One School One Nurse Programme: Social Audit of School Health Services in Bagmati Province
Overview
The “One School One Nurse” programme, led by the Government of Bagmati Province, aims to institutionalize school-based health services by placing trained nurses in community schools. A Social Audit of the programme was conducted to assess its implementation, service quality, institutional effectiveness, and sustainability, with financial and technical support from the Provincial and Local Governance Strengthening Programme (PLGSP).
The programme has expanded to 848 public schools, providing primary health care, health education, and adolescent-friendly services to students across the province.
Key Results
The social audit confirms that school health services have become an effective entry point for improving student well-being. School nurses are delivering first aid, health screening, menstrual hygiene management, nutrition services, psychosocial support, and referral services within schools.
Evidence indicates improved access to health services, better hygiene practices, increased awareness on adolescent health, and positive behavioural changes among students, particularly adolescent girls.
Impact
The programme has contributed to strengthening school health systems and expanding access to basic health services, particularly in remote and underserved areas. It has enhanced community trust and supported improved attendance and overall well-being of students.
Key Challenges
The social audit highlights several structural and operational challenges:
· High vacancy rate of nurse posts (31.7%), affecting service continuity
· Inadequate budget for medicines and health supplies
· Short-term contractual arrangements leading to job insecurity
· Weak monitoring and information management systems
· Limited capacity to address growing mental health needs of students
Strategic Way Forward
The PLGSP-supported social audit identifies key priorities to strengthen programme effectiveness and sustainability:
· Align resources and supplies with actual student needs
· Ensure stable and longer-term human resource arrangements
· Establish integrated human resource and digital information systems
· Strengthen capacity on mental health and psychosocial support
· Promote equitable financing and stronger local government ownership
Conclusion
The Social Audit concludes that the “One School One Nurse” programme is a relevant and effective public service innovation with strong community acceptance. However, addressing institutional, financial, and human resource challenges is essential to enhance its sustainability and scale it as a model for integrated school health services.
