System In Nepal Research Articles

Demystifying Science Teachers’ Epistemic Belief on Chemical Concepts: Students’ Engagement in the School Garden

The purpose of the study was to transforming chemistry learning from the textbooks in the silent classrooms to the school garden through activity-based learning with students’ meaningful engagement in collaboration with the science teachers in the community schools in Nepal. This research also aims to clarifying the epistemological gridlocks (banking concept of education) of school science teachers through measuring pH of garden soil samples by the basic level students’ activities. The concern of this study was facilitating school science teachers to impart the practical knowledge of chemical concept (pH of soil) by simple experiments whose backup is based on the epistemologically Vedic education system in Nepal. In-depth interviews and participant observations were taken with the students and teachers about their epistemic beliefs of teaching and learning the basic chemical concepts of chemistry based on the basic level science curriculum. It is found that the science teachers’ positivist congestions were rooted in the dogmatic approach in chemistry teaching and hinders the eloquent engagement of students in the school gardening activities. Science teachers’ belief system enabled me to understand the positivist epistemology mindset and transform into play way chemistry learning in the school garden. This broader sphere of teachers’ beliefs enabled me to recognize why positivist epistemology and connected traditions linking activity-based chemistry learning superficially forceful in the community schools. It is recommended that the suggestions for the school teacher professional improvement are needed to supervise and facilitate them to clarify the reflections on their situated personal experiences.

ICT Integrated Pedagogy in a Multicultural Classroom: Experiences of Mathematics Teacher

Multiculturalism in the present context is a global issue in education. It has not yet been materialized into the education system in Nepal. The education system of a country should prepare students to function in today’s multicultural society. In this regards, this paper focuses on the issues of the management of multicultural classes, and the role of ICT-integrated pedagogy to manage such a classroom context. It also discusses the context, and experiences of teachers that can bring the multicultural classroom situation into the right track. For this purpose, I apply narrative inquiry of two mathematics teachers (one male and one female) of University Campus Kirtipur with more than seven-year experience. In-depth interview, related to their experiences and practices in multicultural mathematics classes, was conducted and found that they face problems to teach students in a multicultural classes such as language problem, content problem, and level of understanding. There are two types of multiculturalism in our classes they are critical multiculturalism, and Liberal multiculturalism. The management of multiculturalism is a great challenge for teachers. Although teachers are less familiar with the management of multicultural class, they try to manage such types of diversity by supporting their students personally through ICT-integrated pedagogy. The finding of the study shows that ICT-integrated pedagogy is the best strategy to manage multicultural classes by respecting students’ personal feelings.

Integrating biodiversity conservation and ecosystem services into operational plan of community forest in Nepal : status and gaps

After initiation of community forestry system in Nepal, the status of forest cover has improved due to significant roles of people in conservation, management and utilization of forest resources. As a result of increased productivity of the forest and restoration of degraded areas, forest users have been able to receive various economic, social, cultural and environmental benefits to strengthen their livelihood. Despite many positive outcomes of community forestry, there are still some factors which haven’t allowed the proper biodiversity conservation and ecosystem services maintenance. The study carried out on 100 operational plans from different parts of the country and it showed that the incorporation status of biodiversity and ecosystem services into community forest operational plan is worse despite the fact that such plan is the main component to lead the destination of any community forest. In addition to this, some gaps and challenges were observed in community forestry which have not favoured to biodiversity conservation and ecosystem services management systematically at an optimum level. Among them, duplication problem of biodiversity and ecosystem services related issues in operational plan; timber oriented operational plan; limited provision about wildlife conservation and negative perception of people on wildlife and their conservation owing to human wildlife conflict; dominant socioeconomic factors; impact of introduced species, invasive and alien species; lacking in provision of adaptation and mitigation methods to cope with impact of climate change on biodiversity and ecosystem services and shrinking of biological corridor due to habitat fragmentation were major issues. Besides this, to address these issues, it was also identified from the national consultation workshop of forest officials and experts that most appropriate uniform methods, measures and mechanisms are needed to be developed for the complete assessment, prioritization, analysis and development of action plans to main stream biodiversity conservation and ecosystem services management into operational plan of community forestry.

Dimension of Multicultural Education: Issues for School Reform in Nepal

Multicultural education is very important and necessary concept. It is an educational approach designed to ensure equal educational opportunities for all students, including those in marginalized groups. Multicultural issue in the present context is a global issue of socialization. It has not yet been materialized into the education system in Nepal. The education system of a country should prepare students to function in today’s diverse society. There are issues emerging in the electiveness of the multicultural education and the concerns how to better shape the multicultural classroom in Nepal. There are many views on the benefits and/or shortcomings of the multicultural education. The question is not whether a multicultural education should be adopted but it is rather what we understand from multicultural education and how we are going to initiate such a reform within an educational system. In this article, the five dimensions of multicultural education and issues of school reform are described in the Nepalese context.

Issue of Federal System in Nepal

Federal process of Nepal has been guided by some major factors such as elimination of discrimination, equal regional development and political participation. Federalism has been a crucial issue of modern Nepal. The issue of federalism has not been guided by remote past as a vital demand because Nepal has adopted a long history of unitary system. But some regional and marginalized groups have been demanding it since 1950, who were struggling against discriminations. Federalism was not documented even in an initiate part of Interim Constitution 2006. It was also not agenda of Maoist Party which they had put in forty points demand letter. It wasn't materialized till peoples’ movement second. It is supposed that federalism can bring miraculous modification as to solve problems of inequity and marginalization than in the unitary system. Some political parties have documented in their manifesto that federal system is only the alternation for prosperity in Nepal. But it might be incorrect supposition. Long route of unitary system of Nepal was led by few elites, who were specially professed Hindus. Monarchy was also surrounded by prevailing castes. Due to these various reasons conflict began in Nepal which has developed as transitional movement of chronic infection. The issue of federal system is emerged by those who are struggling against discriminations and they want to abolish all kind of social discriminations, problems of regional, religion, gender, cast, and poverty. Aspirations of ownership of all segments and development of nation have guided to make federal state in Nepal.

Human energy and time spent by women using cooking energy systems: A case study of Nepal

In most developing countries, many rural households use fuelwood and a traditional cookstove (TCS). Women are the backbone of the cooking system, as they mostly manage it. Despite several existing efficient cooking energy systems, households generally do not prefer them. Thus, our aim is to find why this is the case. We estimate the time required and human energy expenditure (HEE) for production of cooking fuel for four alternative cooking energy systems in Nepal, as a case study. The time required to produce cooking fuel for the baseline scenario (i.e. fuelwood and TCS) is 40 h/cap/yr and HEE is 41 MJ/cap/yr. System 2 (charcoal and TCS) has the highest demand for time and HEE. The results suggest that the most efficient system is System 1 (i.e. fuelwood and an improved cookstove (ICS)). However, a woman produces cooking fuel for the whole household, which multiples her time and HEE demand to the household size. This system analysis indicates a significant influence in the selection of cooking fuel due to the HEE and time demand. It concludes that in the future, more importance should be attached to the labour required from women in the cooking energy systems in the development of technological improvements.

Delay in diagnosis and treatment of gastrointestinal cancer in Nepal.

e18269 Background: Gastrointestinal (GI) cancers represent a major health challenge worldwide including Nepal where patients (pts) often present with advanced disease. The purpose of this study was to determine the time delay in diagnosis and treatment by evaluating time from first symptoms to diagnosis and treatment and to identify contributing factors from both pts and the health system in Nepal. Methods: An IRB approved cross sectional study was performed in pts with GI cancers. 50 newly diagnosed pts were enrolled and interviewed with a standardized questionnaire during the last 6 months of 2018. Diagnosis delay was defined as time from first symptoms to histopathological diagnosis. Treatment delay was defined as time from diagnosis to surgery and/or treatment by medical/ radiation oncologist. Results: The median age at diagnosis was 52.5 years. 52% had gastroesophageal cancer and 48% had colorectal cancer. 84% presented with Stage III/ IV disease. The median diagnosis delay was 217 days and the median treatment delay was 37 days. The median patient delay (time from first symptoms to first medical consultation) was 150 days. 64% were illiterate, 94% had a history of self medication prior to first medical consultation, 68% were from rural areas with limited healthcare facilities and 72% were unaware of causes of GI cancers. Reasons for diagnostic delay appear to be self diagnosis, self medication and lack of a prompt referral system. Reasons for treatment delay included financial constraint, prolonged wait times for procedures and treatment due to limited skilled manpower. Conclusions: Our data shows there is a significant delay in diagnosis and treatment especially in the time from first symptoms to first medical consultation. We found many preventable reasons for this that, if addressed appropriately, could have a significant impact on reducing the morbidity and mortality of GI cancers. There is an urgent need for intensive and comprehensive cancer education in Nepal and other developing countries.

Health information system as an integral component of cardiovascular surveillance system in Nepal

Introduction: Nepal lacks a comprehensive, integrated health information system (HIS) to address the growing burden of cardiovascular diseases (CVDs). 
 Method: We performed a literature search and reviewed papers, government reports, and websites related to HIS. We included existing situations of HIS, major gaps, strength weakness opportunity threat (SWOT) analysis and role of different stakeholders to address CVD burden in Nepal.
 Results: Health data from different health facility level are filled in district health information software (DHIS-2). DHIS-2 has been implemented in 10 districts in full-fledged manner and partial phase in 22 districts. Data are collected by means of paper-based registers, tally sheets, and monthly data collation forms. The collated data are sent monthly to the district level and entered into the computer using DHIS-2 software and submitted to the national health departments.
 Major gaps in health management information system (HMIS) are lack of separate heading of CVDs and lack of implementation of the existing data collection system. The strengths of the HIS are robust and decentralized health care delivery system in a good number of medical institutions. Weakness is lack of public and private partnership, concrete policy on health information and dissemination. Opportunities are the existence of policies and regulations mandating health facilities to report indicators, the involvement of private institutions and the expansion of existing DHIS-2 system. 
 Conclusion: Nepal currently lacks reliable and accurate data on timely manner to address the growing burden of CVDs. There is a need to strengthen the existing DHIS with a commitment from expertise and leadership.

Apparent Gains, Hidden Costs: Examining Adoption Drivers, Yield, and Profitability Outcomes of Rotavator Tillage in Wheat Systems in Nepal.

The ‘high speed’ rotavator is used for shallow tillage to create a fine tilth and incorporate crop residues, often with a single tractor pass. Rotavator tillage has spread quickly in many parts of South Asia, despite short‐term experimental trials suggesting deteriorating soil quality and crop yield penalties. Evidence of rotavator impacts on farmer fields across soil gradients and time is largely absent. From a farm household survey conducted among wheat farmers in Nepal, we estimate wheat yield and profitability outcomes for rotavator adopters and non‐adopters using propensity score matching. We find that rotavator adoption leads to inferior outcomes, despite significant cost savings for land preparation (US$ 11–15 per hectare). With rotavator adoption, farmers lose about 284–309 kg of wheat grain and about US$ 93–101 of profits on average per hectare per season, and these penalties increase with longer‐term use of the technology. Adoption of rotavator appears to be driven by the cost and time savings for land preparation. Against this backdrop, new policy and extension efforts are required that discourage rotavator use and favour more sustainable tillage technologies.

Social Security System of Elderly Population in Nepal

Population is classified as aging when older population become a proportionately larger share of the total population where as social security refers to the financial support action programme of Govern­ment intended to promote welfare of the population that is potentially directed to vulnerable segment of the society such as children, the elderly, the sick and the unemployed. It is the tool for the government to take care of well being of it's citizen. Population aging generates many challenges. In response to tackle these issues and to address their needs the Government has developed the social security poli­cies, plan and acts. The main objective of this paper is to discuss on process of aging and the policy issue related to social security of old age population in Nepal.
 This paper follows descriptive and analytical method based on the secondary data. The data from these sources are used to analyze the trend and process of aging and social security system in Nepal. Furthermore this paper is based on review of literature mainly books, journal, article and report.
 Nepal is already in the process of population aging. population aging generates many challenges on social, economic and health care system. In response to tackle these issues and to address their needs the Government of Nepal has formulated separate policies and security programme for senior citizen and also committed to the various regional and international convention to promote welfare for senior citizen of the country.

Health Care Utilization and Health Care Expenditure of Nepali Older Adults.

Introduction: Aging is associated with multiple chronic conditions. In older age, health needs and demand for health services utilization increase. There are limited data in Nepal on the health care utilization as well as health care costs among the elderly population. Therefore, it is imperative to explore the factors hindering access to health care among Nepalese older adults. Our study aims to explore the health care utilization and expenditure among Nepali older adults.Method: A community-based cross-sectional survey was conducted among 401 older adults residing in Pokhara Lekhnath metropolitan of Nepal. The survey tool was adapted from the Study on Global Aging and Adult Health (SAGE)'s questions on “Health Care Utilization.” The predictors of health care utilization were assessed in binary logistic regression models.Results: Study participants, mean (±SD) age 70.2 (±8.0) years, had various preexisting conditions such as hypertension (37.7 %), gastritis (28.4 %), asthma (25.4 %), and arthritis (23.4%) reported in the past 12 months but only 70% visited a health facility. A notable proportion (30%) of participants didn't utilize health services despite having a health problem. The utilization of out-patient and in-patient health services were 87.5 and 14.6% respectively. The use of private health facilities (56.4%) was high compared to the use of government health facilities (35.7%). Privileged ethnicity, living with a partner, higher annual income, knowledge of social insurance, and multi-morbidity were associated with higher odds of utilizing health services. Participants of privileged ethnicity, with higher household income, attending private health facility, and having multi-morbidities had significantly higher out of pocket health expenditures.Conclusions: A notable proportion of elderly participants did not utilize health services despite having a health problem. The public health system must develop effective strategies to attract this segment of the society. High dependency on private health facilities, as noted in the study, will only lead toward higher out of pocket health expenditures. The health benefits of regular health screenings must be disseminated among the elderly population. Developing quality and affordable health care services for older adults to ensure equity in accessibility will be a major task for the public health system in Nepal.

Global Challenges of Higher Education and Future Priorities of Civil Society for Inclusive and Equitable Society in Nepal and India

This paper presents global scenario of higher education and tries to show the challenges faced and reformation to be made in higher education in Nepal, in the future as well as see both Nepalese and Indian societies in a similar way without discrimination. Problem Statement: The problem of this study is, What challenges has higher education system faced and what reformation is needed for inclusive and equitable societies between Nepal and India? Purpose: The purpose of this research paper is to make close links between Nepal and India through higher education by making inclusive and equitable societies with the roles of civil society. Methodology: The methodology of this study is document analysis and interview with some professors. Design: This is a qualitative study and no numerical data are used here. Implications: This research paper has got in – depth implications for the people of Nepal and India which shows that these two countries have got similar cultures, societies, religions and common ways of dealing to each other as well as open access to higher education for the people of both countries in either sides. Value: This paper has got great value to make close relation among the group of people living in Nepal and India and avoid discriminations among them. Nepal is a country situated in the lap of Himalayas in Asia which lies between the two large countries; India and China. Nepal and India are very close neighbours having same cultural, social and religious base. There is open border between these two countries. So, system of one affects another. The higher education system in Nepal is also same; of two types; fully funded by government and private sector. Among seven universities in Nepal, only two of them are fully funded by government- Tribhuvan University and Mahendra Sanskrit University. Tribhuvan University is the first university in Nepal and has been the root of higher education in Nepal since 1959. The main exchange of higher education in Nepal is related to Indian systems. But nowAll of the universities and their colleges are facing the impact of globalization. There are changes in higher education system at present which have caused global challenges across countries. Due to global challenges, there are problems in building inclusive and equitable society, which is under the need between Nepal and India. Globalization has made this world as a narrow place and there is mobility of students, teachers and academic group for different purposes all round the world without restriction for quality education. Due to globalization, there is flow of people, goods, ideas and knowledge all round the world. There are challenges in higher education system of Nepal and India in terms of demographic change, socio-economic role, equity, access, convergence of higher education, divergence for inclusion, study subjects, quality and relevancy, technology, brain drain, funding, politics and technology. These are global issues in higher education today which need to be addressed by educational policy makers to build inclusive and equitable society. This paper shows some relations between higher education and society to be equitable and inclusive among the people between India and Nepal.

Learning from Japan for Possible Improvement in Existing Disaster Risk Management System of Nepal

Nepal and Japan, both are multi-hazard prone countries having experience of devastating disasters. It is difficult, if not impossible, to stop natural hazard events at source. However, the impact can be reduced significantly by preventing them from turning into disasters. The impact of disasters can vary depending on the capacity to handle the situation; and the capacity depends on the level of preparedness and mitigation measures taken in advance. Japan has set example for the rest of the world when it comes to Disaster Risk Management (DRM). Recovery and reconstruction after disasters are not just to develop the area as it was earlier, but it has to be taken as an opportunity for developing better than earlier, which is called as “Build Back Better”. This concept was raised by Japanese Government in UN World conference, Sendai in 2015 [1]. Dynamic, evolutionary and proactive DRM policy and plans with innovation, and the use of science and technology to find solutions, and effective implementation of the policy and plans, coupled with the culture of safety among the citizens, and the spirit of never give up “Nana KarobiYa Oki” (Seven times fall down, Eight times get up), are the unique features that every country should learn from Japan’s DRM mechanism. This paper is an effort to buy-in the good practices from Japan to improve DRM system in Nepal. It is a product of three-month intensive research in the University of Tokyo under a PhD research that consisted of reviewing existing DRM documents and several interactive meetings with stakeholders in Japan.

Conceptual Framework of Effective Flood Forecasting and Early Warning System in Nepal: A Case Study of Koshi River Basin.

Conceptual Framework of Effective Flood Forecasting and Early Warning System in Nepal: A Case Study of Koshi River Basin.

Geographies of adolescent distress: A need for a community-based psychosocial care system in Nepal

This paper presents the findings of an ethnographic study conducted among high school students in Nepal. Participant observations, in-depth interviews and focused group discussions were conducted among 35 students (20 girls and 15 boys). The findings suggest three geographies (home, school and community), where adolescents experience distress. Common experiences of adolescent distress included discrimination, domestic violence, heavy workload, poverty, bullying, physical punishment, unsupportive behaviour of the parents and teachers and a lack of basic materials. These findings largely support Bronfenbrenner’s socio-ecological model, emphasising the complex reciprocal interactions between the individual and his/her immediate environment. They also suggest that not only a reciprocal relationship between the sub-systems of the ecological model, but also a ‘mobility’ between and among these sub-systems affects the individual’s emotional-relational well-being. We argue that the micro-systems in which children grow up not only have a social dimension, but a spatial dimension as well. Building on this insight, a five building-block intervention model is presented to help address adolescent distress. Key implications for practice Given adolescents' mobility between home, school and community, a community-based psychosocial care system is proposed that also addresses distress related to the in-between travelling spaces. Such a system would comprise family support, peer-to-peer education, community mobilisation and school mental health. School counsellors should provide counselling in the school, but also use home visits and in-between travelling spaces as implementation sites for interventions.

A glimpse on health care financing in Nepal

This article highlights the important components of Nepalese healthcare financing and aims at examining the health care financing system in Nepal in terms of share of government health care expenditure per capita, household out-of-pocket expenditure, and ratio of total health care expenditure to Gross Domestic Product (GDP). The recent data shows that Government of Nepal allocates meagre 1.11 percent of GDP from government coffer for health care financing where out-of-pocket payment is 3.47percent of GDP and it is about 60 percent of total health care expenditure. It implies that people are heavily dependent on their own source for health care financing. Public Health Expenditure as a percent of Total Health Expenditure 40 percent. Public Expenditure on health as Percent of Total Government Expenditure is 11 percent, Total Health Expenditure (government and out-of-pocket) is 5.8 percent of GDP. The annual per capita government health care expenditure is US$ 44 for 2015. This figure is extremely low in comparison to the other parts of the world like European Union US$ 2192, Western Pacific Region US$ 1338, American Region US$ 1192 even African Region US$114 and South East Asian Region US$ 175 for the same period. This infers that the health care financing in resource-poor country like Nepal relies heavily on household out-of-pocket payments which often results in financial catastrophe for poor and economically vulnerable households. The government needs to make serious effort to bring drastic change in policy priority to improve health care financing to ensure quality change in this sector taking into consideration allocative efficiency and technical efficiency the essential parameters to ensure efficiency in health care financing schemes.

Cancer Cases Referral system in Nepal.

The burden of cancer is estimated to be increasing in Nepal, whilst the country lacks national established guidelines or protocols for referral of cancer cases. Cancer patients are presenting many different health facilities throughout the country. In rural areas almost all cancer patients have their first diagnosis when visiting a health assistant or nurse at their nearest primary health care delivery service. If cancer is suspected, health care assistants or nurses will refer the patient to a medical doctor at the primary health centre, or refer the patient directly to the cancer treatment centre or oncology department of the closest hospital. Patients from urban areas will usually be seen for the first time by a medical doctor initially and then referred to either the cancer treatment centre or oncology department of the hospital. Both in rural and urban areas the referral for treatment is determined by both the patients’ capacity to pay for treatment own healthcare, as well as their geographical location (i.e. availability and accessibility of cancer treatment services.

Implementation research to assess a health workers performance-based management system in Nepal.

To test and refine a performance-based management system to improve health worker performance in Nepal. A mixed-methods implementation research in three districts. The study assessed health workers' job satisfaction at the start and end of the study. Qualitative techniques were used to document processes, and routine health service data were analysed to measure outcomes. Job satisfaction significantly increased in six of nine key areas, and the proportion of staff absenteeism significantly declined in the study districts. It demonstrated an increase in immunisation coverage, the proportion of women who had a first antenatal check-up also having a fourth check-up and the proportion of childbirth in a health facility. The greatest perceived strengths of the system were its robust approach to performance planning and evaluation, supportive supervision, outcome-based job descriptions and a transparent reward system. A functional health facility environment, leadership and community engagement support successful implementation. The performance-based management system has the potential to increase health workers' job satisfaction, and it offers a tool to link facility-wide human resource management. A collaborative approach, ownership and commitment of the health system are critical to success. Considering the Nepal context, a management system that demonstrates a positive improvement has potential for improved health care delivery.

Assessing maternal and neonatal near-miss reviews in rural Nepal: an implementation research study to inform scale-up.

To understand how maternal and neonatal near-miss reviews could be implemented and scaled-up in rural communities through the existing district health system in Nepal. Mixed methods with a modified time series evaluation design were used. The World Health Organization maternal and neonatal near-miss criteria used in multicountry surveys were adapted and used to define maternal and neonatal near-miss cases. The World Health Organization near-miss criteria were mainly applicable at the district hospital setting, but further adaptations were needed for community-level birthing centres, as organ dysfunction and critical intervention criteria were not found appropriate. In birthing centres, disease-based criteria were applicable for maternal near-miss review, and danger and clinical sign-based and condition at birth criteria were applicable for neonatal near-miss review. Primary barriers to implementation were attrition of trained staff due to the frequent transfer of healthcare providers, and time constraints of district hospital medical doctors for case-by-case reviews as they were often busy in hospital and in their private clinics. Adapted maternal and neonatal near-miss review process implementation in Nepal is feasible through the existing government health system.

Battered Women Syndrome: Need for Judicial Objectivity

When the victims of wife-beating are subjected to excessive violence, a syndrome occurs, which during a criminal procedure can be pleaded as BWS (Battered Women Syndrome). It is also referred to as Battered Spouse Syndrome. However; the condition is most common among women than that of men. Wife battering is the most common and least reported crimes in all types of society. Some never mention about it and bear the violence while some others seek help from the law. But there also exists a different group of battered women who kill their abusive partner without any remorse. Some scholars have claimed that is a normal reaction from a woman who has been subjected to acute battering and that they should be given defense by law while some others have opposed to this notion of Battered Woman Syndrome. BWS, as a very new concept to the legal and judicial system of Nepal, still has a lot of gaps to be filled. This paper will analyze the concept and practical implications of Battered Woman Syndrome alongside the legal and judicial trend in case of Nepal. Further, this paper will establish why Battered Women Syndrome cannot blatantly be given as a defense in all cases and yet should be considered by the judiciary. In the end, the paper puts forth the necessity of new law/legal provisions in making the judicial decisions objective and justiciable in case of battered women.