The national health insurance is a real game changer, but it needs to be expanded, not only geographically but also in terms of public outreach and coverage. Ideally a national campaign should be designed and launched
Over the last few months, Health and Population Minister Mohan Bahadur Basnet has incessantly spoken about ensuring the right to health that all Nepalis should enjoy. I am taking the opportunity offered me by this column to respectfully address minister Basnet with some humble suggestions and ideas.
Dear Mr Basnet, I am writing you this open letter not only as a passionate observer of the national affairs of the country but also as someone whom this country is kindly and generously providing home.
Getting the public health right is paramount to jumpstarting the economy needed for Nepal to become a middle-income nation in one decade from now. I am fully aware that this is a gigantic task, and not only your dedication but also the tenacity of a whole system will be needed to achieve it.
With this letter, I am humbly suggesting, what, from my perspective, could propel the creation of such a strong public health system.
I must confess that, despite having worked inthe past in the school and health nutrition sector, I am not a public health specialist.
So please accept the following ideas as a small contribution from my side.
Idea No.1: Let's build more hospitals. The previous Oli government promised to build hundreds of hospitals around the nation.
I often read that the construction of new public health centres, including hospitals, have started. This is an excellent move, giving continuity to what the previous government had decided.
Perhaps, the Ministry of Health and Population should come forward and publicise the whole plan behind the construction of these facilities.
Where will they be built? What will be the timeframe for their competition? Why not have a dedicated online portal tracking the execution of their construction? Idea No.2: Scale up the national health insurance.
As you know very well, this is a real game changer, but it needs to be expanded, not only geographically but also in terms of public outreach and coverage. Ideally a national campaign should be designed andlaunched to make citizens aware of their rights under this facility.
Idea No.3: Set up a special mechanism for the most vulnerable citizens.
This newspaper often carries stories of desperate citizens that are badly in need of public health care. For example, just a few days ago, on September 3, the case of Dil Bahadur Rokaya,32, in Bajura was reported.
He suffers of leprosy but has no access to public health. Only an effective local public health system can offer care and remedy to situations like the one suffered by Rokaya, and I can only grasp the complexity of creating a mechanism to address these cases.
Yet because the work in the health sector being carried out by municipalities is still in its nascent phase, we are still very far from qualitypublic health care being administered locally. That's why we need the federal government should step in.
Idea No.4: Create a unit for the rarest diseases. This newspaper wrote, some time ago, the story of Jyoti Budhathoki, who suffers from a rare form of sclerosis, a disease that requires expensive medications and complex treatments.Through the AIN Secretariat, her case was made known to some senior officers of your ministry. Jyoti still awaits the opportunity to present and share her situation.
She does not only demand that the state fulfill the pledges made, through the constitution, to its citizens in terms of free health care. Jyoti also wants to create awareness about her own condition and other forms of sclerosis that are not covered by the publichealth system. The systemic sclerosis Jyoti has been fighting against forced also the amputation of one of her legs. Like her, there are so many other citizens suffering from complex rare diseases, and the state cannot ignore them.
Idea No.5: Make Hello Sarkar also more responsive to health care issues. It is great to hear that the Prime Minister is strengthening this service where citizens can bring forward their grievances. I am wondering if among the staff working at Hello Sarkar unit, there are also public servants from a public health background so that they can better coordinate with hospitals and public health facilities and local administrative units focused on the provision of public health care. I understand this is a huge task, but better and stronger feedback from the federal units can enhance the overall level of responsiveness of local health care.
Idea No.5. Involve the private sector. Dear Minister Basnet, you know very well that the private hospitals play a huge role in the provision of health services.
They must be made more accessible and better regulated.
Building new public hospitals and health care units will not be enough to address the health needs of a nation. The private hospitals sector remains key in creating a truly national health system.
As challenging as it is going to be, a negotiating table should be established to better integrate private hospitals in the national health system.
Idea No. 6: Fix the ticketing system at Teaching Hospital. Your job as minister is not fixing the horrible queues that the public must face at the main hospital of the country. Yet your intervention might be needed. I recently visited it twice. The first time the numbering at the payment windows were not working, and there was a massive queue. The next time, the numbering system was apparently working, but it was not followed.
I know all these suggestions, perhaps, are too simplistic.
They are all certainly very expensive, and I do hope that you and the whole Federal government will put pressure on the international community, including the World Bank, to come up with a special support package.
A version of this article appears in the print on September 13, 2023, of The Himalayan Times.