Managing the injury burden in Nepal

Clin Orthop Relat Res. 2008 Oct;466(10):2343-9. doi: 10.1007/s11999-008-0384-3. Epub 2008 Jul 29.


Nepal loses about 530,000 disability adjusted life years (DALYs) per year to injury, predominantly due to falls. It takes 30,000 Nepali rupees (NR), or approximately US$430 at 70 rupees per $US saved per DALY to achieve primary prevention and 6000 NR per DALY if we invest in hospitals, versus 1000 NR invested in prehospital care, because simpler less expensive actions performed early have a greater impact on outcome than more complex measures later. A system for prehospital services was planned for medical emergencies at a national level meeting at the Medical University of Nepal to promote healthcare to victims in inaccessible regions by empowered or enlightened citizens. Feasible actions for common emergencies were defined and a tutorial required to help the majority of such victims was created and packaged. The knowledge and attitude component of the tutorial will be delivered through a web site to citizens motivated to learn and help with emergencies. The knowledge will be tested through a net-based Multiple Choice Questions (MCQ) test. Practical training in medical triage skills will be provided to those who qualify for the test at the University or its designated affiliates. A mobile phone-based information system will be created and used to make these enlightened citizens available to the victim at the site/time of the emergency.

MeSH terms

  • Cost of Illness
  • Delivery of Health Care* / economics
  • Delivery of Health Care* / organization & administration
  • Delivery of Health Care* / statistics & numerical data
  • Developing Countries* / economics
  • Developing Countries* / statistics & numerical data
  • Emergency Medical Services* / economics
  • Emergency Medical Services* / organization & administration
  • Emergency Medical Services* / statistics & numerical data
  • Female
  • Health Care Costs
  • Health Care Rationing
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Health Services Research
  • Healthcare Disparities
  • Humans
  • International Cooperation
  • Internet
  • Male
  • Musculoskeletal System / injuries*
  • National Health Programs
  • Nepal / epidemiology
  • Orthopedic Procedures* / economics
  • Orthopedic Procedures* / statistics & numerical data
  • Outcome and Process Assessment, Health Care* / economics
  • Outcome and Process Assessment, Health Care* / organization & administration
  • Outcome and Process Assessment, Health Care* / statistics & numerical data
  • Program Development
  • Wounds and Injuries / economics
  • Wounds and Injuries / mortality
  • Wounds and Injuries / therapy*