The prevention of? and first response to? injuries in Nepal: A review of policies and legislation

Dharel, Milan Raj; Dangi, Amrit; Rai, Writu Bhatta; Joshi, Sunil Kumar; Pant, Puspa Raj; Mytton, Julie

Abstract

Background: Injuries, the cause of an estimated 4.5 million deaths annually and many more disabilities worldwide each year, are the predictable outcome of particular circumstances. One of the most effective ways to prevent injuries is through policy and legislation. The aim of this research study was to identify and critically review all policy and legislation in Nepal that had the potential to prevent injuries. Methods: We identified legislation and policy that met inclusion criteria through a stakeholder meeting, networks and contacts, and websites and electronic resources. Each included document was critically reviewed to identify areas of strength and opportunities for improvement. We compared the included documents against WHO’s recommendations of known effective interventions. Results: Sixty-two documents met the inclusion criteria for this review. Of these, 24 (38.7%) were exclusively related to road injuries, 11 (17.7%) to occupational injuries, 6 (9.7%) to injuries in the home and 5 (8.1%) to injuries at school; 30 (48.4%) documents included text related to the first response to injuries. Of 127 strategic recommendations by WHO that provided an area for policy or legislative focus, 21 (16.5%) were considered adequately met by Nepali policy and legislation, 43 (33.9%) were considered partially met and 63 (49.6%) were not met. Conclusion: We drew five conclusions from this critical policy review, which we have related to recommendations as follows: widening the scope of legislation and policy for injury prevention to emphasize injuries occurring at home or school; addressing the causes of injuries and promoting proven preventive measures; greater clarity on both individual and institutional roles and responsibilities; trustworthy data and quality evidence to inform decision-making; and financial investment and capacity-strengthening for injury prevention and first response. The current system of federal governance in Nepal has potential for strengthening injury prevention and first response at the central, provincial and local levels.

Citation

Dharel, M. R., Dangi, A., Rai, W. B., Joshi, S. K., Pant, P. R., & Mytton, J. (2021). The prevention of? and first response to? injuries in Nepal: A review of policies and legislation. Health Research Policy and Systems, 19(1), Article 65. https://doi.org/10.1186/s12961-021-00686-1

• Journal Article Type: Article
• Acceptance Date: Jan 26, 2021
• Online Publication Date: Apr 14, 2021
• Publication Date: Apr 14, 2021
• Deposit Date: Mar 23, 2021
• Publicly Available Date: Apr 16, 2021
• Journal: Health Research Policy and Systems
• Electronic ISSN: 1478-4505
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• Article Number: 65
• DOI: https://doi.org/10.1186/s12961-021-00686-1
• Public URL: https://uwe-repository.worktribe.com/output/7229711
• Additional Information: We are waiting for the online publication of the article soon.