Nepal

Translational Research Capacity Building Initiative to Address Cardiovascular Diseases in Nepal

TREIN
Nepal team members siting in a semi circle talking to each other

This is a unique opportunity to start the study of implementation science as it relates to cardiovascular diseases in Nepal and we will form the center of excellence for the control of CVD in Nepal which will serve as the model for other resource strained countries like Nepal.

Project summary

Although there are proven measures for prevention and appropriate management of cardiovascular diseases, the implementation of known interventions in real-world settings are challenging especially in low-income countries such as Nepal.

Translational Research provides a means to apply the critical components of implementing proven interventions in these settings.

Dhulikhel Hospital Kathmandu University Hospital, Nepal, will lead work to create a multi-sectoral, multidisciplinary collaborative team to develop Translational research capacity Building initiatives to prevent and manage CVD in Nepal. By the end of the project, we will have developed a critical mass of human Resources in Nepal, collaborating with national and International partners, to conduct Translational Research in CVD.

We will have defined clearly identified prioritized needs and a well- defined Translational Research plan to address one or more major CVD Risk Factors and outcomes.

Dr. Koju, the Principal investigator of the Nepal project, provides insight about the capacity building work in Nepal.

Project goals

  1. To create a multi-sectorial, multidisciplinary collaborative team to build capacity for translational research in cardiovascular disease in Nepal.
  2. To assess national-level infrastructure and capacity to implement evidence-based CVD prevention and management interventions.
  3. To identify and prioritize health issues for cardiovascular disease in Nepal.
  4. To prepare a comprehensive actionable translational research plan for the management of cardiovascular disease in Nepal.
Team members sitting at a table talking with each other
Nepal team conducting a meeting with NHLBI officials for a site visit

Current status

We have successfully consolidated and materialized substantial international and national collaborations. We have created a multi-sectoral, multidisciplinary organizational framework composed of; advisory board members, steering committee members, research team members, fellows, international consultants, and the Nepal core team, who work in close coordination to achieve common goals of the project.

In less than 6 months, our fellows and research team have completed two online course trainings offered by the University of Washington and multiple onsite trainings and workshops on various core topics in relation to translational research. We have developed preliminary needs assessment tools and protocols for conducting a national needs assessment to scale the burden of cardiovascular diseases in Nepal and identified existing infrastructure and capacity of the country for prevention and management of CVD in Nepal.

Potential stakeholders have been identified for engagement, wherever necessary and task force have been formed for needs assessment. We have conducted workshop for all our stakeholders for needs assessment and conducted meetings with task force members.

We have initiated national needs assessment for cardiovascular diseases. We have disseminated our achievements through various workshops, mass media and successfully conducted the first international annual symposium.

Location

The project is at the Dhulikhel Hospital Kathmandu University Hospital, a University Hospital of Kathmandu University located 30 km outside Kathmandu. It is a not-for-profit, community-based tertiary level hospital that serves about 1.9 million people and runs a number of graduate academic programs in health. This 400 bedded hospital with about 1100 full-time staffs, is recognized for high-quality, modernized health care services that are made accessible to people from all socio-economic strata.
It is one of the leading institutions in Nepal for CVD care and recognized for training and research, with more than a dozen major national and international collaborations.

Useful links

Strategy

We will form a collaborative team representing national level key stakeholder organizations to lead this project. Our organizational framework will include a Steering Committee, Research Team, Project Management Team, and Advisory Committee to guide our work. We will consolidate existing partnerships with leading United States Universities and establish new partnerships with regional centers in India and China to train 18 people in translational research for CVD through a structured training program.

We will apply mixed methods (qualitative and quantitative) to assess the existing capacity, needs, opportunities and challenges among the governmental and non-governmental sectors to implement evidence-based interventions for the prevention and management of CVD. We will conduct secondary data analysis of CVD to identify the epidemiology of CVD in Nepal based on which we will identify evidence-based intervention strategies to address CVD in a cost-effective and equitable manner. We will also identify and take steps to address identified deficiencies and appropriate changes in infrastructure to conduct translational research for these strategies.

We will prepare an actionable translational research plan to incorporate into the national health care system for the prevention and management of CVD and its risk factors.

study hall filled with trainees collaborating in small groups
Training session for Nepal trainees at the University

Dissemination

We will disseminate the processes as well as the findings of the project to a wider national and international audience through formal and informal means. We will post all the activities in the official website of our institute and collaborative partners where feasible. We will also use social media as applicable. Scientific information will be published in journal articles. We will publish our quarterly newsletter as well as conduct various workshops when necessary. Our fellows will disseminate information in their respective home organizations.

Our representative health journalist will also help us disseminate necessary information through her media publication articles. Our representative from the Ministry of Health and Population and the government of Nepal will contribute to disseminate required information at the national level to policymakers and related institutes. At the end of the project, we will have developed a critical mass of human resources in Nepal, collaborating with national and international partners to conduct translational research in CVD.

We will have clearly identified, prioritized needs and a well-defined implementation research plan to address one or more major CVD risk factors and outcomes. The team will thus form a ‘Center of Excellence for Translational Research in Cardiovascular Diseases’ in the long run, which will also serve as a model for other resource-constrained settings around the world.

Team Members

Our project has the support of 1 Principal Investigator, 11 Research Team members and 16 trainees.

Team members standing together smiling after workshop.
  • Rajendra Koju

    Rajendra Koju

    Principal Investigator Nepal project

    Dr Rajendra Koju, is the principal investigator of the Nepal TREIN project. He is currently serving as Dean in KUSMS to look after all academic programs of Kathmandu University School of Medical Sciences.

  • Abhinav Vaidya

    Professor of Community Medicine Kathmandu Medical College
  • Annette Fitzpatrick

    Research Professor, Department of Family Medicine, Epidemiology, & Global Health Schools of Medicine and Public Health University of Washington
  • Archana Shrestha

    Project Co-Director Dhulikhel Hospital Kathmandu University Hospital
  • Biraj Man Karmacharya

    Assistant Professor, Department of Community Medicine Chief, Department of Community Programs Dhulikhel Hospital Kathmandu University Hospital
  • David Citrin

    Co-Director, Nepal Studies Initiative University of Washington
  • Natalia Oli

    Lecturer, Department of Community Medicine Kathmandu Medical College
  • Prajjwal Pyakurel

    Assistant Professor, School of Public Health and Community Medicine B.P. Koirala Institute of Health Sciences, Dharan, Nepal
  • Rajeev Shrestha

    Associate Professor, Department of Pharmacology & Lead, Research and Development Division Dhulikhel Hospital Kathmandu University Hospital
  • Rashmi Maharjan

    Program Coordinator Dhulikhel Hospital Kathmandu University Hospital
  • Sushmita Mali

    Project Officer Dhulikhel Hospital Kathmandu University Hospital
  • Abha Shrestha Registrar, Department of Community Programs Dhulikhel Hospital Kathmandu University Hospital
  • Anmol Purna Shrestha Lecturer and Consultant Physician, Department of General Practice and Emergency Medicine Dhulikhel Hospital Kathmandu University Hospital
  • Anu Aryal Capacity Building Officer Possible Nyaya Health Nepal
  • Bobby Thapa Assistant Professor Janamaitri Foundation of Health Sciences, Kathmandu
  • Dipanker Prajapati Assistant Professor and Consultant Cardiologist National Academy of Medical Sciences, Kathmandu
  • Durga Bista Assistant professor, Department of Pharmacy Kathmandu University
  • Manita Pyakurel Lecturer, Department of Community Medicine Nepalgunj Medical College
  • Pranil Man Singh Pradhan Assistant Professor, Department of Community Medicine and Public Health Institute of Medicine, Tribhuvan University
  • Punya Shori Suwal Associate Professor, Public Health Department Nepal Health Institute of Health Sciences
  • Rajan Pandit Assistant Professor, Department of Physiology Nepal Medical College
  • Rajendra Dev Bhatt Lecturer, Department of Biochemistry Kathmandu University School of Medical Sciences
  • Robin Man Karmacharya Assistant Professor, Department of Surgery Dhulikhel Hospital Kathmandu University Hospital
  • Sahadeb Prasad Dhungana Assistant Professor Nobel College, and Teaching Hospital
  • Sujata Sapkota Senior Researcher Nepal Development Research Institute (NDRI)
  • Sumitra Sharma Lecturer, Department of Nursing Kathmandu Medical College
  • Surya B. Parajuli Department of Community Medicine Birat Medical College and Teaching Hospital

Publications and References

These references document the history of research studies by this team.

  • Pradhan PMS. Translational Research for tackling Non-Communicable Diseases: Need of the hour. Global Health Newsletter. 2018.

  • Parajuli SB, Bhattarai P, KC H. Translational research: Current status, challenges and future strategies in Nepal. Nepalese Heart Journal. 2018; 15(2):37. http://nhjournal.info/pdf/vol15no2/21469-67914-1-PB.pdf

  • Maharjan R, Fitzpatrick A, Shrestha A, Koju R, Karmacharya BM. Translational Research Capacity Building Initiative to Address Cardiovascular Diseases in Nepal: Early experience and findings. A consortium of Universities of Global Health; USA.2019