NATIONAL HEALTH SECTOR PROGRAM (NHSP-IP)

5.1 BACKGROUND

Nepal Health Sector Program (NHSP) is a sector wide program focused on performance results and health policy reforms implemented under a Sector Wide Approach (SWAp) with an agreed set of program performance indicators and policy reform milestones for the program duration. The policy reform milestones are outlined in the Nepal Health Sector Program Implementation Plan (NHSP-IP).  Of the eight NHSP outputs, three are defined for strengthening the health service delivery:

  1. Delivery of essential health care services,
  2. Decentralized management of service and
  3. Public private partnership.

The remaining five outputs are designed for improvement in institutional capacity and management in the areas of:

  1. Sector management,
  2. Health financing and financial management including alternative financing,
  3. Physical asset management and procurement,
  4. Human resource management,
  5. Health management information system and quality assurance.

5.2 PURPOSE OF NEPAL HEALTH SECTOR PROGRAM

This program seeks to address disparities in the system and improve the health of the Nepali population, especially the poor and vulnerable.  NHSP marks a new approach in Nepal which aims at the delivery of basic services to poor and rural populations and the aid resources will increasingly support a sector program, rather than isolated projects. The program design was led by the efforts of Nepali themselves and is built under a sound sector strategy. Hence, the Health Sector Strategy with its Nepal Health Sector Program Implementation Plan is a building block of sector wide rationalization aimed towards aid harmonization, strong performance and reform focus.

5.3 PROGRAM OBJECTIVES

The objective of NHSP is to improve health outcomes by expanding access to and increasing the use of Essential Health Care Services (EHCS), especially for the poor with a nationwide coverage.

5.4 NHSP STRATEGIC PROGRAM ACTIVITIES

NHSP strategic program activities are broadly organized in two components that consolidate the eight areas of work in the NHSP-IP: a) Strengthened Service Delivery through the expansion of essential health care services, greater local authority over and responsibility for service provision, and public-private partnerships; b) Institutional Capacity and Management Development through improved health sector management; sustainable health financing and financial management; human resource development; physical asset management and procurement; and health management information system and quality assurance.

5.5 SUMMARY OF ACHIEVEMENTS DURING FY 2062/63 (2005/2006): PROGRAM PERFORMANCE MEASUREMENT STATUS

As defined in the NHSP four key programmatic indicators were agreed to assess annual achievement in program performance: (a) contraceptive prevalence rate (CPR) (b) skilled attendance at birth (c) immunization rates and (d) population€™s knowledge about at least one method of preventing HIV/AIDS. Nepal Demographic and Health Survey (NDHS), 2006 has published a preliminary report showing a remarkable improvement over the period 2001 as a base line on the above indicators.

According to reports from the MoHP, DoHS, Management Division, Health Management Information Section (HMIS) between 2004/2005 and 2005/2006, CPR increased from 41.3% to 42.1 and delivery by trained health workers from 20.2% to 23.4%.  The routine immunization coverage increased from 80% to 93% for DPT3 and from 79% to 88% for measles. As per the NDHS 2006, the knowledge of at least one method of preventing HIV/AIDS has also improved considerably.

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