NATIONAL 2 (Spotlight Weekly)]

Dismal Signs

Despite continuous efforts, Nepal is yet to improve overall health condition of its people

By KESHAB POUDEL

If the recent report called the State of World Population 2000 is any indication, the scenario of Nepal's overall health system and population control efforts are dismal. In this light, Nepal ranks in the lowest rung in South Asia after war-torn Afghanistan. As a country with the population of 23.9 million, Nepal has failed to improve its health care situation.

According to the report, Nepal is the only country in the world where women's average life expectancy is less than that of men. The average life of Nepalese women is 57.1 years compared to 57.6 years of their male compatriots. Even in South Asia which has the highest mortality rate in the world, Nepal is the only country where woman's average life span is less than that of man.

Although Nepal's life expectancy, infant mortality, average growth rate of population and literacy rate is better than some countries, it needs to think seriously to improve the situation.

Hundreds of women are denied the reproductive choices and access to health care, contributing to thousands of unwanted and mis-timed pregnancies each year. Half of the all the deliveries take place without the presence of skilled birth attendant.

Positive side is that Nepal has made significant improvements in the last two decades in some sectors. But the improvements are too little.

According to the World Health Report 1999, in 1978 Nepal's population growth rate was 2.6, fertility rate was 6.2, infant mortality 142 per-thousand, life expectancy at birth was 47 years for males and 45 for females. The Human Development Report 1998 shows that the life expectancy in 1960 was 38.3 on average, infant mortality rate was 195 per thousand.

"We are making joint efforts to reduce the growth of the population through different means," said resident representative of the UNFPA.

United Nations Population Fund (UNFPA) started to support Nepal's population program since 1974. UNFPA now supports in the areas of reducing total fertility rate to 4.0, and raising the life expectancy from 56 to 65 years by 2001, raising the contraceptive prevalence rate over 38 percent by increasing the availability and accessibility of various methods of modern contraceptives, reducing the maternal mortality rate from 830 to 400 deaths per 100,000 live births and the infant mortality from 99 to 50 deaths per 1,000 live births by 2001 as well as reducing maternal morbidity by 15 percent from the current level.

Access to safe drinking water in 1975-80 was 8 percent which has increased to 59 percent now. The access to the safe drinking water in other South countries are like this; Bhutan 85%, Bangladesh 84% India 90%, Sri Lanka 70% and Pakistan 62%. The adult literacy rate was 14 percent in 1970 according to Human Development Report 1998. At present, 77% of women are still illiterate compared to 42% of illiterate males.

Nepal has the highest infant mortality rate in South Asia with 83 per 1,000 live births compared to 79, 63, 72, 74 and 18 in Bangladesh, Bhutan, India, Pakistan and Sri Lanka.

The report examines a broad range of evidence from around the world showing that systematic discrimination against women and girls causes expensive suffering and lost opportunities for both women and men.