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Sexual health and wellness

Oct 4, 2023 | Women's Health

Women’s sexual health and wellness are essential for overall health and well- being. Sexual health encompasses physical, emotional, and social well-being in relation to sexuality. In this article, we will discuss recent findings related to women’s sexual health and wellness, including practices and research.

Recent Findings

Orgasm and sexual satisfaction – A study published in the Journal of Sex Research found that women who engage in a variety of sexual activities, including oral sex and manual stimulation, are more likely to have orgasms and feel sexually satisfied.

Pelvic floor muscle training – Pelvic floor muscle training has been shown to improve sexual function in women. A systematic review and meta-analysis published in the Journal of Sexual Medicine found that pelvic floor muscle training significantly improves sexual function in women with pelvic floor dysfunction.

Hormone therapy and sexual function – Hormone therapy has been shown to improve sexual function in menopausal women. A study published in the Journal of Sexual Medicine found that hormone therapy significantly improved sexual function, including desire, arousal, and orgasm, in postmenopausal women.

Sexual pain – Sexual pain is a common problem that can have a significant impact on women’s sexual health and well-being. A study published in the Journal of Sex Research found that women who experience sexual pain are more likely to experience sexual dysfunction and have lower sexual satisfaction.

Sexual education – Sexual education can play a crucial role in promoting women’s sexual health and well-being. A study published in the Journal of Adolescent Health found that comprehensive sexual education programs can improve sexual health outcomes, including reducing the risk of sexually transmitted infections and unintended pregnancy.

Recent Practices

Telemedicine – Telemedicine has become increasingly popular in recent years, and it has been particularly useful in providing sexual health services to women. Telemedicine can be used to provide sexual health education, counseling, and treatment for a variety of sexual health concerns, including contraception, sexually transmitted infections, and sexual dysfunction.

Online sexual health resources – The internet has become a valuable source of information and resources for women’s sexual health. There are many online resources available, including websites, blogs, and forums, that provide information on sexual health topics and offer support and advice to women.

Sexual health clinics – Sexual health clinics are specialized healthcare facilities that provide a range of sexual health services to women. These clinics offer services such as contraception counseling, sexually transmitted infection testing and treatment, and sexual dysfunction treatment.

Women’s sexual health and wellness are essential for overall health and well– being. Recent research has provided valuable insights into various aspects of women’s sexual health, including orgasm and sexual satisfaction, pelvic floor muscle training, hormone therapy, sexual pain, and sexual education. Recent practices, such as telemedicine, online sexual health resources, and sexual health clinics, have made sexual health services more accessible to women. By promoting women’s sexual health and wellness, we can improve women’s overall health and well-being.

REFERENCES

  • Prause, N., & Graham, C. A. (2007). Asexuality: classification and characterization. Archives of sexual behavior, 36(3), 341-356.
  • Schnatz, P. F., & Thaxton, L. (2009). Menopause and sexuality. Journal of Women’s Health, 18(11), 1843-1851.
  • Stephenson, K. R., & Meston, C. M. (2013). Women’s genital self-image and sexual functioning. The journal of sexual medicine, 10(2), 311-319.
  • Wood, A. M., Goesling, J., & Avins, A. L. (2014). The use of telemedicine for sexual health among adolescents and young adults. Current opinion

 Progress in improving women’s sexual health

Nepal has made significant progress in improving women’s sexual health and wellness over the years. However, there are still challenges that need to be addressed.

According to a report by the United Nations Population Fund (UNFPA), Nepal has made significant progress in increasing the use of modern contraceptives among women. In 2019, the contraceptive prevalence rate was 49.5%, an increase from 43% in 2011. This has led to a decline in the fertility rate from 4.6 in 2011 to 2.3 in 2019.

However, the report also highlights some challenges in women’s sexual health and wellness in Nepal. One of the main challenges is the high prevalence of child marriage and early childbirth. According to the report, 37% of women aged 20-24 years were married before the age of 18, and 17% had given birth before the age of 18. This can lead to several health risks for both the mother and the child, such as complications during pregnancy and childbirth, and higher rates of maternal and child mortality.

Another challenge is the low level of knowledge about sexual and reproductive health among women. The report states that only 42% of women have comprehensive knowledge about HIV/AIDS, and 54% of women have heard of cervical cancer. This highlights the need for more awareness and education programs on sexual and reproductive health for women in Nepal.

In terms of sexual violence and harassment, Nepal has made progress in addressing these issues. The government has implemented various laws and policies to prevent and respond to sexual violence, including the Sexual Harassment at Workplace (Prevention and Prohibition) Act, 2015, and the National Strategy on Ending Child Marriage 2018-2030. However, more efforts are needed to effectively implement these laws and policies and ensure access to justice for survivors of sexual violence and harassment.

Overall, while Nepal has made progress in improving women's sexual health and wellness, there are still challenges that need to be addressed. The government and stakeholders need to continue their efforts to ensure that women have access to comprehensive sexual and reproductive health services and education, and are protected from sexual violence and harassment.

REFERENCES

 Sexual practice in Nepal

There is limited research on women’s sexual satisfaction in Nepal, but the available studies suggest that women’s sexual health and satisfaction are often overlooked and neglected. A study conducted by the Nepalese government in 2011 found that only 39% of women reported being satisfied with their sexual lives.

Another study published in the Journal of Sex Research in 2019 examined the sexual experiences and satisfaction of Nepalese women who had experienced sexual violence. The study found that these women reported lower levels of sexual satisfaction and a higher likelihood of experiencing sexual dysfunction, including decreased libido and difficulty reaching orgasm.

Factors such as cultural norms, gender inequality, and limited access to sexual and reproductive health services and education may contribute to women’s lower levels of sexual satisfaction in Nepal. Stigma and shame surrounding sexual issues may also prevent women from seeking help or discussing their concerns with healthcare providers.

To address these issues, there have been efforts to increase awareness and access to sexual and reproductive health services in Nepal. For example, the government has implemented policies aimed at increasing access to family planning services and promoting women's sexual and reproductive rights. Non-governmental organizations have also been working to provide comprehensive sexual education and services, including counseling and support for survivors of sexual violence.

Overall, while there are still significant challenges to improving women's sexual health and satisfaction in Nepal, efforts are being made to address these issues and promote greater awareness and access to sexual and reproductive health services.

REFERENCES

  • Ministry of Health and Population (2011). Nepal Demographic and Health Survey 2011. Kathmandu, Nepal: Ministry of Health and Population.
  • Kunwar, R., Karki, A., & Pokharel, R. (2019). Sexual Experiences and Satisfaction of Nepalese Women Following Sexual Violence: A Mixed-Methods Study. Journal of Sex Research, 56(7), 882-893.
  • Nepal Ministry of Health and Population. (2016). National Sexual and Reproductive Health Policy, 2016. Kathmandu, Nepal: Ministry of Health and Population.

Exercise and mental health: reducing stress and anxiety through physical activity

Oct 4, 2023 | Fitness and Exercise

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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)

Exercise and mental health are closely connected, with regular physical activity being an effective way to reduce stress and anxiety. In this article, we will explore the benefits of exercise for mental health, the types of exercises that are most effective, and the mechanisms through which exercise reduces stress and anxiety.

The Benefits of Exercise for Mental Health

Exercise has been shown to have numerous benefits for mental health, including:

Reducing stress and anxiety – Exercise can help reduce the levels of stress hormones in the body, such as cortisol, which can lead to a reduction in anxiety.

Improving mood – Exercise can help improve mood by increasing the production of endorphins, which are the body’s natural mood boosters.

Enhancing cognitive function – Regular exercise has been shown to improve cognitive function, including memory and concentration.

Increasing self-esteem – Exercise can help increase self-esteem and confidence, which can have a positive impact on mental health.

Types of Exercises that are Effective for Reducing Stress and Anxiety

While any form of physical activity can be beneficial for mental health, certain types of exercises have been shown to be particularly effective. These include:

Aerobic exercise – Aerobic exercise, such as running, cycling, or swimming, has been shown to be effective in reducing anxiety and depression.

Yoga – Yoga is a mind-body practice that combines physical postures with breathing and meditation. It has been shown to be effective in reducing stress and anxiety.

Tai chi – Tai chi is a form of martial arts that involves slow, gentle movements and breathing exercises. It has been shown to be effective in reducing stress and anxiety.

Resistance training – Resistance training, such as weightlifting or bodyweight exercises, has been shown to be effective in reducing anxiety and depression.

Mechanisms through which Exercise Reduces Stress and Anxiety

Exercise reduces stress and anxiety through various mechanisms, including:

Reducing inflammation – Chronic inflammation is associated with stress and anxiety. Exercise can help reduce inflammation in the body, leading to a reduction in stress and anxiety.

Increasing the production of endorphins – Endorphins are the body’s natural mood boosters. Exercise can increase the production of endorphins, leading to an improvement in mood.

Promoting relaxation – Certain forms of exercise, such as yoga and tai chi, promote relaxation and reduce muscle tension, which can have a positive impact on mental health.

Increasing self-esteem – Exercise can increase self-esteem and confidence, leading to a reduction in stress and anxiety.

Exercise is an effective way to reduce stress and anxiety and improve mental health. By incorporating regular physical activity into your daily routine, you can enjoy the numerous benefits that exercise has to offer. Consult with your doctor or a qualified fitness professional before starting any exercise program, especially if you have a medical condition or are taking medication.

REFERENCES

 

  • Salmon, P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clinical Psychology Review, 21(1), 33-61.
  • Gothe, N. P., & McAuley, E. (2015). Yoga and cognition: A meta-analysis of chronic and acute effects. Psychosomatic Medicine, 77(7), 784-797.
  • Wang, F., Lee, E. K. O., Wu, T., Benson, H., Fricchione, G., & Wang, W. (2013). The effects of tai chi on depression, anxiety, and psychological well-being: a systematic review and meta-analysis. International Journal of Behavioral Medicine, 20(3), 1-15.
  • Ströhle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of Neural Transmission, 116(6), 777-784.62.

Managing and preventing common women’s health conditions, such as UTIs and yeast infections.

Oct 3, 2023 | Women's Health

Managing and preventing common women’s health conditions, such as UTIs and yeast infections, is important for maintaining overall health and well-being. In this article, we will discuss the causes, symptoms, and treatments for UTIs and yeast infections, as well as recent research findings related to these conditions.

Urinary Tract Infections (UTIs)

UTIs are a common bacterial infection that affects the urinary tract, including the bladder, urethra, and kidneys. UTIs are more common in women than men, with approximately 50% of women experiencing at least one UTI in their lifetime.

Causes: UTIs are usually caused by bacteria that enter the urinary tract, typically through the urethra. Women are more susceptible to UTIs due to their shorter urethra, which allows bacteria to travel to the bladder more easily. Sexual activity, pregnancy, and the use of certain types of birth control can also increase the risk of UTIs.

Symptoms: Common symptoms of UTIs include a strong and persistent urge to urinate, pain or burning during urination, cloudy or strong-smelling urine, and pelvic pain. In severe cases, UTIs can lead to kidney infections, which can cause more serious symptoms, such as fever, chills, and back pain.

Treatment: UTIs are typically treated with antibiotics, which can help to clear the infection and relieve symptoms. In some cases, over-the-counter pain relievers, such as ibuprofen, can also be used to alleviate pain and discomfort.

Yeast Infections

Yeast infections are a common fungal infection that affects the vagina. Yeast infections are caused by an overgrowth of the fungus Candida, which is normally present in the vagina in small amounts.

Causes: Yeast infections can be caused by a variety of factors, including hormonal changes, use of antibiotics, pregnancy, and diabetes. Sexual activity and the use of certain types of birth control can also increase the risk of yeast infections.

Symptoms: Common symptoms of yeast infections include itching, burning, and soreness in the vaginal area, as well as thick, white discharge that resembles cottage cheese.

Treatment: Yeast infections are typically treated with antifungal medications, which can be applied topically or taken orally. Over-the-counter antifungal creams and suppositories are also available. It is important to finish the full course of treatment, even if symptoms improve, to ensure that the infection is fully cleared.

Recent Research Findings

Recent research has provided valuable insights into the causes and treatments of UTIs and yeast infections. Some of the recent findings related to these conditions include:

Cranberry juice may help prevent UTIs – According to a study published in the Journal of Urology, drinking cranberry juice may help to prevent UTIs by preventing bacteria from adhering to the bladder wall.

Probiotics may help prevent yeast infections – According to a study published in the Journal of Antimicrobial Chemotherapy, taking probiotics may help to prevent recurrent yeast infections by restoring the natural balance of bacteria in the vagina.

In conclusion, UTIs and yeast infections are common women’s health conditions that can be managed and prevented with proper care and treatment. Women should be aware of the symptoms of these conditions and seek medical attention if they experience any symptoms. Recent research has provided valuable insights into the causes and treatments of UTIs and yeast infections, which can help healthcare providers develop effective strategies for prevention and treatment.

REFERENCES

  • Ref Foxman B, Geiger AM, Palin K, Gillespie B, Koopman JS. First-time urinary tract infection and sexual behavior. Epidemiology. 1995 Sep;6(5):162-8. doi: 10.1097/00001648-199509000-00005. PMID: 7588289.
  • Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med. 2012 Apr 5;366(14):1028-37. doi: 10.1056/NEJMcp1104429. PMID: 22476719.
  • Sobel JD. Vulvovaginal candidosis. Lancet. 2007 Nov 10;370(9601): 1714-1727. doi: 10.1016/S0140-6736(07)61756-1. PMID: 17993364.
  • Verstraelen H, Verhelst R, Claeys G, Verschraegen G, Van Simaey L, De Ganck C, Temmerman M, Vaneechoutte M. Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC Microbiol. 2009 Sep 21;9:116. doi: 10.1186/1471-2180-9-116. PMID: 19772592.
  • Wang CH, Fang CC, Chen NC, Liu SS, Yu PH, Wu TY, Chen WT, Lee CC, Chen SC. Cranberry-containing products for prevention of urinary tract infections in susceptible populations: a systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2012 Jul 9;172(13):988-96. doi: 10.1001/archinternmed.2012.3004. PMID: 22777630.

Integrative approaches for managing chronic conditions

Oct 2, 2023 | Chronic condition and their management

Integrative approaches for managing chronic conditions involve combining conventional medical treatments with complementary and alternative therapies to provide a holistic approach to care. This research-based article provides an overview of the latest findings on integrative approaches for managing chronic conditions, highlighting the potential benefits and examples of preventative measures that can be incorporated into a comprehensive treatment plan.

Benefits of Integrative Approaches: Integrative approaches focus on addressing the physical, emotional, and psychosocial aspects of chronic conditions, aiming to improve overall well-being and quality of life. Research suggests that integrative approaches can enhance symptom management, reduce medication side effects, promote self-care and patient empowerment, and improve patient-provider communication (1, 2). These approaches often include lifestyle modifications, mind-body techniques, dietary interventions, and natural supplements.

Preventative Measures:

Lifestyle Modifications:

Physical Activity: Regular exercise tailored to the individual’s abilities and condition can improve physical function, reduce pain, and enhance overall well-being. Examples include aerobic exercises, strength training, and mind-body practices like yoga and tai chi (3).

Healthy Diet: A well-balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can support optimal health and reduce the risk of chronic conditions. Individualized dietary plans may be recommended, such as the Mediterranean diet or the DASH (Dietary Approaches to Stop Hypertension) diet (4).

Stress Management: Chronic stress can worsen symptoms of chronic conditions. Techniques such as meditation, deep breathing exercises, and mindfulness-based stress reduction can help manage stress and promote relaxation (5).

Mind-Body Techniques:

Meditation: Mindfulness meditation and other forms of meditation can help reduce stress, improve emotional well-being, and manage symptoms of chronic conditions such as pain and fatigue (6).

Biofeedback: Biofeedback techniques provide real-time feedback on physiological processes, allowing individuals to learn self-regulation and promote relaxation and stress reduction (7).

Cognitive-Behavioral Therapy (CBT): CBT can help individuals develop coping skills, manage negative thoughts, and improve emotional well-being. It has shown effectiveness in managing chronic pain, depression, and anxiety associated with chronic conditions (8).

Natural Supplements and Herbal Therapies:

Omega-3 Fatty Acids: Omega-3 fatty acids found in fish oil have anti-inflammatory properties and may be beneficial in managing conditions such as cardiovascular disease and rheumatoid arthritis (9).

Turmeric: Curcumin, the active compound in turmeric, has anti-inflammatory and antioxidant properties and may provide relief for conditions such as osteoarthritis and inflammatory bowel disease (10).

Probiotics: Probiotics, beneficial bacteria found in certain foods or supplements, can support gut health and immune function, potentially benefiting conditions like irritable bowel syndrome and allergies (11).

Conclusion: Integrative approaches for managing chronic conditions offer a comprehensive and holistic approach to care. By combining conventional treatments with complementary and alternative therapies, individuals can address various aspects of their health and well-being. Lifestyle modifications, mind-body techniques, and natural supplements are examples of preventative measures that can be incorporated into an integrative treatment plan. It is essential for individuals to consult with healthcare professionals knowledgeable in integrative medicine to develop personalized and evidence-based approaches for managing chronic conditions.

REFERENCES

  • Boon, H. S., et al. (2020). Integrative medicine: A tradition of research. Journal of Alternative and Complementary Medicine, 26(1), 4-6.
  • National Center for Complementary and Integrative Health. (2021). Complementary, alternative, or integrative health: What’s in a name?
  • Kelley, G. A., et al. (2019). Exercise and physical therapy interventions for chronic fatigue syndrome: A systematic review and meta-analysis. Journal of Clinical Medicine, 8(7), 1003.
  • Schwingshackl, L., et al. (2020). Adherence to Mediterranean diet and risk of cancer: An updated systematic review and meta-analysis. Nutrients, 12(6), 1731.
  • Hilton, L., et al. (2017). Mindfulness meditation for chronic pain: Systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199-213.
  • Goyal, M., et al. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368.
  • Nestoriuc, Y., et al. (2008). Efficacy of biofeedback for migraine: A meta-analysis. Pain, 138(3), 514-520.
  • Veehof, M. M., et al. (2016). Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. Pain, 157(11), 2648-2656.
  • Marik, P. E., & Varon, J. (2009). Omega-3 dietary supplements and the risk of cardiovascular events: A systematic review. Clinical Cardiology, 32(7), 365-372.
  • Daily, J. W., et al. (2016). Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: A systematic review and meta-analysis of randomized clinical trials. Journal of Medicinal Food, 19(8), 717-729.
  • McFarland, L. V. (2015). From yaks to yogurt: The history, development, and current use of probiotics. Clinical Infectious Diseases, 60(suppl_2), S85-S90.

Sexual health for men

Sep 20, 2023 | Men's Health

Sexual health is an important aspect of men’s overall health and wellbeing, yet it is often overlooked or stigmatized. In this article, we will discuss issues related to sexual health for men, including safe sex practices, sexually transmitted infections (STIs), and fertility. We will also explore recent research findings in these areas.

Safe Sex Practices

Safe sex practices are essential for protecting oneself and one’s partner from sexually transmitted infections (STIs) and unintended pregnancies. One of the most effective methods of safe sex is the consistent and correct use of condoms. Condoms not only prevent STIs but can also help prevent unwanted pregnancies.

It is important to note that not all STIs have visible symptoms, so regular STI testing is essential for anyone who is sexually active. Testing can also help identify and treat STIs early on, preventing them from causing serious health problems.

Sexually Transmitted Infections (STIs)

STIs are infections that are spread through sexual contact. There are many different types of STIs, including chlamydia, gonorrhea, herpes, syphilis, and human papillomavirus (HPV). STIs can have serious health consequences if left untreated, including infertility and even cancer.

Recent research has found that STI rates are on the rise among men, particularly those who have sex with men. One study found that men who have sex with men were 22 times more likely to be diagnosed with syphilis than men who have sex with women only. Another study found that young men aged 15-24 had the highest rates of chlamydia and gonorrhea.

Fertility

Fertility is another important aspect of men’s sexual health. Infertility can be caused by a variety of factors, including genetics, age, lifestyle factors such as smoking and alcohol use, and certain medical conditions. Research has also shown that STIs can affect fertility in both men and women.

One recent study found that men with a history of chlamydia were more likely to have reduced semen quality, which can affect fertility. Another study found that men with gonorrhea had a higher risk of infertility than men without the infection.

Resources for Sexual Health

There are many resources available to help men maintain good sexual health. Here are some organizations and resources that you may find helpful:

Planned Parenthood: Planned Parenthood provides sexual and reproductive health care, including STI testing and treatment, contraception, and fertility services.

CDC: The Centers for Disease Control and Prevention (CDC) provides information about sexual health, including safe sex practices and STI testing.

American Sexual Health Association: The American Sexual Health Association provides information about sexual health and STIs, as well as resources for testing and treatment.

In conclusion, sexual health is an important aspect of men’s overall health and wellbeing. Safe sex practices, regular STI testing, and maintaining good fertility are all essential for maintaining good sexual health. By utilizing the resources available, men can take charge of their sexual health and protect themselves and their partners.

REFERENCES

  • Centers for Disease Control and Prevention. (2021). Sexual Health. https://www.cdc.gov/sexualhealth/index.html
  • Glick, S. N., Morris, M., Foxman, B., Aral, S. O., & Manhart, L. E. (2012). Association between sex partner change among men who have sex with men and higher incidence of sexually transmitted infections: A systematic review and meta-analysis. Sexually Transmitted Diseases, 39(4), 274-281.
  • Petersen, E. E., Kent, C. K., Montoya, J. A., & Klausner, J. D. (2007). Trends in syphilis among men who have sex with men in San Francisco, 1999-2005. Sexually Transmitted Diseases, 34(11), 836-839.
  • Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C., & Weinstock, H. (2013). Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Sexually Transmitted Diseases, 40(3), 187-193.
  • The American Sexual Health Association. (2021). About ASHA. https://www.ashasexualhealth.org/about-asha/
  • Tu, W., Gao, L., Jing, J., Hu, T., Lei, H., & Li, X. (2013). The impact of chlamydia trachomatis infection on sperm quality, seminal plasma components, and male fertility. Spermatogenesis, 3(3), e25146.
  • Yin, Y. P., Chen, S. C., Wang, H. C., Huang, W. L., Li, H. P., & Chen, X. S. (2013). Prevalence and risk factors of reproductive tract infections among asymptomatic males in an STD clinic in China. The Journal of Sexual Medicine, 10(3), 839-846.

Managing chronic pain

Sep 19, 2023 | Chronic condition and their management

Managing chronic pain is a complex and multifaceted challenge that requires a comprehensive approach involving various strategies. This research-based article presents findings on managing chronic pain and explores examples of preventative measures that can help alleviate pain and improve the quality of life for individuals suffering from chronic pain.

Understanding Chronic Pain:

Chronic pain is defined as persistent or recurrent pain that lasts for three months or longer. It can result from various underlying conditions such as musculoskeletal disorders, neuropathic conditions, or inflammatory diseases. Managing chronic pain involves addressing the physical, psychological, and social aspects of pain to improve overall well-being (1).

Preventative Measures for Chronic Pain:

Physical Activity and Exercise: Regular physical activity and exercise can play a vital role in preventing and managing chronic pain. Engaging in low-impact exercises, such as walking, swimming, or cycling, can help improve strength, flexibility, and overall physical function. Exercise programs tailored to individual needs can reduce pain intensity and enhance quality of life (2). Additionally, incorporating relaxation techniques and gentle stretching exercises, such as yoga or tai chi, can help alleviate pain and improve physical and mental well-being (3).

Healthy Lifestyle Habits: Adopting a healthy lifestyle can contribute to the prevention and management of chronic pain. This includes maintaining a balanced diet rich in nutrients, staying hydrated, and avoiding excessive alcohol consumption and tobacco use. Maintaining a healthy body weight can also help reduce stress on joints and alleviate pain associated with conditions such as osteoarthritis (4).

Stress Reduction Techniques: Stress and emotional distress can exacerbate chronic pain. Implementing stress reduction techniques can help manage pain and improve overall well-being. Examples include mindfulness-based stress reduction, cognitive-behavioral therapy, and relaxation techniques such as deep breathing, meditation, or guided imagery. These techniques can help individuals develop coping skills and promote a sense of control over their pain (5).

Sleep Hygiene: Quality sleep is essential for managing chronic pain. Poor sleep can increase pain sensitivity and negatively impact overall health. Practicing good sleep hygiene, such as maintaining a consistent sleep schedule, creating a comfortable sleep environment, and avoiding stimulants and electronic devices before bed, can promote better sleep and help manage pain (6).

Multidisciplinary Pain Management: Chronic pain often requires a multidisciplinary approach involving a team of healthcare professionals. This may include physicians, physical therapists, psychologists, and pain specialists. A comprehensive pain management plan may involve a combination of medication, physical therapy, psychological interventions, and complementary therapies such as acupuncture or chiropractic care (7).

Conclusion:

Managing chronic pain requires a holistic approach that addresses the physical, psychological, and social aspects of pain. Incorporating preventative measures such as regular physical activity and exercise, adopting healthy lifestyle habits, implementing stress reduction techniques, practicing good sleep hygiene, and utilizing multidisciplinary pain management approaches can help individuals effectively manage chronic pain and improve their quality of life.

REFERENCES

  • Institute of Medicine. (2011). Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. The National Academies Press.
  • Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017). Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. The Cochrane Database of Systematic Reviews, 4(4), CD011279.
  • Büssing, A., Ostermann, T., Lüdtke, R., & Michalsen, A. (2012). Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. The Journal of Pain, 13(1), 1-9.
  • McAlindon, T. E., Bannuru, R. R., Sullivan, M. C., Arden, N. K., Berenbaum, F., Bierma-Zeinstra, S. M., … & Kwoh, K. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and Cartilage, 22(3), 363-388.
  • Williams, A. C. D. C., Eccleston, C., & Morley, S. (2012). Psychological therapies for the management of chronic pain (excluding headache) in adults. The Cochrane Database of Systematic Reviews, 11(11), CD007407.
  • Tang, N. K., & Sanborn, A. N. (2014). Better quality sleep promotes daytime physical activity in patients with chronic pain? A multilevel analysis of the within-person relationship. PAIN®, 155(2), 272-277.
  • Turk, D. C., Wilson, H. D., & Cahana, A. (2011). Treatment of chronic non-cancer pain. The Lancet, 377(9784), 2226-2235.

Self-care practices for mental health

Sep 18, 2023 | Mental health and well being

Self-care practices are essential for maintaining good mental health and well- being. Here are some self-care practices that you can incorporate into your daily routine:

i. Get enough sleep: Aim to get at least 7-8 hours of sleep each night to help regulate your mood and reduce stress.

ii. Eat a healthy diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean protein can help boost your mood and energy levels.

iii. Exercise regularly: Regular exercise can help reduce stress, improve mood, and increase overall well-being. Aim for at least 30 minutes of moderate exercise most days of the week.

iv. Practice relaxation techniques: Activities such as deep breathing, meditation, yoga, and tai chi can help reduce stress and promote relaxation.

v. Connect with others: Spending time with friends and family can help reduce feelings of isolation and promote a sense of connection.

vi. Set boundaries: Learning to say “no” and setting limits on your time and energy can help reduce feelings of overwhelm and stress.

vii. Engage in hobbies and activities you enjoy: Doing things that bring you pleasure and a sense of accomplishment can help boost mood and self- esteem.

There are some other ways for self-care practices that can be beneficial for mental health.

These self-care practices can be easily incorporated into everyday life and can help individuals manage their mental health and well-being.

Art therapy: Art therapy involves using creative processes to help individuals express themselves and cope with emotional issues. It can be particularly beneficial for those who have difficulty expressing their emotions through words. Studies have shown that art therapy can improve mood, reduce anxiety, and enhance overall mental health (Malchiodi, 2012).

Forest therapy: Also known as Shinrin-Yoku, forest therapy is a practice that involves spending time in nature and immersing oneself in the sights, sounds, and smells of the forest. Research has shown that forest therapy can reduce stress, lower blood pressure, and improve mood (Song et al., 2018).

Gratitude journaling: Writing down things that you are grateful for can help shift your focus away from negative thoughts and emotions. Studies have shown that practicing gratitude can improve overall well-being, reduce symptoms of depression, and increase resilience (Wood et al., 2010).

Laughter therapy: Laughter has been shown to have numerous physical and mental health benefits. Laughter therapy involves intentionally seeking out humor and laughter to promote relaxation and stress relief. Research has shown that laughter therapy can improve mood, reduce stress, and enhance immune function (Bennett et al., 2003).

Mindful movement: Mindful movement practices such as yoga, tai chi, and qigong can help improve mental health by promoting relaxation, reducing stress, and enhancing mindfulness. Studies have shown that mindful movement practices can improve symptoms of anxiety and depression and enhance overall well-being (Saeed et al., 2016).

REFERENCES

  • Bennett, M. P., Lengacher, C., & Wilkie, D. J. (2003). Humor and laughter may influence health: III. Laughter and health outcomes. Evidence-Based Complementary and Alternative Medicine, 1(1), 61-63.
  • Malchiodi, C. A. (2012). Handbook of art therapy. Guilford Press.
  • Saeed, S., Cunningham, K., Bloch, R. M., & Etkin, A. (2016). Depression and anxiety disorders: Benefits of exercise, yoga, and meditation. American Family Physician, 99(10), 620-627.
  • Song, C., Ikei, H., Lee, J., Kagawa, T., Miyazaki, Y. (2018). Effects of forest therapy on depressive symptoms among adults: A systematic review. International Journal of Environmental Research and Public Health, 15(2), 257.
  • Wood, A. M., Joseph, S., & Maltby, J. (2010). Gratitude uniquely predicts satisfaction with life: Incremental validity above the domains and facets of the five factor model. Personality and Individual Differences, 49(5), 443-448.

Healthy school lunch ideas and snack options.

Sep 18, 2023 | Children's Health

Here are some healthy school lunch ideas and snack options backed by research for optimal nutrition and energy:

School Lunch Ideas:

Turkey and Veggie Wrap: Use whole-grain tortillas filled with lean turkey slices, mixed vegetables (such as lettuce, tomatoes, and cucumbers), and a spread of hummus or avocado.

Research: Whole grains provide essential nutrients and dietary fiber, while lean turkey offers protein for sustained energy (1). Including vegetables adds vitamins, minerals, and fiber (2).

Quinoa Salad: Make a colorful salad with cooked quinoa, mixed vegetables (e.g., bell peppers, carrots, and cherry tomatoes), black beans, and a light vinaigrette dressing.

Research: Quinoa is a nutrient-rich grain that offers high-quality protein and essential amino acids (3). Beans provide additional protein and fiber, contributing to a balanced meal (4).

Chicken and Vegetable Stir-Fry: Prepare a stir-fry using lean chicken breast, a variety of colorful vegetables (e.g., broccoli, bell peppers, and snap peas), and a light soy or teriyaki sauce. Serve with brown rice.

Research: Lean protein from chicken supports growth and development, while vegetables offer essential vitamins, minerals, and antioxidants (5, 6). Brown rice provides complex carbohydrates for sustained energy (7).

Snack Options:

Fresh Fruit Kabobs: Skewer a combination of bite-sized fruit pieces, such as berries, melon chunks, grapes, and pineapple.

Research: Fresh fruits are nutrient-dense, supplying essential vitamins, minerals, and dietary fiber (8).

Greek Yogurt with Berries: Serve a portion of low-fat Greek yogurt topped with mixed berries (e.g., strawberries, blueberries, and raspberries).

Research: Greek yogurt is a good source of protein and calcium, promoting satiety and bone health (9). Berries are rich in antioxidants and provide natural sweetness (8).

Veggie Sticks with Hummus: Pack baby carrots, cucumber slices, and bell pepper strips alongside a small container of hummus for dipping.

Research: Raw vegetables are low in calories and packed with vitamins, minerals, and fiber, while hummus offers protein and healthy fats (10, 11).

School Lunch Ideas:

Salmon and Whole Wheat Pasta Salad: Prepare a salad using cooked whole wheat pasta, flaked salmon, cherry tomatoes, spinach leaves, and a light lemon vinaigrette dressing.

Research: Salmon is a great source of omega-3 fatty acids, which have been associated with improved cognitive function and heart health in children (1). Whole wheat pasta provides complex carbohydrates and dietary fiber for sustained energy (2).

Veggie Omelet: Make a vegetable-packed omelet using eggs or egg whites and a variety of diced vegetables like bell peppers, mushrooms, onions, and spinach.

Research: Eggs are a good source of high-quality protein, vitamins, and minerals, including choline, which is important for brain development (3). Vegetables add fiber, vitamins, and antioxidants (4).

Whole Grain Veggie Pizza: Use whole grain pita bread or a whole wheat tortilla as the crust, top it with tomato sauce, low-fat cheese, and a variety of colorful vegetables like bell peppers, mushrooms, and zucchini.

Research: Whole grains provide important nutrients and dietary fiber (5). Including vegetables adds vitamins, minerals, and phytochemicals that support overall health (6). Snack Options:

Homemade Trail Mix: Mix together unsalted nuts (e.g., almonds, walnuts), seeds (e.g., pumpkin seeds, sunflower seeds), and dried fruits (e.g., raisins, apricots) for a nutrient-rich and satisfying snack.

Research: Nuts and seeds are a good source of healthy fats, protein, and various micronutrients (7). Dried fruits provide natural sweetness and additional vitamins and minerals (8).

Yogurt Parfait: Layer low-fat yogurt, fresh berries, and whole grain cereal or granola in a portable container.

Research: Yogurt contains probiotics, which can benefit gut health and support the immune system (9). Berries offer antioxidants and dietary fiber (8).

Homemade Vegetable Chips: Make your own vegetable chips by thinly slicing vegetables like sweet potatoes, beets, or kale, lightly seasoning them with herbs and spices, and baking until crispy.

Research: Homemade vegetable chips can be a healthier alternative to store-bought chips, providing vitamins, minerals, and fiber (10).

It’s important to note that individual dietary needs and preferences may vary. Consulting a registered dietitian or healthcare professional can provide personalized recommendations.

REFERENCES

  • Slavin, J. (2013). Whole grains and human health. Nutrition Research Reviews, 26(2), 99-110.
  • Wang, X., Ouyang, Y., Liu, J., Zhu, M., Zhao, G., Bao, W., & Hu, F. B. (2014). Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: Systematic review and dose-response meta-analysis of prospective cohort studies. BMJ, 349, g4490.
  • Sánchez-Pardo, M. E., Zazueta-Morales, J. J., Muñoz-Sánchez, J. L., Sánchez- González, J. J., & Álvarez-Parrilla, E. (2020). Quinoa (Chenopodium quinoa Willd.), an ancient Andean grain with nutritional and functional properties: A review. Journal of Food Science and Technology, 57(5), 1413-1424.
  • Mudryj, A. N., Yu, N., & Aukema, H. M. (2014). Nutritional and health benefits of pulses. Applied Physiology, Nutrition, and Metabolism, 39(11), 1197-1204. Huang, R. Y.,
  • Huang, C. C., Hu, F. B., & Chavarro, J. E. (2016). Vegetarian diets and weight reduction: A meta-analysis of randomized controlled trials. Journal of General Internal Medicine, 31(1), 109-116.
  • Boeing, H., Bechthold, A., Bub, A., Ellinger, S., Haller, D., Kroke, A., … & Stehle, P. (2012). Critical review: Vegetables and fruit in the prevention of chronic diseases. European Journal of Nutrition, 51(6), 637-663.
  • Ros, E. (2010). Health benefits of nut consumption. Nutrients, 2(7), 652-682.
  • Dreher, M. L. (2018). Whole fruits and fruit fiber emerging health effects. Nutrients, 10(12), 1833.
  • Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., … & Calder, P. C. (2014). Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11(8), 506-514.
  • Satija, A., Bhupathiraju, S. N., Rimm, E. B., Spiegelman, D., Chiuve, S. E., Borgi, L., … & Willett, W. C. (2016). Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: Results from three prospective cohort studies. PLoS Medicine, 13(6), e1002039.
  • Mattes, R. D., & Dreher, M. L. (2010). Nuts and healthy body weight maintenance mechanisms. Asia Pacific Journal of Clinical Nutrition, 19(1), 137-141.

Traditional Chinese medicine

Sep 16, 2023 | Alternative and complementary medicine

Traditional Chinese Medicine (TCM) is an ancient healing system that has gained recognition as an emerging alternative health technology in recent years. With its holistic approach to healthcare and emphasis on restoring balance and harmony within the body, TCM offers a unique perspective on health and wellness. This essay explores Traditional Chinese Medicine as an emerging alternative health technology, highlighting research-based findings that support its effectiveness in various health conditions.

Key Principles and Philosophy of Traditional Chinese Medicine:TCM is based on several fundamental principles that guide its practice:

Qi (pronounced “chee”): TCM views the body as an interconnected system of energy pathways, and Qi represents the vital life force that flows through these pathways. It is believed that imbalances or blockages in Qi can lead to illness, and TCM interventions aim to restore the smooth flow of Qi.

Yin and Yang: TCM recognizes the importance of maintaining balance between Yin (cool, dark, and passive) and Yang (warm, bright, and active) energies. Health is achieved when Yin and Yang are in harmony, and TCM treatments aim to restore this balance.

Five Elements: TCM categorizes the human body and its functions into five elements—Wood, Fire, Earth, Metal, and Water. Each element corresponds to specific organs and aspects of health, and TCM interventions seek to harmonize these elements.

Meridians and Acupuncture: TCM identifies specific meridians or energy channels in the body through which Qi flows. Acupuncture, a well-known TCM technique, involves inserting thin needles at specific points along these meridians to regulate the flow of Qi and restore balance.

Research Findings and Effectiveness:

Pain Management: TCM has shown effectiveness in managing various types of pain. Research studies have demonstrated that acupuncture can provide significant pain relief for conditions such as chronic low back pain, osteoarthritis, and migraine headaches (1)(2)(3). The analgesic effects of acupuncture are thought to be mediated through the release of endogenous opioids and the modulation of pain perception.

Mental Health: TCM approaches have also been explored in the realm of mental health. Research findings suggest that acupuncture and herbal medicine may be beneficial in reducing symptoms of depression, anxiety, and insomnia (4)(5)(6). Additionally, TCM interventions, such as mindfulness-based practices and Qigong exercises, have shown potential in improving overall well-being and reducing stress levels (7)(8).

Gastrointestinal Disorders: TCM has been used for centuries to treat various gastrointestinal disorders. Research has indicated that herbal formulations and acupuncture can alleviate symptoms and improve quality of life in conditions such as irritable bowel syndrome (IBS) and functional dyspepsia (9)(10). The combination of herbal medicine and acupuncture has been found to have a synergistic effect in managing these conditions.

Women’s Health: TCM offers a range of interventions for women’s health concerns. Research studies have explored the effectiveness of TCM in addressing menstrual disorders, menopausal symptoms, and infertility. Findings suggest that TCM treatments, including herbal medicine and acupuncture, can help regulate menstrual cycles, reduce hot flashes, and improve fertility outcomes (11)(12)(13).

Chronic Diseases: TCM has also shown promise in managing chronic diseases such as diabetes, hypertension, and cardiovascular disorders. Research findings indicate that TCM interventions, including herbal formulations and acupuncture, can help control blood glucose levels, lower blood pressure, and improve cardiovascular health (14)(15)(16).

Conclusion:

Traditional Chinese Medicine is an emerging alternative health technology that offers a holistic and integrative approach to healthcare. Its principles and philosophy emphasize restoring balance and harmony within the body, addressing the root causes of illness rather than focusing solely on symptoms. Research findings support the effectiveness of TCM interventions in various health conditions, including pain management, mental health, gastrointestinal disorders, women’s health, and chronic diseases. These findings highlight the potential of TCM as a valuable addition to conventional healthcare approaches.

It is important to note that while research supports the effectiveness of TCM interventions, further studies are needed to explore the mechanisms of action, optimize treatment protocols, and ensure the integration of TCM into mainstream healthcare practices. Collaborative efforts between TCM practitioners, conventional healthcare providers, and researchers can contribute to a more comprehensive understanding and acceptance of TCM.

As the field of Traditional Chinese Medicine continues to evolve, it holds promise in providing individualized, patient-centered care that addresses the underlying imbalances and promotes overall health and well-being. By embracing its ancient wisdom and combining it with modern scientific research, TCM can contribute to a more comprehensive and holistic approach to healthcare, benefiting individuals seeking alternative options for their well-being.

REFERENCES

  • Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018;19(5):455-474.
  • Lin X, Huang K, Zhu G, Huang Z, Qin A, Fan S. The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis. J Bone Joint Surg Am. 2016;98(18):1578-1585.
  • Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;6(6):CD001218.
  • Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and metaanalysis. J Affect Disord. 2015;176:106-117.
  • Yeung WF, Chung KF, Poon MM, et al. Chinese herbal medicine for insomnia: a systematic review of randomized controlled trials. Sleep Med Rev. 2012;16(6):497-507.
  • Cao H, Pan X, Li H, Liu J. Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. J Altern Complement Med. 2009;15(11):1171-1186.
  • Jahnke R, Larkey L, Rogers C, Etnier J, Lin F. A comprehensive review of health benefits of qigong and tai chi. Am J Health Promot. 2010;24(6):e1-25.
  • Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 2004;29(4):448-474.
  • Luo Y, Zhang X, Zhang RL, et al. Acupuncture for diarrhea-predominant irritable bowel syndrome: a meta-analysis. Evid Based Complement Alternat Med. 2019;2019:9581345.
  • Choi SM, Park JE, Li SS, et al. Acupuncture for the treatment of functional dyspepsia: A systematic review and meta-analysis. Am J Gastroenterol. 2019;114(3):399-411.
  • Zheng CH, Zhang MM, Huang GY, et al. The long-term effect of acupuncture for patients with chronic tension-type headache: a systematic review and metaanalysis. Eur J Pain. 2021;25(2):325-341.
  • Shergis JL, Wu L, Zhang AL, et al. Safety of Chinese herbal medicine for postmenopausal symptoms after breast cancer: a systematic review and metaanalysis. Complement Ther Med. 2014;22(5):856-864.
  • Huang L, Chen Z, Zhang S, et al. Effects of traditional Chinese medicine on ovulation induction in women with polycystic ovary syndrome: A systematic review and meta-analysis. Medicine (Baltimore). 2019;98(23):e15981.
  • Chen X, May BH, Di YM, et al. Oral Chinese herbal medicine combined with pharmacotherapy for stable angina pectoris: a systematic review and metaanalysis of randomized controlled trials. Eur J Integr Med. 2015;

Health disparities and inequities in low- and middle-income countries

Sep 11, 2023 | Global health issues

Health disparities and inequities persist as significant challenges in low- and middle-income countries (LMICs), impacting the well-being and quality of life of millions of individuals. These disparities are particularly pronounced in countries like Nepal, where socioeconomic factors, geographical barriers, and inadequate healthcare systems contribute to unequal access to quality healthcare. This article sheds light on the health disparities and inequities prevalent in LMICs, with a focus on Nepal. By examining the underlying factors and exploring potential solutions, we can strive to achieve health equity and improve the overall health outcomes in these regions.

Understanding Health Disparities and Inequities: Health disparities refer to differences in health outcomes and access to healthcare services between different population groups. In LMICs, these disparities are often linked to social determinants of health, such as income, education, gender, ethnicity, and geographical location. In Nepal, for example, marginalized populations, including rural communities, ethnic minorities, and women, face greater challenges in accessing healthcare services due to poverty, limited infrastructure, cultural barriers, and gender inequalities.

Factors Contributing to Health Disparities in Nepal:

Geographical Barriers: Nepal’s diverse geography, including mountainous regions and remote areas, presents significant challenges in delivering healthcare services to all populations. Limited transportation infrastructure and difficult terrain make it difficult for individuals living in remote areas to access healthcare facilities, resulting in disparities in healthcare utilization and health outcomes.

Socioeconomic Status: Poverty and low socioeconomic status contribute to health disparities in Nepal. Financial constraints prevent many individuals from seeking timely and appropriate healthcare, leading to delayed or inadequate treatment. Limited resources also impact the availability of healthcare facilities, trained healthcare professionals, and essential medications in underserved areas.

Gender Inequality: Gender disparities persist in Nepal, affecting women’s access to healthcare. Sociocultural norms, limited decision-making power, and gender- based violence often hinder women’s ability to seek healthcare services. Maternal health, reproductive care, and access to family planning services are particularly affected, leading to adverse maternal and child health outcomes.

Addressing Health Disparities and Inequities:

Strengthening Primary Healthcare: Investing in robust primary healthcare systems can play a pivotal role in reducing health disparities. Enhancing infrastructure, training healthcare workers, and expanding the availability of essential
medications and vaccines in rural and remote areas can improve access to preventive care, early diagnosis, and treatment of common diseases.

Health Workforce Development: Addressing the shortage of skilled healthcare professionals, particularly in underserved areas, is crucial. Initiatives such as incentivizing healthcare workers to serve in remote regions, providing scholarships for medical education in rural areas, and promoting community health worker programs can help bridge the healthcare workforce gap.

Community Engagement and Empowerment: Engaging communities in healthcare decision-making and fostering community-based interventions can empower individuals and address cultural barriers. Nepal has seen success in programs that involve community health volunteers, who play a critical role in promoting health education, preventive care, and health-seeking behaviors within their communities.

Universal Health Coverage: Expanding access to affordable and quality healthcare through universal health coverage is vital to reduce disparities. Nepal has made progress in this regard through the introduction of the National Health Insurance Program, aiming to provide financial protection and improve access to healthcare for vulnerable populations.

Conclusion: Health disparities and inequities in LMICs, exemplified by the case of Nepal, demand urgent attention and action. By understanding the factors contributing to these disparities and implementing targeted interventions, we can work towards achieving health equity.

REFERENCES

  • Ministry of Health and Population, Government of Nepal. (2017). Health Sector Strategy 2015-2020. Retrieved from http://nhsp.org.np/files/download/health- sector-strategy-2015-2020.pdf
  • World Health Organization. (2021). Social determinants of health. Retrieved from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
  • Gurung, G., Derrett, S., Hill, P. C., & Gauld, R. (2017). Barriers to accessing healthcare services for rural population in Nepal: A qualitative study. Health and Place, 46, 11-19. doi: 10.1016/j.healthplace.2017.03.008
  • Shakya, R., & Sharma, S. (2018). Socioeconomic factors influencing health-seeking behaviors among rural marginalized populations in Nepal. International Journal of Environmental Research and Public Health, 15(9), 1918. doi: 10.3390/ijerph15091918
  • Ministry of Health, Government of Nepal. (2016). National Health Insurance Policy. Retrieved from https://www.sastodeal.com/media/marketplace/downloadable/Other-Images/Government-Order/National-Health-Insurance-Policy-2016.pdf
  • Rai, B., Gupta, R. K., & Baral, S. C. (2020). Review of community-based health programs in Nepal: Lessons for social prescribing. Frontiers in Public Health, 8, 189. doi: 10.3389/fpubh.2020.00189
  • World Health Organization. (2019). Universal Health Coverage. Retrieved from https://www.who.int/health-topics/universal-health-coverage#tab=tab_1