Health Status in Madhesh, Nepal Ram K Shah Professor Nepal Medical College, Kathmandu

Health Status in Madhesh, Nepal

Ram K ShahProfessor

Nepal Medical College, Kathmandu

Wecome to Madhesh, Nepal

04/20/23 Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011 2

Land of Budha & Sita


Colourful Atmosphere


Environment Friendly People


Madhesh

• Poor• Ignorant• Iliterate• Underprevileged• Underfinamced• Marginalised• Discreminated


Health Status of Common People in Madhesh

Objectives

• Health Problems• Health Facilities• Peoples’ Expectations• Solution of the

Problems• Conclusions

04/20/23 8Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011

People of Nepal

Population (2009 estimate): 29.3 million.Annual population growth rate (2007 estimate): 2.132%.Population breakdown/distribution (from 2001 census): Rural (86%); female (50%); in the southern Terai region (49%); in the hills (44%); in the mountains (7%). Religions (from 2001 census): Hinduism (81%), Buddhism (11%), Islam (4%), and others (4%). Education: Years compulsory--none, although education is free through Grade 8. Attendance--primary 84% (86% male, 82% female), secondary 43.5% (46% male, 41% female). Literacy--57% (among youth age 15-24: 85% male, 73% female).

Health: Infant mortality rate (2008 estimate)--41 deaths/1,000 live births. Life expectancy--67 years.

Work force: Agriculture 73.9%; non-agriculture 26.1%.


Top Ten Diseases


Top Ten Diseases0.93 0.96

1.06

1.4

1.95

2.02

2.823.13

3.35

5.51

Sore Eye 7 Complaints

Abdominal Pain

Chronic Bronchitis

Ear Infection

Gastritis

Pyrexia

Itestinal Worms

ARI

Diarrhoeal Diseases

STD / HIV & SkinDiseases

Ten Reasons to Attend Hospital

12

Road Traffic Accidents


RTA

• Young Healthy People.• Poor : Female & Children• 10-20 % Death on the Road• 80 % People Die in the Hospital


No Special Care Service for the Victims

Health Sevices

• Promotive : Hygiene & Food• Preventive : Vaccination• Curative : Hospital Care


Economy & Expenditure In Health•Gross Domestic Product (GDP) at producer’s price, in

2000/2001 : Rs.376,433 millions which is higher by 10.9%

of the previous year.

•Total expenditure in health by government:

• 1996/97 is Rs.885.4 million

• 1997/98 is Rs.1049.0 million

• 1998/99 is Rs.1137.4 million

• 1999/2000 Rs.1324.8 million

•The public expenditure on health is 1.2% of GDP.

Note: ($1 = Nrs.78.00)

Health Budget


Health Status


Lack of Money for Health Care


Health Resource


Human Resources in HealthDescription 1999/2000 2000/01 2001/02Doctors* 1259 3600 5415

Nurses 2907 3621 3921

ANM 1748 3242 3942

Kaviraj 292 302 313

Vaidya 322 337 354

Health Assistants 5295 5295 8966

Health Workers 3190 3321 3321

Village Health Workers 4015 3985 3980

Health Volunteers 62546 62546 62546

Human Resource


Health Services

Description 1999/2000 2000/01 2001/02

Hospitals 83 93 89Health Centres 10 10 10Health Posts 711 700 700Ayurvedic Services 275 285 285Sub – Health Posts 3179 3171 3161Primary Health Centres 160 180 205

Hospital BedsGovernment Sector 5190 5250 5310Private Sector 200 300 300

Total OPD Visits as % Total Population 35.8 2001/2

Network of Health Institutions & Community Health Workers

04/20/23 24Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011

Antenatal Care


Hospital Delivery


Child Care


Vaccination


Malnutrition


Woman Health


Envoronment


Health Status


Right to Health





Per Capita Govt. Expenditure


Region 2058/59 2063/64 increment rate(2058/59/, 2063/64

Nepal Rs 3382 Rs 5050 49.3 per cent

Madhesh region Rs 1228 Rs 1730 40.9 per cent

other region Rs 5420 Rs 8306 53.2 per cent

Human Development Index


Human Development Index: 2001

Human Development Index: 2009

Upper hills- 0.386

Upper hills- 0.436

Hill regions- 0.512

Hill regions- 0.543

Madhesh- 0.478

Madhesh- 0.494

According to a 2000/2001 government statistics, only 17.3 per cent of the total budget was allocated for 18 districts of Madhesh (two inner Madhesh districts are not included) but in hill districts, 72.4 per cent budget was allocated. Allocation for upper hill districts was 12.6 per cent.

Curative Health

• Most of Affluent Madheshi Go to India .• Poor People Receive Poor Treatment.• Lack of Suitable Health Facilities in

Madhesh.• Kathmandu is still Inaccessible for

Madheshi.


Solution

• Poverty Alleviation• Increase Literacy Rate• Social Justice• Equal Right to Health• Increase Health Spending• Equity & Access• Targeted Approach


Conclusions

• Madhesh is deprived, disadvantaged, underfinanced and discriminated.

• Health Status is Poor in Madhesh as compared to other parts.

• Needs Integration & Inclusion for a fair Deal.• Proper Share & Distribution of Resources.• Need Based Supply System.


Conclusions

• Satisfactory : Promotive & Preventive Services.

• Poor : Curative Service



Thank youLet us Hope For

Health & WealthOf

Madhesh

Documents

Health Status in Madhesh, Nepal Ram K Shah Professor Nepal Medical College, Kathmandu