Hon. Minister’s speech for Joint Annual Review, 2018
First and foremost, let me welcome you all in this special Joint Annual Review of the health sector, as this is the first review in the federal context. Special welcome to our international delegates who have travelled afar to be with us in this important event.
Honourable NPC Member, secretaries of various ministries, Chief Specialists and Officials of Health Ministry, EDP chair, distinguished colleagues, ladies and gentlemen.
In 2004, we made a strategic shift from projects based approach to Sector Wide Approach (SWAp) and now we enjoy much strengthened partnership in the health sector of Nepal. Partnerships have been the cornerstone of our health achievements and we will continue to harness it to sustain our achievements and tackle existing health challenges. Every year we gather in this important forum of Joint Annual Review (JAR) to reflect on our mutual achievements of the past year and agree on strategic priorities for the next year. Over the last decade we
have been progressively able to increase the meaningful participation of our international development partners, civil society, NGOs, academia, and private sector in the JAR; thereby employing the broad partnership to improve our health outcomes.
Because of our joint effort, we have achieved most of the health related targets of MDGs. Over the last 20 years, we have reduced infant mortality and under-5 mortality substantially. Owing to the revolutionary DOTS programme in curing the TB, we have been preventing thousands of deaths every year. Through
programmes such as free essential healthcare and safe delivery incentive schemes, we are also attempting to mitigate social, cultural, and financial barriers in seeking healthcare. Now the Government of Nepal is committed to achieve the Sustainable Development Goals set for the year 2030.
Ladies and gentlemen We are still in the phase of political transformation. The country is moved from unitary system of governance to the federal form of governance. As mandated by the new Constitution, the present government has successfully held the three elections in this year. As a result, people’s representatives at local levels have already started working. Now the federal and provincial governments are being formed. I believe, this is a remarkable achievement in the process of moving towards implementing the Constitution. Now It is easier for all the 761 governments in the country to reach to the people who were left behind earlier.
In this socio-political climate, health and development landscape bears both opportunities and challenges for us. Our Constitution, for the first time in history of the nation, has guaranteed health as a fundamental right of every citizen. This has provided us with political impetus to expedite our efforts to achieve Universal Health Coverage. Now it’s the duty of the governments of all levels of federal structure to ensure these rights. In this regards, we have developed our sectoral strategy (2016-2020) based on the principles of equity and social justice. I urge you all to take initiative to develop a health system that is based on the social justice and good governance in all levels of governance.
The local governments are mandated by the constitution to provide basic health services, however, it is the responsibility of all of us to make them resourceful. Health is a multi-dimensional sector; I believe that federal structure of governance has made it easier to establish health as a development agenda in the local level In the process of implementing the federalism in health, the service delivery structure of health is already prepared and endorsed. The governance structure of health in the federal context is being prepared and discussed with relevant
agencies. Similarly, other arrangements in the context of implementing federalism are going on. Nepal Government is committed to establish a health facility in each ward and a hospital in each municipal. The Government has also come up with an integrated health infrastructure project. Partner’s support in these endeavours is welcome.
Alongside the need to make further headway in providing equitable access to quality primary healthcare services, we face many emerging health challenges. The burden of non-communicable diseases is increasing; growing health needs of urban poor requires more investment; malnutrition, specially stunting, remains a major issue to be tackled; similarly improving new-born care requires further efforts on our part; out-of-pocket expenditure on health is still very high which warrants fair financing mechanisms; deployment and retention of health workers
in remote areas of the country is still a problem; we must also do more to narrow health disparities specially for hard-to-reach, socially excluded and marginalized population. As if these challenges were not enough, we are vulnerable to natural disasters and now we face adverse effects of climate change. And we have not
forgotten the destruction caused by the 2015 earthquake.
The evidence shows that in order to ensure the access of all people in quality health services, 5% investment of national income is required, however, we are able to invest only less than 2%. Expenditure for health treatment should not be allowed at any cost to be a cause of poverty. I am confident that Nepal government will continue to increase its share of investment in health sector in years to come. The present government has taken many initiatives to ensure constitutional mandate of ensuring health services to its citizens particularly to those who need it most.
As you are aware, the present government has just initiated the implementation of social security scheme in health, by providing Rs 5000 per month for cancer patents, patents with kidney failures, and patents with spinal injuries. Health Insurance Act has been enacted which provides the legal basis for covering all the people in the net of health insurance.
To sustain our achievements, tackle the challenges I mentioned, and to align with the federal context, we have prepared a new health policy with the support and participation of relevant stakeholders and it is already tabled in the Cabinet for approval.
Ladies and gentlemen
I am of the opinion that health should be in the centre of development. Well-being of our population and overall economic progress of our country are intrinsically linked with health outcomes. While Ministry of Health and health development partners have been and remain important actors but so are other line agencies of the government, development partners, private sector, and civil society for achieving and sustaining health results. This has become even more pertinent now, where we live in a world with ever-shrinking global boundaries and everexpanding socio-economic and political interdependence.
As I said, Ministry of Health alone cannot always make a positive dent in health outcomes; there are other structural factors and social determinants affecting health. We are increasingly seeking multi-sectoral response to address the complexities.
Ladies and gentlemen
I wish you all a very productive Joint Annual Review. I wish our international delegates a wonderful stay in Kathmandu.
Thank you very much.