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International PhD Scholarship for Neonatal Health Research in Nepal

by Public Health Update July 25, 2023

written by Public Health Update

Charles Sturt University Rural Health Research Institute – International PhD Scholarship for Neonatal Health Research in Nepal

Charles Sturt University Rural Health Research Institute invites application from eligible candidates for the International PhD Scholarship for Neonatal Health Research in Nepal.

The project will employ a cluster-randomized trial design, involving 1,000 households and targeting pregnant women (approximately 1,000) for the study. The interventions to be tested include homecare, macronutrient supplementation, water, sanitation, and hygiene practices, and micro-enterprise initiatives. We will collect baseline data in the first year, gathering information through a comprehensive questionnaire. The clinical trial phase will commence in the second year, implementing the interventions among the selected households.

Eligibility

As per Charles Sturt University’s standard eligibility requirements for entry to a PhD.
Master’s degree (or equivalent) in public health, medicine, nursing, or epidemiology, with a strong emphasis on quantitative components such as epidemiology and biostatistics.
Proficiency in quantitative research skills, including design, analysis, and writing, along with a strong motivation to further enhance these skills.
Demonstrated track record of scientific publications in areas related to epidemiology and public health.
Working knowledge and understanding of neonatal health or women’s health.
Previous experience in conducting community-based studies in rural and remote areas.
Candidates who can demonstrate excellent written and spoken English proficiency will be given preference (Internationally accredited English tests taken within the last two years).
Candidates with a good command of the local Nepali language will be given preference.

Award value

The scholarship provides the following benefits:

Stipend: This scholarship is valued at $29,863 per annum (2023 rate) payable in fortnightly instalments.

Tuition Fees:
Fee exemption for a period equivalent to 3.5 years (seven sessions) for PhD at full-time study.

Operating Funds: Scholarship candidates are allocated an overall allowance of $6,000 to assist with the reimbursement of costs associated with a candidate’s research

Relocation Allowance: Scholarship recipients may be eligible to receive a relocation allowance for the cost of relocating themselves, their spouse, and dependants, to a maximum of AUD $5,000.

Overseas Health Cover: An International scholarship holder may be entitled to have the University pay the premium for their Overseas Student Health Cover.

Scholarship duration

The scholarship is tenable for 3.5 years for Research Doctorate studies subject to satisfactory progress.

Scholarship candidates are entitled to 20 paid annual leave working days per year and 10 paid sick leave days per year, however, are not eligible for paid primary parental care leave or additional personal leave.

How to apply

Applicants will need to apply for enrolment.

Prospective Higher Degree by Research candidates can apply for a Rural Health Research Institute Scholarship when completing their Charles Sturt course admission application. When given the option to apply for a scholarship select ‘Other’ and enter RHRI Scholarship – Neonatal Health Research in Nepal. (For more info: Dr. Subash Thapa, Senior Research Fellow, Rural Health Research Institute at suthapa@csu.edu.au). Applications close Monday 31 August 2023.

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July 25, 2023 0 comments

Fact Sheet Health in Data Public Health Public Health Update Reports Research & Publication

Department Health Services (DoHS) Annual Report 2078/79 (2021/22)

by Public Health Update July 24, 2023

written by Public Health Update

The Department Health Services (DoHS) Annual Report 2078/79 has released it’s annual report for the fiscal year 2078/79 (2021/22. The annual report of the Department of Health Services (DoHS) for fiscal year 2078/79 (2021/2022) is the twenty-eight consecutive report of its kind. This report focuses on the objectives, targets and strategies adopted by Nepal’s health programs and analyses their major achievements and highlights trends in service coverage over three fiscal years. This report also identifies issues, problems and constraints and suggests actions to be taken by health institutions for further improvements.

The main institutions that delivered basic health services in 2078/79 were the 192 public hospitals including other ministries, the 2,155 non-public health facilities, the 188 Primary Health Care Centers (PHCCs) and the 3,775 Health Posts (HPs) primary health care services were also provided by Primary Health Care Outreach Clinic (PHC-ORC) sites. A total of 16,950 Expanded Program of Immunization (EPI) clinics provided immunization services. These services were supported by 50,229 Female Community Health Volunteers (FCHV). The information on the achievements of the public health system, NGOs, INGOs and private health facilities were collected by DoHS’s Health Management Information System (HMIS).

Executive summary

National Immunization Program (NIP)

In FY 2078/79 compared to FY 2077/78, BCG coverage improved by 13%, whereas DTP-HepB-Hib3 and OPV3 coverage increased by 10% and 13% respectively. The fIPV2 coverage rate has increased to 93% for FY 2078/79. PCV3 coverage has increased to 94%, and PCV1 coverage has reached 98%. Coverage for MR1 and MR2 is now 95% and 93%, respectively.
High coverages of both MR1 and MR2 are necessary (> 95%) at all levels to achieve measles eradication. As a result, MR1 and MR2 coverage still has to be increased. The JE vaccination coverage is 96% at national level.

Integrated Management of Neonatal and Childhood Illnesses

Among all reported live births, chlorhexidine (CHX) was administered to 82.9% of newborns’ umbilical cord (HF+ FCHV).
Use of CHX varied by province, with Sudurpaschim having the highest use (96.9%) and Bagmati Province having the lowest use (64.7%). At the national level, injectable Gentamycin was given to all PSBI cases involving infants under two months old in the fiscal year (FY 2078/79).
A total of 702,504 ARI cases were reported at HF and PHC/ORC in FY 2078/79, of which 13.3% were classified as pneumonia and 0.18% as severe pneumonia. At the national level, there were 55.1 cases of pneumonia (both mild and severe) per 1000 children under the age of five.

Nutrition

The growth monitoring visit has increased by 25.5 percentage points at the national level from FY 2076/77 (65.2%) to FY 2078/79 (90.7%). A significant reach of Growth Monitoring and Promotion (GMP) among the targeted age group is also demonstrated by the coverage of GMP registration across the seven (7) Provinces, with Provincial values ranging from a low of 78.1% in Province No. 1 to a high of 103.7% in Sudurpaschim Province. In FY 2078/79, the Mother Baby Friendly Hospital Initiative (MBFHI) program was assessed in 10 hospitals, and orientation was done in additional five hospitals.
Until FY 2078/79, 15 MBFHI hospitals have been certified. By the end of FY 2078/79, the CNSI training package has been rolled out in 72 districts and five districts of Bagmati province are planned for FY 2079/80.

Safe Motherhood and Newborn Health

Maternal and Newborn Health (MNH) is a high-priority program in Nepal. The National Safe Motherhood Programme implemented by Family Welfare Division (FWD) aims to reduce maternal and neonatal morbidity and mortality, improve maternal and neonatal health through preventive and promotive activities, and address avoidable factors that cause death during pregnancy and childbirth and the postpartum period.
In FY 2078/79, there was a significant increase in key Maternal and Newborn Health (MNH) indicators.
The percentage of pregnant women attending 4 ANC visits as per the protocol increased to 79.4 in FY 2078/79 from 70 in 2077/78. Similarly, institutional deliveries as a percentage of expected live births increased by 14%.
Furthermore, the delivery assisted by SBA increased to 75% in FY 2078/79 from 61% in FY 2077/78.
The national average for Emergency Obstetric Care (EOC) met needs was 11% in this reporting period, improving from 8.2% in FY 2077/78. The proportion of mothers attending three PNC visits as per the protocol increased from 25% in FY 2077/78 to 40.8% in FY
2078/79.
Although there is improvement in key MNH indicators, major gaps in quality of care exist along the continuum of care such as 4 ANC visits and 3 PNC as per the protocol. Similarly, considerable interprovincial gaps were noticed in the quality of care, with around 32% difference in the proportion of women receiving 180 days’
supply of Iron Folic Acid (IFA) during pregnancy, with 80.2% of women receiving it in Gandaki Province while only 47.8%
in Koshi Province in the year 2078/79.
The number of safe abortion service users increased to 90,733 in FY 2078/79 from 79,952 in FY 2077/7 and 87,869 women in FY 2076/77.
Among these, 69% were medical abortions, and 31% were surgical abortions in FY 2078/79. 14.2% of the total pregnancies were terminated by induced procedures at health facilities, and 4.4% were induced using the surgical method. Although the safe abortion service users increased in FY 2078/79, the post-abortion contraception has slightly decreased to 74.7% in FY 2078/79 from 76.7% in FY 2077/78.
Among the safe abortion users, approx. 7% of the women were aged below 20 years.
In FY 2078/79, FWD implemented the MPDSR program in 32 districts and 94 hospitals.
In FY 2078/79, a high percentage of maternal deaths were reported in the antepartum period (34%) followed by the postpartum period after 48 hours of delivery (31%).
FWD also implemented various activities in FY 2078/79 to improve maternal and child health, such as expansion and quality improvement of BEONC and CEONC sites, onsite clinical coaching and mentoring, MNH readiness assessment and emergency referral funds. In this reporting period, 753 municipalities of 77 districts implemented onsite clinical coaching and mentoring programs, and a quality improvement process programme expanded in 65 hospitals.

Family Planning and Reproductive Health

National family planning programme (FP) in 2078/79 has been successful to improve the service access and utilization.
The modern contraceptive prevalence rate (unadjusted mCPR) for modern FP at national level is 41% compared to 39% in FY 2077/78.
Sudurpaschim Province has the highest mCPR of 48% while Bagmati Province has the lowest (35%). The number of districts with mCPR below 30% is in a decreasing trend.
In FY 2078/79, there are 5 districts with CPR less than 30 compared to 9 in FY 2077/78.
This indicates performance improvement among the low mCPR districts. Depo (38%) occupies the greatest part of the contraceptive method mix for all method new acceptors, followed by condom (23%), pills (19%), implant (14%), IUCD (2%), female sterilization (FS- 3 %) and lastly male sterilization (MS-1%) in FY 2078/79.
Immediate postpartum family planning uptake as proportion of total facility delivery is in increasing trend.
Postpartum IUCD uptake as proportion of total facility delivery is also in decreasing trend, while that of contraceptive
uptake among total reported abortion services is 71%, but only 15% have used LARCs indicating women after abortion are relying on less effective methods.

Adolescent sexual and reproductive health

Adolescent Sexual and Reproductive Health (ASRH) is one of the priority programs of FWD guided by The National Adolescent Health and Development Strategy, 2018. The National ASRH program has been scaled up to all 77 districts by Fiscal Year 2078/79. So far, about 1,355 health facilities have been listed and 116 health facilities have been certified as adolescent friendly service sites.
The number of adolescents receiving temporary contraceptive methods (excluding condom) is in decreasing trend.
Among four temporary contraceptive methods, Depo is the most preferred contraceptive method accounting for 58% of the contraceptive method mix. Compared to FY 2077/78, the share of implants in method mix has decreased.
Similarly, utilization of abortion services is also in decreasing trend. This data needs to be cautiously interpreted as adolescents prefer to utilize the sexual and reproductive health (SRH) services from the private sector due to several reasons. It is interesting to note that the share of medical abortion services is decreasing. Almost two-thirds of adolescents (61%) who terminated the pregnancy opted for medical abortion.
In FY 2078/79, Madhesh Province had the highest number of adolescents who received first ANC services and first ANC visit as per protocol. Whereas Gandaki Province has the lowest number of adolescents receiving ANC services.
At the national level, the dropout rate between ANC 1st and ANC 4th visits is around 33% in FY 2078/79 which is lower than the previous year.
Primary Health Care Outreach Clinics
Primary health care outreach clinics (PHC/ORC) extend basic health care services to the community level. In FY 2078/79, 2,289,178 people were served from outreach clinics. Out of planned clinics, 86% were conducted.
There has been a slight increase in the conduction of PHC-ORC Clinics and clients served compared to previous year.
Malaria
Nepal has surpassed the Millennium Development Goal 6 by reducing malaria morbidity and mortality rates by more than 50% in 2010 as compared to 2000. Therefore, the Government of Nepal has set a vision of Malaria free Nepal by Current National Malaria Strategic Plan (NMSP) 2014-2025 was developed based on the epidemiology of malaria derived from 2012 micro-stratification. The aim of NMSP is to attain “Malaria Free Nepal by 2025”.
For assessing the risk areas, the program has been conducting micro-stratification on an annual basis. Total positive cases of malaria increased from 377 in FY 2077/78 to 491 in FY 2078/79 to, where 38 cases are indigenous cases and 453 are imported.
The trend of indigenous is decreasing, however, the number of imported cases is increasing.
As compared to the previous year, the proportion of P. falciparum infections has increased from 13.53% in FY 2077/78 to 23.2% in 2078/79. This proportion is high which is due to the high number of imported P. falciparum cases mostly from India and the Central Africa Region (CAR).
The trend of indigenous Pf malaria cases is decreasing. In FY 2078/79, all PF cases were imported. The trend of clinically malaria cases is slightly increasing and major indicators for malaria program; Test positivity rate (TPR), and Annual Blood Examination Rate (ABER) are in positive trend, however, Annual Parasite Incidence Rate (API) has slightly increased.

Kala-azar

Kala-azar is one of the high priority public health problems of Nepal. Most of the districts have been continuously reported new cases of Kala-azar in recent years. Therefore, to eliminate Kala-azar from Nepal, strategies to improve health status of vulnerable and at-risk populations have been made focusing on endemic areas of Nepal, which leads to elimination of Kala-azar, and it no longer becomes a public health problem. The incidence of kala-azar at national level has
been less than 1/10,000 population since FY 2073/74. However, the trend of Kala-azar cases has been increasing in a few
years. In FY 2078/79, two districts, Okhaldhunga and Kalikot, crossed the elimination threshold with 1.62 per 10,000 in Okhaldhunga and 4.14 per 10,000 in Kalikot.

Lymphatic filariasis (LF)

Lymphatic Filariasis (LF) is one of the mosquitoes borne parasitic diseases with a public health problem in Nepal.
Nepal is among the countries who have started LF MDA in all endemic districts and is on track to achieve elimination status by The goal of the Lymphatic Filariasis Elimination Program is to eliminate LF as a public health problem by reducing the level of the disease in the population to a point where transmission no longer occurs.
As of Poush 2079, MDA has been stopped and post MDA surveillance is ongoing in 48 of 64 endemic districts.
All endemic districts completed 6 rounds of MDA in 2075 other than Rasuwa which has recently been considered endemic from a confirmatory mapping survey.
Triple Drug Regimen (IDA: Ivermectin, Diethylcarbamazine and Albendazole) has been introduced in 5 districts from 2078 and EDCD has planned to expand it in all 15 districts that will implement MDA in 2079.
Since 2060 more than 115 million doses of lymphatic filariasis drugs have been administered to at-risk populations.
A total number of 10,477 hydrocele surgeries have been performed since FY 2073/74 to FY 2078/79.
The morbidity results by community mapping from 44 districts revealed that 30,925 cases of LF have been confirmed of which 21,105 cases of hydrocele, 9,574 cases of lymphoedema and 246 cases of both conditions.

Dengue

Dengue, a mosquito-borne disease, emerged in Nepal in 2062. The goal of the national Dengue control program is to DoHS, Annual Report 2078/79 (2021/22) reduce the morbidity and mortality due to dengue fever, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).
The number of reported dengue cases has decreased significantly since 2066 but cases of dengue have increased in recent years. During FY 2078/79, a total of 733 dengue cases were reported from 62 districts.
The majority of cases have been reported from Sankhuwasabha (79), Kathmandu (65), Dhading (55), and Rupandehi (44).

Scrub Typhus

After the devastating earthquake in 2072, outbreak of scrub typhus has been reported from across the country causing several morbidities and mortalities. Although the surveillance system for scrub typhus is not very well established, the scrub typhus cases were reported through the early warning and reporting system (EWARS) from 2073.
During FY 2078/79, a total of 2,474 dengue cases were reported from 71 districts. The majority of the cases have been reported from Doti (288), Darchula (222), Palpa (205), Kailali (160), Gulmi (133), Baitadi (124) and Sankhuwasabha (101).

Leprosy

During FY 2078/79 (2021/22), 2285 new leprosy cases were detected and put under Multi Drug Therapy (MDT) from 64 districts. Among total new cases, 3.19 % were child cases under 15 years, 7.44 % diagnosed with Grade 2 Disabilities and 43.3% were female cases, 2373 cases were under treatment and receiving MDT at the end of the fiscal year, marking a registered prevalence rate of 0.81 cases per 10,000 populations at the national level.
There is a slight increase in prevalence rate of leprosy might be due to loosening of restrictions due to COVID 19 and continuation of field level activities such as active case detection, IEC/BCC campaigns etc.
Madhesh province reported the highest PR of 1.43/10,000 population followed by Lumbini province (1.12). 16 districts have reported PR>1 per 10,000 population. 561 foreign cases from India were provided treatment in Nepal during FY 2078/79.

Disability inclusive health, rehabilitation, assistive technology and injury prevention

EDCD/ LCDMS has aimed for a disability inclusive health system and population access to rehabilitation services and assistive technology. During FY 2078/79 (2021/22), we developed a Disability management and rehabilitation training
package for primary health care providers and was piloted in Banke and Kaski. Post-COVID rehabilitation protocol, National standard on assistive technology and Operational guideline on priority assistive product list has been developed.
Furthermore, the Systematic Assessment of Rehabilitation Situation (STARS) report was finalized and the Rapid Assistive
Technology Assessment (rATA) was conducted in coordination with the National Health Research Center. Likewise, preliminary data was collected to evaluate the rehabilitation workforce using WHO standardized tools.
Altogether 54,670 new cli- ents were reported in DHIS-2 have received rehabilitation service from 42 different hospitals and rehabilitation centers which shows an increment in data reporting compared to last fiscal year which was 29,814 clients.
This is due to the fact that EDCD has initiated training to private rehabilitation service centers.
Situation assessment and prioritization of strategic intersectoral actions in road safety and the National Policy Dialogue on road safety was organized highlighting the components of the safer system approach.

Zoonoses

Nepal has a dual burden of disease and zoonotic diseases of epidemics; endemic and pandemic potentials are the major public health concerns. Globally more than 300 zoonotic diseases are identified among which about 60 have been identified in Nepal as emerging and re-emerging diseases.
No people die of rabies or poisonous snake bites due to unavailability of anti-rabies vaccine (ARV) or anti-snake venom serum or timely health care services and to prevent, control and manage epidemic and outbreak of zoonosis is the goal of the zoonosis program.
Around 75,000 cases in pets and more than human rabies cases occur each year with highest risk are in the terai.
During FY 2078/79, a total of 85,483 dog and other animal bites cases have been reported throughout Nepal and a total of 9,346 snake-bites cases have been reported. Among cases 8,420 were non-poisonous and 926 were poisonous.

Tuberculosis

Tuberculosis (TB) remains a major public problem in Nepal.
During this FY 2077/78, a total of 37,861 cases of TB were notified and registered at NTP.
Among these, 98.5% (37,287) were incident TB cases (New and Relapse). Among all forms of TB cases 72.1 %were pulmonary TB, and out of them, 57.1% were pulmonary bacteriologically confirmed.
Madhesh Province holds the highest proportion of TB cases (23.7%) followed by Bagmati province (23.3%). Kathmandu district alone holds around 42% (3,672 TB cases) of the TB cases notified from the Bagmati Province while its contribution is around 9.7% in the national total.
In terms of eco-terrain distribution, Terai belt reported more than half of cases (22,904; 60.5%). Most cases were reported in the middle age group with the highest of 45.1% in 15 44 years of age.
The childhood TB is around 8.7%. Out of total registered TB cases, there were 14,539 (38.4%) females and 23,322 (61.6%) males.
The burden of TB can be measured in terms of incidence (defined as the number of new and relapse cases), prevalence and mortality. WHO estimates the current prevalence of all types of TB cases for Nepal at 117,000 (416/100,000) while the number of all forms of incidence cases (newly notified cases) is estimated at 69,000 (235/100,000).
Case notification rate (CNR) of all forms of TB is 129/100,000 population whereas CNR for incident TB cases (new and relapse) is 72/100,000 population.
Among drugs sensitive TB cases registered in FY 2077/78, 91.5% were treated successfully.
There are estimated to be around 2,200 cases of DR-TB annually. However, 942 MDR TB cases are notified annually.
In FY 2077/78, 659 RR/MDR-TB cases were registered for treatment. Among them, Lumbini Province is found to have higher burden followed by Madesh Province, Koshi Province, Bagmati Province, Sudurpaschim province, Gandaki Province, and Karnali Province respectively. Similarly, the burden of Pre-XDR and XDR TB patients was found more at Lumbini Province
followed by Bagmati, Koshi, Madhesh, Sudurpaschim, Gandaki and Karnali provinces respectively.
TB services were provided through 5,971 treatment centers. Regarding diagnostic services, there are 896 Microscopic
centers and 93 GeneXpert centers throughout the country.
DR-TB services were provided through 22 treatment centers and 81 Treatment Sub-centers.
Though the DR-TB services are ambulatory, facility-based services were also provided through 2 TB treatment and referral management center 6 hostels and 1 DR home.

HIV/AIDS AND STI

HIV/AIDS is a priority public health program of the Ministry of Health & Population (MoHP). Nepal remained as concentrated epidemic with prevalence rate 0.12% among adult population (15-49 years) and >5 % among key population i.e. MSM/ TG and PWID.
The total estimated people living with HIV (PLHIV) is 30,300 in Nepal by 2021/22 (FY 2077/78), out of total estimated 4% are children (1,140) aged up to 14 years who are living with HIV in Nepal, while the adults aged 15 years and above account for 96%.
Almost 65% of total estimated infections (19,460) among the population aged 15-49 years. By sex, males account for 55% of the total infections and the remaining infections are in females. Total 22,125 PLHIV are on ART treatment by the end of FY 2078/79.

Non-Communicable Diseases

Non-communicable Diseases (NCDs) are emerging as the leading cause of deaths in Nepal due to changes in social determinants like unhealthy lifestyles, urbanization, demographic and economic transitions.
The deaths due to NCDs (cardiovascular, diabetes, cancer and respiratory disease) have increased from 60% of all deaths in 2014 to 66% in 2018 (WHO Nepal Country Profile 2018).
They are already killing more people than communicable diseases. Thus, Nepal has adapted and contextualized the PEN intervention for primary care in a low resource setting developed by WHO.
The epidemic of non-communicable disease is recognized by UN and addressed in Sustainable Development Goal 3 i.e. “ensure healthy life and promote well-being for all at all ages” of this goal 3.4 targeted to “reduce by one third premature mortality from NCDs through prevention and treatment and promote mental health and well-being”. PEN Implementation Plan (2016-2020) has been developed in line with the Multi-sectoral Action Plan for prevention and control of NCDs (2014-2020).

Mental Health

Mental health and substance abuse are recognized as one of the health priorities and also addressed in Sustainable Development Goals (SDG). Within the health goal, two targets are directly related to mental health and substance abuse.
Target 3.4 requests that countries: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being”. Target 3.5 requests that countries: “Strengthen the prevention and treatment of substance abuse and harmful use of alcohol”. Nepal has a high burden of mental illness but there are limited interventions to address the epidemic of mental diseases.

Epidemiology and Outbreak Management

Epidemiology and Outbreak Management involves working in the area of preparedness and response to outbreaks, epidemics and other health emergencies occurring in different parts of the country. It aligns with the organizational objective to reduce the burden of communicable diseases and unwanted health events through preparedness and responses during outbreak and epidemic situations by using the existing health care system and provides support to the Ministry of Health and Population (MoHP) for drafting national laws, policies, and strategies related to epidemiology and outbreak management. It provides subnational support for outbreak management and capacity building.
Continuation of COVID-19 pandemic was seen in FY 2078/79. In the FY, a total of 318,724 PCR and 94,040 Antigen positive cases were registered.
FY 2078/79 witnessed two cholera outbreaks, in Kapilvastu and Kathmandu Valley. A total of 1,914 Acute Diarrheal Disease (ADD) cases occurred in the outbreak in Kapilvastu district. Out of 21 stool samples tested for stool culture four stool samples tested positive for Vibrio Cholerae O1 Ogawa. Reactive Oral Cholera Vaccination (OCV) campaign was conduct- ed by Kapilvastu district in 10 municipalities.
In Kathmandu valley, until Asar 32,2079, a total of 30 cases of cholera were reported of which 24, 4 and 2 cases were reported from Kathmandu, Lalitpur and Bhaktapur districts respectively.

Surveillance and Research

Early Warning and Reporting System (EWARS) is a hospital-based sentinel surveillance system, established in 1997 – for early detection of six priority outbreak potential vector borne, water and food borne diseases/syndromes.
Currently, 18 hospitals from all provinces and districts in the country have been selected as sentinel sites. Among 118, 13 sentinel
sites reported consistently throughout the 52 epidemiological weeks in 2021 (FY 2077/78).
Being the secretariat of National Drinking Water Quality Surveillance, EDCD conducts drinking water quality surveillance
activities on a regular basis at national and sub-national level. In FY 2078/79 formation of provincial drinking water quality surveillance committee has been completed in the three provinces in this fiscal year and the rest four are planned in the next year.
Monitoring of drinking water quality surveillance and water sample testing for microbiological parameters at sub-national and local level was performed with co-ordination through provincial health ministers/ directorates and associated offices.
A single batch MTOT on water safety plan, drinking water quality surveillance and N-WASH (digita; tool for water supply and quality management) was conducted in this FY to strengthen and capacitate water quality surveillance at provincial and local level.
In FY 2078/79, the call center received 132,687 calls, out of which 122,016 calls were answered and 17,939 times the Interactive Voice Response (IVR) were recorded.
Alert and response System, pandemic response, general response and SMS service on epidemic and outbreak are the major scope of work of call center.

Health sector response to COVID-19 Pandemic

The Government of Nepal intends to gradually immunize its citizens when vaccines become available, starting with the groups most at risk, in order to lower morbidity and mortality associated with COVID-19.
A total of 47,838,854 doses of COVID-19 vaccinations, including 6,873,016 additional doses, have been safely administered.
There are now 108 RTPCR laboratories operating throughout all provinces (45.4% are private and 54.6% are public). Nepal recorded a total of 1,122,201 COVID-19 positive (including RT-PCR and Antigen test).
The total case fatality rate is 1.2%, and the rate for people 60 and older is 6.3%. A total of 695,144 individuals have completed the QR certification.

Curative Services

Minimum Service Standard (MSS) of health facilities is the service readiness tool designed to identify existing gaps towards the quality improvement of hospital services through self and joint assessment and developing an action plan scientifically.
MSS has been implemented in 118 different levels of hospitals all over the country.
There has been significant improvement in the service readiness status of the government hospitals since the implementation of MSS program and in the last two fiscal years the program has been expanded to health posts throughout the country.

Nursing and Social Security

Nursing Capacity Development

The main responsibility of the nursing capacity development section is to facilitate in the process of development of plans, policies, strategies and programs for strengthening various specialties of nursing and midwives’ services.
The major activities and achievements in FY 2078/079 were the school health and nursing program, development of five CPD modules and three clinical protocols, implementation of training on infection prevention and control based on a blended learning approach. In the FY 2078/079 community health nursing program was started in Bhaktapur and Bardibas Municipality.
Similarly, in the FY 2078/079 onsite coaching and mentoring program was started.

Geriatric and Gender Based Violence Management

The constitution of Nepal has ensured the right of the public to free basic health care service and emergency services.
It has also ensured that the elderly people will be entitled to special protection from the nation and are entitled to the right to social security. So, to ensure the accessibility and utilization of health services by older people, the Ministry of Health and Population is extending the geriatric health care services to hospitals with more than 50 beds in this fiscal year.
The geriatric services along with establishment of separate geriatric ward and outdoor services has been extended to 49 hospitals across the country in this fiscal year. Geriatric care center implementation guidelines and standards have been developed in which senior citizens with the many chronic health problems who need nursing care are the major service consumers.
National policy dialogue program related to geriatric health was conducted. This section trained 80 Primary Health Care Professionals (Health assistants and staff nurses) related to Integrated care for elderly people and 14 medical officers for geriatric health care.
Geriatric Review has been conducted among 24 geriatric service available hospitals.
Gender-based Violence (GBV) is a grave human rights issue and public health concern which impacts the physical and mental health of the individual survivor and his/her children, and carries a social and economic cost to society.
The Office of the Prime Minister and Council of Ministers developed a multi sectoral action plan to address the GBV issues in 2010 with celebration of international GBV years.
In line with the action plan and to address needs of GBV survivors in an effective and efficient way MoHP established a hospital based One Stop Crisis Management Center(OCMC).
In FY 2078/79, 88 OCMCs had been established in 77 districts. Orientation of the GBV program was conducted at three local levels. OCMC review was conducted in all provinces in FY 2078/79.

Deprived Citizen Treatment Support Program (Bipanna Nagarik Aushadhi Upchar Program)

The Impoverished Citizens Service Scheme of Social Health Security Section provides the funding for impoverished Nepalese citizens to treat serious health conditions.
Free treatment up to NPR 100,000 per patient via listed hospitals for severe diseases including cancer, heart disease, traumatic head injuries, traumatic spinal injuries, Alzheimer disease, Parkinson’s and sickle cell anemia diseases once in lifetime. Pre-transplant (HLA & cross match) test support up to NPR 50,000; renal transplantation costs up to NPR 400,000 per patient; medication costs up to NPR 100,000 for post-renal transplant cases; Free haemodialysis and peritoneal dialysis services; and free medical treatment for acute kidney infections up to NPR 100,000.
Till FY 2078/79 125,825 patients have received free treatment under impoverished citizens’ services scheme.

Female Community Health Volunteer (FCHV)

The Government of Nepal initiated the Female Community Health Volunteer (FCHV) Program in 2045/46 (1988/1989) in 27 districts and expanded it to all 77 districts thereafter. 51,423 FCHVs recruited a total of 49,605 (as reported in HMIS) FCHVs are actively working in Nepal. In the fiscal year 2077/078 biannual FCHV review meeting was held at local and FCHV day was celebrated.
The major role of FCHVs is to advocate healthy behavior among mothers and community people to promote safe motherhood, child health, for 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 (only in the selected remote area where referral is not possible), refer serious cases to health facilities and motivate and educate local people on healthy behavior related activities. They also distribute iron tablets to pregnant women.

Reimbursement program for free treatment of Janayudhha, Jana-andolan ghaite, Madhesh terai ghaite, Bhukampa pidit.

The program provides reimbursement to the government and community hospitals that claim an amount equal to the free services they have provided to the casualties of various peoples movement and earthquake affected peoples based recommendation by the government authorities stating their casualty status.
In FY 2078/79 a total of 2,500,000 rupees budget was allocated for the program and reimbursement were given to three hospitals that claimed the amount.

Reimbursement to the hospitals for free treatment of Acid Attack Victims

The program provides reimbursement to the four dedicated hospitals that provide free treatment to the acid attack victims. The program covers ambulance expenses, food expenses of the victim and care-taker, in-patient charges, medical and procedure expenses as well as long term medications that must be used by the patients. In FY 2078/79 total budget of 700,000 was provided to the hospitals for treatment of three victims.

Trainings conducted regarding hemodialysis

In FY 2078/79 two categories of training were conducted under hemodialysis specialty. Hemodialysis training for nurses was conducted in two batches with 20 participants in each batch yielding 40 hemodialysis specialist nurses.
Same-way users training for hemodialysis equipment maintenance was conducted in one batch with 10 participants.

Inpatients/OPD services

For the fiscal year, 2078/79 inpatient and outpatient services were provided by all types and levels of hospitals. A total of 1,548,336 patients were admitted to the hospitals. The highest admissions were due to pregnancy, childbirth and
puerperium which accounted for more than 20% of discharged cases. The inpatient hospital death rate was 1.08%. In
addition, the number of emergency visits was also increasing as 2,938,849 patients received emergency care. Outpatient morbidity has been reported in 19 different sections that cover 232 diseases including communicable diseases,
non-communicable diseases, injuries, organ-specific diseases, and mental health problems. Although the majority of tertiary hospitals and private hospitals had not reported outpatient morbidity throughout the year, the maximum OPD cases were related to headaches followed by upper respiratory tract infection (URTI).

Human Organ Transplant Services

Shahid Dharma Bhakta National Transplant Center (SDBNTC) was established in 2012 by the Ministry of Health and Population to strengthen and expand organ transplantation services in the country. This center started its services merely with the OPD services, but within a few years of its establishment it has extended its services beyond organ transplantation.
The number of patients in all these aspects has increased remarkably in FY 2078/79. There were 47,047 patients served in the outpatient department, while the number of admission and discharge were almost similar with 2,106 and 2,099 respectively.
There were 972 minor surgeries and 827 major surgeries in FY 2078/79. The number of kidney transplantations escalated from 49 to 160 in FY 2078/79. The number of sessions of paid dialysis decreased from 2,940 in FY 7078/79 to 2,526 in fiscal year 2077/78.
There has been a slight increase in free dialysis sessions in FY 2078/79. The number of lab tests done in FY 2078/79 was 160,537.

Pashupati Homoeopathic services

Pashupati Homoeopathic Hospital is the only hospital providing homeopathic services to the people of Nepal in the public sector. The homeopathic system is economical, easy and has no adverse effects. The hospital provides OPD service only.
The number of patients receiving homoepptathic services is increasing. Many referred cases are also treated here like allergic rhinitis, urticaria, laryngeal papilloma, PCOD and other skin diseases. People of Kathmandu valley and nearby districts can take free and convenient service at the hospital.
However, People far from Kathmandu valley are not able to take benefits provided by this hospital. It is essential to provide service in all seven provinces of Nepal with utmost priority.

National Health Training

The training network includes seven provincial health training centers and 60 clinical training sites.
It is also responsible for accrediting clinical training sites and Clinical and public health related training courses to maintain the standard of the health training so as to strengthen the capacity of health service providers across the country.

Vector Borne Disease Research & Training

In the FY 2078/79 Vector Borne Diseases Trainings (VBDs) for VBDs focal persons/health workers, malaria microscopic basic and refresher trainings for lab technicians and lab assistants were conducted to enhance their level of knowledge and skills related with prevalent vector borne diseases. Studies conducted during this fiscal year include monitoring of insecticide resistance in malaria vectors and transmission assessment survey of Lymphatic Filariasis.
During the FY 2078/79 VBDRTC conducted Re Pre TAS in Morang, Kailali, Banke, Kapilvastu and Dang districts, TAS-I in Bardiya and Dhankuta districts, and TAS-II in Darchula, Baitadi, Bajhang, Doti, Dadeldhura, Achham, Bajura, Dailekh, Surkhet, Jajarkot, Sunsari, Terhathum, Bhojpur and Udayapur districts.

Health, Education, Information and Communication

NHEICC has been taking a leading role in the SAFER initiative.
In the fiscal year 2078/79 major programme conducted by NHEICC was Tobacco control programme under which advocacy for Tobacco control and regulation with local leaders, journalist interaction and health tax fund programme activities were conducted. NHEICC launched the SAFER initiative for alcohol control and intensive RCCE activities were conducted.
It conducted national level campaigns like mask campaign, mental health wellbeing campaign, and COVID-19 vaccination campaign.
Likewise, advocacy and awareness programmes of health promotion for Samriddha Nepal, FP, RH morbidity, Safe motherhood and newborn care, nutrition child health, immunization, communicable disease, eye health, oral health, environmental health, RTI, mental health andNCDs through mass media and community engagement was carried out.
Similarly, NHEICC used a digital platform to disseminate health related messages and information.

Health Laboratory Services

In FY 2078/79, major public health related activities carried out through NPHL were laboratory-based surveillance of Japanese encephalitis, measles/rubella, polio, antimicrobial resistance (AMR) of selected bacteria, influenza etc.
Apart from public health related activities, it has provided results of thousands of routine and specialized tests from various
departments. NPHL is highly dedicated to quality service. For this it has implemented a two-way LIS system integrating collection, testing machine and reporting, which has dramatically minimized the human errors and effectiveness can be Felt in reports provided by NPHL.
National External Quality Assessment Scheme (NEQAS), one of the oldest programs related to quality service, has been running through NPHL since 1987.
In this program, NPHL prepares various proficiency test panels and dispatches to participating laboratories throughout the country and analyzes their quality based on the received results from them.
Currently more than 600 labs have enrolled in this program. Among them around 400 are private labs and the remaining are government labs. On the other hand, to monitor the service quality of its own, NPHL has participated in various
international External Quality Assessment Scheme (IEQAS) run by renowned institution of the glove like: CMC Vellore,
Birmingham IEQAS, Mahidol university hospital, Sriraaj hospital etc. The blood bank bureau of NPHL supports and regulates the blood banks throughout the country as well as organizes various workshops on planning and managing blood
transfusion service. It also supports blood banks for their capacity building.
In order to provide super specialized service, a flow cytometry lab has been established in NPHL. It provides the diagnosis of various cancers with its modern equipment and cutting-edge technologies.
HLA typing lab is also in full operation which has helped many patients by providing diagnostic requirements for organ transplant at a very reasonable price.
Similarly, an immunohistochemistry lab has been installed and is about to provide service soon. Triple marker and quadruple marker tests are also performed on a regular basis which has helped for screening of genetic abnormalities in fetuses.

Health Service Management:

Procuring, and distributing health commodities for the health facilities and the monitoring and evaluation of health programs. The division is also responsible for monitoring the quality of air, environmental health, health care waste management, water and sanitation.

Logistics Management

The major activities conducted by the IHIMS section in FY 2078/79 are approval of IHIMS’s Roadmap (2022-2030), comprehensive revision of HMIS tools (73 tools), orientation on the revised HMIS tools (M-ToT:89 participants, D-ToT: 168, local level Training: 1,522), DHIS2 dashboard program expanded to 33 LLGs, implementation and training on ICD 11, estimation of target population up to ward level, assessment of routine data quality (RDQA) in five districts (Morang, Dhanusha, Dhading, Tanahu, Pyuthan), preparation and publication of DoHS annual report, initiation of national data warehouse, initiation of DHIS 2 Upgrade from version 2.30 to 2.38, Health Infrastructure Information System (HIIS) integration process. Online self-reporting has been increased from 2,517 to 3,779 from previous FY 2077/78 to this FY 2078/79.
The major activities conducted for the FY 2078/79 were the revision of the LMIS form and Basic Logistics Training Manual, data quality assessment, review and optimization of information flow for the LMIS report, conduction of eLMIS training, implementation/ expansion of eLMIS sites, support through help desk, development and implementation of standard operating procedures (SOPs) for the functionality of the eLMIS along with eLMIS monitoring and data utility for decision making.

Personnel Administration

The Personnel Administration Section (PAS) is responsible for routine and program administrative function. Its major functions include upgrading health institutions (O&M), the transfer of health workers, level upgrading of health workers up to 7th level, capacity building as well as internal management of human resources of personnel.

Financial Management

The preparation of annual budgets, the timely disbursement of funds, accounting, reporting, and auditing are the main.
Out of the total National Budget of Rs. 1,647,576,700,000.00 a sum of Rs. 90,754,500,000 (5.50%) was allocated for the health sector during the fiscal year 2078/79. Of the total health sector budget, Rs. 43,276,927,000.00 (47.68%) was allocated for the execution of programs under the Department of Health Services with COVID-19 control and management.

Medico-legal Services

it is high time for the Nepal Government to facilitate the environment to utilize those experts in the medico-legal field for providing their specialist service to Nepali people.
During the last FY, a number of activities related to medico-legal services were conducted by DoHS and the Ministry of Social Development (Karnali Province).
Around 200 doctors working at the periphery were benefited by these orientation and skill enhancing training.

Monitoring and Evaluation

The Nepal Health Sector Strategy (NHSS) 2015-2022 focuses on better access to and use of information with ICT. It also emphasizes improved and interoperable routine information systems and prioritizes surveys and research for informed decision-making and better policy and planning processes. The strategy promotes upgraded and integrated health sector reviews at various levels that feed into the planning and budgeting process.

Health Councils

The six professional health councils (Nepal Medical Council, Nepal Nursing Council, NepalAyurvedic Medical Council, Nepal Health Professional Council, Nepal Pharmacy Council and Nepal Health Research Council) accredited more effectively the health services, training, research and regulated care providers managed in a scientific manner.

Health Insurance

Health Insurance is a social health security program from the Government of Nepal which aims at enabling its citizens with the access of quality health care services without placing a financial burden on them. In the beginning of FY 2072/73, it was run under the Social Health Development Committee, however since FY 2074/75, it has been running under the Health Insurance Board (HIB) guided by Health Insurance Act and Regulation. The Health Insurance program.
in FY 2073/74. At the end of FY 2076/77, the program was implemented in 58 districts of the country. Till the end of
FY 2078/79, the program was implemented in all 77 districts and 746 Local levels of the country.
The total cumulative numbers of enrolled people are 6,045,192 and total renewed insures are 3,451,951 at the end of FY 2078/79. During this
FY, the total population coverage of the health insurance program is 22.52%. Among the total insured, about 4,248,606
people were active in the health insurance program in FY 2078/79. The leading top five districts based on the number of new enrollments are Jhapa, Sunsari, Morang, Chitwan and Kailali.

Development Partners Support in Health Programs

The outcomes discussed in the previous chapters are the results of combined efforts of the Ministry of Health and Population (MoHP), various development partners (multilateral, bilateral) and other supporting organizations including international organizations and national NGOs and private sectors. The Department of Health Services acknowledges its partnership with these organizations and their large contributions to Nepal’s health sector. This chapter lists the focus of these organizations’ various programs. Partners have also provided technical assistance in their areas of expertise.
In the current sector programme, the World Bank has allocated all its commitment through a Program-for-Results, a tool which disburses funds against a verifiable set of results, called Disbursement Linked Results (DLRs). UKAid and GAVI are also disbursing part of their commitments against some DLRs identified and agreed with the MoHP. In addition, in the Fiscal Year 2021/2022, Development Partners continued to provide additional funding, in-kind and technical support to the MoHP for the preparedness and response to COVID-19 pandemic.

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New WHO guidance on HIV viral suppression and scientific updates released at IAS 2023

by Public Health Update July 23, 2023

written by Public Health Update

The World Health Organization (WHO) is releasing new scientific and normative guidance on HIV at the 12^th International IAS (the International AIDS Society) Conference on HIV Science.

New WHO guidance and an accompanying Lancet systematic review released today describe the role of HIV viral suppression and undetectable levels of virus in both improving individual health and halting onward HIV transmission. The guidance describes key HIV viral load thresholds and the approaches to measure levels of virus against these thresholds; for example, people living with HIV who achieve an undetectable level of virus by consistent use of antiretroviral therapy, do not transmit HIV to their sexual partner(s) and are at low risk of transmitting HIV vertically to their children. The evidence also indicates that there is negligible, or almost zero, risk of transmitting HIV when a person has a HIV viral load measurement of less than or equal to 1000 copies per mL, also commonly referred to as having a suppressed viral load.

Antiretroviral therapy continues to transform the lives of people living with HIV. People living with HIV who are diagnosed and treated early, and take their medication as prescribed, can expect to have the same health and life expectancy as their HIV-negative counterparts.

“For more than 20 years, countries all over the world have relied on WHO’s evidence-based guidelines to prevent, test for and treat HIV infection,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The new guidelines we are publishing today will help countries to use powerful tools have the potential to transform the lives of millions of people living with or at risk of HIV.”

At the end of 2022, 29.8 million of the 39 million people living with HIV were taking antiretroviral treatment (which means 76% of all people living with HIV) with almost three-quarters of them (71%) living with suppressed HIV. This means that for those virally suppressed their health is well protected and they are not at risk of transmitting HIV to other people. While this is a very positive progress for adults living with HIV, viral load suppression in children living with HIV is only 46% – a reality that needs urgent attention.

Here is an overview of other key scientific and normative updates being released by WHO at IAS 2023 conference:

HIV and mpox

An analysis of global surveillance data reported to WHO during the multi-country outbreak of mpox, identified that among more than 82 000 mpox cases, around 32 000 cases had information on HIV status. Among those, 52% were living with HIV, most being men who have sex with men (MSM); and more than 80% reported sex as the most probable route of getting infected with mpox.

Among 16 000 people diagnosed with mpox and living with HIV, around one quarter (25%) had advanced HIV disease or immunosuppression – leading to an increased risk of hospitalization and death. People living with HIV who were taking HIV treatment and with good immunity had similar hospitalization and death outcomes as those who were HIV negative.

In the light of these findings, WHO recommends countries integrate mpox detection, prevention, and care with existing and innovative HIV and sexually transmitted infection prevention and control programmes.

To understand how to better prepare for and respond to future increases in mpox transmission, WHO led a rapid electronic survey in May 2023 to assess community experiences of the 2022-2023 mpox outbreak in Europe and the Americas.

More than 24 000 people participated in the survey which focused on men who have sex with men, and trans and gender-diverse people, with 16 875 eligible individuals completing the survey. Almost 51% changed their sexual behaviour (such as reducing the number of sexual partners), and 35% had maintained these changes one year later. Findings from this survey provide valuable insights into the experiences and needs of affected communities and emphasize the importance of increasing access to mpox vaccination and diagnostics globally.

HIV and COVID-19

An updated analysis from WHO global clinical platform for COVID-19 up through May 2023 revealed a persistent high risk of death in people living with HIV hospitalized for COVID-19 across pre-Delta, Delta and Omicron variant waves, with an overall in-hospital mortality rate of 20%-24%. For people without HIV, the risk of death fell during the Omicron variant wave by 53%—55% compared to pre-Delta and Delta variant waves; but for people living with HIV, the percentage decline in mortality during the Omicron wave period compared to the other waves was modest (16%-19%). This difference resulted in a 142 times increased risk of death among people living with HIV when compared with people without HIV during the Omicron wave period.

Risk factors for in-hospital death that were common across all variant waves of the pandemic were low CD4 count (less than 200 cells per m3), and severe or critical COVID-19 illness at hospital admission.

“Uncontrolled HIV remains a risk factor for poor outcomes and death in the mpox outbreak and COVID-19 pandemic”, said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes. “We must ensure the integration of HIV considerations in pandemic preparedness and response. Protecting people living with HIV from future pandemics is vital and reinforces the need to ensure access to HIV testing and treatment and preventive vaccines for mpox and COVID-19 to save lives; community-led responses that work for HIV will also be beneficial for addressing future pandemics.”

Optimizing HIV testing services through expanded testing options and simplified service delivery

With new recommendations on HIV testing, WHO is calling on countries to expand use of HIV self-testing and promote testing through sexual and social networks to increase testing coverage and strengthen uptake of HIV prevention and treatment services in high-burden settings and in regions with the greatest gaps in testing coverage.

The recommendation comes at a pivotal time, where self-care and self-testing are increasingly being recognized as ways to increase access, efficiency, effectiveness and acceptability of health care across many different disease areas, including HIV.

Primary health care and HIV

A new policy framework on primary health care (PHC) and HIV will help decision-makers optimize work and collaboration underway to advance primary health care and disease-specific responses, including HIV. In the second year of implementation, the Global Health Sector Strategies on HIV, viral hepatitis and sexually transmitted infections for 2022-2030 actively advocate for synergies within the framework of universal health coverage and primary health care.

“Ending AIDS is impossible without optimizing opportunities across and within health systems, including with communities and in the context of primary health care”, said Dr Jérôme Salomon, WHO Assistant Director-General, Universal Health Coverage, Communicable and Noncommunicable Diseases.

This latest research and guidance are being presented at a time when progress towards ending the global AIDS epidemic has lagged, after the COVID-19 pandemic; but the response is rapidly catching up, with some countries now charting a path to end AIDS, including Australia, Botswana, Eswatini, Rwanda, United Republic of Tanzania, and Zimbabwe and 16 other countries that are close to reaching the 95-95-95 global targets, which aim for 95% of people living with HIV knowing their status, 95% of those diagnosed receiving ART and 95% of those on treatment having suppressed viral loads.
WHO

World Brain Day 2023: Brain Health and Disability

by Public Health Update July 23, 2023

written by Public Health Update

World Brain Day is observed on July 22 every year aims to create awareness on brain health, promoting awareness and education for neurological disorders that affect individuals worldwide. The World Federation of Neurology which was established on the same day in 1957 had proposed to observe the day as World Brain Day in the year 2014.

World Brain Day 2023

The focus of World Brain Day is on Brain Health and Disability. It underscores the need to prioritize brain health, especially in people with disability. Many neurological disorders can lead to disabilities that affect an individual’s quality of life, such as mobility, cognitive functioning and emotional well-being.

“This World Brain Day will provide a vital opportunity to fight for the equality of people with disabilities on a global scale. Through advocacy and policy changes, our collective voices will spark a worldwide movement for better health care access.”
– Prof. Tissa Wijeratne, Co-Chair of World Brain Day

2023 World Brain Day Key Messages

Prevention: Brain conditions can be prevented, treated and rehabilitated.
Awareness: Global brain health awareness can reduce the impact of disability associated with brain disorders.
Access: Universal access to care, treatment, rehabilitation and assistive technology is essential.
Education: Education increases equity for those living with brain disabilities.
Advocacy: Brain health is a human right that applies to everyone, everywhere.

World Brain Day 2023 Social media toolkit.

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Digital Mapping of Health INGOs in Nepal

by Public Health Update July 21, 2023

written by Public Health Update

AIN Official Digital Mapping

Health INGOs in Nepal

Action Against Hunger | Action Contre la Faim (ACF)
ADARA Group
ADRA Nepal
AIDS Healthcare Foundation Nepal
AMDA-MINDS Japan
Safe Motherhood and Newborn Health (SMNH)
Asia Foundation
CARE Nepal
CBM Global
CECI
Childaid Network
Community Action Nepal UK
CRS
Damien Foundation
FAIRMED Foundation Nepal
FHI 360 Nepal
German Nepalese Help Association
GNI
Helen Keller International
HI
International Nepal Fellowship
IPAS
Lutheran World Relief (LWR)
LWF Nepal
Marie Stopes International
MDM
Mercy Corps Nepal
Nick Simons Foundation International
One Heart Worldwide
Plan International
PSI
Save the Children
Terre des hommes (Tdh) Foundation
The Leprosy Mission Nepal
UMN
VSO
WaterAid
Welthungerhilfe
World Vision International

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Immunization Agenda 2030: A global strategy to leave no one behind

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Bhutan, Timor-Leste eliminate rubella; Achieve 2023 target of measles and rubella elimination

by Public Health Update July 21, 2023

written by Public Health Update

The World Health Organization South-East Asia Region today announced Bhutan and Timor-Leste have eliminated rubella, a highly contagious disease that causes serious illness and irreversible birth defects in newborns of women infected during pregnancy, but preventable through vaccination.

Bhutan and Timor-Leste had eliminated measles in 2017 and 2018 respectively, and now join Maldives and Sri Lanka to achieve elimination of measles and rubella by 2023, a flagship priority program of WHO South-East Asia Region.

“Strong government leadership and steadfast commitment of health care workers, volunteers and partners, and community participation have been critical to implementation of strong vaccine-preventable disease surveillance and increasing access to immunization services,” said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia, while congratulating Bhutan and Timor-Leste on their achievement.

The announcement follows recommendations made by the Regional Verification Commission for Measles and Rubella Elimination which met in Bangkok, Thailand, in June, which after reviewing the data provided by Bhutan and Timor-Leste, concluded that the two countries had interrupted transmission of endemic rubella virus for more than 36 months.

Cautioning against the risk of virus importation, the Regional Director said continued focused efforts would be needed to now implement a post-elimination sustainability plan that builds on the strategies that led to elimination of endemic measles and rubella.

The Commission, which meets annually, reviewed the data provided by countries and verified that measles elimination has been sustained in Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste; and rubella elimination in Maldives and Sri Lanka.

It recommended documenting the lessons learnt with regard to achieving and sustaining measles and rubella elimination, including cross-border collaboration.

Significant progress is being made even in the endemic countries, the Commission noted, and mentioned the strong political commitment; high-quality and sensitive surveillance; well-functioning laboratory network; well-developed outbreak response plan and ongoing efforts to address gaps in population immunity as per WHO guidelines.

According to the WHO UNICEF estimates of national immunization coverage released on 18 July 2023, coverage with first dose of a measles-rubella containing vaccine in the South-East Asia Region has improved from 86% in 2021 to 92% in 2022 (a 6 percent increase), while coverage of 2nd dose of the vaccine has jumped from 78% in 2021 to 85% in 2022 (a 7 percent point increase).

Six countries in the Region – Bangladesh, Bhutan, India, Maldives, Sri Lanka, Thailand – have achieved a coverage of 95% or more during 2022, while three of these – Bhutan, Maldives and Sri Lanka – have achieved more than 95% coverage with the second dose as well.

The South-East Asia Region has set a target of achieving more than 95% coverage with two doses of measles-rubella containing vaccine in all districts of all countries of the Region.

In 2014 Regional Director Dr Poonam Khetrapal Singh set measles elimination and rubella control as one the flagship priority programs in the WHO South-East Asia Region. In 2019 the flagship goal was revised to measles and rubella elimination by 2023. By then six countries – Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka, and Timor-Leste – had achieved rubella control and four – Bhutan, Maldives, DPR Korea and Timor-Leste – had eliminated measles.

Countries, partner agencies and the communities have worked in unison over the years to prevent and protect children against measles and rubella, major childhood killer and debilitating diseases, globally.

New Delhi | July 21, 2023: Press release 1815

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Pandemic Fund Allocates First Grants to Help Countries Be Better Prepared for Future Pandemics

by Public Health Update July 21, 2023

written by Public Health Update

The Pandemic Fund’s Governing Board has approved grants under its first round of funding allocations aimed to boost the resilience to future pandemics in 37 countries across six regions. The selected projects will receive funding to strengthen disease surveillance and early warning, laboratory systems, and health workforce.

Established in September 2022, and formally launched under Indonesia’s G20 Presidency at the G20 meetings in Bali, Indonesia last November, the Pandemic Fund is the first multilateral financing mechanism dedicated to providing multiyear grants to help low- and middle-income countries become better prepared for future pandemics. The Fund, which is hosted by the World Bank, has already raised $2 billion in seed capital from 25 sovereign and philanthropic contributors.

In May of this year, the Pandemic Fund closed its first Call for Proposals and received 179 applications from 133 countries. The Pandemic Fund’s Governing Board met on July 19, 2023 to make its allocation decision under the first Call, based on the technical recommendations of the independent Technical Advisory Panel (TAP). Based on the proposals recommended by TAP, 19 were selected by the Board, with a focus on the three priority areas of the first Call for Proposals and will benefit 37 countries representing all World Bank geographic regions, with at least 2 projects allocated per region. About 30% of the grants allocated are for projects in sub-Saharan Africa – the region with the highest demand for Pandemic Fund grants. Over 75% of the projects supported by the first Call are in low and lower-middle income countries. The projects involve a variety of Implementing Entities. These projects support the Pandemic Fund’s objectives to bring additional, dedicated resources for pandemic prevention, preparedness, and response, incentivize countries to increase investments, enhance coordination among partners, and serve as a platform for advocacy.

“We are very pleased that the Pandemic Fund has been able to move forward so quickly to allocate funding to projects that represent a good balance across geographical regions, country income groups, and participating Implementing Entities,” said Pandemic Fund Board co-Chairs, Dr. Chatib Basri, former Minister of Finance of Indonesia and Dr. Sabin Nsanzimana, Minister of Health, Rwanda. “The Pandemic Fund Board worked diligently to ensure the selection process was inclusive and transparent, placing equity at top of mind. All proposals were independently reviewed and evaluated by the Technical Advisory Panel (TAP) and we are confident that the portfolio of projects selected by the Board for funding will increase pandemic prevention, preparedness, and response (PPR) capacity and respond to the inequalities that COVID-19 further revealed to the world. As Board co-Chairs, we will continue doing all we can to ensure that the Pandemic Fund delivers support to countries most in need, and that the funding is used wisely for greatest impact.”

In keeping with the Pandemic Fund’s mission to catalyze funding and promote coordination, the $338 million of grants awarded will mobilize over $2 billion in additional resources, adding $6 for each $1 coming from the Fund. Many of the projects involve collaboration between countries, UN agencies and Multilateral Development Banks. In responding to this call for proposals, countries have mobilized civil society and networks of delivery partners. Many of the projects involve cross-border and regional collaboration, a One Health approach— a collaborative approach that combines human, animal and econsystem health, and consideration for gender and equity.

“The demand from countries for grant financing to strengthen pandemic prevention, preparedness and response is clear—the first Call for Proposals was eight-times oversubscribed. I’m very pleased that in the first round, the Pandemic Fund will be able to catalyze significant additional resources, promote coordination and support multi-country projects that foster regional collaboration,” said Priya Basu, Executive Head of the Pandemic Fund Secretariat. “This first round of funding was a learning exercise and we are committed to drawing lessons that will be reflected in how we do business in the future. We are excited to see the results and impact of our funding.”

The Pandemic Fund’s Governing Board aims to launch the second Call for Proposals by the end of 2023, based on lessons learned from the first Call for Proposals.

Grants from the Pandemic Fund catalyze co-financing for projects from public and private sources, and technical expertise from the World Health Organization and other partners. The Pandemic Fund’s Governing Board includes equal representation of sovereign contributors and co-investors, as well as representatives from foundations/non-sovereign contributors and civil society organizations.

The selected proposals are listed below in alphabetical order of beneficiary:

Single-Country Proposals
Name of Project	Beneficiary Country (-ies)	Implementing Entity *
Strengthening disease surveillance systems, capacity of laboratories, and staff skills on public health emergency preparedness and coordination	Burkina Faso	WHO UNICEF FAO
Strengthening pandemic prevention, preparedness and response through one health approach in Bhutan	Kingdom of Bhutan	WHO FAO
Cabo Verde – Strengthening National Health Security through One Health approach	Republic of Cabo Verde	World Bank
Cambodia Pandemic Prevention Preparedness and Response (CamPPR)	Kingdom of Cambodia	World Bank FAO AIIB
Ethio-Pandemic Multi-Sectoral Prevention, Preparedness, and Response (EPPR)	Democratic Republic of Ethiopia	WHO UNICEF FAO
Animal Health Security Strengthening in India for Pandemic Preparedness and Response	Republic of India	World Bank FAO ADB
Strengthening the National Capacity for Pandemic Preparedness and Response to Infectious Disease Outbreaks in Kazakhstan	Republic of Kazakhstan	WHO
Empowering Better Pandemic Preparedness and Response by Strengthening Human Resources, Enhanced Surveillance, and Advanced Lab Systems in Moldova	Republic of Moldova	WHO World Bank
Strengthening pandemic prevention, preparedness and response through One Health in Mongolia	Mongolia	WHO UNICEF
Strengthening Pandemic Preparedness for Early Detection in Nepal (SPEED)	Federal Democratic Republic of Nepal	WHO UNICEF FAO
Strengthening critical pandemic PPR functions in Paraguay through holistic disease surveillance and functional early warning system, enhanced collaboration between human, animal and environmental laboratories and workforce capacity building, within the framework of One health and following IHR recommendations	Republic of Paraguay	WHO UNICEF FAO IADB
Suriname Public Health Emergency Response Effort	Republic of Suriname	WHO
Health emergencies preparedness and response strengthening in Togo	Togolese Republic	WHO UNICEF FAO
Strengthening Pandemic PPR in West Bank and Gaza	West Bank and Gaza	WHO World Bank UNICEF FAO
Yemen pandemic preparedness and response project (PPRP)	Republic of Yemen	WHO UNICEF FAO
Zambia Multisectoral Pandemic Preparedness and Response Project (ZaMPPR)	Republic of Zambia	WHO FAO
Multi-Country Proposals
Reducing the Public Health Impact of Pandemics in the Caribbean through Strengthened Integrated Early Warning Surveillance, Laboratory Systems and Workforce Development	Antigua & Barbuda Belize Commonwealth of Dominica Grenada Cooperative Republic of Guyana Republic of Haiti Jamaica Federation of Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Republic of Suriname Republic of Trinidad and Tobago	IADB
PROTECT – Pandemic Response Optimization Through Engaged Communities and Territories	Plurinational State of Bolivia Republic of Brazil Republic of Chile Republic of Colombia Republic of Ecuador Republic of Paraguay Oriental Republic of Uruguay	WHO World Bank
Pandemic Preparedness and Response through a One Health approach in Central Asia	Republic of Kazakhstan Kyrgyz Republic Republic of Tajikistan Turkmenistan Republic of Uzbekistan	World Bank WHO FAO

WB PRESS RELEASE NO: 2024/005/HD

July 21, 2023 0 comments

Call for Proposal, EOI & RFP National Health News Public Health News Public Health Opportunities Public Health Opportunity

Vacancy Announcement for Nurses [Nepal-UK G2G Agreement]

by Public Health Update July 20, 2023

written by Public Health Update

Nurse Recruitment Pilot: Application process goes live

The Department of Foreign Employment (DoFE) welcomes interested applicants to its online platform for the receipt of applications from eligible participants. The governments of the UK and Nepal have signed a Government-to-Government (G2G) agreement to begin a fair and ethical recruitment process of Nepali healthcare professionals to work in the UK’s health sector. The recruitment process will be undertaken only through DoFE’s online platform. DoFE is working closely with the UK’s Department of Health and Social Care’s (DHSC’s) designated entity on this recruitment.

F1hXEQhaEAAkKf3 — **Call for application**

This platform serves as the only avenue for participating in the application and selection process. Through this platform interested applicants can see details on eligibility requirements, complete the application, as well as participate in the shortlisting and selection process. Successful candidates can then work through this platform to participate in the orientation and seek the final clearances for their move to the United Kingdom. This entire process will be handled through this platform. Participants are directed not to visit DoFE or approach any other third party. Any physical interaction, if required, will be communicated to the applicant through this platform (as well as email and SMS) once they are registered. Applicants are encouraged to send all their queries to uknursing@dofe.gov.np

Applications for the pilot phase of recruitment will open on July 20^th and will close on October 19, 2023. Participants that meet the eligibility criteria can apply immediately, and those that need to complete some of the eligibility requirements can still begin the application process and upload their outstanding eligibility information before the application deadline of October 19^th.

To start your registration and application process, please click here.

Applicant Requirements

The applicants to be recruited for the UK Nursing Initiative shall fulfil the following minimum set of requirements:

Be a Nepali citizen holding a valid Nepali passport. The passport must be valid for atleast one year during time of application for consideration for recruitment.
Have completed either of the following academic qualifications: Staff Nurse, Bachelor’s Degree in Nursing (BSc or BN), or Master’s degree in nursing from a recognised institution of the Government of Nepal or abroad.
Hold a valid professional license from the Nepal Nursing Council.
At least two years of recent professional experience in a registered hospital of Nepal at the time of application. Any work experience completed before 2019 shall not be considered.
Either of one following English language proficiency* :
- For IELTS candidates require at least a score of 7 in the reading, listening and speaking sections, and a score of 6.5 in the writing section.
- For OET, candidates require at least Grade B in reading, writing and listening sections, and Grade C+ in the writing section.

* Applicants can submit scores of up to two tests taken with in a year. They will have the benefit of combining the best score in each band among the two tests increasing their chances of meeting the English language requirement.

Other desirable requirements will include:

Experience in a variety of clinical settings
Evidence of Continuing Professional Development (CPD) during the past 24 months
Experience of a range of other clinical competencies (for example, venepuncture, male catheterisation, current tissue viability, IV administration, blood transfusion)

Note: While completing the application, please provide as much information in your application about your role as you can. While responding to these desirable requirements, include the types of patients you have looked after, clinical areas you have worked in, nurse to patient ratio, responsibilities, etc. This is your chance to tell us about your experience as a nurse.

Applicants are strongly encouraged to read the Implementation Protocol and DoFE Operating Procedures to fully understand the recruitment process.

NOTE OF CAUTION

No other UK or Nepali employer or recruitment agency is permitted to carry out active health worker recruitment activities in Nepal under this G2G agreement. Please refrain from engaging with any third parties. Please direct all your questions through the platform above. Selected nurses will not incur any fees for the recruitment. For successful candidates, the main costs associated with the recruitment purpose will be reimbursed or paid for.

More information

To start your registration and application process, please click here.

Please visit official website for more information: https://ferms.dofe.gov.np/home

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July 20, 2023 0 comments

Communicable Diseases National Plan, Policy & Guidelines Research & Publication

National Leprosy Strategy(2021-2025)

by Public Health Update July 19, 2023

written by Public Health Update

Overview

The National Leprosy Strategy (2021 -2025) highly considered the previous National Leprosy Strategy (2016 -2020), findings and recommendations from the In-depth Review of the National Leprosy Program 2019, National Roadmap for Zero LeprosyNepal (2021-2030) as well as the different health policies and plans of Nepal. It also considers The World Health Organization’s Global Guidelines on: Towards Zero Leprosy: Global Leprosy (Hansen’s Disease) Strategy (2021- 2030).

Vision: Leprosy free Nepal
Goal
Elimination of leprosy (interruption of transmission of leprosy) at the subnational level (municipality). (Interruption of transmission is defined as zero new autochthonous child leprosy cases for consecutive five years at the municipality level).

Objectives

To eliminate leprosy at the subnational level (province, district, local level).
To strengthen clinical case management at district and municipal levels and improve referral system.
To enhance capacity building through training of health staff particularly at the peripheral health facilities.
To enhance prevention of leprosy.
Reduction of stigma and discrimination.
To strengthen leprosy surveillance system and regular monitoring, supervision,
and periodic evaluation at all level.
To strengthen partnerships among different stakeholders.
To strengthen management of leprosy complications like reactions and disability prevention and rehabilitation.
To coordinate with neighboring states of India in management, reporting and referral of cases from border areas.
To promote research and innovations.

Strategic Pillars

Pillar 1: Implement the national leprosy roadmap for zero leprosy across all level-national, provincial, and local.
Pillar 2: Scale up leprosy prevention alongside integrated active case detection.
Pillar 3: Manage leprosy and its complications and prevent new disability.
Pillar 4: Combat stigma and ensure human rights are respected

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Download Nepali Version

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July 19, 2023 0 comments

Fact Sheet Global Health News Health in Data Outbreak News Public Health News Public Health Update Vector-Borne Diseases(VBDs)World News

Situation update of Dengue in Nepal (As of 15 July, 2023)

by Public Health Update July 19, 2023

written by Public Health Update

Overview

Dengue is a viral infection transmitted to humans through the bite of infected Aedes mosquitoes. Dengue is widespread throughout the tropics, with local variations in risk influenced by climate parameters as well as social and environmental factors. Dengue is caused by a virus of the Flaviviridae family and there are four distinct, but closely related, serotypes of the virus that cause dengue (DENV-1, DENV-2, DENV-3 and DENV-4).

Step wise approach for Dengue Case Management

Dengue has become a rapidly growing concern in Nepal. The country has actively conducted vector surveillance in various districts, revealing the presence of Aedes aegypti and Aedes albopictus mosquitoes, which are known vectors for dengue transmission. Nepal has a historical record of all four dengue serotypes circulating, but in 2022, DENV-1 and DENV-3 were the most prevalent, with no evidence of DENV-4. In that same year, Nepal reported 54,784 dengue cases and 88 deaths, marking the highest number ever recorded in the country. This figure was more than three times the number of cases reported in 2019.

Screen Shot 2023 07 19 at 20.34.20 — Trend of dengue cases in Nepal (2004-2023), EWARS and Line-Listing from Districts (as of 15 July 2023), Situation updates of Dengue as of Jan _ 15 July, 2023 (EDCD)

2023 Update

As of 15 July, 2023 a total of 2930 dengue cases have been identified from 68 districts, with Koshi province reporting highest number (1746), followed by Bagmati province (468) and Sudurpaschim Province (279).

Screen Shot 2023 07 19 at 20.34.43 — Number of Dengue cases by Province, EWARS and Line-Listing from Districts (as of 15 July 2023), Situation updates of Dengue as of Jan _ 15 July, 2023 (EDCD)

Screen Shot 2023 07 19 at 20.34.58 — EWARS and Line-Listing from Districts (as of 15 July 2023), Situation updates of Dengue as of Jan _ 15 July, 2023 (EDCD)

National Guideline on Prevention, Management and Control of Dengue in Nepal

Interventions and Activities conducted for Dengue Prevention and Control

The comprehensive Action Plan on Dengue Prevention and Control has been developed by EDCD, which has been disseminated to all provinces, districts and local levels.
EDCD has been conducting routine surveillance of dengue cases through the Early Warning and Reporting System (EWARS). The line-lists of Dengue cases have been shared with 92 local levels in 66 districts to initiate timely response.
A Clinical Seminar on Dengue with a focus on clinical case management was recently organized by EDCD . The seminar brought together international experts in Dengue, and it saw the participation of over 110 doctors and nurses.
The EDCD is actively conducting a series of sensitization meetings with stakeholders from different workplaces to raise awareness about Dengue Prevention and Control. The EDCD has successfully completed sensitization meetings with the Auto-mechanic Proprietors’ Association of Nepal and the Nepal Recollection and Recyclers’ Association (Kawadi)
The Ministry of Health and Population (MOHP) has initiated a campaign encouraging all public offices to conduct a cleanliness campaign in their office premises for at least 10 minute on every Friday at 10:30 am.
In collaboration with NHEICC, EDCD has created a flyer for dengue prevention and control, which is regularly distributed through online and social media channels
Dengue test diagnostic kits are being supplied to provinces and districts on a need basis.
A joint program review of vector-borne diseases, including dengue, was undertaken by a team of national and international experts. This review assessed the issues and challenges related to dengue prevention and control, and identified the key priorities for action.
EDCD is maintaining a regular communication and collaboration with relevant levels, partners, and stakeholders to enhance the recording, reporting, and response to dengue.

Download PDF File

International PhD Scholarship for Neonatal Health Research in Nepal

Department Health Services (DoHS) Annual Report 2078/79 (2021/22)

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Vacancy Announcement for Nurses [Nepal-UK G2G Agreement]

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Applicant Requirements

NOTE OF CAUTION

More information

National Leprosy Strategy(2021-2025)

Overview

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