Date post: | 23-Jan-2018 |
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Healthcare |
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HEALTH SYSTEM OF NEPAL
PRESENTED BY:
DR. S.M. JASHIM UDDIN RAZIB ;
MPH (Health Service Management and Policy)
Department of Public Health and Hospital
Administration
ABOUT NEPAL Nationality: Nepali, Nepalese, Gorkhali
Religions: Hindu 81.34%, Buddhist 9.04%, Muslim 4.38%, Kirant 3.04%, other
2.2% (2011 census).
Literacy: Total population: 48.6%
Population: 29,033,914
Median age:total: 23.6 years
Population growth rate: 1.24%
Birth rate: 19.9 births/1,000 population (2016 est.)
Death rate: 5.7 deaths/1,000 population (2016 est.)
Net migration rate: -1.9 migrant(s)/1,000 population (2016 est.)
Total fertility rate: 2.18 children born/woman (2016 est.)
Urbanization: urban population: 18.6% of total population (2015)
Sex ratio: total population: 0.99 male(s)/female (2016 est.)
Life expectancy at birth: total population: 70.7 years
Maternal mortality rate: 258 deaths/100,000 live births (2015 est.)
Background
The health system in Nepal is 122 years old and based on
primary health care approach
The Health System introduced as the General Health Plan
in 1956 has been expanded by focusing on primary health
care, and a comprehensive network-like Health System
has been developed
Health services are mixed –both government and non-
government (for profit and not for profit)
The Health Care Systems
Health Service Delivery
Community based health services and interventions-immunization (mobile clinics -every month), Vitamin A and albendazole distribution (twice a year) & primary health care out reach clinics (mobile clinics- every month) from local health facility
Female community health volunteers and mothers groups
Hospital and facility based services-general, specialized and mobile
Health Service Organization
Sub Health Post
Health Post
Primary Health Care Centre
District Hospital
General Hospitals- zonal and regional headquarters
National Hospitals
NGO and Private Health Institutions
Health Governance
Ministry of Health and Population (MoHP) consists of 3
departments:
Department of Health Services (DoHS),
Department of Ayurveda (DoA),
Department of Drug Administration (DDA)
5 Regional Health Directorates (RHDs) directly under MoHP
61 districts are managed by District Health Office (DHO) with
support of District Public Health Officer (DPHO), whereas the
remaining 14 districts are managed by DPHO solely
Facility level health/hospital management committees
Regulatory bodies like Nepal Medical Council (NMC),
Nursing council, etc.
Health Financing
Government of Nepal
Donors
Local bodies –increasing trend for last two years
International non-government organizations
7.2% budget in health sector in current financial year
Levels Of Health Care
Primary:
SHPs (Sub-Health Post) HPs (Health Post) PHCCs (Primary Health Care Centers)
Secondary:
District hospitals Zonal hospitals Regional hospitals
Tertiary:
Central hospitals Teaching hospitals
Referral System In Nepal
Major Policies and Initiatives
Health sector reform
Sector wide approach
Millennium development goal
Poverty reduction
Social inclusion
Nepal health partnership compact and international health partnership plus
Global health initiative
Health System Funding Platform
Major Health Programmes
Institutional delivery declared free with maternity incentive scheme
Introduction of Free Health Care (service charges abolished and essential drugs provided for free)
Cash support to poor patients suffering from cancer, heart disease, CKD, Alzheimer’s disease and Parkinson’s disease
Compulsory 2 years posting of physicians (completing MBBS course in government scholarship) outside Kathmandu
Community based neonatal care
Nutrition supplemental programme
Challenges
Climate change and health
Equity, accessibility, quality and coverage of essential health care services
Nutrition
Inter agency coordination
Sustainability of health programme
Reemerging and new emerging diseases
Deployment and retention of Human Resources for Health(HRH) in remote and rural areas
Increase in non-communicable diseases