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National Planning Commission Secretariat
Social Development Division
Reports & Documents
1. Nepal Multiple Indicator Surveillance (NMIS)http://www.npc.gov.np:
NMIS was introduced in late 1994 to provide a baseline of indicators for monitoring progress of the goals of Nepal's National Programme of Action for Children and Development in the 1990s (NPA) as well as institutionalize the process as a recurrent, community-centered and action-based tool for planning, monitoring and evaluating social development programmes.
Six cycles of surveys have been conducted under the coordination of National Planning Commission with financial support from UNICEF Nepal Country Office. The first four cycles were carried out by New Era and the last two cycles by Central Bureau of Statistics. These have been a mix of quantitative and qualitative in order.
Cycle 1 Health and Nutrition: January - March 1995
A total of 144 (18772 households) clusters were randomly selected in the 15 eco-development regions.
Major Findings
- Measles vaccination coverage is low, with one out of three children in the target age group vaccinated (32% among 9-11 month olds, and 59% among 12-36 month olds).
- "Stunting" (chronic malnutrition affecting height of the child) occurs in two out of three children (64%) with dramatic increase from 6 to 18 months of life.
Cycle 2 Primary Education: April - June 1995
Major Findings
- Girls are disadvantaged compared with boys by being less likely to be enrolled into school (the main difference); also they are more likely not to attend classes and to repeat or drop-out altogether.
- Poverty caused to low enrollment in schools.
Cycle 3 Diarrhea, Water and Sanitation: February - April 1996
Major Findings
- Access to 'safe' water is only 44%.
- If all households treated water, even by crude means, the rate of diarrhea in children could be reduced by 4%. Programmes of latrine provision need to emphasize education and community participation.
- A child of a literate mother is 50% more likely to have a short duration diarrhea, when compared with a child of an illiterate mother.
Cycle 4 Early Child Feeding, Nutrition and Development: August - November 1996
Major Findings
- 53% of children aged 6-36 months have chronic malnutrition (stunting) and 16% of children aged 6-36 months have acute malnutrition (wasting).
- 38% of children aged 12-36 months have a mid upper arm circumference (MUAC) less than 13.5cm, indicating moderate malnutrition.
- 12% has a MUAC less than 12.5cm, indicating severe malnutrition.
- There is geographic variation in malnutrition rates. Stunting is highest in the Mountains whereas wasting is highest in Terai regions.
- 36% of children had the colostrum thrown away rather than fed to them.
- The commonest reasons for stopping breast-feeding are pregnancy (59%) and birth of another child (12%). .
Cycle 5 Pregnancy and Delivery Practices: March-May 1997
Major Findings
- The mean time since the last pregnancy was 5.0 years, (s.d. 4.9 years). For 55% the last pregnancy was 3 years ago or less; for 67% it was 5 years or less ago; and for 85% it was 10 years or less ago.
- The mean age at the time of the last pregnancy was 26 years (s.d 6.3 years), median 26 years. Three quarters (76%) of Nepali women giving birth in the last 5 years receive no formal antenatal care.
- Fewer than one in ten women receives the four antenatal care visits that are considered to be desirable in the National
- Maternity Care Guidelines. Among those who had any antenatal care visits.
- 43% went for their first antenatal visit within the first three months of pregnancy. A quarter (25%) of ever-married women of childbearing age (15-49 years) in the survey is literate by self report.
- One in three (34%) of these women admit to smoking during their most recent pregnancy.
- Only one in ten (10%) women receives iron/folate supplements during pregnancy, and only 2% take them for more than three months. Half the women (50%) giving birth in the last 5 years received at least one dose of tetanus toxic during their last pregnancy.
- The median reported duration of labour is 4 hours. 19% of reported labours lasted more than 12 hours. About one in 25 (4%) women reported a health problem during their last labour. A woman with health problems during pregnancy is more than 5 times more likely to develop problems during labour.
- Overall, 2.3% of babies were reported to have been still born or to have died soon after birth.
Cycle 6 Service Delivery in Health and Agriculture: November-January 1998
Major Findings
- Only 12% of households reported one or more contacts with government health services in the last month. But nearly a quarter (24%) of households used non-government health services in the last month; a few used both government and non-government services.
- Nine out of ten users of non-government health services used private clinics and a third used traditional healers.
- The most common government health facility used was the health post (48%), with a quarter (25%) using sub health posts and 22% using district hospitals.
- For nearly all visits (93%) to government health services it is reported that a health worker was available. But this is not so for medicines. The commonest alternative source of medicines is the drug shop (80% of cases).
- The commonest perceived problems with the government health services are lack of medicines (59%), poor condition of the facilities (40%) and bad attitude of the staff (35%). Households would like to see more medicines (57%), more equipment (35%), more staff (34%) and a better attitude of staff (28%) in government health facilities.
2. Between Census Household Information, Monitoring and Evaluation System (BCHIMES)
NMIS was later renamed as BCHIMES - a national survey carried out by the CBS during the year 2000. The findings were used for Nepal's national end decade report on progress made during the 1990s in the world summit for children goals. The number of clusters selected for the survey was 208(181 rural and 27 urban) covering a total of 69 districts and 10,269 households. The survey report presents data at national level, for rural and urban areas, three ecological belts and 13 sub-regions. Out of total household heads, only 9.1% of the household heads were female. Slightly more than half (52.4%) of the household heads were literate, the rate for female heads (19.2%). The literacy rate of the population aged 6 years and above was 57.6% (70% for male and 44.9% for female). The proportion of households in the country, who have access to safe drinking water, was 79.9% (92.3% urban and 78.1% rural). In Nepal, the proportion of households with any type of toilets was 33.2% but the proportion with safe toilets was only 29.4%. Of the total currently married women of reproductive age, who had delivered children in last five years or are currently pregnant, 39.8% of them had at least one ANC check-up during their last pregnancy. About 13% of deliveries took place under the guidance of medically trained persons. Among women aged 15-49 years, 30% had heard of STD, 39% had heard of AIDS. Among children who suffered from diarrhea, 39% were taken to the health care provider. Children aged 6-59 months (89.7%) were fed vitamin A capsules. The percentage of children fully vaccinated was found to be 54.5%.
3. Report on the situation of Women, Children and Households
This survey is improved as recommended by the evaluation committee on Nepal Multiple Indicator Surveillance (NMIS), which completed in sixth cycle during 1995-1998. It is expected to be of great value for planners, policymakers, researchers and implementation agencies for the evaluation and monitoring of plans and programme. Topics covered in this survey were education, household facilities, vital registration, water sanitation, iodized salt, immunization, vitamin A, antenatal care, postnatal care, family planning, breast feeding, information and communication services and HIV/AIDS.
4. A Situation Analysis of disability in Nepal
The study found that based on the definition adopted for this study, the prevalence of disability was estimated to be 1.63 percent in the total population, with estimates of 1.65 percent in rural areas and 1.43 percent in urban areas, and most of the disabled people were found to have multiple disabilities, which accounted for 31.0 percent of the total disabled person in the country.
5. Basic Social Services Study: Analysis of Social Sector Development 1997-2000
(http://www.npc.gov.np/report/basicSocialService/ )
This study is latest addition to the series of studies conducted at regular interval to access the status of implementation of the 20/20 initiative, which calls for the allocation of 20% of the budget of the developing countries and 20% of the total foreign aid, to the basic social services. This study has focused more on sub-sector analysis and has also touched upon the decentralization of basic social services delivery. The finding of the study is that the expenditure on basic social services, though improving, is much below the internationally suggested norm of 20/20 implying shortfalls in investment by the government as well as the donors in Nepal.
The study shows the expenditure on the social sector as a whole ( education, health, water supply + sanitation) accounted for 23% of the total government expenditure and the ratio has remained constant throughout the review period and the ratio of spending on BSS to the government spending stood at 14.9 and ratio of the foreign aid contribution stood at 14. 2 ( 1999/00)
6. National Report on Follow-up to the World Summit for Children
This report summarizes the findings of the end decade view, an assessment of the commitments made at the beginning of the decade. During the decade, HMG has undertaken many initiatives aimed to improve the status of children and women and to realize their rights. The report highlights the gains made in some areas during the decade like high coverage rates of and reduction in polio cases, vitamin A distribution program and being close to achieving universal coverage in water supply. The review has involved consultation with government line ministries, development agencies both bilateral and multilateral, civil society partners including both national and international, non-governmental organizations, as well as children of Nepal. This study was carried out in December 2000.
National Planning Commission Secretariat
Economic Management Division
Singha Durbar, Kathmandu, Nepal
Phone:977-1-4228845 Fax: 977-1-4226500
E-mail: mmd@npcnepal.gov.np
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