**Background:** Nepal is a developing country in South-East Asia with significant health disparities, particularly among children. This literature review aims to identify health issues and inequities faced by school-aged children (5–18 years) in Nepal and propose interventions to enhance their quality of life. The review covers diarrheal illness, stunted growth, dental caries, visual impairment, poor mental health, reproductive health challenges, and low health literacy.
**Methods:** A comprehensive search was conducted in PubMed and Global Health databases in April 2021, including articles published from 2016 onward. Search concepts included 'Nepal,' 'health,' and 'youth.' The initial search yielded 294 articles. After applying inclusion criteria (Nepalese school-aged children 5–18 years), 225 titles were excluded, 69 abstracts were reviewed, and 34 full-length articles were analyzed in-depth. No further articles were excluded during full-text review.
**Key Results:**
- **Diarrheal illness:** 7% of deaths in school-aged children in low-middle income countries (including Nepal) are associated with diarrheal diseases, with 96% attributed to unsafe water, inadequate sanitation, and poor hygiene (WASH). A cross-sectional study in Kathmandu Valley found 13.7% of 196 children under 15 tested positive for parasitic infections. Neurocysticercosis caused 16.9% of seizure disorders in children (mean age 9.7 years) at Manipal Teaching Hospital. WASH problems caused 19% of child mortality worldwide and 3,500 child deaths annually in Nepal. A water quality study of 800 children from 16 schools found 86% of households did not use treated water, and 12% of students did not practice basic hygiene. In Dolakha and Ramechhap districts, over 50% of families had inadequate waste disposal, 77% of water samples were contaminated, and intestinal parasitic infection prevalence was approximately 40%. A WASH intervention group showed decreased stunting and anemia with improved hygiene practices. Another school health program demonstrated significantly lower prevalence of infectious diarrhea and dysentery after one year.
- **Stunted growth:** The Nepal Demographic and Health Survey (1996–2016) reported 36% of children under five were stunted, 12% severely stunted, 10% wasted, 2% severely wasted, 27% underweight, and 5% severely underweight. Only 1% were overweight. Stunting declined between 2011 and 2016, with the highest decline in households where mothers had some primary education. Anemia among adolescent females aged 15–19 rose from 38.5% in 2011 to 43.6% in 2016. Young adolescent girls (10–14.9 years) had the highest prevalence of being underweight (45%), while adolescent mothers (15–19.9 years) had the lowest (19%). Anemia was statistically higher in adolescent mothers (29%).
- **Dental caries:** A descriptive cross-sectional study in a private school (n=356) found dental caries were the most prevalent morbidity. Another study across 18 districts (n=1,135) in 5–6, 12, and 15-year-olds found poor diet associated with poor dental hygiene and increased caries; both underweight and overweight BMI were related to poor diet. A positive association was identified between higher caries quantity and lower oral health-related quality of life, lower school performance, and higher absenteeism in the Newari ethnic group.
- **Visual impairment:** Evaluation of 778 students in integrated schools found 85.9% were blind, 10% had severe visual impairment, and 4.1% were visually impaired. Of those blind, 40.9% had potentially avoidable causes (23.1% preventable, 17.8% treatable). Preventable causes included corneal blindness due to vitamin A deficiency, measles, and harmful traditional eye practices. Treatable causes included cataracts and glaucoma. The VISION 2020 initiative reported a reduction in blindness prevalence from 0.84% to 0.35%.
- **Poor mental health:** A 2019 survey of 6,531 students in 74 schools found 50.7% experienced bullying in the last 30 days, approximately 14% reported suicidal ideation or plan, and 11% attempted suicide. Bullied children were at five times increased risk of substance abuse and 11 times increased risk of physical violence. Post-earthquake PTSD rates in Kathmandu district were 10.7% and 51%. Child soldiers had PTSD rates of 55.3% vs. 20% in non-child soldiers; depression symptoms in 53.2% vs. 24.1%; anxiety symptoms in 46.1% vs. 37.6%.
- **Reproductive health:** Among 1,342 adolescent females, more than half viewed menstruation as a 'bother' or 'curse.' 89% reported restrictions during menstruation, but 60% reported positive menstrual health attitudes. Only 5% of girls had ever visited an adolescent-friendly health service. A sexual health knowledge assessment showed adolescents were interested in sex but faced communication gaps with parents and teachers.
**Clinical Implications:** The review highlights the need for multi-level interventions including WASH programs, nutrition education, school gardens, deworming, vision screenings, mental health support, and comprehensive sex education. Addressing stigmas, improving maternal literacy, and fostering open communication between parents, schools, and adolescents are crucial. Sustainable interventions focusing on prevention can improve health outcomes and quality of life for Nepalese youth.