Himalayan News Service

Kathmandu, April 5:

The government is short of 100 million dollars in its bid to provide essential health care of 5.5 dollars per capita."The estimated cost of essential health care of 5.5 dollars per person indicates the need of around 550 million dollars for five years and a resource gap of approximately 100 million dollars," said Dr B D Chataut, director general at Department of Health Services.

He was presenting a policy paper on health sector development of the government, during a pre-consultation meeting of Nepal Development Forum here on Monday. Even the shoestring amount of $5.5 falls many times short as compared to the $34 per person recommended by the Global Commission on Macroeconomics and Health to cover essential health care for the poor. Chataut said, "The continuation of conflict may erode health gains by worsening the livelihood of the rural poor," and added there were instances when both the Maoists and the security forces challenged health workers and that the conflict had increased health care needs, especially in conflict-ridden areas.

Lack of health insurance mechanisms in the country was resulting in people adopting a regressive and costly mode of health benefit payments. "By paying directly out of their pockets, individuals are sinking deeper into a vicious cycle of medical-poverty trap," said Dr Chataut.Dr Nirmal Prasad Pandey, former member of National Planning Commission said, "The paper should elaborate why we need additional fund and also how we plan to use it." He added that the lack of managerial efficiency was a major hindrance in implementing plans and policies.

Dr Madhur Ghimire said the government needed to decentralise the decision-making process. "The disparity of health status as per gender, caste and topography further underpins the fact that we cannot afford to divert our budget for health and education to other heads." Dr Rita Thapa opined the real challenge lay in providing equal health benefits to a girl born in Mugu as to one born in Kathmandu.