Summary book of Municipalities – Ministry of Federal Affairs and Local Development
Summary book of Municipalities – Ministry of Federal Affairs and Local Development
Structural Arrangement in Federal Context
Structural Arrangement in Federal Context Structural Arrangement in Federal Context
[RESEARCH ARTICLE]: Article Link
Media release
Embargo Date: 23.30 hrs UK time on Monday 11 December
Lay health workers prevents deaths from high blood pressure, a leading cause of global deaths: According to a latest study published in the Lancet Global Health, Female Community Health Volunteers-led life style intervention is effective for the reduction of high blood pressure in the general population of Nepal. Every year 10 million people die due to hypertension related events worldwide. Over 85% of these cardiovascular related deaths occur in low and middle-income countries (LMICs). In Nepal, one in four adults have high blood pressure, and approximately half of them do not know they have it.
Community health workers (CHWs) such as female community health volunteers (FCHVs) of Nepal are the key pillars of health system in many LMICs. Although the effectiveness of CHWs for preventing maternal and child health is univocal, there has been little evidence on whether existing CHWs within formal government health care delivery system could be mobilized for reducing high blood pressure. The new study assessed the effectiveness of lifestyle interventions led by FCHVs in a real life setting in Nepal. The FCHV visited the selected households every three months for providing health promotion messages and screening the blood pressure. This has led to a significant reduction in blood pressure not only those hypertensive but also those who had blood pressure within normal range. “Our study has given a crucial evidence that CHWs can be instrumental in the blood pressure reduction through lifestyle modification”, says Dr Neupane, a Post-doctoral fellow at the Duke Kunshan University, China who led the study. Previous studies have established that even a small drop in blood pressure at the population level is beneficial for reducing cardiovascular disease events and mortality. For example previous studies have estimated that even, a 5 mm Hg reduction in systolic blood pressure could reduce stroke mortality by 14%, of coronary heart disease mortality by 9% and of all-cause mortality by 7%.
The results of this study provide proof of concept. There is now the potential to scale up and replicate this intervention program in other developing countries. Many low and middle income countries have strong community health worker programs that can be utilized for primary care interventions to prevent and reduce the burden of cardiovascular disease. In Nepal alone, there are over 50,000 FCHV’s.
“ In summary while these outcomes are exciting, there is always more work to be done, for improving the length of follow-up of the individuals, as well as the assessing the sustainability of the intervention”, says Dr Neupane. A longer follow-up duration with a large sample size is needed to see how sustainable the blood pressure reduction is, in the long term. Also, it is imperative to convince health authorities to promote and fund such programs.
Media Contact
Dr Dinesh Neupane, Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu 215316, China E: dinesh.neupane@dukekunshan. edu.cn
Shiva Raj Mishra, Research and Communication manager, Nepal Development Society, E:shivarajmishra@gmail.com
List of authors: Dinesh Neupane, Craig S McLachlan, Shiva Raj Mishra, Michael Hecht Olsen, Henry B Perry, Arjun Karki, Per Kallestrup Affiliations: Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark (D Neupane PhD, P Kallestrup PhD); Rural Clinical School, University of New South Wales, Kensington, NSW, Australia (C S McLachlan PhD); Nepal Development Society, Chitwan, Nepal (S R Mishra MPH); Department of Internal Medicine, Holbaek Hospital, University of Southern Denmark, Odense, Denmark (Prof M H Olsen PhD); Department of International Health, Health Systems Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA (H B Perry PhD); and Department of Internal Medicine, Grande International Hospital, Kathmandu, Nepal (Prof A Karki MD).
About the journal, visit official Website. (External Link)
Blog post Contributor: Kamal Ranabhat
The General Assembly,
Recalling its resolutions 63/33 of 26 November 2008, 64/108 of 10 December 2009, 65/95 of 9 December 2010 and 66/115 of 12 December 2011,
Welcoming the outcomes of the major United Nations conferences and summits which have contributed to the advancement of the global health agenda, especially the outcome document of the United Nations Conference on Sustainable Development, held in Rio de Janeiro, Brazil, from 20 to 22 June 2012, entitled “The future we want”, the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, adopted on 19 September 2011, the Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS, adopted on 10 June 2011 at the High-level Meeting of the General Assembly on HIV/AIDS, the Rio Political Declaration on Social Determinants of Health, adopted at the World Conference on Social Determinants of Health, held in Rio de Janeiro, Brazil, from 19 to 21 October 2011, resolution 58.33 of the World Health Assembly, on sustainable health financing, universal coverage and social health insurance, resolution 64.9 of the World Health Assembly, Sustainable health financing structures and universal coverage, and recommendation No. 202 concerning national floors of social protection adopted by the International Labour Conference at its one hundred and first session, and reaffirming the Programme of Action of the International Conference on Population and Development, adopted in Cairo in September 1994, the key actions for the further implementation of the Programme of Action and the Beijing Declaration and Platform for Action,
Reaffirming the right of every human being to the enjoyment of the highest attainable standard of physical and mental health, without distinction as to race, religion, political belief, economic or social condition, and the right of everyone to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond one’s control,
Noting with particular concern that for millions of people the right to the enjoyment of the highest attainable standard of physical and mental health, including access to medicines, remains a distant goal, that especially for children and those living in poverty, the likelihood of achieving this goal is becoming increasingly remote, that millions of people are driven below the poverty line each year because of catastrophic out-of-pocket payments for health care, and that excessive out-of-pocket payments can discourage the impoverished from seeking or continuing care,
Taking note of the World Health Report 2010, entitled “Health systems financing: the path to universal coverage”, and the Social Protection Floor Initiative endorsed by the United Nations Chief Executives Board for Coordination in April 2009, and taking note with appreciation of the outcomes of international and regional meetings that reaffirm the importance of universal health coverage, including the Mexico City Political Declaration on Universal Health Coverage, adopted on 2 April 2012, the Bangkok Statement on Universal Health Coverage, adopted at the Prince Mahidol Award Conference on 28 January 2012, and the Tunis Declaration on Value for Money, Sustainability and Accountability in the Health Sector, adopted on 5 July 2012,
Reaffirming its commitment to make every effort to accelerate the achievement of the internationally agreed development goals, including the Millennium Development Goals, by 2015,
Acknowledging that many of the underlying determinants of health and risk factors of both non-communicable and communicable diseases, in particular tuberculosis, malaria and HIV and AIDS, as well as the causes of maternal and infant mortality, are associated with social and economic conditions, the improvement of which is a social and economic policy issue,
Acknowledging also the need to continue to promote, establish or support and strengthen multisectoral national policies and plans for the prevention and control of non-communicable diseases and to take steps to implement such policies and plans, including by recognizing the importance of universal coverage in national health systems, taking into account their significant impact on the sustainability of health system financing,
Recognizing the importance of universal coverage in national health systems, especially through primary health-care and social protection mechanisms, to provide access to health services for all, in particular for the poorest segments of the population,
Recalling in particular that the sixty-fourth World Health Assembly, in its resolution 64.9, requested the Director General of the World Health Organization to convey to the Secretary-General of the United Nations the importance of universal health coverage for discussion by a forthcoming session of the General Assembly,5
Noting the role of the Foreign Policy and Global Health Initiative in promoting synergy between foreign policy and global health, as well as the contribution of the Oslo Ministerial Declaration of 20 March 2007, entitled “Global health: a pressing foreign policy issue of our time”, which was reaffirmed, with renewed actions and commitments, by the ministerial declaration of 22 September 2010,
Notes with appreciation the note by the Secretary-General transmitting the report of the Director General of the World Health Organization and the recommendations contained in the report on improving coordination, coherence, and effectiveness of governance for global health and addressing the interlinkages between health and environment and health and natural disasters;
Calls for more attention to health as an important cross-cutting policy issue in the international agenda, as it is a precondition and an outcome and indicator of all three dimensions of sustainable development, and for the recognition that global health challenges require concerted and sustained efforts to further promote a global policy environment supportive of global health and sustainable development;
Invites Member States to recognize the links between the promotion of universal health coverage and other foreign policy issues, such as the social dimension of globalization, cohesion and stability, inclusive and equitable growth and sustainable development and sustainability of national financing mechanisms, and the importance of universal coverage in national health systems, especially through primary health care and social protection mechanisms, including nationally determined social protection floors;
Also invites Member States to adopt a multisectoral approach and to work on determinants of health within sectors including, as appropriate, through the health-in-all-policies approach, while taking into consideration the social, environmental and economic determinants of health, with a view to reducing health inequities and enabling sustainable development, and stresses the urgent need to act on social determinants for the final push towards the achievement of the Millennium Development Goals;
Calls upon Member States to value the contribution of universal health coverage to achieving all interrelated Millennium Development Goals, with the ultimate outcome of more healthy lives, particularly for women and children;
Recognizes that, although countries have realized important achievements, all countries have scope for further improvements in their health financing policies to enhance and sustain more efficient, equitable, inclusive and high-quality health systems for their populations, and that health financing systems in many countries need to be further developed in order to provide access to necessary services while providing protection against financial risk;
Reaffirms the leading role of the World Health Organization and the important role of the United Nations system in enhancing the visibility of health issues in the different international forums and in supporting Member States in responding to the challenges of the implementation of universal health coverage;
8.
Recognizes the responsibility of Governments to urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality health-care services;
9.
Also recognizes that effective and financially sustainable implementation of universal health coverage is based on a resilient and responsive health system that provides comprehensive primary health-care services, with extensive geographical coverage, including in remote and rural areas, and with a special emphasis on access to populations most in need, and has an adequate skilled, well-trained and motivated workforce, as well as capacities for broad public health measures, health protection and addressing determinants of health through policies across sectors, including promoting the health literacy of the population;
10.
Acknowledges that universal health coverage implies that all people have access, without discrimination, to nationally determined sets of the needed promotive, preventive, curative and rehabilitative basic health services and essential, safe, affordable, effective and quality medicines, while ensuring that the use of these services does not expose the users to financial hardship, with a special emphasis on the poor, vulnerable and marginalized segments of the population;
11.
Recognizes that the provision of universal health coverage requires full and effective implementation of the Beijing Platform for Action,9 the Programme of Action of the International Conference on Population and Development6 and the outcomes of their review conferences, including the commitments relating to sexual and reproductive health and the promotion and protection of all human rights in this context, and emphasizes the need for the provision of universal access to reproductive health, including family planning and sexual health, and the integration of reproductive health into national strategies and programmes;
12.
Also recognizes that the provision of universal health coverage is mutually reinforcing with the implementation of the Political Declaration on the Prevention and Control of Non-communicable Diseases2 and the Political Declaration on HIV and AIDS;3
13.
Acknowledges that governance to move towards universal health coverage involves transparent and inclusive and equitable decision-making processes that allow for the input of all stakeholders and develop policies that perform effectively and reach clear and measurable outcomes for all, build accountability and, most crucially, are fair in both policy development processes and results;
14.
Recognizes that it is essential to take into consideration the needs of vulnerable segments of society, including the poorest and marginalized segments of the population, indigenous peoples and persons with disabilities, in accordance with the principle of social inclusion, in order to enhance their ability to realize their right to the enjoyment of the highest attainable standard of physical and mental health;
15.
Urges Governments, civil society organizations and international organizations to promote the inclusion of universal health coverage as an important element in the international development agenda and in the implementation of the internationally agreed development goals, including the Millennium Development Goals, as a means of promoting sustained, inclusive and equitable growth, social cohesion and well-being of the population and achieving other milestones for social development, such as education, work income and household financial security;
16.
Calls upon Member States to ensure that health financing systems evolve so as to avoid significant direct payments at the point of delivery and include a method for prepayment of financial contributions for health care and services as well as a mechanism to pool risks among the population in order to avoid catastrophic health-care expenditure and impoverishment of individuals as a result of seeking the care needed;
17.
Acknowledges that the choice of a health financing system should be made within the particular context of each country;
18.
Recognizes that improving social protection towards universal coverage is an investment in people that empowers them to adjust to changes in the economy and in the labour market and helps support a transition to a more sustainable, inclusive and equitable economy;
19.
Emphasizes that Governments should provide those who do not have sufficient means with the necessary financial risk protection and health-care facilities without discrimination;
20.
Recognizes the important role of national and subnational legislative and executive bodies, as applicable, in further reforms of health financing systems with a view to moving towards universal health coverage;
21.
Encourages Member States, in collaboration with other stakeholders where applicable, to plan or pursue the transition of their health systems towards universal coverage, while continuing to invest in and strengthen health-delivery systems to increase and safeguard the range and quality of services and to adequately meet the health needs of the population;
22.
Calls for strengthening collaboration among Member States, in particular through the World Health Organization, through technical assistance and sharing of best practices as well as working with partners, including civil society, to promote effective implementation of universal health coverage on the basis of solidarity at national and international levels;
23.
Acknowledges that when managing the transition of the health system to universal coverage, each option will need to be developed within the particular epidemiological, economic, sociocultural, political and structural context of each country in accordance with the principle of national ownership;
24.
Urges Member States to continue to consider health issues in the formulation of foreign policy;
25.
Recommends that consideration be given to including universal health coverage in the discussions on the post-2015 development agenda in the context of global health challenges;
26.
Calls upon the Economic and Social Council to consider the issue of universal health coverage as part of its 2013 programme of work, with the participation of the World Health Organization, the World Bank, other relevant United Nations entities and other stakeholders, within existing resources;
27.
Decides to continue consultations on the promotion of universal health coverage, regionally and globally, including on the possibility of convening a high-level meeting of the General Assembly;
28.
Requests the Secretary-General, in close collaboration with the Director General of the World Health Organization and with the participation of relevant programmes, funds and specialized agencies of the United Nations system, and in consultation with Member States, to give high priority to universal health coverage and its links to social protection floors within their social programmes and policies;
29.
Also requests the Secretary-General to submit to the General Assembly at its sixty-eight session, under the item entitled “Global health and foreign policy”, a report which compiles and analyses past and current experiences of Member States in the way they succeed in implementing universal health coverage, including its links to nationally determined social protection floors, and in sharing, establishing and strengthening institutional capacity in order to generate country-level evidence-based policy decision-making on the design of universal health coverage systems, including tracking the flows of health expenditure through the application of standard accounting frameworks.
Source of Info
Photo: The USAID ASSIST PROJECT
On 12 December 2012, the United Nations unanimously endorsed a historic resolution urging all countries to accelerate progress toward universal health coverage as an essential priority for international development.
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UHC Day has become the annual rallying point for the growing global movement for health for all. Each year on 12.12, we raise our voices to share the stories of the millions of people still waiting for health, to call on leaders to make bigger and smarter investments in health, and to remind the world that health for all is imperative for the world we want.
UHC means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
UHC enables everyone to access the services that address the most important causes of disease and death, and ensures that the quality of those services is good enough to improve the health of the people who receive them.
Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.
There are many things that are not included in the scope of UHC:
“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.
Almost 70 years after these words were adopted in the Constitution of the World Health Organization, they are more powerful and relevant than ever.
Since day one, the right to health has been central to WHO’s identity and mandate. It is at the heart of my top priority: universal health coverage.
The right to health for all people means that everyone should have access to the health services they need, when and where they need them, without suffering financial hardship.
No one should get sick and die just because they are poor, or because they cannot access the health services they need.
Good health is also clearly determined by other basic human rights including access to safe drinking water and sanitation, nutritious foods, adequate housing, education and safe working conditions.
The right to health also means that everyone should be entitled to control their own health and body, including having access to sexual and reproductive information and services, free from violence and discrimination.
Everyone has the right to privacy and to be treated with respect and dignity. Nobody should be subjected to medical experimentation, forced medical examination, or given treatment without informed consent.
That’s why WHO promotes the idea of people-centred care; it is the embodiment of human rights in the practice of care.
When people are marginalized or face stigma or discrimination, their physical and mental health suffers. Discrimination in health care is unacceptable and is a major barrier to development.
But when people are given the opportunity to be active participants in their own care, instead of passive recipients, their human rights respected, the outcomes are better and health systems become more efficient.
We have a long way to go until everyone – no matter who they are, where they live, or how much money they have – has access to these basic human rights.
The central principle of the 2030 Agenda for Sustainable Development is to ensure that no one is left behind.
I call on all countries to respect and protect human rights in health – in their laws, their health policies and programmes. We must all work together to combat inequalities and discriminatory practices so that everyone can enjoy the benefits of good health, no matter their age, sex, race, religion, health status, disability, sexual orientation, gender identity or migration status.
Happy 14th National FCHV Day !!!
Happy 14th National FCHV Day !!!
International Volunteer Day (IVD) mandated by the UN General Assembly, is held each year on 5 December. It is viewed as a unique chance for volunteers and organizations to celebrate their efforts, to share their values, and to promote their work among their communities, non-governmental organizations (NGOs), United Nations agencies, government authorities and the private sector.
IVD 2017’s theme #VolunteersActFirst. Here. Everywhere. recognizes the contributions of volunteers as first responders in times of crisis. Volunteers are present, all around us, answering calls in times of need, helping save lives today, and supporting those who want to continue living their lives with dignity tomorrow. Risking their lives every day to care for people affected by conflict, violence and humanitarian crises, volunteers brave many dangers to help others, driven by the desire to make a difference in the face of human suffering.
This year, IVD promotes the contributions of such volunteers at the local, national and international level.
In Nepal, National Female Community Health Volunteers (FCHVs) Day is celebrated every year on 5 December across the country by organising various activities.
THEME FOR 14th FCHVs Day is "महिला स्वास्थ्य स्वयं सेविकाको निस्वार्थ सेवाः स्वस्थ, समृद्ध राष्ट्र निर्माणमा टेवा"
Photo: Orientation on Measles Rubella Vaccination Campaign 2012, Urban Health Center, Lekhnath-15
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Female Community Health Volunteer (FCHV) Programme, Nepal: The government initiated the Female Community Health Volunteer (FCHV) Programme in 2045/46 (1988/1989) in 27 districts and expanded it to all 75 districts thereafter. Initially one FCHV was appointed per ward following which in 2050 (1993/94) a population based approach was introduced in 28 districts. There are 51,416 FCHVs with 46,088 at rural/VDC level and 5,328 at urban/municipality level. Urban FCHVs are mobilized through municipalities, while rural FCHVs are mobilized by local health posts or PHCCs. FCHVs are selected by members of Mothers’ Group for Health (MG‐H) with the help of local health facility staff.
FCHVs are selected by healthy mothers’ groups. FCHVs are provided with 18 days (9+9) basic training following which they receive medicine kit boxes, manuals, flipcharts, ward registers, IEC materials, and an FCHV bag, signboard and identity card. Family planning devices (pills and condoms only) iron tablets, vitamin A capsules, and ORS are supplied to them through health facilities.
The major role of FCHVs is to advocate healthy behaviour by mothers and community people to promote safe motherhood, child health, and family planning and other community based health issues and service delivery. FCHVs distribute condoms and pills, ORS packets and vitamin A capsules, treat pneumonia cases, refer serious cases to health institution and motivate and educate local people on healthy behaviour. They also distribute iron tablets to pregnant women.
The government is committed to increase the morale and participation of FCHVs for community health. Policies, strategies and guidelines have been developed to strengthen the programme. The FCHV programme strategy was revised in 2067 (2010) to promote a strengthened national programme. In fiscal year 2064/65 MoH established FCHV funds of NPR 50,000 in each VDC mainly to promote income generation activities. FCHVs are recognised for having played a major role in reducing maternal and child mortality and general fertility through community-based health programmes. Source of Info: DoHS, Annual Report 2072/73 (2015/16)
Female Community Health Volunteer (FCHV) Programme, Nepal
Female Community Health Volunteer (FCHV) Programme, Nepal
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