Nyaya Health operates a hospital and mobile medical care services in Achham, a large district in Nepal. Achham is one of the poorest regions in South Asia, and shoulders some of the world’s highest mortality rates, particularly among women. Following a decade-long civil conflict, the health infrastructure of the region has been ravaged. Nyaya provides essential primary care to the region, as requested and directed by community members. We work in partnership with local government officials as part of an initiative to rebuild the public sector health system. We construct healthcare infrastructure, train local health workers, and provide direct medical services. Our organization employs an all-Nepali staff with supervision and training from volunteer public health experts. We maintain an “open source” approach involving complete transparency in our expenditures, operations protocols, and clinical outcomes.
Nyaya Health’s activities in Achham are centered at the Bayalpata Hospital. The hospital, run as a collaboration between Nyaya Health, local citizens, and the Nepali government, centers around a model of comprehensive primary care, including maternal and child health, infectious disease prevention and treatment, and management of chronic conditions for an expanding catchment population of a quarter million people. The hospital is located in the major transit hub for the region and treats 1,200 patients per month on average. It is run by over twenty Nepali staff including physicians, community healthcare workers, nurse midwives, lab technicians, pharmacists, and project managers. The hospital includes a comprehensive laboratory, pharmacy, clinical diagnosis and treatment rooms, infusion space, a delivery suite, capacity for wet and dry storage, and safe medical waste incineration and disposal. Community health workers constitute mobile teams providing outreach, triage, treatment and follow-up services to a geographically dispersed population. All medical care is provided free-of-charge, with a focus on health equity and outreach to the poorest and most marginalized patients. Over the upcoming year, we are expanding the hospital to include surgical and mental health services. Nyaya’s services have been developed in collaboration with the government of Nepal; our agreements with the government help us strive towards our goal of full integration with public-sector health programs, which involves developing infrastructure that will eventually become part of the new general public health system.