NCDs: Leading Cause of Death in Nepal

In Nepal, non-communicable diseases (NCDs) and injuries are now the leading causes of deaths, surpassing communicable diseases, maternal, neonatal deaths and nutritional diseases. In fact, over half of the country’s death and disability (DALYs) in 2015 was caused by NCDs.

In Accham, a district in far west Nepal, where Possible works, smoking and wood-burning stoves are the main drivers of Chronic Obstructive Pulmonary Disorder.

Through its emphasis on longitudinal care and effective care coordination between the facility and community levels, Possible’s integrated hospital-to-home approach provides an effective model to tackle the NCD burden in the most underserved communities, where the need is the greatest.

Possible has successfully implemented several components of its PEN-PLUS approach NCD care, including CHW follow-up, task shifting, and mental health screening. These innovations have led to improvements in NCD follow-up rates, with rates increasing from 46% to 59% between 2016 and 2017. Possible also successfully helped Nepal earn a spot on the 11-country Lancet Non Communicable Diseases and Injuries (NCDI) Commission, which aims to rethink global policies and to broaden the current NCD agenda in the interest of equity. Possible leveraged Nepal’s success through this commission to help create a long-term, formalized NCD committee within the Nepali government.

Furthermore, CHWs, who hail from and best understand the conditions in the communities they serve, are an important bridge between the community and the health system. Currently, while the CHWs provide follow-up care and counseling to NCD patients, our plan is to include active case finding of NCDs by CHWs in the near future.

As we gather more data on the impact of this package of services, we anticipate seeing improvements in rates of NCD follow-up and control.

You can see a powerful video of CHW Bhajan Kunwar, and her interactions with community members, as part of the global campaign #EnoughNCDs, targeted toward decreasing the rate of non-communicable diseases in low-resource countries.




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