The changing patterns of Non-communicable diseases and injuries in Nepal from 1990-2017: A review of evidence from Global Burden of Disease Study 2017

Abstract Background Nepal has made significant strides towards its commitment to achieve universal health coverage in the past few decades. However, the paucity of evidence on morbidity, mortality and trends in non-communicable diseases (NCDs) has posed a significant hindrance in targeting resources for prevention, screening and treatment services. Thus, we conducted a systematic review of the existing evidence on the distribution of NCDs and their trends in Nepal from 1990 to 2017.Methods We analysed data on disability adjusted life years (DALYs), years lived with disability, years of life lost due to NCDs in Nepal and its comparator countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Pakistan and Sri Lanka) from 1990 to 2017 using all available data sources from Global Burden of Disease 2017. We also conducted supplemental analysis using data from the 2016 Nepal Demographic Health Survey (NDHS) to further elucidate the provincial level prevalence of key NCD risk factors.Results The result showed that between 1990 and 2017, life expectancy at birth increased by 14 years, from 58 years to 71 years on an average in Nepal. The three leading causes of DALYs in 2017 were cardiovascular diseases (CVDs), maternal and neonatal disorders and chronic respiratory diseases. High systolic blood pressure, smoking and high fasting plasma glucose were leading contributors to the NCD DALYs burden in 2017. At any ages ≥ 40 years, NCDs and injuries were responsible for 75–82% of total DALYs. Injuries, self-harm and violence, mental, neurological and musculoskeletal disorders superseded CVDs to become the leading causes of DALYs in young population aged 15–35 years.Conclusions CVDs were the leading causes of death in 2017 followed by chronic respiratory diseases and cancers. Data such as these are an important tool for framing a coherent policy response towards achieving the sustainable development goals, and the targets set by Nepal’s first Multi-sectoral Action plan on NCDs (2014–2020).