Health plan (Targets, Indicators, Strategies, and Achievement)

National Health Policy

The Nepalese government, MOHP / DHS, has adopted several policies, initiatives, laws, and regulations to improve the health of the Nepalese people. Policy and planning are terms used to describe a function that must be developed and supported throughout the health system. All health professionals must understand what the health sector is attempting to accomplish through its overall policy and work to raise community understanding of this vision for health.

National health policy: It has been defined as the orderly process of defining community health problems, identifying unmet needs, and surveying the resources available to meet them, as well as establishing realistic, feasible priority goals and projecting administrative actions to achieve the purpose of the purposed programs.

 Purpose of Health Planning

The goal of health planning is to meet people's health requirements and demands.

Health Planning System in Nepal

Fig: Encouraged- Health Planning System in Nepal

Health Cares System in Nepal

1. Integration of services
2. Primarily based on allopathiEncourage
3. Community participation
4. Various levels of services outlet
5. Different cadres of doctors, nurses, paramedics
6. Accessibility
7. Comprehensive
8. Decentralization, bottom-up planning
9. Extended in Nature

Health Cares Delivery System

Following the establishment of democracy in 1951 AD, periodic development plans were implemented with the goals of raising the gross domestic product, creating jobs, and improving people's living standards.

The DHS was founded in 1953. The goal of health service is to promote, regulate, and manage hospitals, dispensaries, ayurvedic hospitals, and Ayurvedic medicine manufacturers.

First five-year plan (1956-1961)

It was established between 1956 and 1961 with the goals of boosting collective domestic products, creating jobs, and raising people's living standards.

Second 3rd plan (1962-1965)

The second plan had no clear goal. However, a program was created to control malaria in the Terai, eradicate smallpox, control TB and leprosy, and so forth. This was in addition to training health personnel and providing health services in areas where none previously existed.

• Smallpox was eradicated in 1962, leprosy was eradicated in 1963, and tuberculosis was eradicated in 1965.
• In Kathmandu, 450 thousand individuals were immunized against smallpox.
• There are now three hospitals and eight health facilities.

Third five-year plan (1965-70)

It was established to address numerous health issues and to launch various programs with the assistance of foreign aid, such as malaria eradication, leprosy and tuberculosis control, smallpox eradication, and MCH initiatives.

• 1958- Malaria eradication project.
• 1964- Leprosy control and TB control project.
• 1965- Smallpox eradication project.
• 1968- FP& MCH project.

4th five-year plan (1971-75)

By the end of the number of health institutions, the number of hospitals had expanded to 63, health care centers 33, health posts 351, and ayurvedic hospitals dispensaries 82, with a greater emphasis on preventive and curative components of health care.

First long term plan (1975-1990 AD)

It was founded in 1975 with the goal of providing basic healthcare services to the rural population on their doorstep.

Fifth five-year development plan (1975-79 AD)

It was to provide minimum health care to a maximum number of people. In 1978 AD, the government started the integrated community health services development projects.

After the acceptance of primary health care in 1979 by all countries of the world as the key to the attainment of health for all by the year 2000AD. Nepal stepped ahead to expand and strengthen integration to meet the national goal.

Sixth 5-year plan (1980-1985)

Its goal was to give basic health care to as many individuals as possible. The government began developing integrated community health services projects in 1978 AD.

Following the endorsement of primary health care by all countries around the world in 1979 as the key to achieving health for all by the year 2000 AD. Nepal took the initiative to develop and improve its integrated efforts in order to fulfill the national goal.

Seventh 5-year plan (1985-1990)

The primary health goal of the seventh plan was to enhance the physical, mental, and communal health of the general public and develop healthy manpower, offer a maximum number of people with basic health services and lower death rates, prevent and cure disease, and extend MCH service.

• Increased the number of hospitals, hospital beds, health clinics, and health centers.
• Given the emphasis on the basic health needs to reach HFA by 2000.
• Family planning initiatives were established as a national program only in the fiscal year 1965/66.
• Guidelines for developing HP were developed.

8th five years plan (1992-1997)

This strategy was based on the new healthcare policy.

• Providing community health services.
• Offering specialized services.
• Appropriate training for health care workers.
• Improving the management of health institutions and the services they provide.
• Conducting health system research to determine the best cost-effective and sustainable healthcare delivery systems.

9th five-year plan (1997-2002)

This plan aimed to achieve success by bolstering the existing infrastructure for preventive, promotional, curative, and rehabilitation services.

• Integrate and expand basic health services to each VDC gradually, including reproductive health, child nutrition, curative services, mental health, and eye, oral, and dental health.
• Health care has become more institutionalized, with a more dispersed planning system.
• Improving the referral system.
• Increasing the prevalence of small families by improving reproductive health and family planning.
• Ensure proper trash management for hospitals and other organizations.

Tenth five-year plan (2002-2007)

The tenth five-year plan's overarching national goal is to significantly and sustainably reduce the size of poverty among Nepalese people through the building and mobilizing of healthy human resources.

Objectives

• To lower the expanding population, capable and effective types of curative, preventative, promotional, and rehabilitation health services, as well as reproductive health and family planning services, must be made available.
• Aside from enhancing the quality of health care, backward expand access to these services for backward individuals in rural and isolated areas.

Strategies

• Investment in providing basic health services to the impoverished and underserved populations will be gradually expanded.
• As a supplementary health service, Ayurveda, naturopathy, and traditional healing systems will be established.
• According to the Local Self-Government Act of 1998, health services will be gradually decentralized.
• All governmental, non-governmental, and private health facilities at the local level provide basic health services.
• Improving the quality of healthcare services through collaboration across the public, private, and non-profit sectors.

Policies and Work Plan

• Expansion of critical health services.
• Management of Ayurveda, Unani, and other traditional health services, as well as decentralization of the health sectors
• Specialized health care for communicable and non-communicable disorders.
• Service for reproductive health.

Plan

• The illness burden,
• Capacity for implementation, Equity
• Program for the impoverished, downtrodden, and those without opportunities.
• A program that aids in the abolition of poverty.

Second Long Term Health Plan (1997-2017)

The Ministry of Health and Population has created a new 20-year long-term health strategy for the country (1997-2017). The goal is to direct the development of health sectors in order to promote the general health of a population, particularly those whose health requirements are frequently unmet. The goal of SLTHP is to provide a guiding framework for the production of appropriate annual health plans that enhance a population's health status; to establish appropriate annual health plans, strategies, programs, and action plans.

Objectives

1. To promote the health of the most vulnerable populations, particularly those whose health requirements are frequently unmet, such as women and children, rural residents, and the poor and backward.
2. Cost of extending to all districts Public health measures that work.
3. To supply an adequate number of technically qualified and socially responsible health staff.
4. To increase the roles of non-governmental organizations (NGOs), the public and private sectors in providing health care.

Targets

1. To reduce infant mortality to 34.4 deaths per thousand live births.
2. To reduce under-five mortality to 62.5 deaths per thousand live births.
3. To raise life expectancy to 68.7 years by lowering the total fertility rate to 3.05 years.
4. To get the crude birth rate down to 26.6 per thousand people.
5. To reduce the crude death rate to 6 deaths per thousand people.
6. To reduce the maternal ratio to 250 per 100,000 live births.
7. Increasing the proportion of deliveries attended by skilled staff to 95%.
8. To reduce the proportion of newborns weighing less than 2500 grams to 12%.
9. To have vital pharmaceuticals available at all times of the year in all institutions.
10. 100% of institutions will be fully staffed to provide vital health care services.
11. To boost total health spending to 10% of total government spending.

• www.nhssp.org.np/health_policy.html
• https://www.ncbi.nlm.nih.gov › NCBI › Literature › PubMed Central (PMC)
• Pathak, Sumita and Sochana Sapkota. A Textbook of Leadership and Management. Bhotahity, Kathmandu: Vidyarthi Pustak Bhandar, 2014.
• https://www.slideshare.net/mlogaraj/health-planning-50306629
• nhsp.org.np/wp-content/uploads/2016/05/NHSS-English-Book-Inside-final.pdf
• nfhp.jsi.com/Docs/ReviewofhealthandhealthserviceimprovementsinNepal.pdf
• studylib.net/doc/5554195/--department-of-community-medicine-acme-pariyara