This document discusses Nepal's progress towards achieving the health-related Millennium Development Goals. It provides an overview of Nepal's efforts to support the goals and current data on key health indicators related to reducing child mortality, improving maternal health, and combating diseases like HIV/AIDS, malaria, and tuberculosis. While Nepal has faced challenges from political instability, it has exceeded targets for reducing child mortality and is on track to meet most health goals. The document recommends continuing efforts to fully achieve all remaining targets and integrate health programs with local governance to support sustainable development.

1. ACHIEVEMENT AND PROGRESS
TOWARDS HEALTH RELATED
MDGS IN NEPAL
SAgun PAudel
Roll No. 22 (symbol No 11370028)
03/12/2014
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[HES 406.1 Health Seminar in Special Topics]

2. INTRODUCTION
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The United Nations Millennium Development Goals are
eight goals that all 191 UN member states have agreed to
try to achieve by the year 2015 signed in September 2000.
The MDGs have specific targets and indicators. The MDGs
are inter-dependent.1 World leaders have agreed to achieve
the MDGs by 2015.2 Numerical targets are set for each goal
and are monitored by 48 indicator.3

3. Millennium Development Goals
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1. Eradicate extreme poverty and hunger;
2. Achieve universal primary education;
3. Promote gender equality and empower women;
4. Reduce child mortality;
5. Improve maternal health;
6. Combat HIV/AIDS, malaria, and other diseases;
7. Ensure environmental sustainability; and
8. Develop a global partnership for development.

4. Goal 4: Reduce Child Mortality Rate
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Target 5:
Reduce by two thirds, between 1990 and 2015, the Under-five
mortality rate.
Indicator:
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 Under-five mortality rate
 Infant mortality rate
 Proportion of eye year children immunized against measles.

5. Goal 5: Improve Maternal Health
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Target 6:
 Reduce by three quarters, between 1990 and 2015, the
maternal mortality ratio.
Indicator:
 Maternal mortality ratio
 Proportion of births attended by skilled health personnel

6. Goal 6: Combat HIV/ AIDS, malaria,
and other diseases
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Target 7:
 Have halted by 2015 and begun to reverse the spread of
HIV / AIDS.
Indicator:
 HIV prevalence among pregnant women aged 15-24
years
 Condom use rate of contraceptive prevalence rate
 Condom use at last high- risk sex
 Percentage of population aged 15-24 years with
comprehensive correct knowledge of HIV / AIDS

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 Contraceptive prevalence rate
 Ratio of school attendance of orphans to school
attendance of non-orphans aged 10- 14 years
Target 8:
 Have halted by 2015 and began to reverse the incidence
of malaria and other major diseases.

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Indicator:
 Prevalence and death rates associated with malaria
 Proportion of population in malaria-risk areas using
effective malaria prevention and
 treatment measures
 Prevalence and death rate associated with tuberculosis
 Proportion of tuberculosis cases detected and cured under
DOTS.

9. OBJECTIVES
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General objective
 To Explore the Achievement and Progress of Health
Related MDGs in Nepal.
Specific objectives
 To know the effort of Nepal Government to achieve
Health Related MDGs.
 To find out the current situation of Health related
MDG indicators.
 To know the Global post-MDG agenda.

10. METHODOLOGY
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To prepare this Seminar paper Google was used to retrieve
the necessary documents. Google Scholar advanced Google
search, EndNote was used to retrieve the articles. The
articles, Publications and notes related to MDGs were
downloaded and studied. Various secondary data sources
Available on internet are used for preparation of this
seminar paper.

11. FINDINGS
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Nepal government effort in health related MDGs
Nepal is one of 189 countries committed to the MDGs, a
pledge it has renewed in its national development plans.
The primary medium‐term strategy and implementation
plan for reaching its MDGs, the Tenth Plan; Poverty
Reduction Strategy Paper; 2002/03–2006/07 incorporated
the MDGs into its strategic framework.

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The Three-Year Interim Plan 2006/07–2009/10
adopted after the Tenth Plan maintained the focus
on poverty reduction and growth but also stressed
the need for the state to assume a greater strategic
presence in development, especially in remote
areas, and for socially marginalized groups to be
included. The Three- Year Plan 2010/11–2013/14,
continued the call for strategic investment in areas
in need of greater focus if Nepal’s MDGs are to be
achieved.5

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UNDP and the other UN agencies in Nepal are actively
supporting the Government in fulfilling its commitment to
the MDGs.
The Local Governance and Community Development
Program, a large-scale joint program of UNDP, UNCDF,
UNICEF, UNFPA, UN Women and UNV on effective
service delivery at the local level has been in operation
since 2009 which will help create enabling environment at
local level in achieving MDGs.

14. Current situation of health related
MDGs
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Despite the political instability during the post-conflict
period, Nepal has already exceeded a few MDG targets for
2015, under-five mortality rate per 1,000 live births ;attained
50 against the target of 54, maternal mortality ratio (per
100,000 live births, and death rate associated with TB ;per
100,000 of population.6
Nepal is on track and is likely to achieve most of its MDG
targets, despite the prolonged political instability.

15. MDG 4: Reduce Child Mortality
Target: Reduce the under-five mortality rate by two-thirds
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between 1990 and 2015.
Indicator 1990 2000b 2005 2010 2013 Target
(2015)
Infant mortality rate (per 1,000
live births)
108a 64 48c 46 46
(2011)
36
Under-five mortality rate
(per 1,000 live births)
162a 91 61c 54 54
(2011)
54
Proportion of the one-year-old
children immunized against
measles (%)
42d 71 85e 88 88
(2011)
>90
a-Ministry of Health ,New Era, & Macro International Inc. (1996), b- MoHP, New Era, & Macro International Inc. (2001), c-
MoHP, New Era, & Macro International Inc. (2006), d- MoHP, New Era and ICF International (2011), e-NPC & UNCT (2005).

16. MDG 5: Improved maternal health
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Target 5A: Reduce maternal mortality by three-quarters
between 1990 and 2015.
Indicator 1990 2000 2005c 2010 2013 Target(2015)
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Maternal mortality ratio
(per 100,000 live births)
850a 415b 281d 229 170e 213
Proportion of births attended by
skilled birth attendant (%)
7f 11g 19h 36 50i 60
Sources
a- UNDP (1992), b- NPC (2002), c- MoHP, New Era, & Macro International Inc. (2006)., d- FHD (2009)., e-
WHO, UNICEF, UNFPA & The World Bank (2012), - NFHP (1995), g- MoHP, New Era & Macro
International Inc. (2001).. h- MoHP, New Era &, ICF International (2011), i- FHD (2013).

17. Target 5B:Achieve Universal access to
reproductive health by 2015.
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Indicator 1990 2000b 2005c 2010f 2013d Target (2015)
Contraceptive prevalence rate
(modern methods) (%)
24a 35.4 44.2 - 43.2 67
Adolescent birth rate (births per 1,000
women aged 15-19 years)
n/a 110 98e n/a 81 70
Antenatal care coverage
At least one visit (%) n/a 48.5 73.7 89.9 85g 100
At least four visits (%) n/a 14 29.4 50.2 50.1 80
Unmet need for family planning (%) n/a 26.5 24.6 - 27 15
Sources:
a- MoHP (1992) b- MoHP, New Era & Macro International Inc. (2001) c- MoHP, New Era, & Macro International Inc. (2006) d-
MoHP, New Era, & ICF International (2011) e- MoHP (2010) f- DoHS (2010) g- DoHS (2011)

18. Goal 6: Combat HIV/ AIDS, malaria,
and other diseases
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Indicator 1990 2000 2005a 2010 2013 Target (2015)
HIV prevalence among men and
women aged 15–24 years (%)
n/a n/a 0.15 n/a 0.12b Halt and reverse
the trend
Condom use at last high-risk sexual
encounter: youth 15–24 years
n/a n/a 71.2 Males
aged 15-49
years
n/a 65.8c -
Percentage of population aged 15–24
years with comprehensive knowledge
of HIV/AIDS
n/a n/a 35.6 n/a 29.8c -
Proportion of population with
advanced HIV infection receiving
antiretroviral combination therapy
(%)
n/a n/a n/a 21d 28.7e 80
Sources
a- NCASC (2006) b- NCASC (2011) c- MoHP, New Era & ICF International (2011) d- NCASC Fact Sheet (2009) e-
NCASC (2012)

19. TARGET 6C.
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Have halted and begun to reverse the incidence of malaria and other major diseases
by 2015.
Indicator 1990 2000 2005 2010b 2013 2015 target
Clinical malaria incidence (per 1,000
people)
n/a n/a 3.3a 5.67 3.23c Halt and reverse the
trend
Annual parasite incidence (per 1,000 people) n/a 0.55d 0.28a 0.11 0.08e 0.06
Death rate Associated with malaria (per
100,000 people at risk)
n/a n/a 0.05f 0.04 0.00e Halt and reverse the
trend
Percentage of children under five with fever
who are treated with appropriate anti-malarial
drugs
n/a n/a 3.23f 2.85 n/a 2.5
Percentage of children under five who sleep
under a long-lasting insecticide-treated bed
net
n/a n/a 48.2f 94.2g 96.8h 100
Sources:
a- DoHS (2007). b- DoHS, Epidemiology and Disease Control Division (EDCD) (2010). c- DoHS; 2011. d- DoHS; 2001. e- DoHS, Epidemiology and Disease Control
Division; 2012a. f- DoHS, Epidemiology and Disease Control Division; 2006. g- PSI TraC Study conducted in 13 high–risk districts; 2010. h- DoHS, Epidemiology and
Disease Control Division; 2012b.

20. Tuberculosis
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Indicator 1990a 2000 2005 2010 2013 2015 target
Prevalence rate associated with TB (per
100,000 people)
460 310b 280c 244d 238e Halt and
reverse the
trend
Death rate associated with TB (per
100,000 people)
43 23b 22c 22d 21e Halt and
reverse the
trend
Proportion of TB cases detected (%) n/a 70f 70g 76h 73i 85
Proportion of TB case cured under DOTS
(%)
40 89f 89g 90h 90i 91
Sources:
a- DoHS (2007).b - DoHS, Epidemiology and Disease Control Division (EDCD) (2010). c- DoHS (2011). d-DoHS (2001). e- DoHS, Epidemiology and
Disease Control Division (EDCD) (2012a). f- DoHS, Epidemiology and Disease Control Division (EDCD) (2005/06). g- PSI TraC Study conducted in
13 high–risk districts (2010). h- DoHS, Epidemiology and Disease Control Division (EDCD) (2012b).

21. Post MDG Health agenda of United
Nation
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There is wide debate as to what development goals the
global community should set next.
In January 2012, the UN System Task Team on the Post-
2015 UN Development Agenda was established.
The United Nations Development Group is leading efforts
to catalyze a “global conversation” on the post-2015 agenda
through a series of global thematic consultations and more
than 50 national consultations.

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The post-2015 development framework is likely to have the
best development impact if it emerges from an inclusive,
open and transparent process with multi-stakeholder
participation.7
Health priorities in the post-2015 era should include
accelerating progress on the present health MDGs,
advancing sexual and reproductive health and rights,
reducing NCDs and their risk factors, and improving mental
health.8

23. CONCLUSION
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Health is the central part of sustainable development. If we
achieve health related targets of MDGs we can develop our
nation progressively. MDGs are interrelated if we can work
better in health goals there is a positive progression on other
MDGs achievement.
Nepal has made significant progress in achieving its MDGs.
decade-long armed conflict, political instability, and
unfinished national political agenda regarding peace-building,
constitution writing and state-restructuring its
achievements should be considered remarkable.

24. RECOMMENDATIONS
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 Nepal has a good progress on achieving MDGs the effort
should be continue to achieve remaining targets of
MDGS.
 Those targets which are already achieved must be kept in
same manner and sustain it and the programs, efforts
shouldn’t discontinue.
 The resources for MDGs must be increases i.e. financial
resource, human resources and other resources.

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 Need to integrate health system to community and local
governance system in large scale to achieve sustainable
development.
 After MDGs continue the basic 8 goals with some
addition new goals of Post-2015 Global agenda.
 Create healthy environment for United Agencies for their
support, investment for development.

26. REFERENCES
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1. WHO, Millennium Development Goals
http://www.who.int/topics/millennium_development_goals/about/en/
2. United, N. thematic areas/ Millenium development goals.
http://www.un.org.np/thematicareas/mdg
3. Umesh, G. Millennium Development Goals in Nepal
http://umeshg.com.np/millennium-development-goals-in-nepal/
4. NRB (2006) Achieving Millennium Development Goals: Challenges for Nepal.
http://red.nrb.org.np/publications/special_publication/Special_Publications-
Achieving%20Millennium%20Development%20Goals-
%20Challenges%20for%20Nepal.pdf

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5. NPC, G. o. N. (2013) Nepal Millennium Development Goals Progress Report
2013.
http://www.np.undp.org/content/dam/nepal/docs/reports/millennium%20devel
opment%20goals/UNDP_NP_MDG_Report_2013.pdf
6. GON, N. (2010) MDGs progress report
http://www.npc.gov.np/new/uploadedFiles/allFiles/mdg_2011.pdf
7. United, N. (2011) Accelerating progress towards the Millennium
Development Goals: options for sustained and inclusive growth and issues for
advancing the United Nations development agenda beyond 2015, Annual
report of the Secretary http://daccess-dds-ny.
un.org/doc/UNDOC/GEN/N11/410/40/PDF/N1141040.pdf
8. Want, t. w. w. (2013) Health in the post-2015 Agenda, Report of the Global
Thematic Consultation on Health. the world we want,
http://www.worldwewant2015.org/bitcache/aa5345b4af0fae1615b108c3e392a
2ca781ce2ec?vid=366802&disposition=attachment&op=download

28. QUESTIONS COMMENTS?
#कुरो यि आँखाले आफ्ना गल्तीहरु वाहेक संसारका सवै कुराहरु देख्छन…
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