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Aug 27, 2018

Evidence Based Policy and Planning: Our direction for Quality and Safe health care delivery Post 18/24 (June 2018)

This week and prior week was time - spent well. In a sense, I utilised the opportunities plenty in and out of our ministry of health like interactive meetings, workshops, and sometime trainings. I also realised, as many concerned colleagues ask me regularly and i tell them that our ministry is so rich with "knowledge generating activities" as good as any universities. So, we are constantly able to bombard our "neocortex" with constant academic activities, unlike one journalised (although with good intention) recently wrote in a mainstream online news that we just arrive at office, mark our attendance and just go home. Well, that news was partly true that we are not assigned with any divisional role and responsibilities but not the whole truth. Otherwise, we are engaging regularly in various activities as I mentioned earlier. To be honest, I am enjoying this interlude of work experience from joining Ministry of Health and then assignment for Far West Regional Health Directorate and now recalled here at the ministry. It is such an interesting time to both observe and experience at the same time the implementation of federalism that this is our historical moment in the history of Nepal. 

In this climate of change, where we are partly influenced by what is called federal restructuring, I am definitely searching for an opportunity to be useful for our country. I also know that time is always victorious provided you continuously put an honest effort. In this light, I am pragmatic and share benefit of doubt balanced more towards to positive outcome in coming days. Therefore, I am of an opinion that this is an excellent time - period for reading and writing that relates to health related agenda, which is of paramount importance to our people, and in that context, our top tier health professionals need to focus in system strengthening (not fragmenting !!) and that too cemented by scientific evidences and open discussion. It is for that reason, I was fortunate to participate in an "Dialogue for Evidence Based Policy in Federal Context" organised by Policy, Planning and Monitoring Division under Ministry of Health and Population (MoHP) on 16 August 2018 and one day workshop "Evidence Based Health Policy and Planning: Our direction for Quality and Safe Health Care Delivery" organised by Nepal Health Research Council (NHRC) on 21 August 2018.

It was such an atmosphere of positive direction and excitement that Policy, Planning and Monitoring Division took an proactive role in starting the policy dialogue, which was announced that this event will be a regular monthly event in MoHP in the presence of Honorable Health Minister and Madame Secretary of Health. The dialogue went for almost 2 hours, and the topic was procurement and logistic management of medical procurement and logistics management system. The key objective of this dialogue were as following:

  1. Discuss potential approaches and modalities of medical procurement and logistics management system in the federal context
  2. Discuss on potential roles and responsibilities of the federal, provincial and local government on medical procurement and logistics management of medical products
  3. Contribute to develop evidence based policy and plan on medical procurement and logistics management (evidence - based decision making space)

In overall - I found this dialogue rewarding such that we were discussing perennial issue of bottlenecks and red tapes re: public procurement. Although this issue has been lingering in public debate since decades, the representatives from ministry of federal affairs and general administration, ministry of finance (Public Procurement Management Office), National Planning Commission (NPC) and ministry of natural resource (National Natural Resources and Fiscal Commission) took account of opinion raised by participants that life saving medical products and other commodities (like cements/pebble/vehicles etc) can be governed by the same public procurement act. Therefore, there was strong voice raised for review and revision of public procurement act as well as its regulation. Another issue that brought heated discussion was on generic prescription, which is now of agreed consensus such that rationale prescription is what people demand for quality and safe health care and there should be no compromise for quality and safety of the drugs prescribed. Finally, there was proposed various models of public procurement in the context of federal structure. However, there was not single agreed model to be instituted in the changing 3 tier government. Therefore, there was a common understanding that there is need for further extended dialogue on this discussion re: how to adapt public procurement in 3 tier governance.

The workshop organised by NHRC was even more detailed and the key message that I was able to take home was that there is not short cut to health policy and planning without robust and timely evidence base. For that, we need to strengthen health research capacity thought system strengthening and long term investment. Also, we should not forget that there is need for continuous dialogue between research organisations, universities and all sectoral ministries. We should not also forget that health is a developmental agenda, which is also global health security issue of highest importance. In this light, 21st century is the time period for evidence based science, which is undoubted backbone for our future. For more details on this workshop, please visit the Link for the presentation Slides and Group Work Resources of the workshop organised by NHRC

27 August 2018

Anuj in Himalayas

Hi i am connecting disqus with my blog for healthy interaction and open dialogue