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State of post-injury first response systems in Nepal—A nationwide survey

Banstola, Amrit; Smart, Gary; Raut, Raju; Ghimire, Krishna Prasad; Pant, Puspa; Joshi, Prerita; Joshi, Sunil Kumar; Mytton, Julie


Gary Smart
Senior Lecturer in Paramedic Science

Raju Raut

Krishna Prasad Ghimire

Puspa Pant
Research Fellow (SAFETRIP Nepal)

Prerita Joshi

Sunil Kumar Joshi


Injuries account for 9.2% of all deaths and 9.9% of the total disability-adjusted life years in Nepal. To date, there has not been a systematic assessment of the status of first response systems in Nepal. An online survey was cascaded through government, non-governmental organisations and academic networks to identify first response providers across Nepal. Identified organisations were invited to complete a questionnaire to explore the services, personnel, equipment, and resources in these organisations, their first aid training activities and whether the organisation evaluated their first response services and training. Of 28 organisations identified, 17 (61%) completed the questionnaire. The range of services offered varied considerably; 15 (88.2%) provided first aid training, 9 (52.9%) provided treatment at the scene and 5 (29.4%) provided full emergency medical services with assessment, treatment and transport to a health facility. Only 8 (47.1%) of providers had an ambulance, with 6 (35.3%) offering transportation without an ambulance. Of 13 first aid training providers, 7 (53.8%) evaluated skill retention and 6 (46.2%) assessed health outcomes of patients. The length of a training course varied from 1 to 16 days and costs from US$4.0 to 430.0 per participant. There was a variation among training providers in who they train, how they train, and whether they evaluate that training. No standardisation existed for either first aid training or provision of care at the scene of an injury. This survey suggests that coordination and leadership will be required to develop an effective first response system across the country.


Banstola, A., Smart, G., Raut, R., Ghimire, K. P., Pant, P., Joshi, P., …Mytton, J. (2021). State of post-injury first response systems in Nepal—A nationwide survey. Frontiers in Public Health, 9, Article 607127.

Journal Article Type Article
Acceptance Date Mar 24, 2021
Online Publication Date Apr 20, 2021
Publication Date Apr 20, 2021
Deposit Date Apr 20, 2021
Publicly Available Date Apr 20, 2021
Journal Frontiers in Public Health
Electronic ISSN 2296-2565
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 9
Article Number 607127
Keywords emergency medical services, first aid, Nepal, organisation and administration, wounds and injuries
Public URL
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