Free health Care Policy 2006

1. Presented By: Ujwal Raj Sigdel
Eighth Semester
KCHS

2. Introducing the free heath care policy
(2006) in Nepal
Objectives of the policies
Strategies enlisted
Critical analysis

3.  Despite Alma-Ata declaration(1978),
developing countries like Nepal, still face
challenges to meet the health goal for all.
 There are 202 Primary Health Care Centers,
3803 Health Posts, 129 Urban Health Clinics,
83 secondary level district hospitals, 15
tertiary level hospitals (zonal and above),8
specialized hospitals (all located in the
Kathmandu Valley and more than 400 private
hospitals, mostly in the urban areas
(WHO,2018)

4. Government of Nepal has introduced free
health care policy especially targeting the
poor population(2006)
Patient’s fees are the major source of
financing in health sector in Nepal
Health care is considered as fundamental
policy

5. To distribute the health access equally in
all regions, strata, class and community
that remain as fundamental right of citizen
To provide different effective and
accountable health service: Preventive,
Promotive, Diagnostic, Curative and
Rehabilitative
Identification of resource
Quality Health Service

6.  The policy provides free care for the poor (those
whose income is enough to feed their families for
less than six months), the destitute, the elderly,
the disabled, and Femal Community Health
Volunteers (FCHVs).
 A provision has also been made to reduce by
fifty percent fees for inpatient and emergency
services for those whose income is enough to
feed their families for six to twelve months
 The free care policy covers consultation and
treatment, minor surgeries, obstetric
emergencies, both CEOC and BEOC (where
available), x-rays and laboratory services,
essential drugs (for a week), and logistics.

7.  The services have been made effective since
December 2006 at hospitals and PHCCs in
those districts where hospital development
committees have been established.
 Free health care services are provided in
district hospitals (with up to 25 beds) and
PHCCs
 Free health care services will be gradually
phased in to better address deficiencies,
problems, and issues as they become
apparent.

8. Unnecessary use of services
Quality of Care
Risk of medicalization of public health
service
Mismanagement of drugs
Health worker’s resistance towards the
policy

9. Budget for free health care
Quality care for crowd of people
Identifying the poor
Trained health workers
Information about free health care to all
Monitoring and evaluation of practice and
policies regularly

10.  World Health Organization. Declaration of Alma-Ata [Online].
Available from:
URL:www.who.int/hpr/NPH/docs/declaration_almaata.pdf
 Department of Health Services. Annual report, 2006/2007.
Kathmandu: Department of Health Services; 2007.
 RTI International. Implications of the Government of
Nepal’s free health care policy. Kathmadu:
Health Sector Reform Support Program;
2007.
 Mamdani B. Alternatives to user fees for public health care.
Indian J Med Ethics. 2007;4:138-40.
 Oxfam. Government of Nepal scraps user fees for basic health
care [Online]. 2008 Available from: URL:http://
www.oxfam.org.uk/applications/blogs/policy/2008/01