FEATURES NEWS THE RISING NEPAL (DAILY)

By Jhabindra Bhandari

EVERY year, we mark World Health Day on 7th April. This year, the important day particularly addresses the importance of health as a fundamental human right and raise key health problems experienced globally. World Health Day more importantly, urges all sectors of development to respond these issues more creatively and innovatively so that rights of people to healthy life are ensured. In most of the developing countries, the scenario of public health poses many challenges such as poverty and illiteracy. High maternal and infant mortality and morbidity including other infectious diseases like HIV/AIDS have been emerging as more critical in the recent years.

Elusive

Like many other developing countries of the world, Nepal is also striving to achieve health for all. Though poverty is still persistent and has severe impacts on the livelihoods of the majority of the people who are poor, socially disadvantaged and lacking access to resources, the goal of health for all is still elusive.

With the support from External Development Partners (EDPs), ministry of health is committed to provide quality health services for entire population. Based on the primary health care principles, the government of Nepal has identified essential health care services that address the most essential health needs of population and are highly cost effective, as well.

The national health policy was adopted in 1991 to bring about improvement in the health conditions of the people. The primary objective of the policy is to extend the primary health care system to the rural population so that they benefit from modern medical facilities and trained health care providers. The policy particularly highlights preventive, promotive, curative and basic primary health care services.
In addition, community participation is increasingly felt crucial in health care planning and management of services. At the community level, participation of female community health volunteers (FCHVs), traditional birth attendants (TBAs), and other community leaders is very encouraging in terms of educating and empowering rural communities for improved health and sanitation. Their roles have been vital in referrals to peripheral health facilities like health posts and sub health post for health care.

The health ministry has developed a 20- year Second Long-Term Health Plan (1997-2017). This is a major landmark in health sector that serves as a roadmap in health sector development towards improvement of the health of the population, particularly those who are needy and lack access to basic health services. The plan has well addressed key issues like disparity in health care, gender sensitivity, and equitable community access to quality health care services. The plan also envisions a health care system with equitable access and quality services in the urban and rural areas.
According to annual report of department of health services, the long term plan targets to reduce the maternal mortality rate to 250 per hundred thousand births, infant mortality rate to 34.4 per thousand live births and reduce the under-five mortality rate to 62.5 per thousand. This further targets to increase the life expectancy to 68.7 years and also reduce the total fertility rate to 3.05. Undoubtedly, there are many challenges ahead to successfully meet these ambitious targets in the present context.

There have been significant progress in maternal and child health, family planning including other health care service delivery and management over the years. Over the past decades, maternal and child mortality and morbidity rates have been significantly reduced. Besides, the Ninth Plan in the health sector aimed at improving the health situation of the people providing them with preventive, supportive, curative, and rehabilitative health care services, and thus supported poverty alleviation programmes. The Tenth Plan has also set an objective of making health care services easily available, and developing human resources that support for poverty reduction.

Decentralisation in health sector is receiving an increasing priority to respond local health needs. It is very encouraging to note that in some selected districts, Sub-Health Posts have been handed over to Village Development Committees (VDCs). This will further facilitate VDCs in participatory planning in health care so that issues of community participation, local ownership, gender and health; and local health needs will be addressed and integrated into the VDCs' annual development plan.

In order to improve the accessibility and coverage of primary health care, Primary Health Care (PHC) Outreach clinics have been established in VDCs. Such clinics provide a basic minimum service package that includes: health education, counseling and Information Education and Communication (IEC), family planning services, such as pills, condoms, Depo Provera, basic maternity services, minor treatment, referral and follow up. It is learned that there needs more supportive supervision and monitoring from district health offices, health posts and sub-health posts to make the PHC Outreach more effective.

In the context of community health, Female Community Health Volunteer (FCHV) programme has been very effective in terms of empowering local communities with basic knowledge of primary health care, especially related to health of mothers and children. The purpose of this programme is to promote community participation by creating awareness of available health and family planning services in order to reduce infant, child and maternal mortality and the fertility rate.

Crucial

Despite significant progress in health sector, the Health Ministry in coordination and partnership with EDPs including civil society organisations is trying hard to achieve health for all. Coordination and partnership with EDPs and NGOs have been felt crucial and there are emerging needs of inter-sectoral collaboration to improve the health services more effectively. However, there are still challenges to reach the wider coverage due to geographical difficulties, rapid population growth, migration, political conflicts, and poor community awareness in health. The strong political will and commitment is extremely important to reach the goal of health for all.

Other Stories