Context
The German Federal Ministry for Economic Cooperation and Development (BMZ) has been supporting the development of the Nepalese health sector since 1994. Significant progress has been made, such as the substantial reduction in maternal and infant mortality.
Currently the programme is focused on improving the quality of maternity services to ensure safe delivery, and on promoting access to sexual and reproductive health services for adolescents. The Programme also supports the implementation of national health insurance for equitable health financing and HIV prevention for the high-risk group of injecting drug users.
Objective
The use of improved health services by pregnant women, mothers, adolescents and injecting drug users is increased.
Approach
The second Nepal Health Sector Programme (NSHPII) 2010-2015, which was designed and is now being implemented jointly by the Ministry of Health and Population and its development partners, provides the framework for cooperation in the health sector. NSHPII contributes to achieving the Millennium Development Goals, in particular the goals of eradicating poverty, reducing child mortality, improving maternal health and combating HIV/AIDS.
HSSP provides advice and support to the Ministry of Health and Population as well as to district health authorities and the staff of medical facilities, primarily in the less-favoured Mid-Western and Far-Western Regions, through four fields of activity:
Improved quality of medical care, especially for pregnant women and newborns
Improved access to reproductive health services for young People
Capacity development for effective health financing and national health insurance
Improved access and quality of medical and psychosocial services for injecting drug users (harm-reduction)
The Programme cooperates closely with South Korea through a co-financing agreement. Other important partners are the German KfW Development Bank, USA, Great Britain, the World Bank, the World Health Organization (WHO) and the United Nations Population Fund (UNFPA).
Results achieved so far
Health services. The government used its own resources to carry out ‘social audits’ in 149 of 483 health facilities in the targeted districts in 2013. These audits foster citizen participation and help to raise additional funds for the health service. In addition a quality management system has been implemented in 356 health facilities, to help to improve their services.
Adolescent sexual and reproductive health. Adolescent friendly health services were regarded as an innovation not so long ago. They are now increasingly seen as an essential part of government health services and are also supported by other development partners. Adolescents can now obtain advice and treatment for sexual and reproductive health issues in nearly 1,200 health facilities across the country.
Health financing. The Programme has made a significant contribution to the debate over health financing and social protection in case of illness; this has resulted in the adoption in 2014, of a policy decision to introduce national health insurance. Now the related legislation is being drafted.
Harm reduction. The government is setting up the national opioid substitution therapy programme in selected provincial and district hospitals, thereby considerably improving health care services.