Journal of Health and Social Welfare

When Public Health Dreams Meet Policy and Practice: A Personal Reflection from Nepal’s Pandemic Preparedness Journey

Ashok Pandey — 2026-04-10

This viewpoint reflects on a rare and deeply personal journey from research and policy advocacy to witnessing real-world implementation of pandemic preparedness in Nepal. Drawing on the author’s contribution to national policy formulation and subsequent field experience in Sudurpaschim Province, the article highlights how evidence-informed recommendations on epidemic management were translated into national policy priorities and operationalized through the “Strengthening Pandemic Preparedness for Early Detection in Nepal (SPEED)” project. Situating Nepal within the broader global momentum led by the Pandemic Fund, the article underscores the importance of surveillance systems, laboratory strengthening, and workforce development. It argues that bridging the gap between research, policy, and practice is both possible and essential for resilient health systems in low- and middle-income countries.

Assessment of Fiscal Federalism Implementation from a Governance Perspective in Nepal

Bhakta Bahadur Bhandari — 2026-04-10

Federalism enables power-sharing between central and regional administrations, with fiscal federalism focusing on resource allocation to improve governance. Nepal’s 2015 Constitution established a federal system emphasizing decentralization and participatory governance. Despite advancements like Performance-Based Grant Systems, challenges in resource allocation, infrastructure, and coordination persist. This study explored fiscal federalism’s challenges and opportunities to enhance governance and equitable development in Nepal. Using a descriptive cross-sectional design, data were collected from 384 local government officials involved in fiscal policy and management in Nepal. Data analysis was performed using SPSS version 20. The results highlight significant challenges, including insufficient funding (89.3%), political interference (89.6%), and a lack of clear guidelines (85.9%). Opportunities identified include improved local economic growth (mean = 4.74), public service delivery (mean = 4.20), and accountability (mean = 4.17). However, the implementation of fiscal federalism is hindered by issues such as political instability (mean = 4.10) and resource allocation challenges (mean = 3.68). Despite these obstacles, respondents largely agree that fiscal federalism has contributed positively to local governance, with 94.3% agreeing that it has improved governance and 96% noting increased public participation. The study concludes that while fiscal federalism has shown promise in enhancing local autonomy and service delivery, addressing funding shortages, capacity deficits, and coordination challenges is crucial for maximizing its potential to foster equitable development and improve the quality of life in Nepal.

Evaluating the Effectiveness of Telehealth Services in Community Nursing Practice

Sarala KC — 2026-04-10

Telehealth, using digital platforms to provide remote healthcare, has the potential to address geographic and systemic barriers, especially in resource-constrained settings like Nepal. This quantitative study assessed the efficacy of telehealth in community-based nursing care in hospitals of Sudurpaschhim Province, Nepal. A purposive sample of 422 outpatients aged over 18 years was surveyed using a structured questionnaire. Data were collected through face-to-face interviews, ensuring ethical approval, informed consent, and confidentiality. Responses were recorded via Kobo Toolbox and analyzed with SPSS using descriptive statistics, chi-square tests, and logistic regression, with significance set at p < 0.05. Most respondents were male (64%), aged 30–39 years (40.5%), from rural areas (88.9%), and 73.9% had smartphone or internet access. Awareness of telehealth was low, with 58.5% never having heard of it and only 34.6% correctly identifying it as health services via phone or internet. Utilization was minimal, mainly for health advice (11.6%) and prescription refills (4.0%), while preventive and specialized care were rarely used. Acceptance was motivated by convenience, time, and cost savings, but limited by poor connectivity, privacy concerns, and preference for in-person care. The findings highlight the need for targeted education, awareness programs, improved digital infrastructure, and governance to enhance telehealth utilization and integration into healthcare delivery.

An Assessment of the Impact of Faculty Development Programs on Nursing Education

Polina Paudyal — 2026-04-11

Faculty development is essential for improving teaching quality, curriculum effectiveness, and professional competence in nursing education, particularly in contexts facing workforce shortages, limited training opportunities, and resource constraints. This study aimed to assess the role of faculty development programs in enhancing nursing education in Nepal. A quantitative cross-sectional study was conducted among 422 bachelor-level nursing educators from purposively selected nursing colleges in Kathmandu Valley, Nepal, using a structured self-administered questionnaire. Participants were selected through simple random sampling of educators. Data were collected via Kobo Toolbox and analyzed using SPSS with descriptive statistics, chi-square tests, and logistic regression, with statistical significance set at p < 0.05. Findings showed that faculty development programs (FDPs) in nursing education were predominantly offered by private institutions (98.8%). Educators widely adopted learner-centered strategies, particularly community-based clinical practice (mean = 8.00) and simulation (mean = 7.63). FDPs significantly enhanced professional growth, especially leadership (mean = 8.14), mentoring (mean = 8.13), and clinical supervision (mean = 7.68). Strong positive correlations were found between FDPs and teaching strategies, curriculum development, leadership, and graduate attributes (r = 0.83–0.93, p < 0.01). Therefore, faculty development programs are essential for improving teaching quality and professional capacity in nursing education in Nepal. Sustained, contextually relevant FDPs are needed to strengthen faculty capacity and educational outcomes.

Examining Nursing Leadership and Its Role in Driving Quality Improvement among Nursing Students in Kathmandu Valley

Nirmala Balayer — 2026-04-10

Quality improvement (QI) strengthens healthcare delivery, with nurses playing a central role in addressing practice gaps. In Nepal, workforce shortages and inconsistent nursing education limit students’ readiness for QI, making leadership support essential. This study examined the influence of nursing leadership on nursing students’ awareness, participation, and perceptions of QI initiatives in Kathmandu Valley. A descriptive cross-sectional study was conducted, with data collected from 422 students through stratified random sampling and analyzed using descriptive statistics in SPSS. Findings indicated that nursing students in Kathmandu Valley were highly engaged in QI initiatives, participating in projects (mean = 4.42, SD = 0.83), planning (mean = 4.01, SD = 0.83), and implementation (mean = 3.91, SD = 0.76). Leadership awareness and skills were moderate to high, despite limited formal training (mean = 2.99, SD = 1.29). Key challenges included workload (61.6%) and limited supervision (54.3%), while practical examples (64.7%) and instructor support (62.8%) facilitated sustained QI engagement. Incorporating structured leadership development and experiential QI training is essential to enhance nursing students’ competence in leading and sustaining quality improvement initiatives.

Assessing The Potential Of Information Technology In Nepal's Public Health Surveillance

Shyam Adhikari — 2026-04-11

ICT plays a critical role in healthcare, supporting patient records, decision-making, and public health monitoring, but its adoption in Nepal is hindered by challenges such as limited infrastructure, skilled personnel, and privacy concerns. Hence, this study aims to explore the role of IT in enhancing public health surveillance systems in Nepal, with a focus on identifying challenges, benefits, strategies, and the impact of IT to improve public health outcomes. This descriptive quantitative study involved 422 participants from healthcare professions in the Kathmandu Valley, selected using random sampling. Data was collected via paper-based questionnaires and Google Forms, followed by analysis using SPSS, with descriptive and inferential statistics to identify predictors of effective public health surveillance. Content validity was ensured through literature review and expert input, while reliability was confirmed through pretesting and a Cronbach's Alpha test. The findings reveal significant associations between socio-demographic factors and healthcare IT system-related perceptions, with all Chi-square values being highly significant (p-value = 0.0001). Key socio-demographic variables such as age, gender, educational level, profession, and years of experience influence participants' views on challenges, benefits, impacts, and strategies. Additionally, the correlation analysis shows significant positive relationships between the variables. Challenges are positively correlated with benefits, impacts, and strategies, while benefits strongly correlate with impact and strategies. In conclusion, addressing challenges in healthcare IT systems through strategies like training, collaboration, and user-friendly interfaces can enhance benefits, improve impacts, and ultimately lead to better healthcare outcomes.

Nurses Attitudes Toward Caring for LGBTQ Patients and the Factors that Influence Them

Ratna Keshari Suwal — 2026-04-10

The lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations face persistent health disparities due to stigma, societal norms, and gaps in provider competence. Nurses’ attitudes and training influence care quality, yet cultural sensitivity and personal beliefs may limit inclusivity, especially in Nepal. This study aimed to assess nurses’ attitudes toward LGBTQ patients and the factors shaping these attitudes. A descriptive cross-sectional study was conducted in Bhaktapur, Nepal. A total of 422 nurses were selected through the census method from four hospitals chosen by purposive sampling, and data were collected using a self-administered questionnaire. Data were analyzed using SPSS 20 with descriptive and inferential statistics to summarize findings and identify associated factors. Findings indicated that most respondents were young nurses aged 18–27 years (54%), female (98.1%), with PCL Nursing qualifications (64%) and working in wards (62.3%). Knowledge about homosexuality was low (53.6% scored <60%), while attitudes showed stigma alongside some support, 60% viewed homosexuality as immoral, yet 52.1% agreed LGBTQ patients deserve equal care. Regression analysis indicated that general attitudes (β = 0.355), homophobic behavior (β = 0.279), and stereotypes (β = –0.363) explained 66% of variance in care attitudes, while knowledge had minimal impact (β = 0.064). Therefore, these findings highlight the need for targeted interventions to promote LGBTQ-inclusive healthcare.