The Nepal government has pursued various public policies to address political, economic and social problems, especially chronic poverty, under international support since the end of its 10-year-long armed civil conflict. This study aims to review the public health policies and people's health state relevant to the political, economic and social status of Nepal, and to promote effective policy implementation of the project for health service improvement in Tikapur (HIT), Nepal. In the health sector, the Nepal government has implemented mid- or long-term health sector programs based on sector-wide approaches so as to provide equal and free primary health care services to the entire nation. Consequently, part of the 2015 Millennium Development Goals (MDGs) was nearly achieved and other goals were close to the target in 2012. The Nepalese health sector, however, has had serious impediments including over 50% absolute poverty, insufficient resources, geographical limitations, shortage of health sector infrastructures and health workers, high dependence on foreign aid, and weak management capacity. The HIT project has been established to promote self-reliant operating systems through the enhancement of qualified primary health services to the rural majority, thereby upgrading the health infrastructure and reinforcing the local health programs and strengthening management capacity of health workers. In the process, the project is inevitably affected by political, socioeconomic, and cultural environments in the project site. For the successful HIT project implementation, therefore, it is necessary to comprehend national and local contexts, and current socio-political situations in Nepal, to utilize an integrated approach in cooperation with the Nepal government, and to make the project sustainable after completion of the project.