CB-IMCI
program was introduced with support of WHO in Nepal in 1995 to help reduce the
high morbidity and mortality among <5 children through interventions aimed
at improving the case management skills of health workers, improving the
health system for effective management of childhood illness and through
improving family and community practices. The program was initiated in two districts
in December 1997 and the coverage to date is in 48 districts with support of
WHO and other contributing partners such as UNICEF, JICA, USAID/ NFHP.
WHO
has from the very inception advocated and provided technical and financial
support for expansion and strengthening of CB-IMCI program in Nepal. In the current biennium the main achievement through WHO
support has been the implementation of IMCI program in two additional
districts viz. Palpa and Lamjung. Data obtained by CHD from these districts
shows a marked increase in the utilization of services of U5 children for
treatment of ARI, diarrohea, etc. Follow up of health care providers at the
health facilities, trained in IMCI; also show marked improvement in diagnosis
and case management skills.
Government now has
plans to rapidly scale up CB IMCI program to cover all 75 districts within
next 2 years and to maintain
CB-IMCI improved quality and access to services that are already available in
48 districts covering more than 65% under five children in Nepal. WHO’s support in 2008-09 WP is in line with government’s
plans including support to the review of IMCI program in Nepal
depending on the availability of OS funding.
Issues
& Challenges:
· Slow
expansion of IMCI program mainly due to lack of funding support from partner agencies including WHO
· Maintenance
of high coverage and quality of care in current IMCI districts is a challenge
· Frequent
transfer of trained staff from IMCI districts posing a constant problem in maintaining smooth delivery of services
· Monitoring
& supervision needs strengthening
Adolescent
Health
Adolescents comprise 23% of the
total population of Nepal.
Despite the fact that this group’s health needs are great and the benefits to
them and society from better access to information and health services is
high, adolescent health programme in Nepal is still on an adhoc basis and
implemented mainly through NGOs. Government attempts to establish adolescent
friendly services have so far not been very successful. Realizing this fact,
in 2006-07, Family Health Division with WHO support decided to work towards a
more systematic approach to make operational the National AHD Strategy,
formulated in 2000. to do so an“Implementation Guide on
Adolescent Sexual and Reproductive Health for District Health Managers, 2007
” was prepared by FHD with support from WHO . This was achieved through a
consultative process involving key stakeholders involved in adolescent health
program in Nepal
both from national and district level. The guide thus prepared defines the
national standards for Adolescent Friendly Health Services , service package,
how to organize effective services,
conducive environment at health facility, capacity building of providers,
environment building, communication with adolescents, monitoring &
supervision.
In the forthcoming bienna 2008-09, WHO will provide
continued support both technical and financial for activities for
implementation of the guideline, in selected districts in partnership with
other stake holders.
Issues
and Challenges
· AHD programme still on Adhoc
basis
· AFHS mainly conducted by NGOs
· Government experience in
Adolescent Health programming is limited
· Capacity building of programme
managers required
· A major
challenge is mobilizing adequate resources to implement adolescent health
programmes
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