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Dhulikhel Hospital Kathmandu University Hospital/Kathmandu University School of Medical Sciences

Fellowship Site Directors: Dr. Biraj Man Karmacharya

Site Contact: Dr. Biraj Man Karmacharya birajmk@kusms.edu.np Mobile: +9779808660568

Link to research site’s website: https://research.dhulikhelhospital.org/ 

Site Specialties:

Infectious Diseases

Non-communicable Diseases

Implementation Science

Health Systems

mHealth Technologies

Population Health Studies

Clinical Trials

DHKUH/KUSMS is the largest provider of tertiary level health care in Nepal and also spearheads the country’s health sciences research. Its vision is to become a world class research-intensive school over the next decade.

The School of Medical Sciences is the largest school of Kathmandu University (KU) and is the leader in the field of health sciences education and research in Nepal. Every year it produces more than 1,000 medical doctors, 250 specialized doctors and other 1,000 health professionals in different fields. Through Dhulikhel Hospital- its central University Hospital, and the hospitals of other seven affiliated medical colleges, KU is also the largest provider of tertiary level health care in Nepal and also spearheads the field of health sciences research in the country. 

KUSMS offers academic programs in medicine, dentistry, public health, nursing, human biology, pharmacy, lab medicine, radio-imaging technology and physiotherapy. Every year, it produces approximately 2150 health professionals in different fields through the central college and its seven affiliate medical colleges. Dhulikhel Hospital is a community service-oriented hospital guided by the principles of social equity, sustainable development, harmony with nature, and supported by the Dhulikhel community. The hospital was founded with the belief that Quality Health Care should be accessible to people from easy to reach hard to reach communities.

DHKUH is a community service-oriented hospital guided by the principles of social equity, sustainable development, harmony with nature, and supported by the Dhulikhel community. DHKUH is a standalone tertiary care center which provides healthcare services to people from more than 50 districts with the catchment population of approximately 3 million people from Kavrepalanchowk, Sindhupalchowk, Dolakha, Sindhuli, Ramechhap, Bhaktapur, and other surrounding districts. Although there are primary health care centers and health posts under the government health care system there is a huge mass of population and areas that go amiss in seeking care especially for IDs and EIDs. There is an utmost need for an advanced center that caters to the health care needs of these people.

Institutional Core Strength Areas:

Surveys and Longitudinal Studies

DH oversees large surveys ranging from population-based health surveys to quality of care surveys in health facilities. The Dhulikhel Heart Study, started in 2013 is a longitudinal cohort study on non-communicable diseases and their risk factors. There are also ongoing population-based serosurveillance going on in partnership with Stanford University, University of Toronto and other organizations. Several other studies encompass longitudinal studies on women’s health as well including cervical cancer. There is an ongoing work to develop a large cohort on school children in coordination with the School Nurse Program of Bagmati Province. DH also has dedicated teams that are working on the secondary data analysis of major national surveys. As a part of the Healthy City Initiative, DH recently collaborated with the Dhulikhel municipality in conducting household-level health surveys of the municipality and is developing it as a long-term cohort study.

Health Systems and Policies related Studies

There are also multiple health systems related ongoing studies. DH recently completed a Primary Health Care assessment and costing exercise at the local levels of Nepal in partnership with UNICEF. There is also an ongoing study on the assessment of national health insurance program, and determination of facilitators and barriers to insurance enrollment and retention. A nationwide study on patients’ response/satisfaction on the quality of care at hospital level is also under preparation in partnership with the Curative Service Division. Piloting of the study has been completed at Dhulikhel Hospital. A novel study on Unannounced Standardized Patient (USP) for quality-of-care assessment is also underway in partnership with international teams from China, Switzerland and UK. DH also recently completed several studies related to the impact of COVID-19 on health system. Through the funding of SAARC Tuberculosis and HIV Center, we conducted a national assessment of COVID-19 on the Directly Observed Treatment of tuberculosis. DH collaborates with WHO and the Epidemiology and Disease Control Division in conducting studies related to NCD care. A recent effort in partnership with Harvard University, University of Bergen and Kathmandu Institute of Child Health also focuses on Time-Driven-Activity-Based Costing approach to health financing evaluation and impacts.

Implementation Research, Rapid Assessments, and Monitoring and Evaluation

Another major strength of DH lies in the implementation research and community-based rapid assessments. The Behavior Science Center established in partnership with John Snow Inc. and UNICEF led a pioneering work on the rapid assessment of targeted communities on vaccine hesitancy on several parts of the country. The findings were then developed to develop interventions, which were implemented and evaluated as an implementation research project. The team also led the efforts in addressing recent measles outbreak in Western Nepal. There are several other implementation studies going on in the field of non-communicable diseases in partnership with Ministry of Health and Population, Nepal Health Research Council, Provincial and local governments.

Infectious Diseases

A dedicated Center for Infectious Diseases is also leading several clinical, epidemiological, and laboratory-based studies (including genomic studies) on infectious diseases research. This is being done in collaboration with Stanford University, University of Toronto, Harvard University, International Vaccine Institute, National Institutes of Health, Bill and Melinda Gates Foundation, Chan Zuckerberg Biohub, etc. Several clinical trials have been successfully completed and there are several underway. Most notable of this has been the typhoid vaccine trial, COVID-19 vaccine trial and lately the Oral Cholera vaccine trial. A state-of-the-art infectious disease research lab with capacity of advanced molecular works is an asset to these works. Recently the center has also initiated infectious diseases related to climate change and is collaborating with several other institutions to build this area. Norwegian Institute of Public Health is a major partner in this effort.

New Areas and Partnerships

There are also several teams working in establishing dedicated centers for research on gender and migration, domestic violence, adolescent health, and antibiotic stewardship. Recent partnerships with External Development Partners like the WHO, GIZ, UNDP, UNICEF also open newer avenues of collaborative works to bridge government, academia and the development partners.

Capacity Building

As the academic hub of Kathmandu University School of Medical Sciences, DH leads several efforts on capacity building and knowledge management in the field of health research. A dedicated Training Center within the institution serves as one of the largest training facilities of Nepal conducting almost 90 short and long-term trainings annually. The pioneering MScPH (Epidemiology and Global Health) program, and the PhD Program in Health Sciences (including Public Health) drives a constellation of activities focused on health research training. DH/KUSMS also initiated the formation of Consortium of Academic Institutions for Public Health in Nepal (CAIPHEN) and currently houses and leads it. Through this, there is a nationwide effort underway to reform public health training and research. Regular programs on in-house trainings and support for staffs and faculty help improvise and constantly reinvigorate the research and academic programs of the institution.

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