Publication: Needs Assessment of Leadership and Governance in Cardiovascular Health in Nepal
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Good governance and leadership are essential to improve healthy life expectancy
particularly in low and middle-income countries (LMICs). This study aimed to
epitomize the challenges and opportunities for leadership and good governance for
the health system to address non-communicable diseases particularly cardiovascular
diseases (CVD) in Nepal.
Objective
The objective of this study was to understand and document CVD programs and
policy formulation processes and to identify the government capacity to engage
stakeholders for planning and implementation purposes.
Method
A national-level task force was formed to coordinate and steer the overall need
assessment process. A qualitative study design was adopted using “The Health
System Assessment Approach”. Eighteen indicators under six topical areas in
leadership and governance in cardiovascular health were assessed using desk review
and key informant interviews.
Result
Voice and accountability exist in planning for health from the local level. The
government has shown a strong willingness and has a strategy to work together
with the private and non-government sectors in health however, the coordination
has not been effective. There are strong rules in place for regulatory quality, control
of corruption, and maintaining financial transparency. The government frequently
relies on evidence generated from large-scale surveys for health policy formulation
and planning but research in cardiovascular health has been minimum. There is a
scarcity of cardiovascular disease-specific protocols.
Conclusion
Despite plenty of opportunities, much homework is needed to improve leadership
and governance in cardiovascular health in Nepal. The government needs to
designate a workforce for specific programs to help monitor the enforcement of
health sector regulations, allocate enough funding to encourage CVD research, and
work towards developing CVD-specific guidelines, protocols, and capacity building.
KEY WORDS
Cardiovascular diseases, Governance, Leadership, Needs assessment, Nepal
Description
Pradhan PMS,1-3 Bhatt RD,3-5 Pandit R,3,6 Shrestha A,7-10 Maharjan R,3,7,11 Jha N,7 Bajracharya S,7 Shrestha S,7 Koju RP,12,13 Karmacharya BM7,8
1Department of Community Medicine, Maharajgunj
Medical Campus, Institute of Medicine, Tribhuvan
University, Nepal. 2Nepalese Society of Community
Medicine. 3Fellow, CVD Translational Research
Program, Kathmandu University School of Medical
Sciences, Dhulikhel, Kavre, Nepal. 4Wuhan
University, Faculty of Medical Sciences, School
of Health Sciences, Wuhan, China. 5Department
of Biochemistry, Kathmandu University School of
Medical Sciences, Nepal. 6Department of Physiology,
Nepal Medical College and Teaching Hospital,
Nepal. 7Department of Community Programs,
Dhulikhel Hospital-Kathmandu University Hospital,
Dhulikhel, Nepal. 8Department of Public Health,
Kathmandu University School of Medical Sciences,
Dhulikhel, Nepal. 9Department of Chronic Disease
Epidemiology, Yale School of Public Health, New
Haven, USA. 10Institute for Implementation Science
and Health, Kathmandu, Nepal. 11Department of
Nursing and Midwifery, Kathmandu University
School of Medical Sciences, Dhulikhel, Nepal. 12Dean,
Kathmandu University School of Medical Sciences,
Dhulikhel, Kavre. 13Department of Internal Medicine,
Dhulikhel Hospital-Kathmandu University Hospital,
Dhulikhel, Kavre.
Keywords
Cardiovascular diseases, Governance, Leadership, Needs assessment, Nepal