Document Type


Publication Title

Technology and Innovation


Cognizant Communication Corporation

Publication Date



Nepalese agropastoralists’ confrontations with forces of change in the last generation have altered villagers’ abilities to gain access to health services, clean water, and nutrition in Humla District, Nepal. Development efforts and Nepal’s recent armed conflict, in particular, introduced novel technologies and ideologies that a subsection of villagers have responded to in a fashion that we did not expect. In this article, based on theories about the diffusion of innovation and risk, we argue that, together, villagers and other change agents have cocreated new contexts of vulnerability in the postconflict setting of rural Nepal, as observed in remote Humla District. Using ArcGIS to represent landscapes of health and health-seeking behavior, we explore the integration of neoliberal health development in this postconflict setting in which medical pluralism, caste, Hinduism, and cultural conservatism all shape decision making. Based on in-depth and long-term research conducted in the region over the past 15 years, we describe the strengths and weaknesses of GIS as a tool for enhancing our understanding of this “health landscape.” In Humla, topography is a major determinant of access to healthcare. Our analyses reveal interesting relationships among health, culture, and vulnerability and provide insight into directions for future health interventions in similar contexts elsewhere.




©2013 Cognizant Communication Corporation

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