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.
Background:Type 2 diabetes mellitus (T2DM) is common in Nepal, where many people seek primary care through Ayurveda, a widely practiced traditional medical system. However, concerns remain about variability in clinical practice and the quality of care provided by Ayurvedic practitioners. No evidence-based clinical practice guideline (EB-CPG) currently exists for managing T2DM in Ayurveda. To address this, an EB-CPG was developed, and a feasibility trial was conducted to inform a future definitive cluster randomized controlled trial evaluating whether the EB-CPG would improve T2DM management compared to usual clinical practice. Objectives:To explore the experiences and perspectives of Ayurvedic practitioners and patients regarding the two treatment groups (EB-CPG-based care versus usual clinical practice) and participation in the feasibility trial. Design:Constructivist qualitative study. Methods:Semistructured interviews were conducted with Ayurvedic practitioners and patients. Data were analyzed thematically using an inductive approach and the framework method. Results:A total of 41 Ayurvedic practitioners and patients were interviewed. Common themes identified across both groups included facilitators and challenges in the trial patient recruitment, challenges in usual clinical care, experiences with EB-CPG-based care (predominantly positive), ease and difficulties of monthly follow-ups, and pros and cons of patient diaries for assessing medication compliance. Practitioner-specific themes included the diverse populations they serve; patients' motivations for choosing Ayurveda over Western medicine; their motivations for trial participation; balancing clinical duties with the trial demands; confusion about trial roles and responsibilities; and other trial-related issues such as understanding processes and documentation, support and communication, coordination with data collectors, and finances and other resources. Conclusion:The EB-CPG-based approach for managing T2DM by Ayurvedic practitioners in Nepal was well-received and perceived as more beneficial than usual clinical practice. Trial experiences and perspectives were largely positive; however, several challenges related to trial conduct should be addressed in future studies, including the definitive cluster trial.
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.
