Kathmandu Project                                            Damak Project                     Team

KATHMANDU Institute of Child Health (KIOCH)

KIOCH [Kathmandu Institute of Child Health] is a not-for-profit organization established in 2017. It aims to deliver integrated multispecialty high-quality child healthcare that is affordable, accessible, and available to all, thus advancing Quality of Life of Children in Nepal. KIOCH focuses on providing solutions to ever rising healthcare needs and consistent poor health outcomes for millions of children in Nepal. It believes on timely adaptation of scientific medical advances, technologies and valued people-centered care that are of international standards.

KIOCH is led by a group of professionals actively engaged in social welfare and well-being of people. The team comprises of diverse expertise with proven leadership in the field of medical science, social welfare, social enterprise, public communication, and community empowerment, among others. (See Board Members in annex 1)

KIOCH: CORE VALUES

Building on the foundation of high-quality child healthcare, KIOCH defines its values with the five E’s: Excellence, Efficiency, Equity, Ethical, and Empathy.

EXCELLENCE: provide the high-quality of healthcare keeping patient experience at the core through pursuit of research and innovation. KIOCH believes in going the extra mile and caring for each child with a standard of excellence that we would wish for our own family to receive.  EFFICIENCY: create the greatest benefit to the patient and their families using novelty with efficient use of resources towards our sustainability. KIOCH focuses on value for money approach with efficient allocation of while delivering the best possible health outcomes. EQUITY: make high-quality care accessible and affordable, minimizing disparities in health outcomes. At an institutional level, KIOCH finds ways to best allocate resources according to principle of equitable share in healthcare. ETHICAL: treat each patient with absolute integrity and transparency and hold us accountable for patient safety. Our number one goal in providing ethical care is to protect our patients’ human rights, welfare, and safety. EMPATHY: recognize and be responsive to what the child and family is experiencing, to protect the humanity of healthcare. We listen to our patients and their families and try our best to accommodate their needs and enhance their care experience accordingly.

A high time to focus on high-quality integrated multispecialty childcare hospital in Nepal: Almost 25% of the population in Nepal lives in poverty. Over 40% of Nepal’s population is below the age of 18 years, which amounts to almost 12 million children. Disparities in health outcomes by gender, ethnicity, and geographical location exist. Accelerated efforts needed to ensure equitable healthcare considering poor, urban poor, and people from remote areas and marginalized groups. While Nepal has a network of 4,118 health facilities in public sector, and over 350 private sector health facilities, addressing demands for quality child healthcare is overly challenging with only one dedicated child hospitals in public sector which is often overwhelmed. Ensuring constitutional mandate of ‘access to basic healthcare services as a fundamental right of the people’ calls for a viable partnership between state and non-state sectors in federal context. Current evidence shows that many causes of deaths among children could be averted, if the child is able to access specialized healthcare in time. However, there are only a few children hospitals and less than 1000 beds in the country for 12 million children in Nepal.

More importantly KIOCH believes working with FAMILY, COMMUNITY, PROFESSIONAL TEAM and PARTNERS towards successful attainments of our aim.

FAMILY. keep the child and their family at the center of each decision. Family-centeredness is deeply ingrained in how we design our services. We focus on building trust and advocating on behalf of the patient and family.

COMMUNITY. we work with the community, for the community. Improving child health is our duty and responsibility to the future health of our community and our country. Community outreach is one of the core pillars that KIOCH is founded on.

TEAM. our team members are at the core of our success, and we care about keeping them engaged and motivated, focusing on their well-being and development. KIOCH will continuously search for ways to improve well-being and resilience and encouraging mental and emotional stability of our team.

OUR AIMS AND OBJECTIVES Aim: to deliver integrated multispecialty high-quality child healthcare that is affordable, accessible, and available to all, thus advancing Quality of Life of Children in Nepal. Objectives: To deliver high-quality child healthcare through establishment of a multi-specialty children hospital in Kathmandu; To expand high-quality child healthcare through establishing satellite centers in strategic locations of provinces; To advance the child healthcare through strengthening referral system and service delivery network; To be a center of excellence in child healthcare through advancing scientific research, technologies,  innovation and capacity enhancement of care providers; To strengthen community child healthcare through preventive, promotional, and rehabilitative services;

PARTNERS. we nurture our relationships and partnerships that are meaningful in strengthening the way we deliver care and helping us grow. We rely on our partners in health care delivery, such as surrounding health facilities and providers, as well as our donors who help us remain focused on our mission and support our continued success.

 

KIOCH SERVICE MODEL

HUB-AND-SPOKE MODEL:

KIOCH will begin accomplishing its aim by establishing a multi-specialty childcare hospital (hub) in the nation’s capital, Kathmandu. The effort of attracting high-quality medical professionals to remote areas of Nepal is tried and failed. Instead, we offer a solution that allows for concentration of talent, modern equipment and technologies that offer high-quality care in the hub facility.

First, we will focus on strengthening and improving the quality of child health specialty care, making it available in Nepal. Next, the KIOCH “spokes” or satellite centers will be established in strategic locations, at least one in each province. These spokes will act as gateways that channel patients to the main hum in Kathmandu, with coordinated and phased manner.

This hub-and-spoke approach is expected to increase efficiency and efficacy of care for patients from rural, suburban parts of the country. In addition, the use of telemedicine allows for care to be delivered over the phone or video so that patients can stay closer to their homes and receive more immediate consultation. This lowers the cost burden experienced by patients’ families, such as lost wages, transportation expenses, and room and board in Kathmandu. Patients should only have to travel to the main facility when it is absolutely necessary or planned.

 

 

 

 

 

Posting and retention of experienced and senior physicians in remote areas has been a challenge in Nepal. With this hub-and-spoke model senior physicians will be posted in the hub hospitals and they will travel to the spoke hospitals in regular intervals which makes the availability of senior physicians possible in the remote area. Besides this, the spoke hospitals will coordinate with the peripheral public health facilities for systematic referral and feedback. This will make a broad functional network of KIOCH with the health facilities throughout the country.

 

 

 

 

 

 

 

Nepal needs the chance to build up expertise and specialization to be able to better serve the population. Having a central hub facility will bring in a large patient volume for specific types of conditions and therefore increase physician skill level. This will in turn increase physician productivity and more patients can be treated within a given amount of time, allowing KIOCH to achieve economies of scale. The ultimate goal is to create a child healthcare network that supports the needed specialties. Gradually, satellite centers will be built out to be able to provide more advanced care. In summary, the hub-and-spoke configuration suits the geographical challenges and economic conditions of Nepal and will make it possible for pediatric specialty care to be more available, accessible, and affordable.

KIOCH: PROJECT PLAN IMPLEMENTATION

We have developed a phased approach to implement our project.

Phase 1 will begin with building a multi-specialty children hospital with 200 beds in Kathmandu Valley. Meanwhile, we will strengthen our network with provincial partners to explore possibility of establishing satellite hospitals.

 

 

 

 

 

Plan to construct the main building is underway. Detailed building design of hub hospital in Kathmandu has been completed, land development is underway, and support structures being constructed. Soil test and first round of EIA complete, water sourcing in progress.  

While delivering our phase 1 activities, we received demand from provincial partners to establish a satellite children’s hospital in Province 1.  Accordingly, agreement has been reached with Redcross Damak for a long-term lease of a near complete hospital building to establish a satellite hospital. Preparatory works are now underway to start the satellite hospital at Damak. The KIOCH team considered Damak’s project, originally planned as a phase II activity, as an opportunity to provide high quality Pediatric care, especially since the Ministry of Health and Population predicted that a third wave of the COVID-19 pandemic is likely to affect children in higher numbers for Nepal.

Phase 2, KIOCH will build satellite centers in strategic location of provinces. Each satellite center will be equipped with up to 50-beds and initial diagnostics capabilities. Specialty care will be extended to Provinces through the satellite centers. Depending on the availability of resources and active partner, implementation of phased-approach will be revisited for best use of available resources.

FINANCIAL VIABILITY AND SUSTAINABILITY

We understand that KIOCH must maintain financial viability in order to accomplish our mission. Therefore, we have considered multiple sources of financing mechanisms such as a patient payment model that is fair and equitable, social health insurance, public and private financing, philanthropic support and corporate social responsibility (CSR) and alternative revenue streams to support our scope of work. We will reinvest our surplus, if any, into institutional development and patient welfare. KIOCH will abide by good governance that demonstrates the most efficient, effective and transparent use of resources and financial management.

We honor the preferences of partners who may be willing to support our projects under the various scopes of work such as hospital sites, building blocks, specialties, equipment, patient support among others.