Avash Puri

In Nepal, more than one-fourth of the population survives below the poverty line, and the lack of accessible and affordable healthcare is forcing families to choose between food and healthcare. In remote villages, a farming accident can lead to costs of up to NPR 4,00,000 ($4,000), sending many families into extreme poverty. The healthcare system struggles to meet the needs of the poor. From my experience working in these villages, I think it is ambitious to say we can attain the SDGs by 2030 unless we have ensured basic quality healthcare for all, especially for marginalized, vulnerable, and underserved populations.

COVID-19 has exposed how fragile the health system in Nepal is. We stand at a point where the hard-earned progress in healthcare from the last few decades is at risk of being completely reversed. Now it is crucial, more than ever, to chart a viable, people-centric, and sustainable path forward. I believe we need to:

• Strengthen the existing primary health care system to reduce inequalities within and between provinces;
• Expand health service packages with evidence-based services aligning with standards of healthcare quality, and expand the effective implementation of the nascent national health insurance scheme;
• Ensure healthcare is timely and accessible, and that the costs at the point of care (both public and private) are minimized through strict regulations.

If these actions are effectively taken now, we will be able to reduce health inequalities, out-of-pocket expenditure, and the double burden of disease through the provision of quality affordable care for all. Collectively, these three outcomes will help keep the government’s promise to attain SDG 3.8 – Universal Health Coverage by 2030.