Paper presented at 'Nepal Development Conference: Views and Visions of Nepali Ph.D. Scholars Residing in the UK for the Development of Nepal' organised by Embassy of Nepal, London, 7 November 2020

1. Healthcare Governance for the
Development of Health Sector in
Nepal
Bachchu Kailash Kaini, PhD, MHA, MBA, LLB, BEd, Cert Clinical Audit
Nepal Development Conference by Nepal Embassy, London
Views and Visions of Nepali Ph.D. Scholars Residing in the UK
for the Development of Nepal

2. • Committed to principles of universal health coverage
• Committed to reducing the burden of poor health,
especially among disadvantaged populations
• Going through major changes under the Federal
system
• Divided accountability, power and budget
• Limited resources, staff and skills
• Poor quality of care and behind in the development of
health sector
• Disease-centric, donor driven and vertical
programming
Nepalese Healthcare System

3. Good Governance
(Source: UNDP, 1997)

4. Healthcare Governance
• It refers ‘to a wide range of steering and rule-making related
functions carried out by governments/decisions makers as
they seek to achieve national health policy objectives that are
conducive to universal health coverage’.
• It is ‘a political process that involves balancing competing
influences and demands’. It includes:
– maintaining the strategic direction of policy development
and implementation;
– detecting and correcting undesirable trends and
distortions;
– articulating the case for health in national development;
– regulating the behaviour of a wide range of actors; and
– establishing transparent and effective accountability
mechanisms.
(Source: WHO)

5. • It requires whole-of-government and whole-of-
society approach
• It reflects how people shape their societies in the
21st century
• Health in the 21st century is evolving with the
notions of health, democracy and the roles of the
state and society
• Health should be seen as a priority for joined-up
government
• Health sector recognises health as requiring
greater leadership and outreach
Governance for Health
(Source: Governance for Health in 21st Century, WHO Europe, 2012)

6. • Defining roles, responsibilities & accountabilities
• Building leadership
• Communication and stakeholder engagement
• Regulation, assurance and compliance
• Managing risk and patient safety
• Clinical effectiveness and evidence based practice
• Improving quality of care and patient experience
Healthcare Governance at
Operational Level

7. Healthcare Governance Framework
for Healthcare Institutions
Healthcare
Governance
Risk
Management
Clinical Audit
Clinical
Effectiveness
Complaint
and
Complement
Service User
and Staff
Experience
Compliance
and
Standards
Stakeholder
Involvement
Learning and
Sharing
Improving
Quality of Care
Excellent
Outcome
Continuous
Professional
Development
System and
Process
Accountability
Transparency ©BK Kaini

8. • Accountability for practice
• Learning from others
• Involving the service users
• Evidence based practice
• Working with teams
• Reflection of practice
• Working across interfaces
Healthcare Governance for
Healthcare Professionals

9. Opportunities for Improving Health
System in Nepal
• Collaboration between various sectors and
agencies
• Empower local government
• Support hospitals and health centres across
the country
• Educate healthcare professionals and staff
• Manage resources efficiently
• Promoting and maintaining population health
in a participatory and inclusive way

10. • Formal policy, strategy and framework for
healthcare governance in Nepal
• Establishing a regulatory body to assess, monitor
and improve quality of care
• Incorporate in formal university curriculum
• Integrated approach
• Structure, policy and system at every healthcare
organisation and organisational approach
• Promote accountability and transparency
• CPD, training and research
Way Forward in Nepal

11. Thank you.
bkkaini@gmail.com