Women In Kathmandu Research Articles

Prevalence of Perinatal Depression and Its Associated Risk Factors among Nepalese Women in Kathmandu, Nepal.

Perinatal mental health is a major public health issue that arises during pregnancy and/or after birth, with substantial implications for social, parental, and maternal functioning, as well as overall quality of life. The study aimed to determine the prevalence of perinatal depression and its associated risk factors among women who visited a maternity hospital in Kathmandu, Nepal. A cross-sectional study was conducted at the Paropakar Maternity and Women's Hospital in Kathmandu. A total of 300 women in their perinatal period were interviewed. The Edinburgh Perinatal Depression Scale (EPDS) was used to measure perinatal depression. The Poisson regression model was used to determine risk factors associated with perinatal depression. The mean age of respondents was 25.5 (SD 4.5) years; average age during their first pregnancy was 23.5 (SD 3.7) years; and 53.7% of respondents were in the antenatal period. The prevalence of depressive symptoms (EPDS ≥ 10) was 40% (95% CI 31.4% to 45.8%). Unsupportive family members (adjusted prevalence ratio [aPR] 2.23; 95% CI 1.75-2.86), postnatal period (aPR 2.64; 95% CI 1.97-3.53), complications faced during delivery (aPR 1.76; 95%CI 1.30-2.39), history of intimate partner violence (aPR 0.48; 95% CI 0.36-0.64), and first pregnancy at the age of ≤25 years (aPR 0.61; 95% CI 0.42-0.88) were identified as key risk factors of perinatal depression. Strong family support and the active involvement of partners in counselling can contribute to alleviating perinatal depression symptoms. Targeted interventions in health and well-being services should be implemented to address mental health burden during both pregnancy and postpartum periods.

‘It’s All About Education’: Middle-class, High-caste Women’s Aspirations of Choice, Freedom and Modernity in Urban Nepal

Discourses of development are highly influential in Nepal, entwining with sets of social relations and local history to form a nationally shared vision known as bikas (development). This article explores how specific sets of (universalist and local) discourses of development and gender articulate in the subjectivities of young, middle-class, high-caste women in Kathmandu as they negotiate transitions to adulthood. Drawing on ethnographic research, the article highlights how education has afforded young women new possibilities and prompted new aspirations compared to earlier generations, and words such as ‘choice’ and ‘freedom’ figure prominently in their discussions of aspirations. However, generational differences in understanding how these dreams fit in women’s lives are often expressed in intergenerational tension around marriage. The article highlights how different discourses fuse in ways relational to people’s social locations, including along junctures of class, caste, gender and generation, arguing for attention to intersectionality in understanding the circulation of discourses of development and modernity in Nepal.

Ethnographic Studies of Stories of Subordinated, Oppressed Single Women in Kathmandu

Ethnographic Studies of Stories of Subordinated, Oppressed Single Women in Kathmandu

Complexities of Menstruation in Kathmandu, Nepal

To understand women’s experiences with menstrual practices, the author spoke with seventy-one women in Kathmandu, Nepal, the place where she grew up. Based on interview responses, a clear spectrum exists with four specific types: 1. Adherents who strictly follow menstrual practices. 2. Aspirants who would like to practice, if another family member shouldered responsibility. 3. Negotiators, who engage or defy practices when beneficial to them. 4. Opponents, who openly oppose practices, following rarely.

Knowledge and Compliance of Iron and Folic Acid Supplementation among Pregnant & Postnatal Women in a Hospital of Kathmandu

The high prevalence of iron deficiency anemia and low compliance of iron and folic acid supplementation was reported among pregnant women in Nepal. This study aimed to determine the knowledge and compliance of iron and folic acid supplementation among pregnant and postnatal women in Kathmandu. A descriptive cross-sectional study design was adopted for the study. Sample size was 103 and purposive sampling technique was used to collect the data. All Pregnant women of having above 7 month pregnancy and postnatal’s up to 6 months women were included. Data was collected by using self-administered questionnaire .All the obtained data were analyzed with the help of SPSS version 20. Assessment of knowledge revealed that 85.6 % (88) of the participants have adequate knowledge regarding iron and folic acid supplementation .The findings showed 78.6% (81) of the respondents had iron and folic acid compliance as standard of Nepal government that is to be taken minimum 180 tablet before delivery. It concludes that the level of knowledge and compliance rate of iron and folic acid supplementation in Kathmandu is satisfactory in comparisons to national status i.e. 42% according to Nepal Demographic health survey 2016. Pearson chi-square test shows that level of knowledge on iron and folic acid tablet is not associated with the compliance of iron and folic acid tablet (χ²= 0.019, p< 0.889). The main reason of respondents having compliance is due to having proper counseling from health worker and non compliance is due to forgetting to have tablet. Therefore improving knowledge level only can’t improve compliance level, various factors like counseling, accessibility and availability of iron and folic acid tablet, side effect of tablet and family support also affects the compliance of iron and folic acid supplementation.

Knowledge and Practice Regarding Menstrual Health among Physically Disabled Women in Kathmandu, Nepal

Background: Disability is the condition of difficulty in carrying out daily activities normally and in taking part in social life due to problems in parts of the body and the physical system as well as obstacles created by physical, social, cultural environment and by communication. Disability also carries stigma, so disabled people may face layers of discrimination when they are menstruating. The objective of the research is to assess the knowledge and practice regarding menstrual health of disabled women.
 Method: Descriptive, cross sectional study was conducted among 151 participations. Self-structured questionnaire and face-to-face interview were used as data collection tool and technique respectively. Data entry and analysis were done using SPSS version 20. Descriptive analysis like frequency and percentages were computed and presented in a table.
 Results: Most of participants knew 26-30 days were the normal menstrual cycle duration (80.13%). Only 31% of participants bath daily during menstruation. About 83% of participants used sanitary pad, 69.54% of participants changed pad twice a day. Maximum number (91.39%) disposed sanitary pad in dustbin. 76.82% of participants learned about menstrual hygiene from parents and friends. Majority of the participants (61.59%), cleaned the genitalia haphazardly 88.08% cleaned with soap and water Most of the respondent 90.06% had taken rest during menstruation.
 Conclusions: Disabled women were aware about normal duration of menstrual cycle and blood loss. However, improper practices related to menstrual health and hygiene were prevalent among disabled women, it should be timely and rightly approached to prevent and control adverse health conditions that may arise of it. Mother and peer groups could be the best choices of source of information to improve menstrual health and hygiene of differently able women.

Society and Sex Selection; Son Preference among the Educated Middle-Class in Kathmandu

A cultural ecological perspective is valuable in identifying the complex relationship among ecology, culture, society, economy, demography and preference of particular gender especially male preferences. An evolutionary psychology explanation of female infanticide should take into account the role of cultural practices and ecological pressures in shaping psychological antecedents to treating differently even for own genes i.e. male preference and female neglect. In this regards, the relationship between ecology and culture is dynamic, and that macro interventions, such as building of cities, urbanization, development of highways, constructions of high dams in a physical development and advancement of socio-economic parameters associated with human development including leadership development, sustainability, sustainable use of resources, maintain equilibrium among population and resources and opportunities including empowerment of women, ultimately resulting in tightening the screw of social control of women’s sexuality. There should be maintained delicate balance between the relationship between women-men, women-women, and men-men, economically, demographically, socially, physically ecologically biologically or say culturally symbiotic in various forms as a husband or a son or a brother. From the study, it is concluded that, though society and culture are modern, heterogeneous, complex, advancing the conservative or traditional practices of son preference or discrimination based on gender are still practiced and are prevalent in our society and continue to define gender roles and practices especially among the middle-classes that found in Kathmandu. Therefore, son preference, for the middle-class women in Kathmandu, should not be understood superficially. It is a complex whole and it should be studied critically in detail.

Knowledge and practice regarding menstrual hygiene among physically disabled women in Kathmandu, Nepal

Background and Objectives: Disability is the condition of difficulty in carrying out daily activities normally and in taking part in social life due to problems in parts of the body and the physical system. Disability also carries stigma, so disabled people may face layers of discrimination when they are menstruating. The objective of the review is to assess the menstrual hygiene practice of disabled women, the barriers they face, and the available interventions to help them manage their menstruation hygienically and with dignity.
 Material and Methods: This was a cross-sectional descriptive study that was conducted among 151 physically disabled peoples.Self-structured questionnaire and face-to-face interview was used as data collection tools and techniques. Data entry and analysis was done using SPSS 16.0. The results of the study were presented with the help of tabular description using the same software along with Microsoft word and excel 2007.
 Results: Most of respondents knew the 26-30 days as normal cycle duration (80.13%). Majority of respondents had reported that they do not go to holy places (91.39%) and should not cook food (94.03%) during menstruation. Most of respondents had stayed (96.68%) and eat (98.01%) at same place and 31.38% of respondents had bath daily during menstruation. 83.44% of respondents used sanitary while 69.53 % of respondents changed pad twice a day. Maximum number of the respondents 91.39% disposed sanitary pad in dustbin. 87.41% of respondents learned about menstrual hygiene from parents.
 Conclusion: Good and satisfactory knowledge about menstrual hygiene was found among girls of age group 15-24years.

Power and Control in Kathmandu: A Comparison of Attempted Power, Actual Power, and Achieved Power.

We argue that the concept of power has been inadvertently sidelined in recent theory and research on husband violence. Three types of relationship power may matter with respect to husband violence: attempted power, actual power, and achieved power. Analyses of a randomly selected representative sample of 270 married or partnered women in Kathmandu showed that actual power was related to husband violence prevalence, severity, and injury. Achieved power was related to husband violence prevalence and severity, and attempted power was related to husband violence injury. Implications are discussed.

Influence of family members on utilization of maternal health care services among teen and adult pregnant women in Kathmandu, Nepal: a cross sectional study.

BackgroundIn some developing countries a woman’s decision to utilize maternal health care services is not made by the woman herself but by other family members. The perception of family members regarding who is the most influential person for making the decision to utilize these services is inconclusive. Hence, this study aimed to determine the perceived influential person on utilization of antenatal care (ANC) and delivery care services among teen, young adult and adult pregnant women from the perspective of the woman themselves, their husband and their mother-in-law, identify the factors associated with the woman being the most influential person, and assess the level of agreement between the woman’s and her husband’s response to the woman being the most influential person.MethodsA cross-sectional study was conducted at Paropakar Maternity and Women’s Hospital and Tribhuvan University Teaching Hospital. Purposive sampling technique was used to select 315 women of which 105 were from each age group and their accompanied husbands (n = 315) and mothers-in-law (n = 315). The proportion of perceived influential person and mean priority score of the perceived influence with its 95% confidence interval was calculated. The factors associated with the woman perceived as the most influential person were analyzed by multivariate logistic regression model. The agreement was analyzed using kappa statistic.ResultsAmong teens and young adults and their husband and mother-in-law, the woman’s husband was perceived as the most influential person. Among adults, the most influential person for ANC was the woman herself but for delivery care was the woman’s husband. A woman of adult age, having a non-indigenous ethnicity or who was not referred was more likely to perceive herself as the most influential person in the decision to utilize delivery care. A fair to poor level of agreement was found on the perception of the most influential person for ANC and delivery care utilization.ConclusionsBoth women and their husbands influenced the decision to utilize ANC and delivery care but husbands were more influential, especially in teens and young adults. Thus, husband’s involvement is crucial as a strategy to improve maternal health care utilization in Nepal.Electronic supplementary materialThe online version of this article (doi:10.1186/1742-4755-11-92) contains supplementary material, which is available to authorized users.

Contraceptive knowledge and attitudes among women seeking induced abortion in Kathmandu, Nepal

ObjectiveTo map the knowledge about and attitudes toward birth control methods among women in Kathmandu, Nepal, and to compare the results between women seeking an induced abortion and a control group.MethodThis was a cross-sectional cohort study with matched controls. Women aged 15–49 years seeking medical care at the Department of Gynecology and Obstetrics at Kathmandu Medical College were included and interviewed. A case was defined as a woman who sought an elective medical or surgical abortion. A control was defined as a woman who sought medical care at the outpatient department or had already been admitted to the ward for reasons other than elective abortion. A questionnaire developed for the study – dealing with different demographic characteristics as well as knowledge about and attitudes toward contraceptives – was filled out based on the interview.ResultsA total of 153 women were included: 64 women seeking an abortion and 89 controls. Women seeking an abortion had been pregnant more times than the control group and were more likely to have been informed about contraceptives. Women with higher education were less likely to seek an abortion than women with lower education. There was no significant difference in knowledge about and attitudes toward contraceptives between cases and controls. The women considered highest possible effectiveness to be the most important feature when deciding on a birth control method.ConclusionWomen seeking abortion in Kathmandu had shorter education and a history of more pregnancies and deliveries than women in the control group. Education and counseling on sex and reproduction as well as on contraceptive methods probably need to be improved in Nepal to avoid unwanted pregnancies. Attitudes about contraceptives need to be further investigated to develop better and more effective methods to educate women about family planning in order to increase reproductive health.

Evaluation of the “Let's Talk” Safer Sex Intervention in Nepal

This study is an evaluation of a pilot of the Let's Talk Intervention for Nepali women for effectiveness in increasing sexual health communication between women and the men in their lives. The intervention included 88 women in Kathmandu and spanned three 2-hour group sessions. Baseline, posttest, and follow-up knowledge, attitude, and behavior surveys were completed. Results showed women at posttest and follow-up spoke with more women and men about sex than they had at baseline. Attitudes regarding gender norms about sex improved as a result of the intervention, and shame about sex and sexuality for women decreased after intervention. Women also reported greater comfort discussing sex after the intervention. HIV knowledge scores increased after intervention but dropped again at follow-up, likely because of time constraints in addressing this topic in sufficient detail. This is the first program in Nepal that addresses communication about sexual health while focusing on education and prevention for HIV/STIs for women.

Rising property ownership among women in Kathmandu, Nepal: an exploration of causes and consequences

Pandey S. Rising property ownership among women in Kathmandu, Nepal: an exploration of causes and consequencesInt J Soc Welfare 2010: 19: 281–292 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.There is evidence that property ownership empowers women by increasing their self‐confidence, ability to contribute to decisions, control over their reproductive behaviour, ability to borrow and economic independence. Yet, women around the world own negligible assets. It is not surprising that assets ownership among Nepalese women is insignificant. In urban areas of Nepal, however, women's assets holdings have increased dramatically over the last four decades. The article analyses the institutions that resulted in increased asset holdings among women in Kathmandu, Nepal, and shows how strategic action by some men and women has given rise to new norms which favour property ownership among women. The findings are based on a sample of 193 women who legally own property (home or land) in Kathmandu, Nepal.

Etiology of Fever in Pregnant Women in Kathmandu, Nepal

Background: To study the incidence and etiology of fever in pregnancy. Methods: Prospective descriptive study conducted over a period of 24 months from September 2005 to August 2007 in the department of Obstetric and Gynecology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. All the admitted pregnant women with fever ≥100.4 °F (≥38 °C) were enrolled in the study after taking verbal consent. They were investigated and managed according to the hospital protocol. Complete blood count, urine for routine, microscopy, culture and sensitivity, blood culture for Salmonella, Widal test, and blood for malarial parasite were routinely sent for all the cases. Tests like liver function test, AFB staining and culture were done whenever it was thought to be necessary. Result: Total 82 cases of pregnancy with fever were admitted during the study period which accounted for 3.2% of the total pregnancy related admission. Common causes of fever were Urinary tract infection (43.9%), Enteric fever (23.1%) and viral hepatitis (8.53%). Chicken pox (1.2%), Mastitis (1.2%) and tuberculosis (1.2%) were the uncommon etiology. Fever with flu like symptoms without specific diagnosis was present in 20.73% of the cases. Conclusion: Urinary tract infection and enteric fever were the most common cause of fever during pregnancy.Definitve diagnosis was not made in large number of cases due to limited diagnostic facilities for viral infections.

A controlled study of postpartum depression among Nepalese women: validation of the Edinburgh Postpartum Depression Scale in Kathmandu.

To measure the prevalence of depression amongst postpartum and non-postpartum Nepalese women in Kathmandu using the Edinburgh Postpartum Depression Scale (EPDS) and to assess the ease of use and validity of the scale compared with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression. We screened 100 women 2-3 months post-delivery and 40 control women using the EPDS. All those who screened positive for depression and 20% of the negatives also underwent a structured interview to assess depression by DSM-IV criteria. Predictive errors were minimized by using an EPDS score > or =13 to define depression. Using this threshold, there was no difference in depression prevalence between postpartum women (12%) and the control group (12.5%) (Fisher's exact test, P > 0.05). Compared with DSM-IV, the sensitivity, specificity and positive predictive values were 100, 92.6 and 41.6%, respectively. The prevalence of postpartum depression (PPD) in Nepalese women and the validity and ease of use of the EPDS in the setting of a postnatal clinic in Kathmandu are all surprisingly similar to the results of numerous studies in developed countries. Despite poor living conditions, PPD is no more common than the background depression rate amongst Nepalese women. It can be reliably detected by trained clinical nurses using the EPDS screening test. These results may have implications for the planning of mental health resources for women in other developing countries.

The prevalence of anemia in pregnant Nepali women - a study in Kathmandu

Anemia in pregnancy is associated with maternal and perinatal morbidity and mortality. The World Health Organization has suggested that where up-to-date information is not available, prevalence studies should be undertaken. The distribution of hematocrit in 2280 pregnant women attending Patan Hospital, Kathmandu, for their first antenatal visit in a twelve month period, 1994-95, was studied. Anemia was defined as a hematocrit value < or =34% in the first and third trimesters, or < or =33% in the second trimester. Severe anemia was defined as a hematocrit value < or =24%. The prevalence of anemia and severe anemia, and associations with socio-demographic (age, ethnic group, living area, maternal and paternal education and occupation) and biological (height, body mass index, parity, gestation) variables were investigated. The hematocrit values ranged from 11-49% with a mean value of 32.6% (s.d. 3.9). The prevalences of anemia and severe anemia were 62.2% and 3.6%, respectively. High prevalence of anemia was observed among teenagers, farmers, women of short height, the ethnic groups Lama/Sherpa/Tamang, and women married to industrial workers or illiterate men. Also, the risk of anemia increased with gestation. Work within the service professions, higher education and high body mass index, were associated with a lower risk of anemia. A high prevalence of anemia among pregnant women in Kathmandu was observed. The hematocrit values were related to socio-demographic and biological factors. In order to plan focused and effective intervention, studies on the etiology of anemia among pregnant women in rural and urban areas of Nepal need to be carried out.