What We Do

Health Service Support

There is a governmental health service system in Nepal which is based very much on primary care: For a more detailed description of this system please check the health services page on our Nepal Project Area page - or visit the PHASE Nepal website.

The main problem of the health service provision is not so much poor planning – on paper, the format seems quite good for a poor developing country – but in the implementation:
Even when everything does go to plan, the yearly medicine allocation to the health centres is insufficient, so they often run our of essential medicines months before the next delivery is due, and replacement of broken or lost equipment is almost impossible.

Many health centres still have no purpose built accommodation, but have to work out of a village home with no light and mud walls and floor – which is difficult to maintain clean. Where there is a purpose built health centre, often it is cramped and poorly maintained.

Moreover, the more remote an area is, the less likely it is that the health centres will be fully staffed – even if staff do come to their post, they are often absent for long periods of time, partly because in those remote areas there are no local people with the relevant qualifications and anyone not born there can find the harsh living conditions to difficult;
Logistics are also more difficult, so often essential medicines (which are insufficient in quantity anyway) and vaccines never reach their destination.

Moreover, many remote areas have been regularly visited by Maoist rebels who extorted money from anyone with an income (i.e. teachers and health workers), which led to even higher numbers of staff abandoning their posts… Although there is now again a real hope for peace in Nepal, the after-effects of this insecurity will still last some time.

PHASE Worldwide is supporting existing governmental health centres with improved buildings, essential equipment and medicines, and most importantly, staff support: where possible, we support existing governmental staff to stay in their post by giving them extra training, sometimes financial incentives, and more supervision: Many of these health workers are just frustrated by the impossibility of providing a good service with the woefully insufficient logistics they have to cope with – if they are well supported, many of them are quite happy to return to and remain in their posts.

In addition to motivating governmental health workers to fulfil their duties effectively, we liaise with the district health offices and employ health workers through PHASE’s Nepalese partner organisation.

Usually our health workers are “Auxiliary Nurse Midwives” (ANMs), who have experience in antenatal care and delivery care, and supplement the skills of the governmental community health workers.