Comprehensive Analysis of Key Health Indicators of Seven Provinces

Introduction to Nepal’s Health Landscape

Understanding the state of healthcare in Nepal is crucial for policymakers, researchers, and public health advocates. The recently released “Key Health Indicators by Province” report provides a comprehensive look at the healthcare infrastructure across Nepal’s provinces. It includes detailed data on public and non-public health facilities. At PHC Nepal, we’re excited to break down the key features of this report. We will focus on the health indicators for Karnali and Sudur-Paschim provinces. You have the chance to download the official document to dive deeper into the data.

Key Features of the Report

The “Key Health Indicators by Province” report is a vital resource for understanding Nepal’s healthcare system. Here are the standout features:

• Province-Specific Data: The report provides detailed insights into health facilities across multiple provinces, with specific sections dedicated to Karnali and Sudur-Paschim provinces.
• Health Facility Breakdown: It includes data on the number of public hospitals, primary healthcare centers (PHCCs), health posts (HPs), and non-public facilities, offering a clear picture of healthcare distribution.
• Facility Status Metrics: The report evaluates the operational status of health facilities, with percentages indicating their functionality and accessibility in each province.
• Comparative Analysis: By presenting data for multiple provinces, the report allows for comparisons that highlight disparities and opportunities for improvement in healthcare access.

Provincial Health Infrastructure Overview

Nepal’s healthcare infrastructure demonstrates substantial variation across provinces, reflecting the diverse geographical and developmental challenges each region faces1. The distribution of health facilities shows interesting patterns, with Province 3 (Bagmati) leading in non-public facilities with 1,163 institutions, while Karnali Province has the fewest with only 46 non-public facilities1.

Public Hospital Distribution:

• Province 1: 18 public hospitals
• Province 2 (Madhesh): 13 public hospitals
• Province 3 (Bagmati): 33 public hospitals
• Gandaki Province: 15 public hospitals
• Province 5 (Lumbini): 20 public hospitals
• Karnali Province: 12 public hospitals

The reporting status of health facilities varies significantly, with most provinces achieving over 95% reporting rates for public hospitals, though some provinces show gaps in non-public facility reporting

🌐 Why This Report Matters

Understanding Nepal’s provincial health indicators is crucial for achieving equitable health outcomes and meeting Sustainable Development Goals (SDGs). This report, compiled from national datasets (e.g., HMIS 2017/18, NHFS 2015, NDHS 2016), offers an in-depth look at health service delivery, population health status, and system readiness across the provinces—from Province 1 to Sudurpaschim.

🏥 Key Highlights by Thematic Areas

✅ 1. Health Facility Distribution

• Nationwide: 125 public hospitals, 3,808 Health Posts (HPs), and 1,822 non-public facilities
• Province Spotlight: Sudurpaschim has 378 HPs; Bagmati has the highest number of non-public facilities (1,163)

💉 2. Immunization Coverage

• National BCG coverage: 92%
• Province 5 (Lumbini): Best DPT-HepB-Hib3 coverage at 87%
• Sudurpaschim: High full immunization rate at 76%

🤰 3. Safe Motherhood

• ANC 4th visit as per protocol: National avg. is 50%
• Karnali: Best in 1st ANC visit attendance (117%)
• Lumbini: Highest institutional deliveries (75%)

🧒 4. Child Nutrition & Growth Monitoring

• Karnali: Top in growth monitoring registration (126% for 0–11 months)
• Stunting among U5s: Worst in Karnali (54.5%), best in Gandaki (28.9%)

🌿 5. Communicable Diseases

• TB Notification Rate: Highest in Lumbini (140 per 100k)
• Leprosy NCDR: Highest in Province 2 (21 per 100k)
• Diarrhea incidence per 1,000: Karnali (709), Super-paschim (648)

🧪 6. Diagnostic Capacity & Medicine Availability

• Tracer medicine availability (18 items): National avg. <1%
• Health posts with lab services: Highest in Sudurpaschim (31.9%)

👩‍⚕️ 7. Human Resources & Service Coverage

• Government-sanctioned posts filled: Best in Gandaki (78.1%)
• Facilities offering all basic services: Highest in Bagmati (68.9%)
• Use of OPD services: Highest in Gandaki (96%)

🚻 8. Gender Equality & SDG Indicators

• Skilled birth attendance: National avg. 58%, best in Gandaki & Bagmati
• Tobacco use (men 15+): Highest in Sudurpaschim (40.2%)
• Violence against women: Highest in Province 2 (17.4%)

📁 Download the Full Official Report

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Spotlight on Karnali and Sudur-Paschim Provinces

The report highlights critical data for Karnali and Sudur-Paschim provinces, two regions with unique healthcare challenges due to their geographic and socio-economic contexts. Here’s a snapshot of the findings:

• Karnali Province:
  • Public Hospitals: 12 out of 125 facilities, with a 97% operational status.
  • Primary Healthcare Centers (PHCCs): 13 out of 198 facilities.
  • Health Posts (HPs): 13 out of 199 facilities.
  • Non-Public Facilities: 46 out of 1,822 facilities, with a 98% operational status.
  • Public Facilities: 95 facilities, with a 95% operational status.
• Sudur-Paschim Province:
  • Public Hospitals: 14 out of 125 facilities, with a 99% operational status.
  • Primary Healthcare Centers (PHCCs): 16 out of 125 facilities.
  • Non-Public Facilities: 43 out of 1,822 facilities, with a 100% operational status.
  • Public Facilities: 95 facilities, with a 95% operational status.

This data highlights the varying levels of healthcare access across Nepal’s provinces. It also illustrates differences in infrastructure development. Sudur-Paschim shows higher operational status for non-public facilities compared to Karnali.

🔍 What Policymakers & Health Managers Can Do

✅ Use the provincial comparison to:

• Allocate budget and human resources effectively
• Design province-specific intervention programs
• Strengthen underperforming districts
• Monitor SDG and UHC-related indicators more closely

Provincial Health System Strengths and Opportunities

Each province demonstrates unique strengths that can inform best practices for national health system improvement:

Province 1: Strong quality of care standards and low dropout rates
Province 2: High laboratory diagnostic capacity despite other challenges
Province 3: Excellent nutritional outcomes and service availability
Gandaki Province: Superior maternal health outcomes and low violence rates
Province 5: Outstanding institutional delivery rates and maternal care
Karnali Province: Exceptional immunization coverage and growth monitoring

Future Directions and Recommendations

The provincial health data reveals both remarkable achievements and persistent challenges requiring targeted interventions. Successful provinces can serve as models for implementing evidence-based strategies in underperforming regions. Cross-provincial learning and resource sharing could accelerate progress toward achieving national health goals.

Priority areas for improvement include strengthening diagnostic capabilities. Ensuring consistent medicine availability is also crucial. Additional focus should be on improving quality of care standards. It is important to address regional disparities in maternal and child health outcomes. The data shows that significant improvements in health indicators are achievable. This is possible with focused efforts and appropriate resource allocation across all provinces.