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Disaster has impacted the education sector in Nepal. It has disrupted the teaching and learning system with an increased dropout rate of students. Furthermore, it has shaken the resilience of the local communities. Due to this situation, children are exposed to a vulnerable situation and lack a safe learning environment. To mitigate this risk, most of the countries have adopted the comprehensive safe school framework. It is expected to be effective measures in Disaster Risk Reduction in education. In the context of Nepal, Comprehensive School Safety (CSS) legal provisions have been formulated in principle but lack its implementation at school and local level. This article explores the existing guiding provisions contributing to safe schools. The desk study was conducted on the basis of published literature and analyzed. The findings revealed that education is seriously impacted by disaster each year, and there is an inadequate implementation of the existing legal provisions at the local and school level. In addition to that, after disasters situation, school dropouts has been increased, and equal access to education has been challenged and more importantly, teaching and learning process are not continued. This has questioned the effective implementation of CSS and challenged the existing legal provision.

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 with traffic police informed course design. 29 officers in Makwanpur District completed before and after knowledge and confidence assessments prior to a 3-day first-response course. Police teams were supplied with first response packs and asked to complete report forms when first-responder skills were used. Follow-up assessments and interviews at 6-months explored retention and experiences of applying first-response skills. Analysis Pre-course assessments showed that although 97% of participants believed giving first-aid was their responsibility, knowledge and confidence levels were low and minimal training was reported. 95% had experience of transporting road crash victims to hospital. Post-test knowledge scores improved by 40% to 75%. Confidence levels improved post-course and remained high at 6-months. Outcomes During 6-months follow up, 27 participants attended 303 crashes where people were injured. 44% of participants used at least one first-response skill from the course; applying skills on 92 occasions, however only 3 report-forms were completed. Barriers to providing at-scene treatment included; patients already transported to hospital prior to police arrival; resistance from relatives/bystanders and competing police duties. Learning Outcomes Delivering the first-response programme for the traffic-police is feasible and knowledge and confidence can be retained. Barriers to using and reporting first-response skills need to be addressed.

BackgroundThe World Health Organisation has estimated Nepal's road traffic fatality rate as one of the highest in South-East Asia. Road-crashes are the 7th leading cause of mortality in Nepal, but there is currently a lack of nationwide emergency medical services. We developed, designed and evaluated the feasibility of a first responder training programme for the traffic police in Nepal.Methods39 traffic police officers in Makwanpur District participated in the study and 29 attended the 3-day first response course. A training needs assessment survey was conducted with participants prior to course design. A knowledge and confidence pre-test was followed-up by post-testing. Participants were supplied with a trauma-pack and asked to complete a report form when first-responder skills were used. Post-testing and follow-up survey were conducted at 6-months which explored experiences of applying first response skills.ResultsPre-course needs assessment showed that 97% of the participants believed that giving first-aid was their responsibility;95% had experience of transporting road-crash victims to hospital with a range of injuries. Low levels of first-aid training and a lack of standardisation were reported. Knowledge and confidence levels were low in pre-test. Post-test knowledge scores improved by 40% to 75%. Confidence levels improved post-course but were reduced at 6-months. In the 6-month study period, participants attended 303 road-crashes. 44% of the participants had used at least one first-response skill from the course; applying skills on 92 occasions, though incident report-forms were frequently not completed. ConclusionsDelivering a first-response programme for the traffic-police is feasible. Knowledge could be retained and used, and skills were in frequent demand. Barriers to providing treatment included; patient already en-route to hospital; resistance from relatives or bystanders and competing police duties. Further studies will need to reinforce the need to capture the use of incident report forms when first responder skills are applied. It is feasible practically and financially to extend the training to cover other districts/all of Nepal as a low-cost measure to combat road traffic injury in the absence of formal emergency medical services.

Copyright © 2021 Banstola, Smart, Raut, Ghimire, Pant, Joshi, Joshi and Mytton. 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 across Nepal. Identified organisations were invited to complete a questionnaire to explore the services, personnel, equipment, and resources in these organisations, their first aid training activities and whether the organisation evaluated their first response services and training. Of 28 organisations identified, 17 (61%) completed the questionnaire. The range of services offered varied considerably; 15 (88.2%) provided first aid training, 9 (52.9%) provided treatment at the scene and 5 (29.4%) provided full emergency medical services with assessment, treatment and transport to a health facility. Only 8 (47.1%) of providers had an ambulance, with 6 (35.3%) offering transportation without an ambulance. Of 13 first aid training providers, 7 (53.8%) evaluated skill retention and 6 (46.2%) assessed health outcomes of patients. The length of a training course varied from 1 to 16 days and costs from US$4.0 to 430.0 per participant. There was a variation among training providers in who they train, how they train, and whether they evaluate that training. No standardisation existed for either first aid training or provision of care at the scene of an injury. This survey suggests that coordination and leadership will be required to develop an effective first response system across the country. National Institute for Health Research (NIHR) Global Health Research Programme (Project ref 16/137/49) using UK aid from the UK Government.

Not Available.TU Journal, Vol. 26, No. 1, September 2009 Page:139-146