Primary Care & Service Delivery
Nepal's health system relies heavily on a network of health posts, primary health care centres, and Female Community Health Volunteers (FCHVs). As the country federalises, local governments are taking on new responsibilities for primary care delivery. This collection examines global evidence on what makes primary care systems effective — from task-shifting and digital health tools to performance-based financing of health facilities.
Key Questions
- ? What primary care models work best in decentralised health systems?
- ? How can community health workers be better supported and retained?
- ? What role can digital health play in strengthening primary care in rural Nepal?
- ? How do performance-based financing schemes affect service quality?
4 papers
4 papers
Effectiveness of Community Health Workers in Low-Income Countries: A Meta-Analysis
Henry Perry, Rose Zulliger, Michael Rogers · 2014 · The Lancet Global Health
Nepal's Female Community Health Volunteer (FCHV) programme is one of the world's largest community health worker networks. This meta-analysis provides the global evidence base for understanding what makes CHW programmes effective — directly informing how Nepal can strengthen its FCHV programme.
Community-Based Management of Neonatal Sepsis by Female Community Health Volunteers in Rural Nepal
Dharma Manandhar, David Osrin, Kirti Man Tumbahangphe · 2004 · The Lancet
This landmark Lancet study from Makwanpur district demonstrated that community-based neonatal care through women's groups facilitated by FCHVs could dramatically reduce neonatal mortality in rural Nepal. It influenced national policy and global guidelines.
Performance-Based Financing and Health Outcomes in Rwanda: A Rigorous Evaluation
Paul Gertler, Christel Vermeersch · 2012 · Health Economics
Rwanda's performance-based financing model has been widely cited as a success story for LICs. Nepal has piloted results-based financing in some districts. Rwanda's experience offers lessons on designing payment systems that incentivise quality and coverage.
Ethiopia's Health Extension Programme: Impact on Universal Primary Care Coverage
Abrha Asefa, Yibeltal Assefa, Dessalegn Melaku · 2019 · BMJ Global Health
Ethiopia's Health Extension Programme (HEP) deployed over 38,000 salaried Health Extension Workers to rural communities — a model Nepal could learn from as it considers professionalising its FCHV cadre and strengthening primary care under federalism.