PHYSICIANS AND PRINCIPLE CENTERED DELIVERY OF HEALTH SERVICES

Abstract

ABSTRACT
Health is the fundamental right of human beings and the constitution of Nepal also envisages that the state
will follow the policy of developing health of the people to improve their living standards. The national
health policy and the evolution of health services in Nepal reveal that there have been attempts to reach all
the citizens with quality services. Health is defined and understood in different ways by different people.
However, health of the population is determined by situation and services outside the purview of health
services. The extent to which health services can influence health of the people is limited and there are
groups of people who advocate that the physicians be active outside the area of health services and medical
care to promote health.
Ideally the principles that guide the health services are equity, quality, relevance and cost- effectiveness,
efficiency and compassion. The values of beneficence, non-malfeasance and autonomy also form the
cornerstone of the health services. Review of the current health services in Nepal show that further efforts
are needed for our health services to achieve those principles. The health services are yet to reach all the
population, there is a variation in the quality of services available at different places of the country. There
is not much information on the cost-effectiveness of the services. A perusal of the health literature from the
developed countries recognize that medical harm is one of the important cause of illness but the similar
studies is lacking in our country. The issue of autonomy is still in infancy in Nepal. There is not much
evidence of efforts for quality assurance of the services available.
A functional collaboration between medical education, health services and medical practitioners is expected
to achieve ideal values in the health services. There have been a number of international and national
efforts to bring changes in medical education, medical practices and health care system to make the health
services more equitable, relevant, and cost-effective and of high quality. The competences and attitudes the
physicians must have in order to provide principle-centered health services have been identified by a number
of studies. Similarly the ways to achieve those goals through better collaboration among the principal
stakeholders as well as what physicians themselves can do with assistance from these stakeholders have
been suggested.

Key Words: medical education, medical practices, professional councils, health services,
and principles of health services, equality and heath.