Collections > Master's Papers > Gillings School of Public Health > A National Rheumatic Fever/Rheumatic Heart Disease Prevention Plan for Nepal

RF/RHD is a major burden of suffering, especially for children and young adults, in Nepal as well as many other countries. A refusal to curb RF/RHD is regrettable and immoral because it is a preventable disease. The benefits of RF/RHD prevention are numerous, ranging from decreased burden of suffering to cost savings for stakeholders. In 2013, the World Health Assembly included RF/RHD as a disease to be incorporated into national non-communicable disease plans. This development offers a wonderful opportunity for RHD advocates to bring RF/RHD to the attention of policy-makers and Ministries of Health around the world. A systematic literature review identified past and extant RF/RHD prevention programs at the national level. Review of these model programs revealed that RF/RHD prevention can be approached successfully in a multitude of ways. Because of its unique situation, Nepal is likely to benefit most from a hybrid plan, one in which many strategies targeting at both primary and secondary prevention act synergistically to maximize RF/RHD prevention efforts. These disease-specific efforts will occur within the context of an expanding primary health care system in a so-called "diagonal" manner. As the RHD TIPS toolkit recommends, various prevention strategies targeting different populations and points along the disease's causal pathway are highlighted in this paper. Components of the adapted RHD TIPS conceptual framework are prioritized for intervention according to need and resource realities, and short- and long-term objectives were built around identified gaps and opportunities. In turn, the short- and long-term objectives each address various components of the adapted RHD TIPS conceptual framework. Despite immense challenges, the Nepalese RF/RHD prevention plan provides a roadmap for the reduction of the RF/RHD-attributable disease burden in the country. In addition, the program--should it prove to be successful--may both validate the RHD TIPS handbook as an effective tool to guide program design and serve as a model program for other countries wishing to institute national RF/RHD plans. The program's generalizability will be largely dependent on the quality of the program's evaluation.