Cargando…

Implementing Federalism in the Health System of Nepal: Opportunities and Challenges

Nepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential...

Descripción completa

Detalles Bibliográficos
Autores principales: Thapa, Rajshree, Bam, Kiran, Tiwari, Pravin, Sinha, Tirtha Kumar, Dahal, Sagar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499910/
https://www.ncbi.nlm.nih.gov/pubmed/31050964
http://dx.doi.org/10.15171/ijhpm.2018.121
_version_ 1783415849567125504
author Thapa, Rajshree
Bam, Kiran
Tiwari, Pravin
Sinha, Tirtha Kumar
Dahal, Sagar
author_facet Thapa, Rajshree
Bam, Kiran
Tiwari, Pravin
Sinha, Tirtha Kumar
Dahal, Sagar
author_sort Thapa, Rajshree
collection PubMed
description Nepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential opportunities for the national healthcare system. This is because decision making has been devolved to the federal, provincial and local governments, and so they can make decisions that are more representative of their localised health needs. The major challenge during the transition phase is to ensure that there are uninterrupted supplies of medical commodities and services. This requires scaling up the ability of local bodies to manage drug procurement and general logistics and adequate human resource in local healthcare centres. This article documents the efforts made so far in context of health sector federalization and synthesizes the progress and challenges to date and potential ways forward. This paper is written at a time while it is critical to review the federalism initiatives and develop way forward. As Nepal progress towards the federalized health system, we propose that the challenges inherent with the transition are critically analysed and mitigated while unfolding the potential of federal health system.
format Online
Article
Text
id pubmed-6499910
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Kerman University of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-64999102019-05-07 Implementing Federalism in the Health System of Nepal: Opportunities and Challenges Thapa, Rajshree Bam, Kiran Tiwari, Pravin Sinha, Tirtha Kumar Dahal, Sagar Int J Health Policy Manag Perspective Nepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential opportunities for the national healthcare system. This is because decision making has been devolved to the federal, provincial and local governments, and so they can make decisions that are more representative of their localised health needs. The major challenge during the transition phase is to ensure that there are uninterrupted supplies of medical commodities and services. This requires scaling up the ability of local bodies to manage drug procurement and general logistics and adequate human resource in local healthcare centres. This article documents the efforts made so far in context of health sector federalization and synthesizes the progress and challenges to date and potential ways forward. This paper is written at a time while it is critical to review the federalism initiatives and develop way forward. As Nepal progress towards the federalized health system, we propose that the challenges inherent with the transition are critically analysed and mitigated while unfolding the potential of federal health system. Kerman University of Medical Sciences 2018-12-22 /pmc/articles/PMC6499910/ /pubmed/31050964 http://dx.doi.org/10.15171/ijhpm.2018.121 Text en © 2019 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Perspective
Thapa, Rajshree
Bam, Kiran
Tiwari, Pravin
Sinha, Tirtha Kumar
Dahal, Sagar
Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
title Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
title_full Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
title_fullStr Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
title_full_unstemmed Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
title_short Implementing Federalism in the Health System of Nepal: Opportunities and Challenges
title_sort implementing federalism in the health system of nepal: opportunities and challenges
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499910/
https://www.ncbi.nlm.nih.gov/pubmed/31050964
http://dx.doi.org/10.15171/ijhpm.2018.121
work_keys_str_mv AT thaparajshree implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges
AT bamkiran implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges
AT tiwaripravin implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges
AT sinhatirthakumar implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges
AT dahalsagar implementingfederalisminthehealthsystemofnepalopportunitiesandchallenges