Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
Nepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Kerman University of Medical Sciences
2019-04-01
|
Series: | International Journal of Health Policy and Management |
Subjects: | |
Online Access: | https://www.ijhpm.com/article_3579_efbd5a429ffb7cc9b002da8fd85fb0e7.pdf |
id |
doaj-3a22aafffb60425087d3edcbb2b56d0a |
---|---|
record_format |
Article |
spelling |
doaj-3a22aafffb60425087d3edcbb2b56d0a2020-11-25T03:31:03ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392322-59392019-04-018419519810.15171/ijhpm.2018.1213579Implementing Federalism in the Health System of Nepal: Opportunities and ChallengesRajshree Thapa0Kiran Bam1Pravin Tiwari2Tirtha Kumar Sinha3Sagar Dahal4Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Kathmandu, NepalFHI 360 Nepal, LINKAGES Nepal Project, Kathmandu, NepalDeutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Kathmandu, NepalDeutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Kathmandu, NepalProvince Health Directorate, Ministry of Social Development, Dhankuta, NepalNepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential opportunities for the national healthcare system. This is because decision making has been devolved to the federal, provincial and local governments, and so they can make decisions that are more representative of their localised health needs. The major challenge during the transition phase is to ensure that there are uninterrupted supplies of medical commodities and services. This requires scaling up the ability of local bodies to manage drug procurement and general logistics and adequate human resource in local healthcare centres. This article documents the efforts made so far in context of health sector federalization and synthesizes the progress and challenges to date and potential ways forward. This paper is written at a time while it is critical to review the federalism initiatives and develop way forward. As Nepal progress towards the federalized health system, we propose that the challenges inherent with the transition are critically analysed and mitigated while unfolding the potential of federal health system.https://www.ijhpm.com/article_3579_efbd5a429ffb7cc9b002da8fd85fb0e7.pdfchallenges and opportunitiesdecentralizationfederalismhealth reformhealth sectornepal |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rajshree Thapa Kiran Bam Pravin Tiwari Tirtha Kumar Sinha Sagar Dahal |
spellingShingle |
Rajshree Thapa Kiran Bam Pravin Tiwari Tirtha Kumar Sinha Sagar Dahal Implementing Federalism in the Health System of Nepal: Opportunities and Challenges International Journal of Health Policy and Management challenges and opportunities decentralization federalism health reform health sector nepal |
author_facet |
Rajshree Thapa Kiran Bam Pravin Tiwari Tirtha Kumar Sinha Sagar Dahal |
author_sort |
Rajshree Thapa |
title |
Implementing Federalism in the Health System of Nepal: Opportunities and Challenges |
title_short |
Implementing Federalism in the Health System of Nepal: Opportunities and Challenges |
title_full |
Implementing Federalism in the Health System of Nepal: Opportunities and Challenges |
title_fullStr |
Implementing Federalism in the Health System of Nepal: Opportunities and Challenges |
title_full_unstemmed |
Implementing Federalism in the Health System of Nepal: Opportunities and Challenges |
title_sort |
implementing federalism in the health system of nepal: opportunities and challenges |
publisher |
Kerman University of Medical Sciences |
series |
International Journal of Health Policy and Management |
issn |
2322-5939 2322-5939 |
publishDate |
2019-04-01 |
description |
Nepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential opportunities for the national healthcare system. This is because decision making has been devolved to the federal, provincial and local governments, and so they can make decisions that are more representative of their localised health needs. The major challenge during the transition phase is to ensure that there are uninterrupted supplies of medical commodities and services. This requires scaling up the ability of local bodies to manage drug procurement and general logistics and adequate human resource in local healthcare centres. This article documents the efforts made so far in context of health sector federalization and synthesizes the progress and challenges to date and potential ways forward. This paper is written at a time while it is critical to review the federalism initiatives and develop way forward. As Nepal progress towards the federalized health system, we propose that the challenges inherent with the transition are critically analysed and mitigated while unfolding the potential of federal health system. |
topic |
challenges and opportunities decentralization federalism health reform health sector nepal |
url |
https://www.ijhpm.com/article_3579_efbd5a429ffb7cc9b002da8fd85fb0e7.pdf |
work_keys_str_mv |
AT rajshreethapa implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges AT kiranbam implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges AT pravintiwari implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges AT tirthakumarsinha implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges AT sagardahal implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges |
_version_ |
1724573973745762304 |