KATHMANDU:
Calling on all stakeholders to align resources with real needs, Secretary of the Ministry of Health and Population (MoHP) Dr. Bikash Devkota said the country's journey toward Universal Health Coverage (UHC) depends not only on funding but also on prioritizing the right interventions and populations.
He said this while addressing a workshop organized today in Kathmandu on "Priority Setting for Universal Health Coverage: Reprioritizing Health Program Interventions for Updated Essential Health Care Package." The event was jointly hosted by MoHP and the Bergen Centre for Ethics and Priority Setting in Health (BCEPS), University of Bergen (UiB).
Dr. Devkota emphasized the importance of data-driven decisions and delivering high-impact services. "We cannot achieve UHC without resources, but more importantly, we must assess how well we are using what we already have," he said. "We have the policies; now we must overcome the problem of weak implementation." The event brought together government officials, development partners, researchers, and civil society to align on a strategy to strengthen Nepal's Essential Health Care Package (EHCP).
In the first session, Dr. Krishna Prasad Paudel from MoHP highlighted the current EHCP includes nine primary service categories and 98 essential medicines. However, major gaps remain in financing and service delivery. "More than half of health spending in Nepal still comes from people's pockets," Dr. Paudel noted.
Similarly, Achyut Raj Pandey, a PhD scholar of UiB, shared global examples of EHCP updates from countries like Pakistan, Zanzibar, Ethiopia, and Afghanistan. "These countries used a mix of data, fiscal analysis, and stakeholder consultation and the countries that developed focused, data-driven health packages made substantial progress in improving coverage," Pandey highlighted.
Also sharing on the occasion, Ravi Kanta Mishra, Senior Public Health Officer at MoHP, detailed Nepal's ongoing efforts. He explained how Nepal is using both health and economic data to guide decisions and has contextualized a decision support tool developed by the UiB and University of Washington, FairChoices, to Nepal's context to support this work. The initiative is part of a broader effort under Nepal's Health Sector Strategic Plan 2023-2030.
Dr. Krishna Aryal, Senior Researcher of UiB, presented early findings using the FairChoices tool. More than 130 interventions have been analyzed based on cost-effectiveness, health impact, and feasibility. These findings are being refined through expert input and further data modeling. "We are now able to see which interventions save the most lives for the lowest cost, helping us prioritize what truly matters," he said.
Participants also engaged in group work to gather perspectives on interventions for non-communicable diseases, communicable diseases, and RMNCAH-N (Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition).
The final session, led by BCEPS and MoHP, discussed the next steps. Interventions will be ranked based on both quantitative results and qualitative deliberation. Packages will be finalized under two main categories: those essential for basic health services and those for health insurance.
Likewise, Dr. Rajesh Sambhajirao Pandav, WHO Representative to Nepal, expressed strong support to the initiative. "WHO remains committed to offering technical collaboration and helping Nepal build institutional processes that are inclusive and data-driven."
Dr. Deepak Karki, Health Advisor at the British Embassy and Chair of External Development Partners, highlighted affordability, saying, "If UHC is truly our goal, we must ensure that services are not just high quality but also affordable and accessible to those who need them most."
The workshop closed with a shared commitment from all participants to do more in their capacity to build a more equitable, efficient, and people-centered health system in the country.
