Journal Issue: No. 01 (2024): Issue 62 Jan-Mar
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Volume
Number
Issue Date
2024
Journal Title
Journal ISSN
1999-6217
Journal Volume
Articles
Advancing Health and Population Research and Innovations for Achieving Sustainable Development Goals in Nepal
(Nepal Health Research Council, 2024) Dhimal, Meghnath; Joshi, Pramod
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Barriers to Abortion among Women and Girls in Selected Districts of Nepal
(Nepal Health Research Council, 2024) Phuyal, Parash Prasad; Bhattarai, Tejaswee; Pant, Prakash Dev; Devkota, Bishnu; Devkota, Jivan; Dhakal, Madhav Prasad; Karki, Sujan; Ghimire, Jagadishwo; Moore, Brittany
Background: Even after two decades of legalization of abortion in Nepal, most women and girls still do not have knowledge on abortion legality and face abortion barriers. This study will explore perceived barriers to safe abortion and the factors associated with it.
Methods: A Mixed method study design was conducted in 30 wards of 20 Municipals of seven districts of Lumbini and Sudurpaschim provinces. Quantitative data was analyzed for 673 women of reproductive age of 15-49 years. For qualitative data, key informant interviews were conducted. The analysis was done on five different barriers and a composite variable was created from them.
Results: Most women and girls perceived social (34.6%), followed by family (30.6%), physical (30.6%), personal (29.5%), and health facility (14.9%) barriers to access safe abortion services. The key finding was that women and girls with knowledge on abortion legality were more likely to perceive barriers to abortion (AOR:2.31, CI:1.574-3.394). Women and girls with higher educational and economic status as well as Dalit women were less likely to perceive barriers to abortion services whereas never married women and girls perceived more barriers in accessing abortion services.
Conclusions: Women and girls perceived several barriers to access safe abortion services. Women who have better knowledge on abortion legality recognize more barriers regarding abortion. This highlights the importance of raising awareness of women and girls on abortion rights to empower them in recognizing and advocating for the removal of the obstacles that stop them from getting abortion services.
Keywords: Barriers to abortion; caste/ethnicity; legal knowledge; women and girls.
Fetomaternal Outcome of Pregnant Women at Term Undergoing Cesarean Section
(Nepal Health Research Council, 2024) Bharati, Sonu; Dangal, Ganesh; Tiwari, Kenusha Devi; Maharjan, Sunita; Bhandari, Srijana; Karki, Aruna; Pradhan, Hema Kumari; Shrestha, Ranjana; Bhattachan, Kabin
Background: Cesarean section is one of the most common procedures performed in obstetric practice today and is a lifesaving surgery for mother and fetus. Cesarean sections are classified traditionally, as elective cesarean section or emergency cesarean. The purpose of this study is to compare the maternal and neonatal outcomes in elective and emergency cesarean section so that measures can be taken to reduce maternal and neonatal morbidity and mortality.
Methods: A descriptive study including 400 pregnant women who underwent caesarean section were included in this study. Patients were subjected to elective or emergency cesarean section as per the indication and protocol of institute. were included in the study.
Results: During the study period there were total 1080 deliveries. The average age of the women was 29.21±4.07 years. Of the 400 cesarean section cases, only 2.8% had wound infection, 3.8% had fever, 4.8% urinary tract infection (UTI) whereas no women had observed with post-partum hemorrhages (PPH) and maternal death. Regarding fetal outcome, neonatal intensive care unit (NICU) admission was observed in 16%, birth asphyxia was 2.3% poor Apgar score 2.5% and neonatal death was not observed. Rate of fever, UTI, wound infection, need of resuscitation and poor Apgar score was significantly high in emergency section than elective caesarean section whereas NICU admission was not statistically significant.
The most common indication of emergency cesarean section were fetal dress and for previous LSCS.
Conclusions: Emergency cesarean was associated with increased maternal and perinatal complications than in elective cesarean section.
Keywords: Caesarean section; elective caesarean section; emergency caesarean section; neonatal morbidity and mortality.
Perception of Climate Change Vulnerability and its Impact on Sexual and Reproductive Health and Rights in Khutiya and Banganga River Basins
(Nepal Health Research Council, 2024) Poudel, Khusbu; Karki, Sujan; Lamichhane, Kritee; Timilsina, Amit; Dijkerman, Sally; Ghimire, Jagadishwor
Background: Nepal is one of the most vulnerable countries to climate change. The drivers of climate risk include its topography, ecological diversity, climatic variability, natural resource dependency, under-development, and socioeconomic vulnerabilities. Climate change affects women and girls in unique ways. Research conducted in Asia Pacific region highlight negative sexual and reproductive health outcomes from climate change-related stressors such as droughts, floods, and air pollution, factors also linked to decreased SRH services utilization, increased maternal mortality rates, and repercussions on women’s mental health.
Methods: This is a mixed methods study conducted in two river basins including household surveys with 384 females ages 18-49, 12 focus group discussions, and 22 key informant interviews. We conducted descriptive and thematic analysis.
Results: More than half relied on agriculture for income (66%). Despite one-third being heads of households, land ownership was low (13%). Climate change perceptions included rising temperatures (88%), increased heat wave (70%), drying water source (99%), and delayed monsoons (83%), impacting agriculture and increasing women's workload (61%) due to displacement and male migration. 64% reported disturbances in antenatal and postnatal care visits . Inaccessible healthcare facilities during the rainy season increased maternal mortality risks. Heavy river flooding hindered female community health volunteers access leading to childbirth complications. 82% of women feared being unable to protect their children post-climate events. Moreover, 21% of women faced gender-based violence during or after climate disasters.
Conclusions: Our findings suggest clear impacts of climate change on women and the communities. Thus, climate adaptation efforts must be designed to address the unique impacts of the crisis on women and girls, making space for their increased participation and leadership.
Keywords: Climate change; gender based violence; malnutrition; migration; sexual and reproductive health and rights.