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e-Learning Course on Health Financing Policy for universal health coverage

by Public Health Update January 7, 2019
written by Public Health Update

e-Learning Course on Health Financing Policy for universal health coverage (UHC): The first e-learning course on health financing policy for universal health coverage was launched by WHO. The e-Learning Course on Health Financing Policy for universal health coverage is designed to be used in a variety of ways: as preparation for those who will attend a WHO face-to-face course, for those who are for various reasons unable to attend a face-to-face course, and for those who have already attended courses and wish to refresh their knowledge. Individual modules can also be used as part of a programme of blended capacity building.e-Learning Course on Health Financing Policy for universal health coverage.

Details of the course:

Module 1. Overview

    • The goals of universal health coverage
    • Health financing policy and universal health coverage
    • How health financing can influence UHC
    • Beyond health financing: the wider health system and economy
    • What UHC brings to health financing policy

Module 2. Revenue raising

    • Revenue raising and policy objectives
    • What is fiscal space for health?
    • Efforts to increase public spending on health
    • Increasing stability and predictability
    • Summary of key messages
    • Knowledge check

Module 3. Pooling revenues

    • Pooling and policy objectives
    • Desirable characteristics of pooling arrangements
    • Policy responses to fragmentation
    • Summary of key messages
    • Knowledge check

Module 4. Purchasing

    • Strategic purchasing of health services
    • Challenges facing purchasers
    • Institutional arrangements and purchasing instruments
    • Paying for primary health care services
    • Paying for hospital services
    • Summary of key messages
    • Knowledge check

Module 5. Benefit package design

    • Benefits, rationing and policy objectives
    • Benefit package and coverage choices
    • Using the benefit package to promote UHC
    • Aligning benefit packages
    • Summary of key messages
    • Knowledge check

Module 6. Summary

    • Health financing policy overview
    • Revenue raising
    • Pooling
    • Purchasing health services
    • Benefit package design

JOIN & LEARN Health Financing Policy for universal health coverage

Screen Shot 2018 12 28 at 9.40.48 PM

Sample Course completion certificate 


Palika Coordinator – CEHP/ Nepal Red Cross Society

FP Adviser & FP Technical Adviser- The United Nations Population Fund

Assistant Professor & Lecturer-Manmohan Memorial Institute of Health Sciences

Oxford-Weidenfeld and Hoffmann Scholarships and Leadership Programme

January 7, 2019 1 comment
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National Plan, Policy & GuidelinesResearch & Publication

Multi-sector Nutrition Plan II (2018-2022) Nepal (English)

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

Multi-sector Nutrition Plan II (2018-2022) Nepal (English)

Multi-sector Nutrition Plan II (2018-2022) Nepal (English Version) 


National Guideline for Sickle Cell Anaemia and Thalassemia

Multi-sector Nutrition Plan II (2018-2022), Nepal (NEPALI)

3 in 5 babies not breastfed in the first hour of life

Safe Motherhood and Newborn Health in Nepal

Breastfeeding provides the strongest foundation for lifelong health and optimal nutrition

January 3, 2019 1 comment
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National Guideline for Sickle Cell Anaemia and Thalassemia
Research & PublicationNational Plan, Policy & Guidelines

National Guideline for Sickle Cell Anaemia and Thalassemia

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

National Guideline for Sickle Cell Anaemia and Thalassemia: Sickle-cell disease is characterized by a modification in the shape of the red blood cell from a smooth, donut-shape into a crescent or half-moon shape. Thalassaemias are also inherited blood disorders. People with thalassaemia are not able to make enough haemoglobin, which is found in red blood cells. When there is not enough haemoglobin in the red blood cells, oxygen cannot get to all parts of the body. Organs then become starved for oxygen and are unable to function properly. There are two major types of thalassaemia, alpha and beta, which are named for the two protein chains that make up normal haemoglobin.

Thalassaemias are the most common in Asia, the Mediterranean basin, and the Middle East. National burden of haemoglobin disorder has not been estimated in Nepal yet. Some of studies have been conducted based on hospital data. It seems that sickle cell disease is commonly detected in Banke, Bardiya, Dang, Kailali and Kanchanpur. Thalassaemia cases can be found any part of country. 

Rationale for guideline

Haemoglobin disorders are one of the major public health problems in Nepal. Government of Nepal has been trying to reduce the burden of disease by two major interventions:
a] effective case management and
b] preventive measures.

In order to effectively implement these interventions, we must enable our health system by strengthening technical and managerial capacity. For this, we do not have any guiding document. Therefore, a national guideline is required. This guideline is expected to full fill the gap.

Objectives of the Guidelines

  • The general objectives of this guideline is to serve a reference for health managers, doctors, nurses and paramedics for case management and implementing preventive measures.

Specific Objectives

  • To provide basic information about haemoglobin disorders
  • To provide guidelines for diagnosis, treatment and management of sickle cell diseases and thalassemia
  • To make health care professionals be able to cope problems of haemoglobin disorders
  • To improve health status and quality of life to increase life expectancy of patients with haemoglobin disorders
  • To create awareness on haemoglobin disorders in the community

Designated for treatment centres for Sickle Cell Disease

  • Civil Service Hospital, Min Bhawan, Kathmandu
  • Mid-Western Sub-regional Hospital, Ghorahi, Dang 3
  • Mahakali Zonal Hospital, Mahendranagar, Kanchanpur
  • Seti Zonal Hospital,Dhangadi, Kailai
  • Bheri Zonal Hospital,Nepalgunj, Banke
  • Lumbini Zonal Hospital, Butwal,Rupendehi
  • District Hospital, Kapilvastu
  • District Hospital Bardiya
  • District Hospital, Nawalparasi

Source of Info: National Guideline for Sickle Cell Anaemia and Thalassemia

DOWNLOAD 


WHO launched the first WHO Guidelines on Housing and Health

Ambulance Service Operation Guidelines- MoHP

Guideline to Implement livelihood allowance for Cancer, Kidney & paralyzed patients from spinal injuries

Urban Health Promotion Center Establishment & Operation Guideline 2074

Health Facility Operation and Management Committees (HFOMC) Guideline, NEPAL

Interim guideline on use of Oseltamivir (Tamiflu) – EDCD



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January 3, 2019 3 comments
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National Plan, Policy & GuidelinesNoticeResearch & Publication

स्थानीय तह र अन्तर्गतको संगठन संरचना र दरवन्दी तेरिज (स्थानीय तहहरू सबै)

by Public Health Update January 1, 2019
written by Public Health Update

Ministry of Federal Affairs and General Administration released new organization & structure of local level. 

Screen Shot 2019 01 01 at 11.50.00 AM

Direct PDF File DOWNLOAD Link – Ministry of Federal Affairs and General Administration (TOTAL PAGES:1568)


Direct PDF File DOWNLOAD Link – Ministry of Federal Affairs and General Administration (TOTAL PAGES:1568)


संघ प्रदेश र स्थानिय तहको एकमुष्ठ दरवन्दी विवरण

Ambulance Service Operation Guidelines- MoHP

Term of Reference – Province Health Directorate

Term of Reference – Province Health Office

Term of Reference – Ministry of Health & Population

January 1, 2019 2 comments
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Health Literacy, Health Education & PromotionPublic Health

5 tips for a healthy diet this New Year!

by Public Health Update December 29, 2018
written by Public Health Update
5 tips for a healthy diet this New Year!
20 December 2018, WHO
Whatever your New Year’s Resolution, a healthy and balanced diet will provide many benefits into 2019 and beyond. What we eat and drink can affect our body’s ability to fight infections, as well as how likely we are to develop health problems later in life, including obesity, heart disease, diabetes and different types of cancer. 

Eat a variety of food

Some tips to ensure a balanced diet:
  • In your daily diet, aim to eat a mix of staple foods such as wheat, maize, rice and potatoes with legumes like lentils and beans, plenty of fresh fruit and veg, and foods from animal sources (e.g. meat, fish, eggs and milk).
  • Choose wholegrain foods like unprocessed maize, millet, oats, wheat and brown rice when you can; they are rich in valuable fibre and can help you feel full for longer.
  • For snacks, choose raw vegetables, unsalted nuts and fresh fruit, rather than foods that are high in sugars, fats or salt.

Cut back on salt

  • Too much salt can raise blood pressure, which is a leading risk factor for heart disease and stroke. Most people around the world eat too much salt: on average, we consume double the WHO recommended limit of 5 grams (equivalent to a teaspoon) a day. 

Reduce use of certain fats and oil

  • A diet high in this kind of fat has been found to raise risk of heart disease by nearly 30%.

Limit sugar intake

  • Too much sugar is not only bad for our teeth, but increases the risk of unhealthy weight gain and obesity, which can lead to serious, chronic health problems.
  • A single can of soda can contain up to 10 teaspoons of added sugar.

Avoid hazardous and harmful alcohol use

  • Alcohol is not a part of a healthy diet, but in many cultures New Year’s celebrations are associated with heavy alcohol consumption. Overall, drinking too much, or too often, increases your immediate risk of injury, as well as causing longer-term effects like liver damage, cancer, heart disease and mental illness.
  • WHO advises that there is no safe level of alcohol consumption; and for many people even low levels of alcohol use can still be associated with significant health risks .

WORLD HEALTH ORGANIZATION 


Happy nEW YEAR


Global status report on alcohol and health 2018

Men’s health checklist: 5 things men can do for good health

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December 29, 2018 1 comment
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National Plan, Policy & GuidelinesNoticeResearch & Publication

संघ प्रदेश र स्थानिय तहको एकमुष्ठ दरवन्दी विवरण

by Public Health Update December 28, 2018
written by Public Health Update

DOWNLOAD PDF FILE  DOWNLOAD PDF FILE  DOWNLOAD PDF FILE  DOWNLOAD PDF FILE  DOWNLOAD PDF FILE  

Source- http://mofaga.gov.np

December 28, 2018 2 comments
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Public HealthPublic Health Programs

Lymphatic Filariasis Elimination Program updates, Nepal

by Public Health Update December 22, 2018
written by Public Health Update

Lymphatic Filariasis Elimination Program updates, Nepal

Lymphatic Filariasis Burden in Nepal

    • Endemic districts: 61
    • Average prevalence: 13%
    • Population at risk: 25 million
    • Causative agent: Wuchereria bancrofti
    • Transmission vector : Culex quinquefasciatus
    • Reported chronic conditions : > 30,000; majority are hydrocele

DOWNLOAD MATERIALS FOR MDA PLANNING 2019

Lymphatic Filariasis Elimination Program, Nepal
Goal

  • To eliminate LF as a public health problem by 2020

Target

  • To cover with MDA all LF endemic districts by 2014 and achieve <1% prevalence in all endemic districts by 2020

Strategy

  • Interruption of transmission by MDA – Diethylcarbamazine (DEC) and Albendazole, yearly campaign for six years
  • Morbidity management & Disability Prevention

LF Elimination Strategies & Steps

  • Interruption of transmission by Mass Drug Administration (MDA) using two drugs regimen, Diethylcarbamazine (DEC) and Albendazole, once yearly for six years.
  • Morbidity Management by self care and with support using intensive but simple, effective and local hygiene technique.

Monitoring and Evaluation During and After MDA

  • Coverage is monitored at each MDA round to determine whether the goal of at least 65% coverage of the total population was met.
  • After at least five rounds of effective MDA, the impact is evaluated at sentinel and spot-check sites.
  • If all the eligibility criteria are met, a transmission assessment survey (TAS) is conducted before deciding to stop MDA.
  • TAS is repeated twice during post-MDA surveillance phase.

Progress Towards LF Elimination: As of Dec 2018

  • Mapping done: 2001,2005/2006, 2012
  • Geographical Coverage: MDA started from 1 district in 2003 & Reached 100% in 2013,
  • MDA stopped in 46 districts after TAS 1
  • 2 districts are scheduled for TAS 1 in 2019
  • TAS 2 succeeded in14 districts & TAS 3 succeeded in 5 districts
  • Almost 110 million doses of MDA drugs administered.
  • Post MDA surveillance and morbidity management ongoing.
  • 12 districts completed MMDP mapping using Measure SMS Reporting and expanding rapidly.

LF
Morbidity Management and Disability Prevention (MMDP) Status – 2018

  • Free Hydrocele Surgery done – 7327 cases (Till 2018) and free surgeries ongoing in all endemic districts.
  • Morbidity mapping completed in 12 districts and 9 more in plan for 2019 (9511 Cases)
  • Successful Integration with LF and leprosy self care in 1 (Lalgadh) Hospital & in talk with few others.

Source of Info: EDCD Presentation 



DOWNLOAD MATERIALS FOR MDA PLANNING 2019


Egypt eliminates lymphatic filariasis
Diseases Control Program in Nepal : Lymphatic Filariasis
Descriptive Epidemiology of Scrub Typhus in Nepal, 2017
Bye – Bye ??? Trachoma ?‍??‍? from Nepal ??
Classification of Water-related diseases
Malaria Micro Stratification Report 2018

December 22, 2018 2 comments
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National Plan, Policy & GuidelinesReportsResearch & Publication

Malaria Micro Stratification Report 2018

by Public Health Update December 22, 2018
written by Public Health Update

Malaria Micro Stratification Report 2018: Malaria risk stratification identifies geographical areas that are at a potential risk of malaria transmission based on the recent malaria burden, receptivity characteristics, and the potential vulnerability of the area to malaria. Malaria risk stratification is a prerequisite for a rational targeted intervention and an essential step for an effective and efficient resource mobilization. In the past, malaria risk stratification in Nepal was conducted at the district level and the population of the district was defined as the population at risk of malaria. But, with the substantial decline in the burden of malaria during the past decades, and the evidence that only few Village Development committees (VDCs) within the district reported malaria cases while other VDCs remained free of malaria; there was a need to conduct the study at a more basic level such as wards.
Malaria stratification was conducted in 2016 and the study provided the strategic evidence of malaria transmission at the wards level and the population of the ward was defined as the population at risk of malaria. The external malaria program review in 2016 recommended an annual updated malaria risk stratification based on the most recent data. Besides, the review recommended that since the country is moving towards elimination; the weightage allotted to disease burden should be allotted more weight. Malaria risk stratification 2018 was tailored to suit the changing epidemiology of malaria in the country and to ensure appropriate weightage is allotted to key determinants of malaria transmission as recommended by external malaria program review. Malaria data from last three years reveal that even within Rural Municipalities or Municipalities, malaria is concentrated within some wards while other wards remain relatively free of malaria. In these settings, transmission is typically sufficiently low and spatially heterogeneous to warrant a need for estimates of malaria risk at a community level, the wards.
In order, to refine the risk stratification at the community level and thereby define the total population at risk of malaria; malaria risk micro- stratification was conducted at the wards level of Rural Municipality or Municipalities. The methodology used recent malaria burden data supplemented by information on the spatial distribution of key determinants of transmission risk including climate, ecology, and the presence or abundance of key vector species and vulnerability in terms of human population movement.  (Excerpt of executive summary)

List of High & Moderate Risk Wards (MS 2018)

Total High-Risk Wards: 49
Total Moderate Risk Wards: 153
Province 1: Total High-Risk Wards = 0, Total Moderate Risk Wards = 1
DistrictsMunicipalities (Wards)Risk Type
JhapaGauriganj (6)Moderate (1)
Province 2: Total High-Risk Wards = 6, Total Moderate Risk Wards = 8
BaraJitpur Simara NP (6)Moderate (1)
DhanusaGaneshman Charnath NP (1, 3, 9); Mithila NP (3, 4, 11)High (6)
Ganeshman Charnath NP (6); Sabaila NP (3)Moderate (2)
Saptari
 
Bodebarsaien NP (2); Saptakoshi NP (11); Surunga NP (9)Moderate (3)
SarlahiIshworpur NP (1, 2)Moderate (2)
Province 3: Total High-Risk Wards = 1, Total Moderate Risk Wards = 1
SindhuliKamalamai NP (14)High (1)
Dudhouli NP (9)Moderate (1)
Gandaki Province: Total High-Risk Wards = 0, Moderate Risk Wards = 1
Nawalparasi (East)Gaidakot NP (18)Moderate (1)
Province 5: Total High-Risk Wards = 3, Total Moderate Risk Wards = 31
BankeRaptisonari (3)High (1)
Bajnath (1, 2, 4); Duduwa (2); Narainapur (3)Moderate (5)
BardiyaThakurbaba NP (2)High (1)
Bansgadhi NP (1, 2, 5); Barbardiya NP (6); Thakurbaba NP (1, 3)Moderate (6)
 
DangBabai (5, 7); Rapti (9); Shantinagar (6); Tulsipur NP (13)Moderate (5)
KapilbastuMaharajgunj NP (4)High (1)
Buddhabhumi NP (7); Krishnanagar NP (7); Maharajgunj NP (7, 10); Mayadevi (1, 6); Shivraj NP (10); Yasodara (6)Moderate (8)
RupandehiDevdaha NP (9, 11); Kothimai (7); Lumbini Sanskritik NP (6); Sammarimai (4); Siddharthnagar NP (1, 3)Moderate (7)
Karnali Province: Total High-Risk Wards = 8, Total Moderate Risk Wards = 20
MuguKhatyad (8, 10)High (2)
Khatyad (11)Moderate (1)
SalyanKalimati (3)High (1)
Surkhet
 
Barattaal (2); Chaukune (5, 8); Panchapuri NP (4, 10)High (5)
Barattaal (4); Bheriganga NP (1, 6); Birendranagar NP (2, 9, 10, 11); Chaukune (4, 6, 7); Chinghad (3); Ghurbhakot NP (7, 11, 14); Lekhbesi NP (9, 10); Panchapuri NP (3, 5, 8)Moderate (19)
Sudurpashchim Province: Total High-Risk Wards = 31, Total Moderate Risk Wards = 91
Baitadi
 
Melauli NP (1, 6, 7); Pancheswor (6); Shibnath (6)High (5)
Melauli NP (3); Pancheswor (3); Shibnath (4)Moderate (3)
BajuraBudinanda NP (1, 5, 6, 7)High (4)
Budinanda NP (2); Himali (6)Moderate (2)
DadeldhuraParsuram NP (4, 5, 6, 12)High (4)
Aalital (2, 5); Parsuram NP (3)Moderate (3)
KailaliBhajani NP (5); Dhangadi NP (9); Godawari NP (4, 10, 11, 12); Janaki (6); LamkiChuha NP (4, 5, 6, 8, 10); Tikapur NP (4, 8, 9)High (15)
Bardagoriya (1, 2, 5); Bhajani NP (2, 3); Chure (3, 4); Dhangadi NP (1, 2, 4, 5, 7, 12, 14, 15, 19); Gauriganga NP (1, 2, 6, 7, 9); Godagodi NP (3); Godawari NP (1, 2, 3, 5, 6, 8, 9); Janaki (1, 2, 3, 4, 8, 9); LamkiChuha NP (1, 2, 3); Tikapur NP (1, 2, 5, 6, 7)Moderate (43)
Kanchanpur
 
Belauri NP (1); Bhimdatta NP (9); Mahakali NP (3)High (3)
Bedkot NP (3, 4, 6); Belauri NP (2, 3, 4, 6, 7, 8, 9, 10); Beldandi (2); Bhimdatta NP (3, 4, 6, 7, 13, 18); Krishnapur NP (2, 4, 5, 6, 7); Laljhandi (2); Mahakali NP (1, 4, 7, 8); Purnabash NP (4, 7, 8, 9, 11); SuklaPhanta NP (1, 2, 4, 5, 7, 8, 12)Moderate (40)

 

DOWNLOAD DOWNLOAD DOWNLOAD


The World Malaria Report 2018

Countries in WHO South-East Asia to intensify efforts to control dengue, eliminate malaria

Sustain high-level commitment to beat malaria across the WHO South-East Asia Region

World Malaria Day 2018: #ReadyToBeatMalaria #WorldMalariaDay

SDG 3: Ensure healthy lives and promote well-being for all at all ages


December 22, 2018 1 comment
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Global Health NewsPublic HealthPublic Health NewsTobacco Control

Thailand becomes first in Asia to introduce tobacco plain packaging

by Public Health Update December 19, 2018
written by Public Health Update

Thailand becomes first in Asia to introduce tobacco plain packaging; WHO commends efforts
SEAR/PR/1704 WHO South-East Asia Regional Office (PRESS RELEASE) 
New Delhi, 17 December 2018: World Health Organization today commended stronger tobacco control measures being adopted by Thailand which has become the first in Asia and the first low and middle-income country to adopt plain packaging for tobacco products.
“Thailand’s bold steps against tobacco – the single most important cause of preventable deaths worldwide – is commendable and reflects the country’s earnest efforts in promoting health and well-being of its people,” said Dr Poonam Khetrapal Singh, Regional Director World Health Organization South-East Asia, congratulating Thailand for the tobacco legislation on plain packaging adopted last week.
The new legislative announcement on plain packaging is the latest effort of Thai government and adds to the Tobacco Control Act 2017 which enforces 20 years as the minimum age for purchasing tobacco, bans single stick sale and bans tobacco advertisement, promotion and sponsorship.
Plain packaging of tobacco products restricts or prohibits the use of logos, colors, brand images or promotional information on packaging other than brand names and product names displayed in a standard color and font style. Plain packaging is an evidence-based policy being advocated by WHO Framework Convention on Tobacco Control (FCTC), a legal treaty that aims to protect present and future generation against the devastating health and socio-economic impact of tobacco use.
As per Thailand’s new legislation, by September 2019 all tobacco products will have plain packaging. Thailand already has graphic health warnings covering 85% packaging of tobacco products. Introduction of plain packaging is expected to further boost the country’s tobacco control efforts targeting the current and new users.
The prevalence of tobacco use is high in Thailand with 11 million smokers. An estimated one out of every five adult Thai smokes. Nearly 50% men in the age group of 35-54 years smoke. Of concern is the persistently high tobacco use among young people—one out of every six Thai in the aged group of 13-17 years uses tobacco.
Globally, tobacco kills more than seven million people every year – up to half of its users. Tobacco use is a key risk factor for major noncommunicable diseases such as heart attack, stroke, cancer, chronic respiratory diseases and diabetes. Noncommunicable diseases account for over 70% of all deaths in Thailand.
Tobacco is not just a health problem but also a socio-economic issue. Tobacco users who die prematurely deprive their families of income, raise the cost of health care and hinder economic development. Illnesses resulting from tobacco use strain the health system that drain Government’s budget on universal healthcare. In Thailand, the economic loss from tobacco in the year 2009 was estimated at 75 billion Thai Baht or 0.78% of GDP.
Addressing tobacco is important for reversing the growing epidemic of non-communicable disease, a flagship priority programme of WHO South-East Asia Region.
Member countries in the Region are in the forefront in the fight against tobacco with four of them listed among the top five countries globally with largest graphic warning on tobacco product packs.
The Regional Director said WHO remains committed to supporting Thailand and other Member Countries to protect the present and future generation from tobacco’s deadly impact.
 

48362364 1424200591043910 2438144735123079168 n

WHO SEARO


Resolutions of 12th Asia Pacific Conference on Tobacco or Health (APACT12)

”Tobacco Breaks Hearts” World No Tobacco Day 2018

Ministry of Health to be made tobacco-free zone

Tobacco Control Convention Strategy-2030 launched

December 19, 2018 4 comments
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National Health NewsPublic HealthPublic Health News

Health workers threaten to launch protest

by Public Health Update December 17, 2018
written by Public Health Update
HIMALAYAN NEWS SERVICE, Kathmandu, December 16
Health professionals have threatened to launch protest if the government fails to implement the report prepared by a task force formed to suggest amendments to Nepal Health Professional Council Act.
Ten different organisations of health professionals staged demonstration at MoHP today, demanding amendment to NHPC Act. They also demanded licensing examination for health professionals, and regular monitoring of medical colleges and health facilities.
Michael Devkota, a health professional, said Nepal Health Professional Council was providing licence to health practitioners without any examination. Nepal Health Professional Council has been providing licence to dentists, health assistants, ophthalmologists and physiotherapists, among others. There are more than 90,000 licensed health professionals in the country.
According to Bimal Paudel, president of Nepal Ophthalmic Society, the act, which came into force 22 years ago, needed amendment as per the need of time.
“The act must be amended to suit the needs of the present context,” added Paudel. The act does not incorporate radiologists, paramedics and pharmacists, among others.
Meanwhile, health professionals held talks with Deputy Prime Minister and Minister of Health and Population Upendra Yadav today. DPM Yadav promised to implement the task force’s recommendations.
“We have decided to give the government a week’s time to fulfil our demands. If the government fails to keep its promise, we will launch protest,” said Devkota.

NEWS SOURCE: HIMALAYAN NEWS SERVICE, Kathmandu, December 16



Important Notices – Nepal Health Professional Council (NHPC)

Important Notice – Nepal Health Professional Council (NHPC)

Important Notice- NHPC

Syllabus for Public Health Licensing Examination 2073 – Nepal Health Professional Council

December 17, 2018 1 comment
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