The concept of hub and satellite hospitals network, designed to improve communication and coordination between hospitals, was first activated during the health sector response to the Nepal earthquake in 2015. Over the years it has emerged as one of the successful models of public-private partnership led by the Ministry of Health and Population (MoHP) facilitating strategic and structured sharing of available resources and capacities during response to disasters and public health emergencies.
Most recently as the country experienced multiple peaks of COVID-19 transmission and the health system faced unprecedented challenges due to the pandemic, the importance of this network as an essential component of emergency preparedness and response was once again brought to surface.
A glimpse of the presentations held during the event - National Conference on Hub and Satellite Hospital Network 2022 - in Bagmati Province, Nepal. Photo Credit: WHO Nepal
With the objective to further strengthen the network through improved coordination and preparedness, the MoHP recently held a national conference on hub and satellite hospitals network with support from World Health Organization (WHO), Country Office for Nepal, and USAID. The two-day event held in Kathmandu from 12-13 June 2022 saw the participation of Chief Specialists, Director Generals, Joint Secretaries, Directors, Chiefs from the federal health ministry, health secretaries and Provincial Health Directors from all seven provinces, representatives from the Ministry of Home Affairs and Disaster Risk Reduction Authority, coordinators of Hub Hospitals, and chiefs and representatives of Central and Provincial Health Emergency Operation Centers (HEOCs).
Mr Birodh Khatiwada, Minister of Health and Population, providing his remarks during the event.
In his address, Honorable Health Minister Birodh Khatiwada expressed the government's commitment to support the hub and satellite hospitals network. "The Constitution of Nepal guarantees every citizen the right to emergency health service, and we're committed to making the hub and satellite hospitals disaster-resilient," he said.
WHO Representative to Nepal, Dr Rajesh Sambhajirao Pandav, providing his remarks during the event,
Similarly, WHO Representative to Nepal, Dr. Rajesh Sambhajirao Pandav, highlighted the importance of lessons taught by the COVID-19 pandemic and the need to implement actions based on the learnings for improving and strengthening hospital preparedness.
The technical session began with a presentation from the Chief of Health Emergency Operation Center (HEOC), Dr. Samir Kumar Adhikari, which delved into the concept of hub and satellite hospitals and their roles and responsibilities. Following which, there was a presentation from each of the seven provinces on the current state of the hub and satellite network in their respective provinces, the experience of working during COVID-19, challenges faced, and the way forward.
A glimpse of the plenrary discussion held during the event.
“During the second wave, the hub and satellite hospitals received an orientation on how to collaborate between hospitals. This helped to reduce the overflow of patients at Karnali Provincial Hospital as treatment of the less severe cases were referred to other local hospitals. The same modality was adopted when we faced shortage of oxygen during the second wave,” said Dr Rabin Khadka, Health Service Director, Karnali Province.
Noting the historic nature of the event, Dr. Bikash Devkota, Secretary, Ministry of Health and Population, Lumbini Province, said: "This is the first time that professionals working in policy-making to implementation level have come together. We have representatives from the Ministry of Health and Population as well as doctors and nurses who work directly with the people at ground level participating in the conference which has allowed for a rich exchange of experiences and knowledge."
A glimpse of the group exercises held during the event.
“The concept of hub and satellite hospitals was relatively new during the 2015 earthquake. At the time we saw that some hospitals had huge caseloads while at others there were few patients. This was due to a lack of coordination between hospitals. But after the COVID-19 pandemic, the concept of hub and satellite hospitals has become more prominent. We have begun conducting regular meetings with key stakeholders which helps us plan better. As coordination, communication, and collaboration improves, this ultimately has led to saving of more lives,” said Hira Kumari Niraula, Sr. Nursing Hospital Nursing Administrator, Dadeldhura District Hospital.
MoHP Chief Specialist Dr. Gunaraj Lohani, who facilitated a plenary discussion on improving coordination and collaboration between government, non-government, and private sector, commended the hospitals for the role they have played in responding to emergencies starting from the 2015 earthquake to the ongoing COVID-19 pandemic. Putting into practice the lessons learnt will help each institution function as per their prescribed role, he said.
A glimpse of the group work held during the event.
Tribhuwan University Teaching Hospital and Patan Academy of Health Sciences also delivered individual presentations on lessons on Hospital Disaster Preparedness and Response Plan, Medical Countermeasures, Hospital Incident Command System from Nepal Earthquake 2015, and Infectious Hazard Management Plan lessons from COVID-19 pandemic, respectively.
The conference concluded with the signing of an 11-point declaration which commits to further strengthening the coordination and collaboration among hub and satellite hospital networks with Health Emergency Operation Centers (Federal and Provincial) for preparedness and response to disasters and public health emergencies, from planning to evaluation throughout the different phases of the disaster management cycle, including improvement of buffer stocks of medicine and medical equipment for emergencies.
A glimpse of the group discussions held during the event.
Commenting on the outcome of the conference, Dr. Shriram Tiwari, Province Secretary, Ministry of Health and Population, Gandaki Province, said: “We have now decided to hold meetings at least thrice a year and conduct routine mock drills. This will help us be clearer about each other's roles and responsibilities. Similarly, we will keep the necessary equipment for logistics standby for any possible emergencies."