Motorbike traffic in Kathmandu
MannionDaniels have been contracted by HEART (Health and Education Advice and Resource Team – funded by DfID and managed by Oxford Policy Management) to participate in a Mid-Term Review of Nepal’s second Health Sector Programme (NHSP II). This is a 5 year programme whose wide-reaching aims include:
- Improved sector management
- Improved service delivery
- Improved health governance and financial management
- Reduced cultural and economic barriers to accessing health care services
- Strengthened human resources for health
- Increased health knowledge and awareness
- Improved M&E and health information systems
- Improved physical assets and logistics management
- Improved sustainable health financing
This project has involved a team of 9 consultants, working alongside the Nepalese Ministry of Health and Population. During their trips to Kathmandu and Biratnagar, the team have visited health facilities, talked to district health workers, and looked at private sector facilities and pharmacies to measure the progress made in implementing strategies.
Dr Narmeen Hamid, a member of the team evaluating the improvement of health service provision, finds:
“Despite the challenges of political instability, a long conflict and resource constraints, Nepal has managed to make great strides in the health sector. Bringing in the experience from another developing South Asian country, Pakistan, it was interesting to see the completely different way health is prioritized in Nepal with a much higher budget allocation, emphasis on primary rather than tertiary care and constitutional commitments to free basic health, and yet how both countries also face similar pitfalls of aid management, over-centralization and inequities that pose serious challenges to the delivery of effective health care to the people”.
Another aspect of the health sector being evaluated by the review is gender equity and social inclusion (GESI). Dr Poonam Thapa, a member of the team evaluating GESI, explains its current position and importance:
“GESI institutional mainstreaming is still far from being well integrated with service delivery and quality of care. The lack of full implementation of Human Resources for Health (which is actually GESI sensitive) remains the weakest link in the system. There is hope, in that some critical training programmes are being adapted, pro-poor targeted programmes are slowly but surely being expanded and GESI operational guidelines introduced. If planning and management are even more serious about GESI, Nepal could be much closer to achieving most of the MDG targets by 2015 even in the face of current cut backs in public health investment. GESI cannot remain an option on the side for health because the full achievement of it is a necessity for the people of Nepal.”
The team, led by David Daniels, presented its findings to the Nepalese government and development partners in late January 2013.