To innovate solutions in rural health care - throught training and hospital support - and to advocate for their scale up with the government of Nepal.
The three program areas - training, district hospital support, and advocacy - of NSI emerge from Nepal's health care situation.
(1) Nepal has a huge gap between rural and urban health care.
While people in Kathmandu have ready access to neurosurgery, cardiac surgery, and advanced diagnostic test, people in rural Nepal face a different reality.
- 60% of district hosptials don't conduct any operations1 .
- Rural Nepal has 40x fewer doctors per capita2 .
- Rural skilled birth attendance is 4x lower than in cities3 .
(2) Public health services are far better than curative services.
- Immunization rates average 90% and family planning continues to improve4 .
- Nepal is on par with richer neighbors in public health.
- Public health finanical support (including training) at the district level far exceeds that of curative support.
(3) Health care workers are the center-piece of Heath Care system.
- Government buildings continue to expand, even while existing hospitals are understaffed, especially in doctors and nurses.
- Addition of key workers has been shown to transform hospitals.
- Nepal's National Health Sector Program has focused on building up the health care worker3.
(4) Improving health care workers requires a diverse approach.
- In-service training in key areas has had impact on health care.
- Graduates of even the best training programs languish without an enabling environment.
- Support programs provide feedback to training programs.
- Advocacy supports other apsects of the program, while feeding on the information that the other programs provide.
1. Family Health Division, Survey of District Hospitals. 2011. Government of Nepal
2. Nick Simons Institute. Unpublished Data. 2009.
3. Nepal Health Sector Program - Implementation Plan 2. 2011. Government of Nepal
4. Demographic Health Survey. 2011. Government of Nepal