Health lifestyles and Environment

Advocacy plan provides comprehensive guidelines to the concerned advocacy group/s to concentrate their efforts to ensure change. It explains the major issue that need to be addressed by the advocates as the specific target area on which advocacy needs to be continued. The advocacy group/s should be clear on their goal and objectives that help them to be focused, persistent and to have patience in their efforts. Similarly, the advocacy group/s should also identify the advocacy partners who can influence the change and take collaborative actions.

This revised National Safe Motherhood and Newborn Health Long Term Plan (NSMNH-LTP) 2006-2017 has been developed to be in line with the Second-Long Term Plan Health Plan (1997-2017), the Nepal Health Sector Programme Implementation Plan and Millennium Development Goals (MDG). The revision takes into account recent developments such as the increased specific emphasis on neonatal health, recognition of the importance of skilled birth attendance in reducing maternal and neonatal mortalities, health sector reform initiatives, legalisation of abortion, recognition of the significant levels of mother to child transmission of HIV/AIDS and increased emphasis on equity issues in safe motherhood services.

Proven and evidence-based interventions are of paramount importance for achieving the national target of halving new HIV infections. Understanding the dynamics of the HIV epidemic through systematic evidence is critical for addressing the knowledge gaps for an effective policy and planning decisions in response to HIV and Sexually Transmitted Infection (STI). National Centre for AIDS and STD Control (NCASC) and its partners, therefore, developed the National HIV Research Agenda to inform research gaps and to enhance quality, coverage and effectiveness of HIV prevention, treatment, care and support services in Nepal. 

The past three decades have witnessed some impressive advances in leprosy control. Elimination as a public health problem (i.e. registered prevalence below 1 per 10 000 population) was achieved in all countries1. The agenda of eliminating leprosy at the subnational level is still unfinished in many countries and will therefore continue to be pursued in the coming years.

Every year globally, an estimated four million babies die before they reach the age of one month.  Nearly the same numbers die in late pregnancy or are stillborn and these deaths are rarely recorded.  Millions more are disabled because of poorly managed pregnancies, deliveries and neonatal care.  Deaths are far more likely to occur early in the neonatal period. This has been neatly summarized as the “two thirds rule” which states that approximately 2/3 of all deaths in the first year of life occurs in the first month of life. Of these deaths, approximately 2/3 occurs in the first week of life. Of these deaths, approximately 2/3 occurs in the first day of life.

The estimation and projection conducted in 2013 estimated that Nepal has approximately 40,723 persons living with HIV (PLHIV) and prevalence of HIV was 0.23%1. This also projected that the overall HIV epidemic in Nepal is on a decline. Modelling suggests that new infections continue to reduce from 1,437 in 2011 to 818 in 2015. The ART need in 2012 was projected to be 26,876 while 860 HIV positive pregnant women were estimated to require PMTCT services.

HIV in Nepal is characterized as concentrated epidemic. More than 80 percent HIV infections spread through heterosexual transmission. People who inject drugs, female sex workers (FSWs) and men having sex with other men (MSM) are the key populations at higher risk spreading the epidemic. Male labour migrants (particularly to HIV prevalence areas in India, where labour migrants often visit female sex workers) and clients of female sex workers in Nepal are acting as bridging populations that transmit infections from higher risk groups to lower risk general population.

Reproductive Health (RH) is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Reproductive Health therefore, implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and have the freedom to decide if, when and how often to do so. Implicit in this last condition are the rights of women and men Reproductive Health (RH) is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity to be informed of, and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law.