Journal Issue: Volume 21, No. 3 & 4 (1999)
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Volume
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Issue Date
1999
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
A comparison of the quality of care provided and the rational use of drugs in rural public health facilities and private shops
(Institute of Medicine, 1999) Holloway, KA; Gautam, BR
Abstract
The problem of insufficient funding undermining health care in Nepal has led to greater emphasis being placed on the private sector for service delivery. This study
compared the quality of service provided by primary health care public facilities and private shops (the main private primary health care alternative) in rural remote areas of hilly E. Nepal. A cross-sectional survey was done and WHO indicators used. It was found that public facilities provided better access and value for money than shops. Provided adequate levels of drug availability were maintained, public primary health care facilities offered better quality of care than private shops, where there was often misuse of drugs particularly antibiotics due to irrational self-medication or patients not buying what they had been prescribed. However, in many public facilities (not supported by any agency apart from HMG) drug availability was poorer than in the larger shops, leading to a similar misuse of drugs, especially antibiotics, as occurred in shops. When considering strategies to decrease the misuse of antibiotics it may be easier to address poor drug availability in public facilities than change patient-retailer behaviour in shops. The poor dispensing process and large number of people not knowing how to take their drugs are two serious problems, needing urgent action, in both the public and private sectors.
Keywords: public facilities, private drug shops, prescribing habits, quality of care, drug use
Histologic changes in mice fed with staple food
(Institute of Medicine, 1999) Devkota, UN; Steinmann, JP; Böhm, J; Schilcher, F; Veres, B; Helmreich, M; Larsson, S
Abstract
When mice were given staple food of seed quality corn and other cereals by subsistence farmers in Dhading and Bhaktapur areas in Nepal, histopathological changes were frequently found, particularly in the liver. All staple foods from Nepal were severely polluted with mould but only in one sample deoxynivalenol (DON) was found. (The most common liver changes, but to a lesser degree, were also found in the mice given seed quality corn with or without vitamin/mineral mixture.)
Kidney lesions such as tubulonephrosis, suspected parenchymatous degeneration, nonpurulent nephrosis or chronic pyelonephritis were found in mice given Nepalese corn and in the oats group.
In some groups there were histopathological findings like pronounced hyperkeratosis, papillary epithelial surface with hypergranulosis or uneven macropapillary surface observed in the distal part of the oesophagus and in the forestomach.
Because of the similar handling of nutrients for humans and mice, it is suggested that the results of this study be considered when nutritional surveys are made in less developed countries.
What do mothers know about Acute Respiratory Infection: a case from eastern Nepal
(Institute of Medicine, 1999) Onta, SR; Yengden, B
Abstract
A descriptive study was conducted in Eastern Nepal with an objective to assess the knowledge of mothers about acute respiratory infection (ARI). Two hundred
mothers, who had currently at least a child under five, from randomly selected households were interviewed. 50.5% of the mothers correctly knew the signs and symptoms of ARI without pneumonia; 45% had mixed responses. Only 2.5% of the responding mothers reported to have knowledge about danger signs of ARI, 39.5% had wrong answers and 12% did not know about the danger signs of ARI. Regarding knowledge about home care management, 50.5% had correct responses. Both the correct and wrong responses about knowledge of ARI were more or less equally distributed across the educational level, ethnicity and age group of responding mothers. It is concluded that knowledge of mothers about ARI in general is low, particularly very low on danger signs of ARI. This might have led to delayed specific treatment of children with ARI, which could have resulted in various complications including death.
Keywords: ARI, danger signs, maternal knowledge.
Postnatal Depression: A study of prevalence and associated socio-demographic factors
(Institute of Medicine, 1999) Regmi, Shishir K; Khalid, Abdul
Abstract
Perinatal psychiatry is an important aspect of modern clinical practice. Postnatal psychiatric states maybe divided into three categories, which overlap to some extent,
that is, maternity blues, postnatal depression, and puerperal psychosis. In the West, studies have reported that significant postnatal depressive disorders occur in up to 10 percent of women. The present work was undertaken with the aim to study the prevalence of postnatal depression and to study the socio-demographic profile of
women suffering from postnatal depression. The sample for the present study was drawn from women who attended postnatal clinic (Mondays and Wednesdays) of T.U. Teaching Hospital and were in 4-12 weeks postnatal period. All the selected women were asked to rate Edinburgh Postnatal Depression Scale. A total of 100 women in 4-12 week postnatal period were screened and twelve women scored above the cut-off score and were found to be suffering from postnatal depression. Thus the estimated prevalence of postnatal depression in females attending postnatal clinic of TUTH is 12%. The mean age of females was 23.92+3.29 years. The majority of them were housewives, belonged to Hindu religion and came from middle socio-economic strata. Though the sample for the present study was relatively small, it may still be inferred that the prevalence of postnatal depression in Nepal maybe the same as that in the world. Further large-scale community studies are recommended.
Keywords: Postnatal depression, prevalenc, socio-demographic profile