Pilot Field Test of Community-based Injury Survey with Burns Module: Nuwakot and Rasuwa Districts, Nepal 2016 March 31 2017 Pilot Field Test of Community-based Injury Survey with Burns Module: Nuwakot and Rasuwa Districts, Nepal 2016 Dr Hilary Wallace 1,2, *, Uden Maharjan 3, Sangeeta Khimbanjar 3, Subash Gajurel 3, Dr Sushil Chandra Baral 3 1. Consultant 91 Bruce St Nedlands, Western Australia 6009 Tel: +61 (0)439482546 Email: [email protected] 2. Senior Research Fellow Burn Injury Research Unit, M318 The University of Western Australia 35 Stirling Highway, Crawley 6009 Western Australia Tel: +61 (0)439482546 Email: [email protected] 3. HERD International PO Box 24133, Kathmandu Nepal Tel: +977 (0)14238045; 4102072 Fax: +977(0)14102016 Email: [email protected]; [email protected] Web: www.herdint.org.np * Corresponding author March 31 2017 March 31 2017 Table of Contents List of Figures ...................................................................................................................... i List of Tables ....................................................................................................................... i Abbreviations .................................................................................................................... iii Executive Summary ........................................................................................................... iv Acknowledgments ............................................................................................................. vi 1. Introduction ................................................................................................................... 1 1.1 Country background ..................................................................................................................... 1 1.1.1 Nepal - Geography .......................................................................................................... 1 1.1.2 Population ....................................................................................................................... 2 1.1.3 Nuwakot and Rasuwa districts – Geography and population ......................................... 2 1.1.3.1 Nuwakot district .......................................................................................................... 2 1.1.3.2 Rasuwa district ............................................................................................................ 3 1.1.4 Economic and Social Development ................................................................................. 3 1.1.5 Household Characteristics .............................................................................................. 4 1.2 Injuries .................................................................................................................................... 4 1.2.1 Global impact of injuries ................................................................................................. 4 1.2.2 Injuries in Nepal .............................................................................................................. 5 1.2.3 Nepal earthquakes 2015 ................................................................................................. 5 1.2.4 Community-based injury survey with burns module ...................................................... 7 2. Epidemiology of accidental injuries in Nuwakot and Rasuwa districts, Nepal ................. 8 2.1 Objectives ................................................................................................................................ 8 2.2 Methods .................................................................................................................................. 9 2.2.1 Study Population ............................................................................................................. 9 2.2.2 Ethical approval ............................................................................................................... 9 2.2.3 Sample size ...................................................................................................................... 9 2.2.4 Selection of clusters ........................................................................................................ 9 2.3 Implementation process ....................................................................................................... 11 2.4 Data collection ...................................................................................................................... 11 2.5 Variables ................................................................................................................................ 12 2.5.1 Household questionnaire .............................................................................................. 12 2.5.2 Injury questionnaire ...................................................................................................... 13 2.5.3 Burn injury module ....................................................................................................... 13 2.5.4 Impact of injury ............................................................................................................. 13 2.5.5 Progress Out of Poverty Index ...................................................................................... 14 ii 2.6 Recall period and case definition of injury ........................................................................... 14 2.7 Statistics ................................................................................................................................ 14 2.8 Results ................................................................................................................................... 15 2.8.1 Household sociodemographic characteristics by district ............................................. 15 2.8.2 Household energy use by district .................................................................................. 17 2.8.3 Injury deaths at household level by district .................................................................. 20 2.8.4 Non-fatal injuries at household level by district ........................................................... 21 2.8.5 Injury-related deaths – individual level ........................................................................ 22 2.8.6 Non-fatal injuries (all causes) - individual level ............................................................ 25 2.8.7 Injury treatment (all causes) ......................................................................................... 34 2.8.8 Burn injuries .................................................................................................................. 37 2.8.9 Burn injury treatment ................................................................................................... 42 2.8.10 Injury (all causes) impacts – impairment and disability ................................................ 43 2.8.11 Injury (all causes) impacts – economic impact ............................................................. 46 3. Suggested revisions to questionnaire........................................................................... 47 4. Discussion and Conclusions .......................................................................................... 48 References ....................................................................................................................... 52 Glossary ........................................................................................................................... 55 Appendix 1 HERD International Process Report……………………………………………………………59 Appendix 2 Injury Flip-Chart………………………………………………………………………………………149 Appendix 3 Progress Out of Poverty Index…………………………………………………………………187 Appendix 4 Revised Questionnaire - English version…………………………………………….……189 March 31 2017 i List of Figures Figure 1 Map of Nepal ........................................................................................................ 1 Figure 2 Location of Nuwakot and Rasuwa districts, Nepal ................................................. 3 Figure 3 Epicentre of Nepal earthquake, April 25 2015 (Gorkha earthquake) ..................... 6 Figure 4 Categorization of districts affected by Gorkha earthquake 2015 ........................... 7 Figure 5 Field researcher training and monitoring ............................................................ 11 Figure 6 Field researchers taking interviews with household head ................................... 12 Figure 7 Open-fire cookstove and improved cookstove .................................................... 18 List of Tables Table 1 Clusters selected for survey .................................................................................. 10 Table 2 Age – household members ................................................................................... 16 Table 3 Gender - household members .............................................................................. 16 Table 4 Caste/Ethnicity - household ................................................................................. 16 Table 5 Likelihood of household being in poverty ............................................................. 17 Table 6 Current residence ................................................................................................. 17 Table 7 Main type of stove ..............................................................................................