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Case study: How an administrative system is helping to save the lives of cancer patients in Nepal

5th October 2023

It is estimated that  roughly one third of all healthcare spending is wasteful, providing little or no benefit to patients. According to Pulsara, a tele-health app, the wastage amounts to $1 trillion in total. This has severe consequences for many citizens across the globe.

Burdensome administrative processes in healthcare systems can delay diagnosis and treatment and put additional stress on patients, leaving them feeling powerless when it comes to receiving timely treatment for life-threatening diseases such as cancer.

To support their citizens as best as they can, many countries try to tackle inefficiencies in health care administration by simplifying procedures and making better use of Information and Communication Technologies (ICTs).

Infrastructure and geographical challenges: The case of Nepal 

In Nepal, the majority of citizens rely on public healthcare. Whilst the country has made significant progress on health indicators over the past several decades such as an increase in life expectancy and a reduction in maternal and child mortality, it still faces a variety of health challenges, including socio-economic and geographic differences in health service utilisation as well as inadequate resources, health infrastructure and services. This includes long waiting times at hospitals and weak administrative systems to deal with the influx of patients and payments for hospital treatment. 


Taking care of cancer patients: The case of B. P. Koirala Memorial Hospital 

As part of Crown Agents’ public financial management work in Nepal, our team visits hospitals with health ministry officials to jointly assess their financial management arrangements. We then share our findings and recommendations with the hospital management. 

For the B.P. Koirala Memorial Cancer Hospital, we recommended an IT system for ticketing and cash deposits to ensure hospital services went as smoothly as possible for cancer patients who needed urgent health services.  

The hospital took up our recommendations and as a result, have managed to streamline processes and free up additional resources for life-saving treatments. The impact of this has made the life of hospital patients much easier: 

Nine-year-old Bishal Mahat is one of its patients. He has received blood cancer treatment at the hospital for the last two years. When his treatment started, his father would stand in line from 4am to purchase his registration ticket, followed by another queue with more than about 50 people ahead of him to deposit cash in the cash counter. This meant that sometimes, they had to come back the next day to see the doctor.  

After the implementation of the new waiting and payment systems, the family reported that the waiting times had significantly reduced, with only a maximum of 10 people standing in line. This matters, especially for people coming to the hospital from far-away villages – it does not only mean they do not have to travel all night, but it also guarantees them an appointment on the same day they arrive at the hospital. In Nepal, this matters, since rural communities have only limited access to quality care due to inadequate infrastructure and shortage of healthcare professionals. According to the WHO, there were only nine medical doctors available per 10,000 citizens in Nepal during the period of 2013-2021.

The goal of Universal Health Coverage: The need for sustainable health systems 

In the last 3 years, the hospital’s turnover in cash collection has increased by 300%, whilst staffing needs for cash collection decreased by over 80%. The implementation of the new, more effective administration systems has played a crucial part in this development. This way, resources are freed up to allocate to other life-saving services and to sponsor the treatment of those patients who need it most.  

As the World Health Organisation has pointed out, the effectiveness of our systems is crucial if we want to ensure our health services are sustainable and fit for purpose. Only this way, Universal Health Coverage, a human right for all, will become a reality and not just remain a goal for the distant future. 

For more information on our public financial management work and our presence in Nepal, please click here.