Lack of coordination affecting health services: Experts

Kathmandu, Apr. 9: Health experts have highlighted the lack of coordination between concerned authorities in upgrading health sector and making the services qualitative and accessible to all.
The issue was raised by health experts gathered at a discussion organised by the National Planning Commission (NPC) on Friday on the topic “Nepal’s Health Sector: Challenges and Prospects”.
Speaking at the programme, Uma Shankar Prasad, a member of the NPC, said that there were several challenges – institutional, human resource, financial, material, research and innovation – in ensuring quality health services for all.

The NPC organised the programme to gather feedbacks from health professionals to form plans and policies in the future.
“We have a number of laws in health sector. It is the implementation sector where we have not been active,” said Dr. Krishna Prasad Paudel, chief at policy planning and monitor division at the Ministry of Health and Population (MoHP).

“The out-of-pocket expenditure in availing health services should be addressed properly because the people are getting poorer. The health insurance scheme must be made mandatory and a multisectoral approach is required,” said Dr. Paudel.

Informing that the government had taken initiative to construct either 5/ 10 or 15-bed hospitals in all the municipalities, Dr. Roshan Pokhrel, secretary at MoHP, argued that the required manpower to operate those hospitals were not prepared.

“Different ministries in the federal government alongside the authorities in provincial and local levels coordinated effectively during the COVID-19 pandemic. But as the days turned normal, the coordination started fading again,” said Dr. Pokhrel.

He also highlighted the issues related with conflict in the ministerial level and the coordination between one another.
“The priority of the Ministry of Women, Children and Senior Citizens and MoHP is similar but we don’t have a single coordination,” Dr. Pokhrel said.

Health experts have also stressed the need of improving and upgrading services from the district hospitals and providing basic health services from municipal hospitals.
“District hospitals are the backbone of country’s health system. Upgrading the district hospitals to provide high-level health services will provide effective result in the country’s overall health sector,” said Dr. Bhagwan Koirala, chairman of Nepal Medical Council.

“Only structures don’t provide health services, we need quality and enough manpower. We have also failed to conduct effective inspection of health institutions regarding the services they have been providing. Health sectors should be more responsible,” said Dr. Koirala.

The experts also raised problems in budget allocation for health sector.
“The Tribhuvan University Teaching Hospital (TUTH) was allocated a budget of Rs. 130 million for the current fiscal year. What services does the government expect from that amount?” said Dr. Dinesh Kafle, executive director at TUTH.

Speaking at the discussion, Dr. Ram Kewal Shah, vice chancellor at Madhesh Institute of Health Sciences, said, “The government has at least prioritised the tertiary hospitals in Kathmandu, but the ones outside are always forgotten.”
Jyoti Baniya, chairperson of Forum for Protection of Consumer Right Nepal, urged the government to make health services non-profitable and address the voices of the public while outlining plans and policies.

“We still have problem of referring patients to Kathmandu from every corners of the country but they don’t get a bed after arriving here. We have failed to upgrade our health sector. The investment in health should increase,” said Gagan Thapa, a former health minister and general secretary of Nepali Congress.

Suggesting that a multi-sectoral approach was a must to develop the country’s health sector, Dr. Rajesh Sambhajirao Pandav, World Health Organisation’s Representative for Nepal, said that the ministries should work together by identifying common goals and benefits.

“Private sectors invest not only for profit. We love to coordinate with the government bodies in helping the society but we are not utilised properly, said Upendra Mahato, chairperson of Mediciti Hospital.
The members of the NPC informed that the suggestions and feedbacks from the discussion would be forwarded to the ministries and addressed while forming further plans and policies.