Health in Nepal
Encyclopedia
Health care services in Nepal
are provided by both the public and private sector and fares poorly by international standards. Based on WHO data, Nepal ranked 139 in life expectancy in 2010 with the average Nepalese living to 65.8 years. Disease prevalence is higher in Nepal than it is in other South Asian countries, especially in rural areas. Leading diseases and illnesses include diarrhea
, gastrointestinal disorders, goiter, intestinal parasites, leprosy
, and tuberculosis
, visceral leishmaniasis
and tuberculosis
. According to United Nations
data for 2003, approximately 60,000 persons aged 15 to 49 had human immunodeficiency virus (HIV), and the HIV prevalence rate was 0.5%. In spite of these figures, some improvements in health care have been made, most notably its significant progress in maternal-child health. For example, Nepal’s Human Development Index
(HDI) was 0.504 in 2002, ranking Nepal 140 out of 177 countries, up from 0.291 in 1975. Other improvements include:
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Nepal is 380. This is compared with 240.2 in 2008 and 471.3 in 1990. The under 5 mortality rate, per 1,000 births is 51 and the neonatal mortality as a percentage of under 5's mortality is 55. The aim of this report is to highlight ways in which the Millennium Development Goals
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Nepal the number of midwives per 1,000 live births is 4 and 1 in 80 shows us the lifetime risk of death for pregnant women.
is located on hilly or mountainous regions. The rugged terrian and the lack of proper infrastructure makes it highly inaccessible, limiting the availability of basic health care In many villages the only mode of transportation is by foot. This results in a delay of treatment, which can be detrimental to patients in need of immediate medical attention. Most of Nepal
’s health care facilities are concentrated in urban areas. Rural health facilities often lack adequate funding. In 2003, Nepal
had 10 health centers, 83 hospitals, 700 health posts, and 3,158 “sub-health posts,” which serve villages. In addition, there were 1,259 physicians, one for every 18,400 persons. In 2000 government funding for health matters was approximately US$2.30 per person, and approximately 70 percent of health expenditures came from out-of-pocket contributions. Government allocations for health were around 5.1 percent of the budget for fiscal year 2004, and foreign donors provided around 30 percent of the total budget for health expenditures.
’s health care issues are largely attributed by the fact that its political power and resources are mostly centered in its capital, Kathmandu, resulting in the social exclusion of other parts of Nepal
. The restoration of democracy
in 1990 has allowed the strengthening of local institutions. The 1999 Local Self Governance Act aimed to include devolution of basic services such as health, drinking water and rural infrastructure but the program has not provided notable public health improvements. Due to a lack of political will, Nepal
has failed to achieve complete decentralization, thus limiting its political, social, and physical potential.
References:
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
are provided by both the public and private sector and fares poorly by international standards. Based on WHO data, Nepal ranked 139 in life expectancy in 2010 with the average Nepalese living to 65.8 years. Disease prevalence is higher in Nepal than it is in other South Asian countries, especially in rural areas. Leading diseases and illnesses include diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
, gastrointestinal disorders, goiter, intestinal parasites, leprosy
Leprosy
Leprosy or Hansen's disease is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Named after physician Gerhard Armauer Hansen, leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions...
, and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, visceral leishmaniasis
Visceral leishmaniasis
Visceral leishmaniasis , also known as kala-azar, black fever, and Dumdum fever, is the most severe form of leishmaniasis. Leishmaniasis is a disease caused by protozoan parasites of the Leishmania genus. This disease is the second-largest parasitic killer in the world , responsible for an...
and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. According to United Nations
United Nations
The United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and achievement of world peace...
data for 2003, approximately 60,000 persons aged 15 to 49 had human immunodeficiency virus (HIV), and the HIV prevalence rate was 0.5%. In spite of these figures, some improvements in health care have been made, most notably its significant progress in maternal-child health. For example, Nepal’s Human Development Index
Human Development Index
The Human Development Index is a composite statistic used to rank countries by level of "human development" and separate "very high human development", "high human development", "medium human development", and "low human development" countries...
(HDI) was 0.504 in 2002, ranking Nepal 140 out of 177 countries, up from 0.291 in 1975. Other improvements include:
- Mortality rateMortality rateMortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
during childbirthChildbirthChildbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
: From 850 in 100,00 mothers in 1990 to 280 in 2011 - Under-five infant mortalityInfant mortalityInfant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying...
: From 162 per 1,000 live births in 1990 to 50 in 2011 - Child malnutritionMalnutritionMalnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....
: From 72% in 2001 to 38.8% in 2009 - Human Development IndexHuman Development IndexThe Human Development Index is a composite statistic used to rank countries by level of "human development" and separate "very high human development", "high human development", "medium human development", and "low human development" countries...
(HDI): From 0.291 in 1975 to 0.428 in 2010, ranking Nepal 141 out of 172 countries
| Health Indicators | |||
|---|---|---|---|
| Population growth Population growth Population growth is the change in a population over time, and can be quantified as the change in the number of individuals of any species in a population using "per unit time" for measurement.... |
1.28 | ||
| Life expectancy Life expectancy Life expectancy is the expected number of years of life remaining at a given age. It is denoted by ex, which means the average number of subsequent years of life for someone now aged x, according to a particular mortality experience... |
67 | ||
| Infant mortality Infant mortality Infant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying... |
39 | ||
| Fertility Total Fertility Rate The total fertility rate of a population is the average number of children that would be born to a woman over her lifetime if she were to experience the exact current age-specific fertility rates through her lifetime, and she... |
2.64 | ||
| Total expenditure on health per capita (Intl $, 2009) | 69 | ||
| Total expenditure on health as % of GDP (2009) | 5.8 | ||
| Parameters | Overall | Urban areas | Rural areas |
| Children under 5 years: | |||
| Stunned | 51% | 37% | 52% |
| Wasted | 10% | 8% | 10% |
| Underweight | 48% | 33% | 49% |
Maternal and Child Health Care
In June 2011, the United Nations Population FundUnited Nations Population Fund
The United Nations Population Fund is a UN organization. The work of the UNFPA involves promotion of the right of every woman, man and child to enjoy a life of health and equal opportunity. This is done through major national and demographic surveys and with population censuses...
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Nepal is 380. This is compared with 240.2 in 2008 and 471.3 in 1990. The under 5 mortality rate, per 1,000 births is 51 and the neonatal mortality as a percentage of under 5's mortality is 55. The aim of this report is to highlight ways in which the Millennium Development Goals
Millennium Development Goals
The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Nepal the number of midwives per 1,000 live births is 4 and 1 in 80 shows us the lifetime risk of death for pregnant women.
Geographical constraints
Much of rural NepalNepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
is located on hilly or mountainous regions. The rugged terrian and the lack of proper infrastructure makes it highly inaccessible, limiting the availability of basic health care In many villages the only mode of transportation is by foot. This results in a delay of treatment, which can be detrimental to patients in need of immediate medical attention. Most of Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
’s health care facilities are concentrated in urban areas. Rural health facilities often lack adequate funding. In 2003, Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
had 10 health centers, 83 hospitals, 700 health posts, and 3,158 “sub-health posts,” which serve villages. In addition, there were 1,259 physicians, one for every 18,400 persons. In 2000 government funding for health matters was approximately US$2.30 per person, and approximately 70 percent of health expenditures came from out-of-pocket contributions. Government allocations for health were around 5.1 percent of the budget for fiscal year 2004, and foreign donors provided around 30 percent of the total budget for health expenditures.
Political influences on Health care
NepalNepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
’s health care issues are largely attributed by the fact that its political power and resources are mostly centered in its capital, Kathmandu, resulting in the social exclusion of other parts of Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
. The restoration of democracy
Democracy
Democracy is generally defined as a form of government in which all adult citizens have an equal say in the decisions that affect their lives. Ideally, this includes equal participation in the proposal, development and passage of legislation into law...
in 1990 has allowed the strengthening of local institutions. The 1999 Local Self Governance Act aimed to include devolution of basic services such as health, drinking water and rural infrastructure but the program has not provided notable public health improvements. Due to a lack of political will, Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
has failed to achieve complete decentralization, thus limiting its political, social, and physical potential.
References: