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Syfte Syftet med denna studie var att undersöka hur tandförlust påverkar den orala hälsorelaterade livskvalitén genom ett OHIP-14 fråge-formulär samt ytterligare konstruerade frågor, bland patienter som besöker Kantipur Dental College and Hospital (KDCH) i Katmandu, Nepal. Material och metod Data erhölls från ett frågeformulär baserat på OHIP-14, kompletterande frågor och klinisk undersökning. Studien var av beskrivande karaktär och undersökte konsekutiva patienter (n=249) som besökte KDCH. Data från ifyllda formulär analyserades genom SPSS för att undersöka sambandet mellan tandförlust och påverkan på livskvalitén. Resultat Medelåldern var 47.6 år med en könsfördelning på 48 % (n=119) män och 52 % (n=130) kvinnor. Det genomsnittliga antalet saknade tänder var 5, och den genomsnittliga totala OHIP-poängen var 21.57 (SD 12.55). De mest påverkade dimensionerna för OHIP-14 var "Fysisk smärta" (77 %) och "Psykologiskt obehag" (82.5 %). 96.8 % av den undersökta befolkningen upplevde någon form av påverkan på deras orala hälsorelaterad livskvalitet. Slutsats Resultaten i denna studie visar att en stor majoritet av patienterna som besöker KDCH upplever någon form av påverkan på sin oral-hälsorelaterade livskvalitet relaterad till tandförlust. De saknade tändernas position hade ingen signifikant effekt på den orala hälsorelaterade livskvaliteten medan en större inverkan på livskvalitén kunde observeras vid ökande antal saknade tänder. De OHIP-poäng, utifrån de kriterier som använts i denna studie, visade sig vara högre i jämförelse med andra internationella fynd. / Aim The aim of this study was to investigate how tooth loss affects the oral health related quality of life through an OHIP-14 questionnaire and additional questions among patients visiting the Kantipur Dental College and Hospital (KDCH) in Kathmandu, Nepal. Materials and method Data was obtained from a questionnaire based on the OHIP-14 form, additional questions and a clinical examination. The study was of a descriptive nature and investigated consecutive patients (n=249) visiting the KDCH. Data from completed forms were analysed with SPSS to investigate how tooth loss affects the oral health related quality of life (OHRQoL) Results Mean age was 47.6 years with a gender ratio of 48 % (n=119) male and 52 % (n=130) female. The mean number of missing teeth was 5, and the mean total OHIP-score was 21.57 (SD 12.55). The most frequently impacted dimensions for the OHIP-14 were “Physical pain” (77 %) and “Psychological discomfort” (82.5 %). 96.8 % of the investigated population experiencing some form of impact on their OHRQoL. Conclusion A large majority of the patients visiting the KDCH experienced an impact on their OHRQoL related to missing teeth. The number of missing teeth had an impact on OHRQoL, but the position of missing teeth had not. The OHIP score with the criteria used in this study was found to be higher in comparison to other international findings.

The practice of child marriage is deeply rooted in the Nepali history and still occurs in today’s society, even though it is illegal. Child marriages occur frequently in the Terai region, where Nepalgunj Municipality is located. The practice has shown to affect girls’ physical and mental health, as well as their social and financial development. The study aims at investigating the practice of child marriage and its effects on girls’ education in Nepalgunj Municipality. The purpose is further to understand how women, who got married as children, and different societal actors experience the practice of child marriage in relation to girls’ education. The study acknowledges gender and social construction as a theoretical framework and applies the idea of Agenda 2030, and the associated SDGs, as the guidelines for reaching a sustainable development, where all individuals can enjoy their human rights. Focus groups and semi-structured interviews were conducted to gather empirical material. The focus groups were carried through with women and religious leaders. Furthermore, semi-structured interviews were conducted with women and different societal actors; a principal, a government representative, and an employee at Child Workers in Nepal, CWIN, in Nepalgunj. The study showed that married girls’ chances to attend school decreased after the wedding. Several factors that affect their opportunities to continue their education after marriage were identified, such as restriction and surveillance, household work and pregnancy. The society’s idea that girls are not worth investing in also affects their chances to attend school.

Integrated Pest Management (IPM) technologies have proven to be effective at increasing agricultural productivity and have been credited for providing economic, health, and environmental benefits in many developing countries. In South Asia, population growth and the increasing demand for nutritious foods have put pressure on farmers to produce more food with a relatively inelastic supply of land. Productivity enhancing practices, like IPM, have helped some farmers to meet this demand; however, with over 50 million farmers in Bangladesh and Nepal it is difficult to reach them with information about new agricultural technologies. This study evaluates the current IPM dissemination strategy being implemented by the Bangladesh Department of Agricultural Extension (DAE) and uses a linear programming (LP) model to propose alternative strategies that may extend the total benefits from IPM technologies. Additionally, using data from a household survey, a bivariate probit model and a two-step endogenous participation model are used to identify factors that may influence both knowledge and adoption of IPM practices in three regions of Nepal. The results from the LP model suggest that more farmers could be effectively reached by reallocating funding that is currently used for interpersonal communications (i.e. extension agent visits and farmer field schools) to more widespread methods such as mass media and field days. The model also suggests that a dynamic dissemination strategy is necessary to encourage adoption of IPM technologies with differing characteristics and levels of complexity. The econometric analysis suggests that farmers with "network linkages" to agricultural information and inputs, such as membership in a farmer organization, are more likely to be aware of IPM and to adopt IPM practices. The survey data also suggest that farmers who are members of Marketing Planning Committees (MPC) may be more likely to adopt more IPM practices when compared to non-members. Overall, the study suggests that strategically disseminating IPM information is vital to promote the adoption of these technologies in South Asia. / Master of Science

Communities around the world are encountering unprecedented rates of change due to population growth, land use change, development, and increased social vulnerability to natural hazards. Understanding how physical processes and human vulnerability to natural hazards interact is a primary objective of researchers, policy makers, and disaster risk reduction practitioners in order to combat increases in natural hazard frequency and intensity. Nepal, a landlocked mountainous country spanning the central Himalayan region, has about 28 million inhabitants in 147,181 square kilometers. Nepal is exposed to a multitude of natural hazards, requiring individuals and communities to interact with and make decisions on risk acceptability on a day-to-day basis. In many cases, Nepal's geographic location, available resources (human, economic, and capital), and limited government capacity coalesce to turn natural hazards into disasters, resulting damaged infrastructure, economic disruptions, and death. This dissertation evaluates the geographic distribution of natural hazard mortality, quantifies social vulnerability to natural hazards, and models multi-hazard risk in the data deficient environment of Nepal. Chapter 1 conceptualizes relevant terms such as natural hazards, disaster, vulnerability, and risk before discussing the challenges associated with multi-hazard risk assessment in Nepal. Chapter 2 evaluates the spatial and temporal distribution of natural hazard mortalities at the village level using a publicly available disaster database. Results reveal that landslides were the deadliest disasters between 1971-2011. Chapter 3 identifies major social factors and processes that contribute to the vulnerability of individuals and communities using census data. Adapting the Social Vulnerability Index (SoVI) method developed for the US context, this chapter investigates the spatial distribution and clustering of various social vulnerabilities across the country. 'Renter and Occupation', 'Poverty and Poor Infrastructure', and 'Favorable Social Conditions' are three major components that influence social vulnerability in Nepal. Results indicate an interesting regional difference: the eastern and central Tarai are more vulnerable than western Tarai, whereas the eastern Hills and Mountains are less vulnerable than western Hills and Mountains. In Chapter 4, a model of risk from multiple natural hazards in the city of Dharan, Nepal, is presented. Freely available geospatial data in combination with socio-economic data collected from local government and secondary sources are used. Multi-hazard risk assessment is data intensive and requires considerable financial and human resources, which are lacking in Nepal. Results show that geospatial modeling techniques can be used to fill the gap and assist local officers and emergency managers in risk management. Cumulatively, this work offers new insights on natural hazards, vulnerability, risk, the use of geospatial technologies, and their inter-relationships. Research findings advance scholarly understandings of multi-hazard risk in general and particularly in the Nepali context. Additionally, this work is valuable to disaster practitioners who seek to implement more effective disaster risk reduction programs and policies. / Ph. D. / Natural hazards are earth system processes that pose threats to people and have the capacity to disrupt social and ecological processes. Thus, a consideration of both physical and social dimensions is required to better understand natural hazards. This research evaluates social factors and processes that have significant roles in enhancing the vulnerability of individuals and communities. First, this dissertation explores spatial and temporal patterns of natural hazard fatalities at the village level in Nepal. Research findings identified that landslides were the highest contributor to natural hazard fatalities from 1971-2011. Second, this dissertation assesses which social factors and processes contribute most to social vulnerability in Nepal. Additionally, the spatial distribution and clustering of social vulnerability is explored. Finally, geospatial modeling was performed to analyze cumulative risk to floods, landslides, and earthquakes in the municipality of Dharan, Nepal.

AN ABSTRACT OF THE DISSERTATION OFThaman Bastola, for the Doctor of Philosophy degree in Economics, presented on April 2, 2024, at Southern Illinois University Carbondale. TITLE: REMITTANCES IN NEPAL; LANDLOCKEDNESS AND INTERNATIONAL TRADE MAJOR PROFESSOR: Dr. Sajal LahiriThis dissertation concentrates on two key economic areas: trade and remittances. Executing many empirical models using relevant data and estimation techniques on each of these topics, we provide some novel findings about trade in landlocked countries and micro-level determinants of remittances in a landlocked country. The international trade of landlocked countries is critical, experiencing adverse geographical effects for exporting or importing. The first paper of this dissertation focuses on analyzing the impact of preferential trade agreements (PTAs) on the trade of landlocked countries. We find the more significant positive impact that calls for a strategy to join a PTA to address poverty and speed up the growth process through trade in landlocked developing countries. The second paper attempts to determine the probability of remittances related to micro-socioeconomic factors in a landlocked country, Nepal. The results show that gender, caste and ethnicity, income, language, religion, household size, wealth, age, and employment affect the probability of domestic or foreign remittances. The third paper is an extension of the second one, which examines Nepal's extensive and intensive margins of remittances. Most variables exhibit an opposite sign for foreign remittances between the extensive and intensive margins. Groups of households that display a higher rate of migration receive lower amounts of foreign remittances and vice-versa. On the other hand, the results somewhat diverge for domestic remittances, such as wealth have a positive effect in both margins but gender have a opposite effect between two margins; even though many variables are statistically insignificant, either extensive or intensive margins of remittances.

Currently, many developing countries are experiencing rising prevalences of caries associated with changes in lifestyle and living conditions. Objectives: To describe the hygiene, eating habits, and oral health status of Nepalese children. Materials and Methods: A stratifiedsample of 231 children 5–7, 11–13, and 15–16 years of age (53% boys, 47% girls) who attended public high schools in the rural area of the Lalitpur District, Nepal was selected. The study was a field study combining a clinical examination (plaque, gingivitis, calculus, and caries) and a questionnaire. The questions concerned sanitary conditions, health support, personal hygiene, tooth cleaning, and eating habits. Results: During the school day, half of the children ate nothing at all. General personal hygiene was associated with tooth-cleaning frequency.Four out of five children in the entire sample cleaned their teeth once/day or more, using their own toothbrush. The use of fluoride toothpaste was rare.More frequent tooth cleaning and lower plaque indices were seen among girls and older children. More plaque was found on the occlusal surfaces of erupting permanent molars than on fully occluded permanent molars. Most children had a low prevalence of manifest caries in the primary and the permanent dentitions. However, every fifth 5–7-yr-old had manifest caries in three or more primary teeth. The occlusal surfaces of molars accounted for almost all registered caries in both dentitions. Conclusion: Although the prevalence of manifest caries was low, the low level of preventive activities may cause an increase in the prevalence of caries, as in other developing countries. The presumed risk scenario needs to be met by comprehensive and systematic health promotion and preventive measures. / Sammanfattning: I många utvecklingsländer sker förändringar av livsstil och levnadsförhållanden med samtidig ökad förekomst av karies. Mål: Att beskriva hygien, matvanor och munhälsa hos nepalesiska barn. Material och Metod: Ett stratifierat urval av 231 barn, som i åldrarna 5-7, 11-13 och 15-16 år (53% pojkar, 47% flickor), elever i statliga grundskolor på landsbygden, Lalitpur distriktet Nepal, användes. Studien utformades som en fältstudie med klinisk undersökning (plack, gingivit, tandsten och karies) kombinerad med en enkätstudie. Frågorna rörde sanitära förhållanden, hälsostöd från hemmet, personlig hygien, tandrengörings- och matvanor. Resultat: Under skoldagen åt hälften av barnen ingenting alls. Allmän personlig hygien var associerad med tandrengörings frekvens. Av alla barn, som användande sin egen tandborste, borstade fyra av fem, en gång om dagen eller mer. Äldre barn och flickor rengjorde tänderna oftare och hade ett lägre plackindex. Mer plack fanns på erupterande molarers occlusalytor jämfört med molarer i full ocklusion. De flesta barnen hade en låg frekvens manifest karies i primära och permanenta bettet. Dock hade en femtedel av 5-7 åringarna tre eller fler manifesta kariesangrepp i primära bettet. Ocklusal karies på molarerna utgjorde nästan all registrerad karies i båda dentitionerna. Slutsats: Låg frekvens av manifest karies, men en låg grad av förebyggande aktiviteter, kan medföra en ökad kariesfrekvens liknande den i andra utvecklingsländer. Den förmodande risken måste bemötas med behovsinriktade och systematiska hälsobefrämjande och preventiva åtgärder. / <p>ISBN 91-7997-151-2</p>

The number of girls that are being exploited for prostitution in Nepal has increased in recent years, and girls suffer a high risk of being exposed when they come from already poorly conditions. Previously, uneducated girls could be found in the adult entertainment sector, but nowadays even educated girls are being exploited. This thesis aims to gain further understanding to why girls are being exposed and why it is difficult to protect them. By conducting qualitive interviews with employees from several NGOs working to protect girls from being exploited for prostitution, insights has been given about socio-structural factors that influences the situation for girls. By examining these factors with support from theoretical approaches that highlights social injustice, gender discrimination and structural oppression this thesis presents how different factors affect the work of protecting girls, and how the same factors also are contributing to why girls get exposed. The state of Nepal shows several efforts in trying to eradicate the problem and have ratified both the Convention on the Rights of the Child and the Optional Protocol to the Convention on the Rights of the Child on the sale of children, child prostitution and child pornography. The state has also made changes in national law that shall promote and strengthen children's rights. Although the laws are strong, the protection for girls is insufficient and girls are vulnerable to being exploited by traffickers. The Government of Nepal, NGOs and several other authorities are working together to eradicate the problem, but the work needs be strengthened, coordinated and responsive to influencing factors simultaneously in order to achieve a long-term solution. This thesis suggest that cultural norms need to be challenged more and that the Government of Nepal needs to oversee how structural injustices affect opportunities for girls to take part of social benefits. In addition, knowledge about legal and moral rights needs to be increased among girls and in society as a whole, moreover the knowledge about trafficking and prostitution needs to be spread.

This thesis examines how and to what extent humanitarian aid organizations strategically focus on gender roles following disasters, and how they contribute to potential changes in gender roles. The case selected for the study is Nepal after the 2015 earthquakes where the reports of four international humanitarian aid organizations were examined through a qualitative content analysis. The thesis aims to provide a contribution to the disaster risk reduction literature with a special focus on the possibilities to use disasters as catalysts for changes in traditional gender roles. As humanitarian organizations are major actors in the aftermath of disasters, the purpose is to evaluate their efforts and connect that to previous literature in the field. As a theoretical foundation two contrasting theories are incorporated in the study, the first is the idea that a disaster can be a ’window of opportunity’ for changes in gender roles whereas the other one is that vulnerable people is often left more vulnerable after a disaster due to secondary consequences, a so called double disaster.  The main findings of the study demonstrate that none of the four international humanitarian organizations incorporated a gendered perspective in their aid efforts following the earthquakes in Nepal 2015. The organizations seldom separate women from men in their reports, demonstrating an unawareness of the gender power structures at play. Few activities had a potential to empower women and the ones that did lacked a long-term perspective to enhance gender equality and lower vulnerability.

Despite widespread depiction of civil war as a pathway to autocracy or state failure, the empirical record shows significant variation in post-civil war states' regime trajectories. While some states settled into durable authoritarianism, others went on to enter the ranks of electoral democracies shortly after belligerents laid down their arms. What explains this variation? In the extreme, how is it that a state that is staunchly autocratic at the war's outbreak can emerge from it a nascent democracy? This study proposes that post-civil war regime outcomes have wartime origins. Differences in the nature of rebel governance of civilians generate different social and institutional legacies across civil wars. These legacies can endure into peacetime politics, affecting the latter in often unintended ways. The theory centers on two wartime transformations that result from different forms of rebel governance. First, where rebels depend heavily on civilian material support, civilians become mobilized as a political force. Widespread social mobilization can in turn create political pressures on postwar elites to respond with a democratization strategy. Second, where rebel groups engage in extensive wartime "statebuilding," they create formal and informal institutions of governance which they can carry over into postwar politics should they prevail in the war. Because institutions are sticky, how they govern civilians in times of war can affect how they will govern in times of peace. These arguments are tested using both quantitative and qualitative methods. An original cross-national dataset on rebel governance for all civil wars ending between 1950 and 2006 serves as the basis, first, for a novel empirical analysis of rebel governance in civil war, then for statistical tests of the theory. To further probe the theory's causal claims, the study engages in an in-depth analysis of the Nepalese civil war and its political aftermath based on field interviews. The theory is further tested in a comparative analysis of the Ugandan, Tajik, and Mozambican civil wars. Together, empirical findings show that rebel governance in civil war can catalyze significant social and political change, with enduring impacts on postwar political regimes. The study offers theoretical and practical implications for our understanding of, and response to, the politics of violent rebellion and its effects on regime development.