Supporting the health sector in Nepal

Project description

Title: Support to the Health Sector Programme (S2HSP) in Nepal
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Co-funded by: Save the Children
Country: Nepal
Lead executing agency: Ministry of Health
Overall term: 2016 to 2021

Context

Over the past decades Nepal has made significant progress in improving the health of its population, however some systemic deficits persist. These include a lack of efficiency and effectiveness in the newly federalised health system, insufficient social protection in cases of illness, and incomplete data to guide decision-making. Access to quality health services is still inadequate among large segments of the population. The COVID-19 pandemic has exacerbated these challenges.

Objective

The people of Nepal are gaining more equitable access to health services. 

Approach

The project is closely aligned with the Nepal Health Sector Strategy (2015–2020). It advises national authorities on the design of health reforms and supports implementation in selected municipalities and provinces. The project concentrates on five fields of activity:

  • Implementing social health protection 
  • Improving the availability of qualified human resources 
  • Improving governance in health 
  • Digitalising health information systems and work processes
  • Promoting adolescent health 

It also supports the Government of Nepal’s response to the COVID-19 pandemic.

The project cooperates closely with Save the Children/The Global Fund to Fight AIDS, Tuberculosis and Malaria through a co-financing arrangement. Other important partners are the KfW Development Bank, the International Labour Organization (ILO), the United Nations Population Fund (UNFPA) and the World Health Organization (WHO). Bournemouth University, Liverpool School of Tropical Medicine and Hygiene, and Médecins du Monde support the implementation of the project.

Results

The following results have been achieved:

1.    Expansion of social health protection 
National Health Insurance has been introduced in 56 of Nepal’s 77 districts. More than 1.9 million people are insured, 52 per cent of whom are women. More than 166,000 formal sector employees have health and accident insurance through the Social Security Fund.

2.    Introduction of midwifery as a profession
Three universities have established Bachelor and Masters programmes for midwifery education; 113 students are enrolled. The first cohort of 14 midwives graduated in 2020. Two new training programmes are being introduced to allow auxiliary nurse midwives and nurses to re-train as midwives.

3.    Strengthened health management 
Provincial and local governments now manage to provide essential health services better under the new federal system. Policies, regulations, standards and guidelines have been developed, endorsed and incorporated at the sub-national level, particularly in the area of healthcare waste management. Integrated healthcare waste management systems have been supported at the provincial and local levels. 

4.    Harmonised health information systems
Digitalisation has improved the availability of systematically collected data for monitoring progress towards the sustainable development goals. Five existing health information systems are functionally linked to the District Health Information Software 2 (DHIS2) platform; National Health Insurance is administered using open source Insurance Management Information System openIMIS). Twenty-three per cent of Nepal’s 4,890 public health facilities are able to electronically report routine health data.

5.    Improved menstrual health services 
The national MenstruAction summit and MHM Practitioners Alliance have focused attention on menstrual health management (MHM). More than 300 teachers and health service providers have been capacitated as MHM trainers, while more than 13,500 girls have taken part in school health sessions on MHM. Over 4,000 girls benefit from upgraded female-friendly toilets and more than 18,000 girls have access to free sanitary pads in their schools.

6.    Rapid support for Nepal’s COVID-19 response
Twenty-three thousand molecular tests and reagents were provided to the National Public Health Laboratory. Thirteen COVID-19 hub hospitals are being refurbished with healthcare waste treatment centres and laundries. Personal protective equipment, soap, disinfectant and cleaning supplies have improved infection prevention and control systems. More than 100 healthcare waste workers have been trained on safe healthcare waste management practices.

Last update: February 2021