Design and implementation of edutainment-based school intervention to improve knowledge of acute rheumatic fever and rheumatic heart disease among school-going children in Nepal

Rheumatic heart disease (RHD), a preventable yet life-threatening condition, remains a major public health concern in Nepal, particularly among children. Despite the availability of early treatment for acute rheumatic fever (ARF), limited awareness and inadequate access to healthcare contribute to the ongoing burden of RHD. School-based educational interventions that are age-appropriate, engaging, and culturally relevant are essential for strengthening early prevention efforts. This paper describes the design, development, and early implementation of an ongoing edutainment-based, school-based intervention aimed at improving knowledge of ARF and RHD among school-going children in Nepal. A quasi-experimental pretest–posttest design with a waitlist control group is being implemented across twelve public schools in six districts. Schoolchildren from grades six to nine are exposed to a structured edutainment package comprising colouring books, activity books, educational videos, and interactive classroom sessions tailored according to grade level. Knowledge is assessed using a 14-item structured questionnaire administered at baseline and end line. The planned analytical approach includes descriptive and inferential statistics, including paired t-tests and logistic regression models at 5% level of significance. By detailing the design and implementation framework of an ongoing intervention, this paper provides a reproducible and adaptable methodological model for edutainment-based school health programs in low-resource settings. The approach offers practical guidance for future implementation and scale-up, particularly for improving child health literacy related to ARF and RHD in Nepal and similar contexts. Clinical Trials.gov NCT07065474. Ethical approval has been obtained from the Institutional Review Board of the Nepal Health Research Council (REF: 2678, Protocol No: 152_2025).