Hospital Management Strengthening Program (HMSP)

Hospital Management Strengthening Program

In 2011, NSI conducted a literature review and needs assessment into the need for hospital management training in conjunction with National Health Training Centre (NHTC). The findings were published in Journal of Nepal Medical Association. A pilot of Hospital Management Training program was conducted in 2013.  The four participating hospitals (Jiri, Ramechhap, Bardiya, Pyuthan) showed some positive changes in their management system that had direct effects in patient care.

A key finding from the pilot was the need to strengthen the effectiveness of the Hospital Development Committees (HDC).  This includes issues of both accountability of HDCs and support to HDC members. The pilot was developed in conjunction with NHTC.  Learning from the pilot showed that a number of different Divisions in both Ministry of Health and Population and Department of Health Services impact the effectiveness of hospitals.

In June 2014, NSI signed a three year MoU with Ministry of Health and Population to implement Hospital Management Strengthening Program (HMSP) in at least 45 district hospitals.

Program Purpose

To ensure right to health of population by improving the effectiveness of district hospitals through better governance, leadership and management to reach specified national service standards.

Program Goals

  • Refine and clarify the national service standards for district hospitals
  • Strengthen accountability and effectiveness of HDCs
  • Challenge and support the hospitals to reach the standards by fulfilling the gaps through improved leadership and management

Program Organization

The Program is governed by a Steering Committee (chaired by Secretary, Ministry of Health) and a Technical Working Group (TWG) chaired by Chief, Curative Services Division) and including representatives from other Divisions and Centres whose programs impact hospital services.

Program Implementation

1. Minimum Service Standard (MSS) Workshops

MoH and NSI invite 12 to 15 hospital managers (Development Committee Chair and members, District Health Officer, medical officers, nurse/lab/x-ray in-charge, finance and other administrators) to cluster meetings. Cluster meetings bring together the managers of 3 or 4 hospitals to a series of 3 workshops over 6 months. The workshop orients hospitals to the MSS tool, gives management training, and facilitates action plans to fill gaps (and thereby raise MSS scores).

2. Hospital Grant

NSI administers a yearly grant to the Hospital Development Committee (HDC) to help the hospital fill its MSS gaps. Certain criteria must be met: a) HDC must provide justification for how the NSI grant will fill gaps remaining after application of the MoH Management Division’s grant and internally generated funds. B)  Specific itemized requests. c) Appropriate use of MD and NSI funds in the previous year (includes availability of audited accounts for all funds).

3. Hospital Follow-up

NSI staff will follow hospital progress through a minimum of two visits each year.

HMSP Geographical Coverage

HMSP Entry Year






Total: 18

  • Taplejung
  • Panchthar
  • Ilam
  • Jaleshwor (Mahottari)
  • Malangawa (Sarlahi)
  • Taulihawa (Kapilvastu)
  • Tamghas (Gulmi)
  • Sandhikharka (Arghakhanchi)
  • Bhairawa (Rupandehi)
  • Rolpa
  • Rukum
  • Salyan
  • Pyuthan
  • Bajura
  • Doti
  • Accham

Year 1
Total: 27

  • Terhathum
  • Bhojpur
  • Sankhuwasabha
  • Gaighat (Udayapur)
  • Katari (Udayapur)
  • Khotang
  • Jiri (Dolakha)
  • Ramechhap
  • Sindhuli
  • Bardibas (Mahottari)
  • Chandranigapur (Rautahat)
  • Pokhariya (Parsa)
  • Mustang
  • Myagdi
  • Parbat
  • Damauli (Tanahun)
  • Bandipur (Tanahun)
  • Dailekh
  • Dullu (Dailekh)
  • Mehelkuna (Surkhet)
  • Gulariya (Bardiya)
  • Mugu
  • Kalikot
  • Baitadi
  • Darchula
  • Gokuleshwor (Darchula)
  • Bajhang

Year 2
Total: 30

  • Phaplu (Solukhumbu)
  • Rumjatar (Okhaldhunga)
  • Rangeli (Morang)
  • Dhankuta
  • Inaruwa (Sunsari)
  • Lahan (Siraha)
  • Siraha
  • Bhardaha (Saptari)
  • Rasuwa
  • Trishuli (Nuwakot)
  • Dhading
  • Hetauda (Makwanpur)
  • Ratna Nagar (Chitwan)
  • Baghauda (Chitwan)
  • Methinkot (Kavre)
  • Chautara (Sindhupalchowk)
  • Manang
  • Gorkha
  • Shivraj (Kapilvastu)
  • Pipara (Kapilvastu)
  • Prithvichandra (Nawalparasi)
  • Syangja
  • Rampur (Palpa)
  • Palpa
  • Dolpa
  • Humla
  • Jajarkot
  • Jogbudha (Dadeldhura)
  • Tikapur (Kailali)
  • Malakheti (Surkhet)

Year 3
Total: 75






Grand Total








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