To innovate solutions in rural healthcare – through 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 healthcare situation.
(1) Nepal has a huge gap between rural and urban healthcare.
While people in Kathmandu have ready access to neurosurgery, cardiac surgery, and advanced diagnostic tests, people in rural Nepal face a different reality.
- 60% of district hospitals 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 financial support (including training) at the district level far exceeds that of curative support.
(3) Healthcare workers are the center-piece of Healthcare 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 healthcare worker3.
(4) Improving healthcare workers requires a diverse approach.
- In-service training in key areas has had impact on healthcare.
- Graduates of even the best training programs languish without an enabling environment.
- Support programs provide feedback to training programs.
- Advocacy supports other aspects 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 Unpublished Data. 2009.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