Historically, assignment of mental health diagnoses has relied more on completion of top-down checklists of symptoms that are administered by trained health professionals.1 This approach may be problematic due to its limitations on the fact that they are developed in different settings and lacks the local touch. Community-based detection approaches that provide agency to patients and community members may be a viable alternative to the standard biomedical approach. Highlighting this, we developed a culturally contextualized, picture based narrative instrument called the Community Informant Detection Tool (CIDT) for the detection of five common mental health problems in Nepal – epilepsy, alcoholism, depression, psychosis and behavioral disorder. This study describes the stepwise development of the tool. First, a draft tool consisting of narrative descriptions of each 5 disorder using symptom descriptions grounded…

Adolescent aspiration models influence people's behavior choices and exposure to risk and protective factors, which influence adult mental health1. There have been various public health and clinical studies that are aimed at improving these models to try to change behavior and decrease risk factors with the ultimate aim of improving psychological wellbeing2. The objective of this study was to identify adolescent aspiration models in a high-risk, rural Nepali setting to identify potential areas of intervention to improve adolescent mental health. The study used well-established social sciences elicitation techniques to understand the cultural pathway for adult life course(3,4). Life Trajectory Interviews (LTI) were conducted among adolescents aged 15-19 years, their parents and teachers (n=20). Qualitative analysis of the interviews formed the basis for identification of items for a card sorting activity. Card…

There is long history of using social sciences theory and methods in the fields of health and development to examine a range of public health issues in Nepal. Anthropologists have used interdisciplinary approaches to make public health interventions more culturally relevant in community settings[1-3]. However, there is a lack of systematic approaches to identify and address barriers to development and uptake of community-based mental health and psychosocial programs [4]. This formative study aims to qualitatively identify resources, challenges, and potential barriers to development and implementation of culturally adapted community-based mental health programs in accordance with the mental health Gap Action Programme (mhGAP) for persons with severe mental disorders and epilepsy. Focus group discussions (n=9) and key informant interviews (n=26) were conducted in the community including key policy makers, health workers,…

In Nepal, as in other developing countries, migration has been considered a powerful factor for social change. The construction industry and contemporary investments in infrastructure are potentially acting as powerful pull factors for internal labor migration, including for more specialized construction labor throughout the year –the share of the construction industry in non-agricultural wage employment in Nepal has grown from 30% during 1995/96 to 37% during 2010/11 This paper will present findings of research on the urbanization-migration nexus with the construction industry as a proxy for urbanization in Kathmandu, Nepal.  It examines how investments in urban construction and its concurrent demand for labour is giving rise to new and varied temporal forms of migration.The study is based on 83 in-depth interviews conducted with people working in the construction industry, mainly…

Migration in both its internal and international dimensions is not a new phenomenon. However, there has been an exponential growth in the scale of migration in the last few decades and it has directly impacted lives and livelihoods of people all across Nepal, directly as well as indirectly. There is a lacuna of scholarly work on how migration implicates social life. Burgeoning studies on migration and community forestry have tended to focus on how male migration has provided a ‘window of opportunity’ for women in forest governance. However studies on migration, gender and agriculture, suggest that the higher work burden resulting from male migration is disempowering for women because they lack the capacity to undertake the new responsibilities imposed on them and pushes them further into the sphere of unpaid…

Nepal has witnessed the out-migration of health personnel, especially doctors and nurses to the countries of the Global North. A few studies have explored the out migration of health workers from Nepal but little is known about the actual numbers of health workers leaving the country, the policies governing such movement and the consequent impact of the migration of this section of skilled population. The major destination countries for the migration of nursing professionals include United Kingdom, United States of America and Australia. Since Nepal stands as one of the 57 countries listed by the WHO facing critical shortages of health workers, the current outflows is likely to exacerbate the negative impacts already visible in terms of the effectiveness and quality of health service delivery. The paper will be based…

This paper suggests that the principle of autochthony widely practiced by most Nepalis works not categorically but contextually and compels them to practice belonging dynamically, often resulting in multiple identity-making. Based on field research about Himalayan mountaineering and Sherpa semi-migratory lives, this paper explores the mode of dynamic practices of belonging, practices that have allowed a group of Sherpas from Walung, northeastern Nepal, to go through the drastic changes of their lives induced by modernization, transnationalization and sanskritization in the country. Sherpa’s monopoly of the mountaineering industry solidifies ever more along the Himalayan chain, fitting the ethnic group into a niche at the triple nexus: surveillance of the nation state, opposition to other ethnic and caste groups, and compunction of international counterparts. The key to this propping themselves relies on…

Earthquakes, cyclones, and volcanic eruptions are prime examples of an unruly environment. The 9/11 (18/09/2011, 18.10 IST) Himalayan earthquake measuring 6.9 on the Richter scale had its epicenter in the Kanchenjunga Conservation area on the border of Sikkim in India, Nepal, Bhutan and Southern Tibet. The devastation of their dwellings, the destruction of many sacred landscapes and their monasteries is something the affected locals are neither going to ignore nor forget. The lamas and shamans residing in the earthquake affected areas regard the recent earthquake to be a serious message about unsustainability of mega hydropower projects, a response to willful desecration, and a sign of resistance to being colonized. Some sites of my doctoral fieldwork conducted in 2001-02 were devastated and wiped out by the 2011 Great Himalayan earthquake. The…

Decentralized planning has been an important agenda in view of growing concern for decentralization and governance all over the world.  Nepal has been practicing decentralization for decades since 1960s under different political regimes. However, there are critiques that it has been more political rhetoric than the transformation of traditional centralized governance system into participatory local self-governance. Amid such critiques for a long time; Nepal introduced Local Self Governance Act (LSGA), 1999 to address the increasingly challenging issue of decentralization and to institutionalize local self-governance in the country. One of the important responsibilities devolved to local bodies namely District Development Committee (DDC) in Nepal through the LSGA, 1999 is the formulation and implementation of District Development Plan.  Though there are number of studies laden with experts’ own views on decentralization and…

This paper examines the celebration of Dashain, the most celebrated Hindu festival in Nepal, by the Buddhist Tamang people of Kavre district. Many ethnic activists and scholars argue that Dashain and its patronizing by the state is a continual process of creating Hindu cultural hegemony in Nepal. Since the early 1990s, indigenous and other non-Hindu groups have also ‘boycotted’ Dashain as a way of resisting the Hindu state and reclaiming their distinct cultural and religious identities. However, many indigenous and non-Hindu groups such as the Tamangs of Kavre district continue to celebrate Dashain as one of their own cultural events.  In this paper, I focus on the ways in which the Tamangs of Kavre areas have indigenized the Dashain festival, and how they debate about the festival. Drawing on the…