KATHMANDU: The government and nurse activist Jyoti Ranabhat have reached a 19-point agreement, bringing to an end her week-long indefinite hunger strike at Bir Hospital over a range of demands related to Nepal’s nursing sector.

The agreement was signed late Monday following talks between the Ministry of Health and Population and a delegation led by Ranabhat, paving the way for the withdrawal of the peaceful protest.

The deal outlines both immediate and long-term reforms aimed at strengthening Nepal’s nursing profession.

Under the agreement, the government has committed to effectively implementing the nurse-to-patient ratio stipulated in the Health Institution Operation Standards, 2020. It will conduct an Organization and Management (O&M) survey to create the required nursing positions and gradually replace contractual employment with permanent appointments.

The two sides also agreed to ensure staffing positions for nurses at the ninth, tenth and eleventh levels within the public health service.

A task force will be formed within seven days to recommend standards for salaries and service benefits for nurses working in both public and private hospitals, as well as academic institutions. The panel has been given six months to submit its report.

The government has further pledged to introduce the necessary legal provisions to provide nurses with a minimum 25% risk allowance, based on the nature of their work and occupational hazards.

To reduce workload and improve the quality of healthcare services, the government agreed to implement the “One Health Worker, One Health Institution” policy. It will also make nursing processes and nursing care plans mandatory in all hospitals, with regular monitoring to ensure compliance.

The agreement also includes scholarship opportunities for Auxiliary Nurse Midwives (ANMs) to pursue PCL Nursing or Midwifery studies.

In addition, a separate task force will be established to submit recommendations within one month on creating specialized positions such as Specialist Nurse and Advanced Practice Nurse (APN).

The government also agreed to amend the Nepal Nursing Council Act to reflect current needs, involve representatives of nurse activists in drafting a separate law governing nursing and midwifery services, and allow private-sector health workers to participate in training programs conducted by the National Health Training Centre.

The agreement formally ends Ranabhat’s week-long hunger strike. Attention now shifts to whether the government will deliver on its commitments and translate the promised reforms into concrete improvements for Nepal’s nursing sector.