Institutionalization of Minimum Service Standards (MSS) for Health Facilities in Nepal: Exemplary Plan-Do-Study-Act (PDSA) Cycle for Readiness and Service Availability

  • Ambika Thapa Pachya Daayitwa Nepal Public Policy Fellow, Daayitwa, Lalitpur, Nepal
  • Uttam Pachya Senior Medical Generalist, Dept. of General Practice & Emergency Medicine, Bir Hospital, NAMS, Kathmandu
  • Kapil Amgain Associate Professor & Head, Dept. of Clinical Anatomy, Karnali Academy of Health Sciences, Jumla
  • Madan Kumar Upadhyaya Chief, Quality Standards and Regulation Division, Ministry of Health and Population, Kathmandu, Nepal
Keywords: Minimum Service Standards, Quality Improvement, Plan-Do-Study-Act Cycle, Institutionalization, Readiness and Service Availability


Access to health facilities alone, without quality services, does more harm than the benefit to the people’s health.
Nepal has invested more than two decades in expansion of number of health facilities and the journey is still on to
balance level of health facilities based on the federal structure. Institutionalization of Minimum Service Standards
(MSS) for health facilities in Nepal implemented by Ministry of Health and Population is an exemplary Plan-DoStudy-Act (PDSA) cycle for health facilities readiness and service availability for quality improvement. Thus, it is important to document the process for guiding institutionalization of tools. From its design, development, stakeholders’ engagement, implementation to development of action plan makes MSS lively and outcome-oriented
tool. MSS for health facilities in Nepal is an effort of government to prepare foundation of readiness and service
availability to move ahead with effective quality service utilization. Digitalization of the all sets of MSS,
development of MSS to cover the existing type of the health facilities currently present in the country and access
of data set for researchers is the way forward. Developing standards for national accreditation system and
international collaboration is the next step to embrace. Furthermore, MSS gradually reported through selfassessment of the health facilities with occasional monitoring by the local, provincial and federal government and gap fulfillment through routine annual work plan and budgeting is the future direction. It is high time MoHP moves ahead with service specific quality improvement tools integrated with MSS assessment to prepare them for high
quality health systems that can adapt to changing health needs and health shocks.