Nepal National Health Strategy 2030: Bridging Federal Devolution and Universal Health Coverage

Executive Overview

Nepal's constitutional guarantee of health as a fundamental human right (Article 35) marks a landmark transformation in healthcare delivery across South Asia. With the ongoing implementation of the Nepal Health Sector Strategic Plan (NHS-SP) and the Public Health Service Act 2075, local governments (Palikas) have been entrusted with primary healthcare management, maternal immunization, and epidemic surveillance.

Key Strategic Pillars

1. Strengthening Municipal Health Posts: Upgrading sub-health posts to 5 to 15-bed municipal primary hospitals equipped with basic diagnostic laboratories and essential medicines.
2. Social Health Insurance Scheme (SHIS): Accelerating universal enrollment to shield households from catastrophic out-of-pocket health expenditures (OOPE), which still accounts for nearly 52% of total health spending.
3. Integrated Health Information System (DHIS-2): Real-time digital reporting bridging rural health posts, provincial directorates, and the Department of Health Services (DoHS) in Teku, Kathmandu.

Field Challenges & Policy Recommendations

• Human Resources for Health (HRH): Ensuring equitable retention of medical officers, public health officers, and skilled birth attendants (SBAs) in hard-to-reach mountainous zones of Karnali and Sudurpashchim.
• Supply Chain Logistics: Overcoming seasonal monsoon roadblocks to ensure unhindered distribution of the 98 free essential drugs mandated by the Ministry of Health and Population.