Hari Kafle | Pokhara University (original) (raw)

Papers by Hari Kafle

Medicine Science | International Medical Journal, 2017

Satisfaction has been widely recognized as an important indicator to evaluate health care quality... more Satisfaction has been widely recognized as an important indicator to evaluate health care quality and to provide patient centered care. The study was carried out to assess satisfaction level from a hospital based perinatal care. A descriptive cross sectional study was carried out among 428 postnatal women in two tertiary hospitals of western Nepal via structured interview schedule. Maternal satisfaction was measured by 25 item scale. Overall 45.1% of mothers were satisfied with the perinatal care. The level of satisfaction in public hospital (mean 3.44±0.65 out of 5) was greater as compared to private hospital (mean 3.27±0.59 out of 5). The satisfaction score was lower in the physical environment (mean 3.01±0.87 out of 5) and highest in privacy maintained (mean 4.37±0.92 out of 5). Determinants of satisfaction were type of hospital, religion, education, parity, number of living children, mode of delivery, gestational age at birth, maternal condition after delivery, newborn health condition, and duration of stay at the hospital and the gender of the provider (p<0.05). Majority of the respondents were unsatisfied from the services. Satisfaction score in a public hospital was higher as compared to private hospitals.

Submitted 1 Nov 2016; Accepted 22 Nov 2016; Published 25 Dec 2016 It is crucial to monitor the gr... more Submitted 1 Nov 2016; Accepted 22 Nov 2016; Published 25 Dec 2016 It is crucial to monitor the growth and development of a child in early stage of life to take early corrective action in time to ensure normal growth. Child health card (CHC) is a tool used to maintain records and monitor the under five children. The objective of this study was to find out the maternal awareness on CHC and factor associated with its retention. This was a cross sectional analytical study conducted among 198 mothers having <3 years children in Salyan VDC, Kaski, Nepal. The study found 61.1% retention of CHC. Only about one-fourth (25.8%) of the mothers had adequate level of awareness on different aspect of CHC. Of the 24 different independent variables studied; only nine (age of the child; place of delivery; antenatal and postnatal care services utilized; first choice health institution for treatment; maternal awareness on CHC; place of immunization; taking CHC regular to health facility and health w...

It is crucial to monitor the growth and development of a child in early stage of life to take ear... more It is crucial to monitor the growth and development of a child in early stage of life to take early corrective action in time to ensure normal growth. Child health card (CHC) is a tool used to maintain records and monitor the under five children. The objective of this study was to find out the maternal awareness on CHC and factor associated with its retention. This was a cross sectional analytical study conducted among 198 mothers having <3 years children in Salyan VDC, Kaski, Nepal. The study found 61.1% retention of CHC. Only about one-fourth (25.8%) of the mothers had adequate level of awareness on different aspect of CHC. Of the 24 different independent variables studied; only nine (age of the child; place of delivery; antenatal and postnatal care services utilized; first choice health institution for treatment; maternal awareness on CHC; place of immunization; taking CHC regular to health facility and health worker ever counseled on CHC) were found positively associated with retention of CHC (P < 0.05). This study showed retention of CHC only in six-out often studied cases. The study also revealed poor level of awareness on CHC in the study area. The study also highlighted on positive association of retention of CHC with counseling by health workers and increased use of health services.

ÖZET Background: Body image dissatisfaction and incorrect body weight perception are raising prob... more ÖZET Background: Body image dissatisfaction and incorrect body weight perception are raising problems among the adolescents worldwide. They are at increasing level in developing countries undergoing economic and nutritional transition like Nepal. Objectives: To find out the body image satisfaction, body weight perception and knowledge of obesity among adolescents in Kaski district, Nepal. Materials and Methods: A cross sectional study was conducted among 838 adolescents in Kaski district, Nepal from 12 schools selected randomly using multistage cluster sampling. Data collection was done in between October to December, 2013 by using anthropometric assessment and self-administered questionnaire through use of pretested tools. Data was entered and analyzed using WHO anthroplus software v.1.0.4 and SPSS v. 16. Results: Majority of the adolescents, 630(75.2%) were found satisfied with their body image and 208(24.8) weren't. The body image satisfaction rate was comparatively found higher among adolescents with normal BMI for age, 509(79.3%) and the underweight, 86(67.2%). More than half of the overweight adolescents, 27(55.1%) perceived themselves as normal, 19(38.8%) perceived as overweight and 3(6.1%) perceived as obese. Majority of the adolescents had right knowledge on obesity however no significant association was found. Conclusion: Body image satisfaction among the adolescents was found high. Overweight and obese were found likely to underestimate their body weight. Interventions focusing on behavioral modifications and regular anthropometric assessment are essential. ABSTRACT Amaç: Beden imajı memnuniyetsizliği ve hatalı beden ağırlığı algısı tüm dünyada ergenler arasında artmaktadır. Nepal gibi ekonomik ve besinsel açıdan gelişmekte olan ülkelerde durum daha belirgindir. Bu çalışmanın amacı Nepal, Kaski bölgesinde ergenlerin beden imaj memnuniyetleri, beden ağırlık algıları ve obezite bilgilerini değerlendirmektir. Yöntem: Kesitsel bu araştırma Nepal'in Kaski bölgesindeki 12 okuldan çok aşamalı küme örneklemesi ile seçilmiş 838 ergen ile çalışılmıştır. Veri toplama Ekim-Aralık 2013 tarihleri arasında antropometrik değerlendirmeler ve kendi kendine uygulanan soru formlarından oluşan gereçler ile yapılmıştır. Veriler Dünya Sağlık Örgütü anthroplus yazılımı v.1.0.4 ve SPSS v. 16. ile işlenmiş ve analiz edilmiştir. Sonuçlar: Ergenlerin çoğunluğunun (630 kişi, %75,2) beden imajından memnun olduğu, 208 (%24,8) ergenin ise memnun olmadığı saptanmıştır. Beden imajı memnuniyeti normal beden kitle indeksine sahip grupta 509 (%79,3), zayıf gruba göre daha yiksekti (86 (%67,2). Kilolu ergenlerin yarıdan fazlası (27, %55,1) kendini normal olarak algılar iken 19(%38,8) kilolu ve 3 (%6,1) obez olarak algılıyordu. Ergenlerin çoğunluğunun doğru obezite bilgisi olmasına karşın, obezite bilgisi ile beden imajı algısı arasında ilişki bulunmadı. Tartışma: Ergenler arasında beden imajı memnuniyeti yüksek bulundu. Kilolu ve obezler beden ağırlıklarını düşük algılamaktadırlar. Davranış değişikliği ve düzenli antropometrik ölçüm değerlendirmelerine odaklanan müdahaleler önemlidir.

ABSTRACT ABSTRACT Background: Reproductive behavior and its decision making practices are general... more ABSTRACT ABSTRACT Background: Reproductive behavior and its decision making practices are generally exercised in one of the three ways – mutual, dominancy of husband or dominancy of wife. Gender norms and roles prevalent in society affect the practice of reproductive decision making among couples. The aim of this study was to identify the practice of decision making on different reproductive behavior among couples and to examine the associated factors of decision making. Methods: Descriptive cross sectional study was conducted in four Village Development Committee (VDCs) of Syangja district of Nepal by using structured interview schedule. The couples of reproductive age (15-49 years) having at least children of one year were the study population. Results: Decision making on the use contraceptives and plan for pregnancy was mostly mutual (62.1% and 74.8% respectively). Regarding the birth spacing, majority (42.4%) of couples had made no decision followed by mutual decision (41.4%). While 72.0 % couples had gone through mutual discussion to maintain the family size, 27.7% discussed not at all regarding the concerned matter. Only 37.7% of husbands had provided adequate time for nurturing and caring their children. Association was found between decision maker on pregnancy and times of pregnancy (P<0.05), decision maker on birth spacing and interval between children (P<0.05), and employment status of husband and time provided by husband for nurturing and caring of baby (P<0.05). Conclusion: Mutual decision making on reproductive behavior like pregnancy, birth spacing and family size symbolizes the initiation transformational gender norms and roles in Nepalese rural societies. Keywords: Reproductive behavior, Gender, Couples

Safe motherhood has been recognized as a right of every woman since long ago. But still, every da... more Safe motherhood has been recognized as a right of every woman since long ago. But still, every day significant numbers of women are dying due to preventable causes related to pregnancy and childbirth; mostly in developing countries and in rural setting due to unavailability and/or poor quality maternal health services. Available health services are not also utilized properly due to lack of awareness and other socio-cultural factors. The objective of this paper was to review relevant literatures to describe the gap regarding policy prospective and maternal health service provision in Nepal. This paper built on a review of relevant literatures published in between 1990 and 2017. The review revealed that Nepal has provided topmost priority on maternal health since 1990 and it has been getting priority agenda in several policy papers. Progressive improvement in maternal health has been observed in between 1990 and 2017, but achieving national and international policy targets within the specified time frame are still challenging. It is needed to maximize efforts to sustain the current achievement and make further progress on maternal health.

Most of the new born deaths in the developing countries occur due to lack of access to care, as m... more Most of the new born deaths in the developing countries occur due to lack of access to care, as majority of the deliveries occur at home. Even deliveries conducted in health facilities are prone to suffering from traditional care practice after discharge from health facilities. Most of these deaths could be avoided with changes in antenatal, delivery and newborn care practices. This study was conducted to explore the newborn care practices related to cord care, thermal care and breast feeding in rural setting and to identify socio-demographic, antenatal and delivery care factors associated with these practices. A cross sectional study in rural setting of Nawalparasi district included 296 women who had delivered live baby at home or discharged within 24 hours of delivery from hospital proceeding four months of data collection. Chi squire test was applied to compare sociodemographic, antenatal and delivery care factors associated with cord care, thermal care and breast feeding practices. Of the total 296 mother interviewed, only 65.54% have completed ANC visit at least 4 times and 29.05% have received counselling on newborn care during pregnancy. More than half deliveries (53.38%) were home deliveries and Clean Home Delivery Kit was used only one third (39.91%) of these deliveries. Of the three selected newborn care practices, clean cord keeping practice was found in only one fourth (25.70%) of deliveries. However early initiation of breast feeding and delayed bathing practice was found in about half of the deliveries (51.35% and 58.45% respectively). There is strong need to implement the community-based interventions to improve the new born care practices in community level and to reduce the high-risk newborn care practices like unsafe cord care, delayed breast feeding, early bathing, prelacteal feeding and discarding colostrum need through the community level health workers and volunteers.

Medicine Science | International Medical Journal, 2017