At the end of 2022, AMPATH Nepal launched the Nepal Pilot Projects grant opportunity to accelerate the development of collaborative work between the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, Dhulikhel Hospital, and Kathmandu University School of Medical Sciences. This academic partnership seeks to build enduring collaboration across care, education, and research domains to improve the health and well-being of the populations we serve.
The grant serves to support the formation of counterpart teams that will develop collaborative projects to improve quality or access to care, establish training programs, or promote research that will address key challenges and priorities in the health system.
We received many competitive applications. We are excited to announce that we will be supporting the following four proposals:
Cervical Cancer Prevention Program in Rural Nepal: “Expanding reach through Community Health Workers” by Sunila Shakya, MBBS, MD, PhD and Sheela Maru, MD, MPH
Cervical cancer is the most common gynecological cancer in Nepal with high incidence and mortality. Nevertheless, cervical cancer can be detected at its precancerous phase with high performance screening tests and timely appropriate treatment of precancerous lesions. Low public awareness, geographical challenges and limited resources are the major challenges in cervical cancer prevention in Nepal.
This pilot project offers home-based, cervical cancer screening through self-sampled HPV testing and linkage to care through Community Health Workers. The project aims to train and evaluate knowledge and skills of cadre of health care worker on cervical cancer prevention; provide cervical cancer screening and treatment through community health workers; and evaluate screening and treatment program implementation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework for replication or scale up.
A population-based adolescent health needs assessment in Dhulikhel, Nepal, by Lonnie Embleton, PhD, MPH, and Shrinkhala Shrestha, MPHM, PhD
Evidence suggests adolescents aged 10 to 19 years old in Nepal experience a significant burden of communicable and non-communicable diseases and injuries, but several data gaps exist to fully depict adolescent health needs and priorities nationally and at the provincial and municipal levels. To address this significant gap in data, the collaborative team of adolescent health experts from Dhulikhel and New York will co-design and pilot a mixed methods, population-based adolescent health assessment in Dhulikhel municipality with local stakeholders and collaborators.
When adolescent-friendly services are designed using contextually relevant data, services will be responsive to local adolescent health needs. Adolescents will then be more likely to access health services and will ultimately see improvements in their health and well-being. It is anticipated this foundational work will be the first step towards establishing a longitudinal population-based adolescent health assessment that can inform planning, monitor progress, and capture inequalities in adolescent health at the provincial and municipal levels.
Training of Trainer on Simulation Based Education by Jyotsana Twi Twi, MS, BSN; Laly Joseph, DVM, DNP, CNE, RN, C, MSN, APRN, ANP, FNAP; and Sarla Santos, DNP, MS, NPD-BC, CCRN
Simulation-based Education (SBE) is still a new concept in medical education in Nepal. SBE can help develop health professionals’ knowledge, skills, and attitudes, while protecting patients from unnecessary risks, and it can be a valuable tool in learning to mitigate ethical tensions and resolve practical dilemmas.
SBE techniques, tools, and strategies can be applied in designing structured learning experiences, as well as be used as a measurement tool linked to targeted teamwork competencies and learning objectives.
Kathmandu University School of Medical Sciences has a simulation lab that is the first of its kind in Nepal. However, educators require SBE training to effectively utilize the facility. In this project, faculties from different educational institutions will be introduced to SBE and will be trained in providing simulation-based instruction.
Global IMPACT (Improving Emergency Medical Preparedness And Childhood Treatment) by Morgan Bowling, DO, FAAP, and Anish Joshi, MBBS, MD
Children living in areas with limited resources face numerous challenges, including the lack of access to specialized pediatric care. Nepal has shown significant improvement in child mortality; however, the rate remains higher than other nations.
This project will first conduct a needs assessment using a modified version of the National Pediatric Readiness Assessment (NPRP), with the goal of evaluating overall pediatric readiness in the Emergency Department at Dhulikhel Hospital. Second, to improve pediatric morbidity and mortality in the hospital community, it will certify a pilot group of doctors, nurses, and paramedics in the American Heart Association’s Pediatric Advanced Life Support (PALS) program, and then credential local providers to become PALS instructors so the program is self-sustaining.
Finally, to further foster a comprehensive PEM training program, it will develop and implement an in-situ multi-disciplinary simulation program in relevant pediatric clinical vignettes. This project seeks to deliver feasible and sustainable methods to improve the care of critically ill and injured children in Nepal. These pilots have the potential to prevent cancer, advance an adolescent health agenda, improve health care education, and be better prepared to treat children in any emergency or disaster.