Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and (i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the UK.

Background: Over the past 20 years, Nepal has seen major improvements in childhood and maternal survival. In 2015, the Nepalese government introduced a new federal political structure. It is unclear how this has affected the health system, and particularly, maternal and child health care. Hence, this study aims to describe and analyse health facility preparedness in the light of the federalization process with regards to providing appropriate and timely maternal and neonatal health services. Methods: A descriptive cross-sectional study was conducted in Jumla district, Nepal in 2019 covering all 31 state health facilities (HF) to assess the availability of maternal and neonatal health services including appropriate workforce and access to essential medicines. Tests of association between demographic factors and the probability of a facility experiencing a shortage of essential medicine within the last 3 months were also conducted as exploratory procedures. Results: Out ot 31 HFs, more than 90% of them had all their staff positions filled. Most facilities (n = 21) had experienced shortages of essential medicines within the past 3 months. The most common out of stock medicine were: Amoxicillin (n = 10); paracetamol (n = 10); Vitamin A (n = 7); and Metronidazole (n = 5). Twenty-two HFs had referred maternal and newborn cases to a higher centre within the past 12 months. However, more worryingly, twenty HFs or their catchment communities did not have emergency ambulance transport for women and newborns. Conclusion: HFs reported better staffing levels than levels of available drugs. HFs should be supported to meet required minimal standards such as availability of essential medicines and the provision of emergency ambulance transport for women and newborns.

Community health workers (CHWs) have played a vital role in improving primary healthcare services in different parts of the world, in particular, for those services related to the prevention and control of communicable diseases, immunization services, reproductive health, maternal and child health, HIV/AIDS prevention and care and nutrition promotion. The Female Community Health Volunteers (FCHVs) program, which was introduced in 1988 in Nepal, has now reached over 51,000 FCHVs. They are key community level CHWs in Nepal and have contributed significantly in achieving several health and related outcomes and meeting several Millennium Development Goals. In such, there is also a potential and needs for engaging them to prevent and control emerging health challenges such as non-communicable diseases prevention and control and re-emerging health issues. Their effective involvement to ongoing health programs would be critical to achieving Sustainable Development Goals, agenda in particular “SDG 3 – Health and Wellbeing” by 2030.

There has been a significant improvement in maternal and neonatal health in the last two decades around the world. However, many women still die during pregnancy and childbirth. Nepal is one of the United Nations (UN) Member States which is committed to achieving the Sustainable Development Goals (SDGs) to reduce maternal mortality Ratio (MMR) and Newborn Mortality Rate (NMR). Understanding the women’s perspective on the maternity health service is vital for improving the utilisation of the maternity care services. Hence, this study explored women’s perspective on quality of care in maternal and neonatal health (MNH) in the Jumla district of Nepal.This study employed a qualitative methodology which consists of semi-structured interviews with pregnant women and mothers with children under two years of age, from Jumla district, Nepal. Two main themes that occurred during the interviews were experience of care, expected quality of care and MNH service in federalisation.The participants in the study found that the communication and information were clear to them, and the waiting time was from no waiting time to half an hour. Some participants expressed concern about the health worker’s behaviour during their visit to the health facilities. The women also expressed that quality of care for them meant having accessible health services in their local settings.Women’s experiences of care play an essential role in improving the quality of care in maternal and neonatal health. The health system needs to consider women’s experiences while planning for maternal health system in order to improve the maternal and neonatal health outcomes.