The purpose of this paper is to identify the strategies for developing and unlocking the professional capability and capacity of senior hospital managers in Nepal. This research is the first published study outlining the self-perspectives of Nepalese senior hospital managers on their capability and capacity development. The study utilised a qualitative descriptive design as the second phase of a larger sequential mixed methods research project. Data were collected from 11 senior hospital managers through semi-structured interviews conducted online via the Zoom online videoconferencing platform between August to October 2024. Four key themes identified were: Stability, continuity and coherence; Practical and logistical constraints; Interference, conflict and control; and managing the mismatch between ability and expectations. Findings highlight breakages in work roles and pervasiveness of political and opportunistic individual actions alongside complex and lengthy bureaucratic processes that stifled senior public hospital managers working roles. Along with well-organised administrative procedures, appropriate compliance training for senior hospital managers is sought essential. Findings from this study may be broadly applicable to other under resourced countries in the Asia Pacific region.
Objective: This study investigates the common characteristics of countries with high happiness index scores using a cluster analysis of 20 nations. Design: The study is an ecological study where the unit of observation is the population in a country. Setting: Data were drawn from the World Happiness Report, World Bank, WHO, and World Population Review (2023–2025). Main outcome measures: The study focused on five variables: social support, GDP per capita, healthy life expectancy, crude death rate, and health expenditure. Results: Results revealed that countries in higher-performing clusters exhibited consistently strong social support systems, moderate to high GDP per capita, high healthy life expectancy, moderate crude death rates, and substantial public health spending. Among these factors, social support emerged as the most influential determinant, aligning with recent literature emphasizing the psychological and societal benefits of strong interpersonal networks. GDP alone was not a sufficient predictor of happiness; countries with high economic output but lower investment in health and social infrastructure ranked lower in overall well-being. Conclusions: This study demonstrates that countries with high happiness cannot be characterized by economic prosperity alone. The cluster analysis showed that high happiness may coexist with different combinations of economic, social, and health conditions. The study therefore characterizes countries with high Happiness Index scores as heterogeneous rather than uniform.
