Embed Size (px)
Citation preview
National Annual Review FY 2074/75 (2017/18 )
- Health Sector Progress -
Dr Guna Raj Lohani Director General
Department of Health Services Ministry of Health and Population
Outline of Presentation
• Trend of Major Health Indicators
• Financial progress and irregularities
clearance
• Major issues identified
• New initiatives
Trend of Major Health
Indicators
Percentage of Reporting Status of
Public Health Facilities 9
9
98
99
99
99
10
0
10
0
99
97
94
97
96
10
0
98
99
97
85
90
95
100
105
2073/74
Percentage of Reporting Status of Non Public
Health Facilities 5
2
20
52
56
35
37
62
47
40
26
60
47
67
72
[VA
LUE]
49
-5
5
15
25
35
45
55
65
75
85
95
105
2073/74 2074/75
Percentage of Reporting Status of LMIS 8
7
83
88
88
95
78
93
87
80
65
70
83
94
68
[VA
LUE]
77
-5
5
15
25
35
45
55
65
75
85
95
105
2073/74 2074/75
Percentage of Under One Children
Immunized with DPT- Hep B -Hib 3 8
7.0
99
76
76
87
97
85
87
82
87
73
72
87
[VA
LUE]
83
82
50.0
55.0
60.0
65.0
70.0
75.0
80.0
85.0
90.0
95.0
100.0
105.0
2073/74 2074/75
SDG Target: 95%
Percentage of New Growth Monitoring Visit in
under two Years Children 6
4
63
56
69
79
11
0
77
69
66
65
55
79
79
10
6
73
70
30
40
50
60
70
80
90
100
110
120
130
140
2073/74 2074/75
Percentage of Underweight among
New Growth Monitored Under Two
Years Children
2
5
3
1
4
10
7
4 3
8
2 1
4
8
6
4
0
2
4
6
8
10
12
14
2073/74 2074/75
Incidence of Diarrhea Among Under
Five Children
(per 1000) 3
77
33
5
28
8
30
2
41
1
72
2
69
7
40
0
36
4
33
7
26
2
29
0
40
3
70
9
64
8
38
5
0
100
200
300
400
500
600
700
800
2073/74 2074/75
Incidence of Pneumonia Among Under
Five Children (per 1000) 1
68
91
73
82
11
0
19
9
17
0
11
7
11
8
66
60
52
80
17
1
13
0
87
0
50
100
150
200
250
2073/74 2074/75
Percentage of 4 ANC Visit as per
Protocol Among Expected Live
Births 4
4
37
68
59
58
49
55
53
47
34
49
60
61
55
55
50
0
10
20
30
40
50
60
70
80
90
100
2073/74 2074/75
SDG Target:
90%
Percentage of Institutional Delivery
Among Expected Live Births 4
9.0
44
53
46
69
60
68
55
53
34
49
47
75
67
69
54
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
2073/74 2074/75
SDG Target:
90%
Contraceptive Prevalence Rate
48 49
41 36
44
37 41
44 43 48
37 33
41 36
40 41
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
2073/74 2074/75
SDG Target:
60%
Annual Parasite Incidence of
Malaria 0
.02
0.0
4
0.0
3
0.0
2
0.0
8
0.1
3 0
.25
0.0
8
0.0
1
0.0
2
0.0
2
0.0
3
0.0
7
0.3
0
0.2
9
0.0
8
0.00
1.00
2073/74 2074/75
SDG Target:
0
Case Notification Rate of all forms of
Tuberculosis ( per 100,000
population) 9
2
89
12
1
96
14
0
10
1 1
20
10
9
88
87
12
1
92
14
6
95
11
8
10
8
0
20
40
60
80
100
120
140
160
180
200
2073/74 2074/75
SDG Target: 20
Prevalence Rate of Leprosy
( per 10,000 population) 0
.8
1.5
0.3
0.5
1.6
0.6
0.7
0.9
0.7
1.1
1.0
0.3
1.4
0.5
0.8
0.9
0.0
1.0
2.0
2073/74 2074/75
SDG Target: 0
Annual Number of New Cases of HIV
Infection
207 273
630
108 134 9
208
1781
142 133
715
197
526
57 243
2013
0
300
600
900
1200
1500
1800
2100
2400
2073/74 2074/75
Percentage of New OPD visit among
total population 7
8
47
82
96
69
78
71
72
76
45
89
98
73
83
72
74
0
10
20
30
40
50
60
70
80
90
100
110
2073/74 2074/75
Free treatment services for Bipanna Nagarik and Total Expenditure (NRS)
8119
15385
21820
102
117
211
0
50
100
150
200
250
0
5000
10000
15000
20000
25000
2072/73 2073/74 2074/75Total number of cases
Total Expenditure in Crore
Financial Progress of Past Three
Years
80 85 83
0
20
40
60
80
100
2072/73 2073/74 2074/75
Irregularities Clearance of Three
years
50 45 41
0
20
40
60
80
100
2072/73 2073/74 2074/75
Major issues
identified in FY
2074/75
Human Resources Related Issues
• Vacant post of Specialized doctors
• Inadequate number of Skilled Health workers (SBA, AA, Radiographer, Lab Assistant)
• Transfer system
• Mechanism of Reserve Pool to replace HR during study or special leave
Procurement and Supply Chain Management
• Delay in procurement and supply due to insufficient coordination among different level
• Storage capacity at different level
Integrated Health Information Management
• Online reporting of HMIS, LMIS, and EWARS and Bipanna (Incomplete and untimely )
• Internet connectivity in all local bodies
• Monthly meeting, Data Verification and annual review program in provincial and local level ( 2075/76)
Maternal, Newborn Health and Bipanna Nagarik
• Inadequate budget in Aama Program, Bipanna Nagarik and conflict victim
• Limited number of Referral centers for New born care
• Adherence to CBIMNCI protocol by health care providers
• Limited number of Family Planning Training Sites
• Service delivery points not offering LARC services
Disease Control
• Limited Service accessibility of HIV Testing and Counseling, ART and PMTCT
• Declining New Case Detection and increasing Drug Resistant TB
• Shifting epidemiology of vector borne diseases (Malaria, kala-azar, Dengue) to hills and mountains and increasing newly emerging diseases (Scrub Typhus, leptospirosis, Chikungunya)
• Increasing prevalence of Leprosy in some of the Terai districts and few hilly districts; threatening elimination status ( 0.9)
• Increasing trend of Non Communicable Diseases including Mental illness
New Initiatives
New Initiatives of Fiscal Year 2074/75
• Expansion of DHIS 2 in 1200 Health Facilities and e-LMIS in 22 Districts
• LMIS system in 7 Provinces
• Endorsed of Post natal care micro planning guideline
• Budget allocation for Sickle cell anemia in high burden districts
• Health Desk establishment in Port of Entry
New Initiatives of Fiscal Year 2074/75
• Expansion of C/DST lab at 3 Provinces
• Proper allocation of budget for prepositioning of emergency items in provincial level
• Health Promotion Strategy (2018-2030) and FCTC Drafted
• Revision of NHT strategy and PEN Package
New Initiatives of Fiscal Year 2075/76
• Strengthen central warehouse
• Initiation of Advanced Test (Molecular expansion and Genetic pathology laboratory, Cancer related special test and Allergy related tests) by NPHL
Short Treatment regimen for DR TB (9 months) initiated
m health technology and tracker for Identify, Reach, Recommendation, Test, Treat and Retain ( PLHIV)
Strengthening of HMIS in DHIS2 platform in 753 local bodies
New Initiatives of Fiscal Year 2075/76 Minimum Service Standards roll out at different
level of health facilities • Declaration of local bodies with availability of 5 FP
commodities • Strengthening of Comprehensive Reproductive
Health Training sites • Expansion of Maternal and Perinatal Death
Surveillance and Response program (11 districts) • Scholarship Health worker placement from
Province • Basic Health service Package endorsement • Public health Service Act.
Way Forward
• Finalization of O & M , Priority to Samayojan Process, Fully digitalize (Paperless ) administrative procedure
• Institutionalization of online Reporting System from Health Institution-Palika-Province-to Federal level
• Functionalization of Frame work Agreement procurement system for Drug/supplies -align with Insurance Mechanism and intact Supply chain
• Coordinated Supervision and Monitoring- in all levels (federal, Province, Local government)
• Accountable Financing-- Reporting system from Province and Local Government (TABUCS)
• Paradigm shift From Hospital to Community
From Quality to Value
From Health care to health
National Annual Review 2017/18
Government of Nepal Ministry of Health and Population
Thank you
