Editorial»
Wealth of a nation
AUG 04 -
Nepal’s recent record on healthcare has been decidedly mixed. The country has achieved great success in reducing maternal mortality and child mortality and is on course to meet the Millennium Development Goals (MDGs) on the two crucial development indicators. Programmes to combat extreme hunger and malnutrition have also been effective. But not everything is hunky-dory with the country’s healthcare system. Consider the latest findings of the government-run Health Sector Reform Support Programme (HSRSP).
According to HSRSP, 32 percent of males and 37 percent of females in Nepal are deprived of healthcare services due to the lack of funds. Tellingly, 43 percent of the poorest, it was found, do not have any access to health services. Another HSRSP report highlights ethnic disparities in access to health facilities: As compared to 25.58 percent of Brahmins and Chhetris, only 20.28 percent of Dalits utilised outpatient services in the four months to June.
What is remarkable about the two findings is that medical services are completely free for the poorest and the vulnerable sections of population in 35 Nepali districts that rank lowest in Human Development Index. Since 2008 the government has been treating all patients visiting health posts and sub-health posts free of cost. But the disparity is not just between ethnic groups: more men than women, urbanites than residents of rural areas, rich than poor take advantage of healthcare services right across the country.
This suggests that people from certain groups are not even aware of the free health services on offer. In many cases, they might not know they need medical attention. The question is: what can be done about it? One of the things that has to happen is that the health budget has to go up. Even among developing countries, Nepal, which spends around six percent of its annual budget on health, ranks among the lowest spenders in health as a percent of its GDP. One of the big reasons for the low health spending has been the country’s volatile politics. As the level of political violence went up, not only was the state forced to divert its vital resources into maintaining law and order, politicians and top bureaucrats also found it convenient to blame any social malady on political instability.
Nepali policymakers like to grumble that as over 50 percent of the health budget is funded by external donors, they are often kept from channelling the money into where it is needed the most. But that is only half the story. Perhaps the donors would not impose tough conditions had the local health authorities shown a little more initiative. It is hard to find fault with the donor emphasis on transparency and political commitment on the projects they fund. The problem rather is that the state seems to have its priorities wrong. Needless to say, better health for its citizens and production of a healthy and productive manpower should be near the top of its priority list.
Posted on: 2010-08-05 08:43
Headlines
Advertisements
