Management In Nepal Research Articles

Costs of the Supervision, Performance Assessment and Recognition Strategy (SPARS) for improving medicines management in Nepal

Costs of the Supervision, Performance Assessment and Recognition Strategy (SPARS) for improving medicines management in Nepal

P086 MAY MEASURE MONTH 2023: AN ANALYSIS OF BLOOD PRESSURE SCREENING RESULTS FROM NEPAL

Background and Objective: May Measure Month (MMM) is a global annual blood pressure (BP) screening campaign raising awareness about prevention and control of hypertension. Nepal has been participating in this campaign since 2017. We present the results of MMM2023 in Nepal. Methods: Opportunistic BP screening was conducted among adults aged ≥ 18 years from May-August 2023 in Nepal. Participants, selected with convenient sampling, were administered a questionnaire developed by the May Measure Month. Three BP measurements were taken by trained volunteers using digital or manual BP devices. Hypertension is defined using both definitions: 1) BP ≥140/90 mm Hg or currently under antihypertensive medication 2) ≥130/80 mm Hg or currently under antihypertensive medication. Multivariate logistic regression analysis was used to identify factors associated with hypertension. Results: A total of 7,573 adults participated. The mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 119.0 (15.9) and 79.8 (10.6) mm Hg, respectively. 22.3% and 50.1% participants were hypertensive using thresholds of 140/90 mmHg and 130/80 mmHg, respectively. Proportion of hypertension, overweight (BMI≥ 25 kg/m2), tobacco use, e-cigarette use, alcohol use, diabetes, and mean SBP/DBP were statistically significantly higher among males than females. Among hypertensive individuals, 48.9% were aware of their condition, and 42.1% were receiving pharmacological treatment. Among those under treatment, 60.1% had BP under control (<140/90 mm Hg). Factors associated with hypertension were age ≥40 years (OR 4.91, [95%CI 4.28-5.64]), history of cardiovascular diseases (2.15 [1.30-3.56]), diabetes (1.83 [1.52-2.21]), male sex (1.61 [41.41-1.84]), and overweight (1.60 [1.42-1.80]. Conclusions: The MMM 2023 underscored the ongoing challenge of hypertension management in Nepal, reaffirming the strong association of hypertension with risk factors including age, male sex, history of CVDs, diabetes, and overweight. Despite higher proportion of hypertension among males, their awareness, treatment, and control levels were significantly lower than in females. This study highlights the need to strengthen community-based programs to enhance the continuum of hypertension management.

Burn pain management in a female patient with severe burn injuries in Nepal: a case study and review.

Burn injuries in low-resource settings like Nepal present significant public health challenges, leading to substantial morbidity, mortality and severe pain. This paper assesses burn pain management in Nepal, emphasizing the need for enhanced strategies. A case study of a female patient with severe burn injuries from a rural village in Western Nepal illustrates current challenges. Reviewing studies on burn pain management in Nepal shows limited access to specialized facilities, inadequate palliative care, medication shortages and insufficient healthcare professionals. Pharmacological interventions are impacted by financial constraints and a lack of protocols, while nonpharmacological approaches have not been explored and contextualized for the Nepalese context due to similar financial issues. Comprehensive burn pain management requires addressing resource constraints through collaborative health-aid partnerships.

Wheels in Motion: Exploring Challenges and Opportunities in Motorsports Management in Nepal

Nepal is a beautiful country with diverse terrain; Nepal's landscape consists of mainly three zones plain or terai, which occupy a quarter area of the country’s land this is almost surrounded by hills, which is around 40 per cent of the total area of the country. These hills are crowned by the majestic Himalayas including the world's highest peak Mount Sagarmatha (Mt.Everest )and other eight globally recognized mountains over 8000 meters. This unique backdrop of the country landscape gives enough trilling to motorsports events, including motorcycle, four-wheeler sports, and karting. The beautiful landscape of the country, where hill terrain is immediately accessible from the 5-10 km plain terai zone, (Plain Zone) along with beautiful scenes of mountains, lakes, rivers, and greenery, provides an ideal setting. The amazing fact is that when the riders reach the peak of the hills, not only the scenery will attract them but when they feel that the sky and stars are near to them and seem that they can be touched by their naked hand gives both pleasure, enjoyment and race emotion. We can assume Nepal as one of the best locations for the motorsports activities like touring. Additionally, the living cost is low, it is affordable for foreigners, and visitors, safety may be the other wonderful reason thus we can argue that Nepal is the best destination for motorsports tourism, presenting one of the main opportunities for the industry. To capitalize on the above potential, professionalism in event management is essential. Sometimes the traditional definitions of sports management may not work and redefining sports management may require however, traditional concerns of planning, budgeting, organizing, directing and ensuring profitability may need to be done for successful event execution in a country like Nepal. These are the functional areas that Sports managers perform. This article is the pathway to determine the challenges and opportunities in motorsports in Nepal. The findings are assumed to guide the Enthusiasts' club owners/managers and other concerned associates, they are engaged here in this article for their valuable inputs involving them in primary data collection. The Primary data are collected from clubs/ Motorsports Professionals national and international motorsports professionals to determine their major challenges. The importance of a disciplinary attitude among players is also highlighted. Primary data was collected through a questionnaire approach, and focus groups involving stakeholders such as clubs, federations, and provincial associations. The survey aimed to analyze the challenges and opportunities in motorsports management in Nepal. It has been observed that the Nepal Automobile Association (NASA-NEPAL) is the one and only Motorsports Federation, which is working in the development of motorsports in Nepal since its inception in 2008-09. It is affiliated with national and governmental regulating bodies like the Nepal Sports Council and international bodies like FIA, FIM, and CIK. Around 10 national clubs are associated with NASA Nepal and seven Provincial level associations are actively collaborating with the National Federation where approximately 200 players 100 marshals and 100 sports volunteers are primarily engaged in Nepal. During Primary data collection and the focus group discussion, it is also observed that this organized structure provides governance, safeguarding players, providing officiating training, and managing volunteers. In the primary stage of the Nepal motorsports fraternity, Nepalese youth or we can say players are drawn towards motorsports through their enthusiasm and they can be symbolized as self-taught players. Now the scenario has changed second stage Players are now playing the game. Apart from these systematic governing bodies, some of the motorsports clubs are now working in professional and business modules; secondly, Government investments in infrastructure, like racetracks, further enhance opportunities in the motorsports sector in Nepal. However, multiple challenges remain, and we have tried to identify the maximum by the research. Some of the heart-touching and crucial challenges may be financial security for players to compete nationally and internationally, along with the limited involvement of national automobile businesses in event sponsorship. The absence of automobile manufacturers poses challenges in fundraising, but collaborations with numerous other sponsors remain viable in the nation. In conclusion, Nepal's motorsports scene holds immense promise, contingent upon addressing financial challenges and securing support from stakeholders. This article offers insights into the challenges and opportunities in motorsports management in Nepal, contributing to its potential on the global stage.

Integrated assessment of irrigation and agriculture management challenges in Nepal: An interdisciplinary perspective

Agriculture plays a critical role in ensuring food and nutrition security, livelihood, and rural employment in Nepal. Despite substantial investments and institutional reforms, irrigation projects have faced consistently low performance. While existing studies have shed light on technical aspects of irrigation performance, they often focus on specific themes rather than holistic evaluations of sustainability. This research systematically assesses barriers and challenges to effective irrigation water management in Nepal by assessing and ranking the challenges faced by three irrigation systems in western Nepal: Mahakali, Rani Jamara Kulariya, and Babai. To investigate these challenges, we collected data from 449 households, which provided insights into 33 indicators representing key barriers to effective irrigation and agricultural management. The identified challenges were categorized into four broad thematic areas: physical and structural, agricultural and water, socioeconomic and market, and gender and governance. A comprehensive evaluation was conducted to compare these challenges among the three irrigation schemes, different thematic areas, and various locations within each scheme (namely, the head, mid, and tail sections of the system). The findings revealed that timely access and availability of fertilizers, spring water availability and fair market prices of agricultural products are the most significant challenges. The Babai irrigation system faced the most substantial challenges among the three systems, particularly in the mid section. These findings emphasize the interconnectedness of these challenges, highlighting the need for a holistic approach to planning, implementation, and management. Integrated strategies are essential to address socioeconomic, market, and endogenous farming issues, ensuring reliable irrigation water availability for sustainable agricultural production.

Review of community forestry monitoring systems in Nepal

A study was conducted to review the monitoring systems of various stakeholders involved in local level forest management in Nepal. The purpose of this review is to assess the current status of monitoring, identify and document lessons learnt, and explore gaps and opportunities for possible interventions.The study looked mainly at two aspects of existing monitoring systems and practices: a) self-monitoring practices of FUGs), and b) collaborative monitoring practices between FUGs and four different categories of stakeholders - Government, donor field projects, I/NGOs and civil society. A review of concepts related to participatory monitoring is made based on the literature, and aconceptual framework has been proposed for the review of monitoring practices in the context of community forestry in Nepal. Key elements used in the analysis include a) meanings and perceptions of monitoring, b) purpose, c) focus and scale, d) approach, processes and tools, e)contributions to adaptive management.

Assessing the School Management Decision Practices: Insights from the Policy Provisions

This study investigates the management decision-making practices of community school management in Nepal, focusing on the policy perspective. An analytical approach has been used to analyze the information. The authors conducted a comprehensive review of the school education policies that pertain to school management decision-making practices. The authors analyzed the policy requirements on community school management decisions and practices. According to the policy provisions, the school head teachers, school management committee (SMC) members, and teachers' representatives are actively engaged in management decision practices. This study reveals that the head teacher and school management committee hold the authority over important aspects of school management decision-making, such as teacher recruitment, school development planning, and teaching learning activities. The role of local government has crucial in the overall development of community schools in Nepal. Implementing effective school management practices can greatly enhance the development of the school and ensure the delivery of high-quality education. In this context, the authors emphasized the importance of harmonizing management practices to ensure effective decision-making and encourage active participation, ultimately leading to improved school administration.

Determining Consensus Alignment and Barriers of Neonatal Thermal Management in Nepal Using a Modified Delphi Process.

Objective. Neonatal hypothermia is a worldwide health burden with an incidence ranging from 32% to 85% in hospitals and 11% to 92% in homebirths. It is prevalent in Nepal and associated with increased morbidity and mortality. The study objective was to identify key practice standards of newborn thermal management in Nepal. Methods. Our subjects included 6 lead newborn physicians from major birthing centers in Kathmandu. A modified Delphi process was used to identify the top 5 key practice standards for newborn thermoregulation in the hospital, health post, and home, compiled from 14 World Health Organization recommended practices. Results. There was consensus in all ranked practices except using radiant heat sources in the hospital and performing Kangaroo Mother Care in the homebirths. Comments conveyed that interventions during the immediate delivery phase were most impactful and feasible. Conclusion. Nepali physicians prioritized thermoregulatory practices during the immediate resuscitation period over the post-resuscitation period.

Variation of financial benefits from provisioning ecosystem services between nearby and distant users in Partnership Forest Management in Nepal

Partnership Forest Management (PFM) in Nepal was initiated to balance the supply of forest products between nearby and distant users' communities in the Terai region of Nepal. This study in Buddha Shanti Partnership forest analyzed the financial benefits of provisioning services and identified the socio-economic attributes influencing such benefits. A financial analysis of provisioning services was carried out using user prices outlined in the Operational Plan of the forest and on market-price-based approaches. This shows that timber provided more benefits to distant users, while nearby users have reaped more financial gains from fuelwood and fodder. Analysis revealed that home-to-forest distance, along with landholdings and livestock unit are the major factors impacting the overall financial benefits. This shows that the inclusion of distant users in PFM has provided financial benefits from provisioning services to those users.

Policy and Practices of E-Waste Management in Nepal: An Emerging Challenge

Policy and Practices of E-Waste Management in Nepal: An Emerging Challenge

Nurses' knowledge and attitudes regarding children's pain assessment and management in Nepal.

Pain is frequently experienced by children in hospital, and international guidelines for appropriate pain assessment and management are available. Optimal management of paediatric pain has important long-term health, psychosocial, and economic benefits. However, evidence indicates that globally there are deficits in nurses' understanding of paediatric pain assessment and management. This study explored knowledge and attitudes regarding paediatric pain assessment and management among nurses at a tertiary children's hospital in Nepal. In this cross-sectional study all 140 nurses at a tertiary children's hospital in Nepal, were invited to complete the validated Paediatric Nurses Knowledge and Attitudes Survey. Findings revealed substantial deficits in nurse's knowledge and erroneous attitudes towards pain assessment and management in children. Test scores ranged from 14% to 56%, with mean scores of 38%, with no nurses achieving a recommended pass score of 80% regarding knowledge and attitudes in paediatric pain management. Consistent with previous research, nurses had insufficient knowledge and attitudes that did not reflect best practice regarding pain assessment and management in children. Education programmes targeting both trainees and registered nurses are essential to enable nurses to deliver evidence-based care and improve outcomes for children and their families.

Integrated Solid Waste Management for the Circular Economy: Challenges and Opportunities for Nepal

The article emphasizes the importance of implementing Integrated Solid Waste Management (ISWM) and circular economy principles for effective solid waste management, which prioritizes waste prevention, recycling, and environmentally sound disposal practices. The article provides an overview of how ISWM and circular economy principles have been successfully implemented in several countries worldwide and emphasizes the need for their adoption in Nepal, where proper solid waste management systems are often inadequate or non-existent. The article provides insights into the challenges and opportunities for Nepal in adopting such practices and recommends practical methods for improving waste management in the country. The researchers conducted a comprehensive search of the available literature on the topic of ISWM and circular economy in Nepal to draw conclusions and recommendations for the future direction of solid waste management in Nepal. Although, there is the formulation of new laws and policies related to solid waste management in Nepal, the country lacks active implementation of the laws by both governments and waste management companies.

Practice of treating Chronic Subdural Hematoma (cSDH) among Neurosurgeons in Nepal: A nationwide survey with literature review

Objectives: To survey Nepali neurosurgeons regarding the practice of managing chronic subdural hematomas (cSDH). Methods and Materials: A survey questionnaire was sent to all neurosurgeons practicing in Nepal from the database of the Nepalese Society of Neurosurgeons (NESON). Results: 60% (50/84) responded to the questionnaire. There was variation in practice among neurosurgeons regarding the use of drain and the administration of antiepileptics. However, many concurred regarding postoperative computed tomography scan, size of the burr hole, and positioning after surgery. Conclusion: For a common neurosurgical procedure like drainage of cSDH, scientific evidence keeps on changing. Based on the available evidence we need to change our practice for the best possible outcomes. For most of the variables studied, there is concordance with available scientific evidence among neurosurgeons regarding cSDH management in Nepal.

Farmers’ Perspectives on Sugarcane Management in Nepal: Empirical Evidence from Logistic Regression Model

he majority of rural poor in this country, as in most developing countries including Nepal, is dependent upon agriculture. In spite of sugarcane is a major economic crop, Nepalese sugarcane growers are getting problem day by day. The study was undertaken to analyze the viewpoints, attitudes, and perspectives of sugarcane growers on sugarcane cultivation and management among Nepalese farmers. The cognitive behavioral theory was applied to better understand how farmers’ behaviors and decision-making are influenced by their ideas, thoughts, and attitudes towards the industry. The study is based on explanatory research design and collected primary data using structured questionnaire. Following probability sampling techniques, cluster sampling is used to select 280 sugarcane farmers from at ward no. 3,8,9, and 10 of Kabilashi Municipality, a most sugarcane growers in Sarlahi. Data collection was made using kobo toolbox and observation methods. The Binary Logistic Model was used for analyzing farmers’ perspectives on sugarcane management. Results indicate that (80%) sugarcane growers are not getting paid on time and in full. Similarly, the logit model revealed that farmers are well aware of sugarcane management since factors were found to be statistically significant at a desirable probability level in the logit model. The study concludes that although Nepal has a lot of potential to enhance sugarcane production, but the full potential has not yet been fully realized. In this context, the findings of this research will be beneficial for the Ministry of Agriculture, policymakers, and the government to understand the challenges and issues faced by sugarcane growers and to develop policies and solutions to address these issues. How to Cite: Niranjan Devkota, Alika Kumari, Sahadeb Upretee, Devid Kumar Basyal, Surendra Mahato, Deependra Karki, Udaya Raj Paudel, Seeprata Parajuli, Krishna Dhakal, 2023. "Farmers’ Perspectives on Sugarcane Management in Nepal: Empirical Evidence from Logistic Regression Model." Journal of Agriculture and Crops, vol. 9, pp. 222-232.

Anaerobic Digestion (AD) Based Waste Management in Nepal: Technologies and Implementation Modalities

Developing countries are still facing severe challenges for providing access to clean energy, managing waste and struggling to meet Sustainable Development Goals (SDG) targets. Anaerobic Digestion (AD) based waste management technologies have great potential for addressing these challenges. Public Private Partnerships (PPP) are the key government's policy and strategic directions for promoting biogas as a multi-beneficiary's product and services in Nepal. Nepal's biogas promotion PPP model and technologies in domestic biogas sector have been replicated in many African and Asian countries. AD based Gobar Gas Company (GGC 2047 model) and Continuously Stirred Tank Reactor (CSTR) based technologies have been promoted for domestic and large applications respectively in wider scale. Comprehensive review and analysis using technological and implementation progress results through government interventions revealed that with the potential of 1.1 million of domestic biogas 433,173 systems have been installed. Quantification of outcomes of AD based technologies revealed that in addition to the energy access to more than 1.8 million people, these significantly contributed for production of gas amounting 456,282 m3 and substituted equivalent 15,578 nos. of LPG cylinders and 2229.91 tons of fertilizer daily. Under Carbon Development Mechanism (CDM), Total 21.20 million USD have been earned as carbon revenue from this sector, which has played significant role for earning revenue from carbon financing. Similarly, Developing Carbon Program for Large Scale Biogas through ITMO (Internationally Transferred Mitigation Outcomes: a new carbon mechanism) is under way. Overall, biogas sector is contributing for country' s energy security and circular economy through replacement of fossil fuels and chemical fertilizers along with the waste management.

SWOT Analysis of Water Induced Disaster Management Policy, 2072 of Nepal

SWOT analysis is a simple and useful framework for analyzing strengths, weaknesses, opportunities, and threats of any plans, programs, projects and policies developed by an institution. The government of Nepal had formulated and implemented water-induced disaster management policy in 2072 B.S. which was analyzed using SWOT matrix with the help of document analysis and interview methods. Addressing water induced disaster as policy problems, participatory approaches, resource allocation and identification of hazard and vulnerabilities are the strengths of this policy. However, the implementation is not being successful due to lack of institutional ownership and confusing jurisdiction of work among the government institutions, which is the major weakness of the policy. The policy should take opportunities for its improvements according to the new constitution, national policy for disaster risk reduction, and federal setup. Lack of political and institutional commitment, and implementing agencies at central, provincial and local levels, are the main threats to this policy. It is mandatory to implement this policy after successive improvement for sustainable water-induced disaster management in Nepal, in which SWOT analysis helps for decision-making and critical analysis of this policy. Int. J. Soc. Sc. Manage. Vol. 10, Issue-1: 1-4.

Influence of Rural Out-Migration on Household Participation in Community Forest Management? Evidence from the Middle Hills of Nepal

Rural out-migration was a rare socio-economic phenomenon when community forestry began in the 1980s in Nepal. Now, out-migration significantly influences nearly every aspect of rural livelihoods in the country. However, it is unclear how out-migration affects community forestry governance, which is essential for sustainable rural development. Therefore, this paper addresses the following research question: Does rural out-migration affect forest users’ participation in community forestry decision-making and management practices? This paper draws on data collected from an extensive survey of 415 households from 15 community forest user groups in 2 Mid-Hill districts of Nepal. The research used ordered-logit regression to model the impacts of out-migration on participation in forest management and decision-making, while controlling for a number of other socio-economic factors. The model results show that total household size and number of internal migrants, together with multiple resource characteristics and institutional attributes, were major factors affecting participation in decision-making and forest management. However, the number of international migrants did not have a significant role in determining the levels of the participation. This study provides valuable insights for future community forestry policymaking that aims to address the effects of out-migration on community forest management in Nepal.

Prevalence of gastrointestinal parasites in bovines along the elevation gradients of Annapurna Landscape, Nepal

Gastrointestinal (GI) parasitic infection is a great concern for livestock management in Nepal, which may vary with the age and sex of the animals, feeding practices, habitat types, and interaction with other domestic and wild animals. As a consequence of growing environmental changes, it is anticipated that temperature and precipitation variation in altitudinal gradients will influence parasite communities and their hosts with unpredictable impacts. In light of this, the current study aimed to explore the pattern of prevalence and factors affecting GI parasites in bovines along the altitudinal and environmental gradients of Chitwan Annapurna Landscape. A total of 600 faecal specimens of bovines were collected from six different blocks and examined microscopically in the Zoology laboratory of Birendra Multiple Campus, Bharatpur, Nepal in between 2019 to 2020. The presence of cysts, oocysts and eggs of parasites in faecal samples were detected morphometrically using standard qualitative and quantitative methods. Out of 600 faecal samples of cattle and buffaloes examined, 64.8% were found positive for one or more species of GI parasites. The prevalence of parasitic infection was significantly higher in cattle (68.8%) as compared to the buffaloes (62.7%, p=0.007). A total of 16 species (5 protozoans, 11 helminths) were reported. The prevalence of GI parasites was significantly lower with increasing annual rainfall, elevation, distance from the forest and water resources (p=0.0001) but significantly higher with increasing temperature (p=0.001). The calf (p=0.028) and sub-adults (p=0.028) were significantly infected than the adults. Despite the fact that a large number of the herders used veterinary drugs for deworming, GI parasites were still rampant in the cows and buffaloes. We conclude that GI parasites are serious problems in the cattle and buffaloes of Chitwan Annapurna Landscape. Hence, regular health checkups, deworming, cleanliness of the sheds, and water resources are suggested regularly.

Exploring the relevance of community forest operational plan: users’ perspective and implementation status

Community Forestry has long been considered an epitome of decentralized forest management in Nepal. The management of Community Forests are guided by their Operational Plans (OPs), the mandatory technical document. Their preparation demands substantial human and economic inputs. However, their extent of implementation and the significance of these plans to local user are topics of debate. In this context, this study analyzes users' perception about the OP and their implementation status. We took case study approach and conducted key informant interview (n=25), focus group discussion (n=16) and purposive household survey (n=246) in 15 Community Forest User Groups to compile required data. The perceptions were analyzed using qualitative methods. The results revealed that the users have poor understanding of their plans and considered the plan as technical legitimate documents. The implementation status of the plans was of sub-standard. Silvicultural operations prescribed in the operational plans were insufficiently carried out. We found that the users are adopting only the forest product harvest and utilization aspects of the plans. Provided the poor understanding of OPs among the users and quality of plan implementation, this study questions the relevance of current operational plans and emphasizes the need of reviewing the planning process so that their high-standard implementation can be assured.

Tourists’ Perception of Travel Risk and Management in Destination amid Covid-19 Pandemic: Empirical Evidence from Nepal

Travel risk and management views of tourists have a key role in their choice of locations while the COVID-19 epidemic is still causing travel-related concerns. Despite many studies available in the western world, the effect of COVID-19 has been less explored in Nepal. Thus, this research aims to investigate travel risk and management perception in post-COVID tourism activities in Nepal. Based on pathogen stress theory and explanatory research design, this study seeks a causal relationship between Travel Risk and Management in Nepal. Following the purposive sampling technique, data collection is done using KOBO Toolbox through a structured questionnaire. Findings revealed that Risk Management, Transportation Patterns, Distribution Channel, Avoidance of Overpopulated destinations, Hygiene and Safety are significant to Travel risk and management perception whereas Risk Management, Travel risk and management perception, Service Delivery, Distribution Channel, Hygiene and Safety are significant to COVID-19 pandemic in Nepal which supports pathogen-stress theory. Furthermore, travel risk and management perception partially mediate the favorable association between avoidance of overpopulated destinations and the COVID-19 pandemic. Additionally, the primary problems faced by the traveler were securing a comfortable hotel and selecting a destination where COVID risk is minimum. However, the COVID-19 break has caused health concerns among visitors, causing many to cancel their holiday plans. Therefore, in the post-pandemic phase, tourists are more concerned about the influence of the COVID-19 pandemic on their travel activities and choice.