Shaking the foundations: co-creating knowledge exchange to inform alcohol research, policy, and practice in Nepal

Alcohol has complex, historic, and deep cultural significance in Nepal. Countries from the global majority, such as Nepal, experience the highest burden of harm from alcohol with increasing consumption rates compared with high-income countries. Therefore, alcohol harm reduction initiatives that engage meaningfully with cultural and community practices are needed. The Alcohol Co-design and Community Engagement (ACE) study aimed to co-create new understanding of harmful use of alcohol through applying creative and participatory approaches to inform future alcohol research and policy in Nepal. This article reports on the creative methodological process used to co-create knowledge exchange with diverse communities, co-researchers, and policy makers in Nepal. We co-produced a range of creative alcohol policy review activities, including scoping community and cultural assets that could be harnessed to reduce harmful use of alcohol by working with communities, including those with lived experience. This allowed us to understand the nature of any existing health and community support available locally, while highlighting the absence of much-needed support. We achieved this through using multi-modal, participatory approaches to critically review current policy and explored other forms of knowledge – centring indigenous knowledge – for its cultural and contextual relevance to reduce harmful use of alcohol and make recommendations for alcohol research and policy development and implementation in Nepal.