The growing numbers of urban poor around the world face several health challenges, including the double burden of diseases, exposure to environmental and human-made hazards, and limited access to quality and affordable healthcare. Services are not adequately planned and integrated across multiple public, private, and NGO providers and have often not kept pace with the changing disease burden or the needs of the urban poor. Additionally, due to the informality of their living and working conditions, the urban poor, particularly the urban slum population, are frequently overlooked in data, programs, and policies.

The Community-led Responsive and Effective Urban Health System-CHORUS, a Research Program Consortium funded by UK Aid, aims to improve urban health and reduce health inequities in urban communities. The RPC is implemented in Bangladesh, Ghana, Nepal, and Nigeria, with HERD International responsible for implementing the project in Nepal.

Our research focuses on four pillars:

i) Linking the plurality of health care providers.

ii) Building multi sectoral collaboration to address wider determinants of health.

iii) Strengthening systems to prevent and respond to the double burden of non-communicable (NCDs) and communicable diseases (CDs).

iv) Identifying, Reaching and engaging the urban poor.

Projects in Nepal:

HERD International is currently implementing participatory action research on urban health system strengthening in Nepal. Over a span of six years, two primary projects, detailed below, and other small-scale studies supported through CHORUS Innovation fund, referred to as innovation projects, will be conducted.

Understanding the approaches to strengthen the service delivery of non-communicable disease programmes for urban poor at the primary health care setting in Pokhara

In the given context of federalization and COVID-19, our project aims to understand the approaches to strengthen local (municipal/urban) health system that engages with private health providers in delivering quality health services with focus on NCD prevention and care, to urban poor and marginalized

The study has two phases:

i) Need assessment and co-creation phase, through which evidence will be generated to develop an intervention regarding the engagement of local health system actors and private sectors in delivering NCDs, focusing on the urban poor community.

ii) Implementation and evaluation phase that records baseline indicators, implements the intervention package, and evaluates the intervention packages based on the defined indicators at the baseline.

The project has now accomplished the need assessment phase, and now the intervention development is underway.

Innovation projects

Pathways to effective coverage for mental health services among urban adolescents

This study is focused on developing local-based solutions to improve the coverage, utilization and adherence to mental health services in Pokhara City in Nepal, prioritizing the urban poor population. The study aims to improve mental health by developing a pathway that can be supportive to increase accessibility and availability of mental health services specifically tailored for adolescents in Pokhara. The research employs a mixed-methods approach, combining qualitative and quantitative methods, to provide a comprehensive understanding of the factors influencing the uptake and impact of mental health interventions in this specific population.

Ethnographic Study of Intersecting Inequities of Urban Poor in Kathmandu, Nepal

The project aims to identify challenges and opportunities in ensuring equitable access to quality health services among urban poor. To achieve this, the study will understand the characteristics of urban poor and its linkages with pathways to care seeking and how gender and other social variables interacts and creates inequities in terms of access to health services. In addition, the study will look at the health policies to understand if the context of urban poor and the concept of equity and justice has been incorporated. Further the study will identify the potential areas for intervention to address the urban health issues. The research will be primarily ethnographic study in a selected urban poor settlement of Kathmandu district identified from initial listing and consultation with stakeholders.


This programme is a collaboration among the University of Leeds, University of York, HERD  International Nepal, ARK Foundation Bangladesh, University of Ghana, University of Nigeria, BRAC University and London School of Hygiene and Tropical Medicine

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