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National Plan, Policy & GuidelinesPublic Health UpdateResearch & Publication

NHPC Minimum Requirements For the recognition of Master in Public Health

by Public Health Update July 3, 2019
written by Public Health Update

Minimum Requirements For the recognition of Master in Public Health- Nepal Health Professional Council

Screen Shot 2019 07 03 at 21.05.35

Introduction

Nepal Health Professional Council has approved this requirement according to clause of 9 (kha) of the Nepal Health Professional Council Act 2053. This requirement shall be called Minimum requirement for the recognition of Master’s Degree of Public Health Program (2061) and first revision 2076 (2019).

An institution that plans to start or conduct Master’s degree of Public Health Program shall ensure the standard as specified in this minimum requirement in order to qualify for granting accreditation.

Student

Entry Requirement for Students

  • Bachelor degree in Public Health or Health Sciences with minimum 50% marks or equivalent grade score from a University with equivalence from legally authorized concerned organization recognized by Government of Nepal. Besides the basic academic requirement, an entrance examination will be held for all applicants and should secure 50% marks to be eligible for admission.
  • Registered in respective professional council
  • Passed the entrance examination organized by University.
  • Selection of the student shall be done on the basis of merit obtained in the written entrance examination.

Admission Policies

  • Intake of student should be annual.
  • The maximum number for intake of students is 20 for general MPH and 15 for a specialized Master in Public Health Sciences per academic year.

Duration of Study

  • Duration for the completion of all the requirements for the MPH or Specialized Public Health master program as a full-time student is 2 Years in annual system and 24 months (4 Semesters) in semester system or 120 ECTS (European Credit Transfer System) or equivalent.

Attendance Requirements

A student must attend every scheduled lecture, tutorial, practical classes, journal club, seminar, field visit and internship. However, to accommodate for late registration, sickness and other contingencies, the attendance requirements will be a minimum of 80% of the classes actually held.

Course Coverage

A student must attend the core courses (Public Health, Epidemiology, Research Methodology, Health Management, Public Health statistics/biostatistics, Population Health, Health Promotion and Education, Environmental Health, Reproductive/Family Health,Nutrition and other subjects as per nature of specialization)

Student’s Evaluation

A student’s academic performance in a course is evaluated in two phases as:

  • Internally by the concerned faculty member through quizzes, tutorials, lab works, home assignments, class tests, class participation, term papers, internal exam etc.
  • Externally by the Office of the Controller of Examinations of concern University through year/semester-end examinations.
  • Practical, field practice and internship will be evaluated by external examiner through practical, demonstration, presentation and oral exam.

Teaching Faculty

Number of Faculties

Minimum number of faculties for first MPH program should be maintained as follows; 

  • Professor 1 Full time
  • Associate Professor/Reader 2 Full time
  • Assistant Professor/Lecturer 4 Full time

For each additional specialized program, the faculties should be as follows;

  • Professor 1 Full time
  • Associate Professor/Reader 1 Full time
  • Assistant Professor/Lecturer 3 Full time

The above-mentioned faculty number is for the full-fledged master program (single program) and the number of faculties should be at least 7 full time for a first master program. For each additional specialized program there should be at least 5 additional full-time faculties.

For example:
One MPH (Nutrition) – 7 faculties
Next additional MPH (Health Promotion) – 7+5 faculties and so on

If both bachelor and master programs are run by an institution, the required number of faculties for each master program should be the total of bachelor program’s faculties and the required faculties of each specialization.

For example: BPH program – 7 faculties (See minimum requirement of BPH)

BPH and One MPH (Nutrition) – 7+5 faculties Next additional MPH (Health Promotion) – 7+5+5 faculties and so on

There should be at least one full time Professor/Assoc. Professor and two Assistant Professors at the beginning and the number should be increased before the new batch is enrolled.

Council will recognize the minimum qualification of a faculty as per the concerned university service commission eligibility.

  • As per the curricular needs additional part time teachers or teachers in course contract should be managed by Institution.
  • Full time teachers should be from core subjects (Public Health, Epidemiology, Research Methodology, Health System Management, Public Health statistics/biostatistics, Public Health Demography/Population Health, Health Promotion and Education, Environmental Health, Family/Reproductive Health and Public Health Nutrition)

Note: Faculties working as a full timer at one institution can NOT be full timer in another institution.

Teacher Student Ratio in Teaching Learning

There should be sufficient teachers to teach specialized course as per curriculum in a ratio as follows:

  • Teacher student ratio should be 1:15 in theory class
  • Teacher student ratio should be 1:5 in skill-based session

Qualification of Teacher

  • Minimum academic qualification should be at least Master degree in relevant subject with at least 3 years leaching experience
  • Experience and other requirements for the academic positions shall be as per the requirement of concern University

Work Load

For taking the theory and practical classes

  • Principal: 8 hours/week (maximum)
  • Professor: 12 hours/week (maximum)
  • Associate professor: 14 hours/week (maximum)
  • Assistant Professor: 16 hours/week (maximum)
  • Teaching Assistant: 18 hours/week (maximum)

For guiding master’s thesis;

One main thesis supervisor can supervise maximum following numbers of students per academic year.

  • Professor- 3 (can supervise 4 if he/she has already supervised 15)
  • Associate Professor -2 (can supervise 3 if he/she has already supervised 10)
  • Assistant Professor-1,if he/she has already co-supervised 3 (can supervise 2 if he/she has already supervised 5)
  • Teaching Assistant -1 if he/she has already supervised 5 as co-supervisor

 

  • Colleges where BPH and MPH programs are running, one hour of theory class in MPH is equivalent to 1.33 hours of work load (ratio of BPH to MPH workload shall be 1:1.33hours)
  • One thesis supervision equivalent to one and half hour workload per week
  • Co-supervisor’s workload is calculated as half of main supervisor’s workload
  • One is to two (1:2) ratio (MPH to BPH) should be maintained to calculate total students for thesis supervision by each faculty where both MPH and BPH programs exit.

Institution Organizational Structure of the Constitutional or Affiliated Academic Institution

  • Concern constitutional or affiliated academic institution should establish the following committees/sections
    Departments/Instruction committees, Examination section, Student welfare committee, Research Management Committee (RMC), Institutional Review Committee (IRC),
  • A separate organizational financial system should include; Financial viability plan, Annual budget for program, Source of income, Audit system

Principal or Campus Chief or Chief of Central Department or Director

  • Sole Public Health College: S/He should have at least Bachelor Degree in Public Health or Health Sciences with Master Degree or above in Public Health or Public Health Sciences and 7 years of academic/teaching learning experience. S/He should be registered in NHPC.
  • Multidisciplinary Health Science College: S/He should have at least Master’s Degree in any related subjects teaching in the college and 7 years of academic/teaching experience. S/He should be registered in concern council.

(Public Health Sciences include, but not limit to Epidemiology, Public Health Statistics/biostatistics, Population Health, International Health, Primary Health Care, Health System Management, Health Policy, Health Economics, Health Promotion and Education, Health Communication, Public Health Nutrition, Sexual and Reproductive Health, Occupational Safety and Health, Global Health, Community Health, Behavioral Health and other health sciences as decided by NHPC)

Head of the Department (HoD) and/or Coordinator

  • S/He should have at least Bachelor’s degree in Public Health or Health Sciences with Master’s Degree in Public Health or Public Health Sciences and 5 years of academic/teaching experience.
  • S/He should be registered in NHPC.

Administrative Staffs

Administrative staff should be sufficient in number to facilitate the educational/ administrative works. The required staffs are as follows:

  • Administrative Officer: S/He should have passed minimum Bachelor’s degree or equivalent in any subject.
  • Finance Officer: S/He should have passed minimum Bachelor’s degree in Commerce/ Business Studies/Administration or equivalent.
  • Account/Administrative Assistants: Accountant and Administrative Assistants should have passed 10+2 or equivalent.
  • Librarian: The Head of the Library should have University Degree and must have sufficient training in library science.
  • Computer Technician: S/He should have passed minimum Diploma/ Bachelor’s in computer sciences and should be command both in English and Nepali languages writings and reporting.
  • Laboratory Assistant: S/He should have passed University Degree in Laboratory Science or 10+2 (science) with training and or demonstrating laboratory work of Laboratory Assistant in concerning Faculty or Department of particular organization.
  • Any Office Assistants (helper/peon/cleaner/driver) should be a Nepali citizen and should be literate in Nepali (Command in both Nepali and English languages is preferable).

Teaching Facilities

Land, building and physical facilities requirements are as follows:

  • Land and Building: Building with adequate floor space and sufficient land
  • There should be minimum of two rooms for routine classes, and two rooms for group discussion purposes for each master program. Number of classrooms should be increased with the number of sections and specialized programs.
  • The classrooms should have: – Well ventilated with adequate light – 0.75 sq meter space per student – Appropriate desk and bench – White board – Multi-media – The theory classroom should accommodate of at least 15 students.
  • Principal’s office room should have enough space for visitors/ faculties and for small meeting
  • Administration office rooms should have enough space for administrative and financial work.
  • Demonstration room for 15 students at a time on the basis of 1:15 teacher -student Ratio for demonstration.
  • Teachers’ room with sufficient numbers of computers and printers.
  • A Library should have enough space for book and students’ study
    – 1 course book per 5 students must be available in library.
    – Reference book in each subject should be available at ratio of 1:10 students in library.
    – Access to HINARI and/or other related free journals with an internet 15 mbps capacity.
    – At least 10 professional journals should be available in the library.
    – Adequate number of reference books on each subject for teacher should also be available in library.
    – Other related books/dictionaries magazines, newspapers should be made available.
    – Curriculum of the program must be available at office and at the library. Furniture like table, chair, open rack, must be available in the library as per required standard and quantity.
    – Sufficient computer, printer, photocopy machine, emails – internet facilities should be made available.
  • For Classroom, one computer per class should be available.
  • Audio-visual aid equipment should be available for class room.
  • Toilet at a ratio of 1:10 for working staff and student. (male/ female separate)
  • Rooms for each Laboratory with sufficient equipment as described in different section
  • Multipurpose hall (at least 75 persons accommodation with essential facilities) should be available.

Facilities for Other Activities

  • An outdoors athletic ground
  • Indoor games
  • Provision of vehicles for field activities
  • Space for student welfare with counseling services.
  • Students’ hostel (Male and Female separate) is preferable
  • Canteen with safe drinking water, hygienic kitchen and dining hall.

Laboratory and Equipment

Registration for Foreign Degree

  • Must have Bachelor Degree in Public Health or Health Sciences.
  • Duration must be at least two years or 120 ECTS equivalent.
  • Should submit a valid supporting document to prove a regular student (College letter of regular student, passport, visa, immigration documents).
  • Must submit permission letter issued by NHPC for enrolment in the course.
  • Should have equivalence from concern authority of Nepal.
  • Should have passed the entrance examination of a University of Nepal.
  • Must submit transcript having core subjects (Public Health, Epidemiology, Research Methodology, Public Health statistics/biostatistics, and other subjects as per nature of specialization).
  • Must submit the copy of approval sheet of thesis/dissertation.

DOWNLOAD PDF  FILE


Oath of Public Health Professional – NHPC

General Code of Ethics for NHPC Registered Professionals

Important Notices – Nepal Health Professional Council (NHPC)

Important Notice!!! Licensing Exam cancelled – NHPC

Important Notice!!! Licensing Exam cancelled – NHPC

July 3, 2019 2 comments
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Fact SheetHealth SystemsNational Plan, Policy & GuidelinesPublic HealthPublic Health UpdateReportsResearch & Publication

Department of Health Services (DoHS) Annual Report 2074/75 (2017/18)

by Public Health Update July 2, 2019
written by Public Health Update

Department of Health Services (DoHS) Annual Report 2074/75 (2017/18)

The annual report of the Department of Health Services (DoHS) for fiscal year 2074/75 (2017/18) is the twenty-fourth consecutive report of its kind. This report focuses on the objectives, targets and strategies adopted by Nepal’s health programmes and analyses their major achievements and highlights trends in service coverage over three fiscal years. This report also identifies issues, problems and constraints and suggests actions to be taken by health institutions for further improvements.

The main institutions that delivered basic health services in 2074/75 were the 125 public hospitals including other ministries, and 1,822 non-public health facilities, the 198 primary health care centres (PHCCs) and the 3,808 health posts. Primary health care services were also provided by 11,974 primary health care outreach clinic (PHCORC) sites. A total of 15,835 Expanded Programme of Immunization (EPI) clinics provided immunization services. These services were supported by 51,420 female community health volunteers (FCHV). The information on the achievements of the public health system, NGOs, INGOs and private health facilities were collected by DoHS’s Health Management Information System (HMIS).

DoHS, Annual Report 

DOWNLOAD: DoHS, Annual Report 

DOWNLOAD: DoHS, Annual Report 


National Annual Review, MoHP – 2017/18 (Presentation Slides)

Health Sector Progress Report 2018, Ministry of Health & Population

Glimpse of Annual Report Department of Health Services 2073/74 (2016/17)

Annual report of the Department of Health Services (DoHS) 2073/74 (2016/2017)

Annual Report Department of Health Services 2072/73 (2015/2016)

Annual Report of the Department of Health Services (DoHS) – 2071/72 (2014/2015)

Annual Report of DOHS 2070/71 (2013/2014)

Annual Report of DoHS 2069/2070 (2012-2013)

July 2, 2019 0 comments
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Implementation ResearchInternational Plan, Policy & GuidelinesNeglected Tropical Diseases (NTDs)Public Health

Training course on ethics in implementation research

by Public Health Update June 28, 2019
written by Public Health Update

Training course on ethics in implementation research

TDR and WHO’s Global Health Ethics team have jointly developed a training course for researchers and research ethics committees on the important ethical considerations in implementation research (IR). The course comprises six interactive modules interspersed with activities including case studies, role-play and quizzes:

Module 1: Introduction to IR
Module 2: Ethical considerations in IR

Module 3: Ethical issues in planning IR
Module 4: Ethical issues in conducting IR
Module 5: Ethical issues post-IR
Module 6: In-depth ethical analysis of IR using case studies

Downloads

Facilitator’s guide

Participant’s guide

June 28, 2019 0 comments
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Implementation ResearchNeglected Tropical Diseases (NTDs)Public Health

WHO TDR Update: Ensuring ethical conduct of implementation research

by Public Health Update June 28, 2019
written by Public Health Update

Ensuring ethical conduct of implementation research 

Today (28 June 2019), TDR and WHO launched a new training course on ethics in implementation research to ensure appropriate engagement with research subjects and relevant communities and to safeguard against any potential harm.

The challenge

Implementation research (IR) contributes to understanding and addressing barriers to implementation and scale-up of effective and quality health interventions, strategies and policies. IR is thus essential for accelerating progress toward universal health coverage. TDR undertakes a range of activities aiming to strengthen IR capacity in low- and middle-income countries, including the development of training tools such as the IR Toolkit.

As with all research involving human subjects, IR protocols must be reviewed by research ethics committees. However, given the “real life” context of IR, it is important that researchers and research ethics committees are familiar with the specific ethical issues of IR. The need was therefore identified to develop guidance for researchers and research ethics committees on the ethical implications of IR.

The solution

TDR and WHO’s Global Health Ethics team, both part of WHO’s new Science Division, have jointly developed a training course for researchers and research ethics committees on the important ethical considerations in IR. The course comprises six interactive modules interspersed with activities including country case studies, role-play and quizzes.

“This training course meets an important need to address ethical considerations in implementation research conducted in real-life settings,” said WHO Chief Scientist Soumya Swaminathan. “TDR and WHO will facilitate country-led train-the-trainer workshops to help disseminate this training course.”

The training course is being launched at the Global Conference on Implementation Science and Scale-Up, which is co-hosted by the Centre of Excellence for Science of Implementation and Scale-up (CoE-SISU), BRAC James P Grant School of Public Health at BRAC University and UNICEF Bangladesh, and co-sponsored by TDR.

Key ethical questions to consider when planning a study include:

  • Does the study address a priority concern of the community?
  • Who are the stakeholders in this study?
  • How should community or stakeholder engagement occur?
  • Who should represent the community in determining participation in the study?
  • Should informed consent be obtained? If yes, from whom?
  • Who are the research subjects?
  • Who will own the data?
  • How will privacy and confidentiality of data collected electronically be assured?
  • Are there potential harms associated with the intervention? If so, for whom?
  • Who stands to benefit from the study?

The Regional Training Centres supported by TDR (one in each of the six WHO regions) will help disseminate this new ethics training course (along with other implementation research training materials) and facilitate train-the-trainer workshops.

“We are proud to launch this new training course that adds to our growing suite of implementation research training materials, including the IR Toolkit and Massive Open Online Course on IR,” said TDR Director John Reeder.

For more information on all of our research capacity strengthening activities and resources, please visit: https://www.who.int/tdr/capacity/strengthening/en/.

PRESS RELEASE 

Training course on ethics in implementation research



TDR Global Crowdfunding Contest

Call for Applications! TDR Postgraduate Scholarships – BRAC University

June 28, 2019 0 comments
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Communicable DiseasesGlobal Health NewsPublic HealthPublic Health NewsPublic Health Update

UNAIDS and UNDP call on 48 countries and territories to remove all HIV-related travel restrictions

by Public Health Update June 27, 2019
written by Public Health Update

UNAIDS and UNDP call on 48 countries and territories to remove all HIV-related travel restrictions

GENEVA, 27 June 2019—UNAIDS and the United Nations Development Programme (UNDP) are urging countries to keep the promises made in the 2016 United Nations Political Declaration on Ending AIDS to remove all forms of HIV-related travel restrictions. Travel restrictions based on real or perceived HIV status are discriminatory, prevent people from accessing HIV services and propagate stigma and discrimination. Since 2015, four countries have taken steps to lift their HIV-related travel restrictions—Belarus, Lithuania, the Republic of Korea and Uzbekistan.

“Travel restrictions on the basis of HIV status violate human rights and are not effective in achieving the public health goal of preventing HIV transmission,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “UNAIDS calls on all countries that still have HIV-related travel restrictions to remove them.”

“HIV-related travel restrictions fuel exclusion and intolerance by fostering the dangerous and false idea that people on the move spread disease,” said Mandeep Dhaliwal, Director of UNDP’s HIV, Health and Development Group. “The 2018 Supplement of the Global Commission on HIV and the Law was unequivocal in its findings that these policies are counterproductive to effective AIDS responses.”

Out of the 48 countries and territories that maintain restrictions, at least 30 still impose bans on entry or stay and residence based on HIV status and 19 deport non-nationals on the grounds of their HIV status. Other countries and territories may require an HIV test or diagnosis as a requirement for a study, work or entry visa. The majority of countries that retain travel restrictions are in the Middle East and North Africa, but many countries in Asia and the Pacific and eastern Europe and central Asia also impose restrictions.

“HIV-related travel restrictions violate human rights and stimulate stigma and discrimination. They do not decrease the transmission of HIV and are based on moralistic notions of people living with HIV and key populations. It is truly incomprehensible that HIV-related entry and residency restrictions still exist,” said Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The Human Rights Council, meeting in Geneva, Switzerland, this week for its 41st session, has consistently drawn the attention of the international community to, and raised awareness on, the importance of promoting human rights in the response to HIV, most recently in its 5 July 2018 resolution on human rights in the context of HIV.

“Policies requiring compulsory tests for HIV to impose travel restrictions are not based on scientific evidence, are harmful to the enjoyment of human rights and perpetuate discrimination and stigma,” said Dainius Pūras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of health. “They are a direct barrier to accessing health care and therefore ineffective in terms of public health. I call on states to abolish discriminatory policies that require mandatory testing and impose travel restrictions based on HIV status.”

The new data compiled by UNAIDS include for the first time an analysis of the kinds of travel restrictions imposed by countries and territories and include cases in which people are forced to take a test to renew a residency permit. The data were validated with Member States through their permanent missions to the United Nations.

UNAIDS and UNDP, as the convenor of the Joint Programme’s work on human rights, stigma and discrimination, are continuing to work with partners, governments and civil society organizations to change all laws that restrict travel based on HIV status as part of the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination [hyperlink]. This is a partnership of United Nations Member States, United Nations entities, civil society and the private and academic sectors for catalysing efforts in countries to implement and scale up programmes and improve shared responsibility and accountability for ending HIV-related stigma and discrimination.

The 48 countries and territories that still have some form of HIV related travel restriction are: Angola, Aruba, Australia, Azerbaijan, Bahrain, Belize, Bosnia and Herzegovina, Brunei Darussalam, Cayman Islands, Cook Islands, Cuba, Dominican Republic, Egypt, Indonesia, Iraq, Israel, Jordan, Kazakhstan, Kuwait, Kyrgyzstan, Lebanon, Malaysia, Maldives, Marshall Islands, Mauritius, New Zealand, Oman, Palau, Papua New Guinea, Paraguay, Qatar, Russian Federation, Saint Kitts and Nevis, Samoa, Saudi Arabia, Saint Vincent and the Grenadines, Singapore, Solomon Islands, Sudan, Syrian Arab Republic, Tonga, Tunisia, Turkmenistan, Turks and Caicos, Tuvalu, Ukraine, United Arab Emirates and Yemen.

P R E S S   R E L E A S E


TDR Global Crowdfunding Contest

High Level Meeting and Workshop on Snakebite in Nepal

Global Vaccination Summit 2019

June 27, 2019 0 comments
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ConferencePublic Health Events

Global Vaccination Summit 2019

by Public Health Update June 26, 2019
written by Public Health Update

Global Vaccination Summit 2019

The European Commission organises, in cooperation with the World Health Organisation, a Global Vaccination Summit on 12 September 2019, in Brussels.

The event takes place under the joint auspices of the European Commission President Jean Claude Juncker and WHO Director General Tedros Adhanom Ghebreyesus. The overall objective is to give high level visibility and political endorsement to the topic of vaccination and issue a statement to endorse and promote the benefits of vaccination as the most successful public health measure that saves millions of lives every year. It will demonstrate EU leadership for global commitment to vaccination, boost political commitment towards eliminating vaccine preventable diseases and engage political leaders and leaders from scientific, medical, industry, philanthropic and civil society.

The event will be structured around the following three round tables:

  • Roundtable 1: In Vaccines We Trust
    Stepping up action to increase vaccine confidence
  • Roundtable 2: The Magic of Science
    Boosting vaccine research, Development, and Innovation
  • Roundtable 3: Vaccines protecting everyone, everywhere
    Galvanizing global vaccination response – leaving no one behind and towards elimination of vaccine preventable infections

A Summit Declaration making reference to key principles, actions and goals on vaccination will be adopted at the end of the event.

Participants

The Summit will bring together around 400 participants from around the globe, including high-level political decision makers, health ministers, UN organisations, NGOs, academia representatives, renowned researchers and healthcare professionals, vaccine industry CEOs, celebrities and social media influencers who actively support vaccination.

Participation is upon invitation only.

MORE INFO

June 26, 2019 0 comments
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Antimicrobial Resistance (AMR)ConferenceHumanitarian Health & Emergency ResponseNeglected Tropical Diseases (NTDs)Public HealthPublic Health Events

Sydney Statement on Global Health Security

by Public Health Update June 22, 2019
written by Public Health Update

Sydney Statement on Global Health Security

In June 2019, over 800 members of the global health security community gathered in Sydney, Australia, to participate in the first International Scientific Conference on Global Health Security. Participants came from over 65 countries, representing academia, local, national and international governmental and non-governmental organizations, public and animal health and security professionals, and the private sector, all committed to advancing global health security. As a product of this conference, we present “The Sydney Statement on Global Health Security.”

Global health security is a state of freedom from the scourge of infectious disease, irrespective of origin or source. It is achieved through the policies, programmes, and activities taken to prevent, detect, respond to, and recover from biological threats. There are numerous challenges that pose significant risk to global health security, including a wide array of pathogens that present an existing and ongoing threat to both individual and collective health, antimicrobial resistance (AMR) and the emergence of currently untreatable infections, the potential for deliberate use of a biological weapon, and the synthesis of eradicated or novel pathogens. The complexity of addressing these challenges is amplified by a multitude of contextual factors. These threats know no borders and have global consequences requiring more effective collective action.

Addressing global health security threats should be guided by the following set of principles:

  • Global health security interventions must strive to be inclusive, equitable, and data driven.
  • A minimum level of disease prevention, detection, and response capabilities are critical for all countries, as epidemics anywhere threaten the health of everyone. Achieving global health security is also intricately linked with efforts to achieve universal health coverage, efforts to strengthen other vital aspects of broader health and security systems, and the Sustainable Development Goals.
  • Governments must cooperate programmatically, organizationally and financially to foster compliance with the International Health Regulations and other associated legal and regulatory agreements to ensure effective global governance of public health emergencies, and in so doing, encourage international organisations and NGOs to maintain the integrity of international norms, respect for human rights, and social justice. Transparent discussion, sharing, and measurement of global health security capacities is vital for achieving this goal.
  • Achieving global health security requires individual, group, and systems decision making and activities that strengthens capacity across all levels of societal interaction and disciplines. Making the world a healthier, more equitable, and safer place requires action and engagement from all, including the philanthropic, public and the private sector.
  • Global health security must embrace a One Health approach, not only to prevent and respond to disease, but also to protect ecosystems that underpin human, animal, and environmental health. All relevant sectors must be meaningfully involved and engaged, including health, agriculture, environmental, security, and other vital components.
  • Countries with higher capacity to respond to adverse public health events have a moral and ethical duty to work in partnership with those with lower capacity to strengthen their capabilities in a sustainable manner.
  • International partners and national governments must commit to sustainable, comprehensive funding mechanisms to support global health security. Long-term strategic thinking for global health security must be supported by a diverse, inclusive community of practice, committed to providing the best evidence possible to inform transparent decision making. Achieving global health security requires commitment to the above principles, and the institutional arrangements that advance them globally, to reduce infectious disease threats, including local empowerment, capacity building, data and benefits sharing, transparency, and accountability. Stronger health systems, Universal Health Coverage, and Health-In-All-Policies, from the local to the global levels are all dependent upon and supportive of global health security.

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Global Health Security Conference 2019

June 22, 2019 0 comments
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Maternal, Newborn and Child HealthNational Plan, Policy & GuidelinesResearch & Publication

15th Five Year Development Plan (2019/20-2023/24) of Government of Nepal

by Public Health Update June 14, 2019
written by Public Health Update

15th Five Year Development Plan (2019/20-2023/24) of Government of Nepal

Sector: Health and Nutrition

(Unofficial translation by Pratik Khanal, Public Health Professional)


Background

The Constitution of Nepal 2015 has ensured every citizen the provision of basic health services from the state as fundamental right. By taking into note the importance of healthy and productive citizens in national development. It is the state’s responsibility to ensure quality and equitable access to universal health care by increasing investment in health sector. In notion of fair and inclusive state, it is a necessity to transform health sector from profit oriented to service oriented sector. As per the constitution’s sole and shared right, the responsibility of health has been given to federal, provincial and local level government with the activities including health policy, guideline development, quality assurance, monitoring, conventional medicine, control of communicable diseases placed in the jurisdiction of the federal government. For its effective implementation, inter-ministerial coordination and collaboration is a necessity.

As a result of implementation of different health service related programs, infant mortality, neonatal mortality and under-five mortality has been reduced to 32, 21 and 39 per 1000 live births while maternal mortality has been reduced to 239 per 100,000 live births and total fertility rate is 2.3. Likewise, stunting among under-five children has decreased to 36%. In this context, the national action plan is to achieve Sustainable Development Goals (SDGs) taking into account the different international commitments made by Nepal, existing policies of Government of Nepal as well as main problems, challenges and opportunities of health and nutrition sector. It has been felt necessary to increase investment in modern medicine, Ayurvedic, Natural and Homeopathic Medicine, health governance and research for making population healthy. In this plan, state will play the lead role to provide health services to people’s door steps while private and cooperative sector will play complementary role.

Main Problems

  • Lack of fulfillment of people’s expectation of access to quality and uniform health services
  • Inadequate development of service oriented and public health responsible health services and human resources
  • The return of investment in health sector was poor
  • Lack of adequate modern equipment and specialist doctors in public sector health facilities
  • Communicable and Non-communicable diseases
  • Malnutrition
  • Accident and disaster related health consequences
  • Changes in lifestyle and food behavior due to globalization leading to increase in Non-communicable diseases
  • Increase in mental health problems
  • Inconsistency in health workforce product and utilization
  • Climate change
  • Increasing food insecurity
  • Natural disasters leading to humanitarian problems
  • Anti-microbial resistance (AMR)
  • Low decline rate of MMR
  • Under-nutrition among more than one-third of under-five children and reproductive aged women
  • Ineffective regulation and coordination for private sector’s participation in community based health services

Opportunities and Challenges

Challenges

  • Establishing equitable access to all sectors of health
  • Delivery of free and quality basic health services in all local level governments with universal access
  • Provision of health services with focus on ultra-poor and vulnerable population
  • Decreasing out of pocket expenditure
  • Ensuring availability and adequate source of health financing
  • Management of health facilities in federal system
  • Effective implementation of health insurance
  • Gradual transformation of profit oriented health sector to service oriented sector.
  • Management of socially responsible and qualified skill mix health workforce
  • Self-reliance in production of drugs
  • Addressing health problems resulting from climate change, rampant urbanization and unhealthy lifestyle
  • Effective management and regulation of drugs and medical equipments
  • Management of integrated and technology friendly health information system to fulfill the health information needs of all levels and increased use of data in monitoring, evaluation, review, policy formation and decision making process.
  • Development of mechanism to record cause of deaths
  • Regular research
  • Maintaining governance in health and nutrition sector through quality assurance and regulation of health services.

Opportunities

  • Sharing responsibility on health service related constitutional rights among federal, provincial and local level governments.
  • Implementation of health insurance based on policy and legal provision.
  • Increasing investment in health sector from provincial and local level governments through their own funding source
  • Increasing civic sense on health as well as development of infrastructure
  • Expansion of health networks to community level
  • Focus of existing health policy and programs on management and quality of health services
  • Evidence being prioritized by all levels of government in policy formulation and decision making process.

Vision, Goal, Objectives and Action Plan

Vision

Healthy, productive, responsible and happy citizens

Goal

To ensure access to quality health services at the population level by strengthening and expanding health system at all levels.

Objectives

  • Develop and expand all types of health services equitably in central, province and local level.
  • Enhance the government’s responsibility and effective regulation for ensuring accessible and quality health services; transform health sector from pro-profit to service sector.
  • Increase access to and utilization of health services through multi-sectoral coordination and collaboration; make service providers and service users more responsible and promote healthy lifestyle.

Strategy and action plan

1. Ensuring access to quality basic and specialized health services
Action Plan

  1. Necessary package and protocol will be developed and implemented for universal access to free basic health services.
  2. Utilize telemedicine and modern technology in health sector; develop and implement guideline for mobile health program in coordination with private and development sector to expand access of health services to rural population.
  3. Community based rehabilitation centers will be established in all levels.
  4. Based on disease burden and effectiveness, immunization services will be provided and immunization fund will be strengthened for making immunization services sustainable.
  5. Promotional programs will be conducted for improving relation between service providers and service users.
  6. Adequate budget will be ensured for effective implementation of Nepal Health Infrastructure Development Protocol and Minimum Service Protocol for improving quality of health services at all levels of health facility.

2. Develop and expand Ayurvedic, natural medicine and other complementary medicines in a planned way.

Action Plan

  1. Institutional mechanism will be developed for identification, collection, preservation and promotion of locally available medicinal herbs and minerals.
  2. Health tourism will be promoted by establishing service center for Ayurveda and other complementary medicine at national level.

3. Address health needs of population of all age groups based on life cycle approach with more focus on maternal and child health, adolescent health and family management services.

Action Plan

  1. Services related to maternal and neonatal health; child health and adolescent health; and family management services will be further strengthened and expanded.
  2. Health services will be made gender, elderly and disabled friendly.
  3. Provision will be done for screening and diagnosis facilities for timely identification of health risks.
  4. Provision will be made for free screening and diagnosis of diseases like breast cancer and cervical cancer.
  5. Evidence based midwifery education and services as well as special programs will be developed and implemented for reduction of maternal mortality. 

4. Develop and expand health facilities based on population distribution and geography; and build technically sound and social responsible health workforce

Action Plan

  1. At least one basic health service center in each ward; primary hospital in each municipality; secondary level hospital, specialized hospital and one health science academy in province level and super-specialty hospitals in central level will be established.
  2. Expanded health services will be implemented in public sector hospitals with additional services to increase access to services and implement ‘One doctor/health worker-One health facility’ approach.
  3. A master plan will be developed for effective management of health workforce and health institutions.
  4. Scholarship will be provided for study in different health science disciplines based on country’s health needs.

5. Increase government financing in health and build sustainable health financing system.

Action Plan

  1. Integrated national health financing strategy will be developed and implemented.
  2. Basic health services will be provided free of cost; health insurance will be implemented for covering treatment of specialized and other health services.

6. Management and regulation of cooperation and collaboration between public-private and non-government sector.

Action Plan

  1. One school-one health worker’ policy will be implemented in coordination with education sector.
  2. Umbrella structure of health related professional councils will be developed by strengthening its workforce, organogram and working area.
  3. Integrated act will be developed for management of health science academies.
  4. Guideline will be developed for coordination with private, community and non-government health institutions.
  5. Clinical governance will be maintained by incorporating public, private, community and cooperative sector. Regulation of health care cost will be done by developing specific guideline.
  6. Regulatory mechanism will be developed and province and local government will be made responsible for management of health care waste.

7. Regulation of production, import, storage, distribution and utilization of medical equipments, drugs and supplies.

Action Plan

  1. Self-reliance in production of drugs will be built.
  2. Promotion of farming of medical herbs and development of medical industries will be done along with effective production, storage and distribution of medical goods.
  3. Regulatory mechanism will be developed to address antibiotic resistance; implement generic prescribing, set price of drugs and quality control measures and for drug research.

8. Implement integrated measures for control of communicable and non-communicable diseases as well as for disaster preparedness and response.

Action Plan

  1. Integrated institutional mechanism will be developed for prevention, control, elimination, monitoring, surveillance and research of communicable and non-communicable diseases.
  2. Long term plan will be developed through multi-sectoral coordination for effective implementation of prevention, control and treatment services of non-communicable and chronic diseases.
  3. Control and treatment programs will be developed based on research for addressing sickle cell anemia, Thalassemia and other genetic diseases.
  4. Access to mental health services will be expanded at all levels.
  5. Health care services related to eye, ear, nose, throat and oral health will be gradually developed and implemented in central, province and local level.
  6. Guideline for rapid response to disaster, improvement of ambulance services and mobilization of skilled health workers will be developed and implemented.

9. Increase use of evidence based decision making by strengthening health information system.

Action Plan

  1. Use of evidence in decision making at all levels will be promoted through quality and user-friendly data management approach.
  2. Data management will be made technology friendly at health facility level for electronic reporting and electronic health record will be gradually expanded in all health facilities.
  3. A system for integrating locally generated health data with national portal will be developed.
  4. Survey, research and studies will be done based on national health needs and priorities and the evidence generated will be used in policy making and designing programs.

10. Expand working area of Nepal health Research Council to province level.

Action Plan

  1. Institutional arrangement of NHRC will be established in province level in coordination with academic sectors.

11. Develop measures to prevent and manage the public health threats of imported cases.

Action Plan

  1. Management information system will be developed for responding threat of imported infectious cases; and policy and institutional measures will be formulated for providing screening and health care services.

12. Effective implementation of multi-sectoral nutrition plan through coordination and collaboration.

Action Plan

  1. Nutrition related mechanisms and nutrition sensitive and nutrition focused programs will be implemented from all health facility levels.
  2. Access to and utilization of quality and healthy foods will be improved and promotion of healthy food behaviors for reducing malnutrition will be done.

13. Incorporate health in all policies through multi-sectoral coordination.

Action Plan

  1. ‘One Health Approach’ will be implemented by incorporating health in all policies through multi-sectoral approach.
  2. Control and regulation of tobacco and alcohol use, chemicals and unhealthy foods will be done; scientific and effective health messages will be developed to reduce the use of health harming processed foods.
  3. Advocacy and coordination will be done with stakeholders to promote healthy food behavior, physical activity and clean environment.
  4. Mechanism will be developed in central, province and local level for public health impact assessment before the approval of industries, project or any other services.

Expected outcomes

  • At the end of the five year plan, life expectancy of Nepalese population will increase to 72 years.
  • Maternal mortality will be reduced from 239 to 99 per 100,000 live births; neonatal mortality will be reduced from 21 to 14 per 1000 live births and under-five mortality will be reduced from 39 to 24 per 1000 births.
  • Prevalence of under-weight among under-five children will be reduced from current 27% to 15 % while stunting will be reduced from 36% to 20%.
  • Nepalese population will receive basic health services free of cost.
  • Population coverage in health insurance will increase to 60%; Out of pocket payment will be reduced from 55% to 40% and government investment in health sector will increase from 4% to 8%
  • Proportion of population residing within 30 minutes of distance to health facility will be 80%.
  • The proportion of women attending at least four Antenatal check-up will increase from 69% to 81%, delivery attended by skilled birth attendant will increase from 58% to 79% and children receiving full immunization services will increase from 78% to 95%.
  • Malaria, Kala Azar and Lymphatic filariasis will be eliminated from Nepal.

DOWNLOAD PDF FILE (Unofficial translation)

15th Five Year Development Plan (2019/20-2023/24)

June 14, 2019 0 comments
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PH Important DayPublic Health

World Blood Donor Day 2019: Safe Blood for all!

by Public Health Update June 14, 2019
written by Public Health Update

World Blood Donor Day 2019: Safe Blood for all!

World Blood Donor Day is celebrated around the world on 14 June. The theme of this year’s campaign is blood donation and universal access to safe blood transfusion, as a component of achieving universal health coverage. The slogan is “Safe blood for all” to raise awareness of the universal need for safe blood in the delivery of health care and the crucial roles that voluntary donations play in achieving the goal of universal health coverage. 

The theme strongly encourages more people all over the world to become blood donors and donate blood regularly – actions which are key to building a strong foundation of sustainable national blood supplies that are sufficient to meeting the needs of all patients requiring transfusion.

The objectives of this year’s campaign are:

  • to celebrate and thank individuals who donate blood and to encourage those who have not yet donated blood to start donating;
  • to highlight the need for committed, year-round blood donation, to maintain adequate supplies and achieve universal and timely access to safe blood transfusion;
  • to focus attention on donor health and the quality of donor care as critical factors in building donor commitment and a willingness to donate regularly;
  • to demonstrate the need for universal access to safe blood transfusion and provide advocacy on its role in the provision of effective health care and in achieving the goal of universal health coverage;
  • to mobilize support at national, regional and global levels among governments and development partners to invest in, strengthen and sustain national blood programmes.

National Blood Transfusion Policy-2071

Screen Shot 2019 06 14 at 08.03.37

KEY MESSAGE

  • The world needs enough safe blood for everyone in need.
  • Every few seconds, someone, somewhere, needs blood.
  • Transfusions of blood and blood products save millions of lives every year.
  • Health is a human right; everyone in the world should have access to safe blood transfusions, when and where they need them.
  • Regular blood donations are needed all over the world to ensure individuals and communities have access to safe and quality-assured blood and blood products.
  • Everyone who can donate blood should consider making regular voluntary, unpaid donations, so that all countries have adequate blood supplies.
  • Ensuring the safety and well-being of blood donors is critical; it helps build commitment to regular donations.
  • Access to safe blood and blood product is essential for universal health coverage and a key component of effective health systems.
  • Blood and blood products are essential to care for:
    • women with pregnancy and childbirth associated bleeding;
    • children with severe anaemia due to malaria and malnutrition;
    • patients with blood and bone marrow disorders, inherited disorders of haemoglobin and immune deficiency conditions;
    • people with traumatic injuries in emergencies, disasters and accidents; and
    • patients undergoing advanced medical and surgical procedures.

     

  • The need for blood and blood products is universal, but access to safe blood and blood products varies greatly across and within countries.
  • In many countries, it is challenging for blood services to make sufficient blood and blood products available, while also ensuring its quality and safety.
  • Governments, national health authorities and national blood services must work together to:
    • ensure systems and infrastructure are in place to increase collection of blood from voluntary, regular unpaid donors;
    • establish and strengthen quality assurance systems for blood and blood products to ensure safe blood and blood products;
    • provide quality donor care;
    • promote and implement appropriate clinical use of blood; and
    • oversee the whole chain of blood transfusion.

cap

poster 4

MORE INFORMATION: WHO


Blood Connects us All – World Blood Donor Day

National Blood Transfusion Policy-2071

What can you do? Give blood. Give now. Give often – World Blood Donor Day, 14 June 2017

“Thank you for saving my life”- World Blood Donor Day, 14 June 2015

June 14, 2019 0 comments
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Communicable DiseasesNational Health NewsPublic HealthPublic Health NewsPublic Health Update

Dissemination of Findings and Recommendations of Joint External Monitoring Mission(JEMM) of Nepal National Tuberculosis Program

by Public Health Update June 9, 2019
written by Public Health Update

Dissemination of Findings and Recommendations of Joint External Monitoring Mission(JEMM) of Nepal National Tuberculosis Program

Joint External Monitoring Mission (JEMM) is conducted every five years to assess the impact of the National Tuberculosis (TB) Control Programme on the TB epidemic in the country; evaluate progress of the national strategic plans; and provide clear, strategic, prioritized recommendations. The last JEMM for Nepal was conducted in 2013.

To meet the milestones of End TB Strategy and address issues of TB control in Nepal, it will require implementing bold policies that guarantee access to high-quality TB care and prevention to all who need it. This is also part of Universal Health Care agenda which Nepal is pursuing with dedication.

Achievements

Nepal has successfully established a nationwide National TB Programme (NTP) headed by the National Tuberculosis Centre (NTC) and has notified and treated more than 32,000 cases annually for the last 10 years. The NTP has delivered nation-wide comprehensive services for management of drug sensitive TB patients and recently has rolled out a life-saving care system for multi-drug resistant TB (MDR-TB) cases. Effective collaboration with the National Centre for AIDS and STD Control (NCASC) has ensured that most TB patients receive HIV screening, and now, 94% of HIV-infected TB patients receive anti-retroviral treatment (ART).

NTP has introduced modern rapid diagnostic technology (GeneXpert), new TB drugs and new regimens for treatment of MDR-TB, an electronic reporting system now in 46 districts, started a collaboration with the private sector to ensure proper management of patients attending there, and begun a programme to find and treat children with TB. Treatment success had been maintained over 90% over last many years which is excellent.

RELATED:National Tuberculosis Programme Annual Report 2018

Opportunities

As Nepal is transitioning towards federalization, there are opportunities that can be addressed and harnessed to ensure that quality TB services are essential part of border health service delivery agenda. Nepal will need to address persistent health system issues and significantly increase investments in TB from both the domestic and external funding sources to meet the End TB Targets.

Despite consistent programme efforts, the case notification is static around 32,000 for past the 5 years, and 13,000 cases are missed each year.

Sustainability of essential TB functions in the federal context is a huge challenge if stakeholders fail to invest in human and financial resources on time.

There is a need to hugely expand the newer diagnostic tools of TB. People who are diagnosed are not always reported and followed up until end of the treatment. Patients spend huge amount of money in diagnosis and treatment, and lose wages while they are sick. Hence, this disease can drive families to poverty.

Together with all the other UN member states, Nepal has committed to end TB by 2035 at the regional and global high-level forum, and undertook to follow the WHO End TB Strategy. 

Nepal will accelerate TB response and increase investment in TB and reach the End TB targets by 2035.

Major high level Recommendations

  • Stop the collapse of the NTP by addressing the impact of health system weakness and federalization.
  • The MoHP and partners must significantly increase it’s investment in TB control and fully fund the NSP, 2016-2021.
  • To fill the training gap, the MoHP and partners must develop a fully-funded training plan, to be implemented with the aid of the staff.
  • The NTP should ensure that all presumptive cases are tested with GeneXpert. Sputum smear diagnostic should be phased out.
  • The NTP should be open to collaboration with essential stakeholders.

Additional Information

Improving TB services will not only cure people from TB but will be able to generate economy for the country and reduce poverty. TB has one of the highest return on investments, and as per economists, every dollar invested in TB has USD 43 in return. Hence, it is very much worth investing in TB.

TB is the 7th leading cause of death in Nepal, and causes nearly 5,000 – 9,000 deaths every year.

Males are reported nearly 1.6 times more than female of developing TB and children accounts for 6% of the cases.

Each day:

  • 123 new TB cases are reported. Additionally, 27 % (i.e 34 TB cases) which also develops TB, is missed to be reported into the program. They are either not diagnosed, or not reported even if diagnosed.
  • 18 deaths are attributed to TB.
  • 34 new cases develop.

Despite the challenges, once diagnosed, the success rates of TB treatment through the program is more than 90%.

Most of the cases being reported are from Terai region (around 57%) among eco terrain, and from Province 3 (nearly 1/4 of cases) among all provinces.

unnamed 1

Closing Remarks by Mr. Upendra Yadav Chief Guest Hon. Deputy Prime Minister and Minister for Health and Population

Closing Remarks by Mr. Upendra Yadav Chief Guest Hon. Deputy Prime Minister and Minister for Health and Population


For more information, please contact: National Tuberculosis Centre


National Tuberculosis Programme Annual Report 2018

Tuberculosis is the top infectious disease killer in the world

National Strategic Plan for Tuberculosis Prevention, Care and Control 2016 – 2021

New global commitment to end tuberculosis

WHO report signals urgent need for greater political commitment to end tuberculosis

National Tuberculosis Programme, NEPAL

World Tuberculosis Day Observed with theme “It’s Time”

World Tuberculosis Day 2019 – It’s time ! ”Find Treat All #EndTB”

Building a tuberculosis-free world: The Lancet Commission on tuberculosis

Global Tuberculosis Report 2018

Trainee (Health Programme) – Terre des hommes Foundation

June 9, 2019 0 comments
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