situational analysis of MDGs 4,5 and 6 in Nepal
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Transcript of situational analysis of MDGs 4,5 and 6 in Nepal
SITUATIONAL ANALYSIS OF MDGS 4,5
AND 6 GOALS IN CONTEXT OF NEPAL
Presented By:
Kamal Bdr. Budha
Kamala Paneru
Bikal Subedi
Gokarna sapkota
Khagendra Poudel
INTRODUCTION
The UN global conferences of the 1990s drew up a
number of different key global Development goals and
targets to focus equalize and harmonize the needs and
status of the people all over the world.
These goals and targets were known as the International
Development targets. Again in 2000, the representatives
of 189 nations, including 147 heads of state and
Government adopted the Millennium Declaration during
the Millennium Development Summit (September 6-8,
2000) of the United Nations.
The Millennium Declaration focused on peace, security and
development to all people. The representatives made specific
commitment seven area viz.
1. Pease, security and disarmament
2. Development and poverty eradication
3. Protection our common environment
4. Human right, democracy and good governance
5. Protecting the vulnerable
6. Meeting the special needs of Africa
7. Strengthening the United Nations
The international development targets and the
development goals were merged together and renamed as
the Millennium Development Goals (MDGs).
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development.
5
The goal and targets to be reached by 2015 in each of
seven areas are so called the MDGs.
MDGs place health at the heart of development.
3 of 8 goals are directly related to health; 8 of 18
targets are directly related to health; 18 of 48
indicators of the progress are health related.
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Goal 4: Reduce Child Mortality Rate
6
Target 5:
Reduce by two thirds, between 1990 and 2015, the
Under five mortality rate.
Indicator:
Under-five mortality rate (UNICEF-WHO)
Infant mortality rate (UNICEF-WHO)
Proportion of eye year children immunized against
measles.
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Goal 5: Improve Maternal Health
7
Target 6:
Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio.
Indicator:
Maternal mortality ratio (UNICEF-WHO)
Proportion of births attended by skilled health personnel (UNICEF-WHO)
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Goal 6: Combat HIV/ AIDS, malaria, and other
diseases
8
Target 7:
Have halted by 2015 and begun to reverse the spread of HIV / AIDS.
Indicator:
HIV prevalence among pregnant women aged 15-24 years
Condom use rate of contraceptive prevalence rate
Condom use at last high- risk sex
Percentage of population aged 15-24 years with comprehensive correct knowledge of HIV / AIDS
Contraceptive prevalence rate
Ratio of school attendance of orphans to school attendance of non orphans aged 10-14 years
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
9
Target 8:
Have halted by 2015 and began to reverse the
incidence of malaria and other major diseases.
Indicator:
Prevalence and death rates associated with malaria
Proportion of population in malaria-risk areas using
effective malaria prevention and treatment measures
Prevalence and death rate associated with tuberculosis
Proportion of tuberculosis cases detected and cured
under DOTS (internationally recommended TB
control strategy)
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Reduce by two- third between 1990
and 2015 the under five years
mortality rate
11
Indicators 1990 1995 2000 2005 2010 2011 2015
IMR( Per 1000 LB) 108 79 64 61 41 46 34
U5MR(Per 1,000LB) 162 118 91 82 50 54 54
Proportion of 1-year olds
immunized against measles
42 57 71 85 85.6 88 >90
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
12
Infant mortality rate (per 1,000 live births) is decrease
by ½ and more: from 108 [1990] to 41[2010] or/and
46 [2011] and 34 has achieved data of MDGs in 2015.
Similarly,Under-5 mortality rate (per 1,000 live
births) is also decrease from 162 [1990] to 50 [2010]
or/and 54[2011]; which is nearer to the target i.e. 54.
% of 1 year-old children immunized against measles
in 1990 is 42 which is increase by the year 2009
[85.6] and/or 88 in 2011; which is nearest to the
MDGs target i.e. >90.
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Measles coverage
13
7578 76
70
81
72
86 84 8680
9791
88 88 8781
9693
0
20
40
60
80
100
120
NATION EDR CDR WDR MWDR FWDR
2065/66
2066/67
2067/68
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Reduce by third- quarters between 1990 and
2015 the maternal mortality rate15
Indicators 1990 1995 2000 2005 2010 2011 2015
Maternal Mortality Rate 850 or
515
539 415 281 229 - 231 or
134
Percentage of deliveries
attended by skill health
personal
7 9 11 20 28.8 36 60
Contraceptive
Prevalence Rate
24 29 39 44.2 45 49.7 67
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
16
•1: Given in MDGs Progress report 20102:Given in NHSP-PI
Maternal mortality ratio (per 100,000 live
births) in 1990 is 850 which is reduced in year
2009 [229] from this indicator Nepal was
awarded.(1)
Maternal Mortality Ratio decreased from
539/100,000 live births (DHS 1996) to 325 in
2006 and 300 in 2009.(2)
Skilled attendance at birth increased from 13%
(DHS 2001) to 22% in 2006 and 35% by 2009.
2/5/2013
SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Goal 6: Combat HIV/ AIDS
malaria, and other diseases
17 2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Have halted by 2015 and to reverse the
spread of HIV/AIDS18
Indicators 199
0
199
5
2000 2005 2010 2011 2015
HIV prevalence
among 15-49 years
olds (%)
NA NA 0.29 0.25 0.49 -
Contraceptive
prevalence rate (%)
24 29 39 44.2 45 65.8 67
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
19
Knowledge of at least one programmatic method ofpreventing HIV transmission increased from 37.6%(DHS 2001) to 75% for women and 50.8% (DHS2001) to 85% for men.
Given the CPR estimated from the HMIS andNDHS, achieving NHSP‐IP goal of 67 percent by2015 from the current level demands innovativeapproaches and appropriate strategies.
However, there has been decline in Total FertilityRate (TFR) from 3.1 in 2006 to 2.6 in 2011 (NDHS2011) and is expected to meet the NHSP‐IP target of2.5 by 2015.
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
The contraceptive prevalence rate (CPR) for
modern family planning method is 44 percent, it
is comparable with 2011 NDHS (43%).
Central development region reported the highest
level of CPR(51%) and western development
region reported the lowest (32%).
Contraceptive prevalence rate (%) is 24 in 1990
and 45 in 2010. this shows that just nearer to
double % CPR is increased.(1)
Contraceptive Prevalence Rate increased from
39% (DHS 2001) to 43% in 2006 and 47% by
2009.(2) 1: Given in MDGs Progress report 2010
2:Given in NHSP-PI
20
SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN
NEPAL
Have halted by 2015 and to reverse the
spread of Malaria and Other Disease21
Indicators 1990 1995 2000 2005 2015
Prevalence rate associated
with malaria(per 100,000 at
risk)
115 NA 65 78 -
Proportion of population in
malaria risk areas using
effective prevention measures
NA 9.75 6.94 11.4 -
Slide positivity rate 5.1 9.2 4.3 NA -
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Indicators 1990 1995 2000 2005 2010 2015
Prevalence rate associated
with Tuberculosis
460 420 310 280 -
Death rate associated with
Tuberculosis
43 35 23 NA -
Proportion of tuberculosis
cases detected
NA 46 69 71 75 -
Proportion of tuberculosis
cases cured under DOTS
NA NA 89 88 89 -
22
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Case detection and treatment
success rate of TB23
Activity 2005/06 2006/07 2007/08 2008/09
Case
detection rate
65 70 71 75
Treatment
success rate
88 89 88 89
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
24
Prevalence rate associated with malaria(number of
cases per 1000 of the population) is 1.96 in 1990 and
decrease in the year 2009 [0.16].
Prevalence associated with tuberculosis is 460 in
1990 and decrease in year 2005 [280].
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Important milestone in the response to
HIV/AIDS26
1988; Launched the first National AIDS prevention and control Program
1990-92; First medium term plan
193-97; Second medium term plan
1993; National policy on blood safety
1995; National policy on HIV/AIDS
1997-2001; Strategic plan for HIV/AIDS prevention
2000; Situational analysis of HIV/AIDS
2002-06; National HIV/AIDS strategic plan
2003-07; National HIV/AIDS operational plan
2006-2011; New national HIV/AIDS strategic plan
2006-2008; National HIV/AIDS action plan
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
DISCUSSION28
National Free Health Program: to increase
access to and utilization of quality essential
health services by ensuring availability of
essential drugs In both urban and rural health
facilities throughout the year.
Social health protection – to achieve universal
coverage of essential health services by
developing a more comprehensive approach
(structure or system) with the aim of protecting
the population against the financial risks of
expensive health care.2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
29
Urban and Environmental Health – To provide
quality essential health care services to the
municipality population at accessible delivery
points through urban Health clinic in partnership
with MoLD ; To promote environmental health
especially hygiene and sanitation amongst
population in conjunction with other essential
health care services for improved hygiene
practices in partnership with related agencies
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
Conclusion
30
Nepal has made marked progress in some social indicators
leading to the attainment of some MDGs by 2015. But the
progress has halted in the recent years. The country faces
added difficulty in achieving MDGs in the current political
scenario- weak resource base, violence, conflict and weak
governance.
The conflict affect towards achieving MDGs for a number
of reasons including the risk of domestic resource crowd
out, ineffectiveness of service delivery, prolonged absence
of elected representatives at the local bodies, and setbacks
in social mobilization and community participation. 2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
31
MDGs are reinforcing to each other and the attainment of one goal would help the attainment of others.
MDGs can be achieved only through a strategic partnership among government, local bodies, NGOs, CBOs, and donors, strategic partnership in project formulation, execution, coordination of development activities, donor harmonization, and participatory monitoring and evaluation system are highly essential.
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
References 32
1. UNDP, Gov. of Nepal. Nepal Millennium Development Goals -Planipolis - Unesco[Internat]. sep. 2005[Cited feb. 2013]: Available from:
www.planipolis.iiep.unesco.org/upload/Nepal/Nepal%20MDG%202005.pd
www.npc.gov.np
2. CIGI, KDI. Post-2015 Development Agenda: Goals, Ta rgets and Indicators[Internet].Copyright © 2012[ cited feb 2013; p.4. Avalable from: file:///D:/MDGs/Statement%20delivered%20by%20UN%20Resident%20and%20Humanitarian%20Coordinator%20on%20the%20third%20Nepal%20MDGs%20Progress%20Report%202010%20_%20Statement%20_%20UNDP%20in%20Nepal.htm
www.cigionline.org
3. UNDP, Gov. of Nepal. MDG Progress Report for Nepal 2010 - UNDP in Nepal [Internat]. sep. 2005[Cited feb. 2013]: Available from:
www.undp.org.np/pdf/MDG-Layout-Final.pdf
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL
33
7. Gov of Nepal. NHSP-IP 2004-
2009.Ministry of Health; oct. 2009: Availeble
from:
8. Poudel s, Gurung Sa, Gurung Sb, Timilsina
S, Kumal S. MDGs in nepal[Internate]. 2012[
cited 3 feb. 2013].Pokhara: Available from:
www.slideshare.net/sagunpaudel/mdgs-in-nepal
2/5/2013SITUATIONAL ANALYSIS OF MDGs 4,5 and 6 IN NEPAL