Adhikari, Shiva RajMaskay, Nephil MatangiSharma, Bishnu Prasad2026-07-152026-07-152001https://hdl.handle.net/20.500.14572/6948Abstract Health System in the Mahottari and Danusha Districts of Ne pal. The Local Health System in those districts are represented by the purposive selection of Janakpur Zonal Hospital and Mahottari District Hospital since those institutions have the sole facility in their respective districts for diagnosis and treatment of Kala -azar. The objective of the study was to determine the absolute burden of Kala -azar on the Local Health System and its burden relative to other diseases such as encephalitis, malaria and tuberculosis. The materials were obtained through both medica l records and structured questionnaires with key personnel in those institutions. The results indicate that there is a significant burden of Kala -azar on the Local Health System whose direct cost can be seen by the total cost to doctors and the nurse staff as well as the indirect cost through bed occupancy. In addition, analysis of data suggest that comparison for Kala-azar, in relation to other diseases, is tricky since its definition of the Local Health System is much narrower vis-à-vis other diseases. Keywords: Kala-azar, local health system, burden, bed occupancyen-USKala-azarlocal health systemburdenbed occupancyArticle