National Plan, Policy & GuidelinesNoticePublic Health

सरकारले यि आठ प्रकारका रोगहरुमा दिन्छ सहुलियत,जनहितका लागि सेयर गरौ!

by Public Health Update
written by Public Health Update

Bipanna Nagarik Kosh

Bipanna Nagarik Kosh was started after the Janandolan of 2062 BS. With the country slowly recovering from the decade long armed conflict, this Kosh was established to provide some financial relief to people from difficult and expensive diseases. Cardiovascular diseases, Cancer, Renal failure, Alzheimer’s disease, Parkinson’s disease, Head and Spinal injury, Sickle Cell Anaemia and Stroke are covered under this program.


 
new

Required documents

  1. Prescription of patient by any hospital or doctor
  2. Attestation from the local VDC or municipality office (permanent address) that the patient is eligible for the subsidy under the programme
  3. Photocopy of Citizenship & birth registration certificate in case of child. 
  4. Approval from the D(P)HO office granting the subsidy.

If you wish to find out more about the program, contact the nearest District Health Office.

Medical Treatment of Deprived Citizens


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List of Documents required for approval of Study & Extra-ordinary Leave
National Plan, Policy & GuidelinesNoticeResearch & Publication

List of Documents required for approval of Study & Extra-ordinary Leave

by Public Health Update
written by Public Health Update

Here is the List of Documents to be submit for approval of Study & Extra-ordinary Leave enlisted by Department of Health Services (DoHS), Ministry of Health and Population.

अध्ययन बिदा सम्बन्धि सूचना
Document required for Study Leave
Document required for Study Leave

List of Documents to be submit for approval of Study & Extra-ordinary Leave- DoHS, Ministry of Health and Population.

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Syllabus for Public Health Licensing Examination 2073 - Nepal Health Professional Council
NoticeSyllabus

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

by Public Health Update
written by Public Health Update

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

1. Background 

The health sector has often been considered an entry point for overall development of the country. Nepal is one of the 189 countries committed to the Millennium Development Goals (MDGs), universal health coverage and more recently Social Development Goal (SDG). In order to fulfill the goals of SDGs, the impetus created by the Nepal Health Sector Strategy 2015-2020. More importantly, constitution of Nepal has enshrined health as fundamental rights of Nepali people and mandated the provision free basic health care services. This has rightly acknowledged the importance of health sector which demands the production and deployment of quality health service providers in the country. Progress in the health sector over the last decade has been impressive with most key health (and nutrition) indicators showing improvements. Life expectancy at birth in Nepal is rising and is now higher than most other neighboring countries at 67 (Asia-Pacific HDR, 2012), infant mortality has declined to 46 infant deaths per 1,000 live births and maternal mortality now stands at 229 maternal deaths per 100,000 live births (MMM Study 2009). This has suggested that more needs to be done to ensure the constitutional mandates. In this context, Nepal health professional Council has realized the importance of providing the public health licensing through the examination. This will help ensure the quality of public health services through the skilled human resources.
 

2. Broader Principles of Public Health Curriculum 

The broader principle of public health curriculum of both bachelor and master of public health is based on the preventive, promotive and rehabilitative health need of the people. The curriculum offers both knowledge and skills required to understand the situation of health status and plan to prevent the disease or condition, promote the healthy lifestyle and community involvement to support the people with disease or conditions. NHPC, recognizes the following core areas that should cover in public health education. In bachelor degree, students learn the basic knowledge and skills. During the master’s degree, students should get the advanced or specialized knowledge in any specific areas of public health educations. 
  • Introduction to public health and health policies,
  • Understand the disease paradigms and their shifts,
  • Analyze the disease or situation,
  • Different dimension of health,
  • Human biology.
  • Approaches, methodologies of development health to public health,
  • History, development and scope of health to public health,
  • Principles, concept, models, dimensions and elements of health to public health,
  • Practice of health to public health management within and beyond the national to international territory,
  • Use of trans-medical models in modern family and community health studies, 
  • Economics of health and health care,
  • Health systems development,
  • Health promotion and communication,
  • Population and development dynamics in modern public health management,
  • Globalization of health to public health service management,
  • Challenges of modern health to public health management in the region or territory,
  • Ethics and politics of family-community health and development,
  • Health research and development, and
  • Growth and development of professionalism. 

 
The curriculum should address the changing sub-national, national, regional and international public health needs. 

3. Need of Examination 

The main intention of conducting examination is to ensure the supply of skilled public health human resources in the market. It also aims to contribute in the production of quality public health graduates. NHPC is a statutory authority formed under the Nepal Health Professional Council Act 2053 Bikram Era sets out condition for the registration of identified health professional including public health graduates. The Act prohibits any public health professional practice without being registered with NHPC. The council maintains register and those who are registered are granted with practicing certificate. The responsibility of quality control of the health professional education in the nation lies in the hands of NHPC. Taking the mandate from this legal provision, the NHPC has decided to conduct the public health licensing examination. 
 

4. Objective of the Syllabus 

The overall of objective of this syllabus is to ensure the availability of basic public health knowledge among the public health practitioners. The specific objective is to define the core subjects and provide the weightage for the purpose of licensing examination of those who completed 4 years bachelor degree in public health from the recognized universities.
 

5. Examination Methodology 

NHPC collects the online applications from of both masters and bachelor degree graduates. The subject committee reviews the certificates and makes the recommendation to the examination committee. The examination committee following this syllabus takes examination in the periodic basis. Those who have complete 4 years bachelor degree in public health from recognized university are eligible to enter into this licensing examination. The questions of respective subject will be collected from the experts and choose the questions randomly during the examination.
 

Distribution of Weightage by Subjects 

6.1 Bachelor in public health (total mark 100)
nhpc

 

6.2 Basic Science:, anatomy, physiology, biochemistry, microbiology, pharmacology, immunology, toxicology and entomology , pathology and first aid – (10)
Anatomy: 
  • Definition of terminologies used in anatomy, different components of animal cell. basic types of tissues with their characteristic features and organ systems.
Physiology: 
  • Introduction to different components of animal’s cell and their function, different tissue of body and their characteristics, body fluids and electrolyte balance their classification and composition and homeostasis. 
Biochemistry: 
  • Introduction and application of biochemistry in public health, Basic concept of acid, base and salt. Definition, classification, physical and chemical properties of carbohydrates, protein, amino acid and fatty acid. Glucose absorption and its homeostasis. Important aspects of essential amino acids and fatty acids. Biomedical importance of cholesterol, bile salt, macro and micronutrients and vitamins. Microbiology: Introduction to microbial world, Classification of microbial diseases, Introduction to community acquired microbial infection. 
Bacteriology: 
  • Classification of bacteria. Normal bacterial flora on or in the body. Concept of opportunistic and pathogenic organisms. Bacterial physiology and its growth factors. Mechanism of infection. Spread of diseases, pandemic, endemic, epidemic and laboratory infection. Physical sterilization, chemical disinfects ion and radiation. Collection and transport of specimen for identification of common bacterial communicable diseases (respiratory, genital and gastrointestinal diseases). Gram staining and AFB staining in identifying bacteria. 
Parasitology: 
  • Classification of human parasite, introduction to parasitic diseases associated with poor personal and public hygiene. Blood parasites (malaria parasite, kala-azar, microfilaria), life cycle and mode of infection. Collection of sample, processing and identification. Treatment, prevention and control. Intestinal protozoa (entamoeba hystolytica, Giardia lamblia and Cryptosporia). Life cycle and mode of infection. Collection of sample, processing and identification. Treatment, prevention and control. Intestinal worms (Roundworm, hookworm, pinworm, whipworm). Tapeworm: T. saginata, T. solium, echinocococus granulosus. H. nana, life cycle and mode of infection. Collection of sample, processing and identification. Treatment, prevention and control. 
Virology: 
  • Introduction, classification of virus, replication of virus introduction to viral disease of community concern, collection and preservation of viral specimen for laboratory study, prevention and control of viral diseases. 

Immunology: 

  • Introduction to immunology, defense mechanism of body, antigen and antibody hypersensitivity reaction and basic concept of immunology in diagnosis of viral diseases. 
Pharmacy and pharmacology: 
  • Meaning of pharmacokinetics, Pharmaco-dynamics and Pharmacokinetics. Classification of drugs, classification, mechanism of action, fate of drugs, side effects indication and contraindication of life saving drugs. Concept of essential drugs and its implementation in Nepal. Essential drugs used in free health services. Use and misuse of antibiotics. Drug policies, drugs acts and standard treatment protocol. Concept of GMP,GLP, and GCP 
Toxicology: 
  • Definition of Toxicology and terminology used in toxicology. 

Occupational and environmental toxicology 

  • Acceptable limits of toxic exposure, prevention and control. 

Entomology: 

  • Definition and classification of important arthropods and rodents, diseases and health hazards associated with arthropods and rodents. Prevention and control of diseases and health hazards. 
Pathology: 
  • General and systemic pathology (in detail of all system). 
First Aid: 
  • Shock, types of shock, identify first aid measures to the patient, First acid measures in case of poisoning (insecticides, rodenticides, drugs, alcohols), Foreign body in ear, nose, throat and eyes and provide first aid, Injury, identify measures to provide first aid appropriately, Hemorrhage, first aid to control external bleeding, Burns, classification, its percentage and first aid measures to thermal and chemical burns, Measure to manage the case of frost bite, Fractured bones and dislocations, its first aid measurement, Heatstroke and its first aid measurement, Rabid animal bites and its first aid measurement, First aid measures in case of drowning, Measures to be taken in case of snake bites, Acute mountain sickness and its first aid measures. 
6.3 Basic and Applied Epidemiology (15) 
Historical development, definition and scope of Epidemiology, Terminology used in epidemiology. Epidemic, Endemic, Pandemic, Sporadic, Zoonotic, Iatrogenic, infection, communicable disease, pollution, contamination, infestation, epidemic, endemic, sporadic, pandemic, epizootic, enzootic, source of infection, reservoir, case, carrier, host, incubation period, communicable period, secondary attack rate, agent, anti-genicity, infectivity, pathogenicity, virulence, infective dose, environment, vector, Parasite Epidemiology methods: distribution of diseases. Frequency measures used in epidemiology-Proportion, Rate and ratio. Frequency measures used in morbidity, mortality, case fatality, incidence, and prevalence. 
Measures of disease frequency
  • Rate, ratio, proportion, population at risk, prevalence (rate), incidence (rate), cumulative incidence proportion, mortality and morbidity rates/ratio.
Measures of association 
  • Absolute risk: risk difference, attributable fraction, population attributable risk relative risk/risk ratio, and odds ratio. 
  • Epidemiological study design: Descriptive, analytical and experimental, case control study, cohort study and experimental study. 
  • Non-Communicable disease epidemiology: CVD, COPD, Cancer, Diabetes, Accidents, Mental health, Suicide, Drug abuse and Snake bites. 
  • Communicable Disease Epidemiology : Viral, Bacterial, Fungal and Protozoal infections, helminthes infestation, zoonotic diseases and others (Trachoma) 
  • Introduction and consequences of conflict and disaster, disaster planning, preparedness and prevention, conflict management and its importance in health service management, and epidemic investigation component of field epidemiology.
6.4 Research and Bio statistics, population studies (Demography) (15) 
Research: 
  • Meaning, definition and purpose of research, importance of research in public health, basic terms used in research concepts, types of research design, research methods, techniques, tools , steps of research process, and process of writing the research report. 

Population studies: 

  • Importance and implication of population study in public health, population structure, characteristics and components and projection. Demographic health survey in Nepal. Population growth and its trend in Nepal with comparison. Three Components of population growth (Fertility, mortality and Migration). Population policy and program in Nepal. Public Health and application of IT 

Biostatistics: 

  • Definition of Common Statistical Terms, difference between Statistics and Biostatistics –some concepts, definition of biostatistics, scope, role, usefulness of different branches of statistics in the investigation of community health and public health research and uses of Biostatistics in public health research. 
  • Descriptive Statistics: Basic concept of variables, types of variables (discrete and continuous variables), scales of measurement. Collection and recording of statistical information on public health and its related fields from primary and secondary sources, Tabulation, processing and presentation of statistical data: frequency distribution and different types of tables (one way, two way and manifold tables). 
  • Measures of Central Tendency: Mean, Median & Mode. Different partition values (quartiles, deciles & percentiles). 
  • Measures of dispersion (variability): Range, standard deviation, variance and coefficient of variation (CV). 
  • Probability Distribution: Concept of set theory, permutations, combinations, factorial, definition of Probability, Multiplicative Law of Probability, addition law of probability, Conditional Probability, and Bayes’ Theorem, Random variable, discrete and continuous probability distribution, definition and properties of Binomial, Poisson and Normal probability distribution, Expected value and variance of Binomial, Poisson and Normal distribution. Sampling theory, sampling distribution, estimation and hypothesis testing. 
6.5 Introduction to public health, issues and primary health care community health development: (15)
  • Introduction to public health
  • Scope of public health
  • Concepts and distinction between public health, community health, social medicine and socialized medicine
  • Ottawa Charter of health promotion
  • Priorities for health promotion (in reference to Jakarta Declaration)
  • Concepts of Health and Diseases, Prevention and levels of Prevention. Application of public health from different models
  • Health Promotion: Concept and scope of health promotion Legal aspect in Public health. 
Health policies and plans
  • Alma-Ata and other International Declarations, Environmental and occupational health laws. Consumer rights, Patient rights
  • Universal health coverage,
  • Public Health Problems in Nepal: Communicable Diseases, Non-communicable Diseases, Mental Health and drug abuse, Vaccine preventable diseases. Food and waterborne diseases
  • Nutrition deficiency diseases.
  • Issues in public health: Issues in epidemiological study in Nepal (TB, Malaria, Polio, Diabetes etc
  • Issues in Reproductive Health in Nepal: holistic model of family health biomedical, bio-psycho- social models and their determinants, Decreasing Antenatal Visits, Low institutional delivery and CPR, Unmet need of Family planning, addressing gender based violence, Reproductive Health problems of the elderly people.
  • Issues in child health in Nepal: CB-IMNCI, EPI program
  • Issues of healthy ageing in Nepal o Issues in environmental and Occupational health in Nepal
  • Uses of pesticides and its effect in health: Waste management
  • Disposal of health care waste and general waste ,Health of the Agriculture, Industries, factories, Transportation and health institution and laboratory workers.
Development of public health in Nepal
  • Ancient and pre unification period
  • Pre Rana Regime period
  • Rana Regime period
  • Public health after 2007 BS
6.6 Health promotion and education, community health and school health, mental health- (10)
  • Health Promotion and Education: History, meaning, concept, principles, scope and philosophy of health education and promotion. Principles of learning
  • Different theories and modalities for behavioral changes, Change process, modules and strategies for change. Methods and Media for health education and health promotion. Selection of appropriate health education method and Medias and its importance. Health promotion and Education in Nepal
  • Policy and strategy programs regarding health promotion and education in Nepal. Introduction of NHEICC, Programs, Goal, policy, strategies and activities of NHEICC. Planning of health education and promotion program. Importance of health education and promotion planning. Steps of Health Education Planning,
  • PRECED and PROCED framework of health education diagnosis
  • Approaches in health promotion and education planning
  • Monitoring and indicator of health education and promotion programs
6.7 Health system development and managements including health financing: (15) 
  • Meaning, concept, principles, scope and application of public health management and administration
  • Planning, elements of planning,, types and method of planning
  • Health and health service management in Nepal 
  • Various approaches of health service delivery in Nepal
  • Health Service Management, Information System (HMIS)/DHIS
  • Organizational structure of health system in Nepal
  • Brief history of development of health services in Nepal Traditional Health Care practices. Ayurveda, Homeopathic and Allopathic medicine in Nepal. Integrated Health services in Nepal National Health policy-2014. Long-term Health plans in Nepal. Current Five year Health Plans in health services 2015-2020, Three years plans, annual plans
  • Organizational structures of health system in Nepal from central level to community level
  • Brief introduction of various health programs in Nepal in term of goals, objectives, strategies and activities, TB control program, Leprosy control program, Malaria control program, EPI/ National Immunization Programme, Nutrition/MCH, Kalaazar, STDs and AIDS control program. Environmental health and health training.
  • District health system : Organizational structure of DPHO/DHO/PHCC/HP. Roles and responsibilities of DPHO/DHO/PHCC and HP. Supervision Monitoring and evaluation of health programs. Referral system in Nepal from different service providing levels. Coordination mechanism from central to health post
  • Sources of Financing in health system of Nepal Budgeting process, Irregularity clearance mechanism in health system 
6.8 Family health, child health, food and nutrition (10)
Family Health: 
  • Concept and historical development of Family Health. Roles of Family Health in prevention, promotion, treatment and rehabilitation of health. Reproductive Health Policies and Adolescent Health. 
  • Health Problems related to Reproductive health and Safe Motherhood program. 
  • Pattern of communicable and non-communicable diseases concerned to reproductive health and safe motherhood 
  • Family planning principles and methods and importance of counseling Challenges in Family planning program specially in FP contraception 
  • Life cycle approach in health 
  • Ageing and disable people’s health Geriatric and disables health problems under family health care setting in Nepal. Policies, strategies and programs for ageing and disable population 
  • Child Health: Child health and national health care system Child health diseases burden in Nepal. Malnutrition and vaccine preventable diseases. Indicators used in child health program 
  • International declarations on health Food and nutrition: Food classification, Sources and daily requirement of calorie. Unhygienic food and effect in health. Food borne diseases
  • Food hygiene and its importance. Nutrition related health problems in Nepal. Food security and nutrition. Food acts and implementation. Inter-sectoral cooperation, coordination for nutrition problem in Nepal and ultispectral nutrition plan. 
6.9 Environmental and Occupational Health (5)
Introduction to Environmental and occupational Health 
  • Meaning, scope and component of environmental and occupational health. Application and importance of environmental and occupational health 

Environmental Health problems of Nepal: 

  • Unsafe drinking water, Indoor Air pollution, Deforestation and desertification, Flooding and soil erosion, Poor sanitation and hygiene, Industrial pollution in urban 

Water resources management:

  • Source and water contamination Water quality and human health. Waterborne diseases. Water purification
  • Solid waste Management: 
  • Types and source of hazardous waste Management of hazardous waste including hospital waste management.
  • Biodiversity and its conservation: 
  • Concept and importance of Biodiversity. Biodiversity and human health. Conservation of Biodiversity and its impact on human health

Occupational Health and Safety development: 

  • Meaning and concept of occupational health. Most common occupational diseases in Nepal. Policies related to occupational Health. Control and treatment of occupational Diseases. Promotion of occupational Health ∑ Basic concept of environmental toxicology, prevention and control.

Environmental problems:

  • Meaning of global warming and climate change. Global environmental warming: Causes of global warming and climate change. Health impact of global warming and climate change
  • Disposal of hospital waste and human excreta 

Occupational health and safety:

  • Meaning and historical development, occupational Health practices applied to specific exposure (Physical, Chemical and biological). Major occupational diseases and their prevention
6.10 Sociology and Anthropology (5)
  • Introduction: definition and meaning of sociology, anthropology scope and classification of sociology 
  • Basic concept: Definition, basic element and characteristics of society, community, groups and social classes. Meaning and characteristics of social norms. Social process, Socialization, Acculturation, Assimilation. 
  • Enculturation. Conflict
  • Social Institution: Marriage, Family and kinship system: Religious, political and economic institutions, Social and cultural change. Meaning and characteristics of socio-cultural change. Factors for socio-cultural change. Uses of sociology and Anthropology in public health
  • Health behavior, illness behavior and sickness role, Models of health behavior. Sociocultural influences in health behavior
  • Culture and Health: Definition of culture, characteristics, elements and types of culture. Self-medication and other prevailing health care practices in Nepal. Meaning, nature and causes of social problems. Consequences of socio-cultural changes. Meaning and agencies of social control, Practices of social control in health field in Nepal ∑ Social psychology: Basic concept and different dimension. 
  • Concepts of health politics and importance in public health intervention. 
 
 

 
 

 

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National Plan, Policy & GuidelinesResearch & Publication

Social Networking site user manual for Government authorities

by Public Health Update
written by Public Health Update

The Government of Nepal approved the Social Networking site user manual for Government authorities 2075. 

Social Networking site user manual for Government authorities

Social Networking site user manual for Government authorities Social Networking site user manual for Government authorities Social Networking site user manual for Government authorities

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NoticePublic Health

Nipah virus (NiV) : Key facts, Transmission & Prevention

by Public Health Update
written by Public Health Update

Nipah virus (NiV) : Key facts, Transmission & Prevention

Nipah virus (NiV) is an emerging zoonotic virus (a virus transmitted to humans from animals). In infected people, Nipah virus causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. NiV can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.
35062487 1926687997391361 3629675251236864000 n
Nipah virus is closely related to Hendra virus. Both are members of the genus Henipavirus, a new class of virus in the Paramyxoviridae family.
Although Nipah virus has caused only a few outbreaks, it infects a wide range of animals and causes severe disease and death in people, making it a public health concern.
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Transmission

NiV is a zoonotic virus (a virus transmitted to humans from animals). During the initial outbreaks in Malaysia and Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via respiratory droplets, contact with throat or nasal secretions from the pigs, or contact with the tissue of a sick animal.
In the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.
Limited human to human transmission of NiV has also been reported among family and care givers of infected NiV patients. During the later outbreaks in Bangladesh and India, Nipah virus spread directly from human-to-human through close contact with people’s secretions and excretions. In Siliguri, India, transmission of the virus was also reported within a health-care setting (nosocomial), where 75% of cases occurred among hospital staff or visitors. From 2001 to 2008, around half of reported cases in Bangladesh were due to human-to-human transmission through providing care to infected patients.

Prevention

Controlling Nipah virus in domestic animals

Currently, there are no vaccines available against Nipah virus. Routine and thorough cleaning and disinfection of pig farms (with appropriate detergents) may be effective in preventing infection.
If an outbreak is suspected, the animal premises should be quarantined immediately.  Culling of infected animals – with close supervision of burial or incineration of carcasses – may be necessary to reduce the risk of transmission to people. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.
As Nipah virus outbreaks in domestic animals have preceded human cases, establishing an animal health surveillance system, using a One Health approach, to detect new cases is essential in providing early warning for veterinary and human public health authorities.

Reducing the risk of infection in people

In the absence of a licensed vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to and decrease infection from NiV.

Public health educational messages should focus on the following:

  • Reducing the risk of bat-to-human transmission: Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and to other fresh food products. Keeping bats away from sap collection sites with protective coverings (e.g., bamboo sap skirts) may be helpful.Freshly collected date palm juice should be boiled and fruits should be thoroughly washed and peeled before consumption.
  • Reducing the risk of animal-to-human transmission: Gloves and other protective clothing should be worn while handling sick animals or their tissues, and during slaughtering and culling procedures. As much as possible, people should avoid being in contact with infected pigs.
  • Reducing the risk of human-to-human transmission: Close unprotected physical contact with Nipah virus-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people.

Controlling infection in health-care settings

  • Health-care workers caring for patients with suspected or confirmed NiV infection, or handling specimens from them, should implement standard infection control precautions for all patients at all times
  • As human-to-human transmission in particular nosocomial transmission have been reported, contact and droplet precautions should be used in addition to standard precautions.
  • Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories.

Key facts

  • Nipah virus is an RNA virus that is part of the Paramyxovidae family that was first identified as a zoonotic pathogen after an outbreak involving severe respiratory illness in pigs and encephalitic disease in humans in Malaysia and Singapore in 1998 and 1999.
  • Nipah virus can cause a range of mild to severe disease in domestic animals such as pigs.
  • Nipah virus infection in humans causes a range of clinical presentations, from asymptomatic infection (subclinical) to acute respiratory infection and fatal encephalitis.
  • Nipah virus can be transmitted to humans from animals (bats, pigs), and can also be transmitted directly from human-to-human.
  • Fruit bats of the Pteropodidae family are the natural host of Nipah virus.
  • There is no treatment or vaccine available for either people or animals. The primary treatment for humans is supportive care.
  • Nipah virus is on the WHO list of Blueprint priority diseases

WORLD HEALTH ORGANIZATION

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Syllabus

Test Guidelines for the National Licensure Examination for Nurses

by Public Health Update
written by Public Health Update

Test Guidelines for the National Licensure Examination for Nurses (NLEN) 2012

  • Board of Nepal Nursing Council (NNC) on February 27, 2012
  • Revised: August, 2012
  • Second revised September 2014

Nepal Nursing Council is an autonomous body under Nepal Nursing Council Act 2052 formulated by the Government of Nepal. It aims at promoting quality nursing education in order to bring quality nursing service in the country. The Licensure Examination for Nurses is a national examination for nurses developed by the Nepal Nursing Council. ‘National Licensure Examination for Nurses is an examination to qualify as nursing professionals. This National Licensure Examination for Nurses is required for all new graduates of Proficiency Certificate Level (PCL) and Bachelor of Science in Nursing (BSc N.) The examination is geared towards testing knowledge and skills in relation to the job functions most commonly required by entry-level nurses. The examination determines eligibility to earn a title of registered nurse for to begin to working as a professional nurse. Nepal Nursing Council went through several processes to establish the Licensure Examination for Nurses in Nepal. Nursing council took references on licensing exam from SAARC as well as other developed countries. Nepal Nursing Council also received technical and human resource from JICA to support the conduct of the licensure examination.

Objectives

The objectives of licensure examination are as follows:

  • To maintain quality nursing services to the public
  • To maintain professional standard of knowledge and skills among new graduates
  • To recommend for strengthening the capability of nursing institutions for quality nursing education

Eligibility

  • Nepali citizen graduated from Nepal To meet the professional education requirement for licensure as a qualified professional nurse, the candidate must present satisfactory evidence of having received at least a four-year degree (B.Sc N.) or 3 years of Proficiency Certificate Level (Diploma level) program that is approved by NNC.
  • Nepali citizen graduated from other countries Applicants, who have completed nursing education from other country, must have their equivalence certificate from the concerned authority. Individual applicant need to be graduated from the institute recognized from the respective nursing council or authorized government body and must submit the documents.
  • Foreigners graduated from Nepal Foreign applicants graduated from Nepal must have completed nursing program from the institution approved by NNC and must submit the documents.
  • Foreigners graduated from other countries A person, who comes to Nepal to work, must appear National Licensure Examination for Nurses in order to registered in NNC. Person, who stay with tourist visa are not allowed to apply

Exception

  • Reporting prior convictions or discipline against licenses Applicants are required under ‘Regulation of the National Licensure Examination for Nurses’ to report all misdemeanor and felony convictions. Failure to report prior disciplinary action is considered falsification of application and is a ground for denial of licensure or revocation of license.
  • Applicants with differently abled Applicants, who are differently abled, are under Civil Law.

The list of documents required for P.C.L. Nursing/B.Sc. Nursing

  • Application form (original)
  • Photocopies of the following documents * (SLC Mark sheet and Character Certificate, Citizenship, Academic Transcript or Mark sheet and Character Certificate of PCL Nursing, Academic Transcript or 10+2 Mark sheet or I.Sc. Mark sheet and Character Certificate for B.Sc. Nursing, Academic Transcript or Mark sheet and Character Certificate of B.Sc. Nursing
  • Passport Size Photos (6)
  • Examination fee (SBI Bank Voucher Original) Call Deposit A/C No, 20435240100009 (NRS 1500)
  • Document of recognition /accreditation of institute from the nursing council or individual registration in the nursing council or in the authorized body (only in case of non-existence of nursing council) of the respective country (only applicable for the Nepalese graduated from the other countries). Attested by Notary Public for Foreign Degree Certificates, Equivalency letter from CTEVT/TU 1

* Original Certificate Document need to brought for Verification

The list of documents required for Foreign Nurses Items Number

  • Application form, original
  • Photocopy of Certificate of nursing educational degree,
  • Photocopy of Certification of registration from the nursing council of respective country
  • Recommendation letter from the organization in Nepal where the applicant is going to work (original)
  • Photocopy of Valid visa or Passport/citizenship for those who do not need to have visa to enter Nepal,
  • Examination fee (SBI Bank Voucher Original) Call Deposit A/C No, 20435240100009 NRS (2500)
  • Passport size photos (5)
  • Attested Photocopy of the Certificate of Nursing Educational degree by the Concerned Organization where the Individual works.

Examination Process / Rule

Duration of Examination

  • Licensure Examination will be of three and half hours (3:30) duration.
  • Applicants are not allowed to enter the examination room after 15 minutes from starting examination. Applicants can leave the room only after 1 hour of starting the examination.

Type of Questions

All of the test items are Multiple Choice Question (MCQ) with four options. Applicants are to select the most appropriate choice.

Subject wise distribution of test items

Subjects Distribution of test items (%) (Possible numbers of items)

  • Integrated Science 5% (10)
  • Fundamental of Nursing 25% (50)
  • Community Health Nursing 15% (30)
  • Adult Nursing 20% (40)
  • Child Health Nursing 10% (20)
  • Midwifery and Gynecology 20% (40)
  • Leadership and Management 5% (10)
  • Total (200)

Syllabus for NLEN

Integrated Science

Integrated Science includes subjects like Anatomy/ Physiology, Microbiology, and Pharmacology related content but is not limited to:

I. Anatomy/ Physiology

  • Cardiovascular/ Lymphatic System: Body fluid/Electrolytes and Acid- Base Balance Blood Composition, Plasma and Plasma Proteins Physiology of Red Blood Cells, White Blood Cells, Platelets Blood Groups and blood transfusion
  • Anatomy of Cardiovascular System: The Heart and Blood Vessels Physiological Activities of the Heart Physiology of Circulation Cardiovascular Regulation and Adjustments Lymphatic/ Immune system Human cell and its structure
  • Musculoskeletal System: The Human Skeleton, its structure and physiology The Joints The Skeletal Muscles of Human Body Neuromuscular Junction and Muscle Physiology
  • Nervous System: Functional unit of nervous system Central Nervous System Peripheral Nervous System Autonomic Nervous System Somatosensory, Somatomotor System and Reflexes Meninges, Cerebrospinal Fluid, Blood- Brain Barrier and Central Blood Flow
  • Respiratory System: Structure and Functions of Respiratory System Physiology/Mechanism/ Control of Respiration
  • Gastro-Intestinal System: Structure and Functions of Digestive System Digestion and Absorption of nutrients Accessory organs of Gastro-Intestinal system
  • Endocrine System: Structure and functions of endocrine glands and hormones.
  • Urinary System: Functional unit of urinary system Physiology of urine formation
  • Reproductive System: Male Reproductive System Female Reproductive System Physiology of Contraception
  • Special Sensory System: Eye, Ear, Nose, Throat The Skin and Fascia

Microbiology/ Parasitology

  • Factors affecting the growth and survival of micro organisms
  • Types of parasites affecting to human body and its mechanism to develop diseases

Pharmacology:

  • Types and Function of Drugs
  • Pharmacokinetics: absorption, distribution, metabolism, excretion of drug, and factors influencing the pharmacokinetics
  • Pharmacodynamics: drug action, adverse reaction to drugs
  • Essential, emergency and Life Saving Drugs used in Nepal
  • Drugs acting on different body systems

ii Fundamentals of Nursing
 
Related content includes but is not limited to:

  • Ethics in Nursing: International Councils of Nurses (ICN) Code, Nepal Nursing Council Act and Regulation.
  • Patient’s Rights
  • Informed Consent 
  • Assessment (history taking vital signs and physical

Nursing diagnosis

  • Evaluation of nursing care: objective         data 
  • Nursing Process
  • Caring
  • Admission and discharge procedure
  • Role and responsibility   of   nurse   in   laboratory   test/examination:   invasive and    non- invasive   procedures: e.g. blood test, lumbar puncture, thoracentesis,
  • ultrasonography
  • Personal hygiene
  • Safety and Infection Control: Safety Devices, Accident/ Injury Prevention, Infectious Materials, Universal Precaution
  • Rest and Sleep pressure relief measure
  • Comfort/  pain relief measure
  • Meeting nutritional needs Meeting elimination needs: catheterization,  intake
  • Rehabilitative care
  • Care for dead body

Nursing responsibility for drug administration

  • Routes of administration of the drug
  • Dosage Calculation and Administration of drugs
  • Indications, contraindications and interactions, adverse effect , side-effect
  • Responsibility of nurses in administration of medicine: e.g. Six rules in administration of the drug
  • Administration and management of IV fluids, Blood and Blood products

First Aid

  • Basic Cardiopulmonary Resuscitation (CPR)
  • Bites : insects, snake, animals and their first aid management
  • Burn: Degrees / types of management Wounds: Dressing and Bandage Hemorrhage
  • Choking Fracture Drowning Frostbite Poisoning

Community Health Nursing

Related content includes but is not limited to:

  • Community Health and Community Health Nursing
  • Communication skills
  • Community resources
  • Health Education
  • Home visiting

Primary Health Care (PHC): Elements and role of nurses in PHC
Demography/ Health Indicators: (e.g. IMR. MMR, TFR)
Epidemiology 

  • Role of epidemiology
  • Community Diagnosis
  • Role and responsibilities of Nurses in epidemiological approach

Environmental Health: Sanitation, Water, Housing, Pollution
Nutrition

  • Nutritients and their functions
  • Nutritional Deficiency disorders: Types and characteristics
  • Management of the clients with nutritional deficiency

Immunization

  • Types, Purposes and Functions of immunization
  • Administration of immunization Routs
  • National Immunization Program in Nepal

Maternal and Child Health

  • MCH clinics: Antenatal Care (ANC), Postnatal Care (PNC)
  • Growth Monitoring of Under Five Children
  • Under Five’s Clinic

Gender Issues 

  • Sex and gender
  • Gender issues: e.g. gender equity, gender equality, gender discrimination, Domestic Violence

Family Planning

  • Population problems in Nepal
  • Types, methods, advantages and disadvantages of different family planning methods
  • Emergency Contraception and methods
  • FP Counseling

HIV/AIDs, STI

  • Prevention of HIV/AIDS, STI
  • Treatment and management for the clients with HIV/AIDS, STI

Family Health Nursing

III. Adult Nursing

Related content includes but is not limited to:

  • Characteristics of adulthood, developmental tasks of young adult, middle-aged adults, elderly adult
  • Aging process
  • Disorders  of  each  body  system:  Blood,  Body  Fluids/Electrolytes,  Nervous  System,  Circulatory
  • System,  Respiratory  System,  Musculoskeletal  System,  Gastro-Intestinal  and  Nutritional  System, Urinary System, Endocrine System, Sensory System (Common disorders, investigations and medical/surgical treatment of different body system disorders,  Medical/Surgical nursing management for the client with disorders in each system)
  • Mental Health Problems  (Assessment of mentally ill clients, characteristic of mental health, Major and minor disorders, treatment and nursing management)
  • Operation Theatre Nursing (Operation Theatre (OT)  Nursing, Characteristics of OT nurse, OT technique (e.g. aseptic technique, sterilization, scrubbing, gowning, gloving) Role and Responsibilities of scrub nurse, circulatory nurse, and recovery nurse Common surgical materials, equipments, and supplies in OT and their preparation Sterilization and)
  • Pre and Post-operative Nursing care
  • Rehabilitation (Disability: Types and characteristics, Role and responsibility of nurses in rehabilitation, Nursing management of disable client)
  • Nursing  care  of  the  client  in  the  terminal  stage (Stages of dying Grief    and    Loss, Holistic Care)
  • Stress and Crisis Management (Body’s response to stress, Role of nurses  in  stress and crisis  management)

Child Health Nursing
Related content includes but is not limited to:

  • Terminology of Child Health Nursing 
  • Growth and development of child in each stage: infancy,
  • school-age and adolescence
  • Nursing role on promotion of growth and development of childran
  • Nursing care to child and family ( Influences brought by diseases and hospitalization, Nursing care for children with accident/ injury, Nursing care for children with common communicable diseases, Nepal Nursing care for children with congenital/ chromosomal disorders, Nursing care for children with ……….of different body systems : nervous system, musculoskeletal system, respiratory system, circulatory system, blood, gastro- intestinal, urinary system, endocrine system, sensory)

Health Promotion for system children: Nutrition, exercise, play, anticipatory guidance (Mortality and Morbidity in Under Five Children and their prevention, Nursing role on prevention and management of children with HIV/AIDs)
Integrated Management of Childhood Illness (IMCI) program
Paediatric Procedure

  • Oxygen administration (e.g. head box, oxygen tent) Nebulization
  • Positioning/ Restraining
  • Calculation of drugs and its administration
  • Different types feeding
  • IV fluid administration and management
  • Phototherapy
  • Care for incubator
  • Colostomy and tracheostomy care Cardio Pulmonary Resuscitation (CPR) Specimen collection
  • Assisting in common invasive procedures (e.g. lumbar puncture)

Midwifery and Gynecology
Related contents include the following but not limited to:
Deformination of …… and ………….,  Reproduction in human being

  • Components of reproductive health
  • Reproductive rights

Maternal and Newborn Health in Nepal (Strategies and policies of reproductive health in Nepal, Skill Birth Attendant (SBA) policy Safe Motherhood Program)
Nursing care in every stage of female life cycle (Puberty/ Adolescent Health: physical and psychological changes, nursing care for during puberty /adolescent, Reproductive age/years: nursing care for the client of reproductive ages/years, Climacteric care: physical and psychological changes during the peri-menopause, counseling, medical management(e.g. Hormone Replacement Therapy; HRT)
Fetal  growth  and  development:  normality  and  abnormalities  on  fetal,  placenta,  membrane  and cord
Care during Pregnancy

  • Health promotion of pregnant women,
  • Components of antenatal care
  • Birth Preparedness and Complication readiness,
  • Care of pregnant women with minor/major disorders of pregnancy (e.g. constipation, varicose veins, back pain, edema, threatened abortion , placenta preavia)

Care during labor and birth

  • Physiology and mechanism of labor
  • Management of mother in labor : normal delivery, induction and augmentation of labor, Monitoring fetal condition: prevention and manager ……………..)

Postnatal Care

  • Physical and psychological changes during puerperial period
  • Nursing care for women with minor/major problems of puerperium (e.g. hemorrhage, infection,
  • Breast Feeding: Importance, mechanism of secretion of breast milk, nursing care for mother with problems on breast feeding (e.g. mastitis),
  • Breast feeding in HIV / Hepatitis B positive mothers (e.g. PMTCT)

Newborn Baby Care

  • Neonatal assessment, Immediate care of newborn
  • Nursing care for newborn baby with dysfunction and problems (e.g. Respiratory distress syndrome, meconium aspiration syndrome

Obstetric Emergencies

  • Nursing management for the clients with high risk/ critical condition in antenatal period (e.g. PIH)
  • Nursing management for the clients with high risk/ critical condition in perinatal period (e.g mal presentation and prolapse of the cord.)
  • Nursing management for the clients with high risk/ critical condition in postnatal period (e.g. PPH, ruptured uterus )

Nursing Care for Gynecological problems

  • Sub fertility/ Infertility: Types, cause and treatment and nursing management of infertility in both male and female,
  • Sexually Transmitted Infection (STI): National Protocol to manage STIs, Cervical Cancer, Breast Cancer
  • Genital prolapsed …………….fistula)
  • Nursing management obstetric fistula: Recto-vaginal fistula and vesico-vaginal
Leadership and Management

Related content includes but is not limited to:
Concept of Leadership and Management

  • Role, Styles, Characteristics and Functions of Leadership Role and Responsibilities of Health Care Team Members Principles, Types and Functions of Management
  • Conflict Management
  • Purpose, principles, categories of Supervision
  • Qualities of Supervisor

Health     Service     Delivery     System:    

  • Hospital     and Community Methods of Organizational management
  • Organogram Management of Resources
  • Patient assignment methods: Rotation Plan, assignment
  • Job Description of different categories of health personnel
  • Job Description of different level of nursing personnel

Professional Development
Definition and Criteria of Profession

  • Professional Organizations: Nursing Association of Nepal (NAN), Nepal Nursing Council (NNC), International Council of Nurses (ICN), International Confederation of Midwives (ICM)

Health Policy and Planning

  • National Health Planning: SLTHP and Five Year Plans Country Profile

For further information please visit Nepal Nursing Council website:
www.nnc.org.np or contact Nepal Nursing Council office.

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National Plan, Policy & GuidelinesReportsResearch & Publication

The 2015 Nepal Health Facility Survey: Further Analysis Reports

by Public Health Update
written by Public Health Update

The 2015 Nepal Health Facility Survey: Further analysis reports : The 2015 Nepal Health Facility Survey (2015 NHFS) is the first comprehensive assessment of health facilities in Nepal that harmonizes various health facility among the Ministry of Health and health development partners. It was designed to provide information on the availability of basic and essential health care services and the readiness of health facilities to provide quality services to clients.
The NHFS collected information on the general readiness of facilities to provide quality health services. The survey also obtained information on the availability of each of the following services: child health care; maternal and newborn care; family planning; services for sexually transmitted infections (STIs), HIV/AIDS, tuberculosis‑ and malaria‑ related conditions; and services for non‑communicable diseases (NCDs) (diabetes, cardiovascular diseases, and chronic respiratory diseases). – 2015 Nepal Health Facility Survey (NHFS).
 
The DHS Program released following Further Analysis Reports of the 2015 Nepal Health Facility Survey (NHFS).

  1. Health Services Availability and Readiness in Seven Provinces of Nepal (DOWNLOAD)
  2. Quality of Care and Client Satisfaction with Maternal Health Services in Nepal (DOWNLOAD)
  3. Client Satisfaction and Quality of Curative Services for Sick Children in Nepal  (DOWNLOAD)
  4. Quality of Family Planning Services Delivery and Family Planning Client Satisfaction at Health Facilities in Nepal  (DOWNLOAD)

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NoticePublic Health

पानी शुद्दिकरण गर्ने विधि, फैलिनसक्ने पानीजन्यरोगको महामारीवाट वच्ने उपायहरु

by Public Health Update
written by Public Health Update

Flooding and communicable diseases

Floods can potentially increase the transmission of the following communicable diseases:

  • Water-borne diseases, such as typhoid fever, cholera, leptospirosis and hepatitis A
  • Vector-borne diseases, such as malaria, dengue and dengue haemorrhagic fever, yellow fever, and West Nile Fever

WHO

Preventive measures

Communicable disease risks from flooding can be greatly reduced if the following recommendations are followed.

Short-term measures

Chlorination of water

Ensuring uninterrupted provision of safe drinking water is the most important preventive measure to be implemented following flooding, in order to reduce the risk of outbreaks of water-borne diseases.

  • Free chlorine is the most widely and easily used, and the most affordable of the drinking water disinfectants. It is also highly effective against nearly all waterborne pathogens (except Cryptosporidium parvum oocysts and Mycobacteria species). At doses of a few mg/litre and contact times of about 30 minutes, free chlorine generally inactivates >99.99% of enteric bacteria and viruses.
  • For point-of-use or household water treatment, the most practical forms of free chlorine are liquid sodium hypochlorite, solid calcium hypochlorite and bleaching powder (chloride of lime; a mixture of calcium hydroxide, calcium chloride and calcium hypochlorite).
  • The amount of chlorine needed depends mainly on the concentration of organic matter in the water and has to be determined for each situation. After 30 minutes, the residual concentration of active chlorine in the water should be between 0.2-0.5 mg/l, which can be determined using a special test kit.
Vaccination against hepatitis A
  • The use of hepatitis A vaccines for mass immunization is not recommended.
  • Vaccination of high-risk groups, such as persons involved in the management of drinking water, waste water or sewage might be considered.
  • In case of an outbreak of hepatitis A consider immunization of contacts. The use of immunoglobulins is not recommended.
  • Diagnosis of acute hepatitis A is confirmed by anti-HAV IgM antibodies.
Malaria prevention
  • Insecticides: flooding does not necessarily lead to an immediate major increase in mosquito numbers, and there may still be time to implement preventive measures such as indoor residual spraying, or the retreatment/distribution of ITNs in areas where their use is well-known. This will also have an effect on other mosquito-borne diseases.
  • Early detection: it is important to track weekly case numbers and provide laboratory-based diagnosis (perhaps only for a % of fever cases to track the slide/test positivity rate), to pick up the early stages of a malaria epidemic.
  • Free medical care: with artemisinin-based combination therapy should be provided when a falciparum malaria epidemic is confirmed, and an active search for fever cases may be necessary to reduce mortality in remote areas with reduced access to health care services.
Health education
  • Promote good hygienic practice.
  • Ensure safe food preparation techniques.
  • Ensure boiling or chlorination of water.
  • Vital importance of early diagnosis and treatment for malaria (within 24 hours of onset of fever).
Handling corpses
  • Burial is preferable to cremation in mass causalities and where identification of victims is not possible.
  • The mass management of human remains is often based on the false belief that they represent an epidemic hazard if not buried or burned immediately. Bodies should not be disposed of unceremoniously in mass graves and this does not constitute a public health a public health measure, violates important social norms and can waste scarce resources.
  • Families should have the opportunity to conduct culturally appropriate funerals and burials according to social custom.
  • Where customs vary, separate areas should be available for each social group to exercise their own traditions with dignity.
  • Where existing facilities such as graveyards or crematoria are inadequate, alternative locations or facilities should be provided.
  • The affected community should also have access to materials to meet the needs for culturally acceptable funeral pyres and other funeral rites.

For workers that routinely handle corpses

  • Graveyards should be at least 30m from groundwater sources used for drinking water
  • The bottom of any grave must be at least 1.5m above the water table with a 0.7m unsaturated zone. Surface water from graveyards must not enter inhabited areas.
  • Ensure universal precautions for blood and body fluids
  • Ensure use and correct disposal of gloves (no re-use)
  • Ensure use of body bags
  • Ensure hand-washing with soap after handling bodies and before eating
  • Ensure disinfection of vehicles and equipment
  • Bodies do not need to be disinfected before disposal (except in case of cholera)
  • Vaccinate workers against hepatitis B

Long term measures

Legislative/administrative issues

  • Create Disaster-Preparedness Programmes and Early Warning Systems.
  • Improve surveillance on a local, national, international and global level.
  • Promote tap-water quality regulation and monitoring.
  • Enforce high standards of hygiene.

Technical issues

  • Improve water treatment and sanitation.
  • Keep infectious disease control programmes active and efficient.

Flooding and communicable diseases (Risk & Prevention)

Note: This information was copied from website of World Health Organization, Please refer original source for your referencing purpose.

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Flooding and communicable diseases (Risk & Prevention)

Flooding and communicable diseases (Risk & Prevention)


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National Health NewsPublic HealthPublic Health News

Message of Congratulations to newly elected NEPHA central committee

by Public Health Update
written by Public Health Update

Message of Congratulations to newly elected NEPHA central committee

I would like to congratulate the newly elected central committee of Nepal Public Health Association (NEPHA). Congratulations! Hope, this team will straightforwardly fulfill our professional expectations.

GOOD LUCK!

PDFtoJPG.me 1 3

नेपाल जनस्वास्थ्य संघको चुनाव:  आगामी समितिसँग एक जनस्वास्थ्यकर्मीको अपेक्षा – SWASTHYAKHABAR.COM

1 5 2 1

1 6 2 2

नेपाल जनस्वास्थ्य संघको चुनाव:  आगामी समितिसँग एक जनस्वास्थ्यकर्मीको अपेक्षा – SAGUNPAUDEL.COM.NP

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Global Health NewsInternational Plan, Policy & GuidelinesPublic HealthPublic Health News

NCDA civil society statement on 2018 Political Declaration on NCDs

by Public Health Update
written by Public Health Update

NCDA civil society statement on 2018 Political Declaration on NCDs:
STATEMENT ENOUGH: nearly 300 organisations and experts calls on world leaders to seize the ‘do or die’ moment of the third UN High-Level Meeting to address noncommunicable diseases
27 September 2018, New York.- The NCD Alliance and nearly 300 civil society organisations call on world leaders to go above and beyond the vague and unambitious commitments contained in the Political Declaration of the third UN High-Level Meeting on Noncommunicable Diseases (UN HLM on NCDs), adopted in New York on 27th September 2018.
Governments cannot afford to continue sleepwalking into a sick future. The world is reaching an inflection point and a tepid response to NCDs is simply not an option – for the sake of billions of people around the world, it is time for a radical change. Global preventable death, disability, and suffering from NCDs continue to rise because of governments’ failure to act and invest for health. At the current rate of progress, more than half of all countries in the world will fail to meet the Sustainable Development Goal (SDG) 3.4 NCD to reduce the rate of premature deaths from NCDs by one third by 2030.
Whilst we commend the Heads of State and Government embracing the opportunity the HLM presents to celebrate initiatives and progress, we contend that past actions will be insufficient to drive future change. Decisive new action is urgently needed to halt the tsunami effect of NCDs – on people, families, communities, and economies. The imperative for action has never been clearer. Over the coming decade, millions more people and communities will lose loved ones to avoidable and early death due to government inertia. Millions more will suffer pain, disability and anguish because of lack of diagnosis and treatment. Millions will struggle with entrenched poverty caused by catastrophic out of pocket health expenditures. These millions of people each have lives, stories and futures that could be much better. The world’s most marginalised populations are most at risk, exacerbating health inequalities and hindering social and economic development.
The Heads of State and Government that attended the 2018 UN HLM on NCDs have the power to rise up as a united and formidable force against the scourge of NCDs. There is now palpable urgency and impatience for these political leaders to return home and follow up with action and investment, and to coordinate across the whole of government and whole of society, igniting the crucial collective response required to overcome the surging tide of NCDs.
Shortcomings of the Political Declaration
Governments have squandered the opportunity of this HLM to close the financing gap for NCDs with real commitments for the health of their people. Leaders who neglect to make significant investments in NCDs are failing their citizens and will be responsible for untold avoidable suffering and loss of life. Actions to save lives are simple and extremely cost-effective; investing in the tried-and-tested WHO Best Buy interventions yields a seven-fold return in low- and lower-middle-income countries. (1)
The absence of strong language on implementing the Best Buys, which focus on taxation, regulation and legislation, is a glaring omission from the document. This reflects interference and undue influence of health-harmful industries over a few countries who were prepared to shamelessly block progress for all. We are deeply disappointed that too few countries were prepared to stand up and show real leadership to put the health and wellbeing of their people ahead of the short-term and short-sighted economic interests of the few.
Implementing the 16 Best Buys worldwide would save 9.6 million lives by 2025, according to new data by WHO. (2) The enormous life-saving potential of these proven, cost-effective measures in the remaining 2 years until our 2025 deadline includes, for example, nearly 70,000 lives in South Africa, 150,000 in Egypt, almost 250,000 in Italy, 340,000 in Germany, over half a million in the USA, 1.3 million in India and over 1.7 million in China. Failure to comprehensively implement these measures – and to try to block others – to save all these lives is inexcusable.
The anaemic stance on accountability encapsulated within the document is perhaps its greatest failing. The scheduling of the next UN HLM on NCDs in seven years’ time risks prolonged procrastination, when today’s political leaders need to realign the trajectory of progress immediately to meet the targets that they have committed to for 2025 and 2030. We remind our leaders that their failure to date to deliver on their commitments at the 2011 and 2014 UN HLMs is not just statistics and economic losses, it is unnecessary suffering and preventable death in every country. We deplore the absence of new ambitious time-bound commitments and accountability measures in the Declaration to propel the response forward. Robust independent accountability mechanisms, including NCD Countdown 2030, will be essential to ensure that the promises made by the international community are delivered.
Building on the foundations for a healthier future for all
Despite these disappointments in the Declaration, the display of leadership throughout the negotiations on the 2018 UN Political Declaration from several countries in Latin America, the Caribbean, and the Pacific Region was inspiring, with demonstrable commitment to their people and communities – exemplifying the mantra – ‘ENOUGH. Together we are stronger. Together we can beat NCDs.’ The inclusion of a paragraph in the 2018 UN Political Declaration on engaging civil society and people living with and at risk of NCDs in national NCD responses is a clear indication that governments have seen the value of working with civil society and the people most affected.
Recognition of mental health and environmental risk factors for NCDs as core components of the NCD response reflects the reorientation towards a ‘5 x 5’ approach and is a definitive and crucial step towards more fully inclusive action for NCDs. Civil society was also pleased to see the negotiations on the Political Declaration successfully concluded with a compromise on the language concerning the Trade-Related Aspects of Intellectual Property Rights (TRIPS), which has important implications for essential medicines for treatment and care for millions of people living with NCDs worldwide. And, for the first time, an NCD Declaration includes language on respecting human rights obligations. This lays strong foundations for preparations towards the 2019 UN HLM on Universal Health Coverage – in which we expect to see NCD prevention and control fully integrated.
The 2018 HLM on NCDs is a watershed moment for the NCD movement. We will not rest, we will not be polite in our own dedication and energy for a world free from preventable suffering and death from NCDs. We implore leaders: talk to your people and hear their stories, look at the data and commit to action for the sake of the people that the numbers represent, and ask yourselves: are you doing enough to ensure the health and well-being of your people, your societies, and your economies? We will hold leaders to account for their commitments, the organisations who obstruct progress, and those whose action or inaction are costing us all dearly. We have had enough of inaction on NCDs.
We have had enough of apathy. It’s time to invest. It’s time to act. It’s time to deliver. It’s high time to save lives.

  1. WHO (2018), Saving lives, spending less: a strategic response to noncommunicable diseases
  2. WHO (2018) NCD Country Profiles: http://www.who.int/nmh/publications/ncd-profiles-2018/en/ 2\

STATEMENT LINK 

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