National Health Policy 1991 and it's travelouge

It's been 22  years after the National Health Policy (1991) was formulated with a framework of 14 components. More or less, it wouldn't sound wrong that it is in the tip of our tongue. There's no doubt it's a fundamental base of Public Health in Nepal. 

NATIONAL HEALTH POLICY, 1991

The National Health Policy was adopted in 1991 (FY 2048 BS) to bring about improvement in the health conditions of the people of Nepal. The primary objective of the National Health Policy is to extend the primary health care system to the rural population so that they benefit from modern medical facilities and trained health care providers. The National Health Policy addresses the following areas:

1. Preventive Health Services

Priority is given to programs that directly help reduce infant and child mortality rates. Services are to be provided in an integrated manner throughout the health system to sub health posts at the local level.

2. Promotive Health Services

The programs that enable people to live healthy lives will be given priority.

3. Curative Health Services

Curative health services will be made available at all health institutions-central, regional, zonal and district hospitals; primary health care centres (PHCC), health posts (HP), and sub health posts (SHP); and, at health institutions at all levels of the healthcare system. Hospital expansion will be based on population density and patient loads. Mobile teams will be organised to provide specialist services to remote areas. A referral system will be developed to direct the rural population to well-equipped institutions.

4. Basic Primary Health Services

Sub Health Posts will be established in phased manner in all Village Development Committees (VDC). One Health Post in 205 electoral constituencies will be upgraded in a gradual manner and converted to a Primary Health Care Centre.

5. Ayurvedic and other Traditional Health Services

The Ayurvedic system will be developed and other traditional health systems (such as Unani, homeopathy, and naturopathy) will be encouraged.

6. Organisation and Management

Improvements will be made in the organisation and management of health facilities at the central, regional and district levels. This will include the integration of the district hospitals and the public health offices into District Health Offices.

7. Community Participation in Health Services

Community participation will be sought at all levels of healthcare through the participation of female community health volunteers (FCHV), traditional birth attendants (TBA) and leaders of various local social organisations. VDCs will provide sites for the location of SHPs.

8. Human Resources for Health Development (HRH)

Technically competent human resources will be developed for all health facilities. Training centres and academic institutions will be strengthened.

9. Resource Mobilization in Health Services

National and international resources will be mobilized and alternative concepts (such as health insurance, user charges, and revolving drug schemes) will be explored.

10. Private, Non-Governmental Health Services and Inter-sectoral Co-ordination

The Ministry of Health will co-ordinate activities with the private sector, non-governmental organisations (NGOs), and non-health sectors of HMG. The private sector and NGOs will be encouraged to provide health services.

11. Decentralization and Regionalization

Decentralization and regionalisation will be strengthened; peripheral units will be made more autonomous. District Health Offices (DHO) will have a prominent role in the planning and management of curative and promotive health services from district to village levels.

12. Blood Transfusion Services

The Nepal Red Cross Society will be authorized to conduct all programs related to blood transfusion. The practice of buying, selling, and depositing blood will be prohibited.

13. Drug Supply

Improvements will be made in the supplies of drugs by increasing domestic production and upgrading the quality of essential drugs through effective implementation of the National Drug Policy.

14. Health Research

Health research will be encouraged for better management of health services.

Notice for the examination for the post of Public Health Officer (7th Level) by Public Service Commission (लोक सेवा आयोग)

Public Service Commission have finally published the announcement for the examinations for the Post of Public Health Officer-7th Level. It was published in GorkhaPatra Daily of 13th November of 2013.

For more detail, you can log on to Public Service Commission Homepage

And for the information, its PDF version can be accessed through this link Notice published by PSC

There's no doubt on examination  this time. It will be held on stipulated date. PSC have categorized all the vacant seats as per GESI strategy and revised Health Act. I don't think, there's any issues left to knock the court's door this time.

Best of luck to all the contenders of Public Health Officers-7th Level.
See you.



Success Mantra :

1. At least think being a Public Health Officer. "What the mind of man can conceive and believe, it can achieve." So, Practice More. Think More. Take less stress & Get more Confidence.

2. FORGET EVERYTHING. May it be IOMites, May it be Purbanchals (Purbhanchal University) and May it be Pokhrelese (Pokhara University), every human brains are same, human efforts can be different. Hence the result can be different.

Best wishes
Neil. :)

Good Luck.

For any queries, I am available at: Facebook & Twitter as well.

How UNICEF thinks to reduce CHILD MORTALITY by 2015

Goal: Reduce child mortality

Targets by 2015:

To reduce child mortality by two-thirds, from 93 children of every 1,000 dying before age five in 1990 to 31 of every 1,000 in 2015.

Child survival lies at the heart of everything UNICEF does. About 29,000 children under the age of five –  21 each minute – die every day, mainly from preventable causes.More than 70 per cent of almost 11 million child deaths every year are attributable to six causes: diarrhoea, malaria, neonatal infection, pneumonia, preterm delivery, or lack of oxygen at birth. These deaths occur mainly in the developing world.  An Ethiopian child is 30 times more likely to die by his or her fifth birthday than a child in Western Europe. Among deaths in children, South-central Asia has the highest number of neonatal deaths, while sub-Saharan Africa has the highest rates. Two-thirds of deaths occur in just 10 countries.

 And the majority are preventable.  Some of the deaths occur from illnesses like measles, malaria or tetanus. Others result indirectly from marginalization, conflict and HIV/AIDS.  Malnutrition and the lack of safe water and sanitation contribute to half of all these children’s deaths. But disease isn’t inevitable, nor do children with these diseases need to die. Research and experience show that six million of the almost 11 million children who die each year could be saved by low-tech, evidence-based, cost-effective measures such as vaccines, antibiotics, micronutrient supplementation, insecticide-treated bed nets and improved family care and breastfeeding practices.

These measures are the basis for UNICEF’s actions to help children survive, carried through with hundreds of allies and via offices in the field – and well-travelled staff – all over the world.

UNICEF responds by:

Providing high-impact health and nutrition interventions.

In partnership with governments, WHO and others, UNICEF aims to scale up proven, high-impact, cost-effective health and nutrition interventions to reduce the number of neonatal and young child deaths from preventable and easily treatable causes.UNICEF is the world’s largest purchaser of vaccines, procuring more than 40 per cent of all vaccines used in the developing world. While global immunization rates have risen from less than 20 per cent in the 1970s to about 74 per cent in 2002, millions of children must still be reached. UNICEF negotiates favourable prices and forecasts vaccines requirements to ensure sustainable supplies. Targets include increasing immunization coverage to at least 90 per cent at the national level and 80 per cent in all districts, with particular focus on reaching population groups with low coverage levels, and the final eradication of polio. When delivering vaccines UNICEF adds micronutrient supplements to offset malnutrition, another critical factor in child survival. Supplements of vitamin A taken every four to six months can reduce child mortality from all causes by as much as 23 per cent, measles deaths by 50 per cent and deaths from diarrhoea by 33 per cent. Another target in this area is increasing the rate of children sleeping under mosquito nets to at least 60 per cent in malaria-endemic areas. Malaria is responsible for 10 per cent of all under-five deaths in developing countries.

According to the World Health Organization (WHO), poor neonatal conditions are the most prominent cause of young deaths. Four million babies per year die in the first week of life. In response, UNICEF advocates for and promotes programs to increase rates of exclusive breastfeeding. The strongest foundation of baby health is nutrition, and the best food for newborns is breast milk. Breastfeeding protects babies from diarrhoea and acute respiratory infections, stimulates their immune systems and improves response to vaccinations, and contains many hundreds of health-enhancing molecules, enzymes, proteins and hormones.

A mother’s health is also critical to newborns, particularly in light of new research that suggests a sound neonatal environment is an important predictor of future health. Together with the WHO and United Nations Population Fund (UNFPA), UNICEF advocates and lends technical and financial support to comprehensive community health programs for expectant women. This would ideally include providing micronutrient supplements, vaccines, anti-malarial drugs and insecticide-treated bed nets.

 Improving family care practices.

About 80 per cent of health care in developing countries occurs in the home – and the majority of children who die do so at home, without being seen by a health worker. Meanwhile, proper infant feeding and breast feeding are still not practiced by many families. As many as 40 per cent of child deaths could be prevented with improved family and community care – not high-tech health equipment, but access to solid knowledge, support and basic supplies. Working with governments, health providers and communities in the field, UNICEF helps families learn essential skills and basic health knowledge, particularly in the care of newborns. This includes best practices in breastfeeding and complementary feeding, hygiene and safe faeces disposal. UNICEF also works for better integration among systems that deliver basic supplies and health services to the poorest families. Health and outreach workers are enabled to support better parenting, the care of mothers, infant feeding, care-seeking practices among families and communities in favour of disease prevention, and optimal management of childhood illness. These include treatment for diarrhoea, including the use of oral re-hydration salts, and for acute respiratory infections such as pneumonia.

Increasing access to improved water and sanitation.

UNICEF helps develop systems to control water-borne diseases like Guinea worm and cholera that undermine child survival and development, reduce productivity and raise health-care costs. Struggles to find water and hygiene resources also primarily increase burdens on girls and women. Working closely with governments, UNICEF also helps strengthen policies and budgets and support technical capacities in programmes for hygiene promotion, sanitation, cost-effective water supply options and water quality, particularly for poor rural and urban families. These activities also aim toward fulfilling Millennium Goals 4 and 7. UNICEF also helps develop partnerships that pool competencies and resources, particularly in its role as advocate, facilitator and coordinator in emergencies.

Responding rapidly to emergencies.

UNICEF is also one of the first aid organizations on the scene following the outbreak of a crisis, helping to establish monitoring systems, organize partnerships and provide vaccinations and vitamin A supplementation. UNICEF also helps fund and build fresh water and sanitation facilities, helping stem the spread of water-borne diseases. By providing supplies, personnel and assistance with facilities and sanitation, UNICEF also helps get children Back to School, which supports a number of Goals. As well as being registered and accounted for, and supervised by adults, children can also access health care, food and sanitation resources at a school.

Progress

In its sixty years of existence, UNICEF has seen a fifty per cent reduction in under-five mortality between 1960 and 2002. We’ve seen that vitamin A supplementation can save over a quarter million lives a year; oral rehydration therapy can prevent 1 million deaths, and immunization programmes can protect the lives of nearly 4 million children. But progress in meeting this Millennium Goal is the most off track of any. In 2002, 7 of every 1,000 children in industrialized countries died before they were five. In South Asia, 97 of 1,000 children died before they were five. And in sub-Saharan Africa, that number is 174 of every 1,000 children. Ninety countries, 53 of them from developing nations, should be able to meet the 2015 Goal of reducing child mortality by two-thirds, if they maintain their current annual reduction rate.  But 91 developing countries lag far behind. Many have seen mortality rates rise since 1990, countries from sub-Saharan Africa as well as Iraq and former members of the Soviet Union. The number of children orphaned and made vulnerable by HIV/AIDS is projected to reach 25 million by the end of the decade, 18 million of them in sub-Saharan Africa. This, along with only modest progress fighting malaria, means the threats facing child survival are as grave as ever.

***Copied from :http://www.unicef.org/mdg/childmortality.html

A Jump from Class 5 to 9...Remembering the Days in Bridge!!!!

Wish I would have thought like this at that time.Today I think that was the greatest mistake of my life. If not,I would have turned my career to different dimension, would have been in different path. Child psychology with different circumstances might have enforced me as well.

Classes from morning to evening with just a 30 minute break, extra classes in holidays, loads of homework, tight discipline; all these things were creating a kind of distraction towards  that School so called Boarding School. Every evening, a kind of relief, pleasure, excitement used to overwhelm as if I have thrown 100 kg load from my back  but with the next sunrise, these excitement,pleasure meter used to fall down to ZERO.Days were passing by with same story. Dashain & Tihar, for me, were just a festive of Homework,  passing the whole day doing just homework, keeping  pencil between the fingers, eyes in book , Watching friends in Sportive mood  from by terrace .हिटलर जस्तै लाग्दथ्यो मलाई स्कुलको प्रधानध्यापक. I was in class 5 at that time. At that time Government school children used to answer " म पाँचमा पढ्ने हो" and students from Boarding school " म फाईभमा पढ्ने हो" for the same question " कति कक्षामा पढ्ने हो तिमि??." So it was the demarcating line between boarding and School students. Principle Hitler decided we are going to give 8 class district level exam from the government school where he was involved too. I was in dilemma whether I am studying in Class 5 or in भारु Class 5. But I was so excited to give the exam though and passed as well. And I have to answer a great question ahead on my way whether to jump to class 6 or to class 9.

I thought class 9 would be great. Class 9 in early age, freedom from the Hitler cage,  who cares for future!
Finally the way changed. I was on my way to "म नौमा पढ्ने".First day in class 9, in school, is still so vivid in my mind. Class 9, a hall of more than 100 students, a long blackboard from one corner to another, almost 15 to 20 min break after each class. I was so surprised and was in simply wow mood. I found my self so relaxed.Sometime used to entertain big gang fight within the school premises even sometime within the class.Though I forget my Roll no., but I guess, it was in the line of 110 or 120. I was enjoying fully those days. I was among the students with less height, few boys used to enlist  me in बठां group. But now,"hey boys! come and watch me, i'm  5.9."LOL. डर देखाऊने नि सिमा हुन्छ तर बोडिंगमा, Previously in Boarding school, I used to go to school with my mum, in case of one day absence, so as to escape from the fear of लाठ्ठि चार्ज. But now in school, who was there to care my head in between hundreds of head. .

Care free environment in school didn't last long. After all my parents were there to look after me. My parent hired a residential tutor Gyan Bikram BK. It was a challenge though. BK tutor in Brahman house. But in fact, he was among the  honest, loyal helpful man I have ever seen in my life. But his way of teaching was quite different.He used to give emphasis to greater practice, rote learning rather learning by understanding. I was growing up, adding class, with fragile base." लाटोको देशमा गाडो तन्नेरी"a Nepali Idiom came true on me, later my roll no became 4 in class 10, leaving more than 100 students behind. Now my entertainment routine was just opposite than that of boarding school. Pressure at home while relax at school. I used to walk so fast to school and so slow back to home.I used to take almost an hour to have dinner.Sir used to cry from his room " निला कँहा हो तिमि?? खाना खान पनि कति ढिला गरेको हो तिमिले।"  He used to punished differently than that of Boarding. Exercise,If not done as per his instruction, he used to increase the number of times  saying "do it 3 times, do that 4 times".   I still remember I have suffered the punishment so badly in TRIGONOMETRY exercise.