The interdisciplinary research project ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ was reported in several national media in Nepal last week. This project running from 2020 to 2024 is, funded by the Health System Research Initiative, a UK collaboration between three funders: the MRC (Medical research Council), the Foreign, Commonwealth & Development Office, and the Welcome Trust.
The 2015 Constitution brought federalisation and with it, significant changes to the health system. To understand these changes researchers worked in three provinces where they interviewed 243 stakeholders, at all three levels of government. They also conducted 31 Participatory Policy Analysis workshops at local and province levels. The team includes researchers from Manmohan Memorial Institute of Health Sciences (Kathmandu), and PHASE Nepal (Bhaktapur), and three UK institutions (the Universities of Sheffield, Bournemouth, and Huddersfield). It researchers from the UK and Nepal meet with Provincial and Federal MPs to discuss the interim findings of a federalisation and health study.
News articles appeared in national newspapers in Nepal, both in English and Nepali. The Nepali article appeared in the country’s oldest newspaper Gorkhapali, see copy here! Bournemouth University [Thank you Nathaniel Hobby and Stephen Bates] also publicized our press release on this project online. The journalist Nam Raj Bhatta published an item in the online Nepali-language newspaper NepalHealthOnline on April 13. The main meeting to discuss the interim findings of our project took place on Thursday 13 April an hotel close Nepal’s parliament. The interim results highlight how federalisation of the political system has affected Nepal’s health care organisation. The research team summarized the findings for the invited MPs and local and provincial political leaders, and invited their reflections on the political possibilities and obstacles to moving forward with the development of the country’s health system. The Himalayan Times published the article on top of this BU Research Blog as well as the special interview with the University of Sheffield based PI Prof. Simon Rushton.
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health
Earlier this week the editor of the Journal of Nepal Public Health Association informed us the journal had accepted our latest paper ‘Health System Strengthening: The Role of Public Health in Federal Nepal’ . This article addresses some of the key Public Health approaches around the ongoing federalisation of the state of Nepal and the associated decentralisation processes in its health system. This is the third paper of our three-year project, which is UK-funded by the MRC, Wellcome Trust and DFID under the Health Systems Research Initiative and led by Dr. Julie Balen and Prof. Simon Rushton based at the University of Sheffield. The first two papers introduced our international research project ‘The impact of federalisation on Nepal’s health system: a longitudinal analysis’ , and focused on COVID-19 when examining the effects of changing Nepal’s constitution towards a federal republic on its health system .
Prof. Edwin van Teijlingen
CMMPH (Centre for Midwifery, Maternal & Perinatal Health Research)
- Sapkota, S., Panday, S., Wasti, S.P., Lee, A., Balen, J., van Teijlingen, E., Rushton, S., Subedi, M., Gautam, S., Karki, J., Adhikary, P., Marahatta, S., Simkhada, P. for the Nepal Federal Health System Team (2022) Health System Strengthening: The Role of Public Health in Federal Nepal, Journal of Nepal Public Health Association (forthcoming).
- Rushton, S., Pandey, S., van Teijlingen, E., Subedi, M., Balen, J., Karki, J., Simkhada, P. on behalf of the Nepal Federal Health System Team (2021) An Investigation into the Impact of Decentralization on the Health System of Nepal. Journal of Manmohan Memorial Institute of Health Sciences, 7(1): 3–14. https://doi.org/10.3126/jmmihs.v7i1.43146
- Adhikary, P., Balen, J., Gautam, S., Ghimire S., Karki J.K., Lee A.C., Marahatta S.B., Pandey S., Pohl G., Ruston S., Sapkota S., Simkhada P.P., Subedi M., van Teijlingen E.R., on behalf of the NFHS Team. The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system. Journal of Karnali Academy of Health Sciences. 2020; 3(3)
The year 2021 started in many ways in the same way as it had ended with a country gripped in COVID-19 and a national lock down to limit the spread of the disease. It is appropriate timely that the first publication from our international collaboration, studying the health system in Nepal, focuses on COVID-19 . This academic paper forms part of our on-going study of the decentralisation of the Nepal health system. The study is run by the University of Sheffield, the University of Huddersfield and Bournemouth University in the UK and PHASE Nepal and Manmohan Memorial Institute of Health Sciences in Nepal. The study is funded by the UK Health Systems Research Initiative.
This paper was unplanned as nobody (neither in the UK or in Nepal) had heard of COVID-19 when we submitted the grant application in mid-2019. It was only when we started our project officially in April 2020 that COVID-19 had become the pandemic it is today. We took the opportunity to assess some of the early evidence on the effectiveness of the actions taken to deal with COVID-19 by the national government as well as provincial and local governments and the levels of cooperation and coordination between them.
Authors on this include BU PhD graduate Dr. Pratik Adhikary and FHSS Visiting Professor Padam Simkhada, as well as our collaborator on other funded projects, Dr. Sujan Marahatta from Manmohan Memorial Institute of Health Sciences (Nepal).
Prof. Edwin van Teijlingen
- Adhikary P, Balen J, Gautam S, Ghimire S, Karki JK, Lee AC, Marahatta SB, Pandey S, Pohl G, Ruston S, Sapkota S, Simkhada PP, Subedi M, van Teijlingen ER, on behalf of the NFHS Team. The COVID-19 pandemic in Nepal: Emerging evidence on the effectiveness of action by, and cooperation between, different levels of government in a federal system. Journal of Karnali Academy of Health Sciences. 2020; 3(3)