Overweight and obesity prevalence has increased in low-income countries. This study systematically reviewed the obesity trend, disparities, and prevention and control efforts in Nepal.
We searched PubMed and Google Scholar for articles and reports published between January 1, 2004 and December 31, 2022. Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts. Overweight and obesity were defined using the World Health Organization body mass index cut points. Thirty-two studies and reports were included.
Overall, overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited. The combined overweight and obesity (OW/OB) and obesity rates in women aged 15‒49 years increased from 8.5% to 22.2% and from 0.9% to 5.1% between 2006 and 2016, respectively. OW/OB and obesity rates in men were 17.1% and 2.5% based on data from the 2016 Demographic and Health Survey. OW/OB rate in under-five children increased from 0.6% to 2.8% between 2006 and 2016. Obesity rates for school-age (5‒9 years) boys and girls in 2016 were 2.4% and 2.8%, respectively, and were 1.1% and 1.4% for male and female adolescents aged 10‒19 years, respectively. OW/OB prevalence was much higher among women, residents in urban areas and central provinces, and in higher socioeconomic status groups. Projected prevalence of OW/OB and obesity for 2030 in adults aged 15‒49 was 44.7% and 8.3%, respectively, while it was 2.2% for OW/OB in preschool children. Policies and direct interventions that specifically focused on obesity prevention and control are limited.
OW/OB prevalence in Nepal has increased during the past 1.8 decades, disproportionately affecting population groups. Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention. In the future, Nepal needs to develop population-based programs for obesity prevention.
This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion, effectively addressing diverse health challenges that evolved over different periods.
The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986‒2021. We summarized the themes and key achievements, and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.
The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale. The primary purpose and goal are to promote health from regional to global. Significantly, our findings highlight a transition in the primary actors driving health promotion. It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization, governments, and international bodies, to a more inclusive approach involving non-governmental organizations and the general public. This development implies that health promotion has evolved into a collective global endeavor, demanding the proactive involvement of various stakeholders, and forging new alliances in public health. Meanwhile, the coronavirus disease 2019 (COVID-19) pandemic has further shaped the landscape of health promotion, underscoring the need for intensified focus on areas including disease prevention, health education, and the integration of digital health technologies, and emphasizing the importance of a multidimensional, responsive approach in public health initiatives.
Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally. Countries, together with public and private entities, should intensify cooperation. Multisectoral collaboration among partners such as healthcare, education, social security, and the industry is vital for health promotion and achieving global health goals.
Access to improved sanitation is a fundamental human right and an important aspect of Public Health. However, an estimated thousands of people in Ghana especially, the West Mamprusi Municipal Assembly (WMMA) still have no access to adequate toilet facilities. This has brought untold health repercussions to the inhabitants, the community, and the environment at large. To address this menace, the community-led total sanitation (CLTS) was implemented. This study aimed to assess communities’ perspectives on the implementation of CLTS and to understand the factors influencing its success and failures.
A mixed-method approach involving sequential qualitative and quantitative methods was employed in this study. Participants for the quantitative study were randomly selected and surveyed using questionnaires. The qualitative study employed focus group discussion involving purposively sampled participants including assembly members, opinion leaders, and assembly staff.
The CLTS program in WMMA realized an apparent use of construction and proper use of household latrines leading to a reduction of open defecation free (ODF) and two communities achieving sanitized status in the history of the study area, enabling the training of latrine artisans and natural leaders to facilitate the CLTS expansion and sustainability, improved sanitation and hygiene, strengthened the enforcement of community rules and regulations and many others.
The CLTS program has received more widespread acceptance in the study area than the previous government policy of constructing public toilets, which was greeted with massive failures due to poor implementation. To ensure that gains achieved through CLTS implementation are sustained longer, it is recommended that chiefs and opinion leaders should be involved in the CLTS programs to ensure checks and enforcement. The entrenchment of bylaws and more education to address enduring myths and misconceptions will sustain the program. Subsidies in the form of sanitation loans for latrine construction materials by the government and supporting non-governmental organizations (NGOs) will be paramount in sustaining ODF.
Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket (OOP) expenses. The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.
Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development (OECD) iLibrary and National Health Accounts 2019 databases. Gross domestic product (GDP) data from the World Bank was also utilized. Descriptive statistics analyzed the composition and pattern, while the exponential smoothing model forecasted future health expenditures.
The findings revealed that expenditure made by OOP is the primary health financing source, followed by government and pre-paid private spending. The percentage of GDP allocated to total health expenditure remains stable, while the per capita health expenditure fluctuates. Variations in expenditure among states are observed, with Karnataka relying heavily on pre-paid private coverage. Future projections suggest a decline in per capita and total health expenditure as a share of GDP, with a slight increase in the government’s share. Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.
The study highlights variations in health spending in India, characterized by high OOP spending, limited public coverage, and a need for investments, and reforms to improve healthcare access and equity.

