Public HealthPublic Health Notes

Annual Report of DOHS 2070/71 (2013/2014)

by Public Health Update
written by Public Health Update
The Annual Report of the Department of Health Services (DoHS) for fiscal year 2070/71 (2013/2014) is the 20th consecutive report of its kind.




The report focuses on the objectives, targets, strategies adopted by the programs and analyses the achievements of the major activities and attempts to highlight trends in the service coverage of the services over the preceding three fiscal years. This report also identifies issues, problems, constraints and suggests actions to be taken by the related health institutions for further improvements. The executive summary highlights the key issues and observations emerging from the analysis of each programme.

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Public HealthPublic Health Programs

TB remains a Public health problem

by Public Health Update
written by Public Health Update
Tuberculosis still continues to remain a public health problem in Nepal, with the major challenge being reaching the unreached and finding missing cases. According to National Tuberculosis Centre‚ there were 37,025 notified cases of TB who underwent DOTS (directly observed treatment, short-course) treatment in fiscal year 2014-15. However, around 10,000 TB patients miss their treatment annually. At a programme organised to mark World Tuberculosis Day today, Health Secretary Shanta Bahadur Shrestha said the government was committed to achieving the goal of eliminating TB. 

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Himalayan News Service,Kathmandu, March 24



World Tuberculosis Day is marked every year on March 24. Marking the day, the World Health Organisation has called for new commitments and new action in the global fight against tuberculosis,


which WHO describes as one of the world’s top infectious killers.There has been tremendous progress in recent years in fight against tuberculosis, but with 20,000 new sputum positive cases and 5,000-7,000 deaths every year in Nepal according to NTC data, it is still an ongoing epidemic. According to WHO, in 2013, nine million people fell ill with TB and 1.5 million died.According to NTC, 45 per cent of total population are infected with TB and 40,000 people get TB every year in Nepal.Officials at NTC said they were working with an objective to reduce human suffering and socio-economic burden resulting from TB.Last year, NTC launched two mobile vans in bid to reach the unreached and according to an official, the project has been successful in finding hidden cases. The target population included slum dwellers, prisoners, factory workers, people living with HIV and family members of TB patients. According to Health Research and Social Development Forum, last year, 103,867 were screened, of which 14,623 were microscopically tested and 6,159 were tested using Xpert. As many as 654 patients were diagnosed for TB and 66 for Multi-Drug Resistant TB during the screening.

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PH Important DayPublic HealthPublic Health Events

World Tuberculosis Day – 24 March 2015

by Public Health Update
written by Public Health Update
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STOP TB PARTNERSHIP

World TB Day, falling on March 24th each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries. It commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus. At the time of Koch’s announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch’s discovery opened the way towards diagnosing and curing TB. –STOP TB PARTNERSHIP

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Thehimalayantimes (24th March 2015)


Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable.

TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

About one-third of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease.

Key facts
  • Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. 
  • In 2013, 9 million people fell ill with TB and 1.5 million died from the disease. 
  • Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top 5 causes of death for women aged 15 to 44.
  • In 2013, an estimated 550 000 children became ill with TB and 80 000 HIV-negative children died of TB.
  • TB is a leading killer of HIV-positive people causing one fourth of all HIV-related deaths.
  • Globally in 2013, an estimated 480 000 people developed multidrug resistant TB (MDR-TB).
  • The estimated number of people falling ill with TB each year is declining, although very slowly, which means that the world is on track to achieve the Millennium Development Goal to reverse the spread of TB by 2015.
  • The TB death rate dropped 45% between 1990 and 2013.
  • An estimated 37 million lives were saved through TB diagnosis and treatment between 2000 and 2013.
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    Kantipur News Paper 23rd March 2015

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      STOP TB PARTNERSHIP

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      STOP TB PARTNERSHIP

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      STOP TB PARTNERSHIP
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      Public Health NotesPublic Health Programs

      Chlorhexidine Cord Care Program in Nepal (Published by MoHP)

      by Public Health Update
      written by Public Health Update
      The neonatal mortality rate in Nepal is 23 per 1,000 live births and major cause of neonatal death is infection. Among newborns, exposure of the freshly cut cord stump to pathogens through hands instruments, cloths etc. may lead to infection and death.




      Chlorhexidine is a broad-spectrum antiseptic that is safe and effective for reducing bacterial colonization on the skin and umbilical stump of newborns. Pooled analysis of studies including study of 2006 in Sarlahi, Nepal has shown that immediate cleansing of the umbilical cord with 4% chlorhexidine (equivalent to 7.1% Chlorhexidine Digluconate w/v) reduces mortality risk by about 23%. After this a study was conducted in Maternity hospital, Thapathali and demonstrated that a gel preparation was as effective as an aqueous preparation. Another study on acceptability was done at the community level and demonstrated a clear preference for a gel preparation. Then a pilot was done in four districts (Bajhang, Jumla, Banke and Parsa) to determine the coverage and compliance in the Nepalese context and within the existing public health service delivery system.

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       Based on the encouraging results of all studies conducted in Nepal, the government of Nepal approved the use of 4% chlorhexidine for umbilical cord care as part of essential newborn care on 23rd December, 2011 (2068 Poush 8, BS). 


       It has already been scaled up to 49 districts as of February 2015 and included in Health Management Information System, Essential Drug List, Community Based Integrated Management of Newborn and Childhood Illness program and pre-service curriculum of Auxiliary Nurse Midwife. Ministry of Health and Population was awarded with USAID Pioneers Prize 2013 for thechlorhexidine cord care program. USAID through JSI R&T’s Chlorhexidine Navi Care Program and other partners are supporting government to scale up chlorhexidine cord care program in Nepal.

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      Public Health

      Panel formed to review MMR status

      by Public Health Update
      written by Public Health Update
      Rajan Pokhrel
      Kathmandu, February 28
      THEHIMALAYANTIMES
      The government has decided to conduct a technical review of the maternal mortality related data collected in the national census.A 13-member committee coordinated by National Planning Commission member Yagya Bahadur Karki has been set up to review the analysis of maternal mortality data after a population monograph published by the Central Bureau of Statistics put the country’s maternal mortality ratio at 480 per 100,000 live births, implying that the country is far from meeting its MMR target of 134 under the MDGs-2015.

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      THEHIMALAYANTIMES

      According to Karki, a study panel has been formed after the Ministry of Health and Population sought NPC’s help to recheck the current MMR, which has highly confused the health policymakers as well as the multilateral donors who have already invested billions of dollars in country’s health sector.The committee comprises Dr Senendra Raj Upreti, Director General, Department of Health Services as deputy coordinator. Dr Padam Bahadur Chand, Chief, Policy Planning and International Cooperation Division are members. Other members of the committee are CBS Director General Bikash Bista, Deputy DG Rudra Suwal,




      Head of the Central Department of Population Studies Ram Saran Pathak and experts including Puspa Lal Joshi, Laxmi Bilash Acharya, Bal Gopal Vaidya, Bharat Sharma, Ajeet Pradhan, Bishnu Nepal and Mahesh Puri. “The committee will soon recheck the technical processing and analysis of the scary figure related to deaths of new mothers, while being pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by pregnancy,” Karki told this daily.In 2006, National Demographic Health Survey put the country’s MMR at 281, down from 539 in 1996 while the United Nations agencies including WHO, UNICEF, UNFPA and the World Bank estimates from 1990 to 2013 also claimed that Nepal drastically reduced maternal deaths by 75 per cent with latest MMR at 190. 

      MDG Awards Committee, in collaboration with the UN Office for Partnerships, had also awarded Nepal in 2010 for its outstanding national leadership, commitment and progress towards achievement of the MDG related to improving maternal health.The large discrepancy between the major estimates reveals the difficulty of measuring maternal mortality, which makes it even harder to track its progress in Nepal, according to Sameh El-Saharty, Senior Health Policy Specialist in the Health, Nutrition and Population Global Practice of the World Bank. “Strengthening vital registration and use of systems intelligence to triangulate different sources of data will be key to address such a challenge,” he said.
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