Docs urge govt to upgrade facilities to maximise useThe “One Village: One Doctor” programme is envisaged in National Health Policy-2015 which states that based on population size, each Village Development Committee will have a doctor with a doctor for 10,000 people.
While the government’s decision to provide free medical education for prospective doctors from disadvantaged areas has been hailed as a positive step, “scholarship doctors” who are currently stationed in rural districts have called for improving facilities for quality health services in rural areas to maximise the potential benefits of the scheme.
The budget, presented by Finance Minister Bishnu Poudel on May 28, states that to effectively implement the “One Village: One Doctor” programme, students from the same village will be granted scholarship once they pass the MBBS entrance examination. Upon completion of the MBBS, they should return to the village and work there for the next five years.
The doctors, who had completed their MBBS under the government scholarship, said they are willing to go to any parts of the country but have been helpless due to lack of basic facilities at the health institutes.
Many times the unavailability of drugs and diagnostic facilities, including X-ray and simple laboratory, means that the fresh graduates have to refer the patients to other health centres.
Dr Subash Lamichane, who had joined Achham District Hospital under the government bond seven months ago, welcomed the government decision. “Producing doctors from respective villages might be a first step. But it is critical to equip the facilities so that we can work,” said Dr Lamichane.
Those completing MBBS under the government scholarship are required to work in health facilities identified by the Ministry of Health for two years. Anyone failing to comply with the regulation will be denied permanent licence from Nepal Medical Council—the government body that regulates medical education and doctors in the country.
Around 300 graduate under the government scholarship programme every year.
The “One Village: One Doctor” programme is envisaged in National Health Policy-2015 which states that based on population size, each Village Development Committee will have a doctor with a doctor for 10,000 people.
Dr Bom BC of Jajarkot District Hospital, who had initially served under bond in Rolpa Primary Health Care Centre, said that the state is wasting the creativity and the potential of young minds by not equipping the health centres. The ministry deploys these doctors to PHCs which lack basic facilities, he said.
The government would need around 3,900 students to deploy one doctor in each village.
Improving the facilities is important to decrease patient loads in district and other referral hospitals. Referring patients for simple ailments to district hospitals increases the travel cost and treatment time, while regular visits add expenses to the patients. Such unchecked expenditure in the health sector has been one of the major contributing factors towards poverty.
The Patan Academy of Health Sciences has adopted similar model of admitting students from various rural districts for over five years. The effectiveness of the initiative is not yet known as the first batch of MBBS students will graduate this September.
Under this collaborative programme, the students compete in entrance examination with their peers from the same districts. So far 22 students from various rural districts, including Jajarkot, Gorkha, Rolpa, Khotang, Mugu, Humla, Aacham, Baitadi, Dailekh, Dolpa, Ilam, Makwanpur, Darchula, Sankhuwasabha, Taplejung and Panchthar, are studying medicine in the PAHS.
The number of students under this scheme varies each year as per the collaboration of the local bodies although Bhatbhateni Supermarket provides scholarship to two persons each year. Under the arrangement, the district development committees fund certain portion of the total cost with the PAHS matching that amount. In some cases, students also pay around a third of the total cost. To retain doctors in the districts, the original certificate will not be issued until they complete two years in the assigned districts.