In an effort to make health care services more accessible to all, the Social Development Ministry of Karnali Province has decided to provide nursing care at the community level.

To bring the decision into effect, the ministry has started the process to hire over 200 staff nurses and auxiliary nurse midwives in the ongoing fiscal year.

"We will hire 201 staff nurses and auxiliary nurse midwives this year," Rajan Prasad Acharya, information officer at the ministry told the Post. "Hiring nursing staff is part of this fiscal’s planning, and we have also allocated a budget for the same."

Staff nurses and auxiliary nurse midwives, who will be mobilised in the wards of local levels, will be able to reach every community to carry out health check-ups. They will also disseminate information in the community about the importance of maintaining hygiene and about healthy living. The health workers will also be mobilised in schools wherein they will interact with students, covering issues such as health education, adolescent problems and menstrual hygiene.

"If health problems are minor, the nurses will provide immediate care," said Rita Bhandari Joshi, chief at the Health Directorate of Karnali Province. “If not, they will refer the patients to advanced health facilities."

Joshi believes that the mobilisation of staff nurses and auxiliary nurse midwives would help make health care services more accessible to people residing in the province.

Nursing staff and auxiliary nurse midwives will be deployed to far-flung communities that do not have easy access to health care facilities.

The directorate said that mobilising nursing staff will also help continue services in local health facilities—health posts, primary health care centres, birthing centres and in district hospitals, as services at several such centres have been affected by the employee adjustment process.

"We have been trying our best to retain the existing health workers to be able to give continuity to health services at health care facilities in rural areas. We have urged the Ministry of Health and Population to send replacements for transferred health workers at the earliest," Bhandari said. "Some international aid agencies have also been helping us hire trained manpower like doctors and nurses.'

The districts of Karnali Province are the poorest and most food insecure (40 percent food insecurity) compared to the national average (15 percent). The human development index of the region is lower than Ethiopia and Central African Republic, where 42 percent of people live below the poverty line.

The people of the province are deprived of basic health care services, as health workers including doctors do not want to be deployed to the region given its remoteness. The health workers from the province itself have chosen other provinces for adjustment in the employee adjustment process, according to the directorate.

A study shows that 60 percent of children under five years of age in Karnali are stunted, which is an indicator of chronic undernutrition.