Regmi K, Upadhyay M, Tarin E, Chand P B, Uprety S R, Lekhak S C
Health Secretary, Ministry of Health, Government of Nepal, Kathmandu, Nepal.
National Professional Officer, WHO Country Office Nepal, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2017 Apr-Jun;56(206):281-287.
The constitution of Nepal provides appointing a council of ministers both at federal and provincial levels without defining portfolios. There is a political agreement that MOH will be retained at the federal level. This article draws evidences around the world to meet health needs of Nepalese, the role of provincial ministry of health and coordinating structure at district/local level. The constitution emphasises on health and pronounced in 46 articles which provides guidance for the creation of federalized governance levels at federal, provincial and local levels. Retaining ministry of health at federal level without creating devolved structure at province and local levels in health sector will create difficulty in translating the spirit of the constitution and may not be effective in addressing health issues nationally and meeting global achievements like SDGs. It is suggested to establish an elaborate health system accordingly in Nepal to ensure constitutional mandate of health as a basic human right.
尼泊尔宪法规定在联邦和省级层面任命部长理事会,但未明确职责分工。存在一项政治协议,即卫生部将保留在联邦层面。本文借鉴世界各地的经验证据,以满足尼泊尔人的健康需求、省级卫生部的作用以及地区/地方层面的协调架构。宪法强调健康,并在46条条款中作出规定,为在联邦、省级和地方层面建立联邦化治理层级提供指导。在卫生部门,将卫生部保留在联邦层面而不在省级和地方层面建立权力下放的架构,将难以落实宪法精神,在全国解决健康问题以及实现可持续发展目标等全球成就方面可能也不会有效。建议尼泊尔据此建立一个完善的卫生系统,以确保将健康作为一项基本人权的宪法规定得以落实。