Mountain Districts Of Nepal Research Articles

Spatial Variation of Caste/Ethnic Poverty in Mountain Districts of Nepal: An Approximation through Small Area Estimation Technique

Nepal is a multi-ethnic and multi-cultural society where economic condition of various caste/ethnic groups substantially varies. However, adequate attention has not been paid to estimate the level of monetary poverty of various caste/ethnicities and assess how people of the same caste/ethnicity living in different locations (districts) vary in terms of monetary poverty. Focusing only on mountain belt, which is one of the economically poorest areas of the country, this study aims to estimate incidence of monetary poverty for major caste/ethnicities living in the mountain districts with the help of small area estimation (SAE) technique and assess spatial variation in the incidence of monetary poverty of the same caste/ethnic group living along the east-west continuum of the mountain districts. Required data for SAE is derived from Nepal Living Standard Survey (2010/11) and 2011 population census of Nepal. The study shows that, compared to other districts, three eastern mountain districts (Province 1) (Taplejung, Sankhuwasabha, and Solukhumbu) have lowest incidence of poverty for all the caste/ethnicities with much lower incidence in three socioeconomically advanced hill caste groups. Incidence of poverty tends to increase sharply along the east to west continuum of mountain districts with exceptionally high poverty rates for Dalits in the far western mountain districts (Province 7). Some culturally similar caste/ethnic groups follow almost similar pattern of increase in the incidence of poverty along the east-west continuum of the mountain districts and form districts of clusters in each region with similar level of poverty.

Potential of Crop Residues for Energy Production in Nepal

The study aims at assessing the availability of crop residues for energy production in lowland, hill and mountain districts of Nepal. Rice, wheat, maize, millet and barley are included in the study that is based upon two different household surveys: (i) interviews conducted in 240 households to obtain key information about practices of crop harvesting, (ii) determination of the quantity of the main crops, their residues and alternative uses of the latter conducted in 27 households. Apart from the foremost use as fodder, there are five major uses of crop residues: building material, burning on the field, mulching of the field, selling and energy generation. Despite the higher amount of crop residues in the lowland (954 kg dry matter per capita and year) than in the hill district (547 kg capita-1 yr-1 ), the amount of crop residues used for energy generation higher in the hill (207 kg capita-1 yr-1 ) than in the lowland district (152 kg capita-1 yr-1 ). In the mountain district, the crop residue production is 263 kg capita-1 yr-1 , of which 26 kg capita-1 yr-1 are used for energy generation. The annual per capita energy equivalent from crop residues in the lowland, hills and mountains are 2.49 GJ, 3.42 GJ and 0.44 GJ which represent 30%, 33% and 3%, respectively, of the total annual cooking energy consumption.

Health system barriers influencing perinatal survival in mountain villages of Nepal: implications for future policies and practices

BackgroundThis paper aims to examine the health care contexts shaping perinatal survival in remote mountain villages of Nepal. Health care is provided through health services to a primary health care level—comprising district hospital, village health facilities and community-based health services. The paper discusses the implications for future policies and practice to improve health access and outcomes related to perinatal health. The study was conducted in two remote mountain villages in one of the most remote and disadvantaged mountain districts of Nepal. The district is reported to rank as the country’s lowest on the Human Development Index and to have the worst child survival rates. The two villages provided a diversity of socio-cultural and health service contexts within a highly disadvantaged region.MethodsThe study findings are based on a qualitative study of 42 interviews with women and their families who had experienced perinatal deaths. These interviews were supplemented with 20 interviews with health service providers, female health volunteers, local stakeholders, traditional healers and other support staff. The data were analysed by employing an inductive thematic analysis technique.ResultsThree key themes emerged from the study related to health care delivery contexts: (1) Primary health care approach: low focus on engagement and empowerment; (2) Quality of care: poor acceptance, feeling unsafe and uncomfortable in health facilities; and (3) Health governance: failures in delivering health services during pregnancy and childbirth.ConclusionsThe continuing high perinatal mortality rates in the mountains of Nepal are not being addressed due to declining standards in the primary health care approach, health providers’ professional misbehaviour, local health governance failures, and the lack of cultural acceptance of formalised care by the local communities. In order to further accelerate perinatal survival in the region, policy makers and programme implementers need to immediately address these contextual factors at local health service delivery points.

A qualitative study about the gendered experiences of motherhood and perinatal mortality in mountain villages of Nepal: implications for improving perinatal survival

BackgroundWe aim to examine the gendered contexts of poor perinatal survival in the remote mountain villages of Nepal. The study setting comprised two remote mountain villages from a mid-western mountain district of Nepal that ranks lowest on the Human Development Index (0.304), and is reported as having the lowest child survival rates in the country.MethodsThe findings are taken from a larger study of perinatal survival in remote mountain villages of Nepal, conducted through a qualitative methodological approach within a framework of social constructionist and critical theoretical perspectives. Data were collected through in-depth interviews with 42 women and their families, plus a range of healthcare providers (nurses/auxiliary nurses, female health volunteers, support staff, Auxiliary Health Worker and a traditional healer) and other stakeholders from February to June, 2015. Data were analysed with a comprehensive coding process utilising the thematic analysis technique.ResultsThe social construction of gender is one of the key factors influencing poor perinatal survival in the villages in this study. The key emerging themes from the qualitative data are: (1) Gendered social construct and vulnerability for poor perinatal survival: child marriages, son preference and repeated child bearing; (2) Pregnancy and childbirth in intra-familial dynamics of relationships and power; and (3) Perception of birth as a polluted event: birth in Gotha (cowshed) and giving birth alone.ConclusionsMotherhood among women of a low social position is central to women and their babies experiencing vulnerabilities related to perinatal survival in the mountain villages. Gendered constructions along the continuum from pre-pregnancy to postnatal (girl settlement, a daughter-in-law, ritual pollution about mother and child) create challenges to ensuring perinatal survival in these villages. It is imperative that policies and programmes consider such a context to develop effective working strategies for sustained reduction of future perinatal deaths.

Farm households’ perception on climate change and adaptation practices

PurposeThis paper aims to assess the farming community’s perception on important parameters of climate change and identify major practices and technologies adopted to mitigate the impacts of climate change and their determinants in mountain district of Nepal. Being an agrarian economy and dependent on monsoon rain, the impact of climate change on agricultural productivity and production has been experienced. Different adaptation strategies have been adopted by the communities to cope with the consequences of climate change.Design/methodology/approachFour village development committees (VDCs) situated in the buffer zone of Langtang National Park of Rasuwa district representing rice, wheat, maize and potato production area was purposively selected for this study. A two-stage sampling technique was adopted for data and information collection. Thirty households from each VDC were randomly selected. Data on the socio-economic and climate change perception were collected using structured questionnaire. A binary logistic regression technique was used to identify the determinants of climate change adaptation technologies and practices.FindingsThe farmers’ decisions whether to adopt climate change adaptation technologies are governed by the size of landholding, perceived threat of climate change to food security, education level and gender of the interviewee, perception on the increased incidence of droughts during rainy season and income received from the off-farm sources. In a community where agricultural activity is the dominant means of living, adaptive strategies help to increase the capacity of a farming system to survive external shocks and cope with the consequences.Originality/valueThe assessment of farm-level adaptation strategies and factors influencing their adoption decision is important to formulate policies and design programs. This will also help to recognize adaptation as a tool for managing a variety of risks associated with climate change in agricultural sector.

Looking Beyond Supply

Significant disparities in reproductive, maternal, newborn, and child health (RMNCH) outcomes and intervention coverage exist between the Mountains and other ecoregions of Nepal. Delivery of essential health services to remote mountainous areas is challenging and access is a known barrier to utilization. However, the contribution of demand-side barriers is poorly understood. Consequently, policies and programs cannot strategically target constraints to increase coverage. This systematic review identifies demand-side barriers to utilization of RMNCH services in the Mountain districts of Nepal. Research was drawn from MEDLINE, Web of Science, Scopus, Google Scholar, Eldis, and unpublished literature. Beyond inaccessibility, utilization is undermined by costs of care-seeking, traditional attitudes and practices, low status of women, limited health knowledge, dissatisfaction with service quality, and low and inequitable care by community health workers. The intensity and repercussions of these barriers are of greater magnitude in the Mountains where delayed care-seeking combines with long distances for critical health consequences.

Effects of Sustainable Soil Management Practices on Distribution of Soil Organic Carbon in Upland Agricultural Soils of Mid-hills of Nepal

An abundance of soil organic carbon (SOC) generally enhances the quality of lands for agriculture or forestry. Concentration of SOC varies in accordance to the type of land use, the inputs to the soil, and natural factors including climate and vegetation. SOC is vital for sustaining agricultural productivity which chiefly depends on both the inherent soil type and crop management practices affecting depletion or replenishment of organic matter over the years. Assessment of SOC concentration is a characteristic measurement of evaluating soil quality and the carbon sequestration potential of agricultural land. This study aims to assess SOC distribution on selected farmlands of Nepal’s mid-hills, where farmers have adopted sustainable soil management practices in non-irrigable hill terraces (“Bari” land) in comparison with those of surrounding Bari and forests where no such interventions are made. Thus the present study estimated SOC content of three types of land use – farmland with sustainable soil management practices (SSMP), farmland without sustainable management practices (Non-SSMP) and the community managed forest in four mountain districts of Nepal, namely Baglung, Dhading, Kavre and Okhaldhunga. This study found the average SOC stocks in the SSMP land in the range of 20 - 44 Mgha-1,those in non-SSMP agricultural areas 15 to 48 Mgha-1, and in the forested land 16 to 23 Mgha-1. In general, the abundance of SOC stocks are in the order of SSM>Non-SSM>Forests. The analysis indicates the high potential for carbon sequestration in hill agriculture lands through sustainable soil management. Nepal Journal of Science and Technology Vol. 13, No. 1 (2012) 133-141 DOI: http://dx.doi.org/10.3126/njst.v13i1.7452

Seroprevalence of Japanese Encephalitis Virus and Risk Factors Associated with Seropositivity in Pigs in Four Mountain Districts in Nepal*

Japanese encephalitis was recently reported from individuals in the mountain districts of Nepal without travel history to Japanese encephalitis virus (JEV) endemic areas. We performed a cross-sectional study to estimate the seroprevalence of JEV in pigs and subsequently conducted a survey of farmers to identify risk factors associated with seropositivity. In July and August, 2010, 454 pig serum samples were collected and tested by competitive ELISA. Data from a 35-question survey of 109 pig owners were analysed using multivariate logistic regression. Seventy-six (16.7, 95% CI 13.6-20.4) pigs tested positive for anti-JEV antibodies, none of which had been vaccinated against JEV or sourced from JEV endemic areas. Risk factors associated with JEV seropositivity were 'summer abortion', 'wells as a water source', 'urban location', 'reported presence of mosquitoes' and 'lower elevation'. Our results suggest that JEV is likely circulating in the mountain districts of Nepal, and that locally acquired JEV should be considered a risk for residents and travellers in these areas.

Are marketing intermediaries exploiting mountain farmers in Nepal? A study based on market price, marketing margin and income distribution analyses

Against the backdrop of viewing marketing intermediaries in developing countries as parasites, this study examined the validity of such a view, especially in the context of mandarin (a species of orange) marketing in a mountain district of Nepal. Necessary information was collected from all major stakeholders such as farmers, collectors and commission agents, and the relative position of farmers in terms of their gains was analyzed by employing three criteria: price of mandarin, marketing margin and income distribution. Income distribution among marketing functionaries “with” and “without” transaction cost has been analyzed. Similarly, marketing margin and farmers’ share of gross income are also analyzed ‘with’ and ‘without’ the cost of malicious practices by marketing intermediaries. Findings of the study revealed that farmers in the study area are receiving a fair share of the benefit accruing from the marketing of mandarin. However, taking advantage of their weak bargaining power and poor economic condition, marketing intermediaries are harassing and cheating them in different ways. Policy recommendations are made to institutionalize and strengthen the group-marketing system to address such inherent problems.

Family-member DOTS and community DOTS for tuberculosis control in Nepal: cluster-randomised controlled trial

A key component of the DOTS strategy for tuberculosis control (short-course chemotherapy following WHO guidelines) is direct observation of treatment. WHO technical guidelines recommend that health workers should undertake this part of the strategy, but will also accept direct observation of treatment in the community; WHO does not think that a family member should undertake this role. Supporting evidence for these recommendations is not available. The Nepal national tuberculosis programme asked us to develop and test a strategy of direct observation of treatment for the hill districts of Nepal, where direct observation of treatment by health workers is not feasible. We aimed to assess the success rates of two DOTS strategies developed for such areas. Between mid-July, 2002, and mid-July, 2003, we undertook a cluster-randomised controlled trial to compare two strategies-community DOTS and family-member DOTS--in ten hill and mountain districts of Nepal. Districts were used as the unit of randomisation. Primary outcome was success rate (proportion of registered patients who achieved cure or completed treatment), and analysis was by intention to treat. Five districts (549 patients) were allocated to community DOTS and five (358 patients) were allocated family-member DOTS. Community DOTS and family-member DOTS achieved success rates of 85% and 89%, respectively (odds ratio of success for community DOTS relative to family-member DOTS, 0.67 [95% CI 0.41-1.10]; p=0.09). Estimated case-finding rates were 63% with the community strategy and 44% with family-member DOTS. The family-member DOTS and community DOTS strategies can both attain international targets for treatment success under programme conditions, and thus are appropriate for the hill and mountain districts of Nepal. Both strategies might also be appropriate in other parts of the world where directly observed treatment by health workers is not feasible. Our findings lend support to adoption of this patient-responsive approach to direct observation of treatment within global tuberculosis control policy.