Nepal’s health paradox

Despite progressive policies and increased financing, out-of-pocket spending remains alarmingly high.

In 1991, Nepal took a bold step towards modernising its health system by introducing its first comprehensive national health policy. Rooted in the principles of the Alma-Ata Declaration of 1978, the policy aimed to extend primary health care to rural populations, reduce maternal and child mortality, and ensure equitable access to essential services. It envisioned a decentralised, community-driven health system, with sub-health posts in every village and a referral system to guide patients to higher-level care.