book setup 2069 nijamati.indd
book setup 2069 nijamati.indd book setup 2069 nijamati.indd
Management of Childhood Illness (CB-IMCI), the Community-Based Newborn Care Package (CB-NCP), and the National Immunization Programme (NIP). The CB-IMCI package has recently been expanded to all 75 districts. Based on the National Neonatal Strategy 2004, the government is piloting the CB-NCP in 11 districts. This programme promotes the use of skilled birth attendants during delivery, and provides Community-Based counseling, treatment and referral of sick neonatals. It encourages clean delivery, newborn resuscitation, prevention of hypothermia, kangaroo care, use of antibiotics for infection, tetanus toxin vaccination, breast-feeding education, hygiene education and antenatal interventions. And initial assessment of four UNICEF-supported pilot districts (Kavre, Chitwan, Palpa and Dang) suggests that neonatal mortality has fallen to 18 deaths per 1,000 live births compared to the national average of 33 and the IMR to 24 deaths per 1,000 live births (UNICEF, 2009). Neonatal health has also been made an integral part of Safe Motherhood Programme, and provisions have been made to deliver appropriate neonatal care through all health facilities where basic and/or comprehensive emergency obstetric care (BEOC/CEOC) services for pregnant women are available. Figure 3: Maternal mortality ratio (MMR) Figure 4: Percentage of births attended by skill birth attendant The NIP, including vaccination against measles, is a high-priority government programme, and covers the entire country free of cost. It delivers services through routine and supplemental immunization programmes. Following the National Measles Campaign in 2005, both measles-like our-breaks and laboratoryconfirmed measles cases have decreased significantly. The Multi-Year Plan for Immunization (2007-2011) outlines activities aimed at achieving measles elimination by 2011. To sustain achievements made so far, the government conducted a national measles follow-up campaign in 2008. 238
As outlined in the Nepal Health Sector Programme Implementation Plan (NHSP- IP 2004-2009), 75 percent of health facilities are expected to provide prioritized elements of essential health care service (family planning, safe motherhood and neonatal health; child health; communicable diseases control; and out-patient care) in 2009. The government has also introduced a free health care policy, targeting the poor and marginalized; this is expected to raise the demand for health services. Budget allocations to the health sector in general and the child health sector in particular are increasing. The government has adopted a sector-wide approach (SWAp) to funding and programming. In this way, Nepal has made landmark progress in relation to child survival. In recognition of this, it received an award at the International Partners' Forum held in Hanoi in November 2009. Ministry of Health and Population (MOHP) has also been awarded by the Global Alliance for Vaccine and Immunization (GAVI). 5.6. Effects of social inclusion in Nepal. 5.6.1. Social inclusion/exclusion: present scenario Nepal has a mixture of race, caste, class, region, religion and ethnicity, along with gender as a factor in each proposed remedy. The country comprises more than 103 castes and ethnic groups, which speak more than 92 languages, and adhere to differing religions. Population and resources are unevenly divided among regions, so that there are also social and historical differences determined by topography. Above all, the country is moving from a hierarchical society in which one’s place was dictated by gender, by caste and by ethnicity, to one that aspires to making human dignity and equality its fundamental principles. There is a close correlation between poverty and ethnic minorities. Consequently, Nepal is facing the challenge of peace building, nation-building and statebuilding by mainstreaming all the people belonging to all caste, classes, groups and communities. Presently the country has multiple transitions, such as - from monarchy to republic; from authoritarianism to democracy and human rights; from a hegemonic to a participatory system of governance; from a state wholly pervaded by one religion to secularism; and from a heavy centralized unitary system to one characterized by decentralization and autonomy. Smarting under their exclusion, Dalits, Janjatis, Madhesis, people from socially and economically backward areas, and women are formulating their own 239
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As outlined in the Nepal Health Sector Programme Implementation Plan (NHSP-<br />
IP 2004-2009), 75 percent of health facilities are expected to provide prioritized<br />
elements of essential health care service (family planning, safe motherhood and<br />
neonatal health; child health; communicable diseases control; and out-patient<br />
care) in 2009. The government has also introduced a free health care policy,<br />
targeting the poor and marginalized; this is expected to raise the demand for<br />
health services.<br />
Budget allocations to the health sector in general and the child health sector in<br />
particular are increasing. The government has adopted a sector-wide approach<br />
(SWAp) to funding and programming.<br />
In this way, Nepal has made landmark progress in relation to child survival. In<br />
recognition of this, it received an award at the International Partners' Forum<br />
held in Hanoi in November 2009. Ministry of Health and Population (MOHP)<br />
has also been awarded by the Global Alliance for Vaccine and Immunization<br />
(GAVI).<br />
5.6. Effects of social inclusion in Nepal.<br />
5.6.1. Social inclusion/exclusion: present scenario<br />
Nepal has a mixture of race, caste, class, region, religion and ethnicity, along<br />
with gender as a factor in each proposed remedy. The country comprises more<br />
than 103 castes and ethnic groups, which speak more than 92 languages, and<br />
adhere to differing religions. Population and resources are unevenly divided<br />
among regions, so that there are also social and historical differences determined<br />
by topography. Above all, the country is moving from a hierarchical society in<br />
which one’s place was dictated by gender, by caste and by ethnicity, to one that<br />
aspires to making human dignity and equality its fundamental principles. There<br />
is a close correlation between poverty and ethnic minorities. Consequently,<br />
Nepal is facing the challenge of peace building, nation-building and statebuilding<br />
by mainstreaming all the people belonging to all caste, classes, groups<br />
and communities. Presently the country has multiple transitions, such as - from<br />
monarchy to republic; from authoritarianism to democracy and human rights;<br />
from a hegemonic to a participatory system of governance; from a state wholly<br />
pervaded by one religion to secularism; and from a heavy centralized unitary<br />
system to one characterized by decentralization and autonomy.<br />
Smarting under their exclusion, Dalits, Janjatis, Madhesis, people from socially<br />
and economically backward areas, and women are formulating their own<br />
239
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