Health rights: Inclusive Eye and Ear and Hearing Health in Karnali of Nepal”- end line evaluation



Blindness and visual impairment are pressing health issues for individuals aged 50 and above in Nepal’s Karnali province. The primary healthcare system in Nepal doesn’t cover eye care, leaving people in remote areas without access to these services. Non-governmental organizations (NGOs) are still the primary providers of eye care, and Surkhet Eye Hospital is the sole base hospital offering higher-level eye care in the province which is managed by the Nepal Red cross society. A 2020 Rapid Assessment of Avoidable Blindness (RAAB) survey found untreated cataracts to be a significant cause of bilateral blindness in Nepal and Karnali province at 65.3% and 61% respectively. Likewise, survey findings indicate that the results of cataract surgery in Karnali fall short of the World Health Organization’s (WHO) standards, highlighting the insufficiency of the province’s eye care facilities. Despite a national eye health strategy, obstacles to accessing eye care include lack of awareness, surgery-related fears, and financial constraints.

Hearing loss is another major concern, but ear health services are not well-integrated into the primary healthcare system. It is the third-largest cause of years lived with disability worldwide, but it often goes unnoticed due to societal stigma and a lack of attention from policymakers. Over 1.5 billion people currently experience some degree of hearing loss, and this number could rise to 2.5 billion by 2050, with 80% of affected individuals living in low-income countries. Although an Ear, Nose, and Throat (ENT) department was recently established in a provincial hospital in Karnali, there is a lack of scientific research on hearing and ear problems in Nepal, indicating a low priority for these issues in the country’s healthcare system.

The “Health Rights” project, funded by BMZ/CBM and executed by Nepal Netra Jyoti Sangh (NNJS), has a duration of 37 months. It operates in four districts within the Karnali province: Surkhet, Dailekh, Jumla, and Mugu. The project contributes to the improvement of the health of people and prevention of eye and hearing impairment through the establishment of inclusive eye and ear health services, capacity development of medical staff, screening, treatment, and awareness raising in communities as well as lobbying at local, provincial and national government level. 2

The target group of the project includes men, women, girls and boys, people with visual impairment, people with disabilities and health workers. The project has targeted to provide treatment for 11,920 people with eye and/or ear diseases. The total available budget is 774.843,00 Euro including a budget reserve. The impact of the project by its end is the Quality of life of the poor population of the province of Karnali affected by visual and hearing impairments is improved.

Aims of the end line evaluation: To assess the outcomes of the project to show evidence of its effectiveness, value for money (efficiency), potential impact and the likelihood of sustainability and captures learning and draws recommendations to improve future similar operations.

Partner: CBM Country Office Nepal 

Study team;

Dr. Janak Thapa

Ms. Pragya Pokharel

Mr. Nischal Shrestha

Ms. Pabitra Magar

Ms. Salina Thapa



Posted on

December 28, 2023