Suwal, PSPrajapati, DBajracharya, SShrestha, AMaharjan, RShrestha, SJha, NKoju, RPVaidya, A2025-12-192025-12-192021https://hdl.handle.net/20.500.14572/3716Suwal PS,1,2 Prajapati D,2,3 Bajracharya S,4 Shrestha A,4-7 Maharjan R,2,4,8 Shrestha S,4 Jha N,4 Koju RP,9,10 Vaidya A11 1Nepal Institute of Health Sciences, Jorpati Kathmandu, Nepal. 2Fellow, CVD Translational Research Program, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. 3Shahid Gangalal National Heart Centre, and National Academy of Medical Sciences, Kathmandu, Nepal. 4Department of Community Programs, Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchowk, Nepal. 5Department of Public Health, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Nepal. 6Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA. 7Institute for Implementation Science and Health, Kathmandu, Nepal. 8Department of Nursing and Midwifery, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. 9Dean, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Nepal. 10Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchowk, Nepal. 11Department of Community Medicine, Kathmandu Medical College Public Limited, Kathmandu, Nepal.ABSTRACT Background A health care delivery system is the organization of people, institutions, and resources designed to deliver health services. A comprehensive study to explore cardiovascular health service delivery in Nepal is lacking. Objective This study attempted to assess Nepal’s health system gap on organization and delivery of cardiovascular disease prevention and management services. Method This mixed-method study used the six building blocks of the World Health Organization health system framework: organization; access; coverage, utilization and demand; equity; quality of services; and outcomes. We conducted the desk reviews of national and international documents, performed several key informant interviews, calculated the relevant indicators, and assessed the Strengths, Weaknesses, Opportunities, and Threats of the cardiovascular health service delivery. Result We found that most of the cardiovascular services are concentrated in urban areas, and suffer from poor access, quality, utilization, and coverage in most of the areas resulting in poor health outcomes. Though the services have recently improved due to increased primary care interventions, there is scope for the development of competent human resources, advancement of technologies, development of national protocols, and improved monitoring and supervision. Improved disease system including the medical recording and reporting mechanism to incorporate and reflect the true burden of CVD in Nepal is lacking. Conclusion Despite having health facilities from grassroots to the central level, availability, access, and quality of cardiovascular health services are poor. Further improvement and equitable expansion of promotive, preventive, diagnostic, referral, and rehabilitative cardiovascular services are needed to ensure universal health coverage. KEY WORDS CVDs, Health-service delivery, Infrastructure, Needs-assessment, Nepalen-USCVDsHealth-service deliveryInfrastructureNeeds-assessmentNepalArticle