The document outlines the organizational structure and roles of Nepal's central health services. It describes three departments under the Ministry of Health: Department of Health Services, Department of Ayurveda, and Department of Drug Administration. The Department of Health Services has seven divisions that oversee areas like management, child health, and primary care. It also operates several centers for tuberculosis control, health training, public health laboratories, and AIDS/STD control. The organizational structure extends from the central level down to regional, district, and local health facilities. The central level determines resources and plans while lower levels provide services and refer patients within the network.

1. UNIT 2.
CENTRAL HEALTH SERVICES MANAGEMENT
Presenter
Sunita Rajbanshi
BPH 6th semester,KHSC

2. OUTLINE
1.Organizational structure of health services
2.Description and analysis of roles and
responsibilities of divisions and centres of DOHS.
3.Intersectoral coordination between all levels.

3.  There are three Departments under the MoHP:
Department of Health Services (DoHS), Department of
Ayurveda (DoA) and Department of Drug Administration
(DDA).
 The DoHS and other departments are responsible for
formulating programs as per policy and plans,
implementation, use of financial resources and
accountability, and monitoring and evaluation.
 DDA is the regulatory authority for assuring the quality
and regulating the import, export, production, sale and
distribution of drugs.

4.  Department of Ayurveda offer Ayurvedic care to the
people and also implement health promotional activities.
 The overall purpose of the Department of
Health Services (DoHS) is to deliver preventive,
promotive and curative health services throughout nepal.
The DoHS is one of three departments under Ministry of
Health (MoH).
 Director General (DG) is the organisational head of the
DoHS.

5. ORGANIZATIONAL STRUCTURE OF
HEALTH SERVICES
Central ,Regional and
district Level

7. ROLES OF SEVEN DIVISIONS:
 Management Division with infrastructure, planning,
quality of care, management information system and free
medication & treatment for very severe disease to
impoverished Nepalise citizens.
 Child Health Division covering EPI, Nutrition and
CB‐IMCI and Newborn care.

8.  Logistics Management Division covers procurement,
supplies and management of logistics, equipment and
services required by DoHS and below level.
 Epidemiology and Disease Control Division with the
responsibility of controlling epidemics, pandemic and
endemic diseases as well as treatment of animal bites.

9.  Primary Health Care Revitalization Division with the
responsibility of carrying out activities for primary health
care.
 Family Health Division with the responsibility of
reproductive health care, including safe motherhood and
neonatal health, adolescent health, family planning and
Female Community Health Volunteers (FCHVs).
 Leprosy Control Division with the responsibility
of reducing the burden of leprosy and to break channel
of transmission of leprosy from person to persons by
providing quality services to all the affected community.

10. ROLES OF CENTRES OF DOHS
1.National Tuberculosis centre(NTC) engage public and
private health care providers to ensure provision of
quality TB services in line with NTP policy, International
Standard of TB Care (ISTC) and Patient Charter
2. National Health Training Centre (NHTC).
The NHTC coordinates all training programs of the
respective Divisions and implements training by sharing
common inputs and reducing the travelling time of care
providers.

11. 3.National Public Health Laboratory (NPHL)
Extend laboratory services in all hospital and health care
institution upto PHC level,develop NPHL as national reference
laboratory for diagnostic and public health services,address
the diagnostic needs due to emerging and re-emerging
diseases.
4.National Centre for AIDS and STD Control (NCASC) work to
achieve universal access to HIV prevention, treatment, care
and support and with all stakeholders.
5.National Health Education, Information and
Communication Centre (NHEICC). All IEC/BCC‐related
activities are coordinated by NHIECC. These centres support
the delivery of EHCS and work in close coordination with the
respective Divisions.

12. ROLES AND RESPONSIBILITIES OF DOHS
 To provide GoN (Government of Nepal) necessary
technical advice in formulating health related policies,
develop and expand health institutions established in line
with these policies.
 To determine requirement of manpower for health
institutions and develop such manpower by preparing
short and long term plans.
 To ensure supply of drugs, equipment, instruments and
other material at regional level by properly managing
these resources.

13.  To mobilize assistance in the implementation of approved
programmes by preparing, asking for preparation of
objective programmes related to various aspects of
public health (family health, family planning, child health,
infectious disease control, eradication of malnutrition,
control of AIDS and STDs).
 To manage the immediate solution of problems arising
from natural disasters and epidemics.

14.  To establish relationships with foreign countries and
international institutions with the objective of enhancing
effectiveness and developing health services and assist
the Ministry of Health in receiving foreign aid by clearly
identifying the area of cooperation.
 To create a conducive atmosphere to encourage the
private sector, non-governmental organizations and
foreign institutions to participate in health services,
maintain relation and coordination, control quality of
health services by regular supervision and inspection.

15.  To systematically maintain data, statements and
information regarding health services, update and publish
them as required.
 To fix designated positions of employees up to gazetted
2nd class, inter-directorate transfer, initiate departmental
action and provide reward, etc.
 To clear audit irregularities of central level offices,
projects and regional level offices.

16. INTERSECTORAL COORDINATION
BETWEEN ALL LEVELS INCLUDING :
1.Central level(Between the ministries)
2.District levels(Districts line
authorities)
3.Grass Root Levels(Local Level line
organization)
4.Coordination within the system

17.  At the regional level there are five Regional
Health Directorates (RHDs) providing technical
backstopping as well as program monitoring to
the districts.
 The RHDs are directly under the MoHP.
 There are regional, sub‐regional and zonal
hospitals, which have been given decentralised
authority through the formation of Hospital
Development Boards.

18.  In addition, there are training centres, laboratories, TB
centres (in some regions) and medical stores at the
regional level.
 At the district level, the structure varies between districts.
Fifty nine districts are managed by the District Health
Office (DHO), whereas the remaining sixteen are
managed solely by the DPHO.

19.  The DPHOs and DHOs are responsible for implementing
essential health care services (EHCS) and monitor
activities and outputs of District Hospitals, Primary Health
Care Centres (PHCCs), Health Posts (HPs).
 A health post is the first institutional contact point for
basic health services.

20.  HPs and PHC monitor the activities of FCHVs as
well as community‐based activities by PHC outreach
clinics and EPI clinics.
 In addition, HP also functions as the referral centre
of FCHVs as well as a venue for community based
activities such as PHC/ORC and EPI clinics.
 The health post offers the same package of SHPs
plus birthing centres in the respective VDC.

21.  Each level is referral point in a network from Health Post
(HP) to Primary Health Care Centre (PHCC), on to
district, zonal sub‐regional and regional hospitals, and
finally to tertiary level hospitals.
 This referral hierarchy has been designed to ensure that
the majority of population receive public health and minor
treatment in places accessible to them and at a price
they can afford.

22.  Central level determine requirement of manpower for
health institution and develop such ,manpower by
preparing short term and long term plans.
 Central level also supply drugs equipment ,instruments
and other materials at regional level by properly
managing the resources.
 Inversely, the system works as a supporting
mechanism for lower levels by providing logistical,
financial, supervisory, and technical support from the
centre to the periphery.

23. REFERENCE
 Neupane Dinesh,khanal Vishnu,”A text book of
health service management in Nepal”2010
edition,Vidyarthi pustak Bhandar.
 www.dohs.gov.np
 Annual report of fiscal year 2070/71
 www.nphl.gov.np
 www.ncasc.gov.np

24. Thank
you