Estimating the minimal cost of delivering nutrition-specific and nutrition-sensitive interventions in Ethiopia.

The Ethiopia Food and Nutrition Strategy (FNS 2021-2030) aims to provide evidence-based, nutrition-specific, and sensitive interventions to address malnutrition. A costing exercise was done to estimate the minimum financing needed to implement nutrition interventions for the ten-year FNS, and further analysis was made to estimate the investment required to implement the prioritised recommended Lancet series interventions for 10 years. Activity-based costing methodology was used to carry out the FNS costing for nutrition interventions prioritised by the different line ministries, and then estimated costs to implement the 2021 recommended Lancets interventions were examined from the FNS.

Framing health taxes: learning from low- and middle-income countries.

Health taxes are effective policy instruments to save lives, raise government revenues and improve equity. Health taxes, however, directly conflict with commercial actors' interests. Both pro-tax health advocates and anti-tax industry representatives seek to frame health tax policy.

Perceptions of key stakeholders on taxes on tobacco and alcohol products in Nepal.

Background: Non-communicable diseases (NCDs) are on the rise in Nepal. Consumption of alcohol and tobacco products remains high. Taxes on these products are significantly below the rate recommended by the WHO.

Environmental Determinants of Malaria Prevalence and the Adaptation Strategies in Western Nepal.

Background: Current literatures seem devoted only on relating climate change with malaria. Overarching all possible environmental determinants of malaria prevalence addressed by scanty literature in Nepal is found apposite research at this moment. This study aims to explore the environmental determinants of malaria prevalence in western Nepal.

Understanding challenges to malaria elimination in Nepal: a qualitative study with an embedded capacity-building exercise.

Background: The Nepalese Government has made significant progress toward the elimination of malaria. However, given the surge in the prevalence of non-communicable diseases, such as diabetes and hypertension, and the localized nature of malaria prevalence, malaria elimination will remain a challenge. In the current study, the authors sought to understand local perceptions on threats to malaria elimination in three endemic districts.

Household Expenditure on Diarrhea Treatment among Under Five Children in Godawari Municipality of Nepal.

Background: Diarrheal disease is a global public health problem. In Nepal, diarrhea is still the leading cause of waterborne disease, which constitutes 48% among all hospitalized disease cases who come to health center for treatment. Despite low treatment cost of diarrhea, out-of-pocket expenditure required at the time of treatment is a major barrier to seek health care.

Evaluation of Nepal's Free Health Care Scheme from Health System Perspective: A Qualitative Analysis.

Background: Access to high quality medicines is often considered as one of the main obstacle in achieving health for all. With the objective of increasing access to health services of poor segment of population, government of Nepal has implemented free health care program. However, there is strong need for evaluating the performance and coverage of free health Care scheme.

Assessing Nepal's health policies and programs from a human rights perspective.

Background: The right to health is a fundamental part of human rights. Ensuring right to health is not straightforward; there are several challenges. Factors such as capacity of right holders and duty-bearers and practices of providing and utilizing services among others determine to ensure health rights for the whole population.

Universal Access to Essential Medicines: An Evaluation of Nepal's Free Health Care Scheme.

Background: Access to medicine for the poor is recognized to be difficult task and one of the major challenges in achieving universal health coverage, particularly in low-and- middle income countries. In order to ensure the availability of essential medicines free of cost in public health facilities, Nepal has also commenced Free Health Care Services (FHCS). So, this study aims to evaluate availability, expiry, and stock-out duration of essential medicines at front line service providers in Nepal.

High Rates of Enteric Fever Diagnosis and Lower Burden of Culture-Confirmed Disease in Peri-urban and Rural Nepal.

Background: In South Asia, data on enteric fever are sparse outside of urban areas. We characterized enteric fever diagnosis patterns and the burden of culture-confirmed cases in peri-urban and rural Nepal.

Methods: We used national reports to estimate enteric fever diagnosis rates over 20 years (1994-2014) and conducted a prospective study of patients presenting with a >72-hour history of fever to 4 peri-urban and rural healthcare facilities (during August 2013-June 2016).

Economic Costs Associated with Motorbike Accidents in Kathmandu, Nepal.

Background: Road traffic accidents, considered as global tragedies, are in increasing trend; however, the safety situation is very severe in developing countries incurring substantial amount of human, economic, and social costs. Motorcycle crashes, the commonest form, occur mostly in economically active population. However, there is limited number of studies on economic burden of motorcycle crashes.

Designing Evidence-Based Family Planning Programs for the Marginalized Community: An Example of Muslim Community in Nepal.

Context: Family planning (FP), considered as an encouraging trend for development, is thought to be positively correlated with family health and well-being and negatively correlated with poverty levels. Despite being a priority goal of government and development agencies, in a heterogeneous society like Nepal, FP can be an issue that needs to be dealt with consideration for religious and cultural beliefs of different sections of society. Despite steady progress in achieving FP goals, minority populations have lagged behind the rest of the country in achieving improved family health outcomes; Muslim community being one such example.

A New Approach of Measuring Hospital Performance for Low- and Middle-income Countries.

Efficiency of the hospitals affects the price of health services. Health care payments have equity implications. Evidence on hospital performance can support to design the policy; however, the recent literature on hospital efficiency produced conflicting results.

Towards universal health coverage: an example of malaria intervention in Nepal.

A comprehensive and integrated assessment of health-system functioning requires measurement of universal health coverage (UHC) for disease-specific interventions. This paper aims to contribute to measurement of UHC by utilizing locally available data related to malaria in Nepal. This paper utilizes the elements of UHC as outlined by the World Health Organization (WHO).

Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal.

Background: Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options.

Method: The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers.

An assessment of a substitute or complement for inpatient and outpatient care of visceral leishmaniasis in Nepal.

Background & Objectives: The burden of visceral leishmaniasis (VL) in Nepal, as in other developing countries, falls disproportionately upon the rural poor. Promoting use of outpatient (OP) care, an alternative to inpatient (IP) care has long been advocated to reduce cost of care in both the demand and supply sides as substitution of relatively cheaper resources for expensive resources in the production of health care services. The paper aims to assess the intensity of demand for VL care and explore possibilities of the substitutability or complementation patterns between OP care and IP care of VL.

Choice of providers for treating a neglected tropical disease: an empirical analysis of kala azar in Nepal.

Objective: To examine the choice of healthcare providers for treating kala azar (KA) in Nepal.

Methods: Information was collected from clinically diagnosed KA patients seeking care from public hospitals located in KA endemic districts. The survey collected information from more than 25 percent of total KA cases in the country.

Incidence of kala-azar in Nepal: estimating the effects of individual and household characteristics.

Kala-azar (KA) remains a major public health problem in Nepal. The disease is preventable, but various environmental, socioeconomic, health care and health behaviour related variables affect its transmission. Household or individual related factors determine the magnitude and direction of impacts of these factors.

A cost benefit analysis of elimination of kala-azar in Indian subcontinent: an example of Nepal.

Background & Objectives: Visceral leishmaniasis, locally known as kala-azar (KA) has been considered as a major public health problem in Bangladesh, India and Nepal that affects 100,000 people per year with 147 million people at risk. Elimination of infectious disease is an ultimate goal of the public health system, therefore, the efforts have recently gained momentum from various organizations and governments to expand KA interventions in the endemic countries. The paper aims to estimate discounted net benefits and internal rate of return (IRR) to evaluate the economic feasibility for elimination of KA by utilizing available secondary information.

Who pays for health care in Asia?

We estimate the distributional incidence of health care financing in 13 Asian territories that account for 55% of the Asian population. In all territories, higher-income households contribute more to the financing of health care. The better-off contribute more as a proportion of ability to pay in most low- and lower-middle-income territories.

Catastrophic payments for health care in Asia.

Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by those absorbing a large fraction of household resources.

Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data.

Background: Conventional estimates of poverty do not take account of out-of-pocket payments to finance health care. We aimed to reassess measures of poverty in 11 low-to-middle income countries in Asia by calculating total household resources both with and without out-of-pocket payments for health care.

Methods: We obtained data on payments for health care from nationally representative surveys, and subtracted these payments from total household resources.

Health sector policy in the first decade of Nepal's multiparty democracy. Does clear enunciation of health priorities matter?

Nepal experienced a significant political regime shift in 1990 from the partyless Panchyat system to the present multiparty form of democracy. While political instability existed in the decade of the 1990s, reflected in the approximately one government per year, there had been continued enunciation of health policy priorities toward the rural sector, as reflected in the Nepal National Health Policy, 1991 (NHP (1991)) and subsequent plans. The objective of the paper is to assess whether clear enunciation of health priorities have translated into beneficial health outcomes, reflected in reduction of the child death rate, child morality rate, infant mortality rate and increase in the life expectancy rate.