The Imperative for Professional Hospital Management in Nepal's Public Health Sector

The Constitution of Nepal 2072 establishes public health services as a fundamental right. While Nepal's public hospitals provide services to more patients daily than their capacity allows, the quality of service and management often fails to ensure complete patient satisfaction.

Quality service delivery requires effective management of infrastructure, equipment, and human resources. While infrastructure and equipment have seen significant improvements, particularly post-COVID-19, the human resource structure remains largely based on surveys conducted 20-25 years ago.

Hospitals are sensitive institutions operating 24/7. Managing a diverse workforce, from specialist doctors to support staff, is a complex administrative challenge.

The Minimum Service Standards (MSS) developed by the Ministry of Health and Population to measure hospital readiness emphasize three key dimensions for quality service delivery.

Ensuring quality involves managing hospital waste, sanitation, clean drinking water, patient information systems, and equipment maintenance. The Ministry's MSS framework highlights governance and management, clinical service management, and support service management as the three pillars of quality care.

The MSS also identifies the need for Hospital Managers (Hospital Management Officers) to assist hospital heads. These professionals play a vital role in resource optimization, creating patient-friendly environments, and ensuring transparency and accountability.

Although the federal government initiated this program eight years ago, the transfer of hospitals to provincial governments has stalled the creation of permanent positions, forcing many qualified professionals to migrate abroad.

For over 25 years, Pokhara University has been producing graduates in Hospital Management. Despite the government hiring Hospital Management Officers on contract in 46 provincial hospitals, the lack of permanent positions through 'O&M' surveys hinders progress. Some provinces like Karnali and Bagmati, along with the Nepal Police Central Hospital, have taken steps toward formalizing these roles.

International practice and the success of private medical colleges in Nepal demonstrate that professional hospital management is essential. The 'Health Institution Operation Standards, 2077' mandates the presence of Hospital Management Officers in hospitals with 25 or more beds.

Hospital managers bridge the gap between administration and clinical services, ensuring that support services like waste management, security, and logistics function effectively. Creating permanent positions for these professionals is an urgent necessity to improve the quality and accountability of Nepal's public healthcare system.

(Adhikari is currently working as a Hospital Manager at Bhim Hospital, Bhairahawa.)