Open Access Research article

Health improvement for disadvantaged people in Nepal – an evaluation

Ram B Rana1, Rabindra Ghimire2, Mahendra B Shah2, Tirtha Kumal2, Elise Whitley3 and Ian A Baker3*

Author Affiliations

1 Local Initiatives for Biodiversity, Research, Development (LI-BIRD), PO Box 324, Pokhara, Kaski, Nepal

2 The Britain-Nepal Medical Trust, PO Box 20564, Lazimpat, Kathmandu, Nepal

3 Department of Social Medicine, University of Bristol, Canynge Hall, 30 Whatley Road, Bristol, BS8 2PS, UK

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BMC International Health and Human Rights 2012, 12:20  doi:10.1186/1472-698X-12-20

Published: 26 September 2012



An evaluation of progress with participatory approaches for improvement of health knowledge and health experiences of disadvantaged people in eight Districts of Eastern Nepal has been undertaken.


A random selection of Village Development Committees and households, within the eight Districts where participation and a Rights-based Approach had been promoted specifically by local NGOs were compared with similar villages and households in eight Districts where this approach had not been promoted. Information was sought by structured interview and observation by experienced enumerators from both groups of householders. Health knowledge and experiences were compared between the two sets of households. Adjustments were made for demographic confounders.


Complete data sets were available for 628 of the 640 households. Health knowledge and experiences were low for both sets of households. However, health knowledge and experiences were greater in the participatory households compared with the non-participatory households. These differences remained after adjustment for confounders.


The study was designed to evaluate progress with participatory processes delivered by non-governmental organisations over a five year period. Improvements in health knowledge and experiences of disadvantaged people were demonstrated in a consistent and robust manner where interventions had taken place.