The Ministry of Health and Food Hygiene has approved the Guidelines for Operation of Health-Sector Activities under Conditional Grants through Local Levels for FY 2083/84 through a ministerial-level decision dated Shrawan 26, 2083. The guideline establishes standardized implementation, expenditure, monitoring and reporting requirements for local governments and covers 13 major programme areas, including health-sector reform, primary healthcare, tuberculosis, HIV/AIDS and STIs, family welfare, epidemic and disease control, disability and leprosy, health management, health communication, training, curative services, nursing and social security, and Ayurveda. Local governments must enter service data into health information systems every month, report physical and financial progress, follow public procurement and financial rules, and may mobilize additional local resources where federal allocations are insufficient without duplicating funding.
A major component concerns 5-, 10- and 15-bed basic hospitals. Funding is provided for outstanding construction liabilities and for operating completed hospitals, with the operating grant divided broadly into 30% for human resources, 20% for medical equipment, 20% for medicines, 15% for furniture and fixtures, 10% for water, electricity and communications, and 5% for waste management. Hospitals are expected to have at least an MBBS doctor, staff nurse, radiographer and laboratory technician. The guideline also continues Rs 5,000 per month treatment assistance for eligible kidney-transplant recipients, people undergoing dialysis, cancer patients and people with spinal paralysis. Another major initiative, “One Local Level, One Public Health Officer,” assigns public-health officers to lead evidence-based planning, NCD and mental-health prevention, community screening, home-based follow-up for chronic patients, school health, healthy-lifestyle promotion, One Health coordination, climate-health resilience and emergency preparedness.
Disease-control measures include active tuberculosis screening among high-risk and underserved populations, including the use of portable digital chest X-rays, contact investigation and preventive treatment for eligible contacts, particularly children under five. The guideline also provides support for drug-resistant TB patients, HIV treatment and ART services, laboratory monitoring and community-based TB elimination activities. Family-welfare provisions cover immunization, maternal and newborn health, family planning, adolescent and reproductive health and integrated reproductive-morbidity screening, including HPV DNA testing for cervical cancer, alongside screening for breast cancer, obstetric fistula, pelvic-organ prolapse and other reproductive conditions. The epidemic and disease-control programme also places significant emphasis on community screening and awareness for noncommunicable diseases, including a dedicated screening campaign during Falgun.
The remaining programmes strengthen health-data quality, regular facility meetings, verification and review; health education and communication; workforce training; essential curative services; and social-protection programmes. The nursing and social-security section includes support for hospital-based geriatric services, Social Service Units and One-Stop Crisis Management Centres, while the Ayurveda programme supports basic Ayurveda care, medicines, Citizen Wellness (Nagarik Arogya) centres, yoga, healthy-lifestyle promotion and community outreach. Overall, the guideline ties conditional grants to defined activities, target groups, expenditure rules, reporting formats and performance indicators, giving local governments a detailed operational framework for delivering federally funded health programmes during FY 2083/84.
