An Overview of Health in Nepal
By Ken Subedi
It is all about health in Nepal. What improvement did they make in the last few years?
Nepal has made significant progress in improving the health of women and children. Some facts that show improvement in healthcare:-
The mortality rate during childbirth has decreased.
The mortality under the age of five has decreased.
Nutrition in children has improved.
Life expectancy rose from 66 years in 2005 to 71.5 years in 2018.
Nepal is a poor country with at least 25% of the population living below the poverty line, only 27% of the population having access to adequate sanitation and 30%lacking access to safe drinking water; malnutrition, infection, and different diseases are much more prevalent here.
Nepal also has a diverse range of landscapes and climatic conditions, due to this geographical constraint, transportation and communication are very limited, making it difficult for people in rural areas to access health care. On top of that, the country is highly susceptible to natural disasters such as earthquakes, recurring floods, and landslides and not much has been done in the sector of health preparedness and mitigation. Very few hospitals barely meet the earthquake-resistant standard and according to WHO (World Health Organization), the ratio of doctors to the population is one doctor to every 18,000 persons.
With Neonatal Disorders, Ischemic Heart Disease, Chronic Obstructive Pulmonary Disease, Lower Respiratory Infection, Diarrheal Disease, Road Injuries, Stroke and Diabetesbeing the leading causes of morbidity and mortality in Nepal, the life expectancy in Nepal is 71.5 years. Due to lack of proper nutrition, almost 50% of infants under the age of three suffer from stunted growth and the Infant Mortality Rate of the country is 32.20 per 1000 live births. The Maternal Mortality Ratio is 239 maternal deaths per 100,000 live births. However, Maternal Mortality Ratio has significantly decreased over the years, in 2016; roughly 12%of deaths among women of reproductive age were classified as maternal deaths.
Both government and private sector health services are available in Nepal, which often has poor service and facilities, often failing to meet the global standards. Most of the major hospitals with the latest health technology and equipment are centred in urban areas with the supply chain to remote areas often exacerbated. Therefore, the rural areas have very few health posts and clinics where it is impossible to perform surgery or even an important diagnosis. So, if the people from rural areas have serious health issues, they have no choice but to rush to the nearest urban city with a good hospital. The hospitals in the urban areas also rarely live up to their hype as they frequently face the challenges of health staff absenteeism, lack of supervision and medical staff strikes.
"The diverse climatic conditions of the country accompanied by poor hygienic practices and sanitation is offering a home for the continuous emergence and the reemergence of several life-threatening humans infectious diseases. Climate change is a major factor that has a direct impact on the spreading of Vector-Borne Diseases and Nepal is highly susceptible to climate change. Most of the common diseases of Nepal such as Malaria, Dengue, Japanese Encephalitis and Visceral Leishmaniasis is climate-related. Since, temperature, precipitation, humidity, and other climatic factors adversely affect the reproduction, development, behaviour and population dynamics of the arthropod vectors of these diseases, a change in the climatic pattern can make Nepal highly vulnerable to such Vector-Borne Diseases."
The current infectious diseases found in Nepal are Malaria, Tuberculosis, HIV/AIDS, Lymphatic Filariasis, Visceral Leishmaniasis, Dengue Fever, Japanese Encephalitis, Leprosy, Gastroenteritis & Cholera, etc.
Despite the ongoing efforts to prevent and control communicable diseases, Nepal is still facing challenges in accurately identifying, diagnosing and reporting infectious diseases owing to the remoteness of communities, urban-centred healthcare infrastructures, and lack of specialized laboratories with skilled professionals. Waste management of Nepal particularly poses a constant threat to the public health system. Furthermore, Nepal is also prone to many natural disasters, particularly earthquakes, floods, and landslides. Effort and investment are needed to prepare for and mitigate the impact of natural disasters and climate change.
The government has taken the initiative to start a public health insurance plan in the fiscal year 2016-17 and as per the recent updates, the plan is active in most of the districts. Under this plan, a family of up to five members should pay a premium of Rs. 2,500 annually to avail health services up to Rs. 100,000. A family comprising more than five members must pay Rs. 425 for each additional member. This would qualify them for an additional insurance cover of Rs. 10,000.
Another great progress in Nepal's overall health status is the utilization of IT-based platforms to serve the Nepalese community. Organizations like Top Doctors Online (TDO) and other online Health caretakers, Nepal have already taken the initiative to provide online health services such as 24-hour online consultation and nursing care, remote blood sample collection, online clinical laboratory, etc. As Nepal understands the power of information and communication technology, this modern approach to health care can be a great tool to strengthen the overall health status of Nepal