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Descriptive Epidemiology of Scrub Typhus in Nepal, 2017

by Public Health Update November 23, 2017
written by Public Health Update

Descriptive Epidemiology of Scrub Typhus in Nepal, 2017

EXECUTIVE SUMMARY

Scrub typhus is a mite borne acute febrile infectious illness that is caused by Orientia tsutsugamushi. Very few attempts were made in Nepal before 2014 to investigate the presence of this disease. A total of 101 confirmed scrub typhus cases were reported from 16 districts in 2015. The magntitude of the outbreak was so disastrous in 2016 that by the end of third week of December, 831 cases of scrub typhus was reported in 47 of the 75 districts and fatalties reaching to 14. A national wide epidemiological study was thus felt necessary to understand the distribution of the disease. This study in addition documents entomological and rodentological evidence to confirm the presence of the outbreak. Line listing data of scrub typhus cases reported to EDCD were compiled and used for analysis. Data was collected from January to October 2016. Chitwan district was selected for rodentological and entomological study based on the severity and prevalence of the disease. Rodents were trapped; mites collected and laboratatory investigation of rodents and chiggers was done to confirm the presence of Orientia tsutsugamushi. Human blood samples were also collected from suspected scrub typhus patients and both IgM Elisa and IFA, the gold standard assay was done to confirm the presence of the parasite.
Although 831 cases were reported in the country during April-December 2016 in Nepal, complete line listing was available for only 401 cases. Around sixty percent (59.4%) of the cases were female while the median age of the cases was 25 years. Majority of the cases belonged to Janajati/Aadhibasi (44.4%) and Brahmin/Chhetri (44.1%) ethnic groups. From Tarai 81.5% of the cases were reported while on the regional basis, the central region (45.6%) had the highest number of reported cases. Chitwan was the most affected district contributing to 34.4% of the total cases. The outbreak peaked during the month of August and September.
Out of 12 rodents trapped, three were positive for chigger mites. Representative human serum samples tested by IFA confirmed the presence of Orientia tsutsugamushi in Nepal. Out of the 61 samples, 29 cases were confirmed scrub typhus positive by IFA. Similalry, two out of nine rodent serum samples were confirmed scrub typhus positive by IFA. One of the three chiggers’ samples was also confirmed positive by PCR. Thus, there is clear evidence of circulation of Orientia tsutsugamushi in Nepal. The study hints the potential of scrub typhus outbreak in Nepal and there is a clear need of early preparedness and control measures.
Karki KB, Acharya BP, Dhimal M, Aryal KK, Sharma GN, Khanal P, Ranabhat K, Dumre SP, Jha AK. Descriptive Epidemiology of Scrub Typhus in Nepal. Kathmandu, Nepal, 2017. Nepal Health Research Council (NHRC).

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November 23, 2017 0 comments
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National Health NewsPublic Health News

Global Food and Security Strategy launched in Nepal

by Public Health Update November 19, 2017
written by Public Health Update

Global Food and Security Strategy launched in Nepal


Strategy to boost farm sector, improve nutrition introduced Global food security
Nov 18, 2017-The US government, in partnership with the Agricultural Development and Health ministries, launched a five-year Global Food Security Strategy (GFSS) on Friday to boost agricultural productivity and improve nutrition in Nepal.
The strategy builds on the US government’s ongoing Feed the Future initiative and will support Nepal’s Agriculture Development Strategy (ADS) and Multi-Sector Nutrition Plan. Nepal is one of only 12 countries worldwide selected by the US government to implement this strategy. The total cost of the GFSS has not been disclosed. 
The US Agency for International Development (USAID) is currently running two projects under its Feed the Future initiative—$32.7 million Knowledge-Based Integrated Sustainable Agriculture in Nepal (KISAN II) and $15 million Nepal Seed and Fertilizer Programme. These ongoing projects will be integrated with the border GFSS project once it is fully implemented. 
“The new strategy emphasises investments throughout the agriculture value chain to better connect producers to markets, which will improve access to safe, high-quality food and generate income and job opportunities, particularly among youth,” said US Embassy Chargé d’Affaires Michael C Gonzales. Over the next five years, the GFSS will forge new partnerships and greater collaboration among the government, donors, businesses and civil society to accelerate growth and employment in Nepal’s agriculture sector while enhancing nutrition.
As Nepal has endorsed the ADS, a farm blueprint with a 20-year vision and a 10-year planning horizon, and the Multi-Sector Nutrition Plan, the GFSS will play an important role in harnessing the potential of the agricultural sector and increasing incomes of millions of Nepalis, he said. The ADS that envisages transforming Nepal’s farm sector in the face of common challenges such as climate change, food price volatility, low productivity and water stress was implemented in the last fiscal year.
“Nepal has made impressive strides in reducing hunger and malnutrition over the past two decades. It has set an ambitious goal to graduate from low-income country to middle-income country status by 2030. Hence, the policy goals of the ADS and Multi-Sector Nutrition Plan highlight priorities to address hunger, malnutrition and poverty,” said Gonzales. 
23658427 1717011805015687 494072989563839742 n

Photo: USAID NEPAL

“Through the GFSS, we want to maximize the impact to improve the livelihood of the people, particularly targeting disadvantaged communities, women and young people in the agriculture sector.” Nepal has held on to the top position among South Asian countries in the campaign to reduce hunger. According to the 2017 Global Hunger Index (GHI) released by the International Food Policy Research Institute (IFPRI), Nepal experienced rapid improvements in  reducing hunger and is nearing the ‘moderate’ from the ‘serious’ category, largely due to declines in undernourishment, child stunting and child mortality.
Agriculture Secretary Suroj Pokhrel said that the GFSS would strengthen small holders and marginalized farming communities with higher incomes.  The US government claimed that over the past five years, the Feed the Future initiative in Nepal had helped an estimated 1 million Nepalis to increase income through improved agricultural productivity and enhanced nutrition.  As a result, poverty dropped by 36 percent between 2013 and 2015, stunting decreased from 49 percent to 36 percent from 2006 to 2016, and average farmer sales increased from $250 per year to an estimated $700 per year in the 24 south-western and central districts where the US programme has been implemented, the US Embassy said. 


Original Source of Info: http://kathmandupost.ekantipur.com/news/2017-11-18/strategy-to-boost-farm-sector-improve-nutrition-introduced.html

November 19, 2017 1 comment
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Public Service Commission Syllabus
Public Health NotesSyllabus

Public Service Commission Syllabus for Public Health Administrator

by Public Health Update November 19, 2017
written by Public Health Update

Overview

Paper I General Subject
Part I: Management 50 marks
– 6 × 5 = 30 (Short answer)
– 2 × 10 = 20 (Long answer)
Part II: General Health Issues 50 marks
Full Marks: 100
No. of Questions & Weightage
– 4 × 5 = 20 (Short answer)
– 3 × 10 = 30 (Long answer)
Time Allowed: 3 hours

Paper II: Technical Subject
Full Marks: 100
Time Allowed: 3 hours
No. Questions & Weightage
– 4 × 15 = 60 (Critical Analysis)
– 2 × 20 = 40 (Problem Solving)

Paper I General Subject (Management and General Health Issues)

Part I: Management

  1. Management: – concept, principles, functions, scope, role, level and skills of managers
  2. Hospital management
  3. Health manpower recruitment and development
  4. Participative management: concept, advantages and disadvantages, techniques of participation
  5. Time management: concept, advantages, and disadvantages
  6. Conflict management: concept, approaches to conflict, levels of conflict, causes of conflict and strategies for conflict management
  7. Stress management: concept, causes and sources of stress, techniques of stress management
  8. Appreciative inquiry: concept, basic principles and management
  9. Financial management: concept, approaches, budget formulation and implementation, auditing and topics related to fiscal management
  10. Human resource management: concept, functions and different aspects
  11. Planning: concept, principles, nature, types, instrument and steps
  12. Leadership: concept, functions, leadership styles, leadership and management effectiveness
  13. Coordination: concept, need, types, techniques, and approaches of effective coordination
  14. Communication: concept, communication process and barrier to effective communication, techniques for improving communication

Part II: General Health Issues

  1. Present Constitution of Nepal (health and welfare issues)
  2. National Health Policy, 2071
  3. Second long term health plan (1997-2017)
  4. Health services act 2053, health service regulation, 2055
  5. Organizational structure of Ministry of Health at National, Regional and District and Below
  6. International health agencies: role and responsibilities of WHO, UNICEF,
  7. UNFPA and interagency relationships
  8. Professional council and related regulations
  9. Medical ethics in general and its application
  10. Indigenous and traditional faith healing and health practices
  11. Supervision, types and its usage in health sector
  12. Monitoring and evaluation system in health
  13. Health management information system
  14. Health insurance and financing in health care
  15. Effects of environment in public health: air pollution, domestic pollution, noise
  16. pollution
  17. Importance of water, sanitation and hygiene in public health
  18. Effects of disaster in public health: deforestation, landslide, flood, earthquake and fire
  19. Health volunteers involvement in health service delivery
  20. Community involvement in health service delivery
  21. Counseling: – concept, type, importance and its application in health service delivery

Paper II: Technical Subject

A. Epidemiology, Statistics and Research
1. Epidemiology
1.1. Definition and commonly accepted concepts, approaches, methods, incidence, prevalence, association and causation, disease prevention and control
1.2. Aim and use of epidemiology
1.3. Epidemiology of diseases (Infectious and non-communicable disease)
1.4. Dynamics of disease transmission-source of reservoir, Mode of transmission susceptible host, immunity and immunizing agents.
1.5. Investigation of an epidemic
1.6. Screening of diseases
1.7. Health Indicators.
2. Diseases Control
2.1. Prevention and control of communicable and non-communicable disease.
3. Health Statistics
3.1. Sources of health information; Health Management Information System.
3.2. Tabulation graphic and diagrammatic representation of data.
3.3. Statistical methods: averages, dispersion distribution, sampling and sampling size test significance, correlation and regression.
4. Demography
4.1. National population policy
4.1.1. Population trends – World and Nepal
4.1.2. Measure of population dynamics
4.1.3. Factors affecting fertility, mortality and migration
4.1.4. Urbanization
4.1.5. Life expectancy
5. Research Methodology
5.1. Operational and health system research
5.2. Research proposal development
5.3. Literature review
5.4. Objectives and hypothesis setting
5.5. Priorities in health research
5.6. Nepal Health Research Council
5.7. Budgeting
B: Health Service Delivery
1. National Health Programs
1.1. Epidemiology and Disease Control Programme: Malaria Tuberculosis, Leprosy, JE, Zoonosis, sexually Transmitted Diseases, HIV/AIDS etc.
1.2. Reproductive Health- Safe motherhood, new borne care, family planning Adolescent reproductive health, safe abortion, care of elderly women, RTI/STD/HIV/DIS, infertility prevention and treatment.
1.3. Child health
1.3.1. Care of the newborn; Integrated Management of childhood illness.
1.3.2. Growth and development
1.3.3. Care of the under fives
1.3.4. Right of the child
1.3.5. Management and control of child illness
1.3.6. Immunization
1.4. Nutrition
1.4.1. Food and nutrients with nutritional profiles
1.4.2. Nutritional problems
1.4.3. Nutritional factors in selected diseases
1.4.4. Assessment of nutritional status
1.4.5. Food toxication, additives, fortification
1.4.6. Nutritional programs
2. Environmental Health
2.1. Internal and external and ecological factors responsible for impairing health.
2.2. Management and control of basic and fundamental environmental factors
2.2.1. Water, Air, Ventilation, Lighting, Noise, Housing
2.2.2. Solid waste disposal and control
2.2.3. Excreta disposal and control
2.3. Medical entomology-mosquito, housefly, sand-fly, lice, fleas, bugs etc. control
2.4. Insecticides-safe use and resistance
2.5. Rodents control
3. Occupational Health
3.1. Occupational Environment
3.2. Occupational hazards
3.3. Health problems due to industrialization
3.4. Management, Prevention (medical, engineering and legislation) and control of
3.4.1. Occupational diseases and conditions like Pneumoconiosis, lead poisoning, cancers, and dermatitis and radiation hazards
3.4.2. Occupational hazards of agricultural workers
3.4.3. Accidents in industries
3.4.4. Measures for the general health protection of workers.
4. School health
4.1. Curriculum, instruction and training
4.2. Health school environment
4.3. School community cooperation for better health
5. Essential Care Services (EHCS)
5.1. EHCS at the district level and below
5.2. Health care services beyond district level-tertiary and specialized care

Syllabus

  • Public Service Commission Syllabus Health Education Teaching Administrator
  • Public Service Commission Syllabus for Health Education Technician
  • Public Service Commission For ANM Syllabus
  • Public Service Commission Syllabus for AHW
  • Public Service Commission Syllabus Health Assistant
  • Public Service Commission Syllabus for AHW
  • Syllabus for Postgraduate Integrated Entrance Examination
  • Syllabus for Public Health Licensing Examination 2073 – Nepal Health Professional Council
  • Syllabus for Public Health Officer 7th Level Examination – Public Service Commission


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November 19, 2017 0 comments
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PUBLIC SERVICE COMMISSION
Public Health NotesSyllabus

Public Service Commission Syllabus for Public Health Officer

by Public Health Update November 19, 2017
written by Public Health Update

Syllabus for Public Health Officer 7th Level Examination – Public Service Commission

7th

[1st Paper]

HEALTH INSPECTION RELATED

1 Health and Public Health (5%) (Questions-5)

1.1. Meaning of health and disease, Factors that influence health, concept of health and disease, Dimension of disease, Measurement of health, disease and well being
1.2 Public health concept, Historical development and changing concept
 

2 Health Planning and Management (20%) (Questions-20)

2.1 Approaches, models, methods and practices
2.2 Need assessment, planning cycle, Planning, monitoring and evaluation
2.3 Strategic and operational planning
2.4 Inventory management
2.5 Drug management
2.6 Financial management
2.7 Health economics, Health care financing: Basic concepts and economic evaluation of health care services
2.8 Health care need assessment
2.9 Decentralization in health management
2.10 Quality assurance in health care
 

3 General Epidemiology (10%) (Questions-10)

3.1 Definition, concepts, approaches, aims, and use of epidemiology
3.2 Epidemiological methods, Incidence, Prevalence, association and causation, disease prevention and control
3.3 Epidemiology of communicable and non communicable diseases
3.4 Dynamics of disease transmission
3.5 Investigation of an epidemics
3.6 Screening of diseases
3.7 Health indicators
 

4 Health Statistics (5%) (Questions-5)

4.1 Sources of health information, Health information system
4.2 Tabulation, graphic and diagrammatic presentation of data
4.3 Statistical methods; Measures of central tendency, Measures of variability
4.4 Sampling size, Sampling survey and test of significance, correlation and regression

5. Demography (5%) (Questions-5)

5.1 Population trends-world and national
5.2 Measures of population dynamics
5.3 Factors affecting fertility, mortality and migration
5.4 Urbanization, Life expectancy
 

6 Applied Epidemiology and Disease Control (20%) (Questions-20)

6.1 Epidemiology, Prevention and control of communicable diseases including: Measles, Diphtheria, Whooping cough, Acute respiratory tract infection, Rubella, Mumps, Influenza, Tuberculosis, Viral hepatitis, Food poisoning, Typhoid fever, Intestinal worms, Acute diarrhoeal diseases, Filaria, Leishmaniasis, Malaria, Japanese encephalitis, Rabies, Tetanus, Trachoma, Leprosy, STD and HIV/AIDS
6.2 Prevention and control of non-communicable diseases
6.3 Concept of Control, elimination and eradication of diseases
 

7 Food and Nutrition (5%) (Questions-5)

7.1 Nutritional profiles
7.2 Nutritional problems
7.3 Assessment of nutritional status
7.4 Food intoxication, additives and fortification;
 

8 Environmental Health (5%) (Questions-5)

8.1 Management and control of basic and fundamental factors; Water, Air, Lighting, Noise, Housing
8.2 Solid waste disposal and control
8.3 Excreta disposal and control
8.4 Medical entomology-Mosquito, housefly, sand fly, lice, fleas, bugs etc. control
8.5 Insecticides safe use and resistance
8.6 Rodents control

9 Occupational Health (5%) (Questions-5)

9.1 Occupational environment and safety
9.2 Occupational hazards
9.3 Management and prevention of occupational hazards
9.4 Measures for general health protection of workers
 

10 Health Education and Health Promotion (10%)

10.1 Concept, Objectives and principles and their importance
10.2 Methods of health education
10.3 Health education medias and production
10.4 Behavior change communication (BCC)
10.5 Community organization and participation
10.6 Communication and information: concepts and importance
10.7 School health program: concepts, areas and importance
 

11 Primary Health Care (PHC), Essential Health Care Services (EHCS) and Millennium Development Goals (MDGs) (5%) (Questions-5)

11.1 Concept, Components, Status and Prospects
12 International Health 5%
12.1 External development partners and their priorities
12.2 UN agencies: WHO, UNICEF, UNDP, UNFPA, UNAIDS and World Bank
12.3 Bilateral agencies working in Nepal: USAID, JICA, GTZ, DFID, SDC, CIDA, AUSAID, NORAD, FINIDA, KOIKA

[2nd Paper]

HEALTH INSPECTION RELATED

Section A- 30 Marks

1 Health Policies Issues (10%) (Questions-1)

1.1 National Health Policy 1991
1.2 Current National Population Policy
1.3 Second Long Term Health Plan (1997-2017)
1.4 Health Sector in Current Five Year Plan

4. Health Issues and Regulations (20%) (Questions-2)

4.1 Health act, 2053 and Health regulation, 2054
4.2 Current financial administration regulation
4.3 Local governance and decentralization in health
4.4 Health and human right
4.5 Professional council and related regulations
4.6 Ethical issues in health

Section B- 30 Marks

2 Introduction, Objectives, Strategies, Targets and Current Status of National Health programs (30%) (Questions-3)

2.1 Family Planning, Safe Motherhood, Immunization Program, Nutrition, Integrated management of Childhood illness (IMCI), Malaria, Tuberculosis, Leprosy, Sexually transmitted Infections (STI) and HIV/AIDS
2.2 National health training center: basic, refresher and other continuous medical education programme
2.3 National Health Education Information and Communication Center: Critical overview of functions and roles
2.4 Development of District Health Profiles
2.5 Female Community Health Volunteers Programme (FCHV)
2.6 Primary Health Care Outreach Programme (PHC-ORC)
2.7 Disaster Management and Early Warning Reporting System(EWARS)
2.8 Health Sector Reform Program: Strategy and planning programs
2.9 Health Economics and Financing Unit (HEFU)
2.10 Health Management Information System (HMIS)
2.11 Logistic Management Information System (LMIS)
2.12 Human Resource Information Center (HURIC)

 


Section C- 20 Marks

3 Management of Public Health Programme in the District with Special Reference to (20%)(Questions-2)

3.1 Family Planning, Safe Motherhood, Immunization Program, Nutrition, Integrated management of Childhood illness (IMCI), Malaria, Kala-azar, J.E. and other Vector borne diseases, Tuberculosis, Leprosy, Sexual transmission diseases (STD) and HIV/AIDS.
3.2 Training activities in the district;
3.3 Health education, information and communication activities in the District
3.4 Management of Camps

 


Section D- 20 Marks

5 Management Issues in Nepal Health Services (20%) (Questions-2)

5.1 Personnel management: concept, principles, nature
5.2 Human resource management: concept, functions and different aspects
5.3 Community organization: Concepts, principles and process
5.4 Supervision, monitoring and evaluation of health care system: Principles, practice and importance
5.5 Inter and intra-sectoral coordination in health services
5.6 Indigenous and traditional health care system including Ayurveda and other system: Concepts, status and their analytical study
5.7 Analytical study of organizational structure of Ministry of Health and Population and functions

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DOWNLOAD 2ND PAPER 

Syllabus

  • Public Service Commission Syllabus Health Education Teaching Administrator
  • Public Service Commission Syllabus for Health Education Technician
  • Public Service Commission For ANM Syllabus
  • Public Service Commission Syllabus for AHW
  • Public Service Commission Syllabus Health Assistant
  • Public Service Commission Syllabus for AHW
  • Syllabus for Postgraduate Integrated Entrance Examination
  • Syllabus for Public Health Licensing Examination 2073 – Nepal Health Professional Council
  • Syllabus for Public Health Officer 7th Level Examination – Public Service Commission



⚡ Looking for expert analysis, policy briefs, and high-level reviews on Nepal's health sector?

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Latest Posts

  • Call for Registration! National Health Promotion Conference 2026
  • World Atopic Eczema Day 2026: Breaking the Invisible Burden
  • DEVASTATING FLOODS IN NEPAL: PUBLIC HEALTH IMPACT AND A CALL FOR HUMANITARIAN SUPPORT
  • PEN-Plus Orientation Manual for Mid-Level Health Care Workers
  • National Health Training Strategy 2082

Thanks for visiting us.
Disclaimer: The resources, documents, guidelines, and information on this blog have been collected from various sources and are intended for informational purposes only. Information published on or through this website and affiliated social media channels does not represent the intention, plan, or strategies of an organization that the initiator is associated with in a professional or personal capacity, unless explicitly indicated.
If you have any complaints, information, or suggestions about the content published on Public Health Update, please feel free to contact us at blog.publichealthupdate@gmail.com.
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November 19, 2017 1 comment
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PH Important DayPublic Health

Wastewater- World Toilet Day in 2017

by Public Health Update November 19, 2017
written by Public Health Update

World Toilet Day in 2017- ”Wastewater”

In 2013, the UN General Assembly officially designated November 19 as World Toilet Day. The theme for World Toilet Day in 2017 is “wastewater.” 

Toilets Save Lives

Toilets save lives because human waste spreads killer diseases. However, 4.5 billion people live without a household toilet that safely disposes of their waste. World Toilet Day is about inspiring action to tackle the global sanitation crisis.
By 2030, the Sustainable Development Goals, specifically SDG #6, aim to reach everyone with sanitation, and halve the proportion of untreated wastewater and increase recycling and safe reuse.
For that to be achieved, we need everyone’s poo to be contained, transported, treated and disposed of in a safe and sustainable way. Today, for billions of people around the world, sanitation systems are either non-existent or ineffective and, consequently, progress in health and child survival is seriously undermined.
Also, poor water and sanitation cost developing countries around $260 billion a year, 1.5 per cent of their gross domestic product (GDP), while every dollar invested could bring a five-fold return by keeping people healthy and productive.

2017 theme: Wastewater

World Toilet Day 2017 continues the theme from World Water Day earlier this year, with the focus on wastewater. As part of this topic, we are asking the question, ‘Where does our poo go?’ For billions of people around the world, sanitation systems are either non-existent or ineffective. Poo gets out into the environment and spreads killer diseases, seriously undermining progress in health and child survival. Even in wealthy countries, treatment of wastewater can be far from perfect, leading to rivers and coastlines that cannot be safely fished in or enjoyed.
In addition to the profound impact that improved sanitation has on health and living conditions, safely-managed wastewater has massive potential as an affordable and sustainable source of energy, nutrients and water.

The poo journey

The global sanitation crisis is reflected in the following facts, according to reports from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF):

  • Around 60% of the global population – 4.5 billion people – either have no toilet at home or one that doesn’t safely manage excreta.
  • 862 million people worldwide still practise open defecation.
  • 1.8 billion people use an unimproved source of drinking water with no protection against contamination from faeces.
  • Globally, 80% of the wastewater generated by society flows back into the ecosystem without being treated or reused.
  • Only 39% of the global population (2.9 billion people) use a safely-managed sanitation service, that is, excreta safely disposed of in situ or treated off-site.
  • Combined with safe water and good hygiene, improved sanitation could prevent around 842,000 deaths each year.

Source of Info: UN

By 2030, the Sustainable Development Goals aim to reach everyone with sanitation, and halve the proportion of untreated wastewater and increase recycling and safe reuse.

For that to be achieved, we need everyone’s poo to be contained, transported, treated and disposed of in a safe and sustainable way. Today, for billions of people around the world, sanitation systems are either non-existent or ineffective. Human waste gets out and killer diseases spread, meaning progress in health and child survival is seriously undermined.
 
To achieve SDG 6, we need everyone’s poo to take a 4-step journey:

  1. Containment. Poo must be deposited into a hygienic toilet and stored in a sealed pit or tank, separated from human contact.
  2. Transport. Pipes or latrine emptying services must move the poo to the treatment stage.
  3. Treatment. Poo must be processed into treated wastewater and waste products that can be safely returned to the environment.
  4. Disposal or reuse. Safely treated poo can be used for energy generation or as fertilizer in food production.

Source of Info: World Toilet Day

In Nepal, every year 600 children under five die from diarrhoeal diseases caused by dirty water and poor sanitation. This accounts for a third of all child deaths overall.
Only 48% of the population in Nepal has access to a proper toilet, helping to cause widespread disease. The majority of people do not have a latrine and have no option but to defecate in the open. (WaterAid)
The 2015 Update of the WHO-UNICEF Joint Monitoring Programme (JMP), reports that 92% of Nepal’s population have access to improved drinking water, and 64% have access to improved sanitation [inclusive of 18% shared toilets]. The 2014 MICS survey and the DWSS database, suggest that there has been a significant acceleration in sanitation progress both in terms of access to improved sanitation and, very importantly, a substantial decrease in open defecation. atthe end of 2015, out of 75 districts, 27 claim ODF status. And from 217 towns, 81 have declared ODF. Still a good way to go, to ensure sustainability, move towards total sanitation, and take care of fecal sludge. Embedding good hygiene behaviour will take time as well, but it is certainly improving. (Last Updated: 2016) (Ministry of Water Supply and Sanitation)
social media cards WTD2017 EN 01 WTD ODF poster english
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Global Health NewsPublic HealthPublic Health News

New global commitment to end tuberculosis

by Public Health Update November 18, 2017
written by Public Health Update

New global commitment to end tuberculosis

News release: 17 NOVEMBER 2017 | MOSCOW/GENEVA – 
75 ministers agreed to take urgent action to end tuberculosis (TB) by 2030. The announcement came at the first WHO Global Ministerial Conference on Ending Tuberculosis in the Sustainable Development Era: A Multisectoral Response, which brought together delegates from 114 countries in Moscow. President Vladimir Putin of the Russian Federation opened the Conference, together with Amina J Mohammed, UN Deputy Secretary General, and Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“Today marks a critical landmark in the fight to end TB,” said Dr Tedros. “It signals a long overdue global commitment to stop the death and suffering caused by this ancient killer.”
The Moscow Declaration to End TB is a promise to increase multisectoral action as well as track progress, and build accountability. It will also inform the first UN General Assembly High-Level Meeting on TB in 2018, which will seek further commitments from heads of state.
Global efforts to combat TB have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37%. However, progress in many countries has stalled, global targets are off-track, and persistent gaps remain in TB care and prevention.
As a result, TB still kills more people than any other infectious disease. There are major problems associated with antimicrobial resistance, and it is the leading killer of people with HIV.
“One of the main problems has been a lack of political will and inadequate investment in fighting TB,” added Dr Tedros. “Today’s declaration must go hand-in-hand with increased investment.”
The meeting was attended by ministers and country delegations, as well as representatives of civil society and international organizations, scientists, and researchers. More than 1000 participants took part in the two-day conference which resulted in collective commitment to ramp up action on four fronts:

  • Move rapidly to achieve universal health coverage by strengthening health systems and improving access to people-centered TB prevention and care, ensuring no one is left behind.
  • Mobilize sufficient and sustainable financing through increased domestic and international investments to close gaps in implementation and research.
  • Advance research and development of new tools to diagnose, treat, and prevent TB.
  • Build accountability through a framework to track and review progress on ending TB, including multisectoral approaches.

Ministers also promised to minimize the risk and spread of drug resistance and do more to engage people and communities affected by, and at risk of, TB.
The Russian Federation, host of the first Ministerial Conference to End TB, welcomed the Moscow Declaration. “Tuberculosis is a complex, multi-sectoral problem that requires a systemic and highly coordinated response to address the conditions which drive the disease,” said Professor Veronika Skvortsova, Minister of Health, Russian Federation. “The accountability framework we have agreed to develop marks a new beginning, and, with WHO’s support to coordinate and track progress, we expect the Moscow Declaration to lead us forward to the high-level meeting of the UN General Assembly in 2018.” WHO Media Centre 
RELATED: 

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

  • WHO Global Tuberculosis report 2015

  • National Tuberculosis Programme, NEPAL

  • World TB Day 2017 – Unite efforts to leave no one behind #UnitetoEndTB

  • Align national TB strategies with commitment to end TB by 2030: WHO

November 18, 2017 1 comment
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Public Health

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

by Public Health Update November 18, 2017
written by Public Health Update

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

News release (WHO Media Centre)

30 OCTOBER 2017 | GENEVA – Global efforts to combat tuberculosis (TB) have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37%, according to the Global TB Report 2017, released by WHO.
Despite these achievements, the latest picture is grim. TB remains the top infectious killer in 2016. TB is also the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV. Progress in most countries is stalling and is not fast enough to reach global targets or close persistent gaps in TB care and prevention.
“While the world has committed to ending the TB epidemic by 2030, actions and investments don’t match the political rhetoric. We need a dynamic, global, multisectoral approach.” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “The good news is that we finally have two great opportunities to move forward: the first WHO Global Ministerial Conference to End TB in Moscow in 2017, followed by the first UN General Assembly High-Level Meeting on TB in 2018. These will build momentum, get different sectors engaged, and accelerate our efforts to make TB history.”

Global tuberculosis report 2017

WHO has published a global TB report every year since 1997. The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels. This is done in the context of recommended global TB strategies and targets endorsed by WHO’s Member States and broader development goals set by the United Nations. 
The data in this report is updated annually.

DOWNLOAD REPORT

November 18, 2017 2 comments
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PH Important DayPublic Health

“Let them thrive!”- World Prematurity Day 2017

by Public Health Update November 17, 2017
written by Public Health Update

“Let them thrive!”- World Prematurity Day 2017

Let them thrive!
• Quality of care for the smallest
• Improving care for the smallest
• Respectful care for the smallest
World Prematurity Day is observed on November 17 each year. It aims to raise awareness about the issues associated with preterm birth.

Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, based on gestational age:
  • extremely preterm (<28 weeks)
  • very preterm (28 to <32 weeks)
  • moderate to late preterm (32 to <37 weeks).
Induction or caesarean birth should not be planned before 39 completed weeks unless medically indicated. (WHO)
World Prematurity Day is an opportunity to call attention to the heavy burden of death and disability and the pain and suffering that preterm birth causes, as well as a chance to talk about solutions. It supports the values and goals of the Every Newborn Action Plan – an initiative of the Every Woman Every Child movement – which mobilizes global multi-sectoral support to save the lives and improve the wellbeing of mothers and their babies. This year the theme is “Let them thrive,” focusing on quality, equity and dignity.- WHO

Premature birth is the leading cause of death in children under the age of five worldwide. Babies born too early may have more health issues than babies born on time, and may face long-term health problems that affect the brain, the lungs, hearing or vision. World Prematurity Day on November 17 raises awareness of this serious health crisis. Throughout the month we draw attention to the lifesaving research, treatments and community support made possible when we work together to give every baby a fighting chance.  (Marchofdimes) 

Preterm births rising globally

An estimated 15 million babies are born preterm every year – more than 1 in 10 babies around the world and this number is rising. Preterm birth complications are the leading cause of death for children under 5, causing an estimated 1 million deaths in 2015 globally. Many survivors of preterm birth face a lifetime of disability, including learning disabilities and visual and hearing problems.
Preterm birth (born before 37 weeks of pregnancy) and being small for gestational age, which are the reasons for low-birth-weight (LBW), are also important indirect causes of neonatal deaths. LBW contributes to 60% to 80% of all neonatal deaths. The global prevalence of LBW is 15.5%, which amounts to about 20 million LBW infants born each year, 96.5% of them in developing countries.
Countries can reduce their neonatal and infant mortality rates by improving the care for the mother during pregnancy and childbirth and of LBW infants. Experience from developed and low- and middle-income countries has clearly shown that appropriate care of LBW infants, including their feeding, temperature maintenance, hygienic cord and skin care, and early detection and treatment of infections and complications including respiratory distress syndrome can substantially reduce mortality.  WHO

Preterm Birth Estimates (2015)

Nepal
Source of Data

November 17, 2017 0 comments
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PH Important DayPublic Health

Women and diabetes – our right to a healthy future – World Diabetes Day 2017

by Public Health Update November 14, 2017
written by Public Health Update

Women and diabetes – our right to a healthy future – World Diabetes Day 2017

World Diabetes Day was created in 1991 by IDF and the World Health Organization in response to growing concerns about the escalating health threat posed by diabetes. World Diabetes Day became an official
United Nations Day in 2006 with the passage of United Nation Resolution 61/225. WDD is the world’s largest diabetes awareness campaign reaching a global audience of over 1 billion people in more than 160 countries. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight. The campaign is represented by a blue circle logo that was adopted in 2007 after the passage of the UN Resolution on diabetes. The blue circle is the global symbol for diabetes awareness. It signifies the unity of the global diabetes community in response to the diabetes epidemic.

IDF

Key messages (The International Diabetes Federation)

All women with diabetes require affordable and equitable access to care and education to better manage their diabetes and improve their health outcomes.

Supporting facts
  • There are currently over 199 million women living with diabetes. This total is projected to increase to 313 million by 2040.
  • Two out of every five women with diabetes are of reproductive age, accounting for over 60 million women worldwide.
  • Diabetes is the ninth leading cause of death in women globally, causing 2.1 million deaths per year.
  • Women with type 2 diabetes are almost 10 times more likely to have coronary heart disease than women without the condition.
  • Women with type 1 diabetes have an increased risk of early miscarriage or having a baby with malformations.
What needs to be done
  • Health systems must pay adequate attention to the specific needs and priorities of women. 
  • All women with diabetes should have access to the essential diabetes medicines and technologies, self-management education and information they need to achieve optimal diabetes outcomes. 
  • All women with diabetes should have access to pre-conception planning services to reduce risk during pregnancy. 
  • All women and girls should have access to physical activity to improve their health outcomes. 

Pregnant women require improved access to screening, care and education to achieve positive health outcomes for mother and child.

Supporting facts
  • 1 in 7 births is affected by gestational diabetes.
  • IDF estimates that 20.9 million or 16.2% of live births to women in 2015 had some form of hyperglycaemia in pregnancy. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.
  • Half of all cases of hyperglycaemia in pregnancy occur in women under the age of 30.
  • The vast majority of cases of hyperglycaemia in pregnancy were in low- and middle-income countries, where access to maternal care is often limited.
What needs to be done
  • Type 2 diabetes prevention strategies must focus on maternal health and nutrition and other health behaviours before and during pregnancy, as well as infant and early childhood nutrition.
  • Antenatal care visits during pregnancy must be optimised for health promotion in young women and early detection of diabetes and GDM.
  • Screening for diabetes and GDM should be integrated into other maternal health interventions and services at primary healthcare level to ensure early detection, better care for women and reduced maternal mortality.
  • Healthcare workers should be trained in the identification, treatment, management and follow up of diabetes during pregnancy.

Women and girls are key agents in the adoption of healthy lifestyles to improve the health and wellbeing of future generations.

Supporting facts
  • Up to 70% of cases of type 2 diabetes could be prevented through the adoption of a healthy lifestyle.
  • 70% of premature deaths among adults are largely due to behavior initiated during adolescence.
  • Women, as mothers, have a huge influence over the long-term health status of their children.
  • Research has shown that when mothers are granted greater control over resources, they allocate more to food, children’s health and nutrition, and education.
  • Women are the gatekeepers of household nutrition and lifestyle habits and therefore have the potential to drive prevention from the household and beyond.
What needs to be done
  • Women and girls should be empowered with easy and equitable access to knowledge and resources to strengthen their capacity to prevent type 2 diabetes in their families and better safeguard their own health.
  • Promoting opportunities for physical exercise in adolescent girls, particularly in developing countries, must be a priority for diabetes prevention.

Source of Info: (The International Diabetes Federation)

WHO Country and regional data on diabetes1

Women and diabetes - our right to a healthy future - World Diabetes Day 2017

Women and diabetes – our right to a healthy future – World Diabetes Day 2017


Women and diabetes - our right to a healthy future - World Diabetes Day 2017

Women and diabetes – our right to a healthy future – World Diabetes Day 2017

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November 14, 2017 0 comments
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Maternal, Newborn and Child HealthNational Plan, Policy & GuidelinesPublic Health NotesReportsResearch & Publication

The 2016 Nepal Demographic and Health Survey (2016 NDHS)

by Public Health Update November 13, 2017
written by Public Health Update

The 2016 Nepal Demographic and Health Survey (2016 NDHS)

The 2016 Nepal Demographic and Health Survey (NDHS) was implemented by New ERA under the aegis of the Ministry of Health (MOH). Data collection took place from June 19, 2016, to January 31, 2017. ICF provided technical assistance through The DHS Program, which is funded by the United States Agency for International Development (USAID) and offers financial support and technical assistance for population and health surveys in countries worldwide.
SURVEY OBJECTIVES
The primary objective of the 2016 NDHS is to provide up-to-date estimates of basic demographic and
health indicators. The NDHS provides a comprehensive overview of population, maternal, and child health
issues in Nepal. Specifically, the 2016 NDHS:

  • Collected data that allowed calculation of key demographic indicators, particularly fertility and under- 5 mortality rates, at the national level, for urban and rural areas, and for the country’s seven provinces
  • Collected data that allowed for calculation of adult and maternal mortality rates at the national level
  • Explored the direct and indirect factors that determine levels and trends of fertility and child mortality
  • Measured levels of contraceptive knowledge and practice
  • Collected data on key aspects of family health, including immunization coverage among children, prevalence and treatment of diarrhea and other diseases among children under age 5, maternity care indicators such as antenatal visits and assistance at delivery, and newborn care
  • Obtained data on child feeding practices, including breastfeeding
  • Collected anthropometric measures to assess the nutritional status of children under age 5 and women and men age 15-49
  • Conducted hemoglobin testing on eligible children age 6-59 months and women age 15-49 to provide information on the prevalence of anemia in these groups
  • Collected data on knowledge and attitudes of women and men about sexually transmitted diseases and
    HIV/AIDS and evaluated potential exposure to the risk of HIV infection by exploring high-risk behaviors and condom use
  • Measured blood pressure among women and men age 15 and above
  • Obtained data on women’s experience of emotional, physical, and sexual violence

The information collected through the 2016 NDHS is intended to assist policymakers and program managers in the Ministry of Health and other organizations in designing and evaluating programs and strategies for improving the health of the country’s population. The 2016 NDHS also provides data on indicators relevant to the Nepal Health Sector Strategy (NHSS) 2016-2021 and the Sustainable Development Goals (SDGs). 
Ministry of Health, Nepal; New ERA; and ICF. 2017. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: Ministry of Health, Nepal.

Download Full Report The 2016 Nepal Demographic and Health Survey (2016 NDHS)

RELATED POSTS: 

  • Official dissemination of the 2016 Nepal Demographic & Health Survey in Kathmandu. (Live)

  • Key findings – The 2015 Nepal Health Facility Survey (2015 NHFS)

    Nepal Health Facility Survey (2015 NHFS) Preliminary Report

  • Nepal Demographic and Health Survey 2016 Key Indicators Report (Short Notes)

  • 2011 Nepal Demographic and Health Survey (NDHS)

  • Nepal Multiple Indicator Cluster Survey (MICS 2014) Final Report

More Reports 

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