The Government of Nepal has established the Koshi Hospital Development Committee under the Development Committee Act, 2013, setting out a formal governance structure for the hospital’s operation and development. The order provides for a committee with a government-nominated chairperson and other representatives, while defining eligibility, tenure, disqualification and procedures for filling vacant positions.

The committee has been given broad authority over hospital policy and management, including preparing and approving annual plans, programmes and budgets, mobilising financial and physical resources, protecting hospital assets, expanding and improving medical services, managing service charges and overseeing the quality of care. The order also directs the committee to monitor hospital services, strengthen information systems, conduct social audits where required and recommend improvements to the Ministry of Health and Population.

The framework provides for an Executive Director to implement committee decisions, execute approved programmes, supervise hospital operations, manage property and maintain administrative coordination. The ministry may provide government health-service employees to the committee, while additional personnel can be appointed where necessary under approved staffing arrangements.

A separate fund will finance the committee through government grants, support from provincial and local governments, hospital service income, domestic donations and assistance, and approved foreign grants or loans. The order also requires proper accounts, auditing by the Office of the Auditor General, annual reporting to the ministry and compliance with government directives—creating a clearer accountability framework for Koshi Hospital’s management and development.