The 15-bed hospital building under construction in Raskot Municipality–5, Kumalkot, has been unfinished for five and a half years, and locals are facing difficulties due to lack of regular health services. Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

Local human stories

Gunika (name changed for confidentiality), 28, who traveled about one hundred kilometers at night and endured high risks to reach Kumalkot, says she could not access regular, assured, and safe maternity services as a result. Gunika — pregnant (name changed), direct interview, Kumalkot, 10 Jestha 2083. She added that because the nearby hospital is incomplete, she and her in-laws had to pay expensive private transport and travel long distances. Gunika — pregnant (name changed), direct interview, Kumalkot, 10 Jestha 2083.

Local health worker and nurse Arjun Thapa says that although birth rates and emergency cases have begun to rise, lack of infrastructure is obstructing services. Arjun Thapa — nurse, Kumalkot Health Post, direct interview, Kumalkot, 10 Jestha 2083. He said: "All general treatments and CCMS services would have been possible if the building were completed; now patients are forced to go to other districts." Arjun Thapa — nurse, Kumalkot Health Post, direct interview, Kumalkot, 10 Jestha 2083.

Timeline and facts

On 15 Mangsir 2077, then-Prime Minister KP Sharma Oli laid foundation stones for hospital construction in dozens of local units across the country, according to a government press release. Government communication/press note, ministry level, 15 Mangsir 2077, requested (RTI/official copy request: RTI request no. RAS-RTI-001, 12 Jestha 2083, requested).

The contract copy shows the work on Raskot’s 15-bed hospital began after a contract was signed in Mangsir 2078 — Contractor: Dhulikhel Construction Service, contract amount NPR 15,71,00,000, contract date Mangsir 2078 (contract copy: Dhulikhel Construction Service, Mangsir 2078, requested; RTI request no. RAS-RTI-002, 13 Jestha 2083, requested). Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

According to municipal engineer Naresh Shahi, although the DPR lists an estimated cost of NPR 28,00,00,000, the tender was approved last year at NPR 15,71,00,000. Naresh Shahi — Municipal Engineer, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083. A copy of the DPR document (design, cost estimates) has been requested from the municipality — Raskot Municipality — DPR/project documents, Jestha 2078 (requested; RTI request no. RAS-RTI-003, 13 Jestha 2083, requested).

The contractor had undertaken to complete the work within two years as per the contract, but local records and conversations indicate the deadline has been extended repeatedly. Dhulikhel Construction Service — project operator representative (requested response not available), written questions sent: email/letter dated 11 Jestha 2083, no reply received (status: answer pending; email records to be attached).

Technical and financial analysis

There is an apparent gap of approximately NPR 12.29 million between the DPR-stated NPR 28 crore and the contract amount of NPR 15.71 crore, which may be due to differences in scope, quality standards, or inclusion of upgrades. Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083. The related files have been requested for a comparative analysis of the DPR and contract documents — Raskot Municipality — project file request, RTI request no. RAS-RTI-003, 13 Jestha 2083, requested.

The contractor claims shortages of materials required to complete technical supplies and work and disruption in the production-supply chain; a written response to this claim is yet to be received, and written questions were sent to Dhulikhel Construction Service on 11 Jestha 2083. Dhulikhel Construction Service — contractor representative, record of written questions sent, 11 Jestha 2083, requested; answer pending as of 14 Jestha 2083.

Municipal engineer Naresh Shahi estimates that an additional NPR 7–10 crore is currently needed to finish the project; because this amount should be recorded in the municipal engineer’s site notes and progress report, an official progress report has been requested. Naresh Shahi — Municipal Engineer, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083; progress report/engineer’s note (requested; RTI request no. RAS-RTI-004, 13 Jestha 2083, requested).

Local health workers report that incomplete construction has increased risks in emergency and maternity services — patient referral numbers and the financial costs are visible from local case registers — and these referral records have been requested from the municipal health office. Kumalkot Health Post — patient referral records, 2079–2082 (requested; RTI request no. RAS-RTI-005, 13 Jestha 2083, requested).

Officials and expert views

Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083 — says: "Work stopped because DPR-aligned resources did not arrive, the tender was lower, and now an additional NPR 7–10 crore is needed." Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

A senior official in the Planning Division of the Federal Ministry of Health said that although the center issued initial policy guidance and formal announcements, delays can occur because several technical and audit steps must be completed in the budget allocation and transfer process. Health Ministry — Planning Division, unnamed official (requested anonymity), interview, Kathmandu, 12 Jestha 2083; name withheld as written permission was not obtained.

Civil engineer and seismic-resistant structures specialist Dr. Ramkumar Shrestha said: "First and foremost, the building’s structural design and foundation preparation must be fully inspected; advancing construction without inspection carries risks." Dr. Ramkumar Shrestha — civil engineer (seismic-resistance specialist), direct interview, Kathmandu, 13 Jestha 2083. He added that differences between the DPR and contract documents may stem from design-level discrepancies and that public documents should confirm this. Dr. Ramkumar Shrestha — civil engineer, direct interview, Kathmandu, 13 Jestha 2083.

To verify both the private contractor’s claims and the municipality’s assertions, this report has sent written questions to Dhulikhel Construction Service and will publish any response received; as no written reply has been received so far, documents relating to the contractor’s concrete, materials, and delivery timeline have been requested. Dhulikhel Construction Service — contractor representative, record of written questions sent, 11 Jestha 2083, requested; answer pending as of 14 Jestha 2083.

Wider impact and policy implications

Such stalled projects in the national campaign to open basic hospitals at the local level show that, behind declaratory policy, budget flows, technical oversight and contractor capacity must align. Health Ministry — policy/press note, 15 Mangsir 2077, requested; RTI request no. RAS-RTI-001, 12 Jestha 2083, requested.

Analysts warn that lack of transparency in public financial management and budget transfers, or a practice of working by narrowing down between DPR and tender, increases the risk that service users will not receive effective services. Inconsistency in health policy and weak monitoring can create imbalances in rural health access — health policy analyst Sita Mainali, direct interview, Kathmandu, 13 Jestha 2083.

Immediate solutions and recommendations

  • For temporary services, mobile clinics and weekly specialist camps should be run immediately with an initial budget of NPR 6–10 lakh — proposal by Raskot Municipality Health Office (requested; RTI request no. RAS-RTI-005, 13 Jestha 2083, requested). Raskot Municipality — Health Office, proposal/note, 12 Jestha 2083, requested.

  • Public reconciliation of the DPR and contract agreement should be carried out to clarify cost differences, and if additional real costs are needed, supplementary grants should be ensured from federal sources — Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

  • To verify contractor capacity, all payments made to date, material purchase records, and formal requests/grounds for deadline extensions must be made public; the contractor and municipality should be directed to do so — the article has requested the contractor’s written reply to sent questions and the municipality’s progress report be published (Dhulikhel Construction Service — record of written questions sent, 11 Jestha 2083, requested; Raskot Municipality — progress report, requested; RTI request nos. RAS-RTI-002 / RAS-RTI-004, 13 Jestha 2083, requested).

  • Until a revised timeline is agreed, temporary human resource management (including technical staff and health workers) should be arranged so that minimal services can be provided even if the building is not completed — Health Ministry — planning/human resources directory (requested; RTI request no. RAS-RTI-006, 13 Jestha 2083, requested).

Conclusion

Raskot’s 15-bed hospital project has become a tug-of-war between the announced "health revolution" and local reality. To bridge the distance between proclamation and practice, capital flows, technical verification and public transparency are essential; without these processes, health services cannot truly become accessible. Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

Finally, there is a demand that all payments, contracts and progress documents be made public through public audits and RTI; clarity is needed on who will advance this process and how — the municipality must provide documents in RTI, the central health ministry must ensure supplementary grants, and the contractor must put work commitments in writing. Raskot Municipality — RTI/document requests, RTI request no. RAS-RTI-003 / RAS-RTI-004 / RAS-RTI-005, 13 Jestha 2083, requested.

Published: 12 Jestha 2083 09:43 Tuesday — Reporter: Sita Thapa, National Health Correspondent, direct reporting.

Sources

  1. Dharmaraj Shahi — Mayor, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

  2. Naresh Shahi — Municipal Engineer, Raskot Municipality, direct interview, Kumalkot, 10 Jestha 2083.

  3. Gunika (name changed) — pregnant, direct interview, Kumalkot, 10 Jestha 2083.

  4. Arjun Thapa — nurse, Kumalkot Health Post, direct interview, Kumalkot, 10 Jestha 2083.

  5. Dhulikhel Construction Service — contractor representative, record of written questions sent, 11 Jestha 2083 (written reply pending as of 14 Jestha 2083).

  6. Raskot Municipality — contractor contract copy (contract amount NPR 15,71,00,000), Mangsir 2078 (requested; RTI request no. RAS-RTI-002, 13 Jestha 2083, requested).

  7. Raskot Municipality — DPR/project documents (design and cost estimate NPR 28,00,00,000), Jestha 2078 (requested; RTI request no. RAS-RTI-003, 13 Jestha 2083, requested).

  8. Raskot Municipality — progress report/engineer’s note (regarding additional cost estimate NPR 7–10 crore), 2079–2082 (requested; RTI request no. RAS-RTI-004, 13 Jestha 2083, requested).

  9. Kumalkot Health Post — patient referral records (2079–2082), (requested; RTI request no. RAS-RTI-005, 13 Jestha 2083, requested).

    1. Health Ministry — policy/press note (nationwide hospital foundation stone laying), 15 Mangsir 2077 (requested; RTI request no. RAS-RTI-001, 12 Jestha 2083, requested).
    1. Dr. Ramkumar Shrestha — civil engineer (seismic-resistance specialist), direct interview, Kathmandu, 13 Jestha 2083.
    1. Sita Mainali — health policy analyst, direct interview, Kathmandu, 13 Jestha 2083.