Introduction: Road traffic accidents are a major public health concern in Nepal, causing significant morbidity and mortality. The study goal was to determine the trends of road traffic injuries in Nepal from Fiscal Years 2020/21 to 2024/25 (mid-July 2020 – mid-July 2025). Methods: A descriptive retrospective study was conducted to analyze de-identified and pooled road traffic accident records from Nepal, following receipt of ethical clearance from the Nepal Health Research Council (ERB no. 607_2025). Data was analyzed using Microsoft Excel 2019. Results: The findings show that road traffic accidents have shown an apparent spike from FY 2020/21 to 2024/25, with both vehicle collisions and accident incidences ascended significantly. Reported vehicle crashes rose from 33135 in FY 2020/21 to 43165 in FY 2024/25, while total RTAs increased from 20640 to 28692 over the same period. RTAs surged in six provinces of Nepal. Two-wheelers, four-wheelers, and public transport vehicles accounted for the majority of incidents. Speeding 46398 (44.08%), mechanical failure 1173 (39.14%), potholes 685 (21.69%), pedestrian road crossings 5523 (79.55%), and unfavourable weather conditions like fog and mist 122 (26.23%) were major contributing factors. Although injuries increased significantly, fatality rates did not rise same proportion. Conclusions: The results show that road traffic accidents are becoming more common in Nepal, especially involving motorbikes, four-wheelers, and public vehicles. Reducing accident rates and their effects may require increased road safety enforcement, better infrastructure, and awareness-raising initiatives.
BackgroundCommon mental health conditions (CMHCs) such as depression and anxiety often co-occur with noncommunicable diseases (NCDs) like hypertension and diabetes, compounding disability and mortality particularly in low- and middle-income countries (LMICs), with under-resourced health systems. This comorbidity is driven by shared behavioral risk factors including stress, isolation, tobacco use, inactivity, poor diet, and nonadherence to treatment. The World Health Organization recommends evidence-based stress reduction (EBSR), behavioral activation (BA), and motivational interviewing (MI) to address these modifiable risks, but the implementation of such multi-component behavioral interventions in community-based settings remains limited. There is a critical gap in implementation research on how best to deliver these combined interventions through community health workers (CHWs) within public health systems. This study addresses that gap by evaluating the effectiveness, implementation, and scalability of the BEhavioral Community-based COmbined Intervention for MEntal health and noncommunicable diseases (BECOME). The trial assesses clinical outcomes, implementation outcomes using the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework at patient, provider, and health system levels and conducts a comprehensive costing analysis to inform future scale-up.MethodsThis is a stepped-wedge cluster randomized controlled trial involving 20 geographic clusters across two provinces of Nepal and 700 participants aged 40 years and above with at least one CMHC and one NCD. CHWs will be trained to deliver BECOME, comprising EBSR, BA, and MI, while the control period will include enhanced usual care. Primary outcomes include changes in CMHC severity and secondary outcomes include NCD outcomes, behavioral factors, and implementation processes. Focus group discussions and in-depth interviews with CHWs, patients, healthcare providers, and health system leaders will explore intervention acceptability and mechanisms of change. Structured costing analysis will estimate the intervention costs.DiscussionParticipant recruitment began in July 2024 and is currently ongoing. We anticipate completing data collection for the primary outcome measures by January 2027, with the aim of disseminating preliminary findings within the same year. Findings from this study will provide evidence on the effectiveness and feasibility of a CHW-delivered, integrated behavioral intervention, BECOME, for CMHCs and NCDs in LMICs, informing potential scale-up.Trial registrationClinicalTrials.gov, NCT06449521, Registered on 25 April 2024, https://register.clinicaltrials.gov/prs/beta/studies/S000DZJN00000112/recordSummary.
BACKGROUND:The evolving population demographics, healthcare system, and epidemiological transition have highlighted the need for interdisciplinary teamwork to deliver cost-effective and quality care. Despite its importance, research shows it is not consistently practiced in healthcare settings. This study aims to determine nurses' perceptions of interdisciplinary teamwork in clinical settings. METHODS:A descriptive cross-sectional study was conducted in selected tertiary hospitals, Kathmandu. Sample size was calculated using Cochrane formula and convenient sampling was used to enroll 216 nurses. Data were collected using a self-administered modified version of the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ). Frequnecy, percentage and mean were calculated as well as chi-square test was done for analysis. RESULTS:Among 216 nurses, 56.9% had negative perception of teamwork. The overall item mean score and standard deviation for NP-PCOCQ was 2.66 and 0.383, respectively. Perception regarding nurse-physician relations have the highest mean score and nurse-administrative relations have lowest. The majority of nurses in emergency and medical care had positive perception while those in surgical and critical care had negative perceptions of teamwork. The overall moderate perceptions of teamwork were reflected in the NP-PCOCQ score, highlighting the influence of clinical work environment on nurses' collaborative experiences. CONCLUSIONS:Majority of nurses have negative perception of teamwork with nurse-administrative relations scoring the lowest among subscales. Organizations should create a supportive work environment through strategic planning, effective communication, and regular collaboration to ensure teamwork.
Medically relevant mosquitoes have established populations across Nepal, adapting to diverse environmental conditions and altitudes. In addition to arbovirus vectors, the presence of Culex quinquefasciatus, a primary vector of lymphatic filariasis, underscores the need for comprehensive mosquito surveillance. This study investigated the presence, abundance, container preferences, and altitudinal distribution of Aedes aegypti, Aedes albopictus, and Cx. quinquefasciatus across selected districts in Nepal. We also examined the co-occurrence of Aedes species and their association with container type and location. An entomological survey was conducted along an altitudinal transect from 140 meters above sea level (m asl) (Chitwan) to 2340 m asl (Dolakha). Immatures were collected from 1,157 water-holding containers across 636 households using dipper and dropper techniques, while adults were captured using BG-Sentinel traps. Immatures were reared to adulthood for identification, while non-reared specimens were identified via microscopic slides. A total of 1,323 immature and 158 adult mosquitoes were recorded. Among immatures, Ae. albopictus (47.6%) was the most abundant, followed by Ae. aegypti (43.4%). Adults were predominantly Cx. quinquefasciatus (82.9%). Plastic bottles and drums were the most common larval habitats. Aedes species were found across the study transect, from 140 to 2066 m asl. The altitude did not have a statistically significant effect on the number of collected mosquitoes (p = 0.563). These findings highlight the widespread presence of Aedes and Culex species across different altitudes and breeding habitats. The predominance and co-occurrence of dengue vectors and Cx. quinquefasciatus in nearby households underscore the need for integrated vector surveillance and control strategies in Nepal.
