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National Stakeholder Meeting: Nepal


National Stakeholder Meeting: Nepal

In this blog we reflect on a National Stakeholder Workshop held in Nepal as part of the CE4AMR: One Health Approach Challenge Cluster. Over the winter each of the six projects involved in the cluster held workshops or webinars to explore the National priorities on AMR and the scope to involve Community Engagement approaches in achieving these priorities. Our partners in Nepal are HERD International, a research agency based in Kathmandu, Nepal that promotes evidence informed policies and practices through high-quality research and knowledge management. They organised two events in November 2020 to reflect upon Nepal’s AMR priorities.

Due to ongoing COVID-19 restrictions face-to-face workshops were not possible in Nepal. Instead, HERD International used a combination of online media to network with an audience of community members, Ministry officials and wider One Health stakeholders. The team used a Facebook live event in November 2020 to engage over 2000 participants with the issue and challenges of AMR. They then facilitated a zoom workshop which centred around an expert panel discussion reached 80 participants and will be the main focus of this blog.

The workshop was shaped around four main objectives:

  1. Identify local AMR challenges
  2. How was Community Engagement discussed in relation to these AMR challenges?
  3. Opportunities to involve Community Engagement methods toaddress AMR.


The workshop included a panel discussion to frame the current AMR landscape in Nepal. This was conducted with stakeholders from Ministry of Health and Population (MoHP), National Health Research Council (NHRC), Ministry of Agriculture and Livestock development (MoALD), Department of Food Technology and Quality Control (DFTQC), Central Veterinary Laboratory (CVL) and Department of Environment.


  1. Identifying local challenges

Context specific challenges:

Most patients are unnecessarily prescribed antibiotics without diagnostic testing, medicines are prescribed by the pharmacy but self-medication is common, and most people do not comply with the physician-directed duration of treatment and stop taking the medicine once symptoms start to subside. Several antibiotics that are used in humans are also used in livestock husbandry for therapeutic purposes and growth promoters.

There is currently no comprehensive data on the National burden of AMR.


One health focus on AMR challenges:

All sectors of the government highlighted that a One Health Approach would be key in tackling the problem of AMR in Nepal. An integrated National approach was seen as important, for example to generate National level datasets on AMR, but panellists also saw value in promoting decentralized implementation mechanisms to tackle AMR. It is worth noting that Nepal has only recently started its journey on the path to an integrated response to the challenge of AMR. Inter-ministerial and inter-departmental coordination will be key to a successful NAP implementation considering the multiple interfaces between the human, animal and environment domains in the country.


  1. How was Community Engagement discussed in relation to these AMR challenges?

Very few discussions of CE were specifically raised by attendees. One discussed that ensuring dialogue between community members and authorities could empower and enable the community members to take necessary action and improve their health. Others suggested that awareness programmes should be oriented at the grassroot levels, however detailed discussions of these issues did not materialise in this online space.


  1. Opportunities to involve Community Engagement methods toaddress AMR

Delegates suggested that taking a bottom-up approach (involving the community members as early as possible in the implementation of process) will ensure challenges regarding AMR are addressed through conversation and decision-making process between the community and the respective authorities. This will help multiple stakeholders and the community to engage in solutions and work towards modification of behaviour or practices to bring about sustainable change.


Take home messages:

  • Revisit existing policies, strategies, acts and regulations in line with current context.
  • AMR surveillance mechanisms to be accelerated in coordinated manner by all sectors.
  • Tackling AMR will require a coordinated, collaborative and multidisciplinary approach, which will need to bring together stakeholders from a range of sectors, including human health, animal health, environment, agriculture and WASH (One Health).

Even though discussion in this workshop did not focus on Community engagement, there is understanding on the importance of integrating Community engagement approach into AMR.