Morang

District Profile
&
Annual Report

2061/62
Fiscal Year

Editor
Nawa Raj Subba

Ministry of Health
Department of Health Services
Eastern Regional Heath Directorate
District Public Health Office
Morang, Nepal
1
 CHAPTER 2

INTRODUCTION
MORANG: General Background

Historically, Morang district has been derived from Mawarang, the name of Kirati administrative zone
during regime of Kirati king Hang.1 Gograha was its older name of present Biratnagar; headquarter of the
district and Koshi zone, coined during Ranna regime which is connected with the name of King Birat of
Mahabharat era. Now people believe that the capital of King Birat of that Mahabharat era was located at
present Budhanagar V.D.C. which is 10 Km south east from Biratnagar. Morang district is one of the
Eastern Terai district comprising 65 VDCs where 66 governmental health institutions are available for
providing Primary Health Care services.

Geographical Location Health Institutions

™ Eastern Terai district ™ Hospitals: 2 (Koshi Zonal, Rangeli Hospital)
™ Adjoining districts: Panchthar, Ilam, ™ Primary Health Care Centres: 6
Jhapa, Sunsari, Dhankuta ™ (Jhorahat, Haraicha, Mangalbare, Letang, Bahuni, Jhurkia)
™ Area : 1,855 S.Km. ™ Health Posts: 11
™ Total Population: 914,799 ™ (Babiyabirta, Bayarban, Rani, Ranjani, Budhnagar, Dadarbairiya,
Hasandaha, Kerabari, Madhumalla, Majhare, Tankisinwari)
™ Biratnagar Sub-metropolitan
™ Sub Health Post: 49
Population: 181,000
™ FCHV: 655 (VDCs=585, Biratnagar Sub metro=70)
™ Number of VDCs : 65
™ TBAs= 336, EPI-ORC= 303
™ Sub-Metropolitan City :1
™ PHC-ORC= 281 (Fund raised Rs. 33,718.00)
™ Number of Ilakas : 17
™ Ayurvedic= 2, Nursing Home: 7, Pvt. Hospital =2
™ Electoral Constituencies :7
2
MORANG: Human Development Indicators 20012

S.No. Indicators Morang National

1. Life Expectancy 67.28 Yrs 60.98 Yrs
2. Life Expectancy (Female) 67.78 Yrs 61.5 Yrs
3. Life Expectancy (Male) 66.85 Yrs 60.5 Yrs
4. Adult Literacy 52.3% 48.6%
5. Adult Literacy (Female) 39.9 % 34.9%
6. Adult Literacy (Male) 64.9% 62.7%
7. Human Development Index (HDI) 0.531 0.471
8. Proportion of Malnourished Children under 5 years 41.5% 50.5%
9. Access of Safe drinking water 94.07% 20.48%
10. Proportion of below poverty line 34.4% 39.6%
11. Average duration of School stay
12. Average duration of School stay (Female) 2.58 Yrs 1.95 Yrs
13. Average duration of School stay (Male) 4.31 Yrs 3.56 Yrs
14. Proportion of Income (Female) 0.363 0.345
15. Proportion of Income (Male) 0.527 0.485
16. Gender Development Index 0.511 0.452
17. Gender Development Index/Human Development Index 0.963 0.959
18. Women involvement in local level election 18.78% 19.33%
19. Women involved in any occupation 18.38% 18.78%
20. Women involved in administration sector 15.01% 12.71%
21. Proportion of women income 0.271 0.302
22. Gender Empowerment Measurement 0.399 0.391
23. Gender Empowerment status of Morang in country 20th position
24. Number of Factory 2961
25. Organizations for social service 912
26. Per Capita Income (in market value) 21871 ($297)
27. Social Empowerment Index 0.451 0.406
28. Economic Empowerment Index 0.506 0.337
29. Political Empowerment Index 0.919 0.646
30. Human Empowerment Index 0.625 0.463
31. Human Empowerment Index Order in the country 5th

As per Human Development Indicators published by UNDP, Morang district is found in first position in
Eastern development region.

3
 CHAPTER 2

ANNUAL REPORT (F.Y. 2061/62)

Table 1 Target Population (Programme wise)

Population: 914799
Male: 458772
Female: 456027
Under 1 year's population: 22870
Under 3 year's population: 70352
Under 5 year's population: 118289
MWRA: 174510
Expected Pregnancy: 34945

Major Achievements

1. CHILD HEALTH

1.1 Expanded Programme on Immunization (EPI)

1.1.1 Background:

EPI is a priority national programme of HMG/N which has been running nation wide since 1989. Active
surveillance system is weak; therefore it is difficult to measure the impact of the programme. However,
there is no doubt that the programme has contributed significantly towards reduction of infant and child
mortality as evidence by reduction of IMR and U5MR over the last decade3. According to the Annual
Report published by Ministry of Health, Department of Health Services4 noted that measles vaccine
coverage rate of Rauthahat was 120 percent, National 85 percent, Eastern development region 88 percent
and Morang 95 percent in FY 2060/61. However the BCHIMES5 survey conducted in early 2000 and
DHS survey 20016 indicate that the actual coverage is lower than the reported coverage by 5-10%. The
Multi Year Plan of Action 2002-2007 (MYPOA) has set six objectives: 1) increasing routine
immunization coverage to >90% and maintain the level; 2) eradication of poliomyelitis by 2005; 3)
elimination of MNT by 2005; 4) reduction of measles cases and deaths; and 5) introduction of Hep-B
vaccine and 6) promotion of safe injection practices in immunization programme.

1.1.2 Objectives:
• To eliminate neonatal tetanus (less than 1 cases per 1000 live births) by the year 2005;
• To reduce measles cases by 90% and measles death by 95% from the previous level by the year
2005.
• To obtain certificate of poliomyelitis eradication by the year 2005.
• To introduce new vaccine (Hepatitis B).

1.1.3 Targets:
The target population for BCG, DPT, OPV, and Measles vaccines is all infants under one year (12
months) of age. For TT+, the target population is all pregnant women. The EPI covers all the 16 districts
in eastern region. It aims to have uniform coverage in all the districts and sustain high levels of coverage
(i.e. at least 80% for BCG, DPT 3, OPV 3, and Measles in children under one year and 80% coverage for
TT+ vaccine in pregnant women.
4
1.1.4 Strategies:
• Immunization service delivery mainly through outreach sessions, provision of immunization
services by conducting 3-5 sessions per VDC per month, in the district.
• Use of all fixed sites to increase immunization coverage. EPI services provided through fixed
health facilities including Hospitals, PHC, HP, SHP and other health clinics.
• Supplementary immunization activities (NIDs, SNIDs, Mopping up) for polio eradication and
MNTE activities for maternal and neonatal tetanus elimination.
• Control of outbreak of VPDs through appropriate interventions.

1.1.5 Analysis:

Table 2 Target Vs Achievement

Program/ Units Target Achievement % % expenditure Reasons for

Activities Achieved wrt released not achieve
budget 100%
BCG Person 22550 21451 94 1. Measles
Campaign,
DPT3 ,, 22550 16704 73 2. Frequent
Polio3 ,, 22550 18368 82 training for
health workers
Hep-3 ,, 22550 20593 91 due to piloting
MEASLES 22550 18363 81 programmes,
75.8 3. Shortage in
TT2 35006 21673 62 supply of
vaccine for 3
Cold Chain Times 1 1 100
months.
training
Micro Planning/ ,, 1 1 100
DDC
Orientation

Graph 1 Trend of Measles vaccination coverage

Trend of measles
Trend of Measles Vaccination Coverage vaccination seems running
100 above 75 percent over past
90
90 95 7 years. This year
80
76 77 75 82 83 coverage was dropped to
70
60
50
82 percent due to measles
40 campaign, frequent
30
20 movement of health
10
0
workers due to series of
trainings, and shortage of
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05 vaccine supply for three
months.

5
 Table 3 VDC wise BCG coverage in Morang

S.N. VDCs Taget Achievment % S.N. VDCs Taget Achievment %

1 Aamgachhi 137 313 228 34 Hasandaha 292 248 85

2 Rangeli 406 733 181 35 Madhumalla 522 436 84

3 Nocha 104 137 132 36 Mahadewa 122 102 84

4 Dainiya 328 407 124 37 Urlabari 698 583 84
5 Bardanga 265 318 120 38 Tankisinuwari 447 369 83
6 Budhanagar 327 383 117 39 Singdevi 74 61 82
7 Jhurkiya 267 305 114 40 Katahari 509 417 82
8 Sorabhag 278 316 114 41 Bhaudaha 168 137 81
9 Warangi 92 104 113 42 Tetariya 151 122 81
10 Amahibariyati 163 183 112 43 Keroun 337 272 81

11 Thalaha 205 227 111 44 Bayarban 549 441 80

12 Sis. Jahada 194 213 110 45 Indrapur 465 374 80
13 Sub Metro Brt 4540 4932 109 46 Govindapur 406 324 80

14 Pokhariya 75 81 108 47 Motipur 141 112 80

15 Dadarbairiya 215 229 107 48 Rajghat 345 275 80
16 Majhare 242 249 103 49 Takuwa 198 156 79
17 Dangraha 136 139 102 50 Sanischare 642 506 79
18 Tandi 265 270 102 51 Darbesha 453 355 78
19 Yangsila 182 186 102 52 Jante 196 153 78
20 Baijanathpur 122 122 100 53 Haraicha 172 133 78
21 Belbari 530 529 100 54 Dangihat 526 397 76
22 Sijuwa 308 305 99 55 Mirgouliya 350 261 75
23 Sis. Badahara 130 128 99 56 Amardaha 384 282 73
24 Letang 456 447 98 57 Itahara 422 297 70
25 Hoklabari 127 124 97 58 Pathari 586 412 70
26 Dulari 277 267 96 59 Babiyabirta 393 276 70
27 Kadmaha 195 188 96 60 Bahuni 333 232 70
28 Hattimuda 215 207 96 61 Pati 65 44 67
29 Bhatigachha 306 289 94 62 Sundarpur 423 278 66
30 Banigama 218 200 92 63 Ramitekhola 86 53 61
31 Jhorahat 131 116 88 64 Kaseni 195 119 61
32 Kerabari 425 369 87 65 Sidraha 102 58 57
33 Lakhantari 109 93 86 66 Bhogteni 150 83 55

District 22870 21477 94

BCG coverage is heterogeneous which ranges from Aamgachi 222 percent to Bhogteni 55 percent in the
district.

6
Table 4 VDC wise DPT 3 Coverage in Morang district

S.N. VDCs Taget Achievment % S.N. VDCs Taget Achievment %

1 Aamgachhi 137 287 210 34 Kerabari 425 295 69
2 Jhurkiya 267 329 123 35 Bhaudaha 168 113 67
3 Sorabhag 278 339 122 36 Jante 196 130 66
4 Mahadewa 122 133 109 37 Warangi 92 60 65
5 Rangeli 406 436 108 38 Jhorahat 131 85 65
6 Dainiya 328 348 106 39 Katahari 509 326 64
7 Nocha 104 110 106 40 Hoklabari 127 81 64
8 Thalaha 205 210 102 41 Hasandaha 292 180 62
9 Dadarbairiya 215 219 102 42 Yangsila 182 112 61
10 Majhare 242 246 102 43 Haraicha 172 105 61
11 Kadmaha 195 197 101 44 Takuwa 198 120 61
12 Dangraha 136 133 98 45 Tandi 265 158 60
13 Bardanga 265 259 98 46 Bayarban 549 318 58
14 Pokhariya 75 73 97 47 Sanischare 642 370 58
15 Amahibariyati 163 151 92 48 Motipur 141 81 58
16 Baijanathpur 122 112 92 49 Hattimuda 215 122 57
17 Belbari 530 459 87 50 Pati 65 37 57
18 Lakhantari 109 94 86 51 Babiyabirta 393 222 57
19 Budhanagar 327 278 85 52 Kaseni 195 108 55
20 Sis. Jahada 194 159 82 53 Bhogteni 150 82 55
21 Banigama 218 177 81 54 Madhumalla 522 284 54
22 Sub Metro Brt 4540 3663 81 55 Pathari 586 317 54
23 Sijuwa 308 244 79 56 Rajghat 345 186 54
24 Sis. Badahara 130 102 79 57 Govindapur 406 217 53
25 Bhatigachha 306 240 78 58 Itahara 422 225 53
26 Tankisinuwari 447 345 77 59 Sidraha 102 54 53
27 Dulari 277 207 75 60 Singdevi 74 39 53
28 Keroun 337 250 74 61 Ramitekhola 86 44 51
29 Letang 456 328 72 62 Dangihat 526 259 49
30 Indrapur 465 332 71 63 Bahuni 333 160 48
31 Darbesha 453 319 70 64 Amardaha 384 181 47
32 Tetariya 151 106 70 65 Sundarpur 423 197 47
33 Mirgouliya 350 245 70 66 Urlabari 698 318 46
District 22870 16716 73

DPT 3 coverage is heterogeneous which ranges from Aamgachi 210 percent to Urlabari 46 percent in the
district.

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Table 5 VDC wise Measles vaccine coverage in Morang

S.N. VDCs Taget Achievment % S.N. VDCs Taget Achievment %

1 Aamgachhi 137 247 180 34 Bahuni 333 280 84
2 Warangi 92 144 157 35 Bhaudaha 168 139 83
3 Sorabhag 278 422 152 36 Tankisinuwari 447 368 82
4 Mahadewa 122 142 116 37 Ramitekhola 86 71 82
5 Belbari 530 601 113 38 Sanischare 642 518 81
6 Amahibariyati 163 181 111 39 Sis. Jahada 194 156 80
7 Jhurkiya 267 294 110 40 Lakhantari 109 86 79
8 Jante 196 215 110 41 Sub Metro Brt 4540 3572 79
9 Rangeli 406 440 109 42 Bhogteni 150 116 77
10 Dadarbairiya 215 230 107 43 Bhatigachha 306 235 77
11 Pokhariya 75 79 105 44 Pati 65 50 77
12 Yangsila 182 187 102 45 Tandi 265 200 76
13 Hoklabari 127 129 101 46 Madhumalla 522 393 75
14 Baijanathpur 122 121 99 47 Indrapur 465 347 75
15 Banigama 218 214 98 48 Pathari 586 430 73
16 Hasandaha 292 287 98 49 Jhorahat 131 96 73
17 Kadmaha 195 187 96 50 Sijuwa 308 224 73
18 Bardanga 265 254 96 51 Urlabari 698 497 71
19 Letang 456 436 96 52 Katahari 509 356 70
20 Dainiya 328 311 95 53 Budhanagar 327 224 68
21 Nocha 104 98 94 54 Dangihat 526 354 67
22 Dangraha 136 128 94 55 Govindapur 406 271 67
23 Sis. Badahara 130 122 94 56 Babiyabirta 393 257 65
24 Dulari 277 259 94 57 Singdevi 74 47 63
25 Hattimuda 215 198 92 58 Takuwa 198 119 60
26 Kerabari 425 391 92 59 Itahara 422 253 60
27 Rajghat 345 317 92 60 Amardaha 384 223 58
28 Keroun 337 306 91 61 Kaseni 195 110 56
29 Majhare 242 215 89 62 Darbesha 453 250 55
30 Mirgouliya 350 304 87 63 Sidraha 102 54 53
31 Thalaha 205 175 85 64 Haraicha 172 86 50
32 Tetariya 151 128 85 65 Sundarpur 423 200 47
33 Bayarban 549 463 84 66 Motipur 141 63 45
District 22870 18870 83

DPT 3 coverage is heterogeneous which ranges from Aamgachi 180 percent to Motipur 45 percent in the
district.

8
Measles Campaign 2061

Measles campaign 2061 was introduced first time in the

country. Campaign was three week long. Many rumors
raised during campaign by which programme was affected.
DPHO Morang, health workers, volunteers, teachers,
students, civil society, human right activist, NGOs and
media played important role. Overall coverage of measles
vaccination was 85% in the district.

Table 6 VDCs Categorized with Problems and priority 2060/61

Category 1 Category 2 Category 3 Category 4

Low Drop Out Rate (<10) High Drop Out Rate (>10) Low Drop Out Rate (<10) High Drop Out Rate (>10)
High Coverage (>80) High Coverage Rate (>80) Low Coverage Rate (>80) Low Coverage Rate (<80)
Bhaudaha, Bahuni, Thalaha, Sidraha, Motipur, Sundarpur,
Bayarban, Tetariya, Majhare, Kaseni, Haraicha, Ranjani,
Mirgouliya, Keroun, Nocha, Babiyabirta, Amardaha, Itahara,
Kerabari, Hattimuda, Dainiya, Pathari, Takuwa, Singdevi,
Dulari, Sis. Badahara, Bardanga, Indrapur, Govindapur, Dangihat,
Dangraha, Letang, Rangeli, Aamgachhi, Pati, Budhanagar, Katahari,
Kadmaha, Hasandaha, District Bhogteni, Urlabari, Sijuwa,
Banigama, Baijanathpur, Lakhantari, Sanischare, Jhorahat, Tandi A+B,
Madhumalla, Hoklabari, (7 Health Facilities) Ramitekhola, Bhatigachha, Rani,
Yangsila, Pokhariya, Tankisinuwari Siswani Jahada,
Dadarbairiya, Jante,
Jhurkiya, Amahibariyati, (11 Health Facilities) (20 Health Facilities)
Belbari, Mahadewa,
Sorabhag, Warangi,

(28 Health Facilities)

No Problem Priority 3 Priority 2 Priority 1

About half of VDCs of Morang district is having coverage more than 80 percent and drop out rate less
than 10 percent. District average falls under the category 2.

1.1.6 Problems/Constraints And Action To Be Taken

Problem/Constraints Action to be Taken Responsibility Time Frame

Shortage of vaccine Requested RMS and DPHO, EPIS ASAP
supply for 3 months LMD
Frequent Bandhs affected
vaccine supply
Frequent trainings Action has taken to DPHO ASAP
affected service flow minimize the effect

9
1.2 Nutrition

1.2.1 Background:
Malnutrition is a major health problem among the children and women of childbearing age in the country.
Growth monitoring, micro-nutrients distribution, de-worming, Vitamin "A” distribution, promotion of
breastfeeding and control of anemia are being carried out in order to promote health of child and women
under the nutrition program.

1.2.2 Objectives:
• To reduce protein malnutrition among the children under 3 years of age through multi sartorial approach.
• To eliminate Iodine deficiency disorder and vitamin a deficiency by 2005;
• To reduce prevalence of anemia to less than one third by the year 2010;
• To reduce the incidence of low birth –weight to less than 10% of all births by the year 2005.

1.2.3 Target:
• Reduction of sever and moderate malnutrition among children under 3 years of age to half of the
1990 level by the year 2005;
• Reduction of iron deficiency anemia of expected pregnancies by one third of the 1990; Level by
the year 2005.
• Reduction of vitamin "A" deficiency among children under five years of age by 90% in all districts
by preventive measures by the year 2005.

1.2.4 Strategies:
• Promote, facilitate and utilize community participation and involvement for all nutrition activities.
• Integrate/incorporate EPI/FP/MCH and related activities in the nutrition plans.

1.2.5 Analysis:

Table 7 Nutrition: Target Vs Achievement

Program/ Units Target Achieve % % expenditure Reasons for not

Activities ment Achieved wrt released achieve 100%
budget
Growth Monitoring Person 70352 35369 50 1. Measles
Campaign,
Deworming ,, 93862 106230 100 2. Frequent
Anemia ,, 29755 17372 58 training for
health workers
Vitamin "A" Distribution ,, 105595 120643 100 due to piloting
Treated by Vitamin "A" ,, 10560 2191 21 programmes

Albendazole Distribution for ,, 10501 8774 84

Pregnant Mother 75
Supervision Time 2 2 100
Nutrition Review meeting ,, 3 0 0.0
Logistic Supply ,, 2 2 100
Breast Feeding week ,, 1 1 100
celebrate
Iodine month Celebration Time 1 1 100

10
Table 8 VDC wise New growth monitoring in Morang

S.N. VDCs Taget Achievment % S.N. VDCs Taget Achievment %

1 Dulari 852 1314 154 34 Tetariya 464 270 58
2 Singdevi 228 300 132 35 Madhumalla 1604 910 57
3 Motipur 432 539 125 36 Sis. Jahada 596 330 55
4 Hasandaha 899 1055 117 37 Belbari 1630 894 55
5 Yangsila 561 629 112 38 Kadmaha 600 326 54
6 Dangraha 418 450 108 39 Dainiya 1009 537 53
7 Banigama 670 678 101 40 Dangihat 1616 831 51
8 Aamgachhi 421 404 96 41 Sundarpur 1303 664 51
9 Kaseni 601 571 95 42 Sorabhag 856 427 50
10 Thalaha 631 590 94 43 Bhaudaha 517 252 49
11 Tandi 814 749 92 44 Indrapur 1432 688 48
12 Babiyabirta 1209 1109 92 45 Bardanga 815 388 48
13 Amahibariyati 502 455 91 46 Letang 1403 668 48
14 Mahadewa 375 336 90 47 Ramitekhola 266 123 46
15 Majhare 743 649 87 48 Mirgouliya 1077 482 45
16 Sis. Badahara 399 348 87 49 Takuwa 608 261 43
17 Warangi 282 229 81 50 Keroun 1037 439 42
18 Rajghat 1061 848 80 51 Jhorahat 404 159 39
19 Bhogteni 462 350 76 52 Baijanathpur 375 140 37
20 Bahuni 1024 761 74 53 Bayarban 1688 628 37
21 Amardaha 1181 877 74 54 Sijuwa 947 338 36
22 Tankisinuwari 1375 1006 73 55 Kerabari 1307 452 35
23 Pokhariya 231 169 73 56 Lakhantari 334 108 32
24 Budhanagar 1007 733 73 57 Govindapur 1249 397 32
25 Urlabari 2148 1545 72 58 Haraicha 528 166 31
26 Hoklabari 392 279 71 59 Katahari 1567 473 30
27 Nocha 320 206 64 60 Bhatigachha 941 283 30
28 Darbesha 1393 880 63 61 Itahara 1298 387 30
29 Hattimuda 661 412 62 62 Sanischare 1974 485 25
30 Jhurkiya 821 502 61 63 Pathari 1801 439 24
31 Dadarbairiya 660 401 61 64 Sidraha 313 70 22
32 Jante 603 364 60 65 Rangeli 1247 215 17
33 Pati 201 120 60 66 Sub Metro Bir 13965 2298 16
District 70348 35386 50

New growth monitoring coverage is heterogeneous which ranges from Dulari 154 percent to Biratnagar 16
percent in the district.

11
Growth monitoring for 0-3 yr. children was done by 60 percent. Likewise, 0-5 yrs. children were covered
by 100 percent in Vitamin A and deworming. Prevalence of anaemia under three year children was 58
percent in the district. According to Nepal Micro Nutrient Survey 19987, the prevalence of current night
blindness was high among pregnant women (6.1%) with the highest rates recorded in East Terai (13.4%)
and East hills (9.3%). The survey noted that more than 1% of all school aged children had night blindness
with the prevalence increasing with age. There has been little improvement in the nutritional status of
children as measured by stunting over the last 23 years. The prevalence of stunting among 6-59 months
has reduced by only 15.3 percentage points, from 69.4% to 54.1%. Thus, it is clear that past programmes
and policies have not been sufficient and/or appropriate.

Iodine Month Observed

Iodine Month was observed in the district in the
collaboration with partners. Awareness programmes such
as displaying banners, posters, producing pamphlets,
conducting orientations, use of print and electronic media
were held as a part of the programme. DPHO Morang was
joined by Salt Trading Corporation, Nursing Campus,
Aama Milan Kendra, Red Cross, Help Group, BNMT and
Plan Nepal during Iodine month.

Breast Feeding Week Observed

Breast feeding week was observed in the district with

different women groups and mother groups. Sancharika
Samuha, a women journalists group which is active in
awareness programme and income generation programme in
Biratnagar sub-metropolitan ward number 15. Articles were
published in local newspapers and FM programme was also
conducted awareness programme on the breast feeding week.

1.2.6 Problems/Constraints and Action to be Taken

Problem/Constraints Action to be Taken Responsibility Time Frame

Shortage of Weighing Requested Supporting partners DPHO ASAP
machine in HIs
Inadequate supervision DPHO supervisors and DPHO ASAP
supervisors from supporting
partners attempted

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1.3 Control of Diarrhoeal Disease (CDD)

1.31 BACKGROUND:
Diarrhoeal disease is one of the major public health problems among under 5 years of children in the
region and holds 3rd. position in OPD visit. Death rate is also quit high among less than 5 years of age.
Case management service is provided through all health facilities. Community volunteers are serving as
primary ORS providers at the community level. ORT corners are being established gradually in
PHC/HP/SHP.

1.3.2 OBJECTIVES:
• To reduce the mortality due to diarrhoea and dehydration (from estimated 30000 deaths per year)
to a minimum and
• To reduce morbidity from 3.3 episodes per child per year to a minimum.

1.3.3 TARGETS:
• To reduce mortality rate due to diarrhoeal disease by 50% in under 5 years of children
• To reduce morbidity rate due to diarrhoeal disease by 20% in under 5 years of children.
• To raise accessibility of ORS to target population by 90%.
• To raise awareness about ORS use in the treatment of diarrhoea

1.3.4 STRATEGIES:
• By increasing awareness in the community through mobilization of community health workers and
volunteers.
• By ensuring availability of ORS packets and antibiotics.
• By establishing ORT corners in all peripheral health institutions.

1.3.5 ANALYSIS OF ACHIEVEMENT BY MAJOR ACTIVITIES:

Control of diarrhoeal diseases is one of the priority programmes. Table 3 indicates treatment of diarrhoeal
cases has exceeds its target. U5 children are estimated to get sick from diarrhoea three times a year.
Targets are set accordingly. Table suggests good access to health care. FCHVs working at every ward of
VDCs are to be accounted for the good result.

Table 9 Target Vs Achievement

Program/ Unit Target Achieve % % expenditure Reasons for
Activities ment Achieved wrt released not achieve
budget 100%
Treated of Diarrhea cases/ Person 20522 41695 100
Supervision
ORS Purchase Pkt. 93760 48000 51
ORS Supply ,, 93760 37000 39

DPHO Morang failed to achieve the target to purchase ORS. It has taken initiative for purchasing ORS
from Royal Drugs Limited (RD) in time. But RD and its suppliers informed inability of supply very late.
After getting the report from RD and its suppliers, DPHO Morang adopted another option of purchasing
ORS from free market. Suppliers from open market also proved to be unable for supplying the full
requirement of ORS. We asked for support from Logistic Management for additional supply. Nepal
Family Health Programme (NFHP) played important role by supporting to maintain the EOP level of store
located in all institutions around the year. With the help of NFHP we took 5000 packets of ORS from
13
District Health Office Sunsari to maintain the buffer stock of ORS. Under these circumstances, DPHO
Morang issued letters to all under health institutions to maintain their EOP level by purchasing ORS by
their CDP programme as per required. Health institutions used to buy ORS from market as a part of CDP
programme following its regulation.

Coverage

Table 10 Incidence of CDD

Indicators 2059/060 2060/061 2061/062
Incidence of Diarrhea/1,000 349 398 385
% of Severe Dehydration among new cases 1.2 0.4 0.5

It is noted that incidence of diarrhoeal diseases per 1000 population and percentage of severe dehydration
among new cases is in decreasing trend in Morang district. In FY 2060/61, Morang was second highest in
reporting Incidence of diarrhoea per 1000 U5 population and was lowest in reporting percentage of severe
dehydration among new cases8. This indicates the good level of awareness on control of diarrhoeal
diseases in community.

Graph 2 Trend of Severe Dehydration among New Diarrhoeal Cases

Trend of Severe Dehydration among New
Cases
Trend of severe dehydration among new
4.5 diarrhoeal cases is in decreasing trend over
4 4
3.5 past seven years in Morang district.
3
2.5
2 2
1.5 1.3
1 1.2 1.2
0.5 0.4 0.5
0
9

5
/9

/0

/0

/0

/0

/0

/0
98

99

00

01

02

03

04
19

19

20

20

20

20

20

1.2.6 Problems/Constraints and Action To Be Taken

Problem/Constraints Action to be Taken Responsibility Time Frame

ORS supply was inadequate Support taken from LMD DPHO ASAP
to meet demand

1.4 Acute Respiratory Infection (ARI) Program:

1.4.1 Background:
Acute Respiratory Infections are one of the commonest causes of death in children under 5 years of age. It
is also a major public health problem and control of ARI is an integral part of primary health care. The
program recognizes an important role of mothers and caretakers in Identification, Home care and Referral
of pneumonia cases. Clinical experience and intervention studies have indicated that early treatment with
antibiotics can reduce mortality from pneumonia. Many pneumonia deaths occur at home, some after only
a few days of illness. The key to reducing ARI mortality is to ensure better access to and timely use of

14
correct case management of pneumonia. Morang has got community based pneumonia program, where
FCHVs treat the pneumonia cases with first line drug (Cotrimoxazole Pad. Tabs) and if child had any
danger signs they would refer to the nearest Health facilities.

1.4.2 Objectives:
• To improve the situation of child health in Nepal by reducing mortality and morbidity due to ARI
among under 5 years of children.

1.4.3 Targets:
• To reduce mortality from pneumonia in under 5 years of children.
• To reduce morbidity due to ARI in under 5 years of children.

1.4.4 Strategies:
• Raising public awareness through mobilization of community health workers and volunteers by
ensuring availability of antibiotics.

1.4.5 Analysis of Achievement by Major Activities:

Table 11 Target Vs achievement

Program/ Unit Target Achieve % % expenditure Reasons for

Activities ment Achieved wrt released not achieve
budget 100%
Treated of Person 11417 30498 100.0 64.6
Pneumonia Cases

Like CDD programme, the achievement of treated Pneumonia cases is higher than its target. A reason of
this is access of service provided by FCHV at community level. It is clear that community based
pneumonia can be done, and in Nepal, has resulted in a dramatic increase in the percent of expected cases
treated. There is good evidence showing that quality of care is good, that misdiagnosis is unlikely, that
correct treatment is usual, and that referral patterns improve. It also appears that the model used for this
programme is likely to establish a foundation, which will allow community based treatment to be
sustained. The relationship between the community workers providing the treatment and the communities
they serve becomes strong, providing an incentive for the worker and ongoing service to the community.9

Coverage

Table 12 Incidence of ARI and Pneumonia

Indicators 2059/060 2060/061 2061/062

Incidence of ARI/1000 591 657 648
% of pneumonia among new cases 1.0 0.8 0.8

Both incidence of ARI and percentage of Pneumonia among new cases are in decreasing trend in Morang
district. The contribution of FCHV in this programme has been felt and appreciated by community in
Morang.

15
Graph 3 Trend of Proportion of Pneumonia among New ARI Cases

Trend of Proportion of Pneumonia

among New ARI Cases

60
55
50
44 45
40 42 42 41 40
30
20
10
0
9

5
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98

99

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19

20

20

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20

20
ARI is one of the major causes of child morbidity and mortality in the district. FCHV are playing vital role
in serving ARI suffering children in the community. FCHV are trained for diagnosis and treatment of
ARI. FCHV examines a child with her timer by counting respiration rate. She offers counseling for home
treatment or treats with Cotrimoxazole or refers to health institutions.

1.5 Neonatal Health Programme or Morang Initiative for Neonatal Intervention (MINI)

Of the 130 million babies born every year, about 4 million die in the first 4 weeks of life-the neonatal
period. A similar number of babies are stillborn.10 The time has come for these health interventions for
newborn babies to be integrated into maternal and child health programmes, which in turn need to be
strengthened and expanded. Proven cost-effective interventions, delivered through a continuum-of-care
approach, can prevent millions of needless deaths and disabilities. In Nepal 3-4 neonates dies every
hour.11 Direct causes for neonatal deaths in Nepal are Infection, Birth Asphyxia trauma, Pre-maturity and
Hypothermia. DPHO Morang is proud to note that the district has been selected for piloting for Neonatal
health intervention. Since, Infant mortality rate still high in the country and major proportion of its has
been comprised by Neonatal deaths. So, infant mortality will be down until and unless decrease in
neonatal mortality. Reviews of literatures and researches have established the strategy as Neonatal
intervention. Ministry of Health has formulated policy and guidelines for neonatal health programmes in
the country. The success of Morang district's neonatal health programme opens horizon for replication of
the programme in other district of the country. DPHO Morang has made joint effort in collaboration with
JSI R&T under Morang Innovative Neonatal Intervention (MINI) since 2004.
Of course, to treat a neonate is challenging.
Programmes demands hard working of health workers
and FCHVs. Health workers are offering additional
effort for home treatment. The treatment with
Gentamycin has cured infected neonates. Community
has paid due recognition to the service providers.
Community is also getting aware even to take out their
neonates from the home for treatment. However,
FCHVs are taking this programme as both opportunity
and challenge. Series of trainings at different levels
completed. Health workers and FCHVs are now well
trained for neonatal health care. The preliminary data
analysis explains its effectiveness and acceptance.
16
1.6 Community Based –Integrated Management of Child Illness (CB-IMCI)

The IMCI intervention is integrated case management of the five most important causes of childhood
deaths – ARI, Diarrhoea, Measles, Malaria and Malnutrition. The strategy includes a range of other
preventive and curative interventions, which aim to improve practices both in the health facilities and at
home.

Ten batches of twenty peoples in each batch training

concluded resulting more than 200 trained health workers
for IMCI. Plan Nepal supported financially. NEPAS and
Koshi Zonal Hospital supported technically for the
training. Evaluation of the training was also concluded
with the help of NEPAS and Plan Nepal.

The result of the training is expected to be reflected into

the quality care of U5 children. It can be measured by
qualitative method and takes time. However,
recommendation from the evaluation noted that there is
still room to improve the practices of health workers.
1.2.6 PROBLEMS/CONSTRAINTS AND ACTION TO BE TAKEN

Problem/Constraints Action to be Taken Responsibility Time Frame

More time of HWs was Tried to minimized the DPHO ASAP
consumed by trainings effect

2. Reproductive Health

2.1 Family Planning

2.1.1 BACKGROUND:
The main thrust of the National Health Policy (1991) related to the National Reproductive Health and
Family Planning (RH/FP) Programme is to expand and sustain adequate quality family planning services
to the community level through all health facilities. The policy also aims to encourage NGOs, social
marketing organizations, as well as private practitioners to complement and supplement government
efforts. Community-level volunteers (TBAs, FCHVs) are to be mobilized to promote condom distribution
and re-supply of oral pills. Awareness on RH/FP is to be increased through various IEC/BCC intervention
as well as active involvement of FCHVs and MGs as envisaged by the National Strategy for FCHVs.
In this regard, FP services are designed to provide a constellation of contraceptive methods that reduce
fertility, enhance maternal and neonatal health, child survival, and contribute to bringing about a balance
in population growth and socio-economic development, resulting in an environment that will help the
Nepalese people to improve their quality of life.

2.1.2 OBJECTIVES:
Within the context of RH, the main objectives of FP Programme are to assist individuals and couples to:
• Space and/or limit their children;
• Prevent unwanted pregnancies;
• Manage infertility and
• Improve their overall reproductive health.

17
2.1.3 TARGETS:
• To reduce TFR from 4.1 per women to 3.5 by the end of 10th Five Year Plan and to 3.05 in 2017
• To rise the CPR to 47% by the end of 10th 5 Year Plan period and to 58.2% by 2017.
• To achieve approx. 2,293,000 couples using modern contraception by end of 10th Five Year Plan.
• To achieve approximately 536,288 Family Planning Current Users and 23,025 Voluntary Surgical
sterilizations cases in Eastern development region in 2060/61

2.1.4 STRATEGIES:
• Increasing the knowledge and understanding of the benefits of delayed marriage, birth spacing, and a
well planned family norm across the region through integrated RH/ FP/IEC and BCC activities;
• Increasing accessibility and availability of RH/FP services through a combination of approaches;
• Expanding regular year-round and mobile VSC outreach services;
• Expanding IUCD services with special emphasis on thorough counseling and follow-up services;
• Training service providers in collaboration with NHTC;
• Improving the quality of care in accordance with the NMS for contraceptive services;
• Establishing management & treatment services for complications of abortion, including FP services;
• Ensuring adequate supply & distribution of contraceptives at regional, district & below district level;
• Strengthening HMIS for better management of FP programmes;
• Ensuring effective monitoring and supervision of FP programmes and
• Re-supplying pills and distributing condom through FCHV.

2.1.5 ANALYSIS OF ACHIEVEMENT:

Table 13 Achievement of Programme
Program/ Unit Target Achieve % Achieved % expenditure wrt Reasons for not
Activities ment released budget achieve 100%
Current users Person 146000 110487 75.7
66.1
Sterilization ,, 6840 8160 100.0

Table 14 Trend of Family Planning Programme Coverage

Indicators 2059/060 2060/061 2061/062
Contraceptive Prevalence Rate (CPR as % of MWRA) 65.0 62.94 63.3
Condom(%CPR Method Mix) 2.7 2.1 2.0
Pills(%CPR Method Mix) 5.02 3.16 3.1

Depo(%CPR Method Mix) 14.70 12.39 11.9

IUCD(%CPR Method Mix) 1.10 1.42 1.6
Norplant(%CPR Method Mix) 1.52 1.81 1.4
VSC(%CPR Method Mix) 40.0 42.0 44.7
Total number of VSC 7456 8270 8160

Male 182 167 120

Female 7272 8103 8040

Total number of VSC in GO sector 3183 3622 3314
Total number of VSC in NGO sector 4273 4848 4846

18
Graph 4 Trend of Contraceptive Prevalence Rate

Trend of Contraceptive Prevalence Rate in CPR of Morang which is

100 Morang third highest in Nepal
90 and highest in EDR
80
78 which is reached 63
70
60 60 60 62 63 percent in FY 2061/62.
50 52 56
40
30
20
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2.1.6 PROBLEMS/CONSTRAINTS AND ACTION TO BE TAKEN

Problem/Constraints Action to be Taken Responsibility Time Frame

Shortage of Medical Requested RHD and DPHO ASAP
doctors for VSC FHD for doctors

2.2 Safe motherhood

2.2.1 BACKGROUND:
The MoH's Safe Motherhood Programme is the HMG's main thrust to reduce maternal and neonatal
mortality by addressing the high rates of death and disability caused by the complications of pregnancy
and childbirth. The past strategy of carrying out FP/MCH in an integrated manner, promoting attendance
birth through TBAs and promoting ANC visits were not adequate in addressing the issues of MMR.
Experience also showed that the avoidance of the three delays was imperative to achieve goal of reduction
of maternal mortality. Recognizing that every pregnancy is at risk, two major strategies have been
adopted, providing around the clock emergency obstetric care (either comprehensive or basic) and
ensuring the presence of skilled attendants at deliveries, especially in the home setting.
However, because the majority of women do not have access to maternal healthcare services due to social,
economic, and political factors, medical interventions alone are not sufficient to reduce MMR. Specific
non-health approaches are needed. Therefore, the Safe Motherhood Programme takes a multi-sectoral
approach to include both health and non-health interventions that promote access to and utilization of
services. The long-term goal of the 15-year National Safe Motherhood Plan (2002-2017) envisages
establishment of BEOC and CEOC services in all 75 districts, skilled attendance of births & increased
access to emergency fund & transport services.
2.2.2 OBJECTIVES:
• To reduce the mortality and morbidity among pregnant women and new born during childbirth
and the postnatal period through the adaptation of a combination of health and non-health related
measure.
• To improve the quality of antenatal, natal, postnatal and neonatal care through appropriate training
of health personnel, including emergency obstetric care.
• To advocate and raise public awareness about safe motherhood related issues.
• To strengthen referral care.
• To improved legal and socio-economic status of women.
19
2.2.3 TARGETS:
• To contribute to the reduction of the maternal mortality rate from estimated rate of 539/100000
live birth to 300/10000 live birth end of Tenth Five year plan.
• To reduce neo-natal mortality rate from 39-to32 per1000 live births by the end of Tenth five year
plan.
• To increase delivery by health workers to 18% by the end of Tenth plan.
• To increase % of woman attending antenatal care 4 times to 25% by end of Tenth plan.

2.2.4 STRATEGIES:
• Promoting inter-sect oral collaboration at regional district and community level.
• Strengthening and expanding basic maternal care services.
• Supporting activities that raise the status of women.

2.2.5 ANALYSIS OF ACHIEVEMENT:

Table 15 Achievement of Safe motherhood programme
Program/ Unit Target Achiev % % expenditure wrt Reasons for not
Activities ement Achieved released budget achieve 100%
ANC New visit (56%) Person 19603 26938 100.0
Delivery trend HW (16%) ,, 5284 7468 100.0
PNC first visit (18%) ,, 5945 13131 100.0

Table 16 Coverage of Safe motherhood programme

Indicators 2059/060 2060/061 2061/062

ANC first visit as a % of expected pregnancy 79.4 72.2 77.1

% of women with 4th visit among 1st visit 40.0 54.0 35.4
% of delivery conducted at health institutions 7.5 15.5 16.9
(Hospital/PHCC/HP/SHP) Trend of del
Number of delivery conducted in Hospital 1371 3050 4350 workers is 1
trend which
Number of delivery conducted in PHCC 941 1045 1562 coming year
% of home delivery attended by HW 9.2 6.7 4.5
Delivery conducted by Health Workers 15 22 23
PNC first visit as % of expected pregnancy 32.2 40.4 38.4

Graph 5 Trend of Delivery conducted by Health Workers

Trend of Delivery Conducted by HWs (%) in
Morang

50
45
40
35
Trend of delivery conducted by
30
25
health workers is 22 percent which
23
20
16
22 is in increasing in Morang district.
15
14 15
10 10
5 6
0
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5
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20
Table 17 VDC wise status of 4 ANC visits in Morang

ANC ANC
S.N. VDCs 4 visit % S.N. VDCs 4 visit %
First First
1 Rangeli 196 352 180 34 Sijuwa 549 234 43
2 Govindapur 254 287 113 35 Indrapur 371 157 42
3 Lakhantari 86 93 108 36 Jhorahat 350 147 42
4 Amahibariyati 251 242 96 37 Aamgachhi 194 79 41
Sis.
5 Tankisinuwari 264 95 38 251 38
250 Badahara 96
6 Kadmaha 249 205 82 39 Haraicha 454 173 38
7 Rajghat 128 104 81 40 Tandi 217 82 38
8 Darbesha 207 168 81 41 Pathari 339 128 38
9 Dangraha 208 165 79 42 Tetariya 100 37 37
10 Letang 485 369 76 43 Sundarpur 199 72 36
11 Banigama 285 212 74 44 Itahara 338 122 36
12 Amardaha 278 196 71 45 Dadarbairiya 549 180 33
13 Jhurkiya 454 309 68 46 Sis. Jahada 156 50 32
Sub Metro
14 Ramitekhola 145 68 47 4383 32
98 Brt 1390
15 Budhanagar 347 233 67 48 Mirgouliya 253 78 31
16 Bhogteni 125 65 19 49 Madhumalla 391 117 30
17 Bardanga 268 164 61 50 Hoklabari 119 35 29
18 Dainiya 338 199 59 51 Bahuni 919 268 29
19 Warangi 103 60 58 52 Dulari 529 154 29
20 Dangihat 203 116 57 53 Takuwa 211 60 28
21 Belbari 621 353 57 54 Keroun 216 61 28
22 Jante 83 45 54 55 Bhaudaha 184 51 28
23 Hattimuda 280 151 54 56 Baijanathpur 141 39 28
24 Pokhariya 126 67 53 57 Katahari 326 86 26
25 Pati 244 123 50 58 Majhare 812 209 26
26 Hasandaha 444 223 50 59 Sidraha 68 17 25
27 Thalaha 380 189 50 60 Urlabari 2788 608 22
28 Bhatigachha 208 99 48 61 Motipur 299 59 20
29 Kerabari 408 194 48 62 Singdevi 97 19 20
30 Mahadewa 95 45 47 63 Kaseni 202 38 19
31 Sanischare 563 265 47 64 Bayarban 1007 187 19
32 Yangsila 50 22 44 65 Sorabhag 709 131 18
33 Nocha 105 46 44 66 Babiyabirta 491 76 15
District 26693 10949 41

Status of 4 ANC visits in VDCs of Morang district is heterogeneous which ranges from Rangeli 180
percent to Babiyabirta 15 percent in the district.
21
Table 18 VDC wise status of Delivery conducted by Health Workers in Morang

S.N. VDCs Taget Achievment % S.N. VDCs Taget Achievment %

1 Jhurkiya 408 283 69 34 Tandi 404 28 7
2 Urlabari 1067 692 65 35 Sis. Jahada 296 18 6
3 Biratnagar 6937 4327 62 36 Warangi 140 8 6
4 Pokhariya 115 50 44 37 Majhare 369 21 6
5 Amahibariyati 249 87 35 38 Sis. Badahara 198 11 6
6 Darbesha 692 217 31 39 Hoklabari 195 10 5
7 Haraicha 262 74 28 40 Mahadewa 186 9 5
8 Kadmaha 298 69 23 41 Sundarpur 647 31 5
9 Rangeli 620 135 22 42 Ramitekhola 132 6 5
10 Bahuni 509 110 22 43 Madhumalla 797 32 4
11 Thalaha 313 57 18 44 Mirgouliya 535 21 4
12 Aamgachhi 209 36 17 45 Bardanga 405 13 3
13 Letang 697 119 17 46 Banigama 333 9 3
14 Hasandaha 447 76 17 47 Belbari 810 21 3
15 Dangraha 208 35 17 48 Sidraha 155 4 3
16 Dadarbairiya 328 53 16 49 Yangsila 279 6 2
17 Sorabhag 425 68 16 50 Kaseni 298 6 2
18 Motipur 215 32 15 51 Pathari 895 17 2
19 Bhogteni 229 34 15 52 Babiyabirta 600 11 2
20 Tetariya 230 29 13 53 Singdevi 113 2 2
21 Jante 300 36 12 54 Rajghat 527 8 2
22 Sijuwa 471 56 12 55 Takuwa 302 4 1
23 Nocha 159 17 11 56 Sanischare 980 12 1
24 Lakhantari 166 17 10 57 Amardaha 587 7 1
25 Govindapur 620 63 10 58 Dangihat 803 8 1
26 Pati 100 9 9 59 Keroun 515 5 1
27 Budhanagar 500 43 9 60 Bhatigachha 467 4 1
28 Dainiya 501 43 9 61 Indrapur 711 5 1
29 Dulari 423 33 8 62 Bhaudaha 257 1 0
30 Kerabari 649 49 8 63 Hattimuda 328 1 0
31 Baijanathpur 186 14 8 64 Katahari 778 0 0
32 Tankisinuwari 683 50 7 65 Jhorahat 201 0 0
33 Bayarban 838 61 7 66 Itahara 645 0 0
District 34945 7413 21

Status of delivery conducted by health workers is heterogenous which ranges from Jhurkia 69 percent to
Katahari, Jhorahat, Itahara, Hattimudha and Bhaudha 0 percent in the district.

22
Table 19 VDC wise status of PNC 1st Visits in Morang

S.N. VDCs Taget Achievment % S.N. VDCs Taget Achievment %

1 Kadmaha 298 258 86.6 34 Katahari 778 250 32
2 Jhorahat 201 149 74.2 35 Hoklabari 195 61 31
3 Amahibariyati 249 183 73.4 36 Hasandaha 447 136 30
4 Jhurkiya 408 289 70.9 37 Kerabari 649 183 28
5 Sorabhag 425 299 70.3 38 Rangeli 620 166 27
6 Dadarbairiya 328 223 68 39 Hattimuda 328 86 26
7 Urlabari 1067 724 67.9 40 Warangi 140 36 26
8 Tankisinuwari 683 448 65.6 41 Jante 300 74 25
9 Dangraha 208 132 63.6 42 Letang 697 170 24
10 Sub Metro Brt 6937 4391 63.3 43 Keroun 515 124 24
11 Belbari 810 482 59.5 44 Sundarpur 647 155 24
12 Budhanagar 500 296 59.2 45 Itahara 645 150 23
13 Thalaha 313 182 58.1 46 Haraicha 262 59 23
14 Lakhantari 166 93 56 47 Mirgouliya 535 110 21
15 Mahadewa 186 99 53.1 48 Pathari 895 183 20
16 Ramitekhola 132 70 53.1 49 Tandi 404 78 19
17 Babiyabirta 600 314 52.3 50 Baijanathpur 186 34 18
18 Pokhariya 115 60 52.2 51 Dainiya 501 89 18
19 Bhatigachha 467 243 52 52 Bardanga 405 70 17
20 Aamgachhi 209 98 46.8 53 Dangihat 803 130 16
21 Dulari 423 185 43.7 54 Bhaudaha 257 40 16
22 Pati 100 41 41.1 55 Bhogteni 229 33 14
23 Darbesha 692 268 38.7 56 Madhumalla 797 105 13
24 Sanischare 980 377 38.5 57 Sis. Jahada 296 37 12
25 Sis. Badahara 198 74 37.4 58 Singdevi 113 14 12
26 Banigama 333 123 36.9 59 Govindapur 620 76 12
27 Nocha 159 58 36.5 60 Kaseni 298 36 12
28 Tetariya 230 82 35.6 61 Takuwa 302 35 12
29 Sijuwa 471 165 35.1 62 Bayarban 838 95 11
30 Majhare 369 128 34.7 63 Indrapur 711 73 10
31 Bahuni 509 176 34.6 64 Rajghat 527 41 8
32 Motipur 215 73 34 65 Yangsila 279 8 3
33 Sidraha 155 52 33.5 66 Amardaha 587 16 3
District 34945 13788 39

Status of delivery conducted by health workers is heterogenous which ranges from Kadmaha 87 percent to
Yangsila, Amardaha 3 percent in the district.

23
2.1.6 PROBLEMS/CONSTRAINTS AND ACTION TO BE TAKEN

Problem/Constraints Action to be Taken Responsibility Time Frame

ANC check up with Refresher Training DPHO ASAP
counseling is poor given

2.3 Adolescent health

With the help of supporting partners Aama Milan Kendra five VDCs are taken
as conducting piloting Youth friendly clinics in the districts. Health workers
have given training for organizing separate clinics in different days for boys
and girls in the health institutions. Now, hopeful results are coming.

3 DISEASES CONTROL

3.1 National Tuberculosis Programme

3.1.1 BACKGROUND:
Tuberculosis is one of the major public health problems in Nepal and is a leading cause of death in adults.
Introduction of treatment by Directly Observed Treatment Short Course (DOTS) has already reduced the
number of deaths in Nepal from 8000-11000 to 5000-7000. Expansion of this cost-effective and highly
successful treatment strategy, which already has proven its efficacy in Nepal, will have a reflective impact
on mortality and morbidity. The National Tuberculosis Programme’s (NTP), long term goal is to reduce
the transmission of TB to such a level that it is no longer a public health problem. The NTP operates its
diagnostic and treatment services within the general health services of the country. The basic unit of
management for diagnosis and treatment of TB patients is the district hospital and the Primary Health
Centre. Health Post acts as sub-centre for supervision of patients on DOTS in selected health posts in
different districts. Region provides support in managing TB control activities of the districts.

3.1.2 OBJECTIVES:
• To achieve 85% cure rate in new smear positive pulmonary tuberculosis
• To achieve 70% case detection ratio in new pulmonary tuberculosis
• To implement the DOTS activities in phased manner in all districts

3.1.3 TARGET:
• 85% cure rate in new smear positive cases
• 80% conversion rate in new smear positive cases
• 70% case detection rate
• Expansion of DOTS in all districts

3.1.4 STRATEGIES:
• To promote early case detection of infectious pulmonary cases through sputum smear examination
• To ensure effective chemotherapy
• Involvement of community for planning, Implementation and monitoring of T.B. control services.
24
3.1.5 ANALYSIS OF ACHIEVEMENT BY MAJOR ACTIVITIES:

Table 20 Achievement of TB programme

Program/ Units Target Achiev % % expenditure wrt Reasons for not
Activities ement Ach released budget achieve 100%
Sputum examination for Per. 6000 5866 97.8
Suspected cases.
New sputum examination Slide 18000 17291 96.1
Follow up sputum Slide 2804 2639 94.1
examination
New sputum +ve Per. 600 574 95.7
New sputum -ve ,, 480 340 70.8
Extra pulmonary ,, 125 294 100.0
Retreatment case 137 98 71.5
TB Pts to Pts family health ,, 150 150 100.0
Ed. on DOTS 74.3
Dhami Jhakri orientation ,, 20 20 100.0
DOTS center evaluation Times 6 6 100.0
Workshop
World TB day ,, 1 1 100.0
Supervision ,, 60 36 60.0
School Health programme School 25 17 68.0
TB/DOTS orientation for No. 20 20 100.0
social Workers
TB/DOTS orientation for ,, 20 20 100.0
Mothers group

Table 21 Performance Indicators of TB programme

Indicators 2059/060 2060/061 2061/062

Case Detection Rate 56 64 63
Cure Rate on DOTS 90 88 89
Treatment Success Rate 89 88 90
(Cured+Completed)
Sputum Conversion Rate 87 87 93

25
Graph 6 Trend of TB Cure Rate

Trend of Cure Rate of TB (%) in Morang

100
90
88 89 89 87 89
80
78
70
60
50
56 TB Cure rate is in increasing
40 trend in Morang.
30
20
10
0
9

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20

Problem/Constraints Action to be Taken Responsibility Time Frame

Problem in Urban DOTS Operational research DPHO/BNMT ASAP
conducted with BNMT

3.2 Leprosy

3.2.1 BACKGROUND:
Leprosy is one of the major public health problems of eastern region. It is aimed to provide diagnostic and
therapeutic services of leprosy within the general health services. MDT service is available in all health
institutions of the region. Leprosy burden is high in Terai district where as low or eliminated in hill
districts. The regional prevalence rate of leprosy is continually in decreasing trend but the new case
detection rate is not declined as expected. In 1982 leprosy PR was 17.3 per 10000 populations and finally
this value reduced to 2.81. This indicates the achievement of reduction is 83.76% and leprosy elimination
is in the positive trend.

3.2.2 OBJECTIVES:
• Elimination of leprosy by the year 2005 AD (Prevalence rate below 1 cases per 10,000 population)
at national level
• Provision of MDT to all registered cases
• Prevention of disability by early detection and treatment of cases
• Reduction of social stigma by increasing awareness about the disease

3.2.3 TARGET:
• To reduce the present registered prevalence rate to < 1 per 10000 population by the middle of FY
062/063 (end of December 2005)
• To reduce impairment and disability due to leprosy resulting reduction of WHO defined disability
proportion around 5%
• To prevent leprosy transmission by early case detection and increase patient volunteer submission
more than 90%

3.2.4 STRATEGY:
• High priority will be given to undetected cases and treatment
• Increased co-operation and coordination between HMG and I/NGOs will be maintained
26
3.2.5 ANALYSIS OF ACHIEVEMENT BY MAJOR ACTIVITIES:

Table 22 Performance of Health Education Programme

Program/ Units Target Achieve % % expenditure wrt Reasons for not
Activities ment Achieved released budget achieve 100%
School Health education Times 17 17 100.0
Rapid inquiry survey VDC 10 10 100.0 95.5
Supervision Times 40 40 100.0

S.N Indicators MB PB
. 2059/60 2060/61 2061/62 2059/60 2060/61 2061/62
1. New Case 2.6 2.6 1.1 4.1 3.1 1.3
Detection Rate
2. RFT 91.8 87.0 98.9 98.7 94.0 100.0
3. Prevalence Rate 3.15 2.5 2.1 2.09 1.29 1.5

Graph 7 Trend of Leprosy Prevalence Rate

Trend of Prevalence of Leprosy per 10,000
in Morang

20
18
16
Trend of prevalence rate of
14
12
14 Leprosy is in decreasing trend
10
8 8 8
10 but still far from its elimination
6
4 5 4 stage.
2 3
0
9

5
/9

/0

/0

/0

/0

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/0
98

99

00

01

02

03

04
19

19

20

20

20

20

20

Problem/Constraints Action to be Taken Responsibility Time Frame

Prevalence rate is still Awareness campaign conducted in DPHO/NLR ASAP
high in Morang municipality with the help of NLR

3.3 Malaria Program

3.3.1 Background:
Malaria eradication program was started in the year of 1962 in this region and was continued up to the
year 1977. But since the year of 1978 eradication program eventually become Malaria Control Program as
recommended by WHO. At present, this program is carried out in all districts except Solukhumbu district
in the region.
3.3.2 OBJECIIVES:
• Prevention of mortality due to malaria.
• Reduction in malaria morbidity.
• Prevention and control of P. Falciparum epidemics
3.3.3 TARGETS:
• To reduce the annual parasite incidence to 3 cases/1000 population
27
3.3.4 STRATEGIES:
• Early diagnosis and prompt treatment of malaria cases through health facilities
• Selective application of indoor residual spraying in case of epidemic prone areas
• Promotion of personal protective measures
• Improving target setting of blood slide collection and lab facilities for strengthening early
diagnosis of malaria in service outlets of malaria endemic districts
• Training for increased competence of puerperal level health staff in malaria control

3.3.5 ANALYSIS OF ACHIEVEMENT BY MAJOR ACTIVITIES:

Table 23 Malaria: Target Vs Achievement

Program/ Units Target Achieve % % expenditure wrt Reasons for not
Activities ment Achieved released budget achieve 100%
Slide collection No. 6000 14662 100.0
96.5
Malaria Spraying Times 2 2 100.0

Table 24 Malaria Incidence

Indicators 2059/060 2060/061 2061/062

Malaria Parasite Incidene/1,000 0.2 0.2 0.1

Slide Positively Rate 2.5% 1.6% 1.2%

% of PF 15.2 9.9 12.4

Clinical Malaria Incidence Per/1,000 risk population 3.7 5.2 5.7

3.3.6 Problem/Constraints and Action to be taken

SN Problem/ Constraints Action to be taken Responsibility Deadline
2 Increasing SPR Re-activate the PCDV Programme. EDCE/DoHS ASAP
3 Delay budget release Requested DoHS DoHS ASAP

3.4 Kala-azar Program

3.4.1 Background:
Kala-azar has been reported from six districts in this region. This disease is also a public health concern
due to high case fatality rate among the infected cases. It is mostly prevalent in rural area with low socio
economic group of the people.
3.4.2 Objectives:
• To reduce morbidity and mortality due to Kala – azar.
• To prevent epidemic due to Kala – azar.
3.4.3 Targets:
• To reduce the Kala – azar incidence in the region.
• Prevention of epidemic.

28
3.4.4 Strategies:
• Early diagnosis and prompt treatment of Kala–azar through strengthening of referral services at the
peripheral health Institution.
• Early detection and timely containment of epidemics.
• Protection of risk population with indoor residual spraying.
3.4.5 Analysis Of Achievement By Major Activities:

Table 25 Target Vs Achievement

Program/ Units Target Achievemen % % Reasons for
Activities t Achieved expenditu not achieve
re wrt 100%
Spraying Times 2 2 100.0

Target 26 Incidence of Kala-azar

Indicators 2059/060 2060/061 2061/062
Case Incidence/10000 of Population 13.7 12.4 11.4
Number of death due to Kala-azar 1 1 2

Trend of Incidence of Kala-azar Per Trend of Kala-azar Cases and Affected

100,000 Population in Morang VDCs in Morang

140
25
23 120 124
20 Cases
100 103
15
13 12 80
10 70
60 64
5 5.1
0 1 0.3 0.6 40 39 41 41
35
27 23 27 VDCs
20 21 19 17
9

5
/9

/0

/0

/0

/0

/0

/0

0
98

99

00

01

02

03

04
19

19

20

20

20

20

20

5
/9

/0

/0

/0

/0

/0

/0
98

99

00

01

02

03

04
19

19

20

20

20

20

20

Graph 8 Kala-azar is in increasing trend in Morang Graph 9 The trend of Kala-azar, is increasing. Total
district. 41 VDCs are being affected by Kala-azar.

3.5 JE Program

Table 27 Target Vs Achievement

Program/ Unit Target Achieve % % expenditure wrt Reasons for not
Activities ment Achieved released budget achieve 100%
Spraying, Fogging time 2 2 100

Table 28 Incidence of JE
Indicators 2059/060 2060/061 2061/062
Case Incidence/100000 6.6 6.4 3.0
Number of death due to JE 6 8 3

29
3.6 AIDS and STDs Programme Targeted Activities.

Table 29 Performance in HIV/AIDS programme

Program/ Units Target Achievement % % expenditure wrt Reasons for not
Activities Achieved released budget achieve 100%
HIV/AIDS day time 1 1 100 NA
DACC meeting time 2 2 100 NA

World AIDS day was Morang Male Female Total

observed in Morang in HIV/AIDS 196 112 308
collaboration with IDU - - 558
DDC, Schools and
NGOs on 1st
December 2004.

3.7 Curative Service through OPD Service

3.7.1 BACKGROUND:
Curative health services aims to provide appropriate diagnosis, treatment and referral through the network
of PHC outreach to specialized hospitals. It is one of the important and highly demanded services.
Services are provided through all health facilities.

3.7.2 OBJECTIVES:
• To provide curative services to all patients reporting to the health facilities or PHC outreach sites
to reduce duration of illnesses, mortality and improved quality of life.

3.7.3 TARGETS:
• To provide service to all clients attending health facilities with appropriate diagnosis, treatment
and/or referral to specialized facilities.

3.7.4 STRATEGIES:
• Establishment and service delivery through of SHP in all the VDCs.
• Establishment and service delivery through PHCs in all electoral constituencies.
• Establishment of 3-5 out reach clinics in all VDCs for EPI and PHC-ORC.

3.7.5 ANALYSIS OF ACHIEVEMENT BY MAJOR ACTIVITIES:

Table 30 Coverage of OPD

Indicators 2059/060 2060/061 2061/062

Total OPD visits as % of total population 17.6 18.9 19.18

3.8 Epidemics control

Table 31 Epidemics or Out breaks
Epidemics Number of VDCs Affected Number Episode
Measles, Diarrhoea, Skin 5 200 5
30
4. SUPPORTING PROGRAMMES

4.1 Partners Defined Quality

Table 32 Partners defined quality

Supporting Partners No. of Health Benefited Participants Outcome
Institutions
SCF US 50 500 HFMC strengthened

4.2 HMIS

4.2.1 BACKGROUND:
To develop skill in record keeping, analysis and use of information for planning and supervision,
integrated HMIS implementation strategies started in 1993. Efforts are being done to utilize HMIS
information in planning, monitoring, supervision and evaluation at regional and district level.

4.2.2 OBJECTIVES:
• To monitor the coverage, continuity and quality of the health services and to assist service provider
and managers to use the data at the service delivery level.
• To assess the progress of district health programmes.
• To help districts in preparation of work plan.

4.2.3 STRATEGIES:
• Collection of information, analysis and use for planning, monitoring and management.
• Initiate bottom-up planning.
• To organize programme performance review meeting.

4.2.4 ANALYSIS OF ACHIEVEMENT OF MAJOR ACTIVITIES:

• Monthly reports are monitored and feed back given to the concerned VDCs or HIs.
• District level programmes performance review workshop completed.
• Work plan and integrated supervision plan was prepared to cover all 17 Ilakas.

Table 33 HMIS Reporting Status by Institutions (%) FY 2059/060-2061/062

FY District Hosp PHC HP SHP PHC FCHV NGO
/ORC
059/060 100 33 100 100 99 95 96 98
060/061 100 100 100 100 99 92 920 98
061/062 100 100 100 100 98 86 95 98

Table 34 Status of number of Monthly Meeting conducted FY 2061/062.

Number of monthly meeting conducted Name of District Number of Meeting

at district level based on the Monthly Morang 12
Monitoring sheets FY 2061/062

31
Table 35 Average number of People Served by type of health facilities per months
FY District Hosp PHC HP SHP PHC/ORC FCHV NGOs
059/060 40 184 963 663 206 30 24 409
060/061 57 187 1009 706 238 27 34 422
061/062 51 192 1311 584 248 29 43 432

S.N. Problems/ constraints Action to be taken Responsibility Deadline

1 Delay reporting from Feedback given to Incharges of ASAP

Health Institutions concerned institutions HIs
2 Incomplete and -Proper person not Health ASAP
Inconsistent reporting always involved in Institutions
report making Incharges
-Feedback given
3 Lack of training for newly Provision of basic and MD/ NHTC/ ASAP
recruited health workers. refresher training. DoHS

4.3 LMIS

Table 36 Reporting Status by Institutions (%) FY 2061/062

Hospital PHCC/HC HP SHP
District
100.0% 75.0% 100.0% 100.0% 98.5%

Table 37 Health Institutions wise ASL, EOP of Essential Commodities

F.Y. Health Condom Depo Pills ORS Vita. A Cotrim Iron tablets
Institution ASL EOP ASL EOP ASL EOP ASL EOP ASL EOP ASL EOP ASL EOP
2060/61 PHC/HP/ 139715 27943 23530 4706 18325 3665 54445 10889 102355 20471 313305 62661 572275 114455
SHP
District 279430 83829 47060 14118 36650 10995 108890 32667 204710 61413 626610 187983 1144550 343365
2061/62 PHC/HP/
SHP
District

4.4 Female Community Health Volunteer (FCHV)

4.4.1 Background:
To acquire support and active participation of the community in primary health services, the FCHV
programme was initiated in the year of 1988/89 At present FCHVs are involved in the distribution of
condoms, pills, Vitamin "A" Capsules, ORS and also initial management of ARI cases in selected district.
They are also responsible for the dissemination of information and education in the community on FP,
EPI, Nutrition and Sanitation.
4.4.2 Objectives:
• To empower rural women with basic knowledge and skill.
• To develop in every word at least one FCHV as a health resource person who is knowledgeable,
trained and well supported by local mothers.
4.4.3 Strategies:
• Training of FCHVs basic and refresher.
• Review meeting for FCHVs trimester.
• Orientation of VDCs members for selection of FCHVs.
32
4.4.4 Analysis of Achievement:

Table 38 Performance of FCHV programme

Program/ Units Target Ach % % expenditure wrt Reasons for not
Activities Achieved released budget achieve 100%
HFI quarterly meeting Times 3 2 66.7
Quarterly review meeting Person 1755 1170 66.7
72.7
TBA refresher meeting ,, 405 342 84.4
FCHV Day Times 1 1 100.0

Table 39 Service Indicators

Indicators 2059/060 2060/061 2061/062
Average number of Mothers Group 9 11 10
meeting held in a year per FCHV
No of Pills cycle distribution by FCHV 10766 18436 26576
No. of person receiving Condoms 51204 54381 196584
No. of ORS Pkt. distribution by FCHV 31781 43824 48476

Problems / Constraints and Action to Be Taken

S.N. Problem/ Action to be taken Responsibility Deadline
Constraints
1 Delay Release of Provision of release of budget FHD/DoHS ASAP
Budget on time
2 Establish linkage with DDC, DHO/DPHO ASAP
Inadequate VDC hospitals & supporting
encouragement & partners and develop
motivational scheme appropriate motivational
for FCHV scheme (district/center)

4.5 PHC Outreach- clinic Programme.

4.5.1 Background:
Primary Health Care (PHC) Out reach Services are extension of primary health care from PHC/HP/SHP to
the community level. Services are provided to clients / patients at per determined time and place once in a
month in three to five places of each VDCs. It aims to provide services to people residing in remote areas
with community involvement.
4.5.2 Objectives:
• To improve access and coverage of primary health care through a network of 3 to 5 out reach
clinics per VDC per month.
4.5.3 Strategies:
• Operation of outreach clinics by place and schedule involving community with basic minimum
servile package.
• Utilize the services of VHWs and MCHWs.
• Increase community involvement.
33
4.5.4 Analysis of Achievement:

Table 40 Target Achievement of PHC-ORC

Program/ Unit Target Achiev % % expenditure wrt Reasons for not
Activities ement Achieved released budget % achieve 100%
Clinic conducted time 3372 2913 86.4
Management committee time 1 1 100 SCF support
reorientation

Table 41 Performance Indicators of PHC-ORC

Indicators 2059/060 2060/061 2061/062

% of PHC/ORC clinic conducted 95.2 92.0 86.4

Average number of clients served per clinic 30 27 29

4.6 Community Drug Programme (CDP)

4.6.1 Background
CDP programme in Morang district has been started since 2057/58 with the help of UNICF. Now
UNICEF has no programme for monitoring of this programme in the district. BNMT has its programme
on Drug Scheme Programme but only limited VDCs are taken so far till now. But by the end of FY
2061/62 district has got data of all 66 health institutions with 10 million rupees in their respective funds in
Morang district.

5.6.2 Objective
™ To make essential drugs available round the year with the participatory cost sharing approach.
™ To ensure poor and disadvantaged patient with free drugs when needed.

5.6.3 Strategies
™ Drug management committee will ensure all indent and procurement as per needed.
™ Committee will be responsible for overall management including auditing budget.

5.6.4 Analysis of the achievement

Graph 10 Trend of the CDP fund

Total Budget Balance Of Community
Drug Programme of Health Institution
Committees in Morang

8000000 7653533
7500000
7000000 6535728
Rs

6500000
6000000
5500000
h

r
ha
us

As
Po

2
2

/6
/6

61
61

20
20

Point of Time

34
 Table 42. Status of Fund of Community Drug Programme

Ilaka 2061/62 Poush 2061/62 Ashar

Jhurkiya 349810 400532
Haraicha 686648 766707
Mangalbare 617875 713294
Letang 70472 158696
Bahuni 525825 631714
Jhorahat 476117 589295
Rani 266537 272879
Babiyabirta 222830 280538
Ranjani 463242 419340
Budhnagar 45311 199498
Dadarbairia 587121 622277
Hasandaha 258057 290307
Kerabari 648790 724412
Madhumalla 512786 504342
Majhare 60770 298967
Tanki 234127 267155
Bayarban 509410 513580
Total 6535728 7653533

4.7 Training Activities

4.7.1 Background:
Information Education Communication is one of the important components for the supporting health
program. Since 1994, IEC activities have been decentralized and districts are involved in preparing in
work-plan and developing IEC materials locally as per guideline of NHEICC.
4.7.2 Objectives:
• To raise health awareness of the people as to promote improved health status.
• To prevent disease through the effort of people themselves and through utilization available
resources.
4.7.3 Strategies:
• Promotion of IEC activities in all governmental and non-governmental agencies.
• Dissemination of information, education and communication on health issues through health and
health related workers.
• Use of individual group and mass media in health education, information and communication.

35
4.7.4 Analysis of Achievement of Major Activities:

Table 43 Target Achievement of Training Programme

Program/ Units Target Achievem % % expenditure wrt Reasons for not

Activities ent Achieved released budget achieve 100%
FCHV (Biratnagar person 70 70 100 BRT M.
Municipality)
Neonatal Health HWs 400 400 100 MINI
Neonatal Health FCHVs 585 585 100 MINI
CB-IMCI HWs 110 110 100 Plan Nepal

4.8 National Health Information Education & Communication Programme Target Activities.

4.8.1 Annual Activities assigned by Centre

Table 44 Target Achievement of IEC

Program/Activities Unit Target Achiev % % expenditure wrt Reason for not

ement Achieved released budget ach. 100%
Gender awareness workshop for No. 1 0 0.0
health worker
Slide shows in cinema halls Time 910 310 34.1
s
Health education exhibition in ,, 3 1 33.3
Community
Street drama ,, 9 2 22.2
FM Radio programme ,, 180 195 100.0
School Health Programme ,, 173 69 39.9
Interaction programme between ,, 16 12 75.0
46.0
press and concerning personal
District Health Education Dist. 1 1 100.0
review
Health education material Time 3 2 66.7
distribution s
IEC material production Piece 20000 20000 100.0
Health education materials ,, 2 2 100.0
publication/prize
Health education Corner times 53 38 71.7
Health Ed. promotion campaign ,, 53 53 100.0

S.N. Problems/ constraints Action to be taken Responsibility Deadline

1 Delay release of budget MoH, DoHS ASAP

2 Distributed targets were not Delay reporting resulted poor District, HIs ASAP
achieved by HIs performance

36
4.8.2 Health Related Special Days Observed

Table 45 Special days observed in the collaboration with partners round the year
Special days Date
1. World Population day (DPHO Morang stood first position in this occasion on district July 11
wide stall competition organized by UNFPA and Purbanchal University at Biratnagar)
2. World Breast Feeding Week August 1-7
3. Malaria Control Day August 20
4. National FCHV day October 1
5. World Leprosy day January 25
6. Iodine Deficiency Disaoder Month February
7. World TB day March 24
8. World Health Day April 7
9. World No Tobacco day May 31

4.9 Laboratory Services

Table 46 Laboratory Services

Program/ Units Target Achieve % % expenditure wrt Reasons for not
Activities ment Achieved released budget achieve 100%
Malaria Slides Each 45740 9425 21

4.10 Financial Management

Table 47 Budget Expenditure
Programme /Activities Allocated Budget Budget Expenditure % of Irregularities
Budget Released 2061/062 Clearances
Health Education 529 245 245
Leprosy 66 63 63
CDD/ARI 570 368 368
Nutrition 189 141 141
NHTC 652 473 473
Family Planning 3960 3277 3277 70.82
Integrated Supervision 578 449 449
Malaria 940 907 907
TB 150 112 112
EPI 432 327 327
Integrated Supervision 578 449 449
Total-----> 8644 6811 6811

4.11 Human Resources Situation

Table 48 Human Resources (Note: S=Sanctioned post, F= Fulfilled Posts)

Category DHO/DPHO PHCC HP SHP
S F S F S F S F
DPHO/Officers 2 2 6 1 . . . .
District Assistants 14 14 - - - - - -
Nurse/ANM - - 24 21 11 11 - -
HA/AHW - - 18 18 33 33 49 49
Lab. personnel's 3 3 6 6 - - - -
VHW/MCHW - - 6 4 11 10 98 97
Adm/General staffs 12 12 12 11 22 22 - -

37
4.12 Piloting Programmes in Collaboration with EDPs
1 Neonatal Health Programme (JSI R&T)
2 Health Insurance Programme (Ministry of Health)
3 Partners Defined Quality, PDQ (Save the Children)
4 FM Radio Programme Production and Broadcasting (Koshi and Saptakoshi FM)

SECTION 3
3 Supporting Partners

3.1 Governmental: Koshi Zonal Hospital, Rangeli Hospital, Biratnagar Sub metropolitan city, district
level line offices from Education, Agriculture, Veterinary, and Women development.

3.2 Non Governmental and Private Sector

3.2.1 List of INGO/NGO working in collaboration with DPHO in Morang
1. Merry Stopes Clinic 2. Nepal Red Cross, BRT
3. Help Group 4. CBR Project, Biratnagar
5. Aama Milan Kendra, BRT 6. Birat Nursing Home
7. NATA, BRT 8. FPAN, BRT
9. Adarsa Nirman Mandir, BRT

3.2.2 External Development Partners

EDPs Supporting Areas
UNICEF BRT Immunization campaigns
UNFPA, BRT HMIS, RH
Polio Eradication(WHO), Polio and disease surveillance
BNMT, BRT RH, ED, ID, TB
NFHP, BRT RH, IMCI
NLR , BRT Leprosy
SCF(US), BRT PHC-ORC, LQS, PDQ
Plan Nepal, BRT CB-IMCI, Cold chain
MINI, BRT Neonatal Health

3.3 List of Private Hospital/Nursing Homes.

1. Birat Nursing Home. 2. Eye Hospital
3. Abadh Narayan Nursing Home. 4. Koshi Nursing home
5. Purbanchal Nursing Home. 6. Neuro Diagnosis Nursing Home
7. MS Nursing Home. 8. Adarsa Nirman Mandir, Biratnagar

References
1
NPC, Jilla Bastugat Bibaran Morang, National Planning Commission, Statistical Section Morang, 2062
2
Report on Human Development Index, 2004
3
MoH, DoHS, National Immunization Programme of Nepal, Multi-Year Plan of Action, 2002-2007
4
MoH, DoHS, Annual Report of Ministry of Health, Department of Health Services, 2060/61 (2003/2004)
5
Between Census Household Information Monitoring and Evaluation Survey conducted by National Planning Commission,
Bureau of Statistics and UNICEF in March-May 2000.
6
MoH, DoHS/USAID, Nepal Demographic and health Survey, 2001
7
MoH, UNICEF, WHO, New Era, Nepal Micro Nutrient Status Survey, 1998
8
ERHD, Annual Report of Eastern Regional Health Directorate Dhankuta, 2060/61(2003/2004)
9
Houston R, A Short History of Nepal's Community Based Pneumonia Programme, JSI/Nepal, 2001
10
The Lancet, Newborn health: a key to child survival, 2005
11
MoH, DoHS, National neonatal Health Strategy, 2060

38