book setup 2069 nijamati.indd

interventions are required.
• The CB-NCP has been designed to reduce neonatal mortality, but it is a
costly intervention and expansion has consequently been slow. However,
community-based programmes for newborn care need to be scaled up
nationwide. As the introduction of the CB-NCP creates increased demand
for newborn care services, service delivery sites at health facilities need to
be strengthened.
• To meet shortage of health workers at the local level the government (MOHP)
needs to be proactive to overcome the inhibiting factors in the recruitment
process of human resources. Until vacant positions within the Health service
are fulfilled, the vacant positions should be filled up in temporary basis
locally on multi-year contracts or services need to be contracted out to the
private sector.
• In order to improve the accuracy of data on immunization coverage, figures
need to be recalculated using revised population sizes for local areas.
Furthermore, monitoring and supervision of data-reporting for the HMIS
needs to be strengthened, with strong leadership and accountability at all
levels, in order to obtain data from 100 percent of non-government facilities.
• The nutrition component suggested for achievement of MDG 1 Target C
should be strengthened to address the problem of malnutrition.
• Efforts need to be made to mobilize local resource for instance, block
grants provided to local bodies as well as other resources generated at the
local level with guidelines and directives for allocation of funds towards
achieving the target for reducing child mortality.
6. Conclusion
Efforts are made to draw conclusion in general perspective and in the context
of Nepal. Innovation in service delivery is focused in local level where poor,
vulnerable and actual helpless service-seekers reside. Various efforts have been
made to strengthen local bodies in order to enable to involve local people in
understanding developmental activities, mobilize local resources and manage
local affairs. LSGA is considered to be the milestone in regard to impressing
legislative framework for decentralization which has developed wider functions,
power and responsibilities to the local bodies for planning, implementation and
monitoring the development activities and for improving service delivery in an
efficient manner. The local bodies are the key institutions in their respective
areas to co-ordinate and mobilize other agencies, such as - line agencies, NGOs,
civil societies and community groups in course of initiating developmental
programs and other activities.
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