'Too much, too little' - heat wave impact during pregnancy and the need for adaptation measures.

The balls are rolling for climate change, with increasing vulnerability to women and children related to climate extreme events. Recent evidence has shown that acute exposure to heat wave during pregnancy can be associated with adverse health outcomes in childhood, with the risk being significantly higher among socially disadvantaged population, despite their lack of contribution to global carbon dioxide emissions and the rising global ambient temperature. This unequal impact requires utmost attention to develop tools, establish interdisciplinary teams, and to implement evidence-based interventions for the betterment of women and children in climate-vulnerable populations.

Global call to understand intersectionality between heat exposure and perinatal mental health.

Increasing heat events, due to human induced climate change have shown to affect vulnerable populations such as pregnant and postpartum women and their mental health. Moreover, consequences of heat events can be unevenly distributed, affecting communities with existing structural discrimination and socially and economically disadvantaged populations. The risk of perinatal depression might be higher in pregnant and postpartum women.

Every Newborn-Reach Up Early Education Intervention for All Children (EN-REACH)- a parent group intervention for school readiness in Bangladesh, Nepal, and Tanzania: study protocol for a cluster randomized controlled trial.

Background: Vulnerable children, including those with neuro-developmental delays and disabilities, often face barriers in accessing early primary education, thus hindering progress toward Sustainable Development Goal 4.2. Evidence-based interventions are essential to enhancing inclusivity and establishing sustainable implementation strategies to address this challenge.

Effect of non-optimal ambient temperature on preterm birth stratified by social positioning in Nepal: A space-time-stratified case-crossover study.

Background: The ongoing increase in the mean global temperature due to human induced climate change, indicates that women and infants will have higher exposure to heat events leading to adverse outcomes. The study investigates the effect of non-optimal ambient temperature on the risk of preterm birth stratified by social position in Nepal.

Method: This is a space-time-stratified case-crossover design, based on hospital-registered perinatal data between 2017 and 2021 (n = 47,807).

National chlorhexidine coverage and factors associated with newborn umbilical cord care in Bangladesh and Nepal: a cross-sectional analysis using household data.

Background: Preventable newborn deaths are a global tragedy with many of these deaths concentrated in the first week and day of life. A simple low-cost intervention, chlorhexidine cleansing of the umbilical cord, can prevent deaths from omphalitis, an infection of the umbilical cord. Bangladesh and Nepal have national policies promoting chlorhexidine use, as well as routinely collected household survey data, which allows for an assessment of coverage and predictors of the intervention.

'We did everything by phone': a qualitative study of mothers' experience of smartphone-aided screening of cerebral palsy in Kathmandu, Nepal.

Background: International guidelines recommend early intervention to all children at risk of cerebral palsy, but targeted screening programs are often lacking in low- and middle-income settings with the highest burden of disease. Smartphone applications have the potential to improve access to early diagnostics by empowering parents to film their children at home followed by centralized evaluation of videos with General Movements Assessment. We explored mothers' perceptions about participating in a smartphone aided cerebral palsy screening program in Kathmandu, Nepal.

Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal.

Background: Globally, every year, approximately 1 million foetal deaths take place during the intrapartum period, fetal heart monitoring (FHRM) and timely intervention can reduce these deaths.

Objective: This study evaluates the implementation barriers and facilitators of a device, Moyo for FHRM.

Methods: The study adopted a qualitative study design in four hospitals in Nepal where Moyo was implemented for HRM.

Mothers' acceptability of using novel technology with video and audio recording during newborn resuscitation: A cross-sectional survey.

Objective: This study aims to assess the acceptability of a novel technology, MAchine Learning Application (MALA), among the mothers of newborns who required resuscitation.

Setting: This study took place at Bharatpur Hospital, which is the second-largest public referral hospital with 13 000 deliveries per year in Nepal.

Design: This is a cross-sectional survey.

NeuroMotion smartphone application for remote General Movements Assessment: a feasibility study in Nepal.

Objectives: To evaluate the feasibility of using the NeuroMotion smartphone application for remote General Movements Assessment for screening infants for cerebral palsy in Kathmandu, Nepal.

Method: Thirty-one term-born infants at risk of cerebral palsy due to birth asphyxia or neonatal seizures were recruited for the follow-up at Paropakar Maternity and Women's Hospital, 1 October 2021 to 7 January 2022. Parents filmed their children at home using the application at 3 months' age and the videos were assessed for technical quality using a standardised form and for fidgety movements by Prechtl's General Movements Assessment.

Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal.

Background: Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention's successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the implementation of a novel resuscitation package as part of the quality improvement project in Nepal.

The contribution of community health systems to resilience: Case study of the response to the 2015 earthquake in Nepal.

Methods: Key informant interviews and focus group discussions were utilised. Participants included FCHVs, primary healthcare workers, community leaders and mothers, district health managers, representatives from the Ministry of Health and Population, multilateral health organisations, bilateral development partners, local non-governmental organisations, community-based organisations, and international non-governmental organisations. We used thematic content analysis to identify emerging themes.

Association of disrespectful care after childbirth and COVID-19 exposure with postpartum depression symptoms- a longitudinal cohort study in Nepal.

Background: The COVID-19 pandemic has led to unprecedented mental stress to women after childbirth. In this study, we assessed the association of disrespectful care after childbirth and COVID-19 exposure before/during labour with postpartum depression symptoms assessed at 7 and 45 days in Nepal.

Methods: A longitudinal cohort study was conducted in 9 hospitals of Nepal among 898 women.

Improved obstetric management after implementation of a scaled-up quality improvement intervention: A nested before-after study in three public hospitals in Nepal.

Background: We assessed the change in obstetric management after implementation of a quality improvement intervention, the Nepal Perinatal Quality Improvement Package (NePeriQIP).

Methods: The Nepal Perinatal Quality Improvement Package was a stepped-wedge cluster-randomized controlled trial conducted in 12 public hospitals in Nepal between April 2017 and October 2018. In this study, three hospitals allocated at different time points to the intervention were selected for a nested before-after analysis.