National Health

Policies
National Health Policy 1991
• The First National Health Policy was adopted in

1991 (FY 2048 BS) to bring about improvement in

the health conditions of the people of Nepal.
14 policies
1. Preventive Health Services

2. Promotive Health Services

3. Curative Health Services
4. Basic Primary Health Services
5. Ayurvedic and other Traditional Health Services
6. Organization and Management
7. Community Participation in Health Services
8. Human Resources for Health Development (HRH)
9. Resource Mobilization in Health Services
10. Private, Non-Governmental Health Services and
Inter-sectoral Coordination
11. Decentralization and Regionalization
12. Blood Transfusion Services
13. Drug Supply
14. Health research
Second health policy, 2014 AD (2071 BS)
On Friday August 8 2014 the Government of Nepal
launched its new National Health Policy.

Policies
1. Provide access quality health services (universal
Health Coverage) to every citizen in an effective way
and provide basic health services free of cost. (26
Strategies).
2. Plan, produce, retain and develop skilled human
resources to deliver affordable and effective health
services. (13 strategies)
3. Develop Ayurvedic system of medicine by managing
and utilizing the herbs available in the country as
well as protect and do systematic development of
other complementary medicine system.
4. Ensuring simple and effective provision/import and
utilization of quality medicine and medicinal
products and enhancing in country production
capacity gradually head towards self-dependence. (4
Strategies)
5. Improve quality of health research in line with
international standards and establish effective
mechanisms to translate these into policy making,
planning and medicine systems. (8 Strategies)
6. Promote public health by giving priority to health
education, information and communication to people
protecting people's fundamental right to information.
7. Minimize prevalence of malnutrition through
promotion and utilization of healthy food. (7
Strategies)
8. Ensure provision of quality health services through
efficient and accountable mechanism and process of
coordination, monitoring and regulation. (10
Strategies)
9. Ensure professional standards and quality of health
services by making health related professional
councils capable, professional and accountable. (4
Strategies)
10. Gradually mainstream health in all policies by
further strengthening collaboration with multi- sector
 stakeholders in health.
11. Ensure citizens right to live in healthy environment
through effective control environmental pollution for
health protection and promotion (3 Strategies)
12. Improve governance through policies, management
and organizational structure to deliver quality health
services. (14 Strategies)
13. Promote public private partnership for systematic
and qualitative development of health sector. (3
Strategies)
14. Gradually increase state's investment in health sector
and effectively utilize and manage support from
private sector and development partners to ensure
affordable and quality health services and ensure
financial protection in health expenditures.
National Health Policy, 2019 (2076 BS)
• This National Health Policy, 2019 has been formulated
on the basis of the lists of exclusive and concurrent
powers and functions of federal, state and local levels
as per the constitution.
• This policy has been formulated on the basis of the
following guiding principles:

Guiding Principles
• Universal access to, continuous availability of,
transparency and comprehensiveness in quality health
services
• Multi-sectoral involvement, collaboration and
partnership in health system in accordance with the
federal structure
• Special health services targeted to ultra-marginalized,
Dalit and indigenous communities
• Good health governance and assurance of adequate
financial investments
• Diversification of equitable health insurance
• Restructuring in the health services
• Health and multi-sectorial coordination and
collaboration in all policies.
• Professionalism, honesty and occupational ethics in
health service delivery.

Policies
1. Free basic health services for all levels
2. Specialized services shall be made easily accessible
through health insurance
3. Access to basic emergency health services
4. Health system shall be restructured, improved,
developed and expanded at federal, state and local
levels
5. In accordance with the concept of universal
health coverage, promotional, preventive,
curative, rehabilitative and palliative services
shall be developed
6. Collaboration and partnerships among
governmental, non-governmental and private
sectors
7. Ayurveda, naturopathy, Yoga and homeopathy shall be
developed and expanded
8. In order to make health services accessible,
effective and qualitative, skilled health human
resources shall be developed
9. Structures of Health Professional Councils shall be
developed,
10. Domestic production of quality drugs
11. Integrated preparedness and response measures
12. Individuals, families, societies and concerned
agencies shall be made responsible for prevention
and control of non-communicable diseases
13. adulterated and harmful foods shall be discouraged
14. Health researches shall be made of international
standards
15. The health management information system shall
be made modern, qualitative and technology-friendly
16. Right to information related to health and right of a
beneficiary
17. Mental health, oral, eye, ENT health services shall be
developed
18. Quality of health services provided by all health
institutions
19. Good governance and improvement shall be ensured
in policy-related, institutional and managerial
 20. health services around safe motherhood, child
health, adolescence and reproductive health, adult
and senior citizen
21. Necessary financial resources and special fund

22. Urbanization, internal and external migration

23. Demographic statistics

24. Antimicrobial resistance shall be reduced
25. Necessary arrangements shall be made to reduce the
risks of immigration process

Strategy for Each Policy

• 3 strategies to achieve policy 1
• 4 strategies to achieve policy 2
• 6 strategies to achieve policy 3
• 13 strategies to achieve policy 4
• 10 strategies to achieve policy 5
• 6 strategies to achieve policy 6
• 6 strategies to achieve policy 7
• 9 strategies to achieve policy 8
• 4 strategies to achieve policy 9
• 8 strategies to achieve policy 10
• 8 strategies to achieve policy 11
• 8 strategies to achieve policy 12
• 4 strategies to achieve policy 13
• 4 strategies to achieve policy 14
• 5 strategies to achieve policy 15
• 2 strategies to achieve policy 16
• 6 strategies to achieve policy 17
• 6 strategies to achieve policy 18
• 7 strategies to achieve policy 19
• 6 strategies to achieve policy 20
• 6 strategies to achieve policy 21
• 4 strategies to achieve policy 22
• 4 strategies to achieve policy 23
• 3 strategies to achieve policy 24
• 4 strategies to achieve policy 25
Nepal Health Sector Strategy 2015-2020
• Nepal Health Sector Strategy (NHSS) 2015-2020.
• It adopts the vision and mission set forth by the
National Health Policy
• It guides the health sector's response in realizing
government's vision to graduate Nepal from 'Least
Developed Country' to 'Middle Income Developing
country' by 2022.
• 2017 -- Nepal Health Sector Program III (NHSP 3)
– 2017 t0 2022
Five Year Plans of Nepal

Five Year Plans of Nepal

• 1st five-year plan 1956 – 1961
• 2nd 3-year plan 1962 – 1965
• 3rd 5-year plan 1965 – 1970
• 4th 5-year plan 1970 – 1975
• 5th 5-year plan 1975 – 1980
• 6th five-year plan 1980 – 1985
• 7th 5-year plan 1985 – 1990
• 8th 5-year plan 1992 – 1997
• 9th 5-year plan 1997 – 2002
• 10th 5-year plan 2002 – 2007
• 11th Interim plan 2007 – 2010
• 12th Interim plan 2010- 2013
• 13th Interim plan 2013 – 2015
• 14th 3-year plan 2016 - 2019
• 15th five-year plan – 2019-2024
First long term health plan- 1975-1990 ( duration: 15
years)
SLTHP (Second Long Term Health Plan – 1997 to
2017AD/ 2054BS-2074 BS, Duration: 20 years
• Vision: a healthcare system with equitable access and
quality services in both rural and urban areas.
• The system would encompass the concepts of
sustainability, full community participation,
decentralization, gender sensitivity, effective and
efficient management, and private and NGO
participation.

Objectives
• To improve the health status of the population of the
most vulnerable groups
• To improve the management and organization of the
public health sector and increase the efficiency and
effectiveness of health care system
• To improve inter-and intra-sectoral co-ordination
• To extent essential health care service.
• To provide the appropriate number, types and
technically competent health man power.
• To develop the appropriate role of public, NGO and
 private sectors in provision of health financing.

Millennium Development Goals (MDGs: 2000 – 2015)

• In September 2000, representative from 189 countries
at the millennium summit in New York to adopt the
United State Millennium Declaration.
• It aims to bring peace, security and development to all
people. The MDGs drawn from the Millennium.
• There are 8 goals, 18 targets & 48 indicators.
• Goal 1: Eradicate extreme poverty and Hunger
• Goal 2: Achieve universal primary education
• Goal 3: Promote gender
equality and empower
women
• Goal 4: Reduce child mortality
• Goal 5: Improve maternal health
• Goal 6: Combat HIV/ AIDS,
malaria and other diseases
• Goal 7: Ensure environmental sustainability
• Goal 8: Develop a global
partnership for development
• Out of these 3 goals (4, 5 & 6), 8 targets and 18
indicators are directly health related.

Sustainable Developmental Goal

• The head of state and Government and High Representatives,
meeting at the UN Headquarters in New York from 25-27
September 2015 have decided the global new sustainable
developmental goal.
• Planned for implementation 2016-2030.

Altogether there are 17 goals and 169 targets.

(1) No Poverty
(2) Zero Hunger
(3) Good Health and Well-being
(4) Quality Education
(5) Gender Equality
(6) Clean Water and Sanitation
 (7) Affordable and Clean Energy
(8) Decent Work and Economic Growth
(9) Industry, Innovation and Infrastructure
(10) Reducing Inequality
(11) Sustainable Cities and Communities
(12) Responsible Consumption and Production
(13) Climate Action
(14) Life Below Water
(15) Life On Land
(16) Peace, Justice, and Strong Institutions

(17) Partnerships for the Goals

Health Management Information System (HMIS)

• An information system specially designed to assist in

the management and planning of Health Personnel

History
• Before HMIS, there were more than 110 individual
recording and reporting system
• HMIS was implemented in Nepal from fiscal year
2051/052 B.S. there were 38 recording and reporting
forms.
• Latest revision of HMIS was done in 2070/071 BS
• There are total 9 sections and 50 different register forms
 in the latest version of HMIS.

HMIS Sections
• Section 1: Common recording form e. g. OPD register,
master register
• Section 2: Infant and Child Health e. g. Immunization,
nutrition etc
• Section 3: Family Health
• Section 4: Community Services
• Section 5: Malaria, Leprosy and Kalazar
• Section 6: TB
• Section 7: HIV/AIDS and STI
• Section 8: Hospital e. g. Admission-Discharge register
• Section 9: Monthly reporting form

Social health insurance (SHI)

• The Social Health Security Program (SHSP) was
rolled out to three districts viz. Kailali, Baglung and
Ilam in FY 2072/73 (@072 Chaitra 25, from Kailali)
• National Health Insurance Policy was passed
by Government of Nepal in 2014 (12th
Baishak, 2071 BS).
• National Health Insurance ACT: 2074 BS
 • National Health Insurance rules and regulations: 2075 BS
•SHSP- Recent Revisions From Jestha 1, 2076
• Implemented in 75 districts, (due districts:
Kathmandu and Lalitpur).
Main Features
• Families of up to five members have to contribute NPR
3,500 per year and NPR 700 per Additional member.
• Benefits of up to NPR 100,000 per year are available
for families of up to five members with an additional
NPR 20,000 covered for each additional member.
• The maximum amount available per year is NPR 200,000.
• The government bears a contribution amount after 70
years old citizens and Benefits of up to NPR 100,000 per
year.
 • Equal division of Responsibility between Management
and workers.

Job Satisfaction:

• Job satisfaction is the personal evaluation of the condition

existing on the job.

• Individual’s affective response towards the job.

Morale:

• Feelings, attitudes and sentiments that contribute to

general feeling of satisfaction.

Importance of Job satisfaction and morale:

• Employees are more committed to the organizational

goal.

• Reduce absenteeism and turnover rate.

• High discipline is maintained

 • Brings sense of pride among worker

Factor influencing job satisfaction and morale

• Organization itself

• Working conditions

• Work itself

• Interpersonal relationship

• Staff development opportunities

• Leadership

Leader’s role in promoting morale

• Ensure that subordinates clearly understand the

organizational goal
• Create safe working environment.
• Assign the job that suits the knowledge and skills of
individual
• Maintain open line of communication
• Involve people in decision making process
• Give equitable reward to subordinates
• Create positive environment by being role model.
Monitoring:
• Systematic process of collecting, analyzing and

using information to track a program’s progress

toward reaching its objectives.
• Focuses on processes, such as when and where
activities occur, who delivers them and how many
people or entities they reach.
Purpose of Monitoring
• To find out whether the objectives are met or not
• To know whether the staff are doing well or not
• To know the level of effectiveness
• To help in supervision/ evaluation plan
• To help in immediate correction
Steps of Monitoring
• Planning and scheduling
• Determining how to monitor
• Conduct monitoring
• Prepare report