Publication: A National Equity Initiative to Address Noncommunicable Diseases and Injuries: Findings and Recommendation from the Nepal NCDI Poverty Commission
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
We aimed to assess the burden of NCDIs across socioeconomic groups, their
economic impact, existing health service readiness and availability, current policy
frameworks and national investment, and planned programmatic initiatives in
Nepal through a comprehensive literature review. Secondary data from Global
Burden of Disease estimates from GBD 2015 and National Living Standard Survey
2011 were used to estimate the burden of NCDI and present the relationship of
NCDI burden with socioeconomic status.
The Commission used these data to define priority NCDI conditions and recommend
potential cost-effective, poverty-averting, and equity-promoting health system
interventions. NCDIs disproportionately affect the health and well-being of poorer
populations in Nepal and cause significant impoverishment.
The Commission found a high diversity of NCDIs in Nepal, with approximately 60% of
the morbidity and mortality caused by NCDIs without primary quantified behavioral
or metabolic risk factors, and nearly half of all NCDI-related DALYs occurring in
Nepalese younger than 40 years. The Commission prioritized an expanded set
of twenty-five NCDI conditions and recommended introduction or scale-up of
twenty-three evidence-based health sector interventions. Implementation of
these interventions would avert an estimated 9680 premature deaths per annum
by 2030 and would cost approximately $8.76 per capita. The Commission modelled
potential financing mechanisms, including increased excise taxation on tobacco,
alcohol, and sugar-sweetened beverages, which would provide significant revenue
for NCDI-related expenditures. Overall, the Commission’s conclusions are expected
to be a valuable contribution to equitable NCDI planning in Nepal and similar
resource-constrained settings globally.
KEY WORDS
NCDI Poverty Commission, Noncommunicable diseases and injuries
Description
Koirala B,1,10 Adhikari SR,2 Shrestha A,3 Vaidya A,4 Aryal KK,5 Kalaunee SP,6 Shrestha A,3 Mishra SR,7 Sharma SK,8 Karki A,9 Maharjan B,10 Singh S,10 Schwarz D,11 Gupta N,12 Bukhman G,12 Karmacharya BM3
1,10Tribhuvan University, Institute of Medicine
Department of Cardiothoracic and Vascular
Surgery,Maharajgunj, Kathmandu
2Tribhuvan University Faculty of Humanities and Social
Sciences, Central Department of Economics, Kritipur,
Kathmandu
3Dhulikhel Hospital, Kathmandu University School of
Medical Sciences, Dhulikhel, Kavre
4Kathmandu Medical College and Teaching Hospital,
Department of Community Medicine, Sinamangal
Kathmandu
5Bergen Center for Ethics and Priority Setting in Health
Department of Global Public Health and Primary Care
University of Bergen
6Nyaya Health Nepal, Tripureshwor, Kathmandu
7Nepal Development Society, Chitwan, Nepal
8B.P. Koirala Institute of Health Sciences, Dharan.
9School of Health, Medical and Applied Sciences
Central Queensland University
10Kathmandu Institute of Child Health, Budhanilkantha
Kathmandu
11Brigham and Women’s Hospital, Division of Global
Health Equity; Harvard Medical School, Department of
Medicine
12Center for Integration Science, Brigham and Women’s
Hospital; Program in Global NCDs and Social Change
Harvard Medical School; NCD Synergies Project
Partners In Health; NCDI Poverty Network, Boston
USA
Keywords
NCDI Poverty Commission, Noncommunicable diseases and injuries