Nepal

however, is the low proportions of nursing posts (36 percent) and paramedic positions (29 percent) filled in
UHCs. Overall, a slightly higher proportion of positions are filled in the terai region (73 percent) than in the
hill (71 percent) and mountain (70 percent) regions. The higher rate of fulfillment of medical officer positions
in the mountain region (80 percent) than the hill (58 percent) and terai (50 percent) regions may be due to
the preference of new entrants to stay in remote areas, which secures higher marks in the selection process
for scholarship programs. The somewhat higher number of consultant positions filled in the hill region (50
percent) than in the terai region (46 percent) may be due to the high number of specialty hospitals located in
the Kathmandu valley.
Table 3.12 Sanctioned posts filled (NHSS RF: OP1b1.1)
Among all government facilities, percentages of sanctioned MoH posts filled for the indicated provider categories, by
background characteristics, Nepal Health Facility Survey 2015
Background characteristic Consultant MD-GP MO Nurse Paramedic 1
All
providers 2
Facility type
Zonal and above hospitals 48.4 63.2 57.6 73.0 80.6 68.7
District-level hospitals na 51.9 57.6 78.5 80.5 64.3
PHCCs na na 50.7 79.1 83.0 78.0
HPs na na na 70.7 73.1 72.2
UHCs na na na 35.7 28.6 31.8
Ecological region
Mountain na 33.3 79.5 68.4 70.4 69.6
Hill 50.0 55.6 57.5 70.9 72.4 70.5
Terai 45.6 65.5 50.1 75.2 78.1 72.9
Earthquake-affected districts (14) 48.8 52.0 61.3 70.2 64.8 66.3
National average 48.4 56.5 55.9 72.1 74.3 71.3
na = Not applicable
1
Paramedic includes the following: health assistant (HA), auxiliary health worker (AHW), public health inspector,
laboratory technologist, laboratory officer, laboratory technician, laboratory assistant, radiographer, and dark room
assistant.
2
Includes the following: consultant, MD-GP, MO, nurse, and paramedic
3.6 HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS)
The 2015 NHFS collected information on the health management information system in the
surveyed health facilities. Tables 3.13 and 3.14 present findings on various aspects of the state of the HMIS
in health facilities
The vast majority of facilities (94 percent) report that they regularly compile an HMIS report (Table
3.13). However, only half of facilities (54 percent) have a designated HMIS focal person. UHCs (45 percent)
and HPs (50 percent) are least likely to have a designated HMIS focal person. Facilities in the terai region
(62 percent) are more likely than facilities in the other regions to have a designated HMIS focal person
Among those facilities that compile an HMIS report regularly, all had the previous month’s report
available (observed) on the day of the survey. Similarly, all facilities with a designated HMIS focal person
reported that the focal person had received the necessary HMIS training (Table 3.13).
Although the majority of health facilities in Nepal are regularly compiling HMIS reports, only a
minority have guidance on the preparation of these reports available to staff in the facility. Table 3.14 shows
that 4 in 10 public facilities had the HMIS tool kit “Recording and reporting tools in HMIS, 2070” available
(observed) on the day of the survey. An additional 12 percent of facilities reported having the tool kit but
could not produce it that day. UHCs (27 percent) are less likely than the other types of public facilities
(between 41 percent and 53 percent) to have had the tool kit available. About half of public facilities had the
HMIS user manual available on the day of the survey. Zonal and above hospitals (38 percent) and UHCs (22
percent) were less likely than district-level hospitals (51 percent), HPs (54 percent), and PHCCs (57 percent)
to have the HMIS user manual available on the day of the survey. Facilities in the 14 earthquake-affected
districts compare unfavorably with the national average.
52 • Facility-Level Infrastructure, Resources, Management, and General Service Readiness