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The Health Thread

Access to healthcare in developing countries

Feb 10, 2024 | Global health issues

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Written By THT Editorial Team

Sujata Shakya

Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)

Access to healthcare is a fundamental right that should be enjoyed by every individual, regardless of their geographical location or socioeconomic status. Unfortunately, in many developing countries, significant barriers prevent people from accessing the healthcare services they need. These barriers often include limited infrastructure, insufficient healthcare resources, financial constraints, and inadequate healthcare systems. To address these challenges, it is crucial to develop strategies that maximize access to healthcare in developing countries. This article explores research findings and suggests strategies that can effectively improve access to healthcare, ensuring maximum suitability for these regions.

Strengthening Primary Healthcare: Investing in primary healthcare is vital for enhancing access to healthcare in developing countries. By focusing on primary healthcare, countries can provide essential and cost-effective services to a larger population. This strategy includes establishing and adequately funding primary healthcare centers, training and deploying healthcare workers, and expanding the coverage of essential medications and vaccinations. Strengthening primary healthcare can significantly improve access to preventive care, early diagnosis, and management of common diseases.

Telemedicine and Mobile Health: Leveraging advancements in technology, telemedicine and mobile health solutions offer promising strategies to overcome geographical barriers and limited healthcare infrastructure. Telemedicine allows remote consultations, diagnosis, and treatment of health problems through telecommunications technologies, enabling healthcare professionals to reach underserved populations. Mobile health interventions, such as health applications and SMS- based programs, can provide valuable healthcare information, reminders, and educational resources to individuals in remote areas.

Community-Based Healthcare Delivery: Community-based healthcare delivery models have demonstrated success in improving access to healthcare in developing countries. These models involve training and empowering community health workers (CHWs) to deliver basic healthcare services at the grassroots level. CHWs can provide preventive care, health education, and basic treatments, acting as a bridge between the community and the formal healthcare system. Engaging communities and local organizations can enhance the cultural acceptability and effectiveness of healthcare interventions.

Health Financing Reforms: Financial barriers are the significant obstacles to healthcare access. Implementing health financing reforms can ensure that healthcare services are affordable and accessible for all. Strategies may include expanding health insurance coverage, developing targeted subsidy programs for vulnerable populations, and exploring innovative financing mechanisms. Evidence-based research should inform the design of these reforms, considering the local context and socioeconomic factors that affect healthcare accessibility.

Public-Private Partnerships: Collaboration between public and private sectors can contribute to improving healthcare access in developing countries. Public-private partnerships can leverage the strengths of both sectors to address gaps in healthcare infrastructure, service delivery, and resource allocation. This approach can enhance the efficiency and effectiveness of healthcare systems, ensuring that resources are utilized optimally to benefit underserved populations.

Conclusion: Enhancing access to healthcare in developing countries requires a multifaceted approach that considers the unique challenges faced by these regions. Strengthening primary healthcare, harnessing technology, empowering communities, implementing health financing reforms, and fostering public-private partnerships are key strategies that can maximize access to healthcare services. By implementing these strategies based on the research findings and adapting them to the local contexts, policymakers and healthcare stakeholders can make significant progress in ensuring equitable access to healthcare for all individuals in developing countries.

REFERENCES

  • World Health Organization. (2021). Primary health care. Retrieved from https://www.who.int/westernpacific/health-topics/primary-health-care
  • World Health Organization. (2020). Telemedicine: Opportunities and developments in member states: Report on the second global survey on eHealth. Retrieved from https://www.who.int/publications/i/item/9789240010034
  • Lehmann, U., & Sanders, D. (2007). Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impacts on health outcomes. Geneva: World Health Organization. Retrieved from https://www.who.int/hrh/documents/community_health_workers.pdf
  • Kutzin, J. (2013). Anything goes on the path to universal health coverage? No. Bulletin of the World Health Organization, 91(11), 798-798A. doi: 10.2471/BLT.13.132563 World Bank. (2020). Public-Private Partnerships in Health. Retrieved from https://ppp.worldbank.org/public-private-partnership/sector/health

Managing chronic diseases

Feb 7, 2024 | Disease Prevention and Management

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Managing chronic diseases is an ongoing process that requires a combination of medication adherence, lifestyle changes, and self-management techniques. Chronic diseases, such as diabetes, heart disease, and arthritis, require long-term management to prevent complications and maintain overall health.

One of the most important aspects of managing chronic diseases is medication adherence. This means taking medications exactly as prescribed by a healthcare provider. Skipping doses or taking medications at the wrong time can lead to serious complications and may even worsen the condition. Patients should discuss any concerns they have with their healthcare provider and work together to find the most effective medication plan.

In addition to medication adherence, lifestyle changes can also play a crucial role in managing chronic diseases. For example, patients with diabetes can manage their condition by maintaining a healthy diet, exercising regularly, and monitoring their blood sugar levels. Similarly, patients with heart disease can manage their condition by following a heart-healthy diet, getting regular exercise, and taking steps to manage stress.

Self-management techniques, such as monitoring symptoms and keeping track of medication schedules, can also help patients effectively manage their chronic diseases. Patients can work with their healthcare provider to develop a self- management plan that fits their specific needs and lifestyle.

Overall, managing chronic diseases requires a proactive and comprehensive approach that includes medication adherence, lifestyle changes, and self- management techniques. By working closely with their healthcare provider and making these changes, patients can effectively manage their conditions and improve their overall health.

What are some of the self management techniques? Self-management techniques for chronic diseases can include:

1. Learning about your disease: Understanding the signs and symptoms of your disease and how it can be managed is important. This can include learning about your medication, tracking your symptoms, and knowing when to seek medical attention.

2. Making lifestyle changes: Eating a healthy diet, getting regular exercise, quitting smoking, and managing stress can help manage many chronic diseases.

3. Monitoring your health: Regular check-ups with your healthcare provider, keeping track of your symptoms and medication, and monitoring your blood pressure and blood sugar levels can help you manage your disease.

4. Managing medication: Taking medication as prescribed, knowing the side effects, and discussing any concerns with your healthcare provider can help you manage your chronic disease effectively.

5. Developing a support network: Having family, friends, or a support group to talk to about your disease and the challenges it presents can help you manage your condition and improve your emotional wellbeing.

Lifestyle changes to prevent chronic diseases

Feb 6, 2024 | Disease Prevention and Management

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Lifestyle Changes to Prevent Chronic Diseases:

Moving towards a Healthier Life Chronic diseases, such as heart disease, diabetes, and cancer, are major public health concerns worldwide. These diseases are often preventable and manageable through lifestyle changes that promote healthy living. Adopting healthy habits such as regular exercise, healthy eating, and stress management can help prevent and manage chronic diseases. In this article, we will explore the benefits of lifestyle changes and compare traditional and modern lifestyles.

Benefits of Lifestyle Changes:

Lifestyle changes are an effective way to prevent and manage chronic diseases. They can help improve overall health and well-being, reduce the risk of chronic diseases, and improve the quality of life. Some of the benefits of lifestyle changes include:

Reduced risk of chronic diseases: Lifestyle changes such as healthy eating, regular exercise, and stress management can reduce the risk of chronic diseases such as heart disease, diabetes, and cancer.

Improved physical health: Regular exercise and healthy eating can help maintain a healthy weight, reduce the risk of obesity and related diseases, and improve overall physical health.

Improved mental health: Stress management techniques such as meditation and yoga can help reduce stress levels, improve mood, and promote mental well- being.

Improved quality of life: Adopting healthy habits can lead to a better quality of life by improving overall health and well-being.

Comparing Traditional and Modern Lifestyles:

Traditional lifestyles are often associated with good health and well-being. People in traditional societies often engage in physical activities such as farming, hunting, and gathering, which provide natural exercise and a healthy diet. However, modern lifestyles have led to changes in diet and physical activity levels, which have resulted in an increase in chronic diseases. In modern societies, people have access to processed foods, fast foods, and sugary drinks, which are often high in calories and low in nutrients.

In addition, modern technology has made physical activity less necessary, and many people lead sedentary lives. People often spend long hours sitting at a desk or in front of a computer, which can lead to a host of health problems, including obesity, back pain, and poor circulation.

Examples of Lifestyle Changes:

Regular Exercise: Regular exercise can help maintain a healthy weight, improve cardiovascular health, and reduce the risk of chronic diseases. It is recommended that adults engage in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.

Healthy Eating: Eating a diet that is rich in fruits, vegetables, whole grains, and lean protein can help maintain a healthy weight and reduce the risk of chronic diseases. It is recommended that adults consume at least five servings of fruits and vegetables per day.

Stress Management: Stress can have a negative impact on physical and mental health. Stress management techniques such as meditation, yoga, and deep breathing can help reduce stress levels and promote relaxation.

Adequate Sleep: Getting enough sleep is important for overall health and well- being. Adults should aim for 7-9 hours of sleep per night.

Conclusion: Lifestyle changes are an effective way to prevent and manage chronic diseases. Adopting healthy habits such as regular exercise, healthy eating, and stress management can help reduce the risk of chronic diseases and improve overall health and well-being. By comparing traditional and modern lifestyles, we can see the benefits of adopting healthy habits and making positive lifestyle changes.

Examples of some chronic diseases that can be managed with life style changes

  • Chronic obstructive pulmonary disease (COPD)
  • Chronic kidney disease
  • Osteoporosis
  • Hypertension (high blood pressure)
  • Cardiovascular disease (including heart disease and stroke)
  • Diabetes (type 1 and type 2)
  • Depression and other mental health disorders
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Obesity
  • Depression and anxiety

Wearable health technology

Feb 4, 2024 | Healthcare Technology and Innovation

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Written By THT Editorial Team

Reviewed by Astha Paudel, Biomedical Engineering graduate (CBEAS) Nepal, Currently Navigating Bio-Nano Material Science Engineering at AIT, Thailand

Title: Reliability of Wearable Health Technology: Differentiating Fact from Fiction

Introduction:

Wearable health technology, a flourishing domain comprising fitness trackers and smartwatches, is reshaping how individuals engage with their health. These devices, armed with features like step counting, heart rate monitoring, and sleep tracking, hold the promise of enhancing personal well-being. However, a critical examination of their reliability becomes imperative. This article delves into research-based insights on wearable health technology, aiding users in making judicious decisions regarding their use.

Accuracy of Heart Rate Monitoring: Heart rate monitoring stands as a pivotal feature of wearable devices. Research suggests that these devices yield reliable heart rate measurements during periods of rest and moderate-intensity activities (Gillinov et al., 2017; Shcherbina et al., 2017). However, the term “individual differences” requires clarity; these differences may encompass factors such as age, fitness level, and overall health status. Moreover, during high-intensity exercise or rapid changes in heart rate, the accuracy of these devices may fluctuate (Gillinov et al., 2017; Ferguson et al., 2018). Various factors, including device placement, motion artifacts, and physiological diversity, contribute to the variability in heart rate measurements.

Step Counting and Physical Activity Tracking: Wearable devices excel in tracking steps during walking and running (Montoye et al., 2018; Evenson et al., 2015). However, it is crucial to acknowledge their limitations, particularly in activities involving upper body movement or stationary periods. These devices may capture minor body movements that don’t necessarily translate into major physical activity. Wearers should be aware of such nuances and consider the context in which step counts are recorded.

Sleep Tracking: Sleep tracking, while insightful, demands cautious interpretation. Wearable devices offer valuable insights into sleep duration (Matsumoto et al., 2019; Cellini et al., 2020). Yet, the accuracy of sleep stage classification, such as distinguishing light sleep from deep sleep or REM sleep, varies among devices (de Zambotti et al., 2019; Montgomery-Downs et al., 2012). Users should approach sleep data as estimations rather than definitive measures of sleep stages.

Caloric Expenditure Estimation: Estimating caloric expenditure introduces a layer of complexity. Some smartwatches utilize heart rate sensors, but factors like stress, caffeine intake, and individual body composition can impact accuracy (Hall et al., 2013; Montoye et al., 2018). Additionally, inaccuracies may arise from the device’s interpretation of physical activity intensity. Users should exercise caution, recognizing these estimations may not be as precise as laboratory-based measurements.

Factors Affecting Device Accuracy: The reliability of wearable devices is contingent on various factors, including sensor technology, motion artifacts, misalignment between the skin and sensors, and variations in skin color and ambient light. Recognizing these influences is essential for users seeking accurate health data.

Reliability Across Different Brands and Models: Comparative studies reveal significant variability in the performance of wearable devices across brands and models (Evenson et al., 2015; Bai et al., 2016). Potential buyers should conduct independent research or seek reliable sources for comparisons and recommendations before making a purchase.

Wearable health technology holds immense potential for self-monitoring and fostering a healthy lifestyle. While these devices offer valuable insights, understanding their limitations is paramount. Reliability varies across features, activities, and individuals. Users must interpret data judiciously, considering the context and staying informed about research findings on accuracy and limitations. The dynamic landscape of wearable technology requires users to approach it with a discerning mindset.

REFERENCES

  • Bai, Y., et al. (2016). Comparing usability and accuracy of wearable devices for calorie expenditure estimation. Journal of Medical Internet Research, 18(9), e253. doi:10.2196/jmir.5669
  • Cellini, N., et al. (2020). Wearable technology for measuring sleep: A systematic review. Sleep Medicine Reviews, 55, 101–116. doi:10.1016/j.smrv.2020.101419
  • de Zambotti, M., et al. (2019). Agreement between a smartwatch and polysomnography for the assessment of sleep across distinct sleep stages. Sleep, 42(2), zsy203. doi:10.1093/sleep/zsy203
  • Evenson, K. R., et al. (2015). Systematic review of the validity and reliability of consumer-wearable activity trackers. International Journal of Behavioral Nutrition and Physical Activity, 12, 159. doi:10.1186/s12966-015-0314-1
  • Ferguson, T., et al. (2018). Validation of consumer-based hip and wrist activity monitors in older adults with varied ambulatory abilities. Journal of Geriatric Physical Therapy, 41(1), 42–50. doi:10.1519/JPT.0000000000000103
  • Gillinov, S., et al. (2017). Variable accuracy of wearable heart rate monitors during aerobic exercise. Medicine & Science in Sports & Exercise, 49(8), 1697–1703. doi:10.1249/MSS.0000000000001284
  • Hall, K. D., et al. (2013). Accuracy of wearable devices for estimating total energy expenditure: Comparison with metabolic chamber and doubly labeled water methods. Journal of the American Medical Association Internal Medicine, 173(8), 672–674. doi:10.1001/jamainternmed.2013.2296
  • Kooiman, T. J. M., et al. (2015). Reliability and validity of ten consumer activity trackers. BMC Sports Science, Medicine and Rehabilitation, 7(1), 24. doi:10.1186/s13102-015-0018-5
  • Matsumoto, M., et al. (2019). Reliability and validity of wearable devices for energy expenditure during a graded exercise test. Journal of Clinical Medicine Research, 11(9), 627–635. doi:10.14740/jocmr3936
  • Montgomery-Downs, H. E., et al. (2012). Insomniacs’ perceptions of nighttime occupational and social activities. Journal of Clinical Sleep Medicine, 8(4), 431–439. doi:10.5664/jcsm.2136
  • Shcherbina, A., et al. (2017). Accuracy in wrist-worn, sensor-based measurements of heart rate and energy expenditure in a diverse cohort. Journal of Personalized Medicine, 7(2), 3. doi:10.3390/jpm7020003

Vaccinations and immunizations for children

Jan 20, 2024 | Children's Health

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Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Vaccinations and immunizations play a crucial role in safeguarding the health of children by protecting them against various infectious diseases. This article explores common vaccinations recommended for children, their benefits, potential side effects, and interactions with other drugs based on recent research findings. Understanding the importance of vaccines and their potential risks is essential for making informed decisions about children’s healthcare.

Measles, Mumps, and Rubella (MMR) Vaccine: The MMR vaccine is typically administered in two doses, the first around 12 to 15 months of age and the second between 4 to 6 years. It provides protection against measles, mumps, and rubella. Research has shown that the MMR vaccine is highly effective in preventing these diseases and their associated complications (1). The most common side effects are mild and include fever and rash. It is essential to note that the MMR vaccine is not associated with an increased risk of autism (2).

Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine: The DTaP vaccine is usually given in a series of five doses, with the first three doses administered at 2, 4, and 6 months of age, followed by boosters at 15 to 18 months and 4 to 6 years. This vaccine protects against diphtheria, tetanus, and pertussis (whooping cough). Research has demonstrated the effectiveness of the DTaP vaccine in preventing these diseases (3). Common side effects include redness, swelling, or tenderness at the injection site, as well as fever and fussiness.

Polio Vaccine: The polio vaccine is typically administered in a series of four doses, with the first three doses given at 2, 4, and 6 to 18 months of age, followed by a booster dose between 4 and 6 years. The vaccine protects against polio, a highly contagious viral infection. Research has shown that the polio vaccine has effectively reduced the global incidence of polio (4). Side effects are generally mild and include soreness or redness at the injection site.

Haemophilus influenzae type b (Hib) Vaccine: The Hib vaccine is administered in a series of three or four doses, with the first dose given at 2 months of age, followed by subsequent doses at 4 and 6 months. An additional dose may be given at 12 to 15 months, depending on the vaccine brand used. The Hib vaccine protects against Haemophilus influenzae type b, which can cause serious infections, including meningitis and pneumonia. Research has demonstrated the effectiveness of the Hib vaccine in preventing these diseases (5). Side effects are generally mild, with redness, swelling, or tenderness at the injection site being the most common.

Hepatitis B Vaccine: The hepatitis B vaccine is typically administered in a series of three doses, with the first dose given at birth, followed by subsequent doses at 1 to 2 months and 6 to 18 months of age. The vaccine protects against hepatitis B, a viral infection that can cause liver damage. Research has shown the effectiveness of the hepatitis B vaccine in preventing hepatitis B infection (6). Side effects are generally mild and include soreness or redness at the injection site.

Conclusion: Vaccinations and immunizations are vital for protecting children from preventable infectious diseases. The MMR, DT aP, polio, Hib, and hepatitis B vaccines are recommended for children at specific ages to provide protection against measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B. Research has consistently shown the effectiveness of these vaccines in preventing the associated diseases and their complications. While mild side effects such as fever, redness, or tenderness at the injection site may occur, the benefits of vaccination outweigh the risks. It is important to consult healthcare professionals for personalized advice and to address any concerns regarding potential interactions with other medications.

REFERENCES

  • MMR Vaccines: WHO position paper, April 2017. Weekly Epidemiological Record, 92(16), 205-228.
  • Madsen, K. M., Hviid, A., Vestergaard, M., Schendel, D., Wohlfahrt, J., Thorsen, P., … & Melbye, M. (2002). A population-based study of measles, mumps, and rubella vaccination and autism. New England Journal of Medicine, 347(19), 1477- 1482.
  • Kowalzik, F., Barbosa, A. P., Fernandes, V. R. F., & Battersby, A. (2020). A cell- mediated immunity pilot study of the fifth consecutive acellular pertussis booster vaccination in 4 to 6-year-old children: effects of a reduced antigenic load on the vaccine response. BMC Pediatrics, 20(1), 1-9.
  • Immunization coverage. World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
  • de Oliveira, L. H., Camacho, L. A., Coutinho, E. S., Martinez-Silveira, M. S., Carvalho, A. F., Ruiz-Matus, C., … & Andrus, J. K. (2015). Impact and effectiveness of Haemophilus influenzae type b conjugate vaccination in children and adults. Revista Panamericana de Salud Pública, 37(3), 147-154.
  • Zanetti, A. R., Van Damme, P., Shouval, D., Van Herck, K., Van Der Meeren, O., Esteban, R., … & Hezode, C. (2008). The global impact of vaccination against hepatitis B: A historical overview. Vaccine, 26(49), 6266-6273.

Environmental health and disease prevention

Jan 14, 2024 | Disease Prevention and Management

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Environmental health refers to the study of how environmental factors can impact human health. These environmental factors can include air and water pollution, exposure to toxins, and even climate change. Environmental health is a crucial aspect of disease prevention and management, as it can help us identify and reduce risks that may be contributing to the development of diseases.

Air pollution is a significant environmental health concern. It is linked to various respiratory and cardiovascular conditions, including asthma, chronic obstructive pulmonary disease (COPD), and heart disease. In addition to outdoor air pollution, indoor air pollution can also be a concern, especially in homes with poor ventilation or where harmful chemicals are present.

Water safety is another crucial aspect of environmental health. Contaminated water can lead to the spread of infectious diseases, including cholera, typhoid, and hepatitis A. Proper sanitation and access to clean drinking water are essential for preventing these diseases.

In recent years, the impact of climate change on human health has become increasingly clear. Rising temperatures, extreme weather events, and changing disease patterns are all linked to climate change. Climate change can also contribute to the spread of diseases carried by insects, such as mosquitoes, ticks, and fleas.

To prevent and manage diseases related to environmental factors, it is essential to address the root causes of these issues. This can include reducing emissions that contribute to air pollution, improving water treatment and sanitation infrastructure, and taking steps to mitigate the effects of climate change.

Nepal faces various environmental health challenges that can lead to an increased risk of disease. For example, air pollution is a major concern in Nepal, particularly in cities such as Kathmandu. According to a study published in the International Journal of Environmental Research and Public Health 2, air pollution levels in Kathmandu exceed the World Health Organization’s recommended limits, with particulate matter being a major pollutant. This can lead to respiratory problems and other health issues.

Additionally, water safety is another concern in Nepal. According to a study published in the Journal of Water and Health 1, water quality in Nepal can be compromised due to factors such as poor sanitation and inadequate water treatment facilities. This can lead to the spread of waterborne illnesses such as cholera and diarrhea.

Finally, noise pollution is also a concern in Nepal, particularly in urban areas. According to a study published in the Journal of Environmental and Public Health 3, exposure to high levels of noise pollution can lead to various health issues, including cardiovascular disease and mental health problems.

Overall, addressing environmental health challenges such as air pollution, water safety, and noise pollution is crucial for disease prevention and management in Nepal. This requires a combination of individual actions, such as reducing car use and properly disposing of waste, as well as larger-scale efforts, such as improving infrastructure and implementing effective policies.

REFERENCES

Strategies for reducing the risk of infectious diseases

Jan 13, 2024 | Disease Prevention and Management

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Infectious diseases are caused by pathogenic microorganisms such as bacteria, viruses, fungi, and parasites, and can spread from one person to another through different modes of transmission. Some infectious diseases can be prevented by taking certain precautions. Here are some strategies that can help reduce the risk of infectious diseases:

1. Handwashing: Regular and proper handwashing is one of the most effective ways to prevent the spread of infectious diseases. Hands should be washed thoroughly with soap and water for at least 20 seconds, especially after using the toilet, before eating, and after being in public places.

2. Safe food handling: Foodborne illnesses can be caused by eating contaminated food. Therefore, it is important to handle and cook food safely to prevent the spread of infectious diseases. This includes washing hands before handling food, cooking food thoroughly, storing food properly, and avoiding cross-contamination between raw and cooked foods.

3. Vaccination: Vaccines can help prevent many infectious diseases. Immunization programs have helped reduce the incidence of diseases such as measles, mumps, rubella, polio, and hepatitis B.

4. Safe sex: Sexually transmitted infections (STIs) can be prevented by practicing safe sex, which includes using condoms, getting tested for STIs, and limiting the number of sexual partners.

5. Covering the mouth and nose: When coughing or sneezing, it is important to cover the mouth and nose with a tissue or the inside of the elbow to prevent the spread of respiratory infections.

6. Avoiding close contact: Some infectious diseases can be spread through close contact with infected people. Therefore, it is important to avoid close contact with people who are sick and to stay home when feeling ill to avoid spreading the disease to others.

7. By following these strategies, individuals can reduce their risk of contracting and spreading infectious diseases.

Vaccinations

Dec 30, 2023 | Disease Prevention and Management

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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Vaccination are critical tools for preventing and managing various diseases. Vaccines work by introducing a weakened or inactive form of a virus or bacteria into the body, which triggers an immune response. This immune response allows the body to recognize and fight the virus or bacteria in the future, which can prevent illness or reduce its severity.

In Nepal, vaccination efforts have been crucial in preventing the spread of communicable diseases. The government of Nepal, along with various international organizations, has implemented several vaccination programs to protect the population from diseases such as measles, rubella, polio, and hepatitis B. These programs have been particularly successful in reducing the incidence of communicable diseases among children.

For example, the measles vaccine has been a significant contributor to the reduction in measles cases in Nepal. In 2018, Nepal launched a nationwide measles-rubella vaccination campaign, aiming to reach over 12 million children aged 9 months to 15 years. The campaign targeted hard-to-reach areas and populations with low coverage, resulting in a significant increase in measles vaccination coverage. As a result of these efforts, the number of measles cases in Nepal decreased from over 2,400 in 2016 to just 118 in 2019.

In addition to preventing the spread of diseases, vaccination also play a crucial role in managing chronic illnesses. For example, individuals with chronic illnesses such as diabetes, heart disease, and asthma are at increased risk of developing complications from infectious diseases. By getting vaccinated, individuals with chronic illnesses can reduce their risk of developing serious complications or hospitalization from vaccine-preventable diseases.

Overall, vaccination are critical components of disease prevention and management efforts. These programs not only protect individuals from infectious diseases but also contribute to the overall health of the population. It is important to continue to prioritize and invest in vaccination and immunization programs to ensure that everyone has access to these lifesaving interventions.
Here is a list of vaccines that are typically given to a child since birth:

1. Hepatitis B: Given within the first 12 hours of birth

2. DTaP (diphtheria, tetanus, and pertussis): Given at 2, 4, and 6 months of age
3. Hib (haemophilus influenzae type b): Given at 2, 4, and 6 months of age
4. IPV (polio): Given at 2, 4, and 6 months of age
5. PCV13 (pneumococcal conjugate vaccine): Given at 2, 4, and 6 months of age
6. Rotavirus: Given at 2 and 4 months of age
7. Hepatitis A: Given at 12 months of age
8. MMR (measles, mumps, and rubella): Given at 12 months of age
9. Varicella (chickenpox): Given at 12 months of age
10. DTaP booster: Given at 15-18 months of age
11. Hib booster: Given at 12-15 months of age
12. IPV booster: Given at 4-6 years of age
13. MMRV (measles, mumps, rubella, and varicella): Given at 4-6 years of age
14. DTaP booster: Given at 11-12 years of age

HPV (human papillomavirus): Given at 11-12 years of age (can be given as early as 9 years old)
Here are some other commonly used vaccines for adults and children:
1. HPV vaccine: protects against the human papillomavirus, which can cause several types of cancer.
2. Meningococcal vaccine: protects against meningococcal disease, a serious bacterial infection that can cause meningitis and blood infections.
3. Pneumococcal vaccine: protects against pneumococcal disease, which can cause pneumonia, meningitis, and blood infections.
4. Hepatitis A vaccine: protects against hepatitis A, a viral infection that can cause liver inflammation.
5. Hepatitis B vaccine: protects against hepatitis B, a viral infection that can cause liver inflammation and potentially lead to long-term liver problems.
6. Varicella (chickenpox) vaccine: protects against chickenpox, a highly contagious viral infection that causes a blister-like rash, itching, and fever.
7. Rotavirus vaccine: protects against rotavirus, a common cause of severe diarrhea and dehydration in infants and young children.

Vaccine myths:
There are many myths and misconceptions about vaccines that can cause confusion and lead to vaccine hesitancy. Some common vaccine myths include:

Vaccines cause autism: This myth has been thoroughly debunked by multiple studies, yet it still persists in some communities.
Vaccines are not necessary because the diseases they prevent are rare: While it is true that some vaccine-preventable diseases are now less common in certain parts of the world, this is largely due to the widespread use of vaccines. If vaccination rates were to drop, these diseases could quickly make a comeback.
Vaccines can cause serious side effects: While all vaccines can cause some side effects, serious reactions are extremely rare. The benefits of vaccination far outweigh the risks.
Natural immunity is better than vaccine-induced immunity: While natural immunity can be effective, it comes at a cost. Many vaccine-preventable diseases can cause serious complications, including death. Vaccines provide a safe and effective way to build immunity without the risk of serious illness or death.
Vaccines contain harmful ingredients: Some people are concerned about the ingredients in vaccines, such as thimerosal (a preservative) or aluminum. However, these ingredients are used in such small amounts that they are not harmful.

Supporting loved ones with mental health challenges

Dec 11, 2023 | Mental health and well being

The Health Thread Favicon

Written By THT Editorial Team

Dr. Kamal Gautam

Reviewed by Dr. Kamal Gautam, MBBS(KU), MD Psych (IOM), Currently working at Transcultural Psychological Organization Nepal (TPO Nepal)

Supporting loved ones with mental health challenges is an important aspect of mental health and well-being. Recent research has shown that social support can have a significant impact on the mental health of individuals with mental illnesses. A study published in the Journal of Consulting and Clinical Psychology found that providing social support to individuals with mental illnesses can lead to a reduction in symptoms and an overall improvement in their quality of life (Suetani et al., 2021).

Some ways to support loved ones with mental health challenges include:

A. Educate yourself about their condition: Learning about the symptoms and treatment options for your loved one’s mental illness can help you understand their experience and provide more effective support.

B. Be a good listener: Sometimes all your loved one may need is someone to listen to them without judgment or criticism. Try to offer an open ear and show empathy.

C. Encourage treatment: Encouraging your loved one to seek professional treatment can be a difficult conversation, but it is important to express your concern for their well-being and offer support in finding appropriate resources.

D. Offer practical help: Tasks that may seem simple, such as preparing meals or running errands, can be challenging for individuals with mental health issues. Offering practical assistance can be a great way to show support.

E. Avoid stigma and judgment: Mental health stigma and judgment can prevent individuals from seeking treatment and support. Be mindful of your language and avoid using derogatory terms or perpetuating negative stereotypes.

Supporting loved ones with mental health challenges can be a challenging and emotional journey. It is important to remember that you do not have to go through it alone. Seeking out support from a mental health professional, support group, or trusted friend or family member can also be helpful.

REFERENCES

  • Suetani, S., Kisely, S., & Siskind, D. J. (2021). The effectiveness of social support interventions for people with severe mental illness: A systematic review and meta-analysis of randomised controlled trials. Journal of Consulting and Clinical Psychology, 89(4), 303-317. doi: 10.1037/ccp0000651

Health disparities in rural communities

Dec 5, 2023 | Health disparities and equity

Health disparities in rural communities continue to be a significant public health challenge. These disparities are characterized by differences in health outcomes, access to healthcare services, and health-related behaviors between rural and urban populations. Recent research has shed light on the factors contributing to these disparities and highlighted potential strategies to promote health equity in rural areas. This article aims to summarize key findings from recent studies on health disparities in rural communities and explore potential interventions to address these challenges.

Limited Access to Healthcare Services: Access to healthcare services is a critical factor affecting health outcomes in rural communities. Research has consistently shown that rural areas face challenges such as shortages of healthcare providers, limited healthcare facilities, and long travel distances to access care (Ricketts et al., 2020). These barriers contribute to delays in seeking care, inadequate preventive services, and poorer health outcomes in rural populations. Efforts to improve healthcare access in rural areas include telehealth services, mobile clinics, and recruitment and retention strategies for healthcare providers (Henning-Smith et al., 2020; Rosenblatt et al., 2021).

Social Determinants of Health: Social determinants of health play a crucial role in shaping health disparities in rural communities. Factors such as poverty, limited educational opportunities, unemployment, and inadequate housing contribute to poorer health outcomes (Hartley et al., 2019). Recent research has highlighted the need for comprehensive approaches that address the underlying social determinants to reduce health disparities in rural areas. Examples include community development initiatives, economic empowerment programs, and educational interventions (Gale et al., 2020; Bennett et al., 2021).

Behavioral Health and Substance Abuse:

Rural communities face unique challenges related to behavioral health and substance abuse. Research indicates higher rates of mental health disorders, substance use disorders, and suicide in rural populations compared to urban areas (Hansen et al., 2020). Limited access to mental health services and stigma surrounding mental health contribute to these disparities. Recent studies have emphasized the importance of integrated care models, telepsychiatry, and community-based interventions to address behavioral health needs in rural communities (Wheeler et al., 2021; Molfenter et al., 2022).

Health Disparities Among Specific Populations:

Certain population subgroups within rural communities experience greater health disparities. For instance, research has identified disparities among racial and ethnic minorities, older adults, children, and individuals with disabilities in rural areas (Arcury et al., 2017; O’Connor et al., 2020). Culturally appropriate interventions, targeted outreach programs, and policy changes that address the specific needs of these populations are vital to reducing health disparities in rural communities.

Technology and Innovation:

Advancements in technology and innovation offer promising opportunities to address health disparities in rural areas. Telehealth services, mobile health applications, and remote patient monitoring have the potential to improve access to healthcare, enhance disease management, and empower individuals in rural communities (Thomas et al., 2021). However, efforts are needed to ensure equitable access to these technologies and overcome infrastructure challenges in rural areas.

Conclusion:

Recent research highlights the complex nature of health disparities in rural communities and the need for multifaceted strategies to address them. Enhancing healthcare access, addressing social determinants of health, prioritizing behavioral health services, targeting specific population subgroups, and leveraging technology are all important components of a comprehensive approach. By implementing evidence-based interventions and fostering collaborations between healthcare providers, policymakers, and community stakeholders, we can work towards achieving health equity and improving the well-being of rural populations.

REFERENCES

  • Arcury, T. A., Preisser, J. S., Gesler, W. M., & Powers, J. M. (2017). Access to transportation and health care utilization in a rural region. The Journal of Rural Health, 33(4), 383-391.
  • Bennett, K. J., Probst, J. C., & Pumkam, C. (2021). Social determinants of health: Rural-urban differences in social determinants across states. Journal of Rural Health, 37(2), 140-152.
  • Gale, J. A., Coburn, A. F., Croll, Z. T., & Brawer, R. L. (2020). Social determinants of health in rural communities: A review of health behaviors and behavioral determinants. Health Services Research, 55(Suppl 2), 831-843.
  • Hansen, A. Y., Umstattd Meyer, M. R., Lenardson, J. D., & Hartley, D. (2020). Built environments and active living in rural and remote areas: A review of the literature. Current Obesity Reports, 9(4), 367-380.
  • Henning-Smith, C., Kozhimannil, K. B., & Syverson, C. (2020). Rural disparities in preventive care provision to publicly insured Minnesotans. Journal of Rural Health, 36(2), 176-186.
  • Hartley, D., Quam, L., & Lurie, N. (2019). Urban and rural differences in health insurance and access to care among US adults. Journal of Rural Health, 35(4), 457457.
  • Molfenter, T., Brown, R., O’Neill, A., Kopetsky, E., Toy, A., & Cornett, A. (2022). Telehealth implementation in substance use disorder treatment: Perspectives from the field. Telemedicine and e-Health, 28(1), 48-54.
  • O’Connor, A., Wellenius, G., Gilmore, J., & Hamdan, M. (2020). Rural-urban disparities in heat-related mortality: Results from a study of New England Medicare enrollees. American Journal of Public Health, 110(6), 889-895. Ricketts, T. C., Johnson-Webb, K. D., Randolph, R. K., Taylor, P., &
  • Ricketts, T. C. (2020). Rural health in the United States. Oxford Research Encyclopedia of Global Public Health.
  • Rosenblatt, R. A., Andrilla, C. H. A., & Curtin, T. (2021). Evidence of progress toward resolving rural-urban physician disparities. The Journal of Rural Health, 37(1), 5-8.
  • Thomas, S., Jenkins, C., & Montague, J. (2021). The role of technology in addressing health disparities: A narrative review. Journal of Medical Internet Research, 23(3), e23484.
  • Wheeler, S. N., Pollard, S. E., Behringer, B., & Haynes, T. F. (2021). Utilizing telehealth to promote mental and behavioral health in rural areas: A systematic review. International Journal of Environmental Research and Public Health, 18(4), 1841.

 Title: Health Disparities in Rural Communities: A Closer Look at Nepal’s Rural Setting

Introduction: Health disparities refer to differences in health outcomes and access to healthcare services between different populations or geographic regions. While health disparities exist in various settings, rural communities often face unique challenges due to their remote locations, limited resources, and socioeconomic factors. This article aims to shed light on health disparities in rural communities, with a specific focus on Nepal’s rural setting. By examining recent research findings, we can better understand the factors contributing to health disparities and explore potential solutions to address them.

Limited Access to Healthcare Services: Rural communities in Nepal often experience limited access to healthcare services. Geographic barriers, including rugged terrain and poor transportation infrastructure, make it challenging for individuals to reach healthcare facilities (World Bank, 2020). Recent studies have shown that individuals in rural areas have higher rates of unmet healthcare needs, delayed healthcare seeking, and reduced access to essential health services (Gautam et al., 2019; Adhikari et al., 2020).

Shortage of Healthcare Providers: Nepal’s rural communities also face a shortage of healthcare providers, including doctors, nurses, and midwives. Research has indicated that healthcare workers are often concentrated in urban areas, leading to a scarcity of skilled professionals in rural regions (World Health Organization, 2018). This shortage affects the quality and availability of healthcare services, resulting in poorer health outcomes in rural populations (Thapa et al., 2021).

Socioeconomic Factors and Health Disparities: Socioeconomic factors play a significant role in health disparities within rural communities. Poverty, limited education, and unemployment rates are prevalent in rural Nepal, leading to adverse health outcomes. Recent research has demonstrated the link between lower socioeconomic status and higher rates of communicable diseases, malnutrition, and maternal and child health issues in rural areas (Paudel et al., 2020; Acharya et al., 2021).

Health Disparities among Ethnic Groups: Ethnic diversity in Nepal’s rural communities further contributes to health disparities. Studies have highlighted disparities in health outcomes and healthcare access among different ethnic groups. Factors such as cultural practices, language barriers, and discrimination can affect healthcare-seeking behavior and health outcomes (Ghimire et al., 2020; Shrestha et al., 2021). Recent research has emphasized the need for culturally sensitive healthcare services to address these disparities.

Impact of COVID-19 on Rural Health Disparities: The COVID-19 pandemic has exacerbated existing health disparities in Nepal’s rural communities. Limited access to healthcare facilities, information, and resources has hindered the pandemic response in rural areas. Recent studies have shown that rural populations face higher risks of COVID-19 transmission, delayed testing, and inadequate healthcare infrastructure (Dahal et al., 2020; Gautam et al., 2021).

Conclusion:

Health disparities in rural communities, such as those found in Nepal’s rural setting, are complex and multifaceted. Limited access to healthcare services, shortages of healthcare providers, socioeconomic factors, and ethnic disparities all contribute to these inequities. Addressing health disparities in rural areas requires comprehensive strategies, including improving healthcare infrastructure, increasing the healthcare workforce, addressing socioeconomic factors, and promoting culturally sensitive healthcare practices. By recognizing and acting upon these research findings, we can strive to reduce health disparities and promote equitable health outcomes in Nepal’s rural communities and beyond.

REFERENCES

  • Adhikari, S., Shrestha, N., Acharya, D., Bhattarai, A., Shrestha, N., & Acharya, D. (2020). Access to and utilization of health services in rural communities of Nepal: A cross-sectional study. BMC Health Services Research, 20(1), 1-10.
  • Acharya, D., Bhattarai, A., Adhikari, S., Shrestha, N., Shrestha, N., & Acharya, D. (2021). Socio-economic determinants of child malnutrition in rural communities of Nepal. BMC Pediatrics, 21(1), 1-10.
  • Dahal, R. K., Chauhan, P., Shakya, S., Baniya, A., Shakya, S., Rana, S., … & Dhimal, M. (2020). Perceived impact of COVID-19 among rural populations in Nepal: A cross-sectional survey. Frontiers in Public Health, 8, 1-10.
  • Gautam, S., Chhetri, R., Koirala, S., Paudel, R., Adhikari, R., Kadayat, T. M., … & Shrestha, N. (2019). Utilization of health care services by elderly population in rural Nepal: A cross-sectional study. Research Square. doi: 10.21203/rs.2.16454/v1
  • Gautam, S., Chhetri, R., Koirala, S., Paudel, R., Adhikari, R., Kadayat, T. M., … & Shrestha, N. (2021). Barriers and facilitators to COVID-19 testing in rural communities of Nepal: A qualitative study. BMC Public Health, 21(1), 1-11.
  • Ghimire, U., Paudel, G., Ghimire, S., Gurung, Y., & Baral, K. (2020). Factors associated with healthcare utilization among ethnic minority women in Nepal: A community-based cross-sectional study. PloS One, 15(11), e0241792.
  • Shrestha, N., Acharya, D., Bhattarai, A., Adhikari, S., Shrestha, N., & Acharya, D. (2021). Disparities in health service utilization among ethnic groups in rural communities of Nepal: A cross-sectional study. BMC Health Services Research, 21(1), 1-10.
  • Thapa, R., Bam, K., Tiwari, P., Yadav, D. K., Paudel, R., & Thapa, P. (2021). Health workforce in rural Nepal: Current scenario and future directions. Journal of Nepal Health Research Council, 19(1), 1-6.
  • World Bank. (2020). World Development Report 2020: Trading for Development in the Age of Global Value Chains. Retrieved from https://openknowledge.worldbank.org/handle/10986/32437
  • World Health Organization. (2018). Health workforce in Nepal: Snapshot. Retrieved from https://www.who.int/hrh/documents/nepal_workforce_snapshot/en/