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Written By THT Editorial Team

Reviewed by Dr. Ram Prasad Neupane , DM MDGP,  Professor at Tribhuvan University, Maharajgunj Medical Campus

Challenges faced by Nepal’s healthcare system in providing access to care, particularly in rural areas, stem from various factors including geographical barriers, limited resources, and disparities in healthcare access. Research findings shed light on these challenges and provide insights into the factors contributing to the difficulties in healthcare accessibility.

Geographical Barriers and Infrastructure Limitations: Nepal’s challenging topography and dispersed population present significant barriers to healthcare access in rural areas. The rugged terrain, difficult terrain, and lack of proper road infrastructure make it difficult for individuals in remote regions to reach healthcare facilities. Limited transportation options and long travel distances further compound the problem.

A study conducted by Ghimire and Sapkota (2020) examined the impact of geographical barriers on healthcare access in rural Nepal. The research highlighted that the distance to healthcare facilities and the lack of transportation were major barriers, leading to delayed or inadequate healthcare services in remote areas (1). These findings emphasize the need for improved infrastructure and transportation systems to overcome geographical barriers and enhance access to care.

Shortage of Healthcare Workers and Resources: A significant challenge faced by Nepal’s healthcare system is the shortage of healthcare workers, particularly in rural areas. Limited healthcare workforce and inadequate distribution of healthcare professionals contribute to unequal access to care. Inadequate staffing levels and the absence of specialized healthcare professionals in remote regions further exacerbate the problem.

A study conducted by Aryal et al. (2019) assessed the healthcare workforce distribution in Nepal. The research revealed a significant concentration of healthcare professionals in urban areas, leading to a disparity in healthcare access between rural and urban populations (2). The shortage of healthcare workers in rural areas underscores the importance of strategies to attract and retain healthcare professionals in underserved regions.

Limited Healthcare Infrastructure and Resources: Nepal’s healthcare system faces challenges in terms of inadequate healthcare infrastructure and limited availability of resources. Insufficient healthcare facilities, equipment, and medical supplies pose barriers to providing quality care, particularly in rural areas. Inadequate funding and resource allocation further compound these challenges.

A research study by Acharya et al. (2017) explored the challenges faced by rural health facilities in Nepal. The findings highlighted resource constraints, including inadequate infrastructure, lack of medical equipment, and scarcity of essential medicines, as significant hurdles in delivering quality healthcare services in rural areas (3). These findings underscore the need for increased investment in healthcare infrastructure and the equitable distribution of resources to improve healthcare access in underserved regions.

Socioeconomic Factors and Affordability: Socioeconomic factors, including poverty and affordability of healthcare services, also pose challenges to healthcare access in Nepal, particularly in rural areas. Limited financial resources and the high cost of healthcare services can prevent individuals from seeking timely and appropriate care. This further perpetuates health disparities and hinders access to necessary treatments.

A study conducted by Karkee et al. (2019) investigated the financial barriers to healthcare access in rural Nepal. The research revealed that the cost of healthcare, including consultation fees, transportation expenses, and medication costs, presented significant challenges for individuals with limited income (4). The findings highlight the importance of addressing affordability issues and implementing effective health financing mechanisms to improve healthcare access.

Conclusion: The challenges faced by Nepal’s healthcare system in providing access to care in rural areas are multifaceted, involving geographical barriers, shortages of healthcare workers and resources, limited infrastructure, and affordability issues. Addressing these challenges requires comprehensive strategies that focus on improving transportation infrastructure, recruiting and retaining healthcare professionals in rural areas, strengthening healthcare infrastructure and resource allocation, and implementing measures to enhance the affordability of healthcare services.


  • Ghimire, R., & Sapkota, V. P. (2020). Geographical barriers to health service utilization in Nepal. BMC Health Services Research, 20(1), 403. doi: 10.1186/s12913-020-05360-3
  • Aryal, K., Ghimire, A., Kumar, A., Joshi, S. K., & Pandey, A. R. (2019). Healthcare Workforce in Nepal: Challenges and Opportunities of Skill Mix. Frontiers in Public Health, 7, 279. doi: 10.3389/fpubh.2019.00279
  • Acharya, J., Kaehler, N., Marahatta, S. B., Mishra, S. R., Subedi, S., Adhikari, B., & Mishra, S. (2017). Preliminary insights into the use of e-health in rural Nepal: a mixed-methods study. BMC Medical Informatics and Decision Making, 17(1), 115. doi: 10.1186/s12911-017-0514-7
  • Karkee, R., Kadariya, J., Aryal, N., & Shrestha, R. (2019). Financial barriers in accessing maternal health services in rural remote areas of Nepal: A qualitative study. Journal of Health, Population, and Nutrition, 38(1), 1-10. doi: 10.1186/s41043-019-0182-y