The people of Nepal do not have adequate medical care. This is reflected, for example, in high child and maternal mortality rates, an unabated strong population growth rate and insufficient good quality and needs-oriented health services. Furthermore, not enough people make use of the services that are available. This applies in particular to socially disadvantaged population groups in rural areas.

Support for the health sector has been an important part of Nepalese-German development cooperation for many years. The Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, the Centrum für internationale Migration und Entwicklung (CIM) and KfW cooperate very closely in this field. They provide support to the Ministry of Health and Population and its local agencies in implementing health-sector reform. Cooperation focuses on rural areas which are amongst the regions posing the greatest challenges.

To secure access to good medical care for the entire population, the decentralised health centres have to be within everyone’s reach as well as sufficiently well equipped, both in terms of human resources and technical equipment. Together with the ministry, local administrations and other donors, the GTZ team is investigating the reasons why these centres are so poorly frequented. This also involves searching for ways to improve them and delivering the necessary support. A particular focus is on the themes of sexual and reproductive health and youth rights.

Analysing and improving internal processes in the ministry and at the service and management level in the health centres, coupled with the use of modern quality management, has impacted positively on the centres’ work. This has led to better patient treatment and preventive health care as well as greater acceptance for the socially excluded.

Financial cooperation guarantees that bottlenecks in the health-care system will be eliminated. It does so by securing nationwide funding for medicines and contraceptives and by supporting smaller-scale infrastructure measures, including the construction of storage depots to extend the decentralised, demand-oriented medicines logistics system. Piloting private-sector involvement in maintenance work for medical equipment is also intended to improve the quality of the facilities.