Nepal is home to many different ethnic groups; there are more than 100 indigenous languages [28,29]. The translation of all these instruments into multiple languages would be not only enormously resource-consuming but also of questionable value, because every translation would need validating and it was doubtful that the means to do this existed. Nepali is the lingua franca among the different ethno-linguistic groups [28,29], and the official language of Nepal, used in national surveys [15,30,14]. We believe the pragmatic decision to conduct the survey in Nepali was sensible, and vindicated by the participation rate of 99.6%.