Nepal, with a total population of 28 million, has come out of a violent insurgency that took place between 1996 and 2006, initiated by the Communist Party of Nepal – Maoist and fuelled by poverty, unequal distribution of wealth, social marginalisation and disappointment with state governance. Since the 2006 peace agreement, the country has been in a devastating political gridlock around the drafting of a new constitution.
PRIME has been implemented in Chitwan, a district on the southern plains of Nepal. Chitwan has a population of 575 058 people, 73% of whom live in a rural setting and a literacy rate of 70% (compared with the national average of 54%). With two psychiatrists and a psychiatric ward in the district public hospital, the district is better off compared with most in Nepal, but similarly to the rest of the country, it has no mental health services as part of the basic healthcare package delivered in locally available primary care.
For more information, read Development and pilot testing of a mental healthcare plan in Nepal in a special supplement on PRIME published in the British Journal of Psychiatry.
|Dr Mark Jordans
Healthnet TPO, Netherlands
|Mr. Anup Adhikari
|Mr Rajeev Pokharel
Ministry of Health and Population (MOHP), Nepal