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