-Dipti Ghimire
Ms. Ghimire is a research intern at Samriddhi Foundation, an economic policy think tank based in Kathmandu. The views expressed in this article are the author’s own and do not represent the views of the organization. Author can be reached at Dipti Ghimire [email protected]
Nepal’s healthcare system finds itself trapped in a web of challenges that extend far beyond just providing medical care. The turbulent political landscape, characterized by frequent changes in government, serves as a constant threat, disrupting healthcare policies and long-term planning.
Nepal allocates less than 10% of its GDP to healthcare expenses, severely constraining its ability to cater to a population exceeding 29 million people. Notably, in 2018, 57% of healthcare costs in Nepal were paid directly by its citizens through out-of-pocket expenses, imposing a heavy financial burden, particularly for essential healthcare services.
With only 32,118 doctors serving a population of nearly 29.2 million, Nepal’s doctor-to-people ratio stands at 1:909. This glaring shortage highlights a significant deficit in healthcare professionals, making access to critical treatments a distant goal. The magnitude of this problem is further exacerbated by political interference, corruption, inadequate healthcare infrastructure and limited access to essential services.
The government’s practice of appointing under qualified individuals to influential positions and interfering in vital areas such as medical supply procurement and healthcare professional recruitment has further crippled an already fragile system. This has led to troubling instances of healthcare personnel lacking proper qualifications, subpar medical equipment, excessive patient charges, and the delivery of substandard services.
The infiltration of political interference and corruption into the healthcare system not only perpetuates inefficiency but also erodes public trust. When individuals lacking the necessary qualifications are entrusted with critical healthcare decisions, the consequences are severe. Citizens bear the brunt of mismanagement and systemic inadequacies, while the healthcare sector’s reputation suffers.
Amidst these formidable challenges, the need for reform becomes increasingly apparent. Essential steps include amending pivotal laws, such as the Corruption Prevention Act, CIAA Act, and health insurance legislation. Equally crucial is the establishment of regional offices to investigate local-level corruption and political interference in the system, along with an expanded and strict jurisdiction for the CIAA. In the pursuit of transformation, inspiration can be from the United States‘ anti-corruption task force, which achieved remarkable results, recovering $1-3 billion USD over a decade in healthcare.
Transparency, accountability, and meritocracy must take precedence over political interference and corruption within the healthcare system. Regulatory frameworks and substantial investments in healthcare infrastructure are imperative. This shift towards fairness and integrity not only promises to cleanse the system but also opens the doors to a brighter future for healthcare in Nepal – a future where every citizen can trust that their health and well-being are safeguarded, where access to quality healthcare is a reality, and where the integrity of the system shines as a beacon of hope for generations to come.