The
burden of child mortality is still high in Nepal. After all even only one death is 100 percent death for a family. After much prioritization and
investment in child health programmes such as nutrition, immunization,
management of child hood illnesses, and maternal and newborn survival programs,
still the progress we made is far from expectation. Biannual distributions of
Vitamin A and Albendazole, Iodine fortification of salt, Iron fortification in
the wheat flour, Routine immunization, mop up and supplementary immunization
activities and many other activities have helped in achieving improved child
health in Nepal.
“Children
sometimes used to vomit intestinal worms in the past but due to pills of
medicines, children at our home are not suffering with intestinal worms”
iterated a female community health volunteer of Prastoki of Duhabi
municipality. so, We can make the guess of child health status even with such statement.
We
can glance into the Child mortality rate of Nepal to understand status of child
health in Nepal. Nevertheless, the program achievements are equally important
to understand progress in child health status. Even though we have achieved
tremendous progress in decreasing child mortality. Now, large proportion of
babies dies before completing their first month of their life as we can see the
number of neonatal death remaining stagnant and poses challenge to the current
health system.
Trend of Child mortality Rates in Nepal
|
Mortality Rates
|
1990 MDG Baseline
|
1996 NFHS
|
2001 NDHS
|
2006 NDHS
|
2011 NDHS
|
2015 MDG target
|
|
|
Under 5 mortality
rate
|
162
|
118
|
91
|
61
|
54
|
54
|
|
|
Infant mortality
rate
|
108
|
78
|
64
|
48
|
46
|
34
|
|
|
Neonatal mortality
rate
|
46
|
50
|
43
|
33
|
33
|
16
|
|
Some terminologies:
Neonatal mortality: the probability of dying
within first month of life.
Post-neonatal mortality: the probability of
dying after first month of life up to one year of age. Infant mortality minus
neonatal mortality gives post-neonatal mortality.
[Infant mortality – neonatal mortality =
post-neonatal mortality]
Infant mortality: the probability of dying
within first year after birth.
Child mortality: the probability of dying
between exact ages one and five years.
Under-five mortality: the probability of dying
up to the age of five from the day of birth
Some of the development in Child health
policies, plans and programmes
|
Time Frame
|
Activities
|
|
1959
|
Establishment of shree
panch Indra Rajya Laxmi Devi prasuti Griha (Maternity Hospital)
Family planning services by
Family planning association of Nepal
|
|
1965
|
Family planning policy
FP/MCH project
First MCH clinic was
established in 1965 under Bir Hospital Premises.
|
|
1968
|
Family planning and MCH
project had 4 regional offices
|
|
1970
|
Kanti Hospital as children
hospital
|
|
1977/78
|
Inception of EPI
|
|
1978
|
PHC Alma Ata
|
|
1990
|
Ratified the convention on
the rights of the child
|
|
1995
|
National Council for children
|
|
1998
|
Safe motherhood program
IMCI (Integrated management
of childhood illnesses)
National Plan of Action on
Nutrition
|
|
2004
|
National Nutrition policy
and strategy, 2004
National neonatal health
strategy 2004
|
|
2005
|
Infant and Young Child
Feeding strategy
|
|
2006
|
National safe motherhood
and newborn health long term plan (2006-2017)
|
|
2012
|
Multi-sector Nutrition Plan
2013-2017
|
|
2012
|
National Plan of Action for
Children, Nepal 2004/05-2014/15
|
To understand child health status, it is
equally crucial to evaluate the children, who are survived. Their survival
should be accompanied by healthy childhood and better future. Thus the aim of
child health programme should not be limited to decreasing deaths but the well
being of the children and better opportunity in a safe, secure world.
Targets and indicators directly related to
Child health in Sustainable development goals:
|
Targets and Indicators
|
2017
|
2020
|
2022
|
2025
|
2030
|
|
Goal 2: Target 2.2 By 2030,
end all forms of malnutrition, including achieving, by 2025, the
internationally agreed targets on stunting and wasting in children under 5
years of age, and addressing the nutritional needs of adolescent girls,
pregnant and lactating women and older persons
|
|||||
|
2.2a
Prevalence of underweight children <5 years
|
24.64
|
19.19
|
15.55
|
10.09
|
1
|
|
2.2b
Prevalence of stunted children <5yrs
|
30.58
|
23.75
|
19.20
|
12.38
|
1
|
|
2.2c
Prevalence of wasted children <5 yrs
|
9.37
|
7.44
|
6.15
|
4.22
|
1
|
|
2.2d
Proportion of population below minimum level of dietary energy consumption
|
18.71
|
14.63
|
11.90
|
7.81
|
1
|
|
2.2e
prevalence of anaemia among women of reproductive age
|
31.47
|
24.44
|
19.75
|
12.72
|
1
|
|
2.2f
prevalence of anaemia among children <5years of age (%)
|
37.56
|
29.13
|
23.50
|
15.06
|
1
|
|
Goal 3: Target 3.2 By 2030,
end preventable deaths of newborns and children under 5 years of age
|
|||||
|
3.2a
Neonatal mortality rate (per 1000 LB)
|
17
|
14
|
11.3
|
8.5
|
1
|
|
3.2bUnder-five
mortality rate (per 1000 LB)
|
28
|
23
|
18.4
|
13.8
|
1
|
*sources: National Planning Commission,
Government of Nepal. Sustainable Development Goals 2016-2030. National
(Preliminary) Report. 2015