Home delivery in unhygienic environment is common in Nepal. This study aimed to identify whether practice of delivery is changing over time and to explore the factors contributing to women’s decision for choice of place of delivery.

Background: Many studies indicate that various health programmes have been failed because of the lack of appropriate information, education, and communication [IEC] for the target audiences. It is still unanswered which methods/means of communication could be the most powerful for changing behaviour or decision-making capacity. The paper aims to assess the effects of IEC on family enrolment in health insurance programme [HIP] in Nepal. Methods: We employed a household-based observational study with a control group. Altogether 810 household interviews were conducted in Baglung and Kailali districts of Nepal in 2018. The study used a validated structured interview schedule. Background characteristics of the family and respondents and their exposure to the means of communication were the independent variables while enrolment in health insurance [HI] was the dependent variable. Results: Data showed that 72% of the respondents heard about the HI and 66% knew the contribution amount for enrolment in HI. In the total enrolled households, 53% were household heads, 59% belonged to the age group 41–60 and 68% were above 60 years. More than half (56%) of rich compared to 46 and 49% of middle and poor (p < 0.05); 60% of the family member suffering from the chronic disease were enrolled in the HI. Similarly, 68% of those who heard about HI compared to 4 % who did not hear were enrolled (p < 0.001). A vast majority (69%) of those knowing contribution amount, 73% who interact with peer neighbour compared to 39% who did not, and 62% of those who listened to the radio and 63% of those who watched TV were enrolled in HI (p < 0.001). However, heard about HI (aOR = 21.18, 95%CI: 10.17–44.13, p < 0.001), knowledge about contribution amount (aOR = 5.13, 95%CI: 3.09–8.52, p < 0.001), having HI related books or guidelines (aOR = 4.84, 95%CI: 2.61–8.98, p < 0.001), and interact with peer or neighbours (aOR = 1.74, 95%CI: 1.34–2.65, p < 0.01) were appeared to be positive and significant predictors for enrolment in HI. Conclusion: Knowledge about HI and interaction with peers and neighbours about the HI scheme of the government could lead to higher participation in the HIP. It would be better to incorporate this strategy while planning interventions for increasing enrolment in the HIP.

Nutrition education at school can contribute to developing healthy nutritional behaviours in schoolchildren. This paper critically reflects on how participatory action research (PAR) empowered university researchers and a school community to co-develop a school-based nutrition education programme (SBNEP) that promotes healthy nutritional behaviours in basic-level schoolchildren (Grades 1–8). This study followed PAR as the methodological approach, where university researchers collaborated with the school stakeholders, also called ‘co-researchers’, to co-develop a SBNEP. This study was conducted in a public school located in the Chitwan district of Nepal from June 2018 to August 2022. The study involved basic-level schoolteachers, fourth to eighth-grade students and their parents/guardians, school leaders, and the PAR committee members as the co-researchers. The study used in-depth interviews, focus groups, participant observation, informal talks, and bridging-the-gap workshop methods. The interpretive phenomenological method was used to explain the meaning of the data. The findings of the study reflect that exploring the needs for good nutritional behaviours, prioritising them, and co-designing the SBNEP utilising the PAR methodology is a time-consuming project since it demands prolonged fieldwork, self-motivation, commitment, action with critical reflection (praxis), dialogic relation, and negotiation skills from both researchers and co-researchers. The study recommends that basic-level schoolteachers and researchers consider applying SBNEP using a participatory framework for transformational change in students’ nutritional behaviours.

Background: The WHO's Health Promoting Schools (HPS) framework is based on an understanding of the reciprocal relationship between health and education, and the need to take a holistic approach to health promotion in schools. We aim to clarify the degree to which the HPS framework is reflected in the national policies of eight target countries and the issues surrounding its successful implementation. Methods: Date were collected through two expert workshops with participants from eight Asian countries: Cambodia, China, Japan, Korea, Lao PDR, Nepal, the Philippines, and Thailand. In the first workshop, data collected on national policy were mapped against the HPS framework. From this, key issues were identified, and follow‐up data collection was conducted in each country for a second workshop. Results: We identified a policy shift toward the HPS framework in six out of the eight countries. Neither Japan nor Korea had changed their national policy frameworks to reflect an HPS approach; however, in the latter, model programs had been introduced at a local level. We identified various barriers to successful implementation, especially in relation to mental health and wellbeing. Conclusion: Given the recent shift toward the HPS approach in six out of the eight countries in this study, there is a need to conduct research to assess the impact of this framework on the health and wellbeing of students and school staff. At the same time, we call for more dialog in the context of Japan to explore the possible benefits of introducing the HPS framework into schools.

Nepal, a seismically active country located in South Asia, is considered one of the most disaster-prone areas of flood, landslide, and earthquake because of its fragile and complex geophysical setting as it ranks 11 th most earthquake-prone country in the world (National Planning Commission, 2015). Nepal's common disasters include landslides, earthquakes, pandemics, floods, and climatic effects. The country has experienced several devastating earthquakes in its history, including the 2015 devastating earthquake which killed nearly 9,000 people and injured over 22,000 (Goyet et al., 2018). Some noticeable earthquakes are 1255AD/1310BS (7.8M), 1260AD/1316BS (7.1M), 1408AD/1463BS (8.2M), 1681AD/1737BS (8.0M), 1810AD/1866BS, 1823AD/1880BS, 1833AD/1890BS (8.0M), 1934AD/1990BS (8.1M), 1980AD/2037BS (6.5M), 1988AD/2045BS (6.9M), 2011AD/2068BS (6.9M), 2015AD/2072BS (7.8M), 2023AD/2080BS (6.4M). Among the recorded earthquakes, those occurring in 1934 AD/1990 BS and 2015 AD/2072 BS were the most critical, claiming 8,519 and 8,856 human lives respectively (Joshi, 2020; UNICEF, 2023). Earthquakes pose a significant threat to public health in Nepal, as they can cause widespread damage to infrastructure, including healthcare facilities, and disrupt the delivery of essential healthcare services (van der Heijden et al., 2022). The recent hit earthquake on 3 rd November 2023 in Jajarkot killed at least 153 people including 78 children. About 375 persons were injured in Jajarkot and western Rukum districts, where around 5,000 houses were damaged and more than 3,000 were destroyed (2023 Nepal earthquake-Wikipedia).