Younka Kura, The secret of life (Watch Video)

Health care services in Nepal are provided by both the public and private sector and fare poorly by international standards. Disease prevalence is higher in Nepal than it is in other South Asian countries, especially in rural areas. Moreover, the country’s topographical and sociological diversification helps to promote periodic epidemics of infectious diseases, epizootics and natural hazards like floods, forest fires, landslides and earthquakes. Millions of people are at risk of infection and thousands die every year due to communicable diseases, malnutrition and other health-related events which particularly affect the poor living in rural areas. However, some improvements in health care have been made, most notably significant progress in maternal-child health. For example, Nepal’s Human Development Index (HDI) was 0.458 in 2011 up from 0.291 in 1975.

Health care facilities, hygiene, nutrition, and sanitation in Nepal are of poor quality, particularly in the rural areas. Despite that, it is still beyond the means of most Nepalese. Provision of health care services are constrained by inadequate government funding. The poor and excluded have limited access to basic health care due to its high costs and low availability. The demand for health services is further lowered by the lack of health education. Reproductive health care is neglected, putting women at a disadvantage. In its 2009 human development report, UN highlighted a growing social problem in Nepal. Individuals who lack a citizenship are marginalized and are denied access to government welfare benefits. Traditional beliefs have also been shown to play a significant role in the spread of disease in Nepal.

These problems have led many governmental and nongovernmental organizations (NGOs) to implement communication programs encouraging people to engage in healthy behavior such as family planning, contraceptive use, spousal communication, safe motherhood practices, and use of skilled birth attendants during delivery and practice of immediate breastfeeding.[20]

Micro-nutrient deficiencies are widespread, with almost half of pregnant women and children under five, as well as 35 percent of women of reproductive age being anemic. Only 24 percent of children consume iron-rich food, 24 percent of children meet a minimally acceptable diet, and only half of pregnant women take recommended iron supplementation during pregnancy. A contributing factor to deteriorating nutrition is high diarrheal disease morbidity, exacerbated by the lack of access to proper sanitation and the common practice of open defecation (44 percent) in Nepal.

Stagnant growth and political instability have contributed to acute food shortages and high rates of malnutrition, mostly affecting vulnerable women and children in the hills and mountains of mid- and far western regions.Though rates of stunting and underweight have decreased and rates of exclusive breastfeeding has increased in past seven years, 41 percent of children under five years of age remain stunted, a rate that increases to 60 percent in the western mountains. Report from DHS 2016, has shown that in Nepal, 36% of children are stunted (below -2 standard deviation), 12% are severely stunted (below -3 standard deviation), 27% of all children under 5 are underweight, and 5% are severely underweight. Variation in percentage of stunting and underweight is seen among children under 5 in urban and rural region.

Rural areas are more affected (40% stunted and 31% underweight) than urban areas (32% stunted and 23% underweight). There is positive association between household food consumption score and lower prevalence of stunting, underweight and wasting.Children in the food secure household have lowest rates of stunting (33 percent), while children in the food in secure household have rates up to 49 percentage. Similarly, maternal education an inverse relationship with childhood stunting. In addition, the underweight and stunting are also inversely correlated to their equity possessions. Children in the lowest wealth quintile are more stunted (49%) and underweight (33%) than children in the highest quintile (17% stunted and 12% underweight).

The nutritional status has improved over the two decades among the children in Nepal. The decreasing trends of stunting and underweight children have been observed since 2001. The declination of stunted children was 14% between 2001 and 2006 and additional 16% between 2006 and 2011, and dropped by 12% between 2011 and 2016. A similar trend is also observed for underweight children. The trends is moving towards the achievement of Millennium Development Goal (MDG) target. However, there is still a long way to go to meet the SDG target of reducing stunting to 31% and underweight to 25% among children under 5 by 2017 (National Planning Commission 2015).

Micro-nutrient deficiencies are widespread, with almost half of pregnant women and children under five, as well as 35 percent of women of reproductive age being anemic. Only 24 percent of children consume iron-rich food, 24 percent of children meet a minimally acceptable diet, and only half of pregnant women take recommended iron supplementation during pregnancy. A contributing factor to deteriorating nutrition is high diarrheal disease morbidity, exacerbated by the lack of access to proper sanitation and the common practice of open defecation (44 percent) in Nepal.

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