Nepal stands 2nd in South Asia in under-5 child survival rate

By Indira Aryal

Nepal has the second best record in U-5 child survival rate in South Asia and it stands fourth best among the 60 developing countries.

According to Child Survival Progress Report of Save the Children Nepal made tremendous progress in reducing child mortality in the last 10 years. The report found Bangladesh ranks third and India 10th, Pakistan 17th and Afghanistan 39th.

The ranking includes 60 developing countries, which together account for 94 percent of all child deaths worldwide. The rankings are part of the 8th Annual State of the World's Mothers Report, released by Save the Children US.

Dr. Nina Khadka, health team leader at Save the Children, said, "The progress made by Nepal in reducing child mortality has been highly appreciated around the world." She said the successful vaccination programme was crucial and women health volunteers played important role in making the programme successful. She also lauded the role of Child Health Division and Family Health Division of the Department of Health Services in reducing child mortality.
Another reason was the health services and the regular programmes carried by the health posts, sub-health posts and other health institutions were largely unaffected by the conflict, said Dr.

Khadka.
She said programmes for breast-feeding, iodine deficiency and anemia have succeeded, still we have to focus on protein-energy malnutrition, she added. The mortality of newborn babies that was 39 per 1000 live birth in 2001 has now come down to 34 in 2006. Still it is quite high needing focus, Dr. Khadka said. The Child and Family Health Division of the Department has formed a committee to reach to the local level and run package programme against child mortality.
Deputy Health Administrator at the Ministry of Health and Population Dr. Babu Ram Marasini said the reduction of infant mortality was mainly because of high coverage of administering of polio vaccination and Vitamin A along with deworming tablets to nearly 90 per cent of the total population.

However, the preliminary report of the Demographic Health Survey (DHS) initial report shows that the infant (U-5) mortality still high at 65 per 1000 live birth in 2006. It was reported at 79 in 2001. This improvement was because of decreased cases of diarrhea, pneumonia and other diseases.

There has also been marked improvement in the use of contraceptive. Dr. Marasini said that prevalence of modern contraceptive prevalence rate has risen to 44 per cent and the traditional method accounts for four per cent more. He said the total fertility rate had also decreased to 3.1 in 2006 from 4.1 in 2001.
He said the child mortality had rapidly decreased from 1990, adding that the mortality in 1991 was 112 that come down to 91 in 1996 and 79 in 2001. However, death rate is still high in remote parts like Kalikot and Mugu.

A statement issued by Save the Children Sweden Regional Office for South and Central Asia said that among the developing countries, Bangladesh and Nepal are making great strides in child survival despite limited financial resources. "These countries have invested in better health care for mothers, better nutrition for children, and lifesaving health care services to prevent and treat deadly diseases."
The report, however, adds that there still are a lot of problems that need to be resolved in countries of this region including Nepal. "Nearly half of all children U-5 are suffering from moderate or severe malnutrition in Bangladesh, India and Nepal," it said.
"Nearly 90 percent of births in Nepal are not attended by skilled personnel, placing both mother and newborn at greater risk of death," it added.

"The report also notes the three biggest killers of children under 5 years worldwide - newborn disorders, pneumonia and diarrhoea. By using existing interventions, we can save more than 6 million of the 10.1 million children who die every year from easily preventable or treatable causes such as vaccines, oral rehydration therapy (ORT) and insecticide-treated mosquito nets," the report said.