Hailey Tran
Nepal has a mixed healthcare system, with both public and private sector hospitals. In 2021, there were 110 hospitals in the country, with most healthcare facilities concentrated in urban areas. Kathmandu, a city in the Kathmandu Valley, has a range of healthcare facilities, including CT-scan and MRI centers, neuro hospitals, and specialty tertiary care centers. The city has a history of healthcare development, with the establishment of the first health institution by the state in 1857 and the introduction of modern healthcare in 1889 with the opening of the Prithvi Bir Hospital. The country has faced challenges in providing adequate healthcare to rural areas, and efforts have been made to improve access to specialized care, particularly for burn injuries.
| Characteristics | Values |
|---|---|
| Total number of health facilities in Nepal | 14,313 |
| Number of hospitals in Nepal | 110 |
| Number of health posts in Nepal | 3,789 |
| Number of sub-health posts in Nepal | 3,176 |
| Number of primary health centers in Nepal | 203 |
| Number of physicians in Nepal | 1,259 |
| Number of patients served by each health institution in Nepal | 300 to 300,000 |
| Number of medical colleges in Nepal | 19 |
| Number of health centers established in all 109 electoral constituencies in Nepal | 1 |
| Year in which zonal hospitals were established in all 14 zones of Nepal | 1961 AD |
| Number of candidate hospitals identified as "burn stabilization points" in Nepal | 29 |
| Number of configurations of hospitals that would improve access to burn care within 2-, 6-, and 12-hour time thresholds in Nepal | 6 |
| Number of health assistant and nurse schools established in Kathmandu | 1 |
| Year in which Prithvi Bir Hospital was established in Kathmandu | 1889 AD |
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What You'll Learn
Kathmandu's hospitals: public vs private
Nepal has a mixed healthcare system, with both public and private sector hospitals. Kathmandu, as the capital, is likely to have a higher concentration of these hospitals.
Public sector hospitals include primary health centres, district hospitals, provincial hospitals, and tertiary hospitals. These are often underfunded, especially in rural areas, and lack adequate resources and manpower. The public health system in Nepal is designed with a referral hierarchy, so that the majority of the population can receive affordable and accessible healthcare. This includes health posts, which are the first contact point for basic health services, and then moves up through PHCCs, district zonal and regional hospitals, and finally to specialty tertiary care centres in Kathmandu.
Private sector hospitals include general hospitals and super-speciality hospitals, which offer specialised services in areas such as paediatrics, gynaecology, general surgery, medicine, ENT care, and dentistry. These hospitals are equipped with advanced facilities and offer specialty and super-specialty services at a central level.
The specific number of public versus private hospitals in Kathmandu is unclear, but Nepal as a whole had 110 hospitals in 2021, and 14,313 health facilities in total, according to the Nepal Health Facts Sheet 2023. With its urban concentration of healthcare facilities, Kathmandu is likely to have a significant number of both public and private hospitals.
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History of Kathmandu's healthcare system
Nepal has a mixed healthcare system, with both public and private sector hospitals. The country has been working to develop a competent health system for the last 1500 years. During this period, Nepal was ruled by three dynasties: the Lichchhavi kings, the Malla kings, and the Shah kings.
In ancient Nepal, which accounts for the period from the 1st to 879 AD, the health system was based on traditional medicine, with Ayurveda medicine being a major component. During the Lichchhavi period, Aarogyashalawas were established in the Kathmandu valley and other parts of the country, and these were likely Ayurveda medicine-based health facilities.
In the medieval period, the Malla King Pratap Malla established a state-funded Ayurveda dispensary in Hanuman Dhoka Royal Palace, likely to protect people from the high costs of Ayurveda drugs and provide easy access to treatment. The Malla Kings also introduced allopathic medicine to Nepal and established three clinics in Kathmandu, Lalitpur, and Bhaktapur, allowing Christian missionary doctors to treat patients with modern medicine. They worked to treat smallpox patients and eliminate the plague as a public health problem in Kathmandu. However, these clinics closed in 1768 AD after the Malla Kings were defeated by the King of the Gorkha Kingdom, Prithvi Narayan Shah.
In 1847 AD, Jung Bahadur Rana became the Prime Minister of Nepal, initiating the Rana rule, which continued until 1951. In 1850 AD, smallpox vaccination was introduced as the first health intervention based on modern medicine. That same year, a dispensary called Baidhyakhana was established in the Thapathali Durbar complex, providing health services in both Ayurveda and allopathic medicine. Dr HA Oldfield, who worked as a medical doctor at the British Residency in Lainchaur, Kathmandu, was the first medical doctor to receive remuneration from the Government of Nepal. High-ranking officials paid service charges to receive health services from Thapathali Baidhyakhana, while ordinary people received services from a separate, free clinic, likely near Ranipokhari. The Khokana Leprosy Asylum, established in 1857 AD, was the first health institution established by the state to isolate leprosy patients.
In recent years, Nepal has faced challenges in its healthcare system due to political reformation, federalization, and the impact of natural disasters. The country is also dealing with issues such as inadequate essential drug supplies, poorly regulated private healthcare providers, and healthcare disparities between urban and rural areas.
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Specialist hospitals in Kathmandu
Kathmandu is served by a mixture of public and private hospitals. Nepal's healthcare system includes public-sector primary health centres, district hospitals, provincial hospitals, and tertiary hospitals, as well as private-sector general hospitals and super-speciality hospitals. Specialist hospitals in Kathmandu include:
KDC Hospital
KDC Hospital is a multi-speciality hospital that has served patients from around the world for 23 years. It is known for its modern equipment and caring approach. The hospital is home to some of Nepal's most prestigious doctors, who are renowned for developing innovative and revolutionary procedures.
Venus Hospital
Venus Hospital is among the best hospitals in Kathmandu, with its state-of-the-art technology, wide range of services, and expert medical professionals. It offers a variety of services, from general care to highly specialised treatments such as cardiology, internal medicine, gynecology, laparoscopic surgery, mini PCNL for kidney stones, advanced gastroenterology care, and cardiology.
Grande City Hospital
Grande City Hospital provides services in various departments, including cardiology, urology, oncology, gynecology, endocrinology, and psychiatry.
Nobel Hospital
Nobel Hospital provides holistic care in a variety of fields, including general medicine, general surgery, gynecology, and orthopaedics.
Norvic Hospitals
Norvic Hospitals is the first private-sector hospital to receive a "Go-Green Healthy Hospital" certificate. It provides pathological and diagnostic services, as well as general medicine, radiology, haematology, and speech therapy.
Medicity Hospital
Medicity Hospital, located in Bhainsepati, Nepal, offers world-class quaternary care in multiple fields. It is known for providing holistic treatment within a multi-disciplinary framework, with a focus on affordability, accessibility, and personalised medicine care.
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Kathmandu's hospitals: accessibility and location
Nepal has a mixed healthcare system, with both public and private sector hospitals. The public sector includes primary health centres, district hospitals, provincial hospitals, and tertiary hospitals. The private sector includes general hospitals and super-speciality hospitals. The country's healthcare facilities are mostly concentrated in urban areas, with rural health facilities often lacking adequate funding.
Kathmandu, as the capital city, is a hub for healthcare in Nepal. It is home to several hospitals, including the Neuro Hospital, the BP Memorial Cancer Hospital, and the Prithvi Bir Hospital. The city also has a history of leprosy treatment, with the Khokana Leprosy Asylum established in 1857 as the first health institution by the state to isolate leprosy patients. In the same year, a separate leprosy clinic was established in Teku, Kathmandu.
The Health Assistant School and Nurse School were established in Kathmandu to produce paramedics and nurses. In addition, Kathmandu Valley has seen collaborative efforts between Public Health Concern Trust Nepal, Kirtipur Hospital, and international partners to improve burn care capacity and reduce preventable burn-related deaths and disabilities.
Kathmandu's hospitals are generally more accessible than those in rural areas due to the country's challenging terrain and transportation network. However, even within the valley, there are disparities in access. To address this, decentralized healthcare capacity development has been identified as a priority, particularly for rural areas outside the valley.
Overall, Kathmandu's hospitals play a crucial role in providing healthcare services to the local population and supporting the country's mixed healthcare system. The city's hospitals vary in terms of specialisation and accessibility, reflecting the diverse healthcare needs of the community they serve.
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The future of Kathmandu's hospitals
Kathmandu is located in a country, Nepal, with a mixed healthcare system. The country has both public sector hospitals and private sector hospitals. In 2021, there were 110 hospitals in the entire country. However, the specific number of hospitals in Kathmandu is unclear.
Nepal's healthcare system has evolved over time, from ancient Ayurvedic medicine to modern allopathic treatment. The development of the health system has been influenced by different rulers and periods, with continuous improvements and changes. In 1857 AD, the Khokana Leprosy Asylum was established as the first health institution by the state to isolate leprosy patients. In 1889 AD, Rana Prime Minister BirShumsher introduced a modern healthcare system, establishing the 15-bedded Prithvi Bir Hospital in Kathmandu. This was accompanied by the opening of Prithvi Bir dispensaries in Hanuman Nagar, Jaleshwar, Birgunj, Taulihawa, and Nepalgunj.
The country has a history of vertical projects aimed at controlling and preventing various health issues, including smallpox, tuberculosis, leprosy, nutritional disorders, and family planning. In 1956 AD, the government declared its intention to establish one health centre in all 109 electoral constituencies, bringing health services to the sub-district level. Subsequently, in 1961 AD, the government decided to establish zonal hospitals in all 14 zones to provide secondary healthcare under administrative reform. The establishment of medical schools in Nepal began in 1972 with the founding of Rajkiya Ayurvedic Vidyalaya in Nardevi, Kathmandu. Before this, aspiring doctors had to pursue their studies abroad.
Nepal's healthcare system includes public hospitals, primary healthcare centres (PHCC), health posts, non-public facilities, and the Basic Health Service Centre (BHSC). As of 2023, there were 14,313 health facilities registered under the Department of Health Services (DoHS). The health post serves as the first contact point for basic health services, and the system is designed to ensure that the majority of the population has access to affordable healthcare. However, there are challenges, particularly in rural areas, where health facilities may lack adequate funding, manpower, and resources.
Looking to the future, Nepal aims to improve access to healthcare, especially in rural regions outside the Kathmandu Valley. The country faces unique transportation and road access challenges due to its difficult terrain. To address this, Nepal has been working on decentralized healthcare capacity development. Additionally, efforts are being made to enhance burn care in the Kathmandu Valley and across the nation. A collaborative strategy involving Public Health Concern Trust Nepal, Kirtipur Hospital, and international partners focuses on improving patients' access to early and effective resuscitation through the empowerment and organisation of select first-level hospitals.
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