The Central and Regional Hospitals constitute the tertiary level and the Zonal and District Hospitals serve as the secondary level of health care system in Nepal. Also, private health care institutions including Hospitals, Medical College Teaching Hospitals and Nursing Homes have been founded. However, these are not sufficient to combat health problems in Nepal primarily due to the shortage of domestic resources, manpower and supplies, poverty, rapid population growth and urbanization, and the rugged mountainous rural areas.