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The Sustainable and Integrated Management of COPD in Rasuwa, Nepal project was a community-based respiratory and non-communicable disease initiative implemented across Kalika and Gosaikunda Rural Municipalities.

The project aimed to improve COPD prevention, early identification, spirometry access, patient education, referral, and primary healthcare capacity in rural communities where tobacco exposure, household air pollution, occupational dust, difficult geography, and limited diagnostic services increase the risk of delayed diagnosis and treatment.

Approximately 700 community members participated in the screening programme. Activities were conducted at multiple health facilities and community sites across Wards 1–5 of Kalika Rural Municipality and Wards 2, 4, and 5 of Gosaikunda Rural Municipality.

Participants received an integrated assessment that included:

Of the participants screened, 345 completed spirometry. Among them, 196 had an FEV₁/FVC ratio below 0.70, representing 56.81% of those tested. This finding indicated an obstructive lung-function pattern requiring further clinical evaluation; it should not be interpreted as a definitive COPD diagnosis without appropriate post-bronchodilator assessment and clinical correlation.

The screening also identified a substantial burden of associated NCD risks. Among 598 participants with analysed records, 42% had elevated systolic blood pressure, while abnormalities in diastolic blood pressure, body weight, and blood glucose were also identified. These findings reinforced the need to integrate COPD services with hypertension, diabetes, obesity, cardiovascular-risk, and kidney-health assessment.

A major component of the project was strengthening local primary healthcare services. Eight health facilities in Rasuwa received selected equipment, supplies, respiratory-support materials, glucometers, test strips, medical kits, and essential COPD-related resources. Healthcare providers also received practical demonstrations and training in spirometry, respiratory assessment, breathing exercises, inhaler-related counselling, and early identification of COPD.

The project worked closely with municipal health sections, health-post teams, Female Community Health Volunteers, local representatives, healthcare professionals, and community volunteers. Their involvement supported participant mobilization, venue coordination, screening, counselling, referral, and dissemination of the project findings.

Community education focused on:

The project also supported policy and community advocacy by presenting screening findings to local stakeholders. These discussions highlighted the need for continued spirometry services, health-worker training, community awareness, affordable inhalers, stronger referral pathways, pulmonary rehabilitation, and regular follow-up.

The project demonstrated that COPD screening should not be conducted as an isolated camp. Sustainable respiratory care requires trained healthcare professionals, functional equipment, quality-assurance systems, clear clinical protocols, patient registers, referral mechanisms, essential medicines, ongoing supervision, and coordination between community services and higher-level healthcare facilities.

Through integrated screening, healthcare-worker capacity-building, facility support, public-health education, and local-government collaboration, the initiative contributed to strengthening COPD and NCD services in rural Rasuwa.

People reached through screening: Approximately 700
Participant records included in the main analysis: 598
Participants completing spirometry: 345
Participants with FEV₁/FVC below 0.70: 196
Proportion with an obstructive spirometry pattern: 56.81% of those completing spirometry
Health facilities supported: 8
Primary focus: COPD and NCD screening, spirometry, counselling, referral, healthcare-worker training, primary-care strengthening, and household-air-pollution reduction