Mr. Bhim Prasad Sapkota is young and energetic public health professional working at Ministry of Health and Population for Government of Nepal. He has worked for about 17 years in Nepalese health system. His area of interest is on health system research focusing the neglected group of population. Mr. Sapkota has completed the Master’s degree in Public Health from Institute of Medicine, Tribhuvan University Kathmandu in 2012.
He is the PhD Fellow at Center for International Health-Ludwig Maximilian University of Munich, Germany for the academic year 2019-2022. His PhD research is going on entitled “Predictors and prevalence of non-communicable disease risk factors among old aged population in Nepalese Community”
NCD Risk among Nepalese elders: How prepared we are?
Bhim Prasad Sapkota, Center for International Health(CIH),LMU,Germany.
Ursula Berger, Center for International Health(CIH),LMU,Germany.
Klaus G.Parhofer, Center for International Health(CIH),LMU,Germany.
Eva Rehfuess, Center for International Health(CIH),LMU,Germany.
Kedar Prasad Baral, Patan Academy of Health Sciences, Nepal.
Estimated deaths attributed to NCDs in Nepal have increased from 60% in 2014 to 66% in 2016. The prevalence of common NCDs is higher among older compared to younger adults. Nepalese life expectancy at birth has been increasing, from 67 years in 2011 to 71 years in 2019. Aging is inexorable but the growing burden of NCDs among elders is creating challenges. How age affects NCD risk factors among Nepalese elders is still obscure. Although NCDs constitute a major public health problem in Nepal, how to best address NCDs at the primary health care level is poorly understood. The study has been conducted to assess the preparedness and response of health sector against the NCDs and risk factors among Nepalese elders.
The study is based on the qualitative methods; policy review, in-depth interview (IDI) and focus group discussion (FGD). The study was performed during August-December, 2020 incorporating different regions of Nepal. Content analysis was performed for 28 policy documents. Thematic analysis was conducted to analyze the findings of eight FGDs with different cadres of health workers and twelve IDIs with program managers and policy makers. The analysis was based on the six WHO health system building blocks.
NCDs and risk factors are priority issues in national health policy. A multi-sectoral action plan for prevention and control of NCDs has been endorsed. Basic health service package includes primary care for NCDs. The routine health surveillance system monitors morbidity due to major NCDs. Basic drugs required for NCDs/risk factors have been included in the essential drugs list. More than half of national health care spending is dedicated to NCDs.
However, health services are focused on the curative services of the NCDs and concentrated in secondary and tertiary hospitals. Services are not designed to target risk factors. Primary care health workers are less trained on NCDs compared to infectious diseases. Health services targeting the needs of old aged people are neglected.
Existing structure and functions of health system are not sufficiently designed to address the health needs of elders. Due to an aging society in Nepal more research is needed to better understand the age effects on NCDs and their risk factors.