Nepal
The United Nation's Human Development Report 2010 included Nepal in a list of 10 nations making the fastest development gains in terms of the Human Development Index over the last 4 decades. Despite this, evidence points to a chronic shortage in HRH in most cadres, especially doctors, nurses, and midwives (the density is 7 per 10,000 population) (WHO Global Atlas of the Health Workforce, 2010). Health care specialists prefer to join private institutions in urban settings or migrate to developed countries. Health workers with the least experience generally choose air-linked, remote districts to be quickly eligible to practice medicine (CCF Case Study: Nepal: Strengthening Interrelationships between Stakeholders (the Alliance, 2011).
HRH challenges that persist include:
- Poor staff performance in terms of productivity, quality, availability, and competency;
- Fragmented approach to HRH planning, management, and development;
- Imbalance between supply and demand, and narrow skill mix;
- Limited HRH financing;
- Low attraction / retention in public service, and “brain drain” largely due to the migration of health workers (Nepal: Towards building a comprehensive and costed HRH plan through the CCF process in Nepal, 2010).
The currently instituted HRH strategic plan (2003-2017) has not been sufficient to cope with these challenges. However, with the catalytic support of the Alliance from GIZ grant, Nepal’s Ministry of Health and Population has been successful in involving key stakeholders in creating a new, costed HRH strategic plan. Other partners such as WHO and DFID are also supporting the country.
Country Coordination and Facilitation (CCF) in Afghanistan:
Nepal has completed Phases 1 (HRH coordination mechanism) and 2 (HRH situation analysis) of the CCF process and is currently completing Phase 3 (HRH plan development). The following stakeholder categories are represented on Nepal’s CCF HRH Committee:
- Public Health Sector (Ministry of Health and Population, Department of Health Services, Department of Drug Administration, and Department of Ayurveda)
- Training institutions and training centers
- Health workers’ associations
- Professional research councils
- Universities /academia /research centers
- Civil society representatives
- International organizations (GHWA, WHO, EDPs, DFID, and others)
- Private sector
- NGOs
- Faith-based organizations
- A wide variety of other government sectors and constitutional bodies.
An evidence based, comprehensive, and costed HRH strategic plan has been prepared, and obtained validation by the multi-stakeholder CCF Committee in January 2012. The final approval by the cabinet is still pending. The HRH strategic plan is based upon the following four outputs:
- Appropriate supply of health workers for labour market needs
- Equitable distribution of health workers
- Improved health workforce performance
- Effective and coordinated HRH planning, management and development across the health sector
HEALTH WORKFORCE DATA
HUMAN RESOURCES FOR HEALTH PLAN
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Human Resources for Health Strategic Plan 2011-2015
pdf, 2.19Mb
(Draft awaiting Government's approval, January 2012)
HEALTH SECTOR STRATEGIES / PLANS
- National Health Policy 1991
- Ministry of Health and Population National Long Term Health Plan 1997-2017
- Nepal Health Sector Programme Implementation Plan 2010-2015
COUNTRY CASE STUDIES AND OTHER DOCUMENTS
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Nepal: Strengthening Interrelationship between Stakeholders
pdf, 169kb
CCF Case Study by the Global Health Workforce Alliance, 2010 -
Nepal: Towards building a comprehensive and costed HRH plan through the CCF process in Nepal
pdf, 757kb
CCF poster by the Global Health Workforce Alliance, January 2011 - Midwifery in Nepal: In-depth country analysis (UNFPA, 2011)
