Only six months are left to provide surgical treatment to 12,000 women with collapsed wombs, a condition also known as uterus prolapse. But signs are that this target won´t be met.
The ministry had allocated Rs 180 million to meet the target within the current fiscal year.
Health institutions under the government sector are incapable of conducting all the surgeries alone, and the ministry is yet to identify other health institutions with the facilities to provide the treatment.
Regulations to systematize the free surgery delivery have not yet been finalized.
Proposals exist to help set the wheels in motion to perform the surgeries, including the use of medical colleges, and those nursing homes with at least 25 available beds.
But officials are yet to deal with a horde of issues before service delivery can commence. For example, calls for tenders to select health institutions that have adequate numbers of gynecologists and anesthetists to conduct the surgeries are yet to be made.
“We are yet to decide the monitoring and evaluation mechanism, and also have not decided the amount that the health institutions would charge for the service,” said Loknath Gautam, chief of the ministry’s finance administration. “We are already late.”
Service charges also differ between health institutions. For example, Patan Hospital charges Rs 16,000 for the surgery, while Thapathali Maternity Hospital charges around Rs 9,000.
Dr L.B. Thapa, coordinator of the Regulations Draft Committee and chief of the Clinical Section Division at the ministry, also confirms the process has been delayed.
“We are already late in drafting the regulations,” he said.
Dr Babu Ram Marasini, deputy administrator at the ministry, said the ministry devised the scheme following research conducted which showed around 600,000 of women are currently living with uterine prolapse, 180,000 of which are in dire need of surgery for the condition. “Therefore, the ministry took an initiative by launching the project of providing at least 18,000 surgical treatments within two years, with 12,000 this year alone,” he said.
Those most in need are living under third degree of prolapse, where almost the entire womb has collapsed out of the vagina.
A study entitled ´Uterus prolapse, a key maternal morbidity factor amongst Nepali women´ carried out by Samanata, an organization working for safe motherhood, linked the probability of uterine prolapse with the carrying of heavy loads following childbirth. The study said insufficient rest before and after delivery, carrying out hard work during pregnancy, and poor pre and post-pregnancy nutrition are some of the reasons behind uterine prolapse.
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