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UHC issues addressed in Nepal

  • Drug procurement reform including:

    – Drug availability and distribution;
    – Inefficient stock management, without use of logistic management information system as well as financing in districts;
    – Irrational drug use and prescription procedures.

Collective Action Initiatives at end of L4UHC programme (mid-2017)


  • National Steering Committee and Technical Working Group on UHC established.
  • PHCC Pharmacy Guidelines endorsed.
  • Institutional platform for achieving UHC established.
  • Budget allocation to district health facilities increased from USD 5000 to USD 20000 to buy essential drugs directly from suppliers
  • Raised awareness and commitment.


  • Achham: improved rational use of drugs by improving prescription practice through review of prescription patterns, introduction of protocols; information and awareness raising.
  • Ilam: improvement of LMIS reporting at PHCs and ensuing improvement of drug supply.
  • Palpa: increase in supply of essential drugs at point of care.

Progress made since the programme finished

  • In some of the targeted districts, increased usage and patient satisfaction. (cp. statements of participants in Sensemaker®)
  • Central level intervention of amending the Hospital Pharmacy Guidelines approved by the Ministry of Health, with inclusion of provision to establish pharmacies in Primary Health Care Centres
  • At district level, team practicing e-recording of Logistic Management Information system in Ilam and Palpa
  • Drug prescription in Achham continue rationally, but no data available on progress achieved after endline survey back in mid-2017.
  • Other planned activities (e.g. scaling up) halted due to changes in government official positions

Video: Developing Nepal's health financing strategy