See More on Facebook

Culture and society, Current affairs

Nepal needs to ensure quality healthcare

Nepal will struggle to achieve SDGs and universal health coverage without ensuring quality health care, experts say.


Written by

Updated: June 10, 2019

In October 2017, Nepal’s Parliament passed a landmark bill to ensure health care for all.

Mandatory health insurance for the citizens is the major provision of the Health Insurance Bill, which in Clause 21 states that it will consider each household as a unit and all family members must enrol themselves in the programme.

But for a country to achieve universal health coverage, it must put several factors in place–affordability, availability of essential medicines and technologies to diagnose and treat ailments, sufficient capacity of well-trained health workers and above all a strong and efficient health system.

But a recent study puts a spotlight on the country’s fragile health system. It has taken the birthing centres into consideration.

More than 70 percent women of Kaski district bypassed their nearest birth centres in favour of facilities with “adequate drugs and equipment” and “competent health staff”, according to the study.

The trend of bypassing nearby health facilities shows that health facilities are ill-equipped, their service quality is not up to the mark and they lack essential medicines and competent health workers.

These inadequacies reflect an obvious, but largely neglected breach in Nepal’s health system, according to a report published by the Lancet Global Health Commission’s recently.

“The Lancet report is an eye-opener for our policymakers about Nepal’s health care services,” said Mahendra Prasad Shrestha, spokesperson for the Ministry of Health and Population.

According to Shrestha, ineffective health care system will largely affect Nepal’s efforts to meet the Sustainable Development Goals.

“We cannot achieve SDG targets without improving the quality of our health services,” he said.

Nepal needs to reduce the maternal mortality rate, which stands at 239 per 100,000 live births, to 70 by 2030, while the country needs to bring neonatal deaths to 12 per 1,000 from the existing 21 and under-five mortality to 25 per 1,000 from the existing 39 to meet the targets.

Low quality health care increases the burden of illness and health costs.

Only by strengthening the health care system can Nepal achieve SDG targets and universal health coverage, experts and analysts say.

Gagan Kumar Thapa, a lawmaker from the Nepali Congress, who during his stint as the health minister lobbied strongly for the universal health coverage, said: “Lack of access to health care facilities and lack of services at those facilities are the same things.”

“It’s high time we set our priorities right when it comes to health care,” he said. “The country must ensure quality care and patient’s satisfaction while designing the health care facilities,” Thapa, who is also a member of the Lancet Global Health Commission, told the Post.

Nepal was one of the nine national commissions that participated in the “Lancet Global Health Commission on High Quality Health System in the Sustainable Development Goal (SDGs) era”.

“Only those who cannot afford private care or afford to go to cities or abroad have been receiving treatment at government health facilities,” said Dr Baburam Marasaini, former director of the Epidemiology and Disease Control Division. “But the government has hardly invested in strengthening health care facilities and ensuring quality care. This will certainly mean we will fall short of meeting our national commitments and global targets.”

The World Health Organisation recommends 21 health workers per 10,000 people, but in Nepal there are only seven health workers available for a population of 10,000.

There are a little over 1,300 doctors serving in government health facilities–central level hospitals, zonal hospitals, district hospitals, and primary health care centers.

The National Demographic Health Survey 2016 shows only around a half of the health facilities in Nepal provide normal vaginal delivery services. Just over one third of facilities that offer normal vaginal delivery service had at least one staff member who had received relevant in-service training in the preceding 24 months.

Six out of 10 facilities that offer normal vaginal delivery care have emergency transport available.

On an average, 11 percent of the facilities had all medicines regarded as essential for delivery care. A majority of health care facilities even lack blood pressure apparatus, weighing scale and stethoscope.

“Why would one put their life at risk?,” said Thapa, when asked about people bypassing the nearest health facilities. “Only when the state ensures quality health care and trained doctors for their services will people visit health facilities near them,” said Thapa, stressing the need to invest more to strengthen the country’s health care system.

The Lancet report also highlights the shortcomings in the existing model of predominantly disease-centric, donor-driven and vertical programming which it says undermine the government’s capacity and responsibility towards ensuring that people have access to high-quality comprehensive health care.

“Poor care not only jeopardises the health of individuals; it erodes trust and puts the entire health system at risk,” reads the report.

SDGs and universal health coverage both aim at ensuring health care services to all, especially the ones who are the most vulnerable and to achieve both, the only way is setting up a strong and effective health care system.

Professor Bhagwan Koirala, a cardiothoracic surgeon at Manmohan Cardiothoracic Vascular and Transplant Centre, said the focus should be on multi-dimensional aspects to ensure quality care.

“For that, we should ensure quality products–quality of doctors, quality of medicines, quality of infrastructures,” said Koirala. “We need to make our health workers and health facilities competent, monitor them on a regular basis, and make all the people involved accountable.”



Enjoyed this story? Share it.


The Kathmandu Post
About the Author: The Kathmandu Post was Nepal’s first privately owned English broadsheet daily and is currently the country's leading English-language newspaper.

Eastern Briefings

All you need to know about Asia


Our Eastern Briefings Newsletter presents curated stories from 22 Asian newspapers from South, Southeast and Northeast Asia.

Sign up and stay updated with the latest news.



By providing us with your email address, you agree to our Privacy Policy and Terms of Service.

View Today's Newsletter Here

Culture and society, Current affairs

MH17 probe releases new phone calls linking suspects to top Russians

With contributions by AFP. A Dutch-led probe into the shooting-down of flight MH17 over Ukraine in 2014 released new intercepted phone calls on Thursday (Nov 14) between high-ranking Russian officials and suspects facing trial over the crash. Investigators said they were making a “new witness appeal” based on “recorded telephone calls between the leaders of the DPR (Donetsk People’s Republic, a separatist group) and high-ranking Russian officials.” “Ties between Russian officials and DPR leaders appear to have been much closer” than originally believed, Mr Andy Kraag, the head of Dutch police’s Criminal Investigations Division, said in a video statement. Investigators said in June that they were going to put three Rus


By Cod Satrusayang
November 15, 2019

Culture and society, Current affairs

Bangladesh charges 25 in student’s death

‘They sought to strike terror into students’. The accused in Buet student Abrar Fahad murder case had turned so rowdy that they often tortured general students to establish a reign of terror on the campus. Their efforts to create terror resulted in Abrar killing, DMP Additional Commissioner Monirul Islam said as police pressed charges against 25 Buet students, mostly leaders and activists of the university’s BCL unit, in the case yesterday. The move came 37 days after Abrar, a second year student of electrical


By Daily Star
November 14, 2019

Culture and society, Current affairs

Five years later, prosecutorial probe kicks off into Sewol ferry sinking

For some families, it is too little, too late. The Supreme Prosecutors’ Office on Monday launched a special investigation unit to probe allegations surrounding the sinking of the Sewol ferry in 2014. During a press briefing at the Seoul Central District Prosecutors’ Office, the unit said it is “committed to making its probe so thorough that it will be the last one to be conducted into the Sewol sinking.” The unit will take on investigations conducted by a provisional state commission formed in January 2015 with a fact-finding mission on the Sewol case. This is the prosecution’s first organized effort concerning the disaster from over five years ago. On April 16, 2014, the 6,825-ton ferry with a passenger capacity of 921 sank off the coast of South Jeolla Province en route to Jeju Island, killing over 300 people, mostly children. The 18-member prosecution unit is headed by


By The Korea Herald
November 12, 2019

Culture and society, Current affairs

Ayodhya verdict is silent on why Muslims must prove exclusive possession of site

The Indian court has deprived Muslims of the disputed plot because they couldn’t show exclusive possession before 1857. On page 215 of the Ayodhya-Babri Masjid verdict, delivered by a five-judge bench on Saturday, the Supreme Court makes a crucial statement of logic: “It is true that in matters of faith and belief, the absence of evidence may not be evidence of absence.” But in its final findings, the court contradicted this same logic. The crux of the judgment that India has awaited since 1949 is that Muslims failed to show unimpeded possession of the disputed site in Ayodhya between 1528, when the mosque was supposedly built by Mughal emperor Babur, and 1857, when, after a clash between Muslims and Hindus, a railing was erected between the inner and outer courtyards at the disputed site. The inner courtyard is where the mosque demolished by Hindutva mobs in 1992 stood. The outer courtyard has se


By Dawn
November 12, 2019

Culture and society, Current affairs

The government has undermined education

A core value for a country to develop, the federal govenrment must make amends. The High-Level National Education Commission was formed in 2018 to recommend steps to better the country’s education system. After much criticism regarding the secrecy surrounding the findings of the commission, the Education Ministry finally, made public portions of the new education policy. But it seems all is still not well. Analysts and commission members were quick to point out that the new policy has disregarded almost all of the commission’s recommendations, mainly the part where private schools were required to be transformed from ‘for-profit’ to ‘not-for-profit’. Findings of the commission are important documents that ne


By The Kathmandu Post
November 11, 2019

Culture and society, Current affairs

Egypt backs China’s quest to repatriate its artifacts

Egypt has brought back artifacts from western museums under the current government. Egypt’s minister for antiquities said his country supports China’s efforts to repatriate its historical artifacts from around the world, as countries with a rich cultural heritage have a duty to future generations to safeguard these items for their own people and humanity as a whole. Khaled El-Enany spoke to China Daily at the launch of the exhibition Tutankhamun: Treasures of the Golden Pharaoh, which opened on Saturday and will run at London’s Saatchi Gallery until May 3. The exhibition coincides with the 97th anniversary of the discovery of the tomb on Nov 4, 1922, by an expedition led by British historian Howard Carter.


By China Daily
November 6, 2019