Nepal Health Research Council

Intimate partner violence (IPV) and mental health (MH) issues among women in Nepal are deeply influenced by complex intergenerational family dynamics and power hierarchies. The traditional power hierarchies often place mothers-in-law (MILs) in authoritative roles over daughters-in-law (DILs), limiting the latter's autonomy and decision-making power. We designed a multi-component family intervention called MILAP to lower depression and address intimate partner violence by improving communication, promoting gender equity, and improving family relationships. This paper explores the perceptions and experiences of DILs who received the MILAP intervention. A total of 61 families participated in a pilot study of the MILAP intervention. Of these, 8 families (comprising triads of daughter-in-law, mother-in-law, and husband) were purposively selected for in-depth interviews (IDIs). All interviews were conducted immediately after the intervention and at the 6-month follow-up to assess MILAP's sustainability and impact. A thematic approach was used to analyze the data, utilizing Dedoose data management software. Four major themes were identified: (1) Enhanced communication within the family, (2) Strengthened DIL's empowerment, (3) Improved relationship quality, and (4) Increased DIL's freedom of movement. Participants reported improvement in communication among family members, particularly by using active listening skills which in turn contributed to conflict reduction and a more harmonious family environment. DILs experienced increased empowerment. They were more involved in family decision-making as the family unit adopted more equitable gender norms. The intervention strengthened spousal relationship improved MIL-DIL interactions, facilitated mutual understanding, and reduced household stress. Additionally, MILAP enabled DILs to move more freely outside the home. This increased mobility expanded their social networks, as DILs participated in community events, visited natal families, and accessed health services. However, some participants expressed concerns about the long-term sustainability of these changes, highlighting the need for continued reinforcement. Our study underscores the importance of a family-based intervention in improving relationship quality and promoting autonomy among DILs experiencing IPV. The positive shifts perceived within families suggest promise for MILAP to strengthen support structures and address factors that may influence DIL's mental health. However, ongoing follow-up and reinforcement strategies are recommended to maintain the gains achieved from the intervention.

Antimicrobial resistance (AMR) is a global public health issue with multisectoral contribution. It increases morbidity, mortality and health related expenditures. Antibiotics are divided into three groups of Access, Watch and Reserve (AWaRe) in order to consider antibiotic stewardship. This study aimed at assessing the consumption pattern of AWaRe groups of antibiotics by inpatients in different hospitals of Nepal. This was a cross-sectional hospital based study. A proforma was developed to obtain data regarding the use of AWaRe groups of antibiotics. All the patients admitted to medical and surgical wards of the selected referral hospitals of seven provinces were included in the study and data on antibiotics use were collected for a month. Data was entered in Microsoft Excel and analyzed in IBM SPSS version 21 using descriptive statistics. The consumption of AWaRe group of antibiotics among the inpatients were found to be 29.8%, 70.1% and 0.1% respectively. The most frequently consumed antibiotics were Metronidazole and Ornidazole for Access group, Ceftriaxone and Piperacillin tazobactam for Watch group and Linezolid for Reserve group. The target of increasing the proportion of global consumption of Access antibiotics to at least 60% of total consumption is stated by WHO. However, the minimal use of antibiotics from “Access” category and over use of antibiotics from “Watch” category can promote antimicrobial resistance. Rationale and appropriate use of antibiotics are important to minimize antimicrobial resistance.

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Literatures shows that poor air quality index (AQI) is associated with several adverse health impacts, such as asthma, chronic obstructive pulmonary disease, diabetes mellitus, tuberculosis, cancer, pneumonia, cataracts, heart diseases, and mental health disorders. Nepal, one of the lower-middle-income countries, has become vulnerable to adverse health impacts due to poor AQI over time. The capital city of Nepal, Kathmandu, is frequently placed as one of the most polluted cities by IQAir. As such, this statement marks a caution for policymakers and the public to be aware of the future effects of prolonged exposure to air pollution and highlights its causative factors. To solve this burgeoning issue, because of the significant rise in urbanization and population growth, mitigation strategies such as creating awareness, reducing vehicular emission, reducing forest fires, creating and identifying vulnerability maps risk zones for forest fires, switching to electronic vehicles and personal interventions such as staying indoors and reducing physical outdoor activity, wearing face masks must be focused and given priority. Although our study is limited in its methodology and findings, it helps establish a policy base to underscore the need for longitudinal cohort studies to generate further evidences pertaining to not up to par air quality levels and their subsequent health impacts in the Nepalese population.

BackgroundRoad traffic accidents (RTAs) continue to pose a significant menace to global public health in the form of a high incidence of mortality, disability and economic expense. Their space-time trends are of importance for policy decision-making. This particular study employed spatial analysis to identify high-risk zones and found significant clustering of accidents in urban centers as well as increasing semi-urban and rural vulnerabilities, supporting the need for safety interventions and road infrastructure improvements in Nepal. This paper aims to determine and analyze the incidence of RTAs in Nepal from 2019 to 2022, primarily focusing on vehicle-types and spatial distribution.MethodsData from all seven provinces and Kathmandu Valley Traffic Police Office were analyzed to examine RTAs patterns across 77 districts of Nepal. The data were processed and visualized using Quantum GIS (QGIS), and spatial analysis performed using Global and Local Moran’s I statistics, along with Local Indicators of Spatial Association (LISA), to identify spatial clusters of accidents.ResultsThis study identified statistically significant spatial clustering of vehicle types involved in RTAs. High-High (HH) clusters, indicating areas with elevated accident rates surrounded by similarly high-risk zones were concentrated in urban centers particularly Kathmandu, Lalitpur, and Bhaktapur. Conversely, Low-Low (LL) clusters, reflecting lower accident rates in sparsely populated regions, were observed in rural areas. Temporal analysis revealed a steady rise in RTAs incidence, with rates increasing from 63.35 per 100,000 population in 2019–2020 (Moran’s I = 0.741) to 94.46 in 2020–2021 (Moran’s I = 0.595) and 123.05 in 2021–2022 (Moran’s I = 0.556).ConclusionThis present study observed the growing incidence of RTAs in Nepal. The results highlight the critical need for geographically tailored road safety interventions with priority given to urban and semi-urban zones. Effective strategies should emphasize enhanced road traffic law enforcement, strict regulation of commercial and two-wheeled vehicles as well as targeted infrastructure upgrades in an effective manner.

Abstract Introduction Nepal is vulnerable to climate change and extreme weather events, resulting in the expansion of vector-borne diseases such as dengue throughout the country. Due to rising temperatures, dengue cases have been significantly increasing, underscoring the urgent need for a climate-smart approach to public health resilience. This case study assesses how the health system in Nepal has coped with the increase in dengue cases in relation to climate change over the last decade. Methodology We conducted a desk review concerning the impact of climate change on dengue in Nepal using WHO’s six-building blocks framework (leadership and governance, health workforce, health service delivery, health information system, and access to essential medicines). To complement the review, we also held two multi-stakeholder consultative workshops on dengue outbreak management convening academics, government (federal, provincial, municipal), the World Health Organization, private sector, and NGOs. One was conducted before the desk review and the other after the draft report was prepared to validate findings. Findings Our findings reveal that, despite comprehensive federal dengue policies and guidelines, implementation is undermined by limited local capacity, poor multisectoral collaboration, weak information transmission, and inadequate workforce and diagnostic resources. Strengthening health-worker and volunteer training, laboratory and surveillance systems (including collaborative, data-driven climate-smart public health platforms), meaningful community engagement, and sufficient resource allocation are essential to enable timely, locally tailored dengue prevention and control in Nepal. Conclusion Although national policies for dengue control are well established, local implementation suffers from limited capacity, poor coordination, and inadequate surveillance and diagnostics. Investing in workforce training, laboratory and data-driven surveillance enhancements, and community-centered engagement—backed by consistent resource allocation—is critical for timely, locally tailored dengue prevention and control in Nepal.