Globally, Primary Health Care (PHC) is recognised as central to improving health for all, yet COPD patients in Nepal are not receiving adequate PHC, due to inadequate human resources for proper diagnosis and treatment and a lack of infrastructure. Our study will be co-designing a model of care, which aims to find local solutions/innovations to the identified problems at the level of the patient, health professional and health system for improving self-management practices. We expect our program to greatly improve the quality of care and COPD patients’ quality of life in Nepal.

Project Status

Completed Projects

Chief investigator

Uday Narayan Yadav

Project Coordinator

Prof Mark fort Harris, A/Prof.Jane Lloyd, Dr. Hassan Hosseinzadeh

Team member

Prof.Kedar Baral, PAHS, Nepal Prof.Narendra Bhatta, BPKIHS, Nepal Dr. Suresh Mehta, Ministry of Social Development, Biratnagar, Nepal Dr. Roshan Pokharel, Ministry of Health, Nepal Mr. Sagar Dahal, Ministry of Health, Nepal

Project Rationale

Nepal, as like other countries in South-East Asia have committed to achieving the Sustainable Development Goals (SDGs). Despite being signatory of global strategy for prevention and control of non-communicable disease, the country’s response could be strengthened. The increasing incidence of chronic disease is an emerging public health problem in Nepal. Systematic and evidence-based interventions are needed to build Nepal’s capacity to respond to increasing rate of communicable disease. There is a critical paucity of research determining the effect of health literacy and patient activation on COPD self-management in Nepal. Additionally, generated evidence will be used for co-designing and testing model of care and intervention contents with patients and providers the acceptability, usability, and preliminary efficacy of the prototype for the management of multimorbid COPD patients in Nepalese settings.

Project Aim/s

This study aims to co-design and test a model of care and intervention contents to improve self-management practices(SMPs) of multi-morbid COPD patients in Nepal
Specific objectives:
  • To determine the levels of health literacy and patient activation among the study population.
  • To identify determinants of patient activation for self-management in patients with COPD multi-morbid conditions.
  • To determine the determinants of health literacy for self-management among COPD multi-morbid COPD patients.
  • To determine the association of health literacy and patient activation with self-management among multi-morbid COPD patients.
  • To analyze the readiness of health system and key stakeholders in delivering PA and HL informed COPD self-management intervention.
  • To co-design a model of care, intervention contents and to evaluate a COPD self-management intervention informed by the study finding.

Project Design and Method

This will be conducted using mixed method design (Quantitative + Qualitative). The quantitative part involves the survey of COPD patients in the community setting of Sunsari district, Nepal. The study will be conducted considering five steps of co-design approach proposed by proposed by the Hasso-Plattner Institute of design at Stanford. The five steps are arranged into three phases in this study:
Phase I: Exploratory study(QUAN+Qual)
Phase II: IDEATION + Prototyping of model of care and intervention contents.
Phase III: Testing and evaluation of effectiveness of the intervention program.


1. Yadav UN, Hosseinzadeh H, Lloyd J, Harris MF. Self-management practices and its relationship with Health Literacy and Patient Activation among multi-morbid COPD patients from rural Nepal: Findings from a cross-sectional study. BMC Public Health. Available:

2. Yadav UN, Hosseinzadeh H, Lloyd J, Harris MF. How health literacy and patient activation play their own unique role in self-management of chronic obstructive pulmonary disease (COPD)? Chronic Respiratory Diesease [Internet]. December 26, 2018.

3. Yadav U, Hosseinzadeh H, Baral K. Self-management and patient activation in COPD patients: an evidence summary of randomized controlled trials. Clinical Epidemiology and Global Health. 2017;6(3):148-54.

4. News Coverage : (Nepali)


Uday Narayan Yadav Phone: +61-0405846602 Email:

Key Partners

Gadhi Rural Municipality, Government of Nepal



Project lead centre
Project stream
Prevention and Management of Long Term Conditions
Project start date
Project end date