ACHIEVEMENT AND PROGRESS

TOWARDS HEALTH RELATED

MDGS IN NEPAL

SAgun PAudel

Roll No. 22 (symbol No 11370028)

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[HES 406.1 Health Seminar in Special Topics]

INTRODUCTION

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The United Nations Millennium Development Goals are

eight goals that all 191 UN member states have agreed to

try to achieve by the year 2015 signed in September 2000.

The MDGs have specific targets and indicators. The MDGs

are inter-dependent.1 World leaders have agreed to achieve

the MDGs by 2015.2 Numerical targets are set for each goal

and are monitored by 48 indicator.3

Millennium Development Goals

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1. Eradicate extreme poverty and hunger;

2. Achieve universal primary education;

3. Promote gender equality and empower women;

4. Reduce child mortality;

5. Improve maternal health;

6. Combat HIV/AIDS, malaria, and other diseases;

7. Ensure environmental sustainability; and

8. Develop a global partnership for development.

Goal 4: Reduce Child Mortality Rate

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Target 5:

Reduce by two thirds, between 1990 and 2015, the Under-five

mortality rate.

Indicator:

Under-five mortality rate

Infant mortality rate

Proportion of eye year children immunized against measles.

Goal 5: Improve Maternal Health

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Target 6:

Reduce by three quarters, between 1990 and 2015, the

maternal mortality ratio.

Indicator:

Maternal mortality ratio

Proportion of births attended by skilled health personnel

Goal 6: Combat HIV/ AIDS, malaria,

and other diseases

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Target 7:

Have halted by 2015 and begun to reverse the spread of

HIV / AIDS.

Indicator:

HIV prevalence among pregnant women aged 15-24

years

Condom use rate of contraceptive prevalence rate

Condom use at last high- risk sex

Percentage of population aged 15-24 years with

comprehensive correct knowledge of HIV / AIDS

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Contraceptive prevalence rate

Ratio of school attendance of orphans to school

attendance of non-orphans aged 10- 14 years

Target 8:

Have halted by 2015 and began to reverse the incidence

of malaria and other major diseases.

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Indicator:

Prevalence and death rates associated with malaria

Proportion of population in malaria-risk areas using

effective malaria prevention and

treatment measures

Prevalence and death rate associated with tuberculosis

Proportion of tuberculosis cases detected and cured under

DOTS.

OBJECTIVES

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General objective

To Explore the Achievement and Progress of Health

Related MDGs in Nepal.

Specific objectives

To know the effort of Nepal Government to achieve

Health Related MDGs.

To find out the current situation of Health related

MDG indicators.

To know the Global post-MDG agenda.

METHODOLOGY

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To prepare this Seminar paper Google was used to retrieve

the necessary documents. Google Scholar advanced Google

search, EndNote was used to retrieve the articles. The

articles, Publications and notes related to MDGs were

downloaded and studied. Various secondary data sources

Available on internet are used for preparation of this

seminar paper.

FINDINGS

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Nepal government effort in health related MDGs

Nepal is one of 189 countries committed to the MDGs, a

pledge it has renewed in its national development plans.

The primary medium‐term strategy and implementation

plan for reaching its MDGs, the Tenth Plan; Poverty

Reduction Strategy Paper; 2002/03–2006/07 incorporated

the MDGs into its strategic framework.

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The Three-Year Interim Plan 2006/07–2009/10adopted after the Tenth Plan maintained the focuson poverty reduction and growth but also stressedthe need for the state to assume a greater strategicpresence in development, especially in remoteareas, and for socially marginalized groups to beincluded. The Three- Year Plan 2010/11–2013/14,continued the call for strategic investment in areasin need of greater focus if Nepal’s MDGs are to beachieved.5

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UNDP and the other UN agencies in Nepal are actively

supporting the Government in fulfilling its commitment to

the MDGs.

The Local Governance and Community Development

Program, a large-scale joint program of UNDP, UNCDF,

UNICEF, UNFPA, UN Women and UNV on effective

service delivery at the local level has been in operation

since 2009 which will help create enabling environment at

local level in achieving MDGs.

Current situation of health related

MDGs

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Despite the political instability during the post-conflict

period, Nepal has already exceeded a few MDG targets for

2015, under-five mortality rate per 1,000 live births ;attained

50 against the target of 54, maternal mortality ratio (per

100,000 live births, and death rate associated with TB ;per

100,000 of population.6

Nepal is on track and is likely to achieve most of its MDG

targets, despite the prolonged political instability.

MDG 4: Reduce Child Mortality

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Indicator 1990 2000b 2005 2010 2013 Target

(2015)

Infant mortality rate (per 1,000

live births)

108a 64 48c 46 46

(2011)

36

Under-five mortality rate

(per 1,000 live births)

162a 91 61c 54 54

(2011)

54

Proportion of the one-year-old

children immunized against

measles (%)

42d 71 85e 88 88

(2011)

>90

a-Ministry of Health ,New Era, & Macro International Inc. (1996), b- MoHP, New Era, & Macro International Inc. (2001), c-

MoHP, New Era, & Macro International Inc. (2006), d- MoHP, New Era and ICF International (2011), e-NPC & UNCT (2005).

Target: Reduce the under-five mortality rate by two-

thirds between 1990 and 2015.

MDG 5: Improved maternal health

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Target 5A: Reduce maternal mortality by three-quarters

between 1990 and 2015.

Indicator 1990 2000 2005c 2010 2013 Target(2015)

Maternal mortality ratio

(per 100,000 live births)

850a 415b 281d 229 170e 213

Proportion of births attended by

skilled birth attendant (%)

7f 11g 19h 36 50i 60

Sources

a- UNDP (1992), b- NPC (2002), c- MoHP, New Era, & Macro International Inc. (2006)., d- FHD (2009)., e-

WHO, UNICEF, UNFPA & The World Bank (2012), - NFHP (1995), g- MoHP, New Era & Macro

International Inc. (2001).. h- MoHP, New Era &, ICF International (2011), i- FHD (2013).

Target 5B:Achieve Universal access to

reproductive health by 2015.

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Indicator 1990 2000b 2005c 2010f 2013d Target (2015)

Contraceptive prevalence rate

(modern methods) (%)

24a 35.4 44.2 - 43.2 67

Adolescent birth rate (births per 1,000

women aged 15-19 years)

n/a 110 98e n/a 81 70

Antenatal care coverage

At least one visit (%) n/a 48.5 73.7 89.9 85g 100

At least four visits (%) n/a 14 29.4 50.2 50.1 80

Unmet need for family planning (%) n/a 26.5 24.6 - 27 15

Sources:

a- MoHP (1992) b- MoHP, New Era & Macro International Inc. (2001) c- MoHP, New Era, & Macro International Inc. (2006) d-

MoHP, New Era, & ICF International (2011) e- MoHP (2010) f- DoHS (2010) g- DoHS (2011)

Goal 6: Combat HIV/ AIDS, malaria,

and other diseases18

Indicator 1990 2000 2005a 2010 2013 Target (2015)

HIV prevalence among men and

women aged 15–24 years (%)

n/a n/a 0.15 n/a 0.12b Halt and reverse

the trend

Condom use at last high-risk sexual

encounter: youth 15–24 years

n/a n/a 71.2 Males

aged 15-49

years

n/a 65.8c -

Percentage of population aged 15–24

years with comprehensive knowledge

of HIV/AIDS

n/a n/a 35.6 n/a 29.8c -

Proportion of population with

advanced HIV infection receiving

antiretroviral combination therapy

(%)

n/a n/a n/a 21d 28.7e 80

Sources

a- NCASC (2006) b- NCASC (2011) c- MoHP, New Era & ICF International (2011) d- NCASC Fact Sheet (2009) e-

NCASC (2012)

TARGET 6C.19

Indicator 1990 2000 2005 2010b 2013 2015 target

Clinical malaria incidence (per 1,000

people)

n/a n/a 3.3a 5.67 3.23c Halt and reverse the

trend

Annual parasite incidence (per 1,000 people) n/a 0.55d 0.28a 0.11 0.08e 0.06

Death rate Associated with malaria (per

100,000 people at risk)

n/a n/a 0.05f 0.04 0.00e Halt and reverse the

trend

Percentage of children under five with fever

who are treated with appropriate anti-

malarial drugs

n/a n/a 3.23f 2.85 n/a 2.5

Percentage of children under five who sleep

under a long-lasting insecticide-treated bed

net

n/a n/a 48.2f 94.2g 96.8h 100

Sources:

a- DoHS (2007). b- DoHS, Epidemiology and Disease Control Division (EDCD) (2010). c- DoHS; 2011. d- DoHS; 2001. e- DoHS, Epidemiology and Disease Control

Division; 2012a. f- DoHS, Epidemiology and Disease Control Division; 2006. g- PSI TraC Study conducted in 13 high–risk districts; 2010. h- DoHS, Epidemiology and

Disease Control Division; 2012b.

Have halted and begun to reverse the incidence of malaria and other major diseases

by 2015.

Tuberculosis

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Indicator 1990a 2000 2005 2010 2013 2015 target

Prevalence rate associated with TB (per

100,000 people)

460 310b 280c 244d 238e Halt and

reverse the

trend

Death rate associated with TB (per

100,000 people)

43 23b 22c 22d 21e Halt and

reverse the

trend

Proportion of TB cases detected (%) n/a 70f 70g 76h 73i 85

Proportion of TB case cured under DOTS

(%)

40 89f 89g 90h 90i 91

Sources:

a- DoHS (2007).b - DoHS, Epidemiology and Disease Control Division (EDCD) (2010). c- DoHS (2011). d-DoHS (2001). e- DoHS, Epidemiology and

Disease Control Division (EDCD) (2012a). f- DoHS, Epidemiology and Disease Control Division (EDCD) (2005/06). g- PSI TraC Study conducted in

13 high–risk districts (2010). h- DoHS, Epidemiology and Disease Control Division (EDCD) (2012b).

Post MDG Health agenda of United

Nation

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There is wide debate as to what development goals the

global community should set next.

In January 2012, the UN System Task Team on the Post-

2015 UN Development Agenda was established.

The United Nations Development Group is leading efforts

to catalyze a “global conversation” on the post-2015 agenda

through a series of global thematic consultations and more

than 50 national consultations.

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The post-2015 development framework is likely to have the

best development impact if it emerges from an inclusive,

open and transparent process with multi-stakeholder

participation.7

Health priorities in the post-2015 era should include

accelerating progress on the present health MDGs,

advancing sexual and reproductive health and rights,

reducing NCDs and their risk factors, and improving mental

health.8

CONCLUSION

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Health is the central part of sustainable development. If we

achieve health related targets of MDGs we can develop our

nation progressively. MDGs are interrelated if we can work

better in health goals there is a positive progression on other

MDGs achievement.

Nepal has made significant progress in achieving its MDGs.

decade-long armed conflict, political instability, and

unfinished national political agenda regarding peace-

building, constitution writing and state-restructuring its

achievements should be considered remarkable.

RECOMMENDATIONS

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Nepal has a good progress on achieving MDGs the effort

should be continue to achieve remaining targets of

MDGS.

Those targets which are already achieved must be kept in

same manner and sustain it and the programs, efforts

shouldn’t discontinue.

The resources for MDGs must be increases i.e. financial

resource, human resources and other resources.

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Need to integrate health system to community and local

governance system in large scale to achieve sustainable

development.

After MDGs continue the basic 8 goals with some

addition new goals of Post-2015 Global agenda.

Create healthy environment for United Agencies for their

support, investment for development.

REFERENCES

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1. WHO, Millennium Development Goals

http://www.who.int/topics/millennium_development_goals/about/en/

2. United, N. thematic areas/ Millenium development goals.

http://www.un.org.np/thematicareas/mdg

3. Umesh, G. Millennium Development Goals in Nepal

http://umeshg.com.np/millennium-development-goals-in-nepal/

4. NRB (2006) Achieving Millennium Development Goals: Challenges for Nepal.

http://red.nrb.org.np/publications/special_publication/Special_Publications-

Achieving%20Millennium%20Development%20Goals-

%20Challenges%20for%20Nepal.pdf

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5. NPC, G. o. N. (2013) Nepal Millennium Development Goals Progress Report

2013.

http://www.np.undp.org/content/dam/nepal/docs/reports/millennium%20devel

opment%20goals/UNDP_NP_MDG_Report_2013.pdf

6. GON, N. (2010) MDGs progress report

http://www.npc.gov.np/new/uploadedFiles/allFiles/mdg_2011.pdf

7. United, N. (2011) Accelerating progress towards the Millennium

Development Goals: options for sustained and inclusive growth and issues for

advancing the United Nations development agenda beyond 2015, Annual

report of the Secretary http://daccess-dds-

ny.un.org/doc/UNDOC/GEN/N11/410/40/PDF/N1141040.pdf

8. Want, t. w. w. (2013) Health in the post-2015 Agenda, Report of the Global

Thematic Consultation on Health. the world we want,

http://www.worldwewant2015.org/bitcache/aa5345b4af0fae1615b108c3e392a

2ca781ce2ec?vid=366802&disposition=attachment&op=download

QUESTIONS COMMENTS?

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THANKYOU VERY MUCH!!Keep Update with Public Health: (Sagun’s Blog ) http://sagunpaudel.blogspot.com

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