Worldwide, a large number of women experience disrespectful and abusive behavior from care providers during childbirth. This violates the rights of women to attain respectful care. This study aimed to find out the women’s experience of disrespect and abuse during institutional delivery. A cross-sectional study was conducted in two hospitals of Morang district situated in eastern Nepal. Two hundred eighteen women from a public hospital and 109 women from a private hospital (N = 327) with normal vaginal delivery were selected purposively for this study. Data were collected through face-to-face interviews using a structured questionnaire based on the Disrespectful and Abusive Scale by Bowser and Hill. All women had experienced at least one type of disrespect and/or abuse during labor and delivery, most common being non-consented care (100%), non-dignified care (72%), and non-confidential care (66.6%), respectively. Discriminatory care and physical abuse were experienced by 32.33% and 13.23%, respectively. Ethnicity, religion, place of delivery, and numbers of living children were the main predictors of reporting disrespect and abuse. Overall, the occurrence of disrespect and abuse during institutional delivery was found to be very high.

Background: Small children have less control over their dietary intake and parents have a major role to play in it. The aim of our study was to determine parental child feeding practices and their association with the weight status and dietary intake of the child. Design and methods: A cross-sectional study was conducted among 138 parents and preschool children attending two private schools in Kathmandu Valley, Nepal using a structured questionnaire. Parents filled in a self-report questionnaire to assess child feeding practices, perceived activity level of the child, and dietary intake at home. Child’s height and weight was measured using a standard height scale and a digital weighing scale. A digital food scale was used for measuring dietary intake. Results: Eight percent of the children were overweight and another 8% were obese. On bivariate analysis, the BMI of parents had weak, positive, and significant correlation (r=0.206, p=0.016 for fathers; r=0.307, p≤0.001 for mothers) with child’s weight status. Similarly, concern about child’s overweight had a significant, positive correlation (r=0.232, p=0.006) with the weight status of the child. Furthermore, these three independent variables were found to be significant predictors of a child’s weight status on multivariate analysis. None of the studied independent variables was associated with dietary intake. Conclusion: The study concludes that parental BMI and parental concern about the child being overweight is significantly associated with the weight status of the child.

Introduction: Exclusive breast feeding up to first six months of life is the safest and healthiest practice for children all over the world. Various factors may affect to the exclusive breast-feeding though it is necessary for promotion of child's health.Objective: The objective of this study was to identify the factors associated with exclusive breast feeding practices among mothers of infant and young children.Methodology: A cross-sectional study was carried out at Gokarna Primary Health Care Centre, Kathmandu. Total 137 mothers having at least one child 0-23 months of age, attending to Maternal and Child Health Clinic were purposively selected for the study. Consecutive sampling was done. All the mothers who meet the criteria during the period of data collection (August to September, 2017) were included in the study. Ethical clearance was obtained from the Institutional Review Committee of Kathmandu Medical College, Kathmandu. Written consent was taken from each respondent and face to face interview technique was used to collect the data using pre-designed structured questionnaire. Data were analyzed using Statistical Package for Social Science 16.0 version. Both descriptive and inferential statistics were used for data analysis.Results: Majority of the respondents (56.9%) had adequate knowledge on exclusive breast feeding, about 54% of the mothers had initiated breast feeding within one hour of delivery and all in all mothers had ever breast fed their child. More than one third (36.5%) of babies were given pre-lacteal fed, around two thirds of babies were breast fed exclusively at least less than one month but only around 40% of the babies had received exclusive breast feeding for six months. Exclusive breast feeding was significantly associated with, normal vaginal delivery, pre-lacteal fed given and having adequate level of knowledge regarding exclusive breast feedingConclusion: On the basis of findings, mode of delivery, pre-lacteal feeding and level of knowledge on exclusive breast feeding were the factors significantly associated with exclusive breast feeding. The practice of exclusive breast feeding for six months of age was not up to the mark. BJHS 2018;3(2)6:413-417.

Background: Ensuring respectful maternity care is crucial to promote positive childbirth experiences among women. Globally, 22–100% women report experiencing at least one form of disrespect and abuse during facility-based birth, with a study in Nepal reporting 100% prevalence. Thus, interventions like Forum Play are needed to promote respectful maternity care but remain scarce. Forum Play is a participatory theatre technique which encourages the participants to create scenes based on their own experiences illustrating a situation of oppression. This study aimed to assess the effectiveness of a pilot Forum Play intervention in promoting respectful maternity care by investigating self-reported perception and behaviour among care providers. Methods: A quasi-experimental pre–post study with a control group was conducted among doctors and nurses in two tertiary hospitals in Nepal. Participants involved in providing care or interacting with women during labour and delivery were purposively selected for the intervention and control groups. The intervention group comprised 25 care providers (14 nurses and 11 doctors), while the control group included 75 care providers (42 nurses and 33 doctors). Two half-day Forum Play workshops were conducted separately for nurses and doctors in the intervention hospital. Data were collected using a self-administered structured questionnaire at baseline and two months post-intervention in both groups; however, the design was not strictly parallel. In the control hospital, data were collected later at the same intervals to provide contextual comparison. Data were analysed using IBM statistical package for social sciences version 20. Descriptive statistics (frequency, percentage, mean and standard deviation) were used to measure the self-reported perception and behaviour on disrespect and abuse and perceptions of respectful maternity care. Mann Whitney U test was used to compare groups and Wilcoxon Signed Rank test was used to assess within-group changes before and after the intervention. Results: There were no differences in background characteristics between intervention and control groups (p=>0.05), nor in the overall disrespect and abuse of women at baseline (p = 0.09 to 0.35) whereas significant differences were observed at follow-up (p=<0.001 to 0.004, r = 0.33 to 0.61). There were no significant differences in perception scores towards respectful maternity care between the groups at baseline while significant differences were found at follow-up (z = −3.25, p = 0.001 and r = 0.32). The perception score was significantly higher in the intervention group after the intervention (z = −3.073, p = 0.002 and r = 0.61) while no significant difference was observed in the control group (z = −0.120, p = 0.90 and r = 0.05). Conclusion: Forum Play as a method of participatory intervention has the potential to enhance positive perception and behavioral change among care providers towards respectful maternity care. Scaling up the Forum Play intervention and systematically exploring women’s experiences are essential to determine its actual effectiveness.

Background: Medical abortion has been proved to be effective method for safe abortion. It is highly acceptable to women in a variety of settings, including where resources are limited. Objective: The objective of the study was to assess the immediate impact of medical abortion on women’s health and clients’ satisfaction with medical abortion. Methods: A descriptive study was conducted at Marie Stopes Center, Satdobato, Lalitpur. A total of 100 consecutive women visiting the center for medical abortion during 2010 September to 2010 October were included. Respondents were the women attending follow up visit following medical abortion using Mifepristone 200 mg orally followed by Misoprostol 800μg per vaginal after 24 hours of oral Mifepristone. Structured questionnaire was designed and interview method was used for data collection. Statistical Package for Social Sciences version16 was used to analyze the data. Results: The success rate of medical abortion was 91%. Most of the respondents did not have any problems besides the expected effects and side effects of the method such as bleeding, abdominal cramping, nausea, vomiting, dizziness and headache. Majority (79%) of respondents was satisfied with medical abortion and 76% respondents said they would recommend this method to others in future. There was no significant relationship between information and counseling and client’s satisfaction with medical abortion. Conclusions: The immediate impact of medical abortion on women’s health is positive. It is a safe and easy method in termination of early pregnancy and most of the clients were satisfied with this method. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8144 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 91-95