# Tracking Progress of National Health Summit Declarations - Health Policy Analysis: A Qualitative Study

## TL;DR

This study evaluates the progress of health policy declarations from the National Health Summit in Nepal, analyzing their implementation challenges and outcomes.

## Contribution

The study provides insights into the facilitators and barriers of implementing health policy declarations using a realistic evaluation framework.

## Key findings

- Policy influence and advocacy were key contextual factors in declaration implementation.
- Political and bureaucratic challenges, along with financial hurdles, hindered progress.
- Advocacy efforts led to synergistic effects in prioritizing and implementing policies.

## Abstract

The National Health Summit is a policy discussion platform that advocates the policy statement stated by National Health Policy 2019 which results in a set of declarations to address issues in the health system. This study's objective is to monitor the extent of declaration's implementation, its facilitators-barriers, and to formulate recommendation for future National Health Summit declarations and implementation strategies.

This is a qualitative study conducted by Nepal Medical Association. in November-December 2024. Ethical approval from Nepal Health Research Council, Ethical Review Board (Reference number: 1069). The study was designed using the Realistic Evaluation Framework to look into the "context" which are the external factors impacting implementation of the declarations, the "mechanism" which are key elements facilitating or hindering policy changes, and the "outcome" which were the tangible results of NHS declarations.

Review and analysis of the participant responses identified policy influene and advocacy as contexts. The mechanisms identified were political and bureaucratic challenges, collaboration, finaicial hurdles, commitment, accountability, leadership, evidence based practices. The outcome discussed were health system strengthening, health workforce, governance, innovation, advocacy and digaital transformations.

Implementation of declaration is challenging, with fragmentation as major health issues, however, continuous advocacy has had a synergistic effect in implementation and prioritization of the policy.