Welfare in Nepal as a Global South Country

The term Global South and Global North might suggest dividing the countries based on geographical setting but the categorization is based on the socio-economic and political status of the countries. While the developed countries with enough basic needs and access to a functioning education system, Global South comprises the Third World Countries with relatively low GDP and high population. Countries mainly from Africa, South America, and Asia apart from Japan and South Korea (Sawe, 2017).

Gabriele Kohler has described South Asia as an emerging right- based development welfare state with social policies in education, health, employment, and social protection all of which having common concern to poverty, vulnerability, social exclusion, demographic challenges, ecological stress and income disparities. (Köhler, 2014)

Nepal too being a developing country with comparatively low socio- economic status belongs to Global South and falls under the same “right based development welfare state” as it has identified certain aspects like health and education as a basic human right. However, the scenario was not always the same. Previously welfare in Nepal were mostly handled by religious or charitable institution and thus were guided by the religious values. For instance: Guthi was the most effective means of social management for welfare as it worked through land endowment and utilizing the amount with the community. Other practices like Daram Bhakari and Muthhi Dan were also prevalent as social welfare activities of non-government organizations in the past whereas the responsibility of Government in social welfare got significant consideration only after the industrial revolution. (Poudyal, 1984)

Social Welfare Act was developed to relate social welfare activities to provide humanistic livelihood to the weak and helpless and to enhance coordination between social welfare oriented organizations. The Act defines social welfare program and special program relating to social welfare. Moreover, Social Welfare Council was established based on this particular act. (The Official Portal of Government of Nepal, 1992)

In Nepal all the welfare activities are administered via Social welfare council which is responsible to run social activities in an organized way through effective coordination, co-operation and mobilization and promotion of social organizations and institutions (The Official Portal of Government of Nepal, 1992).  Nepal has been working in the field of education, health, employment and social protection as the areas for social welfare (Köhler, 2014). Following are the major policies in which the social welfare is based on:

1. Free and accessible education: Provision of free secondary level education (edusanjal, 2017)
2. Health as a basic human right – Health for all- Interim constitution 2007
3. Labor Rules 1993
4. Social Security Act 2017 which includes six schemes, namely; a) Medical and Health Promotion, b) Maternity Protection , c) Accidental Protection, d) Old age protection, e) Dependent family Protection and f) Unemployment protection (Pioneer Law Associates, 2017)

Since it is hard for government to reach every corner of the country, different Non-Government Organizations, Civil Society organizations and Social Welfare organizations has become more involved in development and welfare activities in Nepal. (Badal, 2017) Till date 245 INGOs and 50358 NGOs are registered in SWC and working in the thematic areas of livelihood, education, healthcare, poverty alleviation and alike. (The Official Portal of Government of Nepal, 1992) Nepal thus follows a mixed welfare model with the equal role of market and state (Badal, 2017). As suggested by the Social Administration approach, the nation has applied both the public and private funded welfare services.

Particularly in Health care management, Department of Health Services (DoHS) is responsible for overall management of health care in Nepal under Ministry of Health and Population (Government of Nepal Ministry of Health and Population , n.d.). Both public and private bodies are equally involved as Government of Nepal encourages private sector in providing quality health services (Shiba K Rai, 2001). Health has been addressed as a fundamental right and thus the nation has made necessary provisions to provide basic health services free of cost (Shiva Raj Mishra, 2015) through health posts, PHCs and district hospitals (eiko Saito, 2016) Another positive part in this is that there is especial provisions for children, pregnant women, elderly and those who cannot afford the health care. For instance, free vaccination.  But since only the primary health care services are free, high range of out of pocket payment can be seen i.e. 81 % in the private sector (Shiva Raj Mishra, 2015). To increase the access to health services and to decrease the financial burden of out of pocket payment Social Health Security Program (commonly known as health insurance) has been implemented since 2013. The subsidy is based on the poverty card provided by the government. Even though the program was started quite a long time ago, it has been implemented in only 15 districts of the country of which only 5% of population are taking part in it  (Lohani, 2017).

The same approach can be seen in education sector of Nepal where there is the provision of free education in Public schools, significant number of privately-run education institutions compete for quality education. However, in case of social protection and labour welfare, mostly the government is in charge.

Government look over the welfare activities that are managed publicly but since the I/NGOS function under the direct supervision of SWC, it is the body responsible for monitoring and evaluation of such activities but due the various reasons line lack of skilled human resources and political instability, it has not become able to effectively monitor national and international non- government organizations. Also, there is a lack of mechanism to incorporate feedbacks received from field monitoring in government policies.  (SWC fails to monitor I/NGOs, 2018). A study carried out in Teaching Hospital of Nepal revealed that 75% of the respondents were satisfied with the services provided by the hospitals in relation to price paid. Also, 50% of them found their expectation of needs met (Shyam Bahadur Katuwal, 2018). Lack of sufficient fund for impoverished citizens and challenges in monitoring of private sector’s health services has made assessing the quality of health services a challenge (Department of Health Services, 2017/18). Also a study carried out in 2015 shows that among the people using modern health services, 80% of them rely on private services and 20% of those who were seeking traditional health services felt that the modern health services were expensive. (Sailesh Bhattarai, 2015)

Only 1.8% and 4.7% expenditure was made by Nepal as share of GDP in 2015 for health and education respectively whereas 2.1% of GDP was spent for social protection. (Köhler, 2014). It is believed that welfare has positive impact on economic development (Raavad, 2013). Since most of the welfare program are being run by the Non profit organizations, different projects for maternal and child health, nutrition, livelihood, education and alike has helped increase the awareness level and improved socio-economic status even in the most remote areas of Nepal.

References

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6. Government of Nepal Ministry of Health and Population . (n.d.). Retrieved from Department and Health Services: https://dohs.gov.np/about-us/department-of-health-services/
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17. SWC fails to monitor I/NGOs. (2018, November 27). Kathmandu, 3, Nepal: The Himalayan Times.