Health Policy of Nepal before 1991 and Health Policy of Nepal after 1991 along with Health Policy at 2071.

1. NATIONAL HEALTH POLICY
PRESENTED BY:-Dr.SWIKRITI KOIRALA
1ST YEAR RESIDENT
DEPARTMENT OF COMMUNITY MEDICINE

2. Outline of seminar
 Introduction
 Past history
 Health services before 1990 s(limitation)
 Health policy 1991(1st national health policy)and 2071
 Objective of policy (1991and 2071)
 Weakness of 1991 health policy(ISSUES)
 Challenges
 Need of new policy (2071)
 Vision , Mission ,Goal
 Strength
 Outcome(Present condition)
 Reference

3. INTRODUCTION
NATIONAL HEALTH POLICY:-
The National Health Policy is a policy framework to
guide health sector development.
FACTOR AFFECTING POLICY ARE:-
Political, Socio-culture, Economic, Demographic

4. PAST HISTORY
 Establishment of Singhdarbar Baidhya khana
 Establishment of Bir Hospital in 1889
 Establishment of Ministry of Health and population
 First long term health Plan(1975-1990 B.S)-15 YEAR PLAN
 Second Long term health plan(1997-2017 B.S)-20 YEAR
PLAN
 Small Pox eradication achieved(1980)
 Different Disease elimination phase-
 Disease control Programs

5. (1) The policy, objectives and strategies of health services were not
village oriented
(2) Health Programmes were not systematic and planned according to
schedule of operations.
(3) The supervision, monitoring and evaluation of the programmes were
not conducted in a regular manner.
(4) Means and resources were fully centralized.
(5) The posts sanctioned for district level health organizations were not
filled.

6. Health policy 1991
After 1990’s -1.Constitutional Monarchy
2.Multi-party Democracy
3. National health policy

7. National health policy 1991

8. 1. Preventive Health Services
2. Promotive Health Services
3. Curative Health Services
4. Basic Primary Health Services
5. Mobilization of Public Participation
6. Improvements in Organization and Management Aspect
7. Development and Management of Health Related Human Resources
8. Private, Non-Governmental and Inter -Sectoral Coordination
9. Ayurved and Other Traditional Health Systems
10. Drug Supply
11. Resource Mobilization in Health Services
12. Health Research
13. Regionalization and Decentralization
14. Blood Transfusion Services
15. Miscellaneous

9. National health policy 2071

10. 1. Provide access quality health services(universal Health Coverage)
(26 STRATEGIES)
2. Plan, produce, retain and develop skilled human Resources (15 STATEGIES)
3. Develop Ayurveda system of medicine (5 STATEGIES)
4. utilization of quality medicine and medicinal products and enhancing in
country production Capacity (4 STATEGIES)
5. Improve quality of health research into translate these into policy making,
planning and medicine systems. (8 STATEGIES)
6. Promote public health (7 STATEGIES)
7. Minimize prevalence of malnutrition(7STATEGIES)
8. Ensure provision of quality health services (10 STATEGIES)
9. Ensure professional standards and quality of health services (4 STATEGIES)
10. mainstream health in all policies
11. Ensure citizens right to live in healthy Environment (3 STATEGIES)
12. Improve governance through policies, management and organizational
structure (14 STATEGIES)
13. Promote public private partnership (3STATEGIES)
14. Gradually increase state 's investment in health sector and effectively utilize
and manage and support

11. OBJECTIVES
1991 2014(2071) 2076(2019)
to upgrade the health
standards of the majority
of the rural population by
strengthening the primary
health care system,
making effective health
care services readily
available at the local level
free of cost the basic
health services that
remains as a fundamental
right of a citizen
Establish effective and
accountable health
services with
essential drugs,
diagnostics and skilled
human
resources.
participation of people in
health services

12. Situation analysis during 1991
 Positive impact

13. Weakness of 1991 health policy(ISSUE)
1. Not equally accessible.
2 half of the children under 5 years of age and women of reproductive age:-
undernourished whereas obesities increasing trend in urban areas.
3.Environmental changes, increasing food insecurity and natural disaster is
creating increase health problems.
4. non communicable diseases are increasing and deaths due to road accidents
and injuries are increasing day by day.
5. Not able to prioritize the sectors for future improvement.

14. 6 Access to quality medicines , rational use of medicines, essential drugs and
equipment production , distribution is not effective.
7 Laboratory services and medical equipment's do not meet standard guidelines
8 Inadequate production of skilled health professionals .
9 Private investment in healthcare is not beneficial to the general
public.
10 Rules and regulations related with health care services is not effective.
11.Improper collaboration of institutions.

15. CHALLENGE
Need for appropriate implementation of a Two way
referral system
Immediate management of highly infectious disease.
To reduce neonatal and maternal motality rate
To control the spread of human and animal related

16.  Strengthening health institution down to the grass route level
and establishment of social health insurance system
 Increasing states investment to the health sector.
 Addressing regional disparity health indicators.
 Need for implementing health related acts, rules, policies
,strategies and action plan in comprehensive and integrated
manner.

17.  increase investment for providing all necessary
health services to person with disabilities.
local government and holding accountable to health
services and also improve people participation in
rural health program.

18. NEED OF NEW POLICY
 To Over come these Problems and threats
 Interim Constitution mentions that –
Fundamental human right
Information right to Individual
 Different Health services- Preventive, Promotive,
Diagnostic, curative, Rehabilitative
Quality Health Services
Identification of resources
NGO/INGOs role
Accountable

19. VISION:-
ALL Nepalese citizen will be able to live productive and quality life ;being
physically, mentally ,socially and emotionally healthy
MISSION:-
Ensure citizen fundamental rights to stay healthy by optimally utilizing the
available resources and fostering strategic cooperation between health service provider,
service users and other stakeholders.
GOAL:-
To Ensure health for all citizens as a fundamental human right by
increasing access to quality health services and accountable health system

20. Strength:
 “Universal health coverage” with equity and social justice.
 Control of communicable disease and decrease mortality rates.
 Control of non communicable diseases, trauma and injury
 Health services to the geriatric population.
 Introduction of telemedicine for providing effective and low cost health services.
 Covers herbal medicine, Ayurveda system and other traditional system.
 Assesses quality of drugs and medical equipment maintaining international standard.

21.  1 health center in each VDC within 30 minutes of walking distance.
 Primary health center covers an area of 20,000 people.
 25 bed hospital in area with 1,00,000 population.
 Provision of 1 doctor and 1 nurse in every VDC regardless of population proportion
and 1 nurse midwife in every ward.
 1 doctor and 23 healthcare workers for every 10,000 population
 Primary care center in every 1 hour distant in major highways
 Every hospital with its own pharmacy.
 Ambulance and air ambulance

22.  Health inspector posted in all Electoral constituencies to ensure better
sanitation, hygiene and address public health issues .
 Provision of specialized health services to rural people.
 Provision of laws on human organ transplantation.
 School health program primarily to control malnutrition.
 A single telephone number is made mandatory for ambulance all over
Nepal .

23. strategies
Total 120 strategies
Each policy has strategies

24. OUTCOME

27. MOST IMPORTANT DATES IN HEALTH SECTOR
OF NEPAL AFTER 1990’s
 1978:-Primary Health Center
 1980:-small pox eradication
 1991:-National Health Policy
 1994:-International conference on Population and Development (ICPD)
 1995:-conference on elimination and discrimination against all the
women (CEDAW)
 1997:-Safe motherhood
 2000:-MDG(Health for all)
 2002:-legalization of Abortion
 2005:-Incentive service
 2007:-Revitalization Of PHC
 2009:-Ama sureksha Program
 2015:-End of MDG started of SDG

28. REFERENCE
National Health Policy 2071
MoHP , National Health Policy, 2071
Annual Report 2074/2075

29. TERMINOLOGY
 POLICY:-
a course or principle of action adopted or proposed by organization or
individual.
GOAL:-
that you want to achieve which is time bounded.
Objectives :-
planned end point of all activities that may be achieved or not ,Presiced
Vision:-what we are going to do?(ambition)
Mission:- what do we do? (purpose, motivation)
Strategies:-program work plan.