Nepal Health Research Council (NHRC) Government of Nepal Ministry of Health and Population Complex, Kathmandu, Nepal.
Policy Research Institute, Kathmandu, Nepal.
Glob Health Action. 2021 Jan 1;14(1):1963069. doi: 10.1080/16549716.2021.1963069.
Nepal adopted the Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (MSAP) in 2014. Implementation of the plan has been challenging, with limited participation from non-health sectors.
The overall aim of the study was to gain the perspectives of key stakeholders involved in the Nepal MSAP on the barriers and facilitators to its implementation, through the participation of relevant sectors in the plan.
We held face-to-face semi-structured interviews with 12 stakeholders working in sectors involved in the MSAP. These sectors included the Office of the Prime Minister and Council of Ministries; Ministry of Health and Population (MOHP); Ministry of Education, Science and Technology; Ministry of Forest and Environment; academia; and professional organizations. Thematic analysis of transcripts was used to identify themes on awareness of NCDs, awareness of the MSAP, and barriers and facilitators to participation in the MSAP.
Participants recognised NCDs as a growing and major burden in Nepal. However, a number of participants were not familiar with the MSAP, identifying a lack of leadership and poor dissemination. Political and systemic transformation, since the adoption of the MSAP, was seen as a key barrier to implementation. International commitments to develop multisectoral action made by the Government of Nepal were identified as drivers. The recent establishment of a separate section for NCDs and Mental Health within the Department of Health Services of MOHP and the promotion of a Health in All Policies (HiAP) approach in recent national documents, were both considered to support implementation.
The establishment of permanent multisectoral or multistakeholder mechanisms has been challenging despite strong political calls for their development. Moving beyond 2020, multisectoral action plans should engage with stakeholders from federal, provincial and local governments in order to develop costed action plans with specific roles and responsibilities for each sector.
尼泊尔于 2014 年通过了《预防和控制非传染性疾病多部门行动计划》（MSAP）。该计划的执行面临挑战，非卫生部门的参与有限。
本研究的总体目的是让参与尼泊尔 MSAP 的利益攸关方了解该计划实施的障碍和促进因素，为此让相关部门参与该计划。
我们与在 MSAP 相关部门工作的 12 名利益攸关方进行了面对面的半结构化访谈。这些部门包括总理办公室和内阁部、卫生部和人口部（MOHP）、教育部、科学和技术部、林业和环境部、学术界以及专业组织。使用主题分析对转录本进行分析，以确定对非传染性疾病的认识、对 MSAP 的认识以及参与 MSAP 的障碍和促进因素等主题。
参与者认识到非传染性疾病是尼泊尔日益严重的主要负担。然而，一些参与者对 MSAP 并不熟悉，认为这是缺乏领导力和传播不力的结果。自通过 MSAP 以来，政治和系统变革被视为实施的主要障碍。尼泊尔政府为制定多部门行动而做出的国际承诺被确定为推动因素。最近在 MOHP 的卫生服务部门内设立了一个专门负责非传染性疾病和精神卫生的部门，以及最近的国家文件中提倡健康的所有政策方法（HiAP），都被认为有助于实施。
尽管强烈呼吁建立多部门或多方利益攸关方机制，但建立这种机制一直具有挑战性。展望 2020 年后，多部门行动计划应与联邦、省和地方政府的利益攸关方合作，制定有成本效益的行动计划，为每个部门制定具体的角色和责任。
