Which health services are included in Nepal’s free Basic Health Services package?

The package includes immunization, maternal, newborn and child health, nutrition, family planning, reproductive health, communicable-disease care, non-communicable-disease care, mental health, elderly health, disability services, general emergency care and health promotion. Provinces and local governments may extend the package.

Where should a person in Nepal start for routine care and referral through the health system?

Start at the nearest suitable Health Post, Community Health Unit, Urban Health Centre, Primary Health Care Centre or Basic Hospital. If the facility lacks the required staff, equipment or treatment, it should arrange referral to a district, provincial, federal or teaching hospital.

What happens when a health institution in Nepal cannot provide the emergency care required?

The institution should begin immediate first aid and treatment rather than waiting for later formalities, then arrange referral to a facility with the necessary capacity. The HEOC coordinates national emergency support, and 102 is identified as Ambulance Nepal, although local availability and travel time vary.

How can someone access mental health support through Nepal’s health services?

Mental health is part of the Basic Health Services package and is increasingly integrated into general health facilities through mhGAP, district referral and psychosocial services. The National Suicide Prevention Hotline is 1166, while access to specialist support remains more concentrated in urban and better-resourced areas.

Why can health care in Nepal still involve personal costs when Basic Health Services are free?

Higher-level or non-covered treatment, private services, transport, diagnostic tests and medicines unavailable through the public system can require payment. Public supply and staffing also vary by location, so a legally free service may not be available at the nearest facility.

Health in Nepal

Nepal’s health system combines public, private, NGO, Ayurveda and accredited alternative providers. Basic Health Services (BHS) are the publicly defined first level of care and are legally intended to be accessible and free for the listed package. Care usually starts near the ward and moves to a Basic Hospital, district or provincial hospital, or a federal or teaching hospital when staff, equipment or referral capacity is insufficient.

Tip

Use the nearest suitable public facility for routine care, but do not assume that distance guarantees the required staff, tests or medicines. For emergencies, seek care immediately and request referral if the facility lacks capacity. Check schedules, transport, follow-up arrangements and likely personal costs before relying on a care pathway.

bySita&Ram

Article 35 of Nepal’s Constitution and the Public Health Service Act 2075 establish access to quality-assured health services without exclusion. The Ministry of Health and Population and the Department of Health Services coordinate national policy and programs. Provincial Health Directorates and Provincial Health Emergency Operation Centers support the seven provinces, while local governments implement basic services through municipal health sections and local facilities. A Health Post, Community Health Unit, Urban Health Centre, Primary Health Care Centre or Basic Hospital can provide first-contact care, depending on the locality and available staff. Government policy targets at least one basic health service unit in each ward, a Basic Hospital at each local level and access to a facility within about 30 minutes, but geography and resources make actual travel times uneven. Primary Health Care and Outreach Clinics, often written as PHC/ORC, may operate on fixed or monthly schedules. Female Community Health Volunteers (FCHVs), local NGOs and community structures support health education, outreach, documentation and referrals. The free BHS package includes routine immunization, maternal, newborn and child health, pregnancy and childbirth care, nutrition, family planning, reproductive health, abortion services, communicable-disease services, non-communicable-disease care, physical disability services, mental health, elderly health, general emergency care and health promotion. Provinces and local governments may add services. The National Immunization Programme covers vaccines such as BCG, polio, pentavalent vaccine, rotavirus, pneumococcal vaccine, measles-rubella, Japanese encephalitis, typhoid and campaign-based HPV vaccination. When a local facility cannot provide the required examination or treatment, the usual pathway leads to a Basic Hospital or Primary Health Care Centre and then, when necessary, to a district, provincial, federal or teaching hospital. The National Patient Referral Guideline 2082 supports this process. Referral quality, transport, higher-level diagnostics and receiving capacity vary by location. Telemedicine can supplement local care under the Department of Health Services guideline 2077, but it does not replace an examination that requires physical assessment and should use registered practitioners. The Basic Health Services Standard Treatment Protocol 2078 and the Emergency Health Service Package cover prevention, screening, diagnosis, treatment, rehabilitation, palliative elements and follow-up, although the available range differs between institutions and provinces. Hypertension and diabetes are increasing concerns, while communicable diseases remain relevant. Nepal’s health system also integrates mental health into general services and is expanding mhGAP-based care, district referral, psychosocial support and epilepsy services. Access remains more concentrated in urban and better-resourced areas. The National Suicide Prevention Hotline can be reached at 1166. Paropakar Maternity and Women’s Hospital opened Nepal’s first dedicated maternal mental-health outpatient unit in 2024. Emergency care has national coordination through the Health Emergency Operation Center and provincial centers. Designated and satellite hospitals, emergency medical teams and emergency supplies support the response. The HEOC identifies 102 as Ambulance Nepal, but local availability and travel time should be checked because transport differs by area and can be affected by mountains, floods, landslides, earthquakes and seasonal disruption. A health institution may not refuse an emergency case; it should begin immediate care and arrange referral if it lacks the required capacity. The National List of Essential Medicines, sixth revision 2021, defines medicines intended for essential care. Government supply, free non-communicable-disease medicines, laboratory services, diagnostic equipment and specialist staff are not equally available everywhere. Private pharmacies and private providers can fill gaps but may create direct costs. Although the listed BHS package is legally free, higher-level or non-covered treatment, private services, transport, diagnostic tests and medicines unavailable through the public system can require payment. Waiting and travel times depend on terrain, season, referral capacity and local staffing. After treatment, follow-up may return to the local BHS facility when clinically suitable. Referral follow-up, postnatal home visits, selected home-based geriatric care, chronic-disease reviews and psychosocial support can be provided through local or district services. Keep referral papers, prescriptions, test results and discharge instructions together so the next provider can continue care with the available information.