PHASE I (2021-2025)

Strengthening Urban Tuberculosis Control Program in the Kathmandu Metropolitan City by Active Tuberculosis Case Finding.

Kathmandu, Nepal’s capital, with a population of 1.7 million and a density of 13,2251/km², faces significant tuberculosis (TB) challenges due to a vulnerable population, a large number of slum populations, migration, informal settings, inequalities, and inadequate health services. Over 50% of the urban population are migrants from rural areas, living in slums with air pollution and poor living conditions that contribute to the transmission and development of infectious diseases, including TB. Kathmandu district alone holds 41% of TB cases in Bagmati Province, with 43% being Pulmonary Bacteriologically Confirmed (PBC). Due to poor infrastructure, lack of health trained workforce, inadequate equipment, and poor supply of essential medicine by public health facilities. Many people, especially the poor, avoid government facilities in favor of private providers, leading to delays in diagnosis and treatment.

The trained and skilled field team conducts an Active Case Finding Camp (ACF) and an awareness/advocacy campaign in the community, as well as observational visits and screenings at urban health clinics in Kathmandu, working closely with local elected members, female community health volunteers, and local health workers in close coordination and collaboration with Kathmandu Metropolitan City/ Public Health Division.

PHASE II (2025- 2028)

Health Promotion of Urban Poor and Vulnerable Population Through Integrated Screening at Health Facilities and Mobile Screening in Community.

Nepal is a low-middle income country. The Multidimensional Poverty Index (MPI), which considers various dimension of poverty indicates that 17.4% (about 5 million) of Nepalese (2019) are deprived of housing materials, years of schooling, assets and nutrition. However, the government’s per capital health expenditure was US$65 (2021). Therefore 51% of healthcare funding was covered by out of pocket (OOP) of patient predominantly in the private sector which exacerbates financial strain for affected households. Thus, suffering chronic disease would lead to a vicious cycle of poverty.

Health access is known to be low in urban poor and vulnerable population. Therefore, to improve the situation, local government establish health clinics providing basic health service including essential medicines free of charge at front line. In-spite of the free services, the utilization of the services is low due to limited services at the health facilities and inadequate skills of health workers. However, the most significant factor of low utilization of urban health clinics is patients with TB and hypertension do not have any sign and symptoms at early stage.

Therefore, the project aims to conduct integrated screening of TB and hypertension for early diagnosis and treatment. Through the activities we strengthen capacity of diagnosis and treatment at the front- line health facilities.