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Abstract Background Dengue poses a significant global public health challenge, including in Nepal. Understanding community’s knowledge, attitudes, and behaviors concerning dengue fever is imperative to developing effective prevention and control strategies. This study aimed to assess the knowledge, attitude, and practices related to dengue fever among residents of Lalitpur Metropolitan City. Methods A descriptive cross-sectional household study was conducted using a mixed-method approach, which included quantitatively studying 636 individuals and conducting 20 qualitative interviews. The data was collected between April 2023 and June 2023. The multistage cluster sampling method was applied for household selection during the quantitative study and a purposive judgmental sampling method was used to identify participants for the qualitative interviews. Face-to-face interviews were conducted using a structured questionnaire for the quantitative study and an interview guide for the qualitative study. Quantitative data were analysed using logistic regression in STATA version 13, and thematic analysis was applied to the qualitative data. The findings were validated through triangulation of results from both the qualitative and quantitative study. Results Regarding knowledge, 64.94% (n = 413/636) reported being informed about dengue fever. In terms of attitude, a substantial majority, 91.51% (n = 582/636), expressed a positive attitudes toward dengue fever, indicating a favorable perception and knowledge of its significance. Concerning practice, 49.84% (n = 317/636) of respondents reported actively engaging in dengue fever prevention measures. The variables gender, previous history of dengue fever and residency were the determinants of dengue fever knowledge. Additionally, gender, residency, and attitude were predictors of preventive practices concerning dengue fever. Conclusion Our study revealed that while the community demonstrated good knowledge of dengue fever and positive attitudes toward prevention, their preventive practices were inconsistent, indicating a gap between knowledge and action. A positive attitude was linked to better adherence to preventive measures. To address this gap, it is crucial to promote a positive attitude toward dengue prevention through initiatives like education efforts and social mobilization programs. Implementing Social and Behavior Change Communication (SBCC) programs focused on dengue prevention and control measures can help bridge this knowledge-action gap.

Health insurance has been recognised as a crucial policy measure to enhance citizens' well-being by reducing the financial burden globally. Nepal has also adopted this scheme to support achieving universal health coverage. Various factors influence the overall performance of the program in Nepal. However, there is a lack of evidence on how different factors have influenced the insurance program in the Nepalese context. Therefore, this study aims to explore facilitators and barriers to the utilisation of national health insurance services among service users and other stakeholders. A qualitative study was conducted by interviewing both demand-side participants and supply-side participants in the Bhaktapur District of Nepal. Thematic network analysis was used to analyse data using RQDA software. The socio-ecological model guides the presentation of the identified factors. The study followed the COREQ guidelines to ensure standard reporting of the results. Factors that encourage the use of health insurance services involve individual, community, and policy-related factors. These factors encompass changes in seeking treatment, assistance during enrollment and renewal by enrollment assistant, proximity to the initial point of contact for care, and policy features like individual cards, contribution amount and cashless treatment system. Likewise, lack of physical infrastructure, poor staff management, long waiting times, poor medicine availability, and delays in budget reimbursement were perceived as organisational barriers. At the interpersonal level, obstacles encompass challenges related to staff behaviour, interpersonal relationships, and the information provided by service providers. Identified health services delivery barriers at different levels emphasised the critical need for improving the quality of healthcare and services delivery mechanisms. Overcoming these obstacles is essential for realising health insurance scheme objectives and progressing toward Universal Health Coverage (UHC).

Abstract Background The Government of Nepal introduced the family-based health insurance program in 2016 to increase financial protection and improve access to health care services. The study aimed to assess factors associated with the utilization of health insurance among the insured population in an urban district of Nepal. Methods A cross-sectional survey using face-to-face interviews was conducted in 224 households in the Bhaktapur district of Nepal. Household heads were interviewed using a structured questionnaire. Logistic regression with weighted analysis was done to identify predictors of service utilization among the insured residents. Results The prevalence of health insurance service utilization at the household level in the Bhaktapur district was 77.2% (n = 173/224). The number of elder members in the family (AOR 2.7, 95% CI 1.09–7.07), having a family member with chronic illness (AOR 5.10, 95% CI 1.48–17.56), willingness to continue health insurance (AOR 2.18, 95% CI 1.47–3.25) and membership duration (AOR 1.14, 95% CI 1.05–1.24) were significantly associated with the utilization of the health insurance at the household level. Conclusion The study identified a particular group of the population who were more likely to utilize health insurance services, including the chronically ill and elderly. Health insurance program in Nepal would benefit from strategies to increase population coverage in health insurance, improve the quality of health services, and retain members in the program.