1. A n nual R e p o rt Department of Health Services 206 2067/68 (2010/2011)GOVERNMENT OF NEPAL MINISTRY OF HEALTH AND POPULATIONDEPARTMENT OF HEALTH SERVICES KATHMANDU

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ExecutiveSummary TheAnnualReportofDepartmentofHealthServicesforthefiscalyear2067/68(2010/2011)isthe 17thconsecutivereportofitskind.Thisreportanalysestheperformanceofdifferentprogramsover theprecedingthreefiscalyearsandalsopresentsproblems/constraints;actionstakenagainstthem andsuggestedactionsforfurtherimprovement. This report is mainly based on the information collected by the Health Management Information System (HMIS) of DoHS from the health institutions across the country. The health institutions reporting to HMIS in this fiscal year include 95 public hospitals; 209 Primary Health Care Centers (PHCCs);676HealthPosts(HPs);and3,129SubHealthPosts(SHPs).Italsoincludesservicecoverage of 12,790 Primary Health Care/Outreach Clinics (PHC/ORC); 16,579 EPI Clinics and 48,680 Female CommunityHealthVolunteers(FCHVs).Atotalof445NGOand315privatehealthinstitutionshave reportedtoHMIS.Thisimpliesthatall75districts;97.9percentofpublichospitals;99.5percentof HPCCs;99.2percentofHPs;98.6percentofSHPs;86.4percentofPHCoutreachclinics;92.9percent of EPI clinics; 89.8 percent of FCHVs; 65.2 percent of NGO hospitals; and 69.2 percent of private hospitals have reported to HMIS in 2067/68 and overall 30.4 percent of the health facilities maintained timely reporting to HMIS. Complete and regular reporting particularly from nonpublic healthfacilitieshavealwaysbeenachallengetoHMIS. CHILDHEALTH IMMUNIZATION The national immunization coverage of all antigens in the regular NIP program in 2067/68 has improved compared to last fiscal years. However, the coverage is not uniform throughout the country. Thirtyone districts (41%) have >90 percent coverage for all antigens. There has been 97 percent coverage for BCG, 95 percent for Polio3, 96 percent for DPTHep BHib 3, 88 percent for Measlesand41percentforTT2topregnantwomen.BCGvsMeaslesdropoutrateincreasedfrom 8.6percentin2066/67to9.8percentin2067/68.ThevaccinewastagerateforDPTHepBHibis8.6 percentwhichishigherthantherecommendedwastagerateoffivepercent(singledosevial)and forOPVitis23.4percentwhichishigherthantherecommendedwastagerateof15percent. School Immunization programme has been continued. Two rounds of National Immunization ProgramandIntensifiedNationalImmunisationDays(NIDs)havesubstantiallycontributedtowards thegoalofeliminatingpolio. NUTRITION Thegrowthmonitoringserviceshavebeenextendedtochildrenlessthan5yearsofage.Therehas been decrease in growth monitoring coverage by 7 percent from 46 percent in 2066/67 to 39 percent in 2067/68. The percent of under 5 years children among new growth monitored having malnourishedstatushasdecreasedfrom3.8percentinlastyearto3.4percentthisyear.Tworounds ofVitaminAcapsulesweredistributedtochildrenaged6to59months.Almosttwothirds(65%)of thepregnantwomenreceivedAntihelmintictreatmentand73percentreceivedirontablets. COMMUNITYBASEDINTEGRATEDMANAGEMENTOFCHILDHOODILLNESS(CBIMCI)ANDNEWBORNCARE CBIMCI program has been implemented up to community level at all districts and it has shown positiveresultsinmanagementofchildhoodillnesses.Therehasbeenasubstantialincrementinthe total number of infants of under 2 months who were treated at health facilities compared to last twoyears,anincrementfrom27,690in2065/66to33,751in2066/67andto48,669thisyear.There has also been an increment in the number of cases treated for PSBI, LBI, Low weight and feeding problems. DoHS,AnnualReport2067/68(2010/2011)i 5. Incidenceofdiarrhoeaper1,000underfiveyearschildrenhasdecreasedfrom598inFY2066/67to 500in2067/68.Howevercasesof'SevereDehydration'hasremainedconstantat0.4percentintwo consecutiveyears.TreatmentofdiarrhoeabyZinc+ORShasincreasedfrom48percentin2066/67to 88percentin2067/68. ARIcasesper1,000underfivepopulationhasdecreasedfrom882in2066/67to824in2067/68and incidence of Pneumonia (Pneumonia + Severe Pneumonia) per 1,000