Abstract for:The role of dietary practices and physical activity in the interaction of social determinants of non-communicable diseases in Nepal: a systems perspective

Background: The objective of this paper was to describe the critical role of prevailing dietary practices and physical activity in the interaction of the social determinants of non-communicable diseases in Nepal.

Method: Qualitative data was collected through key informant interviews (n=63) and focus group discussions (n= 12) from two case districts and policy level in Nepal and case study based thematic analysis was carried out. Qualitative system dynamics modelling was utilized to illustrate the connections between themes. The study also involved sense making and feedback sessions with the stakeholders. 

Results and discussion: Six key thematic areas relating to dietary practices and physical activity emerged facilitating the interactions of social determinants of NCDs as demonstrated in the causal loop diagram. Poor awareness, misconception and complacency relating to diet and physical activity was contributing to increased risk of NCDs. The tradition of healthy and locally produced meals was gradually being displaced by junk foods and drinks and to some extent, linked to junk food availability and declining agricultural activities in the case districts. Socio-economic status was identified as the root cause of poor diet and physical inactivity. Health system were not effective in addressing the issues relating to diet and physical activity.