Phasing out of Technical School Leaving Certificate Programs in Health: A Scenario Analysis

The education and training to the mid-level health workers has been provided in Nepal through the institutions run under the CTEVT. Currently, CTEVT is running various Diploma programs in health sectors like General Medicine, Nursing, Medical Lab Technology, Ophthalmic Science and Dental Science. However, TSLC (Pre-diploma) programs like Assistant Nurse Midwife (ANM), Community Medical Assistant (CMA), Lab Assistant, Assistant Ayurveda Health Worker, Dental Hygienist have been phased out since 2076 after the enforcement of the National Medical Education Act, 2018. Nepal has a shortage of health workers with only seven health workers per 10,000 populations. As a result of the phase out of health-related TSLC programs under CTEVT, there will be scarcity of the mid-level paramedical health workers who have direct relation with the community people and the basic level health services. This review article has tried to highlight the importance of mid-level health workers and effect of phasing out of TSLC programs by CTEVT in the health sector of Nepal. As per the Mathema Report, the major reasons for phasing out of the programs are lack of proper monitoring and regulatory mechanism of institutions running TSLC programs, as most of the colleges practiced to enroll students without quality and lack of proper supervision to the passed-out students. However, due to the removal of the programs, there might be less access to the skilled training, especially of the poor, women, and disadvantaged groups which has created inequitable development of skills in the health workforce. In response to the issues and challenges in incorporating TVET in the development of health workforce, TVET programs, mostly TSLC, should get top priority and the medical education system should be flexible and should reconsider the provision of the National Medical Education Act, 2018 on rethinking for the re-launching the TSLC programs in health so that there will be availability of skilled and technically competent mid-level human resource for health.