Claiming justice in the health sector of Nepal: Exploring causes and consequences of protests among health care workers

Abstract

The health workers in Nepal have engaged in strikes to protest issues within the healthcare sector, confronting the public, health care management, policymakers and educational institutions. This paper examines the evolution and root causes of these strikes, exploring the motivations behind health workers' participation despite work demands and their pursuit of justice. A qualitative, grounded theory lite approach was employed for data collection. Respondents included doctors, nurses, assistant health workers, government and non-government officials and policymakers. To understand the nature of the strike and validate findings, a participant observant approach was utilized. The first author joined in the protest for three days in September 2023 in Kathmandu Valley to observe the demonstrations and negotiation process. Findings reveal that widespread tension stemming from corruption, privatization and politicization in medical institutions has driven health workers to protest. Their demands have included better salaries, workplace safety, an overdue pandemic allowance, and an end to violence in healthcare institutions. While the management of medical institutions and the state remain silent, public perception of health workers has become negative. This has ignited frustration in the public and a sense of helplessness among health professionals. The strikes have created opportunities dialogue to address systemic flaws in Nepal's health sector. However, significant gaps remain, which requires immediate action from the government and relevant authorities. Without sound reforms, Nepal's healthcare sector foresees migration of health workers, tensions between public and health workers and unstable health sector.