Data (in the form of paper records) was collected from 23 health centres in rural areas of Nepal, totalling 33,860 records of individual patient contacts for children under 5 years of age. The format of the record books follows the WHO (Nepal) guidance on Community Based - Integrated Management of Neonatal and Childhood Illness (IMNCI). The data included on the forms includes the following information on all children under 5: unique identifier, date of visit, child’s sex, age, ethnicity/caste, weight, temperature, symptoms of general danger signs, symptoms of acute respiratory infection (including respiratory rate), diarrhoea and dehydration symptoms, symptoms for fever and ear infections, mid upper arm circumference (MUAC) measurements, assessment of nutritional status, classification for one major diagnosis, medicine prescribed (name of medicine), follow up plan, and condition of child on the date of follow up.This project aims to increase academic understanding, and develop appropriate options for responding to, inequalities in health and healthcare amongst under-5 children in remote rural areas of Nepal. These continuing inequalities represent a significant challenge for Nepal's efforts to promote social and economic development and meet the SDG targets. Whilst it is widely known that a variety of social and geographic factors contribute to determining health outcomes (including gender, caste/ethnicity and region), the currently available data lacks the degree of granularity to enable a robust exploration of the relationships between these various forms of inequality and i) health status; ii) utilisation of health services; and iii) quality/appropriateness of treatment received. Whilst the existing data published by the Government of Nepal is available only in an aggregated format, PHASE Nepal - a high-profile and highly-respected NGO that supports government health facilities in some of the most remote areas of the country - has circa 50,000 records of health facility visits by under-5s that have not previously been analysed as they currently exist only in paper format. The project proposed here will allow, for the first time, for the digitisation and rigorous analysis of this individual patient-level data to further understand inequalities and to address a series of Research Questions related to the country's social and geographic inequalities: RQ1: How do geography, age, gender, ethnicity and caste affect the nutrition status of under-5 children presenting in remote health facilities of Nepal? RQ2: Is diagnosis and treatment for malnutrition affected by geography, and child's age, gender, ethnicity and caste? RQ3: How do geography, and child's age, gender, ethnicity and caste affect health-seeking behaviours and utilisation of health services? RQ4: How do geography, and child's age, gender, ethnicity and caste affect the treatment that under-5s receive at health centres?

Data (in the form of paper records) was collected from 23 health centres, totalling 33,860 records of individual patient contacts for children under 5 years of age. The format of the record books follows the WHO (Nepal) guidance on Community Based - Integrated Management of Neonatal and Childhood Illness (IMNCI). The data included on the forms includes the following information on all children under 5: unique identifier, date of visit, child’s sex, age, ethnicity/caste, weight, temperature, symptoms of general danger signs, symptoms of acute respiratory infection (including respiratory rate), diarrhoea and dehydration symptoms, symptoms for fever and ear infections, mid upper arm circumference (MUAC) measurements, assessment of nutritional status, classification for one major diagnosis, medicine prescribed (name of medicine), follow up plan, and condition of child on the date of follow up. Research Assistants visited each of these centres to collect the data. The paper records were either digitally photographed and transported on secure electronic media to the PHASE Nepal office in the Kathmandu valley, or the books themselves were taken to the PHASE Nepal office, photocopied, and later returned to the health centres. Sampling procedure: This project was funded by the GCRF NGO Secondary Data Initiative, with the aim of making available data held by NGOs. The research was carried out with the project partner PHASE Nepal (https://phasenepal.org), a Nepali NGO specialising in health, education and livelihoods. The data digitised and archived in this collection (c.34,000 IMNCI records) is from the health posts run or supported by PHASE Nepal: a total of 23 health posts spread across 5 Districts. The sampling method was therefore based on the presence of PHASE Nepal in these particular health posts, rather than a nationally representative sample. The health posts themselves are in rural areas, given that PHASE specialises in providing community-level services in places where government services are either absent or weak. They are all in the Hill and Mountain areas of Nepal (not the Terai).