My experience as an ECR in Nepal: Opportunities for improving the Nepali healthcare system

As an ECR in Healthcare Management and Leadership, the opportunity to immerse myself in the vibrant yet often challenging healthcare landscape of Nepal has been nothing short of transformative.

Nepal is a land of breathtaking mountains, rich traditions, and, let’s face it, a lot of unexplored research potential! The research landscape here is diverse, spanning areas such as population health, public health, environmental science and social sciences.

For ECRs, this is a golden opportunity to delve into pressing issues such as high burdens of infectious diseases like tuberculosis and HIV, high rates of malnutrition, maternal and child health problems, healthcare accessibility, the impacts of climate change, and the complexities of patient safety, to name just a few.

With various governmental and non-governmental institutions actively working to improve health outcomes and sustainability, I feel ECRs can grab a piece of the action or policies, network with local experts, and contribute to meaningful innovations that could change lives.

A country of contrasts

The healthcare system in Nepal resembles an intricate tapestry, vibrant yet somewhat frayed at the edges. It encompasses a mix of public and private healthcare providers, ranging from small rural clinics to larger urban hospitals. The Ministry of Health and Population plays a significant role in governing healthcare policies. However, the structural challenges include limited resources, an uneven distribution of healthcare workers and urban-rural disparities.

It’s easy to arrive with theoretical frameworks learned in higher-income settings, but the real learning begins when you witness how these concepts are adapted, innovated and sometimes reinvented in resource-constrained environments.

I previously spent 16 years in Nepal as a hospital manager/leader and academic. My perspectives and passion for improving healthcare in Nepal positions me well to bridge healthcare management, policy and healthcare needs.

Opportunities to make a real difference

Currently, I am carrying out two research projects in Nepal: ‘patient safety culture among healthcare professionals’ and ‘the role of hospital managers in aligning climate change policies in Nepali hospitals'.

In Nepali hospitals, patient safety is sometimes akin to playing a game of musical chairs - there’s always a risk of getting left out! In my experience, common incidents include medication errors, infections acquired during hospital stays and complications from surgical procedures.

Climate change is no longer a distant threat; it’s a reality that is reshaping healthcare delivery in Nepal. From increased vector-borne diseases in the Terai to landslides cutting off hospital access in the hills, the effects are severe and escalating.

I believe my research would contribute to the healthcare system in Nepal for improving the quality of healthcare and dealing with the impact of climate change in Nepali hospitals.

Dr Bachchu Kaini, ECR and Senior Lecturer, School of Allied Health and Social Care