System In Nepal Research Articles

Triaging of patients by general practitioners (GPs) in primary health care settings: a neglected aspect in the health policy & practice in Nepal

General Practitioners are the backbones of the primary health care and whole health system around the world. United nation declaration in Alma Ata about primary health care and WHO reinforcement regarding the importance of robust primary health care for universal health coverage are major catalysts to sensitize the government to implement triaging of patients through primary care by general practitioners. Nepal lacks strong primary health care system utilizing general practitioners as frontline health service providers in the community level. This has made people travel a long distance risking high expenses to get basic healthcare. The overcrowding in tertiary care hospitals is a result of improper triaging and referral system. General practitioners in Nepal work in emergency departments of hospitals and medical colleges, do private practices and a small number of GPs work in health departments of Ministry of Health and Population. Proper mobilization of GPs and establishing primary health care system is paramount to achieve equity, efficiency and effectiveness in health services. Current health policies and program must be reviewed and updated based on the evidences from the studies. CME (Continuous Medical Education) was organized in Chitwan for General Practitioners as a regular program of GPEMAN(General Practice and Emergency Medicine Association of Nepal). Participants were asked about primary health care system in Nepal and its opportunities and barriers. Majority of participants 84% (32 out of 38) pointed out that poor health policy and lack of recognition of General Practice for primary health care as first contact physicians by the government are the major challenges and barriers. Evidences will guide government and concerned stakeholders to establish robust primary healthcare system to increase access, efficiency, effectiveness of health service and to reduce out-of-pocket expenditure and disease burden in the community.

IoT-based winter season crop prediction using machine learning on Vyas municipality ward No-13, Nepal

The agricultural system in Nepal is facing a decline primarily due to its traditional practices. Farmers’ morale is low as they invest significant effort but yield low production, leading to an exodus of young people seeking opportunities abroad. While Nepal is often depicted as an agricultural country in literature, the reality falls short. Improving productivity is crucial, and this can be achieved by enhancing labor efficiency and increasing arable land fertility. To address these challenges, the concept of smart agriculture has emerged, and implementing an IoT-based agricultural system could help manage the workforce and retain skilled youth in their homeland. The main objectives of the study were to develop a monitoring system for arable land using IoT and to predict and recommend suitable crops using machine learning. Due to constraints in time and resources, the study focused on Vyas Municipality Ward no-13 in the Tanahun district. Sensor devices were deployed in the selected ward, and data was collected four times a day at half-hour intervals, monitoring key parameters like Humidity, Temperature, Rainfall, and Soil moisture. In this research, Orange, Ginger, Onion, and Spinach are the main crops predicted and recommended suitable times. In conclusion, the implementation of IoT-based agricultural systems and Machine Learning algorithms can offer valuable insights to farmers, enabling them to make informed decisions regarding crop selection and cultivation timing. This could potentially revitalize Nepal’s agricultural sector and reduce the trend of young people leaving the country in search of better opportunities.

Key Factors Influencing Functionality of Community-Managed Rural Water Supply System in Nepal

The paper aims at examining key factors influencing the functionality of the community-managed rural water supply system in developing countries like Nepal. The study adopts a descriptive cum analytical research design based on primary data only. The required data were collected through a telephone interview using a semi-structured questionnaire on a sample of 486 respondents from the respective community-managed rural water supply projects. The collected data were analyzed using correlation, chi-square test, Cramer’s V, and cross-tabulation to find out the results leading to major findings of the study. The study concludes that the key factors influencing the functionality of the community-managed rural water supply system are the systems’ caretakers followed by the operation and maintenance fund, the activeness of the users’ committee, and the availability of spare parts in the context of Nepal.

Challenges and barriers to implementing the WHO Trauma Care Checklist in an emergency department in Nepal: the need for Transformational Leadership

Challenges and barriers to implementing the WHO Trauma Care Checklist in an emergency department in Nepal: the need for Transformational Leadership

Rural Water Supply Systems in Nepal: Factors Affecting Equitable Access to Water

Issues of gender and social inclusion in the governance mechanism of rural water supply systems have been a major concern of users, policymakers, and practitioners in Nepal. Amid changing livelihood context due to migration, transition to a federal governance structure, and social hierarchies, communities face persistent inequities in access to safe water, while its supply continues to diminish. In this context, increasing competition for water has in many instances resulted in the fulfillment of water needs of some groups, while compromising the water needs of others. In such instances, it is usually the poor and marginalized groups who are disproportionately affected. Moreover, understanding the factors affecting equitable access to an adequate supply of water now particularly after Nepal’s entry into the new federal governance system, and COVID-19 pandemic is paramount.
 Based on the learnings of 3-year research project that seeks to understand the role of gender and power dynamics in the functionality of community water systems, this paper will provide insights on collective water management practices. A mix of qualitative inquiries such as focus group discussions, in-depth interviews, social and institutional mapping, and observation were utilized to collect the data. This paper will present evidence from the project sites highlighting how community institutions are managing the supply and distribution of water particularly by discussing factors influencing equitable water supply.

Pro-Poor and Gender Responsive Disaster Financing System in Nepal: A Case Study of Dhangadhi Sub-Metropolitan City

Nepal has made considerable progress in the formulation of disaster-resilient development policies and legal frameworks. However, how such policies have not translated into actions, and financing mechanisms, while governance too remains a prominent issue, which is less discussed in the disaster risk reduction and management sector. As the impact of disasters is disproportional to poor, vulnerable, and deprived groups of the society, disaster financing strategies must have considered pro-poor and gender-sensitive approaches to mitigate, minimize disaster risks, and develop resilient actions. But very limited studies have highlighted critical gaps in pro-poor and gender-responsive (PPGR) disaster financing mechanisms at the sub-national level. This paper draws on both qualitative and quantitative approaches to examine the disaster risk financing tools, policies, practices, and challenges of PPG Rin disaster budgeting at local levels. The study reflects that Dhangadi Sub Metropolitan City has practiced both ex-post and ex-ante-disaster financing tools to cope with the impact of disaster events. The PPG Ranalysis indicated that over three-quarters of the disaster risk reduction and management budget is indirectly gender-responsive whereas only 10per cent of the budget is directly responsive in both fiscal years (2018 &2019). Similarly, the entire disaster risk management budget is in directly pro-poor responsive. The absence of PPGR-specific guidelines, knowledge and skill gaps on the budgeting, and the lack of explicitly articulated disaster, gender, and poverty reduction targets and indicators are the main challenges hindering the implementation of a pro-poor and gender-responsive disaster financing system at the local level.

Stakeholders' Perspective on Building Integrated Social Protection System in Nepal

Following the inception of federalist structure, the three tiers of government is providing more than 80 social protection programmes in Nepal. The main purpose of this study is to assess the extent of coordination and integration of various programmes and provisions related to social protection, and to put forward better ways of coordination among them. This study adopted mixed method and partially applied the coordination toolkit developed by United Nations Development Group (UNDG) and ISPA. The study draws on analysis of available research, and in-depth interviews with concerned stakeholders using semi-structured questionnaires. Findings show that the involvement of multiple mechanisms and agencies for managing social protection schemes have created fragmentation, duplication, inefficiency, and ineffectiveness despite the fact that there is programme level vertical coordination within a single programme in some social protection schemes. There are a severe lack of horizontal coordination at the policy and operational level among programmes and mechanisms related to social protection. Implementation of international obligations, designing national policies and legal frameworks, establishing institutions, provisioning sustained funding mechanisms, generating political willpower, and using Integrated Management Information Systems (IMIS) are some strategies that can contribute to integration of the programmes. Moreover, it is very important to establish a single mechanism for coordinating the fragmented social protection activities for its sustainable implementation.

Women's Motivation for Joining the Maoist Movement in Nepal: A Study of Ex-PLA Participants in Janaki Rural Municipality, Kailali

This research aims to investigate the motivations of women for joining the Maoist movement and strives to challenge outdated beliefs about women's issues. It delves into their socio-cultural, economic, and educational backgrounds, as well as their pursuit of gender equality, leadership, and self-worth while working alongside men on equal terms. The study focuses on 15 Ex-PLA women in Janaki Rural Municipality, employing a purposive sampling method and an anthropological approach involving interviews and observations. The research unravels the challenges in analyzing female participants' experiences and opinions, considering the sensitivity and confidentiality of the subject matter and the cautious approach to human rights and privacy. The discussion reveals the deeply entrenched patriarchal system in Nepal, which has historically relegated women to a subordinate position and deprived them of power and knowledge creation. Despite legislative measures granting women citizenship and some representation, informal barriers and societal attitudes continue to impede their progress. The study highlights various factors motivating women to join the Maoist movement in Janaki Rural Municipality, including the historical patriarchal nature of Nepal, limited property rights for women, extended male absences, the dual burden of coordinating with both Maoist and security forces, and the impact of the Kilosera-2 operation's brutality and upheaval. Ultimately, this research sheds light on the transformative potential of women when given opportunities and challenges the prevailing societal norms, offering insights into the factors driving their participation in the Maoist movement and advocating for their rights and recognition on equal footing with men.

Genodermatoses Picture: Difficulties Faced And Way Forward in Nepal.

Genodermatoses are group of genetic disorders that present with cutaneous manifestations. The exact prevalence on many of these conditions are unknown due to its rarity, need of specialized tests for diagnosis and lack of proper reporting system. Most of the patients are faced with life-long disability and associated stigma. There is a need for specialized centers for proper diagnosis of these conditions and a very elaborated yet simple reporting system in Nepal. These rare conditions should be kept in priority by the government in align with the sustainable development goals to ensure healthy-lives and promote well-being for all. A wider engagement of patient-led support groups might be useful in providing necessary information on the disease to the general population and alleviate the stigma associated with these diseases. Keywords: Epidermolysis bullosa; genodermatoses; rare diseases; Nepal.

Modified Nursery Structures: An Approach to Grow Rice Seedlings in Winter for Early Spring Planting

Raising rice seedlings in cold winter months for subsequent early spring transplanting has a great challenge in rice-rice cropping system in Nepal. An essential technological intervention involves modifying the rice nursery structure to create an optimal environment that supports proper germination and seedling growth during the cold season. Hence, a field experiment was conducted to evaluate the impact of different nursery structures on the germination and growth of rice seedlings in the farmer’s field at Sunwal-12, Bhumahi, Nawalparasi West, from 21st of January- 19th of February, 2021, 2021. The experiment was executed in randomized complete block (RCB) design with 8 different raised bed (1m × 1m) structures as treatments, namely T1: open uncovered beds, T2: plastic tunnel covered beds, T3: mat bed under plastic tunnel, T4: plastic trayunder plastic tunnel, T5: Plastic tray under open condition, T6: Open bed with removal of dew, T7: Ash covered beds and T8: Plastic sheet covered beds. Each treatment was repeated three times. The spring rice variety Chaite-5 was sown at the rate of 60 g m-2, with dry seeds being evenly distributed in rows spaced 10 cm apart. The beds were fertilized at the rate of 1 kg N, 0.8 kg P2O5 and 0.8 kg K2O 100 m-2. Soil temperatures at a depth of 5 cm were monitored regularly at two time points each day, specifically at 8 am and 4 pm, until 30 days after sowing (DAS). The results revealed that the germination index, average height, and above ground weight were significantly higher (40.57, 9.81 cm and 78.67 gm-2, respectively) for the beds under tunnel (T2). Seedlings grown in trays under tunnel exhibited statistically similar plant heights. The highest seedling population m-2 (288% more compared to open beds) was obtained in trays (both open and under tunnel). Trays and mat beds under tunnel recorded higher soil temperature in the morning and evening, as well as higher air temperatures and relative humidity. These favorable conditions were met approximately 16-17 days earlier compared to the uncovered beds. Therefore, the practice of covering seedling beds with plastic tunnels, growing rice seedlings in plastic trays and utilizing mat beds were the better ways for raising rice seedlings in cold environments for early spring transplanting. DOI: https://doi.org/10.3126/ajn.v7i1.62269

Science Teaching in Culturally Diverse Classrooms: Application of Sociocultural Knowledge at a School System in Nepal

ABSTRACT This study focuses on teaching and learning science in three secondary public school classrooms with mostly culturally marginalized students from Gurung and Magar communities in a semirural district in Nepal. The study aims to understand how three science teachers in different schools engage students in culturally relevant transformative science learning. I use a constructivist case study design. Data were collected through 18 classroom observations, three interviews with science teachers, and a student focus group interview. Analysis of the data showed that culturally marginalized students are experts in the cultural knowledge they bring into the classroom, science teachers felt ambivalence between culturally relevant science and success in tests, and science teachers showed a need for greater pedagogical skills in cultural relevancy. The study suggests a need for focused and intentional culturally relevant courses in science teacher education programs and professional development. Educating teachers for more transformative and relational science teaching will support embedding cultural knowledge and values in classroom teaching and curriculum.

Teaching-learning practices of mathematics in semester system: A case study of Tribhuvan University, Nepal

This study explores the practice of mathematics teaching and learning in the semester system in Nepal. Three teachers and six students of Master of Education from the Faculty of Education, Tribhuvan University (TU) were selected purposively for the interview. In addition, 21 students were also selected for focused group discussion (FGD), and classroom observation and FGD were used to collect information from the participants in the study. Thematic analysis is used in the study. It is concluded that the semester system at TU, Central Department of Education, particularly in mathematics, has a radical shift in pedagogical practices. There is the provision of supportive internal and external evaluation systems to promote multiple skills and knowledge in mathematics or the holistic development of learners. The assessments were to encourage and motivate the students in learning. The study supported to enhance the weakness of teaching-learning activities in the semester system. It is the supportive document for effective teaching-learning in the semester system for Nepal.

THE CHALLENGES AND OPPORTUNITIES IN ADAPTATION OF GREEN BUILDING RATING SYSTEM IN NEPAL

Nepal especially Kathmandu Valley is highly rich in huge number of residences and users from all over the country which is major source of increasing Greenhouse Gas emission and CO2 footprints. Haphazardly mushrooming concrete jungle without proper planning, environmental consciousness and future vision is the big, alarming sign of degradation of its beauty and environment. Nepal is leading towards "grey rather than green". Electricity consumption growing rate of approximately 10% per year and the total energy consumption at a rate of 2.4% per year is in increasing order. At present context, the depletion of energy resources and the risk of climate change is demanding for a sustainable development path based on renewable energies and energy efficiency. Therefore, incorporating green features in buildings can substantially save energy, water consumption, and reduce GHG emissions. Green Building Rating System provides framework for healthy, efficient, carbon and cost saving green buildings. It helps the building industry to move toward sustainable development and enhances performance, durability, aesthetic, and sustainability of built environment. In many developed and developing countries, there is a minimum mandatory rule for rating system. Rating of building helps user to know and aware about how much his/ her houses consume energy and reduce; not only energy consumption but also reduces the energy expenses. The knowledge about energy efficiency, green building, green features, design parameters and Green Building Rating System is very low among the general public and most of the technical persons and is the reason why still Green Building Rating System is still not implemented in Nepal. There is a very low demand of Green Building Rating system in Nepal due to the lack of awareness both social and cultural. Lack of education, lack of proper and mandatory green building related guidelines and lack of skilled manpower and technology are the major challenges. Group of renowned Architects and experts of Nepal were involved and tried their best with green building projects to register under LEED certification but was failure to get the certificate. Additionally, draft of ERA guidelines (preliminary) prepared by the group of pioneer Architects of Nepal was the initiation towards establishment of own building rating system in Nepal. Green Building Rating System will be the solution for energy optimization and will mark a turning point for the green design and green movement in building industry in Nepal.

Investment Patterns and Sustainability of Social Security Schemes in Nepal

Social security programme based on contributions of employees was introduced in Nepal by enacting the Employee Provident Fund Act - 1962, primarily to address the security needs of the retiring population. Employees Provident Fund, Citizen Investment Trust, and Social Security Funds are three major competing institutions in the social security market in Nepal. This paper explores the investment of funds accumulated through the contribution of employees for value creation as a means to enhance financial viability and further assesses the long-term sustainability of such programmes. The study is based on reviewing and analyzing the documents relating to the defined objectives and targets, investment policies, investment portfolio, legal framework for investment, and achievements. The study finds that all three social security institutions (SSIs) end up investing the accumulated funds in fixed deposits in the banking and financial institutions (BFIs.). This is despite the act empowering them to mobilize the accumulated funds in several productive sectors and set competitive investment goals. This indicates that they fail to explore productive avenues for sustainable investment of the accumulated funds, which could contribute to the economic development of the nation. The current challenges in the social security system in Nepal are the increasing number of pensioners and the need for sustainable investment; making it imperative for the Nepalese SSIs to evaluate their investment priority; feasibility and diversify for higher and long-term returns; focusing on areas that contribute to economic growth and development; and generating employment opportunities.

Rethinking collaborative governance to enhance legitimacy co-production: a multipurpose rural–urban water transfer in Nepal

ABSTRACT This study examines the Sundarijal Water Supply System in Nepal, which involves over a century of experience on a multipurpose water supply project. Research findings suggest that the liberal idea of justice as fairness in the distribution of risks and benefits fails to appreciate the political nature of state interventions to transfer rural water for urban municipal use. The research rejects the neoliberal idea of procedural justice as creating non-argumentative spaces for decision-making common in collaborative governance in favour of the political ecological approach to developing argumentative spaces to facilitate contested co-production of legitimacy.

Practice of Caste Hierarchy in Nepali Muslim Society

A nation like Nepal, where Hindus make up the bulk of the population, places a greater emphasis on the study of religious minorities. Caste is a distinctive type of stratification. It is purely a Hindu phenomenon that is comprehensible and explicable in terms of Hindu principles and justifications. In addition to the Indian subcontinent, caste is widespread in the Arab world, Polynesia, North and East Africa, Japan, and North America. Like in the Hindu community, there is caste purity and practice of hierarchy in Muslim community. Saiyedism in Muslims society (the Arab domination) like Brahminism in Hindu society is a primary cause of caste prejudice in the Muslim community.
 This paper outlines the crucial steps that must be completed at each stage of the caste hierarchy and is based on qualitative research. The subject is being generalized through an observational technique, in-depth interviews, and library research. Muslim scholars and elderly persons who had experienced such practice were picked as the respondents for the purpose of learning more. The respondents are identified as Res.1, Res.2, Res.3, and so forth because they requested anonymity. The Muslim caste hierarchical system in Nepal is the area of this study. It tries to combat the issue of caste hierarchy among Muslim people in Nepal.

Exploration of Dalit Trauma in Sarad Paudel's Likhe

Dalit community has been suffered in every aspect due to the institutionalized discrimination of the Hindu caste system in Nepal which is also known as the output of the religious and political reasons. This unfair practice has left a clear mark of social division, exclusion and inequality severely ruining Dalits' life and identity. Sarad Paudel addresses this issue and offers a glimpse of being a Dalit or untouchable in his novel Likhe. He narrates episodes of verbal and physical violence; recurrent inter- and intra-caste discrimination, which depicts the traumatic existence of that oppressed community. Other dominations and discriminations are less traumatic in the comparison of the cultural trauma caused by untouchability, which is like an incurable disease. Therefore, the aim of this paper is to examine the Dalit trauma as represented in this novel. To analyze the representation of traumatic experience in Dalits, the researcher has tried to apply the theoretical insights based on Jeffrey C. Alexander, Stuart Hall, Sigmund Freud and Cathy Caruth's exploration on trauma. This paper attempts to reveal how Dalit people have been living in the society bearing harsh torture, trauma and inhuman treatment in the context of Hindu Brahmin dominated society. This study adds new avenue for academic discussion in the field of academia so as to address the age-long discriminatory system in order to create a just and healthy society without any forms of discrimination in the name of race, class caste, color and gender. Therefore, this issue needs further exploration in academic discourse.

Power quality monitoring and analysis of aerodrome supply system: A study in Gautam Buddha International Airport, Nepal

The power supply system may contain disturbances leading to variations in voltage and frequency from their nominal value, non-sinusoidal waveform injection, presence of negative and zero sequence components, etc. Power quality is a measure of characteristic disturbances present in the power supply which ensures the importance of quality of service and consumer requirements. Electrical equipment installed in an aerodrome is more sensitive and prone to disturbance present at the power supply end. This study provides results of a theoretical power flow study, power quality monitoring, quality analysis, and probable remedies for power quality issues in an aerodrome electrical supply system in Nepal. Power quality measurement for supply from the utility here, Nepal Electricity Authority, and internal power generations in Gautam Buddha International Airport (GBIA) Siddharthanagar, Rupandehi, Nepal is performed by using theoretical load flow approach and continuous monitoring using a power data analyzer. The scope and origin of various disturbances which may induce power quality issues are analyzed. It is observed that the power supply at GBIA has voltage fluctuations of about ±12% and total voltage harmonic distortion of 6.5% with the presence of negative and zero sequence components. A remedial solution for the power quality problem is proposed for future enhancement of the electrical supply system at GBIA.

Linking Social Innovation with Inclusive Transformation of Agri-food System in Nepal: A Review

The potential of social interface in agricultural innovation remains masked by extension service agencies. This review collected and studied scattered knowledge generated literature on the role of social innovation in inclusive transformation of agri- food system highlighting on preproduction, production, supply chain and consumption. Search engines; namely google scholar; Science Direct, JSTOR, Directory of Open Access Journals and Scopus were utilized to identify the articles and relevant literatures. The review provides a state of the art on knowledge related to social innovations and inclusive transformation of agri-food system. The findings show that social innovation is becoming a prevalent tool to expedite inclusive transformation of food systems in Nepal. However, there are no clear considerations on social innovations in inclusive transformation of food and agriculture system. To provision these considerations, significance of social innovations for inclusive transformation was well explored for further analysis and conclusion. This review enhances the gaining of insights into the theories and findings of past works related to social innovation, inclusiveness, food system transformation and policies which contributed to develop a strong framework of inclusive transformation of food system from social innovation perspective.

Challenges and Complexities of Providing Emergency Medical Services During Covid-19 Pandemic in Nepal

Introduction:During the Covid-19 Pandemic, the Department of Emergency Medicine is the one of most busy in Nepal. Challenges and complexities of providing emergency medical service during the waves of the Covid-19 pandemic in Nepal were analyzed.Method:Three years (2020 – 2022) of data was analyzed from Covid patients registered in Tribhuvan University Teaching Hospital (TUTH), Institute of Medicine for reference with National Data of Ministry of Health and Population, Government of Nepal.Results:On November 15, 2022, there were 5,969,338 Covid PCR tests and 1,452,639 Covid Antigen tests in Nepal with 1,000,826 (16.8%) PCR, 152,197 (10.5%) being positive. The cure rate was 98.7% (988,316 cases). There were 12,019 mortalities with 1.2% case fatality. In TUTH 2020 – 2022 records; 3,794 total severe Covid-19 patients were admitted; In the first year, only two patients (1M:1F); In the second year 2,056 patients 1.8M:1F and in the third year 1,736 with 1.1M:1F. The age groups with the first wave vs the second wave were 6.42% vs 5.47% of 0-20 years; 24.22% vs 26.84% of 21-40 years; 30.57% vs 30.87 of 41-60 years and 38.57% vs 36.87% of above 60 years. The hospital mortality rate was 751 (19.8%). Challenges were due to resource limitation, limited PPE, scarcity of oxygen, medication, and ventilators. In TUTH, all levels of emergency management and various definite care were provided 24/7 hours in the pandemic period. There are a lot of challenges in Pre-Hospital Emergency Care Service due to a limited number of designated Advance Ambulances during transportation of severe Covid patients. With these challenges and complexities, there were six deaths of their own hospital staff due to severe Covid-19.Conclusion:The challenges and complexities of providing emergency medical services during the Covid-19 pandemic in Nepal have been overcome with teamwork and activation of the emergency care system in Nepal.