Effect of economic and security challenges on the Nigerian health sector.

No Abstrac

Nepalese trekking guides: A quantitative study of sexual health knowledge and sexual behaviour

Background: Tourism, a global industry, brings with it a number of public health problems, one of which is the spread of sexually transmitted infections transmitted between travellers and hosts. Previous studies have largely focused on sex workers and sex tourists. This study assesses sexual behaviour, knowledge and condom use among male trekking guides in Nepal. Methods: A self-administered questionnaire survey (n=324) was conducted using snowball sampling amongst men working as mountain trekking guides in Nepal. Results: Most respondents (59%) had initiated sex before the age of 18. Most (84 %) reported sexual relations with a woman other than their partner, 46% reported foreign partners, 43% had Nepalese partners, and 28% had concurrent foreign and Nepalese partners. Most (70 %) reported ever having sex with a foreign woman and two-thirds had had sexual intercourse with foreign women in the previous 12 months. Participants’ age, education status, age of first sex, smoking and drinking habits and English proficiency were significant predictors of having sex with foreign women. About 60% reported condom use during their most recent occasion of extra-martial sex. A similar proportion had used a condom during last sexual intercourse with a foreign woman. The likelihood of condom use was associated with a guide’s age, educational level, ethnicity, age of first sex and work experience. Conclusions: Most trekking guides reported sexual relations with foreign women as well as irregular use of condoms. Although sexual health knowledge about among trekking guides is high, some misconceptions still result in unsafe sex. Hence there is an urgent need to revise the existing training for trekking guides and implement appropriate health promotion programmes

Young people's knowledge, attitude, and behaviour on STI/HIV/AIDS in the context of Nepal: a systematic review.

Sexual and reproductive health of young people has become a major health problem in recent decades. Recent and rapidly increasing Human Immune Deficiency Virus (HIV) rates show an urgent need for Sexually Transmitted Infections (STIs) and HIV prevention interventions in Nepal

Coffee Production in Kavre and Lalitpur Districts, Nepal

Coffee (Coffea spp) is an important and emerging cash crop having potential to provide farmers employment and income generation opportunities. This crop is well adapted to the climatic conditions of mid-hills of Nepal. Thus, majority of the farmers are attracted towards cultivation of coffee because of demands in national and International market. Coffee is now becoming integral part of farming system in rural areas. However, information on performance of coffee and farmers response has not been well documented. Therefore, we undertook the present work to analyze demography, ethnicity, household occupation, literacy status, average land holding, coffee cultivation area, livelihood and sources of income of coffee growers, production and productivity, pricing, cropping pattern of the coffee and problesm faced by them in mid hill district of Kavrepalanchowk (hereafter ‘Kavre') and Lalitpur Districts. All the samples were taken randomly and selected from coffee producing cooperative of Kavre and Lalitpur. Our analysis showed that the male farmer dominant over female on adopting coffee cultivation in both districts with higher value in Kavre. Brahmin and Chetri ethnic communities were in majority over others in adopting the coffee cultivation. Literate farmers were more dominant over illiterates on adopting the coffee cultivation, The mean land holding was less, ranging from 0.15 to 2.30 ha for coffee cultivation, the history of coffee cultivation in Kavre showed that highest number of farmers were engaged in coffee farming from last 16 years. The mean yield of fresh cherry was 1027.20 kg/ha in Kavre, while it was 1849.36 kg/ha in Lalitpur. The study revealed that majority of the coffee plantations were between 6-10 years old. The major problems facing by coffee farmers were diseases spread, lack of irrigation facility and drying of plants. Despite of that the coffee farming was one of the rapidly emerging occupations among the farmers in both district of Nepal

Modernization and Changes in Attitudes towards Sex and Relationships in Young People

Issues related to sexual and reproductive health (SRH) remain the leading cause of ill health among adolescents and young people worldwide and are of growing concern in Nepal. Young people are defined as those between the beginning of puberty and the attainment of adulthood. It is generally agreed that this period is usually associated with problems and challenges as they learn to become young adults, and sometimes struggle to fit into society. In such case, they may start experimenting with drugs, alcohol, tobacco and sex, which can make them vulnerable to various infections such as human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). It is now recognised that young people have to develop their knowledge and skills to deal with the temptations and dangers associated with being an adult. Limited published literature reveals that Nepali cultures view sexuality as taboo, and it is generally understood that sexual activities outside marriage are not accepted.However, many studies show that a significant proportion of young people take part in pre and extra-marital and high-risk sexual activities. Young people’s sexual health behaviour might also have been influenced by the modernisation currently observed in many Nepali societies. In addition, many young people do not always use sexual and reproductive health services, and health facilities have failed to provide young people with specialised sexual and reproductive health education and services. Therefore, there is an urgent need for effective comprehensive sex education and young people friendly sexual health services in Nepal

Gender Identity: Challenges to Accessing Social and Health Care Services for Lesbians in Nepal

Literature about same-sex love and sexuality in Nepal is rare. However, limited anecdotal evidence on these issues signals that the health and social care needs of lesbians in Nepal are high. This qualitative study explores the challenges faced by lesbians in Nepal in accessing health and social services. In-depth interviews carried out with fifteen lesbians found that Nepalese lesbians face many challenges from families and society which result in a stressful life, homelessness and forced and unwanted relationships and marriage, including self-harming behaviours. They often face discrimination and harassment when coming out at public administration and social institutions. Hence, most lesbians of Nepal prefer not to disclose their sexual identity due to the fear of becoming isolated and not getting quality health care services

Priority public health interventions and research agendas in post-earthquake Nepal

The occurrence of natural disasters including earthquake is becoming more frequent phenomena worldwide. All these disasters trigger huge damages to infrastructure, economies as well as population health. Nepal’s earthquake in 2015 has multiple effects on population health and health services delivery. Many public health facilities, mostly health posts or sub-healthposts, were damaged or completely destroyed. Priority health services such as immunization and antenatal care were also seriously affected. The earthquake has prompted the need for a disaster-related population-health-research agenda as well as renewed disaster strategy in post-earthquake Nepal. Meanwhile, it also unveiled the gap in knowledge and practice regarding earthquake resilience in Nepal. There is an opportunity for school-based and community-based interventions in both disaster preparedness and resilience. Nepal can build on experiences from other countries as well as from its own. We have discussed possible impacts of the Nepal earth- quake on population health and health system infrastructures. We have also suggested possible public health interventions bestowing active awareness among the population and a research agenda in this regard. We strongly urge for the translation of the National Health Policy (2014) into action, as it prioritizes the need of an earthquake resistant infrastructure as well as the implementation of a disaster response pla

Experts warn Nepal Government not to reduce local Public Health spending

The health system in Nepal is currently undergoing some very interesting radical reforms. The new Constitution in 2015 brought a complete restructuring of the country’s political system, creating a Federal Republic with seven Provinces. This change involves a significant devolution of power and resources from central to local level in many sectors including the health sector. This editorial warns of the risk of moving away the political focus from Public Health in a centralised political syste