Key Considerations: Disability-Inclusive Humanitarian Action and Emergency Response in South and Southeast Asia and Beyond

In many settings, people with disabilities face multiple and complex layers of environmental, societal and structural barriers. These barriers can lead to them being disproportionately harmed, neglected and excluded during humanitarian and other emergency responses.1–3 This is especially evident in low- and middle-income countries (LMICs), including Nepal and other South and Southeast Asian nations.4 Limited awareness of the needs of people with disabilities, entrenched social stigma, and inaccessible infrastructure can exacerbate the challenges they face in emergency situations. In addition, there has been little preparation and planning to make disaster and emergency planning disability inclusive.3,5,6 This brief explores disability in the context of humanitarian and public health emergencies in South and Southeast Asia. Its focus is on Nepal, but the principles are universally relevant and can be adapted for any context. It is intended for stakeholders in government, civil society and the humanitarian sector. It aims to support stakeholders to better understand how structural inequities, alongside social and cultural norms and practices, exacerbate the marginalisation and exclusion of people with disabilities in emergencies. This brief presents examples of good practice for disability-responsive humanitarian and emergency planning and intervention. It also provides key considerations for actors aiming to support greater inclusion of people with disabilities in response. This brief draws on evidence from academic and grey literature, and from open-source datasets. It was authored by Obindra Chand (HERD International, University of Essex), Katie Moore (Anthrologica) and Stephen Thompson (Institute of Development Studies (IDS)), supported by Tabitha Hrynick (IDS). This brief is the responsibility of SSHAP

The facilitators of and barriers to antimicrobial use and misuse in Lalitpur, Nepal: a qualitative study

Background: Antimicrobial resistance (AMR) is a pressing global health concern driven by inappropriate antibiotic use, which is in turn influenced by various social, systemic, and individual factors. This study, nested within FIND’s AMR Diagnostic Use Accelerator clinical trial in Nepal, aimed to (i) explore the perspectives of patients, caregivers, and healthcare workers (HCWs) on antibiotic prescription adherence and (ii) assess the impact of a training and communication (T&C) intervention on adherence to antibiotic prescriptions. Methods: Using qualitative, semi-structured interviews, pre-intervention and Day 7 follow-up components, and the Behaviour Change Wheel process, we investigated the facilitators of and barriers to the use and misuse of antibiotic prescriptions. Results: Results of the study revealed that adherence to antibiotic prescriptions is influenced by a complex interplay of factors, including knowledge and understanding, forgetfulness, effective communication, expectations, beliefs and habits, attitudes and behaviours, convenience of purchasing, trust in medical effectiveness, and issues of child preferences. The T&C package was also shown to play a role in addressing specific barriers to treatment adherence. Conclusions: Overall, the results of this study provide a nuanced understanding of the challenges associated with antibiotic use and suggest that tailored interventions, informed by behaviour frameworks, can enhance prescription adherence, may be applicable in diverse settings and can contribute to the global effort to mitigate the rising threat of AMR

New Forms of Development: Branding Innovative Ideas and Bidding for Foreign Aid in the Maternal and Child Health Service in Nepal

Nepal has been receiving foreign aid since the early 1950s. Currently, the country’s health care systemis heavily dependent on aid, even for the provision of basic health services to its people. Globally, the mechanismfor the dispersal of foreign aid is becoming increasingly complex. Numerous stakeholders are involved at variouslevels: donors, intermediary organisations, project-implementing partners and the beneficiaries, engaging not onlyin Nepal but also globally. To illustrate how branding and bidding occurs, and to discuss how this process hasbecome increasingly vital in securing foreign aid to run MCH activities in Nepal