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Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders

BACKGROUND: 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. OBJECTIVES: The overall aim of the study was to gain the perspectiv...

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Autores principales: Dhimal, Meghnath, Dhimal, Mandira Lamichhane, Dahal, Sushma, Shrestha, Mahendra Prasad, Gyanwali, Pradip, Shao, Ruitai, Mikkelsen, Bente, Wickramasinghe, Kremlin, Marten, Robert, Jha, Anjani Kumar, Townsend, Nick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405092/
https://www.ncbi.nlm.nih.gov/pubmed/34448675
http://dx.doi.org/10.1080/16549716.2021.1963069
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author Dhimal, Meghnath
Dhimal, Mandira Lamichhane
Dahal, Sushma
Shrestha, Mahendra Prasad
Gyanwali, Pradip
Shao, Ruitai
Mikkelsen, Bente
Wickramasinghe, Kremlin
Marten, Robert
Jha, Anjani Kumar
Townsend, Nick
author_facet Dhimal, Meghnath
Dhimal, Mandira Lamichhane
Dahal, Sushma
Shrestha, Mahendra Prasad
Gyanwali, Pradip
Shao, Ruitai
Mikkelsen, Bente
Wickramasinghe, Kremlin
Marten, Robert
Jha, Anjani Kumar
Townsend, Nick
author_sort Dhimal, Meghnath
collection PubMed
description BACKGROUND: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-84050922021-08-31 Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders Dhimal, Meghnath Dhimal, Mandira Lamichhane Dahal, Sushma Shrestha, Mahendra Prasad Gyanwali, Pradip Shao, Ruitai Mikkelsen, Bente Wickramasinghe, Kremlin Marten, Robert Jha, Anjani Kumar Townsend, Nick Glob Health Action Original Article BACKGROUND: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Taylor & Francis 2021-08-27 /pmc/articles/PMC8405092/ /pubmed/34448675 http://dx.doi.org/10.1080/16549716.2021.1963069 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Dhimal, Meghnath
Dhimal, Mandira Lamichhane
Dahal, Sushma
Shrestha, Mahendra Prasad
Gyanwali, Pradip
Shao, Ruitai
Mikkelsen, Bente
Wickramasinghe, Kremlin
Marten, Robert
Jha, Anjani Kumar
Townsend, Nick
Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders
title Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders
title_full Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders
title_fullStr Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders
title_full_unstemmed Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders
title_short Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders
title_sort barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in nepal: perspectives of stakeholders
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405092/
https://www.ncbi.nlm.nih.gov/pubmed/34448675
http://dx.doi.org/10.1080/16549716.2021.1963069
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