Nepal has made significant progress in improving drug availability in districts. Pukar Malla, an executive coach at the Nepal Leadership Academy, explains how L4UHC helped create a safe space to innovate, and the importance of starting small and thinking big.

Nepal enlisted the support of L4UHC to address several central- and district-level problems that were preventing people in local communities from getting the right drugs in the right amounts. Centrally, the main problem was a procurement issue, notably ensuring that the money to buy the drugs reached the district level. Locally, the Nepali teamed involved in the L4UHC programme focused on three districts, each with different issues, ranging from irrational drug prescription and poor stock management through to difficulties in using a logistical management information system needed to order drugs.

The team made considerable progress in tackling these problems, using L4UHC’s programme’s 100-day, ‘rapid results’ approach.

Key achievements at the central level included:

  • Creating and institutionalising a National UHC Committee;
  • Establishing Primary Health Centre Pharmacy Guidelines.

District-level advances included:

  • Reducing irrational prescription of drugs in one district from 45% to 25%;
  • Improving the completion rate of stock level reports in another district from 40% to 70%;
  • And, in the third district, nearly doubling the appropriateness of the information fed into the Logistical Management Information System.

In the video below, Pukar explains how L4UHC enabled the team to achieve these results. Apologies for some distortion in the video due to connection issues during the recording.

In addition to being an Executive Coach at the Nepal Leadership Academy, Pukar is the Founder and Chair of Daayitwa – The Responsibility Movement; Nepal Programs Country Director for the Harvard South Asia Institute; and a member of the Gender Think Tank at the Ministry of Women, Children and Senior Citizens.

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