In Dolakha, we took a path of a partnership between the government and a non-government entity to lay the foundation of accessible healthcare for all. Ultimately, it is the government’s responsibility to ensure healthcare for all, and partnerships like these are useful to jump-start the process. Nepal has established itself as a modern progressive and welfare state, with the Constitution pledging to make basic healthcare a fundamental right of all citizens. This handover proves that strengthening healthcare is possible only through a multi-dimensional partnership with short-term support, innovation in healthcare delivery and management, long-term planning and resource management. The municipality has set up an inter-municipal fund to ensure access to care, particularly for the underprivileged at Charikot Hospital, which is providing services also as a referral hospital for the surrounding municipalities and districts. The federal or provincial governments need to manage the necessary Rs2.5 million per month for specialist care, which are beyond the coverage of basic health services. Specialist services with consultants have also been arranged keeping in view the needs of the patients. Nyaya Health, in turn can use data from the hospital for research, including for ongoing projects. Under the terms of the handover, Nyaya Health Nepal transferred to Bhimeswar Municipality all fixed assets and consumables worth Rs62.67 million, its digital systems, and the ownership of all data collected for service management and quality improvement.Įven after the handover, Nyaya Health Nepal will continue back stopping the Municipality in some areas like technical assistance in managing the Electronic Health Record (EHR), monitoring and evaluation, and service improvement till the end of this fiscal year. Dolakha’s health care system thus literally ‘built back better’ after the earthquake. This has increased access to health care, and raised the health status of the local population. Under Nepal’s federal structure, every municipality is allotted a budget specifically to improve the local health system. Recently, the Bagmati Province government declared Charikot Hospital a ‘provincial hospital’ and this paved the way for additional local investment from the continuity of ongoing services. What was unique was that the Government of Nepal and Nyaya Health Nepal both invested in strengthening healthcare during the partnership period – the government with a community hospital grant, medicine and equipment, human resources and Nyaya Health put in $6.8 million and managed treatment and care in the hospital. The government’s readiness to adopt innovations that have been put in place through the partnership is unique, and unprecedented. The organisation was building on its experience in Achham where it manages Bayalpata Hospital under a similar partnership model since 2009.Īlthough there are other similar activities in Nepal’s public health sector, especially in the distribution of healthcare products, there are only a handful examples of partnerships that are for overall management of health institutions.
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Nyaya Health signed an agreement with the Ministry of Health in 2015 to rebuild the damaged healthcare facilities in Dolakha and upgrade the primary healthcare centre in Charikot into a full-fledged hospital. The country’s already under-resourced healthcare is also under strain because of the Covid-19 pandemic.
This is especially remarkable considering that improving public sector healthcare, especially in rural areas, has been a challenge in Nepal. In one of the few arrangements of its kind in Nepal, a public-private partnership initiative has handed over to the local government the management of Charikot Hospital which had been run by a private non-profit organisation ever since the earthquake five years ago.īhimeswar Municipality took over the hospital from the group Nyaya Health Nepal on 30 October in an innovative and successful DBOT (Design, Build, Operate, Transition) model which is significant in Nepal’s new federal structure where local governments take on more responsibility for grassroots healthcare delivery.
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