Our work

Our work

The Exploration, Preparation, Implementation, Sustainment (EPIS) framework guides the phases and the systematic assessments of implementation determinants through its key constructs:  outer context (system-level factors e.g. policy and funding), inner context (facility and provider-level factors e.g. organizational and individual characteristics), bridging factors that span contexts and innovation factors (intervention characteristics, fit).

Work package 1 – situational analysis

We will a assess the health system’s needs and assets to identify determinants for implementing interventions targeting tobacco, alcohol, unhealthy diet, and physical inactivity, and maternal assessment of gestational hypertension, gestational diabetes, and weight gain/retention among pregnant and post-pregnant women and their offspring using a primary health care approach for ANC and PNC services. 

We will apply a convergent mixed methods research design. 

Work package 2 – strategies development

We will adapt evidence-based interventions to the Nepali context and use the findings from WP 1 and a theory driven approach to develop contextually tailored implementation strategies in through an interactive process with stakeholders and users. 

We will conduct workshops and consultative meeting, and pilot the interventions and tailord startegies. We will produce an implementation protocol that includes activities and/or materials for the implementation phase. 

Work package 3– implementation and evaluation

We will initiate NCD risk prevention and reduction interventions using tailored strategies, and evaluate implementation, service and client outcomes in an effectiveness-implementation study.

Project sites

There are seven provinces, 77 administrative districts and 753 municipalities in Nepal. The federal government oversees policy formulation, budgeting and development of national standards and regulatory frameworks. Local (municipality) governments are responsible for the provision of primary health care services. Nepal is divided into mountains, hills and terai regions, and holds diverse ethnic groups with different socio-economic positions, health profiles and consumption practices. Considering Nepal’s diversity, and study feasibility criteria, Gorkha, Nuwakot, and Sarlahi districts are selected, and their largest urban and rural municipalities are selected for primary data collection. We will study the governmental health institutions from the federal, provincial, district, and municipal levels responsible for providing ANC and PNC services. 

Project Organization  

IpreventNCD will be carried out in collaboration with partners in Nepal (Dhulikhel Hospital-Kathmandu University Hospital, Nepal Health Research Council), Norway (Norwegian Institute of Public Health, University of Bergen) and Australia (University of Queensland, Central Queensland University, Monash University). It is funded through a call organized by the Global Alliance for Chronic Diseases, with co-funding from Australia’s National Health and Medical Research Council, and the Research Council of Norway. The project period is for five years from 2024.

Participating institutions