Table 1: Analysis of the researches from the first and second Nepal Health Reseach Council, Health and Population Scientists Abstract Book.

Research Title, Objectives, and Rationales	Methodological approach (M), findings (F), recommendations and conclusions (RC)		What sorts of assumptions and neoliberal traits are seen in the concerned research?
1 - Influence of mothers, knowledge, attitude and behaviour on diet and physical activity of their pre-school children: a cross sectional study from a semi-urban area of Nepal. To explore knowledge, attitude and behaviour of mothers regarding diet and physical activity of their pre-school children[175].	M - Cross-sectional study in a semi-urban area. Nine trained enumerators interviewed all mothers having children aged 2 to 7 years in their homes and scored knowledge, attitude and behaviour responses. F - Poor correlation of mothers’ knowledge and attitude with children’s behaviour regarding diet and physical activity. RC - Improving mothers’ knowledge or attitude may not be enough to improve dietary and physical activity habits of their children. Barriers and facilitators that affect mothers’ practices towards their children should also be explored and addressed[175].		The factory made consumables in various forms, tastes and price are available in the market and to create a desire; various strategies are adopted targeting various age groups. These products are shown to signify various events and also get associated with happiness, adventurism, energizing, sharing, loving, caring, and there is no dearth of superstars endorsing these products. ‘Dietary risk factors and physical inactivity are only partially determined by individual preferences, and are more so substantially influenced by the manufacturing and marketing practices of the food industry and by the built and social environments that permit or impede physical activity’[176]. Programs, projects, researches, campaigns are done such as health literacy, health education and health campaigns. These are all open sources of reliable and accurate information to the society at large. The people at the micro level must act on such information and must make all personal efforts to act responsibly and those who do not, are blamed for sinning. Health is seen as a personal responsibility and individual citizens who do not comply are blamed. The individual has to choose and in this case the knowledge of the mother is assessed and recommendations are made to identify the barriers and overcome them. The whole focus of the research begins and ends with the mother and her knowledge. In fact much research exists to show that social, cultural, economic effects on individual behaviour. But under neoliberalism ‘victim-blaming’[177] [178] rather than, ‘regulatory mechanism defects’ are taken in to account[179]. Knowledge without the ability to buy, without the ability to afford, maintain and sustain can become a burden for further stress.
2 - The effects of an educational intervention on new-born care knowledge, anxiety and confidence among primiparous mothers in Nepal. To determine the effectiveness of newborn care educational program on maternal newborn care knowledge, confidence, and anxiety[175].	M - A randomized controlled trial study with primiparous mothers who delivered a healthy full term baby in a hospital. The intervention group received a one-to-one new-born care educational session 10-15 minutes prior to discharge. Outcome was measured using the New-born Care Knowledge Questionnaire, Karitane Parenting Confidence Scale, and State Trait Anxiety Inventory for Adults prior to the intervention and 5-6 weeks postpartum. F - Educational intervention increased maternal knowledge of newborn care and maternal confidence; and it reduced anxiety in Nepalese primiparous mothers.		Mothers have been one of the focal point of development but the mother that gets created under neoliberalism bears the responsibility to have a healthy baby, and then nurture it and fulfil the biological needs. The fundamentalist assumption is that the mother is an empty vessel and she needs some programming on new-born care. Most existing health programs focuses on the mothering role during their reproductive programs and these programs are based on the fundamentalist assumption that infant mortality is, ‘simply a question of motherhood and ignorance of infant care and management’ and good mothering is an ‘individual responsibility’. If the mother bears resemblance in lifestyle to that of Rakku[180] or Acéphie [181] would George Newman still hold that the, ‘source of infant mortality was ‘ignorance and feckless mothering?[182] The Beveridge Report (1942), strengthened the belief of the individual responsibility by identifying the five great social evils squalor, ignorance, want, idleness and disease and was a defining moment in changing the course of welfare provision[179]. This individualistic approach has been adopted and now it seems like a truism to policy makers, researchers, intellectuals and the citizens at large.
	RC - This educational program could be integrated into routine educational programs to promote maternal and infant well-being in Nepalese society[175].
3 - Knowledge on uterine prolapse (UP) among married women of reproductive age in Nepal. To assess UP knowledge among married reproductive women, and determine the association of UP knowledge with socioeconomic characteristics[175].	M - Cross-sectional descriptive study among 4693 married women aged 15-49 years. Assessed UP knowledge using structured questionnaires. F - Simple regression analysis identified a possible association between socioeconomic characteristics, ever heard about UP and level of UP knowledge. RC - UP-related health promotion programs should target women from all caste/ethnic groups, age groups, and education levels, including urban and rural communities[175].		Spreading knowledge among the ignorant is key to a healthy individual and a healthy society. The awareness of the health condition and knowledge on risk factors of this condition will lead to prevention of it. The risk factors for UP have been known[183], and it has been associated with violation of human rights and also as cultural and structural violence[184]. Health literacy programs, health education and awareness programs are the solutions, usually the only solution. The process of desertification[185], industrial toxic pollution which could result in fetching water for millions and factors such as nature of the job, where they are required to squat for prolonged periods or carry heavy loads are rarely taken into account. What about a physician who smokes a scientist who does not wear a helmet on a motorcycle? Would it be correct to blame lack of knowledge or could it be a host of factors (social, political, cultural, economic, geographical, historical, and legal)? But when it comes to the population being researched, the detached, de-politicized, dehistoricized, dissocialized, reductionist stance is adopted. The Cartesian ontology rules and this has shaped native researchers, teachers, students, policy makers etc.
4 - Knowledge and practice on voluntarily blood donation among bachelor level students of Kathmandu. To assess knowledge and practice on voluntarily blood donation among bachelor students[175].	M - Cross-sectional descriptive study using Self-administered structured questionnaire. F - Programs to promote blood donation in Nepal should focus more on providing information about blood collection facilities or camps. RC - Direct approach with request to donate would increase blood donation[175].		LET IT PASS BYE. The nature of the argument is not applicable to certain researches, such as this. Views could differ. Here to promote blood notation knowledge among students is assessed and direct approach with request to donate blood increases blood donation is the recommendation. Blood donation has largely entered in to the discourse of public health due to disease transmission and the act has remained benevolent where we don’t get anything in return and nor do we expect anything in return apart from what science asks to be provided to the donors. Though attempts to commercialise blood donation was made around the mid nineteen sixties in United States this sector has remained free around the world.
5 - Knowledge diversity and resources of traditional Healers and healing practices in western development region of Nepal. To assess the current situation of traditional healers in terms of healing practices, knowledge and resources used in Western Nepal[175].	M - Cross-sectional descriptive study was carried out using qualitative research method between November 2014 and June 2015. F - Data were collected from 50 traditional healers. This practice was widely prevalent and medicinal plants, minerals animal products, worshiping certain deities, animal sacrifice and certain native procedures were done as treatment. RC - The traditional practical healing practices should be scientifically validated and integrated into the health system[175].		With the implementation of various international policies largely in matters of trade, such as patent, rules of origin and along with the development of corporatization there has been instances where products made from traditional plants ( neem, turmeric, extracts of black pepper, ayahuaska, Hoodia gordonii) were filed for patents[186]. Not surprisingly all the applicants were submitted to US Patent and Trademark Office. Nepal recently became the 148th member of the World Trade Organization (WTO) and was the first least developed country along with Cambodia to join this organization through full Working Party negotiations[187]. The practice of claiming ownership and monopoly over products has been restricted to foreign bodies. When a new product is made, invented, created the creator or manufacturers in the case of medicinal products gets twenty years of unhindered access to the market[188]. When recommending the research calls for scientific validation and integration into the health system. Naive it may sound, but what sort of integration does one have in mind? The health system is closely related to the market system under neoliberalism and the societal; health, education and other societal needs are treated at par with other products. The extreme would be choosing which finger to save, since the insurance covers the cost of only one finger.
6 - Assessment of the knowledge and attitude of clinicians towards research writings in Nepal, the factors promoting and barriers to clinical research. To assess the attitude and awareness of clinicians towards clinical research and identify factors promoting and barriers[175].	M - Survey questionnaire based on 28 items under 3 main headings was prepared and distributed in person. Responses were graded according to the 5-point Likert scale. F&RC. Barriers were lack of structured research training (84.1%), lack of time (79.5%), lack of resources (70.1%), and financial compensation (67.3%). Providing proper training and research environment would definitely improve the clinical research activities in the country[175].		The need for research publications has become an indispensable criterion for promotion in universities. The ‘publish or perish’ approach has been strongly supported. It is not the routine activities such as patient satisfaction or students mandate that even partially determines the promotion. So to reduce these sorts of value laden evaluations, the blinded peer review process comes in to the picture. All academic, research journals are adopting this process. These journals are being created by likeminded scientists, researchers, organizations and universities. Different journals have different philosophies, purposes and principles. They cater to the needs of various parties ranging from pharmaceutical companies to some pressure group. The profound nature of instrumentalization and commercialization of researches has led to unethical research practices both by individuals, groups, foundations, organizations, companies and even nations.
7 - Health literacy and knowledge of chronic diseases in Nepal. To find the health literacy and knowledge of disease among the patients with chronic disease[175].	M - Cross sectional study with 426 respondents from the tertiary care and the primary care who had one of the chronic, diseases (Hypertension, Diabetes Mellitus and COPD) was interviewed face to face. Health literacy measured using translated, pretested, validated European Health Literacy Survey (HLS-EU-Asia-Q) 2 questionnaire, demographic information was collected. Disease related knowledge was assessed using a validated questionnaire. F&RC - 27% of all respondents had sufficient health literacy compared to inadequate health literacy (54%) and problematic health literacy (19%). Respondents with inadequate health literacy knew less about hypertension (12.38 ± 5.230) compared to sufficient heath literacy (18.70 ± 4.296) p<0.001; regarding diabetes mellitus, those with inadequate health literacy knew less about diabetes (4.15 ± 2.348) compared to those with sufficient health literacy (7.90 ± 1.973) p<0.001 and regarding COPD, those with inadequate health literacy knew less about COPD (12.65 ± 6.613) compared to sufficient health literacy (23.40 ± 7.734) p<0.001. Sufficient health literacy knew significantly more about the disease than those with inadequate health literacy. Health literacy is independently associated with disease knowledge[175].		Health literacy which goes beyond mere literacy level. Here the health literacy of patients was assessed and sufficient health literacy, inadequate health literacy and problematic health literacy were the categories identified. Knowledge and lack of it, has been the greatest obstacle for less compliance and adherence by patients. These camouflaged assumptions[189]hide the processes that make individuals conduct the way they do in everyday life. The assumption is that the social, economic, cultural, political, professional and ethnical are beside the point. Like others ahead have asked, is it justified to consider individuals themselves responsible for their being?[190] The temptations, desires must be controlled, though the obesogenic environment is being promoted through various processes that occur under neoliberalism. From toddlers to the old everyone is targeted through various means by the sellers of the products. By adhering to basic social, cultural, legal conditions, various advertisements or popular medias are used to portray different phases of life, relations in life and in different activities one does in one’s life. From diamonds to diapers and from an educational degree to the housing address all signify happiness, love, and prestige to comfort.
8 - Effectiveness of an information booklet on knowledge regarding life style management among coronary heart disease (CHD) patients in a cardiac centre, Kathmandu valley. To identify the effectiveness of educational intervention on ‘Living well with CHD’, identifying demographic and disease related characteristics and level of knowledge regarding life style management among CHD patients[175].	M- Pre-experimental research design used among 100 CHD patients. In pre-test base line information were collected. Using prepared education intervention package regular one hour teaching sessions were arranged in hospital regularly for one week. Each participant was provided the booklet prepared in Nepali during the education sessions. After one month of education intervention program the post test was conducted using same interview.		Arguments in the above tables are relevant to this research too. The assumption that educational intervention through a booklet will be effective for managing one’s lifestyle and one’s disease. Provided certain basic conditions that are required to live are thought to be in place a priori, this method could have still been rationalized. Here the research is detached from the reality, and by adopting a positivist, reductionist stance the research is seen to be oblivious of the conditions in which the researched lives.
	F - Questionnaire and feedback questionnaire and analysed by using percentage and McNemar test for significance at 0.0001 levels among pre and post test score. The patients were categorized into ‘inadequate and adequate knowledge regarding life style management among CHD patients. Education intervention programme had significant role in increasing knowledge of life style management among CHD patients. It was effective and useful for their day to day life style management. RC - Recommends similar type of programme for CHD patients in community setting should be conducted[175].
9 - Interventional study on knowledge and practice of hand washing among school age children in government school of Kathmandu. To assess the effectiveness of educational intervention on knowledge and practice of hand washing among school age children[175].	M - An educational interventional study was conducted using a self-developed interventional package among 86 participants of grade four and grade five children. Pre- experimental research design with one group for pre-test and post-test design was used. Data collection was done through distribution of semi-structured questionnaire to the participants. Comparison of level of knowledge regarding different aspects of hand washing in pre and post-test was done using descriptive statistics and significance of the education intervention was assessed using inferential statistics at 0.05 level of significance. F&RC - Educational intervention can be an effective means for increasing knowledge and practice of hand washing among school age children and change in behaviour was possible if the educational intervention is properly implemented thus this will helps to decline the absenteeism of the students[175].		Modifying risk factors at the individual level have been the dominant approach. Knowledge and practice of hand washing, personal hygiene and sanitation are basic necessities to protect oneself from various diseases such as cholera. From the second half of the nineteenth century onwards rates of mortality and morbidity from infectious diseases began to plummet and behavioural changes regarding hygienic practices such as washing of hand with soap and improved personal hygiene were attributed for the decline. ‘However, it would be erroneous to understand cholera as having been effectively crushed in Western societies due to improved personal hygiene of people in industrialised and industrialising countries in this period’[191].. One factor was historical. In the industrialized West, in the second half of the 19th century, witnessed dramatic improvements in wages, housing, diet, and education. Along with the ‘social uplift’ – and the sanitary movement (‘miasma control’)[192] developed nations erected the solid fortifications of sanitation and public health: sewers, drains, sand filtration, and chlorination of water as defences against cholera and typhoid; sanitary cordons, quarantine, and isolation[193]. Despite the historical evidences (social, economic reforms) of the reasons for decline in disease conditions, the selective approach with its ‘magic bullet’ approach has been the strategy applied in least developed and developing nations. The behavioural change sought in the third world countries relies on strategies taken from health promotion, health education and more recently health literacy. Without accompanying social and economic changes that ensures housing, education and food, the individualistic approach adopted has largely resulted in little success. This research is done in the capital city of Nepal which faces acute shortage of water with irregular water supply usually and that too being available for an hour or too. Also drinking water in Kathmandu is known to be very poor with high bacteriological contamination even in supposedly ‘safe’ water sources[194]. Besides overcoming one’s lack of knowledge regarding hand washing, lack of other enabling factors like regular water supply and financial capacity to buy soaps regularly are also essential to maintain the habit since budgets cuts on public education has seen a deterioration in standards. The colonial way of seeing and understanding has been adopted by the native researchers and when seeing through the colonial lens, the crusades for civilizing the savages have continued till date.
10 - Exploring the level of knowledge, attitude and practices (KAP) of emergency contraceptive (EC) among college students of Banepa Municipality of Kavre district. To assess the knowledge and attitude towards EC, and as well to determine the prevalence of emergency contraceptive use among students[175].	M - Descriptive cross sectional study design was used. Target population was bachelor level students which includes both married and unmarried youths. Total 10 colleges of Banepa Municipality were selected. Simple random sampling was done and 4 colleges were selected randomly for the data collection. Total sample size was 131 including non-responsive errors. Pretesting was done on similar setting to check the validity, consistency, and errors so that necessary modifications on tools can be done. Structured anonymous SAQ was used for the collection of necessary quantitative data. F - Median age of the respondents was 21 years. Among them 56.5% were female. 90% of the respondents had heard about EC. RC - Even though majority of the respondents had heard about EC, many of them had misconception about it. Also, unmarried youths were highly engaged in sexual experience since early age which can create lots of health problems regarding unintended pregnancy, unsafe abortion and abortion related complications[175].		Knowledge builds up the attitude and this leads to practice. Knowledge, attitude and practice studies focus on the individual behaviour and it seeks to discard, change or adopt certain ways of doing particular things. In this case KAP of EC among college students is assessed. Historically contraceptive was first used to prevent pregnancy resulting from illicit affairs. Here the focus is on students (married, unmarried) and the reason for using EC varies. For married couples EC could be used to prevent unplanned pregnancy or not having many children. For unmarried couples the reason of use is to prevent pregnancy since it brings immense shame and humiliation. Most behavioural practices like washing hands, wearing helmet, using mosquito nets (overt) can be observed in the act but for use of contraceptives or EC (covert) in this case can only be known by asking, whether it is used or not used. Indeed for married couples the number of children they have can give us some indication of its use. But for the unmarried especially girls even talking about contraceptives can label them as immoral, having a loose character or even a prostitute. Women are seen as the moral flag bearers and this has historically conditioned the image of the ideal woman, as being of shy nature, having a subdued character, speaking silently and a host of other traits. ‘Socially desirable responding’[195] has been shown to under report or over report. Contraceptive methods are not just ‘things-in-themselves’ They cannot be separated from the social, political, and economic contexts in which they are utilized[196]. Knowledge, attitude, availability are important determinants for use of EC, but as illustrated from research findings on China and India, Amartya Sen established a link between women’s power and control over fertility and it has also been claimed that, the ‘best contraceptives’ are , ‘education and economic independence’[197].
11 - Effectiveness of educational intervention on knowledge regarding uterine prolapse among reproductive age group women of Budhanilkantha municipality ward no 7 of Kathmandu District. To assess the effectiveness of educational intervention on knowledge regarding uterine prolapse among reproductive age group women[175].	M - Semi structured interview schedule consisting of questions related to demographic characteristics and knowledge regarding uterine prolapse was developed by review of literature. An education interventional study was conducted among 45 reproductive age group women of Budhanilkantha municipality using a pre- experimental research design with one group for pre-test and post-test design. The level of knowledge regarding different aspects of uterine was compared using descriptive statistic. F - 45 participants, 57.8% of the participants had good knowledge regarding uterine prolapse in pre-test which was increased to 77.8% in post-test. RC - Educational intervention can be an effective means for increasing knowledge about preventable disease like uterine prolapse among targeted population away from the central communication Medias such as radio, television[175].		The points mentioned in table three are also applicable regarding this research. Detachment from the realities of everyday life of a women and only addressing the problem through educational intervention at the individual level gives a superficial solution to the problem. Carrying heavy loads, doing extensive physical labour during & after pregnancy, giving birth to many children and having a low maternal weight due to lack of nutritious food have been identified as the main risk factors[198]. The invisibilisation of the social, economic, cultural, gendered and political conditions when dealing with any health condition has been a trait of neoliberal thinking.
12 - Effectiveness of educational intervention on knowledge regarding emergency contraceptives among study and control Group of late adolescent girls. To assess effectiveness of educational intervention[175].	M – Educational intervention about emergency contraceptives was done. A quasi-experimental, pre- post-test study design was carried out among 40 late adolescent girls. F&RC - Educational intervention was found to be fruitful for increasing the knowledge score of study group. So, this study recommends for doing educational intervention to the students[175].		The arguments made in table ten are relevant to this research also. The burden of contraception falls heavily on the women[199]. The western forms of hormonal contraceptives has been shown as liberating for women, but with it arrives the baggage of the medical-industrial complex and its underlying ideologies, which seek to benefit from widespread sales, distribution, and use[200]. For women from developing and least developed countries the hormonal contraceptive dosages which has been designed for women in developed nations could be excessively high and resulting in severe side-effects leading to discontinuation and, potentially, unplanned pregnancy[201]. ‘Women are seen as objects rather than subjects (or agents) in their own homes and communities, which is mirrored also within health systems in the philosophy with which reproductive health services were given. Women were considered as means in the course of reproduction, and as targets in the process of fertility control. Services were not provided to women as ends in themselves. Although, women benefited from the process, they were not at its centre[202]. These barriers are often the manifestations of women’s low social status, lack of autonomy, and rights[202]. ‘The Third World market is seen as an incentive, particularly for the less safe hormonal and chemical implants and injectable contraceptives. In addition, it is also seen as a haven for cheap and unethical clinical trials, with easy access to women who can be paid to participate, or can even be experimented upon without their consent’[203]. ‘Contraceptives are important new technological ‘facts’ on the global stage. However, just as importantly they are mental ‘conceptions.’ Methods of contraception ‘do not just ‘work,’ ‘they work in bodies in a wide variety of perceived ways’ and are both medical practices and social constructions[196].
13 - Teachers’ knowledge regarding malnutrition of school children at government schools of Bharatpur sub-metropolitan City. To assess teachers’ knowledge regarding malnutrition of school children at government schools[175].	M - Cross sectional descriptive study was done by using simple random sampling technique. Data was collected through semi-structured self- administered questionnaire. The data was entered into IBM SPSS 19 version and analysed by using descriptive and inferential statistics. F - 70.7% of respondents had been encountered with malnourished children and 79.3% got information on malnutrition through books. Out of 150 primary school teachers, 35% had good, 33% had average, 20% had below average and 12% had very good level of knowledge. The total mean knowledge score of respondents was 30.12 with 6.32 of standard deviation and the total percent of mean score was 60% which shows average level knowledge on malnutrition of school children. RC - Emphasis should be placed on periodical in-service education and training program for primary school teachers to increase their knowledge about nutrition, nutritional disorders where the health and education ministry and its policy can play the key role for uplifting knowledge among teachers, students and society[175].		Malnutrition has been seen as an anomaly that results due to individual habits that are offshoots of low literacy and ignorance. The primary reason for malnutrition is lack of knowledge, and because the family, mother, a particular group or a community does not know about proper dietary regime.Here knowledge regarding malnutrition among government school teachers is assessed at the individual personal level and the biomedical, physiological characteristics of malnutrition are considered as appropriate knowledge. Teachers play an important role in shaping the structure of knowledge, at the school level. The reflexive role of teachers has been highly curbed under a banking mode of education system. Under neoliberalism by ‘cutting the vocal chords’ as explained by Evernden, the attitude of ‘callousness’ is hidden under the garb of ‘scientific detachment’[92]. The neoliberal system of education creates researchers, scientists and teachers embedded with objectivity and scientism who carry with them as Santiago Castro has called the ‘hubris of the zero point’[204].‘The ‘monoculture model’ in the food and agriculture system ‘geared towards genetic unification’ has been labelled as ‘agro colonialism’[205]. The individual is targeted and based on the ‘ceteris paribus’ assumption, the problem is understood, defined, studied, approached with a methodological individualist approach. The ‘Foreign Direct Investment’ (FDI) induced ‘American Way of Life’ ‘industrial diet’, ‘neoliberal diet’ ‘industrial diet’, ‘pseudo foods’ ‘meatification’ ‘privilege taste over nutrition’ ‘spread of fast food establishments’ breeds overconsumption and from the 1950’s to date there has been an astounding increase in different products that are manufactured in mass and many a times most of these products are available at a cheaper price than natural food items.
14 - Knowledge and preventive practices related to avian influenza among poultry workers of Kamalamai Municipality, Sindhuli. Aims to assess knowledge and preventive practices related to Avian Influenza among poultry workers of Kamalamai municipality, Sindhuli, Nepal[206].	M - Cross-sectional descriptive design using semi-structured interview questionnaires to assess the knowledge and preventive practices and checklists to observe the preventive practices. Sample size for this study was 132, Forty-four poultry farms having three workers were selected randomly by using lottery method. On the day of data collection some respondents were absent so that only 122 respondents were interviewed by using semi-structured interview schedule. F - (93.4%) had heard about the Avian Influenza. More than half (54.9%) of the respondents had a 'poor knowledge'; followed by 'average knowledge' (44.3%) and 'good knowledge' (0.8%) about Avian Influenza. Majority of them (93.4%) had 'average practice' for preventing Avian Influenza; followed by 'good practice' (4.9%) and 'poor practice' (1.6%). RC - extensive health education and health promotion programs are recommended to prevent AI in poultry giving more emphasis on mass communication like electronic and print media[206].			Since the late 1990’s the emergence of new highly pathogenic avian influenza strains of viruses, H5N1 flu on and its resulting devastating effects have resulted in guidelines of practices for protection. The chain of virus transmission has the consumers of poultry at the end and its manufacturers the poultry farmers at its starting point. In between these two agents the production process has acquired a procrustean structure where the farmed animals are imprisoned in alien, dysfunctional, and disease-prone bodies genetically manipulated for food traits alone, bodies that in many cases have been surgically altered, creating a disfigured appearance[207]. According to Hinchliffe and Bingham show that the ‘WHO consensus that avian flu can be traced to the interaction of wild bird migration and domestic poultry has meant that measures to counteract avian flu — particularly culling techniques — have disproportionately harmed the poor and benefited large-scale poultry farms that international officials assume to be biosecure’. WHO-prescribed program of massive poultry culling to mitigate the risk of avian flu contagion. The program, based on an emergency-oriented protocol designed to be implemented automatically in the event of disease detection, is an example of the effort to develop a ‘standard, worldwide approach to dealing with ‘out of place’ biological entities.’ the ‘contemporary project of worldwide integration and harmonization of biosecurity measures,’ exemplified by such mass culling programs, ‘is fraught with risks however appealing it might sound’, it may fail to decrease the likelihood of a flu pandemic, while exacerbating problems of hunger and poverty. They suggest that the uncertainties endemic to contemporary biosecurity threats such as avian flu point to the need to develop new ways of living with and managing the possibility of outbreaks that are more nuanced than current attempts to achieve absolute security at the expense of local wellbeing. ‘An alternative theory — that the spread of avian flu can be traced to the international circulation of poultry through legal or illegal trade, and to industrial poultry production and processing — has been largely ignored in inter- national protocols to contain the disease, but would imply a very different set of measures’. ‘Most humans are culturally conditioned to believe that chickens naturally exist as objects for human consumption and use, their ‘natural’ habitat assumed to be the human-constructed world of a farm’[207].
15 – Knowledge and practice on safe use of pesticides among farmers in rural area of Kaski district. Assess knowledge and practice on safe use among farmers in rural area of Kaski district[206].	M - Cross sectional study was conducted among 384 farmers in Six Village development committee (VDC) and farmers using pesticides for any agricultural product were randomly selected. F - Majority (66.4%) of the respondents were female. The mean participant scores for knowledge and safety procedures were 15.48 ± 6.41 out of 41 and 9.23 ± 3.27 out of 22, respectively. Nearly four fifth (79.2%) of the respondents knew about safe use of pesticide. Among them 98% knew about importance of safe use pesticide. But only 66.1% used personal protective equipment (PPE). Level of practice has statistically significant relationship with level of knowledge (P<001). Storage of pesticide at animal shed, disposal of unwanted pesticide by burning, not using adequate protective clothing and not reading label/instruction on pesticide container were identified as unsafe practices. Self-reported health problems due to pesticide exposure were headache (66.7%), eye irritation (32.3%) skin irritation (27.3%). RC - practice regarding safe use of pesticide is still poor among farmers in rural area of Kaski district. Behaviours change and communication programs focusing on proper use of PPE (personal protective equipment), storage, disposal and reading label instruction on pesticide container should be conducted[206].		Pesticides along with many other human creations has created a boomerang effect where traditional geographical boundaries are broken and the risks associated with radioactivity or pesticides have affected the population at all levels irrespective of who they are. Moreover with the pursuit of market oriented goals and the approaches adopted to achieve these goals have led to unethical practices in various sectors throughout the world. Some clear examples such as the thalidomide disaster and Bhopal gas tragedy were the result of narrowing of interest to pecuniary measures. In case of thalidomide the resulting loss of sales which could result if information on its use and effects was disclosed was kept away on purpose and in case of the later gas tragedy cost cutting measures led to the disaster. In both the case the pursuit of commercial gains blinded the actors and the agencies. Pesticides, insecticides, fertilizers, chemicals have been in focus since the publishing of the ‘silent spring; by Carson, and by the nineties the issues of ozone layer depletion, climate change, global warming have come to the forefront in the new international economic order. For a nation like Nepal where most population still rely on agriculture to survive in this new economic order the issue of pesticide is of utmost importance. The government makes decision and based on their decisions the regulation of these products are done by concerned authorities, but since the government is also attached to the world economic order it has to take its decisions based on various international treaties which again recommend principles that are homogenizing, competitive, self-regulatory and profit based. Here the focus of the research is largely focused at the individual behavioural and the local level. Personal actions that must be done for the safe use of a product are identified and if these are adhered to then there will be no negative effects. As to the nature of the ingredients and its qualities its users have to trust the authorities and the government all in all what Foucault termed as the ‘mathesis’ understood as a universal science of measurement and order. The reductionist, commodified approach sees a technocentric solution to problems broken down in parts and the ecology is amenable to change as per human needs and beliefs. Exposure to environmental chemicals has been shown to affect the environment and health of human and non-human beings. ‘Exposure to neurotoxic compounds [like pesticides] at levels believed to be safe for adults can result in permanent loss of brain function if it occurs during the prenatal and early childhood period of brain development’[208]. The acute toxicity testing of pesticides may be reliable to understand the effects from short term but its limitations are unlikely to find out effects on human which may take two or three decades to appear[209][210]. Exposure to environmental chemicals has also been shown to result in increased risk of obesity later in life, and these chemicals have been referred to as obesogens and many of these same chemicals can also increase insulin resistance leading to type 2 diabetes (examples include phthalates, bisphenol A, tributyltins, and several pesticides)[211]. The increased corporate takeover has led to a proliferation of trade agreements, commercial agriculture and encroachment of market values and this has been documented by David Weir and Mark Shapiro in their book ‘Circle of Poison: Pesticides and People in a Hungry World’ and expose the global scandal of corporate and government exportation of pesticides.
16 - Energy drinks: knowledge & perception of consumers and quality parameters. To describe the chemical and microbiological parameters of energy drinks and find out the knowledge & perception of consumers towards it[206].	M - Descriptive cross-sectional and experimental study conducted in different locations Kathmandu valley. Two hundred energy drinks users were interviewed to access the knowledge and perception of consumers. Ten different brands of energy drinks were analysed for chemical and microbial content. The collected samples were evaluated for the compliance of regularity regulatory requirements on labelling. F - 85% were unaware about the content, 54.1% has believed that it can be used with alcohol, 45% thought that all people should have energy drink, 40.8% thought that it provides energy, 43.1% think it is for refreshment. The major motivating factors were friends (36.2%) and advertisement (31.6%). About 55% responded that they had experienced side effects after using energy drinks out of which 67.7% had some mental changes. About three in four (73%) thought that the advertisement given was false and misleading. Out of 10 samples analysed for the regulatory compliance, none of them fully complied with the regulatory requirements of Nepal. On laboratory testing, the amount sodium (197mg to 476mg), sugar (6-16%), carbohydrate (6-18%), and caffeine (0mg-43mg) were either more or less than the claim in eight samples. Other compounds detected in the samples were not uniform. Methyl amine was detected in nine samples out of ten. All the samples passed the limit of microbial count[206]. RC -			Long-gone are the days of Prakash Padukone a noted player who declined promoting an artificial drink despite being given a hefty payment and presently there is no dearth of players with huge fan following endorsing such drinks, despite the fact most may not even be consuming it. The ‘hands off policy’ based on self-policing and self-regulation has given the onus to the manufacturers or the companies itself and in products like foods, drinks and medicines where communities of people are affected the reliance on the claims of the manufacturers has proven to be fallacious in many instances[212]. The impact of preferential trade agreements (PTAs), free trade agreements have been shown to increased life style diseases such as obesity and type -2 diabetes[213]. With the changing global economy from the 1990’s post-colonial countries and low income countries undertook extensive economic liberalization that resulted in significant changes, for instance between 1998 and 2012, the Indian soft drink sales quadrupled from 1.2 million to 4.4 million litres with a decline in the retail selling price from US$ 0.6 to $0.4 per litre (in fixed 2012 dollars, constant prices). Advertisements and marketing strategies adopted such as recruiting sports persons, celebrities and also making ties with schools and colleges so as to installing dispensing machines in schools and promoting activities in the name of public private partnerships. Though the research paper deals with energy drinks the marketing strategies and the related affects with its consumption is similar to more traditional soft drinks such as Coca-Cola. The non-availability of clean drinking water and the availability of Coca-Cola has been an issue of pride in the context of Africa. The standards that need to be adhered to have been flouted here and this comes as no surprise for a nation like Nepal due to its weak structure of overall governance. Beginning onwards the mid 1940’s the trend of manufactured foods and drinks spread around the world. Presently, all around the world Americans, Europeans, Asians, Africans and Australians are all having an ontologically uniform experience of taste despite their being significant differences in their living conditions. The ‘‘loss leading’ and ‘value’ strategies to encourage consumption initially with low prices and small package prices, but then later increase package sizes and prices’[214].
17 - Knowledge, attitude & practice of family planning methods among married women of reproductive age of Kakani VDC, Nuwakot. Assess the knowledge, attitude and practice on family planning methods among married women of Kakani VDC[206].	M - Descriptive cross-sectional study design was used. Likewise, PPS sampling procedure was done for sample size calculation. Similarly, simple random sampling was done for the selection of 109 respondents. Structured questionnaires and interview technique was used to obtain necessary information. F - More than one fifth of the respondents (23.9%) were of age group 28-32 years and more than half of the respondents (51.4%) had marriage at the age of 15-19 years. Similarly two third of the respondents (70.6%) had followed Hindu religion, and majority of them (63.3%) were literate whereas 36.7% were illiterate. Almost all women (93.6%) had reported that Family planning is used to maintain small family. Likewise, Depo-Provera was the device known by all respondents and Implant was the least known (71.6%) device. However, more than half (56.9%) MWRAs had good knowledge on family planning. Similarly, more than half (51.38%) of respondents were currently using family planning devices and among them more than one third had (37.50%) used Oral Pills. Furthermore, attitude towards family planning was positive in most of the MWRAs. RC - The study population had good knowledge and positive attitude towards family Planning devices; however the use of family planning devices was low. It was mainly due to husband being abroad and side effects of the devices[206].		The focus on reproductive health and the delivery of related services along with emphasis on family planning measures have been in focus since Nepal began its quest to be developed. The arguments made in table, 2, 3, 11, 12 & 17 are also applicable here.
18 - Reproductive health knowledge, attitude and health services utilization among adolescents in Kaski district of Nepal. Assess the reproductive health knowledge, attitude and health services utilization among adolescents in rural and urban areas of Kaski district[206].	M - Community based descriptive cross-sectional study was conducted among adolescents (10-19 years of age) in rural and urban areas of Kaski district, Nepal. The period of data collection was October to November, 2014. Altogether 419 participants were taken for the study. F - Out of 419, majority (78.8%) of the respondents were known about family planning, among them only 70 % of respondents were aware about family planning methods. Fifty one percentages of the respondents were aware about the sexually transmitted diseases. Before giving a birth there is need to consult with partner with this fact 68.7 % of the respondents were agree, 23.6 % of the them were neutral and very few (7.6%) of them were disagree. Nearly twenty six percentage of the respondents were faced the reproductive health problems within one month. Out of 107 respondents, 57.9 % were did not utilize reproductive health services because of different reasons.		Arguments made earlier in tables 2,3,11,12 & 17 are also of relevance here, but since this deals with adolescents some of the arguments if related from the earlier tables directly may not be relevant. In a patriarchal system morality and honour are strongly attached to the daughters, sisters and other female members. How would one react if one found a condom or a pill with a 16 year old daughter or a sister or in fact with any unmarried female? The ways traits of masculinity and femininity are embedded, internalized, naturalized and systematized begins from birth and exists at all stages in all spheres of life.
	RC - knowledge towards reproductive health among adolescents was found low. However, levels of attitude towards different reproductive health components were found favourable. Only 42.1% of the respondents were utilized reproductive health services among those who was faced the reproductive health problems within one month which was low coverage of reproductive health services utilization[206].
19 - Knowledge, attitudes and practices of avian influenza among poultry workers of Chitwan district to determine the knowledge, attitudes and practices relating to avian influenza among poultry workers[206].	M - Descriptive cross-sectional study was adopted, study area were registered poultry farms of Chitwan district. Purposive sampling technique with structured interview questionnaire was used to collect the data. F - Most of the respondents don't know about the causative agents of avian influenza, 97% of the respondents have knowledge that avian influenza can be transmitted by eating uncooked meat whereas 47% have knowledge that poultry workers are at risk for transmission of AI. Literate respondents were more aware about causes of AI as well as trained respondents were more aware about causes of AI. Whereas Majority of the respondents agreed that AI is a preventable disease whereas almost all of the respondents knew that AI is a serious disease. Most of the respondents use outer garments for the protection of AI whereas only 6% of the respondents use eye protection measures. Notifying DLSO in case of sick and dead poultry is a common norm. Treatment and burial were common in case of sick and dead poultry[206]. RC -		The arguments from table number 14 are also applicable here. Dr Michael Greger’s book, Bird Flu: A Virus of Our Own Hatching shows how many human ailments from the common cold to AIDS are the result s of cruelty towards animals and more importantly due to the practice of breeding and raising them for food. Though human influenza which has a history of more than 4000 years when ducks were first domesticated and also the previous avian influenza outbreak the 1918 flu pandemic which led to the death of 50 to 100 million human have not changed the ways it has been confronted. The ‘piece meal’, and ‘fine tuning corrections’ has been a trait adopted by industries worldwide where everything is strategized by accepting the neoliberal structure as given. Neoliberalism has established an ‘one dimensional’ ‘presentification’ of ‘eternal present’ of the global way of life.
20 - Knowledge regarding community based newborn care practice among health workers of sub-health posts, Sunsari, Nepal. Assess the existing knowledge of CB-NCP practice among health workers of sub-health posts of Sunsari, Nepal[206].	M. Descriptive cross sectional design was adopted. A total of 49 health workers (AHWs and ANMs) from sub-health posts of Sunsari district, were interviewed by total enumeration technique. Data were collected using a semi-structured questionnaire and analysed using Independent sample t-test, One Way ANOVA and correlation test at 95% confidence interval. F. (57.1%) ANMs and (42.9%) AHWs who achieved mean score of knowledge (54.00±6.77) and (41.14±9.56) respectively. The existing knowledge regarding the CB-NCP practice was significantly higher (p= <0.001) among female health workers as compared to male health workers. The knowledge was found higher among secondary level, upper caste, married, who received CB-NCP training >2 years period and additional training in concerned area and inversely correlated with the increase in age, family size and increasing years of experience.		Arguments from table 2 are also applicable here.
	The total achieved percentage mean score of knowledge was 66.27 ± SD 14.44. RC. Study concludes the positive correlation of number of handling of PSBI and asphyxia new-borns with the knowledge[206].
21 - Knowledge diversity and resources of traditional healers and healing practices in western development region of Nepal to analyse the situation and document knowledge diversity and resources of traditional healers and healing practices in Nepal[206].	M - Cross-sectional study using qualitative method in Western Development Region between January and April 2015. Based on geographical and ethnic variations, firstly, we purposively selected six districts, followed by selection of single VDC and Municipality from each district. We applied aggregate scoring method for selecting 60 respondents in total. Data were collected by in-depth interview. F - Majority of respondent was Janjati (30%), and was involving in farming (52%). They have been recognized in society as Jadibutigyata, Fukfake, Pandit, (lama, Baidya, Shoka and Moulana. Forefathers and Guru were the major sources of knowledge. They expressed their confident to treat 170 varieties of diseases and health conditions using 135 different herbs and mineral. Most of the participants (50 out of 60) were not doing anything for preserving their knowledge and 2/3 respondents did not have any training on traditional medicine. Most of the respondents (87%) replied that they were satisfied with their traditional healing practices. Nevertheless, 80 % of them were worried that young generation was not interested to continue the practice. Unavailability of medicinal plant was identified as the major problem faced by traditional healers. RC - finding indicates that vast diversity of traditional healing practices and resources persist in Western Development Region. However, lack of preservation, lack of interest to continue by young generation, delaying in recognizing, validating and upgrading knowledge pose a serious threat to traditional healing practices[206].		Arguments from table 5 are also applicable here.