer-group discussion approach in improving the prescribing practices. An assessment to identify the sustainability of the strategy and its effect within the district healthcare system after the completion of the research phase was undertaken. The study found that peer-group discussion was discontinued in all targeted districts and the improved practices were not sustained after the completion of the research. Various reasons have been found for not continuing the effective intervention. Key words: Drug use, INRUD, Nepal, Intervention, Sustainability, Peer-group discussion, Self-assessmentPublication In the name of herbal medicine(Institute of Medicine, 1998) Khakurel, B; Prasad, RR; Bhattarai, DD; Sheak, AAbstract In the quest for safe and cost effective medicines, as much as 65-80% of the world's population have resorted to herbal remedies of one system or another, often led by a wrong notion that things originating from ancient practices cannot have detrimental effect on health. There are evidences of use of potentially toxic or ineffective plant substances in the form of crude powder or extracts contained in already marketed products. Herbal medicines even contaminated with ingredients of modern medicines, pests, microbes and heavy metals are marketed for which drug regulatory authorities often are not fully equipped to deal with. There is an increasing amount of cross-practice. Indiscriminate prescribing and illegal sale-distribution of drugs by health professionals belonging to different traditional systems including traditional healers and quacks, which is on the rise. In Nepal, there is no specific legislation to regulate the safety, efficacy, quality, sale-distribution, promotion and utilisation of herbal medicines belonging to traditional systems but quite a good amount of exercise has been done to formulate policies and guidelines on herbal medicines, especially in the line of integrating them with PHC services of the national health care system. There is an acute shortage of professional manpower on herbal medicines. There is also a great deficiency of evaluated information on their practical use. There is a need to look at the toxicity and efficacy of herbal remedies in the light of their past history, usefulness and extent of admixture with allopathic therapeutic agents and animal products. In this article, an attempt has been made to characterise the situation with a view to facilitate identification of issues and approaches towards rationalisation of the sector. Keywords: Medicinal plants, herbal medicine, Ayurveda, traditional medicine, regulation/legislation & policies, Nepal, work of WHO in areas of herbal medicine