Desired subject areas for tourism and development of Arghakhanchi districts: Agriculture, Tourism, Education, Technical education, Health, Hydropower related, Industries, Physical Infrastructures, Startup sectors and viability. Home Stay viability wit the area selection. https://www.ratopati.com/story/350218/sushila

1. Health status of Arghakhanchi
and its development
Ashok Pandey (MPH/BPH, DGH)
Policy Researcher
Google Scholar:
https://scholar.google.com/citations?user=ZI5jDykAAAAJ&hl
=en
ORCID: https://orcid.org/0000-0001-8471-1253
Researchgate: https://www.researchgate.net/profile/Ashok-
Pandey-17
3/7/2023 1

2. Table of content
General introduction on health status
Methodology
The present health status of the
Arghakhanchi
Problem identification and reasons
Program to develop: Short term: At least
within a financial year
Long-term: At least 5 years plan in the
specific area.
Recommended reading materials
3/7/2023 2

3. Declaration of conflict of interest
The authors affirm that I have no competing interests regarding the subjects.
The policy researcher's knowledge and experience are used to create this
presentation. Only academic and research purposes will be served by it. The
majority of the contents are well-cited and taken from reports and
publications at the national level as well as from peer-reviewed journals.
- Ashok Pandey
3/7/2023 3

4. Methodology
1. Online Literature Review:
• Nepjol: Total number of research articles on
Arghakhanchi is 95 among them 3 are related to health
(Source: Nepjol, 26-02-2023)
• Pubmed: 9 peer-reviewed publications
2. Reports: Annual report of DoHS, Annual report of
Lumbini provinces, Provincial profile, District health
annual report
3. Newspaper: Kantipur, The Kathmandu Post,
Arghakhanchi.com
3/7/2023 4

5. The present health status of the Arghakhanchi
Municipality PHCCs HPs UHCs CHUs Total
Malarani RM 6 2 8
Panani RM 8 1 9
Chhatradev RM 1 6 7
Shandikharka Municipality 6 1 8
Sitganga Municipality 1 6 7
Bhumikasthan Municipality 7 1 8
Total 2 39 1 4 47
Primary Health Care Facilities
3/7/2023 5

6. Service Outlets Arghakhanchi Lumbini
Government Hospital 1 20
Primary Health Care 2 30
Center Health Post 39 570
Urban Health Center 1 97
Community Health Unit 15 66
PHC-ORCS 80 1942
Immunization Clinics 171 2704
FCHVS 845 8994
Private Health Facilities 7 192
Nutrition Rehabilitation Home 1 2 (Rup)
Birthing Center 18 363
Disaster Recovery Center 0 2 (Rup, Banke)
Disaster Recovery Sub Center 1 13
Gene-Xpert 0 10
ART Sites 1 14
Opioid Substitution Therapy Sites 0 2
Health facilities
3/7/2023 6

7. Disease status
Diseases Arghakhanchi Lumbini Nepal
Tuberculosis PBC_ CNR New 33.6 62 48.3
PBC_CNR_Relapse 2.5 5.8 4.4
CNR_TB 87.9 114.2 94.7
Total TB Cases 178 5872 28800
Dengue 2074/75 4 120 811
2075/76 5 96 3424
2076/77 50 1902 10808
2077/78 5 73 489
Total clients on ART 109 3911 20,883
COVID positive cases Male: 2323 Female: 999 Total: 3322
3/7/2023 7

8. Health insurance
Health insurance Arghakhanchi Nepal
Total No. of Insuree till
Aasad 2077
51386 32,26,964
Total Renew Insuree 33266 20,30,795
Total New Insuree 9523 13,43,569
Active Insuree 42789 33,74,364
Total Insured 60909 45,70,533
3/7/2023 8

9. Public health facilities
Public health facilities Non-public health
facilities
Total
health
faciliti
es
(publi
c +
non-
public
)
Outreac
h
Clinics
conduct
ed
Immuniza
tion
Clinics
conducted
FCHVs
report
submitt
ed
Organizati
on unit
Hospit
al
Prima
ry
health
center
Healt
h
post
Urba
n
healt
h
centr
e
Commu
nity
health
unit
Basic
healt
h
servi
ce
centr
e
Othe
r
healt
h
facili
ty
Total
publi
c
healt
h
facili
ty
Hospit
al
Other
priva
te
healt
h
facili
ty
Total
nonpub
lic
health
facility
Nepal 201 189 379
4
557 690 1136 113 668
0
470 1612 2082 8762 9227 16615 47235
Lumbini 30 28 569 102 103 168 20 102
0
58 110 168 1188 1515 2827 8831
Arghak
hanchi
1 2 39 1 4 9 56 1 9 10 66 65 161 813
3/7/2023 9

10. Immunization services, FY 2077/78
EPI Coverage (% of children under one year
Immunized)
% of children
12-23 month
BCG DPT-
Hep B-
Hib (3rd
dose)
OPV (3rd
dose)
PCV (3rd
dose)
IPV (3rd
dose)
MR MR JE
Nepal 90.7 87.3 81.6 80.2 81.6 82.3 80.9 84.4
Lumbini 94.4 92.9 91.6 87.8 91.6 88 94.2 94.2
Arghakha
nchi
66.8 75.2 75.1 71.7 76.5 71.6 87.8 83.4
3/7/2023 10

11. Vaccine wastage and drop out
Dropout Rate (%) Wastage Rate (%)
BCG vs
Measles/
Rubella1
DPT-
HepBHi
b
1 vs 3
DPT-
HepBHib1
vs
MR1
Measles/
rubella 1
vs 2
BCG DPTH
epB-
Hib
OPV PCV IPV Measle
s/
Rubella
JE TD
Nepal 9.3 0.95 6.7 5.5 78.8 22.2 23.2 14.3 26.8 48.3 46.5 36
Lumb
ini
6.8 -0.66 5.3 0.25 79.2 16.3 17.7 9.2 24.2 44.9 41 29.8
Argha
khanc
hi
-7.2 2.3 7.1 -1.2 88.6 26 26.6 12.7 35.9 64 59.4 45
3/7/2023 11

12. Neonatal and child health
% of
newborns
with low
birth
weight
(<2.5kg)
among
total
delivery
by HWs
% of
children
aged 0-11
months
registered
for growth
monitoring
ᵃ
% of
children
aged
12-23
months
registered
for
growth
monitoring
% of
children
aged 0-23
months
registered
for
growth
monitoring
Average
number
of visits
among
children
aged
0-11
months
registered
for
growth
monitoring
Average
number of
visits
among
children
aged 12-23
months
registered
for growth
monitoring
Average
number
of visits
among
children
aged 0-23
months
registered
for growth
monitoring
ᵃ
% of
children
0-11
months
registered
for
Growth
Monitoring
(New) who
were
Underweig
ht
% of
children
12-23
months
registered
for Growth
Monitoring
who
were
Underweig
ht
% of
children
aged 0-
23
months
registere
d for
Growth
Monitori
ng (New)
who
were
Underwe
ight
Nepal 11.2 84.2 60.8 72.7 3.3 3.2 3.3 2.5 3.4 2.9
Lumbini 12.1 89.6 63.3 76.9 3.7 3.6 3.6 2.6 3.1 2.8
Arghakh
anchi
5.8 90.4 86.5 88.7 4.1 3.1 3.7 1.4 0.7 1.1
3/7/2023 12

13. Safe Motherhood programme
% of at
least one
ANC
check up
% of four
ANC
check-ups
as
per
protocol
% of
women
who
received
a 180 day
of
Iron
% of
institutiona
l
deliveries
% of
births
attended
by
SBA
% of
births
attended
by a
health
worker
other than
SBA
% of
normal
deliveries
% of
assisted
(Vaccum
or
Forceps)
deliveries
% of
deliveries
by
caesarean
section
% of
PNC
check-
up
within
24
hours of
delivery
% of
women
who had
3 PNC
check-
ups as
per
protocol
Nepal 101 55.4 44.8 64.9 60.9 4.4 77.8 2.16 20 60 25.1
Lumbi
ni
97.8 60.7 54.9 79.7 77 2.7 79.8 3.25 17 77 29.2
Arghak
hanchi
85.9 64.9 57.4 88.2 87.3 0.94 78.4 2.26 19.4 83.3 29.8
3/7/2023 13

14. Abortion services
Abortion
Complicatio
n
Abortion
Number of
Women <
20 Years-
Medical
Abortion
Number of
Women <
20 Years-
Surgical
Abortion
Number of
Women ≥
20 Years-
Medical
Abortion
Number of
Women ≥
20 Years-
Surgical
Post
Abortion
Care
(PAC) This
facility-
Medical
Abortion
Post
Abortion
Complicatio
n
Medical
Abortion
Post
Abortion
Complicati
on
Surgical
Nepal 5525 4415 2509 52935 20093 11115 540 855
Lumbini 1275 845 482 10844 5326 2844 83 448
Arghakhan
chi
2 14 8 526 109 86 1 0
3/7/2023 14

15. Temperature (maximum
Season 1971 2023
Winter 0 1
PeM 0 1.51
Mon 0 2.24
PoM 0 1.77
The temperature change of
last 52 years in the
Arghakhanchi in centigrade
3/7/2023 15

16. District-wise
top five
hazards of
Province 5
3/7/2023 16

17. Good news
Medical oxygen production begins at
Arghakhanchi Hospital
• Capable of filling 70 large cylinders in 24 hours
In 2021, Arghakhanchi Hospital takes first place in
terms of minimum service standards in Lumbini
and third position among 32 hospitals across the
country
It completed a Comparison of the latest MSS Score
• District Hospital Taplejung, Koshi Provinces 89 % (no. 1)
• Lumbini Provincial Hospital, Lumbini provinces 48 %
• Arghakhanchi Hospital 74%
https://english.khabarhub.com/2021/20/171731/
3/7/2023 17

18. Good news
अर्घाखघाँची जिल्लघको सन्धिखक
ा
नगरपघजिकघ वघर्ा नम्बर १ बगाँचघमघ Food
Bank मघ "हुनेिे जिएर िघऔ नहुनेिे
जिएर िघऔ" (२०७७-५-१०)
िीर्ारोगी जबरघमीकघ िघजग जनिःशुल्क औषजि
जवतरण
3/7/2023 18

19. Problem identification and reasons
1. Lack of health workers in prisons, problems in treating prisoners
• The jail has a capacity of 40 prisoners, 15 women, and 25 men. However,
there are 72 inmates/prisoners assigned to the prison. There are eight
women and 64 men.
• The prison has 17 inmates/detainees with complex mental illnesses, three
taking depression medication, and 14 with minor mental illnesses.
Similarly, there are three senior citizens, two men, and one woman.
• There are 14 chronic patients. Three detainees are imprisoned due to a lack
of timely resolution of their court case.
Source: INSEC 2023
2. Major Cold Wave prone areas Arghakhanchi: Between 1990-2013,
there were 12 deaths (Source: Arghakhanchi District (MoHA, Des Inventar)
3/7/2023 19

20. Current health ….
3. Beneficiaries are in difficulties due to the lack of medicine
at the health post (INSEC, 2020)
4. Specialized medical care is absent and people who require
it have to be transported to the nearest cities of Butwal or
Bhairahawa, 4-5 hours away, if they are able to cover such
costly expenses
5. Only the Covid-19 hospital in Arghakhanchi does not
have an intensive care unit (May 16, 2021, The Kathmandu
Post)
6. Garbage at the entrance of Sandhikharka
7. Free Available medicine are not available
8. Non-communicable disease is increasing
9. Officially 103 Medicinal plants are available & unofficial
more than 7500 medicinal plants are available in Arghakhanchi
https://www.drove.com/campaign/5ec30638fe76810001a124ea
3/7/2023 20

21. Associated health problems
1. Leopard attacks on children increase in Arghakhanchi
2. Arghakhanchi man seeks financial assistance to treat abdominal ailment (Source: Nov 17, 2021, The
Himalayan)
3. Arghakhanchi’s population stood at 197,632 as per the 2011 census, but it declined to 172,000 by 2021.
This number increased by 62 percent to 1,602 between mid-April 2021 and mid-March 2022. Most of the
migration has occurred in Malarani Rural Municipality.
45,000 youths from the district working in countries such as India, Qatar, Malaysia, Saudi Arabia, and the
UAE.
4. A survey conducted by Sathi Saving and Credit Cooperatives and Arghakhanchi Saving and Credit
Cooperatives two years ago showed that 80 percent of the remittances received are being spent in
unproductive sectors.
3/7/2023 21

22. District (Arghakhanchi) Reports (Source: Nepal Monitor)
https://nepalmonitor.org/reports/district/arghakhanchi?page=2
3/7/2023 22

23. िघगू औषि जनयन्त्रण
सम्बिी कघयायोिनघ,
२०७५
• अद्यावधिक लागू औषि
धियन्त्रणका लाधग तयार भएको
लागू औषि धियन्त्रण सम्बन्धी
धिल्ला स्तरीय कायय योििा,
२०७५ लाई अद्यावधिक गरी चालू
आ.व. २०७६/०७७ को लाधग
लागू औषि धियन्त्रण
• सम्बन्धी धिल्ला स्तरीय कायय
योििा, २०७६ लागू भई कायय
योििा बमोधिमका धवधभन्न
काययक्रम सञ्चालि र धियन्त्रण
गररएको ।
3/7/2023 23

24. EXTERNAL DEVELOPMENT PARTNERS
• WHO: Immunization-preventable disease
• United Nations Children’s Fund (UNICEF):
Immunization and Immunization Supply Chain
(ISC) & MNCH program, Multi-sectoral Nutrition
Plan
• United Nations Population Fund (UNFPA):
Adolescent Sexual Reproductive Health (ASRH)
• Suaahara II- Good Nutrition Program
• Ipas Nepal: safe abortion
3/7/2023 24

25. क्र.
स
ऐन/जनयमघविी/जनिेजशकघ नघम िघरी जमजत कजियत
१ बधथिंङ सेन्टर स्थापिा तथा संचालि सम्बन्धन्धत
काययधवधि
२०७५
२ ल्याब सेवा संचालि सम्वन्धन्धत काययधवधि २०७५
३ एम्बुलेन्स सेवा संचालि काययधवधि २०७७
४ आकन्धिक प्रसुती िधिलता प्रेषण सम्बन्धस्ि
धिर्देधिका
२०७८
५ र्दीर्य रोगका धबरामीहरुलाई धििुल्क औषिी
धवतरण काययधवधि
२०७९
स्थघनीय तहको स्वघस्थ्य सम्बन्धि ऐन/जनयमघविी/जनिेजशकघ
तयघरी तथघ प्रकघशन

26. Program to develop: Short term
1. Increase the number of birthing centers.
2. Increase health insurance coverage
3. Decrease the dropout rate of vaccines (Follow up)
4. Decrease vaccine wastage of BCG (Maintain cold chain and
infrastructure)
5. Increase ANC check-up (Incentive)
6. Legalize locally produce marijuana for medicinal and research purpose.
7. Health Tourism (Supadeurali)
8. Plantation of ayurvedic medicine
9. Arghakhanchi Cement Industry constructs health post in Mainahiya of
Siyari Rural Municipality – 2 in Rupandehi district (May, 2021)
3/7/2023 26

27. Program to develop: Long term
1. Promote local resources and outlaw plastic bags
2. Consider the increased use of white chemicals (sugar, wheat flour,
salt, glucose, etc.)
3. Discourage abuse of alcohol, cigarettes, and other drugs by
regulatory, educational, and taxation measures.
4. Developing connections between Arghakhanchi-origin persons who
live elsewhere and preventing the exodus of health professionals
5. Create specialized healthcare facilities
6. Consider how local ecological harm and global warming are causing
climate change.
7. Work with CRS to create an endowment fund for persons in need.
8. Boost the existing health facilities' effectiveness and efficiency in
providing services.
9. Promotion of Medical garden on Panani and Supadeurali area
3/7/2023 27

28. Reading materials
1. Pandey A, Mahotra NB. A comparative study of menstrual hygiene issues between public and private school going
adolescent girls in Kathmandu Valley. JMMIHS [Internet]. 2019;5(1):14–6. Available from:
https://www.nepjol.info/index.php/JMMIHS/article/view/24067
2. Pandey A. Assessing health education techniques in enhancing the knowledge of HIV/AIDS among adolescents.
Kathmandu Nepal: Population Department, Tribhuwan University; 2014.
3. DOHS/MOHP. Annual Report [Internet]. DoHS. Kathmandu; 2021. Available from: https://sec.gov.gh/wp-
content/uploads/Annual-Reports/2019-Annual-Report.pdfFF
4. Dhakal A, Khanal S, Pandey M. Ethnoveterinary practice of medicinal plants in Chhatradev Rural Municipality,
Arghakhanchi District of Western Nepal. Nusant Biosci. 2021;13(1).
5. Khadka Mishra D, Bhusal R, Pokharel R, Sharma S. Depression Among the University Students in Arghakhanchi District.
Am J Appl Psychol. 2021;10(4):95.
6. Manandhar SR, Manandhar DS, Adhikari D, Shrestha J, Rai C, Rana H, et al. Analysis of Health Facility Based Perinatal
Verbal Autopsy of Electoral Constituency 2 of Arghakhanchi District, Nepal. J Nepal Health Res Counc. 2015;13(29):73–7.
7. USAID. Rapid assessment of district health systems 2013 Arghakhanchi. 2013.
8. Directorate H. Annual Health Report 2075/76. Butwal; 2019.
9. Bista B, Thapa P, Sapkota D, Singh SB, Pokharel PK. Psychosocial Problems among Adolescent Students: An Exploratory
Study in the Central Region of Nepal. Front Public Heal. 2016;4(August):1–7.
10. Manandhar SR, Manandhar DS, Adhikari D, Shrestha JR, Rai C, Rana H, et al. Analysis of Obstetric Near Miss Cases of
Different Health Facilities of Electoral Constituency Two of Arghakhanchi District. Nepal J Obstet Gynaecol. 2014;9(2):38–
41.
11. District Disaster Risk Management Plan (DDRMP) Arghakhanchi District, 2011. FAO Technical Assistance to the
Government of Nepal (TCP/NEP/3201 (D) and UNJP/NEP/OO5/UNJ)
3/7/2023 28

29. Source: Arghakhanchi.com
Thank you
Any queries
3/7/2023 29