Butwal / The Minimum Service Standard (MSS) for Hospitals aspires to ensure the availability and readiness of services to deliver quality health services that are expected from them. MSS covers holistic dimensions of Governance and Management, Clinical Service Management and Support Service Management which can be compared to three parts of structure of human body.
In Lumbini Province, the Minimum Service Standard was rolled out in all 13 province-level hospitals. Analyzing the status of MSS scoring, the MSS scores of hospitals are in increasing trend, with Kapilvastu Hospital being one of the highest MSS scorer in whole Nepal
The MSS was evident to contribute to quality of services provided by hospitals with instances of improved governance, management, clinical and support services. The MSS score sensitized hospitals to expand the services. This encouraged Ministry of Health (MoH) to allocate additional budget for MSS monitoring and assessment. Lumbini Province have been separating budgets for Hospital Strengthening program, and HSP budget utilization is done based on the MSS gap identified from MSS assessment of hospitals.
As suggested by evidence, the MSS contributed in achieving significant improvements in hospital services in all three dimensions.
Governance and Management:
• Hospital Management Committees, which were vacant in many hospitals are fulfilled now.
• In many hospitals, the position of accountants used to be vacant, and works was carried out bringing the accounting staffs from another office. As a result, there was a problem with the budget received in the hospital. Now many hospitals have filled the posts of accounting staff.
• The problem of recording reporting of services provided by hospitals is being gradually improved by on-site coaching during MSS follow-up visits and routine data reviews.
Clinical service management:
• In order to manage the OPD services provided by the hospitals, at least 1 specialist doctor is being managed in each hospital.
• With the aim that preventive service should also be provided by hospitals, MCH clinic has been established in all 13 hospitals under the province and the service of ANC, PNC, FP, Immunization has been started.
• According to the government policy, the hospitals have started their own pharmacy and the management of manpower for 24 hours service has been done by the province government. Among the 13 hospitals under Lumbini Province, 24 hours regular operation service has been started from all hospitals except Palpa hospital and on-process in Rukum East Hospital.
• After MSS, separate wards required for inpatient service have been managed in many hospitals.
• There has been significant improvement in diagnostics and investigations. USG, X-ray service with CR system in all 13 hospitals and CT scan service has been expanded in Lumbini and Rapti provincial hospitals.
• Radiology Department in Lumbini Provincial Hospital has come into operation in a separate building also MRI service will be expanded in this fiscal year.
• Free Sickle cell screening facility has been provided by 6 hospitals in Terai.
• Realizing the need for dental services in hospitals, Dental Department services with dentists have been started from all 13 hospitals.
• All 13 hospitals have managed Mortuary Freeze with at least 4 chambers to manage Postmortem services. According to MSS standards, physiotherapy services required in hospitals have been resumed from all 13 hospitals with manpower.
Support Service Management:
•Separate CSSD, Laundry and Housekeeping departments have been organized.
•During the MSS follow-up inspecting different departments, expensive medical equipment’s used to be broken and stored so it was felt that there is a need for a separate Repair and Maintenance department in the hospital. To address that, Repair and Maintenance departments with Biomedical Engineers or Biomedical Technicians have been established in many hospitals.
•For the management of hazardous waste coming out of the hospital, there is an arrangement of Autoclave in every hospital, so that such waste is disposed of only after being sterilized.
•According to the policy of the government, a social service unit has been established and free treatment has been arranged for the poor and destitute helpless citizens from all the 13 hospitals of the province.
Now, as the MSS Score of the hospitals improves, the services provided by the hospital will also become easier In Fiscal Year 2078/79, there has been successful implementation of MSS program with subsequently increase in MSS scores of all hospitals of Lumbini Province. After the completion of MSS implementation, Provincial Review on Minimum Service Standard (MSS) was done with sharing major strengths of hospitals and discussing way forwards for strengthening the hospital services for better quality services for further.
Also, the first progress report on Hospital Strengthening Program including Minimum Service Standard has been published including details of all primary, secondary and tertiary level hospitals under Lumbini Province.
Family planning Officer
Health Directorate Lumbini Province