Bishnu Prasad Aryal, Republica Daily, 16 Dec 2017
The availability of government health facilities in the country remains the highest in Province 2, and the lowest in Province 6.
According to the Ministry of Health (MoH), health facilities are categorized as health posts, primary hospitals, secondary hospitals, tertiary hospitals, academic hospitals, specialized hospitals and central hospitals. There are a total of 4,108 government health facilities across this country of some 29 million people.
Province 1 with a total population of 4,534,943 has 705 health facilities, including two tertiary hospitals, one teaching hospital, two secondary hospitals and 147 primary hospitals. The rest of them are health posts. The province has no specialized hospital.
Province 2, with a population of 5,404,145, has 789 health facilities including one tertiary hospital, one teaching hospital, three secondary hospitals and 126 primary hospitals. The rest of the facilities are health posts, and there is no specialized hospital in Province 2 either.
Province 3, with a population of 5,529,452, has 705 health facilities including one central specialized hospital (Bir Hospital), seven specialized hospitals, one tertiary hospital, two teaching hospitals, three secondary hospitals and 127 primary hospitals. The remaining facilities are health posts.
Province 4, with a total population of 2,403,757, has 524 health facilities that include one specialized hospital, one tertiary hospital, one teaching hospital, one secondary hospital and 91 primary hospitals. The remaining facilities are health posts.
Province 5, with its population of 4,499,272, has 614 facilities including one specialized hospital, one tertiary hospital, one teaching hospital, one secondary hospital and 111 primary hospitals. The rest are health posts.
Province 6 with its population of 1,570,418 has 362 health facilities including one tertiary hospital, one teaching hospital and 80 primary. The rest of the facilities are again health posts. There is no other category of health facility in Province 6.
Province 7, with a population of 2,552,517, has 403 health facilities. These include one teaching hospital, one tertiary hospital, one secondary and 90 primary, the remaining being health posts. There is no other hospital in Province 7 either.
Shambhu Kafle, an official at the Federalism Implementation Unit of MoH, said they are working to restructure the administration of health facilities at the ministry and in the provinces. “There will be at least one primary hospital of 5 to 100 beds in each of the 753 local bodies across the country,” he said. “We have to open other specialized and teaching hospitals in the provinces where such facilites do not exist now,” he added. “Each of the wards in the local bodies will have at least one health post.”
Officials at MoH said that not all the wards have at least one health post. “There are some local bodies without primary hospitals either,” they said. “The availability of health professionals in many of the health facilities is quite disappointing.”
There are 159 private hospitals, nursing homes and clinics in the country. However, most of these are located in the city areas and are for-profit.
This disparity emerges from the Nepal Demographic Health Survey 2016. It also shows that child health and mortality are more precarious than other health parameters across the country.
The government has allocated Rs 31.78 billion in 2017/18 for the implementation of health programs, excluding the expenses for primary health services to be allocated in the local bodies as per the federal constitution. There are around 35,000 posts for health workers and medical professionals, including about 1,500 doctors, at government health facilities.