Building a resilient health system

Everyone in Nepal has the right to access to quality, affordable healthcare, no matter who they are or where they live. As the country transitions to a federal model of governance, it is a vital opportunity for Nepal to build a resilient health system for the future.

The Nepal Health Sector Support Programme (NHSSP) is an initiative of the Nepal Federal Ministry of Health and Population (FMoHP), funded by UK Aid, to build a resilient health system and deliver quality health services in the federal context.

It supports the National Health Sector Strategy (NHSS) and provides technical assistance to the FMoHP, ministries of Social Development and Health in three selected provinces, 39 municipal Health Offices and the Department of Urban Development and Building Construction (DUDBC). Our experienced advisors are embedded within the government so they can work closely with counterparts at all levels to enhance institutional and individual capacities to deliver the NHSS and support the transition to federalisation.

The programme addresses three thematic areas which support the new subnational governments’ overarching priorities:

1. Leadership and Governance: improving health sector stewardship through improved policymaking, planning, procurement and financial management
2. Coverage and Quality: institutionalising sustainable quality assurance and improvement processes with access to quality basic healthcare services
3. Data for Decision-making: facilitating the use of high-quality data to enable decision-making.

Cutting across and supporting the above three areas are:

• Health infrastructure: retrofitting priority hospitals to be multi-hazard resilient, supporting integrated health infrastructure development planning, capacity enhancement and policy development.
• Gender, Equity and Social Inclusion: supporting the health sector to develop policies and implement strategies to address gender-based violence and reach marginalised and vulnerable groups.

NHSSP is improving quality of care and access to and use of services, so that no one is left behind. We are helping ensure evidence-based policy and planning at the national level leads to prioritisation of health service delivery at the local level. By combining robust global evidence with local insights, we help all levels of government to make effective and informed decisions.

We are also making essential systems and processes more efficient. Using a range of tools, we are increasing the capacity of national and sub-national governments to deliver sustainable public financial management and supporting streamlining of procurement practices.

Ensuring infrastructure can withstand natural disasters such as earthquakes is critical in a country like Nepal. We are building government capacity to ensure health facility construction is more resilient to future hazards. We are also overseeing the retrofitting of two major hospitals in Bhaktapur and Pokhara. 

Management and delivery of health services has been dominated by the COVID-19 pandemic since early 2020. In response to this, NHSSP has provided support and technical assistance to all levels of government, including provision of information tracking the evolution of the epidemic and its impact on key services, inputs into epidemic response policy and planning, and support to the procurement and distribution of vaccines and other essential commodities.

Results

• Getting the health system ready for devolution - supporting finalisation of structures for the devolved function of the health system, such as the Public Financial Management Strategic Framework (PFMSF), the Public Procurement Strategic Framework (PPSF), and roll-out of sub-national accounting systems.
• Development of the Safe Motherhood and Newborn Health Roadmap 2030 and the National Nursing and Midwifery Policy, Strategy & Costed Action Plan, to help Nepal accelerate its progress towards meeting the SDGs.
• Finalising the National Mental Health Strategy and Action Plan and the Geriatric Health Service Strategy and helping develop the Health Sector Gender Equality and Social Inclusion Strategy.
• Responding to COVID-19 by converting patient decanting spaces at the retrofitting sites (Western Regional Hospital, Pokhara and Bhaktapur Hospital) to COVID-19 Treatment Centres.
• Strengthening the Health Management Information System (HMIS) and the use of data for planning and management, by helping to introduce routine data quality monitoring mechanisms. We are now supporting the development of integrated health information systems.

NHSSP is implemented by a Nepali-led team which brings together technical expertise from Options, HERD International, and Oxford Policy Management.