Nawaraj Upadhaya

University of Amsterdam | UVA · Department of Sociology and Anthropology

Evidence on the effectiveness and implementation of mental health and psychosocial support (MHPSS) interventions for men in humanitarian settings is limited. Moreover, engagement and retention of men in such interventions has been challenging. Adaptations may therefore be required to improve the appropriateness and acceptability of these interventi...

This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommodates integration of stand-alone mental health pro...

Introduction In Afghanistan coverage of childhood vaccinations is very low, especially in remote and insecure areas with a weak public health structure. Private health providers (PHPs) in these areas play an important role in health care provision, some of whom have received (para)medical training. In 2009 HealthNet TPO initiated a Public-Private P...

Despite extensive ethnographic and qualitative research on traditional healers in Nepal, the role of traditional healers in relation to mental health has not been synthesized. We focused on the following clinically based research question, “What are the processes by which Nepali traditional healers address mental well-being?” We adopted a scoping r...

Background Maternal and child health care services are available in both public and private facilities in Nepal. Studies have not yet looked at trends in maternal and child health service use over time in Nepal. This paper assesses trends in and determinants of visiting private health facilities for maternal and child health needs using nationally...

Background Despite having the high rate of stillbirth in most of the countries of South Asia, there is a lack of synthesized evidence based on factors associated with stillbirth. This study systematically synthesizes the evidence on factors associated with stillbirth in the four selected countries of South Asia. Methods This review was conducted u...

Background: Despite many important developments in the global mental health arena in the past decade, many people with mental health problems still do not have access to good quality mental health care. The aim of this study was to evaluate the perceived impact of a mental health care package (MHCP) in integrating chronic care elements in primary...

Background: Maternal and child health care services are available in both public and private facilities in Nepal. No study has yet looked at trends in maternal and child health service use over time in Nepal. This paper assesses trends in and determinants of visiting private health facilities for maternal and child health needs using nationally rep...

Background: The barriers and facilitating factors for integrating mental health into primary health care have been well documented in the literature, but little is known about the perspectives of primary health care workers (who provide integrated mental health care) on barriers and facilitating factors of the health system for scaling up mental h...

Background In most low- and middle-income countries (LMIC), routine mental health information is unavailable or unreliable, making monitoring of mental healthcare coverage difficult. This study aims to evaluate a new set of mental health indicators introduced in primary healthcare settings in five LMIC. Method A survey was conducted among primary...

Background There is a global drive to improve access to mental healthcare by scaling up integrated mental health into primary healthcare (PHC) systems in low- and middle-income countries (LMICs). Aims To investigate systems-level implications of efforts to scale-up integrated mental healthcare into PHC in districts in six LMICs. Method Semi-struc...

Background Successful scale-up of integrated primary mental healthcare requires routine monitoring of key programme performance indicators. A consensus set of mental health indicators has been proposed but evidence on their use in routine settings is lacking. Aims To assess the acceptability, feasibility, perceived costs and sustainability of impl...

Background: Stunting is one of the most commonly used indicators of child nutrition and health status. Despite significant efforts by the government and external development partners to improve maternal and child health and nutrition, stunting is consistently high in Nepal. This paper assesses the potential determinants of stunting among children...

Background Little is known about the household economic costs associated with mental, neurological and substance use (MNS) disorders in low- and middle-income countries. Aims To assess the association between MNS disorders and household education, consumption, production, assets and financial coping strategies in Ethiopia, India, Nepal, Nigeria, S...

Introduction Adolescent pregnancy is a significant cost to mother, newborn, and their family and society. Despite the enormous health and social impact of adolescent pregnancy, there is a dearth of nationally representative studies on factors associated with adolescent pregnancies in Nepal. Therefore, this study aimed to examine trends and factors...

Background: This study evaluates the feasibility, acceptability, and outcomes of a combined school- and family-based intervention, delivered by psychosocial counselors, for children with behavior problems in rural Nepal. Methods: Forty-one children participated at baseline. Two students moved to another district, meaning 39 children, ages 6-15,...

Background: Psychotropic drugs play an important role in the treatment of mental, neurological and substance use disorders. Despite the advancement of the use of psycho-pharmaceuticals in the developed countries, the psychotropic drug production and supply chain management in low- and middle- income countries are still poorly developed. This study...

This paper presents the findings of an ethnographic study conducted among high school students in Nepal. Participant observations, in-depth interviews and focused group discussions were conducted among 35 students (20 girls and 15 boys). The findings suggest three geographies (home, school and community), where adolescents experience distress. Comm...

Background Assessing and understanding health systems governance is crucial to ensure accountability and transparency, and to improve the performance of mental health systems. There is a lack of systematic procedures to assess governance in mental health systems at a country level. The aim of this study was to appraise mental health systems governa...

Background Service user and caregiver involvement has become an increasingly common strategy to enhance mental health outcomes, and has been incorporated in the mental healthpolicies of many developed nations. However, this practice is non-existent or fragmented in low and middle income countries (LMICs). Instances of service user and caregiver inv...

Objective: To identify community perceptions on psychosocial and mental health problems of older people in postearthquake situation in Nepal. Method: A qualitative methodology was adopted to explore the experience and opinions of older people, social workers, school teachers, health workers, and nongovernmental organization workers on the psycho...

Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy imp...

Background Mental, neurological and substance use disorders contribute to a significant proportion of the world’s disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, So...

Adolescents' psychosocial problems are a growing public health concern in both developed and developing countries. Research on this subject is limited in low- and middle-income countries. This paper examines the national scenario for psychosocial problems among adolescents in Nepal using data from the Nepal Adolescents and Youth Survey (NAYS) 2010/...

Background Research on information systems for mental health in low and middle income countries (LMICs) is scarce. As a result, there is a lack of reliable information on mental health service needs, treatment coverage and the quality of services provided. Methods With the aim of informing the development and implementation of a mental health info...

Background: Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to deve...

High-quality information to measure the need for, and the uptake, cost, quality and impact of care is essential in the pursuit of scaling up mental health care in low- and middle-income countries (LMIC). The aim of this study was to identify indicators for the measurement of effective coverage of mental health treatment. We conducted a two-round De...

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psycholo...

Despite increased attention to global mental health, psychiatric genetic research has been dominated by studies in high-income countries, especially with populations of European descent. The objective of this study was to assess single nucleotide polymorphisms (SNPs) in the FKBP5 gene in a population living in South Asia. Among adults in Nepal, dep...

Studies on child behavioral problems from low and middle income countries are scarce, even more so in Nepal. This paper explores parents', family members' and teachers' perceptions of child behavioral problems, strategies used and recommendations to deal with this problem. In this study, 72 free list interviews and 30 Key Informant Interviews (KII)...

Armed conflicts and other humanitarian crises impact mental health and psychosocial wellbeing. In contexts of overwhelming need and overstretched government health systems, nongovernmental organisations may play important roles. In this paper, we reflect on the role of Nepali nongovernmental organisations in providing mental health and psychosocial...

This paper explores protective and risk factors for mental health and psychosocial wellbeing among 300 child solders (verified minors) through a longitudinal study. Both the Hopkins Symptoms Check list and the Posttraumatic Stress Disorder Checklist (civilian version) were used to measure mental health problems, while the Generalised Estimating Equ...

Background Collaborations among researchers, clinicians, and individuals with mental illness from high-income countries (HICs) and low- and middle-income countries (LMICs) are crucial to produce research, interventions, and policies that are relevant, feasible, and ethical. However, global mental health and cultural psychiatry research publications...

For more than 20 years, thousands of Bhutanese refugees have been living in refugee camps in eastern Nepal, in an uncertain and challenging situation. Now, the possibility of resettlement is bringing even more challenges into their lives. In recognition of this situation, the nongovernmental organisation Transcultural Psychosocial Organisation Nepa...

Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. An adult cohort completed the Beck Depression...

ABSTRACT: Mental health and psychosocial wellbeing are key concerns in displaced populations. Despite urban refugees constituting more than half of the world's refugees, minimal attention has been paid to their psychosocial wellbeing. The purpose of this study was to assess coping behaviour and aspects of resilience amongst refugees in Kathmandu, N...

English back-translations of Nepali DSRS and CPSS. The final English back-translations of the Depression Self Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS) are compared with the original English items on the DSRS and CPSS. Comments are provided explaining changes in wording, use of probes, and structuring of items.

Nepali versions of the DSRS and CPSS. The final Nepali language translations of the Depression Self Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS).

The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings...

This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration....

A rich set of reflections on experiences with the Inter-Agency Standing Committee Mental Health and Psychosocial Support Guidelines in Emergency Settings has recently been published in this journal. This paper describes a case study of using the guidelines in Nepal, which focused primarily on detailed implementation of preparatory steps. In effect,...

Implementation of current international consensus guidelines regarding mental health and psychosocial support in emergencies requires the consideration of findings from both the medical and social sciences. This paper presents a multi-disciplinary review of reported findings regarding the relations between political violence, mental health and psyc...

The causes of ethnic and caste-based disparities in mental health are poorly understood. The study aimed to identify mediators underlying caste-based disparities in mental health in Nepal. A mixed methods ethnographic and epidemiological study of 307 adults (Dalit/Nepali, n=75; high caste Brahman and Chhetri, n=232) was assessed with Nepali version...

Midst the ploughs (ards) nowadays used in the Himalayan arc, the one employed in upper basin of the Karnali can be classed among the more archaic. Entirely made of wood and equipped with a wooden share, this instrument is efficient for working the soil, burying the compost and covering over the sown seeds. In this article not only the process of fa...