situational analysis of mdgs 4,5 and 6 in nepal

SITUATIONAL ANALYSIS OF MDGS 4,5

AND 6 GOALS IN CONTEXT OF NEPAL

Presented By:

Kamal Bdr. Budha

Kamala Paneru

Bikal Subedi

Gokarna sapkota

Khagendra Poudel

INTRODUCTION

The UN global conferences of the 1990s drew up a

number of different key global Development goals and

targets to focus equalize and harmonize the needs and

status of the people all over the world.

These goals and targets were known as the International

Development targets. Again in 2000, the representatives

of 189 nations, including 147 heads of state and

Government adopted the Millennium Declaration during

the Millennium Development Summit (September 6-8,

2000) of the United Nations.

The Millennium Declaration focused on peace, security and

development to all people. The representatives made specific

commitment seven area viz.

1. Pease, security and disarmament

2. Development and poverty eradication

3. Protection our common environment

4. Human right, democracy and good governance

5. Protecting the vulnerable

6. Meeting the special needs of Africa

7. Strengthening the United Nations

The international development targets and the

development goals were merged together and renamed as

the Millennium Development Goals (MDGs).

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

8. Develop a global partnership for development.

5

The goal and targets to be reached by 2015 in each of

seven areas are so called the MDGs.

MDGs place health at the heart of development.

3 of 8 goals are directly related to health; 8 of 18

targets are directly related to health; 18 of 48

indicators of the progress are health related.

2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL

Goal 4: Reduce Child Mortality Rate

6

Target 5:

Reduce by two thirds, between 1990 and 2015, the

Under five mortality rate.

Indicator:

Under-five mortality rate (UNICEF-WHO)

Infant mortality rate (UNICEF-WHO)

Proportion of eye year children immunized against

measles.


Goal 5: Improve Maternal Health

7

Target 6:

Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio.

Indicator:

Maternal mortality ratio (UNICEF-WHO)

Proportion of births attended by skilled health personnel (UNICEF-WHO)


Goal 6: Combat HIV/ AIDS, malaria, and other

diseases

8

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

Contraceptive prevalence rate

Ratio of school attendance of orphans to school attendance of non orphans aged 10-14 years


9

Target 8:

Have halted by 2015 and began to reverse the

incidence of malaria and other major diseases.

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 (internationally recommended TB

control strategy)


Goal 4: Reduce Child Mortality

Rate

10 2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL

Reduce by two- third between 1990

and 2015 the under five years

mortality rate

11

Indicators 1990 1995 2000 2005 2010 2011 2015

IMR( Per 1000 LB) 108 79 64 61 41 46 34

U5MR(Per 1,000LB) 162 118 91 82 50 54 54

Proportion of 1-year olds

immunized against measles

42 57 71 85 85.6 88 >90


12

Infant mortality rate (per 1,000 live births) is decrease

by ½ and more: from 108 [1990] to 41[2010] or/and

46 [2011] and 34 has achieved data of MDGs in 2015.

Similarly,Under-5 mortality rate (per 1,000 live

births) is also decrease from 162 [1990] to 50 [2010]

or/and 54[2011]; which is nearer to the target i.e. 54.

% of 1 year-old children immunized against measles

in 1990 is 42 which is increase by the year 2009

[85.6] and/or 88 in 2011; which is nearest to the

MDGs target i.e. >90.


Measles coverage

13

7578 76

70

81

72

86 84 8680

9791

88 88 8781

9693

0

20

40

60

80

100

120

NATION EDR CDR WDR MWDR FWDR

2065/66

2066/67

2067/68


Goal 5: Improve Maternal Health


Reduce by third- quarters between 1990 and

2015 the maternal mortality rate15

Indicators 1990 1995 2000 2005 2010 2011 2015

Maternal Mortality Rate 850 or

515

539 415 281 229 - 231 or

134

Percentage of deliveries

attended by skill health

personal

7 9 11 20 28.8 36 60

Contraceptive

Prevalence Rate

24 29 39 44.2 45 49.7 67


16

•1: Given in MDGs Progress report 20102:Given in NHSP-PI

Maternal mortality ratio (per 100,000 live

births) in 1990 is 850 which is reduced in year

2009 [229] from this indicator Nepal was

awarded.(1)

Maternal Mortality Ratio decreased from

539/100,000 live births (DHS 1996) to 325 in

2006 and 300 in 2009.(2)

Skilled attendance at birth increased from 13%

(DHS 2001) to 22% in 2006 and 35% by 2009.

2/5/2013

SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL

Goal 6: Combat HIV/ AIDS

malaria, and other diseases


Have halted by 2015 and to reverse the

spread of HIV/AIDS18

Indicators 199

0

199

5

2000 2005 2010 2011 2015

HIV prevalence

among 15-49 years

olds (%)

NA NA 0.29 0.25 0.49 -

Contraceptive

prevalence rate (%)

24 29 39 44.2 45 65.8 67


19

Knowledge of at least one programmatic method ofpreventing HIV transmission increased from 37.6%(DHS 2001) to 75% for women and 50.8% (DHS2001) to 85% for men.

Given the CPR estimated from the HMIS andNDHS, achieving NHSP‐IP goal of 67 percent by2015 from the current level demands innovativeapproaches and appropriate strategies.

However, there has been decline in Total FertilityRate (TFR) from 3.1 in 2006 to 2.6 in 2011 (NDHS2011) and is expected to meet the NHSP‐IP target of2.5 by 2015.


The contraceptive prevalence rate (CPR) for

modern family planning method is 44 percent, it

is comparable with 2011 NDHS (43%).

Central development region reported the highest

level of CPR(51%) and western development

region reported the lowest (32%).

Contraceptive prevalence rate (%) is 24 in 1990

and 45 in 2010. this shows that just nearer to

double % CPR is increased.(1)

Contraceptive Prevalence Rate increased from

39% (DHS 2001) to 43% in 2006 and 47% by

2009.(2) 1: Given in MDGs Progress report 2010

2:Given in NHSP-PI

20

SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN

NEPAL

Have halted by 2015 and to reverse the

spread of Malaria and Other Disease21

Indicators 1990 1995 2000 2005 2015

Prevalence rate associated

with malaria(per 100,000 at

risk)

115 NA 65 78 -

Proportion of population in

malaria risk areas using

effective prevention measures

NA 9.75 6.94 11.4 -

Slide positivity rate 5.1 9.2 4.3 NA -


Indicators 1990 1995 2000 2005 2010 2015

Prevalence rate associated

with Tuberculosis

460 420 310 280 -

Death rate associated with

Tuberculosis

43 35 23 NA -

Proportion of tuberculosis

cases detected

NA 46 69 71 75 -

Proportion of tuberculosis

cases cured under DOTS

NA NA 89 88 89 -

22


Case detection and treatment

success rate of TB23

Activity 2005/06 2006/07 2007/08 2008/09

Case

detection rate

65 70 71 75

Treatment

success rate

88 89 88 89


24

Prevalence rate associated with malaria(number of

cases per 1000 of the population) is 1.96 in 1990 and

decrease in the year 2009 [0.16].

Prevalence associated with tuberculosis is 460 in

1990 and decrease in year 2005 [280].


Situation of HIV in Nepal (2011)

25


Important milestone in the response to

HIV/AIDS26

1988; Launched the first National AIDS prevention and control Program

1990-92; First medium term plan

193-97; Second medium term plan

1993; National policy on blood safety

1995; National policy on HIV/AIDS

1997-2001; Strategic plan for HIV/AIDS prevention

2000; Situational analysis of HIV/AIDS

2002-06; National HIV/AIDS strategic plan

2003-07; National HIV/AIDS operational plan

2006-2011; New national HIV/AIDS strategic plan

2006-2008; National HIV/AIDS action plan


Adult (15-49) HIV Prevalence

27


DISCUSSION28

National Free Health Program: to increase

access to and utilization of quality essential

health services by ensuring availability of

essential drugs In both urban and rural health

facilities throughout the year.

Social health protection – to achieve universal

coverage of essential health services by

developing a more comprehensive approach

(structure or system) with the aim of protecting

the population against the financial risks of

expensive health care.2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL

29

Urban and Environmental Health – To provide

quality essential health care services to the

municipality population at accessible delivery

points through urban Health clinic in partnership

with MoLD ; To promote environmental health

especially hygiene and sanitation amongst

population in conjunction with other essential

health care services for improved hygiene

practices in partnership with related agencies


Conclusion

30

Nepal has made marked progress in some social indicators

leading to the attainment of some MDGs by 2015. But the

progress has halted in the recent years. The country faces

added difficulty in achieving MDGs in the current political

scenario- weak resource base, violence, conflict and weak

governance.

The conflict affect towards achieving MDGs for a number

of reasons including the risk of domestic resource crowd

out, ineffectiveness of service delivery, prolonged absence

of elected representatives at the local bodies, and setbacks

in social mobilization and community participation. 2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL

31

MDGs are reinforcing to each other and the attainment of one goal would help the attainment of others.

MDGs can be achieved only through a strategic partnership among government, local bodies, NGOs, CBOs, and donors, strategic partnership in project formulation, execution, coordination of development activities, donor harmonization, and participatory monitoring and evaluation system are highly essential.


References 32

1. UNDP, Gov. of Nepal. Nepal Millennium Development Goals -Planipolis - Unesco[Internat]. sep. 2005[Cited feb. 2013]: Available from:

www.planipolis.iiep.unesco.org/upload/Nepal/Nepal%20MDG%202005.pd

www.npc.gov.np

2. CIGI, KDI. Post-2015 Development Agenda: Goals, Ta rgets and Indicators[Internet].Copyright © 2012[ cited feb 2013; p.4. Avalable from: file:///D:/MDGs/Statement%20delivered%20by%20UN%20Resident%20and%20Humanitarian%20Coordinator%20on%20the%20third%20Nepal%20MDGs%20Progress%20Report%202010%20_%20Statement%20_%20UNDP%20in%20Nepal.htm

www.cigionline.org

3. UNDP, Gov. of Nepal. MDG Progress Report for Nepal 2010 - UNDP in Nepal [Internat]. sep. 2005[Cited feb. 2013]: Available from:

www.undp.org.np/pdf/MDG-Layout-Final.pdf


http://www.planipolis.iiep.unesco.org/upload/Nepal/Nepal MDG 2005.pd

http://www.npc.gov.np/

http://www.cigionline.org/

http://www.undp.org.np/pdf/MDG-Layout-Final.pdf





33

7. Gov of Nepal. NHSP-IP 2004-

2009.Ministry of Health; oct. 2009: Availeble

from:

8. Poudel s, Gurung Sa, Gurung Sb, Timilsina

S, Kumal S. MDGs in nepal[Internate]. 2012[

cited 3 feb. 2013].Pokhara: Available from:

www.slideshare.net/sagunpaudel/mdgs-in-nepal


http://www.slideshare.net/sagunpaudel/mdgs-in-nepal





situational analysis of mdgs 4,5 and 6 in nepal

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