https://hdl.handle.net/20.500.14356/835 NRR 2026-04-03T07:12:32Z https://hdl.handle.net/20.500.14356/2830 Title: Integration of NCD screening, management and care continuity through primary health care using pen program in Nepal: assessing practices and barriers Authors: NHRC Abstract: Conclusion: The study reveals several gaps in PEN service provision in all levels of health systems including inadequate budget, human resources, medicines, equipment, NCD recording and reporting forms, supervision and monitoring, and financing. PEN guidelines use is also limited by service providers at the primary healthcare facilities. Findings from the study, including the factors affecting the success or failure of the program, will be used for improving the performance as well as to plan the further scale-up of the PEN program in Nepal. Government should strengthen PEN implementation through training all staff in PHCs and HP through onsite or online platform; train a cadre of health providers to share tasks and delivery NCD care (such as counselling, monitoring of BP, glucose, medicine, community awareness) at the community level; ensure adequate finances and set up of diagnostic tests, supplies, equipment and medicine; expand social health insurance to all health facilities; make protocols visible and easier to use; integrated NCD information into HMIS and DHIS-2; systematically supervise and monitor PEN program; and extend communitybased activities to raise awareness and strengthen linkages with clients. Description: Research report. 2025-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/2829 Title: Exploring eco-bio-social determinants of dengue prevention and control measures across diverse eco-regions of eastern Nepal Authors: NHRC Abstract: Nepal must shift from reactive, outbreak-driven responses to a proactive, climateinformed, community-centered vector control strategy. Strengthening surveillance, enhancing local government capacity, and integrating eco-bio-social insights into national policy are essential to reduce the growing burden of dengue and other vector-borne diseases. Description: Research Report. 2025-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/2828 Title: Spatiotemporal dynamics and environmental drivers of the 2022-2024 dengue outbreak in Nepal Authors: NHRC Abstract: Executive Summary: Dengue incidence has risen significantly in Nepal in recent years, posing an escalating public health challenge. Understanding the spatial distribution of cases and the environmental drivers that shape transmission is essential for guiding effective control measures and targeted intervention strategies. In this study, we utilized publicly available environmental and socioeconomic geospatial covariates sourced from multiple geoportals, alongside monthly dengue case data extracted from situation reports published by the Epidemiology and Disease Control Division (EDCD), Government of Nepal. We first characterized the spatiotemporal dynamics of the outbreak and mapped spatial patterns using Global Moran’s I and Local Indicators of Spatial Association (LISA) to identify statistically significant clustering. Subsequently, we applied a Random Forest (RF) machine learning model to predict case distribution and assess associations between dengue incidence and geographic covariates. The results revealed heterogeneous spatial distribution of dengue cases across the study years, with significant clusters emerging in different regions of the country. Monthly patterns showed sporadic and spatially unstructured distribution until June, followed by a sharp rise from July, peaking in September, and declining thereafter—producing statistically significant monthly clusters. The RF model indicated that districtlevel spatial variation was primarily driven by urban related environmental factors, including road density, nighttime lights (NTL), and the Human Footprint Index, along with precipitation. In contrast, temperature played a comparatively minor and variable role across outbreak years. These findings provide important insights for designing spatially targeted dengue control and intervention strategies in Nepal. Description: Research report. 2025-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/2827 Title: Assessment of knowledge, attitudes, and practices towards dengue fever and its vectors among residents of various ecological regions in eastern Nepal Authors: NHRC Abstract: Executive Summary: Dengue virus is a single-stranded RNA virus transmitted by Aedes mosquitoes. It belongs to the genus Flavivirus (family Flaviviridae) and includes four serotypes capable of causing disease ranging from self-limiting dengue fever to life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Globally, dengue has surged, with an estimated 390 million infections each year; around 96 million of these result in clinically apparent disease, many of which are severe. The Americas, South-East Asia, and Western Pacific regions are the most affected, with Asia accounting for approximately 70% of the global disease burden. Since the first dengue outbreak in 2006, Nepal has faced regular annual dengue outbreaks, from lowland to highland areas, with particularly significant outbreaks in 2022. Understanding people’s perceptions and behaviors is critical to designing effective, context-specific prevention and control strategies. Although several studies have examined dengue in Nepal, little attention has been given to differences across altitudinal regions in eastern Nepal. This study therefore aimed to assess people’s knowledge, attitudes, and practices (KAP) regarding dengue and vector prevention and control at different altitudes in eastern Nepal. In this cross-sectional study conducted in six districts of eastern Nepal, participants were categorized according to residence in highland or lowland areas. Knowledge, attitudes, and preventive practices related to dengue were assessed using a structured questionnaire, and KAP scores were calculated. Sociodemographic characteristics were recorded and analyzed to examine associations with KAP levels, using logistic regression for comparison. Among 662 participants, 31.1% resided in highland areas and 68.9% in lowland regions. Almost all participants (98.3%) had heard of dengue. However, only 6.9% demonstrated good knowledge, 75.4% showed a positive attitude, and 26.7% reported good preventive practices, with no significant differences between highland and lowland residents. Gender, education level, and income were significant predictors of both attitude and practice. There was a negative correlation between knowledge and attitude, and between attitude and practice, while knowledge showed a weak but statistically significant positive correlation with preventive practices. These findings highlight a critical gap: while most participants have heard of dengue and many hold positive attitudes toward prevention, this does not translate into adequate preventive practices. Poor knowledge and limited behavior change directly impede effective dengue prevention at the community level. For policymakers, this underscores the need to:Â Prioritize targeted, evidence-based health education and risk communication strategies tailored to different sociodemographic and altitudinal contexts. Â Strengthen community-based behavior change interventions that go beyond raising awareness to actively support and sustain preventive practices. Â Integrate dengue prevention messages into existing health and social services, schools, and local governance structures, with particular focus on women, lower education groups, and lower-income households. Effective, sustained educational and community engagement strategies are essential to translate awareness and positive attitudes into concrete preventive actions and to reduce the dengue burden in eastern Nepal. Description: Research Report. 2025-01-01T00:00:00Z