How the International Health Partnership will help in Nepal
The International Health Partnership (IHP), launched in September 2007, aims to make aid more effective by getting donors to work together to meet the health priorities of developing countries. As one of the first wave of countries in the IHP, Nepal will have the opportunity to ensure that assistance to its health sector is better coordinated and addresses the major needs of its people.
The scale of the challenge
Image courtesy of Piers Benatar/Panos Pictures
Nepal is the poorest country in South Asia and the 12th poorest in the world.
Almost a third of the population lives below the poverty line (31%). Ten years
of conflict ended in November 2006.
Improving health for Nepal's people is a major challenge. Every hour, a woman in
Nepal dies due to pregnancy and child-birth related complications, and only one
in five births is attended by a trained health worker. Almost a quarter of the
population lacks access to even the most basic health care services, and almost
a half of Nepalese children under five suffer from under-nutrition.
Poor people generally find the cost of health services a serious barrier to
access, and live further away from health services than wealthier people.
It is estimated that health spending in Nepal (both public and private) is
around a half ($14 per person) of that recommended by the
Commission on
Macroeconomics and Health for developing countries ($34 per person). The share
of government health expenditure is less than $5 per person.
Progress made so far
Despite the conflict, Nepal has made good progress in improving the health of
its people. Maternal mortality in Nepal has been halved over the past ten years,
from 539 maternal deaths per 100,000 child births (equivalent to a woman dying
every two hours) to 281 deaths per 100,000 child births (equivalent to a woman
dying every four hours). DFID supported this through long term investment in the
training of doctors and nurses, the legalisation of safe abortion services,
emergency care, and improved transport and communication.
Infant and under five mortality rates have dropped by a quarter in the last five
years. In 2006, only one in sixteen children died before their fifth birthday,
compared to one in 11 in 2001. Nepal has a potential to meet the
child
mortality Millennium Development Goal by 2015 and is on track for meeting the
maternal mortality goal.
HIV/AIDS is regarded to be in a stage of ‘concentrated epidemic’ (0.3%
prevalence) but has the potential to develop into a more generalized epidemic.
Improving development assistance
More than ten major international development partners contribute to 40% of
public health expenditure in Nepal (£39 million annually). However, the number
of separate projects, together with attendant monitoring reports, review
missions and technical support, places a huge burden on the
Ministry of Health
and Population.
DFID and theWorld
Bank are directly supporting the Government to implement the
Nepal Health Sector Programme (2004-2009) through a ‘pooled’ financing
mechanism. It is hoped that more donors will provide their support through this
mechanism, and the IHP should add further impetus. Commitments by development
partners at a global level will speed up donor action at a country level.
Better coordinated assistance and more support for improved health services
should result in more trained doctors and nurses, more hospitals and health
centres, an end to user fees, and therefore better access to medicines and healthcare for
the people of Nepal. This will help Nepal take another step forward towards
achieving the Millennium Development Goals.
Links
Last updated 05 September 2007
