TY - JOUR
T1 - Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal
T2 - perspectives of stakeholders
AU - Dhimal, Meghnath
AU - Dhimal, Mandira Lamichhane
AU - Dahal, Sushma
AU - Shrestha, Mahendra Prasad
AU - Gyanwali, Pradip
AU - Shao, Ruitai
AU - Mikkelsen, Bente
AU - Wickramasinghe, Kremlin
AU - Marten, Robert
AU - Jha, Anjani Kumar
AU - Townsend, Nick
N1 - Funding Information:
for this study was provided by the Government of the Republic of Korea through support from the WHO NCD implementation research programme. We are thankful to Ms Pratima Gautam and Ms. Tamanna Neupane, Programme Officers of NHRC who supported the transcribing of interviews. We are also grateful to all policy makers, programme managers and academics who participated in this study and shared their experiences and opinions. We are also very grateful to Dr. Lonim Prasai Dixit, National Professional Officer and Dr. Md Khurshid Alam Hyder, Technical Officer, of WHO Country Office for Nepal, for their technical advice during the study.
PY - 2021/12/31
Y1 - 2021/12/31
N2 - Background: Nepal adopted the Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (MSAP) in 2014. Implementation of the plan has been challenging, with limited participation from non-health sectors. Objectives: The overall aim of the study was to gain the perspectives of key stakeholders involved in the Nepal MSAP on the barriers and facilitators to its implementation, through the participation of relevant sectors in the plan. Methods: We held face-to-face semi-structured interviews with 12 stakeholders working in sectors involved in the MSAP. These sectors included the Office of the Prime Minister and Council of Ministries; Ministry of Health and Population (MOHP); Ministry of Education, Science and Technology; Ministry of Forest and Environment; academia; and professional organizations. Thematic analysis of transcripts was used to identify themes on awareness of NCDs, awareness of the MSAP, and barriers and facilitators to participation in the MSAP. Results: Participants recognised NCDs as a growing and major burden in Nepal. However, a number of participants were not familiar with the MSAP, identifying a lack of leadership and poor dissemination. Political and systemic transformation, since the adoption of the MSAP, was seen as a key barrier to implementation. International commitments to develop multisectoral action made by the Government of Nepal were identified as drivers. The recent establishment of a separate section for NCDs and Mental Health within the Department of Health Services of MOHP and the promotion of a Health in All Policies (HiAP) approach in recent national documents, were both considered to support implementation. Conclusions: The establishment of permanent multisectoral or multistakeholder mechanisms has been challenging despite strong political calls for their development. Moving beyond 2020, multisectoral action plans should engage with stakeholders from federal, provincial and local governments in order to develop costed action plans with specific roles and responsibilities for each sector.
AB - Background: Nepal adopted the Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (MSAP) in 2014. Implementation of the plan has been challenging, with limited participation from non-health sectors. Objectives: The overall aim of the study was to gain the perspectives of key stakeholders involved in the Nepal MSAP on the barriers and facilitators to its implementation, through the participation of relevant sectors in the plan. Methods: We held face-to-face semi-structured interviews with 12 stakeholders working in sectors involved in the MSAP. These sectors included the Office of the Prime Minister and Council of Ministries; Ministry of Health and Population (MOHP); Ministry of Education, Science and Technology; Ministry of Forest and Environment; academia; and professional organizations. Thematic analysis of transcripts was used to identify themes on awareness of NCDs, awareness of the MSAP, and barriers and facilitators to participation in the MSAP. Results: Participants recognised NCDs as a growing and major burden in Nepal. However, a number of participants were not familiar with the MSAP, identifying a lack of leadership and poor dissemination. Political and systemic transformation, since the adoption of the MSAP, was seen as a key barrier to implementation. International commitments to develop multisectoral action made by the Government of Nepal were identified as drivers. The recent establishment of a separate section for NCDs and Mental Health within the Department of Health Services of MOHP and the promotion of a Health in All Policies (HiAP) approach in recent national documents, were both considered to support implementation. Conclusions: The establishment of permanent multisectoral or multistakeholder mechanisms has been challenging despite strong political calls for their development. Moving beyond 2020, multisectoral action plans should engage with stakeholders from federal, provincial and local governments in order to develop costed action plans with specific roles and responsibilities for each sector.
KW - implementation
KW - Multisectoral
KW - noncommunicable disease
KW - policy
KW - prevention
UR - http://www.scopus.com/inward/record.url?scp=85113696054&partnerID=8YFLogxK
U2 - 10.1080/16549716.2021.1963069
DO - 10.1080/16549716.2021.1963069
M3 - Article
AN - SCOPUS:85113696054
VL - 14
JO - Global Health Action
JF - Global Health Action
SN - 1654-9716
IS - 1
M1 - 1963069
ER -
