Dearth Of Doctors

Nepal’s health sector is not in good shape. The state-run health institutions are creaking under the strain. On one hand, the government hospitals are obliged to provide quality health services to the larger section of people. On the other hand, they have suffered from the acute dearth of budget and human resources. The state has been unable to earmark budget for the health sector in line with the World Health Organisation (WHO), which recommends that every country should allocate at least 10 per cent of its total budget for this sector. But Nepal’s economy, beset with numerous structural problems, is not in a position to meet the WHO’s standards. In the recently unveiled budget for the fiscal year 2026/27, Rs. 101.95 billion has been allocated for the health sector, which constitutes 5 per cent of Rs. 2,124 billion fiscal outlay. But, the allocated budget is not sufficient to develop the health facilities required for the nation’s 29.6 million people.  

The shortage of physicians is glaring in the health centres, especially outside the urban areas. The doctor-to-patient ratio is highly uneven, forcing patients to wait long to receive healthcare from the doctors. The WHO suggests ensuring one doctor for every 1,000 people. But in Nepal, this ratio is around 1:3,000 and in rural areas it stands at 1:150,000. Most doctors are confined to the cities, showing their reluctance to go to the remote villages. Their disregard has left rural people vulnerable. Currently, the total number of doctors in government service across the country is 1,916. This number is far below the requirement prescribed by the WHO. Realising the paucity of doctors, the present government has decided to add 977 more permanent posts in the health sector. The Ministry of Health and Food Safety has approved a total of 2,893 posts of doctors at the federal level. 

The fact is that out of the 1,916 doctors on duty, not all are actively engaged in the medical services - some are in administrative sections while some others are on study leave. The dearth of high-level medical workforce has negative repercussions for the entire health sector. The state-run health institutions are supposed to serve the people with low income. But they cannot get health service from there if they have to undergo surgery instantly. They have to wait for months for the essential service. This is a reason why they have to visit private hospitals that charge exorbitant fees from them. The WHO has even warned that Nepal is unlikely to achieve Sustainable Development Goals (SDGs) related to health within the given time frame due to the shortage of doctors. 

It is estimated that around 40,000 doctors are working in government and private hospitals but more than 70 per cent of them are concentrated in cities. The government's decision to create new posts for doctors is positive but this is not enough to bring about tangible changes to the health sector. It should generate a conducive environment for doctors so that they will not leave the country for better prospects abroad. At least 2,500 doctors graduate inside the country annually but most of them do not get a chance to work in the government hospitals. The ministry must increase the posts of specialised doctors such as surgeons in district and local health centres. This must be accompanied by basic facilities and equipment so that people do not have to visit the capital to get specialised services.