Four categories of hospitals in federal setup

May 08, 2017

The Himalayan Times, 7th May 2017, Kathmandu

The Ministry of Health has provided for a provision of four categories of government-run hospitals as per the federal set-up.

According to the Nepal Health Infrastructure Development Standard, 2017 endorsed by the Cabinet on May 4, there shall be hospitals of first, second, third, and specialised category at the rural municipality, municipality, provincial, and central levels respectively.

Similarly, villages and ward levels of municipality shall have at least one health post, or People’s Health Centre, or Community Health Unit each.

“Procurement, operation, maintenance, and management of all bio-medical and auxiliary equipment will be strengthened and made scientific at all levels of hospitals,” read the standard.

According to the Standard, the government will be required to develop physical infrastructures, skilled human resources, and necessary equipment for the health facilities in an integrated manner.

Pratap Paudel, chief advisor to Minister for Health Gagan Kumar Thapa, said that all hospitals would now be categorised on the basis of the type and quality service they provide. Earlier, the government used to classify them depending on the number of beds in the hospital.

Health institutions of ward level will provide vaccination, family planning, pregnancy test, general maternity, neonatal, DOTS system, nutrition, mental health, lab test and councelling services and screening of communicable and non-communicable diseases.

Similarly, the health facilities of sub-metropolitan and metropolitan cities will carry out functions relating to public awareness programmes against non-communicable diseases, their control and prevention, medical check-up, and vaccination besides providing councelling service.

Rural municipalities and municipalities will have at least one primary hospital each, with no less than 15 beds in them. Such hospitals will be obliged to provide round-the-clock emergency, cesarean section and specialised, maternity, pediatric, gynecology, and orthopedic services in addition to the facilities required to be delivered by the hospitals of ward levels.

The hospitals of provincial level will receive and take care of patients referred by the ward, rural municipality, and municipality level health facilities and provide service to complicated cases of pregnancy and labour, and will have maternity, renal disease, TB, asthma, opthalmology, mental disease, ENT, pediatrics, orthopedic and dermatology departments with Intensive Care Units.

According to the standard, each province will be allowed to establish at least one Provincial Health Sciences Academy. “There will be a Central Specialised Hospital to provide specialised service of all types, including for cardiovascular diseases, cancer, maternity issues, and pulmonary diseases,” said Paudel.

The authority to set standards of directives on services to be provided by the hospitals of all categories shall rest with the federal government, the standard further states.