To strengthen Nepal’s capacity in responding to snakebite emergencies, the Epidemiology and Disease Control Division (EDCD), under the Department of Health Services (DoHS), has officially released the “Standards for the Establishment of Snakebite Treatment Centers, 2076.” Formulated under Section 64 of the Public Health Service Act, 2075, this comprehensive directive provides a national framework for standardizing snakebite care across health facilities.
The standards outline comprehensive requirements, including:
- Essential human resources for health
- A list of essential and additional medicines
- Required medical equipment and instruments
- Furniture and support items
- Necessary consumables
Requirements for Establishment and Renewal
Health institutions wishing to operate a snakebite treatment center must:
- Submit an application (Annex 9) to the EDCD
- Fulfill all requirements outlined in Annexes 1–7
- Undergo on-site evaluation by EDCD
- Receive a 4-year operation permit (Annex 8) upon approval
For renewal:
- Submit an application (Annex 10) three months prior to permit expiry
- Existing centers (before 2076) must apply for compliance within six months of the directive's enactment
Infrastructure and Facility Standards
The guidelines specify detailed infrastructure and supply needs, including:
- Annex 1: Physical Infrastructure – Emergency Room, Doctor’s Room, 4-bed Ward
- Annex 2: Medical Equipment – Ventilator, Oxygen Cylinders, Autoclave, Patient Monitor
- Annex 3: Emergency Medicines – Adrenaline, Anti-Snake Venom Serum
- Annex 4: Other Medicines – Ceftriaxone, Paracetamol+Ibuprofen, IV fluids
- Annex 5: Consumables – Gloves, Syringes, Cannulas
- Annex 6: Furniture & Equipment – Beds, Refrigerator, Solar Power/Inverter
- Annex 7: Human Resources – Medical Officer, Nurses, Paramedics, Cleaner, Storekeeper
Anti-Snake Venom (ASV) Supply
- ASV should be obtained from the respective Provincial Health Supply Management Center
- If unavailable, it can be directly requested from the EDCD
- The Department of Health Services will ensure free availability of ASV
Monitoring and Reporting
- Centers can be monitored at any time by the Ministry, DoHS, or EDCD using the checklist in Annex 11
- Monthly service reports, as per Annex 8 and the Integrated Health Management Information System (IHMIS), are mandatory
- Page 25 of the guideline includes a reporting format covering snakebite cases, ASV usage, and stock status
Hospitals and health centers interested in setting up snakebite treatment centers are invited to submit their Expression of Interest (EOI) to EDCD for assessment and approval.
This move marks a crucial step toward improving access to timely and effective snakebite care across the country.
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