The document outlines Nepal's multi-sector nutrition plan to reduce undernutrition among women and children. The objectives are to update on the current nutrition situation and share the plan and its implementation arrangements. It provides an overview of the plan which was prepared in close consultation with several key ministries. The plan aims to accelerate reduction of undernutrition through multi-sector interventions focusing on the critical window of opportunity from pregnancy to age two. It establishes leadership and coordination structures and outlines strategic objectives and results across sectors including health, agriculture, education, and local development to holistically address the causes of undernutrition.

1. OBJECTIVES
• TO UPDATE ON CURRENT UNDER-
NUTRITION SITUATION AMONG WOMEN
AND CHILDREN OF NEPAL
• TO SHARE THE MULTI-SECTOR NUTRITION
PLAN AND ITS IMPLEMENTATION
ARRANGEMENTS AMONG THE REGIONAL
STAKEHOLDERS OF FAR WEST DISTRICTS

2. AN OVERVIEW OF
MULTI-SECTOR NUTRITION PLAN
Prepared by: National Planning Commission, GON
in close consultation with
Ministry of Health and Population
Ministry of Agriculture Development
Ministry of Federal Affairs & Local development
Ministry of Urban Development
Ministry of Education
Lead Technical Support: UNICEF
in close collaboration with WB, HKI, WFP and Other Developing Partners
Government of Nepal
National Planning Commission

3. Nutrition Situation of Women
and Children in Nepal

4. NEPAL IS ON TRACK TO REACH MDG4 : REDUCING CHILD MORTALITY
153
118
91
61 54 54
102
79
64
48 46
34
45.9 50
39 33 33
15
0
40
80
120
160
200
1991 1996 2001 2006 2011 2015
MDG
U5MR IMR NMR
Mortality Trend and MDG Goal
(Under 5, Infant and Neonatal)
Deaths associated with
under-nutrition
At - min 35%
Diarrhoea
12%
Other
29%
Pneumonia
20%
Malaria
8%
Measles
5%HIV/AIDS
4%
Perinatal
22%
About 35-60% of Child
Mortality is associated
with undernutrition
Sources:
EPI/WHO. Black et al, 2008. The Lancet Series on Maternal and Child
Under-nutrition.
Without Improvement in
Nutrition, Further Child
Mortality Reduction is
less likely

5. Status of Undernutrition in U5 Nepal
Source: NDHS 2011
57
49
41
28
43
39
29
27
11
13
11
5
0
10
20
30
40
50
60
NDHS 2001 NDHS 2006 NDHS 2011 MDG Target 2015
Percent
Stunting Underweight Wasting

6. 28.3
26.7
24.4
18.2
6.5 8.6
13.5
0
5
10
15
20
25
30
NFHS 1996 NDHS 2001 NDHS 2006 NDHS 2011
Women’s Under-nutrition is Declining But
Over-Nutrition is on the Increase
Maternal Under-nutrition Maternal Overnutrition

7. Fig 24: Stunting (-2SD) Trend for children between 6-23 months,
by Wealth Index
0%
10%
20%
30%
40%
50%
60%
1996 2001 2006
Poorest
Poorer
M iddle
Richer
Richest
Total
Ref: DHS 2001 and 2006. Adapted from Ramu Bishwakarma. Social Inequalities in Child Nutrition in Nepal. August 2009
(Background paper for Nepal Nutrition Assessment and Gap Analysis, November 2009)
65% reduction in
richest quintile!
12% increase in
poorest quintile!
14% reduction
overall
MARKED INEQUITY: Wealth Quintiles, Ecology, Ethnicity
Nutrition context: trend in stunting prevalence by wealth index
High
Inequity

8. Percent of children under age 5
who are too short for their age
(based on WHO standards)
Eastern terai
31%
Central terai
41%
Western mountain
60%
Mid-western
terai
44%
Far-western
hill 58%
Eastern hill 46%
Central
hill 31%
Western hill
36%
Mid-western hill
52%Far-western terai
32%
Western terai
40%
Central mountain
46%
Eastern mountain
45%
Marked Disparity in Stunting Across the Regions
> 30%: High Prevalence
> 40: Very High Prevalence
41%

9. Percent of children under age 5
who are too thin for their height
(based on WHO standards)
Eastern terai
10.3%
Central terai
10.4%
Western mountain
13.2 %
Mid-western terai
13.9%
Far-western
hill 17%
Eastern hill 10.5%
Central
hill 15%
Western hill
7.6%
Mid-western hill
8%Far-western terai
7.9%
Western terai
15.2%
Central mountain
7.9% Eastern mountain
8.4%
>15%: Serious
>10%: Critical
Marked Disparity in Wasting Across the Regions
11%

10. IYCF Practices among Under 5 Children
Exclusively
breastfed
70%
Breast milk
plus water
10%
Breast milk
plus other
milk
9%
Breast milk
plus other
non-milk
liquids
<1%
Breast milk
plus
compleme
ntary foods
10%
Not
breastfed
1%
Breastfeeding Status Under 6
Months
Percent of children 6-23 months
Recommended IYCF Practices among 6-23 months
children

11. Improvements in Micronutrient
malnutrition
• Sustained High Vitamin A
Supplementation and De-
worming to Children
Focus on: 6-11 months – below 80
% and Urban below 90%
• Household Use of
Adequately Iodized Salt (>15
ppm) 80% Nearing Universal
Salt Iodization Target
Focus on: Mid/Far West Hills-
38%, Eastern Hill - 53.5,
• Increased Iron Folic Acid and
Deworming Coverage
Targeted Towards Anemia
Reduction
Focus on:
Among 6-23 months -68%
Adolescent Girls – IFA with de-
worming
Increasing IFA Compliance among
pregnant/lactating
75
23
2
59
52 48 46
0
20
40
60
80
IFA Deworming Anemia
1998
2001
2006
2011
Ref: National Micronutrient Status Survey 1998, DHS 2001 , 2006 and 2011
Anemia trend
among children 6-
59 months

12. Anemia Prevalence High in Children:
The Problem is serious among 6-23 months children
78
74 72
57
44
38
25
46
0
10
20
30
40
50
60
70
80
90
6-8 9-11 12-17 18-23 24-35 36-47 48-59 Total
Age in months
Percentofchildrenage6-59monthswith
anemia
Source: NDHS 2011

13. Mid-Western Terai
56.9
Central Hill
40.2
Mid-Western Mountain
52.7
Eastern Hill
42.3
Western Terai
48.8
Eastern Mountain
51.3
Far-Western Terai
60.4
Central Mountain
33.1
Eastern Terai
49.5
Western Mountain
52.7
Western Hill
43.6
Far-Western Mountain
52.7
Far-Western Hill
40.9
Central Terai
46.7
Mid-Western Hill
36
46%
Anaemia Among U5 Children is More than Critical
Critical: > 40%, Serious > 20%

14. Consequences of
Malnutrition

16. Severe forms of malnutrition
Impact of Malnutrition
• Are rare - a few percent
• Represents the tip of the
iceberg
• Should not be seen as “the
nutritional problem”

17. More than 80% brain development –
within 2 years of age

18. Malnourished & ill
due to high burden
of infections
―Empty Brain‖ – Irreversible Damage
Diminished Learning Capacity
Reduced Economic Productivity
& Income (Diminished Life)
Well nourished
& healthy
Smart Child— Meets Full Potential
Enhanced Learning & Performance
Increased Productivity & Higher
Income (>7% or More)
High Social and Economic
Burden
Human Capacity Resource,
Increased Productivity
Consequences of Malnutrition
Child’s Brain Growth and Development
By: Prof. Ascobat Gani

19. 19
Growth and muscle mass
Body composition
Metabolic Syndrome:
programming of metabolism
of glucose, lipids, protein
Hormone/receptor/gene
Brain
development
Cognitive and
educational
performance
Immunity
Work Capacity
Diabetes, Obesity
Heart Disease
High blood pressure
Cancer, stroke,
and ageing
Poor nutrition
in uterus
and early
childhood
(STUNTING)
Short term Long term
Death
LIFE COURSE CONSEQUENCES OF POOR MATERNAL AND CHILD
UNDERNUTRITION (MCU)
(James et al 2000)

20. Stunting is preventable
Need to act before the child is 2 years
The Critical “Window
of Opportunity”
1000 DAYS
Pregnancy: 9*30= 270 days
2 years: 365*2=730 days

21. Strategic Shift Needed
Priority focus on pregnancy to under 2 years:”
0 3 10 70
Brain’s development
potential
Age
Spending on Health,
Education and Welfare
Spending vs. Brain Development
Total National Budget ‘000s: NRs.
329167675 in F/Y 2069/70-2011/12)
Health Budget: NRs. 20124858
(6.11 % of Total National Budget)
Nutrition Budget: NRs. 511074
(2.54 % of Total Health Budget)
(0.16% of Total National Budget)
Nutrition in National Budget

22. Multi-Sector Nutrition Plan
Development Process

23. Malnutrition &
death
Inadequate dietary
intake
Disease
Insufficient
food security
Inadequate Maternal
& Child Care
Insufficient health services
& unhealthy environment
Political, Ideological,
Economic structures
Resource Control
+
Organizational structures
Root
causes
Underlying
causes
Immediate
causes
Manifestations
7/15/201323

24. Nutrition Assessment and
Gap Analysis (2009-2010)
Build the National
“Nutrition Architecture”
(2011-2012):
• Identified
strengths, weaknesses,
and gaps;
• Need for a national
nutrition architecture;
and
• A multi-sectoral
approach through an
agreed nutrition
determinants model.
• NPC led High Level Nutrition and
Food Security Steering
Committee chaired by the Vice
Chair of the NPC in place and
National Nutrition and Food
Security Coordination
Committee;
• Technical working group to
guide multi-sectoral nutrition
review, and planning; and
• Nutrition and Food Secretariat
being established at the NPC –
with links to NNC of the MoHP
and MoAD

25. Nutrition Multi-Sectoral
Reviews: A consultative
Process (2011)
Costed Multi-sectoral
Nutrition Plan of Action
• Nutrition reviews by sector:
Health;
Agriculture, Education, Physical
Planning and Works, and Local
development
• Defined scope: Global and
national evidences for ‘what
works’: essential nutrition
specific interventions through
the Health sector & nutrition
sensitive interventions through
other sectors
• Systematic consultation:
through Reference Group
Meetings by sector at key stages
and All Reference Group
Meetings to identify the cross-
 Clear leadership: the NPC and
actively involving health &
other sectors
 Focused: the first 1,000 days
of life and stunting reduction
 Addressing the
immediate, underlying and
basic factors:
• women and children’s access to
health and nutrition;
• safe water & sanitation; and
• education and inequity.
 Emphasis on decentralized
implementation: initially in
selected districts (2012-2014)
 Vision to gradually scale up:
to all other districts by 2016
(A new approach: learning by

26. Multi-sectoral Nutrition Planning Framework
Child growth
failure/ death
Low Birthweight
baby
Low weight &
height in teenagers
Early pregnancy
Small adult
woman
Small adult man
The intergenerational transmission of growth
failure: When to intervene in the life cycle
SO 2. Ministry of Health
and Population
R 2.1 Maternal Infant Young Child
MIYC micronutrient status improved
R 2.2 MIYC feeding improved
R 2.3 IYC Malnutrition better managed
R 2.4 Nutrition related
policies, standards and acts updated
SO 4. Ministry of
Education
• R 4.1 Adolescent girl’s
awareness and behaviours in
relation to protecting foetal, infant
and young child growth improved
• R 4.2 Parents better informed
with regard to avoiding growth
faltering
• R 4.3 Nutritional status of
adolescent girls improved
• R 4.4 Primary and secondary
school completion rates for girls
increased
SO 5. Ministry Federal
Affairs and Local
Development
R 5.1 Nutritional content of local
development plans better articulated
R 5.2 Collaboration between local
bodies’ health, agriculture, and
education sector strengthened at
DDC and VDC level
R 5.3 Social transfer programmes
corroborated for reducing chronic
under nutrition
R 5.4 Local resources increasingly
mobilized to accelerate the reduction
of MCU
SO 6. Ministry of Agriculture Development
R6.1 Increased availability of animal foods at the household level
R 6.2 Increased income amongst young mothers and adolescent girls from lowest
wealth quintile
R 6.3 Increased consumption of animal foods by adolescent girls, young mothers
and young children
R 6.4 Reduced workload of women and better home and work environment
Strategic Objective (SO) 1. National Planning Commission
Result (R) 1.1. Multi-sectoral commitment and resources for nutrition are increased
R 1.2. Nutritional information management and data analysis strengthened
R 1.3 Nutrition capacity of implementing agencies is strengthened
SO 3. Ministry of Urban
Development
R3.1 All young mothers and
adolescent girls use improved
sanitation facilities
R 3.2 All young mothers and
adolescent girls use soap to wash
hands
R 3.3 All young mothers and
adolescent girls as well as children
under 2 use treated drinking water

27. Declaration of Commitment for
Accelerated Improvement of
Maternal and Child Nutrition in
Nepal signed by the NPC
VC, Secretaries form 7 key
Ministries, Representatives of the
UN, REACH, NNG, EDPs
Health, Civil Society and Private
Sector, 17 September 2012
Multi-sector Nutrition Plan for
Accelerated Reduction of
Maternal and Child Under-
nutrition in Nepal, 2013-2017
(2023) launched by HE Prime
Minister Rt. Hon Prime Minister
Dr. Babu Ram Bhattarai , 20th
September 2012

29. HIGHLIGHTS OF MULTI-
SECTOR NUTRITION PLAN

30. ax'If]qLo kf]if0f of]hgf
p2]Zo
dfgj k"FhL / ;du| ;fdflhs cfly{s ljsf;df
s'kf]if0f cj/f]wsf] ?kdf g/xg] cj:yf ;'lglZrt
ug{sf nflu pNn]vgLo ?kdf bL3{ s'kf]if0f
Go"gLs/0f ug]{tkm{ d'n'snfO{ cu|;/ u/fpg'
nIo
• cfufdL kfFrjif{df dft[ tyf lzz' kf]if0fsf]
l:yltdf ;'wf/ / tbg';f/ dft[lzz' tyf
afnaflnsfsf] s'kf]if0fnfO{ Go"g u/L
cfdfx?sf] zf/Ll/s 3gTj ;"rfÍ (BMI) /
aRrfx?sf] k'8sf]kgdf Ps ltxfO{n] sdL
Nofpg]
• ;dfhsf ;a} :t/df dft[lzz' kf]if0fsf] l:yltdf

31. ax'If]qLo kf]if0f of]hgf
tLg d'Vo pknAwLx?
• pknAwL g+ !M /fli6«o / :yfgLo:t/df
gLlt, of]hgf / ax'If]qLo ;dGjodf ;'wf/
cfPsf] x'g]5 .
• pknAwL g+ @M …kf]if0f–nlIftÚ jf
…kf]if0fk|lt ;Dj]bgzLnÚ ;]jfx?sf] pRrtd
k|of]u ug]{ Jojxf/df ;'wf/ e} cGttM
dft[lzz' kf]if0fsf] l:yltdf ;'wf/ x'g]5 .
• pknlAw g+ #M cfwf/e"t ;]jfnfO{ ;dfj]zL /
;dtfd"ns 9Ën] k|jfx ug{sf nflu s]Gb|Lo tyf
:yfgLo ;/sf/x?sf] kf]if0f;DaGwL Ifdtf ;'b[9
ePsf] x'g]5 .

32. ;g @)!& sf] cGTo;DddfM
• kfFr jif{d'lgsf afnaflnsfdWo] k'8sf]kg
x'g]sf] k|ltzt @( eGbf sd ePsf] x'g]5 .
• kfFr jif{d'lgsf afnaflnsfdWo] sd tf}n
x'g]sf] k|ltzt @) eGbf sd ePsf] x'g]5 .
• kfFr jif{d'lgsf afnaflnsfdWo] Vofp6]kg
x'g]sf] k|ltzt % eGbf sd ePsf] x'g]5 .
• dlxnfx?df bL3{ zlQm sdL (Chronic Energy
Deficiency) x'g]sf] ;+Vof -BMI sf] ?kdf dfkg
x'g]_ !% k|ltzt eGbf tn x'g]5 .
• sd tf}n e} hGdg] aRrfsf] -≤@%)) u|fd_ Ü sd
ePsf] x'g]5 .
• k|fylds tyf cfwf/e't :s"n lzIff k'/fgug]{
afnaflnsf tyf lszf]/ lszf]/Lsf] k|ltzt
36]sf] x'g]5 .

33. cf7 k|ltkmnx? - k|ltkmn g+=
!Mkf]if0f nlIft Pj+ ;+j]bglzn ;"rsx? ;dfj]z ug{ /fli6«o tyf
:yfgLo:t/sf gLlt tyf of]hgfx?sf] k"g/fjnf]sg e} cBfjlws
ul/Psf] x'g]5 . b]xfosf ;fÍ]lts ls|ofsnfkx? sfof{Gjog u/L
/fli6«o of]hgf cfof]u tyf If]qut dGqfnox? -:yfgLo
ljsf;, :jf:Yo, lzIff, s[lif, ef}lQs of]hgf tyf lgdf{0f_ of]
k|ltkmn xfl;n ug{ lhDd]jf/ x'g]5g .
!=! If]qut dGqfnox?sf kf]if0f;DaGwL e"ldsfdf
clea[l4 ug]{ .
!=@ kf]if0fsf] ljifonfO{ cfkmgf] of]hgfdf k|fyldstf
lbg / kf]if0f nlIft Pj+ ;+j]bglzn d'Vo d'Vo ;"rsx?nfO{
;dfj]z ug{ dGqfnox?df k}/jL ug]{ .
!=# ax'If]qLo kf]if0f of]hgf cg'?k /fli6«o kf]if0f gLlt
tyf /0fgLltnfO{ cBfjlws ug]{ / cg'udg tyf d"NofÍgsf]
k|f?k cBfjlws ug]{ .

34. k|ltkmn g+= @M
/fli6«o / :yfgLo txdf ax'If]qLo ;dGjo
;+oGqx? ls|ofzLn ePsf x'g]5g . b]xfosf
;fÍ]lts ls|ofsnfkx? sfof{Gjog u/L /fli6«o
of]hgf cfof]u / :yfgLo lgsfox? of]
k|ltkmn k|flKtsf nflu lhDd]jf/ x'g]5g
@=! kf]if0f / vfB ;'/Iff;DaGwL
ls|ofsnfkx?nfO{ 6]jf k'¥ofpgsf nflu
/fli6«o of]hgf cfof]udf Ps ;lrjfnosf]
:yfkgf÷;'b[9 agfpg] .
@=@ ;dGjodf ;'wf/ Nofpg k|efjsf/L ;+rf/
k|0ffnL :yfkgf ug]{ .

35. k|ltkmn g+= #M
ljz]if u/L ;dfhsf ljkGg / kx'Fr jflx/ /x]sf
;d'bfodf dft[lzz' kf]if0fsf ;]jfx? pkof]usf]
l:yltdf ;'wf/ cfPsf] x'g]5 . b]xfosf ;fÍ]lts
ls|ofsnfkx? sfof{Gjog u/L of] k|ltkmn xfl;n ug{
:jf:Yo If]q lhDd]jf/ x'g]5 .
#=! Jofks b[li6sf]0f cjnDag u/L dft[lzz' tyf
afnaflnsfsf] kf]if0fsf] sfo{s|d sfof{Gjog
/ la:tf/ ug]{ .
#=@ ljz]if u/L kx'Frjflx/ /x]sf ;d'bfox? tyf
s'kf]if0faf6 a9L k|efljt lhNnfx?df hf]8 lbO{
cfdf, lzz' tyf afnaflnsfx?sf] ;"Idkf]if0fsf]
l:yltdf ;'wf/ Nofpg] sfo{s|dx?nfO{ lg/Gt/tf
lbg] / la:tf/ ug]{ .
#=# vf;u/L a9L c;/ k/]sf lhNnfx?df lzz' tyf
afnaflnsfx?df /x]sf] clt Pj+ dWod s8f s'kf]if0f

36. k|ltkmn g+= $M
lszf]/Lx?sf] dftflktfx?sf] lzIff, hLjgofkgsf ;Lkx?
/ kf]if0fsf] l:yltdf clea[l4 ePsf] x'g]5 . b]xfosf
ls|ofsnfkx? sfof{Gjog u/L of] k|ltkmn xfl;n u
$=! ljz]if u/L cfdfx? / afnaflnsfx?sf] kf]if0fdf
;'wf/ / bL3{ s'kf]if0fnfO{ Go"gLs/0f ug]{ s'/fdf
hf]8 lb+b} lszf]/Lx?nfO{ k|bfg ul/g] hLjgofkgsf
;Lkx?df kf]if0fsf] ljifonfO{ PsLs[t ug{ ;xof]u
ug]{
$=@ lszf]/Lx?df bL3{ s'kf]if0fnfO{ Go"gLs/0f ug]{
1fg / l;ksf] clea[l4 ug]{ .
$=# cfdf tyf afnaflnsfx?sf] x]/rfx /
vfglkg;DaGwL Jojxf/df ;'wf/ Nofpg
cleefjsx?sf] lzIffsf nflu ;|f]t ;fdu|Lx?
tof/cBfjlws ug]{ .
$=$ cfdf / afnaflnsfx?sf] x]/rfx / vfglkg;DaGwL
Jojxf/sf ljifodf cleefjsx?sf] 1fgdf clea[l4
ug{ sfo{s|dx? cfof]hgf ug]{ .

37. k|ltkmn g+= %M
sd pd]/sf cfdfx?, lszf]/Lx?, lzz'x? /
afnaflnsfx?df emf8f kvfnf / ARI sf
36gfx?df sdL cfPsf] x'g]5 . of] k|ltkmn
k|flKtsf nflu ef}lts of]hgf tyf lgdf{0f
If]q lhDd]jf/ x'g]5 .
%=! ljz]if u/L
lszf]/lszf]/Lx?, afnaflnsfx? / ;–;fgf
aRrfsf cfdfx?nfO{ hf]8 lb+b} vf; vf;
;dodf ;fj'gn] xftw'g] afgL a;fpg
k|a4{gfTds cleofgx? cfof]hgf ug]{ .
%=@ a9L k|efljt lhNnfx?nfO{ ljz]if hf]8

38. k|ltkmn g+= ^M
pko'Qm ef]hgsf] pknAwtf tyf pkef]udf -
u'0f:t/, k/Ldf0f, vfgf vfg] k6s / ;'/Iffsf b[li6n]_
a[l4 Pj+ dlxnfx?sf] sfo{af]emdf sdL cfPsf] x'g]5
. b]xfosf ls|ofsnfkx?sf] sfof{Gjog u/L o;
k|ltkmnsf] k|flKtsf nflu s[lif, tyf :yfgLo ljsf;
If]qx? lhDd]jf/ x'g]5g .
^=! 3/kl/jf/ / ;d'bfosf] txdf h}ljs ;|f]tdf
cfwfl/t vfgf nufot ;"Id kf]ifstTjo'Qm ef]hg
pknAw u/fpg]
^=@ ;"Id kf]ifstTjo'Qm :yfgLo afnLx?sf] ;'q ljsf;
/ k|a4{g ug]{
^=# sd cfo;d"xsf lszf]/Lx?, ue{jlt dlxnfx? / #
jif{eGbf sd pd]/sf aRrfx?nfO{ :tgkfg u/fpg]
cfdfx?df ;"Id kf]ifstTjo'Qm ef]hg tyf cfodf
a[l4 ug{ ljleGg sfo{s|dx?jLr ;x;DaGw :yfkgf

39. k|ltkmn g+= &M
s]Gb|, lhNnf, gu/ tyf uflj; txx?df cfdf / aRrfx?sf]
kf]if0fdf ;'wf/ Nofpg pko'Qm ;xof]u pknAw u/fpg]
Ifdtfdf clea[l4 ePsf] x'g]5 . of] k|ltkmn xfl;n
ug{sf nflu /fli6«o of]hgf
cfof]u, :jf:Yo, lzIff, ef}lts of]hgf tyf
lgdf{0f, s[lif / :yfgLo ljsf; If]qx? lhDd]jf/
x'g]5g .
&=! s]Gb| / :yfgLo txdf hgzlQmsf] ax'If]qLo
kf]if0f Ifdtf ljsf; ug]{ u/fpg]
&=@ ;+u7gfTds ;'b[9Ls/0fsf nflu ;Da4 If]qx?sf]
;+u7g tyf Joj:yfkg;DaGwL n]vfhf]vf ug]{ .
&=# Ps} lsl;dsf] tyf glthfd'vL k|ltj]bg k|0ffnLsf]
:yfkgf ug]{ .
&=$ ax'If]qLo kf]if0f of]hgfsf k|d'v ;"rsx?nfO{
;dflji6 ug{ ul/jL cg'udg tyf ljZn]if0f k|0ffnL
(PMAS) / lhNnf ul/jL cg'udg tyf ljZn]if0f k|0ffnL
(DPMAS) sf ;"rsx?sf] k'g/fjnf]sg ug]{ .

40. k|ltkmn g+= *M
/fli6«o tyf :yfgLo txx?df ax'If]qLo kf]if0f
;"rgf k|0ffnLsf] ljsf; e} k/:k/ cfj4 / cBfjlws
ul/Psf] x'g]5 . of] k|ltkmnsf] k|flKtsf nflu
/fli6«o of]hgf cfof]u, :jf:Yo, lzIff, ef}lts
of]hgf tyf lgdf{0f, s[lif / :yfgLo ljsf; If]qx?
lhDd]jf/ x'g]5g
*=! k|d'v ;/f]sf/jfnfx?nfO{ ;dflji6 u/L -
:Jff:Yo Joj:yfkg ;"rgf k|0ffnL, lzIff
Joj:yfkg ;"rgf k|0ffnL, vfg]kfgL tyf
;/;kmfO{, s[lif tyf :yfgLo ljsf;sf_
s]Gb|:t/df ax'If]qLo kf]if0f;DaGwL ;"rgf
ul/jL cg'udg tyf ljZn]if0f k|0ffnL ;Fu
k/:k/ cfj4 / cBfjlws ug]{ .

41. sfo{of]hgf – :jf:Yo
pknlAw != dft[lzz' tyf afnaflnsfx?sf]
cfxf/df ;'wf/ x'g]5 .k|ltkmn !=)M ue{jtLsf] cfxf/ Jojxf/df ;'wf/ x'g]5 .
!=! :jf:Yo :jo+;]ljsfx? dfkm{t ue{jtLsf] a]n}df klxrfg u/L btf{ ug]{
!=@ ue{jtL tyf kl/jf/sf ;b:ox?nfO{ ay{ lk|Ko/8g]z Kofs]h cg';f/ h}ljs
;|f]tsf] vfgf pkef]u ug{ k}/jL ug]{
!=# ue{jtLsf] cfxf/ Jojxf/df ;'wf/ ug{ kf]if0fsf] nflu ;~rf/ /0fgLltsf]
c+usf] ?kdf Jojxf/ kl/jt{g ;~rf/ sfo{qmd ug]{
k|ltkmn @=)M hGdg]lalQs} :tgkfg u/fpg] tyf k"0f{ :tgkfg -
cfdfsf] b"wdfq_ u/fpg kxn ;'? ePsf] x'g]5
@=! ;fd'bflos :jf:Yo sfo{stf{ tyf :jo+;]jsx?nfO{ lzz' tyf s]6fs]6Lsf]
cfxf/ ;DaGwL tflnd k|bfg ug]{
@=@ cfdf, gjhft lzz', afn:jf:Yo tyf ljsf;;DaGwL tflnddf IYCF Kofs]h
cfTd;ft ug]{
@=# k|ltkmn ! sf] !=# lqmofsnfk
k|ltkmn #=)M 5 b]lv @# dlxgf;Ddsf afnaflnsfsf] k"/s
cfxf/ pknAwtfdf ;'wf/ x'g]5 .

42. sfo{of]hgf – :jf:Yo
pknlAw @=)M dft[lzz' tyf afnaflnsfsf] ;"Id
kf]if0fsf] l:yltdf ;'wf/ x'g]5 .k|ltkmn $=) ue{jtL tyf k|;"ltkZrft cfdfx?aLr cfO/g / h'sf
lgoGq0f rSsLsf] vkt a9L x'g]5 .
$=! :jf:YosdL{ tyf dlxnf :jf:Yo :jo+;]ljsfx?nfO{ cfO/g tTj ld;fpg]
;DaGwdf k"gtf{huL tflnd k|bfg ug]{
$=@ k|lt dlxgf dlxnf :jf:Yo :jo+;]ljsfx? dfkm{t #) rSsL cfO/g kmf]lns
Pl;8 afF8g nufpg] tyf cfdfx?nfO{ vfg] ug{ pTk|]l/t ug]{, ;Demfpg]
$=# :jf:Yo sfo{stf{x? dfkm{t cfO/g kmf]lns Pl;8 -uef{j:yfdf !*) rSsL /
uef{j:yfkl5 :tgkfg u/fpFbf $% rSsL_ tyf ! h'sf lgoGq0f rSsL -
uef{j:yfdf_ afF8g nufpg]
$=$ ue{jtL tyf cfdfx?n] cfO/g kmf]lns Pl;8 tyf ! h'sf lgoGq0f rSsL
vfg'kg]{ ;DjGwdf ue{jtL dlxnf tyf cGo kl/jf/sf ;b:onfO{ k}/jL ug]{
$=$=! ;"Id kf]ifstTj ;e]{If0f ug]{
k|ltkmn %=) cfO/g tTj ld;fPsf] vfg]s'/fsf] pkef]u a9g]5
%=! 3/kl/jf/n] cfO/g tTj ld;fPsf] cGgsf] pkef]u a9fpg] ljifodf cleofg
;~rfng ug]{
%=@ ;do ;dodf lk;fgL ldnx?sf] cg'udg u/L vfg]s'/fdf cfO/g tTj pko'Qm
lsl;dn] ld;fPsf] ;'lglZrt ug]{

43. sfo{of]hgf – :jf:Yo
pknlAw @=)M dft[lzz' tyf afnaflnsfsf] ;"Id
kf]if0fsf] l:yltdf ;'wf/ x'g]5 .k|ltkmn &=) 5 b]lv t]O; dlxgfsf lzz'aLr ;"Idkf]ifstTj o'Qm
kfp8/sf] pkof]u a9]sf] x'g]5 .
&=! ;"Idkf]ifstTj kfp8/ &% lhNnfdf lj:tf/ ug{]
&=@ 5 b]lv t]O; dlxgfsf lzz'x?nfO{ ;"Idkf]ifstTj o'Qm kfp8/
v'jfpg'kg]{ ljifodf :jf:YosdL{ tyf dlxnf :jf:Yo :jo+;]ljsfdfkm{t
cfdf Pj+ kl/jf/sf cGo ;b:onfO{ ;/;Nnfx ;]jf k|bfg ug]{
k|ltkmn *=) dft[lzz' tyf s]6fs]6Lx?df x'g] ;+qmd0f 36]sf]
x'g]5
*=@ IMCI k"gtf{huL tflnd dfkm{t dft[lzz' tyf s]6fs]6Lx?df x'g]
;ªqmd0fsf ljifodf hf]8 lbg]
*=@ CB-NCP&% lhNnfdf lj:tf/ ubf{ dft[, lzz' tyf s]6fs]6Ldf x'g]
;+qmd0f ljifodf hf]8 lbg]
*=# ue{jtL, lszf]/lszf]/L tyf afnaflnsfsf lglDt cfjZos ;+Vofdf LLIN
sf] kof{Kt ljt/0f ug]{
*=$ lgoldt bfb'/fsf] vf]ksf] ;+Vof a9fpg ;~rf/ dfWodsf] pkof]u
j[l4 ug]{

44. sfo{of]hgf – :jf:Yo
pknlAw #=) lzz' tyf afnaflnsfx?df /x]sf] s'kf]if0fsf]
kof{Kt Joj:yfkg ePsf] x'g]5.k|ltkmn !)=) ) b]lv #^ dlxgf;Ddsf afnaflnsfsf] kf]if0fsf]
l:ylt cg'udg u/L clws s'kf]if0f klxrfg ug]{
!)=! PHC/ORC k'gM lqmofzLn ubf{ s'kf]if0f ePsf
afnaflnsfsf] klxrfg tyf kf]if0f :t/ cg'udg ;'b[9 ug]{
!)=@ ljZj :jf:Yo ;+u7g j[l4 u'0f:t/ cg';f/ ;d'bfodf cfwfl/t j[l4
cg'udg sfof{Gjog x'g]5 .
k|ltkmn !!=) kfFr jif{d'lgsf ;a} afnaflnsfsf] clts8f
s'kf]if0f 36g]5 .
!!=! ;d'bfodf cfwfl/t s8f s'kf]if0f Joj:yfkg sfo{qmd w]/}
clt s8f s'kf]lift afnaflnsf ePsf #% lhNnfdf lj:tf/ ug{]
!!=@ w]/} clts8f s'kf]lift afnaflnsf ePsf #% lhNnfdf
kf]if0f k'gM:yfkg u[x lj:tf/ ug]{
k|ltkmn !@=) kfFr jif{d'lgsf ;a} afnaflnsfsf] dWod
s'kf]if0f 36g]5

45. sfo{of]hgf – :jf:Yo
pknlAw $M :jf:Yo If]qsf kf]if0f;DaGwL
P]g, lgod, gLlt, /0fgLlt / dfkb08x?nfO{
cBfjlws ul/Psf] x'g]5 .k|ltkmn !#=) /fli6«o kf]if0f gLlt tyf /0fgLlt ;+zf]wg
tyf cBfjlws ul/Psf] x'g]5 .
!#=! ;/sf/L tyf u}/ ;/sf/L ;/f]sf/jfnfx?sf] ;xof]udf ljBdfg
/fli6«o kf]if0f gLlt tyf /0fgLlt ;+zf]wg ug]{ .
!#=@ kf]if0fsf] ;~rf/ /0fgLlt th'{df ug]{ .
!#=# ;+zf]lwt /fli6«o kf]if0f gLltcg'?k :jf:Yo If]qsf]
nufgL;lxtsf] ax'jifL{o kf]if0f of]hgf th'{df ug]{ .
k|ltkmn !$=) kf]if0f;DaGwL a[xb tflnd Kofs]hx?
tof/ ul/g]5 .
!$=! ljBdfg ljleGg kf]if0f;DaGwL tflnd ;fdu|L
k'g/fjnf]sg u/L ;+zf]wg ug]{ .

46. sfo{of]hgf – :jf:Yo
pknlAw %M ax'If]qLo kf]if0f of]hgfdf :jf:Yo If]qsf]
:jf:Yo If]qsf] ;'wf/fTds of]ubfgsf] nflu ;+:yfut ;'b[9Ls/0f
tyf Ifdtf ljsf; ePsf] x'g]5 .k|ltkmn !^=) ax'If]qLo kf]if0f of]hgfsf] k|f?k cg'?k ;a}
txdf ;+:yfut Joj:yf k'g/fjnf]sg ug]{, :jf:Yo tyf hg;+Vof
dGqfnocGtu{t /fli6«o kf]if0f s]Gb| :yfkgf;lxt
!^=! ;+u7g tyf Joj:yfkg l8hfOg tyf n]vfhf]vf ug]{ Ifdtf ljsf;
cfjZostf;lxt
!^=@ /fli6«o kf]if0f s]Gb|sf] ;+u7gfTds ;+/rgf tof/ u/L :jLs[t ug]{
!^=# ;+u7g tyf Joj:yfkg n]vfhf]vf tyf /fli6«o kf]if0f s]Gb|sf]
;+u7gfTds ;+/rgf cg';f/ Ifdtf ljsf; of]hgf th'{df ug]{
!^=$ :jLs[t ;+u7gfTds ;+/rgfsf] b/jGbL cg';f/ kbk"lt{ ug]{
k|ltkmn !&=) ;a} txdf :jf:YosdL{x?sf] -dlxnf ;fd'bflos
:jf:Yo sfo{stf{;lxt_ kf]if0f;DaGwL Ifdtf ljsf; ug]{
!&=! a[xb kf]if0f tflnd Kofs]h cg';f/sf tflnd sfo{qmd ;~rfng ug]{
k|ltkmn !*=) dft[lzz' s'kf]if0f 36fpg :jf:Yosf hgzlQmn]
cGo If]q;Fu ;dGjo u/L of]ubfg ug]{

47. glt
hf
z[+v
nf
ljj/0ffTds
;+If]k
sfo{;Dkfbgsf ;"rsx?
nIo k'8sf]kg
36fpg hf]8
lbg]
ax'If]qLo
k|of;df lzIff
dGqfnosf]
of]ubfgdf
clej[l4 x'g]5
.
@)!^ sf] cGTo;Dddf lhjgofkgsf ;Lkdf
cfwfl/t kf]if0f sfo{qmd;DaGwL
tflnd k|fKtug]{ lzIfsx?, ;|f]t JolQmx?
tyf afn Snasf ;b:ox?sf] ;+Vof a9]sf]
x'g]5 .
p2]]
Zo
lszf]/Lx?sf]
lzIff,
lhjgofkgsf
;g @)!& sf] cGTo;DddfM
@)!^ sf] cGTo;DddfM
lszf]/Lx?dWo] sIffdf xflh/L tyf sIff
sfo{of]hgf –lzIff If]q

48. sfo{of]hgf – lzIff If]q
pknlAw !=) ue{ tyf lzz' tyf afnaflnsfsf] j[l4
;DaGwdf lszf]/Lx?sf] hfu/0f / Jojxf/df ;'wf/
cfPsf] x'g]5
k|ltkmn !=! bL3{sfnLg s'kf]if0f Go"gLs/0f ug]{ ljifo
lszf]/Lx?nfO{ k|bfg ul/g] hLjgofkg;DaGwL lzIffdf
a9L eGbf a9L ;dfj]z ul/Psf] x'g]5 -;an jftfj/0fsf]
l;h{gf ug]{_ .
k|ltkmn !=@ lszf]/Lx?df bL3{sfnLg s'kf]if0fnfO{
Go"gLs/0f ug]{ 1fg / ;Lksf] clej[l4 x'g]5 .
pknlAw @=) ;–;fgf afnaflnsfsf] x]/rfx / cfxf/
Jojxf/df ;'wf/ u/L j[l4 ljkmntfsf] km}nfj6
/f]Sg ;lsg] ljifodf cleefjsx? -dlxnf_ /fd|/L
;';"lrt ePsf x'g]5g .
k|ltkmn @=! afnaflnsf x]/rfx tyf cfxf/ Jojxf/sf

49. sfo{of]hgf – lzIff If]q
pknlAw # lszf]/L 5fqfx?sf] kf]if0f:t/df ;'wf/
x'g]5
k|ltkmn #=! ECD afnaflnsf tyf lszf]/L 5fqfx?n] -
* sIff ;Dd_ lbjfvfhf k|fKt ug]{5g .
k|ltkmn #=@ cfwf/e"t lzIffdf -sIff !–*_ lszf]/L
5fqfx?sf] z}lIfs ;xeflutf tyf pknlAwdf ;'wf/
x'g]5 .
pknlAw $ ax'If]qLo k|of;df of]ubfg of]ubfg
k'¥ofpg lzIff If]qsf] Ifdtf cleaj[l4 ePsf] x'g]5
k|ltkmn $=! kf]if0f lglb{i6 lzIff cWofkg ug{ lzIff
dGqfnosf k|lzIfs Pj+ lzIfsx? -k"j{ ;]jfsfnLg tyf
;]jfsfnLg_ k"0f{?kdf tof/ ul/Psf] x'g]5 .
k|ltkmn $=@ k'8sf]kg 36fpg] ljifodf lzIf dGqfno

50. glth
f
z[+v
nf
ljj/0ffTds
;+If]k
sfo{;Dkfbgsf ;"rsx?
nIo k'8sf]kg
36fpg] sfo{df
ltj|tf lbg]
ax'If]qLo
k|of;df zx/L
ljsf; dGqfnosf]
of]ubfg x'g]5 .
zx/L ljsf; dGqfnosf]
jflif{s tyf ax'jflif{s
of]hgfdf vfg]kfgL tyf
;/;kmfO sfo{qmdx?
dfkm{t s'kf]if0f 36fpg
of]ubfg k'Ug] nIf
k|ltlalDat ul/g]5
p2]] l56f] aRrfkfpg] ;g @)!& sf] cGTo;DddfM
sfo{of]hgf –vfg]kfgL tyf
;/;kmfO -zx/L ljsf;_

51. pknlA
w !
;fa'g kfgLn] xftw'g] cEof; a9]sf] x'g]5 .
pknlA
w @
;a} nlIft ljBfno, uflj; Pj+ gu/kflnsf v'Nnf
lb;fd'Qm If]q x'g]5g .
pknlA
w #
hn ;'/Iff If]q 3f]if0f ePsf] x'g]5
pknlA
w $
;+o'Qm sfo{ of]hgf tyf cg'udg k|0ffnL :yfkgf
ePsf] x'g]5
pknlA
w %
s]Gb|Lo tyf :yfgLo:t/df hgzlQm ljsf; x'g]5 .
k|ltkm
n !
;a} l56f] aRrf kfpg] cfdfx? tyf lszf]/Lx?sf]
xftw'g] ;'ljwfx?df kx'Fr e} xftw'gsf] nflu
;fa'g k|of]u u/]sf x'g]5g .
k|ltkm
n @
;a} l56f] aRrfkfpg] cfdfx? tyf lszf]/Lx?n]
;'wfl/Psf] ;/;kmfO ;'ljwf tyf :jR5s/ Jojxf/
k|of]u u/]sf x'g]5g .
k|ltkm
n #
;a} ue{jtL Pj+ :tgkfg u/fpg] cfdfx?sf ;fy;fy} @
jif{d'lgsf afnaflnsfn] ;kmf kfgL k|of]u u/]sf
x'g]5g .

52. glthf
z[+vnf
ljj/0ffTds ;+If]k sfo{;Dkfbgsf ;"rsx?
nIf bL3{sfnLg s'kf]if0f
36fpg] sfo{df tLj|tf
lbg] ax'If]qLo k|of;df
s[lif tyf ;xsf/L
dGqfnosf] of]ubfgdf
clej[l4 x'g]5 .
s[lif sfo{qmd
kf]if0f ;+j]bgzLn
x'g]5 .
p2]Zo sd cfo ePsf
lszf]/lszf]/Lx? / sd
pd]/df ue{jlt x'g]]
cfdfx? tyf
afnaflnsfx?aLr
lalawtfk"0f{ vfgf
;"Id kf]if0fo'Qm
vfgfsf] pkef]u %)Ü
n] a9]sf] x'g]5 .
k|f0fLhGo ;|f]tsf]
vfgfsf] k|of]u
sfo{of]hgf – s[lif If]q

53. k|ltkm
nx?
k|ltkm
n !=)
3/kl/jf/ / ;d'bfosf] txdf
vf;u/L ;"Id kf]ifstTjo'Qm
ef]hg h:t} h}ljs ;|f]tdf
cfwfl/t vfgf, xl/of ;fukft /
kmnkm"n, Rofp, bfn cflb
ljljwtfk"0f{ vfgfsf]
pknAwtf 3/kl/jf/ / ;d'bfo
:t/df j[l4 x'g]5 .
cfufdL %
jif{df
3/kl/jf/ /
;d'bfodf:t/df
;"Id
kf]ifstTjo'Qm
vfgfsf]
pTkfbg %)Ü
a9g]5
k|ltkm
n @=)
sd cfoePsf kl/jf/sf] cfo j[l4
e} o;df sd pd]/df ue{jlt x'g]]
cfdfx? / lszf]/lszf]/Lx?sf]
o:tf] cfodf kx'r tyf lgoGq0f
cfufdL %
jif{df nlIft
3/kl/jf/sf]
cfodf @)Ü a'l4
sfo{of]hgf – s[lif If]q

54. glth
f
z[+v
nf
ljj/0ffTds ;+If]k sfo{;Dkfbgsf ;"rsx?
nIf kf]if0f k|a4{g
sfo{df ltj|tf lbg]
ax'If]qLo k|of;df
:ygLo ;'zf;g Pj+
;fdflhs ;'/Iffsf]
of]ubfgdf clej[l4
x'g]5 .
lhNnf:t/df kf]if0f ;"rgfsf]
kx'Frdf clej[l4 e} kf]if0f
;]jfx?df ;'wf/ x'g]5 .
p2]Z
o
kf]if0f k|a4{g
sfo{df ltj|tf lbg]
k|of;df ;xof]u
k'¥ofpg :yfgLo
;g @)!@ b]lv :yfgLo ;'zf;g gLlt
tyf sfo{qmddf l8hfOg tyf
th'{dfdf kf]if0f k|ltlalDat
x'g]5 .
sfo{of]hgf – :yfgLo ;'zf;g

55. k|ltkmn !M
:yfgLo lgsfosf
of]gfdf kf]if0f
:ki6?kdf /flvg]5
;g @)!# b]lv lhNnf tyf gu/ ljsf;
cfjlws of]hgf / oL ;+:yfsf] jflif{s
of]hgfdf kf]if0f ljifo k|ltljlDjt
x'g]5 .
;g @)!# b]lv :yfgLo lgsfo cg'bfg
lgb]{lzsfdf nlIft ljsf; sfo{qmdsf]
k|a4{gfTds nufgL If]qcGtu{t ;dflxt
ug{;Sg] u/L kf]if0f ;dfj]z ul/Psf] x'g]5
.
k|ltkmn @M
k'8sf]kg
tLj|t/?kdf Go"g
ug{ :yfgLo ;|f]t
kl/rfng qmlds
?kdf a9b} uPsf]
x'g]5 .
;g @)!$ b]lv 5gf]6 ul/Psf uflj;x?df ==Ü
uflj;:tl/o ;fd'bflos ;+:yfx?
kf]if0f;DaGwL k}/jLdf ;+nUg x'g]5g .
;g @)!# b]lv ;fdflhs k/LIf0f tyf
;fj{hlgs ;'g'jfO d~rx?sf 5nkmndf
kf]if0fnfO{ :yfg lbFb} ;f] ljifo logsf
k|ltj]bg tyf sfo{ of]hgfdf /flvPsf]
pknlAw ! :yfgLo ;'zf;g /0fgLlt tyf sfo{qmd l8hfOg ubf{
kf]if0f b[li6uf]r/ ul/g]5

56. pknlA
w @
:yfgLo ;/sf/sf] th'{df ul/Psf] of]hgfsf] k|ltkm Pj+ ljleGg
If]qaLr ax'If]qLo ;dGjo ug]{ Ifdtf ljsf; ePsf] x'g]5 .
k|ltk
mn $
lhlj; Pj+ uflj;:t/df
:yfgLo lgsfo, :jf:Yo,
s[lif / lzIff If]qaLr
;xof]u ;'b[9 ePsf]
x'g]5 .
;g @)!@ sf] cGTo;Dddf lhlj;, gu/kflnsf /
uflj;:t/df kf]if0f tyf vfB ;'/Iff lgb]{zd
;ldlt lqmofzLn x'g]5 .
;g @)!# b]lv lhNnfdf sfof{Gjog x'g]
kf]if0f;DaGwL sfo{qmd :jLs[t ug{ Pj+
k|ult ;dLIff ;DalGwt If]qaf6 u/fO{
bL3{sfnLg s'kf]if0f 36fpg cfjZos
lqmofsnfkx? l;kmfl/; ug{ ;ldltsf]
a}7s q}dflzs ?kdf a;]sf x'g]5g .
k|ltk
mn %
ax'If]qLo k|of;df
of]ubfg k'¥ofpg
sd{rf/Lsf] Ifdtf
ljsf; ul/g]5 .
;g @)!# b]lv :yfgLo lgsfosf ;Dks{
;+:yfx?n] kf]if0f sfof{Gjog / cGo
;+:yfx?;Fu ;dGjo, cfˆgf] sfo{ ljj/0f
cGtu{tsf] sfdsf] ?kdf, u/]sf x'g]5g .
;g @)!# b]lv :yfgLo lgsfosf ;Da4
sd{rf/LnfO{ kf]if0f;DaGwL sfo{ut
lhDd]jf/L lbOPsf] x'g]5 .
;g @)!$ sf] cGTo;Dddf :yfljd+ tyf
:yfgLo lgsfosf tf]lsPsf d'Vo
sd{rf/LaLr kf]if0f;DaGwL 1fg a9]sf]
x'g]5 .
k|ltk lhNnf ul/aL cg'udg ;g @)!# b]lv kf]if0f;DaGwL k|ult -lnË,

57. NEPALFar-Western
Region Mid-Western Region
Western Region
Central Region
Eastern Region
Initial MSNP
Roll-out Districts
DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWAL
PARASI
KAPIL-
BASTU
RUPAN-
DEHI
DANG
BANKE
ACHHAM
KALIKOT
JHAPA
MORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-
DHURA
KANCHAN-
PUR
BAJURA
PARSA
BARA
RAUT-
AHAT
DHANUSA
MAHO-
TARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-
PUR
CHITWAN
KASKI
TANAHU
PALPA
SYANGJA
PARBAT
ARGHAK
HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-
PUR DHAN-
KUTA
TAPLEJUNG
OKHAL-
DHUNGA
TERHA-
THUM
KHOTANG
LALIT
BHAK
KATHM SULUK-
HUMBU
DOLAKHA
SANKHUWA-
SABA
NUWAKOT
SINDHU-
PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUT-
HAN
ROLPASALYAN
MYAGDI
DAILEKH
JAJARKOT
RUKUM
MUSTANG
MANANG
SIX INITIAL MOEL DISTRICTS (Bajura, Jumla, Kapilvastu, Nawalparashi, Parsa and Jumla)
PROPOSED BASED ON 14 INDICATORS
Criteria/Indicators for selection
1. Average of 1 to 4 quarters food security phase
2. Net Enrolment Rate (NER) Basic Education
3. Working Children 10-14 years
4. Sanitation coverage
5. Per Capita Development Budget Expenditure
6. DPT 3 immunization under 1 year of age
7. Expected frequencies of diarrheal outbreaks
8. Ratio of girls to boys in secondary education
9. Proportion of severely underweight children less than 5 years
10. Minimum Conditions and Performance Measures (MCPMs) of Local Bodies of Nepal
11. Proportion of births attended by Skilled Birth Attendant as % of expected pregnancies:
12. Stunting Prevalence
13. Access
14. Similar MSNP actions by on-going programs/partners
Central Region
MSNP implementation period
(First Phase): 2013-2017

58. ;+u7gfTds tyf
Joj:yfksLo ;+/rgf

59. /fli6«o txM pRr:t/Lo kf]if0f tyf vfB
;'/Iff;DaGwL lgb]{zs ;ldlt
dfggLo pkfWoIf, /fli6«o of]hgf cfof]u, cWoIf
/fli6«o of]hgf cfof]usf dfggLo ;b:ox?
-:jf:Yo, s[lif tyf jfl0fHoIf]q x]g]{ ;b:o
;lrj, s[lif tyf ;xsf/L dGqfno ;b:o
;lrj, :jf:Yo tyf hg;+Vof dGqfno ;b:o
;lrj, :yfgLo ljsf; dGqfno ;b:o
;lrj, jfl0fHo tyf cfk"lt{ dGqfno ;b:o
;lrj, cy{ dGqfno ;b:o
;lrj, lzIff dGqfno ;b:o
;lrj, ef}lts of]hgf tyf lgdf{0f dGqfno ;b:o
;lrj, dlxnf, afnaflnsf tyf ;dfhsNof0f dGqfno – ;b:o
$ hgf lj1x? -kf]if0f, vfB ;'/Iff, jfl0fHo tyf cfk"lt{;DaGwL_
;b:o
;b:o ;lrj, /fli6«o of]hgf cfof]u ;b:o ;lrj
;x;lrj, ;fdflhs ljsf; dxfzfvf,
/fli6«o of]hgf cfof]usf] ;lrjfno ;x–;b:o ;lrj

60. gLltut dfu{bz{g / cg'udgsf ;fy}
pRr:t/Lo kf]if0f tyf vfB ;'/Iff;DaGwL
lgb]{zs ;ldlt lgDg sfo{x?sf nflu klg
lhDd]jf/ x'g]5 M
• ax'If]qLo kf]if0f / vfB ;'/Iff;DaGwL
a[xt gLltx? th'{df ug]{Ù
• cfGtl/s tyf afXo ;|f]tx? ;'lglZrt ug]{Ù
• /fli6«o tyf cGt/f{li6«o txdf
kIfkf]if0f ug]{ / k|lta4tfx? JoQm
ug]{Ù
• sfo{qmd sfof{Gjog l:yltsf] ;dLIff
tyf d"Nofªsg ug]{Ù /

61. pRr:t/Lo kf]if0f tyf vfB ;'/Iff;DaGwL
lgb]{zs ;ldltsf] ;xof]usf nflu Ps
;lrjfno /xg]5 hf] lgDg sfo{x?sf nflu
lhDd]jf/ x'g]5 M
• ;"rgf Joj:yfkgM ul/aL cg'udg tyf
ljZn]if0f k|0ffnL, lhNnf ul/aL
lgjf/0f tyf ljZn]if0f k|0ffnL, :jf:Yo
Joj:yfkg ;"rgf k|0ffnL, lzIff Joj:yfkg
;"rgf k|0ffnLnufot;Fu ;DaGw :yflkt
ug]{ .
• ;"rgf ;Dk|]if0f÷kIfkf]if0f ug]{ .
• Ifdtf ljsf;sf nflu ;xof]u ug]{ .

62. df=;b:o -:jf:Yo tyf kf]if0f If]q_, /fli6«o of]hgf cfof]u
–;+of]hs
df=;b:o -s[lif If]q_, /fli6«o of]hgf cfof]u
–;x–;+of]hs
;x–;lrj, gLlt of]hgf tyf a}=;= dxfzfvf, :jf:Yo tyf hg;+Vof dGqfno
–;b:o
;x–;lrj, vfg]kfgL dxfzfvf, ef}lts of]hgf tyf lgdf{0f dGqfno
–;b:o
;x–;lrj, ah]6 tyf sfo{qmd dxfzfvf, cy{ dGqfno
–;b:o
;x–;lrj, k|zf;g, ;+:yfg tyf cfk"lt{ dxfzfvf, jfl0fHo tyf cfk"lt{ dGqfno
–;b:o
;x–;lrj, of]hgf tyf j}b]lzs ;xof]u ;dGjo dxfzfvf, :yflgo ljsf; dGqfno
–;b:o
;x–;lrj, of]hgf dxfzfvf, s[lif tyf ;xsf/L dGqfno
–;b:o
dxflgb]{zs, s[lif ljefu –
;b:o
dxflgb]{zs, kz';]jf ljefu –
;b:o
dxflgb]{zs, vfB k|ljlw tyf u'0f lgoGq0f ljefu
–;b:o
dxflgb]{zs, l;+rfO ljefu –
;b:o
/fli6«o kf]if0f tyf vfB ;'/Iff ;dGjo
;ldlt

64. kf]if0f tyf vfB ;'/Iff If]lqo
;dGjo ;ldlt
ax'If]lqo kf]if0f of]hgfsf] sfof{Gjogdf
;xof]u / ;dGjo ug{ tyf sfof{lGjt
sfo{qmdsf] ;'kl/j]If0f / cg'udgsf nflu
If]lqo:t/df cfjZostf cg';f/ If]lqo
k|zf;ssf] ;+of]hsTjdf ;Dj4 ljifout
lgsfox? / ;/f]sf/jfnfx? ;d]t ePsf]
kf]if0f tyf vfB ;'/Iff If]lqo ;dGjo ;ldlt
u7g ug{ ;lsg]5 .

65. lhNnf:t/M kf]if0f tyf vfB
;'/Iff;DaGwL lgb]{zs ;ldlt
lhlj; ;efklt,
cWoIf
lhNnf :jf:Yo÷hg:jf:Yo clws[t ;x–
cWoIf
:yfgLo ljsf; clwsf/L
;b:o
nfOg Ph]G;Lsf k|d'vx? -s[lif, kz' ;]jf, lzIff, vfg]kfgL_
;b:ox?
dlxnf ljsf; clws[t
;b:o
sfo{sf/L clws[t, gu/kflnsf
;b:o
cWoIf, lhNnf pBf]u jfl0fHo ;+3
;b:o
cWoIf, lhNnf u}/;/sf/L dxf;+3
;b:o
k|ltlglw, lhNnf:t/df sfdug]{ ljsf; ;fem]bf/÷-c_u};;x?

66. ;fªs]lts?kdf pQm lgb]{zs ;ldltsf]
sfof{b]z lgDgfg';f/ x'g]5 M
• lhNnfdf sfof{Gjog x'g] kf]if0f;DaGwL
sfo{qmdx?sf]
ljZn]if0f, ;dLIff, cg'df]bg ug]{ /
ax'If]qLo kf]if0f of]hgfsf] dd{cg'?k
lhNnf kl/ifbdf :jLs[ltsf nflu
l;kmfl/; ug]{ .
• lhNnfsf] cfjlws / jflif{s of]hgfx?df
kf]if0fsf ;"rsx? ;dfj]z ug]{ .
• nfOg Ph]G;Lx? / lhNnf ul/aL cg'udg tyf
ljZn]if0f k|0ffnLsf] k|ult ;dLIff ug]{ .

67. gu/kflnsf :t/ M
kf]if0f tyf vfB ;'/Iff;DaGwL
lgb]{zs ;ldlt
d]o/, gu/kflnsf
cWoIf
lhNnf :jf:Yo÷hg:jf:Yo clws[t
;x cWoIf
sfo{sf/L clws[t, gu/kflnsf
;b:o
k|d'v, nfOg Ph]G;Lx? -s[lif,kz'
;]jf, lzIff, vfg]kfgL_ ;b:ox?
of]hgf clws[t, lhlj;
;b:o
k|d'v, gu/ :Jff:Yo s]Gb|, gu/kflnsf-ljBdfg
eP_ ;b:o

68. uflj;:t/M
kf]if0f tyf vfB ;'/Iff;DaGwL
lgb]{zs ;ldlt
cWoIf, uflj;
cWoIf
k|ltlglw, s[lif ;]jf s]Gb|, kz' ;]jf s]Gb|
/ :jf:Yo rf}ls jf s]Gb|
;b:ox?
k|ltlglw, :jf:Yo ;]jf Joj:yfkg ;ldlt
;b:o
cWoIf, ljBfno Joj:yfkg ;ldlt
w]/} eP 5flgPsf] !_
;b:o
k|ltlglw, jf8{ l;l6hg kmf]/d,

69. ;fªs]lts?kdf pQm lgb]{zs ;ldltsf]
sfof{b]z lgDgfg';f/ x'g]5M
• lhNnfdf cjnDag ul/Psf] ax'If]qLo
kf]if0f of]hgf cg'?k x'g] u/L uflj;sf
jflif{s of]hgfx?df kf]if0fsf
sfo{qmdx? ljZn]if0f ug]{ / ;dflxt ug]{
.
• kf]if0f sfo{qmdx?sf] sfof{Gjogsf]
k|ult ;dLIff ug]{ .
• uflj;df bL3{ Go"gkf]if0f 36fpgsf nflu
ax'If]qLo ;dGjo ug]{ .

71. ah]6 af+8kmf+8 tyf sfof{Gjog