Opportunities and Challenges for effective implementations of Karnali Province Health Policy

In 2015, Nepal became a federal republic and replaced a unitary government with a federal government at the central level, seven provincial and 753 local governments having more authority and resources in planning and managing than before. In the spirit of Constitution of Nepal 2015 and with the vision to make the health services of the country universal and qualitative, Ministry of Health and Population of Nepal (2019) revised National health policy in 2019. National Health policy 2019 of Nepal has expanded its plan and strategies according to federal structure of the country to improve health sector.2 The revision of health policy paved the way forward towards health system reform in the country which is further supported by Local Government Operation Act 2017.3 With the new governance structure, accountability has also been divided among the three tiers and the local level is responsible for the program implementation responsibilities.4 5 The Ministry of Health and Population is responsible for managing the health system at the federal level, whereas at the provincial level leads by the Ministry of Social Development and local governments metro/sub-metropolitan, municipality and rural municipality are responsible for its management.6 This indicates that the health system must gear up to meet the escalating healthcare needs of every citizen and upgrading the system as per the structure of the country.