Introduction to Public Health Programmes in Nepal
1.1 What is Public Health?
Public health is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society.
It focuses on the population as a whole, not just individual patients.
Key Elements of Public Health:
- Health promotion (e.g., encouraging breastfeeding)
- Disease prevention (e.g., vaccination programs)
- Early diagnosis and treatment (e.g., TB screening)
- Health policy making (e.g., smoking bans)
In Nepal, public health programs aim to reduce health inequalities and ensure universal access to healthcare.
1.2 Evolution of Public Health in Nepal
| Timeline | Major Events |
| Before 1950 | Traditional healing systems (Ayurveda, faith healers) dominated. |
| 1950s | Start of modern healthcare with the establishment of hospitals (e.g., Bir Hospital). |
| 1960s-70s | Vertical programs: Malaria eradication, smallpox, tuberculosis control. |
| 1978 | Nepal endorsed the Alma-Ata Declaration for Primary Health Care. |
| 1991 | National Health Policy formulated — focus on health posts in every VDC. |
| 2000 onwards | Emphasis on decentralization and integrated programs. |
| 2015 | New Constitution — health recognized as a fundamental right. |
| 2015-Now | Federalism: Power shared among federal, provincial, and local governments. |
1.3 Legal and Policy Framework for Public Health in Nepal
- Constitution of Nepal 2015:
- Article 35: Right to free basic health services.
- Health as a fundamental right.
- National Health Policy 2019:
- Promotes preventive, promotive, curative, rehabilitative, and palliative health services.
- Emphasis on equity and quality.
- Public Health Service Act 2075 (2018):
- Defines responsibilities of governments at all levels for public health service delivery.
- Establishes public health as a right and duty.
1.4 Current Structure of Public Health System in Nepal
| Level | Health Structures |
| Federal | Ministry of Health and Population (MoHP), Department of Health Services (DoHS) |
| Provincial | Provincial Ministries of Social Development (MoSD), Provincial Health Directorates |
| Local | Health Coordination Units, Municipal Health Offices |
Nepal has about:
- 4,000+ Health Posts (HPs)
- 800+ Primary Health Care Centers (PHCCs)
- 125+ District Hospitals
- 12 Tertiary Hospitals
1.5 Goals of Public Health Programmes in Nepal
- Universal Health Coverage (UHC) by 2030.
- Achieve Sustainable Development Goals (SDGs):
- SDG 3: Good Health and Well-being.
- Reduction of maternal and child mortality.
- Control/elimination of communicable diseases (e.g., malaria, leprosy).
- Prevention and control of non-communicable diseases (e.g., diabetes, hypertension).
1.6 Major Features of Public Health Programmes
- Equity-focused: Special attention to poor, marginalized, remote populations.
- Decentralized: Planning and implementation at provincial and local levels.
- Community Participation: Through Female Community Health Volunteers (FCHVs), Ward Health Committees.
- Multi-sectoral Collaboration: Linking health with education, environment, agriculture.
1.7 Achievements of Public Health Programmes
| Indicator | Status |
| Life Expectancy | Increased to 71.2 years (2021) |
| Maternal Mortality Ratio (MMR) | Reduced to 151/100,000 live births |
| Under-5 Mortality Rate | Reduced to 28/1,000 live births |
| Immunization Coverage | >90% for major antigens |
| Malaria | Near elimination in many districts |
1.8 Challenges in Public Health of Nepal
- Geographical barriers: Difficult terrain makes access difficult.
- Shortage of human resources: Especially in remote areas.
- Financial constraints: Limited budget allocation for health.
- Double burden of diseases: Communicable + Non-communicable.
- Disasters and Emergencies: Earthquakes, floods, pandemics like COVID-19.
1.9 Recent Trends and Innovations
- e-Health Initiatives: Telemedicine, Health Information Management Systems (HMIS).
- Health Insurance Expansion: Target to cover all citizens.
- Urban Health Centers: Addressing urban population needs.
- COVID-19 Response: Mass vaccination, quarantine and isolation facilities, testing expansion.
📚 AHW र ANM लोकसेवा तयारी गर्नेहरूका लागि सुनौलो मौका!
✅ OBJECTIVE Notes
✅ SUBJECTIVE Written Notes
✅ MODEL Questions with Answers & Explanation
✅ PUBLIC MANAGEMENT Notes
✅ MNEMONICS र GOLDEN POINTS
📥 PDF COLLECTION – Mobile मा सजिलै पढ्न मिल्ने!
🎯 PRICE: Rs. 2990/- मात्र अब Rs. 590/- मा‼
📲 तुरुन्तै सम्पर्क गर्नुहोस्: +977-9700353904 (WhatsApp Available)
📌 पूर्ण तयारीको लागि एक मात्र समाधान –
MERO HEALTHLINE’s Complete Loksewa Notes Package!
अब तयारी गर्नुहोस् स्मार्ट तरिकाले ✨
Share गर्न नबिर्सनुहोस् साथीहरूलाई पनि सहयोग होस् 🙌