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Health Status in Madhesh, Nepal. Ram K Shah Professor Nepal Medical College, Kathmandu. Wecome to Madhesh, Nepal. Land of Budha & Sita. Colourful Atmosphere. Environment Friendly People. Madhesh. Poor Ignorant Iliterate Underprevileged Underfinamced Marginalised Discreminated.
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Health Status in Madhesh, Nepal Ram K Shah Professor Nepal Medical College, Kathmandu
Wecome to Madhesh, Nepal Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Land of Budha & Sita Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Colourful Atmosphere Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Environment Friendly People Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Madhesh • Poor • Ignorant • Iliterate • Underprevileged • Underfinamced • Marginalised • Discreminated Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Objectives • Health Problems • Health Facilities • Peoples’ Expectations • Solution of the Problems • Conclusions Role 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%. Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Top Ten Diseases Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Top Ten Diseases Sore Eye 7 Complaints 0.93 0.96 1.06 Abdominal Pain 5.51 Chronic Bronchitis 1.4 Ear Infection Gastritis 1.95 Pyrexia Itestinal Worms 2.02 ARI 3.35 Diarrhoeal Diseases 2.82 3.13 STD / HIV & Skin Diseases
Road Traffic Accidents Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
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 Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Health Sevices • Promotive : Hygiene & Food • Preventive : Vaccination • Curative : Hospital Care Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
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 Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Health Status Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Lack of Money for Health Care Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Health Resource Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Human Resources in Health Description 1999/2000 2000/01 2001/02 Doctors* 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 Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Health Services Description 1999/2000 2000/01 2001/02 Hospitals 83 93 89 Health Centres 10 10 10 Health Posts 711 700 700 Ayurvedic Services 275 285 285 Sub – Health Posts 3179 3171 3161 Primary Health Centres 160 180 205 Hospital Beds Government Sector 5190 5250 5310 Private Sector 200 300 300 Total OPD Visits as % Total Population 35.8 2001/2
Network of Health Institutions & Community Health Workers Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Antenatal Care Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Hospital Delivery Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Child Care Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Vaccination Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Malnutrition Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Woman Health Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Envoronment Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Health Status Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Right to Health Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Per Capita Govt. Expenditure Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Human Development Index 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. Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
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. Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Solution • Poverty Alleviation • Increase Literacy Rate • Social Justice • Equal Right to Health • Increase Health Spending • Equity & Access • Targeted Approach Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
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. Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Conclusions • Satisfactory : Promotive & Preventive Services. • Poor : Curative Service Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011
Let us Hope For Health & Wealth Of Madhesh Thank you Role of NGO & INGO in Developing Madhesh, 14-15 Nov. 2011