Nepal- Health System

TABLE OF CONTENTS

Introduction1

Location/Geography1

Population2

Government2

Economy3

Evolution4

Education5

State of Health5

Key Determinants of Health6

Key Health Status Indicators6

Burden of Disease7

Culture/Traditional Medicine7

Maternal Health and Nutrition7

Healthcare System and Delivery8

Health Priorities9

Nursing Implications10

Recommendations10

Conclusion11

References13

Nepal-Health System

Introduction

Nepal is a country of stunning contrasts, is the birthplace of the world's highest mountains, ancient cities and impenetrable jungle, which dominate the majestic tigers and rhinos unperturbed.

Location/Geography

Nepal - a sovereign independent state, bordering on the north by the Tibet Autonomous Region of China and south-east, and west by India. The length of the kingdom - 885 km. from east to west, and its width varies from 145 km. up to 241 km. from north to south. The country is divided into three major geographic regions (Rishikesh , 2001).

Figure: Geographical Location of Nepal

Population

Hindus make up around 81% of the population. The other major religious groups are the Buddhists (at 10.7% of the total population), Muslims (4 %) and Kirant (3.6%). The chief ethnic groups are the Chhettris (15.5% of total population), the Brahman-Hills (12.5%), Magar (7%) and the Tharus (6.6%). Around 84% of the population lives in rural areas. The population is young with a median age of 21.2 years as people aged 65 and above constitute only 4.2% of the total population.

Figure: Major Religions in Nepal

Government

Type: Representative democracy.Constitution: Interim constitution promulgated on January 15, 2007. Constituent Assembly convened May 2008 to begin drafting a new constitution.Branches: Executive--President (head of state), Prime Minister (head of government). Legislative--The Constituent Assembly is a unicameral Parliament, consisting of 601 members; 240 members were elected through a direct electoral process representing single-member constituencies across the country; 335 members were nominated from party lists through a proportional representation system; and 26 were nominated by the cabinet as representatives of ethnic and indigenous communities.

Economy

Nepal experienced stable economic growth rates in the 1990s. However, during 2000-10, the economy has suffered from continued Maoist insurrections, which has hurt the tourism industry severely. Fluctuating agricultural production, largely a result of low productivity and heavy dependence on monsoon, coupled with a narrow industrial base has also led to a slowdown in economic growth. The budget deficit has shown an uptrend during 2007-09 due to high military spending, aimed at curbing Maoist violence, which has resulted in low spending on social sectors. To finance increasing deficits, the government has resorted to higher domestic and foreign borrowing. Low economic growth resulting from a moribund agricultural sector and slackening tourism industry has failed to generate adequate employment opportunities. Thus, the unemployment rate remains extremely high at 55.9% and a large proportion of Nepalese look for employment opportunities in India and the Middle East. The agricultural sector contributes 35% of GDP while the services and industrial sectors contribute 49% and 16% of GDP respectively. Nepal also faces the challenge of a growing trade deficit because of high petroleum imports. During 2002-08, the economy recorded an average growth rate of 3.5%. The economy recorded a GDP growth rate of 4.7% in 2009.

Figure: Sector specific GDP in Nepal 2009

Evolution

The following are some of the key events in the economic history ...