KATHMANDU, MARCH 25
Health stakeholders across federal, provincial, and local governments have been urged to make effective use of evidence from a comprehensive analysis on the burden of disease (BoD) and probability of premature death (PPD) to co-create evidence-driven health system reforms.
Such a call was made during a workshop held in Lalitpur on Wednesday to disseminate new BoD and PPD analyses to senior health officials from federal and provincial governments. The findings, among others, highlight shifting health priorities, identify current implementation bottlenecks, and underscore the need to revisit existing health policies.
The analyses were carried out as a foundational analysis of health status in Nepal under the PPD analytical component of the Nepal Chapter of The Lancet Commission on Investing in Health (Nepal CIH), within the dialogue for innovation and impact project implemented by HERD International (HERDi) in coordination with the Ministry of Health and Population (MoHP) and the Nepal Health Economics Association (NHEA). The initiative was supported by the British Embassy Kathmandu (BEK) in partnership with the Bergen Centre for Ethics and Priority Setting in Health (BCEPS) at the University of Bergen (UiB), Norway.
According to public health experts involved in the research, the analyses, developed through consultations with all three tiers of government, aim to generate evidence to guide the country's future health system using systems thinking and political economy analysis.
"We have so far focused on three areas under this work," said Dr. Sushil Chandra Baral, Managing Director of HERDi. "First, the burden of disease, particularly why people die prematurely. Second, key drivers of non-communicable diseases (NCD) in Nepal, including sugar-sweetened beverages and industrially produced trans fats. Third, human resources for health (HRH) on how HRH reform should evolve to meet the changing needs."
The analyses drew on data from the 2023 Global Burden of Disease Study and the country's 2021 National Population and Housing Census. Additional data sources included the Health Management Information System, various national surveys, and hospital statistics.
On health taxation, the team conducted policy reviews and market analyses, including laboratory validation of widely sold sugar-sweetened beverage products in the country.
Similarly, in the area of human resources for health, the analyses recommend the types and distribution of workforce needed to strengthen the health system.
Drawing further attention of participating government public health officials to the analyses, a public health researcher and BCEPS PhD scholar, Achyut Raj Pandey, said a key area to explore in addressing the disease burden is identifying where resources can be saved. "We can't simply increase the budget size, yet the need is more than double. At the same time, the burden of NCDs is surging. We cannot manage without saving resources within the health system."
MoHP Secretary Dr. Bikash Devkota, who was present on the occasion, stressed the importance of evidence-informed decision-making and the efficient use of resources. He also highlighted that these results and recommendations are very timely as we are working on the annual work plan and budget of the health sector for the next fiscal year.
Among those present at the dissemination event were department heads from the ministry, focal persons from health sector agencies across all seven provincial governments, and Chair of Health Development Partners and BEK Health Advisor Dr Deepak Karki.
Saying that the initiative has helped create a very useful platform for improving evidence to policy dialogue and decision making, BCEPS Senior Researcher Dr. Krishna Aryal, who also leads the first area of this initiative on BoD/PPD analysis and coordinates the Nepal CIH, said the recommendations were the result of strong collaboration among key stakeholders and, if applied well, would benefit all levels of government and Nepali people. "The University of Bergen will continue to work alongside the Government of Nepal in strengthening evidence-informed health policies," he said.