NATIONAL 8 (Spotlight Weekly)

A New Beginning

Launched to promote family health and reduce fertility, Nepal Family Health Program has a long way to go

By KESHAB POUDEL

Frustrated and desperate, rural Nepalis seem to be gradually losing hope in the future of the country. Following the latest round of Maoist assaults on the basic infrastructures like health posts, school buildings and telecommunication facilities, the rural people do not know where the country is heading.

If this situation continues, the country's health infrastructures, which were built painstakingly over the last five decades, will be ruined within a few months. Because of increasing violence in the rural areas, well-coordinated grass-roots workers are also on the verge of paralysis. Nepal has one of South Asia's best organized ladder of health manpower, but the recent upsurge in violence and continuing disturbances in the mountain areas have made it non-functional.

A Woman with her child : .Health concerns

In such a difficult situation, Nepal's development partners, however, are trying to protect the achievements made in the areas of family health and fertility. With an aim to support family health, Nepal Family Health Program (NFHP) was formally launched on Monday. Supported by USAID\Nepal, the program is a new five-year bilateral activity.

Thank to the continual involvement of donors and participation of the local community, Nepal has made tremendous improvements in the areas of family health and women fertility. According to a recent report of Ministry of Health, infant mortality has drastically dropped to 91\1000.

Access to health services, too, has increased over the years. Despite frequent political trouble and violent insurgency, the country has made major achievements in the health sector.

"Recent reports have shown that Nepal has made major progress in infant mortality rate and health services. As in the past, USAID will continue its support in the future," said Joanne T. Hale, mission director of USAID mission to Nepal.

Although Nepal has been launching various programs to improve the family health and fertility, it still needs many programs. "The NFHP will ensure a basic package of FP\MCH services is available at each level of the health care system, particularly the community level. It will strive to improve the quality of family planning, mother and child health services provided by health facilities and community health workers and improve sustainability of FP\MCH services by increasing support to FCHVs by local management committees," said Dr. Penny Dawson, chief of party, NFHP.

The NFHP is a fully integrated program in which community; district and national components are coordinated, inter-linked and mutually supportive. Along with INGOs and bilateral donor agencies, United Nations agencies have also been active in the health sector.

"We have been supporting Nepal to provide family health programs and other issues and we will continue to work with the Nepalese government, as the UNFPA and the government have signed the fifth country program," said J. Bill Musoke, representative of UNFPA.

Other, too, agree on the need to take substantial steps to sustain the achievement made in the family planning and fertility sector. "Nepal has made much progress in the infant mortality rate and the country is in a leading position in polio eradication and other major health problems," said Stewart McNab, representative of UNICEF.

Government officials have expressed hope that they would continue to receive support to achieve their targets in the health sector. "The Ministry of Health will provide all kinds of support to make the program a success," said Secretary of Health Mahendra Nath Aryal.

To support government's long-term goal of reducing fertility and under-5 mortality within the context of the current National Health policy and Second Long-Term Health Plan 1997-2017, the program will focus its activities on reducing fertility and protecting family health. Community and district activities will cover 17 high-population core program districts, Jhapa, Morang, Sunsari, Siraha, Mahottari, Dhanusha, Rautahat, Bara, Parsa, Chitwan, Rasuwa, Nawalparasi, Banke, Bardiya, Kailali, Kanchanpur and Bajura. Saptari, Sarlahi, Makwanpur, Bhaktapur, Kathmandu, Lalitpur, Gorkha, Kaski, Rupandehi and Dang.

Besides, the NFHP will assist the Ministry of Health in implementing activities to strengthen the delivery and use of Family\Planning and Maternity and Child Health services at household and community levels.

According to the program, assistance will be provided in close collaboration with District Health Offices to maximize the quality of the FP\MCH services.

A study recently published by Ministry of Health shows that a large section of the population is yet to have access to contraceptives. According to the program, national-level activities will facilitate employment of a standard package of family planning service all government health facilities and sustain the dramatic impact of the National Vitamin A program. The NFHP will also support the expansion of the Community Based-Integrated Management Childhood Illness and help maintain a close working relationship with Safe Motherhood Program.

JSI, Engender Health, and John Hopkins University\Center will implement the program for Communication Program (JHU\CCP) and John Hopkins University Program in International Education on Reproductive Health.

At a time when Nepal is struggling to improve family health status and to reduce fertility, the implementation of the NFHP contains significant importance. The program also shows the commitment of donors like USAID in supporting Nepal's effort to sustain the progress made in health sector.