COHESION team members; Dr. Claudia Rutte, SNF r4d Project Coordinator; Prof. Dr. Joanna Schellenberg and Dr Andrew Cassels, SNF r4d Advisors met for a first site visit to Nepal from November 27th  to December 2nd 2017. The goal of the one-week meeting was to share results, reflect on progress so far, understand the local context and plan next steps for the upcoming year. The meeting provided a unique opportunity for sharing experiences and transferring knowledge among participants.

During the first day, the teams came together to discuss recent updates, share expectations and enrich next day presentations with the feedback from other team members. On the second day, the Project Coordinator, Advisors and Nepali stakeholders from different institutions (see list of participants) joined the team to learn about the project progress thus far. The interaction between the COHESION team and the participants facilitated identifying commonalities and differences between the three study countries, where it was interesting to see that although the countries may be far in distance, their cultures and realities are not so far apart.

The exchange with local stakeholders built a momentum for continuous discussion about how the project could help strengthen the health systems of Mozambique, Nepal and Peru to respond to the needs of the most vulnerable affected by NCDs and NTDs. How could COHESION interventions respond to the needs expressed by stakeholders from the community, health system and policy levels during the co-creation sessions? How could we address the linkages between NCDs – NTDs? How could we design interventions that are innovative, equitable, sustainable and feasible within the scope of the project?

The richness of the second day discussions, particularly about the possible interventions, highlighted many complex issues and challenges that had to be considered more deeply and completely. Presentations from the SNF r4d Advisors during the second and third day provided excellent “food-for-thought”, which was reflected upon in all subsequent discussions. The intervention design discussions followed until the next day and were also stimulated by a visit to one of the selected sites: Baniyani.

After an exciting bus trip from Dahran to Baniyani, representatives from the community welcomed the COHESION delegation to the Baniyani primary health care (PHC) center. Flowers, colors and the cordiality of the locals gave life to a conversation between the community and the visitors, where community members shared their needs and expectations with the project and with the COHESION partner in Nepal, B.P Koirala Institute of Health Sciences. The team later returned to Dharan where the SNF Project Coordinator and Advisors provided feedback to the team, paving the way to the planning discussion that took place the following and last day.

The COHESION team is grateful for the feedback provided by the SNF representatives and by the Nepali stakeholders who joined the discussions. We are especially thankful to the Nepali community for the cordiality expressed during this site visit, for welcoming the Project, and to letting us experience your history and current reality.