Nepal-WHO country cooperation strategy (CCS) 2018-2022.

Research Report.

SUMMARY: Nepal has made impressive progress in health outcomes relative to its income level. Life expectancy has been steadily increasing and Nepal's progress in reducing maternal and child deaths has been lauded internationally, even though the maternal mortality remains the highest in the South-East Asia Region. There are notable achievements in reducing prevalence of HIV and TB and Nepal is on track to be malaria-free by 2025. Aggregate improvement in health outcomes, however, mask the large urban-rural, gender, poverty, ethnicity and caste inequities. Following decades of political uncertainty, the country is going through a political transition from a unitary state to a federalized structure with new roles and responsibilities for local, provincial and federal governments. Nepal's newly endorsed Constitution enshrines the right to healthy living and access to health services as a fundamental human right. It guarantees every citizen with the right to free basic health services from the State, emergency health services, and equal access to health services. This implies a significant restructuring of the state and provides an enviable opportunity to re-organize the health systems around the principles of universal health coverage. While closely following these historic developments, tge CCS is also informed by the aspirational national policies and strategies-National Health Policy (2014) and Nepal Health Sector Strategy (2015-2020)-and its international commitments made by the Government of Nepal, and the Sustainable Development Goals (SDGs). It was developed in consultation with senior officials in the Ministry of Health and Population, partners and WHO Country Office staff. A CCS Committee was formed in the Ministry of Health and Population that provided technical guidance for its development. Several rounds of discussions with Secretary of Health, senior management of the Ministry of Health and Population, and the Regional Office, coalesced around four strategic priorities for WHO over the next five years. Four strategic priorities for WHO collaboration in Nepal 2018-2022: (1) Advancing universal health coverage in a federalized governance structure. (2) Effective delivery of priority public health programmes. (3) Enhance health security and disaster preparedness and response. (4) Multisectoral engagement and partnerships for improved health outcomes. Looking ahead, it is paramount that WHO in Nepal seek to forge meaningful partnerships with other government agencies, other ministries, UN agencies and nonState actors to address important public health problems and to influence the social, economic and environmental determinants of health. This marks an important departure and a more pro-active engagement of WHO in the SDG era. WHO will need to extend its support beyond the federal ministry to subnational levels, to accommodate changes being introduced under a federalized form of governance. The Organization will focus on its competitive advantages, and define the scope of its support, in alignment with government priorities and harmonized with development partners. The Organization will be more accountable regarding its commitment to achieving agreed-upon targets and deliverables.