The breakthrough will not only enable the country to allocate resources for health more effectively at a federal, provincial and local level, but also provide a systematic framework for holding the different levels of government to account for implementing the strategy.

The need for the government to have a strategy for allocating and managing health resources has become increasingly urgent as health costs and out-of-pocket expenditure have risen, putting healthcare beyond the reach of many. Nepal’s recent transition to federalism has also made the situation more complex and challenging. For instance, there are now 761 different government institutions at the federal, provincial and local level.

“There had been several attempts to develop a health financing strategy over the last 10 years, but the key stakeholders couldn’t come to a mutually agreed approach,” says Pukar Malla, L4UHC’S Leadership Coach in Nepal. “That’s a common challenge in many fields and it’s fundamentally a question of leadership. More specifically, it requires the collective leadership needed to mobilise different stakeholders towards a shared purpose.

“L4UHC provided a platform and disciplined process to enable that collective leadership. This included supporting the Ministry of Health and Population in creating four ‘Rapid Results Initiative’ (RRI) teams with 33 members from different government organisations and development partners. They developed different sections      of the strategy and facilitated high-level buy-in of the relevant stakeholders within and outside the government.

“L4UHC’s focus on rapid results – specifically, results within 100 days, or at least 100 working days – was critical. In fact, the entire strategy was written by Nepali government officials, in the Nepali language, within 100 working days. This included collaborating through Zoom and Viber during major episodes of COVID.

“Another important step was involving a range of stakeholders, such as the National Planning Commission, in the development of the strategy. This helped build the government’s confidence, enabling the Cabinet to approve the strategy in June this year.”

Find out more about Nepal’s progress here > 

And for a participant’s perspective of L4UHC’s contribution, check out the short video below (1min 30secs)