Astana Declaration on Primary Health Care 2018
Kathmandu Declaration on: National Conference on Family Planning 2075
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World Health Day 2019 (April 7, Sunday) falls midway between the 2018 Global Conference on Primary Health Care in Astana – where countries including Nepal committed to strengthen Primary Health Care (PHC) as essential step towards Universal Health Coverage (UHC) – and the UN General Assembly high-level meeting on UHC, to be held in New York in September 2019. The Day is one of many opportunities to communicate about the importance of equity in health-care services, not only for the health of individuals, but also for the health of community and society at large.
World Health Day 2019 activities
On the Day, people from all walks of life will be invited to reflect, draw, and sign on the theme of World Health Day – Primary Health Care – at the premises of Kathmandu Durbar Square. Via the interactive art program, organized by National Health Education, Information and Communication Centre (NHEICC) under Department of Health Services (DoHS), Ministry of Health and Population (MoHP) and World Health Organization (WHO) – Country Office Nepal, the common public will become more aware on the concept of UHC and PHC.
UHC means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care. It does not only mean free health coverage, but rather enabling everyone to access the services that address the most significant causes of disease and death and ensures that the quality of those services is good enough to improve the health of the people who receive them. A key to attain this goal is through strengthening PHC.
World Health Day 2019 activities
PHC with basic health services can cover majority of a person’s health needs throughout their lives. It addresses the broader determinants of health and focuses on comprehensive and interrelated aspects of physical, mental, and social health and wellbeing. A fit-for-purpose workforce is essential to deliver PHC, and the world has an estimated shortfall of 18 million health workers. Of the 30 countries for which data are available, only 8 spend at least US$ 40 per person on PHC per year.
PHC is crucial to attain UHC, and hence, at the program, the common public, health professionals, and policymakers will sign on agreeing to take care of their health, recognizing that everyone has a responsibility towards achieving good health.
World Health Day 2019 activities
The program will be concluded by handing over the final signatures and artwork – showcasing that we are ready for UHC and understand the important of PHC – to dignitaries from MoHP. Citizens, health professionals, dignitaries from MoHP, media, various organizations, and WHO Country Office for Nepal, will also hold hands to form a human chain around the canvases, taking responsibility towards UHC and leaving no one behind.
More Information
Sujan G. Amatya
Communications Officer
UN House, Pulchowk | P.O Box: 108 | Lalitpur | Kathmandu | Nepal
Tel. +977-1-5523200
Mob. +977-9818239744
Email: samatya@who.int , Website: http://www.searo.who.int/nepal
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New Delhi, 5 April 2019: The World Health Organization today said quality healthcare services for people at the community level across all age groups, wherever they live and whenever they need them, without financial hardship, is fundamental to advancing universal health coverage for achieving health and well-being of everyone, everywhere.
“A well-functioning primary care system that meets most of a person’s health needs, throughout the life course, is central to universal health coverage,” said Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia, on World Health Day, celebrated every year on 7 April. The theme of the day this year is Universal Health Coverage, ‘Health for All: Everyone, Everywhere’.
Universal health coverage or UHC is WHO’s number one goal globally. In the WHO South-East Asia Region, UHC has been a flagship priority program since 2014. The Region has seen encouraging progress, with essential health service coverage improving in all countries, along with the availability of doctors, nurses and midwives. There is also growing inter-country collaboration to improve access to quality medicines through the South-East Asia Regulatory Network.
However, more needs to be done as, despite progress, around 800 million people still lack full coverage of essential health services and at least 65 million people are pushed into poverty because of health spending, most of which goes on medicines, Dr Khetrapal Singh said.
Identifying opportunities and areas where efforts are needed to advance UHC, the Regional Director said frontline services must adapt to emerging challenges – such as for continuing care for increasing numbers of people with noncommunicable diseases and health issues associated with ageing. Primary care services should lead in preventing and treating disease.
Frontline and hospital services should work together, to increase the use of primary care and decrease over-crowding in hospitals.
“As a large share of outpatient care is delivered by private providers and financed by out-of-pocket payment, we need new approaches to address the double challenge of protecting people from financial exploitation and poor-quality care, while harnessing the private sector’s extensive assets,” the Regional Director said.
Community and local government representatives are key allies in building healthy communities. Digital technologies could be better leveraged to empower people and communities to look after their own health.
In October 2018, at the Global Conference on Primary Health Care in Astana, countries from across the world agreed that providing quality primary health care was fundamental to advancing UHC. In September 2019, the UN General Assembly will hold a high-level meeting on UHC, where delivering more equitable access to primary health care will be core to the discussion to achieve ‘Health for All: everyone, everywhere’.
“Now more than ever, the Region can harness the momentum from these global processes and drive real impact where it matters most: in countries, and at the grassroots. Doing so is crucial to achieving health and well-being for all, at all ages,” the Regional Director said.
World Health Day : Health for all – everyone, everywhere
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Universal health coverage is WHO’s number one goal. Key to achieving it is ensuring that everyone can obtain the care they need, when they need it, right in the heart of the community. Progress is being made in countries in all regions of the world.
But millions of people still have no access at all to health care. Millions more are forced to choose between health care and other daily expenses such as food, clothing and even a home.
This is why WHO is focusing on universal health coverage for this year’s World Health Day, on 7 April.
World Health Day is a chance to celebrate health and remind world leaders that everyone should be able to access the health care they need, when and where they need it. Advocacy events will be held around the world to fuel the momentum of the #HealthForAll movement and to highlight our goal of achieving a fairer, healthier world – in which no one is left behind. The focus will be on equity and solidarity – on raising the bar for health for everyone, everywhere by addressing gaps in services, and leaving no one behind. The tagline for World Health Day is: Health for all – everyone, everywhere.
Universal health coverage means that all people have access to the quality health services they need, when and where they need them, without financial hardship. We believe this is possible and it starts with strong primary health care. Primary health care is a whole-of-society approach to health and wellbeing centred on the needs and preferences of individuals, families and communities. To make health for all a reality, governments need to invest in quality, accessible primary health care. Health workers need to care and advocate for patients and educate them on how to get and stay healthy. Individuals and communities need to be empowered to take care of their own health. Health is a human right. Together, we can make health for all a reality.
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Universal Health Coverage (UHC)
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Women outlive men everywhere in the world – particularly in wealthy countries. The World Health Statistics 2019 – disaggregated by sex for the first time – explains why.
“Breaking down data by age, sex and income group is vital for understanding who is being left behind and why,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“Behind every number in the World Health Statistics is a person, a family, a community or a nation. Our task is to use these data to make evidence-based policy decisions that move us closer to a healthier, safer, fairer world for everyone.”
The gap between men’s and women’s life expectancy is narrowest where women lack access to health services. In low-income countries, where services are scarcer, 1 in 41 women dies from a maternal cause, compared with 1 in 3300 in high-income countries. In more than 90 per cent of low-income countries, there are fewer than 4 nursing and midwifery personnel per 1000 people.
Attitudes to healthcare differ. Where men and women face the same disease, men often seek health care less than women. In countries with generalized HIV epidemics, for example, men are less likely than women to take an HIV test, less likely to access antiretroviral therapy and more likely to die of AIDS-related illnesses than women. Similarly, male TB patients appear to be less likely to seek care than female TB patients.
The report also highlights the difference in causes of death between men and women – some biological, some influenced by environmental and societal factors, and some impacted by availability of and uptake of health services.
Of the 40 leading causes of death, 33 causes contribute more to reduced life expectancy in men than in women. In 2016, the probability of a 30-year-old dying from a noncommunicable disease before 70 years of age was 44% higher in men than women.
Global suicide mortality rates were 75% higher in men than in women in 2016. Death rates from road injury are more than twice as high in men than in women from age 15, and mortality rates due to homicide are 4 times higher in men than in women.
Published to coincide with World Health Day on 7 April, which this year focuses on primary health care as the foundation of universal health coverage, the new WHO statistics highlight the need to improve access to primary health care worldwide and to increase uptake.
“One of WHO’s triple billion goals is for 1 billion more people to have universal health coverage by 2023,” said Dr. Tedros. “This means improving access to services, especially at community level, and making sure those services are accessible, affordable, and effective for everyone – regardless of their gender.”
“These statistics underscore the need to prioritize primary health care urgently to effectively manage noncommunicable diseases, and to curb risk factors.” said Dr. Samira Asma, WHO Assistant Director General for Data, Analytics and Delivery. “For example, something as simple as controlling blood pressure is just not happening on the scale needed and tobacco use remains a leading cause of premature death.”
Between 2000 and 2016, global life-expectancy at birth increased by 5.5 years, from 66.5 to 72.0 years. Healthy life expectancy at birth – the number of years one can expect to live in full health- increased from 58.5 years in 2000 to 63.3 years in 2016.
Life expectancy remains strongly affected by income. In low-income countries, life expectancy is 18.1 years lower than in high-income countries. One child in every 14 born in a low-income country will die before their fifth birthday.
For the first time, this year, WHO’s Global Health Statistics have been disaggregated by sex. This new analysis has provided insights into the health and needs of people around the world. But many countries still struggle to provide gender disaggregated information.
“Closing data gaps will accelerate and is important to closing the gender gap,” said Dr. Richard Cibulskis, the report’s main author. “Collecting, analyzing, and using good quality, disaggregated data is central to improving people’s health and wellbeing. Health policy and practice must be underpinned by robust and reliable data, generated in countries.”
4 April 2019, News release, Geneva
World Health Statistics 2019: Monitoring health for the SDGs
13th International Congress on AIDS in Asia & the Pacific
The World Health Statistics series is the World Health Organization’s (WHO’s) annual compilation of health statistics for its 194 Member States. The series is produced by WHO’s Division for Data, Analytics and Delivery, in collaboration with WHO technical departments and regional offices. World health statistics 2019 summarizes recent trends and levels in life expectancy and causes of death, and reports on the health and health-related Sustainable Development Goals (SDGs) and associated targets. Where possible, the 2019 report disaggregates data by WHO region, World Bank income group, and sex; it also discusses differences in health status and access to preventive and curative services, particularly in relation to differences between men and women.
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World health statistics 2017: Monitoring health for the SDGs, Sustainable Development Goals – WHO
World Health Statistics 2018: Monitoring health for the SDGs
New Delhi, 27 March 2019 – On March 27, WHO South-East Asia Region was certified polio-free, proving wrong many public health experts who believed that the Region, which accounts for one-fourth of the global population, would be the last bastion for polio eradication. Five years on, the Region not only continues to maintain its polio-free status but is demonstrating how the polio legacy can effectively strengthen overall immunization and other programs.
“Member countries, partners and the community themselves continue to work together to keep the crippling virus at bay. The polio program’s emphasis on innovation and reaching everyone, everywhere is being replicated by many other public health programs with impressive results,” said Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region.
The last case of wild poliovirus in the Region was reported from West Bengal, India, where a two-year old girl suffered polio paralysis on 13 January 2011. An intense response by Government of India supported by WHO, UNICEF, Rotary International and other partners ensured it remained the last case in WHO South-East Asia Region.
Post certification, these efforts continue. Every year, more than 32 million children across the Region are being reached with oral polio vaccines under routine immunization and through mass polio vaccination campaigns to maintain high population immunity against polio. In India, an additional 460 million doses of oral polio vaccines were given to children through four mass polio vaccination campaigns conducted in 2018.
As a part of the vigilance for polio in the Region, surveillance for polio continues to be further strengthened. More than 75 000 stool samples were tested in 16 poliovirus laboratories in the Region in 2018. Environmental surveillance for poliovirus detection has been expanded three-fold in the last five years. Samples are now collected for testing from 74 sites in India, Indonesia, Bangladesh, Nepal, Myanmar and Thailand. In 2014, environment surveillance was conducted only in India, from 23 sites.
While continuing to maintain a strict vigil against polio, the entire polio machinery in the Region is also geared towards strengthening routine immunization to further boost defense against polio as well as other vaccine preventable diseases. There has been a steady progress in immunization coverage of the basic vaccines provided in the first year of life. Nearly 88% children in the Region are receiving three doses of the basic vaccines before they achieve the age of one year. In seven of the 11 countries, this coverage is over 90%. All countries have introduced at least two new vaccines under their routine immunization program to protect children from vaccine preventable diseases.
Polio programme and its lessons are guiding efforts to eliminate measles and control rubella, a flagship priority programme in WHO South-East Asia Region.
The polio networks are also supporting countries to strengthen vaccine preventable disease surveillance.
“This day is a reminder of our momentous victory against polio, a reminder of our commitment to health of our children, and a reminder of our potential, of our determination to turn impossible into possible,” the Regional Director said.
WHO Nepal
UN House, Pulchowk | P.O Box: 108 | Lalitpur | Kathmandu | Nepal
Tel. +977-1-5523200
Website: http://www.searo.who.int/nepal
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Tuberculosis (TB) remains a major public problem in Nepal. In 2017/18, the total of 32,474 cases of TB were notified and registered at NTP. Among these, 98% (31,723) were incident TB cases (New and Relapse). 71 % of among all TB cases were pulmonary TB, and out of them, 80% were bacteriologically confirmed. Among those bacteriologically confirmed, 30% (9,897) were confirmed using Xpert MTB/RIF testing. More than three-fifths of all TB cases (21,462, 66%) were reported from Province 2, Province 3 and Province 5. Province 3 holds the highest proportion of TB cases (24%). Kathmandu district alone holds around 41% (3,183 TB cases) of the TB cases notified from the province 3 while its contribution is around 10% in the national total. Whereas in terms of eco-terrain distribution, Terai belt reported more than half of cases (18,590, 57%). Most cases were reported in the productive age group (highest of 50 % in 15-44 year of age). The childhood TB is around 5.5% while men were nearly 1.73 times more than women among the reported TB case.
Among 32,474 cases notified during the year, 19% of cases were reported by the private sector and 20% by community referral.
Case notification rate (CNR) of all forms of TB is 112/100,000 whereas CNR for incident TB cases (new and relapse) is 109/100000 population. This year CNR of all forms of TB has increased by 1% compared to that of the previous year.
TB services were provided through 4,323 treatment centers, however, only 80% of these facilities had registered and managed 1 or more cases of TB this year. There are further 96 Urban DOT centers providing DOT services in the country. Regarding diagnostic services, there are 624 Microscopic centers and 55 Genexpert centers (with 58 Genexpert machines in total) in the country. DRTB services were provided through 21 treatment centers and 86 Treatment Sub-centers. Though the DRTB services are ambulatory, facility-based services were also provided through 2 referral centers located in Nepalgunj and Kalitmati Kathmandu, 6 hostels and 1 DR home for a patient with limited access to these centers for daily DOT or needing inpatient services. Culture and DST facilities for DRTB patients were provided from rational reference laboratories at NTC and GENETUP at the central level.
In 2017/18, USD 11.16 million budget was approved for the National TB Programme from the source of Domestic, Global Funds, & LHL International. Out of the total approved amounts 70.5% budget consumed by the programme.
Excerpt from Executive Summary
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March 24 | Kathmandu
On the occasion of World Tuberculous (TB) Day 2019, Honorable Minister of Health and Population, Upendra Yadav, launched the annual report (2019) on TB, at the premises of National Tuberculosis Programme (NTP).
Celebrations at NTP. Photo Credit – S.G.Amatya, WHO – Nepal
The report, published by NTP, states that tuberculosis remains a major public problem in Nepal and the burden of multidrug-resistant (MDR) TB poses a health threat. However, the burden of MDR TB in Nepal is not as high as the South-east Asian or global burden.
In 2017/18,
More than 32,000 cases were notified and registered at NTP
6,000 annual deaths was caused by TB
An estimated 87 people fall ill due to TB & 16 die from the disease, every day in Nepal
Every USD 1 (NRs. 109) invested to end TB returns USD 43 (NRs. 4,690)
The report states that in 2017/18, more than 32,000 cases were notified and registered at NTP, and some 6,000 annual deaths was caused by TB. According to this data, an estimated 87 people fall ill due to TB, and some 16 die from the disease, every day in Nepal.
National Tuberculosis Programme Annual Report 2019
Tuberculosis, a contagious airborne disease and one of the world’s deadliest infectious killer, spreads via inhaling respiratory droplets that contain TB bacteria from the coughs or sneezes of an infected person.
Despite TB being a preventable and curable disease, TB remains world’s top infectious killer affecting most economically productive age group which impacts the economy of the country. TB not only makes people sick, but the cost of TB treatment plunges TB affected families in vicious cycle of sickness and poverty. It is known that every USD 1 (NRs. 109) invested to end TB returns USD 43 (NRs. 4,690) plus the multiple benefits of a healthy functioning society. Hence, investment in TB is not just combating TB but makes economic sense.
Celebrations at Myagdi. Photo Credit – JANTRA
World TB Day is commemorated each year on March 24 to raise public awareness about the devastating health, social, and economic consequences of TB, and to step up efforts to end the global TB epidemic. The theme of this year’s World TB Day – ‘It’s time’ – highlights, the drive to end TB which has reached a critical phase, both regionally and globally.
The member states of South East Asia Region issued call for action in March 2017, highlighting the political, technical and strategic interventions needed to route this disease. In March 2018, in the Delhi End TB Summit, member states unanimously adopted a statement of Action pledging to intensify efforts towards ending TB by or before 2030. In September 2018, at the UN General Assembly’s high-level meeting on ending TB, Member States made vital contributions to the Political Declaration on the fight against Tuberculosis.
In keeping with these and influence, the Government of Nepal is making all possible efforts in designing effective interventions in TB control such as early case finding approaches, engaging communities and private sectors, and increasing investment in TB control efforts.
During the program at NTP, the Honorable Minister of Health reemphasized Nepal’s political commitment to end TB nationally, and stated, “No one should die because of this preventable disease. We need to increase public awareness, especially in the marginalized community, to reduce social stigma, and so that they get timely treatment and come for checkup. We need to develop health centers at the local and provincial level with better diagnostic capabilities.”
The country, in collaboration with World Health Organization (WHO) – Nepal, and other partners is also going one step ahead to understand the true burden of TB in the country through a TB prevalence survey which started in 2018 in which WHO ensures the survey quality. The average participation rate for the survey so far is nearly 90.83%, which is a major success especially considering the geographical and logistical challenges posed by highly sophisticated nature of the survey. Internationally, participation rate of over 85% is often considered as the benchmark for good participation rate.
National TB programme with support from WHO had also developed several standards and newer guidance embracing innovations such as newer diagnostics and more effective treatment regimens for TB following latest WHO recommendations.
Stakeholders reiterated that ending TB requires concerted action by all sectors of our society to provide the right services, support and a safe environment in the right place, at the right time. Everyone is accountable and has a role to play in ending TB, working towards achieving sustainable development goals, and truly leaving no on behind.
Celebrations at NTP. Photo Credit – S.G.Amatya, WHO – Nepal
A media statement from the Regional Director of WHO South-East Asia Region, Dr. Poonam Khetrapal Singh, stated: “On World TB Day, we must reflect on the momentum already developed and the accomplishments we can achieve. It’s time to seize the moment and do what’s needed to End TB”.
This year, World TB Day is also being observed at all the provinces and at the local levels focusing on advocacy for local leaders to increase investment in TB at the local level and to create awareness at the community level about TB. Several advocacy activities supported by WHO in collaboration with National TB Programme and community group, JANTRA are also being carried out at the TB prevalence survey sites at Begkhola (Myagdi), Jhapa (Mechinagar municipality), and Jajarkot District (Majhkot VDC).
For more information, please contact:
Sujan G. Amatya, Communication Officer, WHO – Nepal, Tel: 9818239744; samatya@who.int
World Tuberculosis Day 2019 – It’s time ! ”Find Treat All #EndTB”
New WHO recommendations to accelerate progress on TB
The National Conference on Family Planning (NCFP) planned for March 18-19, 2019 organized by Government of Nepal, Ministry of Health and Population (MoHP) and Family Welfare Division (FWD) with the support from the United Nations Populations Fund (UNFPA), ADRA Nepal, along with 20 other organizations working on family planning (FP) sector, had 350 participants from all over the country, 30 and above presentations, 28 Poster Presentations and four Plenary Sessions embedded on the important theme “Reaching the Unreached” has been successfully completed.
Internalizing the contributions of family Planning for overall national development, several commitments have been declared which are as follows:
ABSTRACT BOOK
Inaugural Presentation from the Chair
ORAL PRESENTATIONS
| 1. | Plenary Session 1_Dr. Prakash D Pant | View/Download |
| 2. | Plenary Session 2.1_Kabita Aryal | View/Download |
| 3. | Plenary Session 2.2_Deepak Karki | View/Download |
| 4. | Plenary Session 3_Dr. Mahesh Puri and Dr. Aparna Sundaram | View/Download |
| 5. | Plenary Session 4_Dr. Guna Nidhi Sharma | View/Download |
Family Planning : A Global Handbook for Provider, The 2018 edition
National Family Planning Costed Implementation Plan (2015-2020)
Barriers to Family Planning Use in Eastern Nepal: Results from a Mixed Methods Study
Family Planning ”Opportunities, challenges & Priorities in Nepal
Family Planning 2020 (FP2020) Commitment, Nepal
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