43 pc poor sans health services

KATHMANDU, JUL 23 - The Health Sector Reform Support Programme (HSRSP), under the technical support of RTI International, was over in July.

The three-year programme that began in August 2006, in support of the Department for International Development, collaborated with the Ministry of Health and Population (MoHP) in policy development, health system development and service delivery sectors.

During the programme, it was found that 32 percent of males and 37 percent females could not seek healthcare due to the lack of funds. Similarly, 43 percent of the poorest could not get any health service and less than half of the sick went to government health facilities.

A household survey showed only 19 percent of the poorest people sought the care in district hospitals whereas in the case of the rich it was nearly half.

“The HSRSP findings have made us realise the role of geographical, economic, social and gender differences in people’s access to health,” said Dr. Laxmi Raj Pathak, secretary at the MoHP.

MoHP introduced free care following Janaandolan II to what it says meet new popular expectations in the sector. The HSRSP provided cost estimates and benefits of several policy choices—free to all, free only for poor and free to poor and marginalised—in order to formulate the free healthcare policy.

Electronic Annual Work Planning and Budgeting (e-AWPB) is developed under the programme which was used by the MoHP to analyse the budget. The e-AWPB can be accessed online in Nepali and English languages.

“As a result of the budget analysis, programme fund for district increased from seven percent in 2004/05 to 25 percent in 2009/10,” said Dr. B.R. Marashini, senior public health administrator at the MoHP.

Under the HSRSP, Local Health Governance Strengthening Programme package of health management devolution framework was developed and a memorandum of understanding was prepared between the MoHP, Ministry of Local Development and local governments. It has been implemented in five districts—Doti, Kailali, Surkhet, Banke and Okhaldhunga—from this fiscal year.

During the programme period, 44 publications were brought out and out of 94 deliverables, the MoHP has adopted 66 as its policies and strategies including decentralisation, public private partnership, federalism and