Minimum service standards assessment tool and the hospital strengthening program: a novel first step towards the quality improvement of Nepal's national hospital system.

UNLABELLED

District hospitals in Nepal, as in other Low- and Lower - Middle Income Countries (LLMICs), struggle to provide quality care due to inadequate investments in equipment, human resources, and hospital infrastructure. To address these challenges, under the leadership of the Ministry of Health and Population (MoHP), Nick Simons Institute (NSI) developed and implemented the novel Minimum Service Standards (MSS) assessment tool in close partnership with the Government of Nepal. The MSS tool routinely assesses a hospital's readiness to provide mandated care and identify gaps, which are then closed via a small annual grant to the health facility, together providing the knowledge and resources to improve hospital readiness and service availability. Since its inception in 2014, the program has expanded to 130 government hospitals as of April 2024. The program provides a blueprint for hospitals to pursue excellence and has tracked and motivated substantial improvements in services since 2014, such as basic laboratory investigations (+46%), cesarean sections (+40%), and spinal anesthesia (+32%). The program has impacted healthcare policy due to the close collaboration with the MoHP, influencing budget allocation, insurance payments, and hospital upgrade criteria, cementing its sustainability and long term impact.

FUNDING

No external funding.