Non-communicable diseases another urgent area SEP 03 - ekantipur/2013/09/03/development/non-communicable-diseases-another-urgent-area/377410.html When doctors at the Prashuti Griha diagnosed complications in the delivery of her first baby, 22-year-old Simran Dhakal (name changed) was just a few hours from becoming a mother . While the baby showed healthy movements in the womb, the family of the would-be mother was desperate to have the newcomer’s first glimpse. The cold December morning, however, had a tragedy to unfold. The doctors, all of a sudden, came across a neonatal complication, demanding an immediate surgery on the pregnant. The infant had suddenly showed slow movements in the womb. However, owing to the lack of abundant hands at the maternity hospital, Dhakal could not be taken to the operation theatre immediately. By the time doctors got hold of the infant’s head through the mother ’s operated abdomen, the infant was no more moving. Had Dhakal been operated a little earlier, it was later known, chances of the infant surviving could have been higher. This being just a case in point, hundreds of mother s across the country are perpetually losing their unborn infants to a weak examination system that often fails to deal with complications on time. Dhakal’s dreadful tragedy that occurred in one of the country’s most sophisticated maternity hospitals hints at how situations are in other parts. An estimated 65 newborns die every day in the country which accounts for around 60 percent of the total child-mortality and a challenge for Nepal in its way to a successful accomplishment of the Millennium Development Goals (MDGs). Also, 170 expecting mother s die per 100,000 births which have to be reduced to 134 by 2015 to meet the health MDG. MDGs are eight in number, which all the 189 UN member states have agreed to try to achieve by 2015. Signed in September 2000, the goals ask world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women, among others. The health MDGs (Goals No 4, 5 & 6) are three—reduce child mortality; improve maternal health; combat HIV/AIDS, malaria and other diseases. Nepal is on track to achieving the health MDGs and also its efforts have been recognised worldwide as it received an MDG award for outstanding national leadership, commitment and progress towards attaining maternal mortality rate in 2010. Other indicators such as infant mortality rate, which was 48 in 2006, decreased to 46 in 2011 that has to be further reduced to 32 per 1,000 live births by 2015. There have also been good achievements in covering immunisation. For now all the efforts and resources are focused more on achieving the MDGs but debates have been going on as to what would be the plan of the government after 2015, also termed as the post-MDG period. What could be the areas in which the Ministry of Health and Population is likely to focus on in the post-MDG period? While there are talks of new programmes, the existing MDGs have to be focussed similarly and should take along new programmes too. For instance, Nepal has to make sure that only 133 mother s die in 100,000 births. But the number is quite high despite the achievement of the goals and the government has to ensure that no mother or fewer mother s would die during childbirth. Also, major efforts are needed to reduce deaths of children less than 28 days. “Although Nepal is doing a remarkable job, the newborns should be its main focus for now and beyond,” said Stephen Adkisson, deputy regional director, Unicef. Officials are also mulling over possible intervention in non-communicable diseases (NCDs) which have been a major challenge for the country. NCDs that include cardiovascular diseases, chronic obstructive pulmonary diseases (COPD), cancer and diabetes have been a major problem in the country. A study conducted by the Nepal Health Research Council in 2010 showed that out of the total admitted patients, 36.5 percent suffered from NCDs. Among them, 38 percent were having heart diseases, followed by COPD (33 percent), whereas diabetes and cancer accounted for 10 percent and 19 percent cases, respectively. Out of the total heart diseases, nearly half the patients suffered from hypertension, the research showed. “NCDs have been a major challenge worldwide and low-income countries have been bearing the brunt of the disease more,” said Dr Baburam Marrassini, a high-level official at the Health Ministry. “The post-MDG debate should address the issue in earnest.” He also said that the priority has to be shifted to the disease escalated by climate change. In terms of financing, there is a strong debate that the MDGs have channelised a majority of the funds in attaining the goals while many health programmes have been overshadowed. There is a gradual increase in the funding of the programmes in the MDG areas while burning issues such as NCDs are yet to be prioritised. Health Budget Analysis for 2011/12 shows that the funds in the programmes targeting women have directly increased by 21.8 percent while also the tuberculosis programme saw 71 percent rise. “The allocation of budget in the MDGs is valid. But, sometimes, this allocation tends to put all the efforts and financial tasks of the ministry towards MDGs while there are many areas which need similar attention,” said Dr Ghanashyam Gautam, a health financing expert. This, Dr Gautam believes, can lead families to ‘catastrophic expenditures’, a condition where a family might become broke due to the health care bill. “So major focus has to be on universal health coverage, which could also reduce individual costs, in the post-MDG debate,” said Dr Gautam. Posted on: 2013-09-03 08:49
Posted on: Fri, 06 Sep 2013 05:34:48 +0000
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