Needs, Challenges, and Opportunities in Establishing and Maintaining Medical Education in Karnali Academy of Health Sciences (KAHS)
The constitution of Nepal (2015), article 35 (Right relating to health) stated that every citizen shall have the right to free basic health services from the State, and no one shall be deprived of emergency health services. According to the World Bank report (collection of development indicators compiled from various official sources, 2016), Nepal has 81% rural and remote populations. Health service delivery is a complex reality for the rural and remote populations and faces enormous challenges. One of them is insufficient and uneven distribution of health workforce. The World Health Report concluded that "the severity of the health workforce crisis is in some of the world's poorest countries, of which 6 are in South East Asia out of 57 countries having critical shortages of health workforce."1Even after 13 years situation has not much improved. Nepal faces a critical shortage of trained health workforce, especially in rural and remote areas. Health workforce recruitment and retention in rural and remote areas is a difficult task challenged by the preferences and migration of health workforce to urban areas in country, or even abroad for better life and professional development.2 One of the most effective strategies for health workforce recruitment and retention for rural and remote areas could be that of establishing and maintaining Medical Education in rural and remote areas decentralized from urban academic medical centers.
Rural and remote medical education is designed to enroll local students or others from rural and remote backgrounds. Medical literature suggests that the students from rural and remote backgrounds work experience are more likely than urban students inclined to practice in a rural and remote community after graduation. 3,4Greater exposure to diverse learning opportunities in rural and remote areas will make graduates confident to work anywhere. 5,6Further, extended and early exposure to rural and remote experience has a strong association to long-term rural and remote service. 7This could be the long-term solutions to long standing problems of recruitment and retention of doctors for underserved populations.
In line with this, the Government of Nepal has established KAHS in Jumla. Karnali Academy of Health Sciences was established in October 20, 2011 (2068/07/03), by an Act of parliament of Nepal with the mission to prepare health professionals to deliver quality health care to marginalized /backward areas through educational excellence, innovative research, patient-centred care, public health and community. Karnali Academy of Health Sciences is the only one Stand Alone rural Academy of this kind in remote and rural Nepal. Establishing and maintaining a rural and remote Medical Educational requires a holistic approach fulfilling the needs of both the student and the community. This article describes the Needs, Challenges, and Opportunities in Establishing and Maintaining Medical Education in KAHS.
Keywords: Karnali Province, Medical Education, KAHS (Karnali Academy of Health Sciences), MBBS Program, MDGP Program, MD/MS Program, Needs, Challenges, Opportunities