Nepal counts down to 2015 Dr. Pradhan Y.V Director, Child Health Division Department of Health Services, Ministry of Health & Population Nepal

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Nepal Facts 2005 Population (million)25.2 Children under 5 (million)3.7 GNI per capita (US$)240 Population below 1 US$ per day (%)24 Health expenditure/capita/year (US$)6.5 Including private sector (US$)26

Trend in Under-Five Mortality MDG = 54 deaths per 1000 live births by 2015

Vitamin A supplementation Community based pneumonia treatment Newer interventions to reduce neonatal mortality Three Major Programmes

Nepal Vitamin A Programme High dose Vitamin A post-partum supplementation within six weeks of delivery High dose Vitamin A supplementation to 6-59 months children twice a year Treatment of measles, prolonged diarrhea, xerophthalmia, severe malnutrition with Vitamin A Promotion of vitamin A rich foods National Role-out

Impressive coverage: > 3.5 million children reached each round (> 90 %) Vitamin A Coverage by Year ( ) 12,000 child deaths averted each year Nepal Vitamin A Programme

Female Community Health Volunteers

48,000 FCHVs 75 districts 4,000 VDCs 35,217 wards 80 households each

FCHVs assess and treat with Cotrim Community Based Treatment of Pneumonia Timer

25 districts covered in 2005 Community Based Treatment of Pneumonia

Proportion of Expected Pneumonia Cases Treated (%) 8,500 deaths averted each year

Interventions to reduce neonatal mortality MIRA Reducing maternal and neonatal mortality using participatory women’s groups MINI Reducing neonatal mortality with management of neonatal infections by FCHVs

Keys to Success Openness to research findings and new ideas Development, testing and refinement of local implementation model Gradual expansion with quality control Willingness to delegate preventive and designated curative services to non-health professionals (FCHVs) Continued dedication of the FCHVs and other health workers Good government-partner collaboration and coordination