Browsing by Author "Subedi, L"
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Publication Assessment of Community Based Health Insurance in Sunsari District(Kathmandu University, 2018) Subedi, L; Regmi, MC; Giri, YABSTRACT Background Community Based Health Insurance (CBHI) Schemes are promising alternatives for a cost sharing health care system which hopefully leads to better utilization of health care services, reduce illness related income shocks and eventually lead to a sustainable and fully functioning universal health coverage. Objective This study focused on factors influencing the people’s enrolment and hindrances for enrollment of CBHI program. Method Altogether 316 households were taken according to population proportionate sampling method.Community based cross-sectional analytical study was carried out with preformed questionnaire among members and non- member in four villages. Sample unit for enrollee were selected by using population proportionate systematic random sampling method using enrolled register and for non-enroll systematic random sampling technique was used using household list from VDC. Result For non- members 28.3% small benefit package was main reason for non membership. Provision of partial payment would be a motivating factor for 26.4% of the respondents. Non-members (30.5%) felt disparities in treatment while providing good medicines (11.9%). Financial help for the treatment was good part of the program for 43.0% of the respondents. Among 9.3% of members who would not renew reported of tedious process of taking service as the main reason. The educational status of the respondents is directly related to the enrolment in the CBHI scheme (<0.001). Conclusion The study gave some insight about factors influencing the utilization of health insurance schemes in low resourced countries. Properly implemented CBHI schemes would add on better health financing and better utilization of health care in developing countries. KEY WORDS Community, Enrollment, Health, InsurancePublication Epidemiological Study of Tobacco Smoking Behaviour amongst Residents of the Hill Region of Nepal(Kathmandu University, 2016) Sah, RB; Pradhan, B; Subedi, L; Karki, P; Jha, NABSTRACT Background Tobacco use is still a serious public health problem in the world and represents a major cause of morbidity and mortality in most parts of the world. Objective To measure the prevalence of tobacco use and to identify the factors associated with tobacco use among the residents of Dhankuta Municipality. Method The cross-sectional study was conducted among the residents of the Dhankuta Municipality where 205 households were taken as subjects. Pretested semi- structured questionnaire was used for data collection and face to face interview was conducted. Univariate and multivariate logistic regression was used to see the association between various factors and tobacco use and identify the predictor variables. Result Overall prevalence of tobacco consumption in Dhankuta Municipality was found to be 57.1%. Prevalence of tobacco consumption among the male was significantly higher (67%) than female (47.1%) (p<0.05). Most of the respondents (56.4%) started consuming tobacco due to peer pressure and for recreation (24.8%). The multivariate logistic regression showed that the people with illiterate have higher chances of consuming tobacco than above School Leaving Certificate (OR 38.395, 95% CI=3.209- 459.417). The respondents below poverty line (<1.25 US$) was consuming tobacco more than above poverty line (≥1.25 US $) (OR 6.814, 95% CI= 1.255-36.986). Conclusion The aims of this study was to measure the prevalence of tobacco use and to identify the factors associated with tobacco use among the residents of the Dhankuta Municipality. We conclude that the prevalence rate of tobacco consumption in the Dhankuta Municipality was found to be moderately high. Factors like male in gender, Brahmin/Chhetri in ethnicity, lack of education, poor occupation like farmer and housewife, poor economic status were associated with tobacco use. KEY WORDS Epidemiological study, residents, tobacco smoking behavior