title: Barriers to evidence-based disaster management in Nepal: a qualitative study.
abstract: OBJECTIVE
  Globally, the incidence of natural disasters is increasing with developing countries tending to be worst affected. Implementing best practices in disaster management that are evidence-based is essential in order to improve disaster resilience and response. This study explores the barriers to evidence-based disaster management encountered in Nepal.
  
  
  METHODS
  A qualitative study was conducted in Nepal involving interviews with key informants in the disaster management field.
  
  
  METHODS
  Government officials, academics, programme managers, disaster management practitioners and policymakers involved in disaster management were purposively sampled and invited to interview. 11 agreed to participate and were interviewed. The face-to-face interviews were recorded, transcribed and analysed using thematic analysis.
  
  
  RESULTS
  The interviews uncovered population-level barriers such as contextual factors (e.g. poverty), local custom and culture, as well as community-level issues (e.g. level of engagement and understanding). System-level barriers included limited demand for, availability and accessibility of the evidence-base. The implementation of evidence was influenced by the configuration of the disaster management system and system processes. Political ownership and leadership is an essential determinant of practice.
  
  
  CONCLUSIONS
  Several barriers to evidence-based practice in disaster management exist in Nepal. The relative influence of the different barriers varies with political determinants likely to have greater importance in countries such as Nepal where system governance and leadership is insufficiently developed. These issues affect a country's vulnerability to disasters and need to be addressed.
authors.affiliation: The School of Health and Related Research, The University of Sheffield, United Kingdom. Electronic address: Andrew.lee@shef.ac.uk.
authors.forename: A C K
authors.initials: AC
authors.lastname: Lee
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration*; D055317:Evidence-Based Practice / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D009390:Nepal; D011057:Politics; D036301:Qualitative Research
keywords: Disasters; Evidence-based practice; Nepal; Qualitative research