Health Care Access In Nepal: Education, Infrastructure and NGO Collaboration
March 3, 2019
By Michael Lockfeld
The most basic function of human beings is to live. Before we communicate, we must eat, breathe, walk. Likewise, if our goal is to build sustainable communities, we must provide the resources to nurture healthy individuals. The health care system in rural Nepal unfortunately lacks this ability.
This is primarily because of a lack of infrastructure needed for access, with poorer communities in small rural districts facing the greatest challenges.
Nepal is fragmented into 14 zones and 75 districts. The country’s population is spread out, with 86% of its citizens residing in mountainous rural areas, making modern transportation nearly impossible. Due to this fact, the Ministry of Health has local sub-health posts scattered throughout the hundreds of villages in Nepal.
This makes community health volunteers the primary health care providers in rural Nepali districts. The Ministry of Health reports, there are more than 48,500 community health volunteers. Although a significant health care labor force, the local sub-health posts lack the capabilities to test for certain diseases due to limited supplies, unstable energy sources, lack of training, etc. This unreliable infrastructure causes many patients to be referred to better equipped hospitals, often miles away from their geographically isolated locations.
If a local sub-health post is unable to properly treat or test for a specific illness, they will refer patients to the nearest hospital in the region that has proper resources. These referrals leave patients unable to work due to the long distances they would have to travel, and for rural families struggling to get by, that time off is far too costly.
Even in cases where patients do receive proper medication, they often face medical supply shortages. If there is an outbreak in a populated region like Katmandu, the medication is routed to those urban centers. This leaves the poorer communities in the Nepal countryside without medication for a long period of time, creating even more health complications due to the lack of consistent prescriptions.
Furthermore, providing medical support to address Nepal’s infrastructure problem is critical to reducing poverty. According to the World Health Organization’s report on the effects of health on communities: disease creates poverty, but health will create economic growth. In order to achieve this, financial constrains must be eliminated by increasing investments in health.
According to the WHO Nepal case study report, coordination between the MoH and NGOs needs to be further developed in order to improve health outcomes and alleviate poverty. The government needs to engage with the NGOs in the private sector and by doing so, will increase access to Essential Health Care Services (EHCS) and the number of staff at local sub-health posts in the rural isolated regions.
NGOs, like Possible (a partner organization of Paul Farmer’s Partners in Health), work to rebuild these health centers. The organization utilizes a “durable healthcare model”, where the Nepali government pays the NGO to distribute care to specifically poorer Nepali citizens. Since Possible’s first engagement in 2008, the NGO has treated 276,050 patients and is currently building 21 health care facilities.
More NGOs need to collaborate with the Nepali government in order to address its infrastructure problems and more community health volunteers need to be trained and deployed to rural areas. In doing so, we can expand access to health care, bolster community development and allow these culturally rich communities to Thrive.
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