Call for feedbacks on formulation of Nepal's New
National Health Policy 2074
On behalf of People's Health Movement Nepal, this is to inform you that Ministry of Health, Nepal is formulating New National Health Policy 2074 based on the current federal structure and emerging health needs. It is appreciative that MoH has announced a notice asking for feedback for the revision of National Health Policy 2071 from different professional groups and citizens as mentioned in the following link.
(http://www.mohp.gov.np/app/webroot/upload/files/Final%20notice%20about%20revision%20of%20national%20health%20policy.pdf).
In this regard People's Health Movement Nepal has drafted this document to raise some pertinent issues that needs to be considered by the state while formulating new national health policy 2074. This email is to request you to go through the following document and provide your valuable inputs so that our voices would be stronger and uniform. Please take this just as a zero draft to initiate discussions among us and build consensus.
We highly appreciate your comments. Please feel free to share this draft with your colleagues who believe and act as per the spirit of PHM. We hope to receive your comments no later than 27th September, 2017.
You can email your inputs to email address: [email protected]
Zero draft of: Feedback from People's Health Movement Nepal to the formulation of Nepal's New National Health Policy 2074
(http://www.mohp.gov.np/app/webroot/upload/files/Final%20notice%20about%20revision%20of%20national%20health%20policy.pdf).
In this regard People's Health Movement Nepal has drafted this document to raise some pertinent issues that needs to be considered by the state while formulating new national health policy 2074. This email is to request you to go through the following document and provide your valuable inputs so that our voices would be stronger and uniform. Please take this just as a zero draft to initiate discussions among us and build consensus.
We highly appreciate your comments. Please feel free to share this draft with your colleagues who believe and act as per the spirit of PHM. We hope to receive your comments no later than 27th September, 2017.
You can email your inputs to email address: [email protected]
Zero draft of: Feedback from People's Health Movement Nepal to the formulation of Nepal's New National Health Policy 2074
- Health has been established as a fundamental human right by the New Constitution of Nepal 2072. Therefore, state should expand the services currently being provided as free basic health care services to ensure better health of people. It is necessary to restructure health systems so that most of the health services are financed through general taxes and provisioned by public services. Such a model best promotes equity in health care access.
- Currently GoN is implementing insurance system with the claim to address financial catastrophic expenditure. Does services equivalent to rupees 50,000 for a family will address financial catastrophic expenditure? This policy has not addressed equity issue, because the premium amount is equal for all classes of society irrespective of their economic status. What is the scientific basis/study/review for decision to implement insurance system in our context? Policy should strongly stipulate about evidence based health provisions and programs in the country. Also introduction of new vaccines in the country, new health programs should follow scientific study/researches and epidemiological considerations.
- As health status is an outcome of multiple factors, state should develop clear mechanism for integrated efforts to improve health addressing all the social determinants of health. New National Health Policy should mandate the reporting of annual progress on health dimensions of all SDG goals so that multisectoral efforts are monitored and responded effectively.
- There is no adequate mechanism to absorb human resources in public system which must be addressed by the New National Health Policy. Universal Health Coverage requires an adequate and functional health workforce. The ratio of doctors and nurses to population in Nepal indicates severe crisis in human resources of health. This must be addressed by the state. Regarding international recruitment of health workers, legally binding interventions are required and provisions are necessary so that sending countries get reimbursed for losses linked to health workers migration from Nepal to other so called developed countries. Also policy has emphasized only doctors and nurses as human resources of health which must be explicitly defined to broaden the scope and appreciate the efforts of public health professionals, mid level, grassroots health care workers and support staffs.
- The structure of global economy underpins social and health development. This area, under SDG8, anticipates very high economic growth rates in LMICs including Nepal based on the current corporate dominated extractivist model. This approach cannot mitigate local inequities nor is it environmentally sustainable. State should point out this contradiction and strenuously promote the review of this economic model.
- State should lead policies to regulate the increasingly monopolized and globalised food system which is simultaneously threatening food sovereignty and promoting unhealthy diets. National policy should mandate about the imposing taxes on specific commodities- such as the taxes on tobacco, alcohol and foods having negative impact on health, taxes on extractive industries and pollution.
- Ambitious goals of SDGs demands high investment in health sector for rapid development of infrastructures and production of skilled human resources. The current share of health sector is only 3.8 percent of GDP, less than last year's share and is far below the WHO 10% standard. Also budget allocation should consider equity aspect. More budget is required for those with highest health need.
- There are no any policy documents regarding antimicrobial resistance, non-communicable diseases, addressing safe and healthy foods, elderly health even these are posing big threats in Nepal. National health policy 2071 had overlooked zoonotic diseases, occupational health, home based palliative care and mental health services. Therefore, these issues should be considered by New National Health Policy.
- Preventive care, rehabilitative and palliative care are less emphasized in the health policy and there are unclear strategies to strengthen these services. Therefore, these services should be provisioned strongly to reduce the health care cost in the long run.
- Policy should provision about strategic purchasing which means government acting as a single payer in the health sector. This will help to regulate private sectors and NGOs working in health.
- Public healthcare system should retain a certain excess capacity in terms of health infrastructure, human resources, and technology which can be mobilized in times of medical disasters, epidemics, outbreak and crisis. Therefore, new health policy should consider this.
- Expanding the network and quality of blood banks across the country to ensure improved access to safe blood is an urgent need to be addressed by the New National Health Policy 2074.