Many municipal hospitals short of mandatory beds

For an administrative unit to be a municipality, it has to have a hospital with at least 25 beds, according to the Local Government Operation Act 2017. Only seven municipalities in Province 5 meet this criteria. The remaining 25 municipalities do not have a hospital with 25 beds; 10 of them have a 15-bed hospital each. There is no new initiative to add beds. 

Universal Medical College in Siddharthanagar municipality in the district of Rupandehi has 50 beds. So do Crimson Hospital in Tilottama municipality and Devdaha Medical College in Devdaha municipality. These are private medical colleges. 

Prithvi Chandra hospital in Ramgram municipality in the district of Nawalparasi also has 50 beds. But Lumbini Sanskritik municipality and Sainamaina municipality (both in Rupandehi) are without hospitals, compelling locals to travel elsewhere for medical treatment. 

The plan to make Pyuthan Hospital in Bijuwar a 50-bed hospital has been gathering dust for over a decade. Patients from Pyuthan as well as from the neighboring districts of Gulmi, Rolpa and Arghakhanchi visit this hospital, and many of them struggle to get beds. Those from areas bordering India also have to travel across the frontier for treatment. 

The Ministry of Health and Population has recently started the process of increasing the number of beds at a primary health center in Swargadwari municipality, Pyuthan, to 15 from the existing three. Two years after it was declared a municipality, there is no sign of a 25-bed hospital. Local representatives are in fact glad to get a 15-bed medical center. 

Likewise, two years after Sitganga in Arghakhanchi district was declared a municipality, residents cannot get specialized medical services locally and have to travel to Kathmandu, Butwal or Bhairahawa; the primary health center and health post there provide only general medical services. The municipality has recently started the process of converting the health center into a 15-bed hospital. Municipality Chief Surya Prasad Adhikari says there is no space to build a bigger hospital. 

District Hospital Rolpa has only 15 beds. Rolpa Municipality Chief Purna KC says the hospital, built with an investment of Rs 310 million, has the approval to upgrade to 50 beds—and yet nothing is happening. 

Similarly, District Hospital Gulmi is in the process of getting 50 beds; the ministry has already signed off on an upgrade. “But the approval notwithstanding, the hospital has neither the required number of doctors nor proper physical infrastructure,” laments municipality chief Dilli Raj Bhusal. 

Netra Raj Adhikari, chief of Shivaraj Municipality in Kapilvastu, bemoans that locals have to depend on private clinics and health centers for medical services. Of the 11 wards in the municipality, only eight have health centers. 

Bishal Subedi, head of the Pyuthan Medical Center, says the federal ministries’ strategies are not in lockstep with the requirements set by the Local Government Operation Act 2017. “Municipalities must have a 25-bed hospital; a 15-bed hospital is not enough,” he emphasizes.