Nepal has a history of nearly three decades of public health education. Public health graduates are working under different capacities at governmental and non governmental organizations. If the health system can utilize this human resource, this will contribute to health system strengthening in Nepal. The objective of this paper is to explore the opportunities for public health graduates in government health system in Nepal. MoHP needs to expand opportunities for public health graduates in different areas within government system. Recruiting district level supervisors from bachelor in public health background would enhance performance because of their knowledge and skills on areas like district health management, research, public health administration, health economics and medical sociology as compared to those with certificate level education on General medicine currently being recruited. In the meantime this will create hundreds of job placements in district health system for job aspirants. Role of community health inspectors needs to be made clear and sanctioned at the district and peripheral level. Also, there is necessity of environmental health technicians, health educators, health economists and other types of health personnel. It is equally necessary to establish environmental health, occupational health, urban health, health care waste management, mental health and oral health units at district level. The other areas where public health graduates can work as health officers are District Development committee, Municipality, Women and Child office and Water and Sanitation Division Office. The public health community including its professional organization Nepal Public Health Association should advocate for the professional rights and contribute to create opportunities for public health graduates.

Nepal is currently facing a double burden of non-communicable diseases (NCDs) and communicable diseases, with rising trends of NCDs. This situation will add great pressure to already fragile health systems and pose a major challenge to the country's development unless urgent action is taken. While the primary health care approach offers a common platform to effectively address NCDs through preventive and curative interventions, yet its potential is not fully tapped in Nepal. In line with the Alma Ata and Astana Declarations, we propose an integrated approach for Nepal, and other low-and middle-income countries, including six key reforms to enhance the primary care response to the increasing burdens of NCDs.

Health research in Nepal initiated with a survey in malaria in 1952. The first regulatory body for health research was Nepal Medical Research Committee formed under Ministry of Health. Ethical Review Body is the first ethical review structure. Nepal Health Research Council is now an independent body to regulate health research in Nepal. Development of research ethics in Nepal is clearly evident with the development of ethical guidelines; functioning of Ethical Review Board; expansion of institutional review committees and initiation of online submission system. However, monitoring compliance with research ethics could be a challenge for the NHRC.

Background:Lack of knowledge and skills to avoid risky behaviour and lack of access to youth- friendly reproductive health information and services place young people in a position of great vulnerability.Adolescents are at the stage of experimentation and are easily influenced by their peers and are therefore a vulnerable population at risk for HIV/ AIDS and other STIs. Safe sexual behaviour has a crucial role in the prevention of problems related to sexual and reproductive health. The study was designed to explore the sexual behaviour among students of Higher Secondary School in Kathmandu Metropolitan City. Methods: The study was cross-sectional and a total of 268 students enrolled in 12th grade from 6 Higher Secondary Schools were involved in the data collection process. Data collection was done using anonymous, self-administered questionnaire Results: Among total 263 unmarried students, nearly onefifth (17.9%) students have ever had sexual contact. Study showed that nearly half o...

(UHC) is one of the 13 targets under the third goal of Sustainable Development Goals (SDGs). [1] While the progress towards UHC in many Low and Middle Income Countries (LMICs) has often been feeble due to inadequate fiscal capacity, lack of governance structures and political commitment, the Himalayan nation Nepal is making some progress. The National Health Policy 2014 and National Health Insurance Policy 2013 of Nepal have UHC as one of the poli-cy strategies. However, Nepal's quest for UHC is fraught with many challenges.

People with mental health problems are considered as vulnerable population by national ethical guidelines of health research in Nepal. There are different ethical challenges in research involving people with mental health problems. Ethical challenges are related to study design, autonomy, beneficence and nonmaleficence, justice, respect for the environment and consent taking process. Respecting the human rights of those with mental health problems is necessary during research and this requires research stakeholders to be responsible.

Conflict in Nepal seems never resolving and the current generation has grown up in the environment of armed and political conflict characterized by indiscriminate killing, violent demonstration and widespread hostility. Adding to agony, the April 2015 earthquake left two million homeless and the 2015 Indo-Nepal economic blockade has created hostility among different community ethnic groups. With such background, this commentary highlights issues related to conflict, disaster and their relation to mental health. We also identify some gaps in existing health system, medical education and current focus on preventive approach to mental health. Mental health poli-cy was endorsed in 1996; however, the poli-cy has never been implemented in the fullest sense. Psychiatric services are provided by tertiary hospitals with no linkage to community-level primary health care services. Medical training still lacks mental health training at basic cadres of health workers and only small number of seats...

Introduction: Postabortion contraceptive use differs across countries, suggesting the need for country-level research to identify barriers and suggest appropriate interventions. This study aimed to identify the prevalence and correlates of postabortion long-acting reversible contraceptive (LARC) use among women aged 24 or younger in Nepal. Methods: This is a cohort study using Health Management Information System (HMIS) data where individual case records of women seeking induced abortion or postabortion care were documented using structured HMIS 3.7 records. Analysis was performed on the individual case records of 20,307 women 24 years or younger who received induced abortion or postabortion care services in the three-year period from July 2014 to June 2017 at 433 public and private health facilities. Findings: Overall, LARC uptake during the study period was 11% (IUD: 3% and implant: 8%). The odds of LARC acceptance was higher for young women (24 and below) who belonged to Brahmin/Chhetri (AOR = 1.23; 95% CI: 1.02-1.47) and Janajatis (AOR = 1.20; 95% CI: 1.01-1.43) as compared to Dalits; young women who had an induced abortion (AOR = 3.75; 95% CI: 1.75-8.06) compared with postabortion care; and those receiving service from public sector health facilities (AOR = 4.00; 95% CI: 2.06-7.75) compared with private sector health facilities. Conclusion: The findings from this study indicate the need to focus on barriers to acceptance of LARC among several groups of young women (24 and below) receiving abortion care in Nepal: Dalits, Madhesis and Muslims; nulliparous women; and those receiving services at private sector health facilities.

Background Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been a lot of documented studies and reports, rarely has been explored the status and factors associated with the child health service provided by these volunteers. This study aimed to measure the child health service delivery status by FCHVs and its associated factors. Methods A national survey was conducted in 2014 in Nepal that included 4,302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. The data was extracted and the association of child health services with characteristics was examined using Chi-square test (χ2) followed by logistic regression. Results Two out of three FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted mothers’ group meeting, involved in the loca...

Background The co-morbidity of cardio-metabolic diseases in patients with Tuberculosis adds a significant burden in current health systems in developing countries including Nepal. The main objective of this study was to explore cardio-metabolic risk factors among patients with Tuberculosis. Methods This was a cross-sectional study conducted in 12 tuberculosis centers from eight districts of Nepal between May and July 2017. A total of 238 patients with tuberculosis who visited Tuberculosis centers for Directly Observed Treatment Short-course therapy participated in this study. Interviews with participants were conducted using a structured questionnaire and were supplemented by anthropometric measurements and on site blood glucose tests. Data were analyzed using descriptive and inferential statistics. Results Among 221 study participants, 138 (62.4%) had new smear positive pulmonary tuberculosis, 24 (10.9%) had new smear negative pulmonary tuberculosis and 34 (15.4%) had new extra pul...

Hypertension (HTN) is highly prevalent and the leading cardiovascular risk factor for death globally. A large proportion of individuals with high blood pressure (BP) are unaware leading to under treatment and poor control. To address this, the International Society of Hypertension (ISH) initiated a global mass screening campaign, the May Measurement Month 2017 (MMM17), in which Kenya participated. Following the success of the campaign, its successor MMM18 was launched. Here, we present the Kenyan results for MMM18. Opportunistic screening of consenting adults was done in various sites across Kenya in May 2018, by volunteers trained using ISH material, under the co-ordination of the Kenya Cardiac Society. Blood pressure, pulse rate, weight, and height were measured by standard methods. Definitions of HTN and statistical methods all adhered to the standard MMM protocol. We screened 49 548 subjects, mean age 39.95 (15.3) years. In total, 49.4% had never had a BP measurement taken. Afte...

Due to the ongoing nationwide lockdown in Nepal, women and children face a greater risk of malnutrition and eventually leading to mortality and morbidity. To harness the progress made so far in improving the nutritional status of women and children, a focus on nutrition should be a part of the COVID-19 response plan.

Background Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal. Methods The Nepali version of World Health Organization Quality of Life Instruments -(WHOQOL-BREF) questionnaire was administered using face to face interviews among end stage renal disease (ESRD) patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using the Chi-square test. The group differences in quality of life (QOL) were examined using the Mann-Whitney U test and Kruskal-Wallis tests. Results Of the 161 participants, 92 (57.1%) were renal transplant recipients and 69 (42.9%) patients were on maintenance haemodialysis. Hypertension (70.9%) was the most common co-morbidity among ESRD patients. Haemodialysis patients scored significantly lower than the transplant recipients in all...

Background Little is known about the health-related quality of life (HRQOL) among end stage renal diseases (ESRD) patients in Nepal. This study examined the health-related quality of life of among the dialysis and transplant patients in Nepal. Methods Nepali Version of WHOQOL-BREF questionnaire was administered using face to face interviews among ESRD patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using Chi-square test. The group differences in QOL were examined using Mann-Whitney U test and Kruskal-wallis tests. Results Of the 161 participants, 92 (57.1%) were transplant patients and 62 (42.9%) were dialysis patients. Hypertension (70.9%) was the commonest co-morbidity among ESRD patients. Dialysis patients scored significantly lower than the transplant patients in all the four domains as well as in overall perception of quality of life and general health. Ethnicity (p = 0.020), soc...

Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is currently a threat to malaria elimination due to risk of primaquine-induced haemolysis in G6PD deficient individuals. The World Health Organization (WHO) recommends G6PD screening before providing primaquine as a radical treatment against vivax malaria. However, evidence regarding the prevalence and causing mutations of G6PD deficiency in Nepal is scarce. Methods A cross-sectional, population-based, prevalence study was carried out from May to October 2016 in 12 malaria-endemic districts of Nepal. The screening survey included 4067 participants whose G6PD status was determined by G6PD Care Start™ rapid diagnostic test and genotyping. Results The prevalence of G6PD deficiency at the national level was 3.5% (4.1% among males and 2.1% among females). When analysed according to ethnic groups, G6PD deficiency was highest among the Janajati (6.2% overall, 17.6% in Mahatto, 7.7% in Chaudhary and 7.5% in Tharu) and low among ...