Sunil Kumar Joshi

Kathmandu Medical College | KMC · Department of Community Medicine

Background Road traffic crashes and injuries are increasing in Nepal, and post-crash response services are early in their development. Ambulance services are offered by multiple providers and most of them lack trained emergency medical technicians. Once an ambulance arrives at the hospital, trauma victims are transported to the emergency department...

Background Motorcycle taxis are an emerging mode of urban mobility in lower- and middle-income countries (LMICs) especially in Asia and sub-Saharan Africa. The epidemiology of injuries associated with motorcycle taxi use is unclear, and there is limited information about safe motorcycle taxi systems. Objective To systematically gather published re...

Background In Nepal, road injuries are responsible for approximately 2800 deaths and 15000 injuries each year. Road safety policies play a significant role in reducing road injuries by setting standards and regulations for road safety measures. Policy reviews may generate knowledge to inform national policy makers to prioritize and invest in road s...

Background Road traffic injuries are the twelfth leading cause of mortality globally. Nepal, one of the least developed countries in the world, has a rapidly rising rate of road traffic related morbidity and mortality. There is incomplete reporting of traffic crashes for Nepal in the last three WHO global status reports on road safety. Together wit...

Background Globally, 30% of road traffic deaths involve motorcycles rising to 43% in South-East Asia, where motorcycles are often used as taxis. Road transport provides the main mode of mobility in Nepal, and in Kathmandu valley motorcycles constitute 79.1% of the total vehicle fleet. Nepal does not have any legislation authorising the development...

Background Since 2017, Nepal has implemented a devolved system of government with 7 Provincial and 753 Local governments (known as Palikas). Palikas now have both the funding and the authority to oversee local roads and manage transportation infrastructures within their jurisdictions. Objectives Through the mobilisation of communities in 8 palikas...

Background The built environment and transport services can affect the health and well-being of people with a disability. Improving road safety while ensuring the needs of those most exposed to injury are met is fundamental to achieving Sustainable Development Goal 11.2. Research regarding mobility among people with disability is growing. However,...

Background Public transport is the primary mode of transportation in Nepal. It has a high road traffic fatality rate with bus crashes on long-distance routes accounting for 13% of fatalities and 31% of serious injuries. Only limited information is available in police records. Objective To examine the factors associated with road traffic crashes, i...

Background Road traffic crash reports in the Nepali media often lack in-depth information about the causes and impacts of these crashes. Most reports focus on the number of casualties, vehicle type, and crash location. They rarely consider factors such as road user behaviour or road and vehicle safety standards. There are seldom follow-up reports o...

Background The prehospital care system in Nepal is underdeveloped, with multiple providers, limited co-ordination of services and no national coverage. With no national ambulance service or emergency services phone number, people often call local hospitals during emergencies. Local hospital ambulances often only convey victims without providing car...

This study culturally adapted and validated a Nepalese version of the Abuse Assessment Screen (AAS) tool for identifying domestic violence among pregnant women in Nepal, creating the Nepalese Abuse Assessment Screen (N-AAS). International and national topic experts reviewed the initial N-AAS version using the Delphi method, and pregnant women parti...

Introduction Unsafe methods in handling pesticides, especially in middle and low-income countries like Nepal are practiced, although the harmful health effects either go unnoticed or are missed or are diagnosed late. This study aimed to assess knowledge, attitude, and practice regarding pesticide use among agricultural workers and farmers’ awarenes...

Introduction The current climate change scenario poses significant challenges for mountaineering expeditions. The accelerated melting of glaciers, altered climbing conditions, and changing weather patterns are reshaping the mountaineering process. The changing climate has significantly amplified the hazards linked to climbing, leading to increased...

Introduction The heightened risk of burnout within healthcare professionals is poised to significantly impact both their personal lives and the quality of patient care. This study aims to evaluate the extent of burnout experienced by healthcare workers during the COVID-19 pandemic. Materials and Methods This cross-sectional study involved healthca...

Background The prehospital care system in Nepal is poorly developed, with multiple providers, limited co-ordination of services and no national coverage. There is little published evidence reporting the prehospital care of patients with trauma, data which are important to inform the development of the prehospital care system. Objectives In order t...

Background Police road crash and injury data in low-income and middle-income countries are known to under-report crashes, fatalities and injuries, especially for vulnerable road users. Local record keepers, who are members of the public, can be engaged to provide an additional source of crash and injury data. Methods This paper compares the applic...

Background Injuries are an important public health issue in Nepal, contributing significantly to both morbidity and mortality. There is no injury surveillance system available, however healthcare service use is routinely reported to central government using the Health Management Information System (HMIS). The study was conducted as part of a wider...

Most road traffic crash reports published in Nepali media provide little information about their causes, impacts, or prevent-ability. Three workshops involving 31 journalists from diverse media platforms were held using published World Health Organisation resources, to provide training in good road safety reporting. Participants were invited to com...

Unintentional injuries are one of the leading causes of ill health, disability & death among the children and young adults worldwide. As these injuries are strongly related to social determinants, the burden falls mainly upon the Low- and Middle-Income Countries (LMICs) like Nepal. Thus, the main objective was to explore the epidemiology of uninten...

Background Domestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, par...

Introduction: In this fast-developing world, food production has also been changing, making people suffer from various health issues because of pesticide poisoning. Unsafe methods in handling pesticides, especially in middle and low-income countries like Nepal are still practiced, although the deleterious health effects either go unnoticed or are m...

Background Domestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, par...

Introduction: Maternal mortality is a top global developmental agenda. The main cause of being underutilization of available delivery services especially in a developing country like Nepal. Various socio-demographic, socio-cultural and health service-related factors affect the utilization of these services. Thus, the study aims to identify the deli...

Background/Aims Road traffic injuries are increasing in Nepal with the rapid expansion of roads and traffic and despite current road safety legislation. The aim of this study was to identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. Methods Using Delphi methodology, stakeholders from governm...

Background/aims There is growing awareness of the burden of suicide in Nepal, but currently, no evidence-based suicide prevention programme is available. Methods The Delphi expert consensus method was used to elicit prioritized research questions for suicide prevention. Participants included suicide prevention experts (psychologists, psychiatrists...

Background: Routinely collected injury data can help to identify populations at risk of injury, circumstances surrounding those injuries, and can be used to develop targeted interventions. However, routinely collected injury data in Nepal are at risk of being incomplete or poorly coded and are underutilised. Therefore, this study aimed to explore...

Background Gender inequality and violence are not mutually exclusive phenomena but complex loops affecting each other. Women in Nepal face several inequalities and violence. The causes are diverse, but most of these results are due to socially assigned lower positioning of women. The hierarchies based on power make women face subordination and viol...

Background: Road traffic injuries are a significant and increasing public health burden in Nepal, but there is no national coverage of regulated and standardized emergency medical service systems. Therefore, this study was designed to develop a first responder trauma training program for the Nepal traffic police and to evaluate the feasibility of...

Background Suicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to devel...

Objective To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. Design Delphi study. Setting Nepal. Participants Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants t...

Background: Healthy lifestyle behaviours have been consistently associated with reduced non-communicable disease related morbidity, mortality and wellbeing. Unhealthy behaviours are major contributors to the global burden of disease. The main aim of this study is to access lifestyle behaviours in adults during the corona virus disease-19 pandemic....

Introduction Road traffic injuries are a major but neglected global challenge. There are high and rising rates of road traffic injuries in Nepal. Most of the studies reporting these injuries in Nepal have used quantitative methods to describe the injury burden. Little qualitative research has been conducted to describe the contexts and social proce...

Objective: Accurate road crash reporting is essential for evaluating road safety interventions and plans. Under-reporting of road traffic crashes, injuries, and fatalities in police records has been widely described. The aim of this study was to apply and evaluate a community crash recording system, and assess the quality of the data in comparison...

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases in the Department of Forensic Medicine in a tertiary care ce...

This study aimed to develop and evaluate a model of hospital-based injury surveillance and describe the epidemiology of injuries in adults. One-year prospective surveillance was conducted in two hospitals in Hetauda, Nepal. Data were collected electronically for patients presenting to emergency departments (EDs) with injuries between April 2019 and...

Background Heavy goods vehicle drivers are an influential driving population in Nepal, with over 90% of goods in the country are transported by road. Due to the time spent on the road, drivers have long periods of exposure to the risk of crash involvement. The study explores the perceptions and experiences of heavy goods vehicle drivers and represe...

Background: Suicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to deve...

Ageing is a natural process. The elderly population is increasing in Nepal.When there is presence of diseases, physical inability, and financial harshness, the elderly in Nepal have to face many problems. This study was thus conducted to assess the socio-economic milieu and spectrum of gynaecological problems among women living in old age homes of...

Introduction: Job satisfaction is one of the determinant factors for professionals. The job satisfaction concerning school teachers reflects their strong motivation towards their job. This study aimed to measure the job satisfaction among teachers of Government and Private schools of Changu Narayan Municipality. Methods: A cross-sectional study wa...

Road traffic injuries in Nepal are increasing despite being largely preventable. Little evidence exists regarding the barriers and facilitators to a safer road system. This study aimed to explore the perspectives of professionals whose jobs had the potential to influence road safety in Nepal regarding challenges and potential solutions. Semi-struct...

Background: Abortion is legal up to 12 weeks’ gestation period in Nepal. Due to a lack of proper abortion services and socio cultural stigma, every year many women died due to abortion. The aim of this study was to asses the knowledge, attitude and practice of abortion in the residents of slum area of Kathmandu district. Methods: The cross-section...

Introduction: It is estimated that one billion people in the world have vitamin D deficiency and observed as a public health problem. The main objective of this study is to assess and compare the Vitamin D knowledge among MBBS, BDS and BSc. Nursing students of Kathmandu Medical College, Duwakot (before and after educational training). Methods: This...

Background: Abortion is legal up to 12 weeks’ gestation period in Nepal. Due to a lack of proper abortion services and socio cultural stigma, every year many women died due to abortion. The aim of this study was to asses the knowledge, attitude and practice of abortion in the residents of slum area of Kathmandu district. Methods: The cross-sectiona...

Worldwide, a large number of women experience disrespectful and abusive behavior from care providers during childbirth. This violates the rights of women to attain respectful care. This study aimed to find out the women’s experience of disrespect and abuse during institutional delivery. A cross-sectional study was conducted in two hospitals of Mora...

Background Globally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5–24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely c...

Almost 10% of global deaths are secondary to injuries, yet in the absence of routine injury surveillance and with few studies of injury mortality, the number and cause of injury deaths in many countries are not well understood. This study aimed to develop and evaluate the feasibility of a method to identify injury deaths in rural Nepal. Working wit...

Introduction: Medical doctors have profound influence on other health professions including physiotherapist as they are at the top of the pyramid of healthcare profession. There is a lack of knowledge of physiotherapy among medical doctors. They may not be knowing of all physiotherapy services and practice. The objective of this study was to find a...

Background and Objectives: Due to Covid-19 lockdown period undergraduate medical institutions across the country are moving towards e-learning for continuity of education. The purpose of this study is to determine the perceptions of students towards e-learning and to analyze medical students’ perception on e-learning vs. conventional learning. Mate...

Introduction: The greater risk of burnout among healthcare professionals is likely to develop an adverse effect on their personal life and the patients’ care. The main aim of this study was to assess the levels of burnout experienced by healthcare workers. Methods: A cross-sectional study was conducted from November 2020 to March 2021 among healthc...

Injuries account for 9.2% of all deaths and 9.9% of the total disability-adjusted life years in Nepal. To date, there has not been a systematic assessment of the status of first response systems in Nepal. An online survey was cascaded through government, non-governmental organisations and academic networks to identify first response providers acros...

Introduction: The job of security guard is to protect the property and the people who reside or work on the premises where they guard. The occupational safety requires the maintenance and the promotion of workers’ health and working capacity by improving the working environment and the development of working organizations. The aim of study was to a...

Background Injuries, the cause of an estimated 4.5 million deaths annually and many more disabilities worldwide each year, are the predictable outcome of particular circumstances. One of the most effective ways to prevent injuries is through policy and legislation. The aim of this research study was to identify and critically review all policy and...

Introduction: Vitamin D also known as the sunshine vitamin, helps in bone metabolism and calcium homeostasis. It is estimated that one billion people in the world have vitamin D deficiency making it a public health problem. The objective of this study is to find out the knowledge regarding vitamin D among first-year medical undergraduate students o...

Objective Injuries are a global health problem. To develop context-specific injury prevention interventions, one needs to understand population perceptions of home and workplace injuries. This study explored a range of views and perceptions about injuries in a variety of settings and identified barriers and facilitators to injury prevention. Desig...

Occupational health and safety (OHS) is essential for every professional especially healthcare workers who work day and night serving patients. According to the WHO, health workers should not face any kind of workplace violence during their professional activities. Attention should also be paid to the mental and psychological health of healthcare w...

Gender inequality and violence against women are present in every society and culture around the world. The intensities vary, however, based on the local guiding norms and established belief systems. The society of Nepal is centered on traditional belief systems of gender roles and responsibilities, providing greater male supremacy and subordinatio...

Background Injuries are an important public health issue in Nepal, contributing significantly to the burden of morbidity and mortality. There is no injury surveillance system available, however healthcare service use is routinely reported to central government using the Health Management Information System (HMIS). Methods To explore the epidemiolo...

Background Nepal is fast expanding its road network, and over 90% of goods are transported by road. Large numbers of truck drivers are therefore exposed to the risk of crashes. We explored the perceptions and experiences of truck drivers and representatives from their professional association regarding road dangers. Understanding crash risk in comm...

Background Among the children who meet unintentional injuries every year globally, many are left with some form of disability. The rehabilitation of these children is costly and difficult to afford due to poor economic resources. Thus, it highlights the importance of prevention of unintentional injuries. Methods A cross-sectional analytical study...

Background Unintentional Injuries comprise the fifth leading cause of death in Nepal in 2017, an increase of 23% compared to 1990. In Nepal, there is minimal community-derived evidence of home or occupational injuries. Our aim was to describe the epidemiology of injuries in the Makwanpur district, including the causes and risk factors associated wi...

Background When designing a logo for the Nepal Injury Research Centre a predicament arose: there is no direct Nepali translation for the word ‘injury’. A ‘loan-word’ was used, but this highlighted a broader issue – what do different stakeholders in Nepal understand when we talk about injuries, and what implications might this have for engaging them...

Background Availability of injury related mortality data can play a vital role in planning health services for injury prevention and monitoring progress towards Sustainable Development Goal 3.4. In the absence of a robust death registration system, this study explored the feasibility of a model to identify injury deaths occurring outside hospital i...

Background A number of sustainable development goals (i.e. SDGs 3, 8, 11 and 16) can be addressed by reducing injuries and incorporating injury prevention into national legislation, plans and policies. Institutions can be more effective if national laws guide prioritisation, development and implementation of plans. No comprehensive review of policy...

Background Busy and poor road infrastructure along routes to school poses high risk of traffic injury for children. Every child’s safe and healthy journey to/from school is fundamental to achieving Sustainable Development Goal 3.6. However, there is little evidence reporting children’s views about their school travel from developing countries. This...

Context Road crashes are the 7th leading cause of mortality in Nepal, but there are poorly developed nationwide emergency medical services. Contributing to achieving SDG 3.6 to reduce deaths from road crashes, we designed and evaluated the feasibility of a bespoke first-responder training programme for traffic police in Nepal. Process Interviews w...

Context There are daily media/news reports of road traffic crashes in Nepal mostly focusing on the number of people killed or injured. Few consider the causes, impacts or preventability. Media is recognised as a major stakeholder in road safety. We aimed to engage journalists in Nepal to improve the quality of their reports. Process We conducted t...

Context Nepal Injury Research Centre (NIRC) is dedicated to injury-related studies in Nepal. One of the key objectives of NIRC is to conduct standardized research additional to building the capacity of local researchers in adopting a robust Electronic Data Capture (EDC) system. Process A NIRC data manager was appointed and trained by a REDCap expe...

Background Injury surveillance is important for national injury control and prevention initiatives and enables monitoring of progress towards Sustainable Development Goals 3.4 and 3.6. In the absence of a national injury surveillance system in Nepal, we evaluated the feasibility of a model of hospital-based surveillance. Methods An injury surveill...

Context Through a collaboration between the University of the West of England, Bristol and Kathmandu Medical College in 2017, we established the Nepal Injury Research Centre. An innovative capacity strengthening programme underpins our ethos and activities, and contributes to SDGs 17 (Capacity development) and 4 (Education). Process Facilitated th...

Background: Busy and poor road infrastructure along routes to school poses high risk of traffic injury for children and adolescents. Ensuring every young person’s safe journey to and from school is fundamental to achieving reductions in road injuries and Sustainable Development Goal 3.6. However, there is little evidence reporting adolescent’s v...

Introduction: Almost a billion people in the world are affected by Vitamin D deficiency. During pregnancy, the deficiency of Vitamin D can manifest as gestational diabetes, pre-eclampsia, preterm birth, or miscarriage in the early stages of pregnancy. The objective of this study was to assess the knowledge, attitude, and practice, and importance of...

Research involving human participants needs to be scientifically valid and should be conducted according to accepted ethical standards. Research ethics provides guidelines for responsible conduct of research on human participants. It primarily protects the human participants of research and also educates and monitors researchers conducting health r...