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Livestock depredation by the snow leopard Panthera uncia threatens the livelihood of communities and the survival of snow leopard populations. Shey Phoksundo National Park in Nepal supports some of the highest densities of snow leopards in the country. The support of local communities is essential for effective snow leopard conservation, yet these communities are heavily affected by livestock depredation. We conducted a quantitative questionnaire survey in the lower Dolpo and upper Dolpo regions of the Park in 2022 to assess local attitudes towards the snow leopard and understand the factors that best explain these attitudes. We found that households residing in the lower Dolpo had a more positive attitude towards snow leopards than those living in the upper Dolpo. Whilst the number of livestock lost to snow leopard depredation did not significantly influence attitude, respondents were more likely to hold a positive attitude if they had more years of formal education, lived in the lower Dolpo, were male, had received a greater level of external conflict mitigation support, and if they perceived a greater change in the level of support from government and snow leopard conservation groups over the last 5 years. Our findings show that attitudes can become more positive if conflict mitigation strategies are accessible to those with fewer years of education and if they are available to households in the upper Dolpo. We recommend greater access to this support to promote coexistence between snow leopards and local communities.
Leisure pursuits involving wildlife, nature-based tourism and ecotourism enrich visitor experiences and satisfaction. However, the growing popularity of watching wildlife can cause additional pressure on ecosystems. These pressures can disrupt wildlife behaviours such as foraging, migration and reproduction. Understanding visitor preferences to conserve the natural sites they visit is equally important for sustainability. In this study, we elicited willingness to pay, using the contingent valuation method, for conservation of the Endangered red panda Ailurus fulgens in eastern Nepal. During 15 March–3 April 2021, we conducted surveys with 102 visitors in Sandakpur. Using a questionnaire, respondents were asked to state their entry fee preferences for red panda conservation. The study used logistic regression to analyse the determinants of willingness to pay, and a five-point Likert scale to assess visitors’ satisfaction level. The mean willingness to pay was USD 14.21. The primary reason for visitors’ willingness to pay was to promote conservation and improve habitat management. In contrast, those unwilling to pay cited a concern that their donations would not be managed properly. These insights will help inform the design of conservation strategies for ecotourism and wildlife management in Nepal, and our findings could serve as a model for balancing visitor engagement with sustainable wildlife management in similar contexts elsewhere.
Tinnitus is a common and potentially distressing symptom associated with chronic ear disease. Its burden in patients with chronic suppurative otitis media in low-resource settings is not well characterised.
Methods
A cross-sectional study was conducted during an ear surgery camp in Nepal. One hundred patients with chronic suppurative otitis media completed the validated Nepali Tinnitus Handicap Inventory. Severity was categorised using established grading systems. Associations between sex and severity were assessed using chi-squared analysis.
Results
Nepali Tinnitus Handicap Inventory scores ranged from 0 to 94. Overall, 62 per cent of patients reported moderate or worse tinnitus, and 36 per cent reported severe or catastrophic symptoms. Female patients demonstrated a greater burden, with a higher proportion in severe and catastrophic categories. This difference was statistically significant (χ2 = 11.05; df = 4; p = 0.026).
Conclusion
Patients undergoing surgery for chronic suppurative otitis media experience a substantial and under-recognised tinnitus burden. Routine assessment may support more comprehensive, patient-centred care.
Despite global initiatives like WHO’s mhGAP, mental health treatment gaps remain substantial, especially in LMICs. Barriers are often presented collectively, with an emphasis on supply-side solutions, while demand-side factors are frequently overlooked. Distinguishing these barriers and implementing tailored strategies is critical for improving access and utilization. This study explores stakeholders’ perceptions and experiences of demand- and supply-side barriers to mental healthcare in Nepal.
Qualitative interviews were conducted with 65 community stakeholders, including people with lived experience, using vignettes and the McGill Illness Narrative Interview (MINI) guide. Data were analyzed thematically in NVivo and interpreted through Levesque et al.’s access framework, which examines health system characteristics and individual capabilities.
Demand-side barriers included spiritual attributions of mental illness, stigma, low perceived need, financial hardship, lack of family support and limited awareness of conditions and available services. These factors hindered recognition, help-seeking, affordability and engagement. Supply-side barriers involved frequent staff transfers, inadequate training, lack of privacy, poor infrastructure and irregular psychotropic medicine supply, affecting service acceptability, availability and appropriateness.
Access to mental healthcare in Nepal is shaped by interconnected demand- and supply-side barriers. Addressing these requires culturally sensitive stigma-reduction, mental health literacy programs, workforce stabilization, reliable medication supply, privacy-friendly facilities and financial protection.
The Chinese pangolin Manis pentadactyla is categorized as Critically Endangered on the IUCN Red List because of illegal hunting, trafficking and habitat loss across its range. Although previously reported from many parts of Nepal, its presence in Sunsari district has remained unverified. We documented the first photographic evidence of the Chinese pangolin in Sunsari district through a short-term camera-trap survey in Panchakanya forest, a sacred but highly disturbed community forest in the Siwalik foothills. Two camera traps were rotated over 14 nights at selected trails and burrows in January 2025. After 7 nights, a male Chinese pangolin was recorded, confirming the species’ presence for the first time in this district. Field observations indicated abundant foraging signs linked to soft, moist soils supporting ant and termite colonies, aligning with the pangolin’s specialized diet and burrowing habits. This confirmed record increases the number of districts in which the Chinese pangolin has been documented in Nepal to 28. The presence of the Chinese pangolin in a fragmented, disturbed sacred forest highlights both the adaptability of this pangolin and the conservation value of culturally protected community forests outside protected areas.
Population resettlement, an integral part of settler colonialism, has also been practiced in post-colonial countries to obtain territorial control over the contested territories. Studies analyze resettlements in relation to settler-colonial and post-colonial states. The resettlement policies of the Nepali state, which has remained independent throughout its history, are outside their attention. Nepal relocated its dominant Hill Hindu high-caste people to the Tarai region to enhance economic growth and development. However, settlement projects hindered languages, cultures, customary laws, and natural resources of the Madhesi and the Tharu Indigenous Peoples, ultimately displacing them from their ancestral territories. In response, ethnic and Indigenous Peoples intensified their demands for autonomy and self-rule, which they considered as measures to prevent further erosion of their collective rights. This finding contests the prevailing theoretical explanations that population resettlement projects weaken ethnic solidarity, illustrating that settlement projects can also become a reason for heightening autonomy movements.
Chapter 7 examines the function of humor, clowns, and fools within religious systems. The systems under discussion are from India, biblical Israel, Nepal, Europe, and even corporate England. The chapter argues that clowns and fools act as signal generators reflecting the dissonance within the systems and challenging the internal boundaries on which systems depend to maintain order. This humorous disruption enhances the dynamic quality of the systems, permitting its viability over time.
By understanding participation in transitional justice as the capacity of victims to exercise agency in addressing their needs, this chapter shows how victim mobilisation is a form of participation that can advance victims’ agendas independent of any formal process. Using the lens of critical victimology to both highlight and privilege the agency of victims of violations, we show how relatives of persons missing in Nepal’s armed conflict have successfully renegotiated their relationships with their families, community, and even local government, in ways that impact how they experience victimhood. This shows how collective action and empowerment can serve to drive social change in the everyday spaces that victims occupy in ways that can transform their lives, even though impunity remains institutionalised by the authorities. This reframes participation in transitional justice as something that can be realised largely independent of a formal process.
Se is an important micronutrient that plays a key role in brain development. Only a few studies have explored the associations between prenatal maternal Se concentration and motor development in early infancy. We have previously described that 36 % of pregnant Nepalese women had Se concentration below the cut-off of 71·1 µg/l in early pregnancy. In the current cohort study, we aimed to describe the association between maternal plasma Se concentration and infant motor development measured at 8–12 weeks of age. From a cohort of 800 Nepalese mother–infant pairs, we included 711 dyads with available data on maternal Se concentration and motor development scores. Maternal Se concentration was measured in plasma samples collected within 15 weeks of gestation using inductively coupled plasma MS. Motor development was measured by the Test of Infant Motor Performance (TIMP). We examined the association between Se concentration and the TIMP scores in regression models adjusted for age of the mother and socioeconomic status. There was no association between maternal Se concentration and the TIMP scores (coefficient for the total TIMP score: −0·035 (95 % CI: −0·105, 0·036). In conclusion, even though a considerable proportion of the women had Se concentration below the cut-off of 71·1 µg/l, there was no association between maternal Se concentration and early motor development in their infants. Our findings do not support Se supplementation during pregnancy to enhance early infant motor development. However, Se may still be essential for other aspects of maternal and infant health.
Inter-Asian Law is starkly absent from constitutional accounts of reproductive rights in Asia. Instead, Asian jurisdictions tend to draw from the Global North, with the United States Supreme Court decision in Roe v Wade occupying norm status. To explicate the potential of Inter-Asian Law in transforming reproductive rights, an act of imagination is required, suspending Roe as the central comparative frame and introducing alternate, hypothetical referents from Asia. This chapter conducts this task at two stages. First, it develops imagination as a method of comparative constitutional law. Second, applying the imaginative method, it hypothesizes what reproductive rights might look like if Nepal served as a referent for India and India as a referent for Bangladesh. In documenting explicit shifts in the constitutional construction of these rights, the chapter cements the place of Inter-Asian Law.
Electroconvulsive therapy (ECT) is considered among the safest and most effective treatments for mental disorders. In Nepal, ECT is practised but data regarding its use, techniques and protocols are limited. The use of non-modified ECT in Nepal is also debatable concerning ethical issues and its outcomes.
Aims
To explore the characteristics of ECT practice, its availability in psychiatric services and to determine the standards and techniques of ECT practice in Nepal.
Method
A cross-sectional, descriptive study via an online survey with a questionnaire was used. All hospitals providing in-patient psychiatric services in Nepal were included in the study. Data were collected using Google Forms with a URL link. Questionnaires were sent to the psychiatrist at each facility. Ethical approval was obtained from Nepal Health Research Council (reference no. 2352).
Results
Of 32 centres, 31 responded (96.9%). ECT practice was employed in 23 (74.2%) of these; 14 (60.9%) had a written ECT protocol and 95.7% obtained written family consent. Pre-ECT work-up was performed in all cases. Brief-pulse devices were used in 81.8% (n = 18), with bitemporal placement being most common. Modified ECT was practised in 16 (69.6%) centres; 4 (17.4%) used both modified and unmodified ECT and 3 (13%) used only unmodified ECT – mainly due to lack of either equipment or an anaesthesiologist. Propofol (82.8%, n = 18) and ketamine (31.8%, n = 7) were the most commonly used anaesthetics, and all centres used succinylcholine for modified ECT. Catatonia (95.7%, n = 22) was recorded as the most common indication.
Conclusions
This nationwide survey shows that ECT is widely used in Nepal, mainly in the form of modified bitemporal ECT, although some centres are still relying on unmodified ECT due to limited resources.
This research analyzes the factors that determine the placement of development NGOs in Nepal through the examination of the placement data of 39,606 NGOs. Using multivariate ordinary least squares, this investigation demonstrates that the location of an NGO is determined by: level of community needs, resource availability, and the level of political engagement. NGOs are in fact active where their support services are in high demand. However, the other two determinants: ‘resource dependency’ and ‘political engagement’ suggest that development outcomes may be limited due to placement concentration in areas of high human resource availability and high political activity.
This study compares the need of the communities, the availability of financial resources for the organizations, and the density of existing organizations on NGOs' and NFCs' founding behavior in Nepal between 2012 and 2018. The study uses negative binomial regression models to demonstrate that NGOs and NFCs emerge in relatively prosperous areas than serving the communities with need. Furthermore, the density of similar organizations also affected where NGOs and NFCs emerge. This research also demonstrates that night time light data can serve as a reliable alternative proxy for measuring the communities' well-being and wealth at the subnational level in developing countries.
This paper examines the role of development NGOs (nongovernmental organizations) in furthering the political participation of the poor, with data from Bangladesh and Nepal. The topic is discussed from three aspects: the role of NGOs in prodemocracy movements, the issues raised by antiglobalization movements, and the extent of NGO involvement in local government elections. The paper draws on fieldwork conducted in two villages—one in Bangladesh and the other in Nepal. It is concluded that development NGOs tend to contribute more to elite interests than to the democratic political participation of the poor.
This article examines the unique roles of NGOs with special attention to the changing socio-political contexts of NGOs in terms of their partnerships with Rights-Holder Organizations (RHOs), which claim the rights of particular groups of excluded population. It reviews an example of the NGO working with RHOs in Nepal. NGO relationships with RHOs are delicate and not always equitable due to their different backgrounds and expertise. NGOs, comprising mostly people who are not members of the rights-holding groups, use their expertise to work for others over fixed periods, whilst RHOs work for their own constituencies through movements. Until the 1990s, NGOs supported so-called ‘beneficiaries’ who were members of excluded groups whose rights were being denied. Today, RHOs are formed directly by excluded groups. Some NGOs are trying to change their role to become promoters for RHOs, whilst others remain as their proxies, which merely creates an extra layer between RHOs and donors. The article attempts to prove that building equitable relationships between NGOs and RHOs is possible if NGOs have professionalism, expertise in capacity development and a readiness to become more inclusive. Though there are still several challenges ahead, such efforts by NGOs make it possible to change funding flows for RHOs and contribute to inclusive aid.
This article considers the relationship of civil society to the domain of the political from the actors’ perspectives. It explores the attempt by a citizens’ movement (CMDP) in Nepal to construct new political realities in the context of the autocratic regime of king Gyanendra and then during the democratic transition. This was, paradoxically, to be achieved through the construction of an apolitical space. Theoretically, this production of apoliticality by civil society actors shows that civil society is not only implicated in the expansion of what is understood as ‘political’ but also in setting its boundaries. The broader aims of the article are to contribute to the ethnography of civil society and to add to current understandings of the relationship of actually existing civil societies to the political domain. Practically, it argues that debates over whether civil society is or is not political in the Nepal case and normative positions within development circles that it should not be political are misconceived since civil society is a site for the production of both politicality and apoliticality.
Background: The thinking healthy program (THP) is an evidence-based psychological intervention for perinatal depression designed for delivery by nonspecialist health workers. To ensure its relevance in Nepal, we adapted THP using the mental health Cultural Adaptation and Contextualization for Implementation (mhCACI) framework. Methods: Using mhCACI’s 10-step process, we applied a participatory approach involving a multidisciplinary team to adapt both content and implementation strategies. A qualitative study nested within a pilot trial was conducted to assess feasibility and acceptability of adapted THP through in-depth interviews with perinatal women (n = 20), family members (n = 11) and focus group discussions with Female Community Health Volunteers (FCHVs) (n = 16). Results: FCHVs were selected as delivery agents. Implementation adaptations included reducing the number of THP sessions from 16 to 8, integration of additional 2.5-day Foundational Helping Skills training and skill-based training methods. Manual revisions included simplified language, cultural idioms, visual aids and locally relevant examples. Referral pathways for gender-based violence, suicide and severe mental illness were included. The adapted THP was well received by providers and recipients. Conclusion: The adaptation demonstrates how global interventions can be contextually tailored for low-resource settings while preserving therapeutic integrity, offering a scalable model for community-based mental health care.
Rapid population declines of three species of Gyps vultures endemic to Asia were caused by unintentional poisoning by the non-steroidal anti-inflammatory drug (NSAID) diclofenac. Despite a ban on its veterinary use across South Asia, diclofenac has continued to be supplied for this purpose. Here, we report updated results from undercover pharmacy surveys, conducted between 2012 and 2024, in India, Nepal, Bangladesh, and Pakistan to investigate the availability and prevalence of veterinary NSAIDs. The purpose was to establish whether sales of diclofenac had continued and to determine which other veterinary NSAIDs were available. In India, the availability of diclofenac had declined in all Vulture Safe Zones (VSZs), but it was still readily available (up to 25% of sales) in Rajasthan where intensive conservation advocacy had not occurred. Elsewhere in the region, prevalence of diclofenac was low. The vulture-safe meloxicam continued to be the most commonly available veterinary NSAID throughout most of the region, especially in Nepal (85–100%), but still accounted for only 25–45% of products offered in other countries. In Bangladesh, the vulture-toxic ketoprofen was the most prevalent drug overall, but levels declined to a low level (<1% in 2024), following the nationwide ban on veterinary use of the drug in 2023. Fourteen different NSAIDs were recorded in our surveys, several of which are known or suspected to be toxic to vultures. Of special concern is a rapid increase in the prevalence of flunixin in Bangladesh. Flunixin has not been banned in any of the South Asian vulture range states. Conservation priorities should include awareness campaigns, stronger measures to implement current bans, safety-testing of other NSAIDs, especially flunixin, followed by bans on veterinary use of all NSAIDs found to be toxic to vultures. Prior evidence of safety to vultures should be a requirement for the licensing of all new veterinary NSAIDs.
Despite being one of the most critical agricultural inputs, chemical fertilizers are often misused by farmers in developing countries due to limited knowledge of proper nutrient management. Understanding current fertilizer application practices is essential for improving efficiency and enhancing crop productivity. This study examines the adoption and determinants of the 4R nutrient stewardship principles (also referred to as best management practices) – applying the right fertilizer source, at the right rate, at the right time, and in the right place (4Rs) – among major cereals (rice and maize) and vegetables (cauliflower) in Nepal. Using a multivariate probit model, we analysed data from 926 surveyed households across 11 districts. Our findings reveal that only 30% of farmers used the right fertilizer source supplying nitrogen (N), phosphorus (P), and potassium (K), while just 7% applied these nutrients at the right time. Additionally, 19% of farmers placed fertilizers correctly, and only 6% applied nitrogen at the right rate. Key factors influencing right nutrient management practices include gender, age, educational level of the household head, access to credit, smartphone ownership, and proximity to cooperative offices. Farmers with small landholdings, more years of farming experience, access to smartphones, and those who borrow agricultural loans are more likely to apply the right rate of nitrogenous fertilizers. The factors contributing to excessive use of nitrogenous fertilizers vary by crop type. Given the low adoption rates of 4R soil nutrient management practices, agricultural policies in Nepal should prioritize promoting these best management practices to enhance fertilizer efficiency, optimize yields, and improve long-term soil health.
Drawing on two decades of collaborative legal ethnographic research with Indigenous communities, this article weaves personal narrative and lived experience to highlight working-class scholar-activism and embodied spiritual rituality as an act of resistance within academia. It critically challenges Western research ethics paradigms by emphasising ethics as a lived, relational practice grounded in rituality and interconnectedness rather than mere compliance. Through an audiovisual lens, it demonstrates how visual storytelling can embody and amplify more-than-human voices, fostering relationality and responsibility. The paper offers two key contributions: recentring the positionality of working-class scholars and recentring the agency of the more-than-human int he field of law as vital in knowledge production. While decolonial and Indigenous scholarship advocate for diverse epistemologies, they often overlook working-class perspectives rooted in societal justice. I argue that a heart-based resistance grounded in critical care, relationality, Indigenous ontologies and spirituality can foster transformative academic knowledge.