Professor Dr. Ramesh Adhikari is a distinguished researcher and educator renowned for his work in maternal and child health, gender studies, and project evaluation. Holding a Ph.D. in Demography and a Master’s in Population and Reproductive Health from Institute for Population and Social Research (IPSR), Mahidol University, Bangkok, he has been recognized with the prestigious Dean's List Award in 2011 and the Distinguished Thesis Award in 2012 by the Faculty of Graduate Studies at Mahidol University. Dr. Adhikari boasts over 70 publications in peer-reviewed journals and extensive expertise in qualitative and quantitative research methodologies, project evaluation, and research design and analysis. His collaborative efforts with multidisciplinary teams and participation in national and international conferences underscore his commitment to advancing social research. With a professional reach extending across South and East Asia, Dr. Adhikari has worked with renowned organizations and institutions. Moreover, his 25 years of teaching experience at Mahendra Ratna Campus, and Graduate school of Education (GSE) Tribhuvan University, Nepal have significantly contributed to the academic growth of students and the field of education

2012    Ph.D. in Demography, Institute for Population and Social Research (IPSR), Mahidol University, Bangkok, Thailand

2005    Master's Degree in Population and Reproductive Health, Institute for Population and Social Research (IPSR), Mahidol University, Bangkok, Thailand

Major Subjects: Demography, Research Techniques, Statistics for Social study, Reproductive Health, Behavior and Social Dimension of AIDS, Monitoring, and Evaluation of Reproductive Health Program, Gender roles and Health development

1998    Master's Degree in Population Studies, Central Campus, Tribhuvan University, Kirtipur, Kathmandu, Nepal Center Department of Population Studies (CDPS) Kirtipur Central Campus, Kathmandu, Nepal

Major subjects: Demography, Quantitative Technique, Population Analysis, Demographic Technique, Migration and Urbanization, Family Planning Evaluation, etc.

1994    Bachelor's Degree in Arts (1994) Birendra Multiple Campus, Bharatpur, Tribhuvan University,             Chitwan, Nepal

Major subjects: Mathematics and Economics

Professor: Faculty of Education, Tribhuvan University, Kathmandu (Since May 2019 to date)

• Faculty for Advanced Quantitative Research at Graduates School of Education for MPhil leading to Ph.D. students, Faculty of Education, TU
• Faculty for Health Education at Graduates School of Education for MPhil leading to Ph.D. students, Faculty of Education, TU
• Faculty for Applied research Method at Mahendra Ratna Campus, Tahachal Kathamdu for MEd Students

Associate Professor: Faculty of Education, Tribhuvan University, Kathmandu (Since February 2013 to April 2019)

Assistant professor/Lecturer:  Mahendra Ratna Campus, Tribhuvan University, Kathmandu (March 1999 to Jan 2013)

1. Pandit, S., Adhikari, R., & Thasineku, O. C. (2025). Methodological Review: Contributing Factors on Children’s Educational Achievement. Prithvi Academic Journal, 8, 126–136. https://doi.org/10.3126/paj.v8i1.78896
2. Acharya, D., Sharma, M.K., Adhikari, R., Khatri, B.B., Panta, N., Tripathi, K.P., Sharma, L.K., Nepal, P. and Ghimire, S. (2025), Associated Factors in Terms of Having Multiple Sex Partners in Nepal: A Cross-Sectional Study. Health Science Reports, 8: e70467. https://doi.org/10.1002/hsr2.70467
3. Giri S., Acharya D., Adhikari R., Sharma M. K., & Ranabhat C. L. (2024). Status and Associated Factors of Health Insurance Enrollment Among women in Nepal. World Medical & Health Policy, https://doi.org/10.1002/wmh3.638 
4. Sharma M. K., Adhikari R., Khanal S. P., Acharya D., & Van Tejilingen, E. (2024). Do school Water, Sanitation, and Hygiene facilities affect students' health status, attendance, and educational achievements? A qualitative study in Nepal. Health Science Reports. Wiley 2024; 7:e2293. doi:10.1002/hsr2.2293
5. Acharya D., Adhikari R., Sharma M. K., & Sharma S (2024). Factors Associated with Household Headship in Nepal. Does Policy Matter in Female Household Headship? Shikshya Sandesh, ISSN 2645-8721, Volume 6 (13): 99-111,  https://doi.org/10.3126/ss.v6i1.63103
6. Adhikari, A., Acharya, D., & Adhikari, R. (2024). Determinants of Functional Difficulty among Women in Nepal: A Cross-sectional Study. Janapriya Journal of Interdisciplinary Studies, 12(1), 7–20. https://doi.org/10.3126/jjis.v12i1.62206
7. Adhikari, M. R., & Adhikari, R. (2024). Parental Migration and Mental Health Status of the Left- behind. Education and Development, 33(1), 57–70. https://doi.org/10.3126/ed.v33i1.66604
8. Silwal M, Koirala D, Adhikari R, Katel K,  KC D, Gurung S and Thapa B (2024). Risk Factors leading to Adolescent Substance Use. DOI: https://doi.org/10.70250/mjpahs22
9. Lal, B. K., Bhatta, G. K., Adhikari, R., Karn, A., K.C, R. ., Nyaupane, S., Adhikari, A., Shrestha, B., Shrestha, M., Bhattarai, P., Sah, S. ., & Shrestha, B. (2024). Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study. Journal of Nepal Medical Association, 62(275), 439–445. https://doi.org/10.31729/jnma.8662
10. Sharma MK,  Adhikari R,  van Tejlingen E,  Devkota  B &  Khanal SP (2024) Improved water, Sanitation and Hygiene Facilities at School and their effect on educational achievement in basic level students in Nepal, International Journal of Health Promotion and Education, DOI: 10.1080/14635240.2024.2314459
11. Pandit, S., & Adhikari, R. (2024). Effect of Internal Migration of Families on the Educational Achievement of their Children. Asian Journal of Population Sciences, 3(1), 83–97. https://doi.org/10.3126/ajps.v3i1.61835
12. Koirala D., Silwal M., Pokhrel S., & Adhikari R. (2023). Awareness of Breast Self-Examination among Female Community Health Volunteers of Pokhara. Journal of Nepal Health Research Council, 20(4), 952-957. 10.33314/jnhrc.v20i4.4341
13. Ramesh Adhikari, Shiva Raj Adhikari, Dilli Ram Upreti, and Keshav Prasad Adhikari. 2023. “Effectiveness of TVET in Nepal”. Journal of Technical and Vocational Education and Training 17 (1):35-48. https://doi.org/10.3126/tvet.v17i1.52413.
14. Kosh Bilash Bagal, Ramesh Adhikari, Devaraj Acharya (2023). Regional variation in knowledge and practice regarding common zoonoses among livestock farmers of selective districts in Nepal. PLoS Negl Trop Dis 17(2): e0011082. https://doi.org/10.1371/journal.pntd.0011082
15. Acharya, Devaraj, Ramesh Adhikari, Gary L. Kreps, Bishnu Prasad Wagle, and Sushil Sharma. 2023. “An Association Between the Mosquito Nets and the Wealth Status: Public Health Promotion Planning and Intervention”. Prithvi Academic Journal 6 (1):59-73. https://doi.org/10.3126/paj.v6i1.54613.
16. Kosh Bilash Bagal, Ramesh Adhikari, Devaraj Acharya and Gary L. Kreps (2023). Implications from the health belief model concerning zoonoses-related threat perceptions held by livestock farmers in Nepal. World Medical & Health Policy. https://doi.org/10.1002/wmh3.563
17. Kosh Bilash Bagal, Ramesh Adhikari, Devaraj Acharya, Bhimsen Devkota, and Suresh Shrestha. (2023). Demand of One Health Activities by Community-Level Service Providers in Selected Districts of Nepal. Asian Journal of Population Sciences 2 (1):54-67. https://doi.org/10.3126/ajps.v2i1.51090
18. Ramesh Adhikari Aakriti Wagle, and Anuska Adhikari (2022). Inequality in Institutional Delivery of Recent Birth Among Married Women in Nepal: A Trend Analysis. Mangal Research Journal 3 (1):55-72. https://doi.org/10.3126/mrj.v3i1.51656.
19. Ramesh Adhikari, Devraj Acharya, Aakriti Wagle (2022) Sociodemographic characteristics as predictors of knowledge regarding mode of transmission of Lymphatic Filariasis among population of Nepal. PLOS Glob Public Health 2(10): e0000082. https://doi.org/10.1371/journal.pgph.0000082
20. Ramesh Adhikari, Aakriti Wagle. (2022). The trend of intention to not use contraception among married women in Nepal. J. Women Health Care and Issues, 5(4) DOI: 10.31579/2642-9756/119.
21. Bagale, Kosh Bilash, Ramesh Adhikari, and Devaraj Acharya. 2022. “Educational Association With Zoonotic Related Knowledge and Practices of Livestock Farmers in Selective Districts of Nepal”. Journal of Health Promotion 10 (1):127-42. https://doi.org/10.3126/jhp.v10i1.50993.
22. Bastola, Bidur, Unnata Timalsina, Ranju K.C, and Ramesh Adhikari. 2022. “Food Insufficiency Among Returnee Migrants During COVID-19”. Journal of Health Promotion 10 (1):39-48. https://doi.org/10.3126/jhp.v10i1.50986.
23. Sharma M. K. & Adhikari R. (2022). Effect of Water, Sanitation, and Hygiene on the School Absenteeism of Basic Level Students in Government School Nepal. Frontiers in Education Educational Psychology (Q2) Received: 05 Feb 2022; Accepted: 31 May 2022. https://www.frontiersin.org/articles/10.3389/feduc.2022.869933/abstract
24. Dhakal, K., Ghimire, S., & Adhikari, R. (2022). Effect of Mass Media on Awareness of Abortion Law among Women in Nepal. Tribhuvan University Journal, 37(1), 30–41. https://doi.org/10.3126/tuj.v37i1.48210
25. Sharma MK, Adhikari R and Teijjingen van E (2022). Handwashing stations in Nepal: Role of wealth status in establishing handwashing stations at home. World Medical & Health Policy. https://onlinelibrary.wiley.com/doi/10.1002/wmh3.523
26. Sharma MK, Adhikari R (2022). Effect of School Water, Sanitation, and Hygiene on Health Status Among Basic Level Students’ in Nepal. https://doi.org/10.1177/11786302221095030
27. Bastola1 B, Adhikari R, Sherpa M, Pandey N, Dangol SK, Shrestha S, Shrestha M and KC R (2022). COVID-19 Vaccine Acceptance among People in Kailali, Nepal. https://ecronicon.net/assets/ecgy/pdf/ECGY-11-00747.pdf
28. Pokhrel P; Aryal K,; Adhikari R, Dulal DP, Karki DK, Dahal HR, Dangol MS, Poudel P, Bhattarai N, Lamichhane, P (2022). Socioeconomic Determinants of Inequalities in the Use of Modern Contraception among Currently Married Women. http://jnhrc.com.np/index.php/jnhrc/article/view/3738/1198
29. Sharma M. K. & Adhikari R. (2022). Effect of Water, Sanitation, and Hygiene on the School Absenteeism of Basic Level Students in Government School Nepal.           Frontiers in Education Educational Psychology (Q2 https://www.frontiersin.org/articles/10.3389/feduc.2022.869933
30. Acharya, D., Adhikari, R., & Simkhada, P. (2022). Prevalence and Determinants of Anaemia among Women aged 15-49 in Nepal: A Trend Analysis from Nepal Demographic and Health Surveys from 2006 to 2016. Asian Journal of Population Sciences, 1(1), 32–48. https://doi.org/10.3126/ajps.v1i1.43593
31. Acharya D, Adhikari R and Badal K (2022). Determinants of Discriminatory Attitudes Towards People Living with HIV Among Women of Reproductive Age in Nepal: A Trend Analysis from National Surveys. Journal of Population and Social Studies (JPSS). 391-407. https://so03.tci-thaijo.org/index.php/jpss/article/view/258734/172471
32. Ramesh Adhikari, Bidur Bastola, Unnata Timilsina and Ranju KC (2022). Experience of Violence due to COVID-19 among Returnee Migrants of Far-Western Province of Nepal. TVET Journal, Vol.-1, Issue-16, PP 72-84. 2022. http://ctevt.org.np/public/uploads/kcfinder/files/TVET%20Journal%20Vol.%202%202022.pdf
33. Bastola, B, Adhikari R and Dangol SK (2022). Use of Contraceptives Among Married Women of Reproductive Age in Nepal. EC Gynaecology 11.1 (2022): 01-11. https://ecronicon.net/assets/ecgy/pdf/ECGY-11-00698.pdf Ramesh Adhikari, Aakriti Wagle, & Min Raj Adhikari. (2021). The smoking behavior of women of reproductive age in Nepal. Journal of Health Promotion, 9(01), 8–18. https://doi.org/10.3126/jhp.v9i01.40958
34. Sharma, M. K., Khanal, S. P., Acharya, J., Adhikari, R., & Budhathoki, C. B. (2021). COVID-19: Knowledge, Attitudes, and Practices among the Scholarly Cohorts of Nepal. Nepal Journal of Science and Technology, 20(2), 75–84. https://doi.org/10.3126/njst.v20i2.45777
35. Acharya, D., Adhikari, R., Ranabhat, C., Paudel, R., Kreps, G. L., Bhandari, T. R., Bhattarai, R., & Pathak, K. P. (2021). Factors Associated with Intimate Partner Violence and the Utilization of Maternal Health Services: Findings from Nepal Demographic Health Survey 2016. Europasian Journal of Medical Sciences , 3(2), 65-75. https://doi.org/10.46405/ejms.v3i2.279
36. Kosh Bilash Bagale, Ramesh Adhikari, Devaraj Acharya, Basant Gaire, Bidhusi Pokhrel. (2021). Ethnocultural influences for zoonoses transmission in multi-ethnic communities in Nepal. Journal of Health Promotion, 9(01), 19–31. https://doi.org/10.3126/jhp.v9i01.40959
37. Mohan Kumar Sharma, Shanti Prasad Khanal, Ramesh Adhikari, Jib Acharya (2021). Maternal health care services in Nepal: A qualitative perspective based on the socio-ecological model. Journal of Health Promotion, 9(01), 42–54. https://doi.org/10.3126/jhp.v9i01.40961
38. Bhabani Adhikari, Ramesh Adhikari (2021). Access and utilization of the youth-friendly sexual and reproductive health services in Nepal: What does literature show?. Journal of Health Promotion, 9(01), 100–115. https://doi.org/10.3126/jhp.v9i01.40971
39. Devaraj Acharya, Ramesh Adhikari, and Gary L. Kreps (2021). Does Exposure of mass media associate with utilisation of ANC services? A trend analysis from Nepal demographic and health surveys. Int J Health Plan Mgmt. 2021; 1-17. https://doi.org/10.1002/hpm.3285
40. Devaraj Acharya, Ramesh Adhikari, Gary L. Kreps, Kamal Gautam, Krishna P. Dhakal, Pushkar S. Raikhola, and Radha Bhattarai (2020). Educational Status of Female Youth in Nepal: A Foundation for Health and Well-being. Where Should programs Focus? South Asian Survey 27(1) 7–18, 2020. https://journals.sagepub.com/doi/pdf/10.1177/0971523120907207
41. Ramesh Adhikari and Sudha Ghimire (2020). Open defecation free: where do we need to focus? Health Prospect. Vol 19 No 1. https://doi.org/10.3126/hprospect.v19i0.27394
42. Mohan Kumar Sharma, Shanti Prasad Khanal, and Ramesh Adhikari (2019). Menstrual Hygiene Management Among Girl’s in Rural Schools of Rukum Nepal. 8 (10) pp 962-970. https://www.ecronicon.com/ecgy/pdf/ECGY-08-00413.pdf
43. Ramesh Adhikari, Devraj Acharya, Chhabi Lal Ranabhat, and Ranju KC (2019). Factors Associated with Non-Use of Contraceptives among Married Women in Nepal.  Journal of Health Promotion, 7, 7-18. https://doi.org/10.3126/jhp.v7i0.25490
44. Kosh Bilash Bagale and Ramesh Adhikari (2019). Risk of Zoonoses among Livestock Farmers in Nepal. Journal of Health Promotion, Vol 7, 2019. DOI: https://doi.org/10.3126/jhp.v7i0.25520
45. Krishna Prasad Dhakal and Ramesh Adhikari (2019). Unintended Birth among Married Women in Nepal. Global Women's Health (GWH). Applis Publisher. https://applispublishers.com/wp-content/uploads/2016/07/GWH-02-000107.pdf
46. ASM Shahabuddin, Therèse Delvaux, Christiana Nöstlinger, Malabika Sarker, Azucena Bardají, Alyssa Sharkey, Ramesh Adhikari, Sushil Koirala, Md Asadur Rahman, Tahrima Mridha, Jacqueline E. W. Broerse, Vincent De Brouwere (2019). Maternal healthcare-seeking behaviour of married adolescent girls: A prospective qualitative study in Banke District, Nepal. PLOS ONE. https://doi.org/10.1371/journal.pone.0217968
47. Ramesh Adhikari and Ranju KC (2018) Effect of Maternal Child Marriage on Experiencing Child Death Among Nepalese Mothers. J Midwifery Women’s Health Nurs Pract 2018: 24-31. https://norcaloa.com/journals/MWNP/MWNP-102017.pdf . ISSN: 2637-9260
48. Dev Raj Acharya, Bhimsen Devkota, and Ramesh Adhikari (2018). Willingness to Pay for Family Health Insurance: Evidence from Baglung and Kailali Districts of Nepal. Global Journal of Health Science; Vol. 10, No. 12; 2018.  https://doi.org/10.5539/gjhs.v10n12p144
49. Ramesh Adhikari and Aakriti Wagle (2018). Effect of Intimate Partner Violence on Pregnancy Outcomes. Journal of Reproductive Health and Contraception Vol.3 No.3: 17. http://contraceptivestudies.imedpub.com/effect-of-intimate-partner-violence-on-pregnancy-outcomes.pdf
50. Ramesh Adhikari, Bir Bahadur Rawal, and Ranju KC (2018) Sexual Risk Behaviours among Returnee Migrants from India: Are They at Risk of HIV? J Health Sci Educ 2(4): 142. http://escires.com/articles/Health-1-142.pdf
51. Ramesh Adhikari (2018). Child Marriage and Physical Violence: Results from a Nationally Representative Study in Nepal. Journal of Health Promotion. Vol 6, June 2018. ISSN: 2631-2441. https://www.nepjol.info/index.php/jhp/article/view/21804 (DOI: https://doi.org/10.3126/jhp.v6i0.21804)
52. Ramesh Adhikari and Ranju KC (2018). Uterine prolapse and treatment-seeking behavior among women. Frontiers in Women's Health 3 (2). ISSN: 2398-2799. DOI: 10.15761/FWH.1000145. http://www.oatext.com/pdf/FWH-3-145.pdf   
53. Asm Shahabuddin, Vincent Debrouwere, Ramesh Adhikari and Thérèse Delvaux (2017). Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011. BMJ Open 7(4)· ISSN 2044-6055. http://bmjopen.bmj.com/content/7/4/e012446 DOI: 10.1136/bmjopen-2016-012446 (impact factor 2.41)
54. Ramesh Adhikari (2016). Effect of Women’s autonomy on maternal health service utilization in Nepal: a cross sectional study. BMC Women Health. 16 (26).  ISSN 1472-6874.  http://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-016-0305-7. DOI: 10.1186/s12905-016-0305-7 (impact factor 1.57)
55. Ramesh Adhikari (2016).Knowledge on legislation of abortion and experience of abortion among female youth in Nepal: A cross sectional study. Reproductive Health 13 (48). ISSN: 1742-4755.  http://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-016-0166-4 DOI: 10.1186/s12978-016-0166-4. (Impact factor 2.21)
56. Ramesh Adhikari (2015). Prevalence and Correlates of Sexual Risk Behaviors among Nepalese Students. Social Science Asia. Vol. 1 (4): pp 38-50. DOI: 10.14456/ssa.2015.29.http://www.socialscienceasia.nrct.go.th/index.php/SSAsia/article/view/72  (ISSN: 2229-2608)
57. Ramesh Adhikari (2015). Effect of Women’s Role on Household Decision Making on Institutional Delivery of the Recent Child in Nepal. Journal of Management and Development Studies. Vol. 26: pp 51-61.ISSN 2392-4896. http://www.nasc.org.np/journal/effect-women%E2%80%99s-role-household-decision-making-institutional-delivery-recent-child-nepal
58. Ramesh Adhikari, Aree Jampaklay, Aphichat Chamratrithirong, Kerry Richter, Umaporn Pattaravanich, Patama Vapattanawong (2014). The Impact of Parental Migration on the Mental Health of Children Left Behind. Journal of Immigrant and Minority Health. 16 (5). PP 781-789. ISSN 1557-1920.  https://link.springer.com/article/10.1007%2Fs10903-013-9809-5  (Impact factor 1.16)
59. Ramesh Adhikari (2013). Violence in Dating Relationship: Extent, Nature and Consequences. The Journal of University Grants Commission, 2(1), 2013. ISSN 2350-8566.
60. Ramesh Adhikari, Aree Jampaklay, Aphichat Chamratrithirong, Kerry Richter and Umaporn Pattaravanich (2012). The Impact of Parental Migration on the Health of Children Living Separately from Parents: A Case Study of Kanchanaburi, Thailand. Journal of Population and Social Studies, 20 (2), 2012. (ISSN: 2465-4418) https://www.tci-thaijo.org/index.php/jpss/article/view/84520  
61. Ramesh Adhikari, Aree Jampaklay and Aphichat Chamratrithirong (2011). Impact of children's migration on health and health care-seeking behavior of elderly left behind. BMC Public Health 2011, 11:143 http://www.biomedcentral.com/1471-2458/11/143  (ISSN: 1471-2458) (Impact factor=2.32)
62. Ramesh Adhikari and Yothin Sawangdee (2011). Influence of women’s autonomy on infant mortality in Nepal. Reproductive Health 2011, 8:7 http://www.reproductive-health-journal.com/content/8/1/7 (Impact factor 1.62)
63. Ramesh Adhikari, Kusol Soonthorndhada and Fariha Haseen (2011). Labor force participation in later life: Evidence from a cross-sectional study in Thailand. BMC Geriatrics 2011, 11:15 http://www.biomedcentral.com/1471-2318/11/15  (Impact factor 2.00)
64. Ramesh Adhikari and Jyotsna Tamang (2010). Sexual coercion of married women in Nepal. BMC Women's Health 2010, 10:31 http://www.biomedcentral.com/1472-6874/10/31 (impact factor 1.66)
65. Ramesh Adhikari and Chai Podhisita (2010). Household headship and child death: Evidence from Nepal. BMC International Health and Human Rights 2010, 10:13 http://www.biomedcentral.com/1472-698X/10/13 (Impact factor 1.10)
66. Ramesh Adhikari (2010). Demographic, socio-economic, and cultural factors affecting fertility differentials in Nepal. BMC Pregnancy and Childbirth 2010, 10:19 http://www.biomedcentral.com/1471-2393/10/19 (Impact factor 2.18)
67. Ramesh Adhikari (2010). Are Nepali students at risk of HIV? A cross-sectional study of condom use at first sexual intercourse among college students in Kathmandu. Journal of the International AIDS Society 2010, 13:7 https://onlinelibrary.wiley.com/doi/abs/10.1186/1758-2652-13-7  (impact factor 5.13)
68. Ramesh Adhikari (2010). Attitude of college students towards providing contraceptive services for unmarried youth in Nepal. Nepal Population Journal (PAN) July, 2010
69. Fariha Haseen, Ramesh Adhikari and Kusol Soonthorndhada (2010). Self-assessed health among Thai elderly. BMC Geriatrics 2010, 10:30 http://www.biomedcentral.com/1471-2318/10/30 (impact factor 2.00)
70. Ramesh Adhikari, Kusol Soonthorndhada, and Pramote Prasartkul (2009). Correlates of unintended pregnancy among currently pregnant married women in Nepal. BMC International Health and Human Rights 2009, 9:17 http://www.biomedcentral.com/1472-698X/9/17 (Impact factor 1.10)

71.  Aryal , B., Maharjan , S. K., & Adhikari , R. (2025). Advancing Sexuality Education for Adolescent Development: Addressing Harmful Sociocultural Norms and Practices. Journal of Health Promotion, 13(1), 1–6. https://doi.org/10.3126/jhp.v13i1.87158

72. Thasineku OC, Pandit S, Gurung YB, Adhikari R, Acharya D, Dulal BP (2025).  Factors associated with the choice of delivery place in Nepal based on dual pathway analysis using demographic and health survey 2022. Discover public health 22 (1), 602. doi.org/10.1186/s12982-025-01005-7