Child Health in Nepal

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