TY - JOUR AU - Dulal, Ram Krishna PY - 2009/04/01 Y2 - 2024/03/28 TI - Health Federalism: The Role of Health Care Professionals in Nepal JF - Journal of Nepal Medical Association JA - J Nepal Med Assoc VL - 48 IS - 174 SE - Short Communication DO - 10.31729/jnma.243 UR - http://jnma.com.np/jnma/index.php/jnma/article/view/243 SP - 191-5 AB - <p>Nepal has entered from its unitary system into a new “Federal Democratic Republic State.” The <br />current constitution presents basic health care services as a fundamental right.The Ministry for Health <br />and Population has been providing resources to meet health demands, but managers are wrestling <br />to meet these demands. Persistent disparities between rural and urban and across regions resulted <br />inferior health outcomes e.g. life expectancy in an urban district like Bhaktapur is 71 years, whereas <br />in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past <br />systems prompted people to seek a different model. Ultimately, all political parties except one have <br />agreed on federalism. The exact number of federal states that are going to be created is unknown. In <br />federalism, all federated states have to assume certain relationships between the locality, the region, <br />and the nation that apply not only in politics but in health care too. Managing changes in health care <br />organization during the transitional period and after restructuring the unitary Nepal into federal <br />states should be carefully planned. In case, if new system also fails to deliver necessary health care <br />services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be <br />ignored. In order to outline a structure and give life to a health care system under federalism, health <br />care professionals need to engage themselves seriously.<br />Key Words: disintegration, disparities, federalism, health care, life expectancy</p> ER -