Overview
The Ministry of Health and Population (MoHP) has released a report titled Baseline Assessment of GHG Emissions of Nepal’s Health Sector, 2024. This marks the first-ever study of its kind in Nepal, shedding light on the environmental impact of the country’s healthcare system.
The report provides a comprehensive baseline analysis of greenhouse gas (GHG) emissions within Nepal’s health sector, including emissions from supply chains. Conducted with consideration of the sector’s pressing requirements, the study aims to support MoHP in developing sustainable and climate-resilient health policies.
Executive summary
The Ministry of Health and Population (MoHP) of Nepal made health commitments on Climate Resilient and Sustainable Low Carbon Health Systems at the UNFCCC COP26. The commitments made at COP26 constitute a big step forward in the effort to reduce greenhouse gas emissions from healthcare systems. In light of this, the Ministry of Health and Population has been working with World Health Organization (WHO) to develop a sustainable, low-carbon health system. The GHG study considering health facilities is still in its early stages in around the world including in Nepal, hence it lacks a real-world data base. Realizing this fact, this study aimed to carry out baseline assessment of GHG emissions of Nepal’s health sector.
This study conducted baseline analysis of Nepal’s health system’s GHG emissions, including supplier chains, in consideration of its pressing requirements and support for MoHP. The health care facilities (HCFs) taken into consideration for this study were selected based on several factors, including location, province, topography, HCFs type, and other inimitable characteristics. HCFs from the following categories were considered in this study: central hospital, regional health directorate, provincial/regional hospital, district hospital, community hospital, specialized hospital, private hospital, and health service center.
The sample locations consist of three ecological zones and all seven provinces. Both the primary and secondary data collection method was carried out to collect the data. To gather the available data, the checklist/questionnaire, structural questionnaire, key informant interview, general group discussion, interaction and onsite physical observation were used. To estimate national activity data, each HCF category’s total number was multiplied by the average activity data referring DoHS annual report of 2020/21 and onsite consultations. The GHG footprint from HCFs for the base year 2022 was calculated using the Climate Impact Checkup (CIC) tool, developed by Health Care Without Harm (HCWH), considering various activity data, variables, emission factors (EFs), and global warming potential (GWP) of various gases.
This study for the first-time estimated Nepal’s GHG emissions from health sector, which is 0.002% of the global GHG emissions (i.e.1,164,719 tCO2e); 4.1% of Nepal’s GHGs emissions and 0.05% of global GHG emissions from health sector. The total contribution of GHG emissions was maximum from indirect sources i.e. 678,317 tCO2e (58.2%) (i.e. business trips, employee computing, patient commuting, inhalers, extra supply chain, electricity transmission and distribution losses, and off-site waste) followed by direct emission i.e. 474,847 CO2e(40.8%) (i.e. stationary combustion, mobile combustion, fugitive emission, and on-site waste) and purchased electricity i.e. 11,555 tCO2e (1%). Under indirect emissions, the extra supply chain contributed the most to GHG emissions (50.4%), followed by patient commuting (4.8%), and other sources (business travel, employee commuting, inhalers, and garbage) contributed the final 3%.
The largest portion of the total GHG emissions under direct emission was from fugitive emissions (28.1%) to which cooling, and fire suppression made the largest contributions (27.7%). Others (stationary combustion, mobile combustion, and waste) accounted for 12.6% of the total GHG emissions. The emissions were highest for the direct sources followed by indirect sources and purchased electricity in the scenario where the extra supply chain was excluded. DPI inhalers were utilized the most (75%) and MDI (25%), respectively, among all inhalers. The MDI (93%) contributed more to the overall GHG emissions, though. The top 5 emitter categories like other manufactured products (33%), construction (22%), business services (19%), medical instruments/equipment (9%) and paper products (8%) contributed to over 91% of the GHG emissions of the indirect emission – supply chain sub-category (i.e. production and distribution of a commodity). To our knowledge, this study is the first time in Nepal regarding GHG emission inventory for HCFs at national level, which could be a valuable references and guidance in the preparation of action plans for developing sustainable low carbon health system. Moreover, it provides actionable insights and recommendations for stakeholders to contribute to a greener and sustainable healthcare system especially through energy-efficient appliances, renewable energy technologies, low carbon transportation pathways, e-cooking, and advanced waste management technologies.
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