Barriers and facilitators of evidence-informed health policymaking in Nepal: A scoping review

Abstract

Background Evidence-informed health policymaking (EIPM) is essential for strengthening health systems and achieving equitable health outcomes. Despite policy commitments in Nepal, the translation of research evidence into policy and practice remains limited. This scoping review synthesizes the barriers and facilitators influencing EIPM across health policy domains in Nepal. Methods We conducted a scoping review following the Arksey and O’Malley framework and PRISMA-ScR guidelines. Peer-reviewed studies published between 2015 and 2025 that examined barriers and facilitators of EIPM in Nepal were identified through searches of PubMed, Scopus, Embase, and Global Health. Two reviewers independently screened studies, extracted data, and conducted descriptive and thematic analyses. Results Of 2,139 records identified, 26 studies met the inclusion criteria. The studies covered maternal and neonatal health, non-communicable diseases (NCDs), nutrition, emergency care, health systems governance, climate-health, public health regulation, and COVID-19 ethics. Barriers were grouped into five themes: systemic and governance challenges; capacity and resource constraints; evidence-related issues; contextual and cultural factors; and operational gaps. Common barriers included political interference, fragmented coordination, workforce shortages, inadequate funding, donor-driven agendas, poor dissemination of research, and limited implementation guidance. Facilitators clustered into four themes: institutional and structural enablers, political and leadership commitment, capacity building and stakeholder engagement, and global and donor support. Sector-specific differences were observed, with socio-cultural barriers more prominent in maternal and neonatal health, governance and coordination challenges particularly evident in NCD policies, and technical capacity and data limitations more pronounced in climate-health policy. Conclusions Nepal’s EIPM landscape reflects strong commitment but uneven institutionalization. Strengthening governance, institutional capacity, evidence systems, and coordination across federal, provincial, and local institutions is essential to improve the translation of research into policy and practice. Institutionalizing EIPM requires not only producing evidence but also creating systems that routinely generate, translate, and use evidence for decision-making.