Nepal’s health sector is at crossroads now with the future looking cloudy at best. With public hospitals mostly in sorry state due to rampant political interference and mismanagement, the health sector is now dominated by exorbitantly costly private hospitals catering to the bulk of a largely destitute populace. With failure to teach evidence-based medicine at medical schools and to adopt a culture of healthy research among practitioners, we have been left behind even among sour South Asian neighbors. The blatant and anarchic commercialization of medical education is compromising quality of health care services in general.
If the reforms that we have long been pressing for are implemented – ending chaos in medical education through legislation, ending political interference in regulatory bodies leaving them to competent and professional people, ensuring judicious geographic distribution of health facilities and medical schools even to remote areas, ensuring entry of qualified but poor students to the field, adopting latest approaches of teaching-learning in medical schools and ending the culture of impunity in medical education and health sector among others – much will change by 2030.
With the reforms, both the scope and quality of health care will improve. Simultaneously though, it would threaten the interest of various players enjoying the dividend of the current chaos – unscrupulous medical school owners providing subpar education, party cadres enriching their parties by siphoning off illicit money from regulatory bodies, political parties surviving on patronage and nepotism and so on.
Implementing those reforms is going to be a tough job but if we want to see any betterment even by 2030, these reforms are mandatory. With them, it will be possible to carry secondary and tertiary services to all districts and primary care to villages. The capital can then innovate and have pioneering hospitals intent on retaining patients who now fly abroad for treatment instead of engaging on smuggling of patients from government hospitals to private ones.