Background Nepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition. Methods The Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017. Results There were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death. Conclusions The increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

Introduction: Unintentional home injury is an important cause of death and disability among children, especially those living in low‐ and middle‐income countries (LMICs). This systematic review aimed to synthesize evidence about the effectiveness of environmental interventions to prevent unintentional child injury and/or reduce injury hazards in the home in LMICs.Methods: Seven electronic databases were searched for randomized controlled trials (RCTs) and controlled before and after (CBA) studies published up to 1 April 2018. Potentially eligible citations were screened by title and abstract and full texts of studies obtained. Synthesis was reported narratively, and where possible, meta‐analysis was conducted.Results: Four studies met the inclusion criteria: One CBA study reported changes in injury incidence, and three RCTs reported changes in frequency of home hazards. In one study, child resistant containers were found effective in reducing the incidence of paraffin ingestion by 47% during and by 50% postintervention. A meta‐analysis of two trials found that home inspection, safety education and safety devices reduced postintervention mean scores for poisoning hazards [mean difference (MD) −0.77; 95% CI [−1.36, −0.19]] and burn‐related unsafe practices (MD −0.37; 95% CI [−0.66, −0.09]) but not for falls or electrical and paraffin burn hazards. A single trial found that home inspection and safety education reduced the postintervention mean scores for fall hazards (MD −0.5; 95% CI [−0.66, −0.33]) but not for ingestion hazards.Conclusion: There is limited evidence that environmental change interventions reduce child injuries but evidence that they reduce some home hazards. More evidence is needed to determine if altering the physical home environment by removing potential hazards reduces injuries in LMICs.

Background Globally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5–24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. Methods A new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations. Results The total number of children <18 years of age presenting with injury was 2696, representing 27% of all patients presenting with injuries enrolled. Most injuries in children presenting to the emergency departments in this study were unintentional and over half of children were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with poisonings, burns and drownings presenting proportionately less often. Over half of injuries were cuts, bites and open wounds. In-hospital child mortality from injury was 1%. Conclusion Injuries affecting children in Nepal represent a significant burden. The data on injuries observed from falls, road traffic injuries and injuries related to animals suggest potential areas for injury prevention. This is the biggest prospective injury surveillance study in Nepal in recent years and supports the case for using injury surveillance to monitor child morbidity and mortality through improved data.

In Nepal, unintentional home injury is a leading reason for death and disability among pre-school children. However, there is a lack of evidence to inform culturally appropriate interventions to reduce home injuries. This study explored the potential for home environmental change at a community level to prevent unintentional home injury in children and identified the barriers to, and facilitators of, such changes. Focus groups were conducted in the Nepali language with mothers, fathers, teachers, school students and community health volunteers in rural areas of Makwanpur district in Nepal. The discussions were audio-recorded, transcribed, translated into English and analysed thematically. NVivo software was used to support coding and identification of themes. Five focus groups, involving forty-seven participants, were completed leading to the development of four themes. Overall, the findings highlight that community people perceive injuries to be a normal part of childhood and, therefore, few prevention measures were considered. Parents were, however, able to identify ways to change their environment that made it safer. Changes included removing hazards or adding safety equipment, adapting the home or restricting access to potential hazards. Barriers to implementation included limited awareness about injury hazards and risk management, poor quality housing and financial constraint. Facilitators included raising community awareness, acquiring resources and financial support and involving the family and community. Development of interventions to prevent injuries at home in pre-school children should reflect local context and culture; this is best achieved through engagement with parents.

This study aimed to develop and evaluate a model of hospital-based injury surveillance and describe the epidemiology of injuries in adults. One-year prospective surveillance was conducted in two hospitals in Hetauda, Nepal. Data were collected electronically for patients presenting to emergency departments (EDs) with injuries between April 2019 and March 2020. To evaluate the model’s sustainability, clinical leaders, senior managers, data collectors, and study coordinators were interviewed. The total number of patients with injuries over one year was 10,154, representing 30.7% of all patients visiting the EDs. Of patients with injuries, 7458 (73.4%) were adults aged 18 years and over. Most injuries (6434, 86%) were unintentional, with smaller proportions due to assault (616, 8.2%) and self-harm (408, 5.5%). The median age of adult patients was 33 years (IQR 25–47). Males had twice the rate of ED presentation compared with females (40.4 vs. 20.9/1000). The most common causes were road traffic accidents (32.8%), falls (25.4%), and animal/insect related injuries (20.1%). Most injured patients were discharged after treatment (80%) with 9.1% admitted to hospital, 8.1% transferred to other hospitals, and 2.1% died. In Nepal, hospital-based injury surveillance is feasible, and rich injury data can be obtained by embedding data collectors in EDs.

An increasing number of people are relocating to search for work, leading to substantial implications for both local and global health. Approximately 3.6% of the global population (281 million) migrates annually. Nepal has experienced a notable surge in labour migration in recent years, with a substantial proportion of its residents actively seeking work opportunities abroad. Understanding work-related risks is crucial for informing policies, interventions, and practices that can improve the welfare of this hard-to-reach population. This scoping review aims to systematically identify and analyse occupational health hazards encountered by Nepali migrant workers employed overseas. Medline, Scopus, Directory of Open Access Journals (DOAJ), and the NepJOL databases were systematically searched for primary research papers published in English up to July 2024. Relevant data, including workplace hazards and their impact on health outcomes, were extracted and narratively synthesised by highlighting key themes in the existing literature. A total of 24 articles met the inclusion criteria and were included in this review. Of these, twelve studies were conducted in Nepal, five in Gulf countries, four in Malaysia, two in Hong Kong, and one each in India and Korea. Workplace injuries (motor vehicle injuries, machinery injuries, falls from a height, and falls on a heavy object), poor working environment (including long working hours, work without leave, discrepancy in pay scale, limited access to drinking water and toilet/bathroom facilities), workplace abuse, sexual abuse, and torture were identified as key occupational health hazards faced by the Nepali migrant workers abroad. Multi-level intervention strategies, such as safety training standards, improving working conditions, and eliminating exploitative labour practices, are critical to improving occupational health and safety standards for Nepali migrant workers abroad. This includes creating a supportive working environment where employees can easily and timely access health services as needed.