The Ministry of Health and Population had planned to carry out an independent study on the effectiveness and impact of work being done by female community health volunteers serving throughout the country in the current fiscal year.

The programme, however, has been halted indefinitely, with its donor, the USAID, suspending funding.

“It is impossible to carry out the study in the current fiscal year even if other agencies or the government provide us with the required budget,” said Hira Kumari Niraula, director of the Nursing and Social Security Division under the Department of Health Services. “Also, the report cannot be prepared in the current fiscal year [which ends mid-July].”

Along with the nationwide survey of female community health volunteers, several other studies, including the planned micronutrient survey, and health facilities survey, among others, have been suspended indefinitely due to the abrupt suspension of USAID support.

Many other programmes related to Nepal’s health care have been affected due to the US government’s decision to suspend nearly all US assistance worldwide for three months.

Health officials say the abrupt aid cut by USAID, a major donor, has affected not only ongoing programmes but also planned ones, as well as policy-making, which will have long-term consequences.

“We will be in the dark about the progress so far from our investment in health care if we don’t have health care data,” said Dr Bibek Kumar Lal, director at the Family Welfare Division under the Department of Health Services. “We won’t know what needs to be done to ensure the effectiveness of the programmes and what new measures should be taken.”

Health officials say that an indefinite halt in health surveys and data collection puts the country in the dark about updated health indicators and affects efforts to track progress on Sustainable Development Goals (SDGs) targets.

SDGs, a follow-up on the Millennium Development Goals (MDGs), aim to end poverty and hunger and all forms of inequality in the world by 2030, and Nepal has committed to meeting the goals.

Health officials say the government does not invest in data generation and independent studies, and most officials think it is a waste of national resources. Moreover, the data collected through government channels are also not considered credible by international agencies, as officials can manipulate them to show progress.

For reliable or internationally acceptable data, an independent study is required, according to officials.

“We won’t have independently verified data if the study is not carried via an independent channel, meaning that our data will not be taken as authentic by international health bodies,” said Lal. “Government-generated data are taken as administrative data, but to demonstrate real progress in healthcare, both to the international community and the public, we need data from independent agencies.”

Public health experts say the government must ensure a sufficient budget for independent study while designing health care programmes.

“We ensure a budget for independent study of every immunisation programme,” said Dr Shyam Raj Upreti, former director general at the Department of Health Services. “The government should have the same approach for other health programmes.”

Some experts say there is ample evidence that data from some studies including a nutrition-related one, both funded and evaluated by USAID fund in the past, were manipulated to serve the agency’s interest. They, however, refused to name specific studies.

They said that data generated by international agencies will be questionable if the same agency funds both the programme and provides its evaluation.

Other affected programmes include ‘outbreak investigation training’ for doctors, training for hundreds of doctors and nurses to save neonates born either in hospitals or brought there for treatment, breastfeeding promotion efforts, and various SDG-related programmes, including maternal and child health, nutrition, reproductive health and family planning.