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Scientific Articles

Assessment of Health Situation in Eastern Development Region of Nepal

To cite the article: Nawa Raj Subba, Deepak Paudel, Shiba B. Karkee, Asha Lal Tamang, Rajmukut Bhusal, Shyam K. Subedi, Laxmi Bhattarai, Basanta K. Parajuli, Shiva R. Acharya, Chanda Rai. (2004). A Summary Report on Assessment of Health Situation in Eastern Development Region of Nepal. The Britain Nepal Medical Trust, Kathmandu, Nepal.

Background: The study to assess the health and health care delivery status in Eastern Development Region of Nepal was carried out by the Health Improvement Program of The Britain Nepal Medical Trust (BNMT) in close collaboration and coordination with Eastern Regional Health Directorate. This assessment was funded by BNMT and facilitated jointly by BNMT and Eastern Regional Health Directorate. 

Objective: This study is expected to provide insights into the current status of health; gaps in availability, accessibility and utilization of health care services; current and potential aspects that affect health and thus to guide health managers and partners to identify appropriate interventions to improve health status in the Eastern Development Region of Nepal through strengthening the capacity of local communities. 

Methodology: This is probably the first assessment of this kind covering a wide range of information collection approaches in all districts of the region. AC Nielsen Nepal Private Limited provided technical support for tools development, training of supervisors and enumerators, data entry and preliminary analysis of the data. This report includes the key findings of the assessment. Information was collected from households, health facilities, private clinics, nursing homes, private drug retailers and traditional faith healers from all 16 districts of the region.

Findings: The proportion of children under five years of age is higher among the disadvantaged households and low level of awareness of various diseases, especially HIV, their symptoms and treatment. About one-third households belonged to Dalits. Only 42% of households (60% general and 24% disadvantaged) visited had a toilet. Health workers are not accessible, especially to disadvantaged groups. People felt the most urgent need was for trained manpower, medicines and equipment to be available in health institutions. Only about one-fourth of sick household members visit health institutions. Large communication gaps between service providers and users. About one-third of disadvantaged households were aware of free drugs for the treatment of TB. About nine out of ten deliveries take place at home, but only one mother out of three mothers who gave birth at home used a safe delivery kit.oPeople expressed dissatisfaction with health institutions and health workers, saying that often health workers were not available when they visited.oWomen hesitate to visit the health institution because of a lack of female health workers. Reasons given for not going to health institutions included caste discrimination andan inadequate supply of medicines. Among service providers, the survey found:oMost health institutions had unfilled posts. The staff shortage puts service providers under extremepressure, as they cannot provide quality services with adequate time for the patients. Facilities and infrastructure in hospitals were satisfactory and almost all available facilities were in use. In health institutions without drug schemes, about 70% of key drugs were available (range 41 to 97%). Only 55% of pregnant women visiting hospitals received iron and folic acid tablets, although 79% of pregnant women were anaemic. Service providers noted the increase in people going to health institutions for treatment, and gave credit for this to the female community health volunteers, traditional birth attendants and community health education. Service providers agreed that short opening hours and the capacity and behaviour of health workers were also reasons why people did not visit health institutions.

The Morang Innovative Neonatal Intervention (MINI) Program

Nawa Raj Subba, Penny Dawson. (2006). A Report On The Morang Innovative Neonatal Morang Innovative Neonatal Intervention (MINI) ProgramIntervention (MINI) Program Increased Access Through Community Based Management In Morang Nepal. Ministry of Health District Public Health Morang/ JSI (R & T). 

Background: Ministry of Health District Public Health Morang and JSI (R & T) jointly launched a neonatal health intervention program in Morang (MINI) aiming to lower the neonatal death rate in the district. MINI followed the model established by the community–based management of ARI/pneumonia program management of ARI/pneumonia program. MINI has demonstrated that FCHVs can follow an algorithm for MINI has demonstrated that FCHVs can follow an algorithm for classification of sick neonates, initiate treatment, and facility classification of sick neonates, initiate treatment, and facilitate referral system. MINI has shown that VHW/MINI has shown that VHW/MCHWsMCHWscan provide Gentamicin, with can provide Gentamicin, with high treatment completion high treatment completion rates. This has resulted in increased has resulted in increased rates of appropriate treatment, and likely contributed to reducing rates of appropriate treatment, and likely contributed to reduction ion in neonatal deaths in neonatal deaths

Objectives: To determine whether Community based FCHVs FCHVs (Female Community Health Volunteers)(Female Community Health Volunteers)and the most peripheral Government Health and the most peripheral Government Health Workers can perform a set of activities that Workers can perform a set of activities that result in improvement in the early result in improvement in the early identification and correct management of identification and correct management of neonatal infections.

Findings: Neonatal health intervention reached to all 100% target population od disadvantaged tribes, most socially deprived, disadvantaged flat-land groups and 60 percent of relatively advantaged tribes and 84 percent of the upper caste target population. Breastfeeding practice within an hour improved from 30% (baseline) to 70% of the mothers. Among 5105 infants 680 (10%) infants had low birth weight (LBW) and percentage of LBW with PSBI was found in 150 (22%) infants. Among 9546 recorded infants the community health workers recorded 2953 (31%) infants were sick, 2040 (21%) were with the local bacterial infection and 1286 (13%) infants were found with possible severe bacterial infection (PSBI).
Management of possible severe bacterial infection (PSBI) covered 1360 episodes in neonates (93%) and among them, 1233 (91%) episodes completed Gentamicin injection. Total births recorded in the program was 9546 that is 60% of the projected population. Among them, female community volunteers (FCHV) followed within 2 months 8810 (92%) newborns. Total 157 neonatal deaths (within 28 days)recorded and it was 16 per 1000 live births. It was 21 per 1000 live births recorded in 2005.

This presentation was presented in an International seminar in Bangkok by Nawa Raj Subba (District Public Health Office Morang) and Penny Dawson (MINI/JSI). Preview/Download

A Study of Public Health Indicators of Morang Nepal by Lot Quality Assurance Sampling

Nawa Raj Subba* and Gagan Gurung

To cite the article: Nawa Raj Subba, Gagan Gurung. (2007). A study of public health indicators of Morang Nepal by Lot Quality assurance sampling method.Nepal Medical College Journal; Vol.9, No.2, June 2007 pp117-119.

Corresponding author: [1] Nawa Raj Subba. Email id:


This article is the result of findings of Lot Quality Assurance Sampling that present and compares the findings of Public Health status indicators of Morang district over 2004 and 2006. Surveys’ findings are also been compared with data that come from Health Management Information System. This study aimed to see the trend of status of coverage of public health services in the district. Contraceptive Prevalence Rate (CPR) has slightly been increased from 41.0% in 2004 to 42.0% in 2006. Percentage of women having 4 ANC by Health Workers increased from 42.0% in 2004 to 46.0% in 2006. Proportion of mothers who received iron tablets during last pregnancy increased from 70.0% in 2004 to 80.0% in 2006. Similarly, proportion of mothers who received Vita A during last pregnancy also increased from 45.0% in 2004 to 55.0% in 2006. Percentage of mother who fed breast milk within 1 hour during last natal period increased from 24.0% in 2004 to 31.0% in 2006. Percentage of delivery conducted by health workers has been also increased from 52.0% in 2004 to 57.0% in 2006. Continue reading A Study of Public Health Indicators of Morang Nepal by Lot Quality Assurance Sampling

Health Seeking Behavior of Rajbanshi Community in Katahari and Baijanathpur of Morang District, Nepal

Nawa Raj Subba 

Citation: Nawa Raj Subba. (2004). Health Seeking Behavior of Rajbanshi in Katahari and Baijanathpur of Morang District, Nepal. Journal of Nepal Health Research Council. Vol.2, No.2, October 2004, pp14-17.

Corresponding Author: Nawa Raj Subba, E-mail:


Introduction In Nepal, there are numbers of ethnics having their own traditional health-seeking behavior. Rajbanshi is one of the indigenous people of Morang district whose health-seeking behavior varies depending upon their socio-economic status.
Objectives The objective of the study was to assess the practices of using modern, self and alternative medication on the basis of socio-economic status.
Methods The study was a cross-sectional study of descriptive type. Information has been collected from the field survey by using semi-structured questionnaires containing both open and close-ended questions. Total 175 households of two VDCs was selected from the VDCs rosters using a random number table for convenience and to cover the expected households. Data were analyzed utilizing the Epi Info 6.0 version.
Results Modern, Alternative and Self-medication were common in Rajbanshi community. Modern medication was popular but was expensive to afford as reported by the majority of people. A significant proportion of Rajbanshi people having less than 2 bighas land and uneducated was adopting self-medication in Katahari and Baijanathpur of Morang.
Conclusion There is a relationship between economic, education status and health-seeking behavior in Rajbanshi community.
Keywords Rajbanshi, Health seeking behavior, Modern, Alternative and Self-medication

Continue reading Health Seeking Behavior of Rajbanshi Community in Katahari and Baijanathpur of Morang District, Nepal