Nepal adopted a federal system of governance in its constitution on September 20, 2015 and thus, transformed its unitary system of governance into a three-tier governance structure comprising of a federal, 7 provincial and 753 local governments. Following this transformation, provincial governments have authorized power to exercise their exclusive and concurrent powers of making laws, policies, plans, and programs that fall under their respective jurisdictions while also making public their finances and budgeting. 1. Family Health Program 2. Epidemiology and Disease Control Program Management Program 3. Curative Service Program 4. Nursing and Social Security Program 5. Management Program 6. National Tuberculosis ControlProgram 8. National AIDS and STI ControlProgram 7. National Health Training Program 9. National Health Education, Information and Communication Program This slide tells about the overview of health programs at provincial level in Nepal.

1. Overview of Health Programs
at
Provincial Level
Presented By:
Arvind K. Shahi
Neeru Magar
MPH Second Semester, SHAS, Pokhara University
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2. Presentation Outline
• Introduction
• Health programs
• References
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3. Introduction
• Nepal adopted a federal system of governance in its constitution
on September 20, 2015 and thus, transformed its unitary system
of governance into a three-tier governance structure comprising
of a federal, 7 provincial and 753 local governments.
• Following this transformation, provincial governments have
authorized power to exercise their exclusive and concurrent
powers of making laws, policies, plans, and programs that fall
under their respective jurisdictions while also making public their
finances and budgeting.
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4. 4

5. Health system at Province level
Ministry of Social Development (5)/Ministry of Health and population
(Gandaki Province) Ministry of Health and population and Family
Welfare(Lumbini Province)
 Provincial Health Directorates (7)
Provincial Health Logistic Management Center (7)
Provincial Health Training Centre (7)
Provincial Public Health Laboratory (7)
Health Offices (77)
Provincial Hospitals/Secondary Hospitals
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6. Ministry of Social Development
• Currently we have 5 Ministry of Social development in 5
provinces. The ministry is assigned responsibilities related to
education,
health,
women, children, senior citizens, persons with disabilities,
social security,
youth sports,
labor employment,
science and technology
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7. 7

8. Role/functions of Provincial Health
System
• Formulation and regulation of provincial health policies and law
• Co-ordination between Local level and Federal level.
• Management of promotive, preventive, curative, rehabilitative health services
at province level
• Licensing and regulation of academics, occupational and professional
associations
• Interprovincial and inter-sectoral partnership and coordination
• Development and management of Human resources
• Research and development
• Management of health information system
• Public health surveillance
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9. Health Programs in
Provincial Ievel
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10. • National Immunization Program
• CB-IMNCI Program
• Nutrition Program
• Maternal and Child Health Program
• Family Planning, Adolescent, Sexual and Reproductive Health
Program
1. Family Health Program
• Mental and Non- Communicable Disease Control Program
• Epidemiology and Disease Control Program
• Zoonotic and Other Communicable Disease Control Program
• Disease Surveillance and Research Program
• Vector Borne Disease Control Program
• Leprosy and Disability Management Program
2. Epidemiology and Disease
Control Program
3. Curative Service Program 4. Nursing and Social Security Program
5. Management Program 6. National Tuberculosis ControlProgram
8. National AIDS and STI ControlProgram
7. National Health Training Program
9. National Health Education, Information and Communication Program
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11. 1. Family Health Program
 National Immunization Program
 CB-IMNCI Program
 Nutrition Program
 Maternal and Child Health Program
 Family Planning, Adolescent, Sexual and
Reproductive Health Program
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12. National Immunization Program(1)
• Review meeting on immunization data verification, validation
and monitoring for sustainability of municipality for Full
Immunization Declaration Program at district level.
• Support for Cold Chain Management.
• Orientation, meeting, human resource mobilization,
supervision and monitoring for routine immunization as well
as other vaccination campaigns.
• Identification and vaccination for zero dose and drop out
children.
• Adverse events following immunization (AEFI) surveillance
and VPD surveillance through WHO-IPD SMO network.
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13. National Immunization Program(2)
• Orientation regarding hygiene promotion and sustainability of
Full Immunization Declaration Program at district and local
levels.
• Information dissemination for routine immunization
strengthening by the use of local media, e.g. radio, TV.
• Assurance and transportation of regular supply of vaccines
,other commodities and IEC/BCC materials for immunization
program.
• Training to the health workers involved in vaccination and
cold chain management.
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14. CB-IMNCI Program
• Procurement of drugs and commodities for CB-IMNCI Program.
• Basic and Refresher training to health workers working at health
facilities.(CB-IMNCI, KMC)
• Free neonatal treatment from listed hospitals at province.
• Conduction of review meeting at district level.
• Conduction of onsite coaching through Health Offices.
• Monitoring and Supervision
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15. Nutrition Program(1)
• Province level review meeting including health office chief,
nutrition focal person, MOSD, health directorate and other
sections representatives and EDPs work in on nutrition.
• Supply of nutrition logistics such as RUTF, Bal Vita, recording-
reporting tools, etc. to districts and local levels.
• Financial and managerial support for NRH.
• Formation of Nutrition Technical Committee(NuTeC) at province
level.
• Preparedness and response for nutrition in emergency through
Nutrition Cluster.
• Celebration of Nutrition days, weeks(Breastfeeding, school health
and nutrition), months (Iodine) ,etc.
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16. Nutrition Program (2)
• Procurement and supply of Super cereal( fortified flour) as
continuity of MCHN program.(Kalikot, Jumla, Mugu, Humla,
Dolpa, Solukhumbu)
• Monitoring and Supervision of Nutrition Program.
• Onsite coaching in hospitals with ITC service at province level.
• CNSI Program and Training.
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17. Maternal and Child Health Program
• Onsite coaching mentoring and monitoring of MNH program( safe
motherhood, MPDSR,VA) through health office and health
directorate.
• Orientation regarding MNH update, Continuum of care ANC to PNC
to service providers through HO.
• Continuity and expansion of MPDSR program at community level.
• Human resource management in contract basis at provincial
hospitals.
• Onsite coaching/mentoring to the maternity service providers
(SBA and Non SBA).
• Training on Safe Abortion (MA/ MVA).
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18. Family Planning, Adolescent, Sexual and
Reproductive Health Program
• Capacity enhancement of FP and ASRH service providers.
• Strengthening of FP and ASRH service and expansion of ASRH
program.
• Expansion and Strengthening of FP after abortion and child
birth.
• Prevention and treatment of POP.
• Screening and management of RH morbidities(Breast Cancer,
Obstetric Fistula, POP, CA Cervix, Infertility).
• Establishment of Infertility Centre at Provincial Hospitals.
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19. 2. Epidemiology and
Disease Control Program
 Mental and Non- Communicable Disease Control
Program
 Epidemiology and Disease Control Program
 Zoonotic and Other Communicable Disease Control
Program
 Disease Surveillance and Research Program
 Vector Borne Disease Control Program
 Leprosy and Disability Management Program
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20. Epidemiology and Disease Control Program
• Support and Capacity enhancement to the district and local
level RRT.
• Operation and management of Health Desks at boarders.
• Risk Communication and Community Engagement(RCCE)
Committee formation and management.
• Strengthening of Provincial Public Health Laboratory for
diagnosis of possible epidemics.
• Training on Risk Communication and Community
Engagement(RCCE) to health workers.
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21. Disease Surveillance and Research Program
• In hospitals, orientation on Early Warning and Reporting
System(EWARS) and Operation of sentinel sites.
• Outbreak Surveillance.
• Review of Early Warning and Reporting System(EWARS) for rapid
response of diseases like Malaria, Kala-azar, Dengue, Cholera,
Diarrhea, Influenza, etc.
• Drinking water quality surveillance.
• Reagent and other commodities procurement for the testing of
drinking water.
• Food quality surveillance.
• Covid-19 and other communicable disease surveillance.
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22. Leprosy and Disability Management
Program
• Review and planning for Leprosy control,Disability Management
and Rehabilitation Program.
• Celebration World Leprosy day and International day of Leprosy
affected.
• Training to Health workers. ( BLT, CLT, Disability management and
rehabilitation)
• Orientation on disability diagnosis,counselling and referral
services.
• Drugs and equipment procurement for the management of leprosy
complication.
• Provision of assistive equipment for disabled people due to
Leprosy.
• Strengthen the timely diagnosis and referral system. 22

23. National Tuberculosis Control Program(1)
• Nutrition allowance for Retreatment TB patients who are poor and
underprivileged.
• Nutrition, Transportation, testing and complication management
for MDR/XDR TB patients.
• Operation of Hostel for DR TB patients.
• Gene X-pert service expansion, strengthening and management.
• Training on eTB Register, DHIS-2, TB Modular and Refresher.
• Cohort analysis and Biannual Review Workshop at district level.
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24. National Tuberculosis Control Program(2)
• Various activities related to TB Free Nepal Declaration Campaign.
• Transportation of drugs and logistics from provincial logistic
supply centre to district.
• Laboratory strengthening, maintenance and equipment
procurement, management of culture lab.
• Microscopic maintenance, lab reagent and other logistics
procurement and transportation, LQAS training, Onsite coaching.
• Sputum Microscopy Lab and DOTS center strengthening.
• Printing TB HMIS tools, Onsite coaching and monitoring, QC Slide
collection, World TB Day Celebration.
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25. National AIDS and STI Control Program(1)
• ART sites, OST sites operation and management.
• Review meeting for ART Committee biannually.
• Training to laboratory personnel on HIV and STI diagnosis.
• Procurement, packaging and transportation of drugs and
logistics for HIV and STI
• Orientation to the political leaders regarding stigma and
discrimination related to HIV/AIDS.
• Nutrients for mother and child living with HIV.
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26. National AIDS and STI Control Program(2)
• Co-ordination with Nepal Police, APF and other stakeholders
and use of media to minimize stigma, discrimination and
violence related to HIV.
• Training to service providers.(PMTCT/eVT, STI Case
Management, HIV and Human rights and medical ethics)
• Monitoring and Supervision
• Province level HIV data review and verification workshop.
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27. Curative services(1)
1) Drug procurement for Basic and Emergency Service
2) Monitoring, review and follow up of Minimum Service Standard in Basic Health
Service Center (Health Post),PHC and Hospitals in Province.
3) Conducting Clinical Audit program in Provincial Hospitals.
4) Hiring Hospital Management Officer in Karar Service for management of
Provincial hospitals (for hospitals having more than 50 beds) .
5) TOT Training for health workers under emergency and basic and emergency
service program in ENT and oral health .
6) SKILL LAB conduction expenses for PTC/BLS training
7) Telemedicine Program Conduction in Provincial Hospitals
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28. Curative services(2)
8) Conduction of PTC/BLS training for Health workers working in
health institution in provinces.
9) Conduction of Basic health service Standard Treatment
Procedure ( BHS/STP) orientation.
10) Conduction of Emergency health service Standard Treatment
Procedure ( EHS/STP) orientation.
11) Celebration of World Eye ,oral health and Ear day.
12) Capacity Building Training to improve social accountability by
health sector
13) Publication Of (BHS STP and EHS STP)
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29. Nursing and Social Security Program
 National FCHV program( respectful farewell, Basic and
Refresher training and Training materials distribution.
 National Woman Community Health Volunteers TOT training.
Procurement of commodities for training of FCHV
Capacity Building Program of assistant level health workers
in Jestha Nagarik Health related service.
Establishing Geriatic ward in hospitals ,Running of Social
Service Unit and OCMC(One Stop Crisis Management)
program
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30. Management Programs(1)
Program name :
 United review of HMIS ,LMIS , HISS and other programs
Activities:
Publication and distribution monthly supervision of documents and forms in
health institution of local level of HMIS ,LMIS , HISS and other programs.
To keep proper record of Drug, Vaccine, and Vaccine Related materials , vehicle ,
material repackaging and delivery . Forms and documents.
Onsite coaching by Health Directorate to health institution regarding for statistics
quality improvement HMIS ,LMIS , HISS and other programs.
Formation of Statistics Management Committee and Regular presentation after
evaluation evaluation of statistics.
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31. Management Programs(2)
Orientation program to newly established health
institution regarding upgraded HMIS ,LMIS , HISS ,DHIS2.
Quarterly data verification of district ,Local levels and
hospitals by province.
United annual review if health office and hospitals by
health Directorate.
Hire and karar health workers regarding upgraded HMIS
,LMIS , HISS ,DHIS2.
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32. National Health Training Program(1)
 RoUSG training to Nursing staffs /21 days
 Basic IUCD training ( for Nursing Staff)/8 days
 Training for ASRH related/5 day
VIA with Cold coagulation training3 day
Primary Emergency Care TOT to physicians/ health workers
/nursing staffs(6 days)
 Role of health in control GBV training to physicians/ health
workers /nursing staffs(4 days)
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33. National Health Training Program(2)
Mental Health Training to MO/HW (6 days)
Clinical Training Skill(CTS) training(5 day)
Safe Abortion Training(SAS) to physicians/ Nursing Officer
/nursing staffs
 Implant Training to HW (8 day)
SBA training to nurse and ANMs(2 months)
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34. Health ,Education ,Information and
Communication program
Information dissemination from local telecommunication
mediums(Cable television/ Internet/FM/ Newspaper)
 Health Promotion Service related Advocacy program for media
person and health workers
 Monitoring and supervision program in provincial and local level
 School health Education Program
Health Day celebration Programs
Communication program for Reduction of tobacco and alcohol
consumption.
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35. Mental health and NCD Program(1)
 PEN Tot and training
Celebrating days related to NCDs
Establishment of NCD corner in provincial hospitals
 Review and workshop program of Mental health and NCD
Program of district levels under Province
Drug and equipment procurement related to NCDs
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36. Mental health and NCD Program(2)
Training and Drug procurement related to mental health
Mental Health Rehabilitation Program
Mental Health Specialist Service Procurement Program
Program related to Sickle Cell Anemia and Thalassemia
Disease
 Mental Health Program ( community Mental health )
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37. Zoonosis and Other Communicable Disease
Control program
 Rabies, Snake Bite etc zoonotic and other Communicable
disease control Program(Orientation, awareness,
Advertisement ,day celebration). Orientation program for
Rabies Disease ( Stakeholders ,Students and Health Workers)
and rabies Vaccine Use (HWs ) .
Training to health workers for Snakebite Treatment
Review related to Snakebite and Rabies vaccine and drugs
procurement required for treatment .
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38. Vector Born Disease Control Program
 Annual Provincial Level Review and meeting of VBD( Malaria, Kalazar,
Dengue, JE, Lymphatic Filariasis ,Zika, Scrub Typhus, Free Hydrocele
Surgery ) program.
Surveillance of VBDs
Day celebration, Monitoring and onsite coaching ,Coordination and
meeting with related stakeholders.
Insecticide Spraying program (Malaria and Kalazar) in endemic areas .
Basic Microscopy Training to Malaria Disease related Lab workers.
 Refresher training to Malaria Disease related Lab workers.
 Provincial level Review meeting with VBD Lab workers.
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39. Refrences
https://dhsprogram.com/pubs/pdf/FA115/FA115.pdf
Health Service Guideline for Provincial Level
https://mohp.gov.np/program/medical-treatment-of-
deprived-citizens/en#
https://nepaleconomicforum.org/nepal-provincial-plans-
and-programs-for-fiscal-year-2021-22/
file:///C:/Users/DELL/Downloads/Annual%20Report%202
078-79%20shisiradhikari.com.pdf
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