A critical analysis of health system in Nepal : Perspective's based on CoVID-19 response.
EXECUTIVE SUMMARY: Nepal moved from a unitary government to federal system of government in 2015 in accordance to its constitution. Nepal is a federal democratic republic governed with three levels of government: a federal, provincial and local level. The response to COVID-19 in Nepal has majorly l...
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| Format: | Book |
| Language: | English |
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c2021.
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| Online Access: | Visit NHRC Library |
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| Summary: | EXECUTIVE SUMMARY: Nepal moved from a unitary government to federal system of government in 2015 in accordance to its constitution. Nepal is a federal democratic republic governed with three levels of government: a federal, provincial and local level. The response to COVID-19 in Nepal has majorly led and controlled by the federal government. Federal government is leading for COVID-19 management. It has been developing policy and guidelines. All three levels of government are performing their responsibilities however facing a range of challenges in responding to COVID-19. The overall purpose of the study is to critically analyze the health system of Nepal in the context COVID-19 response. It aims to analyze the roles, responsibility and the performance of the three tiers of health system based on COVID-19 response. This study helps to identify the actual gaps in three tiers of health system and eventually provide concrete and feasible recommendations for well- strengthen health system response to health emergencies. A qualitative cross sectional study with phenomenological approach was used to analyze health system response to COVID-19 in Nepal. We conducted 41 IDIs among the policy makers, health workers and stakeholders at federal, provincial and local level (Karnali). We used a convenient sampling method for the selection of the participants and determine the sample size by the principle of data saturation. We used both primary (In-depth interview) through phone calls and secondary (Desk Review) data. The interview was audio recorded and transcribed. The transcription was translated into English. The thematic analysis was done. This study concludes that there was a significant impact of COVID-19 on routine health care with mostly maternity services, immunization as the health facilities were mainly providing COVID related services. Consequently, there was an increase in home deliveries, immunization dropout rate and neonatal deaths. However, all three tiers of government performed their roles and responsibilities in this COVID-19 pandemic response and management. The federal and provincial level were more concentrated on formulation of the various plans, policies, guidelines, and directives, and facilitated in their implementation. And, the local government was more responsible in the implementation and followed the plans, policies and guidelines provided by the federal and provincial government. However, there was poor coordination and unclear roles and responsibilities which led to miscommunication. So, things got overlapped regarding work between the local, provincial and federal level. Hence, a proper coordination and clarity on roles & responsibilities between three tiers is required. It is very essential for all three tiers of government to coordinate together for preparing and communicating the information in this time of emergency. Besides, it is very essential to strengthen the local level government in order to sustain the federal health system in Nepal. |
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| Item Description: | Thesis Report. |
| Physical Description: | viii,68p. |