Federal Hospitals

National Joint Annual Review 2078/79
Federal Hospital Presentation

Outline of the Presentation
• Federal hospitals of Nepal
• Trend of some basic hospital indicators
• Innovations
• Service expansion
• Glimpse of good practices
• Upcoming projects
• Issues and challenges
• Way forward
2
Federal Hospitals of Nepal
1. Kanti Children’s Hospital 14. Birendra Hospital, Chhauni
2. Sukraraj Tropical and Infectious Disease 15. National Trauma Center
Hospital
16. Manmohan Cardiothoracic Vascular and
3. Paropakar Maternity and Women’s Hospital Transplant Center
4. Mental Hospital 17. Human Organ Transplant Center
5. Shahid Gangalal National Heart Center 18. Nepal Police Hospital
6. Tribhuvan University Teaching Hospital 19. Nepal Armed Police Force Hospital
7. Koshi Hospital 20. Civil Hospital
8. Narayani Hospital 21. Bhaktapur Cancer hospital
9. Bheri Hospital 22. Bharatpur Hospital
10.Dadeldhura Hospital 23. Center Jail Hospital
11.Ayurved Hospital, Naradevi 24. G.P. Koirala National Center for Respiratory
Disease
12.B.P Koirala Memorial Cancer Hospital
25. Sushil Koirala Prakhar Cancer Hospital
13.Gajendra Narayan Singh Hospital
3
OPD Client Visit Trend
• Recording of all OPD clients is
450000
questionable
400000 • Need of effective EMR system
350000
300000
250000
200000
150000
100000
50000
2076/77 2077/78 2078/79

4
IPD Client Visit Trend
Ayurved
GP Koirala
Central Jail
Bharatpur
BCH
APF
MCVTC
Trauma
Gajendra
BPKMCH
Bheri
Narayani
TUTH
Mental
PMWH
STIDH
Kanti
0 5000 10000 15000 20000 25000 30000 35000
2078/79 2077/78 2076/77
5
Emergency Client Visit Trend
60000
50000
40000
30000
20000
10000
2076/77 2077/78 2078/79

6
Bed Occupancy Rate
• Bed occupancy is satisfactory in most of the hospital
• Need to think about interdepartmental bed allocation, and 100 100
100 Hospital turn away rate. 92.6
88.6 89.92
90
77.9 78.61 79.24
80 76.46
74
70
70
60
60 54.14
49.4
50 42.3
40
28.9
30
20
10
7
Innovations
• Comprehensive lactation management center (CLMC) at Paropakar
Maternity and Women Hospital
• Cardiac CT Scan (can scan 512 slice within one second) operational at
Manmohan Cardiovascular Thoracic and Transplant Center (MCVTC)
• Prisoner Information Management System (PIMS) started at Central Jail
Hospital
• Human resource retention plan at rural areas initiated by Dadeldhura
Hospital
• Screening and treatment of retinopathy among premature babies through
laser therapy initiated at PMWH in coordination with Nepal Eye Hospital
• Transcatheter aortic valve replacement first time done in Nepal on
February 2022 at Shahid Gangalal National Heart Center, Bansbari.
8
Service Expansion
• IVF service started at Paropakar Maternity and Women’s hospital.
• Expansion of Intesive care Units( ICU) in most of the hospitals.
• Dental CT Scan at B.P Koirala Memorial Cancer Hospital, Bharatpur.
• Endoscopic Bronchoscopic/Esophaguscopic Ultra Sonography Service and
dialysis services at B.P Koirala Memorial Cancer Hospital, Bharatpur.
• Tele medicine-based leprosy referral clinic at Sukraraj Tropical and Infectious
Disease Hospital, Teku on Baisakh 2079.
• Laparoscopic and hysteroscopic surgery at PMWH.
• Provision of specialized services for prisoner at central jail hospital by MOU
with central specialized hospitals
• Health insurance was done for all the prisoners of central jail
9
Service Expansion
• Expansion of Human organ transplant services at Pokhara .
• At transplant center, 98% survival after kidney transplant and 96% survival
on dialysis over 10-year period (Total kidney transplant - 966)
• Suicide prevention help line – 1166 initiated at Mental Hospital
• Fully electronic record keeping registration at Mental Hospital
• Extended Health Service program (PMWH, National Trauma Centre)
• Preventive and promotive services started at Nardevi Ayurved Hospital
• Minimum Service Standard implemented in most of the hospitals
• 50 bedded Emergency ward services Started at Bharatpur hospital
• Regular COVID-19 vaccination clinic started at STIDH - Teku
10
Some Glimpse of Good Practices
Risk waste management and horizontal autoclave at STIDH

11
12
Human Milk Bank at PMWH
PICU and Oxygen Pipeline at Narayani

Hospital
Oxygen Plant at GP Koirala
13
Modular OT, Sterile corridor at Bharatpur Hospital

14
Upcoming Projects
Hospital Description of the projects
Kanti Children Hospital Institute of Child Health (ICH)
• DPR and Master Plan started
Shukraraj Tropical and Infectious 300 Bedded Infectious Disease Hospital
Disease Hospital • tender in the process.
Mental Hospital Upgrade of Mental Hospital
• Detail master plan prepared in collaboration
with DUDBC
Koshi Hospital Surgical Building/block
• Approved by MoHP
B.P Koirala Memorial Cancer Cashless and Paperless Hospital
Hospital • Process started
15
Issues and challenges
• Inadequate human resource
• No O & M survey as per the allocated hospital beds
• Multiple brand of same generic medicine/problem in procurement
• Old equipment requiring regular maintenance
• Shortage of equipment and beds
• Hospital waste management
• Cumulative irregularities (Beruju)
16
Issues and challenges
• Insufficient infrastructure
• Inadequate awareness about human organ donation
• Uniformity of EMR/HER - no official guidance on minimal dataset and

user forms on the software
• Reporting from Naradevi Ayurved Hospital (as a federal hospital) not

included in central HMIS reporting system
17
Way forward
• Conducting impending O & M survey including O & M survey of Hospital
Development Committee as well.
• Basic health services should be provided by all federal hospital free of cost .
• Strengthening of referral mechanism .
• Strengthening of pre-hospital care.
• Uniformity of clinical forms and formats across all public and private hospitals.
• Research and academic grants for all hospital.
• Separate policy for hospital development committee .
18
Way forward
• Establishment of Level 1 Trauma center at central level and level 2 trauma
center in each provinces (in alignment with federal hospital).
• Systemic Mechanism should be developed for the effective implementation

of satellite clinic .
• One door social security scheme.
• Human resource retention plan – One health worker one health institutions
• Extended health service should be implemented effectively
• Coordination between MoHP and MoHA should be strengthened to
streamline the central jail hospital in National health system (in terms of
recording, reporting, and regulation)
19
Thank You !
20

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National Joint Annual Review 2078/79

Federal Hospital Presentation

2076/77 2077/78 2078/79

2076/77 2077/78 2078/79

Risk waste management and horizontal autoclave at STIDH

PICU and Oxygen Pipeline at Narayani

Oxygen Plant at GP Koirala

Modular OT, Sterile corridor at Bharatpur Hospital

• No O & M survey as per the allocated hospital beds

• Multiple brand of same generic medicine/problem in procurement

• Old equipment requiring regular maintenance

• Shortage of equipment and beds

• Hospital waste management

• Cumulative irregularities (Beruju)

• Inadequate awareness about human organ donation

• Uniformity of EMR/HER - no official guidance on minimal dataset and

• Reporting from Naradevi Ayurved Hospital (as a federal hospital) not

• Strengthening of referral mechanism .

• Strengthening of pre-hospital care.

• Research and academic grants for all hospital.

• Separate policy for hospital development committee .

• Systemic Mechanism should be developed for the effective implementation

• One door social security scheme.

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