The Ministry of Health and Population is waiting for a copy of the health workers’ contract directive endorsed by the federal government to hire health workers, including doctors.

A recent Cabinet meeting had endorsed directive tabled by the ministry some four months ago.

"The concerned agencies under the federal, provincial and local level governments can hire health workers for more than 5,000 vacant posts once we forward the copy of the endorsed contract directive," Mahendra Prasad Shrestha, spokesperson at the Health Ministry, told the Post. "We are waiting for the endorsed copy of the directive."

State-run healthcare facilities—health posts, primary health care centres, district hospitals, regional hospitals and central level hospital—are facing an acute shortage of health workers to provide services to the patients.

Of the 31,591 health workers employed by the government, around 27,400 are serving in various health facilities across the country. According to Shrestha, the posts of health workers, including doctors, nurses, health assistants, auxiliary nurse midwives and lab technicians, have been lying vacant due to various reasons such as retirement, death, study leave and, resignation.

The ongoing employee adjustment process has also hampered the services in various health care facilities throughout the country. Several medical services—emergency care and cesarean delivery services, among others—have been affected in multiple healthcare facilities.

Bir Hosptial, the country’s central hospital, lacks nurses to serve in the emergency ward during the night, officials said. Around 2,000 patients from across the country reach Bir Hospital every day, hoping to get quality care at affordable prices. The hospital has been unable to run an advanced, new building constructed by the Japan International Cooperation Agency due to a staff crunch.

Kanti Children Hospital, which is the national referral centre for the treatment of children, has shut down several beds of intensive care unit due to a shortage of staff, including doctors and nurses.

"The directive will allow respective governments to hire health workers only for the vacant posts," said Dr Bikas Devkota, chief of Policy Planning and Monitoring Division at the Health Ministry. "Additional budget is not needed to hire manpower in the existing posts as it is always allocated in the fiscal year’s budget."

New posts of health workers have not been created for the last 26 years and thousands of existing posts have not been filled for years.

"The new health workers contract directive would help ease the existing crisis," said Devkota, "But without creating additional posts of health workers including doctors, we cannot ensure universal health coverage to all."

Nepal has committed to ensuring health care services to all as per its commitment towards the World Health Organization's Universal Health Coverage to all. For that, the country must fulfil the required criteria, including affordability, availability of essential medicines and technologies, to diagnose and treat ailments and ensure sufficient capacity of well-trained health workers and, above all, a strong and efficient health system.