This study attempts to explore the involvement of fathers of children under two years of age in Maternal and Child health care in the Dhading district of Nepal. Four focus groups discussions with 38 fathers were conducted. Six major themes emerged from the analysis as follows: Access to health facility; knowledge on ANC and PNC visits; helping the pregnant and lactating mother; family decision-making; male parent's preference of health facility and the male's suggestions on how to improve the health care system for MCH care. The results revealed that priority was given to faith healers for health services; male parents were less aware of the importance of ANC and PNC visits and that social stigma negatively impacts the help given to the pregnant and lactating mother. Most of the participants were helpful and supportive of their wives during pregnancy and lactating. The mistrust created by the unavailability of health workers in the health facility, long distances to the health facility with roads inaccessible to ambulances and a lack of human resources in the village were all reasons for home delivery. Involvement of the male in health care activities and providing them with health education opens a window of opportunity to help achieve Maternal and Child health-related goals.

Burns are one of the most serious global public health challenges, and Nepal is no exception. This study aims to present national and local-level data regarding burn injuries within Nepal. Similarly, this study shows how the trained rural first responders respond to burn injuries at the community level, with an example from the Dhading district of Nepal. Police and Emergency Medical Services (EMS) records were used to describe the national and community-level burn injury patterns. The most common cause of burns was found to be household fire, mainly from cooking. The burn cases are distributed across all ages; however, young age group comprises a notable proportion. Victims who were injured but were still able to move primarily accessed emergency health services by walking to the closest facility. Mainly, burn victims received a dressing and cold sponging service at the primary health center. This study described the Emergency Medical Services (EMS) in detail and identified that appropriate training to the community people to respond the burns injuries minimizes the severity of the cases. Lessons learned from this project can be utilized to implement emergency burn injury management for the public and local responders in other rural areas at minimum costs. We recommend establishing burn care instruction in all rural/remote villages and health care centers in Nepal.

Background In 2021, the Nepal national emergency care system’s assessment (ECSA) identified 39 activities and 11 facility specific goals to improve care. To support implementation of the ECSA facility-based goals, this pilot study used the World Health Organization’s (WHO) Hospital Emergency Unit Assessment Tool (HEAT) to evaluate key functions of emergency care at tertiary hospitals in Kathmandu, Nepal. Methods This cross-sectional study used the standardized HEAT assessment tool. Data on facility characteristics, human resources, clinical services, and signal functions were gathered via key informant interviews conducted by trained study personnel. Seven tertiary referral centers in the Kathmandu valley were selected for pilot evaluation including governmental, academic and private hospitals. Descriptive statistics were generated and comparative analyses were conducted. Results All facilities had continuous emergency care services, but differed in the extent of availability of each item surveyed. Academic institutions had the highest rating with greater availability of consulting services and capacity to perform specific signal functions including breathing interventions and sepsis care. Private institutions were found to have the highest infrastructure availability and diagnostic testing capacity. Across all facilities, common barriers included lack of training of key emergency procedures, written protocols, point of care testing, and ancillary patient services. Conclusion This pilot assessment demonstrates that current emergency care capacity at representative tertiary referral hospitals in Kathmandu, Nepal is variable with some consistent barriers which preclude meeting the ECSA goals. The results can be used to inform emergency care development within the region studied and demonstrate that the WHO HEAT assessment is feasible and may be instructive in systematically advancing emergency care delivery at the national level if implemented more broadly.

Background In 2021, the Nepal national emergency care system’s assessment (ECSA) identified 39 activities and 11 facility-specific goals to improve care. To support implementation of the ECSA facility-based goals, this pilot study used the World Health Organization’s (WHO) Hospital Emergency Unit Assessment Tool (HEAT) to evaluate key functions of emergency care at tertiary hospitals in Kathmandu, Nepal. Methods This cross-sectional study used the standardized HEAT assessment tool. Data on facility characteristics, human resources, clinical services, and signal functions were gathered via key informant interviews conducted by trained study personnel. Seven tertiary referral centers in the Kathmandu valley were selected for pilot evaluation including governmental, academic, and private hospitals. Descriptive statistics were generated, and comparative analyses were conducted. Results All facilities had continuous emergency care services but differed in the extent of availability of each item surveyed. Academic institutions had the highest rating with greater availability of consulting services and capacity to perform specific signal functions including breathing interventions and sepsis care. Private institutions had the highest infrastructure availability and diagnostic testing capacity. Across all facilities, common barriers included lack of training of key emergency procedures, written protocols, point-of-care testing, and ancillary patient services. Conclusion This pilot assessment demonstrates that the current emergency care capacity at representative tertiary referral hospitals in Kathmandu, Nepal is variable with some consistent barriers which preclude meeting the ECSA goals. The results can be used to inform emergency care development within Nepal and demonstrate that the WHO HEAT assessment is feasible and may be instructive in systematically advancing emergency care delivery at the national level if implemented more broadly.