The Ministry of Health and Food Hygiene approved the Guidelines for Operation of Health-Sector Activities under Conditional Grants through Provinces for FY 2083/84 through a ministerial-level decision on Shrawan 26, 2083. The document provides implementation, expenditure, monitoring and reporting rules for 13 programme areas: health-sector reform; tuberculosis; HIV/AIDS and sexually transmitted infections; family welfare; epidemic and disease control; disability prevention and leprosy; health management; health education, information and communication; health training; curative services; nursing and social security; and Ayurveda services. Provincial agencies must enter health-service data regularly into designated information systems, report physical and financial progress, follow procurement and financial laws, and submit quarterly financial reports, particularly where foreign assistance is involved.

A major focus is the expansion and modernization of tuberculosis services. The guideline says Nepal’s TB-Free Campaign has expanded to 107 additional local levels in FY 2083/84, bringing the total to 256 local levels. Provinces are instructed to strengthen drug-resistant TB centres and hostels, expand GeneXpert/Truenat and microscopy services, conduct active case finding among high-risk populations using AI-supported portable digital chest X-rays, improve contact tracing and laboratory quality control, and train health workers in electronic TB reporting. Drug-resistant TB patients attending treatment centres may receive Rs 3,000 per month for nutrition and transport, while those using hostel accommodation may receive Rs 1,000 per month, alongside access to free health insurance for the patient and up to five family members.

The broader programme supports ART, HIV testing and counselling, prevention of mother-to-child HIV transmission, reproductive and maternal health, newborn and child health, immunization and family planning, with provincial and district reproductive-health coordination mechanisms expected to review service performance. Disease-control activities include malaria surveillance and response under the “1-3-7” approach—reporting a malaria case within one day, investigating it within three days and completing response measures within seven days—along with programmes for other communicable diseases, noncommunicable diseases and public-health emergencies. Provincial hospitals and health institutions are also required to strengthen Minimum Service Standards (MSS), essential medicine forecasting, health-data quality, staff training and supervision.

The social-protection component continues support for One-Stop Crisis Management Centres (OCMCs), Social Service Units and geriatric health services, with hospitals required to report beneficiaries through the ministry’s dedicated OCMC, SSU and Geriatric Portal System. Ayurveda and alternative-medicine facilities must similarly improve service quality through MSS self-assessment, gap analysis and action plans, while provincial programmes support Ayurveda treatment, health promotion and coordination. The guideline also finances salaries for scholarship-contract doctors and health workers deployed to provinces and local levels, as well as personnel and operating costs for Global Fund-supported HIV, TB and malaria programmes, making the document the principal operational framework for federally funded provincial health activities in FY 2083/84.