COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system

A new coronavirus disease (COVID-19) caused by a novel pathogen (SARS-CoV-2) spread rapidly around the world in the early months of 2020, and was declared a pandemic by the World Health Organization (WHO) on 11 March. COVID-19 has, and continues to have, large implications for individuals, societies, and for national health systems across the globe. Due to its novelty and impact, it has challenged all health care systems where the virus has taken hold. The ways in which governments and health systems have responded have varied widely across the world. In the case of Nepal, the pandemic represented a major test for the newly decentralised health system, created as a result of the implementation of the 2015 federal constitution. This paper, which forms a part of our large on-going study of the decentralisation of the health system in the country, presents some of the early evidence on the effectiveness of the actions taken by Federal, Provincial and Local Governments and the levels of cooperation and coordination between them

Participatory policy analysis in health policy and systems research: reflections from a study in Nepal

Background Participatory policy analysis (PPA) as a method in health policy and system research remains underexplored. Using our experiences of conducting PPA workshops in Nepal to explore the impact of the country’s move to federalism on its health system, we reflect on the method’s strengths and challenges. We provide an account of the study context, the design and implementation of the workshops, and our reflections on the approach’s strengths and challenges. Findings on the impact of federalism on the health system are beyond the scope of this manuscript. Main body We conducted PPA workshops with a wide range of health system stakeholders (political, administrative and service-level workforce) at the local and provincial levels in Nepal. The workshops consisted of three activities: river of life, brainstorming and prioritization, and problem-tree analysis. Our experiences show that PPA workshops can be a valuable approach to explore health policy and system issues – especially in a context of widespread systemic change which impacts all stakeholders within the health system. Effective engagement of stakeholders and activities that encourage both individual- and system-level reflections and discussions not only help in generating rich qualitative data, but can also address gaps in participants’ understanding of practical, technical and political aspects of the health system, aid policy dissemination of research findings, and assist in identifying short- and long-term practice and policy issues that need to be addressed for better health system performance and outcomes. Conducting PPA workshops is, however, challenging for a number of reasons, including the influence of gatekeepers and power dynamics between stakeholders/participants. The role and skills of researchers/facilitators in navigating such challenges are vital for success. Although the long-term impact of such workshops needs further research, our study shows the usefulness of PPA workshops for researchers, for participants and for the wider health system. Conclusions PPA workshops can effectively generate and synthesize health policy and system evidence through collaborative engagement of health system stakeholders with varied roles. When designed with careful consideration for context and stakeholders’ needs, it has great potential as a method in health policy and systems research

Parks, people, and conservation: A review of management issues in nepal's protected areas

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43480/1/11111_2005_Article_BF01254607.pd

In situ agrobiodiversity conservation for regional development in Nepal

© Springer 2005The majority of rural communities have limited agricultural development opportunities within the hills and mountains of Nepal. While the dominant development model, which focuses on technology transfer and the evolution of commercial production systems, is effective when access to inputs and markets enables farmers to produce and trade successfully, many communities are marginalised from development opportunities by poverty and poor infrastructure. Complementary development approaches that value, conserve, develop and market agrobiodiversity could alleviate the extreme poverty where these conditions prevail as in the hills and mountains, the rural margins of Nepal. Formalised in situ approaches to agrobiodiversity conservation are in their infancy in Nepal, yet suggest that opportunities exist for a complementary agricultural development approach in the rural margins based on working with the local diversity, rather than its elimination. The obstacles of widespread poverty and inadequate infrastructure ensure that effective in situ agrobiodiversity conservation programs must provide for the needs of local people for sustainable development.Douglas Bardsley and Ian Thoma