Workers In Nepal Research Articles

Workplace harassment faced by female Nepalese migrants working aboard

BackgroundNepal has a long history of labour migration over the years. Migrants can experience a range of problems in their destination countries, and women are more at risk than men. This paper is the first to explore the problems faced by Nepalese women migrants while working abroad. MethodsThis study was conducted among 1,889 women who were registered as migrant returnees at an organisation called Pourakhi Nepal. The study extracted and analysed data from a non-governmental organisation that supports returning female migrant workers in Nepal. ResultsAround half (43.1%) of the women were 35 or older, 30.9% were illiterate, and 63.6% were in their first overseas job. More than one-third (38.5%) had self-reported workplace harassment. Physical violence was the most prevalent (68%), followed by verbal abuse (37.5%), mental stress (29.7%), and sexual abuse (14.1%).Women who were illiterate (adjusted odds ratio [AOR]1.25, 95% confidence interval [CI]: 1.01 to 1.55), unmarried (AOR 1.27, 95% CI: 1.05 to 1.56), worked abroad twice or more (AOR 1.35, 95% CI: 1.10 to 1.66), changed their place of work (AOR 2.38, 95% CI: 1.42 to 4.01), lived without documents (AOR 1.24, 95% CI: 1.03 to 1.50), worked as domestics (AOR 3.56, 95% CI: 2.03 to 6.23), worked in other than Gulf Cooperation Council countries (AOR 1.45, 95% CI: 1.06 to 1.99), women who did not have a fixed salary (AOR 1.64, 95% CI: 1.28 to 2.10) and did not receive salary (AOR 3.71, 95% CI: 2.88 to 4.77) were more likely to be harassed at work. ConclusionOur findings suggest that the host governments should introduce and enforce policies protecting women in the workplace. Migrant women should be provided with better information about health risks and hazards as well as how to improve preventive measures in destination countries to reduce workplace harassment.

Service Readiness of Primary Health Care Facilities for Non-Communicable Diseases Management.

NCDs prevalence and associated risk factors impacts on the burden of disease and premature mortality. Effective NCD service delivery requires well equipped facilities with trained providers and resources. Evaluating readiness and its determinant is crucial for enhancing NCD management. The study examines readiness in primary health care facilities for managing non-communicable disease in Syangja district. A cross-sectional research was conducted among 117 Primary health care facility health workers in Nepal's Syangja District. The data was collected through face-to-face interviews using modified WHO-SARA tool. The chi-square test was used to evaluate the relationship between NCD readiness and its associated factors and multivariable logistic regression was utilized to determine the strength of the correlation. Only 6 percent of the healthcare facilities in Syangja district had developed the system for readiness against non-communicable diseases. The mean percentage scores for service-specific domains ranged from 40% to 58%, indicating variations in readiness across different domains mainly contributed by basic amenities and training. Approximately 80.3% of health facilities received support from the local government, while equipment or commodities support was provided to the third- quarter of the health facilities. Total service readiness was very low in the diagnostic and medicine facilities of Syangja. It demonstrates that there is a discrepancy between the present situation of the incremental trend of NCDs and the related level of service preparedness in primary health care settings. The development of the service readiness mechanism is imperative considering the increasingprevalence of non-communicable diseases in Syangja.

Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal

ObjectivesBrick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence...

Prevalence and associated factors of respiratory symptoms and illnesses among brick kiln workers in Nepal

Prevalence and associated factors of respiratory symptoms and illnesses among brick kiln workers in Nepal

Personal Exposure to Fine Particulate Air Pollution among Brick Workers in Nepal

Prior studies suggest brick workers in Nepal may be chronically exposed to hazardous levels of fine particulate matter (PM2.5) from ambient, occupational, and household sources. However, findings from these studies were based on stationary monitoring data, and thus may not reflect a worker’s individual exposures. In this study, we used RTI International’s MicroPEMs to collect 24 h PM2.5 personal breathing zone (PBZ) samples among brick workers (n = 48) to estimate daily exposures from ambient, occupational, and household air pollution sources. Participants were sampled from five job categories at one kiln. The geometric mean (GM) PM2.5 exposure across all participants was 116 µg/m3 (95% confidence interval [CI]: 94.03, 143.42). Job category was significantly (p < 0.001) associated with PBZ PM2.5 concentrations. There were significant pairwise differences in geometric mean (GM) PBZ PM2.5 concentrations among workers in administration (GM: 47.92, 95% CI: 29.81, 77.03 µg/m3) vs. firemen (GM: 163.46, 95 CI: 108.36, 246.58 µg/m3, p = 0.003), administration vs. green brick hand molder (GM: 163.35, 95% CI: 122.15, 218.46 µg/m3, p < 0.001), administration vs. top loader (GM: 158.94, 95% CI: 102.42, 246.66 µg/m3, p = 0.005), firemen vs. green brick machine molder (GM: 73.18, 95% CI: 51.54, 103.90 µg/m3, p = 0.03), and green brick hand molder vs. green brick machine molder (p = 0.008). Temporal exposure trends suggested workers had chronic exposure to hazardous levels of PM2.5 with little to no recovery period during non-working hours. Multi-faceted interventions should focus on the control of ambient and household air pollution and tailored job-specific exposure controls.

Perceived External CSR from Employees’ Perspective in Nepalese Banking Industry

In order to better understand how external corporate social responsibility (CSR) efforts in the Nepalese banking industry affect different employee-related outcomes, this paper examines how employees perceive these activities. In this study, staff of Nepalese commercial banks were given questionnaires as part of a descriptive research design in order to gather primary data. The sample size is 120 individuals from an actual sample. This finding suggests that workers have a strong understanding of external CSR activities taking place outside of the organization. It is also clear that employees are conscious of the effects of the CSR efforts and give them a favorable evaluation. The study also investigates the link between work happiness, organizational engagement, and overall views of CSR and employee perceptions of external CSR actions outside the firm. This finding suggests that workers in Nepal's banking industry may see external CSR efforts as positively affecting their loyalty to the firm and job happiness. The relevance of this poll emphasizes how crucial an external CSR strategy is to successfully raising employee happiness and fostering organizational engagement. The report's suggestions for commercial banks are meant to help them match their CSR initiatives with employee expectations and values to foster a productive workplace. Future study objectives include looking at ways to increase employee involvement in CSR initiatives, assessing the long-term effects of CSR efforts, and doing industry comparison studies. Overall, this study helps understand how Nepalese banking industry employees feel about external CSR initiatives.

Prevalence and factors associated with depression, anxiety and stress symptoms among construction workers in Nepal.

The construction industry in Nepal, which employs a significant proportion of the population, ranks as one of the largest industries in the country. Construction work is physically demanding and can be risky due to the use of heavy machinery and the presence of intense physical labor. However, the physical and mental health of construction workers in Nepal is often neglected. This study aimed to assess psychological distress (depression, anxiety, and stress symptoms) and its association with socio-demographic, lifestyle, and occupational factors among construction workers in Kavre district, Nepal. We conducted a cross-sectional study from 1st October 2019 to 15th January 2020 among 402 construction workers in Banepa, and Panauti municipalities of Kavre district, Nepal. We collected data with face-to-face interviews using a structured questionnaire consisting of a) socio-demographic characteristics; b) lifestyle and occupational characteristics; and c) depression, anxiety and stress symptoms. We collected data using electronic forms in KoboToolbox and imported them into R version 3.6.2 for statistical analysis. We present parametric numerical variables as mean and standard deviation, and categorical variables as percentage and frequency. The confidence interval around proportion was estimated with the Clopper-Pearson method. We applied univariate and multivariable logistic regression to determine factors associated with depression symptoms, anxiety, and stress. The result of logistic regression was presented as crude odds ratio, adjusted odds ratio (AOR), and their 95% confidence interval (CI). The prevalence of depression, anxiety and stress symptoms were 17.1% (95%CI: 13.6-21.2), 19.2% (95%CI: 15.5-23.4) and 16.4% (95%CI: 12.9-20.4), respectively. In multivariable logistic regression analysis, depression symptom was positively associated with poor sleep quality (AOR = 3.51; 95%CI: 1.5-8.19; p-value: 0.004); stress symptom was positively associated with Brahmin ethnicity (AOR = 3.76; 95%CI:1.34-10.58; p-value: 0.012) and current smoking (AOR = 2.0; 95%CI: 1.11-3.82 p-value: 0.022). But anxiety symptoms were not associated with any of the variables. The prevalence of depression, anxiety, and stress symptoms were high among construction workers. Developing evidence-based and appropriate community-based mental health prevention programs among laborers and construction workers is recommended.

Learning from health system actor and caregiver experiences in Ghana and Nepal to strengthen growth monitoring and promotion.

Globally, growth monitoring and promotion (GMP) of infants and young children is a fundamental component of routine preventive child health care; however, programs have experienced varying degrees of quality and success with enduring challenges. The objective of this study was to describe implementation of GMP (growth monitoring, growth promotion, data use, and implementation challenges) in two countries, Ghana and Nepal, to identify key actions to strengthen GMP programs. We conducted semi-structured key informant interviews with national and sub-national government officials (n = 24), health workers and volunteers (n = 40), and caregivers (n = 34). We conducted direct structured observations at health facilities (n = 10) and outreach clinics (n = 10) to complement information from interviews. We coded and analyzed interview notes for themes related to GMP implementation. Health workers in Ghana (e.g., community health nurses) and Nepal (e.g., auxiliary nurse midwives) had the knowledge and skills to assess and analyze growth based on weight measurement. However, health workers in Ghana centered growth promotion on the growth trend (weight-for-age over time), whereas health workers in Nepal based growth promotion on measurement from one point in time to determine whether a child was underweight. Overlapping challenges included health worker time and workload. Both countries tracked growth-monitoring data systematically; however, there was variation in growth monitoring data use. This study shows that GMP programs may not always focus on the growth trend for early detection of growth faltering and preventive actions. Several factors contribute to this deviation from the intended goal of GMP. To overcome them, countries need to invest in both service delivery (e.g., decision-making algorithm) and demand generation efforts (e.g., integrate with responsive care and early learning).

How positive deviants helped in fighting the early phase of COVID-19 pandemic? A qualitative study exploring the roles of frontline health workers in Nepal.

Positive deviance is an approach wherein learnings from persons who fare better than their peers under similar circumstances are used to enable behavioral and social change. Such behaviors and solutions are likely affordable, acceptable, sustainable, and fit into the socio-cultural milieu. Despite the wide use of positive deviance in many public health programs and research, it has yet to be used to study frontline workers in the context of COVID-19. Therefore, this study aimed to explore the positive deviance traits among frontline health workers during the early days of the COVID-19 pandemic in Nepal. This qualitative study followed a grounded theory approach. The data was collected through in-depth interviews among the 17 identified participants representing different cadres of the health workforce, types of health facilities, and regions across Nepal purposively. The findings are structured around four major themes: challenges, finding solutions and innovations, positive lessons, and motivations. The personal challenges included fear and anxiety about the uncertainties. The professional challenges included stigma, infection control, and changing work style with the use of personal protective equipment. Despite the challenges, they managed available resources and innovated low-cost, technological, and practice-based solutions. They were able to reflect upon the positive lessons learned, such as self-sustainability, teamwork, and policy direction and research, and self-reflection of personal growth and patient care. The intrinsic motivation included their inherent value system, and the extrinsic motivation included appreciation and acknowledgment, family and social support, psychosocial support from peers, and support from higher authorities. This study provides insights into how the positive deviance approach can help identify the solution amid the most challenging circumstances, such as the COVID-19 pandemic in low-resource settings. However, more extensive studies are warranted to explore deeper into positive deviance and its long-term effects in bringing positive outcomes during the pandemic.

Psychological Impact of COVID-19 among Health-care Workers in Nepal: An Analytical Cross-sectional Study

Context: Many psychological problems including stress, anxiety, insomnia, depression, frustration, denial, anger, and fear emerged during coronavirus disease 2019 (COVID-19) outbreak. Aims: This study was done to assess the prevalence and associated factors of depression, anxiety, stress, insomnia, and fear experienced by health-care workers (HWs) during COVID-19 in Nepal. Settings and Design: This was web-based analytical cross-sectional study conducted among health-care workers from December 27, 2020, to February 28, 2021, all over Nepal. Subjects and Methods: All the HWs including doctors, nurses, and allied health-care professional from 7 provinces were selected using convenience sampling technique. Data collection was done using the validated questionnaires. Statistical Analysis Used: Univariate and binary logistic regression analyses were performed to find the association between the different variables. Statistical significance was set at P < 0.05. Results: A total of 608 HWs completed the survey with a mean age of 30.82 ± 6.68. About 27% had symptoms of depression, 28% anxiety, 10% stress, 18% insomnia, and 49.8% fear of COVID-19. Resident doctors and health workers who had bachelor level of education and working experience <2 years were significantly associated with higher odds of experiencing depression and anxiety. Health workers working 2–5 years and with more than 5 years' experience had significantly lower odds of experiencing fear. History of tobacco use or medical condition had significantly higher odds of experiencing depression, anxiety, stress, insomnia, and fear. Conclusions: This study concluded that the prevalence of depression, anxiety, insomnia, and fear was found to be high. Resident doctors and health workers with bachelor level of education, working experience <2 years, and history of medical condition were significantly associated with experiencing adverse mental health outcomes.

A mixed methods evaluation of a World Health Organization competency-based training package for foundational helping skills among pre-service and in-service health workers in Nepal, Peru and Uganda.

Health systems globally demand more competent workers but lack competency-based training programs to reach their goals. This study evaluates the effectiveness of a competency-based curriculum (EQUIP-FHS) for trainers and supervisors to teach foundational helping knowledge, attitudes and skills, guided by the WHO/UNICEF EQUIP platform, to improve the competency of in-service and pre-service workers from various health and other service sectors. A mixed-methods, uncontrolled before-and-after trial was conducted in Nepal, Peru, and Uganda from 2020 to 2021. Trainees' (N = 150) competency data were collected during 13 FHS trainings. Paired t-tests assessed pre- to post-change in ENACT competency measures (e.g., harmful, helpful). Qualitative data was analyzed using thematic analysis. EQUIP-FHS trainings, on average, were 20 h in duration. Harmful behaviors significantly decreased, and helpful behaviors significantly increased, across and within sites from pre-to post-training. Qualitatively, trainees and trainers promoted the training and highlighted difficult competencies and areas for scaling the training. A brief competency-based curriculum on foundational helping delivered through pre-service or in-service training can reduce the risk that healthcare workers and other service providers display harmful behaviors. We recommend governmental and nongovernmental organizations implement competency-based approaches to enhance the quality of their existing workforce programming and be one step closer to achieving the goal of quality healthcare around the globe.

Novel Approaches to Community-Based Psychoeducation to Improve Mental Health Awareness in Diverse Settings

Background/Objectives: The authors are early career psychiatrists practicing worldwide who aim to increase access to mental health care and reduce associated stigma by utilizing culturally informed psychoeducation-based programs tailored for nontraditional communities. Methods: The authors chose four distinct communities to provide mental health psychoeducation, including churches in Philadelphia, a fandom group in the Philippines, nonpsychiatric healthcare workers in Nepal, and families of patients in Morocco. Results: Dr. Atasha Jordan founded the Christian Mental Health Initiative to improve mental health outcomes of Christians in the US and the Caribbean; in a pilot study (n = 29), the research team used Mental Health First Aid to increase mental health care literacy and mental health care utilization in Black Churches. Dr. Bernadett Carandang co-created Hallyu Wednesdays, an online fandom-based mental health group that meets weekly to explore mental health topics through Korean media and provide online safe spaces for their community. Dr. Kristin Nguyen, as part of the Health, Equity, Action, Leadership (HEAL) global mental health fellowship program, co-created psychoeducational videos on burnout and ways to mitigate it for the staff of a hospital in rural Nepal that can be disseminated to other Nepali healthcare workers. Dr. Wydad Hikmat implemented a family psychoeducation program, Profamille, for caregivers and families of patients with psychosis, leading to improved mood and coping strategies for patients. Conclusions: All four psychoeducational interventions used innovative approaches to addressing mental health challenges and promoting mental wellness among diverse populations worldwide.

Women's Participation in Foreign Labour Migration and Spousal Violence: A Study on Returnee Women Migrant Workers in Nepal

While existing studies point to a high degree of physical and sexual violence 1against women in Nepal, there is a lack of studies assessing the extent of violence among women who participate in foreign labor migration. This paper tries to fill this research gap by assessing the prevalence of spousal violence against women in overseas employment by using survey and interview data from a non-probability sample of 138 returnee women migrant workers (WMWs). The data used in this paper was collected in Dhading and Rupandehi districts in 2017 by a team of researchers, including the authors of this paper, for a comprehensive study on gender-based violence against WMWs. The study found the rate of lifetime physical violence among WMWs ten percent higher than the national average of 22 percent (MOHP 2012). This rate was highest among Dalit women and women above 35. The physical and sexual violence rates were lowest among women with secondary education or above. Similarly, the rates of physical and sexual violence were lowest among the WMWs whose husbands had secondary or higher levels of education, and the rates were highest among the WMWs whose husbands did not have a formal education. The study found only a weak relationship between women’s participation in labor migration and violence from their husbands and family members. For many WMWs, the violence prevailed in the pre-migration and post-return phases, and some women had participated in labor migration due to the violence in the family itself.

Knowledge and Perception of COVID-19 Pandemic during the First Wave: a Cross-Sectional Study among Nepalese Healthcare Workers

Objectives: This study aimed to assess knowledge and perception of COVID 19 among frontline health care workers in Nepal. Methods: A web-based cross-sectional study was conducted among frontline healthcare workers involved in managing and treating COVID-19 in Nepal by adapting the questionnaire from the World Health Organization. Data were analyzed using the Statistical Package for Social Science version 26.0. A chi-square test was used to investigate the association level among variables at 95% level of significance. Results: A total of 285 health professionals participated in this study, among them male (50.5%), and female (49.5%). The mean (± SD) age of participants was 27.21 ± 5.42 years old. Most of the participants got information on COVID-19 from social media (50.5%) and online news/newspapers (40.3%). On the other hand, a significant proportion of Health care workers (HCWs) had poor knowledge about its transmission (n=170, 59.6%) and an incubation period (n=129, 45.3%). Conclusion: There was a significant gap in knowledge and perception, particularly about the transmission and incubation period. A concerned national initiative to respond the pandemic could help better compliance with behavioral guidelines to respond to this public health emergency.

Women Participation in School Governance in Lalitpur, Nepal: A Participatory Development Practice

Participation is an important dimension of good governance. In Nepal, there seem positive changes in women's participation in School Management Committees (SMC), Parent Teachers Association (PTA), and school administration but the participation of women has become a far-reaching goalin public school governance. This article is about exploring how women's participation could contribute to promoting good governance practices in community schools. Authors have applied an interpretative inquiry and participation and feminist standpoint theories to make out the meaning in this study which was carried in two public schools in Lalitpur, Nepal. The finding reveals that his meaningful representation of women in school governance is likely to minimize the governance challenges such as absenteeism, low parents’ participation, poor resource mobilization, transparency, and accountability.These positive transformations contribute to the community development process. However, enabling environment for women is needed to ensure their meaningful representation in school governance structures. This study is beneficial to educationists, planners, and development workers in Nepal.

The Narratives of Former Entertainment Workers in Nepal: An Explorative Study of Becoming and Being an Entertainment Worker

This paper explores experiences as being and becoming of entertainment Worker in Nepal. Entertainment sectors, conceptualized here, a place where girls and Women are kept for sexual purposes. In doing so, the timing of events model, and narrative theory were applied to explore how events timing changes the life experiences of former entertainment Workers. Twelve former entertainment Workers were selected from NGO's who were rescued and helped by Youth for Transformation. The oral narration was taken as an interviewing method. Their problems and narratives as being Workers, and the process of becoming, off timing stages of entertainment workers intertwined in family system/sub-system or outside inter-personal system, were recorded, transcribed, analyzed, and discussed as informed by thematic techniques, and off timing stage model.
 Following timing of events model and narrative theory, five off timing events led sequential patterns in clients’ life were identified: a) chronic poverty and bigger family size led-sequences; b) single mother led-sequences; c) early child marriage led-sequences; d) love marriage led- sequences, and d) parent’s death led-sequences. Likewise, research generates the client’s construction of the four dominant themes were: a) stigmatization; b) enactment of social expectations; c) role mediation and feminization, and d) health condition.

Knowledge, attitude and reported practice regarding donning and doffing of personal protective equipment among frontline healthcare workers against COVID-19 in Nepal: A cross-sectional study.

Coronavirus Disease 2019 (COVID-19) is a respiratory infection with a high rate of transmission primarily via airborne route and direct contact. Proper use of personal protective equipment (PPE) is a proven and effective way to prevent COVID-19 spread in healthcare settings. This study was done aiming to assess the knowledge, attitude, and reported practice, and identify the associated factors regarding donning and doffing of PPE among frontline healthcare workers in Nepal. A cross-sectional study was conducted from 25th April to 30th July 2021 among 205 frontline healthcare workers of Nepal selected randomly from among the contacts of the investigators. A structured self-administered questionnaire prepared in google form was used as a study tool and shared via social media to the participants to obtain information on socio-demographic and workplace characteristics along with their knowledge, attitude, and reported practice regarding donning and doffing of PPE. A total of 79.5% of participants had satisfactory knowledge while 75.6% had satisfactory practice scores regarding donning and doffing of PPE. Factors such as the profession of the participants (p-value = 0.048), their workplace (p-value = 0.005), provision of PPE at workplace (p-value = 0 .009), and availability of designated space at workplace for methodical donning and doffing of PPE (p-value = 0.010) were significantly associated with satisfactory knowledge score whereas availability of designated space at workplace for donning and doffing of PPE was significantly associated with good practice score (p-value = 0.009). This study demonstrated an overall good knowledge, attitude, and reported practice regarding donning and doffing of PPE among frontline healthcare workers in Nepal. However, the reported shortcomings like poor knowledge regarding the sequence of donning and doffing and corresponding flawed practice behaviors need to be addressed.

Association of social stigma of COVID-19 with work satisfaction, burnout and fatigue among healthcare workers in Nepal

Background: Stigma towards the patient of coronavirus disease (COVID-19) has been reported in various media reports, including negative behaviour among health care workers (HCWs) towards COVID-19 patients. Moreover, the negative behaviour of HCWs towards COVID-19 patients could affect the professional quality of life of these HCWs.Objective: We aimed to assess stigma related to COVID-19 patients among HCWs and explore its impact on their professional quality of life during COVID-19 pandemic in Nepal.Methods: An online cross-sectional study was carried out among 421 HCWs (health assistants 35.6%, nurses 33%, doctors 23.3% and paramedics 8.1%), 52.7% female, working in health facilities in Nepal. The measures included background characteristics, stigma in terms of - discrimination towards COVID-19 patients, acceptance of COVID-19 patients and fear of COVID-19, and professional quality of life in terms of - work satisfaction, burnout and fatigue. Descriptive and inferential statistics were utilised to analyze the data in SPSSvs20.Results: While around two-third of the study participants showed discriminating attitude towards COVID-19, a half showed negative attitude towards acceptance of COVID-19 patients, and a fifth reported attitude of fear of COVID-19. Multivariable regression analysis indicated that while presence of fear of COVID-19 was associated with low satisfaction, low burnout, and low fatigue; attitude of acceptance of COVID-19 patients was associated with low burnout and low fatigue; and attitude of discrimination towards COVID-19 patients was associated with only low satisfaction.Conclusion: Strategies directed towards - reducing fear and discrimination towards COVID-19 patients, and enhancing positive attitude of acceptance towards COVID-19 patients among HCWs, and thus, creating enabling environment for reducing their burnout and fatigue, and increasing work satisfaction are recommended.

COVID-19 pandemic and its influence on mental health of healthcare professionals in Nepal

Given the unprecedented global public health crisis due to the covid-19 pandemic, it is important to recognize the psychological impact on health care professionals. Previous experiences from the smaller scale epidemiology and new literature on COVID-19 have shown that increased pressure on healthcare professionals is associated with rise in the psychological incidence rates. We have described the psychological burden of the covid-19 pandemic on health care workers in Nepal and reviewed the literature on the impact of previous epidemics on front-line health care workers. In addition, we discussed potential triggers and measures to minimize the front-line psychological pressure to deal with this biological threat.

The wounded healer during COVID-19: unraveling the violence against healthcare workers in Nepal

The wounded healer during COVID-19: unraveling the violence against healthcare workers in Nepal