Mid-term Evaluation- Improving palliative care services in Nepal (SUNITA Nepal)



The Sunita Nepal project, implemented by the International Nepal Fellowship (INF), focuses on improving palliative care services in Nepal. The project aims to ensure that people in Nepal who require palliative care receive it near their homes through integrated primary and specialist services, supported by a caring society. The project operates in several districts in West Nepal, including Kaski, Rukum, Lamjung, Surkhet, Banke, and Kapilvastu.

During the reporting period from April 2022 to March 2023, the project faced challenges due to the planned demonstration hospital being taken over by the Government, which prevented it from serving as the sole model for the project. Additionally, there were delays in obtaining permissions for community research and training in the district, resulting from post-election issues. To overcome these obstacles, the project adapted by transitioning to a 3-district model, including the involvement of two community hospitals, slightly adjusting the timeline for two pilot sites, and ensuring all necessary community permissions were obtained.

Summary of Previous Report for the Sunita Nepal Project by International Nepal Fellowship (INF) – Palliative Care


The previous report for the Sunita Nepal project by International Nepal Fellowship (INF) highlighted significant achievements and challenges in the implementation of palliative care services in Nepal. The project focused on providing integrated primary and specialist care to individuals in need of palliative care, with the goal of establishing a caring society that supports their needs.


The project made notable progress in various areas during the reporting period. Training initiatives were successfully conducted, surpassing both annual and project targets. Health workers, welfare officers from the Gurkha Welfare Trust (GWT), community volunteers, and other relevant stakeholders received comprehensive training, contributing to the overall improvement of palliative care services. Specifically, 526 health workers and GWT welfare officers were trained, exceeding the planned target of 255. Additionally, 36 Female Community Health Volunteers (FCHVs) received training, surpassing the planned target of 30.


Efforts were also made to involve community group members, teachers, and students in the project. A total of 412 community group members were trained, far surpassing the initial target of zero. Moreover, 74 teachers and students received training, although this represented only a small fraction of the planned target of 2,700.


However, the project also faced challenges that impacted its progress. One significant obstacle was the unexpected takeover of the planned demonstration hospital by the Government, which prevented it from serving as the sole model for the project. This required the project to adapt and adopt a 3-district model instead. Additionally, delays in obtaining permissions for community research and training in the target district due to post-election issues caused further setbacks.

Despite these challenges, the project demonstrated resilience and adaptability by adjusting its approach and engaging with alternative community hospitals. Nonetheless, the project fell short in the recruitment of the planned number of patients, highlighting a limitation in reaching the intended beneficiaries.

Overall, the previous report showcased the project’s commitment to improving palliative care services in Nepal. By exceeding training targets and adapting to unforeseen circumstances, the project laid a strong foundation for the future rollout of the National Palliative Care Strategy by the Government of Nepal. The experiences and lessons learned during the reporting period will inform future strategies and actions to enhance palliative care accessibility and quality for individuals in need across the target districts.

The purpose of the mid-term evaluation is to:1) establish the status of Sunita’s indicators in its revised log frame, halfway through the project, 2) compare these with the baseline survey and 3-year targets, and 3) recommend changes to achieve these targets.


Dr. Janak Thapa

Ms. Pragya Pokharel

Ms. salina Thapa

Ms. Pabitra Magar

Duration:  June 2023 to December 2023

partner: EMMS International, Edinburgh, UK


Posted on

September 3, 2023