Nepal’s Federal Health Structure: An updated and Complete Package

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Nepal’s transition to federalism has profoundly affected its health system. It aims to decentralize healthcare services for better accessibility. This is particularly important in undeserved areas. The federal health structure involves several layers. The central government and local entities have distinct roles. They have responsibilities in managing and delivering health services.

Organogram of Nepalese Health Systems

Structures in the Federal health system

1. Ministry of Health and Population (1)
2. Departments (3)
3. Divisions and centers (5\5)
4. Councils (6)
5. Central Hospital under MOHP (14)
6. Cental Hospital under other ministries
7. Academia and Institutions
8. External Development Partners ( unilateral, Bilateral, Multilateral)
9. Private Hospitals and Medical colleges

References: Organogram-of-the-Ministry-of-Health-prior-to-federalization_fig1

At the Federal Government level, the Ministry of Health & Population oversees the entire public health system in Nepal. This ministry is divided into several divisions, each focused on specific areas:

• Policy, Planning & Monitoring Division
• Health Coordination Division
• Quality Assurance & Regulation Division
• Population Management Division
• Administration Division

The ministry also includes specialized units, such as the Health Emergency and Disaster Management Unit (HEOC), which plays a vital role in emergency preparedness and response.

Organogram of MoHP Nepal

Divisions of the MOHP

1. Policy Planning and Monitoring Division
2. Health Coordination Division
3. Quality Assurance and Population Division
4. Population and Management Division
5. Administrative Division

Sections Under Divisions

1. Policy Planning and Monitoring Division (4 sections)

• Policy and Planning Section
• Monitoring and Evaluation Section
• Curative Service, Education, and Research Section
• Ayurveda and Alternative Medicine Section

2. Health Coordination Division (4 sections)

• Provincial and Local Health Coordination Section
• Multisectoral -Coordination Section
• Development Support and Coordination Section
• Public Information Coordination Section

3. Quality Standard and Regulatory Division ( 2 sections)

• Quality Standard and Regulation Section
• Information, Communication and Technology section

4. Population Management and Information Division ( 2 sections)

• Population Management and Information Section
• Gender Equality and Social Inclusion Section

5. Administrative Division (4 sections)

• Personal Administrative section
• Financial Administrative section
• Legal Section
• Internal Administration Section

Councils that regulate different health professions include:

• Nepal Medical Council
• Nepal Nursing Council
• Nepal Ayurvedic Medical Council
• Nepal Health Professional Council
• Nepal Pharmacy Council
• Nepal Health Research Council

Additionally, Central Hospitals provide tertiary care and support the national health strategy.

Table listing these central hospitals, their locations, official addresses, phone numbers, and websites:

S.N.	Hospital Name	Location (District)	Official Address	Phone Number	Website
1	Bir Hospital	Kathmandu	Kanti Path, Kathmandu 44600, Nepal	+977-1-4221119	birhospital.gov.np
2	Kanti Children’s Hospital	Kathmandu	Maharajgunj, Kathmandu, Nepal	+977-1-4411550	kantichildrenhospital.gov.np
3	Paropakar Maternity and Women’s Hospital	Kathmandu	Thapathali, Kathmandu, Nepal	+977-1-4260405	pmwh.gov.np
4	Sukraraj Tropical and Infectious Disease Hospital	Kathmandu	Teku, Kathmandu, Nepal	+977-1-4253396	stidh.gov.np
5	Mental Hospital	Lalitpur	Lagankhel, Lalitpur, Nepal	+977-1-5521612	mhl.org.np
6	Civil Service Hospital	Kathmandu	Minbhawan, Kathmandu, Nepal	+977-1-4107000	csh.gov.np
7	National Trauma Center	Kathmandu	Mahankal, Kathmandu, Nepal	+977-1-4221119	ntc.gov.np
8	Shahid Gangalal National Heart Center	Kathmandu	Bansbari, Kathmandu, Nepal	+977-1-4371322	sgnhc.org.np
9	Patan Hospital	Lalitpur	Lagankhel, Lalitpur, Nepal	+977-1-5522295	patanhospital.org.np
10	Nepal Police Hospital	Kathmandu	Maharajgunj, Kathmandu, Nepal	+977-1-4412430	nph.nepalpolice.gov.np
11	National Academy of Medical Sciences (NAMS)	Kathmandu	Mahabouddha, Kathmandu, Nepal	+977-1-4258554	nams.org.np
12	B.P. Koirala Memorial Cancer Hospital	Chitwan	Bharatpur, Chitwan, Nepal	+977-56-526305	bpkmch.org.np
13	B.P. Koirala Institute of Health Sciences	Sunsari	Dharan, Sunsari, Nepal	+977-25-525555	bpkihs.edu
14	Manmohan Cardiothoracic Vascular and Transplant Center	Kathmandu	Maharajgunj, Kathmandu, Nepal	+977-1-4371374	mcvtc.gov.np
15	Nepal Eye Hospital	Kathmandu	Tripureshwor, Kathmandu, Nepal	+977-1-4250691	nepaleyehospital.org.np

Departments and Centers Under Federal Health

Key departments under the Ministry include:

• Department of Health Services (DoHS)
• Department of Drug Administration (DDA)
• Department of Ayurveda and Alternative Medicine (DoAA)
• Vector Borne Disease Research and Training Center (VBDRTC)

Under the Department of Health Services (DoHS), specialized centers and divisions focus on areas such as health education, communicable diseases, and training:

• National Health Education, Information and Communication Centre (NHEICC)
• National Health Training Centre (NHTC)
• National Centre for AIDS and STD Control (NCASC)
• National Tuberculosis Control Centre (NTC)
• National Public Health Laboratory (NPHL)

These centers work through various divisions, including the Management Division, Family Welfare Division, Curative Service Division, Nursing and Social Security Division, and Epidemiology and Disease Control Division (EDCD). Each division is supported by sections like the Administration Section and Finance Administration Section.

In the Department of Drug Administration (DDA), divisions include:

• Drug Evaluation and Registration Division
• Planning, Coordination, and Management Division
• Inspection, Evaluation, and Law Enforcement Division
• National Medicines Laboratory (NML)

The Department of Ayurveda and Alternative Medicine (DoAA) further supports traditional and alternative health practices with its Herbs, Medicine, and Research Division, Ayurveda Medicine Division, and Alternative Medicine Division.

Organogram of Central/Federal Health System Nepal

Provincial Health Systems of Nepal

Each of Nepal’s seven provinces manages healthcare through the Provincial Health System, under the Ministry of Social Development (MoSD). Key divisions include:

• Hospital Development and Medical Service Division
• Policy, Law, Standard, Planning, and Public Health Division

Provincial Health Level of Nepal

• Ministry of Social Development/PMoHP-7
• Provincial Health Directorate-7
• Provincial Logistics Management Centres-7
• Provincial Health Training centre-7
• Provincial Reference Laboratory-7
• Health Offices -77
• Provincial Hospitals–
• Private Hospitals/Academia/ NGOs

Offices within the provincial system, such as the Health Directorate, PHEOC, and Provincial Health Logistic Management Center, ensure resources and policies are effectively managed. Provincial Hospitals, Health Offices, and Provincial Reference Laboratories provide secondary and specialized healthcare services across the provinces.

Table listing hospitals in their respective provinces and official addresses:

S.N.	Province	Hospital Name	Official Address	Phone Number	Website
1	Koshi Province	Koshi Hospital	Biratnagar-10, Morang, Koshi Province, Nepal	+977-21-471137	koshihospital.gov.np
2	Koshi Province	Provincial Hospital Bhadrapur	Bhadrapur-8, Jhapa, Koshi Province, Nepal	+977-23-523024	provincehospital.koshi.gov.np
3	Bagmati Province	Hetauda Hospital	Hetauda Sub-metropolitan City, Makwanpur District, Bagmati Province, Nepal	+977-57-520254	hetaudahospital.gov.np
4	Gandaki Province	Pokhara Academy of Health Sciences	Ramghat, Pokhara, Kaski District, Gandaki Province, Nepal	+977-61-522999	pahs.gov.np
5	Lumbini Province	Lumbini Provincial Hospital	Butwal, Rupandehi District, Lumbini Province, Nepal	+977-71-540244	lph.gov.np
6	Lumbini Province	Rapti Provincial Hospital	Tulsipur, Dang District, Lumbini Province, Nepal	+977-82-520011	rph.lumbini.gov.np
7	Karnali Province	Karnali Provincial Hospital	Birendranagar-4, Kalagaun, Surkhet, Karnali Province, Nepal	+977-83-523200	provincehospital.karnali.gov.np
8	Sudurpashchim Province	Seti Provincial Hospital	Dhangadi, Kailali District, Sudurpashchim Province, Nepal	+977-91-520489	sph.gov.np
9	Sudurpashchim Province	Mahakali Provincial Hospital	Mahendranagar, Kanchanpur District, Sudurpashchim Province, Nepal	+977-99-520386	mph.sudurpashchim.gov.np

Local Level Health System of Nepal

At the Local Government level, health services are organized under various structures depending on the area’s designation as a metropolitan, sub-metropolitan, rural municipality, or municipality. These include:

• Metropolitan Health System
• Sub-Metropolitan Health Section
• Rural Municipality Health Section
• Municipality Health Section

Health Facilities

• Primary Hospitals (5,10 & 15 Beds Hospitals)
• Urban Health Centre
• Health Post (Total no 3808)
• PHC- ORC (Total no 11974)
• EPI-ORC (15835)
• FCHV (Total Number of FCHV is 52420)
• CBO/Pharmacies/Local NGOS/clubs

Primary healthcare facilities at this level include Primary Hospitals, Primary Health Care Centers, Health Posts, Urban Health Promotion Centers, and Community Health Units. Programs like the Expanded Program on Immunization Clinics and Primary Health Care Outreach Clinics extend essential services to communities, with support from Female Community Health Volunteers.

Organogram and staffing details of 15 bedded hospital

Strengthening Nepal’s Health System through Federalism

The decentralization process enables local governments to address health needs more effectively. It fosters a sense of ownership and accountability. However, there are challenges, including equitable resource distribution, intergovernmental coordination, and ensuring healthcare service quality across provinces.

The government of Nepal and stakeholders are building a fully functional federal health system. They focus on universal health coverage and primary healthcare. They also prioritize the recruitment and retention of skilled health professionals. This federal health system has the potential to transform healthcare in Nepal. It aims to make it more responsive, inclusive, and sustainable for all citizens.

Disclaimers: The data, documents, and facts presented here are based on various references and may change over time. We kindly request that you verify the information on their respective sites.