Reforms in Oral Health Services in Nepal

Saujanya Karki


Nepal is modelling for its federal state with seven provinces and seven hundred and forty-four local bodies. These local bodies have jurisdictions over collecting taxes and manage them accordingly. The local bodies now can decide on the investment in health and organize effective health care services. Different thoughts and views were presented on the formation of the health services with a vision of improving health and well-being of its citizen. Oral health can be integrated with the overall health care system. The know truth social, economic, political, and geography of Nepal is a barrier to sustain development. These factors when combined with the expectation of the citizen can be the root breakers.

Initial Plan

  1. Oral health Policy and its implementation

An approach of inclusion of oral health in national health policy and treating the oral health as a part of general health. At this stage, oral health policy should illustrate the importance education, provision of services and oral health promotion. Additionally, it should be focused on research to outline the distribution and pattern of the oral diseases, the impact of the oral problems on quality of life and well-being, and association of oral health with social, political or economic structure. The oral health policy should prioritize the periodic population oral health surveys of children and adults.

  1. Resourcing oral health

This includes the strengthening of the oral health workforce and facilities. The development of the oral health care system with a structured organogram can be planned. The structured system should emphasize the production and distribution of skilled work force, and the management of current workforce. Furthermore, the system should provide knowledge and skills on need assessment, professionalism and skills to work as a team, and continuous learning opportunity. Team should comprise the clinician, hygienists, therapist, nurses, and oral health community workers. This structure will lead to a high degree of oral care and coordination. The hiring and mobilization of the professionals should be done effectively by the local bodies itself. The ratio of the oral work force to the population should be monitored regularly. The development and digitalization of oral health care information (patient information) systems have vital role in improving the oral health care.

  1. Strategies to provide services

Availability of oral services in primary health care, models on community led preventive oral health program, and oral health education and promotion should be focused at this stage. The concept of 3-stage referral system can be implemented (Fig.1)

Future Plan

  • Strengthening the role of primary health center.
  • Introduction of the dental health insurance (except cosmetic treatments).
  • Supervision and Evaluation of the quality dental services.
  • Development of the oral health information system into next level.
  • Ensuring the capabilities of research and innovation from municipal 1