Federalism in health care system of Nepal.

              Federalism is that a government in which power is divided between state and national levels. In the federalism government is divide into two level central and local level. The reasons of implementing this federal system in Nepal to develop the nation forward as fast as possible.

          Federalism in health care system of Nepal become opportunistic and challenges both. In Nepal, the maternal under five and infant mortality rate is high. This rate is high mostly in vulnerable and marginalized group of people. Due to which federalism become opportunistic to solve this type of problem. Because, federalism provide legal power to local government due to which the decision and planning will be carry on according to their local community people for example: In poor group people the diseases like malnutrition, diarrhea, stunting, wasting, etc. Are high so, the government of such community will focus on that diseases indispensably.

         Like wise, According to Alma-Ata to improve health status of people PHC became the vital part of health facility. To improve the utilization of PHC federal system help the Nepal government. By, the federal facilities are provided in backward and rural area also. Due to which the health staff take interest to work in rural or village area in too. So, that the all people get opportunity to utilize the health services. 

           The federal context  provides fertile ground for more effective budgeting and need based planning. Due to which people will get equal opportunity to improve their health status.

      Similarly, Federal system give power to the local level government. Which increase the employment opportunity. Due to which the economy of people increase day by day and their standard also become highly socialized. So, which improve the health status of people.

Despite of opportunity, Federalism also become the challenges to decision making power is given to local government. There may be lack of human resources in rural due to which it make difficulties to make planning how to improve the health status. By, this obstacles health services may not be equally provided to all sectors.

Federalism is the DE prioritization of the social sector including health over other needs. Another cross is that human resources management present human resources is not sufficient to provide adequate health service delivery in context of changing burden of diseases and growing advancement in health care. Similarly federalism are implemented to advance the development and facilities of health sector for the advance facilities new technologies and machines are needed. But in Nepal due to low economic it make difficulties to provide necessary equipment in all health care sector.

      For the planning of health services utilization the leader and planner may have to knowledge about the health science and health related topics. But by the federalism in many backward area due to lack of human resources planning and budgeting are implement by improper way.

CONCLUSION 

The relation must be strong at any platform or at any kind of society.

          Now to overcome all these quarries the human resources should be increase by empower the education system. In the rural and backward are all the facilities should be provided. So, the well educated and experience health worker take interest to work in such area. Government have to provide criteria to choose leader for the planning and budgeting. Time to time monitoring and evaluation must be taken by the central level of government. So, that the problems can be solved. As, well as the citizen of Nepal must use the health services. As, we utilize the health facilities we know what improvement should be done.