A Comparative Assessment of ACCESS Auditor’s Manual and ISO 9001:2015 Standards in the Perspective of Training on ISO 9001 to Cooperative Staff and Board Members

Cooperatives are people-centred enterprises owned, controlled and run by and for their members to realise their common economic, social, and cultural needs and aspirations. For the proper functioning of the cooperative, various tools such as ACCESS are used. ISO 9001 and similar standards are used for the proper management of the particular organisation. Both the approaches follow different sets of criteria to assess the level of organisation, but there are many similarities between them. They have focused on achieving sustainability and prosperity of the organisation by implementing such criteria in the organisation. This article has aimed to reveal such similarities and dissimilarities and proposed the way of implementing them in a holistic way.

Relative Importance of Risks in Hydropower Projects and Project Finance in Nepal

Hydropower is the sole internal source of electricity in Nepal. Since the government policy of private participation in hydropower sector launched, Independent Power Producers (IPPs) have gained significant presence under Public-Private Partnership (PPP) model of infrastructure development. Risk management is crucial in PPP projects as mishandling of any risk threatens sustainability and may result in project failure. This study analyses four major risks including Hydropower Sector Specific Risks, Project Finance Specific Risks, Hydropower Project Financing Risks and Country Specific Political and Legal Risks. Self-administrative survey utilizing questionnaire was conducted among the IPPs and domestic Banking and Financial Institutions (BFIs). Relative Importance Indices have been used to determine the importance of each risk item. Exchange rate changes, currency mismatch between local revenue and foreign loan, cost and time overrun, inflation, political turmoil and highly volatile political environment are few of the most critical risks found. For Project Finance proper allocation of risks among the stakeholders is crucial to make the projects bankable. Findings from this study indicate no risk should be neglected and relative importance of risks is critical in allocating risks among stakeholders. This study highlights assessment and the use of RII in the process of allocation and management of risks in infrastructure projects in general and hydropower in particular.

Perception of Respondents on Factors Affecting Management of Nursing Education Institutes

Management in education institute entails working with and through teachers, non teaching staff and students to get things done effectively. A descriptive cross-sectional study design was used to find out the management of nursing education institutes in selected colleges at Kathmandu valley. Data was collected in 2019 from 14 colleges. Sample size was 620, including 14 administrators, 229 faculties and 377 bachelor level final year nursing students. Ethical approval was taken from Nepal health research council. Self-administered structured questionnaire was used to collecting data and analysis was done in SPSS version 16.Keys factors were identified that may affect the management of nursing education institutes (NEI). All most all administrators agreed in all indicators. But there was different opinion on faculties and students. Highest percent of faculties disagreed on visions, mission, staffs understood (70%), class schedule, clinical supervision and students’ teacher ratio, nursing leadership (17%) and resource availability. Fifteen percent students disagreed in functioning alumni, library facility, strategic plan and function of executive committee (36.1%), use of operation plan, lesson plan (22.3%), class schedule (16.4%), and facility of skill laboratory (9.1%), clinical supervision (27.6%) and proper students’ teacher ratio (36.3%). In quality assurance system majority of the facilities disagreed and all most all students undecided. Analysis of variations between group (administrators, faculties, students) found statistical significance (p-value <0.05). So it is concluded the perception of students, faculties and administrator were found different on management of the nursing education institutes.

The Practice of OTC Dispensing by Community Pharmacist in Nepal

Over the counter (OTC) medications are the group of drugs that can be sold without the prescription of a registered medical practitioner to the consumers. Pharmacists are the most accessible health care professionals to the patient for the treatment of their minor illness. To provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC) medication counselling, community pharmacists need access to current and reliable information about medicines. A descriptive study was conducted on fifty pharmacists present in the community pharmacy of Kathmandu and Lalitpur districts. Predesigned validated questionnaire consisting of 16 questions were taken for the collection of data. Qualification of pharmacists, numbers of consumer asking for OTC medication in a week, most commonly dispensed OTC medicines by pharmacists, common symptoms told by consumers and average working hour of community pharmacists were recorded. The approval from the concerned authorities was taken. The study was a community based descriptive study done for 3 months. The data of the study was analyzed by using SPSS version 18. Out of 50 Pharmacists, 27 were males and 23 were females. Most of the study populations were qualified as assistant pharmacy. 82% of Community Pharmacy encountered more than ten consumers in a week. Analgesics and antipyretics, drugs for gastritis, antiprotozoals and antihistamines were the most commonly dispensed drugs by the pharmacies. The most common symptoms enquired by patients/consumers were fever (92%), common cold (90%) and headache (86%) as reported by pharmacists respectively. Average working hours of community pharmacists were 67 hours per week. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. There is increasing use of OTC medicines in Nepal. The study on community pharmacy practices regarding over the counter medicines can assist in evaluating pattern of use of OTC medicines by consumers thus help to reduce abuse and misuse of such medicines.

Depression, Stress and Anxiety among Residents of Nepal during COVID-19 Lockdown

Covid-19 illness is a pandemic infectious disease caused by a new coronavirus that originated in Wuhan, China. Nepal being a landlocked underdeveloped country is particularly vulnerable to the pandemic. Similarly, the dread of contracting the coronavirus is making people concerned about a global pandemic. It is vital to determine the impact of viral outbursts on mental health. Hence, this study aims to identify level of depression, stress and anxiety during lockdown among Nepalese residents. Cross-section web-based research design was undertaken at Bagmati province, Gandaki province and Lumbini province with four hundred twenty-two (n=422) (n=422) Nepalese residents by using a multistage proportionate stratified random sampling method. The Dass-21 tool was used to assess level of depression, stress and anxiety. Among 422 respondents only 5.9% had extremely severe level of anxiety, whereas 14.5% were moderately depressed, 77.5% did not have any stress during lockdown. There was statistically significant difference between depression and age (p=0.016), depression and sex (p=0.023). Also, there was a significant difference between stress and age (p=0.023), sex (p=0.0263) and education level (p=0.049).It is concluded that more than two-third of the respondentsere found to be in normal ranges for depression, stress and anxiety. Less than one-fourth of respondents had moderate to severe level of anxiety and depression.

Care Perception of Postnatal Mother on Care during Labour in Tertiary Level Hospital, Nepal

Background: Labour and delivery experience is one of the most significant events in a woman’s life. Support in labour has an impact on the childbirth experience and childbirth outcomes. A positive childbirth experience can help in mastering the major change in life. Therefore, the objective of this study was to find out postnatal mothers' perception on care during labour. Methods: A descriptive cross-sectional design was used to explore the perception on care during labour of postnatal mothers in postnatal ward Tribhuvan University Teaching Hospital. Total 294 postnatal mothers with normal delivery were selected by purposive sampling method after receiving ethical approval from research department of Institute of Medicine and concerned authority. Data was analyzed by using descriptive as well as inferential statistics. Results: Among 294 women; 208(70.75%) were received care on infection prevention, 160(54.42%) received bladder care, 175(59.66%) received care on hydration maintenance, 149(50.57%) received care on injury prevention, 103(34.88%) care on comfort measures, 180(61.14%) care on information, 207(70.54%) care on emotional support, and 201(68.31%) care immediately after childbirth. There is significant relationship among different types of care during labour (such as emotional support (44.44%), infection prevention care (19.7%), care for bladder empty (14.5%), maintenance of hydration (17.1%), care for prevention of injury (31.9%), care on pain relieve and comfort measures (50.1%), informational care (64.5%), and care immediately after delivery (18.5%)) and overall perception on care during labour. The perception level was based on mean score and was categorized as; below 3 is negative perception, 3 and above is positive perception. The finding of this study shows that 93(31.6%) postnatal mothers were perceived care negatively and 201(68.4%) perceived care positively during labour. It indicates that care during labour needs to be improved for best care perception. Conclusions: Women expect professional, supportive and respectful care during labour. Continuous care and support during labour has meaningful benefits for women and infants. It indicates that the care during labour need to be improved for best care perception.

Effectiveness of Specific Lumbar Stabilization Exercise for LBP among Postpartum Women: A Quasi-Experimental Study

Background: Postpartum back pain is common, with up to 75% of women experiencing back pain immediately following birth due to ligament laxity and postural changes. Besides the lack of pelvic floor muscles strength, urine leakage problem during coughing and sneezing also arises in this condition. The purpose of this study was to explore the effect of stabilization exercise (SE) and Kegel exercise. Objective: To evaluate the pain intensity in rest and different functional activities before and after introducing spinal stabilization exercises in postpartum women with low back pain and also find out the effect of Kegel exercise. Study Design: A Quasi-Experimental (one group) pretest-posttest design was used. Methodology: 27 patients who were fulfill inclusion criteria within this study period with postpartum low back pain, attended at Gynecological and Women's Health unit, CRP, Mirpur, Dhaka was purposively chosen to conduct the study. Spinal stabilization exercise was applied to the participants to find out the effectiveness of this exercise. Kegel exercise was also introduced who have urine leakage problem among 27 patients. Participants received the exercise for 45 minutes, 2 times a week & total 6 weeks. Besides this they performed the exercises at home 5 times a day also. A numeric pain rating scale was used to measure pain intensity in different functional activities such as swiping, squatting, chair sitting, heavy weight lifting, walking, and journey by bus or rickshaw, and stair climbing. Pain score was analyzed by calculating the "Wilcoxon Signed Ranked Test". Results: Results showed that relative improvement occurs in all participants in the experimental group. Pain scores on numeric pain rating Scale on different functional activities such as during toilet sitting, stair climbing, walking, during weight lifting, were relatively reduced which was also statistically significant (p≤ .05). Participants who have a urine leakage problem also recover from this problem. Conclusions: Lumbar stabilization exercises has effect on reducing pain and improving functional activities, and to solve the urine leakage problem Kegel exercise effective.

Preventive Practices against COVID-19 during the Period of Lockdown in the Eastern Part of Kathmandu

A brief study of health seeking behavior was studied in the eastern region of the Kathmandu. 50 respondents were taken in the study. Their knowledge on the pandemic, their views of preventive measures, the practices they are doing and what are the problems they are facing and ultimately the possible way out of the disease was discussed with them taking their view. 50 respondent having equal number of male and female of the indigenous Tamang community were enrolled in the study taking their consent to take part in the study. The majority of the respondents were less educated with low income, thus have to work regularly for their daily essentials. Majority 92 % had stayed in one place and they were aware of the social distance (64%) as well. Regarding the hand washing with the soap and using sanitizer, they were found less serious about it.

Perception on Management of Nursing Education Institutes among Bachelors Students in Selected Nursing Colleges at Kathmandu

Management is a process of planning, decision making, organizing, leading, motivating and controlling, and an effective utilization of the resources to reach the organizational goals efficiently and effectively. Management has a crucial role in quality of work and production in any institutions. Although a rapid increase of Nursing Education Institutions in Nepal since last decade which had been trained thousands of nursing cadres, the management aspects of these institutions are not studied adequately. Thus current study intended to explore the current status of Nursing Education Institution Management as experienced and perceived by the bachelors nursing students. A descriptive cross-sectional study was conducted among the nursing institutions in Kathmandu valley. Of the total 28 in the valley, 14 were selected purposively. From the selected institutions, all 377 eligible students currently in final year of study were selected. Among them, 208were from BSN and 169 were from B Sc program. The data was collected through the self administered structured questioners after taking informed consent. Data entry and analysis was done in SPSS version 16 software. The findings of the study show that 70% students were satisfied in institutional management (mean59.62, SD ± 3.66). In academic management (78%), (mean139.82, SD ± 6.22), followed by human resources 67%, (mean43.54, SD ± 2.79) and were in physical resources management 75% students were satisfied (mean45.02, SD ± 3.08). Analysis of variations between group (administrators, faculties, students) found statistical significance (p value <0.05). So it is concluded the perception of students, faculties and administrator were different on managing the nursing education.

Knowledge and Perception Regarding Hypertension among Hypertensive Patients at a Tertiary Hospital in Kathmandu, Nepal

Background: Hypertension has a great impact on cardiovascular disease and death all over the world. Low and middle-income countries including Nepal are facing higher disease burden because of complications arise from uncontrolled hypertension. Patient’s knowledge and perception play an important role for the proper management of hypertension. There are limited studies related to knowledge and perception of hypertension, therefore, this study aimed to assess the knowledge and perception of hypertension among hypertensive patients at a tertiary hospital in Nepal. Methods: This is a hospital based, mixed-method, cross-sectional study which was conducted among 400 hypertensive patients in the outpatient department of Sahid Gangalal National Heart Center, Kathmandu, Nepal. Patients who were diagnosed as hypertensive at least 6 months before were selected by simple random sampling technique and were interviewed using semi- structured questionnaire, and interview schedule from March to May 2019. Data were analyzed using descriptive and inferential statistics. Results: The mean age of the respondents was 58.86 ±11.07 years and nearly half (47.8%) of them were in the age group of 60 years and above. More than half, (58%) were male, 77.8% were overweight, about half of them had a significant family history of hypertension with first degree relatives. Regarding the knowledge, the total mean score was 16.16±3.032 and had significant difference with age (p= 0.002), gender (p=.000), education (p=0.002), occupation (p=0.000), and duration of HTN diagnosis (p=0.000). Majority of them perceived hypertension as less serious illness and had significant difference with education level (p=0.001) and duration of HTN diagnosis (p=0.000). Conclusions: Majority of participants had inadequate knowledge of hypertension and they perceived hypertension as less severe illness which might hinder the adherence to treatment recommendations. Hence, mass awareness program strategies might be helpful to increase hypertension related knowledge and perception.