Nepal - Current Situation in Control Strategies and Health Systems in Asia
- 1. Current situation in control strategies and Health Systems in Nepal DR AJIT RAYAMAJHI KANTI CHILDREN’S HOSPITAL KATHMANDU
- 2. NEPAL •Area – 56827 square miles •Population- 30 million •Hindu- >80% •Brahmans& Rajput- >55% •Shah dynasty- 1768- 2008 •FDRN- May 28, 2008 •Administratively- 75 Districts, 14 Zones, 5 Regions R i •Geographically: 8/10- tallest peak in the world •
- 3. Geographical Diversity g p y
- 4. Nepal- Health Profile p Crude birth rate (per 1000 population) 28.4 Crude death rate (per 1000 population) 9.9 Total fertility rate 3.1 Gross national product per capita (US $) 300 Adult literacy rate (%) 53.7 53 7 Physicians per 10,000 population 2 Nurses per 10,000 population: 2 Total Expenditure on Health as % of Gross Domestic Product 5.3 Life expectancy at birth (years): 60 Maternal mortality rate (per 10000 live birth) 281 Out-of-Pocket Spending on Health as % of Private Expenditure 92 on H lth Health
- 5. Bandh (Strike) ( )
- 7. National Health Policy y Ad t d i 1991 Adopted in Objective- Extending primary health care system to the rural population so that they b h l l i h h benefit ffi from modern medical facilities and trained health care providers. id Second Long Term Health Plan (1997- 2017): Guiding f idi frame work f the d l k for h development of annual f l health plans, appropriate strategies, programmes and action plans that reflect national h l h d i l h fl i l health priorities.
- 8. National Child health Policy y G id d b WHO MDG 4: R d Guided by Reduce child mortality hild li Target: Reduce under 5 mortality rate by two-thirds between 1990 and 2015 b t d - Infant Mortality Rate 108 – 34 (2009- 41) - U d fi years mortality rate 162 – 54 ( Under five li 6 (2009-50) ) - Proportion of one year olds immunized against Measles % M l 42% – 90% ( % (2009-92%) %) International Partner’s Forum (2009): Awarded for significant progress in areas of child s r i al survival
- 9. National Policy on Non Communicable Diseases (NCD) Control and Prevention (Aug 2009) (Aug,2009) B i Being formalized soon f li d Goal: To reduce morbidity and mortality related to NCD i l di thalassaemia. C including h l i NCD contributes to 42% of total deaths. The major morbidities being cardiovascular disorders, cancer, diabetes mellitus, chronic lung diseases etc. No national level surveillance conducted including g thalassaemia
- 10. Proposed strategies on NCD Control a d Prevention oposed st ateg es o NC Co t o and eve t o D Develop and endorse l i l ti f patient right l d d legislation for ti t i ht Promote advocacy and community mobilization Establish effective disease surveillance including risk factors through Health Management Information System reporting Establish network and develop mechanism to monitor activities of different government and non government organizations working in NCD
- 11. Proposed strategies on NCD Control and Prevention Prioritize cost effective socio-culturally acceptable measures in planning and implementation p g p Allocate regular budget and local revenue for preventive activities Develop appropriate human resources Produce effective tool for monitoring and evaluation and conduct periodic research activities based on it
- 12. Other Supports to Patients pp Th support of bl d and bl d products f patients The t f blood d blood d t for ti t of thalassaemia, since 1966, ‘Blood Bank’ established by Nepal Red Cross Society and operates by ‘The The National Guidelines on Management of Blood Transfusion Service developed in 2008. Service’ 2008 ‘Nepal Thalasaemia Society’ was established in 2003 f the welfare of patients. M i t i s records for th lf f ti ts Maintains ds of patients of thalassaemia, provides blood for transfusions free of cost, facilitates provision of cost chelating agents, conducts blood donation camps and manages a blood transfusion center
- 13. Thank you y