Research

Articles published in different journals


12. Traditional and Modern Maternal and Child Health Care Practices and Effects among Rajbanshi community in Nepal.
Abstract
This is a descriptive and cross-sectional study on the Rajbanshi of Nepal in 2010. The common theories in Ethnographic/Indigenous Psychological perspective, Social Construction theories and Public Health perspectives have navigated the study. This study poses both qualitative and quantitative methods: interviews, observations and examinations. Household samples were randomly taken and clusters taken by purposive sampling method. Altogether 1514 people accounted in samples. Tools were semi-structured questionnaires, checklists, EPDS, weighing machine and measuring tape.

Rajbanshi community is one of the marginalized indigenous people resided in the southeastern part of Nepal. They have unique tradition and culture. They have owned traditional health care practices. Guru Gosai and Gosai are traditional healers. In the Rajbanshi tradition, the causes of diseases and illnesses are deities, witchcraft, evil spirits, the touch of pithiya/chhatka and dirty environment or poor sanitation. They diagnose disease by looking at jokhana. After the findings, they treat patients by chanting of mantra or jharphuk, jadibuti, buti, ferani or bhakal. They are mainly taking modern care services from different levels private clinics/nursing home/hospitals and public health post/hospitals simultaneously.

In the study 93.87% samples adopted modern and traditional dual practices concurrently. 74.14% samples visited local medical clinics, and 14.41% visited hospitals for the treatment at first.  Total 28% samples adopted solely modern care where nobody adopted solely traditional practices. However, 11.50% samples took traditional care at first for the mother and the child care. 16% pregnant took first care from traditional healers. The study also identified the trend of traditional and modern care practices. Hospital delivery increased from 30.67% to 69.33% between first and last deliveries where home delivery decreased to 29.23% from 69.33%.

In spite of good access to modern care services the maternal and child mortality rates estimated high in those who are very poor, illiterate, remote and traditional practicing families in the community. Likewise, children with underweight were in an alarming situation (72.53%) in those who are very poor, labor, illiterate, rural and traditional practicing. Postpartum depression in mothers associated with their stress and sleeplessness were statistically significant. The PPD in mothers also tested with husband’s smoking habit and find statistically highly significant (p=<.0001).  Women of three groups are vulnerable: 1. Pithiya is a woman whose baby has died or stillbirth. 2. Chhatka is a mother who is suffering from abortion. 3. Tantra/mantra practicing women. These women are considered as causes of diseases. In such sociocultural circumstances, they become victims of social stigma.

Traditional practices involve local barbers to cut the umbilical cord during delivery. They shave newborn’s head with the traditional knives after few days of the delivery. They are unsafe and can cause infection including neonatal tetanus. They need training on using sterile blades. Awareness of reproductive rights in mothers needs to rise. They need integrated mental health program. More nutritional programs required for the children.  Thesis download


11. Managing Hepatitis Outbreak in Biratnagar Nepal
This is a review article on jaundice outbreak occurred in Biratnagar during April-July 2014. The study reviewed the reports on hepatitis outbreak presented by District Public Health Officer Morang during a seminar organized by Nepal Health Research Council (NHRC), District Disaster Management Committee (DDMC) meetings and HMIS (Health Management Information System) database. District Public Health Office (DPHO) recorded 2,789 Jaundice patients in Morang district including Biratnagar city. Most of the patients (80.67%) recorded from Biratnagar. In the outbreak sex ratio of female to male was 0.56:1. Hepatitis infection was highest among 15-29 age groups and noticed remarkable among 15 to 54 years age groups. District Disaster Management Committee declared the outbreak in Biratnagar on April 28 when 95 jaundice patients recorded in the hospitals. The number reached at peak level 176 patients on May 6 and the trend came downward to normal level on July 8, 2014. Total 12 deaths recorded in the outbreak. Of them 8 deaths recorded from Biratnagar, 3 deaths from Morang district and 1 death from Saptari district. In Biratnagar ward No. 11 listed 5 deaths, ward No. 8 listed 2 deaths and ward No. 3 listed 1 death. Case fatality rate in the Biratnagar outbreak calculated as 0.43%. The causes of hepatitis infection were hepatitis viruses E and A. The transmission of infection in Biratnagar was due to sewage contamination through leaking pipes in water distribution. The level of community awareness on taking safe water observed in the Biratnagar. Before the outbreak, people used to drink tap water without treatment. After the outbreak, people changed their behavior to boil or filter water to drink in houses. Many people started to purchase mineral water in jars and bottles from the market. However, government water supply system in Biratnagar is poor which demands an upgrade to meet WHO standard of drinking water.
To cite this article
Nawa Raj Subba, Managing Hepatitis Outbreak in Biratnagar Nepal, Science Journal of Public Health. Vol. 3, No. 6, 2015, pp. 808-814. doi: 10.11648/j.sjph.20150306.12
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10. Suicides in Ilam District of Nepal
American Journal of Applied Psychology, Volume 4, Issue 6, November 2015, Pages: 137-141. Received: Sep. 20, 2015; Accepted: Sep. 29, 2015; Published: Oct. 12, 2015
DOI: 10.11648/j.ajap.20150406.11 Views 29 Downloads 4
Nawa Raj Subba, Department of Psychology, Tribhuvan University, Kathmandu, Nepal
To cite this article
Nawa Raj Subba, Suicides in Ilam District of Nepal, American Journal of Applied Psychology. Vol. 4, No. 6, 2015, pp. 137-141. doi: 10.11648/j.ajap.20150406.11
Abstract
This is a review of suicides through post-mortem reports committed in Ilam district of Nepal. The review is base on all total 112 post-mortem reports of three consecutive fiscal years (2001/02, 3002/03, 2003/04) available in District Health Office Ilam. Epi-Info software used to analyze the samples in the computer. Findings showed the ethnic distribution of the samples was indigenous Janajati 53.7%, Brahmin 29.5%, Dalit 8.9% and Chhetri 8%. Sex ratio of female to male was 2:1. The mean age of suicide noticed in male 34 years and in female 35 years. Suicides from Ilam municipality, Mangalbare and Maipokhari villages recorded high. Means of suicides were hanging 71.43%, organophosphate poisoning 12.5% and weapon 1.79%, fire 1.79%, fall 1.79%, and drown 0.89%. The highest suicides noted in 20-29 ages group. The trend of suicides was increasing over the past 11 years (1992-2003) in the district.
Keywords
Suicide, Demographic Information, Trend, Ilam Nepal.
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9. Traditional Practices on Mother and Child Health Care in Rajbanshi Community of Nepal
Nawa Raj Subba. Email address: dr.subba2015@gmail.com)

To cite this article: Nawa Raj Subba. Traditional Practices on Mother and Child Health Care in Rajbanshi Community of Nepal. American Journal of Health Research. Vol. 3, No. 5, 2015, pp. 310-317. doi: 10.11648/j.ajhr.20150305.18

Abstract: This is a qualitative study on traditional health care of mother and child in Rajbanshi community in Nepal. The aim of the study was to explore traditional maternal and child health care and to uncover harmful practices. Methods in this descriptive study employed in - depth interviews and FGDs with traditional birth attendants, traditional healers, female community health volunteers, health workers and mothers. Tools were semi - structured questionnaire and checklists. The study sample included 60 from Morang, Jhapa, and Sunsari districts. Of them, 30 were from traditional healers, traditional birth attendants (TBA), and female community health volunteers (FCHV) and health workers another 30 were mothers included for three FGDs conducted in 2013. Findings show Rajbanshi culture has native care of mother and child health. Guru Gosai, Gosai, Ojha, and Dhami are traditional healers in the community. Guru Gosaiis also essential to conduct birth, marriage and death rituals. The traditional causes of diseases are deities, witchcrafts, evil spirits, a touch of pithiya/chhatka, and poor sanitation. Traditional healers find the cause through a jokhana. They treat patients by chanting a mantra, jharphuk, jadibuti, buti, and ferani. TBAs and health workers conduct home delivery however trend of hospital delivery increased. The study figured out a mark of a stigma where women pithiya or chhatka are suspected as cause of disease and illness in others. Community people perceive them unholy and unfriendly. Thus, pithiya and chhatka women face unfair treatment. They are vulnerable to maternal and child health. On the other, the traditional practice of cutting the umbilical cord by a barber during a delivery and shaving off newborn's head after a delivery by the barber are harmful practices.
Keywords: Traditional Practice, Maternal Child Care, Stigma, Harmful Practices, Rajbanshi Nepal

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8. Postpartum Depression Relating to Smoking and Drinking Habits of Husbands Among Rajbanshi Mothers in Nepal  (American Journal of Health Research)

Nawa Raj Subba*, Shishir Subba. 

This is a cross-sectional study on postpartum depression (PPD) among Rajbanshi mothers in Nepal. The objective of the study was to find out the prevalence rate of PPD and association between PPD in mothers with smoking/drinking habits of the husbands and perceived stress among Rajbanshi community. Quantitative methods employed using semi-structured questionnaires. The sample size was 375 households from Morang, Jhapa and Sunsari districts. Data collected by in-depth interviews with mothers. Researcher filled the semi-structured questionnaires asked on workload, sleep, perceived stress and treatment history using the Edinburgh Postnatal Depression Scale during interviews. In the findings, PPD and maternal stress associate with husband's smoking/drinking habits. Prevalence of PPD was 12.27% in sampled Rajbanshi mothers (EPDS cutoff≥13). PPD in mothers find associated with maternal stress (P= <.0001) and smoking habit of the husband (P=<.0001) which are statistically highly significant. Similarly, sleeplessness in mothers associated with smoking (P=<.005) and drinking (P= <.0001) habits of husbands are also statistically highly significant. In conclusion, PPD among Rajbanshi mothers associates with a smoking habit of the husband. Both smoking and drinking habits of husbands were responsible for causing maternal stress and sleeplessness in mothers and these factors associated with PPD. Smoking and drinking habits of husbands find out risk factors for PPD and perceived stress in her wife. To deal successfully with the poor situation of PPD among Rajbanshi mothers need to change smoking/drinking habits of husbands, raise awareness on health as well as the socio-economic development of the community.

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To cite this article:
Nawa Raj Subba, Shishir Subba. Postpartum Depression Relating to Smoking and Drinking Habits of Husbands Among Rajbanshi Mothers in Nepal.American Journal of Health Research. Vol.3, No. 5, 2015, pp. 293-297.doi: 10.11648/j.ajhr.20150305.15

  1. Traditional and Modern Maternal and Child Health Care Practices and its Effects on Rajbanshi Community in Nepal
Nawa Raj Subba (dr.subba2015@gmail.com)
Department of Psychology (Health Psychology), Tribhuvan University
March, 2015
Abstract
Background: Rajbanshi is one of the indigenous and underprivileged communities in Nepal. The present research is a descriptive and cross sectional study onRajbanshi community. The study was an attempt to explore and examine the modern and traditional health care seeking practices and estimate their effects on mother and child health.
Methods: Both qualitative and quantitative methodology was employed. Qualitative data were collected using in-depth interview checklist, FGD guideline, naturalistic observation, case study approach. Quantitative data were collected using questionnaire on household survey from 1514 participants.
Results: Guru Gosai and Gosai were main traditional healers in the sampledRajbanshi community. Deities, witchcrafts, evil spirits, touching of pithiya/chhatka,dirt, or poor sanitation, were the major causes of diseases or illnesses. Healers identified such causes through the process of jokhana. Based on the findings healers treat or heal the patients by chanting mantra, jharphuk, use of jadibuti, buti, ferani or making promises to the spirits, deities, or gods and goddess. On the other hand,Rajbanshi people are shifting in their health seeking behavior by accepting modern health care services from different levels such as private clinics/nursing home, and public health post, hospitals, etc. This confirms the existence of duel health care practices among a large proportion (93.87%) of sampled Rajbanshi community. The trend of hospital delivery increased from 30.67% to 69.33%, whereas trend of home delivery decreased from 69.33% to 29.23% between the first and last births. The microanalysis indicated that the trend to lean more on modern health care has increased significantly.  Postpartum depression among mothers associated with their stress and sleeplessness was statistically significant. The PPD in mothers tested with husbands’ smoking habit and found statistically highly significant (p=<.0001).
Conclusion: Mortality rate of mother and child and proportion of underweight children was high in very poor, laborer, illiterate, rural and traditional care practicing families.  Women suffering from reproductive health problems called pithiya, chhatka and so-called tantra/mantra using women are stigmatized and vulnerable. Shaving of newborn's head and cutting of umbilical cord by barber are risky cultural practices.
Citation: Nawa Raj Subba (2015). Traditional and Modern Maternal and Child Health Care Practices and its Effects on Rajbanshi Community in Nepal. Journal of Public Health in Developing Countries, 2015 PhD thesis abstract.Click
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  1. Modification of Delivery Practice in Rajbanshi Mothers of Nepal.
Nawaraj Subba, Shishir Subba.
Abstract
Introduction: This is a cross-sectional study with the objective of identifying modification in delivery practice in Rajbanshi mothers of Nepal.Methodology: Both qualitative and quantitative tools were used. Semi-structured questionnaires covering 375 samples of its resident districts Morang, Jhapa and Sunsari districts and check lists for in-depth interview were used in the study.Results: People were adopting both traditional and modern care practices concurrently. Among 375 households; 40% adopted local clinic/ hospital/ traditional healer concurrently. Similarly 31.20% adopted local clinic/ traditional healer/ hospital, 10.67% adopted hospital/traditional healer. There were 11.47% (urban 0.54% and rural 10.93%) respondents were having traditional care system as a first choice. During first delivery among 375 mothers 265 (70.67%) had traditional home delivery and 110 (29.33%) had hospital delivery. During last delivery, this was 115 (30.67%) in traditional home delivery and 260 (69.33%) in hospital delivery. Therefore trend of hospital delivery was increasing whereas trend of traditional home delivery was decreasing. It was statistically highly significant (p=<.0001).

Conclusion: Trend of hospital delivery was increasing (from 30.67% to 69.33%) and trend of home delivery was decreasing (from 69.33% to 29.23%) in between first and last child delivery.There was remarkable increased in using trained HW/Nurse/Doctor at hospitals is 66.4% during last delivery which was only 6.13% during first delivery. Traditional care was more practiced in rural than in urban population.

Keywords: Traditional home delivery, Modern hospital delivery, Rajbansi, Nepal

Citation: Nawaraj Subba, Shishir Subba. (2014) Modification of Delivery Practice in Rajbanshi Mothers of Nepal. Journal of Nobel Medical College Vol. 3, No.1 Issue 5, pp10-15.

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  1. Delivery Practices among Rajbanshi
Nawaraj Subba
Abstract
This is a cross-sectional study on Rajbanshi of Nepal with the objective of uncovering delivery practices among mothers. Methodology employed quantitative tools semi-structured questionnaires, checklists covering 375 samples from different clusters of districts Morang, Jhapa and Sunsari districts by systematic sampling method. In Findings, Among Rajbanshi population 69.33% has done hospital delivery and 30.67% has home delivery. Home delivery is practiced by economic condition very poor (18.87%), poor (8.8%) and rich (4%). Hospital delivery is practiced by economic condition very poor (20.53%), poor (20.27%) and rich (28.53%). Similarly, home delivery is higher by occupation labour (24.27%), by education illiterate (10.67%), by geography rural (34.28%). In Conclusion, status of hospital delivery of Rajbanshi in overall was better than the district and national level of the country but there was less hospital delivery and more home delivery find among very poor, illiterate, labour and rural than rich, literate, urban and general population.
Keywords: Home delivery, hospital delivery, Rajbansi, Nepal
Citation: Nawaraj Subba. (2014).  Delivery Practices among Rajbanshi. Researcher: A Research Journal of Culture and Society 02/2014; 1(2). DOI: 10.3126/researcher.v1i2.9886.
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  1. Post Partum Depression among Rajbanshi Mothers
Nawaraj Subba. (2013). Post Partum Depression among Rajbanshi Mothers. Researcher
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  1. A study of public health indicators of Morang Nepal by Lot Quality assurance sampling method.
Nawaraj Subba, Gagan Gurung.
Abstract
This article presents the findings of public health status indicators of Morang District as studied by Lot Quality Assurance Sampling (LQAS) methods 2006. The contraceptive prevalence rate (CPR) and women receiving antenatal service from health workers were 42.0% and 46.0%, respectively. A total of 80.0% mothers were receiving iron tablets whereas 55.0% mothers gave history of taking Vita A during their last pregnancy. Nearly three-fifth (57.0%) of deliveries was conducted by health workers. Thirty-one percent of mothers fed their breast milk within 1 hour during last natal period. These figures were higher compared with previous years.
Keywords: LQAS, health indicators, Morang District, Nepal.
Citation: Nawaraj Subba, Gagan Gurung. (2007). A study of public health indicators ofMorang Nepal by Lot Quality assurance sampling method.Nepal Medical College Journal; Vol.9, No.2, June 2007 pp117-119.
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  1. Health Seeking Behavior of Rajbanshi in Katahari and Baijanathpur of Morang District, Nepal. 
Nawaraj Subba
Abstract
Introduction In Nepal there are numbers of ethnics having their own traditional health seeking behavior. Rajbanshi is one of the indigenous people of Morang district whose health seeking behavior varies depending upon their socio-economic status.
Objectives The objective of the study was to assess the practices of using modern, self and alternative medication on the basis of socio-economic status.
Methods The study was a cross sectional study of descriptive type. Information has been collected from the field survey by using semi-structured questionnaires containing both open and close ended questions. Total 175 households of two VDCs was selected from the VDCs rosters using random number table for convenience and to cover the expected households. Data were analyzed utilizing the Epi Info 6.0 version.
Results Modern, Alternative and Self medications were common in Rajbanshi community. Modern medication was popular but was expensive to afford as reported by majority people. Significant proportion of Rajbanshi people having less than 2 bigahas land and uneducated was adopting self medication in Katahari and Baijanathpur of Morang.
Conclusion There is a relationship between economic, education status and health seeking behavior in Rajbanshi community.
Key words Health, Behave, Alternative and Self-medication
Citation: Nawaraj Subba. (2004). Health Seeking Behavior of Rajbanshi in Katahari and Baijanathpur of Morang District, Nepal. Journal of Nepal Health Research Council. Vol.2, No.2, October 2004, pp14-17.
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  1. Demographic Assessment on Vasectomy Clients of Sankhuwasabha Nepal,
Nawaraj Subba
Abstract
This paper presents the demographic status of vasectomy clients in Sankhuwasabha district in Eastern Nepal based on the 427 fact-sheets taken at camps in district during 3 consecutive years. More than half (55.0%) of the clients were Brahmin and Chhetri. Major occupation of clients was agriculture (73.7%) with s literacy rate of 83%. Mean age of vasectomy clients and their wives was 32.5 and 28.7 years respectively and age of youngest female child was 3.9 years. Of the total, 55.8% couple have had used temporary contraceptives before having vasectomy. As a part of screening procedure, blood pressure of more than half clients (54.6%) was measured and found to be within normal range.Keywords
Vasectomy, face-sheet analysis, Sankhuwasabha, Nepal.
Citation: Nawaraj Subba. (2003). Demographic Assessment on Vasectomy Clients of Sankhuwasabha Nepal, Nepal Medical College Journal. Vol.5, No.2, December 2003, pp98-99.
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REVIEW ARTICLES
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Collection of review articles in Nepali on contemporary Public Health issues of the country. Books could be useful for Public health students, researchers and planners. Books are available for free of charge to download.
Janaswasthya-pata-bata-anubhuti   Janaswasthyaka-sawalharu

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