Introduction: Diagnostic radiology services are severely lacking in many rural settings and the implementation
of these services poses complex challenges. The purpose of this paper is to describe the implementation of
diagnostic radiology services at a district-level hospital in Achham, a rural district in Nepal.
Methods and Materials: We conducted a retrospective review of the implementation of diagnostic radiology
services. We compiled a list of implementation challenges and proposed solutions based on an internal review
of historical data, hospital records, and the experiences of hospital staff members. We used a seven-domain
analytic framework to structure our discussion of these challenges.