Social activists have been demanding reforms in health care services for a very long time. The new economic policy (NEP) and the structural adjustment programmes (SAP), officially stated by the government since 1991, have only made the need to take action in the field of health care very urgent. The international experiences of SAP have conclusively shown that health care is one of the important components of the social sector which is getting adversely affected by the governments attempt to reduce its expenditure. In our country there are several reasons why such an adverse impact on health care is going to be very severe. Such an impact is as much due to the kind of health service system that exists as the high level of existing poverty. We shall not fo into the latter, namely how the NEP and SAP could accentuate poverty and the problems of the poor. We shall explain briefly what it could do and is doing to make health care accessible to the people. That will be followed by our suggestions on the strategy that the social activists could employ.

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