Nepal Health Sector Programme- Implementation Plan III (NHSP -IP 2) 2010 – 2015

Abstract

Lessons from Nepal Health Sector Programme (NHSP) 2004-10 Nepal has experienced two decades of steady improvement in health outcomes and impact. Progress accelerated and was accompanied by significant improvements in equality of access during the first NHSP (2004-10). Nepal met or exceeded nearly all of the outcome and service output targets that were set for 2004-10, and is on track to meet the child and maternal mortality MDGs. It is estimated that NHSP-1 saved 96,000 deaths and nearly 3.2 million disability-adjusted life years (DALYs) at a cost of $144 per DALY saved. The current plan thus represents a continuation and further refinement of earlier policies and plans that were based on the imp lementat ion of cost-effective, evidence-based health interventions. If the targets of NHSP -2 are broadly achieved by public health spending in line with a “middle case” scenario, this achievement would be broadly maintained, saving a further 45,000 deaths and nearly 1.5 million DALYs at a cost of $147.Expenditure in health remains low at 5.3 percent of GDP and per capita health expenditure at USD 18.09 in 2006. More than 55 percent (USD 9.0) of total health expenditures is financed through out-of-pocket expenditure by households at the time of service. EDPs finance nearly half of Government spending on health, and the substantial gains achieved in reducing child and maternal mortality will not be sustained without continued external support. NHSP-2 examines three scenarios for the future growth in resources available, low, middle and high. All three scenarios adopt the 2010-11 budget ceiling for health that was proposed by the Ministry of Finance in February 2010, but they make different assumptions about absorption and about future growth in resources.