जलवायु परिवर्तन विश्वव्यापी अभियानमा थप चुनौती

१२ डिसेम्बर २०१५ मा विश्वका १९५ राष्ट्रहरुले फ्रान्समा भेला भई विश्व तापक्रम २ डिग्री सेन्टिगे्रट भन्दा बढ्न नदिने प्रतिबद्धता सहित पेरिस सम्मेलन गरे । यसमा हालसम्म १४८ मुलुकहरुले प्रतिबद्धता स्वरुप हस्ताक्षर गरिसकेका छन् । तर हालै आश्चर्यजनक रुपमा अमेरिकाले उक्त विश्वसम्मेलनमा पारित प्रतिवद्धताबाट हात झिकेको छ । खासगरी औद्योगिक मुलुकहरुका उद्योग कलकारखाना, यातायात आदिबाट बढी मात्रामा भएको कार्वन उत्सर्जनलाई योजनावद्ध ढंगले क्रमसः कम गर्दै लैजान अभियानले आव्हान गरेको छ । त्यतिमात्र होइन बढी कार्वन उत्सर्जनबाट जलवायुमा प्रतिकूल प्रभाव पर्ने नेपाल जस्ता मुलुकलाई क्षतिपूर्ति दिने व्यवस्था पनि यसमा गरिएको छ । Continue reading जलवायु परिवर्तन विश्वव्यापी अभियानमा थप चुनौती

एम्बुलेन्स सेवा प्रभावकारी बनाउने उपाय

डा. नवराज सुब्बा

आकस्मिक रूपमा चाहिने एम्बुलेन्स सेवा स्वास्थ्य प्रणालीको महत्वपूर्ण सहायक सेवा हो । यातायात पुगेका स्थानमा आजकल समुदायस्तरबाट समेत एम्बुलेन्सको व्यवस्था गरिएको छ । गाउँ गाउँमा खुलेका सहकारी, अस्पताल तथा सामाजिक धार्मिक संघ संस्थाहरूले पनि एम्बुलेन्स सेवा संचालन गरेर सेवा दिन थालेका छन् । तर यही अत्यावश्यक एम्बुलेन्स सेवाप्रति आम जनसमुदाय आज ढुक्क हुनसकेका छैनन् । भनेको बेलामा एम्बुलेन्स नपाइनु, आपद विपद् परेको बेला एम्बुलेन्सको लागि सम्पर्क गर्दा फोन नउठाउने गरेको, सम्पर्क भईहाले एम्बुलेन्स बिग्रेको भनेर नआउने गरेको विविध प्रकारको जनगुनासो छन् भने अर्कातिर अस्पतालको गेट वरिपरि एम्बुलेन्स थुप्रिएर बस्ने गरेको पाइन्छ । Continue reading एम्बुलेन्स सेवा प्रभावकारी बनाउने उपाय

Articles published in different scientific journals

12. Traditional and Modern Maternal and Child Health Care Practices and Effects among Rajbanshi community in Nepal.
Abstract
This is a descriptive and cross-sectional study on the Rajbanshi of Nepal in 2010. The common theories in Ethnographic/Indigenous Psychological perspective, Social Construction theories and Public Health perspectives have navigated the study. This study poses both qualitative and quantitative methods: interviews, observations and examinations. Household samples were randomly taken and clusters taken by purposive sampling method. Altogether 1514 people accounted in samples. Tools were semi-structured questionnaires, checklists, EPDS, weighing machine and measuring tape.Rajbanshi community is one of the marginalized indigenous people resided in the southeastern part of Nepal. They have unique tradition and culture. They have owned traditional health care practices. Guru Gosai and Gosai are traditional healers. In the Rajbanshi tradition, the causes of diseases and illnesses are deities, witchcraft, evil spirits, the touch of pithiya/chhatka and dirty environment or poor sanitation. They diagnose disease by looking at jokhana. After the findings, they treat patients by chanting of mantra or jharphuk, jadibuti, buti, ferani or bhakal. They are mainly taking modern care services from different levels private clinics/nursing home/hospitals and public health post/hospitals simultaneously.In the study 93.87% samples adopted modern and traditional dual practices concurrently. 74.14% samples visited local medical clinics, and 14.41% visited hospitals for the treatment at first.  Total 28% samples adopted solely modern care where nobody adopted solely traditional practices. However, 11.50% samples took traditional care at first for the mother and the child care. 16% pregnant took first care from traditional healers. The study also identified the trend of traditional and modern care practices. Hospital delivery increased from 30.67% to 69.33% between first and last deliveries where home delivery decreased to 29.23% from 69.33%.In spite of good access to modern care services the maternal and child mortality rates estimated high in those who are very poor, illiterate, remote and traditional practicing families in the community. Likewise, children with underweight were in an alarming situation (72.53%) in those who are very poor, labor, illiterate, rural and traditional practicing. Postpartum depression in mothers associated with their stress and sleeplessness were statistically significant. The PPD in mothers also tested with husband’s smoking habit and find statistically highly significant (p=<.0001).  Women of three groups are vulnerable: 1. Pithiya is a woman whose baby has died or stillbirth. 2. Chhatka is a mother who is suffering from abortion. 3. Tantra/mantra practicing women. These women are considered as causes of diseases. In such sociocultural circumstances, they become victims of social stigma.Traditional practices involve local barbers to cut the umbilical cord during delivery. They shave newborn’s head with the traditional knives after few days of the delivery. They are unsafe and can cause infection including neonatal tetanus. They need training on using sterile blades. Awareness of reproductive rights in mothers needs to rise. They need integrated mental health program. More nutritional programs required for the children.  Thesis download

11. Managing Hepatitis Outbreak in Biratnagar Nepal
This is a review article on jaundice outbreak occurred in Biratnagar during April-July 2014. The study reviewed the reports on hepatitis outbreak presented by District Public Health Officer Morang during a seminar organized by Nepal Health Research Council (NHRC), District Disaster Management Committee (DDMC) meetings and HMIS (Health Management Information System) database. District Public Health Office (DPHO) recorded 2,789 Jaundice patients in Morang district including Biratnagar city. Most of the patients (80.67%) recorded from Biratnagar. In the outbreak sex ratio of female to male was 0.56:1. Hepatitis infection was highest among 15-29 age groups and noticed remarkable among 15 to 54 years age groups. District Disaster Management Committee declared the outbreak in Biratnagar on April 28 when 95 jaundice patients recorded in the hospitals. The number reached at peak level 176 patients on May 6 and the trend came downward to normal level on July 8, 2014. Total 12 deaths recorded in the outbreak. Of them 8 deaths recorded from Biratnagar, 3 deaths from Morang district and 1 death from Saptari district. In Biratnagar ward No. 11 listed 5 deaths, ward No. 8 listed 2 deaths and ward No. 3 listed 1 death. Case fatality rate in the Biratnagar outbreak calculated as 0.43%. The causes of hepatitis infection were hepatitis viruses E and A. The transmission of infection in Biratnagar was due to sewage contamination through leaking pipes in water distribution. The level of community awareness on taking safe water observed in the Biratnagar. Before the outbreak, people used to drink tap water without treatment. After the outbreak, people changed their behavior to boil or filter water to drink in houses. Many people started to purchase mineral water in jars and bottles from the market. However, government water supply system in Biratnagar is poor which demands an upgrade to meet WHO standard of drinking water.
To cite this article
Nawa Raj Subba, Managing Hepatitis Outbreak in Biratnagar Nepal, Science Journal of Public Health. Vol. 3, No. 6, 2015, pp. 808-814. doi: 10.11648/j.sjph.20150306.12
Go to Science Journal of Public Health Click

10. Suicides in Ilam District of Nepal
American Journal of Applied Psychology, Volume 4, Issue 6, November 2015, Pages: 137-141
Received: Sep. 20, 2015; Accepted: Sep. 29, 2015; Published: Oct. 12, 2015
DOI: 10.11648/j.ajap.20150406.11 Views 29 Downloads 4
Nawa Raj Subba, Department of Psychology, Tribhuvan University, Kathmandu, Nepal
To cite this article
Nawa Raj Subba, Suicides in Ilam District of Nepal, American Journal of Applied Psychology. Vol. 4, No. 6, 2015, pp. 137-141. doi: 10.11648/j.ajap.20150406.11Abstract
This is a review of suicides through post-mortem reports committed in Ilam district of Nepal. The review is base on all total 112 post-mortem reports of three consecutive fiscal years (2001/02, 3002/03, 2003/04) available in District Health Office Ilam. Epi-Info software used to analyze the samples in the computer. Findings showed the ethnic distribution of the samples was indigenous Janajati 53.7%, Brahmin 29.5%, Dalit 8.9% and Chhetri 8%. Sex ratio of female to male was 2:1. The mean age of suicide noticed in male 34 years and in female 35 years. Suicides from Ilam municipality, Mangalbare and Maipokhari villages recorded high. Means of suicides were hanging 71.43%, organophosphate poisoning 12.5% and weapon 1.79%, fire 1.79%, fall 1.79%, and drown 0.89%. The highest suicides noted in 20-29 ages group. The trend of suicides was increasing over the past 11 years (1992-2003) in the district.Keywords
Suicide, Demographic Information, Trend, Ilam Nepal.

Continue reading Articles published in different scientific journals

Transformation of Delivery Practice in Rajbanshi Mothers of Nepal

 Nawa Raj Subba, MPH
District Public Health Office, Morang, Nepal
nrsubba@yahoo.com

 Abstract
This is a cross-sectional study with the objective of identifying modification in delivery practice in Rajbanshi mothers of Nepal. Methodology: Both qualitative and quantitative tools were used. Semi-structured questionnaires covering 375 samples of its resident districts Morang, Jhapa and Sunsari districts and check lists for in-depth interview were used in the study. Findings: People were adopting both traditional and modern care practices concurrently. Among 375 households; 40% adopted local clinic/ hospital/ traditional healer concurrently. Similarly 31.20% adopted local clinic/ traditional healer/ hospital, 10.67% adopted hospital/traditional healer. There were 11.47% (urban 0.54% and rural 10.93%) respondents were having traditional care system as a first choice. During first delivery among 375 mothers 265 (70.67%) had traditional home delivery and 110 (29.33%) had hospital delivery. During last delivery, this was 115 (30.67%) in traditional home delivery and 260 (69.33%) in hospital delivery. Therefore trend of hospital delivery was increasing whereas trend of traditional home delivery was decreasing. It was statistically highly significant (p=<0.0001). There was also remarkable increased in using trained Health Worker/Nurse/Doctor at hospitals is 66.4% during last delivery which was only 6.13% during first delivery. It is statistically highly significant (p= <.0001). Conclusion: Trend of hospital delivery was increasing (from 30.67% to 69.33%) and trend of home delivery was decreasing (from 69.33% to 29.23%) in between first and last child delivery. There was remarkable increased in using trained HW/Nurse/Doctor at hospitals is 66.4% during last delivery which was only 6.13% during first delivery. Traditional care was more practiced in rural than in urban population.

Keywords: Traditional home delivery, Modern hospital delivery, Rajbanshi, Nepal Continue reading Transformation of Delivery Practice in Rajbanshi Mothers of Nepal

मोरङको आधारभूत मानसिक स्वास्थ्य स्थिति — नवराज सुब्बा

विश्व स्वास्थ्य संगठनले गरेको परिभाषा अनुसार केवल रोग मुक्त र दुर्बल नहुँदैमा कुनै व्यक्ति स्वस्थ भयो भन्न मिल्दैन । शारीरिक, मानसिक, सामाजिक एवम् आत्मिक हिसाबले कुनै ब्यक्ति तन्दुरुस्त रहेको अवस्थालाई मात्र स्वास्थ्य भनिन्छ । मनोवैज्ञानिक दृष्टिकोणले हेर्दा समय र वातावरण अनुसार अगाडि बढ्ने क्षमता, भावनात्मक द्वन्द्वबाट ज्यादै विचलित नहुने क्षमता, अर्थपूर्ण रूपले जीवन यापन गर्न सक्ने क्षमता, उत्पादनशील काम गर्ने क्षमता, अरूसंग सम्बन्ध राख्ने वा निरन्तरता गर्ने क्षमता, कुनै प्रकारको मानसिक रोगको खास लक्षण नभएको अवस्थालाई मानसिक स्वास्थ्य भनिन्छ ।

सामान्यतयाः मानसिक रोग चार प्रकारका वर्गीकरण गरिएको हुन्छ । १. साइकोसिस वा पागलपन २. डिप्रेसन वा उदासपन, ३. चिन्तारोग वा मानसिक तनाव र ४. अन्य अर्थात् छारेरोग, लागुपदार्थ मादकपदार्थका दुव्र्यसनी, सुस्त मनस्थिति आदि । मानसिक रोगका कारणहरूमा वंशानुगत, मानसिक तनाव तथा घटनाविशेष, पूर्व प्रसूती तथा उत्तर प्रसूती अवस्थामा पर्ने असर पर्दछन् । यस्तै संक्रमण जस्तै मेनिन्जाइटिस्, इन्सेफलाइटिस्, टाउकोमा चोट, लामो समयसम्म मद्यपान, उपचार नगरिएको छारेरोग र स्नायु प्रणालीमा उत्पन्न परिवर्तन पनि मानसिक रोगका मुख्य कारणहरू हुन् । Continue reading मोरङको आधारभूत मानसिक स्वास्थ्य स्थिति — नवराज सुब्बा

राष्ट्रिय दादुरा रुबेला खोप अभियानः जान्नु पर्ने केही कुराहरू

राष्ट्रिय दादुरा रुबेला खोप अभियानः जान्नु पर्ने केही कुराहरू
— नवराज सुब्बा
पृष्ठभूमि
दादुरा अति संक्रामक रोग हो । नेपालमा ५ वर्ष मुनिका बालबालिकाहरु मृत्यु गराउने प्रमुख कारण मध्ये दादुरा रोग एक हो । दादुरा खोपबाटै विश्वमा दादुरा रोगमा कमि आएको छ । नेपालमा सन् २००४ र सन् २००८ मा दादुरा खोप अभियान संचालित थियो । फलस्वरुप नेपालमा ५ वर्ष मुनिका बालबालिकाहरुमा सन् १९९० को दशकको तुलनामा बालमृत्युदरमा ५० प्रतिशतले कमि आएको छ । Continue reading राष्ट्रिय दादुरा रुबेला खोप अभियानः जान्नु पर्ने केही कुराहरू

बिपन्न मोरङवासीलाई औषधोपचारमा सरकारी सहायता – नवराज सुब्बा

नेपाल सरकारले २०६७ साल चैत्र महिनादेखि आर्थिक रुपले बिपन्न नागरिकलाई क्यान्सर, हृदयरोग, एल्जाइमर, पार्किन्सन्स वा मृगौला आदि जस्ता कडा रोग लागेको अवस्थामा उपचार गराउँदा आर्थिक सहायताको व्यवस्था गरेको छ । यसरी कडा रोग लागेर विरामीलाई नेपालमा वा विदेशमा गई उपचार गराउँदा मेडिकल बोर्डको सिफारिसमा बढीमा रु एक लाख रुपैयासम्मको औषधी उपचार खर्च प्रदान गर्ने व्यवस्था मिलाएको हो । २०६८ कार्तिक महिनाअघि यो रकम रु ५० हजार रुपैयासम्म मात्र तोकिएको थियो । Continue reading बिपन्न मोरङवासीलाई औषधोपचारमा सरकारी सहायता – नवराज सुब्बा

भाइरल ज्वरो सम्बन्धी महत्वपूर्ण तथ्यहरू – नवराज सुब्बा

१. विषयप्रवेश
सामान्य भाषामा भन्नुपर्दा इन्फ्लुएञ्जा रोगलाई भाइरल ज्वरो, रुघामर्घी वा रुढी वा फ्लू भनेर पनि चिनिन्छ । तर कहिलेकाहीं यसले घरपरिवारका धेरै सदस्यलाई, विद्यालय वा छात्रावासका धेरै विद्यार्थीलाई तथा अस्पताल, कारागार, ब्यारेकजस्ता एकत्रित भएर बस्ने मानिसलाई एकसाथ प्रभावित पार्दछ । जसलाई हामी महामारी भन्दछौं । मोरङ जिल्लामा गत आर्थिक वर्ष २०६८/६९ सालमा ३७१४ जनाले इन्फ्लुएञ्जा रोगको उपचार स्वास्थ्य संस्थाहरुमा गरेको तथ्यांक जिल्ला जनस्वास्थ्य कार्यालय मोरङमा रहेको पाइन्छ । उक्त तथ्यांक हेर्दा वर्षैभरि यो रोग देखिएता पनि वैशाक देखि भाद्र महिनासम्म यो रोगको विरामीदर बढी देखिन्छ । Continue reading भाइरल ज्वरो सम्बन्धी महत्वपूर्ण तथ्यहरू – नवराज सुब्बा