The Nick Simons Institute is a Nepal-based organization whose mission is to innovate solutions in rural healthcare –through training and hospital support– and to advocate for their scale-up with the government of Nepal. The country's mountainous terrain and poverty pose immense barriers to the provision of medical care for people living in remote communities. More than half of Nepal's rural districts don't have basic emergency services, including operations.
NSI works according to the following principles:
- Collaborate closely with the Nepal government – the main rural healthcare provider.
- Select strategic training cadres – which involves 'task-shifting' from traditional medical roles.
- Extend beyond training – to include workplace support and advocacy.
- Innovate – based on a growing body of research in the Nepal context.
NSI was established in 2006 in the memory of Nick Simons, a young man from America who worked in Nepal, grew to love the country and died in 2003. The organization is governed by the Executive Committee of distinguished Nepalese professionals.
NSI's values are:
- Share and care
- Integrity, and
- Respect for the Individual
To innovate solutions in rural healthcare – through training and hospital support – and to advocate for their scale-up with the government of Nepal.
Two principles guide NSI’s training section: (1) Select those cadres most likely to have impact in the government’s rural system, and (2) Partner with Nepal’s best hospitals to provide quality training.
Choosing the right people for training.
Which workers constitute the ideal rural healthcare team? Who must be present in order to perform an operation, set a fractured arm, manage a patient with fever, or a child failing to thrive?
NSI works closely with Nepal’s Ministry of Health to fill gaps in the essential healthcare team. This frequently involves a programmatic approach known as ‘task-shifting’: doing the job with the available workers.
|Anesthesia Assistant||Basic anesthesia for emergency operations||Nurses and paramedical|
|Biomedical Equipment Technician||Equipment repair and preventive maintenance||
College grads and hospital support staff
|Continuing Medical Education||Distance course in patient management||General doctors|
|Continuing Professional Development||Maintaining competence in the medical profession||Doctors, Para medicals and Nurses|
|Mid-Level Practicum||Clinical skills for general care||Paramedics|
|Operation Theatre Technic Management||Management of Operation Theatre||Nurses|
|Skilled Birth Attendant||Routine and complicated deliveries||Nurses and midwives|
Training through a diverse network.
Quality healthcare training requires clinical experience in an apprenticeship modality. NSI works through a network of larger hospitals – mission, NGO, and government – mostly located outside of Kathmandu.
District Hospital Support Program (DHS)
In 2014, the two programs of NSI, the Rural Staff Support Program (RSSP) and Hospital Management Strengthening Program (HMSP) merged and formed District Hospital Support Program (DHS).
The objectives of DHS are as follows:
- Expand the capacity and improve the quality of curative healthcare services in government district hospitals in Nepal.
- Create models in human resource deployment and hospital management that are appropriate for scale-up by Nepal's Ministry of Health.
The Nick Simons Institute works to change perceptions and policies that affect the rural healthcare worker. Advocacy and NSI’s other programs complement each other. Advocacy urges policy changes that will augment training and rural staff support. Fieldwork provides ‘on-ground-information’ that makes advocacy credible.
Although healthcare workers are essential members of every rural community – and local people realize this – often times the government and general public living in the cities don’t appreciate the role of rural workers nor realize the situations they work under.
Some key advocacy issues are
- Creation of adequate numbers of appropriate government posts to complete rural healthcare teams.
- Development of institutional environment, including management systems, to promote rural healthcare workers’ work.
- The realization that rural healthcare workers often perform heroic tasks that go unnoticed.
- Reducing the sense of professional isolation, which is a barrier to effective work.
- NSI works through a number of mechanisms to advocate for rural healthcare workers: radio, print, and public speaking; worker conferences and newsletters; and knocking on the doors of policymakers.
Nick Simons Institute
Box 8975, EPC 1813
Sanepa, Lalitpur, Nepal
Phone: 977-1-5451978, 5420322, 5450318
Email: [email protected]