Project news and events

Participatory Policy Analysis Presented at Public Health Conference at Kathmandu University

On 25 May 2025, organized by the Consortium of Academic Institutions of Public Health Education in Nepal (CAIPHEN), Ms. Amshu Dhakal from the Nepal Federal Health System Project presented at the Public Health Conference held in Dhulikhel, Kathmandu University. Her presentation, “Inter-Level Participatory Policy Analysis in Nepal’s Federal Health System: Insights from Lumbini and Bagmati Provinces,” highlighted how participatory policy analysis (PPA) can support effective health governance across federal levels.

The presentation emphasized that Inter-Level PPA is not only a valuable diagnostic tool but also a vital component for routine health planning under federalism. It can improve role clarity, strengthen accountability, and enhance responsiveness of health services. The project team recommended institutionalizing PPA within provincial and local health planning cycles to support Nepal’s evolving federal health system.

Governance Dialogue at NEPHA Conference 2025

On 16–17 May 2025, a team member from Nepal Federal Health System Project Ms. Amshu Dhakal presented findings from the Nepal Federal Health System project at the Nepal Public Health Association (NEPHA) Conference held at the Nepal Administrative Staff College in Lalitpur. Her presentation, “Impact of Federalisation on Nepal’s Health System: Opportunities and Challenges,” sparked meaningful discussion among policymakers, researchers, and local government officials on navigating implementation challenges under federal governance.

Nepal Federal Health System Project disseminates Community Health Governance Research at 22nd BNAC Nepal Study Days, Liverpool

On 24-25 April 2025, the Britain-Nepal Academic Council (BNAC) hosted the 22nd BNAC Nepal Study Days in Liverpool, UK. Representing the Nepal Federal Health System Project, researcher Ms. Amshu Dhakal presented her research titled “Performance of Health Facility Operation and Management Committees in Nepal: Implications for Community-Based Health Governance.” The work was shared as part of the conference’s virtual presentations and contributed to ongoing discussions on strengthening community-based health systems in Nepal where queries were responded by other team members present in-person at the conference.

The presentation underscored the importance of strengthening local health governance mechanisms to ensure equitable and high-quality service delivery. It emphasized the need for targeted capacity-building, improved monitoring and supervision systems, and strategic investments in health facility infrastructure.

These insights contribute to broader global discussions on decentralisation and community-led governance, offering practical policy recommendations to enhance the effectiveness of local health systems in Nepal and similar settings.

Nepal Federal Health System Project at the 11th National Summit of Health and Population Scientists, Kathmandu, Nepal

On 10-12 April 2025, the Nepal Health Research Council organized three days 11th National Summit of Health and Population Scientists in Nepal under the theme “Health, Climate, and Population Dynamics: Building Resilient Health Systems for a Sustainable and Equitable Future.” The summit brought together researchers, policymakers, and practitioners to share evidence for strengthening Nepal’s health system.

At this event, Ms. Amshu Dhakal, a researcher under Nepal Federal Health System Project based at Manmohan Memorial Institute of Health Sciences presented “Performance of Health Facility Operation and Management Committees (HFOMCs) in Nepal: A Self-Evaluation Study.” The study highlighted strong community engagement and coordination with local governments, alongside challenges in governance practices, infrastructure management, workforce supervision, and maternal health services. The findings emphasized the need for capacity building, improved monitoring systems, and strategic investments to strengthen local health governance in Nepal.

Presenting Health System Findings at Nepal Health Conclave December 2024

On 26th and 27th December, Amshu Dhakal based at Manmohan Memorial Institute of Health Sciences (MMIHSS), presented findings from our Nepal Federal Health System Project in Kathmandu. The event, Nepal Health Conclave 2024, was organised by the Ministry of Health and Population and supported by WHO (World Health Organization) Nepal and UNFPA. The event aimed to help strengthen Nepal’s health services. This year’s conclave, themed “Bridging the Gap Between Global Expertise and National Needs”, brought together Nepalese diaspora health professionals and national stakeholders to foster collaboration and innovation in health systems.

Amshu presented two posters at the event: (1) The Impact of Decentralisation on Health Systems: A Systematic Review of Reviews which systematically reviewed how decentralisation affects health systems globally, highlighting key opportunities and challenges across WHO’s six building blocks; and (2) Transforming the Health System in Nepal: The Impact of Federalisation, which examined how the transition to a federal system reshaped Nepal’s health system, identifying gaps, opportunities, and actionable recommendations for improvement.

NHRC Conference April 10-12, 2024 -Presenting Health System Findings and Recommendations

Professor Julie Balen and Bikash Koirala presented project findings and recommendations at the 10th National Summit of Health and Population Scientist in Nepal organized by Nepal Health Research Council (NHRC) in April 10-12, 2024.

High Level Forum on Post-Federalisation Health System Strengthening, 9-10 Jan 2024

On the 9th and 10th of January 2024, the research team engaged in discussions with those responsible for running the health system at different levels of the new federal system in Nepal. The aim of this two day participatory research project was bring together stakeholders from all levels of government (local, provincial and federal), to develop solutions, practical actions and recommendations for different levels of the political system to address some of the five areas our research identified as possible priorities. Nepal changed from a centralised political system of government to a federal system in 2015. It is easy to see how such change in the political system might affect the organisation, funding, governance, human resources, etc. of all sub-systems in society, such as the education system, the police, and in the area of our particular interest, the health system.

Extensive media coverage of project's engagement event with parliamentarians, April 2023

Several national media outlets in Nepal covered our engagement event with National and Provincial parliamentarians in April 2023.

High Level National Forum for Political Leaders and Policy Makers held in Kathmandu, 13 April 2023

The High-Level Forum for Political Leaders in Health System Development was recently convened in Nepal, bringing together 18 participants to discuss the country's transition towards federalization and its implications for the health sector. The forum aimed to shed light on the challenges and opportunities arising from this significant structural change and to explore strategies for strengthening the health system.

One of the key issues raised during the forum was the conditional grants provided by the central government to provincial and local levels. While these grants were intended to support the delivery of health services, participants noted that they often come with stringent requirements and limitations, making it difficult for subnational governments to effectively utilize the funds. There was a consensus among the participants that a more flexible and supportive approach to conditional grants is needed to enhance the health system at all levels.

The lack of coordination among different tiers of government was another major concern discussed. With the shift towards federalism, the responsibilities and authority in health service provision have been decentralized. However, the coordination mechanisms between the federal, provincial, and local levels have not been adequately established, leading to fragmentation and duplication of efforts. Participants stressed the importance of strengthening coordination mechanisms to ensure effective collaboration and resource sharing among different levels of government.

The uneven distribution of health manpower across the country was also highlighted as a significant challenge. While urban areas have relatively well-staffed health facilities, rural and remote regions face a severe shortage of healthcare professionals. This disparity in the distribution of human resources hampers access to quality healthcare services for the population residing in remote areas. The participants emphasized the need for targeted policies and incentives to attract and retain health workers in underserved regions, along with strategies to enhance the deployment and utilization of existing resources.

The forum also emphasized the importance of shifting the focus of the health system towards health promotion and prevention. While curative care has traditionally received more attention, participants recognized the need for a paradigm shift towards proactive measures that address the underlying determinants of health. This includes investing in primary healthcare, health education, disease prevention, and early detection programs. Strengthening public health interventions and prioritizing preventive healthcare would not only improve population health outcomes but also reduce the burden on the healthcare system.

The role of parliamentarians in health system development was a key aspect discussed during the forum. Participants highlighted the significance of parliamentary oversight in ensuring effective implementation of health policies and programs. They emphasized the need for parliamentarians to play an active role in human resource management, including monitoring the recruitment, deployment, and performance of health workers. Furthermore, the forum stressed the importance of adequate budget allocation for the health sector and the role of parliamentarians in advocating for increased health financing.

To address these challenges and capitalize on the opportunities presented by federalization, several recommendations were put forward by the participants. First, there is a need for clarity in the roles and responsibilities of different levels of government in the health sector. This would help establish clear lines of authority, avoid duplication of efforts, and promote effective coordination. Second, stronger engagement of local-level governments and communities is crucial to ensure that health services are tailored to the specific needs and context of each region. This includes empowering local governments to make decisions related to health service provision and involving communities in planning and implementation processes.

Third, participants emphasized the importance of evidence-based decision-making and scientific analysis in health workforce planning. Accurate data on population health needs, existing health workforce capacity, and future projections are essential for informed decision-making and resource allocation. Participants called for comprehensive workforce planning that takes into account factors such as population demographics, health service demands, and geographical distribution.

In conclusion, the High-Level Forum for Political Leaders in Health System Development provided a platform for meaningful discussions on the challenges and opportunities arising from Nepal's federalization process.

Project Coverage at Nepal Health Research Council 9th National Summit, 11-12 April 2023

On the 11th and 12th of April 2023, the 'Ninth National Summit of Health and Population Scientists in Nepal' held in Kathmandu provided excellent coverage of our research on the effects of federalism on Nepal's healthcare system. The annual conference is organized by the Nepal Health Research Council. During the plenary session, Prof. Sujan Marahatta, and Prof. Simon Rushton from the University of Sheffield presented their findings. They jointly outlined the preliminary study findings. In the afternoon, our collaborator Dr. Jiban Karki (Liverpool School of Tropical Medicine) presented more detailed findings on ‘Human resource management at local level in Nepal’s federalised health system’ from the same study.

Throughout the entire day, we also showcased a poster presentation titled 'COVID-19 as a challenge to Nepal's newly-federalized health system: Capacities, responsibilities, and mindsets.' The poster provided a comprehensive analysis of the impact of the COVID-19 pandemic on Nepal's recently federalized healthcare system. It highlighted the various challenges faced in terms of capacities, responsibilities, and mindsets within the system. The presentation aimed to shed light on the implications of the pandemic and stimulate discussions among the attendees regarding potential strategies and improvements to effectively address such challenges in the future.

HSRI Nepal Team Concludes Field Work

HSRI Nepal project team has finally completed all of its field-works with the completion of the second round of KIIs and a PPA workshop in Panchpokhari Thangpal Rural Municipality of Sindhupalchok District in December 2022. This concludes the second round of the data collection of this 3-year longitudinal study. With several papers published and the successful submission of a policy brief to the Ministry of Health and Population from the data analysis of the first round of fieldwork, the analysis of the second round of data collection has also started. In this final round of fieldwork, the project team has collected recent updates in terms of progress and challenges of the federalized health system and will soon share via reports, articles, conferences and policy briefs.

Second Round of Province Level PPA Workshops Completed in Surkhet,

Karnali Province ( 10-11 November 2022)

The HSRI Nepal project team successfully completed the second round of PPA workshops with the new and old participants of Karnali Province, Surkhet. The workshops were very interactive and informative. The types of Information gathered from both old participants and new participants in two separate workshops were similar confirming the current scenario of the health system at the province level

Project Findings Presented at Global Nepal Conference, Sydney, Sep 16-18 2022.

Dr. Pratik Adhikary, one of the HSRI research leads from PHASE Nepal travelled to Sydney Australia to take part in the Global Nepali conference held in Sydney, Australia, Sept 16-18, 2022. In the conference, he presented a the paper titled "Health professionals' perspectives on health service delivery in federal Nepal: A qualitative analysis."

Second Round PPA Workshops in Mugu and Nawalparasi

The HSRI Nepal team from PHASE Nepal and Manmohan Institute of Health Science has successfully completed the second round of Participatory Policy Analysis (PPA) Workshops in Mugu and Nawalparashi respectively at the selected local municipal governments. In the months of August and September 2022, a total of 8 workshops were completed 4 of which were with the new participants of the local governments while the other 4 workshops were with the repeated participants from the 1st round of workshops as a follow to get and update on progresses and challenges in the health system and health service delivery. The workshops completed with very interactive discussions providing important findings for the project.

Second Round PPA Workshops in Chautara, Sinchupalchok

The HSRI Nepal team successfully completed the 1st batch of the 2nd round of the Participatory Policy Analysis (PPA) Workshop in Chautara, Sindhupalchok in the last week of June 2022. With interesting discussions and findings, two separate workshops were held with existing and new participants, respectively. There were a total of 13 participants in the new group and 6 participants in the repeat group.

Team workshop, April 22-23 2022

This April researchers from both UK and Nepal physically gathered in Nepal and successfully ran a two-day workshop followed by a series of small group interactions among partner organizations of the project. The workshop was very successful in following up with the current progress of the project, the impact of the project as well as discussing the publication of the rich information contained in the project data.

Among several of the achievements such as presenting and participating in the Nepal Health Research Council Annual Conference, the project was successful in presenting a policy brief to the Ministry of Health and Population. The recommendations from the project will feed into Nepal Health Sector Strategic Plan 2022-30.

PPA workshop, Panchpokhari Thangpaldhap Rural Municipality, 14 November 2021

The workshop was conducted at the premises of Panchpokhari Thangpaldhap Rural Municipality. The workshop was conducted with 10 Participants with mix of health professionals and elected representative. The workshop highlighted the importance of health system in Nepal mostly concerned at rural setting with difficult geographical terrains. As well as, the discussion was largely concentrated on the impact of federalization in delivering health services in Nepal. Lastly, the concluding remarks was provided by the Chairman of Panchpokhari Thangpaldhap Rural Municipality and addressed few points that needs to be adopted to make positive changes in health sector of Nepal.

PPA workshop, Chautara, 4 October 2021

Nepal Public Health Association Dialogue on COVID-19, July 4 2020

Simon Rushton represented the Nepal Federal Health System team at a Public Health Dialogue webinar arranged by the Nepal Public Health Association. He discussed the lessons that Nepal could learn from the UK on how to respond to COVID-19. Other contributors to the session discussed the lessons to be learned from Italy and Australia.

Expert panel on 'The COVID-19 Pandemic: Challenges and Pathways Forward, 7 June 2020

Edwin van Teijlingen, Padam Simjkhada, Simon Rushton and Sujan Marahatta, along with other experts, were all part of a panel discussion on June 7 2020 sharing their ideas and experiences of the COVID 19 crisis and its implications for Nepal’s health and education systems.

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