Experiences of the COVID-19 Pandemic in Nepal: Lessons for Health System Strengthening and Preparedness for Future Pandemics

Abstract

Using quantitative analysis of survey data collected between November 1, 2021 and January 16, 2022, this thesis explores the experiences of both community members and health workers during the COVID-19 pandemic in Nepal. In particular, this survey assessed perceptions of COVID-19 risk, attitudes towards vaccines, experiences and perceptions of childhood immunization services, COVID-19 vaccination, and sources of health information. Challenges and negative impacts of the pandemic in Nepal include the disproportionate impact on healthcare workers, strain on the healthcare system, disruption of routine childhood immunization and other health services, low confidence in the government and distrust of politicians, and negative economic impacts. Nepal also has strengths that enabled an impressive pandemic response for a lower-middle income country, such as high vaccine acceptance, collectivist values, and high engagement and trust on the local level. Recommendations for health system strengthening and future pandemic preparedness include expanding the healthcare workforce, improving the quality of quarantine centers, involving local healthcare workers and the private sector in decision making, improving coordination between the three levels of government, expanding telehealth services, and expanding electronic health record systems.