Annual Report 2067 68 Final PDF

A n nual
R e p o rt
Department of Health Services
206
2067/68 (2010/2011)
GOVERNMENT OF NEPAL
MINISTRY OF HEALTH AND POPULATION
DEPARTMENT OF HEALTH SERVICES

KATHMANDU

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ExecutiveSummary
TheAnnualReportofDepartmentofHealthServicesforthefiscalyear2067/68(2010/2011)isthe
17thconsecutivereportofitskind.Thisreportanalysestheperformanceofdifferentprogramsover
theprecedingthreefiscalyearsandalsopresentsproblems/constraints;actionstakenagainstthem
andsuggestedactionsforfurtherimprovement.
This report is mainly based on the information collected by the Health Management Information
System (HMIS) of DoHS from the health institutions across the country. The health institutions
reporting to HMIS in this fiscal year include 95 public hospitals; 209 Primary Health Care Centers
(PHCCs);676HealthPosts(HPs);and3,129SubHealthPosts(SHPs).Italsoincludesservicecoverage
of 12,790 Primary Health Care/Outreach Clinics (PHC/ORC); 16,579 EPI Clinics and 48,680 Female
CommunityHealthVolunteers(FCHVs).Atotalof445NGOand315privatehealthinstitutionshave
reportedtoHMIS.Thisimpliesthatall75districts;97.9percentofpublichospitals;99.5percentof
HPCCs;99.2percentofHPs;98.6percentofSHPs;86.4percentofPHCoutreachclinics;92.9percent
of EPI clinics; 89.8 percent of FCHVs; 65.2 percent of NGO hospitals; and 69.2 percent of private
hospitals have reported to HMIS in 2067/68 and overall 30.4 percent of the health facilities
maintained timely reporting to HMIS. Complete and regular reporting particularly from nonpublic
healthfacilitieshavealwaysbeenachallengetoHMIS.
CHILDHEALTH
IMMUNIZATION
The national immunization coverage of all antigens in the regular NIP program in 2067/68 has
improved compared to last fiscal years. However, the coverage is not uniform throughout the
country. Thirtyone districts (41%) have >90 percent coverage for all antigens. There has been 97
percent coverage for BCG, 95 percent for Polio3, 96 percent for DPTHep BHib 3, 88 percent for
Measlesand41percentforTT2topregnantwomen.BCGvsMeaslesdropoutrateincreasedfrom
8.6percentin2066/67to9.8percentin2067/68.ThevaccinewastagerateforDPTHepBHibis8.6
percentwhichishigherthantherecommendedwastagerateoffivepercent(singledosevial)and
forOPVitis23.4percentwhichishigherthantherecommendedwastagerateof15percent.
School Immunization programme has been continued. Two rounds of National Immunization
ProgramandIntensifiedNationalImmunisationDays(NIDs)havesubstantiallycontributedtowards
thegoalofeliminatingpolio.
NUTRITION
Thegrowthmonitoringserviceshavebeenextendedtochildrenlessthan5yearsofage.Therehas
been decrease in growth monitoring coverage by 7 percent from 46 percent in 2066/67 to 39
percent in 2067/68. The percent of under 5 years children among new growth monitored having
malnourishedstatushasdecreasedfrom3.8percentinlastyearto3.4percentthisyear.Tworounds
ofVitaminAcapsulesweredistributedtochildrenaged6to59months.Almosttwothirds(65%)of
thepregnantwomenreceivedAntihelmintictreatmentand73percentreceivedirontablets.
COMMUNITYBASEDINTEGRATEDMANAGEMENTOFCHILDHOODILLNESS(CBIMCI)ANDNEWBORNCARE
CBIMCI program has been implemented up to community level at all districts and it has shown
positiveresultsinmanagementofchildhoodillnesses.Therehasbeenasubstantialincrementinthe
total number of infants of under 2 months who were treated at health facilities compared to last
twoyears,anincrementfrom27,690in2065/66to33,751in2066/67andto48,669thisyear.There
has also been an increment in the number of cases treated for PSBI, LBI, Low weight and feeding
problems.
DoHS,AnnualReport2067/68(2010/2011)
Incidenceofdiarrhoeaper1,000underfiveyearschildrenhasdecreasedfrom598inFY2066/67to
500in2067/68.Howevercasesof'SevereDehydration'hasremainedconstantat0.4percentintwo
consecutiveyears.TreatmentofdiarrhoeabyZinc+ORShasincreasedfrom48percentin2066/67to
88percentin2067/68.
ARIcasesper1,000underfivepopulationhasdecreasedfrom882in2066/67to824in2067/68and
incidence of Pneumonia (Pneumonia + Severe Pneumonia) per 1,000 <5 children decreased from
255/1,000in2066/67to246/1,000in2067/68.Similarly,thepercentageofseverepneumoniahas
declinedfrom0.6in2065/66to0.5in2066/67and0.4in2067/68.Thedeclineofseverepneumonia
cases for three fiscal years is due to the early detection and proper management of ARI cases by
healthworkers,VHW/MCHWandFCHVsandincreasedaccesstothefreehealthservices.
The Government of Nepal, with the objective of reducing neonatal mortality, initiated Community
BasedNewbornCarePackage(CBNCP)in10districtsin2065/55andthiswasfurtherexpandedto
additional15districtsin2067/68.
FAMILYHEALTH
FAMILYPLANNING
Thecontraceptiveprevalencerate(CPR)formodernfamilyplanningmethodis44percentanditis
comparable with2011 NDHS(43%).Central developmentregionreported thehighestlevelofCPR
(51%) and western development region reported the lowest (32%). Given the CPR estimated from
theHMISandNDHS,achievingNHSPIIgoalof67percentby2015fromthecurrentleveldemands
innovativeapproachesandappropriatestrategies.However,therehasbeendeclineinTotalFertility
Rate(TFR)from3.1in2006to2.6in2011(NDHS2011)andisexpectedtomeettheNHSPIItargetof
2.5 by 2015. In FY 2067/68 the share of spacing method of the total CPR was 41 percent which is
lowerthantheestimationof2011NDHSdata(47%).
SAFEMOTHERHOOD
Service statistics of the fiscal year 2067/68 shows that 85 percent of the mothers received first
antenatalcareservicesandlessthanthreefifthsofthemmadefourvisitsindicatingthatmorethan
two fifths of the mothers did not complete the recommended four ANC visits. Skilled birth
attendance during delivery has increased from 31 percent in 2066/67 to 37 percent in 2067/68.
NDHS2011hasalsoshown36percentofdeliveriesattendedbySBA.Servicestatisticsofthefiscal
year2067/68showsthat37percentofthemothersdeliveredinhealthfacilities,thisisclosetothe
findings of NDHS 2011 (35%). There has been a slight increase in the percentage of mothers who
receivedpostnatalcareatthehealthfacilitycomparedtolastfiscalyear.
The SMNH long term plan (20062017) has a target of providing CEOC services in 60 districts; 80
percentofPHCCsprovidingBEOCservices;and70percentofHealthPostsprovidingdeliveryservices
by2017.In2067/68comprehensiveemergencyobstetriccareserviceswereprovidedfrom99public
and private hospitals in 43 districts. Out of 99 CEOC sites, 37 were public hospitals, 14 medical
collegesand48wereprivate/NGOhospitals.EOCmonitoringdatareceivedfrom44districtsinthe
year2067/68showsthataboutonefifthofthebirthstookplaceinB/CEOCfacilities.Atotalof192
providersincluding74nurseshavebeentrainedonsafeabortionservices(SAS)and95,306women
receivedsafeabortionservicesfrom487listedsites.
There has been a significant improvement in the number of facilities providing delivery service;
number of institutional delivery; and SBA during delivery after the launch of Aama Surakchhya
program. Almost nine in every ten (89%) of the mothers who delivered in health facility have
ii

receivedtransportationincentive.Therehasbeenasubstantialincreaseinthebudgetallocationfor
AamaSurakchhyaProgramandalsoincreaseinabsorptioncapacityoftheDoHSoverthelastcouple
ofyears.
FEMALECOMMUNITYHEALTHVOLUNTEERS
The major role of the Female Community Health Volunteers (FCHVs) is promotion of safe
motherhood,childhealth,familyplanning,andothercommunitybasedhealthservicestopromote
healthandhealthybehaviourofmothersandcommunitypeoplewithsupportfromhealthworkers
andhealthfacilities.Atpresentthereare48,680FCHVsactivelyworkingalloverthecountry.FCHVs
havecontributedindistributionof49percentoralpillsand50percentORSpacketsatthenational
level.FCHVsdistributedatotalof6,905,532packetsofcondomsintheFY2067/68.Servicestatistics
ofthisshowsthatmorethanonehalf(55%)ofthediarrhoeaandARIcasesweretreatedbyFCHVs.
FCHVs contributed significantly in the distribution of oral contraceptive Pills, Condoms and Oral
RehydrationSolution(ORS)packetsandcounsellingandreferringtomothersinthehealthfacilities
fortheserviceutilization.
PRIMARYHEALTHCAREOUTREACHCLINIC(PHC/ORC)
PrimaryHealthCareOutreachClinics(PHC/ORC)arebasicallytheextensionofbasichealthservices
at the community level. Eightysix percent of the targeted 153,480 PHC/ORC were conducted in
2067/68 and this was five percent more than the previous year. On an average 21 clients were
servedperclinicpermonthduring2067/68,comparedto20clientsin2066/67.
DISEASECONTROL
MALARIA
Atotalof160,868bloodsmearswerecollectedagainstthetargetof collecting150,000. However,

only 66.3 percent (106,598) of collected blood smears could be examined. The Annual Blood Slide
Examination Rate (ABER) decreased from 0.75 percent in 2065/66 to 0.66 percent in 2066/67 and
remainedsamein2067/68whereasAnnualParasiteIncidence(API)increasedfrom0.14per1,000
in2066/67to0.16in2067/68.ProportionofP.Falciparum(PF)decreasedbyaround5percent,from
20.5percentin2066/67to15.7in2067/68.Thedatahasrevealedthatimportedmalariacasesare
remarkably high in number indicating need of more attention for cross border monitoring and
surveillanceofmalaria.Likepreviousyears,tworoundsofIndoorResidualSprayingwerecarriedout
thisyearin15districtsthatprotected716,572people.
KALAAZAR
Kalaazarisamajorproblemin12districtsofeasternandcentralTerai.IncidenceofKalaazarhas
decreasedfrom1.71per10,000areasatriskpopulationin2065/66to1.33in2066/67andto0.94in
2067/68 (excluding foreign cases). Out of the 12 districts five districts have an incidence of more
than1,while7districtshaveanincidenceoflessthan1caseper10,000areasatriskpopulation.A
totalof806Kalaazarcaseswererecordedandofthem802(99.5%)improvedafterthetreatment
while4patients(0.5%)diedin2067/68.
LYMPHATICFILARIASIS(LF)
LymphaticFilariasisisapublichealthproblemandmaincauseofmorbidity,primarily,lymphoedema
of legs and hydrocele in many endemic areas of the rural and slum areas of the country. The
government had initiated implementation of Mass Drug Administration (MDA) in Parsa district in
2003.Sincethentheprogramhasexpandedgraduallyinotherendemicdistrictsaswell.MDAhas
iii

stoppedin5districts(Parsa,Makawanpur,Chitwan,Nawalparasi,Rupandehi)infiscalyear2067/68
aftercompletionof5roundsofMDA.
DENGUE
Dengueoutbreakin2006hadshownitsfacewith32confirmeddenguecasesfollowedby27casesin
2007,10casesin2008,30casesin2009and917casesin2010withmajoroutbreakinChitwanand
Rupandehi districts. In the fiscal year 2067/68 different districts showed dengue endemicity as
reportedinpreviousyears.
TUBERCULOSIS
TuberculosisisamajorpublichealthprobleminNepal.TreatmentbyDirectlyObservedTreatment
Short course (DOTS) have been implemented in all 75 district of the country and TB patients are
beingtreatedwithDOTSat1,118treatmentcentersand3,103subcenters.TheTreatmentSuccess
Rate(TSR)standsat90percentandCaseFindingRate(CFR)at73percent.
LEPROSY
Leprosyisindecliningphase,however,thisdeclineisnotenoughtoreachthegoalofelimination.
Thenewcasedetectionratehasdeclinedfrom1.99/10,000populationin2065/66to1.15/10,000in
2066/67 and to 1.12/10,000 population in 2067/68. A total of 3,142 new leprosy cases were
detectedand5,362casesreceivedtreatmentwithMDTand2,979casescompletedtreatmentand
weremadeRFT.AmongtheregisteredMBcases2,174(94.4%)and2,286(96.9%)PBhascompleted
treatmentwithinthegiventimeframe.
HIV/AIDSANDSTI
HIVinNepalischaracterizedasconcentratedepidemic,wheremajorityofinfectionsaretransmitted
through sexual transmission. Prevention of HIV among key population is the key programmatic
strategies,whileprovidingqualitytreatment,care andsupport forinfected andaffected isequally
importantstrategicdirectionstoachievetheendresultsofnationalresponse.Sincethedetectionof
the first AIDS case in 1988, the HIV epidemic in Nepal has evolved from a low prevalence to
concentrated epidemic. As of 2011, national estimates indicate that approximately 55,600 adults
and children are infected with the HIV virus in Nepal. A total of 18,396 cases of HIV out of them
7,437advancedHIVinfectioncaseshadbeenreportedasofAsar2068.Theestimatedprevalenceof
HIVintheadultpopulationis0.33percent.
SUPPORTINGPROGRAMS
HEALTHTRAINING
National Health Training Centre has a network of 5 Regional Health Training Centres, one Sub
RegionalHealthTrainingCentre,districtleveltrainingfacilitiesin30districtsand14TrainingHealth
Posts in appropriate district sites. A team of 57 district training team provide training to the
concerned health workers. Clinical competency based training are provided through 19 clinical
training sites attached to regional and zonal hospitals. Various EDPs are providing collaborative
support to National Health Training Centre in planning and execution of training programs. NHTC
have able to meet 90 percent of the targeted SBA training in 2067/68 and this has contributed in
filling the gap of required number of SBA service providers in the country. NHTC also conducted
basic, inservice, refresher, upgrading training along with clinical, nonclinical and other
managementtraining.
HEALTHEDUCATION,INFORMATIONANDCOMMUNICATION
Health Education, Information and Communication Centre (NHEICC) is responsible for developing,
producinganddisseminatingmessagestopromoteandsupporthealthprogramsandservicesinan
iv

integrated manner. The health education and communication units in the district Health Offices
implement IEC activities utilizing various media and methods according to the needs of the local
peopleinthedistrict.Localmediaandlanguagesareusedinthedistrictfordisseminationofhealth
messages.
The main activities include health education programmes in the schools and community; print
materialsproductionanddistribution;productionanddisseminationofregular,weeklyandperiodic
radio,televisionandFMradioprograms;publicationanddisseminationofhealthmessagesthrough
newspapers, social mobilisation, advocacy, workshop/seminar, folk events, observation on special
daysandexhibitions.
LOGISTICSMANAGEMENT
ThemajorfunctionofLogisticManagementDivision(LMD)istoprocure,storeanddistributehealth
commodities for the government health facilities. It also involves repair and maintenance of bio
medicalequipments,instrumentsandthetransportationvehicles.LMDhasbeenimplementingand
monitoring Pull System for contraceptives, vaccines and essential drugs in the districts. Rural
TelemedicineProgramhasbeenimplementedin25hillandmountaindistricts.
HEALTHLABORATORYSERVICES
National Public Health Laboratory (NPHL) is a nodal institute for developing policy, guidelines and
overall framework for capacity building in laboratory sector. Attention has been given in
strengthening laboratory procedure and communication between national, regional and district
levelsandinstrengtheningthesystemensuringtheavailabilityofessentialequipment,logisticsand
human resources. At present there are eight central hospital based laboratories, three regional
hospital based laboratories, two sub regional hospital based laboratories, 11 zonal hospital based
laboratories,66districthospitalbasedlaboratories,and204PHCCbasedlaboratoriesinthecountry.
In the private sector there are above 1,300 laboratories. NPHL is also conducting the laboratory
surveillanceactivitiesonvariousdiseasepathogenssuchasMeasles/Rubellasurveillance,Japanese
encephalitissurveillance,InfluenzasurveillanceandAntimicrobialresistancesurveillance.
PRIMARYHEALTHCAREREVITALIZATION
Primary Health Care Revitalization Division (PHCRD) works towards reducing poverty by providing
equal opportunity for all to receive quality and affordable health care services. This division is
envisagedtorevitalizePHCinNepalbyaddressingemerginghealthchallengesinclosecollaboration
withotherDoHSdivisionsandrelevantactors.In2067/68monitoringcommitteesweredeveloped
at all levels of health system; citizen charter were displayed in most of health facilities on EHCSs;
trainings were conducted on rational drug prescription in 75 districts; integrated public health
campaignswereorganizedin8districtsandPeersGroupdiscussionwereconductedforrationaluse
of drugs in 22 districts. PHCRD also provided transportation cost for marginalized community and
seniorcitizen.CommunityHealthInsurancepilotingactivitiesiscontinuedin8PHCCs.
PERSONNELADMINISTRATIVEMANAGEMENT
The administrative section under the Department of Health Services (DoHS) manages to distribute
the health work force to deliver health services in the country. Altogether 27,300 employees are
recordedunderMoHPofwhich21,000aretechnicaland6,300personsareadministrative.Under
thetransferpolicyDoHSmanagestransferandpostingofstaffupto7thlevel.Thereisastrongneed
ofimprovingpersonnelrecordkeepinganddefiningemployeesrolesandresponsibilities.
FINANCIALMANAGEMENT
Out of total national budget of Rs. 297,818,882,000 a sum of Rs. 23,813,993,000 (8.0%) was
allocated for the health sector in 2067/68 (2010/2011). Of the total health sector budget, Rs.

15,035,390,000 (63.1%) was allocated for execution of programs under the Department of Health
Services.OfthisRs.13,635,303,000(90.7%)wasallocatedtorecurrentandRs.1,400,087,000(9.3%)
wasallocatedtocapitalbudget.TheEDPscontributioncomprised48.4percentofthetotalbudget
underDoHS.
PLANNING,MONITORING,SUPERVISIONANDINFORMATIONMANAGEMENT
As in the previous years Management Information System (MIS) Section continued providing
trimesterreportingtoallDivisions,Centres,RegionalDirectoratesandDistrictHealth/PublicHealth
Offices. Annual Performance Review workshops were conducted at district, regional and national
levels. Management Division also conducted several training activities on oral health, nursing
leadership and management, quality assurance to improve skills of heath workers. Some health
facilities were upgraded to higher level. It continued implementation of Health Sector Information
System(HSIS)inthreedistricts:Llitpur,ParsaandRupandehi.
OtherPrograms
DRUGADMINISTRATION
AsinthepreviousyearstheDepartmentofDrugAdministrationconductedanumberofactivitiesto
raiseawarenessontherationaleuseofmedicinesthroughdifferentmedia;auditeddrugindustries
for good manufacturing practices; checked quality of marketed drugs; and drafted good
manufacturingpracticeregulationandrevisednationalmedicinepolicyandnationallistofessential
medicines.
AYURVEDA
A total of 784,822 people received health care services from Aurveda health facilities in 2067/68.
Thehighestnumberofpeoplewereservedinwesternregion(219,195)whereastheleastnumber
ofpeoplewereservedinfarwesternregion(87,048).
vi
HealthServiceCoverageFactSheet
FiscalYear2065/662067/68(2008/092010/11)
INDICATORS
REPORTINGSTATUS(%)
PublicHospitals
PrimaryHealthCareCentres
HealthPosts
SubHealthPosts
PHCORCclinics
EPIclinics
FemaleCommunityHealthVolunteers
NGOandPrivateHealthInstitutions
IMMUNIZATIONCOVERAGE
BCG
DPTHepBHib3
Polio3
Measles
PregnantwomenreceivingTT2
NUTRITION
%ofpregnantwomenreceivingIrontablets
%ofpostpartumMotherreceivingVitaminA
ACUTERESPIRATORYINFECTION(ARI)
ReportedIncidenceofARI/1,000<5Yrs.ChildrenNewVisits
AnnualReportedIncidenceofPneumonia
(Mild+Severe)/1,000among<5Yrs.ChildrenNewVisits
ProportionofSeverePneumoniaamongNewCases
CaseFatalityRate/1,000<5Yrs.Children
DIARRHOEALDISEASES
IncidenceofDiarrhoea/1,000<5Yrs.ChildrenNewCases
%ofSevereDehydrationamongTotalNewCases
CaseFatalityRate/1,000<5Yrs.Children
SAFEMOTHERHOOD
Antenatalfirstvisitsas%ofexpectedpregnancies
DeliveryconductedbySBAathealthfacilityas%ofexpected
pregnancy
SBAdeliveryas%ofexpectedlivebirth
Institutionaldeliveryas%ofexpectedlivebirth
DeliveryconductedbySBAathomeas%ofexpectedpregnancy
DeliveryconductedbyotherthanSBAathealthfacilityas%of
expectedpregnancy
DeliveryconductedbyotherthanSBAathomeas%ofexpected
pregnancy
TotaldeliveriesconductedbySBA&otherthanSBAathealth
facilities&homeas%ofexpectedpregnancies
PNCfirstvisitas%ofexpectedpregnancies
FAMILYPLANNING
ContraceptivePrevalenceRate(ModernMethod)*
CPRMethodMixCondom
CPRMethodMixPills
CPRMethodMixDepo
CPRMethodMixIUCD
CPRMethodMixImplant
CPRMethodMixSterilization
2065/66
2066/67
2067/68
(2008/2009) (2009/2010) (2010/2011)
79
83
98
97
93
99
97
95
99
96
93
99
80
81
86
90
87
93
86
85
90
67
65
67
85
94
97
81
82
96
81
83
95
75
86
88
35
43
41
73
92
73
46
59
55
765
882
824
237
0.59
0.08
67
255
0.48
0.01
598
0.38
0.00
87
15.86
26.17
30.84
21
32
36
19
3.08
31
3.22
37
1.78
1.37
2.28
2.36
11.27
9.61
7.69
31.58
41.28
42.67
37.42
49.72
43.47
2.94
3.23
8.57
1.44
1.51
25.77
50.54
488
0.58
0.08
40.53
3.00
2.61
8.41
1.02
1.16
25.39
246
0.40
0.01
500
0.37
0.00
85
43.73
3.07
3.01
8.18
1.75
1.82
25.90
vii

INDICATORS
MALARIA/KALAAZAR
AnnualBloodSlideExaminationRate(ABER)per100
AnnualParasiteIncidence(API)per1,000
ProportionP.falciparum(PF%)
ClinicalMalariaIncidence(CMI)/1000
IncidenceofKalaazar/10,000RiskPopulation
TUBERCULOSIS
TreatmentSuccessRateonDOTS
SputumConversionRate
LEPROSY
NewCaseDetectionRate(NCDR)/10,000
PrevalenceRate(PR)/10,000
DisabilityrateGrade2amongnewcases
HIV/AIDSANDSTI
EstimatedHIVcases
CumulativeHIVreportedcases
CURATIVESERVICES
TotalOPDnewvisits
TotalOPDnewvisitsas%oftotalpopulation
2065/66
2066/67
2067/68
(2008/2009) (2009/2010) (2010/2011)
0.75
0.68
0.66
0.18
0.15
0.16
22.18
20.48
15.71
5.72
5.41
4.10
1.33
0.95
0.75
89
90
90
89
89
89
1.66
1.15
1.12
1.09
0.77
0.79
3.90
2.72
3.50
70,000
70,000
56,000
14,787
16,138
18,396
18,947,923
20,894,118 19,708,800
69.19
75.98
70.39
Note=*Unadjusted
Source:NTC,LCD,NCASC,EDCDandHMIS/DoHS
viii
TableofContents
ExecutiveSummary..................................................................................................................................i
TableofContents...................................................................................................................................ix
Acronyms...............................................................................................................................................xi
INTRODUCTION.......................................................................................................................................1
1.1 BACKGROUND...........................................................................................................................1
1.2 DEPARTMENTOFHEALTHSERVICES(DoHS)..................................................................................2
1.3 SOURCESOFINFORMATION.........................................................................................................5
1.4 STRUCTUREOFTHEREPORT........................................................................................................7
CHILDHEALTH.........................................................................................................................................9
2.1 IMMUNIZATION.........................................................................................................................9
2.2 NUTRITION.............................................................................................................................22
2.3 COMMUNITYBASEDINTEGRATEDMANAGEMENTOFCHILDHOODILLNESSES(CBIMCI)AND
NEWBORNCARE......................................................................................................................35
FAMILYHEALTH.....................................................................................................................................50
3.1 FAMILYPLANNING...................................................................................................................50
3.2 SAFEMOTHERHOODANDNEWBORNHEALTH..............................................................................61
3.3 FCHVPROGRAM.....................................................................................................................75
3.4 PRIMARYHEALTHCAREOUTREACH............................................................................................79
3.5 DEMOGRAPHYANDREPRODUCTIVEHEALTHRESEARCH.................................................................82
3.6 ADOLESCENTSEXUALANDREPRODUCTIVEHEALTH.......................................................................86
DISEASECONTROL................................................................................................................................90
4.1 MALARIA...............................................................................................................................90
4.2 KALAAZAR.............................................................................................................................97
4.3 LYMPHATICFILARIASIS............................................................................................................102
4.4 DENGUE...............................................................................................................................105
4.5 TUBERCULOSIS......................................................................................................................108
4.6 LEPROSY...............................................................................................................................121
4.7 HIV/AIDSANDSTI.................................................................................................................132
CURATIVESERVICES............................................................................................................................143
5.1 BACKGROUND.......................................................................................................................143
5.2 ANALYSISOFACHIEVEMENTS....................................................................................................144
SUPPORTINGPROGRAMS...................................................................................................................153
6.1 HEALTHTRAINING.................................................................................................................153
6.2 HEALTHEDUCATION,INFORMATIONANDCOMMUNICATION........................................................162
6.3 LOGISTICSMANAGEMENT.......................................................................................................166
6.4 PUBLICHEALTHLABORATORYSERVICES.....................................................................................177
6.5 PERSONNELADMINISTRATIONMANAGEMENT...........................................................................184
6.6 FINANCIALMANAGEMENT......................................................................................................187
6.7 MANAGEMENT.....................................................................................................................194
6.8 PRIMARYHEALTHCAREREVITALIZATION...................................................................................199
ix

OTHERPROGRAMS.............................................................................................................................203
7.1 DRUGADMINISTRATION.........................................................................................................203
7.2 AYURVEDA...........................................................................................................................207
DEVELOPMENTPARTNERS................................................................................................................212
8.1 MULTILATERALORGANIZATIONS..............................................................................................213
8.2 BILATERALORGANIZATIONS....................................................................................................214
8.3 INTERNATIONALNONGOVERNMENTORGANIZATIONS(INGOs)...................................................215
8.4 NONGOVERNMENTALORGANIZATIONS....................................................................................221
REFERENCES........................................................................................................................................222
ANNEXES
ANNEX1: ACTIVITIESCARRIEDOUTINFY2067/68...........................................................................224
ANNEX2: HEALTHINDICATORS.........................................................................................................236
ANNEX3: HEALTHSERVICES..............................................................................................................243
Acronyms
AAIN
ABSA
ACDP
ACSM
ACT
ADT
AEFI
AF
AFP
AFR
AFS
AHW
AIDS
AMR
AMTSL
ARI
ARS
ART
ASRH
BCC
BCG
BEOC
BMET
BMI
BNMT
BPCR
CAC
CBIMCI
CBLP
CBNCP
CDR
CEOC
CLT
CMAM
CPR
CTS
D/PHO
DACC
DBN
DDA
DDC
DF
DFID
DG
DHF
DHIB
DHMC
DHO
ActionAidInternationalNepal
AmericanBioSafetyAssociation
AnnualCommodityDistributionProgram
Advocacy,CommunicationandSocialMobilization
ArtemisininbasedCombinationTherapy
ARVDispensingTool
AdverseEventFollowingImmunization
AdolescentFriendly
AcuteFlaccidParalysis
AdolescentFertilityRate
AdolescentFriendlyService
AuxiliaryHealthWorker
AcquiredImmunodeficiencySyndrome
AntiMicrobialResistant
ActiveManagementofThirdStageofLabor
AcuteRespiratoryInfection
AayurvedaReportingSystem
AntiRetroviralTherapy
AdolescentSexualReproductiveHealth
BbehaviourChangeCommunication
BacilleCalmetteGuerin
BasicEmergencyObstetricCare
BiomedicalEquipmentTechnician
BodyMassIndex
BritainNepalMedicalTrust
BirthPreparednessandComplicationReadiness
ComprehensiveAbortionCare
CommunityBasedIntegratedManagementofChildhoodIllness
CentralBiddingLocalPayment
CommunityBasedNewbornCarePackage
CentralDevelopmentRegion
ComprehensiveEmergencyObstetricCare
ComprehensiveLeprosyTraining
CommunityManagementofAcuteMalnutrition
ContraceptivePrevalenceRate
ClinicalTrainingSkills
District/PublicHealthOffice
DistrictAIDSCoordinationCommittee
DrugBulletinofNepal
DepartmentofDrugAdministration
DistrictDevelopmentCommittee
DengueFever
DepartmentforInternationalDevelopment
DirectorGeneral
DengueHemorrhagicFever
DistrictHealthInformationBank
DistrictHealthManagementCommittee
DistrictHealthOffice
xi

DIN
DoA
DoHS
DOTS
DPHO
DSS
DST
DTLO
DUDBC
EAP
EDAT
EDCD
EDP
EDR
EHCS
EPI
EQA
EWARS
FCHV
FELM
FHD
FMIS
FPAH
FWDR
FY
GBV
GFATM
GIZ
GMP
GoN
HCT
HFMS
HFOMCM
HIIS
HIV
HMIS
HP
HPAI
HSIS
HuRDIS
HuRIS
ICC
IDD
IEC
IFPSC
IMCI
IMNMP
IPD
IRS
ISTC
IUCD
DrugInformationNetwork
DepartmentofAyurved
DepartmentofHealthServices
DirectlyObservedTreatmentShortCourse
DistrictPublicHealthOffice
DengueShockSyndrome
DrugSusceptibilityTesting
DistrictTB&LeprosyOfficer
DepartmentofUrbanDevelopmentandBuildingConstruction
EquityandAccessProgram
EarlyDiagnosisandAppropriateTreatment
EpidemiologyandDiseaseControlDivision
ExternalDevelopmentPartners
EasternDevelopmentRegion
EssentialHealthCareServices
ExpandedProgramonImmunization
ExternalQualityAssurance
EarlyWarningReportingSystem
FemaleCommunityHealthVolunteer
FinnishEvangelicalLutheranMission
FamilyHealthDivision
FinancialManagementInformationSystem
FamilyPlanningAssociationofNepal
FarwesternDevelopmentRegion
FiscalYear
GenderBasedViolence
GlobalFundagainstAIDS,TBandMalaria
GesellschaftfrInternationaleZusammenarbeit
GoodManufacturingPractices
GovernmentofNepal
HIVCounsellingandTesting
HealthFacilityMappingSurvey
HealthFacilityOperationManagementCommitteeMembers
HealthInfrastructureInformationSystem
HumanImmunodeficiencyVirus
HealthManagementInformationSystem
HealthPosts
HighlyPathogenicAvainInfluenza
HealthSectorInformationSystem
HumanResourceDevelopmentInformationSystem
HumanResourceInformationSystem
InteragencyCoordinationCommittee
IodineDeficiencyDisorder
Information,EducationandCommunication
InstitutionalizedFamilyPlanningServiceCentre
IntegratedManagementofChildhoodIllness
IntensificationofMaternalandNeonatalMicronutrientProgram
ImmunizationPreventableDiseases
IndoorResidualSpraying
internationalstandardofTBcare
IntrauterineContraceptiveDevice
xii

IYCF
JICA
LBI
LEC
LF
LIS
LLIN
LMD
LMIS
LQAS
MA
MARP
MC
MCHC
MCHW
MD
MDA
MDM
MDT
MDVP
MGH
MI
MIS
MISP
MIYC
MNH
MNP
MO
MoAC
MoF
MoHP
MSI
MSM
MSPAN
MWDR
MWRA
NAC
NACC
NAGA
NAMS
NASRH
NAWB
NCASC
NCD
NCIP
NDHS
NDVS
NEQAS
NFHC
NGO
NHEICC
InfantandYoungChildFeeding
JapanInternationalCooperationAgency
LocalBacterialInfection
LeprosyEliminationCampaign
LymphaticFilariasis
LaboratoryInformationSystem
LonglastingInsecticideTreatedbedNet
LogisticsManagementDivision
LogisticsManagementInformationSystem
LotQualityAssuranceSampling
MedicalAbortion
MoreAtRiskPopulation
MicroscopyCentre
MotherandChildHealthCare
MaternalandChildHealthWorker
ManagementDivision
MassDrugAdministration
MedecinsDuMondee
MultiDrugTherapy
MultiDoseVialPolicy
Mothers'GroupforHealth
MicronutrientInitiative
ManagementInformationSystems
MinimumInitialServicesPackage
MaternalInfantandYoungChild
MaternalandNeonatalHealth
MicronutrientPowder
MedicalOfficers
MinistryofAgricultureandCooperatives
MinistryofFinance
MinistryofHealthandPopulation
MarieStopesInternational
MenhavingSexwithMen
MultiSectorPlanofActiononNutrition
MidwesternDevelopmentRegion
MarriedWomenofReproductiveAge
NationalAIDSCouncil
NationalAIDSCoordinatingCommittee
NepalNutritionAssessmentandGapAnalysis
NationalAcademyofMedicalSciences
NationalAdolescentSexualandReproductiveHealthProgram
NepalAssociationfortheWelfareoftheBlind
NationalCentreforAIDSandSTDControl
NonCommunicableDiseases
NationalCommitteeforImmunizationPractices
NepalDemographicandHealthSurvey
NepalDevelopmentVolunteersServices
NationalExternalQualityAssuranceScheme
NationalFreeHealthCare
NonGovernmentOrganization
NationalHealthEducation,InformationandCommunicationCentre
xiii

NHP
NHSP
NHTC
NHTCC
NHTS
NIC
NID
NIP
NISN
NLR
NML
NNSC
NPC
NPHL
NQC
NRCS
NSI
NTAG
NTAGM
NTC
NYF
ORS
ORT
OT
OTP
PAL
PEM
PEP
PHC
PHC/ORC
PHCC
PHCRD
PHO
PLAMAHS
PLHA
PME
PMTCT
PPH
PPM
PR
PSI
RBM
RH
RHCC
RHD
RHDP
RHTC
RQCC
RTAGM
RTLO
SAM
NationalHealthPolicy
NepalHealthSectorProgram
NationalHealthTrainingCentre
NationalHealthTrainingCoordinationCommittee
NationalHealthTrainingStrategy
NationalInfluenzaCentre
NationalImmunizationDay
NationalImmunizationProgram
NationalInfluenzaSurveillanceNetwork
NetherlandsLeprosyRelief
NationalMedicinesLaboratory
NationalNutritionSteeringCommittee
NationalPlanningCommission
NationalPublicHealthLaboratory
NationalQualityControlCentre
NepalRedCrossSociety
NickSimonsInstitute
NepaliTechnicalAssistanceGroup
NationalTechnicalAdvisoryGroupforMalaria
NationalTuberculosisCentre
NepalYouthFoundation
OsmolarOralRehydrationSolutions
OralRehydrationTherapy
OperationTheatre
OutpatientTherapeuticProgram
PracticalApproachtoLung
ProteinEnergyMalnutrition
PostExposureProphylaxix
PrimaryHealthCare
PrimaryHealthCareOutreachClinics
PrimaryHealthCareCentre
PrimaryHealthCareRevitalization
PublicHealthOfficer
PlanningandManagementofAssetsinHealthCareSystem
PeopleLivingwithHIV/AIDS
Planning,Monitoring,andEvaluation
PreventionofMothertoChildTransmission
PostpartumHaemorrhage
PublicPrivateMix
PrevalenceRate
PopulationServicesInternational
RollBackMalaria
ReproductiveHealth
ReproductiveHealthCoordinationCommittee
RegionalHealthDirectorate
Cooperation/RuralHealthDevelopmentProject
RegionalHealthTrainingCentre
RegionalQualityControlCentre
RegionalTechnicalAdvisoryGrouponMalaria
RegionalTuberculosisandLeprosyOfficer
ServiceAvailabilityMapping
xiv

SAS
SBA
SDC
SEARO
SHN
SHP
SLTHP
SO
SOP
SPN
SR
SWA
TB
TFR
TIMS
ToT
TT
TTI
TWG
UMN
UNFPA
UNICEF
UP
USAID
VAD
VBD
VBDRTC
VCT
VDC
VHW
VPD
VSC
WAN
WDR
WHO
SafeAbortionServices
SkilledBirthAttendants
SwissAgencyforDevelopment
SouthEastAsiaRegionalOffice
SchoolHealthandNutrition
SubHealthPosts
SecondLongTermHealthPlan
StandardOperating
StandardOperatingProcedures
SunauloParivarNepal
SubRecipients
SectorWideApproach
Tuberculosis
TotalFertilityRate
TrainingInformationManagementSystem
TrainingofTrainers
TetanusToxoid
TransfussionTransmissibleInfection
TechnicalWorkingGroup
UnitedMissiontoNepal
UnitedNationsPopulationFund
UnitedNationsChildren'sFund
UterineProlapse
UnitedStatesAgencyforInternationalDevelopment
VitaminADeficiency
VectorBorneDiseases
VectorBorneDiseaseResearchandTrainingCentre
VoluntaryCounsellingandTest
VillageDevelopmentCommittee
VillageHealthWorker
VaccinePreventableDisease
VoluntarySurgicalContraception
WaterAidinNepal
WesternDevelopmentRegion
WorldHealthOrganization
xv
Chapter1
1.1
INTRODUCTION
BACKGROUND
TheAnnualReportofDepartmentofHealthServicesforthefiscalyear2067/68(2010/2011)isthe
17th consecutive report of its kind. This report analyses the performance and achievements of
DepartmentofHealthServices(DoHS)inthefiscalyear2067/68(2010/11).Itmainlydealswiththe
program specific policies, goal, objectives, strategies, major activities and achievement. It also
presents the problems/issues/constraints raised by different wings of DoHS and stakeholders and
recommendationforactionstobetakeninordertoimproveperformanceandtargetsforthenext
fiscalyear.
Inaddition,thisreportalsoprovidesinformationoncontributionsfromotherdepartments,partners
and stakeholders, contemporary issues in the health sector as well as progress status of major
programsimplementedthroughDoHS,RHDs,D/PHOsandhealthinstitutionsunderDoHS.
PreparationofthisreportfollowedtheRegionalAnnualPerformanceReviewMeetingsconductedin
allfivedevelopmentregionswhichculminatedintheNationalAnnualPerformanceReviewMeeting.
These review meetings were attended by the Regional Directorates, Divisions of DoHS, Centres,
Centralhospitals,andrepresentativesfromExternalDevelopmentPartnersandNGOs/INGOsateach
level.
Duringtheworkshop,policystatementsofeachprogramwerereviewedinthelightofthepresent
contextandanalysedtoanextent.ThedatageneratedfromtheHMISintheformofrawnumbers,
werecarefullyandcriticallyanalysedutilisingtheselectedindicatorsalongwithdataavailablefrom
othersources.Thesedatawereinterpretedduringthepresentationsanddiscussions.
TheNationalAnnualPerformanceReviewMeetingachievedthefollowingobjectives:
Reviewed the status of achievement against target set for the FY 2067/68 (2010/2011) by
Divisions/Centres/SectionsofDoHSwithrespecttoreleasedbudgetandexpenditure.
ComparedtrendofservicecoverageoftheFY2067/68withprevioustwosuccessivefiscalyears
andanalyzethefact.
Reviewed the status of implementation of recommendation made by the previous National
AnnualPerformanceReviewMeting.
Identified management issues/problems/constraints in implementing the program and
suggestedrecommendationsandspecificstrategyandactionsplanstoaddressthoseissues.
FacilitatedtheprocessofgeneratingspecificstrategiesforlowcoverageRegionandDistrictsto
boost up their coverage and moderating on specific action plan to scale up the level of
achievement and highlight the best performing Region & districts to be replicated to achieve
mostadvantageousresults.
Interaction among Region/Department of Health Services/Ministry of Health and Population
andExternalDevelopmentPartners(EDPs).
TheoutcomeofthisworkshopcanbeseenintheprogramspecificchaptersofthisAnnualReport.
Detailed districtspecific raw data and analysed data are available in each of the five Regional
ReportsaswellasinAnnex3ofthisdocument.
1.2
DEPARTMENTOFHEALTHSERVICES(DoHS)
Ministry of Health and Population has been delivering preventive, curative, promotional and
rehabilitative health care services and other health system related functions such as policy and
planning,humanresourcedevelopmentandmobilisation,financingandfinancialmanagement,and
monitoring and evaluation. It has six Divisions: Administration Division, Policy, Planning and
International Cooperation Division, Curative Services Division, Human Resources and Financial
Management Division, Public Health Administration and Monitoring and Evaluation Division, and
Population Division. There are five autonomous bodies established by law for education, research
andservicedeliverypurposes.Inadditiontothese,therearefourprofessionalcouncilsto provide
accreditationtohealthrelatedschools/trainingcentresandtoregulatecareproviders.
TherearethreeDepartmentsundertheMoHP:DepartmentofHealthServices(DoHS),Department
ofAyurved(DoA)andDepartmentofDrugAdministration(DDA).TheDoHSandotherdepartments
are responsible for formulating programs as per policy and plans, implementation, use of
appropriate financial resources and accountability, and monitoring and evaluation. DDA is the
regulatoryauthorityforassuringthequalityandregulatingtheimport,export,production,saleand
distribution of drugs. Department of Auyurveda offer Aurvedic care to the people and also
implementhealthpromotionalactivities.
Department of Health Services (DoHS) is responsible for delivering preventive, promotive and
curative health services throughout Nepal. Director General (DG) is the organisational head of the
DoHS. The recent reorganisation of the DoHS includes six Divisions: Management Division with
infrastructure,planning,qualityofcareandmanagementinformationsystem;FamilyHealthDivision
withtheresponsibilityofreproductivehealthcare,includingsafemotherhoodandneonatalhealth,
family planning and Female Community Health Volunteers (FCHVs); Child Health Division covering
nutrition, IMCI, and EPI; Epidemiology and Disease Control Division wit the responsibility of
controllingepidemics,Pandemicandendemicdiseasesaswellastreatmentofanimalbites;Logistics
ManagementDivisioncoversprocurement,supplies andmanagementoflogistics,equipmentsand
services required by DoHS and below levels; and newly formed Primary Health Care Revitalization
Divisionwiththeresponsibilityofcarryingoutactivitiesforprimaryhealthcare.
KeyfunctionsofDoHSinclude:
ProvideGoNwithnecessarytechnicaladviceinformulatinghealthrelatedpolicies,developand
expandhealthinstitutionsestablishedinlinewiththesepolicies;
Determine requirement of manpower for health institutions and develop such manpower by
preparingshortandlongtermplans;
Manage procurement and supply of drugs, equipment, instruments and other logistics at
regional,districtandbelowlevels;
Coordinatetheactivitiesandmobilizeresourcesintheimplementationofapprovedprograms;
Managetheimmediatesolutionofproblemsarisingfromnaturaldisastersandepidemics;
Establishrelationshipswithforeigncountriesandinternationalinstitutionswiththeobjectiveof
enhancing effectiveness and developing health services and assist the Ministry of Health and
Population in receiving and mobilizing foreign resources by clearly identifying the area of
cooperation;
Create a conducive atmosphere to encourage the private sector, nongovernmental
organizations and foreign institutions to participate in health services, maintain relation and
coordination,controlqualityofhealthservicesbyregularsupervisionandmonitoring;
Systematicallymaintaindata,statementsandinformationregardinghealthservices,updateand
publishthemasrequired;
Human resource management and development as per rules and regulations and assigned
authority;and
FinancialmanagementofDoHS,RHDs,D/PHOsandsettlementofirregularities.
TherearefiveCentreswithadegreeofautonomyinpersonnelandfinancialmanagement:National
HealthTrainingCentre(NHTC),NationalHealthEducation,InformationandCommunicationCentre
(NHEICC), National Tuberculosis Control Centre (NTC), National Centre for AIDS and STD Control
(NCASC)andNationalPublicHealthLaboratory(NPHL).TheNHTCcoordinatesalltrainingprograms
of the respective Divisions and implements training by sharing common inputs and reducing the
travellingtimeofcareproviders.Similarly,allIEC/BCCrelatedactivitiesarecoordinatedbyNHIECC.
These centres support the delivery of EHCS and work in close coordination with the respective
Divisions.
At the regional level there are five Regional Health Directorates (RHDs) providing technical
backstoppingaswellasprogramsupervisiontothedistricts.TheRHDsaredirectlyundertheMoHP.
Thereareregionalandzonalhospitals(15),whichhavebeengivendecentralisedauthoritythrough
theformationofHospitalDevelopmentBoards.Inaddition,therearetrainingcentres,laboratories,
TBcentres(insomeregions)andmedicalstoresattheregionallevel.
At the district level, the structure varies between districts. Sixtyone districts are managed by the
District Health Office (DHO) with support of the District Public Health Office (DPHO), whereas the
remaining 14 are managed solely by the DPHO. The DPHOs and DHOs are responsible for
implementing essential health care services (EHCS) and monitor activities and outputs of District
Hospitals,PrimaryHealthCareCentres(PHCCs),HealthPosts(HPs)andSubHealthPosts(SHPs).
The service delivery outlets in the country include 3,129 SHPs, 676 HPs, 209 PHCCs, 65 district
hospitals, 10 zonal hospitals, 2 sub regional hospitals, 3 regional hospitals, and 8 central level
hospitals.
Asubhealthpostisthefirstinstitutionalcontactpointforbasichealthservices.SHPsmonitorthe
activitiesofFCHVsaswellascommunitybasedactivitiesbyPHCoutreachclinicsandEPIclinics.The
health post offers the same package of essential health care services plus birthing centres in the
respectiveVDCandmonitorstheactivitiesoftheSHPsintheirgeographicalareaaswell.However,a
SHP also functions as the referral centre of the volunteer cadres of female community health
volunteers(FCHVs)aswellasavenueforcommunitybasedactivitiessuchasPHCoutreachclinics
andEPIclinics.EachlevelabovetheSHPisareferralpointinanetworkfromSHPtoHealthPost(HP)
to Primary Health Care Centre (PHCC), on to district, zonal and regional hospitals, and finally to
tertiary level hospitals. This referral hierarchy has been designed to ensure that the majority of
population receive public health and minor treatment in places accessible to them and at a price
theycanafford.Inversely,thesystemworksasasupportingmechanismforlowerlevelsbyproviding
logistical,financial,supervisory,andtechnicalsupportfromthecentretotheperiphery.

Fig.1.2:OrganogramofDepartmentofHealthServices(DoHS)
DEPARTMENTOFHEALTHSERVICES
PHCRD
EDCD
LMD
LCD
FHD
CHD
MD
ZONALHOSPITAL10
DISTRICT
HOSPITAL65
SUBHEALTHPOST3129
PRIMARYHEALTHCARECENTRE/HEALTH
CENTRE209
HEALTHPOST676
DISTRICTHEALTH
OFFICE60

CENTRALHOSPITALS8
REGIONALTBCENTRE5
REGIONALMEDICALSTORE5
DISTRICTPUBLICHEALTH
OFFICE15

FCHV
48680
REGIONALTRAININGCENTRE5
SUBREGIONALHOSPITAL2

REGIONALHOSPITAL3
CENTRE
REGIONALHEALTHDIRECTORATE5
DIVISION
NHEICC
NPHL
NHTC
NTC
NCSAC
MINISTRYOFHEALTHANDPOPULATION
PHC/ORCCLINIC
12790
EPIOUTREACHCLINIC
16579
1.3
SOURCESOFINFORMATION
Sources of health sector information in Nepal include management information systems (MIS),
disease surveillance, vital registration, census, sentinel reporting, surveys, rapid assessments, and
research(Figure1.3).TheMISwithinthehealthsectorincludetheHealthManagementInformation
System (HMIS); Logistical Management Information System (LMIS); Financial Management
Information System (FMIS); Health Infrastructure Information System (HIIS); Planning and
Management of Assets in Health Care System (PLAMAHS); Human Resource Information System
(HuRIS);TrainingInformationManagementSystem(TIMS);AayurvedaReportingSystem(ARS);and
DrugInformationNetwork(DIN).TheHealthSectorInformationSystem(HSIS),beingpilotedinthree
districts(Rupandehi,ParsaandLalitpur)proposestointegratealloftheMIS.
Fig.1.2:SourcesofHealthSectorInformationinNepal
H e a l t h S e c t o r I n f o r m a t io n S y s t e m
H M IS
L M IS
F M IS
H I IS
H u R IS
T IM S
ARS
H e a lth
M anagem ent
In fo r m a t io n
S y s te m
L o g is tic a l
M anagem ent
In fo r m a t io n
S y s te m
F in a n c ia l
M anagem ent
In f o r m a tio n
S y s te m
H e a lth
I n fr a s tr u c t u r e
In f o r m a tio n
S y s te m
H um an
R e s o u rc e
In f o r m a tio n
S y s te m
T r a in in g
In fo r m a t io n
M anagem ent
S y s te m
A a y u rv e d a
R e p o r tin g
S y s te m
PLAM AH S
P la n n in g &
M anagem ent
o f A s s e ts
in H e a lth
C a re
S y s te m
D IN
D ru g
In fo r m a t io n
N e tw o rk
R o u tin e H e a lth In fo rm a tio n S y s te m s
C O M P R E H E N S IV E H E A L T H S E C T O R IN F O R M A T IO N S Y S T E M
D i s e a s e S u r v e i l la n c e
V i t a l R e g is t r a t i o n
P o p u la t i o n B a s e d I n f o r m a t i o n
C ensus
S e n t i n e l R e p o r t in g
S u rv e y s
R a p id A s s e s s m e n t s
R e s e a rc h
National Health Policy (NHP) 1991 and Second Long Term Health Plan (SLTHP) 1997 2017,
recognized the need for a comprehensive health sector information system (HSIS) to achieve the
health sectors objectives. The Health Sector Strategy: An Agenda for Change, 2002, therefore,
proposed the establishment of HSIS, and this was one of the primary objectives for the NHSPIP
20042009.TheHSISNationalStrategywasdevelopedin2005withthefollowingaims:
1. Developanintegratedinformationsystem
An integrated system simply refers to all MIS utilizing a uniform coding system, thus enabling
data from different systems to be linked, and for all MIS to feed in to a District Health
InformationBank(DHIB).
2. Toprovidecomprehensiveinformationfromallhealthfacilities
HSIS aims to collect data from public health facilities, private health facilities, and NGO run
healthfacilities.
3. Togeneratedisaggregatedinformation
HSISaimstoproducedatadisaggregatedbycaste/ethnicityandgeography.
4. Togeneratedataatalllevels
HSISaimstogeneratedataatalllevels(facility,ilaka,districtandcentral).
5. ToestablishaDistrictHealthInformationBank(DHIB)
5. ToexploitmoderntechnologiesincludingGIS.
TheHealthManagementInformationSystem(HMIS)is based in the MIS Section in the
ManagementDivision, Department of Health Services (DoHS) and has been in operation since
1994.Itincludesinformationrelatingtotheprovisionofhealthservices,healthstatusandprogram
performance.TheHMISdataismonthlycompiled,reported,andreviewedatIlaka,district,regional
andnationallevel.
DataCollectionandReportingProcesswithinHMIS
FCHVsarevolunteerswhoprovideservicesatthecommunitylevel,andmaintainapictorialHMIS27
FCHV register. Each month they are visited by the VHW or MCHW (to resupply family planning
commoditiesandotherdrugs)whocollectstheregister.
TheVHWs/MCHWssubmitaHMIS31VHW/MCHWReportingFormmonthlytotheirassignedhealth
facility (either a subhealth, health post or PHCC). This collates data from the FCHV registers and
theiroutreachservices.
Subhealth post and nonilaka health posts compile a HMIS 32 PHC/HP/SHP Reporting Form and
submititonamonthlybasistotheilakahealthpostorilakaPHCC.Thisalsocollatesdataforitsown
coverageincludingVHW/MCHWreportingformsandFCHVsregisters.
TheIlakaHPandPHCCscompileaHMIS32PHC/HP/SHPReportingFormandsubmititonamonthly
basistotheDistrict/PublicHealthOffice(D/PHO).Thiscollatesdatafromthefacility,anySHPsand
nonIlakaHPsunderthatfacility.
District, Zonal, Subregional, Regional and National level hospitals and including Other public and
nonpublic hospitals submit HMIS 34 Hospital Based Reporting Form to the D/PHO every month.
Some hospitals enter data electronically, but as there is no uniform system developed for this,
databasesvary.However,inrealitymostofthehigherlevelhospitalssubmitreportsdirectlytothe
HMISSectionandalargenumberofnonpublichospitalsreportsarenotcoveredtoHMIStilldate.
D/PHO compiles all the reports received from health facilities and submits the HMIS 33 District
ReportingFormtotheRegionalHealthDirectorateandtheMISSection,ManagementDivision,DoHS
eachmonth.
Regional Health Directorates monitor and supervise district public health programs; ensure timely
reporting from D/PHOs and hospitals to the centre; participate in district and other reviews and
performregionalreviewbasedonanalyzeddatareceivedfromthecentre.
MISSectionatthecentrallevelentersthemonthlyreportsreceivedfromtheD/PHOsandhospitals
intoanelectronicHMISdatabasethatcanbeaccessedviatheinternetandLAN.Theinternetaccess
is restricted and needs a password to access the HMIS data. The MIS Section provides monthly
compiled data to all program divisions and centres, RHDs and D/PHOs through online access for
planningandmonitoringpurposes.

Fig.1.2:InformationflowinHMIS
DEPARTMENT OF HEALTH SERVICES
Management Information Section
DPHO
Regional Health Directorate
HMIS 33a District Reporting Form
(DPHO)
Regional / Zonal Hospitals

HMIS 34 Hospital Based Reporting Form
(Medical Recorder)
District Hospitals
HMIS 34 Hospital Based Reporting Form
(Medical Recorder)
Ilaka HP / PHC
HMIS 32 PHC/HP/SHP Reporting Form

(
SAHW or HA)
Sub HP / Non -Ilaka HP
HMIS 32 PHC/HP/SHP Reporting Form

(AHW,VHW, or MCHW)
VHW / MCHW
HMIS 31 VHW / MCHW Reporting Form
FCHV
HMIS 27 FCHV Register
1.4
STRUCTUREOFTHEREPORT
Thisreporthas8chapters.Chapter1,thischapter,brieflypresentedthebackgroundtothepractice
ofannualreportpreparation,organogramoftheDoHS,andsourcesofinformationinhealthsector
inNepal.ChaptertwotosixcoverthedifferentprogramswithintheDoHS;chaptersevenpresents'
programs of other departments within the Ministry of Health and Population; and chapter eight
presentsabriefsummaryofdevelopmentpartnerscontributingtohealthsectorinNepal.Chapter
two to seven contain five sections in each chapter: Section one gives a brief background to the
program; section two presents major activities within the program; section three analyses the
achievementsoftheprograminthelastthreeyears;sectionfourpresentsproblems/constrainsof
theprogramasdiscussedintheregionalandnationalreviews;andthelastsectionpresentstargets
forthenextfiscalyear.
Annexonepresentsthetargetvs.achievementoftheactivitiescarriedoutinthelastfiscalyearby
different programs; Annex two lists the HMIS Indicators used to monitor different programs; and
Annexthreeprovidestherawandanalyzeddataofdifferentprogramsdisaggregatedbyecological
regionsanddistricts.
Measles Vaccination and Coverage

Fiscal Year 2067/68 (2010/2011)
No. of infants immunized
Kath man d u
Jh ap a
Mo ran g
Ru p an d eh i
Dh an u sh a
Sarlah i
Sirah a
Rau tah at
Bara
Su n sari
Mah o ttari
Kailali
Sap tari
Dan g
Kap ilvastu
Naw alp arasi
Parsa
Ch itw an
Ban ke
Kaski
Kan ch an p u r
Su rkh et
Makaw an p u r
Dh ad in g
L alitp u r
Bard iya
Kavre
Ach h am
Dailekh
Ud ayp u r
G u lmi
Pyu th an
Syan g ja
T an ah u
Ilam
Bag lu n g
Ro lp a
Baitad i
Salyan
Do ti
Sin d h u li
Sin d h u p alch o w k
Nu w ako t
Palp a
Ru ku m
G o rkh a
Jajarko t
Bajh an g
Bh aktap u r
Arg h akh an ch i
Pan ch th ar
Kh o tan g
Do lkh a
Ramech h ap
L amju n g
Bh o jp u r
Baju ra
Dad eld h u ra
Dh an ku ta
San kh u w asab h a
Kaliko t
Darch u la
T ap leju n g
Parb at
O kh ald h u n g a
Myag d i
Ju mla
So lu kh u mb u
T eh arth u m
Hu mla
Mu g u
Rasu w a
Do lp a
Mu stan g
Man an g
25,952
Jajarko t
24,648
Baju ra
21,011
Ach h am
19,669
Pyu th an
17,232
Mu g u
16,969
Rau tah at
16,626
Dailekh
16,241
Mah o ttari
15,924
Sirah a
15,760
Jh ap a
15,175
Kaliko t
15,125
Bajh an g
14,107
Bara
13,042
Ro lp a
12,979
Ju mla
12,683
Dad eld h u ra
11,472
Sarlah i
9,658
Dh an u sh a
9,552
Do ti
9,223
Kap ilvastu
Salyan
8,738
8,401
Do lp a
8,293
Ru ku m
Su rkh et
8,054
8,016
Ru p an d eh i
7,967
Sap tari
Darch u la
7,928
7,634
Dan g
7,007
Baitad i
Hu mla
7,000
Kath man d u
6,967
6,849
Ud ayp u r
6,516
Rasu w a
6,366
Dh ad in g
6,266
Parsa
G u lmi
6,163
T ap leju n g
6,077
Ban ke
5,953
Myag d i
5,898
Su n sari
5,725
Mo ran g
5,675
5,525
Pan ch th ar
5,449
Arg h akh an ch i
So lu kh u mb u
5,443
San kh u w asab h a
5,322
Kailali
5,227
Do lkh a
5,081
Bag lu n g
4,764
L amju n g
4,739
Kaski
4,661
Naw alp arasi
4,476
Kan ch an p u r
4,144
Makaw an p u r
4,117
Sin d h u li
3,888
Ilam
3,807
Syan g ja
3,775
Ramech h ap
3,702
Dh an ku ta
3,691
Palp a
3,498
Kavre
3,482
Bh o jp u r
3,349
T an ah u
3,163
Nu w ako t
3,144
Kh o tan g
2,898
T eh arth u m
2,716
L alitp u r
2,695
Bard iya
2,578
Sin d h u p alch o w k
2,295
O kh ald h u n g a
2,174
G o rkh a
1,410
Parb at
1,302
Ch itw an
1,017
Bh aktap u r
791
Mu stan g
192
Man an g
102
Source: HMIS/MD, DoHS
Coverage
132
132
123
117
115
112
111
110
110
109
109
106
105
105
105
104
102
101
101
100
99
98
97
96
95
93
92
92
92
91
90
87
86
86
86
85
85
84
84
83
81
81
81
80
80
80
79
78
78
77
76
76
75
74
74
74
73
73
72
72
70
70
70
69
N A TION A L
69
69
EA STER N
68
67
C EN TR A L
67
67
W ESTER N
65
64 MID - W ESTER N
61
50
34
FA R W ESTER N
88
88
87
81
96
93
Chapter2
ChildHealth:Immunization
CHILDHEALTH
2.1 IMMUNIZATION
2.1.1 Background
The NationalImmunizationProgram (NIP)isahighpriority program(P1)of Government ofNepal.

Immunizationisconsideredasoneofthemostcosteffectivehealthinterventions.NIPhashelpedin
reducingtheburdenofvaccinepreventablediseases(VPDs)andchildmortalityandhascontributed
inachievingtheMillenniumDevelopmentGoalonchildmortalityreduction(MDG4).
Currently NIP provides vaccination against TB (BCG), diphtheriapertussistetanushepatitis B and

haemophilusinfluenza(DPTHepBHiB),poliomyelitis(OPV)andmeaslesthroughoutthecountryand
JEvaccineinhighriskpostcampaigndistrictsthroughroutineimmunization.TTvaccinationisprovided
toallpregnantwomen.Theroutineimmunizationservicesareprovidedthroughhealthfacilities(fixed
clinic),private,NGOorINGOclinics,urbanclinics,outreachsessionandmobileteamingeographical
inaccessible areas. All vaccines under NIP are provided free of cost. Since the past decades new
vaccinesareavailableinthemarkets,andtheGovernmentiskeentoprovideallavailablevaccinesto
reduce morbidity and mortality. Since last 10 years several new vaccines (hepatitisB, Hib and JE)
wereintroducedintoroutineimmunization.InadditiontoroutineimmunizationservicesNIPcarries
out several supplementary immunization activities either to eradicate, eliminate or control vaccine
preventablediseases(VPDs).TheNIPhascomprehensivemultiyear(5year)immunizationplan(cMYP)
which outlines goal, objectives, activities with milestones and financial plan. The current cMYP runs
from20072011.NIPisalsoguidedbyNHSP2.
The National Immunization Program under the Child Health Division has a lead role in all
immunization related activities at the national level. The NIP works closely in coordination with
otherdivisionsofDoHS,RegionalHealthDirectoratesandDistricts.TheRegionalHealthDirectorate
(RHD) acts as a facilitator between the centre and the districts and carries out periodic review of
districtperformancesandconductsupportivesupervisiontostrengthenimmunizationservices.Itis
theresponsibilityoftheD/PHOtoensurethatasuccessfulimmunizationprogramisimplementedat
the district and below level. PHCCs, HPs, and SHPs implement immunization programs in their
respective municipalities and Village Development Committees (VDCs) ensuring all target children
receiveimmunizationservicesespeciallymarginalizedandhardtoreachpopulation.
Immunizationdatageneratedattheservicelevelarereportedtothedistrict,regionandthecentral
level(HMIS)onmonthlybasis.Theinformationreceivedisverified,analyzedfollowedbycorrective
actions at different levels. Based on immunization data received from HMIS, NIP monitors the
coverage by antigens, dropout rate for different antigens (DPTHepBHib1 vs DPTHepBHIb3, and
BCGvsMeasles)andvaccinewastagerate(particularlyforMDVPvaccinesDPTHepBHib,OPV,TT)
by districts and provides feedback. In addition to HMIS, surveillance data on certain vaccine
preventable diseases (AFP, Measles like illnesses, MNT, pneumonia for AI and AES) are reported
throughintegratedAcuteFlaccidParalysis(AFP)surveillancesystemfromweeklyzeroreportingsites
supported by WHO/IPD. Similarly outbreaks of VPDs are reported through both the HMIS and
integratedAFPnetwork.
Several activities were carried out in achieving objectives and milestones set in cMYP (20072011)
andNHSP2.Vaccinationofeveryeligiblechildisimportantespeciallymarginalizedandhardtoreach
children.AccesstoroutinevaccinationhasimprovedinvillagesandmunicipalitiesthroughRECmicro
planning,advocacyandsocialmobilizationactivities,capacitybuildingtrainings,logisticssupply,data
analysisreviewmeetingatvariousleveletc.Supplementaryimmunizationactivitieswerecarriedout
to achieve or sustain eradication (polio), elimination (MNT) or control (measles & JE) of targeted
VPDs.SeveralroundsofpoliocampaignswerecarriedoutinhighriskdistrictsandJEcampaignin4
districtsinthisFY.OnlyonewildpolioviruswasdetectedinlastFYinRauthautdistrictwithdateof
onsetinAugust2011.NepalcontinuetosustainMNTeliminationstatus,hasachievedtheobjective
ofreducingmeaslesmortalityby90percentcomparedto2003databy2009,hasreducedmortality
fromJE.
Theissues,challengesandrecommendationsmadebythedistrictsduringtheregionalperformance
review meeting has guided NIP to better organized immunization related activities in order to
achieveitsgoalandobjectives.
Goal
The goal of National immunization Program is to reduce child morbidity, mortality and disability
associatedwithvaccinepreventablediseases.
Objectives
TheobjectivesoftheNationalImmunizationProgramareasfollows:
Achieveandsustain90percentcoverageofDPT3byandofallantigens
Maintainpoliofreestatus
SustainMNTeliminationstatus
Initiatemeasleselimination
Expandvaccinepreventabledisease(VPDs)surveillance
Accelerate control of other vaccine preventable diseases through introduction of new
vaccines
Improveandsustainimmunizationquality
Expandimmunizationservicesbeyondinfancy
NHSP2targetstoachieve85percentofchildrenunder12monthsofageimmunizedagainstDPT3
andmeasles.
Table2.1.1presentstheimmunizationscheduleofNIP.ThetargetpopulationforNIPinclude:
Allinfants(under12months)forBCG,DPTHepBHib,OPV,andmeaslesvaccinesand1223
monthschildrenforJEvaccine
AllpregnantwomenforTTvaccine
Allgrade1studentforSchoolTTimmunization
Table2.1.1:ImmunizationScheduleofNationalImmunizationProgram
TypeofVaccine
BCG
OPV
DPTHepBHib
Measles
TT
TT(Schoolimmunization)
JE
NumberofDoses
1
3
3
1
2
1
1
RecommendedAge
Atbirthoronfirstcontactwithhealthinstitution
6,10,and14weeksofage
6,10,and14weeksofage
9monthsofage
Pregnantwomen
Grade1students
1223monthsofage
10
Thekeystrategiestoachievetheaboveobjectivesare:
1. StrengthenroutineimmunizationthroughREDstrategies
REDmicroplanninginalldistricts
Supportivesupervisionandmonitoring
Increase and promote public awareness and demand through social mobilisation for
immunisationservicesandIEC/BCCinterventions
Partnershipwithprivate,CBOs,NGOsandothers
2. Strengthenmunicipalityimmunizationservices
Fulfilvacantpostofvaccinators
Ensureavailabilityofvaccineandotherlogistics
Supportivesupervisionandmonitoring
3. Conduct supplementary immunization activities and surveillance for eradication of
poliomyelitisandcontrolofmeaslesandJE.
4. Sustain Maternal and Neonatal Tetanus elimination status through expansion of school TT
immunizationprogramandhighTTcoverage.
5. StrengthenandexpandintegratedsurveillanceofVPDsbuiltonAFPSurveillance(AFP,Measles,
NeonatalTetanusandJapaneseEncephalitis)andinitiatediseaseburdenstudyofothervaccine
preventablediseaseslikeHibandRubella,PneumococcalandRota.
6. Conduct periodic meetings of National Committee for Immunization Practices (NCIP), Adverse
EventFollowingImmunization(AEFI)andInteragencyCoordinationCommittee(ICC)committee.
7. Conduct capacity building for relevant health staff (MLM, refresher training, cold chain and
vaccinemanagement,maintenancetraining,incountryobservationtourbyEPIstaff).
8. ControloutbreakofVPDsthroughappropriatereporting,investigationandresponse.
9. Improvequalityofimmunizationservicespracticinginjectionsafetypolicy.
10. Introductionofnewandunderusedvaccinesbasedondiseaseburden.
2.1.2 MajorActivities
ThefollowingwerethemajoractivitiescarriedoutduringFY2067/68.Achievementstatusofthemajor
activitiesispresentedinAnnex1.
1.
Provision of routine immunization services delivery either through fixed sites or outreach
sessions:35session/month/VDCaspermicroplan,conductedREDmicroplanningindistrictsof
EDR
2.
Supportedstrengtheningofmunicipalimmunizationthroughmicroplanningin4municipalities,
Kathmandumetroandreviewofimplementationofmicroplanin16municipalities
3.
Conductedreviewof immunizationservicesasanintegrated childhealth in5 regions,atVDC
levelandreviewbyinternationalteam
4.
Conductedcapacitybuildingtrainings(ToToncoldchainrepairandmaintenancefor2batches,
AEFIToT(20persons)andRRTin37districts,MLM(1batch),newvaccinators(VHW,MCHW)
8,000persons)
5.
ConductedmeetingsofNCIP,ICCandAEFIcommittees
6.
Conductedsupplementaryimmunizationactivities(JEcampaignin4districts,NIDin75districts,
7roundsofresponsiveMopup(1Rin18districts,3Rin8districtsand3Rin3districts)
7.
ContinuedschoolTTimmunizationprogramin12districts
8.
Continued integrated vaccine preventable diseases surveillance (AFP, Measles, NT, AES,
pneumoniaforAIandHib),measlescasebasedsurveillanceexpanded,outbreaksofsuspected
measlesinvestigatedandrespondedfollowedbylabconfirmation
9.
Continued cross border meeting with Indian counterpart to improve coordination and
cooperationforSIAsandAFPsurveillance
11
10.
11.
12.
Conductedjointsupervisionandmonitoringinpoorperformingdistricts
Celebrated"immunizationmonth"
ConductedincountryexchangevisitsbyEPIstaffforsharingofexperiencesandmonitoringof
EPIprogram
2.1.3 AnalysisofAchievement
Year
2065/662008/09
2066/672009/10
2067/682010/11
DPTHepBHib3
2065/662008/09
coverage
2066/672009/10
2067/682010/11
Polio3
2065/662008/09
coverage
2066/672009/10
2066/672009/10
Measles
2065/662008/09
coverage
2066/672009/10
2067/682010/11
TT2&TT2+coverage 2065/662008/09
(Pregnantwomen)
2066/672009/10
2067/682010/11
EDR
87.4
90.4
92.9
83.3
80.1
92.2
82.9
82.0
90.9
78.0
83.8
87.7
65.6
86.0
82.7
CDR
89.8
96.9
100.7
83.2
82.0
97.0
83.2
82.7
96.0
75.9
86.0
87.0
57.2
76.0
74.9
Region
WDR MWDR
78.5
85.7
86.1
104.7
90.7
104.4
76.6
83.5
75.8
88.1
88.0
104.5
75.7
83.7
76.7
92.2
88.0
104.3
69.5
80.8
80.2
97.4
80.9
96.1
57.0
66.7
77.7
80.2
83.7
76.5
FWDR
77.2
99.1
99.4
76.1
86.5
103.3
76.1
89.4
103.2
71.7
91.5
92.8
51.8
66.9
67.6
75
88
86
95
83
81
81
Indicators
BCGcoverage
82
96
97
85
94
RoutineImmunization
Theoverallnationalimmunizationcoverageforall
Routine Immunization Coverage
Fig 2.1.1
FY 2065/66 to 2067/68
antigens during the FY 2067/68 compared to
110
previousyearsishigh.BCGcoverageis97percent,
100
DPTHepBHib395.8percent,OPV395percent
and Measles 88 percent and JE coverage of 27
90
districts54percent.Coverageofallantigensisin
80
increasingtrendcomparedtolasttwoyears(Table
70
2.1.2 and Figure 2.1.1). However teh coverage is
notuniformthroughoutthecountryanddoesnot
60
BCG
DPT3
OPV3
meet target of achieving 90 percent coverage for
all antigens. Only 31 districts (41%) have >90
2065/66
2066/67
percent coverage for all antigens and 36 districts
(48%)have<90percentcoverageofDPT3.
Table2.1.2:ImmunizationCoverage,byRegion,FY2065/66to2067/68
Measles
2067/68
National
84.9
94.5
97.2
81.2
81.6
95.7
80.9
83.3
95.0
75.4
86.4
87.7
59.8
78.4
78.0
Source:HMIS/MD,DoHS
1.
AccessandUtilizationofImmunizationServices
Evaluation of access of immunization services are based on first dose of DPTHepBHib coverage
(>80%asgoodaccess),whileutilizationofimmunizationservicesareevaluatedagainstdropoutrate
DPTHepBHib1 against DPTHepBHib3 (<10% dropout as good utilization). Number of un
vaccinatedchildrenisanotherimportantindicatorofimmunizationperformance.DistrictsandVDC
12
are categorized and prioritized in 4 groups based on access and utilization of DPTHepBHib
vaccine.
Category1includesdistrictswithhighcoverage(>80%)andlowdropout(<10%)andareconsidered
asdistrictswithgoodaccessandutilization,category2includesdistrictswithhighcoverage(>80%)
and high dropout (>10%) and are considered as districts with good access but poor utilization,
category3includesdistrictswithlowcoverage(<80%)andlowdropout(<10%)andareconsidered
asdistrictswithpooraccessandgoodutilizationandcategory4includesdistrictswithlowcoverage
(<80%) and high dropout (>10%) and are considered as districts with poor access and poor
utilization.Table2.1.3showsthatin2067/6850districtsfellincategory1,onlyonein category2
and24districtsincategory3.Noneofthedistrictsfellincategory4.However,24districtshaveDPT
HepBHib1 coverage <80 percent which is very alarming. We still have children which are never
reachedbyimmunizationservices.
Table2.1.3:CategorizationofDistrictsBasedonAccessandUtilization,2067/68
Category
Category:1
HighCoverage(80%)
LowDropOut(<10%)
(50districts)
Category:2
HighCoverage(80%)
HighDropout(10%)
Category:3
LowCoverage
LowDropout(<10%)
(24districts)
Category:4
HighDropout(10%)
LowCoverage(<80%)
Districts
Jhapa,Morang,Panchthar,Sankhuwasabha,Saptari,Siraha,Solukhumbu,Sunsari,
Taplejung, Udayapur, Bara, Dhadhing, Dhanusha, Kathmandu, Mahottari,
Makwanpur, Parsa, Rasuwa, Rautahat, Sarlahi, Sindhuli, Arghakhanchi, Baglung,
Gulmi,Kapilbastu,Myagdi,Nawalparasi,Rupandehi,Banke,Dailekh,Dang,Dolpa,
Humla,Jajarkot,Jumla,Kalikot,Pyuthan,Rolpa,Rukum,Salyan,Surkhet,Achham,
Baitadi,Bhajang,Bajura,Dadeldhura,Darchula,Doti,Kailali,Kanchanpur
Mugu
Bhojpur, Dhankuta, Ilam, Khotan, Okhaldhunga, Terhathum, Bhaktapur, Chitwan,

Dolakha, Kavre, Lalitpur, Nuwakot, Ramechhap, Sindhupalchowk, Gorkha,
Lamjung,Manag,Mustang,Palpa,Parbat,Syangja,TanahuandBardiya
None
80
81
91
93
72
76
70
81
86
87
84
78
75
86
88
88
97
96
NumberofUnimmunizedChildren
The total unimmunized children against DPTHepBHib3 in this fiscal year are 27,714 against
Fig 2.1.2
Measles Coverage
131,011inthepreviousfiscalyear.Thesearethe
FY 2065/66 to 2067/68
children never reached by any immunization 110
services.
100
MeaslesCoverage
90
Nepal was able to achieve target of >90 percent
80
Measlescoveragein31districts.Overall,Measles
70
coverage in FY 2067/68 has slightly increased
compared to FY 2066/67 (~1%), but has
60
National
EDR
CDR
WDR
MWDR FWDR
substantially increased compared to FY 2065/66
(~12%). Measles coverage was highest in MWDR
2065/66
2066/67
2067/68
(96%)andlowestinWDR(81%)(Figure2.1.2).
13
67
67
-4
-1
-2
-26
-8
-7
-1
52
57
57
68
76
80
84
78
75
76
83
60
66
78
78
86
TT2+Coverage
% of Pregnant women Immunized with TT2 & TT2+
Fig 2.1.3
Figure2.1.3,showsthetrendofnationalcoverage
FY 2065/66 to 2067/68
ofTT2+vaccinationinpregnantwomeninthelast 91
three years. The coverage at national level in FY 81
2067/68is78percentwhichis1percentlessthan 71
FY2066/67.Infiscalyear2067/68TT2+coverage 61
51
hasdecreasedin EDR,CDRand MWDRexceptin 41
WDR and FWDR compared to fiscal year to 31
21
2066/67.
11
National
EDR
CDR
WDR
MWDR
FWDR
DropoutRates
Dropout rates have been calculated for DPT
2065/66
2066/67
2067/68
HepBHib 1 against DPTHepBHib3 and BCG
againstmeasles.Infiscalyear2067/68,thedrop
Fig 2.1.4
DPT-Hep B 1 vs DPT-Hep B 3 Drop-out Rates
FY 2065/66 to 2067/68
out rate of DPT1 vs DPT3 is negative ( which
10
means children received more DPTHepBHib3
0
dose than DPTHepBHib 1 dose), while BCG vs
Measles is positive i.e., more children received -10
BCGvaccinethanMeasles(Figure2.1.4).
-20
DPTHepBHib1Against3
-30
In FY 2067/68, 585,815 children received DPT
HepBHib1 while 627,998 children received DPT -40 National
EDR
CDR
WDR
MWDR FWDR
2065/66
2066/67
2067/68
HepBHib3 doses. Thus 42,183 more children
receiveddosesofDPTHepBHib3thanDPTHepB
Hib1.Figure2.1.4showsthatdropoutrateofDPTHepBHibwasnegativeinallregionsexceptEDR.
BCG vs. Measles Drop-out Rates

BCGAgainstMeasles
FY 2065/66 to 2067/68
Nationally62,811childrendroppedouttoreceive 17
measles doses even after they were enrolled for 15
BCG and 52,840 children dropped to receive 13
measlesafterDPTHepBHib3doses.
11
9
Figure2.1.5showsBCGvsMeaslesdropoutrate
in the last three years. Nationally dropout 7
increased from 8.56 percent in 2066/67 to 9.8 5
percentin2067/68.Thehighestdropoutratewas
2065/66
2066/67
2067/68
observedintheCDRwith13.8percentincurrent
fiscal year compared to 11.3 percent in previous
FY 2065/66. The lowest dropout rate was
Vaccine Wastage Rate
FY 2065/66 to 2067/68
observedinWDRwith6.77percent(Figure2.1.5). 120
105
VaccineWastageRate 90
Figure2.1.6showsthevaccinewastagerateinthe 75
60
last three years. For DPTHepBHib the wastage 45
rateis8.6percentwhichislessthanpreviousyear 30
(11.6%)butishigherthanrecommendedwastage 15
0
rate of 5 percent (single dose vial). Similarly
BCG
DPT
Polio
Measles
wastagerateofOPVis23.4percentcomparedto
2065/66
2066/67
2066/67
22.3percentin2066/67,whichishigherthanthe
recommended wastage rate of 15 percent. Since
14
11
11
11
National
10
11
11
14
15
Fig 2.1.5
EDR
CDR
WDR
MWDR
FWDR
11
23
22
22
25
64
63
61
79
78
80
Fig 2.1.6
thesevaccines(DPTHepBHib,OPV&TT)fallundermultidosevialpolicywhichNepalendorsedin
2002,vaccinewastagerateshouldbeminimized.VaccinewastagerateofBCGis78.7percentand
Measles is 64.3 percent which is not uncommon since these vaccines are supplied per vial per
sessionanditsmandatorytoopenthevialevenonechildattendstheimmunizationsession.
2.
SupplementaryImmunizationActivities
NationalImmunizationDays(NIDs)forPolioEradication
In fiscal year 2067/68 one case of wild poliovirus type 1 was reported from Rautahat district. This
wasthecontinuationofthetransmissionofwildpoliovirusfromfiscalyear2066/67.Atotalofseven
roundsofMopupandtworoundsofNIDwereconductedin2067/68tostopthetransmission.
Figure 2.1.7 shows the NID coverage from 1996/1997 to 2010/2011 in number and percentage of
childreon immunized in each round of NID. In FY 2067/68, the findings of independent monitors
shows<10percentmissedchildreneitherthroughhousetohousesearchorchildreninthestreet.
Fig2.1.7:NIDCoverageFY1996/1997to2010/2011
#1stRound
#2ndRound
%,1stRound
%,2ndRound
140
4,400,000
4,300,000
4,200,000
121
117
4,100,000
120
100
99
97
94
99
94
101
100
100
103
102
100
99
95
94
95
94
4,000,000
93
92
89
88
92
91
80
3,800,000
60
3,700,000
Percentage
Number
3,900,000
40
3,600,000
3,500,000
20
3,400,000
3,300,000
1996/97
1997/98
1998/89
1999/00
2000/01
2001/02
2002/03
2003/04
2005/06
2007/08
2008/09
2009/10
2010/11
JECampaign
As per government plan to conduct JE campaign in phased manner, four districts conducted JE
campaigntargetingallpopulationaboveoneyearofagereaching1,394,320(75%)in2067/68.The
JE campaign was started in 2006 and 31 districts have completed the campaign until 2011 (Table
2.1.4).
15
Table2.1.4:JECampaignbyDistrict
S.N.
1
2
3
4
5
District
Banke
Bardiya
Dang
Kailali
Rupendehi
Target
424,152
420,863
503,821
684,718
768,893
Achievement
363,298
358,513
456,063
584,642
715,943
%
86
85
91
85
93
AgeGroup
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Kanchanpur
426,938
347,367
81
Allabove1yrs
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Morang
Sunsari
Dhanusha
Mahottari
Jhapa
Kapilvastu
Nawalparsi
Parsa
Chitwan
Lalitpur
Bhaktapur
Saptari
Udayapur
Bara
Rautahat
Siraha
Kathmandu
365,009
271,868
296,222
243,543
304,503
263,903
251,005
219,493
209,400
151,244
100,575
656,885
336,951
649,171
630,225
659,149
1,311,596
311,881
270,057
307,638
247,538
289,043
234,656
224,253
212,399
212,300
157,012
115,563
654,555
351,397
590,051
639,223
622,858
978,254
85
99
104
102
95
89
89
97
101
104
115
100
104
91
101
94
75
115Years
115Years
115Years
115Years
115Years
115Years
115Years
115Years
115Years
115Years
115Years
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
24
25
26
27
28
29
30
31
Sarlahi
Makwanpur
Sindhuli
Surkhet
Dhadhing
Kavre
Kaski
Palpa
Total
712,109
441,426
331,229
358,531
392,166
440,600
443,572
303,500
13,573,260
560,460
261,023
269,825
303,012
322,573
340,511
399,948
223,071
11,924,927
79
59
81
85
82
77
90
73
88
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
Allabove1yrs
MonthandYearofSIA
14July18Aug2006
14July18Aug2006
14July18Aug2006
14July18Aug2006
14 Jul18 Aug 2006 and 7
Jun 31Aug2007
14July 18 Aug 2006 and 7
Jun 31Aug2007
7Jun31Aug2007
7Jun31Aug2007
23Sept18Oct2007
414May2008
5Jun7July2008
28May15Jun2008
15Jun15July2008
230Jun2008
6 28Jun2008
27Aug17sept2008
27Aug17sep.2008
724Feb2009
7Feb12Mar2009
22Feb27April2009
30Jan18Feb2009
25May13Jun2009
1 Aug 2009 (VDCs) and July
2010(Metro)
AprilMay2011
129April2011
19April16May2011
5April5May2011
22Aug16Nov2011
13Sept22Oct2011
17Aug16Sept2011
11Sept18Oct2011
3.
VaccinePreventableDiseaseSurveillance
Nepal has a strong network of integrated VPD surveillances (AFP, measles/rubella, AES, NNT,
pneumoniaforAI)supportedbySurveillanceMedicalOfficers.Thereare>431weeklyzeroreporting
sitesand89activesurveillancesitesthroughoutcountry.Thereportingsitesincludehospitals,PHCs,
HPs and SHPs, private clinics and even community informers. This network is sensitive enough to
pickupcasesandoutbreaksofVPDsfromanypartofthecountry.
AFPSurveillance
In2067/68atotalof575AFPcasesfrom70districtswerereportedandinvestigated.Nationalnon
polioAFPrateandadequacyofstoolcollectionarecertificationstandard.Fivedistrictswhichhave
not reported AFP cases are with very sparse population and do not expect AFP case each year. In
fiscalyear2067/68onewildpoliocasewasdetectedinRautahtinJokahaVDCwiththeonsetof30
August 2010. This WPV1 was the continuation of the internal transmission from rest of the four
caseswithinthedistrictinpreviousyear(Figure2.1.8).
16
Figure2.1.8
Acute Flaccid Paralysis (AFP), Nepal, 2067-68
AFP cases = 575

District with AFP cases = 70
Data as of 27 Dec2011
Measles/RubellaSurveillance
Infiscalyear2067/68atotalof177measlescaseswerereportedfrom40districtsthroughroutine
reportingandmeaslescasebasedsurveillancesites.Atotalof54suspectedmeaslesoutbreakswere
reportedfrom28districts.Outofwhich16outbreakswerelaboratoryconfirmedmeaslesoutbreaks
from 8 districts and 29 were lab confirmed rubella outbreaks, 3 were measles and rubella mix
outbreaks, 2 were negative for both measles and rubella and remaining discarded for insufficient
samples.
RoutineMeaslescases,2067/68(n=177)
Measles(n=16)andRubella(n=29)Outbreaks,206768
1
v
v
v
v
v
Measlesoutbreak
Rubellaoutbreak
v
1
Confirmed Measles and Rubella Cases, Nepal, 2003-2011

* Includes lab-confirmed and epi-linked cases
1600
Rubella Cases
Measles Cases
1400
1200
1000
Phase II
Phase I
600
Follow-up
Measles
Campaign
Phase III
Phase I
800
Phase II
Catch-up
Measles
Campaign
No.ofCases
A successful completion of measles catchup

(2003/04) and follow up campaign (2008) the
number of measles cases drastically reduced.
Thenumberofrubellacaseshasincreased.
JapaneseEncephalitisSurveillance
In fiscal year 2067/68 a total of 1,367 AES
caseswerereportedfrom62districtsofwhich
88 were laboratory confirmed JE cases from
29districts.
400
200
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
2003
2004
2005
2006
2007
2008
2009
2010
2011
MonthsandYear
Note: Rubella IgM test started from Jan 2004
Data as of 27 Dec 2011
17
JEcampaignstartedin2006inhighriskdistricts.FollowingJEcampaignthenumberofJEcaseshas
drasticallyreduced.
NeonatalTetanusSurveillance
In FY 2067/68 a total of 12 NT cases were reported from 7 districts through integrated VPD
surveillancenetwork.
Reported Neonatal Tetanus (NT) Cases, Nepal, 2067-68
NTcases=12
DistrictswithNTcases=7
Nepal achieved Maternal and Neonatal Tetanus elimination status in 2005. Since then Nepal has
sustainedMNTeliminationstatus.
InjectionSafety
NepalusesADsyringestovaccinateeachchild.Onereconstitutionsyringesareusedtoreconstitute
eachvialsofmeaslesandBCGvaccine.Allusedsyringesarecollectedinsafetyboxesanddisposed
eitherbyincineratororbyburnandburymethod.
18
MultiDoseVialPolicy
Nepal endorsed multi dose vial policy (MDVP) in 2003 for DPTHepBHib, OPV and TT vaccines.
MDVP guideline have been developed and districts apply MDVP where applicable based on the
recommendationintheguideline.
AdverseEventsFollowingImmunization
Adverse Events Following Immunization (AEFI) sentinel surveillance was initiated in 2004. In FY
2067/68, 20 persons received ToT on AEFI and training was conducted in 37 districts for RRT
members.ThemonthlyreportingofAEFIisirregular.Minorcaseshavebeenoccasionallyreported
howeverallmajorcaseshavebeenreportedandinvestigated.Atotalof7majorAEFIwerereported
in2067/68andoutofwhich5died.
2.1.4 Problems/Constraints
NIPregularlymonitorstheimmunizationprogram.QuarterlyreviewofHMISdataatthecentrallevel
andregularfeedbacktodistrictshasbeenuseful.Regionallevelreviewwasdonetwiceintheyear.
ThesereviewshavehelpedtheNIPinidentifyingtheissues,challengesandsolutiontoovercomethe
challengesfaced.Thesereviewshaveprovidedguidancetotheprogramforfutureplanning.Table
2.1.5 presents the problems/constraints discussed in the reviews and the actions taken and
responsibility.
Table2.1.5:Problems/Constraints
Problems/Constraints
Qualityofimmunization
data
Negativedropout
Underandover
reporting
Availabilityofmicroplan
Actiontobetaken
1. Servicelevel
Registervaccinationimmediately
VerifywithHMIS5andtallysheetwhiletransferring
datainHMIS
2. Ilakaanddistrictlevel
IlakaIncharge/EPISupervisorshouldreviewthe
numberofchildrenforeachantigensagainstthetarget
andpreviousmonthscoverage
Supervisionbasedontheunimmunizednumbersof
children,datainconsistencyagainstentryand
successivedoses
3. Centrallevel
Periodicanalysisandfeedback
Supervision
1. Developmicroplan
Mapofcatchmentsarea
Sessionplan
Highriskpopulationidentifiedandstrategiestoreach
themdeveloped
Supervisionplan
2. Periodicupdateofmicroplanbasedonthehighrisk
populationidentification
3. Conductsupervisionbasedonlowperforminghealth
facilities(Numberofunvaccinatedchildren,inadequacy
ofimmunizationsessions,highdropout,unmatcheddata)
4. Usesupervisionchecklist
5. Updatelinelistingofunimmunizedtargetpopulation
Responsibility
District/
Regionand
CHD/HMIS
Districts
19
Inventoryupdate
Immunizationmonth
Heldonadhocbasis
Reportnotavailable
HumanResource
Vacantpostof
vaccinators
Vaccinatordoesnot
existonpopulation
based
Inappropriate
positioningofcold
chainpeopleandEPI
supervisor
Insufficientnumberof
vaccinatorsoncontract
andtheircontinuity
ColdChain
Inadequatespareparts
Ageingofcoldchain
equipments
Inadequatevaccine
transportcost
Actiontobetaken
Updateinventoryofcoldchainequipments
Updatemonthlyinventoryonvaccine,syringes,diluents
etc.
Usethevaccine/diluents/syringerequisitionformatall
level(vaccine/syringes/diluentsneed=maximumstock
stockathand)
Prioritizehealthfacilitiesquarterly
TargetHFwithaccessibilityproblem,highdropout,
sessionsnotregular,morenumberofunimmunized
children
Intensifytheactivitiestoaddresstheabovementioned
problemsinBaishak,JesthaandAshadh
ReporttheachievementinCHDseparately
Alternativeprovisionofvacantpostofvaccinators(Fill
vacantpostorcontractoutlocally)
Reallocateexistingimmunizationstaffsatdifferentlevel
Responsibility
Districts
Supplyofcoldchainspareparts
Replacementofageingequipments
DoHS,LMD
Allocationofadequatevaccinetransportcostbasedon
districtcostestimation
DoHS/CHD
Districts
MoHP/
DoHS
2.1.5 Targetsfor2068/69
Table2.1.6presentsthetargetsforFY2068/69.
Table2.1.6:TargetsforFY2068/69
S.N.
1
2
Activities
RoutineImmunisationactivitiesaimingforhighercoverage
TT2+Immunisationforallpregnantwomen
Unit
Children<1year
Pregnantwomen
Targets
659,016
769,699
Source:EPI/CHD,DoHS
Note:PleaseseeAnnex3.3fordistrictspecificdata.
20
Nutrition
Fiscal Year 2067/68 (2010/2011)
Proportion of malnourished children
(weight/age new v isit) <5 Children
Growth Monitoring New Visits as

% of <5 Children
H umla
10 8
K a lik ot
R ukum
74
D olpa
73
72
71
Ma na ng
70
O k ha ldhunga
D a de ldhura
70
68
R a suwa
Gulmi
D ot i
B a ra
B a nk e
55
54
54
B a jura
53
J ha pa
52
B a jhang
51
Ma hott a ri
Sarla hi
49
Tana hu
Mus t ang
49
49
Parbat
48
B hojpur
48
B a it a di
48
Salya n
Surk he t
46
46
K a pilva s t u
43
43
Sya ngja
42
D hanusha
B a glung
42
42
Pyut ha n
42
Sindhuli
41
D olk ha
K a vre
38
Sapt ari
37
U day pur
36
Sira ha
K a t hmandu
33
K a nc hanpur
33
Sindhupa lc howk
32
Mora ng
Pancht har
32
32
N uw ak ot
31
D ot i
30
Sank huwa s abha

Suns ari
30
29
Ma ka w anpur
29
B hak t a pur
D hading
28
28
A c hha m
N a walpara s i
27
26
K hot ang
C hit wa n
26
25
Teha rt hum
24
D a ile kh
22
D hank ut a
22
Taple jung
Palpa
20
19
K a ila li
0
Parsa
0
0
R a suw a
R ukum
2 .9
2.9
N a walpa ra s i
2 .8
N uwak ot
Salya n
B hak t apur
2 .7
2 .7
2.6
2 .4
2.4
2 .3
2 .2
K a ila li
D a ile kh
2 .2
2 .1
Surk he t
C hit wa n
G ork ha
2.0
2 .0
1 .8
1.6
1 .6
1 .6
Siraha
1 .5
K hot ang
J ha pa
My agdi
1 .4
K a vre
Sindhuli
1 .4
1 .3
D hading
Panc ht har
1 .3
1 .2
Teha rt hum
B a glung
NATIONAL
39
1 .5
1 .5
1 .4
Sindhupalc howk
Soluk humbu
A rghakha nc hi
1 .2
1 .0
1 .0
0 .8
K a sk i
0 .7
G ulmi
R a me chha p
Sankhuw a sa bha
0 .7
0 .6
0 .6
Ta na hu
0.6
Parbat
Ta ple jung
0.6
0 .6
NATIONAL
D olk ha
D ha nk ut a
0 .5
0 .5
E AS TE RN
E AS TE RN
37
CE NTRAL
36
Sya ngja
Must ang
0 .3
0 .3
37
Lamjung
B hojpur
0 .3
0 .1
Ma na ng
0 .0
W E S TE RN
18
Lalit pur
3 .1
3 .0
3 .0
R olpa
U da ypur
36
35
R amec hha p
Pyut ha n
D a ng
Ma hot t ari
Ilam
40
38
Gork ha
4 .0
3 .3
3.3
3.2
Ma ka wa npur
Ok ha ldhunga
Sapt ari
44
A rghak ha nchi
B a ra
4 .8
4.7
4 .4
4 .3
D olpa
45
Ila m
B a jhang
R a ut ahat
Sarlahi
A chha m
Palpa
Suns ari
B a rdiya
49
R a ut aha t
5 .0
4 .9
D ha nusha
50
50
R olpa
6 .3
5 .5
5 .3
B a nk e
Mora ng
56
B a rdiy a
D a rc hula
6 .9
6 .4
6 .4
6 .3
K a t hmandu
D a de ldhura
58
D a ng
9 .0
8 .4
7 .0
K a pilva s t u
D a rc hula
B a it a di
59
59
Mugu
1 4.7
1 1.1
1 0.3
J umla
K anchanpur
J ajarkot
67
63
K a sk i
My agdi
2 0.5
H umla
K a likot
B a jura
83
79
Solukhumbu
Lamjung
R upa ndehi
Mugu
95
Ja jarkot
J umla
MID-W E S TE RN
FAR W E S TE RN
55
35
Lalit pur
Pars a
R upa nde hi
3.4
2.1
CE NTRAL
W E S TE RN
MID-W E S TE RN
FAR W E S TE RN
3.6
1.8
4.7
6.0
ChildHealth:Nutrition
2.2
NUTRITION
2.2.1 Background
The National Nutrition Program under Department of Health Services has laid the vision as all
Nepali people living with adequate nutrition, food safety and food security for adequate physical,
mentalandsocialgrowthandequitablehumancapitaldevelopmentandsurvivalwiththemission
toimprovetheoverallnutritionalstatusofchildren,womenofchildbearingage,pregnantwomen,
and all ages through the control of general malnutrition and the prevention and control of
micronutrient deficiency disorders having a broader inter and intrasectoral collaboration and
coordination, partnership among different stakeholders and high level of awareness and
cooperationofpopulationingeneral.
Malnutrition remains a serious obstacle to child survival, growth and development in Nepal. The
most common form of malnutrition is proteinenergy malnutrition (PEM). The other forms of
malnutrition are iodine, iron and vitamin A deficiency. Each type of malnutrition wrecks its own
particularhavoconthehumanbody,andtomakemattersworse,theyoftenappearincombination.
Even moderately acute and severely acute malnourished children are more likely to die from
commonchildhoodillnessthanthoseadequatelynourished.Inaddition,malnutritionconstitutesa
serious threat especially to young child survival and is associated with about one third of child
mortality.MajorcausesofPEMinNepalislowbirthweightofbelow2.5kg,duetopoormaternal
nutrition, inadequate dietary intake, frequent infections, household food insecurity, feeding
behaviourandpoorcareandpracticesleadingtoanintergenerationalcycleofmalnutrition.
An analysis of the causes of stunting in Nepal reveals that around half is rooted in poor maternal
nutritionandhalfinpoorinfantandyoungchildnutrition.Aroundaquarterofbabiesarebornlow
birthweight.AsperthefindingsofNepalDemographicandHealthSurvey(NDHS,2011),41percent
ofchildrenbelow5yearsofagearestunted.Thesurveyalsoshowedthat29percentofthechildren
areunderweightand11percentofthechildrenbelow5yearsarewasted.Malnutritionisnotevenly
distributed throughout Nepal; it varies both ecologically and regionally. The report has shown
stunting, underweight and wasting being more common in mid and far west hills and mountain
areasthanotherpartofthecountry.AllthreeindicatorsarealsopoorinthecentralTerai.Inorder
to address the under nutrition problem in young children, Government of Nepal (GoN) has
implementedcommunityInfantandYoungChildFeeding(IYCF),CommunityManagementofAcute
Malnutrition (CMAM) and hospital based nutrition management and rehabilitation. The program
treats severe malnourished children at Outpatient Therapeutic Program (OTP) centres in Health
Facilities and prevent from further deteriorating mild malnutrition through IYCF counselling at
community.Asperrequirement,thepackagewaslinkedwiththeothernutritionprogramslikeChild
NutritionGrant,MNPdistributiontoyoungchildren(623months)andfooddistributioninthefood
insecure areas. Based on the package, MoHP organised an Infant and Young Child Feeding
Counselling Training in 17 districts of Nepal. Nutritious food for 623 months children was also
distributedinKarnalidistricts.
IodineDeficiencyDisorder(IDD)wasanotherendemicproblem inNepal,especiallyinthewestern
mountainsandmidhillsforwhichMinistryofHealthandPopulationadoptedapolicytofortifyall
ediblecommonsaltwithiodineanddecidedtocelebrateFebruaryasthemonthtocreategeneral
awareness about the use of adequately iodized salt through mass campaign to contribute in the
preventionofIodineDeficiencyDisorders.Withanobjectivetoincreasethedemandanduse,GoN
endorsedtwochildlogoiodisedpacketsaltintheEasternTeraiRegion,iodisedsaltsocialmarketing
22
campaignwasconductedinJhapa,SunsariandSaptaridistricts.Wellequippedmodernwarehouses
havebeenconstructedinvariouspartsofthecountryforsafeguardingbufferstockofiodisedsalt.
Another problem among schoolaged children and women is the Vitamin A deficiency leading to
nightblindnessbothinchildrenandwomen.Nocasesofnightblindnessarereportedsofaramong
children below 5 years due to a regular semiannual supplementation of high dose Vitamin A
supplementation to preschool children (200,000 I.U.). The National Vitamin A Supplementation
Program with community support is considered as the one of the internationally recognized
successfulprogram.NepalGovernmentalsocompletedthepilotingofnewbornVitaminAdosing
program in four district of Nepal (Nawalparasi, Tanahun, Bardiya and Sindhuli). A high dose of
vitamin A supplementation for mother during postpartum period is also ongoing throughout the
country.
TheprevalenceofworminfestationinNepalremainingstillhighleadingtodecreasedresistanceto
infectionandcontributingtoanaemicstatus,whichinturnsinducesmalnutrition,andalso,leadsto
anaemiaimpairingcognitivefunctioninchildren.Therefore,dewormingofchildrenonetofiveyears
of age is incorporated into the national biannual Vitamin A supplementation program which has
been implemented in the entire country. Similarly, deworming of all pregnant women with single
doseofalbendazoletabletafterfirsttrimesterofpregnancyisbeingroutinelypracticedthroughall
health facilities in Nepal. In addition, under School Health and Nutrition (SHN) Program biannual
school deworming is also launched to the school students studying at government schools
throughout the country. GoN is planning to upscale deworming chemotherapy to students from
grade1to10ofallpublicandprivateschoolsofthecountry.
Anaemia caused by iron deficiency is also a major public health problem in Nepal affecting all
segments of the population. As per findings of NDHS 2011, 46 percent of children ages 6 to 59
monthsareanaemic.Themajorityofchildrenwhosufferfromanemiaareclassifiedashavingmild
or moderate anemia (27 and 19%, respectively) while less than 1 percent are severely anemic.
Anemia is less common among women; 35 percent show evidence of anemia, and the majority is
mildlyanemic(29%).Anemiaamongbothchildrenandwomenisespeciallyprevalentinruralareas,
wherenearlyhalfofthechildren(46%)andmorethanonethirdofwomen(36%)havesomedegree
ofanemia.TheNDHS2011foundmorethan70percentofchildrenaged6to23monthsareanaemic
compared with 25 percent of children aged 48 to 59 months. Anaemia is most common among
children less than 5 years in the farwestern terai (60%) compared to central mountain (33%).
Overall,therehasbeennosignificantimprovementintheanemiastatusofchildrenandwomenin
Nepalbetween2006and2011.
As per the government policy, all pregnant women and postpartum mothers are given iron tablet
startingfromsecondtrimestertopostpartumperiodfreeofcost.Inordertoincreasecoverageand
complianceofirontabletsamongpregnantandpostnatalmothersIntensificationofMaternaland
NeonatalMicronutrientProgram(IMNMP)isimplementedthroughtheexistinghealthfacilitiesand
communitybased outlets like FCHVs with special emphasis on creating awareness. Awareness
raising activities mainly include advocacy, information through public media and training of health
workers/volunteers at all levels. IEC materials such as flip chart and posters are also being
distributedforthispurpose.Bytheendoffiscalyear2067/68,theprogramhasbeenintroducedin
70districts(Outoftotal75districts).
Food fortification with iron is a low cost intervention for providing iron rich nutrients to a larger
population without changing their food consumption patterns. In view of this, wheat flour
fortificationprogramhasbeenlaunchedwithsupportfromMicronutrientInitiative(MI).Similarly,a
pilotprojecthasalsobeenlaunchedinaVDCofLalitpurwithMIsupportwherecerealflours(mainly
23
maize)arebeingfortifiedwithiron,folicacidandvitaminAatsmallwatermills.Now,Ministryof
Agriculture and Cooperatives (MoAC) has made a mandatory provision of fortification in wheat
floursproducedbyrollermills.
AccordingtoWHO2011guideline,micronutrientpowdersupplementationisrequiredintheareas
wheremorethan20percentunderfivechildrenpopulationissufferingfromanyformofanaemia.In
Nepal,irrespectiveofgeographicalregions,theanaemiaprevalenceishigherthan20percentinthe
under five children and the situation is more critical in under two years children where the
prevalence is as high as 70 percent, according to the Nepal Demographic Health Survey, 2011. To
address the problem, MoHP Nepal has endorsed a permissive policy on home fortification of
micronutrientpowder(MNP)inthecomplementaryfoodinordertocorrectAnaemiaPrevalencein
623 month children. Linking the distribution of MNP to 623 months children with Governments
Infant and Young child Feeding Promotion Program, the MNP distribution program has been
implementedin6districtsofNepalviz.Rupandehi,Parsa,Gorkha,Rasuwa,PalpaandMakawanpur.
Theplanistoscaleupthisprogramall75districtsby2015.
In order to reduce the prevalence of low weight among young children, anaemia among the
pregnant women, nursing mothers and young children, MoHP along with WFP support has
implemented the Mother and Child Health Care (MCHC) activity in remote food deficit districts of
NepalinDadeldhura,Doti,Darchula,Baitadi,Bajhang,Bajura,AchhamandSalyandistrictsthrough
theexistinghealthfacilitiessuchasHP,SHPandPHCORCclinics.Ajointreviewofthisprogramby
MoHP,MoEandWFPhasrecommendedthattheprogramisstillrelevantinthoseareashavinghigh
level of food security and has also explored the possibility of integration of the program with the
government programs. It is also recommended for evaluation of impact of MCHC program for
furtherscalingofscalingupinchronicallyfoodinsecuredistricts.
2.2.2SummaryofPolicyInitiatives
Realizing a need for a comprehensive document on nutrition for generating support and effective
implementationoftheprogram,aNationalNutritionPolicyandStrategywasformulatedin2004AD
with the technical assistance of External Development Partners (EDPs) which is the main policy
documentwhichhaveguidedthenutritioninterventionsinthehealthsector.TheMoHPhasalsoput
inplaceSchoolHealthandNutritionStrategy2006.Similarly,NepalHealthSectorProgramII2010
2015(NHSPII)hasgivenaspecialpriorityfornutritionandhasalsoemphasisedtheneedforamulti
sectoralapproach.
The Nepal Nutrition Assessment and Gap Analysis (NAGA) in 2009, led by the Child Health
Division/MinistryofHealthandPopulationandsupportedbytheWorldBank,USAID,UNICEF,WHO
andWFP,providedtheimpetustodevelopadetailedmultisectorNutritionActionPlanforthenext
fiveyears(20122016).Thisreportoutlinedthekeyrecommendationstostepuptheprogresson
nutrition within the country, with a call to establish the national nutrition architecture and to
mobiliseallthekeysectorstotackletheprevailinghighratesofmalnutritioninasustainedmanner
throughmultisectoralapproach.AfterendorsementfromtheMoHP,thefindingofthereportwas
shared with the National Planning Commission seeking its coordination role to implement the
findingsandtherecommendationsbythereportfromkeysectors.Asaresult,NPCconstitutedan
apex coordinating body, National Nutrition Steering Committee (NNSC) based on the
recommendationofNAGAreportwhichappointedthe13NutritionFocalOfficersinthekeysectors
in order to develop nutrition actions in coordinated way. As a result, the three years National
Development Plan 2011 2013 with improved nutrition action in key sectors was developed with
collective contribution from the relevant sectors. Currently, NNSC has been merged with National
24
Food Security Steering Committee and become a high level National Food Security and Nutrition
SteeringCommitteeunderthechairmanshipofVicechancellorofNationalPlanningCommission.
Subsequently, National Planning Commission (NPC) initiated and consolidated separate sectoral
reviewsincollaborationwithdifferentministriesandprovidedinputstoanevidencebasednational
nutritionpackagethatwouldfocusonthecriticalwindowofopportunitythefirst1000daysand
this package would target stunting reduction and would improve maternal nutrition in Nepal to
address the high rates of low birth weight in the newborns. The longerterm vision of the multi
sectoral nutrition plan, over the next ten years, is to embark the country towards significantly
reducing chronic malnutrition to ensure that it no longer becomes an impeding factor to enhance
humancapitalandforoverallsocioeconomicdevelopment.Thegoal,overthenextfiveyears,isto
improvematernalandchildnutritionspecificallyfocusedonstuntingreduction,whichwillresultin
thereductionofMaternalInfantandYoungChild(MIYC)undernutrition,intermsofmaternalBody
MassIndex(BMI)andchildstunting,byonethird.Themainpurposeistostrengthencapacityofthe
NPCandthekeyMinistriestopromoteandsteerthemultisectoralnutritionprogramforimproved
maternalandchildnutritionatallthekeylevelsofsociety.Theplanfocusesonimprovingmaternal
andchildundernutritioninordertoreducegrowthfalteringduringthewindowofvulnerabilityfrom
conception to two years of age, as measured by young child stunting and will complement other
relevantsectoralpoliciesandstrategies.
Schoolagedchildren,especiallyinthegovernmentrunschoolsarealsooneofthevulnerablegroups
tosufferfromPEMproblems.Toaddressthisissue,a'NationalSchoolHealthandNutritionStrategy'
has also been jointly developed and approved by MoHP and MoE in 2006. With the help of JICA
technical assistance all components of SHN strategy is implemented on pilot basis in 2 districts,
SyangjaandSindhupalchowkfromJune2008andwillcontinueuptoMay2012whichalsoaimedto
replicatetheresultsandexperiencesinotherdistrictsinaphasewisemanner.Themaingoalofthe
SHNP is to develop physical, mental, emotional and educational status of the school children. A
baseline survey and midterm review was carried out to know the preliminary results of the pilot
project. The end line survey has recently been carried out and it was found that there had been
notable positive improvement seen in terms of most of the indicators that were used during the
baselineandmidtermsurvey.
2.2.3NationalNutritionProgram
Goal
The overall goal of national nutrition program is to achieve nutritional well being of all people in
Nepal to maintain a healthy life to contribute in the socioeconomic development of the country,
throughimprovednutritionprogramimplementationincollaborationwithrelevantsectors.
Theprogramaimstoachievethefollowingtargets:
Reduce IMR 36/1,000; <5 mortality rate 54/1,000 and MMR 250/100,000 live births by 2015
(MDGs)
ReduceIMR34.4/1,000LBand<5mortalityrateto62.5/1,000LBbytheendof2017(SLTHP)
NutritionSpecificMDGsGoal
ThefollowingNutritionSpecificGoalsaretobeachievedbytheendof2015(MDGs):
ReducesubclinicalVADto7pecent
Reduceanaemiainpregnantwomento43percent
25
Reduceanaemiainallagewomento42percent
Reduceanaemiainchildrento43percent
Increaseconsumptionofadequatelyiodizedsalt(15PPM)atHHslevelto88percent
Reduceprevalenceofnightblindnessinpregnantwomento1percent
Reduceprevalenceofunderweightin<5yearschildrento27percent
Reduceprevalenceofstuntingin<5yearschildrento28percent
Reduceprevalenceofwastingin<5yearschildrento5percent
Increaseexclusivebreastfeedingin<6monthschildrento88percent
Reduceprevalenceofthinness(BMI18.5below25)inwomento15percent
Reduceworminfestationrateinchildren(Preschool)tolessthan15percent
Objectives
GeneralObjective
ThegeneralobjectiveoftheNationalNutritionProgramistoenhancenutritionalwellbeing,reduce
childandmaternalmortalityandistocontributeforequitablehumandevelopment.
SpecificObjectives:
Reducegeneralmalnutritionamongwomenandchildren
ReduceIronDeficiencyAnaemiaamongchildrenandpregnantmother
MaintainandsustainIodineDeficiencyDisorder(IDD)andVitaminADeficiencyDisorder(VAD)
Improvematernalnutrition
AlignwithMultisectoralNutritionInitiative
ImproveNutritionrelatedBehaviourchangeandcommunication
ImproveMonitoringandEvaluationforNutritionrelatedPrograms/Activities
Targets
In order to improve the overall nutritional status of children and pregnant women, the national
nutritionprogramhassetthefollowingtargets:
To reduce PEM in children under 5 years of age and reproductive aged women to half of the
2000levelbytheyear2017.
To reduce the prevalence of anaemia among women and children to less than 40 percent by
2017.
TovirtuallyeliminateIDDandsustaintheeliminationby2017.
TovirtuallyeliminatevitaminAdeficiencyandsustaintheeliminationby2017.
Toreducetheinfestationofintestinalwormsamongchildrenandpregnantwomentolessthan
10percentby2017.
Toreducetheprevalenceoflowbirthweightto12percentbytheyear2017.
To improve household food security to ensure that all people can have adequate access,
availabilityandutilizationoffoodneededforhealthylifeinordertoreducethepercentageof
peoplewithinadequateenergyintaketo25percentby2017.
Toimprovehealthandoverallnutritionalstatusofschoolchildrenthroughtheimplementation
ofSchoolHealthandNutritionProgram.
Toreducethecriticalriskofmalnutritionandlifeduringexceptionallydifficultcircumstances.
Tostrengthenthesystemforanalyzing,monitoringandevaluatingthenutritionsituation.
26
Topromoteexclusivebreastfeedingtilltheageofsixcompletedmonths.Thereafter,introduce
complementaryfoodsalongwithbreastmilktillthechildcompletes2yearsormore.
ToreducetheInfestationofintestinalwormamongChildrenandPregnantWomentolessthan
10percentby2017.
Strategies
ThefollowinggeneralstrategieshavebeenpursuedtoaddressthenutritionalsituationinNepal:
To reduce proteinenergy malnutrition (PEM) in children less than five years of age and
ReproductiveagedWomentohalfofthe2000levelbytheyear2017throughamultisectoral
approach.
Promote, facilitate and utilize community participation and involvement for all nutrition
activities.
Develop understanding and effective coordination between various concerned Sections,
DivisionsandCentreswithintheDepartmentofHealthServices.
Maintainandstrengthencoordinationamongotheragenciesinvolvedinnutritionactivities,i.e.,
the Ministries of Agriculture, Education, Local Development and the National Planning
Commission,aswellaswithEDPs,NGOs,INGOsandprivatesector.
Decentralise authority to the region, district, Health Post, Sub Health Post and community for
needsassessment,planning,implementation,andmonitoring.
Conduct national advocacy and social mobilization campaigns; Integrate/incorporate activities
(such as Expanded Program on Immunization, Integrated Management of Childhood Illness,
MaternalandFamilyHealthandotherconcernprogram,etc.)intonutritionplans.
DevelopasystematicapproachforMonitoringandEvaluationofallnutritionprogramactivities.
Celebrate different events related to nutrition program like School Health and Nutrition Week
(Jestha 1 to 7), Breast feeding week (August 17), Iodine month (February) to raise awareness
abouttheimportanceofNutrition.
ImplementSchoolHealthandNutritionProgramasperNationalStrategy.
Growthmonitoringwillbeusedasascreeningtooltoassessthegeneralmalnutritionstatusof
childrenunderlessthanfiveyears.
SpecificStrategies
1. ControlofProteinEnergyMalnutrition(PEM)
PromotionofIYCFthroughcreatingawarenessregardingtheimportanceofgrowthmonitoring
and exclusive Breast Feeding up to 6 month of age and timely introduction of complementary
foods.
Provide growthmonitoring services, ANC checkups, deworming during Pregnancy through
outreachclinics,SubHealthPosts,HealthPosts/PHCinfoodinsecuredistricts.
Protect,Promote&SupportOptimalFeedingPracticeforInfant&YoungChildren.
Increaseawarenessamongmedicalprofessionalsthroughadvocacyefforts,suchasbyincluding
sessionsonbreastfeedingonseminars/workshopsheldbyvariousassociations.
BCCforChangingtheDietaryPractices.
CelebrateBreastfeedingWeek(August17)asanadvocacyfortheprotectionandpromotionof
breastfeeding.
Strengthen Nutrition Rehabilitation Home and community based management of acute
malnutrition(CMAM).
Improve Maternal and Adolescent Nutrition & Low Birth Weight Baby Through improved
MaternalNutritionPractices.
27
2. ControlofIDD
Strengthen the implementation of Iodized Salt Act, 2055 for regulation and monitoring of
iodizedsalttradetoensurethatallediblesaltisiodized.
Increasetheaccessibilityandmarketshareofiodizedpacketsaltwithtwochildlogo.
Create awareness about the importance of use of iodized salt for the control of IDD; through
SocialMarketingCampaign.
CelebratemonthofFebruaryasaniodinemonth.
3. ControlofVitaminADeficiency(VAD)
Distribute highdose vitamin A capsules to children between 6 and 59 months biannually
throughFCHVs.
Advocateforincreasedhomeproduction,consumptionandpreservationofVitaminArichfoods
atthecommunitylevel.
Explorethefortificationofsuitablefoods(suchassugarandcookingoil)withVitaminA.
StrengthentheusageofVitaminATreatmentprotocol.
SupplementationofVitaminAcapsule(200,000IU)topostpartummothersthroughhealthcare
facilitiesandcommunityvolunteers.
4. ControlofAnaemia
Increasecoverageandcomplianceofiron/folatesupplementationforpregnantwomen.
Reducetheburdenofparasiticinfestations(helminths,malariaandKalazar).
Identify and implement food fortification to increase the dietary iron intake focusing on
commercialaswellassmallscalecommunitybasedfortificationinitiatives.
Promote dietary diversification to improve the quality of food consumed with an emphasis on
bioavailableiron.
Promotematernalcarepracticesandservicestoimprovehealthandnutritionalstatusofmother
andbabies.
Identify and implement the effective modalities to address iron deficiency in adolescents and
nonpregnantwomenofreproductiveage.
5. Deworming
Deworming of pregnant women through health facilities with single dose tablet (Albendazole
400mg)startingfrom2ndtrimester(4months)ofthepregnancy.
Distribute Biannual deworming tablet to Primary School Children in 75 districts (Government
schools).
Followupthecomprehensivedewormingworkplan.
1. ProtectionandPromotionofInfantandYoungChildFeeding(IYCF)Counselling
CarriedouttrainingonIYCFcounsellinginsevendistricts:Doti,Bardiya,Dang,Nuwakot,Morang,
MahottariandSankhuwasabha.
CelebratedBreastfeedingWeek(August17)inalldistrictswithrallies,talkprogram,adolescent
orientationandSchoolhealthandnutritionprogrametc.
Promotional messages broadcasted for exclusive breastfeeding through mass media and
distributedbookletsonbreastfeedingforhealthworkers.
Integrated Infant and Young Child Feeding Community Promotion program with Child Grant in
fourdistricts:Humla,Jumla,Kalikot,andDolpa.
28
Distributed Nutritious food to 623 months children in the districts of Karnali zone (Humla,
Jumla,Kalikot,MuguandDolpa).
Advocacy and technical support provided to draft Multi Sector Plan of Action on Nutrition
(MSPAN).
DesignedMaternalInfantandYoungChildNutritionPrograminordertoimplementittoall75
districtsby2015.
Explore the possibility of using Nepal Development Volunteers Services (NDVS) Cadres in
NutritionProgramthroughdevelopingtrainingguidelineforthemandprovidingorientationon
nutritiontothemincoordinationwiththeNationalPlanningCommission.
2. GrowthMonitoringforScreeningandPreventionofPEM
Continued regular growth Monitoring at Hospital, PHC, Health Posts, Sub Health Posts and
Outreachclinics.
Suppliedsalterscaleandgrowthmonitoringcard.
CapacityBuildingandOrientationonGrowthMonitoringtoHWs.
NutritionRehabilitationCentresextendedtoallRegionalandZonalHospitals.
Continued Community Based Management of Acute Malnutrition in five districts (Bardiya,
Achham,Mugu,KanchanpurandJajarkot).
3. ControlofIodineDeficiencyDisorder(IDD)
RegularsupervisionandmonitoringofiodizedsaltconductedatSTC'swarehouses.
ConductedIodizedSaltSocialMarketingCampaigninthreedistricts,Jhapa,SunsariandSaptari.
IDD month celebrated throughout the country in the month of February for intensification of
promotionalactivities.
Surveillance on consumption of iodized salt along with Vitamin A was continued in three
municipalities and FCHV registers used for Intensification of Maternal and Neonatal
MicronutrientProgram(IMNMP)wasalsousedforthispurpose.
Nationalscalesurveyfortrackingtheprocesstowardspreventionofiodinedeficiencydisorders
inNepaliscontinued.
DistributedsubsidizedsaltinRemote&inaccessibleDistricts.
4. ControlofVitaminADeficiency(VAD)
ContinuedbiannualmassdistributionofhighdosevitaminAcapsulestochildrenbetween6to59
monthsthroughoutthecountry.
Continued nutrition education activities through media, communitylevel health workers and
agricultureextensionworkers.
ContinuedpostpartumvitaminAsupplementationthroughhealthinstitutionsandFCHVs.
ContinuedcasetreatmentwithvitaminAthroughhealthfacilities.
InitiatedcommunitybasednutritionreactivationtrainingtoHWswithemphasisonVitaminAin
selecteddistricts.
ConductedaworkshoptoreviseIECmaterialsonnutrition,especiallyonVitaminA.
5. ControlofIronDeficiencyAnaemia(IDA)
Continued distribution of iron and folate tablets to pregnant and lactating women through
Hospital,PHCC,HPs,SHPs,ORCs,andFCHVs.
Continued Intensification of Maternal and Neonatal Micronutrient Program" (IMNMP) 70
districts.
ExpansionofMCHCactivityinSolukhumbudistrict.
Completed Micronutrient supplementation program linked with IYCF promotion in 6 districts:
Rupandehi,Parsa,Rasuwa,Gorkha,MakawanpurandPalpa.
29
Productionofwheatflourfortifiedwithiron,folicacidandvitaminAstartedatabout10(50%)
rollermillsonvoluntarybasis.
ContinueddistributionofFlipChartandposteronmaternalmicronutrientandanemia.
Initiatedadvocacyonuseoflowcostirontabletstopregnantandpostnatalwomenattending
MaternityHospitalinKathmandu,andotherRegionalaswellasZonalHospitals.
ConductedsurveillanceonconsumptionofironalongwithVitaminA.
6. Deworming
Continuedregularbiannualdewormingofchildrenaged15yearsalongwithvitaminAcapsule
distribution.
ContinueddewormingofpregnantwomenasperthePolicyandprotocol.
Scale up on strengthening the school deworming Program to other Development regions.
Orientation on School Deworming through School Health and Nutrition Program in three
regions,FWDR,CDRandEDR.TrainingonschooldewormingtohealthstaffsunderMoHP,and
resource persons, school supervisors and school teachers under MoE in four districts;
Sankhuwasabha,Morang,NuwakotandMahottari.
7. Miscellaneous
Finalised National Development Plan 2011 2012 with nutrition actions in key sectors (MoHP,
MoAC,MoE,MoPPWandMoLD).
Drafted costed Multi Sector Plan of Action on Nutrition under the leadership of National
Planning Commission in coordination with the key sectors (MoHP, MoAC, MoE, MoPPW and
MoLD).
HighlevelpoliticalcommitmentpaperonNutritionreleasedintheLeastDevelopmentCountry
MeetingandScalingUpNutritionMeeting.
FormationofNUTEC.
Initiatedforthedevelopmentoffooddietaryguideline.
Fig 2.2.1
Fig2.2.1
New Growth Monitoring Coverage

FY 2065/66 to 2067/68
(new visits as % of <5 children)
70
65
55
57
55
60
43
36
37
39
37
40
44
42
45
35
50
44
44
48
46
55
39
Table 2.2.1 presents the trend in growth

monitoring coverage among under 5 children
over the last 3 years. Nationally, there has been
decrease in growth monitoring coverage by 7
percentandatregionallevelithasdecreasedby
8 percent in farwestern development region
which is the highest among five development
regions whereas the least decrease by 2 percent
is observed at midwestern development region
(Figure2.2.1).
45
46
2.2.5 AnalysisofAchievements
35
National
EDR
CDR
WDR
2065/66
MWDR
2066/67
FWDR
2067/68
30
Table2.2.1:NutritionProgram,byRegion,FY2065/66to2067/68
Indicators
Totalno.of<3year
Childrengrowth
monitored
Year
2065/66
2066/67
2067/68
TotalNo.of<5years
2065/66
Childrengrowth
2066/67
monitored
2067/68
GrowthMonitoring
2065/66
coverageasapercentof
2066/67
children<5years(%)
2067/68
Averageno.ofgrowth
2065/66
Monitoringvisitsby<5per 2066/67
case(%)
2067/68
VitaminAdistributionto
2065/66
Children659months
2066/67
2067/68
VitaminAdistributionas
2065/66
percentofchildren659
2066/67
months(%)
2067/68
No.ofpregnantwomen
2065/66
receivingIrontabs
2066/67
2067/68
Percentageofexpected
2065/66
pregnantwomenreceiving 2066/67
Irontabs(%)
2067/68
EDR
294,115
255,221
227,047
360,405
305,275
266,861
44.04
41.73
37.10
2.46
2.96
3.31
794,034
664,405
756,699
97
94
106
166,512
143,345
142,667
70.49
80.88
79.39
CDR
386,491
412,467
324,387
480,740
501,891
406,834
38.99
43.33
35.69
2.03
2.09
2.19
1,232,221
909,237
1,022,240
100
90
108
249,511
237,034
158,589
74.87
92.89
61.57
Region
WDR
292,364
257,906
194,531
355,993
298,989
236,492
48.10
45.71
36.87
2.14
2.36
2.57
607,662
503,409
581,388
82
82
94
132,830
124,741
93,280
66.70
82.83
61.28
MWDR
238,535
224,436
215,979
297,825
279,668
262,266
55.33
57.11
54.56
1.90
2.00
2.03
468,639
310,079
479,285
87
111
120
104,530
104,366
94,421
76.77
102.4
91.57
FWDR
144,879
133,347
107,024
175,018
161,839
126,048
44.27
44.13
35.06
2.92
3.27
4.28
329,865
259,537
251,202
83.44
73
101
82,019
87,616
69,618
80.14
120.41
94.65
National
1,356,384
1,283,377
1,068,968
1,669,981
1,547,662
1,298,501
44.81
45.51
38.87
2.21
2.41
2.61
3,432,421
2,646,667
3,090,814
92.11
90.0
106
735,402
697,102
558,575
73.03
92
72.91
Source:HMIS/MDandNutritionSection/CHD,DoHS
Table 2.2.2 shows the national and regional trend in nutritional status of children <5 years of last
threeconsecutivefiscalyears.Atthenationallevel,thepercentofunderfiveyearschildrenamong
newgrowthmonitoredhaving'Malnourished'statushasdecreasedbyonly0.4percentcomparedto
lastyear.
Table2.2.2:NutritionStatus,byRegion,FY2065/66to2067/68
Indicators
Malnourishedasa
percentofnewgrowth
monitoredcases<5year
children
Year
2065/662008/09
2066/672009/10
2067/682010/11
EDR
3.2
2.4
2.1
CDR
4.7
4.1
3.6
Region
WDR MWDR
3.1
6.7
1.9
5.0
1.8
4.7
FWDR
7.4
6.4
6.0
National
4.7
3.8
3.4
Source:HMIS/MD,DoHS
31
Fig 2.2.2
Fig2.2.2
Trends in Total Growth Monitoring Visits

FY 2065/66 to 2067/68
225,000
210,000
195,000
180,000
165,000
150,000
135,000
120,000
105,000
90,000
75,000
60,000
Total Grow th M onitor ing V is its

2065/66 = 1,646,103
2066/67 = 1,547,662
2067/68 = 1,298,501
2065/66
Shrawan
153,556
Bhadra
151,711
Aswin
130,997
Kartik
133,700
2066/67
131,990
130,062
106,891
130,101
2067/68
124,387
123,675
111,576
98,555
Mangsir
134,185
Poush
140,077
Magh
136,667
Falgun
122,079
Chaitra
131,004
Baisakh
121,378
Jestha
138,613
Ashad
152,136
126,759
122,423
130,153
109,643
119,697
114,365
110,270
215,308
106,767
111,555
103,849
105,074
104,227
99,433
104,632
104,771
Growth Monitoring Visits

2065/66
2066/67
2067/68
5
5
2
2
2
2
4
3
4
4
Proportionofmalnourishedchildrenbasedonthenewgrowthmonitoredcasesdecreasedslightlyin
allregionsoverthelasttwofiscalyears.Figure2.2.2presentstrendsingrowthmonitoringvisitsfor
the past three fiscal years by month. The
among New growth Monitored
number of growth monitoring visits by Fig 2.2.3 % of Malnourished
(among <5 Children)
FY 2065/66 to 2067/68
month has decreased in FY 2067/68
comparedtothelastfiscalyear2066/67.
8
Figure2.2.3 presentsthe nutritionalstatus

of children less than five years who were
brought to the health institutions for 4
growth monitoring. In FY 2067/68, at the
national level, 3.4 percent of those who 0
National
EDR
CDR
WDR
MWDR
FWDR
were growth monitored for the first time
were found malnourished. The percentage
2065/66
2066/67
2067/68
ofmalnourishedcasesdecreasedbyalmost
1percentcomparedtoFY2066/67.
FWDRhasreportedthehighestpercentageofmalnourishedchildren(6%)followedbyMWDR(5%).
ThelowestpercentageofmalnutritionwasobservedintheWDR(2%).Inallregions,theproportion
ofmalnourishedchildrendeclinedduringtheFY2067/68comparedtopreviousfiscalyears.
2.2.6Problems/Constraints
Table 2.2.3 presents the problems/constraints discussed during the regional and national reviews,
recommendedsolutionandtheresponsibleagency.
32
Inadequatecoverageofnutrition
interventionstomanage
malnutrition
RecommendedAction
ExpandCMAM,CBIYCFprogram,NRHand
supplementaryfeeding.
CapacitybuildingofHWsonIYCFcounseling.
DevelopguidelinesandtrainHWsonmanagement
ofmoderatemalnutrition.
ExpandMNPdistributionprogramfor623months
childrenintegratingwiththeIYCFcommunity
promotionprogramandscaleupitto75districtsby
2015inaphasewisemanner.
Carryoutmicronutrientsurvey.
InitiationofthenegativeconsequencesofDisasters
andEmergenciesinthenutritionstatusofchildren
andwomenofNepalthroughDisasterRisk
ReductionandEmergencyPreparednessprograms.
ExpandNRHinafewmoredistricts.
Responsibility
CHD/DoHS/MoHP
Exploreeffectiveinterventionstoaddressmaternal
nutritionproblems.
CreateawarenessonimportanceofvitaminAinlow
coveragedistricts.
Developgeofocuseffectivecommunication
messageonIDDtoincreasetheuseoftwochild
logoiodisedsaltathouseholdlevel.
Createawarenessonimportanceoftowchildlogo
iodizedpacketsaltfocusinginthelowcoverage
pocketareas.
RecommendtoSaltTradingCorporationtoimprove
distributionof2CLadequatelyiodizedpacketsalt
andphaseoutloosecrystalsalt.
Conductcapacityenhancingactivities.
CarryoutO&Msurveyforinstitutional
strengtheningfornutritionprogram.
CHD/DoHS/MoHP
andDistricts
CHD/DoHS/MoHP
andDistricts
CHD/DoHS/MoHP
andDistricts
Highprevalenceofanemiaamong
623monthsagegroup,nosucha
etiologyisexplored
Lackofresourcesforscalingupof
priorityprogramstoaddressSAM
andMAM
Insufficientofnutrition
rehabilitationhomesforseverely
malnourishedchildren
Limitedinterventionstoaddress
maternalnutritionproblem
LowVitaminAcoveragein611
monthschildrenandurbanarea
LowadequateHHiodine
consumptioninHillandMountain
districts(73%)andrural77.7%
Speciallylowinthehillyareasin
theMidWest,Farwestand
Easternregion
Inadequatenationalcapacity(HR
andInstitutional)fornutrition
CHD/DoHS/MoHP
CHD/DoHS/MoHP
CHD/DoHS/MoHP
CHD/DoHS/MoHP
2.2.7 TargetsforFY2068/69
Table2.2.4presentsthetargetsforFY2068/69.
SN
1
2
3
4.
Activities
VitaminAdeficiency(Prevention+treatmentofvitaminAdeficiency
diseasesamongchildrenbetween6to59months)
PreventionandtreatmentofIrondeficiencyAnaemia
(Increasecoverageandcomplianceofirontabletsamongpregnantand
postnatalwomenthroughallhealthfacilitiesincludingoutreachclinicsand
FCHVs)
Deworming
DistributionofAlbendazoletablettoallchildrenaged15years
DistributionofAlbendazoletablettoGovernmentSchoolchildrenClass15
of75districts
Unit
Persons
Persons
Targets
4,850,000
1,000,000
Persons
3,500,000
Persons
4,500,000
Source:HMIS/MD,NutritionSection/CHD,DoHS
33
CB-IMCI
Fiscal Year 2067/68 (2010/2011)
Proportion of Sev ere Pneumonia
among New Cases
Proportion of Sev ere Dehydration

Among Total New Cases
K alik ot
4.97
Siraha
4 .14
Mugu
Palpa
J aja rkot
0 .99
Lalit pur
D ha nkut a
R ukum
0 .91
D olpa
J aja rkot
0.87
Saly an
D olpa
0.75
D ade ldhura
0.75
K hot ang
0.66
K apilvast u
0.65
Mana ng
Sank huwasa bha
B aglung
Sindhupa lchowk
0 .6
Jumla
0.51
Parsa
B ajura
0.51
K apilvast u
D ot i
Mugu
0 .47
K alik ot
Mahot t ari
0.44
K aila li
Parbat
0.39
Solukhumbu
Mus t ang
0 .38
Sindhupalc howk
0 .38
N uwa kot
K at hma ndu
0.37
D hading
Sankhuw as a bha
0.36
B ajha ng
Gulmi
Taplejung
0 .32
B ajura
D olkha
0 .32
A chham
Sarla hi
R olpa
0 .3
R aut ahat
H umla
0 .27
B ajhang
0 .27
R as uw a
K aila li
0 .27
Panc ht ha r
B hak ta pur
0 .27
K anc hanpur
Sapt a ri
0 .26
B ha kt apur
U day pur
0 .26
Parsa
0 .26
B aita di
Soluk humbu
0.24
K hot ang
D ha ding
0.24
B hojpur
Sindhuli
0.24
Must ang
B ait a di
0 .23
A chham
0.22
G ulmi
Palpa
B ardiya
B aglung
0.22
D ot i
Salya n
0 .18
D archula
B ara
D ang
0 .17
K av re
0 .17
Sunsari
Gork ha
0 .17
Tehart hum
N uwa kot
0 .15
Taple jung
D aile kh
0 .11
Surkhe t
Okha ldhunga
0 .11
Myagdi
R ame chha p
0 .11
D ailekh
B ara
0 .11
D ha nus ha
0 .11
Syangja
Tehart hum
Ilam
Sindhuli
0 .11
R amec hhap
0 .11
Maka wanpur
K ancha npur
0 .1
Lamjung
B anke
0 .1
Okha ldhunga
Pyut han
Ila m
0 .1
Jhapa
0 .1
R olpa
0.09
Mora ng
Mya gdi
0.09
Sira ha
D arc hula
0.09
N awa lparasi
0.09
A rghakha nchi
A rghakhanchi
Surkhet
N awa lpara si
D ang
0 .08
B ank e
0.07
D olkha
Mahot t ari
B ardiya
0.06
Panc ht har
0.06
Mak aw anpur
0.06
Gorkha
0.06
K at hma ndu
Mora ng
Pyut ha n
0.04
C hit wa n
0.04
Lamjung
0 .03
Suns ari
0 .03
R asuwa
0.02
B hojpur
D hankut a
U da ypur
N A TION A L
R upande hi
Manang
K as ki
Tanahu
Sarla hi
0.37
D hanus ha
0.69
EA STER N
Tanahu
R upandehi
C EN TR A L
0.27
J ha pa
Sapta ri
0.02
0
Lalit pur
0 .32
D ade ldhura
1.1
1.1
H umla
0 .92
R aut ahat
1.6
1.6
1.5
J umla
R uk um
1.69
W ESTER N
0.23
K avre
Sya ngja
MID - W ESTER N
0.38
C hit w an
Parbat
FA R W ESTER N
0.26
K as ki
0.9
0.9
0.9
0.8
0.8
0.7
0.7
0.7
0.7
0.7
0.7
0.7
0.6
0.6
0.6
0.6
0.6
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.2
0.2
0.2
0.2
N A TION A L
0.2
0.2
EA STER N
0.2
0.2
0.2
C EN TR A L
0.2
0.1
W ESTER N
0.1
0.1
MID - W ESTER N
0.1
0.1
FA R W ESTER N
0.0
0.4
0.34
0.33
0.29
0.58
0.55
ChildHealth:CBIMCIandNewbornCare
2.3
COMMUNITY BASED INTEGRATED MANAGEMENT OF

CHILDHOODILLNESSES(CBIMCI)ANDNEWBORNCARE
2.3.1 Background
CommunityBasedIntegratedManagementofChildhoodIllness(CBIMCI)Programisanintegrated
package of childsurvival interventions and addresses major childhood killer diseases like
Pneumonia, Diarrhoea, Malaria, Measles, and Malnutrition in 2 months to 5 year children in a
holisticway.CBIMCIalsoincludesmanagementofinfection,Jaundice,Hyperthermiaandcounselling
on breastfeeding for young infants less than 2 months of age. With the implementation of this
packagechildrenarediagnosedearlyandtreatedappropriatelyformajorchildhooddiseasesatthe
healthfacilityand communitylevel.Atthe communitylevelFCHVsarethe mainvehicle ofservice
deliveryandalsoplayskeyroletoincreasecommunityparticipation.
In 1997, the program was initiated in Mahottari as a piloting district for IMCI. Based on the
recommendations it was decided to include a community component, enabling mobilisation of
community health workers (VHWs and MCHWs) and FCHVs to provide CDD, ARI, Nutrition and
Immunisation services to the community. As a result the Community based ARI and CDD (CBAC)
programwasmergedintoIMCIin1999andisnowcalledtheCommunityBasedIMCI(CBIMCI).At
the end of fiscal year 2066/67 (2009/2010) CBIMCI Program has covered 75 districts. In 2004,
NewborncomponentwasaddedtoCBIMCI.
Vision
Contributetosurvival,healthygrowthanddevelopmentofunderfivechildrenofNepal.
AchieveMDGGoal4by2015.
Goal
To reduce morbidity and mortality among children underfive due to pneumonia, diarrhoea,
malnutrition,measlesandmalaria.
Targets
Toreduceneonatalmortalityfromthecurrentrateof33/1,000livebirthsto17/1,000livebirths
by2015.
Toreduceneonatalmorbidityamonginfantslessthan2monthsofage.
Objectives
Reduce frequency and severity of illness and death related to ARI, Diarrhoea, Malnutrition,
MeaslesandMalaria.
Contributetoimprovedgrowthanddevelopment.
Strategy
ThefollowingstrategieshavebeenadoptedbyCBIMCIprogram:
35
1. Improvingknowledgeandcasemanagementskillsofhealthcarestaff
CBIMCIaimstoimprovetheskillsofhealthcarestaffthrough
trainingtoallhealthworkersonCBIMCIincludingzinctreatmentfordiarrhoea;
regularintegratedreviewandrefreshertrainingstohealthserviceproviders;
inclusionofCBIMCIinthecurriculumofpreservicemedicalandparamedicalschools;
technical support visits should include visits from the central and regional level to districts,
DHOtoallHFs;HFstoFCHVs;and
capacitybuildingtrainingtotheCBIMCIfocalpersonsofthedistricts.
2. Improvingoverallhealthsystems
CarryoutCBIMCIProgrammaintenanceactivitiesaspertherecommendationsmadebyIMCI
workinggroupandglobalcontext.
Improvelogisticsupply.
Regularizemothersgroupmeeting.
Strengthenreportingsystematalllevels.
Strengthensupervisionandmonitoring.
3. Improvingfamilyandcommunitypractices
Disseminating key behavioural message through FCHVs to families and communities using
relevantIECmaterials.
Reaching the disadvantaged and hardtoreach communities through reactivated mothers
groupmeeting.
Disseminationofkeyfamilypracticemessagesthroughinterpersonalcommunication.
Majoractivitiescarriedoutinthefiscalyear2067/68includethefollowing:
Managementofsickunderfivechildrenthroughhealthfacilitiesandcommunityhealthworkers
andFCHVs.
Expansion of community based newborn care package from 10 districts in 2066/67 to 25 in
2067/68
CBIMCI training for newly recruited and transferredin medical officers, health workers and
FCHVs
CBIMCImaintenanceactivities
CBIMCIandCBNCPdrug/equipmentsprocurement
CBNCPassessment
Supervisionandmonitoring
CBIMCIandCBNCPpreserviceorientationtomedicalcolleges,
CBIMCIstrengthensthefollowingmajorcomponents:
1.
Managementofsickchildrenbelow2monthsofage
Health workers assess each case and classify into following categories (one or more) according to
IMCIprotocol.
PossibleSevereBacterialInfection(PSBI)
LocalBacterialInfection(LBI)
Jaundice
Hypothermia
Lowweightorfeedingproblem
36
Based on the classification they manage the cases following the IMCI protocol. They also mention
whetherthecasewastreatedbyCotrimoxazoleand/orGentamycine(forinfection)andrefertothe
appropriatefacilityifneeded.
2.
Managementofsickchildren2monthsto5yearsofage
ManagementofAcuteRespiratoryInfection(ARI)
TheMinistryofHealthandPopulation(MoHP)recognisesAcuteRespiratoryInfection(ARI)asoneof
themajorpublichealthproblemsinNepalamongchildrenunder5yearsofage.CBIMCIProgram
followsWHOguidelines(IMCIProtocol)onstandardARIcasemanagement.Accordingly,allcasesof
ARIassessedbyhealthworkersshouldbeclassifiedintooneofthefollowingcategories:
SeverepneumoniaorVeryseveredisease
Pneumonia
Nopneumoniacoughandcold
The program recognises the important role of mothers and other caretakers in identifying the
differencebetweentheneedforhomecareandforreferraltohealthfacilities.Therefore,allhealth
workers should be able to communicate the necessary information effectively to mothers and
caretakers.
ManagementofDiarrhoealDiseases
Diarrhoea is still a leading killer disease in Nepal. CBIMCI program intensely focuses on
managementofDiarrhoealdiseasesamongtheunderfiveyearschildren.Standarddiarrhoeacase
management with Oral Rehydration Therapy (ORT), continued feeding and Zinc tablet have been
providinginthehealthinstitutions.Allhealthfacilitiesandcommunityhealthvolunteershavebeen
serving as the primary health providers in the treatment of Diarrhoea with Low Osmolar Oral
RehydrationSolutions(ORS)andZincsupplementation.
ThetargetsofimportantcomponentsoftheCBIMCIprogramwereachievedby100percentinthree
consecutivefiscalyears(Annex1.1).
ZincSupplementation
Zinc tablet in the treatment of diarrhea was introduced in FY 2062/63 as a pilot program in two
districtsofNepal(RautahatandParbat).Thescalingupoftheprogramwascompletedin2066/67.
SinceFY2064/65,CBIMCIProgramdata(asreceivedfromHealthFacility,VHW/MCHWandFCHV)has
beenincorporatedintoHMIS.Therefore,fromFY2064/65onwards,thenationalleveldataisatotalof
HFlevel+VHW/MCHW+FCHVleveldata.
1. Managementofbelow2monthscases
Table 2.3.1 presents the status of the undertwo month's registered cases at health facilities in FY
2067/68.
37
Table2.3.1:ClassificationandTreatmentof<2MonthCases,byRegionfrom2065/66to2067/68
Indicators
Classification
TotalCases<2Months
PossibleSevere
BacterialInfection
(PSBI)
LocalBacterial
Infection(LBI)
Jaundice
Hypothermia
LowWeightorFeeding
Problem
Treatment/Referal
TreatmentbyCotrim
Treatmentby
Gentamycin
Refer
No.ofDeadCases
Year
EDR
CDR
WDR
MWDR
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2067/68
2067/68
2065/66
2066/67
2067/68
2067/68
2067/68
8,831
9,222
12,295
2,134
1,952
2,093
4,125
4,308
5,284
263
36
921
823
1,255
5,681
5,967
8,905
1,563
1,168
1,449
2,018
2,749
5,588
425
116
726
787
805
3,559
4,520
6,997
637
653
625
1,371
1,833
2,826
433
97
527
603
1,103
5,547
10,128
12,446
1,150
2,458
3,511
2,531
3,976
4,344
383
144
798
1,135
1,315
4,650
2,091
5,628
1,042
4,558
460
2065/66
2066/67
2067/68
2067/68
520
515
500
76
559
521
570
103
301
358
412
23
FWDR National
27,690
33,751
48,669
6,226
7,173
9,108
11,478
14,594
21,305
1,672
460
3,490
4,057
5,380
22,503
8,000
22.48
21.25
18.71
41.45
43.24
43.78
3.44
0.95
12.60
12.02
11.05
4,772
3,071
4,072
3,914
8,026
742
942
1,430
1,433
1,728
3,263
168
67
518
709
902
2,895
1,336
448
537
537
55
346
307
348
205
2,174
2,238
2,367
462
8
7
5
46.24
16.44
Source:HMIS/MD,DoHS
2.
Figure2.3.1
Under 2 Months Cases Treated at Health Facilities
FY 2065/66 to 2067/68
2065/66
2067/68
5,380
4,057
3,490
21,305
14,594
11,478
9,108
6,226
15,000
7,173
33,751
45,000
30,000
2066/67
48,669
60,000
27,690
Table 2.3.1 and Figure 2.3.1 show the national

andregionalstatusofnumberof<2monthssick
young infants registered and treated at the
healthfacilities.
InFY2067/68,atotalof48,669infantofunder2
months were treated at health facilities. This
number is quite high in comparison to FY
2065/66and2066/67(Figure2.3.1).Inthesame
way, there has also been an increment in the
number of cases treated for PSBI, LBI, Low
weight and feeding problems. This could be the
result of CBNCP Package which improved
treatment seeking behaviour of mothers/
caretakers.
0
Total <2 Months Cases
PSBI
LBI
Low w t. FP
Source:HMIS/MD,DoHS
Diarrhea
IMCIprogramhasimpartedpositiveimpactontheskillsandknowledgeofhealthworkers,enabling
them to better identification, classification and treatment of diarrheal diseases. Health workers
classify diarrhoeal cases as 'No Dehydration', 'Some Dehydration' and 'Severe Dehydration'
accordingtothetreatmentprotocolofCBIMCI.
38
Table 2.3.2 shows the classification of dehydration by region over the last three years. At the
nationallevelcasesof'SevereDehydration'hasremainedconstantat0.4percentintwoconsecutive
yearsandithasremainedalmostthesameinalltheregionsexceptEDR.
Table2.3.2:ClassificationofDehydration,byRegion,FY2065/66to2067/68
Indicators
TotalCases*
NoDehydration
Cases*
Some
Dehydration
Cases*
Severe
Dehydration
Cases*
Year
2065/66 08/09
2066/67 09/10
2067/68 10/11
2065/66 08/09
2066/67
09/10
2067/68
10/11
2065/66
08/09
2066/67
09/10
2067/68
10/11
2065/66
08/09
2066/67
09/10
2067/68
10/11
EDR
449,903
471,649
361,064
367,592
81.7
395,268
83.8
316,290
87.6
79,806
17.7
75,165
15.9
31,366
8.7
2,505
0.6
1,216
0.3
2,403
0.7
CDR
497,724
521,056
452,232
419,703
84.3
447,408
85.9
407,684
90.2
75,280
15.1
71,615
13.7
28,824
6.4
2,741
0.6
2,033
0.4
1,202
0.3
Region
WDR
296,223
314,752
271,658
261,260
88.2
285,545
90.7
248,172
91.3
33,581
11.3
28,527
9.1
13,504
5.0
1,382
0.5
680
0.2
601
0.2
MWDR
319,435
420,309
368,463
275,923
86.4
375,670
89.4
331,069
89.8
41,199
12.9
42,443
10.1
20,103
5.5
2,313
0.7
2,196
0.5
1,335
0.4
FWDR
254,213
307,126
282,427
224,847
88.4
279637
91.0
255,806
90.6
27,737
10.9
25,951
8.4
12,874
4.6
1,629
0.6
1,538
0.5
708
0.3
National
1,817,498
2,034,892
1,735,844
1,549,325
85.0
1,783,528
88.0
1,559,021
90.0
257,603
14.2
243,701
12
106,671
6.1
10,570
0.6
7,663
0.4
6,249
0.4
Source:HMIS/MD,DoHS
Note:*Casereportedfromhealthfacilityandcommunity
Table 2.3.3 shows that there has been decrease in the reported number of diarrhoeal cases in FY
2067/68comparedtopreviousfiscalyears2065/66and2066/67.
Table2.3.3: DiarrhoeaamongChildrenUnder5YearsofAge,byRegion,FY2065/66to2067/68
Indicators
Year
Total<5yrspopulation
2067/68
Totaldiarrhealcases* 2065/66 08/09
2066/67 09/10
2067/68 10/11
CaseFatalityRate/
2065/66 08/09
1,000<5yrs.
2066/67 09/10
Population
2067/68 10/11
EDR
719,297
449,903
471,649
361,064
0.11
0.01
CDR
1,140,023
497,724
521,056
452,232
0.02
0.01
0.00
Region
WDR
MWDR
641,434 480,671
296,223 319,435
314,752 420,309
271,658 368,463
0.15
0.04
0.01
0.05
0.00
0.00
FWDR
359,500
254,213
307,126
282,427
0.13
0.20
0.00
National
3,340,925
1,817,498
2,034,892
1,735,844
0.08
0.04
0.00
Source:HMIS/MD,DoHS
Note:*Casereportedfromhealthfacilityandcommunity
39
Table2.3.4: Treatment of Diarrhea at Different

Levels
National
1,735,844 100.0
HFLevel
464,546
27.0
VHW/MCHW
310,269
18.0
FCHV
961,029
55.0
TotalCommunity
1,271,298
73.0
(VHW/MCHW+FCHV)
Source:HMIS/MD,DoHS
Figure 2.3.2: Incidence of Diarrhoea /1,000 <5 Children
838
749
643
733
EDR
CDR
WDR
2065/66
409
399
450
384
404
National
481
593
645
487
550
598
500
1000
950
900
850
800
750
700
650
600
550
500
450
400
350
300
250
200
150
100
858
FY 2065/66 to 2067/68
488
Thenationalincidenceofdiarrhoeaper1,000
underfive years children has decreased
significantlyfrom598in2066/67to500/1,000
in 2067/68, which is slightly higher than in
2065/66 (Figure 2.3.2). Likewise the reported
incidence of diarrhoea has decreased in all
regions. The highest incidence was observed
at FWDR (749/1,000 under five children) and
MWDR (734/1,000 under five children)
comparedtootherregions.
Outofthetotal1,735,844diarrhealcases,27
percentweretreatedatHFs,18percentwere
treated by VHW/MCHWs and 55 percent
were treated by FCHVs (Figure 2.3.3 and
Table 2.3.4). This implies that 73 percent of
diarrheal cases who seek care in the public
sector were treated at community level,
eitherbyFCHVsorbyVHW/MCHW.
MWDR
2066/67
FWDR
2067/68
Figure2.3.4
Diarrhoeal Deaths <5 Year Population
FY 2065/66 to 2067/68
2065/66
2066/67
2067/68
147
91
62
80
NEPAL
100
44
60
43
48
EDR
WDR
CDR
11
6
10
20
13
18
21
33
40
Figure 2.3.4 shows the three years trend of

reported diarrhoeal deaths of under five
years children. In FY 2067/68 the diarrhoeal
deaths decreased by 52 percent whereas it
was decreased by 38 percent in FY 2066/67
compared to the previous year. At the
regional level the highest diarrhoeal deaths
were reported from EDR (18) followed by
CDR(11),FWDR(7),MWDR(5)andWDR(3)
in FY 2067/68. Amongst the region the
diarrhoeal death decreased significantly in
FWDRandMWDR.
MWDR
FWDR
Source:HMIS/MD,DoHS
The Case Fatality Rate/1,000 has decreased
from 0.08 in 2065/66 to 0.04 in FY 2066/67
andto0.00in2067/68(Table2.3.3).
Table 2.3.5 presents the treatment of diarrhoea by IV fluid and ORS. In FY 2067/68 the diarrhoeal
casestreatedbyORSandZinchasincreasedincomparisontoFY2065/66and2066/67andonthe
otherhanddiarrhoealcasestreatedbyIVFluidhasremainedconstantat0.03percent.However,the
40
treatment of diarrhoea by Zinc+ ORS has increased from 48 percent in 2066/67 to 88 percent in
2067/68.
Table2.3.5:TreatmentofDiarrhoealDiseases,byRegion,FY2065/66to2067/68(2008/092010/11)
Indicators
TotalCases(HF+
CommunityLevel)
Year
2065/66
2066/67
2067/68
2065/66
EDR
449,903
471,649
361,064
Zinc+ORS
99,919
22.21
2066/67
169,937
36.0
2067/68
316,983
87.8
TreatedwithIVFluid 2065/66
1,438
0.3
2066/67
977
0.2
2067/68
1,071
0.3
Source:HMIS/MD&IMCISection/CHD,DoHS
Region
WDR
296,223
314,752
271,658
170,254
57.5
180,415
57.3
233,766
86.0
971
0.3
826
0.3
1,011
0.4
CDR
497,724
521,056
452,232
237,266
47.7
251,246
48.2
412,109
91.1
2,328
0.5
2084
0.4
1741
0.4
MWDR
319,435
420,309
368,463
135,396
42.4
241,993
57.6
321,214
87.2
1,802
0.6
1,951
0.5
1,424
0.4
FWDR
254,213
307,126
282,427
82,996
32.6
127,007
41.3
240,799
85.3
803
0.3
812
0.3
780
0.3
National
1,817,498
2,034,892
1,735,844
725,831
39.9
970,598
47.7
1,524,871
87.8
7,342
0.4
6,650
0.3
6,027
0.3
AcuteRespiratoryInfection
Figure 2.3.5: Reported ARI New Cases/1,000 <5 Children

FY 2065/66 to 2067/68
1027
979
859
804
751
681
663
704
666
700
864
1024
917
887
1100
900
1089
1040
1300
882
824
Atthenationallevel,reportedARIcasesper
1,000 underfive population has decreased
from 882 in 2066/67 to 824 in 2067/68
(Figure 2.3.5). The highest rate of new ARI
casesper1,000wererecordedintheMWDR
(1,040) followed by FWDR (979), EDR (917)
and WDR (751) and CDR (666). The
escalation of ARI new cases per 1,000
children is mainly due to the data
incorporated for the treatment provided by
the FCHVs at the community level and
completionofscalingupofCBIMCIprogram.
765
3.
MWDR
FWDR
500
300
100
National
EDR
CDR
WDR
2065/66
2066/67
2067/68
41
Indicators
Targetpopulation
<5years
TotalNewCases*
%ofNoPneumonia
%ofPneumonia
%ofSevere
Pneumonia
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
EDR
818,268
731,488
719,297
725,636
749,067
659,596
67.2
68.7
67.4
32.8
31.3
32.3
0.6
0.4
0.3
CDR
1,233,110
1,158,425
1,140,023
817,420
815,446
758,721
70.3
72.8
70.7
29.7
27.2
29.0
0.5
0.4
0.3
Region
WDR
741,498
654,071
641,434
504,968
525,808
481,892
69.9
73.5
72.8
29.8
26.5
26.9
0.5
0.4
0.3
0.6
0.6
0.6
0.5
MWDR
538,227
489,732
480,671
463,533
533,072
499,986
66.2
68.3
66.9
33.8
31.7
32.5
0.8
0.7
0.6
0.3
0.4
0.5
0.4
0.3
0.3
0.4
0.4
0.5
0.6
0.6
0.7
0.7
0.8
Figure 2.3.6: % of Severe Pneumonia Among New Cases
Outoftotal2,752,266ARIcases,822,352
FY 2065/66 to 2067/68
(30%) were reported as Pneumonia
1.0
(Pneumonia + Severe Pneumonia) in
2067/68. At national level the 0.8
percentage of severe pneumonia has
declined from 0.6 in 2065/66 to 0.5 in 0.6
2066/67and0.4in2067/68(Table2.3.6
0.4
and Figure 2.3.6). It has declined in all
five regions. The highest percentage of 0.2
severe pneumonia was found in MWDR
and FWDR (0.6%) followed by other 0.0 National
EDR
CDR
WDR
MWDR
FWDR
regions (0.3) and EDR, CDR and WDR
(0.3). The decline of severe pneumonia
cases at the national as well as at the
2065/66
2066/67
2067/68
regionallevelforthreefiscalyearsisdue
to the early detection and proper management of ARI cases by health workers, VHW/MCHW and
FCHVsinCBIMCIdistrictsandalsoduetothefreehealthservice.
Table2.3.6:TotalARINewCaseswithClassification,byRegion,FY2065/66to2067/68
FWDR
395,314
366,692
359,500
339,554
376,491
352,071
71.4
73.0
71.9
28.6
27.0
27.5
0.6
0.7
0.6
National
3,726,417
3,400,408
3,340,925
2,851,111
2,999,884
2,752,266
68.9
71.1
69.7
31.0
28.9
29.9
0.6
0.5
0.4
Source:HMIS/MD,DoHS
Note:*Casesreportedfromhealthfacilityandcommunity
Theincidenceofpneumonia/1,000<5childrenwas246andreportedtotalARIrelateddeathswas
1,139atthenationallevel(Table2.3.7).IncidenceofPneumonia(Pneumonia+SeverePneumonia)
per 1,000 <5 children decreased from 255/1,000 in 2066/67 to 246/1,000 in 2067/68 but it is still
highcomparedto237/1,000in2065/66.Thehighestrateofincidenceofpneumoniawasobserved
inMWDR(338/1,000),andthenfollowedbyEDR(296/1,000),FWDR(270/1,000),WDR(202/1,000)
andCDR(193/1,000).TheincidenceofpneumoniainCDRhasslightlyincreasedincomparisontothe
previousyear(2066/67).
ThereportedARIcasefatalityrateamongunderfivechildrenhasdecreasedfrom0.08in2065/66to
0.11in2066/67andto0.01in2067/68(Table2.3.7).ARIcasefatalityratehasdecreasedinallthe
regions.
42
Table2.3.7:IncidenceofPneumonia,Deaths,MortalityandCaseFatalityRate,byRegion
Indicators
TotalPneumoniaCases
%ofPneumonia
(Pneumonia+Severe)
IncidenceofPneumoniaCases
(Pneumonia+Severe
Pneumonia)
ARIrelateddeaths
ReportedARIcasefatality
rate/1,000
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
EDR
238,279
234,095
213,120
32.8
31.3
32.3
291
320
296
74
164
136
0.10
0.22
0.01
CDR
242,424
222,116
220,013
29.7
27.2
29.0
197
192
193
25
25
90
0.03
0.03
0.01
Region
WDR
150,498
139,108
129,644
29.8
26.5
26.9
203
213
202
14
19
35
0.03
0.04
0.02
MWDR FWDR
156,552 97,005
168,772 101,585
162,690 96,885
33.8
28.6
31.7
27.0
32.5
27.5
291
245
345
277
338
270
88
36
83
28
153
232
0.19
0.11
0.16
0.07
0.02
2.02
Nationa
l
884,758
865,676
822,352
31.0
28.9
29.9
237
255
246
237
319
646
0.08
0.11
0.01
Source:HMIS/MD,DoHS
Table2.3.8showsthatatotalof2,752,266newARIcasesamongunderfivechildrenweretreated
inFY2067/68.OutoftotalARIcases763,023(28%)weretreatedatHFs,474,823(17%)caseswere
treatedbyVHW/MCHWsand1,514,420(55%)weretreatedbyFCHVs(Figure2.3.7).Thisisapositive
impact of the CBIMCI Program that more than 72 percent of ARI cases are treated at community
level.
Table2.3.8: TotalARICasesTreatedatDifferentLevel
inFY2067/68(2010/11)
TotalARINewCases
%
National
2,752,266
100.0
HFLevel
763,023
28.0
VHW/MCHW
474,823
17.0
FCHV
1,514,420
55.0
TotalCommunity
1,989,243
72.0
Source:IMCISection/CHD&HMIS/MD,DoHS
TreatmentofARIathomehasdecreasedfrom70percentin2066/67to59percentin2067/68and
treatmentwithantibiotics(Cotrimandotherantibiotics)hasincreasedfrom30percentin2066/67
to41percentin2067/68(Table2.3.9).
Table2.3.9:TreatmentofARICases,2065/662067/68
Indicators
TotalCases(HF+
Community)
HomeTreatment(%)
Antibiotic(CotrimPaed.)
(%)
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
EDR
725,636
749,067
659,596
65.5
68.3
55.7
32.3
29.5
44.3
CDR
817,420
815,446
758,721
69.5
71.4
61.6
28.3
26.1
38.4
Region
WDR
504,968
525,808
481,892
67.9
72.8
63.8
28.2
25.1
36.2
MWDR
463,533
533,072
499,986
65.6
67.9
54.3
32.7
30.5
45.7
FWDR
339,554
376,491
352,071
71.5
72.6
59.8
26.6
25.8
40.2
National
2,851,111
2,999,884
2,752,266
67.8
70.4
59.0
29.8
27.5
41.0
Source:HMIS/MD,DoHS
43
4.
CommunityBasedNewbornCarePackage(CBNCP)
Nepal Family Health Survey 1996, Nepal Demographic and Health Surveys and WHO estimations
overthetimehaveshownthatneonatalmortalityinNepalhasbeendecreasingataslowerratethan
infant and child mortality. Nepal Demographic and Health Survey 2011 has shown 33 neonatal
deathsper1,000livebirths,whichaccountsfor61percentofunder5deaths.Themajorcausesof
neonataldeathinNepalareinfection,birthasphyxia,pretermbirth,andhypothermia.GivenNepals
existing health service indicators, it becomes clear that strategies to address neonatal mortality in
Nepalmustconsiderthefactthat72percentofbirthstakeplaceathome(NDHS2011).
Therefore,asanurgentsteptoreduceneonatalmortality,MinistryofHealthandPopulation(MoHP)
initiatedanewprogramcalled'CommunityBasedNewbornCarePackage(CBNCP)'basedonthe
National Neonatal Health Strategy 2004. The program was implemented as pilot program in ten
districtsinFY2065/66andfurtherexpandedin15districtsinFY2067/68.InFY2068/69,itwillbe
scaledupin10moredistricts.
ThegoalofCBNCPistoreduceneonatalmortality(NMR)throughthesustainedhighcoverage(use)
ofeffectivecommunitybasedinterventions.ThespecificobjectivesofCBNCPinclude:
TopreventandmanageNewborninfection;
Topreventandmanagehypothermiaandlowbirthweightnewborns;
Tomanagepostdeliveryasphyxia;and
Todevelopaneffectivesystemofreferralofthesicknewborns.
PilotingofCBNCPprogramwasstartedin2065/66in10districtsanditwasscaledupinadditional
15districtsin2067/68.Itwillbescaledupinadditional10districtsin2068/69.
Phase
Year
Piloting 2065/66
Scaling 2067/68
up
2068/69
Districts
Dhankuta,Morang,Sunsari,Parsa,Chitwan,Kavre,Palpa,Dang,BardiyaandDoti
Sankhuwasava, Therathum, Sarlahi, Myagdi, Kailali, Saptari, Bajhang, Banke,
Nawalparasi,Kapilvastu,Arghakhanchi,Mahottari,Dailekh,Jumla,Salyan.
Jajarkot, Lamjung, Humla, Kanchanpur, Taplejung, Bara, Baglung, Dolpa, Rautahat
andBaitadi
DataRecordingandReportingSysteminCBNCPDistricts
The CBNCP uses seven different types of recording and reporting tools at community and health
facility level. Out of them, five are for recording and two are for reporting. The recording tools
includeCBNCP11,22and33forFCHVs,CBNCP44forVHW/MCHWsandCBNCP55forHFs.CBNCP
66 and 77 are compilation tools that are used by HFs for reporting all services provided by FCHVs,
VHWs/MCHWs and HFs. In addition, CBNCP also uses CBIMCI OPD register (HMIS 16A) for
reportingofsomeoftheindicatorsinCBNCP7.
MonitoringResultsofCBNCPfrom10PilotDistricts,2067/68
FCHVRegisterfortheregistrationofpregnantwomen.
FCHVRegistertorecordtheservicesprovidedbyFCHVstopregnantwomenandnewbornupto28daysofbirth.
3
FCHVRegistertorecordthetreatmentandreferralprovidedtosickbabies059daysbyFCHVs.
4
VHW/MCHWRegistertorecordthetreatmentprovidedtosickbabies059days.
5
HFRegistertorecordtheservicesprovidedtosickbabies059days.
6
CompilationformusedatHF.ItreportstheservicesprovidedbyFCHVs,VHWs,MCHWsandHealthworkers.
7
CompilationformusedatHFs.ItreportsservicesprovidedbyVHWs,MCHWsandHealthWorkerstosickbabiesaged059
daysandalsoincludestheinfectioncasesreferredbyFCHVs.
2
44
TheCBNCPservicedatapresentedinthissectionisfortheFY2067/68(2010/11).Astheprogram
was piloted in ten districts in 2065/66 and 2066/67 at different time periods, data for these two
yearsisavailableforsomedistrictsandnotforothers.Therefore,inordertomaintainconsistencyin
reportingdurationandcompletenessofreports,theservicedataonlyoftheFY2067/68hasbeen
analyzedandpresentedhereunder.
AnalysisofAchievement
CoverageofCBNCP
InCBNCPdistricts,FCHVsmakealistofpregnantwomenofherward/catchmentareainCBNCP1
and register them in CBNCP2 (newborn service register) when the babies are born. FCHVs record
differentservicesreceivedbyapregnantwomanduringantenatalanddeliveryperiodaswellasthe
servicesreceivedbyhernewborn.Afterthenewbornis28days,herrecordgetsclosed.Therefore,
the outcomes of CBNCP depend largely upon the number of pregnant women captured by the
FCHVsinthenewbornservice
Figure2.3.8:CoverageofCBNCPintermsofexpectedpregnancies
register and the number of
andexpectedlivebirthscapturedbyFCHVsinFY2067/68
newborns who received
different services. Figure
2.3.8 compares the coverage
ofCBNCPinthepilotdistricts
in FY 2067/68 calculated as
the proportion of CBNCP 2
forms closed after 28 days of
delivery against the number
of (i) expected pregnant
women and (ii) expected live
births.Here,servicesprovided
by FCHVs in the VDCs of the
pilot districts and recorded in
CBNCP2andreportedinCB
Source:CBNCPSecretariat/CHD,DoHS
NCP6hasbeenanalysed,therefore,thedenominatorincludesonlytheexpectedpregnantwomen
and expected live births of the VDCs and does not include the expected pregnant women and
expectedlivebirthsofthemunicipalities.
Figure 2.3.8 shows that there is a variation in program coverage among the pilot districts in FY
2067/68.InDoti,thecoverageofCBNCPexpressedintermsoftheexpectedpregnantwomenand
expectedlivebirthscapturedbytheFCHVsare78percentand87percentrespectively,whichisthe
highest reported amongst the 10 districts. In three other districts Sunsari, Parsa and Bardiya, CB
NCP coverage is satisfactory (above twothirds of expected pregnancies and expect live births). In
Dhankuta and in Kavre, the coverage is less than onethird, both in terms of expected pregnant
womenandexpectedlivebirthscapturedbyFCHVs.
Deliveryservices
Table2.3.10portraystheproportionofdeliveriesdisaggregatedbyplace,SBAattendanceinhome
births,andFCHVpresenthomebirthsintheCBNCPdistrictsinFY2067/68.InCBNCP,FCHVsrecord
theplaceofdeliveryofallthewomenwhoshecapturesintheNewbornServiceregister(CBNCP2).
Therefore,thetotalformsclosedcorrespondwiththetotaldeliveriescapturedbytheFCHVs.
Among all the pregnant women registered by FCHVs in CBNCP 2 and their forms closed after 28
daysofdelivery,datashowsthatinsevenoutofthetenpilotdistricts,institutionaldeliveryishigher
45
than 50 percent, with the highest in Chitwan (80%). In the remaining three districts, deliveries
predominantlyoccurredathome.TheCBNCPdesiresthepresenceofFCHVsinhomedeliveriesand
the data reveals that in eight of the ten districts, the presence of FCHV in home deliveries was
universal.InDotiandSunsari,79percentand86percentofthehomedeliverieshadFCHVpresent
duringhomedelivery.WithrespecttotheSBAassistedhomedeliveriesinthepilotdistricts,Parsa
hadthehighestachievementat49percentandDotihadthelowestat2percent.
Table2.3.10:ProportionofHFandHomeDeliveryamongTotalFormsClosed/TotalDeliveriesCaptured
byFCHVs,SBAAttendanceinHomeDeliveriesandFCHV'sPresenceinHomeDeliveries
TotalForms ProportionofHF
closed/Total deliveryamong
deliveries
formsclosed
Bardiya
7,859
76
Dang
8,146
73
Sunsari
11,504
70
Doti
4,632
35
Kavre
2,950
61
Morang
11,549
73
Chitwan
5,689
80
Palpa
2,871
59
Dhankuta
1,186
39
Parsa
8,704
38
Proportionof
homedelivery
amongforms
closed
24
27
30
65
39
27
20
41
61
62
Proportionof
Proportionofhome
homedeliveries
deliverieswhere
attendedbySBAs FCHVswerepresent
11
100
14
100
11
86
2
79
9
100
9
100
22
100
20
100
3
100
49
100
Treatmentofsickbabies059daysreportedinCBNCP7
OneoftheimportantcomponentsofCBNCPisthetreatmentofsickbabiesaged059daysatHF
andcommunitylevel.InCBNCP,thesickbabiesareclassifiedasPSBI,LBIandnobacterialinfection
bytheVHW,MCHWandhealthworkers.Table2.3.11analysestheinfectioncasesamongbabies0
59daysinthepilotdistrictsdisaggregatedbyagegroups,incidenceofreportedPSBI,proportionof
PSBI among total infection cases and the treatment of PSBI by injection Gentamycin in the FY
2067/68.
Datashowsthattheinfectioncasesarehigheramongthenewbornsthanamongbabiesaged2959
days in most districts. The reported incidence of PSBI among babies 059 days out of the total
expectedlivebirthsseenbyVHWs,MCHWsandatHFsvariesgreatlyacrossthepilotdistrictsandis
highestinBardiya(219per1,000expectedlivebirths)andlowestinPalpa(3per1,000expectedlive
births).ParsadidnotreportanyPSBIcases.Table2.3.11alsopresentstheproportionofPSBIcases
amongthetotalinfectioncasesreportedinCBNCP7.InDang,theproportionofPSBIcasesoutofall
the infection cases was high at 94 percent showing that nearly all the infection cases were PSBI
cases.InChitwanandBardiya,aboutonehalfoftheinfectioncaseswereclassifiedasPSBIcasesand
in the remaining districts with the exception of Parsa, the proportion of PSBI cases was between
onequarter to twofifths. The table also shows that above 95 percent of all the PSBI cases were
treatedbyinjectionGentamycinindistrictsotherthanKavre,DhankutaandChitwan.
46
Table2.3.11:Reported Incidence of Infection, and Treatment of PSBI among Babies Aged 059 days
ReportedinCBNCP7
Districts
Bardiya
Dang
Sunsari
Doti
Kavre
Morang
Chitwan
Palpa
Dhankuta
Parsa
%of
%of
Expected Total
infection infection
Live
infection cases028 cases2959
Births
cases
days
days
10,805
12,385
14,779
5,337
9,967
22,087
11,680
7,332
4,422
11,002
5,090
217
2,996
346
165
2,996
315
93
266
0
77
59
62
56
47
62
66
63
50
0
23
41
38
44
53
38
34
37
50
0
Total
PSBI
cases
2,370
203
1,235
137
51
1,235
160
24
44
0
Reported
Incidenceof
PSBI(per
1,000ELBs)
Proportionof
PSBIamong Treatmentby
totalinfection
Inj.
cases
Gentamycin
219
16
84
26
5
56
14
3
10
0
47
94
41
40
31
41
51
26
17
0
100
97
99
96
73
99
89
108
84
0
Note:ELBExpectedLiveBirths
Table2.3.12presentstheproblems/constraintsdiscussedintheregionalandnationalreviews.
ActionstobeTaken
SustainingthequalityofIMCI
Increasefrequencyofsupportive
StillthecoverageofZincintheTreatmentof supervision
Diarrhoeaislow
IMCIProtocolnotusedproperlyatalllevels
supervision
CBIMCIregisterandrecording/reporting
Revisionofprotocoland
formforVHW/MCHWneedtobe
DevelopmentofVHW/MCHW
introduced
Registerwillbecompletedwithin
2068/69
HMISRegister31and32forCBIMCI
Workoutontherevisionisgoingon
Programneedtoberevised
andwillbecompletedwithin
2068/69
WeakSupervisionandmonitoringatall
levels
supervision
Newborncomponenttobeadequately
Revisionofprotocoltoaddressnew
addressedinCBIMCIatcommunitylevel
bornisgoingonandwillbe
completedwithin2068/69
ExpansionofCBNCP
Needmoreresourcesandincrease
Slowscaleupduetoresourceconstraints
capacityofCHD
andinadequateHRcapacityofCHD.
Responsibility
RHDs/Districts/IMCI
FocalPersons/CHD
RHDs/Districts/IMCI
FocalPersons/CHD
IMCISection,CHD
IMCISection,CHD,
HMIS/MD
RHDs/Districts/IMCI
FocalPersons/CHD
RHDs/Districts/IMCI
FocalPersons/CHD
IMCISection,CHD
47
Table2.3.13presentsthetargetsfor2068/69.
Table2.3.13:Targetsfor2068/69
Diarrhoea
SN
Activities
1 ORSpurchase
2 Zinctabletpurchase
ARI
1 PurchaseofARISoundTimer
2 ProcurementofCotrim.Paed.
Unit
Pkts.
Tabs.
AnnualTargets
4,900,000
17,000,000
Units
Tabs.
10,200
33,000,000
BudgetRs.'000
23,275
10,370
3,872(GoN+Donor)
14,190
Source:IMCISection/CHD,DoHS
48
Family Planning
Fiscal Year 2067/68 (2010/2011)
Contraceptiv e Prev alence Rate
(CPR)
Lalitpur
Parsa
Dhanusha
Rautahat
Saptari
79.1%
72.7%
68.6%
61.2%
60.4%
Morang
Siraha
Mahottar i
Makawanpur
59.6%
59.3%
58.0%
56.8%
Sarlahi
Jhapa
Sur khet
Bardiya
56.3%
51.9%
51.7%
51.5%
Kavre
Kailali
Dhading
Rasuwa
50.5%
50.0%
48.9%
48.9%
Dang
Ilam
Khotang
Kanchanpur
Chitwan
Bara
Sunsar i
44.0%
43.8%
42.8%
42.2%
Solukhumbu
Nawalparasi
Jumla
Kathmandu
41.8%
41.3%
40.8%
39.9%
Nuwakot
Kaski
Rolpa
Dolpa
37.7%
37.3%
36.7%
36.5%
Sindhupalchowk
Palpa
Humla
35.8%
35.3%
35.0%
Dhankuta
Jajarkot
Dailekh
Kapilvastu
34.0%
33.9%
33.8%
33.4%
Salyan
Dolkha
Myagdi
Rupandehi
33.3%
33.0%
31.7%
31.6%
Bajur a
Lamjung
Okhaldhunga
Baitadi
31.5%
31.0%
31.0%
30.6%
Tanahu
Mugu
Gulmi
Sindhuli
Taplejung
Udaypur
Dadeldhura
30.6%
30.4%
30.4%
30.2%
27.9%
27.8%
27.7%
Sankhuwasabha
Syangja
Gorkha
Ramechhap
27.2%
26.9%
26.6%
26.0%
Panchthar
Bhojpur
Doti
Parbat
25.9%
25.2%
24.2%
23.8%
Teharthum
Baglung
Manang
Bajhang
Darchula
Rukum
Kalikot
Arghakhanchi
Achham
23.5%
23.5%
23.5%
23.4%
22.4%
21.7%
21.3%
20.9%
19.1%
NATIONAL
43.7%
EASTERN
47.1%
CENTRAL
WESTERN
MID-WESTERN
FAR WESTERN
Baitadi
Humla
Kalikot
Dhading
Rolpa
156.3%
154.3%
146.9%
122.1%
119.5%
Bajura
Achham
Dolpa
118.6%
118.1%
116.2%
Dar chula
Jajarkot
Rautahat
115.8%
114.9%
114.9%
Jumla
Solukhumbu
Gulmi
Doti
114.4%
110.5%
109.2%
109.0%
Dailekh
Mugu
Khotang
Bajhang
Bara
Siraha
Dhanusha
Kanchanpur
Saptari
Surkhet
48.7%
47.2%
46.8%
46.4%
45.8%
44.5%
44.3%
Banke
Mustang
Bhaktapur
Pyuthan
Target Vs Achiev ement

as % of Current Users
51.3%
31.7%
41.3%
36.2%
109.0%
108.6%
106.1%
104.5%
103.5%
103.3%
103.0%
101.9%
101.7%
101.3%
Dang
Salyan
Lalitpur
100.8%
100.7%
100.4%
Bardiya
Kapilvastu
Kailali
100.3%
99.5%
99.0%
Sarlahi
Tanahu
Makawanpur
Mahottari
98.6%
98.2%
96.5%
96.2%
Rasuwa
Rukum
Pyuthan
Mustang
Ilam
Nawalpar asi
Morang
Nuwakot
Dolkha
96.2%
95.9%
95.7%
95.4%
93.9%
92.3%
91.4%
91.4%
91.2%
Parsa
Sindhupalchowk
Kavre
91.2%
91.0%
91.0%
Syangja
Banke
Jhapa
Myagdi
90.6%
90.6%
90.4%
90.3%
Parbat
Lamjung
Manang
89.7%
88.9%
87.4%
Ramechhap
Sankhuwasabha
Udaypur
Rupandehi
Sunsari
Sindhuli
Gorkha
Palpa
Arghakhanchi
Chitwan
87.2%
86.9%
85.8%
83.8%
82.9%
82.5%
81.9%
81.5%
80.7%
80.3%
Kathmandu
Taplejung
Bhojpur
80.3%
79.8%
79.4%
Baglung
Dhankuta
Okhaldhunga
Tehar thum
79.1%
78.0%
77.8%
76.0%
Kaski
Panchthar
Bhaktapur
Dadeldhur a
75.5%
72.9%
71.8%
53.2%
NATIONAL
94.0%
EASTERN
91.7%
CENTRAL
WESTERN
94.2%
88.0%
MID-WESTERN
102.0%
FAR WESTERN
102.1%
Chapter3
FamilyHealth:FamilyPlanning
FAMILYHEALTH
3.1 FAMILYPLANNING
3.1.1 Background
The main thrust of the National Family Planning Program is to expand and sustain adequate quality
familyplanningservicestocommunitiesthroughthehealthservicenetworksuchashospitals,primary
health care (PHC) centres, health posts (HP), sub health posts (SHP), primary health care outreach
clinics (PHC/ORC) and mobile voluntary surgical contraception (VSC) camps. The policy also aims to
encouragepublicprivatepartnership.Femalecommunityhealthvolunteers(FCHVs)aremobilizedto
promotecondomdistributionandresupplyoforalpills.AwarenessonFPistobeincreasedthrough
variousIEC/BCCinterventionaswellasactiveinvolvementofFCHVsandMothersGroupsasenvisaged
bytherevisedNationalStrategyforFCHVprogram.
In this regard, family planning services are designed to provide a constellation of contraceptive
methods/services that reduce fertility, enhance maternal and neonatal health, child survival, and
contribute to bringing about a balance in population growth and socioeconomic development,
resultinginanenvironmentthatwillhelptheNepalesepeopleimprovetheirqualityoflife.
Objectives
Withinthecontextofreproductivehealth,themainobjectivesoftheFamilyPlanningProgramareto
assistindividualsandcouplesto:
Spaceand/orlimittheirchildren
Preventunwantedpregnancies
Improvetheiroverallreproductivehealth
Targets
PeriodicandlongtermtargetsfortheFamilyPlanningProgramhavebeenestablishedasfollows:
ToreduceTFRto2.5childrenperwomanby2015
ToincreasetheContraceptivePrevalenceRate(CPR)to67percentby2015
Strategies
InordertoachievetheCPRandtheTFRtargetsmentionedabove,atotalof2,580,000coupleswere
expectedtobeusingmoderncontraceptionbytheendoftheFY2067/68.Recognizingtheimportance
of spacing of births, the Family Planning Program has been placing greater emphasis on promoting
temporarymethodsofcontraception.Morespecifically,thelongtermobjectiveistoreducetheshare
ofpermanentsterilizationinoveralluseoffamilyplanningmethods.However,theemphasisonVSC
servicesshouldbecontinuedtoaddresstheunmetdemandofthosewhodesiretolimitfurtherbirths.
TheFamilyPlanningProgramaimstoprovideaconstellationofcontraceptiveservicesthroughoutthe
country.Thestrategytoachievethefamilyplanninggoalsincludesthefollowingelements:
50
PeriodicreviewofpolicythroughnationalRHsteeringcommitteemeetings.
Coordination of FP program and activities through RH coordination committee networks
includingFamilyPlanningSubCommittee.
Institutionalization of policy/operational guidelines and clinical protocols to ensure maximum
coverageandqualityoffamilyplanningservices.
Increasing the knowledge and understanding of the benefits of delayed marriage, birth spacing,
andawellplannedfamilynormacrossthecountrythroughintegratedRH/FP/IEC/BCCactivities.
IncreasingaccessibilityandavailabilityofFPservicesthroughacombinationofstatic,outreachand
referralservices.
EstablishFPserviceasapartofhospitalserviceandstrengthenInstitutionalizedFamilyPlanning
ServiceCentres(IFPSC).
ExpandingregularyearroundandmobileVSCoutreachservices,andexpandingIUCDservicesto
PHCandHP,withspecialemphasisonthoroughcounselingandfollowupservices.
LinkingFPprogramwithessentialHealthCareService.
Providing nonclinical methods (condoms, pills, and injectables) through static and outreach
services.
Trainingofserviceproviders.
ImprovingthequalityofcareinaccordancewiththeNationalMedicalStandardsforcontraceptive
services, with special attention on counseling, infection prevention and management of side
effectsandcomplications.
Providingrecanalizationservicesinselectedhospitals.
EstablishingpostpartumFPservicesininstitutionswithasignificantcaseloadofdeliveries.
Integratingfamilyplanningserviceswithpostabortioncareandsafeabortioncare.
Identifying national requirements and ensuring adequate procurement of contraceptives and
logisticsupplies.
Promote wider use of Health Management Information Systems (HMIS) and health system
researchforbetterplanningandprogrammanagement.
EnsuringeffectivemonitoringandsupervisionofFPprograms.
Increasing free access to condom by having condom boxes at all health institutions and re
supplyingpillsanddistributingcondomthroughFCHVs.
Inordertoprovidethereproductivepopulationwithoptionstolimitorspacebirths,variousmodern
contraceptive methods were made available under the national health services delivery system.
Family planning services were provided through different health institutions at various levels by
conducting static services as well as mobile camps. As in the past, the Family Planning Program
continued to receive support from various NGOs, INGOs and other supporting agencies. The major
activitiesimplementedduringFY2067/68arebrieflydescribedbelow:
1.
VoluntarySurgicalContraception(VSC)
VSC services include vasectomy, minilap and postpartum tubal ligation. At least one type of VSC
service was made available in all districts except Solukhumbu through hospitals and/or mobile
outreach services. VSC mobile outreach program was conducted in all 74 districts during the FY
2067/68.
51
2.
SpacingMethods
SpacingmethodssuchasDepoProvera(injectables),OralPillsandCondomsweremadeavailableupto
the community level. Distribution of Oral pills and condoms were made through FCHVs at the ward
level.Inaddition,ImplantandIUCDserviceswereofferedthroughselectedHPs,PHCCsandhospitals.
Few SHPs also offered IUCD services. Spacing methods were also made available through private
practitioners,contraceptiveretailsalesoutlets,pharmacies,andotherNGOsandINGOs.
3.
FPCounseling
Counseling is an important activity for assisting clients to make informed choice regarding an
appropriate family planning method. Family planning counseling services are provided to potential
clients by front line FP providers. Accordingly, comprehensive family planning counseling trainings
wereprovidedforvariouscategoriesoffamilyplanningserviceproviders.
4.
Referral
Referral is one of the main approaches for increasing access to family planning services. In the
communitylevel,condomsandpillswereresupplied,throughanetworkofFCHVs,whilerequestsfor
other family planning services were referred to the PHC Outreach clinics, SHPs or to mobile camps.
Healthfacilitiesrefertheclientstotheappropriateinstitutionsormobilecampsforthefamilyplanning
servicesthattheydonothave.
1.
CurrentUsers
Table 3.1.1 shows the number of current users of modern family planning methods in the FY
2067/68. At national level, 94 percent of the target has been achieved. The achievement exceeds
100percentinMWDRandFWDRwhereastheachievementis92,94and88percentsinEDR,CDR
andWDR,respectively.
Table3.1.1:FamilyPlanningCurrentUsers(allmodernmethods)byRegioninFY2067/68
Region
EDR
CDR
WDR
MWDR
FWDR
National
Unit
Couples
Couples
Couples
Couples
Couples
Couples
Target
666,500
1,043,200
397,300
290,000
183,000
2,580,000
Achievement*
610,919
982,244
349,642
295,845
186,837
2,425,521
PercentAchieved
91.7
94.2
88.0
102.0
102.1
94.0
Note:*Unadjusteddata
Source:HMIS/MD&FHD,DoHS
The annual target of current users and achievements both in terms of absolute number and
percentageforthelastthreefiscalyearsarepresentedinTable3.1.2.Overall,theachievementisin
increasingtrendandstandsat94percentinthecurrentfiscalyear.However,theincreasehasbeen
marginalintheFY2067/68fromthelevelofFY2066/67.Thepaceofachievementishigherthanthe
paceofincreasingthetargets.Forexample,thetargetwasincreasedbyaboutonepercent(30,000)
in FY 2066/67 and by 2 percent (50,000) in 2067/68 from the previous year. The achievements
increasedbyabout6percentand3percent,respectivelyinthesameperiod.
52
Table3.1.2:TrendinFamilyPlanningCurrentUsers(allmodernmethods)
FiscalYear
2065/66
2066/67
2067/68
Target
2,500,000
2,530,000
2,580,000
Achievement*
2,219,392
2,353,532
2,425,521
Achievement(%)
88.8
93.0
94.0
2.
NewacceptorsofVoluntarySurgicalContraception(VSC)
Table 3.1.3 shows the number of VSC cases by method in FY 2067/68. At the national level 74
percent of the expected cases were achieved. Regional disaggregation shows that achievement in
threeregions(EDR,CDRandFWDR)isaroundthreefourthandcomparablewiththenationallevel
achievementwhereasitwaslessthan70percentinWDRandMWDR.
Table3.1.3:VSCUsersbyRegioninFY2067/68
Region
EDR
CDR
WDR
MWDR
FWDR
NATIONAL
ExpectedCases
20,900
39,300
8,950
9,700
6,150
85,000
Minilap
14,505
23,451
3,888
3,032
2,952
47,828
Vasectomy
1,042
6,221
2,322
3,401
1,786
14,772
Total
15,547
29,672
6,210
6,433
4,738
62,600
Percent
74.4
75.5
69.4
66.3
77.0
73.6
Table3.1.4presentsthenumberofVSCnewacceptorsrecruitedbyprocedureinthelastthreefiscal
yearsbyregion.ThetotalnumberofVSCnewacceptorsisdecreasingoverthethreeyearsperiodof
comparison.Ithasdecreasedfrom77,675inFY2065/66to62,600inFY2067/68.Thedecreasehas
been noted in all five development regions. Moreover, it has decreased in spite of the increased
contribution of nongovernment (NGO) sector in sterilization services. In FY 2066/67 the share of
NGOsinVSCnewacceptorswas27percentwhichincreasedto43percentinFY2067/68.Theshare
ofbothmaleandfemaleVSCnewacceptorsofthetotalVSCnewacceptorsremainsalmostsamein
all fiscal years, with threefourth share of female VSC new acceptors and remaining onefourth of
maleVSCnewacceptors.
Table3.1.4:TrendofVSCNewAcceptorsbyProcedure,byRegion
Procedure
Minilap
Vasectomy
Totalnew
VSC
acceptors
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
EDR
17,339
15,087
14,505
1,020
1,112
1,042
18,359
16,199
15,547
CDR
30,100
27,102
23,451
7,556
7,029
6,221
37,656
34,131
29,672
Region
WDR MWDR
4,291
4,657
4,822
2,972
3,888
3,032
3,209
4,137
2,232
4,964
2,322
3,401
7,500
8,794
7,054
7,936
6,210
6,433
FWDR
3,790
3,225
2,952
1,576
2,242
1,786
5,366
5,467
4,738
National
totalVSC
60,177
53,208
47,828
17,498
17,579
14,772
77,675
70,787
62,600
Procedureasa
%oftotalVSC
77.5
75.2
76.4
22.5
24.8
23.6
Source:HMIS/MD,DoHS
53
WhenVSCnewacceptorisanalyzedbytypeofprocedureitisseenthatthetotalnumberofVSCnew
acceptorsforbothmalesandfemaleshavedeclinedintheFY2067/68ascomparedtotheprevious
fiscalyears.Andasaresult,thetotalnumberofVSCnewacceptorsalsodeclined.IntheEDR,MWDR
and FWDR the new acceptors for male VSC increased in FY 2066/67 as compared to the previous
fiscalyear,howeveritdeclinedintheFY2067/68(Figure3.1.1).Thistypeoftrendisalsoobservedin
case of female VSC new acceptors in WDR. Moreover, the female VSC new acceptors in the FY
2067/68incomparisontopreviousfiscalyearslightlyincreasedinMWDR(Figure3.1.2).However,
thehighestpercentageofdecline(31%)innewacceptorsofmaleprocedurewasalsoobservedin
thisregioninthesameperiodofcomparison,andforfemaleVSCnewacceptorsitwasintheWDR
whereitdeclinedby19percent.
Fig. 3.1.2: Female VSC Acceptors

Fig. 3.1.1: Male VSC Acceptors
FY 2065/66 to 2067/68
FY 2065/66 to 2067/68
40,000
14,000
17,498
60,177
NEPAL
17,579
12,000
53,208
NEPAL
30,100
14,772
30,000
47,828
27,102
10,000
23,451
7,556
20,000 17,339
7,029
8,000
15,087
6,221
14,505
6,000
4,964
4,137
3,209
10,000
3,401
4,000
4,657
2,322
3,0323,790
4,291 4,822
2,952
2,232
2,242 1,786
3,888
2,972
1,112
3,225
1,576
2,000
1,020
1,042
0
EDR
CDR
WDR
MWDR
FWDR
0
EDR
CDR
WDR
MWDR
FWDR
2065/66 2066/67
2067/68
Source: HMIS/MD & FHD, DoHS
2065/66 2066/67 2067/68
Table3.1.5:TrendinVSCUsersbyRegion
ExpectedCases
Achieved
Percent
Achievement
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
EDR
21,500
20,800
20,900
18,359
16,199
15,547
85.3
77.9
74.4
Region
WDR
9,900
8,950
8,950
7,500
7,054
6,210
75.8
78.8
69.4
CDR
38,550
39,400
39,300
37,656
34,131
29,672
97.7
86.6
75.5
MWDR
9,250
9,700
9,700
9,794
7,936
6,433
105.6
81.8
66.3
National
FWDR
5,900
6,150
6,150
5,366
5,467
4,738
90.9
88.9
77.0
85,100
85,000
85,000
77,675
70,787
62,600
91.3
83.3
73.6
Table 3.1.5 and Figure 3.1.3 show the VSC

performance as a percentage of expected cases
for the last three fiscal years. The overall
achievement as against the target at national
level has decreased from 91 percent in FY
2065/66to83percentinFY2066/67,andfurther
to74percentinFY2067/68.VSCachievementsas
against the target is lowest in MWDR (66%)
followedbyWDR(69%)inthecurrentfiscalyear.
Moreover, the achievement is not only lowest in
MWDR but has also highest decline (16% points)
in FY 2067/68 from the level of FY 2066/67.
VSC Expected Cases vs. Achievement

FY 2065/66 to 2067/68
Fig. 3.1.3
110
98
100
95
91
90
87
85
83
91
89
79
78
80
74
74
82
76
76
77
69
70
66
60
50
NEPAL
EDR
CDR
2065/66
WDR
MWDR
2066/67
FWDR
2067/68
54
Method
Pills
Depo
IUCD
Implant
Condoms
Total
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
EDR
27,879
29,312
25,578
61,285
60,185
57,230
2,542
6,163
5,371
3,110
4,126
3,817
28,761
29,937
30,307
123,577
129,723
122,303
CDR
31,828
34,964
32,172
88,397
88,395
82,336
7,640
13,515
11,805
7,724
9,878
7,604
47,739
42,303
47,353
183,328
189,055
181,270
Region
WDR
18,603
20,144
20,361
40,492
42,223
38,390
2,127
5,023
4,820
1,740
2,477
2,739
32,095
28,619
30,345
95,057
98,486
96,661
23,956
23,334
16,734
31,858
28,031
FWDR
8,711
11,687
11,646
19,737
23,993
27,172
617
1,114
1,515
853
2,600
3,293
19,840
23,770
25,421
49,758
63,164
69,047
170,372
160,258
MWDR
19,781
23,381
20,869
44,296
45,338
42,536
4,530
6,043
4,520
3,307
4,875
5,881
31,787
34,673
36,912
103,701
114,310
110,718
159,338
NEPAL
260,134
247,664
17,456
119,488
110,626
106,802
254,207
Programshouldfocusitsattentionwithappropriateoptionsingeneraltoenhanceitscurrentlevel
ofperformance.
3.
NewAcceptorsofSpacingMethods
NewacceptorexpressesthenumberofMWRA Fig.3.4
New Acceptors of Spacing Methods
Fig.3.1.4
who adopt specific method of contraception
FY 2065/66 to 2067/68
350,000
for the first time in their life. Table 3.1.6 and
555,457
300,000
594,774
Figure 3.1.4 show the number of new
580,033
250,000
acceptors who had adopted different spacing
200,000
methods during the last three fiscal years. As
150,000
can be seen in the figure, there has been an
100,000
increase in the number of new acceptors of
50,000
mostofthespacingmethodsfromFY2065/66
0
Pills
Depo
IUCDs
Implant
Condoms
to 2066/67 but it declined in the FY 2067/68.
The biggest decline is for DepoProvera as it
2065/66
2066/67
2067/68
declined by more than 12,000 new acceptors. Source: HMIS/MD, DoHS
However,thetrendwasoppositeforcondoms
as it has increased in the current fiscal year. Such an erratic trend was observed in all the
development regions of the country (Table 3.1.6). Among the five development regions, there is
increasing trend for most of the spacing methods except for pills in FWDR. Similarly, there is
increasingtrendofnewacceptorsofImplantinWDR,MWDRandFWDRwhiletheoppositeistruein
EDRandCDR.
Table3.1.6:TrendinNumberofNewAcceptorsofSpacingMethodsbyRegion
National
106,713
119,488
110,626
254,115
260,134
247,664
17,421
31,858
28,031
16,714
23,956
23,334
159,801
159,338
170,372
555,457
594,774
580,033
Note:Newacceptorsofcondomareestimatedbydividingtotalcondomsdistributedby150.
Source:HMIS/MD,DoHS
TheproportionofnewacceptorsofdifferentspacingmethodsrecruitedintheFY2067/68isshownin
Figure3.1.5.Ofthetotal580,033newacceptersofspacingmethods,43percentwereDepoProvera
usersfollowedbyCondom(29%)andOralPills(19%).NewacceptorsofIUCDconstitutes5percentand
ofImplant4percent.
55
Figure3.1.6 showstrendinnewacceptorsforspacingmethodasapercentofMWRA.Overallthe
new acceptors for spacing methods constitute about 10 percent of the MWRA, and this has
remainedalmostconstantoverthelastthreeyears.ThenewacceptorsofDepoProveracomprise
nearly 5 percent, condoms 3 percent, pills about 2percent and long acting methods such as IUCD
andImplantlessthanonepercentofthetotalMWRA.Exceptforcondoms,theproportionofnew
acceptorsofallspacingmethodsaspercentofMWRAinthecurrentfiscalyearhasslightlydeclined
ascomparedtothepreviousFY2066/67.
Fig.3.1.5NewAcceptorsofFPSpacingMethod(Mix)
FY 2067/68
Condoms (170,372)
29.37%
Pills (110,626)
19.07%
Implant (23,334)
4.02%
IUCDs (28,031)
4.83%
Total: 580,033
4.
Depo (247,664)
42.70%
FY 2065/66 to 2067/68
3.0
2.9
Condoms
3.1
2.0
2.2
Pills
2.0
4.8
Depo
4.8
4.5
0.3
IUCDs
0.6
0.5
0.3
Implant
0.4
0.4
Total
0.0
2065/66
10.4
11.0
10.5
12.0
2066/67
2067/68
FamilyPlanningCurrentUsersandContraceptivePrevalenceRate(CPR)
TheContraceptivePrevalenceRate(CPR)isoneofthemainindicatorsformonitoringandevaluating
the National Family Planning Program. The number of current users of the permanent method in
CPRisadjustedbasedontheageexitandthemortalityofmalesandfemalesinthereproductiveage
groupeveryyear.
ThetrendinnumberofcurrentusersandestimatedCPRbyregionareshowninTable3.1.7.Overall
the total number of current users (both spacing and permanent) has been increasing. The total
numberofcurrentusersinFY2067/68was2,425,521.Atthenationallevelthenumberofcurrent
users of temporary methods increased from 958,056 in FY 2066/67 to 988,800 in FY 2067/68.
Similarly,thenumberofcurrentusersofpermanentmethodsincreasedfrom1,395,476to1,436,721
overthesameperiod.Regionalvariationshowsthatthecurrentusersofbothtypeofmethodshas
increasedinalltheregionsexceptMWDR.
Table3.1.7:TrendinCurrentUsersofSpacingandLimitingMethodsbyRegion
Region
Year
EDR
CDR
WDR
MWDR
Spacing
2065/66
242,386
306,502
124,425
125,763
methods
2066/67
247,978
333,119
131,016
159,294
2067/68
249,930
350,848
139,780
158,709
Permanent
2065/66
337,301
590,253
206,871
130,850
methods*
2066/67
344,410
609,403
209,531
137,262
2067/68
360,989
631,396
209,862
137,136
Totalusers*
2065/66
579,687
896,755
331,296
256,613
2066/67
592,388
942,522
340,547
296,556
2067/68
610,919
982,244
349,642
295,845
Estimated
2065/66
49.0
47.9
31.76
36.2
CPR
2066/67
46.0
50.3
31.6
42.4
(percent)*
2067/68
47.1
51.3
31.7
41.3
FWDR
65,278
86,613
89,499
89,727
94,870
97,338
1,55,005
181,483
186,837
29.3
36.0
36.2
National
Total
864,390
958,056
988,800
1,355,002
1,395,476
1,436,721
2,219,392
2,353,532
2,425,521
41.6
43.5
43.7
56
Percent
The CPR for modern family planning Fig. 3.1.7:
Contraceptive Prevalence Rate (CPR) by Region
method, as shown in Figure 3.1.7, is 44
FY 2065/66 to 2067/68
percentandcomparablewith2011NDHS 70
(43%).Ithasremainedalmostconstantin 60
51
the last two fiscal years. The 2011 NDHS
50
49 47 47
48
50
42 43 44
alsoshowednonincreaseinCPRoverthe
42 41
36 36
36
fiveyearsperiod.Oneof thereasonsfor 40
3232 32
nonincrease in CPR could be high 30
29
spousal separation due to migration for
employment reason.Asurveyconducted 20
intheruralareasofNepalshowednearly 10 National
EDR
CDR
WDR
MWDR
FWDR
Note: Unadjusted CPR
onethird of the MWRA reported their
Source:MIS/MD,FHD,DoHS
2065/66
2066/67 2067/68
husbandswerelivingawayatthetimeof
thesurvey(NFHPIIandNewERA,2010).
Coupleswhoarenotlivingtogetherforlongerdurationarelesslikelytousefamilyplanningasthey
are not in immediate need. The same study showed a much higher CPR among couples living
together than those couples whose husbands were living away. Moreover, the CPR among the
couples living together has increased thus reflecting that family planning services have been
reachingtothosecoupleswhoareinimmediateneed.AlthoughoverallCPRasshownbyHMISand
2011NDHS,hasnotincreasedtherehasbeendeclineinTotalFertilityRate(TFR)from3.1in2006to
2.6in2011(NDHS2011)andisexpectedtomeettheNHSPIItargetof2.5by2015.Furtheranalysis
isneededtounderstandthefactorscontributingtodeclineinTFRwithoutincreaseinCPR.
AsshowninFigure3.1.7thereiswidevariationinCPRattheregionallevel.ThehighestlevelofCPR
isnotedinCDR(51%)andlowestinWDR(32%).CPRhasremainedconstantintherecenttwoyears
in EDR, WDR and FWDR, increased slightly in CDR but declined slightly in MWDR. Given the CPR
estimated from the HMIS and survey data, achieving NHSPII goal of 67 percent by 2015 from the
current level is also a challenge that should be addressed by the program with innovative
approachesandappropriatestrategies.
Figure 3.1.8 shows trend in method mix of CPR

Fig. 3.1.8: Trend in Method Mix of CPR
from the HMIS data. The program emphasis, as
120
mentioned in the beginning of this chapter, has
100
been to increase the use of spacing methods of
80
family planning. In FY 2067/68 the share of
59
59
61
60
spacingmethodofthetotalCPRwas41percent
whichislowerthantheestimationof2011NDHS
40
data (47%). While the program has been
41
41
20
39
successful in increasing the share of spacing
0
2056/66
2066/67
2067/68
methods from 39 percent in 2065/66 to 41
percent in 2066/67, however it has remained
Spacing Limiting
unchangedintheFY2067/68.
The2011NDHSalsoshowedmarginalincreaseinshareofspacingmethodsbetween2006and2011.
Thesedataindicatethatmoreeffortsareneedediftheprogramhastoincreasetheshareofspacing
methodsinthecontraceptivemethodmix.
57
5.
UnmetNeedforFamilyPlanning
Fig.3.1.9:MetandUnmetNeedforFamilyPlanning
As estimated by the 2006 NDHS the CPR

Expressing no demand
(all methods) was 48 percent with an
27%
unmet need of 25 percent of which 10
Total: 451,850
percent is for spacing and 15 percent is
Unmet need for limiting
15%
forlimiting(Figure3.1.9).Unmetneedis
muchhigheramongcoupleswhoarenot
living together than among couples who
arelivingtogether(NFHPIIandNewERA,
Unmet need for spacing
2010).
9%
Using to space
Nepals family planning program is
Using to limit
5%
directed toward reaching couples with
43%
unmet need and reducing the Source:NDHS2006
proportion of women who express "no
demand" through information and awareness activities. Since data on unmet need is not yet
availablefrom2011NDHSthereforetheanalysisusesdatafrom2006NDHS.BoththecurrentCPR
(modernmethod)obtainedfromHMISdataandfrom2006NDHSindicatesthatthemetneedforFP
serviceshasincreasednarrowingthegapofunmetneed.However,the2010study(NFHPIIandNew
ERA)showednodeclineinunmetneedintherecentpast.Thisismainlyduetodefinitionofunmet
needascoupleswhoarenotlivingtogetherareincludedinitscalculation.CountriessuchasNepal
wherehusbandorwifelivingawayisveryhightheprogramshouldusedisaggregatedata(current
living status with husbands) in order to programming and evaluating. The 2011 NDHS will provide
recentevidenceonlevelandtrendinunmetneed.
Table3.1.8presentstheproblems/constraintsinfamilyplanningprogram,actionstobetakenand
the responsible agency as identified during the regional and national annual reviews in the FY
2067/68.
Table3.1.8:Problems/ConstraintsandActionstobeTaken
Problem/Constraints
Limitedtrainingsitesandserviceproviders
forlongactingFPservices
DelayinprocurementofFP/RHcommodities
(Implant,equipments,instrumentsetc.)
PostpartummothersnotcapturedbytheFP
program
LowFPacceptorsinpostabortioncare
Highunmetneedamongcoupleswhoarenot
livingtogether
Actionstobetaken
Developmoretrainingsites,Identifyand
mobilizepartnerstosupportintraining
Procurement process should be in place
timely
InitiatepostpartumFPprogram andalso
link FP with immunization to reach
postpartummothers
StrengthenpostabortionFPservice
Address the unmet need of returning
migrants
Responsibility
FHD/NHTC
LMD
FHD/CHD/
D(P)HO
D(P)HO
DoHS/FHD
3.1.4 TargetforFY2068/69
Table3.1.9and3.1.10presenttheactivitiesplannedfor2968/69.
58
Table3.1.9:ActivitiesplannedforFY2068/69
SN
Activities
Unit
Targets
1 FamilyPlanningCurrentUsers
Couples 2,580,000
2 ExpectednumberofVSC
Numbers
70,000
3 VSCpreparatorymeetings
District
75
5 IncreasepostpartumFPcounselingandservicesatdistrictlevel
District
6
6 PreVSCmeetingwithFCHVsinlowperformingdistricts
District
10
7 IncreasepostpartumFPcounselingandservicesatcommunitylevel District
20
8 Conductsatelliteclinicsforlongactingmethods
District
75
Source:FHD,DoHS
Table3.1.10:PlannedNumberofVSCMobileCampSitesandDaysforFY2068/69
Region
EDR
CDR
WDR
MWDR
FWDR
National
Numberofsites
95
128
112
82
75
492
Numberofdays
510
745
405
500
285
2,445
Source:FHD,DoHS
Note:PleaserefertoAnnex3.4fordistrictspecificdata.
59
Safe Motherhood
Fiscal Year 2067/68 (2010/2011)
% of Deliv ery Conducted by SBA
K aski
% of Deliv ery (including SBA)

D ha nus ha
81
B a nk e
K a t hma ndu
La lit pur
D ha nus ha
60
D aile k h
71
Lalitpur
68
Sira ha
67
66
Suns a ri
53
Surk he t
71
Mugu
65
62
D a de ldhura
73
K a t hma ndu
65
C hit w a n
83
B a nk e
70
Suns a ri
93
K aski
71
52
C hitw a n
52
J ha pa
63
61
J ha pa
48
D a de ldhura
61
Mugu
47
Ma hott ari
60
59
Sira ha
45
R aut a ha t
Mora ng
44
D a ile k h
59
B a ra
59
K a ila li
42
39
Surk he t
38
H umla
Pa lpa
R upa nde hi
H umla
57
51
48
B ajura
38
K anc ha npur
36
K a ila li
46
B ardiy a
36
Mora ng
45
44
Pa lpa
B ajura
34
K av re
33
R upa nde hi
41
32
K a pilv a s t u
41
D a ng
D ot i
31
Lamjung
29
A chha m
25
B a ra
25
D ot i
40
B a glung
40
38
A chham
38
Sarla hi
37
24
K anc ha npur
Soluk humbu
24
Soluk humbu
37
B a glung
23
B ardiya
37
J umla
36
23
Lamjung
My a gdi
23
Mya gdi
35
Mus t a ng
23
J umla
35
Sank huw as a bha
Ma k a w a npur
B a jha ng
D ha ding
34
K av re
22
21
D a ng
34
21
G ulmi
34
G ulmi
33
J a ja rk ot
20
33
B ajha ng
Sa ly a n
20
Sapta ri
20
D olpa
32
20
O k ha ldhunga
32
R a ut a ha t
20
Sapta ri
19
K hot a ng
R olpa
Pa nc ht ha r
31
29
29
Ta ple jung
K alik ot
19
R uk um
19
K a lik ot
29
28
18
R uk um
U da y pur
18
Mus t a ng
28
O kha ldhunga
18
Pa rba t
27
D olpa
Pa rba t
27
Sa nk huw a s a bha
18
R a me c hha p
17
Sindhuli
27
J a ja rk ot
17
U da y pur
27
Sa rla hi
17
K hot a ng
17
D a rc hula
27
D olkha
26
Pa rs a
26
R a me c hha p
16
16
D ha ding
25
15
Sa ly a n
25
Py utha n
15
Py utha n
D olk ha
15
Ma hott a ri
Ila m
G ork ha
25
24
R olpa
24
R as uw a
15
R a s uw a
14
Pa nc ht ha r
23
Sindhuli
14
Ma k a w a npur
23
14
D arc hula
N uw a k ot
Sya ngja
14
Te ha rt hum
13
A rgha k ha nc hi
13
Sindhupa lc how k
13
D ha nkut a
33
E AS TE R N
35
11
N a wa lpa ra s i
11
Ta ple jung
10
B ha k ta pur
B ait a di
C E NTRA L
33
Pa rs a
6
4
20
Te ha rt hum
20
N uw a k ot
20
Sy a ngja
18
D ha nk ut a
18
17
Sindhupa lc how k
16
B a ita di
W E S TE RN
27
B hojpur
Ma na ng
NATIONAL
13
K a pilva s t u
21
A rgha k ha nc hi
13
Ta na hu
23
22
Ila m
G ork ha
MID-W E S TE RN
36
Tana hu
15
B hojpur
15
32
Ma na ng
43
E AS TE R N
43
CE NTRA L
W E S TE R N
MID-W E S TE RN
48
35
42
14
N a w a lpa ra s i
10
B ha k ta pur
FA R W E S TE RN
NATIONA L
FAR W E S TE R N
39
FamilyHealth:SafeMotherhood&NewbornHealth
3.2
SAFEMOTHERHOODANDNEWBORNHEALTH
3.2.1 Background
ThegoaloftheNationalSafeMotherhoodProgramistoreducematernalandneonatalmortalities
byaddressingfactorsrelatedtovariousmorbidities,deathanddisabilitycausedbycomplicationsof
pregnancyandchildbirth.Globalevidenceshowsthatallpregnanciesareatrisk,andcomplications
during pregnancy, delivery and the postnatal period are difficult to predict. Experience also shows
thatthreekeydelaysareofcriticalimportancetotheoutcomesofanobstetricemergency:(i)delay
in seeking care, (ii) delay in reaching care, and (iii) delay in receiving care. To reduce the risks
associatedwithpregnancyandchildbirthandaddressthesedelays,threemajorstrategieshavebeen
adoptedinNepal:
Promoting birth preparedness and complication readiness including awareness raising and
improvingtheavailabilityoffunds,transportandbloodsupplies.
Encouragingforinstitutionaldelivery.
Expansion of 24hour emergency obstetric care services (basic and comprehensive) at
selectedpublichealthfacilitiesineverydistrict
Sinceitsinitiationin1997,theSafeMotherhoodProgramhasmadesignificantprogressintermsof
thedevelopmentofpoliciesandprotocolsaswellasexpansionintheroleofserviceproviderssuch
asstaffnursesandANMsinlifesavingskills.Thepolicyonskilledbirthattendantsendorsedin2006
by MoHP specifically identifies the importance of skilled birth attendance at every birth and
embodiestheGovernmentscommitmenttotraininganddeployingdoctorsandnurses/ANMswith
therequiredskillsacrossthecountry.Similarly,endorsementofrevisedNationalBloodTransfusion
Policy 2006 is also asignificant step towards ensuring the availability of safeblood supplies in the
eventofanemergency.
Inordertoensurefocusedandcoordinatedeffortsamongthevariousstakeholdersinvolvedinsafe
motherhood and neonatal health programming, government and nongovernment, national and
international,theNationalSafeMotherhoodPlan(20022017)hasbeenrevised,withwidepartner
participation.TherevisedSafeMotherhoodandNeonatalHealthLongTermPlan(SMNHLTP2006
2017) includes recent developments not adequately covered in the original plan. These include:
recognitionoftheimportanceofaddressingneonatalhealthasanintegralpartofsafemotherhood
programming;thepolicyforskilledbirthattendants;healthsectorreforminitiatives;legalisationof
abortion and the integration of safe abortion services under the safe motherhood umbrella;
addressingtheincreasingproblemofmothertochildtransmissionofHIV/AIDS;andrecognitionof
the importance of equity and access efforts to ensure that most needy women can access the
servicestheyneed.TheSMNHLTPidentifiesthefollowinggoal,purposesandoutputs.
Goal
Safemotherhoodandneonatalhealthaimsatimprovingmaternalandneonatalhealthandsurvival,
especially of the poor and excluded. The main indicators for this include reduction in maternal
mortalityratioandneonatalmortalityrate.ThedetailindicatorsaregiveninTable3.2.1.
61
Table3.2.1:KeyIndicatorsforSafeMotherhood
SLTHP MDG
Indicator
19972017 2015
Maternalmortalityratio(MMR)
250
134
Infantmortalityrate(IMR)
34.4
34
Totalfertilityrate(TFR)
5.05
2.5
Contraceptiveprevalencerate(CPR)
58.2
67
Neonatalmortalityrate(NMR)
16
%ofdeliveryassistedbySBA
60
60
%ofwomenwhotookirontabletsor
syrupduringthepregnancyoftheir
lastbirth
%ofinstitutionaldelivery
40
40
%ofEOCmetneed
%ofcaesareansection
Obstetriccasefatalityrate
NHSP2
2011 2013 2015
250
192 134
46
38
32
3.0
2.75 2.5
48
52
67
30
23
16
40
60
82
86
90
27
4
<1
35
43
4.3
<1
40
49
4.5
<1
Current
status
281
46
2.6
43
33
36
79.5
35
15.3
4.9
2.7
Year Source
2006 NDHS
2011 NDHS
2011 NDHS
2011 NDHS
2011 NDHS
2011 NDHS
2011 NDHS
2011
2010
2010
2010
NDHS
HMIS
HMIS
HMIS
Strategies
Followingstrategieshavebeentakentoachievethegoalsofsafemotherhoodprogram:
1. Promotingintersectoralcollaborationbyensuringadvocacyforandcommitmentstoreproductive
health,includingsafemotherhood,atthecentral,regional,districtandcommunitylevelsfocusing
onpoorandexcludedgroups;
EnsuringthecommitmenttoSMNHinitiativeatalllevelsbypromotingcollaborationbetween
sectorslikehealth,education,andsocialwelfare,legalandlocaldevelopment.(Strengthening
RHSC,RHCC,DistrictRHCCandSMNSC)
Mobilizing nationalauthorities,District Health ManagementCommittee(DHMC), community
leaders and community members to play active roles in creating suitable environment for
promotingsafemotherhood.
2. Strengthening and expanding delivery by skilled birth attendant, basic and comprehensive
obstetriccareservices(includingfamilyplanning)atalllevels.Interventionsincludethefollowing:
Developingtheinfrastructurefordeliveryandemergencyobstetriccare.
Standardisingbasicmaternitycareandemergencyobstetriccareatappropriatelevelsofthe
healthcaresystem;
Strengtheninghumanresourcemanagement;
Establishing functional referral system and advocating for emergency transport systems and
funds from communities to district hospitals for obstetric emergencies and highrisk
pregnancies;
Strengtheningcommunitybasedawarenessonbirthpreparednessandcomplicationreadiness
throughFCHVs,increasingaccessofallrelevantmaternalhealthinformationandservice.
3. Supportingactivitiesthatraisethestatusofwomeninsociety;
4. Promoting research on safe motherhood to contribute to improved planning, higher quality

services,andmorecosteffectiveinterventions.
62
1.
BirthPreparednessPackageandMNHActivitiesatCommunityLevel
FamilyHealthDivision(FHD)continuedsupportforexpansionandmaintenanceofMNHactivitiesat
communitylevelwhichincludesrevisedBirthPreparednessPackage(JeevanSurakshaFlipChartand
JeevanSurakshaCard)andMatriSurakshaChakki(Misoprostol)distributionforpreventionofpost
partumhaemorrhage(PPH)athomedeliveryfocusingcontinuumofcarefrompregnancy,through
birthandthepostpartumperiod,includingthenewborn.Suchcommunitylevelactivitiespromote
strengtheningbirthpreparednessandcomplication readiness(preparednessofmoney,SBA/health
facilities,transportandblooddonors),promotionofkeyANC/PNCservices(Iron,TT,Albendazole),
self care in pregnancy and postpartum period (food, rest, no smoking and no drinking alcohol),
identification and prompt care seeking for danger signs in pregnancy, delivery and postpartum
period and education and distribution of Matri Suraksha Chakki for prevention of PPH at home
delivery.
In 2067/68, several external development partners (EDPs) such as NFHP II/USAID, UNICEF, UMN,
RHDP/SDC, Care Nepal and Plan Nepal supported FHD in maintenance of BPP in the existing 41
districts(25GoNand16partners)andinexpansionofrevisedBPPin30districts(25byGoNand5by
partners).
In2066/67,theGoNapprovedPPHeducationandMatriSurakshaChakkidistributionbyFCHVsfor
preventionofPPHathomedelivery.FHDhasaplantoexpandMSCto2districtswithGoNfunding.
MSCwillbeprocuredbyGoNfundingforalldistrictsfromthisyear.Poolofnationaltrainerswillbe
developedforexpandingtheMSCinterventioninintegrationwithBPP.
These community level interventions have increased the demand and access of information and
servicesatthecommunitylevel.Thishascontributedtoincreasetheserviceutilizationinpregnancy,
deliveryandpostpartumcareincludingessentialnewborncare.
2.
RuralUltraSoundProgram
Theobjectiveofthisprogramistotimelyidentifythecomplicationduringpregnancyreferraltothe
appropriate health faculty for complication management. This program is being piloted in two
districts Mugu and Dhading. The preliminary finding shows the increment in ANC cases and
increasedtimelyreferraltohighercentres.Inthisprogramatrainednurseuseaportableultrasound
machineforscanpurposeonly.
3.
UterineProlapse
UterineProlapse(UP)relatesonnearlyeveryaspectofmandateintheareaofReproductivehealth
(RH) and Rights, gender equity, and empowerment of women. The many factors that directly and
indirectlycausethismorbidityhavethepotentialtoserveasanentrypointforimprovingwomens
Reproductive Health and Reproductive Rights. While UP is not an MDG indicator, it is indirectly
relatedtoGoal
Uterine prolapsed is the priority one program of GoN. In the last 4 years separate fund has been
allocatedforuterineprolapsed.Uterineprolapsetreatmentandsurgeryoperationalguideline2065
firstrevise2066hasbeendeveloped andonefocalpersonhasbeenidentifiedintheFHD.Tillthe
endofFY2067/66morethat26,000surgerieshaveseendoneandintheFY2067/068approximately
63
14,041 surgeries have been performed. More than 7000 women have been treated with
conservativemanagementwithringpressirary.
4.
HumanResource
Atotalof1,342ANMsand25staffnurseshavebeenrecruitedonlocalcontracttosupport24hour
delivery services in PHCCs and HPs. Nine MDGP/Gynaecologists were recruited locally in nine
districtsforCEOCservices.ThishasresultedinincreasednumberofCSinthesedistricts(SeeAnnex
sheetonSafeMotherhood).NationalAcademyofMedicalSciences(NAMS)hasnowinitiatedone
yearDiplomacourseinGynaecologyandObstetricsandsixdoctorsareundertakingthetraining.
FamilyHealthDivisionhasbeencoordinatingwithNHTCtoprovideSBAtrainingtodoctorsandstaff
nurses.SinceinserviceSBAtrainingwasinitiatedin 2007,atotalof2535SBAshavebeen trained
and27doctorsaretrainedinadvancedSBAtrainingincludingcaesareansection.
5.
EquityandAccessProgram(SamataRaPahunchKaryakaram)
Equity and Access Program (EAP), a targeted rightsbased community mobilisation program, was
extended to 85 new VDCs in 7 new districts (Doti, Baitadi, Gulmi, Rukum, Jajarkot, Parsa and
Taplajung) making a total of 16 districts in fiscal year 2067/68. In line with the Governments
strategyofpromotingpartnershipwithcivilsocietyorganisationstheDistrict(Public)HealthOffices
(D/PHO)havedevelopedanagreementwithlocalNGOsasserviceproviderorganisationstomanage
and implement the program. Based on the local level decisions made by D/PHOs in coordination
with the Reproductive Health Coordination Committee (RHCC) followup program is undergoing in
morethan60previouslyselectedVDCsofthenineprogramdistrictswherethemajorityofpoorand
sociallyexcludedpeoplelive.
Themainobjectiveoftheprogramistoincreaseaccesstoandutilizationofsafemotherhoodand
newbornhealthservicesinselectedVDCsoftheprogramdistricts.Theprogramisalsoexpectedto
generatepracticallessonstoD/PHOstofacilitatecommunitymobilisationprocessesandtoinfluence
policymakerstoscaleuptheequityandaccessinitiatives.
Overallthisprogramhascreatedanenablingenvironmentfortargeted/excludedcommunitygroups
toaccessSMNHservicesathealthfacilities.Followingarethekeyachievements/outputsobserved
duringthisfiscalyear.
More than 1,000 community groups (with 25,000 women members) have been formed/
reformedandmobilised)intheselectedcommunityoftheprogramdistricts.
All the community groups have created emergency fund and most of them have local
transportmechanismtouseinemergencies.
There has been increase in service utilisation by the poor, Dalits and Janajaties who
previouslyhadnoorverylimitedaccesstohealthservices.
Localresourceshavebeenmobilizedforhealthservicestrengtheninge.g.VDCs/DDCshave
started contributing in ANM recruitment, construction of birthing centre, mothers group
trainingetc.
Thegroupshavestartedraisingcollectivevoicesagainstviolence,rape,physicalandsexual
abuses,childmarriage,dowryetcinthecommunity.
Major challenge: The provision of annual agreement with local NGOs has affected in completing
socialmobilisation,groupfacilitationandawarenessraisingcyclesresultinginlossofgroupinterest
64
intheempowermentprocess.Amultiyearcontractwiththelocalpartners/NGOs,atleastforthree
fiscalyears,wouldfacilitatesmooth,effectiveandsustainableimplementation.
6.
EmergencyReferralFund
Thereareevidencessuggestingthat15percentofthepregnantwomendevelopcomplicationduring
pregnancy and 5 percent of them need CS for delivery. In difficult geographical and inadequate
BEOC/CEOCservices,itisveryimportanttohavereferralservicestothosepregnantwomeninthe
remotedistricts.ToaddressthisissueFHDhaslunchedemergencyreferralfundprogramtofacilitate
referralservicesinfiveremotedistrictsnamelyDolpa,Humla,Jajarkot,DarchulaandBajura.Atotal
oftwohundredthousandrupeeshasbeenallocatedasseedmoneyforeachdistricttobeusedbya
locallyformedcommitteeaspertheguidelines.Themainobjectiveofthisprogramistoprovidethe
referralservicestothosewomenfrompoor,Dalit,Janjati,geographicallydisadvantage;sociallyand
economically disadvantage communities who need emergency caesarean section (C/S) or
complicationmanagementduringpregnancy.
7.
Maternal&NeonatalHealthUpdate(clinicalupdateforANMsandStaffNurse)
MNH update is essentially a 3days update of health workers (namely doctors, staff nurses, ANMs
and MCHWs) working in health facilities that provide 24hour delivery services (hospital, PHC, HP
andSHP),basedonthestandardSBAtrainingpackage.FHDconductedMNHupdatein75districts.
Duringtheupdate,serviceprovidersweretrainedontheuseofpartographs,activemanagementof
third stage of labor (AMTSL) for prevention of PPH including conduction of normal labor,
management of PPH, use of magnesium sulphate (MgSO4) for severe pre/eclampsia and neonatal
resuscitation.
8.
SafeAbortionServices
Despiteasteadyincreaseinthecontraceptiveprevalencerate(CPR),successivenationalsurveysin
Nepalshowthattheprevalenceofunintendedpregnancyamongwomenofreproductiveage(1549
years)increasedfrom25percentin1991(NFHS1991)to35percentin2001(NDHS2001).According
to the NDHS 2006 one in four (25%) currently married women has an unmet need for family
planning,withninepercenthavinganunmetneedforspacingand15percenthavinganunmetneed
for limiting. This finding suggests that there is a need to increase the availability of quality
contraceptive methods closer to the women in the community, and in the primary health care
centres.Ifallcurrentlymarriedwomenwhosaytheywanttospaceorlimittheirchildrenwereto
usefamilyplanningmethod,theCPRwouldincreaseto73percent.
PreventingunwantedpregnanciesthroughaqualityfamilyplanningServicesisafirststeptowards
addressingwomen'sreproductivehealthneeds,andincreasingaccesstosafeabortionserviceshas
been considered as a missed opportunity to prevent unwanted pregnancy, however, there is a
dearthneedstomakethisserviceavailableinordertopreventmortalityandmorbidityformunsafe
abortion. A comprehensive approach needs to be integrated between three services, family
planning, safe abortion and post abortion care. This means ensuring the availability of
comprehensive abortion care (CAC) that refers termination of unwanted pregnancies through safe
techniquewitheffectivepainmanagement,postprocedurefamilyplanninginformationandservice
toensurewomenareabletoplanwhentohavechildrenandavoidfurtherunwantedpregnancies.
According to the law, only listed (trained) doctors or health workers can provide safe abortion
services at listed (approved) health facilities, with the consent of women and according to the
nationalstandard.Theincreasingtrendinabortionutilizationshowsthatmoreandmorewomenare
65
seekingsafeabortionservices.InFY2067/68atotalof95,306womenreceivedsafeabortionservice
from487listedsites.
Inthecountrywherethereishighturnoverofdoctors,trainingnurseproviders,especiallyAuxiliary
NurseMidwife,insafeabortionserviceisseenasaneffectivewaytoavoidserviceinterruptiondue
tounavailabilityofprovider.InFY2067/68atotalof192providersincluding74nurseshavebeen
trainedonsafeabortionservices(SAS).
DuringFY2067/68animplementationresearchwasconductedinPHCCsandHPsof10districtsviz:
Dhankuta,Jhapa,Dhading,Lalitpur,Kavre,Tanahu,Chitwan,Kaski,Surkhet,Kailali.Eachyear5new
districtswillbeincludedintheresearch,expandingitto25districtsbytheendof2014.Withtheaim
toimproveaccesstoabortionservicesparticularlyinruralareasSBAtrainedANMsfromthoseHPs
andPHCCsweretrainedtoprovidemedicalabortion(MA).
Evaluationoftheimplementationwasdonetoassessthefeasibility,acceptabilityandeffectiveness
of MA service provision by ANMs at peripheral health facilities, and to collect evidencebased
feedback and recommendations for scaleup of services during the next phase. During the
implementation period, MA service by ANMs was provided by 56 peripheral facilities (PHCCs and
HPs)in10districts.Thefindingsrevealedthat1799clientsreceivedMAservicesfromDecember1,
2010toJune15,2011.Outofthe120ANMstrainedinMA,115wereactivelyprovidingMAservice.
ThepostMAcomplicationof0.3percentwaslowerthan0.6percentduringinitialpilotingofMAby
staffnursein2009andisfarlessthantheacceptablelabelofpostMAcomplication(2%).Thefollow
uprateof98percentexceededthefollowupratesof96percentwhenMAwasinitiallypilotedin6
districtsin2009(FHD,2011).ThepostMAcontraceptionutilizationrateof83percentwasrelatively
higher. Overall, all 56 pilot sites in 10 districts have been smoothly providing MA service, well
supportedbylocalanddistrictstakeholders,andwidelyacceptedbyperipheralhealthfacilitystaff,
FCHVsandmedicalabortionclients.
The existing FCHV network has been used to reach women in their communities with the
informationaboutthelegalstatusinNepal,referwomenasperneedsforRHservices(ANC,FPand
CAC)usingurinepregnancytestsforearlydetectionofpregnancy.Medicalpersonnelnetworkssuch
as pharmacist associations and nursing college teachers groups have also been utilized to reach
womenaswellascurrentandfutureserviceproviders.
Publichearingshavebeenconductedin22districtsandcommitmentscollectedfromtheconcerned
officials participating in the hearings. Messages of safe abortion service disseminated from radio
serial drama, radio spot advertisements and billboards, and orientation trainings for journalists in
coordinationwiththeHealthJournalistsAssociationofNepal(HEJAN).
9.
AamaSurakchhyaProgramandAntenatalIncentiveProgram
Aamasurakchhyaprogramnowincludes:
Incentives to mothers: A cash payment after delivery at health facility (state and listed non
state).
NRs.1,500inmountainareas,NRs.1,000inhillareasandNRs.500inthetarai.
Freedeliveryservices:Apaymenttohealthfacilityfortheprovisionoffreecare.
Normaldeliveryathealthfacilitywith25andmorebedsNRs.1,500andhealthfacilitywithless
than25bedsNRs.1,000;ComplicationNRs.3,000;CSectionNRs.7,000.Thiscoverscostofall
required drugs, supplies, instruments, and a small incentive to health workers NRs. 300. This
66
provisiondoesnotrequireindividualclaimsfromhealthworkers;however,institutionrequires
submittingtheclaim.
Incentive to health workers for homedelivery has been reduced to NRs 200 from NRs. 300 to
discouragethehomedelivery.
AamaSurakchhyaprogramisbeingimplementedby52nonstatehospitals.
AntenatalIncentiveProgram
A mother gets NRs. 400 if she completes 4 ANC visits as per the ANC protocol, institutional
deliveryand1stPNC.
A significant increase has been observed in the number of facilities providing delivery service and
numberofinstitutionaldeliveryafterthelaunchofAamasurakchhyaprogram.
Serviceoutletshaveincreasedforcsectionandcomplicationmanagement(Table3.2.3).
Twentyfourhourdeliveryserviceisavailableat148PHCCs,533healthpostsand326SHPs.
The number of birthing centres is in rise and many communities have now established new
birthingcentresandstartedprovidingnormaldeliverycareservices.
CoverageofdeliveriesassistedbySBAsandhealthworkershaveincreased
Alargemajorityofthemotherswhodelivered
in health facility have received transportation
incentive (89%) (FHD Administrative record,
2067/68).However,thetrendshowsthatthere
was a rapid increase in the proportion of
mothers receiving the incentive from 51
percentin2063/64to100percentin2066/67
buttherehasbeenaslightdeclineinthisfiscal
year(Fig3.2.1).
Finance
There has been a substantial increase in the budget allocation for Aama Surakchhya Program and
alsoincreaseintheabsorptioncapacityoftheDoHSoverthelastcoupleofyears.However,there
hasbeenaslightdeclineinabsorptioncapacityasonly76percentoftheallocatedbudgetwasspent
in2067/68ascomparedto81percentin2066/67(Table3.2.2andFigure3.2.2).
Table3.2.2: Total Budget Allocation and

ExpenditureinNRsMillion
FiscalYear Allocation
Expenditure
2062/63
139.85
59.27
2063/64
159.2
111.58
2064/65
194.5
143.7
2065/66
444.6
336.7
2066/67
574.3
463.5
2067/68
850.0
648.7
Source: AamaSurakchhyaProgram,Financialreporting,
FHD
67
SocialAuditing
In2066/67socialauditwasconductedat21facilitiesof7districts.However,socialauditcouldnot
takeplaceinthefiscalyear2067/68duetovariousreasonsincludinglatereleaseofbudget.
1.
AntenatalCare
Antenatalcareservicesinclude:
Atleastfourantenatalcheckups:firstat4thmonth,secondat6thmonth,thirdat8thmonthand
fourthat9thmonthofpregnancy;
Monitorbloodpressure,weightandFetalheartrate;
Provide information, education and communication (IEC) and behaviour change communication
(BCC) for danger signs and care during pregnancy, delivery , postnatal and immediate newborn
careforbothmotherandnewbornandtimelyreferraltotheappropriatehealthfacilities;
Birthpreparednessandcomplicationreadiness(BPCR)forbothnormalandobstetricemergencies
(deliverybyskilledbirthattendants,money,transportationandblood);
Detectionandmanagementofcomplications;
Provision of tetanus toxoid (TT) immunisation, iron tablets, deworm to all pregnant women and
malariaprophylaxiswherenecessary.
ANC 1st Visits as % of Expected Pregnancies

FY 2065/66 to 2067/68
90
89
81
85
87
66
65
68
65
74
80
70
87
86
80
90
85
87
100
88
98
Fig 3.2.3
67
Service statistics of the last three years

shows that the national average of ANC
first visit as percentage of expected
pregnancy has decreased from 87 percent
in2066/67to85percentin2067/68(Figure
3.2.3).Attheregionallevel,westernregion
has made some progress whereas there is
declineby6percentineasternregionand
by9percentdeclineinmidwesternregion.
60
50
40
53
49
50
48
48
50
57
61
59
59
61
58
56
56
60
56
57
57
AtleastfourANCvisitswithinthespecified
30
NEPAL
EDR
CDR
WDR
MWDR
FWDR
interval are considered standard for
complete antenatal care. Mothers are
2065/66
2066/67
2067/68
encouragedtomakeatleastfourantenatal
checkups: first at 4th month, second at 6th Fig 3.2.4 Four Time Antenatal Visits as % of ANC 1st Visits
month,third at8thmonth andfourthat9th
FY 2065/66 to 2067/68
80
month of pregnancy for a complete ANC
care (see the section on Aama Surakchhya
70
Program). There is a monitoring system in
60
placetotrackthetimingofANCvisitsasper
the ANC protocol since last year. Figure
50
3.2.4showsthepregnantwomenattending
40
at least 4 ANC visits, irrespective of the
30
timing of visit, as percentage of the first
ANC visit. Less than three fifths of the
20
NEPAL
EDR
CDR
WDR
MWDR
FWDR
motherswhoattendedfirstANCinthefiscal
2065/66
2066/67
2067/68
year 2067/68 made four visits indicating Source: HMIS/MD, DoHS
thatmorethantwofifthsofthemothersdid
notcompletetherecommendedfourANCvisits.
68
2.
DeliveryCare
Deliverycareservicesinclude:
Skilledbirthattendantsatdeliveries(eitherhomebasedorfacilitybased);
Earlydetectionofcomplicatedcasesandmanagementorreferralafterprovidingobstetricfirstaid
byhealthworkertoappropriatehealthfacilitywhere24hoursemergencyobstetricservicesare
available;
Obstetricfirstaidathomeand/orHP/SHPifcomplicationsoccur,usingEmergencyObstetricCare
Kit(EOCkit);
Identificationandmanagementofcomplicationsduringdeliveryandreferraltoappropriatehealth
facilityasandwhenneeded;
Registrationofbirthsandmaternalandneonataldeaths.
Fig 3.2.5
SBA delivery as % of expected live births

FY 2065/66 to 2067/68
33
36
33
36
37
39
36
28
30
30
25
18
16
15
23
25
32
35
40
45
21
Nepal has committed in achieving 60

percent deliveries by SBA by 2015
(2071/72). HMIS started collecting
information on SBA and other than SBA
only after FY 2064/65. The SBA includes
doctors, staff nurses and ANMs while
other than SBA include HA, AHW, MCHW
and VHW. It is important to note that
deliverybySBAhasincreasedoverthelast
couple of years. It has increased from 21
percent in 2065/66 to 32 percent in
2066/67 and 36 percent in 2067/68
(Figure3.2.5).NDHS2011hasalsoshown
15
5
NEPAL
EDR
CDR
WDR
2065/66
MWDR
2066/67
FWDR
2067/68
38
40
35
38
16
15
17
22
26
29
30
33
31
20
19
31
37
40
36 percent of deliveries attended by

Fig 3.2.6
Institutional delivery as % of expected live births
FY 2065/66 to 2067/68
SBA.
55
There has been an increase in
institutional delivery in the last three
45
years in Nepal. Service statistics of the
35
fiscal year 2067/68 shows that 37
percent of the mothers delivered in
25
health facilities (Fig 3.2.6), this is close
tothefindingsofNDHS2011(35%).
15
5
3.
PostnatalCare
NEPAL
EDR
CDR
WDR
MWDR
FWDR

2065/66
2066/67
2067/68
Postnatalcareservicesinclude:
Three postnatal visits: First visit
within 24 hours of delivery, second
visitonthethirddayandthirdvisitonseventhdayafterdelivery;
Identificationandmanagementofmother'sandnewbornincomplicationsofpostnatalperiodand
referraltoappropriatehealthfacilityasandwhenneeded;
Promotionofexclusivebreastfeeding;
Personalhygieneandnutritioneducation,postnatalvitaminAandironsupplementationforthe
mother;
Immunisationofnewborns;and
Postnatalfamilyplanningcounsellingandservices.
69
31
36
35
39
37
41
46
45
46
49
50
51
53
50
52
50
51
55
Percentage of mothers who received Fig 3.2.7

Postnatal Service Coverage
as % of Expected Pregnancies
postnatalcareatthehealthfacilityamong
FY 2065/66 to 2067/68
70
expected pregnancies has increased from
65
50 percent in 2066/67 to 51 percent in
60
2067/68. At the regional level, there has
55
50
been some decline in PNC in western and
45
mid western development regions
40
compared to the last fiscal year (Figure
35
30
3.2.7).
25
20
4.
NewbornCare
15
10
NEPAL
EDR
CDR
WDR
MWDR
FWDR
Newborncareincludes:
2065/66
2066/67
2067/68
Healtheducationandbehaviourchange
communication on essential newborn
carepractices,Identificationofneonataldangersignsandtimelyreferraltotheappropriatehealth
facility.Delivery byskilledbirthattendantbothathome and healthfacility,immediate newborn
care(warmth,cleanliness,immediatebreastfeeding,cordcare,eyecareandimmunization)and
newbornresuscitation
Community based Newborn Care program and community based IMCI is dealt in Chapter 2, Child
Health.
NewbornCordcarewithChlorhexidine
Thecurrentneonatalmortalityrateof33per1000livebirthsinNepaltranslatestoaround23,000
neonatal deaths per year (NDHS 2011). Studies have shown that immediate cleansing of umbilical
cordwith4percentchlorhexidine(Kawach)reducescordinfectionandreducesneonatalmortality
by about 23 percent. After the results of a study to compare the efficacy of Kawach lotion versus
aqueous, and another study to examine acceptability and ease in the use of different Kawach
formulations (liquid or lotion) for prophylactic application on freshly cut umbilical cord stumps in
Nepal, the DoHS endorsed a pilot Kawach program in four districts. The results of the study
conductedinthreeofthefourdistrictsshowedthatapplicationofChlorhexidinewasbetween47to
67 percent in these three districts, and the compliance was between 68 to 77 percent (NFHP II &
NewERA2011).Theresultsofthestudyweredisseminatedatinternationalandnationalmeetings.
Based on the results of the pilot program, use of 4 percent Kawach to prevent Umbilical cord
infection on newborn program has been approved from MOHP for scale up at national level in a
phasewisemanner.
5.
EmergencyObstetricCare
BasicEmergencyObstetricCare(BEOC)coversmanagementofpregnancycomplicationsbyassisted
vaginaldelivery(vacuumorforceps),manualremovalofplacenta,removalofretainedproductsof
abortion (manual vacuum aspiration), and administration of parental drugs (for postpartum
haemorrhage, infection and preeclampsia/eclampsia), resuscitation of newborn and referral.
ComprehensiveEmergencyObstetricCare(CEOC)includessurgery(caesareansection),anaesthesia
andbloodtransfusionalongwithBEOCfunctions.SafebloodtransfusionisanessentialpartofCEOC,
andtosupportthis,thenationalbloodtransfusionpolicywasrevisedin2006andbloodtransfusion
guidelinedeveloped.
70
TheSMNHlongtermplan(20062017)hasenvisagedthatby2017CEOCserviceswillbeavailablein
60 districts, 80 percent of PHCCs will provide BEOC services and 70 percent of HPs will provide
delivery services. Table 3.2.3 presents the status of CEOC, BEOC and birthing centres in fiscal year
206768.
Table3.2.3:StatusofBEOC/CEOCasofJuly2011
Regions
EDR
CDR
WDR
MWDR
FWDR
Total
CEOC
CEOC
BEOC
Districts Hospitals Hospitals
10
21
10
12
41
9
9
21
13
7
11
9
5
5
7
43
99
48
BEOC
PHCC
29
21
17
27
18
112
(53%)
Birthing
Centres
(PHCC)
20
33
25
2
1
81
Birthing
Centres
(HP)
114
114
111
106
88
533
(79%)
Birthing
Centres
(SHP)
67
56
27
117
59
326
(10%)
TotalBC
(PHCC,HP&
SHP)
201
203
163
225
148
940
Comprehensive emergency obstetric care services were provided from 99 public and private
hospitals in 43 districts in 2067/68. Out of 99 CEOC sites, 37 were public hospitals, 14 medical
collegesand48wereprivate/NGOhospitals.
Table 3.2.4 presents EOC monitoring data obtained from 44 districts in the last three fiscal years
from2065/66to2067/68.ThenumberofdistrictsreportingEOCmonitoringdatatoFamilyHealth
Divisionincreasedfrom26infiscalyear2065/66to38in2066/67andto44in2067/68.
EOCmonitoringdatareceivedfrom44districtsintheyear2067/68showsthataboutonefifthofthe
births took place in B/CEOC facilities; EOC met need was 23 percent; caesarean section rate was
recordedat2.3percentandC/Smetneedwas46.6percent(Table3.2.4).
71
Table3.2.4:EOCMonitoringin44Districts,2067/68
S
N
Districts
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
Bhojpur
Dhankuta
Ilam
Jhapa
Khotang
Morang
Okhaldhunga
Panchthar
Sankhuwasabha
Saptari
Siraha
Solukhumbu
Sunsari
Taplejung
Udayapur
Kavre
Makwanpur
Rasua
Sindupalchowk
Parsa
Sarlahi
Baglung
Gorkha
Kapilvastu
Kaski
Myagdi
Nawalparasi
Arhgakhanchi
Parbat
Lamjung
Rupandehi
Tanahu
Banke
%ofbirthatB/CEOC
site
65/66 66/67 67/68
NR
2.5
5.2
2.8
4.5
8.4
NR
8.6
14.8
NR
10
7.3
NR
4.4
12.3
24.9
35.7
35.3
8.1
8.1
10.5
7.8
7.9
9.4
NR
26.9
31.5
26.5
23
36.3
13.1
12.5
13.5
NR
23.7
9.1
35.7
42.7
14.3
NR
12.3
10.4
16.4
7.9
19.5
16.9
32.2
27.9
NR
9.5
15
3.1
4.1
3.7
NR
NR
3.1
NR
NR
26.3
NR
12.5
6.3
12.5
12.7
11.7
NR
NR
16.8
3.3
8
1.8
61.7
73
75.6
12.9
14.7
13.6
5.4
17.2
3.3
NR
NR
9.8
6.4
6.7
8.5
NR
NR
16
49.9
47.3
29.5
NR
4.2
9.4
22.5
37
43.5
Obstetriccomplications
managed(No.)
65/66 66/67 67/68
NR
75
NA
40
42
62
NR
218
617
NR
326
414
NR
77
60
2644
3071
3087
104
122
123
205
250
260
NR
44
168
908
753
821
167
155
235
NR
172
9
1118
1241
247
NR
71
35
162
78
147
293
482
328
NR
233
171
12
3
6
NR
NR
7
NR
NR
706
NR
21
80
112
185
217
NR
NR
234
47
38
18
668
483
611
30
30
60
101
112
60
NR
NR
46
29
13
36
NR
NR
355
2495
2824
1630
NR
93
24
917
1734
1792
MetNeedofEOC(%)
65/66
NR
5.4
NR
NR
NR
65.4
16.5
23.9
NR
38
7
NR
37.6
NR
12.9
17.2
NR
6.6
NR
NR
NR
9.2
NR
2.3
35.7
6
3.9
NR
4.2
NR
77.5
NR
52
66/67
9
5.6
16
9.6
8.3
75
19
29
6.5
31
6.6
38
41
12
6.2
28
13
1.6
NR
NR
0.8
15
NR
1.9
25
6
4.3
NR
1.9
NR
87
6.6
98
67/68
NA
8.2
46.2
11.6
6.4
75.6
19.2
29.9
24.6
34.3
9.9
2
8.3
6
11.6
18.9
9.9
3.2
0.5
33.5
3.1
17.5
19
0.9
32.3
11.8
2.3
5.1
5.1
46.1
50.2
1.7
100
TotalC/SDone(No.)
65/66
NR
NA
NR
NR
NR
1787
42
33
NR
324
0
NR
2109
NR
NA
245
NR
0
NR
NR
NR
35
NR
0
1515
0
0
NR
0
NR
2356
NR
499
66/67
0
0
148
583
2
2073
33
77
43
531
5
8
2253
0
0
461
123
0
NR
NR
10
42
NR
0
1607
0
27
NR
0
NR
2404
0
1026
67/68
NA
6
148
482
0
2259
66
80
30
511
0
0
1347
0
0
588
38
0
0
78
17
45
101
0
1846
0
3
3
0
132
699
0
836
C/Srate
65/66
NR
NA
NR
NR
NR
6.6
1
0.6
NR
2
NR
10.6
NR
NA
2.2
NR
NR
NR
NR
0.4
NR
12.1
0
NR
NR
11
NR
4.2
66/67
0
0
1.7
2.6
0
7.7
0.8
1.3
1
3.3
0
0.3
11
0
0
4
1.1
0
NR
NR
0.1
0.5
NR
0
12
0
0.2
NR
0
NR
11
0
8.7
MetneedofC/S(%)
67/68
NA
0.1
1.7
2
0
8.3
1.5
1.4
0.7
3.2
0
0
6.7
0
0
5.1
0.3
0
0
0.6
0.1
0.5
1.2
0
14.6
0
0
0
0
2.6
3.2
65/66
NR
NA
NR
NR
NR
132.6
20
11.6
NR
40.7
NR
213
NR
NA
43
NR
0
NR
NR
NR
8.6
NR
242.7
0
NR
NR
219.6
NR
84.8
66/67
0
0
33.6
51.3
0.6
153
15.7
26.9
19.1
66.9
0.6
5.4
227
0
0
80.8
21.5
0
NR
NR
1.2
10.3
NR
0
257
0
3.1
NR
0
NR
223
0
173
67/68
NA
2.4
33.2
40.7
0
166
31
27.6
13.2
64
0
0
135
0
0
101.8
6.6
0
0
11.1
2
10.9
24.6
0
293
0
0.3
1
0
51.4
64.6
140.6
72
%ofbirthatB/CEOC
S
site
Districts
N
65/66 66/67 67/68
34 Bardiya
NR
10.8
16.8
35 Mahottari
NR
NR
6.5
36 Dailekh
7.6
6.9
5.9
37 Dang
22.7
24.8
10.3
38 Humla
13.5
28.7
20
39 Jumla
14.4
14.3
17.4
40 Mugu
9.2
16.2
18.1
41 Surkhet
28.5
24
26.5
42 Achham
4
3.5
4.9
43 Kailali
19.3
17.9
23.5
44 Kanchanpur
NR
14.8
40.6
Total
22.3
21.3
19.1
Note:NR=NotReported;NA=NotAvailable
Obstetriccomplications
managed(No.)
65/66 66/67 67/68
NR
631
225
NR
NR
55
120
102
70
589
778
392
44
57
11
102
138
47
77
81
27
627
600
603
65
73
89
865
887
1032
NR
221
181
12541 16439 15398
MetNeedofEOC(%)
65/66
NR
NR
12.3
26.9
27.9
26.9
43.9
45.5
6.8
29.5
NR
22.3
66/67
34
NR
10
35
20
36
46
43
7.6
30
12
28
67/68
12.3
2.5
7.1
17.6
3.8
12.2
15.2
42.9
9.1
34.7
10
23.0
TotalC/SDone(No.)
65/66
NR
NR
14
48
NA
2
NA
294
0
287
NR
9590
66/67 67/68
391
10
NR
0
40
17
134
96
0
0
2
0
0
0
275
297
1
32
439
564
87
77
12825 10408
C/Srate
65/66
NR
NR
0.2
0.3
NA
0.1
NA
3.2
1.5
NR
3.6
66/67
3.2
NR
0.6
0.9
0
0.1
0
3
0
2.2
0.7
3.3
MetneedofC/S(%)
67/68
0.1
0.3
0.6
0
0
0
3.2
0.5
2.8
0.6
2.3
65/66
NR
NR
4.3
6.6
NA
1.6
NA
64
29.4
NR
100.8
66/67
64.6
NR
12.3
18.3
0
1.6
0
59.5
0.3
44.7
14.5
66.5
67/68
1.6
5.1
12.9
0
0
0
63.4
9.9
56.9
12.7
46.6
73
Issues/Constraints
SustainabilityofAamaprogram
Recommendations
FundingfromGoNsourceneedtobe
increaseeveryyear
Inappropriatelocationofhealth Healthfacilitieslocationshouldbedecided
facilities
withcommunityparticipation
YearlycontractofMDGP,SNAA, Multiyearcontractsystemshouldbein
ANM,SMCoordinator
place
Referralmechanismnotwell
Needtodevelop referralguideline
established
Inadequateandtimelysupplyof needtosimplifyprocurementsystem
equipmentsandcommodities
Decentralizationofprocurementsystem
Responsibility
MoHP,FHD
MoHP,DHO/DPHO
MoHP
FHD
MoHP,LMD,FHD,
District
Activities
ANCfirstvisit
Deliveryconductedbytrainedhealthworkers
PNCfirstvisit
ScreeningofuterineprolapseandlistingforOperation
FollowupforBEOC,CEOCandBirthingunits
Source:FHD,DoHS
Target
700,000
450,000
430,000
75districts
50sitesinselecteddistricts
74
FamilyHealth:FCHVProgram
3.3
FCHVPROGRAM
3.3.1 Background
Recognizing the importance of women's participation in promoting health of the people, GoN
initiatedtheFemaleCommunityHealthVolunteer(FCHV)PrograminFY2045/46(1988/1989)in27
districtsandexpandedtoall75districtsofthecountryinaphasedmanner.Initially,theapproach
wastoselectoneFCHVperwardregardlessofthepopulationsize.Laterin1993populationbased
approach was introduced in selected (28) districts. At present there are 48,541 FCHVs actively
workinginthecountry(FHD,Administrativerecord,2010/11).
FCHVsareselectedbymembersofMothers'GroupforHealth(MGH)withthehelpoflocalhealth
personnel. They are provided 18 days basic training in two phases (9+9 days) on selected primary
health care components. After the completion of the basic training, FCHVs are provided with a
certificateandMedicinekitboxfreeofcostconsistingofnecessarydrugsandsupplies.TheFCHVs
are also provided with manuals, flip chart, ward register, IEC materials, FCHV bag, signboard and
identitycard.ForFamilyPlanningservices,regularsupplyofcommodities(pillsandcondomsonlyto
FCHVs)isinstitutedthroughlocalhealthfacility.
ThemajorroleoftheFCHVistopromotehealthandhealthybehaviourofmothersandcommunity
peopleforthepromotionofsafemotherhood,childhealth,familyplanning,andothercommunity
basedhealthserviceswiththesupportofhealthpersonnelfromtheSHPs,HPs,andPHCCs.Besides
the motivation and education, the FCHVs resupply pills and distribute condoms, ORS packets and
vitamin A capsules; and treat pneumonia cases and refer more complicated cases to health
institution. Similarly, they also distribute iron tablets to pregnant women in districts with Iron
IntensificationPrograms.
Variouspolicy,strategyandguidelineshavebeendevelopedtostrengthentheprogram.Numerous
factorsinfluencetheprogramincludingnationalhealthsectorreform,decentralizationandhanding
over of health facilities to VDCs, as well as the depth and breadth of experience gained from
programimplementationatthecommunitylevel,andtherecognitionthatcommunitybasedhealth
programsarethekeytoreducingmaternalandchildmortalityandfertilityinNepal
The FCHVs program strategy has been revised in 2067 (2010) and document provides strategic
directions and critical approaches to ensure a strengthened national program and consistent,
continuoussupportofeveryFCHVs.
NepalgovernmentiscommittedtoincreasethehighmoralofFCHVs&participationincommunity
healthdevelopment.Infiscalyear2064/65MoHPestablishedFCHVsfundbyprovidingRs.50,000to
eachVDC.Themobilizationofthisfundforincomegeneratingactivitiesisexpectedtobenefitthe
FCHVsandthecommunityatlarge.
Goal
ThegoalofFCHVprogramistosupportthenationalgoalofhealththroughcommunityinvolvement
inpublichealthactivities.Thisincludesimpartingknowledgeandskillsforempowermentofwomen,
increasing awareness on health related issues and involvement of local institutions in promoting
healthcare.
75
Objective
FCHVprogramhasthefollowingobjectives:
Toactivatethewomenfortacklingcommonhealthproblemsbyimpartingrelevantknowledge
andskills
Toprepareapoolofselfmotivatedvolunteersasafocalpersonforbridgingthehealthprograms
withcommunity
Toprepareapoolofvolunteerstoprovideservicesforcommunitybasedhealthprograms
Toincreasetheparticipationofcommunityinimprovinghealth
TodevelopFCHVashealthmotivator
Toincreaseutilizationofhealthcareservicesthroughdemandcreation
MajoractivitiescarriedoutduringtheFY2067/68includethefollowing:
Advocacy
FCHV television drama that reflects volunteerism spirits of FCHVs is being produced with support
fromNFHPII/USAID.Likewise,FCHVdocumentaryisbeingpreparedwithsupportfromUNICEF.
BirthPreparednessPackage(BPP)
BPPtrainingwasprovidedtoFCHVsthroughGoNsupportin19districts;3districtsweresupported
by WHO & 2 districts by RHDP/SDC. Mother's cards were distributed to pregnant women through
FCHV.TheBPPflipchartswereusedtoeducateandcreateawarenessinthecommunitytohelpin
birthpreparednessandreducedelays.
OtherkeyactivitiescarriedoutduringtheFY2067/68include:
VDC level fund management committee members of seven districts (Morang, Udaypur,
Mahottari, Rolpa, Surkhet, Dang, Jumla) were provided with two days FCHV Fund utilization
training with support from NFHP II/USAID and UNICEF. District supervisors, health facility in
chargesandstakeholderswereprovidedwithonedayorientationonfundutilization.
TwodaysregionallevelFCHVsprogrammeetingwasheld infourregions. Mainagendaof the
meeting was to learn from district managers and supervisors on strengthening FCHV program.
Theactivityinthreeregions(eastern,centralandmidwesternregion)wassupportedbyNFHP
II/USAIDwhileUNICEFsupportedinfarwesternregion.
An approach designed to strengthen Mothers' Group for Health (MGH) was piloted in eight
lowest performing VDCs of Rautahat district with support from NFHPII/USAID. Its findings will
supportinrevisingexistingguidelineofMGH.
National Annual Performance Review Workshop reviewed the recommendation and plan of
operationpreparedattheregionalworkshops.
MajoractivitiescarriedoutintheFY2067/68arepresentedinAnnex1.Allthetargetedactivitiesfor
the fiscal year 2067/68 were completed except for volunteer exit of FCHVs. In the fiscal year
2067/68, a total of 1,848 FCHVs were expected to receive voluntary retirement however only 49
percentoftheFCHVstookvoluntarilyretirement.
76
Pills Distribution
(cycle)
Services
Pillsdistribution(Cycles)
Condomdistribution(Persons)
ORSdistribution(Packets)
Irontabletsdistribution
2065/66
608804
165726
1282631
1014524
10,604
10,021
1,487
1,570
1,282
684
719
608
Numbers in thousand
9,250
A total of 10 million persons had

contacted FCHVs for information and Fig 3.3.1 FCHV Contribution in Selected Health Services
FY 2065/66 to 2067/68
(,000)
servicesrelatedtoFP,SM,andCDD/ARI
12,000
inthefiscalyear2067/68(Figure3.3.1).
FY
There has been slightly decrease in
10,000
2065/66
distribution of oral contraceptive pills
to
8,000
2067/68
(684,701 cycles) and ORS (1,487,613
6,000
packets) in the FY 2067/68 in
4,000
comparison to last fiscal year (Table
2,000
3.3.1). FCHVs have contributed 49
0
percent in oral pills distribution and 50
percent in distribution of ORS packets
2065/66
2066/67
2067/68
at the national level. FCHVs distributed
atotalof6,905,532packetsofcondoms
intheFY2067/68.
Table3.3.1:FCHVContributioninSelectedHealthServicesFY2065/662067/68
ORS Distribution
(packets)
2066/67
719451
1264717
1570419
1033362
Number of pepole served
2067/68
684701
NA
1487613
16242529
FCHVs have a large share in treatment of diarrhea and ARI. Of the total 1,735,844 diarrhea cases
treated in FY 2067/68 more than one half (55%) of them were treated by FCHVs (Fig. 3.3.2).
Similarly, 55 percent of the total ARI cases treated in one year (2067/68) were treated by FCHVs
(Figure3.3.3)(SeeChapter2,Section2.3.3).
Inadditiontotheaboveactivities,FCHVshavesupportedincounsellingandreferringmotherstothe
health facilities for the service utilization; providing Vitamin A capsules, Iron supplementation and
deworming to pregnant women and polio immunization to children below 5 years during NID;
communitybasedmanagementandtreatmentofARI/CDD;andotherpublichealthactivities.
77
Table 3.3.2 presents the problems/constraints faced and actions to be taken, and the responsible
agenciesasdiscussedinthenationalannualreview2067/68.
Issues/Constraints
High program demand for community
basedinterventions
AgeingFCHVs
Inadequate initiatives for FHCV fund
management
Recommendations
StrengthencapacityofFCHVs
Responsibility
MoHP,DoHS/FHD
Adoptappropriateexitpolilcy
FHD/DoHS,MoHP
FundManagementorientationforFCHVs FHD/DoHS/RD/DHO
FundManagementCommittee
3.3.5 ActivitiesPlannedforFY2068/69
Table3.3.3presentstheactivitiesplannedforthenextfiscalyear(2068/69).
Table3.3.3:ActivitiesPlannedforFY2068/69
Activities
Centrallevel
FCHVDayCelebration
DistrictLevel
FCHVDayCelebration(AllVDC)
FCHVBiAnnualReviewMeeting(AllVDC)
Rewardforvoluntaryretirement
AdditioninFCHVFund(Rs.10,000)
Reactivationandorientationto8000MotherGroup Health
OrientationtoFCHVfundmanagementcommittee
IncentiveforDress
Unit
Time
Times
Person
Person
VDC
District
District
Times
Target
1
97,134
1,457
3,915
75
7
1
78
FamilyHealth:PrimaryHealthCareOutreach
3.4
PRIMARYHEALTHCAREOUTREACH
3.4.1 Background
Asenvisagedinthenationalhealthpolicy1991,healthfacilitieswereextendeduptovillagelevel.
However, utilization of services provided by health facilities, especially preventive and promotive
services, has been found to be limited because of limited accessibility. Therefore it was felt that
servicesshouldbeclosertothecommunity.ThusPrimaryHealthCareOutreach(PHC/ORC)services
wasinitiatedandestablished.
PrimaryHealthCareOutreachClinic(PHC/ORC)programwasestablishedin1994(2051BS)withan
aimtoimproveaccesstosomebasichealthservicesincludingfamilyplanningandsafemotherhood
services for rural households. PHC/ORC clinics are the extension of PHCCs, HPs and SHPs at the
community level. The primary responsibility for conducting the PHC outreach clinics lies with
MCHWsandVHWs.AtPHCCandHPlevel,ANMs,AHWandVHWsareresponsibleforcarryingout
the PHC outreach services. AHWs and others staff of HP/PHCCs also help in conducting the PHC
outreachclinics.FemaleCommunityHealthVolunteers(FCHVs)andotherlocalNGOs/CBOssupport
serviceprovidersinconductingPHC/ORCclinicsandalsoforrecording/reportingandothersupport
activities.
BasedonthelocalneedsPHCoutreachclinicsareconductedeverymonthatfixedlocationsofaVDC
on specific dates and time. The clinics are held at locations not more than half an hour's walking
distanceforthepopulationresidinginthatarea.
VHWs and MCHWs or ANMs/AHWs provide basic PHC services (FP and ANC services/Health
Education/MinorTreatment)toaprearrangedplaceclosetocommunitiesonapredeterminedday
onceinamonth.AccordingtoPHC/ORCstrategy,followingservicesareprovidedbyPHCORC.
1. SafeMotherhood&NewbornCare
Antenatal,postnatal,andnewborncare
Irondistribution
Referralifdangersignsidentified
2. FamilyPlanning
DMPA,(Depoprovera)PillsandCondom
Monitoringofcontinuoususers
EducationandcounsellingonFPmethodsandemergencycontraception
CounsellingandreferralforIUCD,ImplantandVSCservice
Tracingdefaulter
3. ChildHealth
Growthmonitoringofunder5children
Pneumoniatreatment
Diarrhoeatreatment
4. HealthEducationandCounselling
FamilyPlanning
MaternalandNewbornCare
ChildHealth
79
STI,HIV/AIDS
Adolescents'reproductivehealth
Others
5. Firstaidtreatment
3.4.2 MajorActivitiesofFY2067/68
PHC/ORC Reactivation and Micro Planning Orientation was conducted in 1305 VDCs of 75
Districts.
PHCORCkitswithrecommendedequipmentanddrugswerepurchasedtobeusedduringPHC
ORCclinic(3,108Clinicsof50Districts).
AchievementoftheactivitiescarriedoutintheFY2067/68ispresentedinAnnex1.
Table3.4.1presentsthenumberofoutreachclinicsconductedinlastthreeyears.
Table3.4.1: PHCOutreachClinicsConductedbyRegion
2065/66(2008/2009)
Regions Targets Achievement
EDR
38,808
34,511
CDR
49,260
40,033
WDR
38,484
25,716
MWDR
22,560
18,193
FWDR
16,620
13,103
National 165,732
131,556
%
87
79
75
78
79
80
2066/67(2009/2010)
Targets Achievement
38,124
35,245
49,440
37,863
31,097
23,833
22,848
18,332
16,656
13,720
158,160
128,993
%
91
77
76
80
82
81
2067/68(2010/2011)
Targets Achievement
35436
32394
48720
41283
30432
28802
22200
18239
16692
13867
153480
132585
%
91
85
88
82
83
86
Note:Target:Totalnumberofclinicsexpectedtoruninayear;Achievement:Totalno.ofclinicsreportedtohavebeen
conducted
Source:HMIS/MD,DoHS
79
82
83
88
78
80
82
75
76
85
87
79
77
80
81
86
91
91
PHC Outreach clinics conducted

Targetvs.achievementofPHCoutreach Fig 3.4.1
FY 2065/66 to 2067/68
clinic (PHC/ORC) at national level and
100
by region for the last three fiscal years
are shown in Table 3.4.1 and Figure
90
3.4.1. Of the total targeted PHC/ORC,
86 percent of the clinics were % 80
conductedatthenationallevelandthis
70
isfivepercentincrementfromlastyear.
60
The EDR achieved 91 percent of the
50
targeted number followed by WDR
NEPAL
EDR
CDR
WDR
MWDR
FWDR
(88%) and CDR (85%). Achievement of
2065/66
2066/67
2067/68
CDR was increased from 77percent in
2066/67 to 85 percent in 2067/68. The
MWRcouldconductonly82percentofthetargetednumberofPHC/ORC.
This year there has been a slight increase in the average number of people served per month in
PHC/ORCcomparedtothelasttwofiscalyears(Figure3.4.2).Onanaverage21peoplewereserved
perclinicpermonthduring2067/68,comparedto20clientsin2066/67.Theregionalbreakdown
80
22
21
21
18
16
17
18
Number
19
19
20
21
22
showsthatnumberofclientsperclinicwashighestinFWDR(33).Thenumberofclientsservedby
PHC/ORCwaslowestinWDR(16)anditwasthesamecaseinthelasttwofiscalyears.
Therehasbeenagradualincrease Fig. 3.4.3:

PHC Outreach clinics conducted by
in conduction of PHC/ORC clinics
Ecological Zone
FY 2065/66 to 2067/68
each year in all three ecological
88
100
87
85
82 82
regions (Figure 3.4.3). In Terai 88
80
86
90
percent of the targeted PHC/ORC
81
80
77
were conducted whereas it was
80
73
71
%
only 77 percent in the mountain
70
region. Given difficult geographic
terrain in the mountain region
60
makingitdifficultforthepeopleto
50
visit to the health facility program
NEPAL
Mountain
Hill
Terai
now needs to focus more on this
2065/66
2066/67
2067/68
regioncomparedtootherregions.
Therehasbeen1percentincrease Fig 3.4.4

Average No. of Clients Served per PHC
inaveragenumberofclientserved
Outreach Clinic by Ecological Zone
FY 2065/66 to 2067/68
by PHCORC compared to FY
24
2066/67 (Figure 3.4.4). There has
been a gradual increment in the
22
average number of clients served
20
in PHC/ORC in all three ecological
18
regionswithmarkedimprovement
in the hills, which increased from
16
19 clients per clinic in 2066/67 to
14
21 in 2067/68. It is obvious that
12
due to high population density as
10
well as easy access, more clients
NEPAL
Mountain
Hill
Terai
mighthavevisitedPHC/ORCclinics
in Terai compared to mountain
2065/66
2066/67
2067/68
area.
Table3.4.2presentstheissuesdiscussedintheregionalandnationalreviews.
Issues/Constraints
InadequateservicesinPHC/ORCclinics
Recommendations
ChangeindicatorsofPHC/ORCclinics
(DepoandAntenatalservices)
Responsibility
FHD,MD/HMIS
3.4.5ActivitiesPlannedforFY2068/69
OrientationofPHCORCStrategyandPrinting.
ReactivationandmicroPlanningofPHC/ORCclinics.
PurchaseofDrugandEquipmentforPHC/ORCclinics(2,610clinicsof75Districts).
81
FamilyHealth:Demography&ReproductiveHealthResearch
3.5
DEMOGRAPHYANDREPRODUCTIVEHEALTHRESEARCH
3.5.1 Background
Planning, evaluating and monitoring the reproductive health (RH) activities fall under the
responsibility of the Demography Section of the Family Health Division. This section conducts
periodic and ad hoc studies and research in the area of RH and coordinates research and studies
carried out by other organisations in Nepal. The Reproductive Health Research SubCommittee
(RHRSC)isguidedbyareproductivehealthresearchpolicyandstrategy,whichwasformulatedand
endorsedbytheReproductiveHealthCoordinatingCommittee.
MajorresponsibilitiesoftheDemographySection/FHDinclude:
DeveloptheannualnationaltargetsforFamilyPlanningandSafeMotherhoodservicesincluding
familyplanningacceptors,users,andnumbersofsterilizationbydistrictsandtoestimatetheRH
commoditiesforallprogramsinFamilyHealthDivision.
CarryoutregularmonitoringofRHandEOCactivitiesincoordinationwithMISSection.
ProvidesupportivesupervisorysupporttoDHO/DPHOandalllevelsofhealthfacilities.
Conduct periodic and adhoc research and study on Family Planning, Maternal and Neonatal
Health, Comprehensive Abortion Services, Female Community Health Volunteer Services, and
otherRHprogram.
Provide support to the ongoing piloting of new maternal health program initiatives including
medical abortion by ANM trained as SBA and misoprostol for prevention of postpartum
haemorrhageathomedeliveries.
Inordertofulfiltheseobjectives,theDemographyandRHResearchSectionconductedthefollowing
activitiesintheFY2067/68.
1. Developedannualnational,districtprogrambudget.
2. Estimatedcontraceptiverequirement.
3. SupportedregionalreviewworkshopsonRHprogramandconductedRHandEOCmonitoringin
differentdistricts.
4. Data analysis of process indicators for monitoring SM activities and maternal perinatal death
review.
5. Carriedoutthreestudiesnamely:
a. StudyonGenderBasedViolenceinNepal:Types,LevelandPrevention.
b. ImpactStudyofStretcherandTricycleAmbulance.
c. Perception,ExperienceandHealthOutcomeoftheWomenwhohadundergoneUPSurgery
inDotiDistrict.
ThesectionbelowpresentssomeglimpsesofthethreestudiescarriedintheFY2067/68.
1.
StudyonGenderBasedViolenceinNepal:Types,LevelandPrevention
Genderbasedviolence(GBV)isthekeyconcernsareaoftheGovernmentofNepal(GoN).GBVisthe
mostpervasiveyetleastrecognizedhumanrightsabuseintheworldthatconcernsallsectorsofsociety.
Violencehasafardeeperimpactthantheimmediateharmcaused.Ithasdevastatingconsequencesfor
82
thewomenwhoexperienceitandatraumaticeffectonthosewhowitnessit(WHO,2005).Thegender
based violence begins even before the childhood. It isalso inone of the most hiddenforms. It takes
placeinintimaterelationships,withinthefamilyandatthehandsofstrangersanditaffectswomenin
everycountryintheworld(Amnesty,2007).
Since domestic violence has negative impacts on psychological, physical, and sexual wellbeing, it is
importanttoknowtheprevalenceofviolenceanditsdeterminingfactors.However,norepresentative
studyofdomesticviolenceexperiencedbymaleandfemalestudentshaseverbeenconductedinNepal.
The study insights on the experience and prevalence of gender based violence and consequences of
genderbasedviolenceamongNepaliwomenandschoolstudents.
Themainobjectivesofthestudyweretoexamineprevalenceofdomesticviolence;andexploreonthe
nature of domestic violence; coping strategy; factors that perpetuate domestic violence; and the
consequencesofdomesticviolence.
A two staged stratified random sampling technique was applied for the selection of the VDCs and
cluster.Firstly,twoVDCsineachdistrictwereselectedrandomly.Secondly,twoclusterswereselected
randomlyineachVDC.Atotalof12clusters(4clustersin3districts)wereselectedfromthreedistricts
(Kanchanpur,KaskiandSankhuwasabha).Fromeachcluster,32marriedwomenaged1549yearswere
selectedforstructuredinterview.
Keyfindingsofthestudyinclude:
Onlyonethirdofwomenwereinvolvedindecisionmakingprocessathouseholdactivities.
Twentyone percent women reported to have been emotionally abused by their husband; 15
percentexperiencedphysicalviolence;and16percentweresexuallyabusedbyhusbands.Overall,
morethanonefourth(27%)ofthewomenhadeverexperiencedatleastonetypeofviolencein
theirlife.
Thecommonformsofphysicalviolencewerekicked/draggedorbeatenupbytheirhusbands(7%);
hit with fist or with something else (7%); and threatened to use or actually used knife or other
weapons(4%).
Regardingsexualviolence,morethanoneineverytenwomen(11%)reportedthattheirhusband
hadforcedthemtohavesexualintercoursewhentheydidnotwantto.Fewwomenreportedthat
theywereforcedtodosomethingsexualthatshefounddegradingorhumiliating(5%).
Domesticviolencevariedsignificantlywithdistricts,husband'seducationallevel,husband'salcohol
consumptionhabitandhusbandhasanotherwife.
Those women who have not involved in decision making process have significantly higher
experienced of domestic violence (28%) than those who have involved in decision making on
householdandpersonalactivities(23%).
Amongthosewomenwhoreportedexperienceofviolence,aboutoneinthree(33%)hadeverbeen
physicallyinjuredasaresultoftheviolence.
Allthesewomenwhohadfacedphysicalorsexualviolence,morethantwothirds(67%)reported
facing psychological problems as a result of the violence. Commonly reported psychological
problemsweretension(37%),depression(27%),fear(17%)andsuicidalfeeling(17%).
Majorityofthesampledstudents(67%)werestudyingin9and10gradeswhileaboutoneinthree
studentswerestudyingin1112grades.
Three in five students (59%) were aware about womens right in the Interim Constitution. About
halfofstudents(48%)werealsoawarethatthereislegalprovisionthatrestrictsandpunishesthe
actofgenderdiscriminationandviolence.However,onlyfewstudents(35%)wereawarethatNepal
policehasestablishedtheseparateservicescentretoinvestigatethecrimerelatedtowomenand
83
children.Similarly,onlyaboutathirdstudents(32%)wereawareaboutParajudicialcommittees'
establishedindistrictandcommunitylevel.
2.
ImpactStudyofStretcherandTricycleAmbulance
Free and easy access of women to safe motherhood facilities is one of the most crucial social
protectionprograms,whichhastobeexpandedtoalloverthecountryinnotime.Mostimportantly,
theInterimConstitutionofNepalhasprovisionedtoensurethepeople'srightstohealthincluding
thewomen'srightstoreproductivehealth.Therefore,theGoNisprovidingfreematernityservices
andtransportationincentiveforinstitutionaldelivery.InNepalthekeychallengesinaccessinghealth
services include difficult terrain; lack of transportation particularly in the hills; remoteness and
distancetohealthfacilities;andinsufficientnumberoftrainedhumanresources.
FHDcarriedoutonestudyonimpactofstretcherandtricycleambulanceinfivedistricts.Thebasic
objectives the study were to assess the use of stretcher and Tricycle ambulance as means of
transportation; community mobilization; effectiveness and impact of these means; and make
suggestionsfortheirimprovement.
Thestudyparticipantsincludedthreegroupsnamelycommunitymembers(serviceusers,teachers,
club members, health institution management committee members, local politicians and other
stakeholders); service providers (Health Post Incharge, ANM, MCHW, and AHW); and mother
groups.
The study covered 5 districts (Panchthar and Myagdi Hill districts and Sarlahi, Rupndehi and
KanchanpurTeraidistricts)representing2ecologicalbeltsoftheHillsandTerai.
Keyfindingsofthestudinclude:
Boththemeansarequickandveryusefulmeansoftransportationforthepregnantmothersand
otheremergencypatientswhocannotwalkormovebecauseofpainorotherailingsituations.
Thesearebeneficialgenerallyforallbutparticularlytothe communitieswithlowincome,the
poorandforthosewhodon'thaveothermeansoftransportationfacilitiesinthecommunity.
These are not only cheap and affordable for all people but are also easy to handle, carry and
store.
Theserequireno/littlecostformaintenance.
3.
Perception,ExperienceandHealthOutcomeoftheWomenwhohadundergoneUPSurgery
inDotiDistrict
UterineProlapse(UP)isoneofthemajorpublichealthproblemsinNepal.Despitetherearemany
programsfocusedtoincreaseutilizationofhealthservices,reproductivehealthproblemsofwomen
stillremainneglectedissuesinNepal.UPislargelyhiddenproblemandtheseissuesarenotopenly
shared due to shyness, stigma and discrimination. To address the issue, Government of Nepal has
initiated nationwide program to identify and provide necessary treatment and council service to
womenwhoaresufferingfromUP,withthehelpfrompublicprivatepartnership.Tosystematizethe
UPserviceprovision,UPguidelinehasbeendevelopedtoimplementandmanagetheUPscreening
and treatment program effectively. Official records indicate that 24498 women have already
received free UP surgery between the fiscal years 2065/66 to 2067/68. However, the health
conditionofwomenwhoreceivedsurgeryisunknown.FHD,therefore,commissionedonestudyto
know whether or not the women received follow up service after surgery, whether their health
84
status have improved after surgery and what are the perceptions and experience towards service
andtheirdailylifeaftersurgery.
Theobjectivesofthestudyweretoexplorewomensperceptionaboutherhealthstatusbeforeand
after UP surgery; examine the post UP surgery complication and related health care seeking
behavior;andtoexaminethewomensandserviceprovidersperceptionsonUPandaccesstoUP
treatmentinthedistrict.
KeyFindingsofthestudyinclude:
Twooutoffive(40%)womenwhohadundergoneUPsurgeryexperiencedcomplicationsafter
surgery.
The complication was higher (41%) among women who did surgery in Nepal compared to
womenwhodidsurgeryinIndia(31%)indicatingthatthequalityisbetterinIndia.
More than half (53%) of the women reported that they were very satisfied and 40 percent
womenreportedthattheyweresatisfiedwiththeservicestheyreceived.
Sevenoutoftenwomenwerehumiliatedinfrontofotherpeoplebytheirhusbandfollowedby
45 percent were slapped by their husband indicating high prevalence of domestic violence
amongwomenwhohadundergoneUPsurgery.
Postsurgerycounselingservicewasnotsatisfactory.
Thestudyhasrecommendedthefollowingthings:
Coordinatewithothersocialsectorstodiscourageearlymarriage,earlybirth,hardworkduring
pregnancy.
Comprehensiveandintegratedpackageincludingpreventive,promotivetreatmentandsurgery
activityofUPshouldbedevelopedandimplementedasearlyaspossible.
Policymakersshouldgiveattentionondomesticviolanceissues.
Communityawarenessonprevalence,consequenceandtreatmentofUPthroughmassmedia
Referthewomenneededoperationtotheappropriatehospital
ProvidefreeUPoperationandpostoperativetreatmentwithproperfollowupmechanism
3.53 Problems/Constraints
Table3.5.1presentsproblems/constraints,actionstobetakenandtheresponsibleagencytocarry
outtheactivityasidentifiedintheregionalandnationalreviewsinFY2067/68.
Problems/constraints
Institutionalisationofprocess
indicatorsformonitoringSMactivities
Actiontobetaken
Phasewiseexpansionoftrainingondesigned
tools,manualsandtrainingmaterials
Institutionalisationofmaternaland
Setupnational andhospitallevelMPDR
perinataldeathreview(MPDR)system committee,revisetheMPDRformandweb
baseddatabasemanagementsystem,
reorientation,conductannualreviewmeeting
InstitutionalizationofPopulation
Phasewiseexpansionofpopulationprogram
indicatorsformonitoringof
indicatorsinHMISsystem
populationprograms
Responsibilities
FHD,HMIS
Section
FHD
Population
Division,FHD
andHMIS
85
FamilyHealth:AdolescentSexual&ReproductiveHealth
3.6
ADOLESCENTSEXUALANDREPRODUCTIVEHEALTH
3.6.1 Background
National Adolescent Sexual and Reproductive Health Program (NASRH) is one of the programs of
MinistryofHealthandPopulationbeingimplementedunderFamilyHealthDivision/DoHS.
NepaldevelopedandpublishedNationalAdolescentHealthandDevelopmentStrategyin2000. An
implementationguidelineonAdolescentSexualandReproductiveHealth(ASRH)has been developed
in2007tosupportdistricthealthmanagersinoperationalisingthestrategy.In2008,adraftnational
ASRH program under the leadership of FHD was developed with the support of GIZ. This national
ASRHprogramwaspilotedin2009in26publichealthfacilitiesinBardia,Surkhet,Dailekh,Jumlaand
Baitadi districts. Based on the findings from the pilot interventions, a national ASRH program was
designed in 2011 and is now implemented gradually to meet the NHSP II target of making 1,000
healthfaciliesAdolescentFriendly(AF)by2015.
Sincethefiscalyear2009/2010,FHDisscalingupandimplementingthenationalASRHprogram.In
2011, FHD has developed final National ARSH Program Package which consists of 4 different
orientations for district health managers, district stakeholders, health service providers and
HFOMC/CommunityStakeholders.
Goal
The overall goal of National ASRH Program in line with the National Adolescent Health and
DevelopmentStrategy2000istopromotethesexualandreproductivestatusoftheadolescents.
Objectives
Toincreasetheavailabilityandaccesstoinformationaboutadolescenthealthanddevelopment,
andprovideopportunitiestobuildskillsofadolescents,serviceprovidersandeducators.
To increase accessibility and utilization of adolescents health and counseling services for
adolescents,and
To create safe and supportive environments for adolescents in order to improve their legal,
socialandeconomicstatus.
Targets
Themajortargetoftheprogramistomake1,000healthfacilitiesadolescentfriendlyby2015asper
thetargetofNepalHealthSectorProgram(NHSP)II.Inaddition,itaimstoreducetheAdolescent
FertilityRate(AFR)to70per1,000women(1519yrs)by2015,thetargetofNHSPIIandMDG5b.
Indicators
TheprimaryindicatoroftheprogramisAdolescentFertilityRate.However,thefollowingindicators
willalsobemonitored:
Ageatmarriage(NDHS2006:MediaAgeatMarriage20.6yrsforMaleand17.2yrsforFemale)
ContraceptivePrevalenceRateamongadolescents(NDHS2006:Currentusers13.8among15
19yrs)
Unmetneedforfamilyplanning(NDHS2006:38.8percentamong1519yrs)
86
ThenationalASRHprogramfocusedonthefollowingactivitiesandtheachievementsincludinginthe
FY2067/2068(2010/2011)are:
Makingthepublichealthfacilitiesadolescentfriendly
Creatingdemandfortheservicesinthecommunities
Equipping the health facilities with necessary equipments to provide private and confidential
servicestoadolescents
TrainingthehealthworkersonASRHandprovidingthemwithIECmaterials(8booklets)anda
counselingflipchartonASRH(throughNHEICC)
Involvingadolescentindecisionmakingofhealthfacilities(HFOMC)
Provisionofappropriatesexualandreproductivehealthservicestoadolescents(familyplanning,
HIVandSTIservices,safeabortionetc.)
ThefollowingaretheactivitiesthathavebeenimplementedaspertheAHDstrategy2000:
1. InformationandSkills
Informationdisseminationthroughhealthfacilities
Printinganddistributionof20,000SARHIEC/BCCbooklets
RevisedandprintingofASRHflipchart(inprocess)
2. SkillsBasedTrainingandOrientationtoHealthServiceProviders
ASRHskillbasedtraining(4daytraining)tomidlevelhealthserviceprovidersbyNationalHealth
TrainingCentres
ASHRprogramorientationsofRegionalHealthManagersinallthefivedevelopmentregions
ASRHProgramorientationstoDistrictHealthManagementof17programdistricts
ASRH program orientation to district stakeholder including RHSS members in the program
districts
ASRHprogramorientationtoservice providers in the programdistricts
ASRHprogramorientationtolocalstakeholdersincludingHFOMCmembersinprogramHFs
3. HealthServicesandCounseling
Makinghealthfacilitiesadolescentfriendly
Integratingadolescenthealthservicesintotheexistinghealthcaredeliverysystemanddelivery
initfriendlyway
Involving and establishing links with youth clubs, NGOs and the private sector to expand and
improvingservice deliveryforadolescents
4. SafeandSupportiveEnvironment
FunctionalAdolescentSexualandReproductiveHealthSubCommitteeunderchairofFHD
DevelopedAdolescentFriendlyService(AFS)logofordisplayatHFs
ASRH program orientation to district stakeholders including RHCC members in the program
districts
ASRHprogramorientationtolocalstakeholdersincludingHFOMCmembersinprogramHFs
87
Issues
ReportingnotyetincludedinHMIS
Anumberofdifferentactivities
relatedtoASRHlikepopulation
program,schoolhealthetc.,are
implementedinparallelwithinDHO
Actionstobetaken
Responsibility
Incorporateselectedindicatorsinthe MD
HMISreportingforms
DHO
Developbetterharmonizationof
DHO/DPHOandASRH
differentactivitiesrelatedtoASRH
focalperson
withDHO
3.6.4 TargetforFY2068/69(2011/2012)
Scaleuptheprograminadditional195healthfacilitiesin15newdistrictsinthenextfiscalyear
2068/69.ThedistrictsidentifiedforthescaleupofASRHprogramandthesupportagenciesare:
Banke,Dang,Doti,Accham,Kailali(GIZ);Udaipur,Rautahat,Baglung,Rolpa,Dadeldhura,(GoN)
(District Health Managers orientation support by WHO); Humla, Jajarkot, Rukum, Bajura,
Darchula(UNICEF)
SupportcontinuationofASRHprogramin17districts.
3.6.5 ImplementationStatusofASHRProgram
FY
Districts
2065/2066
Bardia
Surkhet
Dailekh
Jumla
Baitadi
2066/2067
Morang
Bara
Dhading
Parbat
Gulmi
2067/2068
Jhapa
Kaski
Nawalparasi
Dolakha
Kavrepalanchowk
Kapilvastu(SC)
Puythan(SC)
Remarks
Allofthe17districtswhere
ASRHprogramhasbeen
implementeduntilFY2066/067
aresupportedbyFHDfor
sustainabilityoftheprogram
88
Malaria Control
Fiscal Year 2067/68 (2010/2011)
Blood Slides Examined Rate
Ilam
4 .66
K a ila li
2 .52
K anc hanpur
2 .49
Ma hottari
1 .7 9
K avre
1 .7 9
R upandehi
Tehart hum
Surkhet
0 .37
0 .36
A chham
1.56
Mahottari
1.54
R upa ndehi
1 .30
Ilam
Surkhet
1 .23
Sindhuli
1 .23
K apilvas tu
1.17
N a walparas i
B hojpur
1.0 4
Taple jung
0.40
B hojpur
Okhaldhunga
N awalpa ra si
0 .4 6
B ardiy a
1.99
Jhapa
0.53
Jhapa
2 .10
K ailali
0.6 0
Ok ha ldhunga
2.31
B ardiya
1 .30
K anchanpur
2.32
Sankhuwa sabha
1.77
D adeldhura
0.27
0.23
0 .2 0
0 .2 0
0 .2 0
0 .1 8
0.15
K aski
0.13
Mora ng
0 .79
D hanusha
Sindhuli
0.77
Panchthar
Palpa
0 .73
B anke
0.11
Sindhupalc howk
0.71
Palpa
0.10
0 .09
D hanusha
0.68
Morang
B anke
0.65
Teha rthum
D a de ldhura
0.65
R auta ha t
B ara
0.62
Sarlahi
0.13
0.11
0 .09
0 .07
0 .07
Sarla hi
0.5 6
D ailekh
0 .07
C hitwa n
0 .4 9
Makawa npur
0 .06
K ask i
0 .4 5
Taplejung
0 .04
K apilvastu
0 .44
C hitwan
0 .04
0.39
B ara
0 .04
D hankuta
0 .37
Sira ha
0 .04
Lamjung
0 .37
Gulmi
0.0 3
Siraha
Makawa npur
0.30
D hank ut a
Gulmi
0.28
Gorkha
0.0 3
Gork ha
0.27
Sindhupa lchowk
0.0 2
D a ilekh
0.26
U daypur
0.0 2
0.0 3
D ang
0.25
D a ng
Suns ari
0.25
K avre
0.0 2
R amechha p
0.24
Sunsari
0.01
Lalitpur
0.22
Lamjung
0.01
Tanahu
0.20
R olpa
0.01
Parsa
0.16
Parbat
0.01
Sapt ari
0.16
B a glung
0.01
Pyut ha n
0.1 5
Tana hu
0.01
R a ut ahat
0.1 5
D oti
0.01
U day pur
0.1 2
K alikot
0.01
Myagdi
0.1 2
Saptari
0.01
Parbat
0.1 1
B a jhang
0.01
D hading
0.0 9
Sya ngja
0.00
A chha m
0.0 9
0.0 2
Sankhuwa sabha
0.00
Syangja
0.0 8
K hot ang
0.00
R olpa
0 .05
R amec hhap
0.00
B aglung
0 .05
D olkha
0.00
K alik ot
0 .0 4
Lalitpur
0.00
B aitadi
0 .0 3
N uwakot
0.00
K hota ng
0 .0 3
D hading
0.00
R ukum
0 .02
Pars a
0.00
Salya n
0 .02
My agdi
0.00
B ajhang
0 .01
D oti
0 .00
Pyuthan
0.00
Jajark ot
0 .00
R ukum
0.00
Solukhumbu
0 .00
Salyan
0.00
D olk ha
0 .00
Jajarkot
0.00
B haktapur
0 .00
Jumla
0.00
K a thmandu
0 .00
B aita di
0.00
N uwakot
0 .00
D archula
0.00
R asuwa
0 .00
Manang
0 .00
Must ang
0 .00
D olpa
0 .00
Jumla
0 .00
Mugu
0 .00
H umla
0 .00
0 .00
0 .00
B a jura
N A TION A L
No Program districts
B a jura
D a rchula
A rghakhanchi
Source: EDCD, DoHS
0.66
Soluk humbu
EA STER N
0.75
B hakt apur
K athmandu
C EN TR A L
R asuwa
0 .56
Mana ng
W ESTER N
0.6 3
Mustang
D olpa
MID - W ESTER N
FA R W ESTER N
0 .56
Mugu
1 .0 3
H umla
B ajura
0.00
No Program districts
Panc hthar
Malaria Parasite Incidence Rate/1,000

Population
N A TION A L
EA STER N
0 .16
0 .11
C EN TR A L
0.07
W ESTER N
0.09
MID - W ESTER N
0 .11
FA R W ESTER N
0.72
Chapter4
DiseaseControl:Malaria
DISEASECONTROL
4.1
MALARIA
4.1.1 Background
MalariacontrolprojectwasfirstinitiatedinNepalin1954withthesuppotfromUSAID(thenUSOM).
TheobjectiveoftheprojectwastocontrolmalariamainlyinsouthernTeraibeltofcentralNepal.In
1958,nationalmalariaeradicationprogram,thefirstnationalpublichealthprograminthecountry
was launched with the objective of eradicating malaria from the country within a limited time
period. Due to various reasons the eradication concept was reverted to control program in 1978.
FollowingthecallofWHOtorevampthemalariacontrolprogramsin1998,RollBackMalaria(RBM)
initiativewaslaunchedtoaddresstheperennialproblemofmalariainhardcoreforested,foothills,
innerTeraiandvalleyareasofthehills,wheremorethan70percentofthetotalmalariacasesofthe
country prevail. The high risk of getting the disease is attributed to the abundance of vector
mosquitoes, mobile and vulnerable population, relative inaccessibility of the area, suitable
temperature, environmental and socioeconomic factors. Currently malaria control activities are
carriedoutin65districtsatriskofmalaria.Thedistrictsaredividedintofourdifferentcategoriesas
follows:
Highriskdistricts(13):Ilam,Jhapa,Morang,Sindhuli,Dhanusa,Mahottari,Kavre,Nawalparasi,
Banke,Bardiya,Kailali,Kanchanpur,Dadeldhura
Moderate risk districts (18): Panchthar, Dhankuta, Sunsari, Saptari, Siraha, Udayapur, Sarlahi,
Rautahat, Bara, Parsa, Makawanpur, Chitwan, Sindhupalchowk, Rupandehi, Kapilvastu, Dang,
Surkhet,Doti
Lowrisk34Districts(Minimaltransmission)(34)
NoriskDistricts(10)
The Global Fund is supporting malaria control program in the high risk 13 endemic districts and
moderaterisk18endemicdistricts.
Objective
Overall incidence of (probable and confirmed) malaria in population at risk brought below 2
casesper1,000by2011.(2005baseline:4.1casesper1,000)
Hospitalbasedseveremalariacasefatalityratereducedtobelow15%by2010.
By 2010, weekly incidence of malaria (probable and confirmed) in all outbreak wards brought
belowoutbreakthresholdlevelwithin6weeksofdetection.
Communitymobilizationandcommunitypartnershipinmalariacontrol.
Targets
80percentofpeopleinhighriskareas(stratum1VDCs)sleepingunderLLIN(lastnight)by2011.
90
80percentofmalariacasesreportedbypublicsectorhealthfacilitiesinhighriskareas(stratum1)
confirmedbymicroscopyorRDTby2011.
80percentofcareprovidersatruralpublicsectorhealthfacilitiesprovidingappropriatetreatment
formalariaby2011.
Strategies
VectorControlandPersonalProtection
Tworoundsofroutineindoorresidualspraying(IRS)willbecarriedoutannuallyineachhighrisk
VDCsunlessLLINpopulationcoverageinthatVDCexceeds80%
Intheeventoflimitedinsecticidestocksround2oftheIRScampaignmaybewithheldandtarget
VDCswillbeprioritizedaccordingtomalariaburden.
Insecticides for IRS will be WHOPES approved and will be selected by the insecticide Technical
WorkingGroup(TWG)onthebasisoflikelycosteffectiveness(insecticideresistanceprofilesfor
primaryvectorswillbetakenintoconsideration).
IRSoperationswillaimtocoveratleast80percentofhouseholdsintargetVDCs.
WHOPESapprovedlonglastinginsecticidetreatedbednets(LLINs)willbeprovidedfreeofcharge
toallpeoplelivinginhighriskVDCs(1LLINper2peopleeverythreeyearsassumingathreeyear
lifefortheLLIN).
LLINdeliverycampaignswilltakeplaceinonethirdoftargetedVDCsineachdistricteachyearso
that total coverage of the target population is achieved by year 3 and maintained thereafter.
AdditionalWHOPESapprovedLLINswillbeprovidedtoallpregnantwomenattendingANCcheck
upsinhighriskVDCs(oneLLINperpregnancy).
EarlyDiagnosisandAppropriateTreatment
Diagnosticservicesformalariawillbeprovidedfreeofchargeatallpublicsectorhealthfacilities.
Microscopywillformthediagnosticmethodofchoiceathospitalandprimaryhealthcarecentre
levelandsomeselectedhealthpostsandsubhealthposts.
Below primary health care centre level falciparum specific and RDTs will form the diagnostic
method of choice in high and moderate risk areas. To minimize wastage, use of RDTs will be
strictlylimitedtodiagnosingclinicallysuspectedcasesonly.
EDCDwillimplementacomprehensivequalityassurancesystemformalariamicroscopyandRDTs
through the referral laboratory network (District, Regional and Central). This will be linked to
needsbasedrefreshertraining.
Antimalarialdrugswillbeprovidedfreeofchargefromallpublicsectorhealthfacilities.
Antimalarial drugs will be provided free of charge through the Female Community Health
Volunteer(FCHV)networkinhighriskareaaccordingtonationaltreatmentguidelines.
Artemisininbased combination therapy (ACT) will be provided for confirmed falciparum malaria
casesthroughoutthecountryaspernationaltreatmentguidelines.
Chloroquine will be provided for confirmed vivax cases and suspected malaria cases as per
nationaltreatmentguidelines.
Primaquine will be provided for the radical cure of confirmed vivax cases as per national
treatmentguidelines.
Nationalmalariatreatmentguidelineswillbereviewedregularlyandrevisedasappropriatebased
onthefindingsofdrugresistancesurveillance.
National malaria treatment guidelines (and any revisions to them) will be implemented at all
public sector health facilities throughout the country within one year of ratification by the
RegionalTechnicalAdvisoryGrouponMalaria(RTAGM).Recommendedantimalarials,including
ACT,willbeincorporatedintotheessentialdruglist.
91
MalariaSurveillanceandEpidemicPreparedness
A simple malaria outbreak early warning system will be established in selected public health
facilities (one sentinel site/endemic district). This will be complimentary to existing surveillance
networks.
Technical and operational linkages between EDCD and epidemic prone districts will be
strengthenedforaneffectivecoordinatedactioninresponsetooutbreaks.
Intheeventofanoutbreak,focalIRSwillbecarriedoutintheward(s)wheretheoutbreakwas
detectedandinalladjacentwards.
Intheeventofanoutbreak,districtlevelteamswillcarryoutRDTbasedactivecasedetectionin
the outbreak ward(s) and in all adjacent wards. Confirmed cases will be treated according to
nationaltreatmentguidelines.
BehaviourChangeCommunication(BCC)
Carefully tailored locally appropriate malaria related IEC/BCC will be delivered through 5
methodologies: interpersonal communication (health workers, religious and community
members); primary and secondary education (malaria incorporated into vector borne disease
controlmodule);massmedia(electronicandprint);specialevents(malariaday);and,highlevel
advocacy.
Final development and production of BCC materials will be outsourced to private/INGO/NGO
sectorspecialists.
Maximumusewillbemadeoffreepromotionalopportunitiessuchasarticlesinnewspapers,and
newsbulletins,anddramasontelevisionandradio.
ProgramManagement
Capacitybuilding:Aholisticpackageofcarefullytailoredtechnicalandmanagementtrainingwill
be developed and will be implemented through central and district level staff in order to
strengthenthefunctionalityofserviceprovisionintheperiphery.
Planning: Technical Working Groups (TWGs) will be established and maintained for all key
technical areas including: diagnostics; case management; vector control; IEC/BCC; monitoring &
evaluation;andoperationalresearch.
Existingtechnicalguidelines,includingguidelinesoncasemanagement,vectorcontrol,epidemic
preparedness and control, monitoring drug and insecticide resistance will be updated by the
TWGs/TAanddisseminated.
Policies, strategies and guidelines will be reviewed regularly by TWGs in light of findings from
periodicevaluationsandinviewofrecommendationsresultingfromsurveillanceandoperational
researchactivities.
To ensure equitable and evidencebased distribution of services, allocation of all program
commoditieswillbecarriedoutbytherelevantTWG.
ANationalTechnicalAdvisoryGroupforMalaria(NTAGM)willbeestablished.Thegroupwillhave
representationfromMoHP,EDCD,NPHL,NHEIC,VBDRTC,DHOs,theINGO/NGOsectorandWHO
(and other key agencies as appropriate). This committee will meet annually in order to review
programmaticprogressandtoratifyanypolicy/strategychanges.
OperationalResearch
Theprogramwillimplementamodestneedsbasedpackageofoperationalresearchinassociation
withimplementingpartnersandnationalandinternationalresearchinstitutes.
ResearchprioritieswillbereviewedannuallybyaTWGandtheresultingresearchagendawillbe
ratifiedbytheNTAGMalaria.
92
CommunityParticipation
Enhance community participation and partnership building in malaria control through the
progressiveexpansionofRollBackMalaria(RBM)initiative
1.
CaseDetectionandTreatment
Blood slide collection from fever cases residing in areas at risk of malaria were continued through
health workers and health institutions. In malaria endemic areas without laboratory facilities, fever
cases were classified as clinical malaria based on clinical signs and symptoms and were treated for
malariawithoutmandatorybloodsmearcollection.However,inhighrisk13districtsand18moderate
risk districts, Pan specific rapid diagnostic test kits (detecting both pf and pv) were introduced to
facilitateearlydiagnosisandappropriatetreatment(EDAT)atperipheralinstitutionsthatdonothave
easyaccessformicroscopicdiagnosis.Atotalof3239peoplewithconfirmedmalariacasesand83,527
clinical malaria cases were treated in the FY 2067/68. Besides, the program gave high emphasis on
strengthening the skills of health personnel at all levels of health service delivery for early diagnosis
andappropriatetreatment,referralandmanagementofsevereandcomplicatedmalariacases.
2.
PreventionandControlMeasures
Selective and sustainable control measures are the main tools for malaria control. Two rounds of
Selective Indoor Residual Spraying (IRS) in malarious areas of 15 districts was carried out based on
criteria set for IRS which included areas with previous history of outbreaks, new settlements and
ongoingdevelopmentprojectsinhighriskmalariousareas,epidemicpronesituations,highprevalence
ofP.falciparumcases,andareaswithdrugresistantmalaria.InadditiontoIRS,activitiestopromote
useandacceptanceoflonglastinginsecticidalbednets(LLIN)werealsocarriedoutunderGlobalFund
programin13districts.LLINsarealsodistributedtothepregnantwomenresidingathighriskVDCsin
13highriskdistrictsthroughANCclinicsunderDHOs/DPHOs.
3.
EpidemicPreventionandControl
Outbreak preparedness and response of malaria has been operationalized through district rapid
response teams. For this purpose a stock of antimalarial drugs was maintained in outbreak prone
districts.Indoorresidualsprayingoperationswerecarriedoutinoutbreakaffectedareas.Malariarapid
diagnostic test was continued in all high endemic districts along with the expansion of on the spot
microscopycentreasanattempttostrengthenearlydiagnosisandappropriatetreatment.Behaviours
ChangeCommunication(BCC)activitieswerecarriedouttopromotecommunitypartnershipinthese
areas.P.falciparumaffectedareaswereregularlymonitoredforanyindicationofemergenceofdrug
resistance.WorldMalariaDayiscelebratedin25Aprilwiththesloganof'Countingmalariaout'in13
highlyendemicdistricts,5regionsandincentre.
4.
Training/Orientation
ThefollowingtrainingswereconductedduringtheFY2067/68(2010/2011)
BasicandRefresherTrainingonMalariaMicroscopyforLaboratoryTechniciansandAssistantsby
VBDRTC.
TrainingonMalariatohealthworkers.
ReviewofMalariacontrolprogramthroughquarterlyreviewmeetingsatfiveregions.
FieldbasedentomologicaltrainingandsurveillanceforVCO/MI.
93
5.
OperationalResearches
Thefollowingresearcheswerecarriedout;
RoutinelongitudinalentomologicalsurveillanceinthemonthofAugustOctoberoftheyear2010
foreffectivemalariavectorcontroloperations.
VectorinsecticideresistancestudyinKanchanpur,Dang,NawalparasiandDhanusadistricts.
1.
Surveillance
Thisyearatotalof160,868bloodsmearswerecollectedagainstthetargetof150,00.However,only
66.26percent(106,598)ofcollectedbloodsmearscouldbeexamined.Duringthisfiscalyear28,765
bloodsamplesweretestedwithpanspecificmalariaRDT.TheRDTtestresultshowed3.7percent
(1,062)positiveandrest(2,179)outoftotalpositivecases(3,241)wereconfirmedwithmicroscopy.
About30percentofperipheralbloodsmearscouldnotbeexaminedduetothelackoflaboratory
facilities,shortageofskilledhumanresources,reducedaccountabilityofrelatedhealthworkersand
delayed transportation of the slides to the laboratories with examination facility. However, the
countryismovingtowardsadoptingmalariapreeliminationstrategy(20112016)insteadofpresent
control strategy which gives emphasis on at least 90 percent of malaria diagnosis based on
parasitological(microscopy)orserological(RDT)confirmation.
2.
MalariometricIndicators
Thenumberoflaboratoryconfirmedmalariacaseshasincreasedfrom2,920in2066/2067to3,241
in 2067/68; however 31 cases are reported as unclassified from the districts. The proportion of P.
falciparumcaseshasdecreasedconsiderablyfrom20.5percentlastyearto15.7percentthisyear.
The number of clinical malaria cases reported during this fiscal year has decreased by (28%)
comparedtopreviousfiscalyear.AlthoughAnnualParasiteIncidence(API)rateandSlidePositivity
Rate(SPR)hasincreasedincomparisontothepreviousyear,AnnualBloodExaminationRate(ABER),
hasremainedconstantin2067/68.ThisisimportanttonotethatproportionofPfhasdecreasedby
fivepercent andtherewerenooutbreaksinanypartofthecountryin2067/68(Table4.1.1).The
datahasrevealedthatimportedmalariacasesareremarkablyhighinnumber.Thisdemandsmore
attentionforcrossbordermonitoringandsurveillanceofmalaria.
Atotalof106,598,slideswereexaminedand2,179weredetectedasmalariapositivecasesandout
ofexaminedbloodslidebymicroscopyatotalof1,062weredetectedasmalariapositivecaseson
RDT in 2067/68. Among all positives 3,241 (Microscopy and RDT), FWDR together contributed to
nearly50percentoftotalcases.TheleastnumberofpositivecaseswasreportedfromtheMWDR
(10%).TheAnnualBloodSlideExaminationRate(ABER)decreasedfrom0.75percentin2065/66to
0.66 percent in 2066/67 and remained same in 2067/68 where as Annual Parasite Incidence (API)
increased from 0.14 per 1,000 in 2066/67 to 0.16 in 2067/68. Proportion of P.Falciparum (PF)
decreasedbymorethan6percent,from20.5percentin2066/67to15.7in2067/68.
94
Table4.1.1:MalariometricIndicators
Fiscal
Year
2065/66
Totalslides
examined
148,693
Total
+ve
3,577
ABER
(%)
0.75
SPR
(%)
2.41
API
(/1000)
0.18
%
IMP
24.53
%
Pf
22.20
CM
113,872
2066/67
136,719
2,920
0.66
2.13
0.14
32.70
20.48
10,8179
2067/68
106,598
3,241
0.66
2.39
0.16
37.64
15.71
83,527
3.
AgeGroupDistribution
Majority (88%) of cases were among people over 5 years of age in 2067/68. In all regions similar
pattern of age group distribution was observed. However, western development region reported
highest percentage (39%) of cases in above 5 years age group whereas the second highest
percentage(18%)ofthecaseswererecordedinCDR(Annex3.5).
4.
IndoorResidualSpraying
Like previous years, two rounds of Indoor Residual Spraying were carried out in FY 2067/68 in 15
districtsthatprotected716,572people.
Table 4.1.2 presents the problems/constraints discussed in the regional and national reviews and
actionstaken.
Table4.1.2:Recommendations Made During Regional and National Reviews in 2066/67 and Actions
Takenin2067/68
Bloodslidecollectionand
examstilllow
Irregularandinadequate
supplyofantimalarial
drug
Actiontobetaken
Malariamicroscopytrainingtobe
provided
Regularandadequatesupply
Lackoforientationon
malariaprogramtoall
healthworkers
Training/orientationofmalaria
programtohealthworkersofnon
GFATMsupporteddistricts
IrrationaluseofRDTand
malariamicroscopy
againstnationalprotocol
Orientationtotherelatedmanager
andfocalpersonneedtobegivenon
where,whenandtowhomRDTand
malariamicroscopyshouldbe
performed
Trimestermeetingshouldbe
introducedtoStrengthencourier
movement
Lackofcoordination
betweenthemicroscopic
networks&collection
centre
Actiontaken
Regulartraininghasprovidedthrough
VBDRTC
Initiationtosupplydrugsand
logisticsregularlyandtimelywith
closecoordinationwithLMD/RMS.
LMISwebbasefullfunctioningwill
solvetheproblem.
Intradistrictcoordination.
Malariatrainingprovidedto
Healthfacilityinchargeand
VHW/MCHW
Malariatrainingtoalllevelof
healthworkersinGFATMdistricts
Theinstructionhasbeengiventoall
districtstoperformmicroscopyfor
malariawherethefacilityisavailable
anduseRDTwherethereisno
microscopy.
Budgetallocatedtodistrictfor
trimestermeeting
95
4.1.5Targetsfor2068/69
SN
1
2
Activities
BloodSlideCollection
SprayingtwotimesayearforMalariaControlathighriskandoutbreak
proneareas
3 OrientationonVBDsforHFI,MCHW/VHWs
4 Maintenanceofsprayingpumps
5 StudyonresidualconcentrationofInsecticide,effectivenessof
InsecticideandIRSprogramandbionomicsofanopheles(malaria
vectors)mosquitoes
6 Emergencyfocalsprayinginmalariaoutbreakarea
7 QuarterlyandAnnualEDCD/VBDProgressReview
8 LongLastingInsecticidetreatedNets(LLIN)fortransmissionrisk
reductiontogeneralpublicandpregnantwomen
9 Regionwisequarterlyregionalreview
10 CelebrationofWorldMalariaDay
Source:DiseaseControlSection/EDCD,DoHS
Unit
Slides
Districts
Targets
150,000
15
Persons
Times
Districts
1900
2
2
Times
Districts
Districts
Regions
Districts/region
2
22
31
5
36
96
DiseaseControl:KalaAzar
4.2
KALAAZAR
4.2.1 Background
The government of Nepal has committed to the regional strategy to eliminate Kalaazar and with
IndiaandBangladeshissignatoryofthememorandumofunderstandingthatwasformalizedduring
theWorldHealthAssemblyheldinMay2005onKalaazarelimination,withthetargetofachieving
thediseaseeliminationby2015.
In 2005, Epidemiology and Disease Control Division (EDCD) of Department of Health Services
formulated a National Plan for the Elimination of Kalaazar divided in it into three phases:
Preparatory Phase: 20052008; Attack Phase: 20082015 and Consolidation Phase: 2015 onwards.
TheoverallgoaloftheplanisTocontributetoimprovingthehealthstatusofvulnerablegroupsand
atriskpopulationslivinginKalaazarendemicareasofNepalthroughtheeliminationofKalaazarso
thatitisnolongerapublichealthproblem.Thetargetis:ToreducetheannualincidenceofKala
azartolessthan1per10,000populationsatthedistrictlevelby2015.ExpectedoutputsofthePlan
aresixrelatedtothedifferentcomponentsofthesystemthatneedtobestrengthenedinorderto
achieve the elimination goal. One of the outputs is to develop a functional network that provides
diagnosisandcasemanagementwithspecialoutreachtothepoorest.
EDCDhasrevisedtherecommendationsforthediagnosisandtreatmentofKalaazarinNepal.The
rK39 test kit has been accepted and introduced as a diagnostic test and Miltefosine as a first line
treatmentinKalaazarexceptinsomesituations.ThisstrategyisbeingpilottestedinSaptaridistrict
thatwillinturnserveasademonstrationdistrictforalltheotherendemicareastobetrained.
Kalaazar is an vectorborne disease caused by parasite Leishmania donovani, transmitted by the

sandfly,Phlebotomusargentipes.Thediseasecharacterizedbyfeverformorethantwoweekswith
splenomegaly,anemia,progressiveweightlossandsometimesdarkeningoftheskin.Intheendemic
areas, children and young adults are its principal victims. The disease is fatal if it is not timely
treated.KalaazarandHIVcoinfectionshaveemergedasahealthprobleminrecentyears.
Over the last decade, there have been some significant advances both in the diagnosis and
treatment of Kalaazar. The rK39 dipstick test kit, a rapid and easy applicable serological test has
beendemonstratedtohavehighsensitivityandspecificityinvaliditystudiesconductedintheIndian
subcontinent.Forthefirsttime,anoraldrugMiltefosinehasproventobeefficaciousindrugtrials
andhasbeenregisteredfortheuseinKalaazar.
Goal
ReduceincidenceofKalaazartolessthan1caseper10,000populationsatdistrictlevelby2015.
Objectives
Reducing the incidence of Kalaazar in the endemic communities including the poor, vulnerable
andunreachedpopulation;
ReducingcasefatalityratesfromKalaazar;
TreatmentofPKDLtoreducetheparasitereservoir;and
PreventionandtreatmentofKalaazarHIVTBCoinfections.
97
Strategies
BasedontheregionalstrategyproposedbySouthEastAsiaKalaazartechnicaladvisorygroupand
theadjustmentsproposedbytheNepalexpertgroupdiscussions,GovernmentofNepal,Ministryof
HealthandPopulationhasadoptedthefollowingstrategiesintheimplementationoftheKalaazar
eliminationprograminNepal.
Improveprogrammanagement
EarlyDiagnosisandCompleteTreatment(introducingnewtechnology)
IntegratedVectorManagement
EffectiveDiseaseSurveillanceandVectorSurveillance
SocialMobilizationandPartnerships
Clinical,ImplementationandOperationalResearch
CasedetectionandTreatment
As in the previous fiscal year various training programs for health workers at different health
institutionswereconductedsoastodevelopthedesiredcompetencyinthepreventionandcontrol
of Kalaazar to achieve the KalaAzar elimination by 2015. EDCD continued conducting training
programsforthelaboratorypersonnelfromthedistricthospitalsonrK39dipstickdiagnosisofKala
azar.CurrentlyhealthinstitutionsinKalaazarendemicdistrictsareusingthisdiagnostictechnique.
Peripheral level health workers were trained on appropriate skills required for prevention and
controlofvectorbornediseasesincludingKalaazar.Similarly,asinthepreviousyear,VectorBorne
Disease Research and Training Centre (VBDRTC) also conducted training on Kalaazar and other
VectorBorne Diseases (VBDs) for District Health Officers (DHOs, Medical Officers (MOs), Public
HealthOfficers(PHOs)andotherhealthpersonnel.Kalaazareliminationactivitieswerecarriedout
inSaptariDistrictasapilotprogram.
IndoorResidualSprayinginPriorityselectedKalaazarAffectedAreas
Two rounds of selective Indoor Residual Spraying (IRS) was carried out in prioritised Kalaazar
affected areas of 11 districts based on the national guideline on IRS. IRS for the prevention and
controliscarriedoutonlyinthosevillageswhereKalaazarcaseswererecordedinpreviousyearor
inareaswithanoutbreakintherecentpast.CollateralbenefitfortheKalaazareliminationprogram
hasbeengainedfromtheIRSusedforthepreventionandepidemicresponseformalariainKalaazar
endemicandKalaazarnonendemicdistrictstoo.
ContinuationofTreatmentthroughMiltefosineandAmphotericineB
Asinthepreviousfiscalyear,Miltefosine(oraldrug)asfirstlinedrugandAmphotericinBassecond
linedrughavebeencontinuallyutilisedforthetreatmentofKalaazarinendemicdistrictsandSukra
RajTropicalHospitalinthisfiscalyear2067/2068.
VectorControl
Indoor residual spraying in two cycles was conducted in Kalaazar affected areas of 11 endemic
districts with 100 percent achievements against the set targets. During this fiscal year a total of
1,359,085peoplewereprotectedwithindoorresidualinsecticidespraying.
98
CaseDetectionandTreatment
Atotalnumberof806caseswerereportedandtreatedindifferenthealthfacilitiesin2067/68(Table
4.2.1).Outofthe806cases802(99.5%)caseswereimprovedafterthetreatmentwhile4patients
(0.5%)weredied.
Table4.2.1:KalaazarCases&Incidenceper10,000byRegion&DistrictFY2065/66to2067/68
Districts/Health
Institutions
Jhapa
Morang
Sunsari
Saptari
Siraha
Udayapur
Easternendemic
districtstotal
Dhanusha
Mahottari
Sarlahi
Rautahat
Bara
Parsa
Centralendemic
districtstotal
Okhaldhunga
Makawanpur
Rasuwa
Dang
Palpa
Kailali
Kalikot
Daduldhura
Jajarkot
Rolpa
Salyan
Rupandehi
Surkhet
Acham
Pyuthan
Bardiya
Khotang
Dhading
Solukhumbhu
Dolpa
BPKIHS
TekuHospital
KantiChildren
VeriZonal
Hospital,Banke
Otherstotal
NationalTotal
FY2065/66(2008/2009)
No.of
cases Incidence Deathno
76
0.94
0
60
0.60
0
54
0.72
1
135
2.01
2
47
0.70
13
0.52
1
385
0.93
4
FY2066/67(2009/2010)
No.of
Death
cases Incidence
no.
23(2)
0.53
1
107(0)
1.21
0
34(0)
0.52
1
128(15)
2.03
0
65(4)
0.86
0
5(0)
0.12
0
362(21)
0.88
2
FY2067/68(2010/2011)
No.of
cases Incidence Deathno
22(0)
0.53
0
175(0)
1.95
3
30(0)
0.49
0
66(4)
1.03
0
69(1)
1.01
0.
11(0)
0.24
0
373(5)
0.90
3
58
162
223
31
18
0
492
0.73
2.49
2.97
0.48
0.27
0
1.40
2
2
0
0
0
0
4
32(2)
177(117)
134(73)
43(5)
9(2)
1(0)
396(199)
0.47
2.51
1.36
0.57
0.13
0.01
0.95
0
0
0
0
0
0
0
42(15)
145(91)
107(62)
8(0)
9(0)
1(0)
312(168)
0.58
2.49
1.12
0.13
0.13
0.01
0.85
0
0
0
0
0
0
0
5
28
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
64
41
NA
NA
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12(0)
3(0)
1(0)
2(0)
5(0)
1(0)
1(0)
1(0)
1(0)
1(0)
0(0)
1(0)
1(0)
0
0
0
0
0
0
0
3
NA
NA
NA
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2(0)
1(0)
1(0)
1(0)
1(0)
0(0)
0(0)
0(0)
1(0)
0(0)
1(0)
0(0)
3(0)
1(0)
1(0)
1(0)
1(0)
1(0)
1(0)
2(0)
76(0)
23(0)
2(0)
1(0)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
109
1,371
1.71
0
8
33
791(220)
0
1.33
0
2
121
806(173)
0
0.94
1
4
99
ReportedcasesofKalaazarincreasedfrom791in2066/67to806in2067/68.EDRreportedmore
cases(373)in6endemicdistrictsreflectingtheincidenceof0.90per10,000areasatriskpopulation
than the CDR (312) with incidence of 0.85. Highest number of cases was recorded in Morang,
Mahottari,Sarlahi,Siraha,Saptari,DhanusaandSunsariinthechronologicalorder.However,ifwe
excludetheforeignercases(Indian)Morang,SirahaandSaptariranksintopintheKalaazarcases
where there are more than 60 cases as shown in Table 4.2.1. The reported cases from referral
hospitals like BPKIHS Dharan and Sukraraj Tropical and Communicable Disease Hospital, Teku,
Kathmanduarenotsegregatedasthereisnodetailaboutaddressofthepatient.Sincethereported
casesarecompilationofreportsfromgovernmenthealthinstitutionsmainly,therealscenariomay
bedifferent.ItisknownthatcasesofKalaazaralsocrosstheborderfortreatmentatthehospitals
andprivateclinicsfromNepaltoIndiaorviceversa.Atotalnumberof173foreignerpatientsofKala
zarwerealsotreatedduringthereportingyearasgiveninthebracketsinthetableabove.
KalaazarIncidence
Kalaazarincidenceper10,000areasatriskpopulationsrangedfrom1.95inMorangto0.01inParsa
reflecting the national incidence of 0.95 per 10,000 areas at risk population (excluding foreign
cases).Outofthe12districts5districtshaveanincidenceofmorethan1,while7districtshavean
incidenceoflessthan1caseper10,000areasatriskpopulation(includingforeignercases).However,
the incidence rate becomes more than 1 in only 3 districts (Morang, Saptari and Siraha), if we
excludetheIndiancasesofKalaazar.
Table 4.2.2 presents the recommendations made during the regional and national reviews of
2066/67andactionstakenduring2067/68.
Table4.2.2:RecommendationsMadeDuringtheRegionalandNationalReviewsof2066/67andActions
TakenDuring2067/68
ResourcesforKalaazar
eliminationpilotingandscalingup
ShortageofstaffforOutbreak
investigationandcontrol
Delayedresponsedueto
unavailabilityofstaff
Incompletereporting
Staffaresomuchoverwhelmed
bycontrolactivitiesthat
investigationandfinding
determinantsofthedisease
outbreakhindered
Inadequatebudgetforoutbreak
managementofregionand
districts
Delayedornocareseeking
Actiontobetaken
Mobilizeexternalresourcesfor
expandingtheKalaazarelimination
programtoallKalaazarendemic
districts
Tostrengtheningtheoutbreak
response
tocreatepostof2MOHAatEDCDto
strengthenexistingRRT
createpostofoneepidemiologist,
onesurveillanceassistantatallfive
region
atthedistrictlevelcreateonepostof
surveillanceassistant
restructurealllevelRRTssoasto
involveotherpotentialstakeholders
Increasethebudget
Actiontaken
ScalingupofGoNfunding
andongoingexplorationof
additionalfunds
IncentivepackageforKalaazar
patientsandtheircaretakers
Budgethavebeenallocated
inthedistrictprogram
Effortsareongoing
Incrementinthedistrictand
regionalbudgetweremade
100
SN
1
2
3
4
5
Activities
EarlydetectionandtimelyappropriatetreatmentinKalaazarendemicdistricts
IndoorresidualsprayinginhighlyaffectedKalaazarareas
SupplyofrK39diagnostictoolsanddrugsMiletefosineandAmphotericinB
Transportationallowancefor1,000patients
OneLLINforallKalaazarpatients(1,000patients)fromendemicdistrictswho
completesthetreatment
6 OnedayorientationforFCHVsonKalaazar
7 TwodayorientationforhealthworkersonKalaazar
Source:EDCD,DoHS
Unit
Districts
Times
Districts
Districts
Districts
Targets
12
2
12
12
12
Districts
Districts
12
4
101
DiseaseControl:LymphaticFilariasis
4.3
LYMPHATICFILARIASIS
4.3.1 Background
Lymphatic Filariasis (LF) is a public health problem in Nepal. The disease is a major cause of
morbidity,primarily,lymphoedemaoflegsandhydroceleandimpedessocioeconomicdevelopment
inmanyendemicareasofthe country.Thediseaseisprevalent intheruralandslumareasofthe
country,predominantlyaffectingthepoorersectorofthecommunity.TheLFmappingcompletedin
2005byusingICT(Immunochromatography)cardtestrevealed60outof75districtsasendemicfor
lymphatic filariasis in the country. The disease has been detected in different topographical areas
ranging in attitude from 300 feet above sea level in the plain Tarai ecological zone to 5,800 feet
abovesealevelinhighhillareas.MorefilarialcasesareseeninTaraiwhencomparedwiththehills.
WuchereriabancroftiistheonlyrecordedparasiteinNepal.Themosquito,Culexquinquefasciatus,
an efficient vector of the disease has been recorded in all the endemic areas of the country. The
government of Nepal is fully committed to eliminate the disease from the country within the
stipulatedtime.
EpidemiologyandDiseaseControlDivisionundertheDepartmentofHealthServiceshasformulated
a National Plan of Action (20032020 AD) for Elimination of Lymphatic Filariasis in Nepal by
establishing a National Task Force under the Chairpersonship of DirectorGeneral, Department of
Health Services. The government had initiated the implementation of Mass Drug Administration
(MDA) in Parsa district in 2003. Since then the program has expanded gradually in other endemic
districts as well. MDA has stopped in 5 districts (Parsa, Makawanpur, Chitwan, Nawalparasi,
Rupandehi)infiscalyear2067/68aftercompletionof5roundsofMDA.
Figure4.3.1:LFEndemicities inNepal
Humla
41611
Kanchanpur
386569
Non
Endemic
Mugu
45088
Baitadi
239855
Jumla
Doti
211841
Dolpa
91607
30467
Mustang
Endemic
15540
Kailali
630821
Rukum
192825
Rolpa
214908
Manang
10122
Kaski
389534
275128
Palpa
275026
T anahu
322567
Sindhu
312854
Kavre
Solu
Sankhuwa
110419
162766
394647
T o tal po pulatio n at ris k: 2 5 millions

in 6 0 e nde mic dis tric ts
S o urce : EDCD, DOHS
Goal
EliminationoflymphaticfilariasisfromNepalbytheyear2020byreducingthediseaseinpopulation
tosuchalevelthattherewillbenotransmissionofthediseasetothepeoplelivinginNepal.
102
Objectives
Tointerruptthetransmissionoflymphaticfilariasis;
Toreduceandpreventmorbidity;
ToprovidedewormingbenefitthroughuseofAlbendazoletoendemiccommunityespeciallyto
thechildren;and
To reduce mosquito vectors through application of suitable and available vector control
measures(IntegratedVectorControlManagement).
Strategy
Interruption of transmission by yearly Mass Drug Administration using two drug regimens
(DiethylcarbamazineandAlbendazole)forsixyears.
Morbiditymanagementbyselfhelpandwithsupportusingintensivebutsimple,effectiveand
localhygenictechniques.
Baselinesurveyformicrofilariaprevalencein10differentdistricts(5fromeasternand5inmid
westernregion).
PostMDAcoveragesurveyconductedin4differentdistricts.
MDAPlanningandReviewmeeting.
TrainingmanualsandIECmaterialsdevelopedanddistributed.
Distributionofmedicine(Massdrugadministration).
Coordinationandinteractionprogram.
AdvertisementforMDAprogram.
Supervision and monitoring were done from various levels e.g. central, regional, district and
localhealthfacility.
MDA carried out as per the suggestions given by the experts who investigated the severe
adverseeffect(SAEs)afterMDAtochangethescheduleofMDAfromsummertowintermonths
VDCLevelInteractionProgramattheVDC(AtHealthFacility)amongvariousGO/NGOs/INGOs
representatives.
Pressmeetheldatdistrictheadquartersandatcentre.
MassDrugAdministration(MDA) carriedoutasperthesuggestionsgivenbytheexperts who
investigated the SAEs after MDA to change the schedule of MDA from summer to winter
months.
Table4.3.1showsscalingupandcoverageofMDA.
Table4.3.1:ScalingUpandCoverageofMDA
FY
2062/63
(2005/2006)
2063/64
(2006/2007)
2064/65
(2007/2008)
2065/66
(2008/2009)
2066/67
(2009/2010)
2067/68
(2010/2011)
#Districts
3
#oftablets
Albendazole
6,250,000
#oftablets
DEC
1,498,800
#peopleat
risk
2,075,812
#eligible
people
1,960,977
#people
treated
1,729,059
Coverage
(%)
82.6
21
12,850,000
30million
10,844,541
10,247,915
8,777,110
85.5
MassDrugAdministration(MDA)isnotcarriedoutduetosometechnicalreasoninthisFY.
21
9,258,000
40million
10,779,864
10,025,009
8,280,343
76.8
30
14,000,000
40million
14,162,850
13,339,351
11508311
81.3
36
16500000
14.5million
15505463
14533412
12276826
79.1
Note: TotaldistrictscoveredwithMDAprogramtilldateare41,where5districts(Parsa,Makawanpur,Chitwan,Nawalparasi,
Rupandehi)havebeenphasedoutaftercompletionof5roundsofMDA.
103
Fig u re 4 .3 .2 : MDA 2 0 1 0 /1 1 Co v erag e in 3 6 Districts
Hum l a
41611
M ugu
45088
Bai t adi
239855
J um l a
Dot i
211841
Dol pa
91607
30467
M us t ang
Kanchanpur
386569
15540
Kai l al i
630821
Rukum
192825
Ro lp a
2 1 4 9 08
M anang
10122
Kas ki
389534
275128
Tanahu
322567
Pal pa
275026
Si ndhu
312854
Sol u
Sankhuwa
110419
162766
DistrictsMDAcoverage>=80%
5IUs achieved interruption of transmission
Dis trictMDA Coverage <65%
MDAPlanned in 2012 in 10 new districts

District MDA coverage 6580%
MDAplan in 2013 in 9 Districts
MajorChallenges
Outof60endemicdistricts,tillFY2067/2068(2010/11)LFeliminationprogramwascarriedout
in36districts.Toachieve100percentcoverage,LFMDAneedtobeinitiatedin19additional
districtsandtobecompletedthe6roundsofMDA.
Moreeffortsforresourcemobilization(budgetandlogisticsupport)arerequired.
Morbidity management component need to be addressed more meticulously through
establishmentofmanagementclinics.
The active surveillance is to be expanded and strengthened in order to monitor the program
performance in five MDA stopped districts (Parsa, Makawanpur, Chitwan, Nawalparasi,
Rupandehi).
Masscampaignforsocialmobilization.
Publicawarenessaboutthedisease.
ToincreasethecoverageofMDAinurbancommunities,especiallyinKathmanduvalleywhere
thecoverageislessthan70percent.
NewguidelinesofLymphaticFilariasisEliminationandstrategiestoberevised.
SN
1
2
3
4
5
6
7
8
9
Activities
TOTforHWsandtrainingforVHWs/MCHWs/Volunteers
Districtlevelinteractionforsocialmobilization
Datacollection/updatingbydrugdistributors
MassDrugAdministrationonfilarial(Inboothin1st dayandhousetohouse
visitinsecondandthirdday)
SupervisionandmonitoringofMDA
IECactivitiesfocusingMDA
ManagementofsevereadverseeffectsfollowingMDA
Mediainteractionprogram
ReviewandplanningmeetingforMDAin46districts
Unit
Persons
Time
Time
Time
Targets
90,000
46
1
1
Time
Times
Persons
Time
Time
1
10
1500
46
3
104
DiseaseControl:Dengue
4.4
DENGUE
4.4.1 Background
Dengue, a mosquitoborne disease emerged in Nepal in the form of Dengue Fever (DF), Dengue
Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). The earliest cases were detected as
earlyas2006.Thesporadiccasescontinuedandoutbreaksoccurredin20092010.Initiallymostof
thereportedcaseshadtravelhistorytoneighboringcountry(India),howeverlatelyindigenouscases
werealsoreported.
Dengueoutbreakin2006hadshownitsfacewith32confirmeddenguecases(amongthetotalcases
identified,94percentwereadults;maletofemaleratiowas4:1),followedby27casesin2007,10
cases in 2008, 30 cases in 2009 and 917 cases in 2010 with major outbreak in Chitwan and
Rupandehi districts. In 2010/11, different districts showed dengue endemicity as reported in
previous years. The affected districts were Kanchanpur, Kailali, Banke, Bardiya, Dang, Kapilvastu,
Parsa, Rupandehi, Rautahat, Sarlahi, Saptari and Jhapa, indicating spread throughout the country
fromwesttoeastlyingintheplainTerairegion.
Aedes aegipti (mosquitovector) has been identified in 5 periurban areas of Tarai region (Kailali,
Dang, Chitwan, Parsa and Jhapa) during entomological surveillance conducted by EDCD during the
year20062010,indicatinglocaltransmissionofdengue.
Studies carried out in close collaboration of WARUN/AFRIMS in the year 2006 by EDCD/NPHL
showedall4subtypes(DEN1,DEN2,DEN3andDEN4)ofDengueviruscirculationinNepal.
Goal
Toreducethemorbidity due toDengueFever (DF),DengueHemorrhagicFever(DHF)andDengue

ShockSyndrome(DSS)
Objectives
Todevelopanintegratedvectorcontrolapproachforpreventionandcontrol.
TodevelopcapacityondiagnosisandcasemanagementofDF/DHF/DSS
Tointensifyhealtheducation/IECactivitiesand
Tostrengthenthesurveillancesystemforpredication,earlydetection,preparednessandearly
responsetooutbreakofdengue.
Strategies
Earlycasedetection,diagnosis,managementandreportingoftheDD,DHF&DSS
RegularCasesofDF/DHF/DSSSurveillancethroughtheEWARS
MosquitoVectorSurveillanceindifferentmunicipality.
Integrated vector Control approach. A combination of several approaches directed towards
containermanagementandsource
105
DiseaseControl:Dengue
To achieve the goal of controlling dengue, following activities were carried out during 2067/68
(20102011).
Trainingondenguecasedetection,diagnosis,managementandreporting
Interactionwithstakeholdersfordenguecontrol
Denguevectorlarvaesearchanddestroyprogramindengueaffecteddistricts
Advocacymeetinginthecentreanddengueaffecteddistrictsforitscontrolandprevention
Laboratorydiagnosticsupport
HealthEducation
Rapidresponseemergency/AedesaegyptiLarvasurveycontrol(SearchandDestroy)
Operationresearch
Denguecaseandvectorsurveillance
IntegratedVectorManagement
SN
1
2
3
4
5
6
Activities
Searchanddestroyoflarvaeofdenguevector
Interaction/orientationondengue/chikungunyaforFCHVs,HWsandother
stakeholders
AdvertisementandpublicationIECmaterialsfocusingtocontrolofdengueand
chikungunyaduringepidemicsituation
1dayinteraction/trainingondengueforHWandstakeholders
PrintingofNationalDengueGuidelinesforClinicalManagement,Preventionand
Control
Testkitsprocurementforthediagnosisofdengueandchikungunya
Unit
Times
Times
Times
Districts
Booklet
Times
Target
2
2
2
6
1000
1
106
Tuberculosis
FiscalYear2067/68(2010/11)
Source:NTC
DiseaseControl:Tuberculosis
4.5
TUBERCULOSIS
4.5.1 Background
Tuberculosis(TB)isamajorpublichealthprobleminNepal.About45percentofthetotalpopulation
isinfectedwithTB,ofwhich60percentareadult.Everyyear,40,000peopledevelopactiveTB,of
whom 20,000 have infectious pulmonary disease. These 20,000 are able to spread the disease to
others.TreatmentbyDirectlyObservedTreatmentShortcourse(DOTS)hasreducedthenumberof
deaths;however5,0007,000peoplestilldieperyearfromTB.Expansionofthiscosteffectiveand
highlysuccessfultreatmentstrategyhasprovenitsefficacyinreducingthemortalityandmorbidity
inNepal.Byachievingtheglobaltargetsofdiagnosing70percentofnewinfectiouscasesandcuring
85percentofthesepatientswillprevent30,000deathsoverthenextfiveyears.Highcureratesand
SputumconversionratewillreducethetransmissionofTBandleadtoadeclineintheincidenceof
thisdisease,whichwillultimatelyhelptoachievethegoalandobjectivesofTBcontrol.
DOTS have been successfully implemented throughout the country since April 2001. The NTP has
coordinated with the public sectors, private sectors, local government bodies, I/NGOs, social
workers,educationalsectorsandothersectorsofsocietyinordertoexpandDOTSandsustainthe
presentsignificantresultsachievedbyNTP.By16thJuly2011NTPhas1,118DOTStreatmentcentres
with3,103subcentres.Thetreatmentsuccessratestandsat90percentandcasefindingrateof73
percent. At the national level 36,951 TB patients have been registered of whom 15,000 infectious
(sputumsmearpositivenewcases)andarebeingtreatedundertheDOTSstrategyinNTPduringthe
FY2067/68(2010/2011).
Vision
TheNTPsvisionisTBfreeNepal.
Mission
ToensurethateveryTBpatienthasaccesstoeffectivediagnosis,treatmentandcure
TostoptransmissionofTB
TopreventdevelopmentofmultidrugresistantTB
ToreducethesocialandeconomictollofTB
Goal
Toreducethemortality,morbidityandtransmissionoftuberculosisuntilitisnolongerapublic
healthprobleminNepal.
Objectives
Achieveuniversalaccesstohighqualitydiagnosisandpatientcentredtreatment
ReducethehumansufferingandsocioeconomicburdenassociatedwithTB
ProtectpoorandvulnerablepopulationsfromTB,TB/HIVandmultidrugresistantTB
Supportdevelopmentofnewtoolsandenabletheirtimelyandeffectiveuse
108
Targets
TargetslinkedtotheMDGsandendorsedbytheStopTBPartnership:
by2005:detectatleast70percentofnewsputumsmearpositiveTBcasesandcureatleast85
percentofthesecases
by2015:reduceprevalenceofanddeathduetoTBby50percentrelativeto1990
by2050:eliminateTBasapublichealthproblem(<1casepermillionpopulation)
KeyactivitiesofNTPareasfollows:
Provideeffectivechemotherapytoallpatientsinaccordancewithnationaltreatmentpolicies.
PromoteearlydiagnosisofpeoplewithinfectiouspulmonaryTBbysputumsmearexamination.
Establish a network of microscopy centres and a system of quality control of sputum smear
examination.
Organisetreatmentcentresforevery100,000populationwithintheexistingprimaryhealthcare
system.
Provide continuous drugs supply to all treatment centres. This includes systems for
procurement,storage,distribution,monitoringandqualitycontrolofdrugs.
Maintainastandardsystemforrecordingandreporting
Monitor the result of treatment and evaluate progress of the program, by analysing periodic
treatmentoutcomeincohortsofpatients.
ProvidecontinuoustrainingandsupervisionforallstaffinvolvedintheNTP,ateachlevel.
DevelophealtheducationmethodstoimprovecommunicationbetweenhealthworkersandTB
patientsandtopromotecommunityawarenessaboutTB.
Strengthencooperationbetweennongovernmentorganisations(NGOs),bilateralaidagencies
and donors involved in the NTP. Coordinate NTP activities with other primary health care
activities,especiallyleprosyandAIDS/STDprograms.
CarryoutresearchprogramstoimprovetheNTPperformance.
1.
DOTSandMicroscopyCentreExpansion
TheNTPhasrapidlyexpandedtheDOTSstrategyinitiatedin1996with4pilotcentresandbymid
July2011thenumberofDOTScentreshavereachedto1,118with3,103subcentresandintegrated
in the general health services throughout the country (Fig. 4.5.1 and 4.5.2). By midJuly 2011,
number of microscopy centres reached to 505 (Gov407 and partners/INGOs98). Beside the
government health institutions major partners in DOTS implementation are the private sector
nursinghomesandpolyclinics,cementandcigarettefactories,I/NGOshealthclinics,eyehospitals,
prisons, UMN hospitals, refugee camps, police hospitals, medical colleges, municipalities, Village
Development Committees, District Development Committees. Different approaches have been
adopted in difficult to access areas. DOTS by community volunteers and I/NGOs has been found
effectiveinsomehillandmountaindistricts.AlldiagnosedTBpatientsarebeingtreatedwithDOTS
inthereportingyears.
109
Figure4.5.1:TrendofDOTSExpansion
No.of DOTS Treatment
centre
No of Treatment Sub
Centre
2428
2007
2006
3500
3000
2500
2000
1500
1000
500
0
2011
1099 1122 1118

874 1079
560
2005
2004
2003
2002
227 273 32 4 384 462

2001
122 202
2000
41
1999
29
1998
1997
500
1996
784 909
2010
1407
1872
2009
1000
3 117 3147 3132 3098 3103
2795
2008
1500
Source:NTC
Figure4.5.2:ExpansionofMicroscopyCentres
Source:NTC
2.
CaseFinding
Theprogramisnowmovingintotheconsolidationphase.ThetargetdefinedbyWHOtodiagnose
andtreatatleast70percentoftheestimatednumberofsputumsmearpositivenewcaseshasbeen
fulfilled since the FY 2058/59 (2002/03) to till now by building partnerships with private sectors,
medicalcollegesandcommunity.AsTBspreadseasilyinareasofhighpopulationdensity,manyTB
patientsarefoundinthecitiesandTaraiareas.Casefindingrate(73%)inthe2067/68hasdecreased
thanprevioustwoyears.
Figure4.5.3:CaseFindingTrend
Case Finding Trend, %
80%
69%
70 %
71%
71%
70 %
7 0%
70%
72%
75 %
7 6%
73%
62%
70%
60%
46%
48%
5 0%
50%
40%
3 0%
30%
20%
2067/68(2011)
2066/67
(2009)
(2008)
2065/66
2064/65
(2007)
(2006)
2063/64
2062/63
(2005)
2061/62
(2004)
2060/61
(2003)
2059/60
(2002)
2058/59
(2001)
2057/58
(1999)
2055/56
(1998)
2054/55
(1997)
2053/54
(1 996)
(1995)
0%
2052/53
10%
2051/52
Source:NTC
110
3.
TreatmentOutcome
DOTSwasintroducedinNepalinApril1996covering1.7percentofthepopulationinfourselected
districts.NowithasbeenexpandedtoallthedistrictsofNepal.TBpatientshavebeentreatedwith
DOTS achieving 90 percent treatment success rate. This rate has been sustained since DOTS was
introduced.Treatmentsuccessrateisalmostsame(around90%)fromFY2007/8to2009/10(Figure
4.5.4).
Figure4.5.4:TrendofTreatmentSuccessRate
100
90
91
87
88
88
88
87
87
88
88
88
89
88
89
90
90
80
Percentage
70
60
50
40
30
20
10
2010/2011
2008/2009
2007/2008
2006/2007
2005/2006
2004/2005
2003/2004
2002/2003
2001/2002
2000/2001
1999/2000
1998/1999
1997/1998
1996/1997
1995/1996
4.
LaboratoryNetworkinNationalTBControlProgram
SputumMicroscopyandMicroscopyNetworking
Tuberculosisdiagnosisandmonitoringrelyinlaboratorydiagnostic.Sputummicroscopyismainstays
of NTP. Because of its low cost and easier to perform, direct sputum microscopy is popular
worldwide. At present there are 505 microscopy centres catering the sputum microscopy
examinationthroughoutthecountry.Mostofthemicroscopycentresareestablishedingovernment
setting and few are established in nongovernmental organization and private sectors. NTP is
providing reagents, chemicals and equipment to every microscopy centres and they are providing
sputumsmearexaminationfreeofcost.Toreducetheworkloadinhighburdenmicroscopycentres,
FlorescenceMicroscopyisprovided.ThismicroscopydoestheworktentimesmorethanBrightfield
Microscopy.
External Quality assurance is another important task for this program. There is good laboratory
networkingbetweenmicroscopycentres(MCs)DHO/DPHO,RQCCandtheNTP.Microscopycentres
send their slides to their respective regional quality control centres via district health office. Five
Regional quality control centres (RQCC) are functioning smoothly with help of skilled and trained
quality control assessors. BNMT/NATA is working EQA in eastern region; NTC is working EQA at
central region. RTC Pokhara is working EQA at western, Midwestern regional health Directorate,
workingEQAinMidWesternRegionandNLRDhangadhiisworkingEQAatFarWesternregion.
On a quarterly basis all positive and 10 perent of the negative sputum slides used to send for
recheckingtotheRQCC.Insteadofconventionalmethodsofslidescollection,NTPNepalisgoingto
implement Lot Quality Assurance Sampling system (LQAS) for External Quality Assurance (EQA). In
LQAS,slidesarecollectedbyusingstandardstatisticaltools,systematicsamplingtechnique,forre
111
checkingofslidestofindagreementbetweenmicroscopycentreandqualitycontrolcentre.Figure
4.5.5 shows that agreement rate of slide rechecking is 97.4% in the FY 2010/11. Moreover
agreementrateisslightlyincreasingwithvalue95percentto97percentfromFY2006/7to2010/11.
NTC lab is working as a National Quality Control Centre (NQC). Feedback is provided by Regional
quality control centres (RQCC) to the microscopy centres through their DHO/DPHO for their
improvement.
Figure4.5.5:QualityControlofSputumSmearMicroscopy
2010/11
1.1
1.5
2009/10
1.3
1.4
2008/09
2.1
1.2
2007/08
1.9
2.1
2006/07
2.3
3
2005/06
1
1.5
2004/05
1.5
1
2003/04
1.5
1.2
2002/03
1.8
0.9
2001/02
1.7
1.3
2000/01
1.3
1.8
Source:NTC
Agreement
False+ve
False-ve
9 7.4
97
97
96
95
97
97
97
97
95
95
SputumCultureandDrugSusceptibilityTesting(DST)
National Reference Laboratory and GENETUP are providing culture and DST facility. GENETUP is
working under the TB Supranational LabGauting, Germany. Gauting, Germany is looking external
qualityassuranceto theselaboratories.CulturefacilitiesareavailableinBPKIHSDharaninEastern
RegionandRTCPokharainWestern Region.Tomanagethetoxiceffectofdrugs,NTPisproviding
additionalhaematologicalandbiochemicaltestsfreeofcosttoMDRTBpatients
TrainingandSupervision
Basicmodulartraining,RefresherMicroscopytraining,OrientationtoLQASarebeingconductedon
regular basis as a part of quality assurance program. On site evaluation is done at the time of
supervision.
TrainingisfundamentalcomponentofNTP.Everylaboratorypersonnelhavebeenprovidedsputum
microscopytraining.
Basic Sputum Microscopy Training is five days training It develops education and skill of
laboratorypersonnel
Sputum Microscopy Refresher Training, three days training, is provided to the laboratory
personnelaftertwoyearsofbasissputummicroscopytraining.
112
LotQualityAssuranceSampling(LQAS)Trainingisalsoprovidedtothelaboratorypersonnelto
improveperformance.
5.
DOTSandMicroscopyCentresbyRegion
DOTShavebeenimplementedinall75districtofthecountryandTBpatientsarebeingtreatedwith
DOTSat1,118treatmentcentresand3,103subcentres(Table4.5.1).
Table4.5.1:NoofDOTSandMicroscopyCentresbyRegion
DevelopmentRegion/Centres
No.oftreatmentcentres
No.ofSubcentres
DOTSPluscentres
DOTSPlussubcentres
Microscopycentres
EDR
229
715
2
7
114
CDR
349
1,021
3
36
181
WDR
239
663
3
10
81
MWDR
180
417
1
5
67
FWDR
121
287
3
5
62
Total
1,118
3,103
12
62
505
Source:NTC
6.
CaseFindingRate
Figure 4.5.6 presents the case finding rates since the fiscal year 2062/63 to 2067/68 (2005/06
2010/2011). More patients are being diagnosed and treated with DOTS every year with strong
partnershipofprivatesectorsandcommunitymobilizationinallregions.
Figure4.5.6:CaseFindingRatesbyRegion
Source:NTC
7.
TreatmentSuccessRate
Casefinding,caseholdingandtreatmentwithDOTSarethemainactivitiesofNTP.AllregisteredTB
patientsaretreatedwithDOTS.About95percentofdiagnosedTBpatientsaresupervisedbyhealth
workersand therestare byFCHVandcommunity volunteersduring the treatment.Asaresultan
encouragingresultoftreatmentsuccessratehasbeenachievedinalldevelopmentregionsofnew
smearpositivecases(Figure4.5.7).
113
Figure4.5.7:TreatmentSuccessRate
Source:NTC
8.
Research
InordertoimprovethequalityofcareforpeoplewithtuberculosisinNepalandtoassistineffective
PlanningandimplementingtheTBcontrolprogram,theNTPhadbeencarryingouttheresearchon:
MDRSurveillance
AssessmentofHIVamongsputumsmearpulmonaryTBpatientsregularly.
TherearenumbersofoperationalresearchinNTPworkplanwhichhasbeenimplementingin
collaborationwithsubrecipients.
9.
DrugResistanceTuberculosis
The NTP has carried out repeated surveys on drug resistance. The last survey showed that Multi
DrugResistant(MDR)TBisalmostconstantinnewlyregisteredcases.ThisisasignofagoodDOTS
program. Fourth MDR TB survey was conducted in collaboration with WHO and results at 2.9
percent.
10.
HIV/AIDSandTuberculosis
TheprevalenceofHIVisrisingrapidlyinNepal,andeffectivecontrolmeasuresforAIDSaswellas
for TB are more important now than ever before. NTP is conducting regular surveys to find the
extentofHIVamongTBpatients.In2006,2.4percentoftuberculosispatientsalsohadHIVinfection.
ThiscouldriserapidlyifHIVincreases.4thsententialsitesurveyofHIVinTuberculosispatientswas
conducted.Thissurveyisconductedineverytwoyearintervaloftime.
11.
TBHIVCollaborativeActivities
HIV epidemic has posed major challenges to TB control efforts globally. HIV weakens the immune
system.SomeonewhoisHIVpositiveandinfectedwithTBis57timesmorelikelytodevelopactive
TB than someone infected with TB but not infected with HIV. TB is leading cause of death among
peoplewhoareHIVpositiveaccountingforabout11percentofAIDSdeathworldwide.OverallHIV
prevalenceinNepalisestimatedat0.49percentintheadultpopulation.Anditiscategorizedasa
concentratedepidemic.SoaneffectivecontrolmeasureforAIDSaswellasforTBismoreimportant
114
now than ever before. The NTP adopted TB/HIV strategy and policy in 2009. Some activities are
currentlycarriedoutThroughGlobalFundagainstAIDS,TBandMalaria(GFATM)Round4,Round7
andNationalStrategyPlan(20102015).TB/HIVcollaborativeactivitieshaveundertakenbyNational
TuberculosisCentre(NTC)asoneofthestrategicprioritiesinlinewiththeglobalStopTBstrategy
and the Millennium Development goals. In this context, functional collaboration has been
establishedbetweenNTCandNCASCforimplementingTB/HIVactivitiesthroughjointplanningand
coordinationforgeneratingevidenceforadvocacy,mobilizingpartnershipandresourcestoraisethe
awareness on TB/HIV. BNMT, HERD, FAITH, HSWO, NFWLHA, Naya Nepal are the main Sub
Recipients (SRs) of GFATM working especially for TB/HIV in the program implementing districts.
Advocacy, Training, operational research, IEC materials development, surveillance are the main
componentsofTB/HIVcollaborationactivitiestodecreasetheburdenofHIVamongTBpatientsin
Nepal.
12.
DRTBManagement
DRTBmanagementprogramwasinitiated/startedinSeptember2005withtheapprovalofWorld
HealthOrganization(WHO),GreenLightCommittee.WHOacceptedtotreat350MDRtuberculosis
casesfortwoyearsperiod.InthebeginningDRtuberculosismanagementprogramwasstartedat5
treatment centres and 16 subtreatment centres with the technical and financial assistance from
WHO.NowNationalTuberculosisProgramhasexpandedDRtuberculosismanagementservicein5
development regions of the country with 12 treatment centres and 62 subtreatment centres till
Ashad2068.TotalNo.ofpatientsregisteredupto2068Ashadwere1026.CurerateofMDRTBfor
theyear2067/68is71.5percent.MDRTBhostelshavebeenestablishedinfivedevelopmentregions
in five places (Morang NATA, INF Banke, NEPID Nepal Dhangadi, NMC Parsa, and Central NATA
Kathmandu)in2067/68.
Figure4.5.8:No.ofMDRTBCases
No.ofMDRTBcases
194
138
2064/65
150
131
2063/64
200
213
158
100
Source:NTC
2067/68
2066/67
2065/66
50
0
192
2062/63
No.ofMDRTBcases
250
115
Figure4.5.6:ExpansionofDRTBCentres
ExpansionofDRTBCenters
NoofDRTBCentres
NoofDRTBSubcentres
70
62
60
50
50
Number
39
29
40
30
22
11
20
5
10
10
2064/65
2065/66
11
12
2066/67
2067/68
0
2062/63
2063/64
Source:NTC
Figure4.5.10:TrendofMDRTBTreatmentOutcomeRates
TrendofMDRTBTreatmentOutcomeRates,%
CureRate
DiedRate
FailedRate
DefaultedRate
80
60
66.3
72
71.5
65.2
40
17.4
20
0
11.60
4.70
2062/2063(2005/6)
13.00
10
5.00
2063/64
18.1
8.00
13.3
8.70
2064/65
5.70
8.20
2065/66(2008/9)
Source:NTC
13.
Advocacy,CommunicationandSocialMobilization(ACSM)
The Government of Nepal, National Tuberculosis Centre developed a comprehensive National

strategy plan (20102015). The New Strategy builds on the previous national strategy and outlines
enhancedandmorefocusedcommitmentfortacklingtheTBepidemic,consistentwithMillennium
DevelopmentGoalsinlinewiththeStopTBPartnershiptargets.
Ensureaccesstoqualitytreatment,diagnostics,ACSM, MDR casemanagement,PublicPrivateMix

and TBHIV care and support services for infected, affected and vulnerable groups in Nepal within
thecontextofacomprehensiveresponsetoHIVandAIDS.TheACSMinterventionapproachfocusing
on improving case detection and treatment adherence, combating stigma and discrimination,
empoweringpeopleaffectedbyTBandmobilizingpoliticalcommitmentandresourcesforTB.
These challenges will not be met without far greater prioritization and improvement in TBrelated
communication activities. In addressing each of these issues, there are strong organizational
synergies with efforts to combat HIV/AIDS. To cope above mentioned situation, the following
activitieswerecarriedoutduringfiscalyear2067/68.
116
AppointedTuberculosisGoodwillAmbassadorsfortheNationalTuberculosisProgram.
OrganizedinteractionprogramwithjournaliststoadvocateTBprogramatNationallevel.
CelebratedWorldTBdayon24thMarch2011.
OrganizedTBorientationtoslumpeople.
BroadcastedTB/HIVmessagesthroughNationalTelevision,RadioandFMs.
CarriedoutmonitoringactivitiesofACSMactivities.
Revised/developedTBposters,pamphlets,leafletsetcanddistributedthemtothedistricts.
DevelopedCDsoffolksonganddistributedtothedistricts.
DevelopedACSMpolicyandstrategydocumentforNTP.
ConductedskilldevelopmenttrainingtoMDRTBpatientsaspilotprojectinJhapaandMorang.
Carried out many different advocacy, communication and social mobilization activities in the
districtsbythestakeholders.
OrganizedNationalTOTonACSM.
14.
PracticalApproachtoLung(PAL)
Endorsement of New Stop TB Strategy on 2006, the certain components of the strategy has been
launchedintheNTPmainstream.OneofthecomponentsofstrategyisHealthSystemStrengthening
andwithinthatNTPhasfocusedtoincreasecasefindingwherethecasefindingisrelativelylow.PAL
is one of the activities which can achieve the objectives of the NTP particularly in TB case finding.
ThemainobjectivesofthePALprogramare:
Managementofrespiratoryillnessofover5yearspopulation.
IncreaseTBcasefinding.
Rationaleuseofanantibioticsandothersmedicationtorespiratorysymptomatic.
Capacitybuildingofhealthworkers.
Implementation of the PAL in 9 districts namely Sunsari, Bhaktapur, Lalitppur, Kathmandu,

Nawalparasi, Rupandehi, Kapilvastu, Dang and Kailali in five regions was carried by GoN since last
year. In the fiscal year 2068/69, PAL activity is going to be further expanded in Siraha, Dhanusha,
Tanahu, Bardiya and Baitadi districts in five regions. The aim of the program is to manage all
respiratorypatientsbyprovidingemergencymanagement,referral&feedback.SoalltheHP&PHC
are selected for implementation, and districts, Zonal and Regional hospitals are concerned for
referralhospital.
15.
PublicPrivateMix(PPM)
TheobjectiveofthisPPMistoengagePublicandprivatehealthcareproviderstoensureprovisionof
qualityTBservicesinlinewithNTPpolicyandinternationalstandardofTBcare(ISTC).Inorderto
achieve this objective, Linkage (referral and feedback) between existing DOTS centres and private
health care providers was established in various urban districts in Nepal. Living support to
clients/target population was provided to poor TB patients who are in need (migrants, TB/HIV co
infected, homeless, slums dwellers). One day orientations on PPM/ISTC in medical colleges and
hospitalareorganized.SoNTPhasplantoextendPPMactivitiesinKathmandu,Lalitpur,Bhaktapur,
Biratnagar,Pokhara,Nepalgunj&Kanchanpurcities.
16.
SupervisionandMonitoringPolicy
SupervisionandmonitoringiscarriedoutduringregularsupervisoryvisitsasoftheNTPpolicy.In
additiontosupervisionandmonitoring,quarterlyreportingofactivitiesiscarriedoutintheregular
117
planningandreportingworkshopatvariouslevelsasshowninFigure4.5.11.TheNTPhasintroduced
acomputerizedfeedbacksystemaspartofitsmonitoringactivities.
Figure4.5.11:NTPSupervisionPolicyandEvaluationSystem
NTPEvaluationSystem
NTP Supervision Policy
Central level
Regional Level
District Level
Treatment Centre
Region/District,
Treatment centre/
Sub centre
District,
Treatment centre/
Sub centre
Every Four Month
International
Level
InternationalReview
Annually
NationalLevel
National
Recording/Reportingand
PlanningMeeting
Trimester
RegionalLevel
Regional
PlanningMeeting
Trimester
DistrictLevel
District
PlanningMeeting
Trimester
Treatment
CenterLevel
TCRecording/Reporting
andPlanningMeeting
Treatment centre/
Sub centre
Sub centre
Every Two Month
Trimester
17.
LogisticSupplySystem
TheNationalTuberculosisControlProgramprovidesalldrugsandotherlogisticsuppliesonaregular
basis. In order to avoid supply shortages and stock outs of drugs the NTP has developed a drug
ordering system that uses the trimesterly reporting meetings for clinic staff to calculate their
requirements based on trimesterly utilization and buffer stocks requirements. Each level has to
maintain2to6monthsadditionalbufferstocktopreventstockout.Inordertoimprovecompliance
intakingmedicines,andinordertoprotectrifampicin,theNTPhasswitchedovertoFDCdrugswith
HR and HE combination. This has also reduced the amount of tablets patients have to take. The
buffer stock kept out at regional level has been increased from 4 to 6 months in order to guard
against shortages caused by delays in delivery from national level due to unforeseen natural and
otherdisturbances.
Figure4.5.12:LogisticSupplySystem
118
18.
TargetversusAchievement(Financialreport)
Financialreportofthecentralbudgetofthefiscalyear2067/68hasbeenshowninTable4.5.2.Only
83percentofthetotalbudgethasbeenspentintheFY2067/68.
Table4.5.2:Budget/ExpenditureofFY2067/68
SN
1
2
3
4
Total
Budget
33,756,000
15,774,000
476,101,000
4,850,000
530,481,000
Expenditure
30,533,049
13,967,579
397,003,605
1,299,198
442,803,431
Expenditure(%)
90
89
83
27
83
Source
GoN
Norway
GlobalFund
WHO
Source:NTC,AccountSection
Someofproblems/constraintsraisedinannualperformancereviewmeetingoftheFY2067/68are
listedinTable4.5.3.
SN
1
2
3
4
NosanctionpostofChestphysicianat
National,RegionalandZonallevel
hospitals
Lackofculturefacilitiesatregional
level
NopostforQualityControl
assessorsatregionallevel
NochesthospitalatNationalLevel
Actionstobetaken
Createchestphysicianpostat
nationalandregionallevelhospitals
Responsibility
MoHP/DoHS
Establishculturefacilitiesatregional
level
Sanctionatleastapostforquality
controlassessoratregionallevel
EstablishednationallevelTBhospital
MoHP,DoHS,NTC,
NPHL,RHD
MoHP,DoHS,NTC,
NPHL,RHD
MoHP/DoHS
119
Leprosy
FiscalYear2067/68(2010/11)
DiseaseControl:Leprosy
4.6
LEPROSY
4.6.1 Background
Leprosy has existed in Nepal since time immemorial and was recognized as a major Public Health
problem as early as 1950. Khokana Leprosarium near Kathmandu was established more than 160
yearsagotoprovideservicestotheleprosypatients.
For ages, leprosy has been a disease causing public health problem and has been a priority of the
government of Nepal. Thousands of people have been affected by this disease and many of them
hadtolivewithphysicaldeformitiesanddisabilities.
Activities to control leprosy in an organized and planned manner were initiated only from 1960.
Accordingtoasurveyconductedin1966,anestimated100,000leprosycaseswerepresentinNepal.
DapsonemonotherapytreatmentwasintroducedasaPilotProjectintheLeprosyControlProgram.
NepalLeprosyControlProgramwasstartedinthecountryin1966.MultiDrugTherapy(MDT)was
introducedin1982infewselectedareasandhospitalsofthecountry.Bythistime,thenumberof
registered leprosy cases had reached 21,537 with a Prevalence Rate (PR) of 21 per 10,000
population.SixtytwodistrictsofthecountryhadPRofover5,whileonlythreedistrictshadPRless
than1per10,000inhabitants.
Theprogramwasintegratedintothegeneralhealthservicesin1987.By1996MDTwasexpandedto
all 75 districts. The country conducted Leprosy Elimination Campaign in 1999 (LEC1) and again in
2001 (LEC2) which was an active case detection activity. In high endemic pockets special
interventions were undertaken for case finding. Community mobilization and participation during
LEC contributed to voluntary case reporting due to reduction of stigma and discrimination against
leprosyaffectedpersons.Highcureratesthroughflexibleandpatientfriendlydrugdeliverysystems
were ensured. Monitoring and supervision of the activities were undertaken to keep track of
progresstowardselimination.
Allinitiativeswerecoordinatedamongst
the national, international and local
EvolutionofLeprosyControlProgram
nongovernmental
organizations.
Specialized care for leprosy affected
1960 LeprosysurveyincollaborationwithWHO
persons was provided in Leprosy
1966 PilotProjectlaunchedwithDapsonetherapy
hospitals and referral clinics run by
NGOs and the government. WHO and
1982 IntroductionofMultiDrugTherapy
other major partners supporting the
program are Sasakawa Memorial
1987 Integration of vertical program into general basic
Health Foundation, The Nippon
healthservices
Foundation, Netherlands Leprosy
Relief,
The
Leprosy
Mission,
1991 Nationalleprosyeliminationgoalwasset
International Nepal Fellowship and
1995 Focalpersons(TLAs)appointedfordistricts&regions
NepalLeprosyTrust.
Leprosy Control Division, the guiding body for leprosy control activity in Nepal, functions in close
coordinationwiththeRegionalHealthDirectorate,DistrictHealthSystem,donoragenciesandallthe
supportingpartners.RegionalHealthDirectorate(RHD)supervisesandmonitorstheprograminall
districts within the region. Disease control activities including leprosy controlactivities are headed
121
by respective officer as appointed by Regional Director in RHD. Regional Tuberculosis and Leprosy
Officer/Assistant (RTLO) is the focal person of leprosy in RHD. In addition, District TB & Leprosy
Officer/Assistant(DTLO),implementtheprograminrespectivedistrict.
MDTserviceisbeingdeliveredthroughallthepublichealthfacilities(PrimaryHealthCentres,Health
PostsandSubHealthPosts)inNepal.Majorityofhealthcareprovidersservingatcommunitybased
healthfacilitieshaveundergoneComprehensiveLeprosyTraining(CLT)andareeffectivelyproviding
MDTservice.Inadditionmorethan90percentFemaleCommunityHealthVolunteers(FCHVs)have
received orientation on leprosy and are suspecting and referring cases to the nearest HF for
confirmation of diagnosis and treatment. Capacity building is a key intervention area and is
conductedwithsupportfromtheWHOandINGOsmentionedabove.Inadditiontocapacitybuilding
INGOsupportedreferral centresalsoprovideprimary,secondaryandtertiary levelcare to leprosy
patients.
Vision
Tousherinaleprosyfreesocietywheretherearenonewleprosycasesandalltheneedsofexisting
leprosyaffectedpersonshavingbeenfullymet.
Mission
Toprovideaccessibleandacceptablecosteffectivequalityleprosyservicesincludingrehabilitation
andcontinuetoprovidesuchservicesaslongasandwhereverneeded.
Goal
Reducefurthertheburdenofleprosyandtobreakchanneloftransmissionofleprosyfrompersonto
personsbyprovidingqualityservicetoallaffectedcommunity.
Objectives
To eliminate leprosy (Prevalence Rate below 1 per 10,000 population) and further reduce
diseaseburdenatdistrictlevel;
Toreducedisabilityduetoleprosy;
Toreducestigmainthecommunityagainstleprosy;and
Providehighqualityserviceforallpersonsaffectedbyleprosy.
Strategies
Earlycasedetectionandprompttreatmentofcases.
Enableallgeneralhealthfacilitiestodiagnoseandtreatleprosy.
EnsurehighMDTtreatmentcompletionrate.
Preventandlimitdisabilitybyearlydiagnosisandcorrecttreatment.
Reducing stigma through information, education, and advocacy by achieving community
empowermentthroughpartnershipwithmediaandcommunity.
Sustainqualityofleprosyserviceintheintegratedsetup.
Targets
ReduceNCDRby25percentatnationallevelbytheendof2015incomparisonto2010.
122
ReducePRby35percentatnationallevelbytheendof2015incomparisonto2010.
Reduce by 35 percent GII disability amongst newly detected cases per 100,000 population by
theendof2015incomparisonto2010.
Additionaldeformityduringtreatment<5percentbyEHFscore.
80percenthealthworkersareabletorecognizeandmanage/referreaction/complications.
PromotePODandSelfcare.
1.
MDTServiceDelivery
DuringtheFY2067/68,3,142newleprosycasesweredetectedand5362casesreceivedtreatment
with MDT. 2979 cases completed treatment and were made RFT in the fiscal year. Secondary and
tertiary care was provided to the needy leprosy patients through the existing network of referral
centres through the support of supporting partners. MDT and anti reaction drugs were freely
available in the country throughout the year. Though some district faced problem and managed
locally.
2.
CapacityBuilding
ComprehensiveLeprosytrainingwasprovidedtonewrecruits..RefresherTrainingwasprovidedto
healthworkersprovidingserviceintheendemicandlowendemicdistricts.Similarly,orientationto
FCHVs is an ongoing activity. At present, each and every health facility has more than one staff
trainedinleprosy.
3.
InformationEducationandCommunication
Toenhancecommunityawareness,passivecasedetectionandtoreducestigma,IECactivitieswere
undertakenonaregularbasisusingelectronicandnonelectronicmedia.Duringtheyear,relevant
messages were broadcasted using mass media. Posters and leaflets were printed and distributed
fromnational.Likewise,Leprosymessageweredisseminated,broadcastedthrough300flexboards
and 144 Street Drama were showed. Similarly 1200 times leprosy messages broadcasted in local
languagethroughFM,Radioatdistrictlevel.
4.
WorldLeprosyDay
World leprosy day was celebrated in national level by releasing message of Honorable President,
Honorable Prime Minister, Health and Population minister, Secretaries for Health & other official
dignity through national news paper. Interaction with Journalists and celebration interaction
programwithstakeholdersjointlyorganizedbyLCD&LeprosyNetWorkNepal.Similarlyregional&
districtlevelalsocelebratedWorldLeprosyDay,interactionwithdifferentgroups,procession,rally,
andtalkprogrametc.
5.
ProgramMonitoringandFollowupWorkshopatPHC/HPLevel
Duringtheyear,3monitoringworkshopswereorganizedin19endemicTeraidistrictsonceinevery
four months. Personnel from SHPs/HPs/PHC met at Ilaka level to compile and aggregate data,
discuss problems faced in the field and to share their experiences. Facilitators from LCD,
district/regional health directorates, supporting partners assisted the staff in these meetings.
Presentationsonrelevanttopicswerealsomadeduringthesemeetings.
123
6.
DistrictandRegionalReviewMeetings
Regular Review Meetings were held once in every 4 months at district and regional level. During
thesemeetingsaggregateddatawaspresentedanddiscussed.Administrativeissueswereattended
too. Activities that are to be undertaken in near future were presented and the details regarding
theirimplementationwerediscussedandagreedupon.
7.
FourMonthlyPerformanceReviewWorkshopatCentralLevel
TheworkshopisheldeveryfourmonthsatLCDtoassesstheoutcome&monitoringoftheprogram.
The workshop is chaired by Director of the Leprosy Control Program. RTLOs, representatives from
LMDandHMISsection,regionalstatisticalofficers,INGOpartnersandWHOattendtheworkshop.
Duringtheworkshophinderingfactorsareidentified(ifany)andmeasuresaresuggestedtoaddress
it.
8.
PatientsandTheirNeighborFamilyExamination
This activity is in the Index case based approach HW/ FCHV's visit every household of a newly
detected leprosy case and their neighbor using the chase card (pictorial card). They examine all
household family members for any signs and symptoms of leprosy and refer suspected case of
leprosytonearesthealthinstitutionforconfirmationofdiagnosis,treatment management.During
this year 130,000 family member were examined which is 67 percent of annual targeted. Among
totaldetectedofnewcases5percentofcaseswerefoundthroughthisactivity.
9.
SchoolHealthEducation
Thisactivitytargetmainlysecondarylevelschoolstudents.Themainobjectiveofthisactivityisto
awarestudentsandteachersaboutearlysignandsymptomsofleprosy,benefitsofearlytreatment
and options of treatment available at treatment facilities. During this FY 2380 Schools had given
healtheducationamongtargeted2500schools.
10.
ProcurementofAntiReactionDrugsandMDTLogistic
We are thankful to generous donation by the Nippon Foundation followed by Novartis and the
NovartisFoundationforSustainableDevelopmentofthecountrythatwearereceivingMDTfreeof
cost for all patients through WHO. Maintaining MDT supply and improving its distribution shall
alwaysbeahighpriority.AsperthenumbersofpatientsrequiringMDTdrugs,logisticalsupportfor
its effective distribution will need to be assured. It is essential to ensure that treatment of any
patientisnotinterruptedduetoshortageofdrugsatthehealthcentre.
The Leprosy Control Division supply of MDT through Regional Medical Store with general drug
deliverysystematthedistrictlevels.Healthfacilitieswhereleprosycasesarediagnosedandtreated
musthavebeenassuredsupplyofMDTdrugs.CasesshouldstartMDTatthecentrewherediagnosis
isconfirmed,andtreatmentshouldcontinueatthehealthfacilitynearesttothepatientsresidence,
atthepatientsowndiscretion.AccompaniedMDTmaybegiventocertaincategoriesofpatients
those from hardtoreach or distant areas, migrant laborers, nomads, those with jobs which entail
constanttravel,etc.
Where necessary, the referral centre that first treats a case should provide the MDT drugs to the
localunit(PrimaryHealthCentre/HealthPost/SubHealthPostinLowendemicdistrictsandatSub
HealthPostsinHighendemicdistricts)thatwillcontinuethetreatment.Thedrugsandmaterialsfor
124
treatingcomplicationssuchasreactions,woundsandplantarulcersshouldbemadeavailablefrom
thepharmaciesofgeneralhealthfacilities.MDTstockmanagementremainedsatisfactorythroughout
the year though some districts managed the shortage by neighboring districts. There was no
discontinuationintreatmentofleprosycasesduetoshortageofanytypeofMDTblisterpacks.
11.
Publications
Duringtheyear,LeprosyControlDivisionpublisheditsannualreport2066/67(200910)containing
the salient features of the current leprosy situation, activities undertaken during previous year,
achievementsandobstaclesfacedbytheprogram.
12.
HealthManagementInformationSystem(HMIS)
Datageneration,compilation,aggregation,andreportsubmissionweretimelydonethroughoutthe
year.Consolidateddatawasreceivedatevery4monthsatdistricts,regionsandcentre.Feedbackon
vitalissuesthathademergedwasprovidedtospecificprogramareaduringthereviewmeetings.
13.
SkinCamp
Thisactivitywasfocusedinhighendemicdistrictstodetectearlyleprosycases.Duringfiscalyear,16
campswereconductedin16differentendemicdistricts.
14.
DisadvantageGroupProgram
This activity was conducted to access the unreached community (Dalit, Janajati and other
disadvantagedgroup).Stigmareductionandmotivationforactiveparticipantintheleprosycontrol
activity and services of the community were focused. During this fiscal year this activity was
conducted in 145 places of different districts. In some places and the community identified
suspectedcasesandreferthemtonearthehealthinstitutionsfordiagnosis&treatment.
15.
CaseValidationandUpdatingofRecords
Thisactivitywasdesignedtocorrectoperationalerrorslikeoverdiagnosis,reregistered,removalof
nonexistingcasesfromtheprevalencepool,andoverstayintreatment.
16.
SupervisionandMonitoring
To provide technical guidance to the staff at peripheral health facilities and district health offices,
supervisoryvisitswereundertakenregularlybythestaffofLCD,RegionalHealthDirectorate(RHD)
and District Health Offices (DHO). A part from the budget made available by GoN for this activity,
additional funds were also provided by WHO, NLR and other supporting partners. Additional
technicalsupportthroughsupervisoryvisitswasalsoprovidedbythestaffofWHO,NLR,NLT,INF,
AnandabanHospital&othersupportingpartners.
17.
OtherSignificantEventsoftheYear
DuringtheFY2067/68variouseventstookplaceinLCDamongwhichfollowingarethemajorones
thattookplaceatthecentrallevel:
TheHealthEducationAdvisoryCommitteewasheldatLCD.
DTLOseminarforDisseminationofNewNationalStrategy20112015atBharatpur.
125
Following activities were carried out in high endemic districts with the assistance from supporting
partner/s:
Supportedcommunityawarenessandparticipatoryprogramatdifferentlevel
Orientationtodifferentcommunitymembers
ProvisionofPrimary,secondaryandtertiarycarethroughreferralcentres
CapacitybuildingofGoNstaf
Technicalsupportthroughsupervision
POIDandRehabilitativeservices
SupportinIECactivities
Detailsofactivitiescarriedoutin2067/68atcentralanddistrictlevelispresentedinAnnex1.
126
1.
Prevalence
BytheendofFY2067/68therewere2,210
casesreceivingtreatmentforleprosyinthe
country. Leprosy elimination has also been
achieved at regional level. The highest
number of leprosy cases receiving
treatment (800) were in the central region
followedbyeasternregion(558)(Fig4.6.1).
Prevalence rate (PR) was highest in the
eastern development region 0.91 per
10,000 population followed by farwestern
region (0.87/10,000 population). Besides
the registered PR, new case detection
proportion of children among new cases,
DisabilityofGradeIIamongnewcasesarealsoshowninTable4.6.1.
Table4.6.1:RegionwisePR,NCDR,ChildProportionandDeformityGradeII,2067/68
No.ofregisteredpatients
attheendofthisyear
Region
EDR
CDR
WDR
MWDR
FWDR
National
MB
390
486
252
199
184
1511
PB
168
314
96
63
58
699
Total
558
800
348
262
242
2210
NewCase
PR
0.87
0.82
0.64
0.72
0.91
0.79
MB
444
522
262
215
201
1644
PB
406
645
201
113
133
1498
Total
850
1167
463
328
334
3142
NCDR
1.32
1.19
0.85
0.9
1.25
1.12
Amongnew
patients
Child
DGII
Prop.
Prop.
6.94
3.29
5.74
3.26
1.3
1.94
5.49
3.96
3.89
6.29
5.19
3.47
Inthebeginningoftheyearthenumberofthe
casesontheregisterwas2,104andbytheend
oftheyearthisnumberhasincreasedslightly
to2,210cases.AtthenationallevelthePRhas
increased from 0.77/10,000 population in
2066/67to0.79/10,000populationin2067/68
(Figure 4.6.2). As a result number of irregular
patients,defaultersaswellasMDTcompletion
rate will improve further. In 2067/68, the
highest PR was observed in the far western
development region (0.94/10,000 population)
andthelowestinwesterndevelopmentregion
(0.64/10,000 population) among the five
regions.
127
2.
NewCaseDetectionRate
Fig.4.6.3:CaseDetectionbyRegion
During 2067/68, a total of 3,142 new leprosy

cases were detected. One third of these new
caseswerefemaleandthechildrenconstituted5
percent of the new cases registered. About 52
percent of these new cases were grouped under
multibacillaryleprosy.
The new case detection rate has declined from

1.99/10,000 population in 2065/66 to
1.15/10,000 in 2066/67 and to 1.12/10,000
population in 2067/68 (Figure 4.6.4). In 2067/68, the NCDR was highest in eastern development
region(1.32/10,000)andlowestinwesterndevelopmentregion(0.85/10,000population).
2.
DisabilityRate
Overall in 2067/68 the grade II disability at

national level was 3.5 percent (Figure 4.6.6).
The grade II disability was highest in the far
west region (6.3%) and lowest in western
region(1.9%).
3.
OutcomeoftheCasesRegistered
During the Fiscal Year 2067/68 a total of 2979 (MB 1507 and PB 1472) cases had completed
treatment and were removed from treatment (Table 4.6.2). The remaining cases are undergoing
treatment. Total transferred out cases were 54, number of defaulter cases was 31 and other
deductions were 122 (other than defaulters and transferred outs), which include death, double
registration and wrong diagnosis. The number of patients who restarted MDT in the current year
was 42. Please see Annexes for detail information on district, regional & national level data
breakdowns.
4.
TreatmentCompliance(CohortAnalysis)
Theproportionofnewpatientswhocompletetheirtreatmentontimeisanindicationofhowwell
theleprosypatientsarebeingservedbythehealthservices.TherateiscalculatedseparatelyforPB
&MBpatientsasacohortanalysis.Acohortissimplyagroupofpatientswhoallstartedtreatment
inthesamebatch,usuallyinthesameyear.
128
Theproportionofnewpatientswhocompletetheirtreatmentontimeisanindicationofhowwell
theleprosypatientsarebeingservedbythehealthservices.TherateiscalculatedseparatelyforPB
&MBpatientsasacohortanalysis.Acohortissimplyagroupofpatientswhoallstartedtreatment
inthesamebatch,usuallyinthesameyear.
During the fiscal year 2064/65 (2007/08) total of 2,302 MB patients and 2,380 PB patients were
registered. Among the registered MB cases 2,174 (94.4%) and 2,286 (96.9%) PB have completed
treatmentwithinthegiventimeframe.Inthisperiod33MB&34PBcasesdefaulted.Thetreatment
completionratethisyearissatisfactory.
4.6.4 Problem/Constraints
Nonexisting(crossborderissues)casesonprevalencepool
Doublereportingofcasesattheplaceofdiagnosis&atresidenceHFlevel
Stillhighprevalenceinsomedistricts
ActionTaken
Patientsverification,casevalidation(Bara,Rautahat,Rukum,Morang,Jhapa,Sunsari)
Updatingrecords/reports(Quarterly,onthespot,Fax,Tel.)
Patientscounseling,intensificationofcontactexaminationhasdone
PostEliminationStrategyFinalized
Impression
EliminationcontinuedRPRhasincreased
12DistrictsStillremainhighPrevalence,PRincreasedto>1ineliminateddistrictRautahatand
Chitwan
IncreasedDisabilityGradeII
ChildproportionandFemaleproportionRemarkablydecreased
Strength
Trainedmanpowerservinginallhealthfacilities.
Accessiblenetworkofpublichealthandservicesprovidedbypartnerorganization.
Freeleprosyservice.
Minimumstigmaanddiscriminationagainstpeopleandfamiliesaffectedwithleprosy
Regularreviewmeetings.
UninterruptedMDTsupply.
Elaboratedatabaseofgoodquality.
Goodcommunicationandcollaborationwithsupportingpartners
Weakness
Lowpriorityofprogramatperiphery.
129
Challenges
Tosustainleprosyeliminationatalllevel.
Tomaintainqualityofservicesinlowendemicmountainandhillydistrictssituations.
Tostrengthensurveillance,drugsupply,logistic,information,andjoborientedcapacitybuilding
forgeneralhealthworkersandanefficientreferralnetwork.
Toassessthemagnitudeofthedisabilityburdenduetoleprosy.
Tofurtherreducestigmaanddiscriminationagainstaffectedpersonsandtheirfamilies.
FutureCourseofAction
IntensiveIECactivitiestoraisethecommunityawarenessaboutleprosyanditstreatment.
StrengthenregularnewcasedetectionactivitiesinclusterareaofEndemicdistricts.
PromotecommunityparticipationinNationalLeprosyEliminationProgram.
Improveaccessofunreachedgroup.
4.6.5 TargetforFY2068/69
Activities
Centrallevel
MOTrainingforleprosy
MOTrainingforleprosy
Orientationprogramfordistrictprogrammanager
MDTmanagement
MDTmanagement
Purchase&distributionofsupportivedevicefor Disableleprosyaffectedpeople
Purchase&distributionofsupportivedeviceforDisableleprosyaffectedpeople
Purchaseofcomplicationmanagementdrug&equipmentforreferralcentres
TransportationcostforPatients
Leprosysurveyat5municipalityforslumarea
SpecialinterventionprograminPR>1endemicdistricts
Annualreportpublication
MessagebroadcastingthroughRadio/FM
Messagetelecastthroughtelevision
Messagedisseminationthroughnewspaper
IECmaterialsandsupportivematerialsforHW
WorldLeprosyDaycelebrationatcentre&regionallevel
4Monthlyperformancereviewmeetingcentral&regionallevel
4Monthlyperformancereviewmeetingcentral&regionallevel
4monthlycoordinationmeetingwithsupportingpartners
ProgramSupervision,monitoring&followupcentral&regionallevel
ProgramSupervision,monitoring&followupcentral&regionallevel
GrantforleprosypatientofKhokanaLeprosarium&othergroups
OfficeExpenses
Target Budget
1
123
3
720
5
600
3
99
3
72
2
500
2
826
1
1,000
2,000
2,000
5
800
30
3,000
200
50
200
500
3
500
6
200
1
500
1
600
3
1,170
3
310
3
25
22
500
15
240
3
1,200
1,505
17,040
130
Activities
DistrictLevel
2daysprogramorientationforBHSstaff
Patients&patientsneighborfamilyexamination
Patients&patientsneighborfamilyexamination
TransportationforRFTpatients
SkinCamp
SkinCamp
LeprosymessagebroadcastingthroughlocalFM
LeprosymessagebroadcastingthroughlocalFM
FlexBoard
Schoolhealtheducationprogram
Marginalizedgroupparticipatoryprogram
WorldLeprosyDaycelebration
District,PHC,HPlevelProgrammonitoring&followupworkshop
Supervision&Monitoring
Seedmoneyfroselfhelpgroup&groupformation
Mainstreamingofleprosyrelateddisabilitytogeneraldisabilitiesorientationon
UNCRPD
OfficeExpenses
Target Budget
8
563
3
446
23,000
805
166,66
5,000
6
3,000
3,000
14
700
2
100
2,000
1,200
125
75
300
500
1,500
1,500
18
396
150
3,300
50
500
25
250
3
5,100
1,700
3,500
15
1,500
8
800
220
29,455
131
DiseaseControl:HIV/AIDSandSTI
4.7
HIV/AIDSANDSTI
4.7.1 Background
History of Nepals response against HIV/AIDS begun with the launching of first National AIDS
Prevention and Control Program in 1988. In 1995, a National HIV/AIDS Policy with 12 key policy
statements and supportive structures like National AIDS Coordination Committee (NACC) and
District AIDS coordination Committee to guide and coordinate the response at central and district
level was endorsed. As directed by the
Box4.7.1:MilestonesinResponsetoHIV/AIDS
National HIV/AIDS Policy, a multisector
1988
LaunchedthefirstNationalAIDSPrevention
National AIDS Coordinating Committee
andControlProgram(shortterm)
(NACC)chairedbytheMinisterofHealth,
19901992
FirstMediumTermPlan
with representation from different
ministries, civil society, and private 19931997 SecondMediumTermPlan
NationalPolicyonBloodsafety
sectorwasestablishedatcentretobuild 1993
NationalPolicyonHIV/AIDS
the coordination mechanism to support 1995
and monitor the activities implemented 19972001 StrategicPlanforHIV/AIDSPrevention
SituationAnalysisofHIV/AIDSNepal
through NCASC. Similarly, DACC was 2000
established to coordinate and monitor 20022006 NationalHIV/AIDSStrategicPlan
theactivitiesatdistrictlevel.
20032007 NationalHIV/AIDSOperationalPlan
20062011 NationalHIV/AIDSStrategicPlan
In 2002 a National AIDS Council (NAC) 20082011 NationalHIV/AIDSActionPlan
was established, chaired by the Prime 2007
NationalHIV/AIDSandSTDControlBoard
Minister,toraisetheprofileofHIV/AIDS.
established
The NAC was intended to set overall 2008
NationalHIV/AIDSActionPlan
policy, lead high level advocacy, and 2010
NewNationalPolicyonHIV/AIDS
provideoverallguidanceanddirectionto 20112016 NewNationalHIV/AIDSStrategicPlan
thenationalresponsetoAIDSinNepal.
ThelatestnationalpolicyonHIVandAIDS(2010)haveenvisionedamoreconcretepolicyframework
formakingAIDSfreesocietywiththeoverallpolicyaimofreducingimpactofHIVamongpeopleby
reducingnewHIVinfections.
Recently Nepal has expressed its high level political commitment to Political Declaration on
HIV/AIDS:IntensifyingourEffortstoEliminateHIV/AIDSJune2011.The2011declarationbuildson
twopreviouspoliticaldeclarations:the2001DeclarationofCommitmentonHIV/AIDSandthe2006
Political Declaration on HIV/AIDS. At UNGASS, in 2001, Member States unanimously adopted the
Declaration of Commitment on HIV/AIDS. This declaration reflected global consensus on a
comprehensiveframeworktoachieveMillenniumDevelopmentGoalSix:haltingandbeginningto
reversetheHIVepidemicby2015.
Thus,toensuretheeffectiveresponsetotheHIVepidemicinNepalandsotofulfiltheaccountability
oftheresponse,NepalhasalreadyimplementedthreeroundsnationalHIV/AIDSstrategicplan.The
recent National HIV/AIDS Strategy 20112016 has laid a concrete road map in planning,
programmingandreviewingofthenationalresponsetotheepidemic.
132
NationalHIV/AIDSStrategy(20112016)
Box4.7.2:GuidingPrinciples,20112016
Vision
UniversalAccessofPrevention,Treatment,
CareandSupportservicesforallpeopleon
Nepal will become a place where new HIV
equitablebasis
infectionarerareandwhentheydooccur,every
Decentralized,integrated,multisectoraland
person will have access to high quality, life
interdisciplinaryengagement
extending care without any form of
Evidenceinformedplanningandprogramming
discrimination.
HealthSystemStrengtheningandCommunity
SystemStrengthening
Servicedeliverybasedontheprincipleof
Goal
PrimaryHeathCareApproach
EquityandHumanRights
To achieve universal access to HIV prevention,
Gendermainstreaming
treatment,careandsupport.
Greaterinvolvementofpeoplelivingwith
HIV/AIDS(GIPA)principle
Objectives
ReducenewHIVinfectionsby50percentby2016,comparedto2010;
Reduce HIVrelated deaths by 25 percent by 2016 (compared with a 2010 baseline) through
universalaccessontreatmentandcareservices;and
ReducenewHIVinfectionsinchildrenby90percentby2016(comparedwitha2010baseline)
The National HIV/AIDS Strategy is a national guiding document and a road map for the next five
yearsforallsectors,institutionsandpartnersinvolvedintheresponsetoHIVandAIDSinNepalto
meetthenationalgoal;toachieveuniversalaccesstoHIVprevention,treatment,careandsupport
withtwomajorprogrammaticobjectives(i)reducenewHIVinfectionsby50percent,and(ii)reduce
HIV related deaths by 25 percent, by 2016. The strategy delineates the central role of the health
sectorandtheessentialrolestheothersectorsplay,inresponsetotheHIVepidemic.
Box4.7.3:ContinuumofPreventiontoTreatment,
The current national HIV/AIDS Strategy,
CareandSupport
therefore, builds on two critical program
strategies: (i) HIV prevention, and (ii) treatment
care and support of infected and affected. To
ensure the achievements of program outcomes,
crosscuttingstrategiesaredevisedtosupports(i)
creating enabling environment: health system
strengthening,legalreformandhumanrightsand
community system strengthening (ii) strategic
information (HIV and STI surveillance, program
monitoringandevaluationandresearch).
Table4.7.1: LinkageofNationalHIV/AIDSStrategicPlan,20112016withOverallNationalDevelopment
Plans
ReducePoverty
AchieveMillennium
DevelopmentGoals
DevelopmentPlanofGovernmentofNepal
NepalHealthSectorProgram ImplementationPlanII
NationalHIV/AIDSStrategy
AchieveMillennium
ReduceNew Reduce AIDS
DevelopmentGoals20112015
HIV
related
UniversalcoveragetoEssentialHeathCare
infections
deaths
Servicesfreeagainstcatastrophichealth
expenditure
Source:NCASC(2011)NationalHIV/AIDSStrategy,20112016
133
Building on the achievements, lessons and experiences of the past five years, the strategy (2011
2016)willfocusonthefollowingkeypoints:
Addressing the all dimensions of continuum of care from prevention to treatment care and
support
Effective coverage of quality interventions based on the epidemic situation and geographical
prioritization
Healthsystemandcommunitysystemstrengthening
Integration of HIV services into public health system in a balanced way to meet the specific
needsoftargetpopulations
Strong accountability framework with robust HIV surveillance, program monitoring and
evaluationtoreflecttheresultsintoNHSPIIandNationalPlan.
Table4.7.2:ImpactLevelIndicatorsandTargets
Indicators
Baseline2010
HIVprevalenceinthepopulationaged1524
0.12%(2010)
PercentageofadultsandchildrenwithHIVknowntobe 89% 12months
ontreatment12,24and36months
84%24months
70%36months
Target2016
0.06%
Atleast93%12months
Atleast90%24months
Atleast85%36months
Source:NCASC(2011)NationalHIV/AIDSStrategy,20112016
HIVinNepalischaracterizedasconcentratedepidemic,wheremajorityofinfections(morethanfour
ineveryfivenewinfections)aretransmittedthroughsexualtransmission.Peoplewhoinjectdrugs,
menwhohavesexwithothermen,andfemalesexworkersarethekeypopulationsathigherriskof
HIV in Nepal. Thus, prevention of HIV among key population is the key programmatic strategies,
while providing quality treatment, care and support for infected and affected is equally important
strategicdirectionstoachievetheendresultsofnationalresponse(Table4.7.3)
Table4.7.3:Targeted Programs on HIV Prevention, Treatment, Care and Support Services Currently
AvailableinNepal
Servicepackage
ComprehensiveHIVpreventionpackageforkey
populationathigherrisktoHIV:
Comprehensivecondomprogramming
Behaviourchangecommunications/interventions
HIVtestingandcounseling
Diagnosisandtreatmentofsexuallytransmittedinfections
Antiretroviraltherapyandmanagementofopportunity
infections
PreventionofmothertochildtransmissionofHIV
Stigmaanddiscriminationreduction
Capacitydevelopment
Targetpopulations
Peoplewhoinjectdrugs
Femalesexworkers
Menwhohavesexwithmenand
transgenders
Clientsofsexworkers
Malelabourmigrants
Otherpopulationsatriskandvulnerableto
HIV
PeoplelivingwithHIV(PLHIV)
Antenatalcareattendees(womenandgirlsof
reproductiveagegroups)
Allpopulationgroups
Healthcareproviders
134
As of July 2011, response to HIV has been made available through the following service delivery
pointsinacrossNepal:
Table4.7.4:ProgramCoveragebyServiceDeliveryPoints(servicesites)inNepal
HIVtestingandcounseling
Sitesforsexuallytransmittedinfection
Antiretroviraltherapysites
Opportunisticinfectionssites
Communitycarecentresites
PreventionofMothertoChildTransmissionsites
DistrictswithDistrictAIDSCoordinationCommitteeCoordinators
Otherservices(TB,Sexualandreproductivehealthservices,nutrition
support)
Targetedpreventioninterventionsforkeypopulationsathigherrisk
toHIV
200+sitesin75districts
200+sitesin75districts
26+10sites
58sites
22+8centres
21sites(+3communitybasedsites)
35districts
Manypublicandprivatesites
50+districts
Figure4.7.1:SituationofHIVinNepal
1.
EpidemicAnalysis
Since the detection of the first AIDS case in 1988, the

HIV epidemic in Nepal has evolved from a low
prevalence to concentrated epidemic. As of 2011,
national estimates indicate that approximately 55,626
adults and children are infected with the HIV virus in
Nepal(Figure4.7.1).AsofAsar2068,atotalof18,396
casesofHIVoutofthem7,437advancedHIVinfection
Figure4.7.2:Adult(1549)HIVPrevalence
cases had been reported to the National Centre for
AIDS and STD control (NCASC). The estimated
prevalence of HIV in the adult population is 0.33
percent(Figure4.7.2).
More than 80 percent HIV infections are transmitted

through heterosexual transmission (NCASC, 2011).
People who inject drugs, men having sex with other
men and female sex workers are the key high risk
populationgroupsspreadingtheepidemic.Malelabor
migrants (particularly to India, where labor migrants
often visit female sex workers) and clients of female
sexworkersinNepalareactingasbridgingpopulation
groupsthattransferinfectionsfromhighriskgroupsto
low risk general population. As the epidemic is
maturing (about 23 years after the first HIV case
reportedin1988),moreandmoreinfectionsarebeing
recorded among low risk general men and women
populations. However, the epidemic has never
maintained through heterosexual transmission in the
general population in Nepal, rather driven by the
infections among high risk populations and their sexual partners. About three fifths (58%) of the
infectionwasamongadults(1549),whereasitwas8percentamongchildrenunderageof15years
6percentamongpopulationabove50years(Figure4.7.3).
135
The high risk population groups (IDUs, Table4.7.3: HIV Infections Estimates by Population Group,
2010
MSM, FSWs, male labor migrants and
clients of FSWs) shared 58 percent of all
PopulationGroup
No.
%
adult HIV infections (Table 4.7.3). The low Injectingdrugusers
1,367
2.9
risk general male and female population MSWs,transgenderand clients
3,345
7.0
shared about 42 percent of all estimated Other MSM who do not sell and/or
6,724
14.1
infections.Highestinfectionisestimatedin buysex
the age group of 2549 years who are Femalesexworkers
650
1.4
economically productive and sexually Clientsofsexworkers
2,440
5.1
active. The younger stratum of population Malelabourmigrants
13,219
27.7
below the age of 15 has lowest infections
Remaininglowriskmen
7,378
15.5
and most are due to mother to child
Remaininglowriskwomen
12,522
26.3
transmission Nepal has produced evidence
47,645
100
(NCASC, 2011) that effective prevention Total
Source:Nationalestimate2010,NCASC
interventions are working to stop the
spread of HIV, particularly among key high risk population groups such as IDUs, FSWs and their
clients.However,therateofnewinfectionshasincreasedamongMSM/TGinNepal.Inoverall,the
adult (1549) HIV prevalence has started declining slowly (Figure 4.7.2). This demands for a
continued effective prevention efforts to be sustained among high risk populations, especially
amongyoungandnewentrantsintotheriskbehaviors.
It is notable that migrants, remaining male and female subpopulation groups have contributed
majority in the total estimated number of HIV infection (prevalence pool) (Table 4.7.4 and Table
4.7.5). This is due to their disproportionately bigger population sizes, in contrast to that of the
MARPs.However,themaindriversoftheepidemicsare,infact,theMARPsincludingmigrantsand
clientsofsexworkersduetotheirhighlevelofHIVprevalenceandbehavioralfactorsthatassociated
withandcontributedtoHIVtransmission.
Table4.7.4:CumulativeHIVInfectionbySubGroup,AgeandSex,ReportedasofAsar2068(July2011)
SubGroup
SexWorkers(SW)
InjectingDrugUsers
MenhavingSexwithMen(MSM)
BloodorOrganRecipients
ClientsofSexWorker
Housewives
MalePartnersofFSW/FemaleIDU/FemaleMigrant
Children
SubgroupNOTidentified
Total
AgeGroup
04
59
1014
1519
2024
2529
3039
4049
50above
Total
Male
7
2,672
206
39
8,138
44
719
59
11,884
Female
930
64
15
104
4,894
472
33
6,512
290
318
122
282
1,368
2,497
4,858
1,690
459
11,884
172
222
82
301
1,009
1,506
2,281
733
206
6,512
Total
937
2,736
206
54
8,242
4,894
44
1,191
92
18,396
462
540
204
583
2,377
4,003
7,139
2,423
665
18,396
Source:Routinereporting,NCASC
136
Table4.7.5:EstimatedHIVInfectionandPrevalencebyRiskPopulationGroups,2010
Populationsubgroups(1549Yrs)
TotalInfection
Prevalence
Injectingdrugusers
1,367
4.4
MSWs,transgenderandclients
3,345
4.5
OtherMSMwhodonotselland/orbuysex
6,724
3.8
Femalesexworkers
650
2.5
Clientsofsexworkers
2,440
0.3
Malelabormigrants
13,219
1.0
Remaininglowriskmen
7,378
0.2
Remaininglowriskwomen
12,522
.02
Total
47,645
Source:Nationalestimate,2010,NCASC
ThehighprevalenceratesamongIDUs,MSM, migrantsandclientsofFSWssignifyaclearneedto
expandtheinterventionprogramsamongsttheseMARPs.Atthesametime,theapparenttransferof
the HIV load to the remaining male and female populations also necessitates strengthening
interventionstargetingthesevulnerablegroups.
2.
HIVCounsellingandTesting(HCT)
HIV counselling and testing (HCT) offers an important entry point to prevention, care and support
services. It is an essential component of comprehensive programming of response to HIV. HCT
serviceistheprocessofprovidingpeoplewithprofessionalcounsellingbeforeandafteranHIVtest.
TheprocesshelpspeopleprepareforandunderstandtheirHIVtestresults.Itisapowerfulstrategy
thatcanequippeoplewithknowledgeandskillsforsustainablehealthybehavior.HCTmainlyaims
for:
preventionofHIVtransmission:(i)from+vetestedpeopletoveoruntestedpartner/s(ii)
from+vetestedmothertochild(iii)tovetestedpeoplefrom+veoruntestedpartner/s;
promoteearlyuptakeofservices:(i)medicalcare(ARVtherapy;treatmentandprevention
ofopportunityinfections;PMTCT)(ii)familyplanning(ii)emotionalcare(iv)counselingfor
positive living (v) social support (vi) legal advice and future planning (vii) normalization of
HIV(viii)challengingstigma(ix)promotingawareness,and(x)supportinghumanrights.
HIVtestingandcounselingofHIVwasfirststartedinNepalin1995atNCASC.Asofnow,thereare
altogether196HCTsitesalloverthecountry.HIVtestingandcounselingservicesisprovidedfreeof
cost to the key populations at higher risk to HIV, including general population from all over the
country according the national HTC guidelines. The guidelines for HIV testing and counseling was
firstdevelopedin2003andupdatedin2007,and2010.
ThelastfouryearsdatafromHIVtestingandcounselingservicesshowsatrendofincreasednumber
of people getting tested and counselled (Table 4.7.6). However, is critical to have more HIV tests
conductedamongkeypopulationsathigherrisktoHIV,andeffectivelycounselled.
137
Table4.7.6:ServiceStatisticsonHIVTestingandCounselinginNepal:2008July2011
Indicator
PretestCounseling
TestedforHIV
HIVPositive
Posttestcounseled
2008
65,167
53,309
2,387
51,845
2009
71,377
62,672
2,110
61,170
2010
115,013
106,325
2,015
104,666
July2011
66,299
62,871
1338
62,150
Source:NCASC(2011)HIVtestingandcounselingprogram monitoringreport.
3.
AntiRetroviralTherapy(ART)Services
Figure4.7.4:Cumulativenumberofpeoplewithadvanced
HIVinfectioneverstartedART,asofJuly2011
The national antiretroviral treatment program was
started in Nepal in February 2004 from Teku
Hospital. At present 3 or more ARV drugs are
recommended for the treatment of people with
HIV infection. The main goals of the Antiretroviral
Therapy are (a) Maximal and durable suppression
ofviralload(2)Restorationand/orpreservationof
immunologic function (3) Reduction of HIV related
morbidityandmortality(4)Improvementofquality
of life of HIV infected persons (5) Prevention of
Mother to Child Transmission (PMTCT) (6) Post
ExposureProphylaxix(PEP).ByJuly2011,total5,876patientswithadvancedHIVinfectionwereon
treatmentin36ARTcentresacrossthecountry(Figure4.7.4and4.7.5).ThegovernmentofNepalis
providingfreeofcostARTserviceforallthoseinneedundertheNationalARTguideline.
Figure4.7.5:PeopleonAntiretroviralTreatment
The proportion of adults among people with

Figure4.7.6:OutcomeofARTprogrammeinNepal,
advancedHIVinfectionwhoarecurrentlyonART
AsofJuly2011
is 96 percent and the proportion of children is 6
percent. By sex, the proportion distribution of
current on ART is 56.6 percent for male 43.1
percent for female and 0.3 percent for third
gender. As per the cohort analysis, people with
advanced HIV infection, who are alive and
currentlyon ARTafter12 monthsof treatmentis
92 percent, who are alive and currently on ART
after 24 months of treatment is 84 percent and
who are alive and currently on ART after 36 Source:RoutinereportingNCASC

monthsoftreatmentis70percent.
138
4.
PreventionofMothertoChildTransmission(PMTCT)ofHIV
Prevention of HIV infection is a priority for the Government of Nepal. Even though our reported
overall prevalence rate remains well under one percent, major efforts will be needed to stop the
epidemic spreading from more atrisk populations (MARPs) into the general population. Already,
morethanoneineveryfivereportedcasesofHIVinfectionisamongfemalepartnersofHIVpositive
men, and 96 percent of these are women of child bearing age. Prevention of mothertochild
transmission(PMTCT)ofHIVisthereforeanimportantpartofourNationalHIVandAIDSStrategy.
In early 2007, the National Centre for AIDS and STD Control, UNICEF and other members of the
National PMTCT Working Group undertook an operational Review of our pilot program of PMTCT
services,whichhadbeenlaunchedinDecember2003.Thereviewnotedthattheexistingprogram
had a strong focus on hospitalbased services much stronger than its reach to the community
throughpreventionbasedinterventionsandtheprovisionofcare,treatmentandsupportforpeople
livingwithHIV(PLHA).
Prevention of mother to child transmission was started in two capital city sites in 2005 and had
expanded to 21 sites of which 20 sites offer Pediatric ART. Besides this CommunityBased PMTCT
service is available up to primary Health Care Centre (PHC), Health Post (HP) and Sub Health Post
(SHP) in 2 districts: Achham (14 sites) and
Figure4.7.7:Comparisonoftrends;HIVpositivedeliveryvs
Sunsari(12sites).
ARVprophylaxisreceivedbymotherandexposedbabies
AlthoughHIVpositivemotherandHIVexposed
babies are benefited from PMTCT service
expansion in the country. Service statistics
indicatethatdetectionofHIVpositivepregnant
womenandservicereceivedhasincreasedover
the time, but there is still challenge to provide
100 percent service to the mothers and babies
whorequiredARVprophylaxis(Figure4.7.7).
Table4.7.7:TrendsofARTProfileofNepal,AsofJuly2011
Indicator
People living with HIV ever enrolled on
ART(cumulative)
People with advanced HIV infection
receivingARVs(Cumulative)
Peoplelosttofollowup(Cumulative)
PeopleStoppedtreatment
Totaldeath(cumulative)
2005/06
July
522
2007
July
1180
2008July
522
32
3
36
2452
2009
July
3968
2010
July
5539
2011
July
7437
891
1997
3226
4509
5876
54
2
114
182
5
276
293
18
447
426
11
653
647
12
872
139
Table4.7.8:ServiceStatisticsonPMTCTinNepal(2005/06July2011)
Indicator
PregnantwomentestedforHIV(ANC&
Labor)
HIVpositiveidentifiedpregnantwomen
Totaldeliveriesbypositivemothers
MotherreceivedProphylaxisandART
BabiesreceivedProphylaxis
2005/06
28485
2007
32,553
2008
42,733
2009
65,791
2010
94551
2011
July
66,926
71
48
35
38
59
38
28
34
84
61
47
57
133
96
77
89
138
120
96
112
93
74
64
67
5.
LogisticManagement
NationalHIVandAIDSlogisticsystemhasbeenstartingsinceJanuary2006.Infiscalyear2067/068
HIVandAIDSlogisticsunithasdistributed132itemsofHIVcommoditiesto198servicedeliverysites
through153transactions.Similarly,54staffsworkingatservicedeliverypointsweretrainedonHIV
and AIDS logistic management and 15 people were trained on ARV Dispensing Tool (ADT). During
thisperiodtherewasnostockoutofARVdrugsatservicedeliverypoints.
Table4.7.9:FinancialProgressinFiscalYear2067/068
Level
Centre
Region
District
Totalbudgetallocated/
disbursed(Rs'000)
16,72,61
10,00
12,47,22
Totalexpenditure
(Rs'000)
11,31,71
10,00
22,40,1
Progress
(%)
68
100
18
Due to the delayed agreement with Global fund and other donor, fund disbursement to district
made at the end of fiscal year. Hence program couldnt perform as per initial plan and saving
incurred.
Problems/IssuesRaisedinNationalReview,2067/68
WhetherallPHCCscanbeVCTcentres.
Allorphanchildcarehomeareinastageofbeingshutdown.
TraffickedwomenissuesshouldbeaddressedinnationalHIV/AIDSprogram.
HowcanwemakelinkagewithDOTSclinicforTBHIVcoinfection.
CanHIV/AIDSissuebeintegratedinallsector/services.
140
RegionalLevelReview
Problem/Constraints
Frequent transfer of trained staff in the
districtsresultsinserviceinterruption
NospecificfocalpersonforHIVprogramin
thedistrict
Uncertainlyofprogram,sustainability
Integration of HIV/AIDS related reporting

inHMIS
Servicescaleup(VCT,ART,PMTCT)
Recommendation
NCASCtrainsmorethanonestaffasabackupstaff
DoublereportingofHIV+vecases
UniqueIDsystemisbeingdeveloped.Trainingfocusedonthe
reductionofsuchcases
MOHP to decide on the provision of focal persons for HIV

relatedprograminthedistrict
It happened due to delayed grant signing and budget
disbursementfromtheglobalFund.(willbeimproved)
Opportunities to link the recording and reporting system is
beingexplored
NCASC has plan to scaleup VCT and PMTCT up to the
community level; establishment of 10 more ART centres in
coming5years
Challenges
DespitemanyeffortsbytheMinistryofHealthandpopulation,programsarechallengedtoprovide
equitable access to services. Curative Services are unevenly distributed between regions. Even
whereservicesexist,staffingconstraintsandmotivationproblemsleavecommunitiesunderserved.
Hospitalshavecriticalgapsintheirabilitytoprovidequalityservicesforcommonhealthproblems.
There is lot of improvement areas regarding quality service delivery. Access to services is further
constrainedbyadifficultandmountainousgeographyandsocialandeconomicfactors.
4.7.4 FuturePriorities
DecentralizationofHIVAIDSprogram
ExpansionandscalingupofHIV/AIDSservices
StrengtheningM&Esystem
ActivatingandreactivatingDACC
Increasecoveragefortargetedintervention(UAtarget)
EnhancequalityassurancesystemforHIVrelatedtests
StrengtheningLMDcapacityforprocurementandsupplymanagement
141
Morbidity
Fiscal Year 2067/68 (2010/2011)
Total OPD New Cases
Sarla hi
Siraha
OPD Total New Cases as % of

Total Population
766 ,6 89
628,3 97
D hanusha
591,971
K at hmandu
5 60 ,387
Morang
Sapt ari
555,1 09
536,9 16
H umla
1 94
Must ang
183
D adeldhura
1 29
Palpa
1 26
O khaldhunga
125
Soluk humbu
120
Jhapa
5 08 ,752
A chham
B ara
Suns ari
5 07 ,095
500,3 38
Gulmi
1 16
Parba t
113
K a pilvast u
C hit w an
4 71 ,030
459,5 48
B a jura
1 12
D ailekh
1 11
Ma hot t ari
B ardiya
420 ,5 91
419,9 40
Ma na ng
K a sk i
419 ,3 48
Lamjung
R aut ahat
D ang
408,6 65
406,1 84
K a ilali
G ulmi
404,599
4 03 ,684
N awalparasi
401,3 57
Palpa
3 98,303
Surkhet
1 01
Salya n
Taplejung
100
100
Sarlahi
99
D olkha
98
Sankhuw as abha
3 84,639
Myagdi
B a nk e
K a vre
382,4 38
3 77 ,336
R ukum
320,577
1 10
109
1 01
Jajarkot
Surkhet
A c hham
117
98
97
93
Siraha
91
K a sk i
91
D hading
D aile kh
3 04 ,434
2 99 ,743
R asuw a
B ardiya
90
Sya ngja
Gork ha
2 98 ,335
2 95 ,081
B ait adi
90
K a nc ha npur
2 73 ,701
B a glung
2 72 ,168
90
Mugu
90
Pyut han
89
A rghakhanchi
87
Salyan
255,1 19
Gork ha
B ait adi
U daypur
2 49 ,486
242,6 37
Tehart hum
86
B a glung
85
Sindhupalc howk
D olkha
240,7 90
238 ,9 70
O khaldhunga
230 ,0 35
Pyut ha n
A rghak hanchi
226,9 87
214 ,6 47
87
B hojpur
86
K avre
82
Sya ngja
81
B anke
K apilva st u
81
80
212,1 96
210,4 56
C hit wa n
B ajhang
80
78
Tana hu
2 10 ,063
Parba t
B hojpur
2 09 ,596
201,732
Sapta ri
R olpa
78
78
K hot ang
R olpa
201,1 47
195,2 76
R a me chha p
D ot i
77
76
Lamjung
R ukum
Ma ka wanpur
195,1 46
D adeldhura
194 ,8 30
D hading
K hot ang
75
75
74
74
73
73
R a me chha p
193 ,2 66
B ara
D olpa
D ot i
Sankhuw as abha
190 ,3 67
183,0 11
D hanusha
D archula
N uwak ot
Jajarkot
1 67 ,256
161,7 95
D ang
D hankut a
72
72
Taple jung
1 57 ,878
B ajhang
Ila m
1 56 ,499
155,930
U daypur
69
K alikot
68
Soluk humbu
B hak t apur
1 51,450
1 48 ,877
Sindhupa lchow k
B a jura
1 45,622
Ma hott ari
63
Sindhuli
D hankut a
1 45,391
141 ,4 45
R aut aha t
61
Jhapa
N awa lpa rasi
61
59
Panc ht ha r
My agdi
1 31,868
1 30 ,465
Teha rt hum
113,3 58
D arc hula
106,7 13
H umla
9 4,268
K alik ot
Jumla
85,37 3
74,89 4
R a suwa
Mugu
4 8,205
47,09 1
Must ang
D olpa
Manang
Lalit pur
Parsa
R upande hi
3 1,690
25,90 5
1 3,715
NA
NA
NA
Jumla
70
65
Suns ari
65
K ancha npur
Tana hu
58
56
Pancht ha r
Mora ng
55
55
N ATIONA L
B hakt a pur
K a ila li
54
52
E AS TE RN
N uwak ot
Ila m
49
46
Sindhuli
Maka wanpur
43
41
K at hmandu
Lalitpur
41
Parsa
R upande hi
NA
NA
NA
CE NTR AL
W E S TE R N
70
72
59
73
MID-W E S TE RN
FA R W E S TE RN
90
76
Chapter5
CurativeServices
CURATIVESERVICES
5.1 BACKGROUND
Government of Nepal is committed to improving the health status of rural and urban people by
deliveringhighqualityhealthservicesthroughoutthecountry.Curative(outpatient,inpatientand
emergency)servicesarehighlydemandedcomponentofhealthservicesbythepeople.Thepolicyis
aimed at providing prompt diagnosis and treatment, and referral of cases through the health
networkfromPHCoutreachclinicstothespecialisedhospitals.
The Interim Constitution of Nepal 2063 has emphasized that every citizen shall have the rights to
basichealthservicesfreeofcostsasprovidedbythelaw.Ultimately,governmentofNepaldecided
toprovideessentialhealthcareservices(emergencyandinpatientservices)freeofchargetopoor,
destitute, disabled, senior citizens and FCHVs up to 25 bedded district hospitals and PHCCs
(December15,2006)andallcitizensatSHP/HPlevel(8October,2007).
Objectives
The overall objectives of curative services is to reduce morbidity, mortality and to provide quality
health services by means of early diagnosis, adequate as well as prompt treatment and appropriate
referral,ifnecessary.
TargetGroup
Allpatientsattendingathealthfacilities.
Strategies
Providecurativeservicesonthebasisofacomprehensiveandeffectivereferralsysteminitiating
fromPHCOutreachClinicstohigherlevel.
Improve coordination between public and private sector. Promote private medical
colleges/hospitals,nursinghomes,andhospitalsrunbyINGOs/NGOsandprivatepractitionersas
complementarytoMoHPfacilities.
Provide required human resources to Regional Health Directorates and District Public/Health
Officesandauthoritytorendercurativeservicesmoreeffectively.
ConsidereveryVillageDevelopmentCommittee(VDC)inthecountryasthebasiclevelforcurative
healthservicesthroughSubHealthwiththreehealthworkers;anAuxiliaryHealthWorker(AHW),
aVillageHealthWorker(VHW)andaMaternalandChildHealthWorker(MCHW).
IncreaseaccesstothereproductivehealthservicessuchasDepo,Pills,Condomsandantenataland
postnatalservices,childhealthservices,minorcurativeservicesandhealtheducationthroughPHC
OutreachclinicsineachVDC.
HealthPostsprovideservicessimilartothoseprovidedbytheSubHealthPosts.Inaddition,they
superviseandevaluatetheactivitiesoftheSubHealthPostsandbelow.
Upgrade Sub Health Post to Health Post; Health Post to PHCCs and PHCC to hospital in the
differentelectoralconstitutions.
143
CurativeServices
Makeprimaryhealthcareandtreatmentservicesavailableatlocal,districtandregionallevelby
strengtheningtheRegionalHealthDirectoratesandDistrictHealthOffices.
Consolidatereferralsystemforthedevelopmentofeffectivemedicalservices.
Curative health services were provided through the existing health facilities on an outpatient
includingemergencywhereeveravailableandinpatientbasis.
Inpatient services were provided by 99 government hospitals including INGOs/NGOs, Private
medicalcollegehospitals,nursinghomes,andprivatehospitalsasperthereportavailable.
Essentialdrugsandotherlogisticmaterialswereprovidedtoallhealthinstitutions.
Recordkeepingandreportingweredoneonadaily,weeklyandmonthlybasisatallinstitutions.
Medicalcampswereorganisedindifferentplacesespeciallyintheremotedistricts.
JEvaccinationcampaignswereconductedinJEaffecteddistricts.
5.2 Analysis of Achievement
Thissectionhastwosubsections:outpatientsandinpatientsservices.Outpatients'servicesinclude
servicesdeliveredthroughallservicedeliveryoutletsfromsubhealthpoststotertiarylevelhospitals
whiletheinpatientsservicesincludehospitalsonly.
Fig 5.1
Total New OPD Visits
5.2.1 OutpatientServices
Atotalof19,708,800outpatientsnewvisitswere
reported in 2067/68 (except Lalitpur, Parsa and
Rupandehi districts8). The highest number of
outpatients new visits 5,774,617 (29%) was
recorded in the CDR followed by EDR 4,640,003
(24%) while the lowest number of outpatients
new visits was recorded in the FWDR 2,042,394
(10%)(Figure5.1).
The percentage of outpatients' new visits has

declined from 76 percent in 2066/67 to 70
percentin2067/68(Figure5.2).Ithasdeclined
in all the regions except central region. Mid
western region observed the highest
percentage of outpatients new visits (90%)
followed by FWDR (76%) and WDR (73%) and
lowest percentage was observed in central
developmentregion(59%)in2067/68.Analysis
of district specific data indicates that the
percentageofoutpatientnewvisitswashigher
than the total population of the district in 14
districts (Annex). The highest percentage of
outpatientcaseswasobservedinHumladistrict
(194%)followedbyMustang(183%).
FY 2067/68
CDR (29%)
5,774,617
National: 19,708,800
WDR (20%)
3,981,678
EDR (24%)
4,640,003
MWDR (17%)
3,270,108
FWDR (10%)
2,042,394
Source:HMIS/MD,DoHS
Fig 5.2
OPD New Visits as % of Total Population

FY 2065/66 to 2067/68
100
76
80
69
70
79
78 72
71
95 90
87
87
85
73
73
76
59 59
55
60
40
20
NEPAL
EDR
CDR
MWDR
FWDR
2066/67
2067/68
WDR
2065/66
Source:HMIS/MD,DoHS
RecordingandreportingtoolsinthesethreeHSISpilotdistrictsaredifferentfromthe72nonpilotdistrictsandthedatabasesarenot
compatibletoeachother.
144
CurativeServices
OutpatientMorbidity
Figure5.3showsthetoptencausesofoutpatients'morbidityin2067/68.Pyrexiaofunknownorigin
was recorded the number one among the top ten outpatients' morbidity (3.7%) followed by
Headache (Migraine) (3.7%), Gastritis (APD) (3.6%). ARI/Lower respiratory tract infection (3.6%),
Upperrespiratorytractinfection(3.4%),Othermajorreportedcausesforoutpatients'morbidityare
Intestinal worms (3.2%), Impetigo/Boils/Furunculous (2.7%), Presumed noninfectious diarrhoea
(2.2%),AmoebicDysentery(2.2%)andFalls/Injuries/Fractures(2%).
Top Ten OPD Diseases as % of Total population
Fig 5.3
FY 2067/68
2
1
0
r
Py
of
ia
ex
kn
Un
n
ow
Or
in
ig
a
ad
He
ch
M
e(
r
ig
)
ain
s
Ga
tis
tri
I/L
AR
PD
(A
er
ow
sp
re
ry
to
ira
c
tra
tio
ec
nf
tI
p
Up
re
er
to
ira
sp
ry
f
In
ct
tra
n
tio
ec
t
In
tin
es
W
al
Im
m
or
g
pe
/
ils
Bo
o/
it g
Fu
e
Pr
nc
ru
m
su
o
ul
ed
sis
no
tio
ec
nf
us
rh
ar
di
a
oe
Am
eo
t
en
ys
cD
i
b
ry
/In
lls
Fa
r
ju
ie
ur
ct
ra
s/F
es
Table5.1:TenLeadingMorbidity(TotalNewVisitsasaPercentageofTotalPopulation),2067/68
SN
1
2
3
4
5
6
7
8
9
10
Disease/Conditions
PyrexiaofUnknownOrigin
Headache(Migraine)
Gastritis(APD)
ARI/LowerrespiratorytractInfection
UpperrespiratorytractInfection
IntestinalWorms
Impetigo/Boils/Furunculosis
Presumednoninfectiousdiarrhoea
AmoebicDysentery
Falls/Injuries/Fractures
National
3.74
3.71
3.64
3.63
3.43
3.19
2.75
2.24
2.19
1.99
EDR
3.17
3.91
3.20
3.96
3.46
4.58
3.15
2.24
2.00
1.72
DevelopmentRegion
CDR
WDR MWDR FWDR
5.34
2.65
2.37
3.34
2.54
3.72
5.51
5.04
2.58
4.42
5.42
4.55
2.56
3.93
4.65
4.78
2.38
3.82
4.92
4.36
2.59
2.41
3.82
2.77
2.80
2.12
3.43
2.02
1.89
1.90
3.14
2.97
1.70
2.08
3.43
3.03
1.55
2.51
2.37
2.63
Source:HMIS/MD,DoHS.
145
CurativeServices
Communicable and Noncommunicable
Fig 5.4
Communicable vs. Non-Communicable
Diseases
FY 2067/68
Of the total 19,708,800 OPD new visits in

Communicable
3,477,955 (18%)
2067/68, more than four fifths (82%) of the
cases were identified non communicable
diseases (Figure 5.4), which is same as in the
previous year. Of the total OPD new patients,
the proportion of communicable disease was
higher in mid western region (21%) followed
Non communicable
16,230,845 (82%)
by eastern and far west regions (18%), and it
waslowestinwesternregion(15%)(Table5.2).
Table5.2:CommunicableandNonCommunicableDiseasesamongTotalOPDNewCases
Level
Eastern
Central
Western
MidWestern
FarWestern
National
Communicable
No.
%
847,989
18.3
991,843
17.2
599,708
15.1
678,021
20.7
360,394
17.6
3,477,955
17.6
NonCommunicable
No.
%
3,792,014
81.7
4,782,774
82.8
3,381,970
84.9
2,592,087
79.3
1,682,000
82.4
16,230,845
82.4
Total
4,640,003
5,774,617
3,981,678
3,270,108
2,042,394
19,708,800
Ofthetotalcommunicablediseasesreported,morethanonefourth(29%)werereportedincentral
region,followedbyeasternregion(24%);andthelowestcaseswerereportedinfarwesternregion
(10%)(Figure5.5).Likewise,ofthetotalnoncommunicablediseasesreported,morethanonefourth
(29%)werereportedinCDR,followedbyeasternregion(23%);andthelowestcaseswerereported
infarwesternregion(10%)(Figure5.6).
Fig 5.5
Non-Communicable Cases
Fig 5.6
Communicable Cases
FY 2067/68
FY 2067/68
EDR 847,989
(24%)
CDR 991,843
(29%)
CDR 4,782,774
(29%)
EDR 3,792,014
(23%)
Total: 1,623,0845
Total: 3,477,995
FWDR 1,682,000
(10%)
FWDR 360,394
(10%)
WDR 599,708
(17%)
MWDR 678,021
(19%)
Source:HMIS/MD,DoHS
WDR 3,381,970
(21%)
MWDR 2,592,087
(16%)
Source:HMIS/MD,DoHS
OutpatientMonthlyTrend
Analysisoftheoutpatientcasesbymonthshowsthathighestnumberofcaseswerereportedduring
the months of Jestha and Asar (May, June, July) and lowest during the months of Kartik, Mangsir,
Poush and Magh (October, November, December, January, February) (Figure 5.7). This trend has
remainedalmostthesameoverthelastthreeyears.
146
CurativeServices
Monthly Trends in Total OPD New Visits:

Comparison from 2065/66 to 2067/68
Fig 5.7
3,500,000
3,000,000
2,500,000
2,000,000
1,500,000
1,000,000
500,000
0
Bhadra
Aswin
Kartik
Mangsir
Poush
Magh
Falgun
Chaitra
Baisakh
Jestha
Ashad
2065/66 1,674,609
Shrawan
1,843,627
1,421,206
1,306,884
1,404,448
1,252,090
1,338,569
1,372,446
1,612,440
1,638,755
1,936,454
2,080,943
2066/67 1,897,691
2,069,932
1,531,548
1,608,450
1,444,953
1,269,145
1,363,059
1,446,082
1,732,772
1,694,466
1,825,368
3,010,652
2067/68 1,927,786
2,220,923
2,053,898
1,339,381
1,342,110
1,270,043
1,320,254
1,508,766
1,599,332
1,512,158
1,762,751
1,851,398
2065/66
2066/67
2067/68
5.2.2 InpatientServices
100
85
96
98
98
77
63
72
84
98
83
85
96
93
83
79
83
98
This section analyses the inpatient services Fig 5.8

Hospital Reporting Status
provided by public and non public hospitals.
FY 2065/66 to 2067/68
150
Reportingoftheservicesismainlyfrompublic
130
hospitals. Not all nonpublic hospitals are
reporting to HMIS. Very few nonpublic
110
hospitals have reported to HMIS, some are
90
reportingpartiallyandsomearenotreporting
70
at all. Overall, at the national level the
50
reporting status of public and non public
hospitals has increased from 83 percent in
30
NEPAL
EDR
CDR
WDR
MWDR
FWDR
2066/67to98percentin2067/68(Figure5.8).
At the regional level, hospital reporting status
2065/66
2066/67
2067/68
varied from 96 percent in eastern region to
100percentinfarwesternregionin2067/68.Atotalof386,947patientswereadmittedinhospitals
andofthem371,523patientsweredischargedfromthehospitalsin2067/68.
InpatientMorbidity
Of the total 371,523 inpatients recorded in 2067/68, 85 percent cases (314,603) were classified
under ICD code (Table 5.3). Single spontaneous delivery (O80) was the most common morbidity
followed by Diarrhoea and Gastroenteritis of Presumed Infectious Origin (A09) and Single
spontaneousdelivery,unspecified(O80.9)isthethirdleadingcausesforhospitalization.
147
CurativeServices
Table5.3:TopTenReasonsforHospitalisation,2067/68
SN
1
2
3
4
5
6
7
8
9
10
ICDCode
CauseofHospitalization
O80
Singlespontaneousdelivery
A09
Diarrhoea&gastroenteritisofpresumedinfectiousorigin
O80.9
Singlespontaneousdelivery,unspecified
A01
Typhoidandparatyphoidfevers
J22
Unspecifiedacutelowerrespiratoryinfection
J18
Pneumonia,organismunspecified
R69
Unknownandunspecifiedcausesofmorbidity
J44
Otherchronicobstructivepulmonarydisease
O06
Unspecifiedabortion
O82
Singledeliverybycaesareansection
AllOthersreasons
TotalnumberofdischargePatients
Patients(N)
79,391
14,295
12,891
10,704
9,142
9,016
8,604
8,237
7,096
6,223
149,004
314,603
Percent
25.2
4.5
4.1
3.4
2.9
2.9
2.7
2.6
2.3
2.0
47.4
100
Source:HMIS/MD,DoHS
Table5.4presentstheageandsexdistributionofdischargedinpatientsforfiscalyear2067/68.More
thanonethird(37%)oftheinpatientsdischargedwereintheagegroupof2029years.
Table5.4:InpatientsMorbiditybyAgeandSex,2067/68
AgeGroup
<28days
29days1yrs
14yrs
514yrs
1519yrs
2029yrs
3039yrs
4049yrs
59yrs
60yrs+
Total
Female
N
4,447
5,518
6,848
8,638
29,376
108,114
26,004
10,983
8,253
14937
223,113
Male
%
1.4
1.7
2.2
2.7
9.3
34.4
8.3
3.5
2.6
4.7
70.9
N
6,414
10,514
10,620
12,696
5,655
9,268
7,624
7,245
6,850
14,613
91,487
%
2.0
3.3
3.4
4.0
1.8
2.9
2.4
2.3
2.2
4.6
29.1
Total
N
%
10,861
3.5
16,032
5.1
17,468
5.5
21,334
6.8
35,031
11.1
117,382
37.3
33,628
10.7
18,228
5.8
15,103
4.8
29,550
9.4
314,603
100
Source:HMIS/MD,DoHS
Table5.5: Hospital Deliveries, Surgeries and

A total of 122,837 deliveries were conducted at
MaternalDeaths,2066/67
hospitalsin2067/68(Table5.5).Similarly,atotalof
Totaldeliveriesconducted
122,837
3,976 deaths were recorded and of them 46 were
Maternaldeaths
46
maternaldeaths(1.2%).Thedatashowsthat56,768
56,768
surgeries were done in the hospitals in 2067/68. The Surgeries
Totalhospitaldeaths
3,976
average length of stay at hospital was recorded at
Totalinpatientdays
1,237,740
3.3daysandbedoccupancyratewas56.6.
Averagelengthofstayathospital
3.3
56.6
Figure 5.9 shows the total number of inpatient Bedoccupancyrate
Source:HMIS/MD,DoHS
morbiditybycommunicableandnoncommunicable
diseases.Alargemajorityoftheinpatientsdischarged(89%)wereadmittedfornoncommunicable
diseasesand11percentwereadmittedforthecommunicablediseasesin2067/68.
148
CurativeServices
Figure 5.10 shows the death rate among inpatients by communicable and noncommunicable
diseases.Thedeathrateamonginpatientswithcommunicablediseasesishigherthanthatofnon
communicablediseaseamongthehospitalizedcasesinthecountry.
Communicable vs. Non-Communicable

Diseases among Inpatient
FY 2067/68
Death Rate among Inpatient

FY 2067/68
Fig 5.10
1.2
1.1
Fig 5.9
0.9
1.0
Non communicable
280,041 (89%)
0.8
0.6
0.4
0.2
Communicable
34,562 (11%)
0.0
Communicable
Non-communicable
5.2.3 CentralHospitals
Table 5.6 highlights the comparative curative services rendered by different central level hospitals
during the fiscal years 2065/66 to 2067/68. As compared to 2065/66, the services rendered to
inpatientsfromNationalAcademyofMedicalSciences(NAMS)/Birhospital,ParopkarMaternityand
Women's Hospital, Mental Hospital, Sukraraj Tropical and Infectious Diseases Hospital, Shahid
Gangalal National Heart Centre and BP Koirala Institute of Health Sciences has increased except
Kantichildren'sHospitalin2067/68comparedto2066/67.
Table5.6:CentralLevelHospitalsStatistics,2065/66to2067/68
NameofCentralHospital
NationalAcademyofMedicalSciences(NAMS)Bir
Hospital
KantiChildren'sHospital
ParopakarMaternityandWomen'sHospital
MentalHospital
SukrarajTropical&InfectiousDiseaseHospital
ShahidGangalalNationalHealthCentre
BPKoiralaInstituteofHealthSciences
Fiscal
Beds
Years
Available
2065/66
460
2066/67
2067/68
2065/66
314
2066/67
2067/68
2065/66
415
2066/67
2067/68
2065/66
45
2066/67
2067/68
2065/66
100
2066/67
2067/68
2065/66
150
2066/67
2067/68
2065/66
585
2066/67
2067/68
Outpatients&
emergencycases
325,920
319,079
336,400
155,858
158,640
149,951
164,970
170,491
176,728
23,233
26,182
28,022
25,828
24,689
16,230
99,253
104,217
111,271
311,660
330,640
333,190
Inpatients
9,303
10,396
10,935
10,924
11,302
9,520
26,547
28,821
29,268
730
826
893
5,636
3,843
3,874
8,268
11,492
12,301
34,952
38,095
38,909
Source:RespectiveHospitals
149
CurativeServices
Table 5.7 shows the Bed Occupancy Rate, Death Rate among inpatients in 2067/68 in central
hospitals.Thebedoccupancyrateofthesevencentralhospitalsrangesfrom34percentinSukraraj
Tropical & Infectious Disease Hospital to more than 92 percent in Kanti Children's Hospital. The
highest bed occupancy rate (92%) is observed in Kanti Children's Hospital followed by Paropakar
MaternityandWomen'sHospital(84%)comparedtootherhospitalsandthelowestbedoccupancy
ratewasobservedinSukrarajTropical&InfectiousDiseaseHospital(34%).Thehighestdeathrateof
5.6 percent among inpatients was reported in National Academy of Medical Sciences (NAMS) Bir
HospitalfollowedbyBPKoiralaInstituteofHealthSciencesat3.3percent.Latearrivalorarrivalat
the critical stage was reported as one of the main reasons for the high death rate among the
inpatients.
Table5.7: Bed Occupancy Rate, Death Rate among Inpatients and Percentage of Female Patients
treatedbyCentralHospitals,2065/66to2067/68
NationalAcademyofMedicalSciences(NAMS)
BirHospital
ParopakarMaternityandWomen'sHospital
MentalHospital
SukrarajTropical&InfectiousDiseaseHospital
ShahidGangalalNationalHeartCentre
BPKoiralaInstituteofHealthSciences
Fiscal
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
Bed
OccupancyRate
67.0
72.4
53.2
90.3
91.5
92.2
75.0
80.4
84.0
95.1
72.8
82.0
37.6
30.9
34.3
77.9
77.4
78.1
73.2
75.8
69.7
DeathRate
(Inpatients)
10.4
7.8
5.6
1.7
1.2
1.8
0.0
0.0
0.0
0.%
0.%
0.%
1.1
2.0
2.1
1.1
2.4
2.4
3.4
3.5
3.3
Female
(%)
NA
NA
NA
NA
NA
NA
100
100
100
NA
NA
NA
NA
NA
NA
NA
NA
NA
85.0
NA
NA
Table 5.8 and Table 5.9 show the five leading causes of morbidity and mortality pattern among
inpatients within the seven central level hospitals. The five leading causes of inpatients morbidity
and mortality are quite different because of the different services are being provided by the
differenthospitals.
150
CurativeServices
Table5.8:FiveLeadingCausesofMorbidityamongInpatients,2067/68
CentralHospitalName
NationalAcademyofMedical
Sciences(NAMS)BirHospital
ParopakarMaternityandWomen's
Hospital
MentalHospital
SukrarajTropical&Infectious
DiseaseHospital
SthahidGangalalNationalHear
Cemter
BPKoiralaInstituteofHealth
Sciences
I
Fracture
(614)
Pneumonia
(3,677)
Delivery
Bipolar
affective
disorder
Gastro
enteritis
(2,167)
Coronary
Artery
Diseases
Normallive
born
(9,020)
FiveLeadingcausesofMorbidity(no.ofpatients)
II
III
IV
V
COPD
Cholelithiosis
Appendicitis
HeadInjury
(448)
(447)
(375)
(331)
AcuteA/G
NNS
Abscess
EntericFever
(998)
(498)
(252)
(249)
Abortion
Menstrual
Hyperemesis
Fibroid
Complication
disorders
Gravidarum
Uterus
Schizophrenia
Alcohol
Depression
AcuteAnxiety
&related
Dependent
disorders
disorder
Syndrome
PLHA
EntericFever DengueFever
Snakebite
(424)
(267)
(203)
(209)
HeartFailure
Normal
delivery
(6,245)
Congenital
Heart
Diseases
Caesarean
Section
(2,521)
Rheumatic
Heart
Diseases
Cholelithiasis
(1,258)
Infective
Endocarditis
Acute
Appendicitis
(1,258)
Table5.9:FiveLeadingcausesofMortalityamongInpatients,2067/68
CentralHospitalName
NationalAcademyof
MedicalSciences(NAMS)
BirHospital
I
COPD
(64)
ParopakarMaternityand
Women'sHospital
MentalHospital
SukrarajTropical&
InfectiousDiseaseHospital
ShahidGangalalNational
HeartCentre
BPKoiralaInstituteof
HealthSciences
NNS
(109)
FiveLeadingCausesofMortality
II
III
IV
Pneumonia
CVA
Burn
(38)
(37)
(37)
V
ALD
(31)
Malnutrition
(6)
Meningitis
(2)
Encephalitis
(2)
Eclampsia
(3)
Respiratory
Diseases
(39)
PPH
(1)
Septicemia
(1)
PLHA
(57)
Coronary
Artery
Diseases
Cardiac
Arrest
(104)
Tetanus
(7)
Rheumatic
Heart
Diseases
Birth
Asphyxia
(100)
G/E
(4)
Congenital
Heart
Diseases
LowBirth
Weight
(94)
Rabies
(4)
HeartFailure
Hepatitis
(2)
Arrhythmia
Septicemia
(71)
Bacterial
SepsisofNB
(65)
Table5.10showsthepercentageofexpenditurebythecentralhospitalswithrespecttothereleased
budget. The lowest percentage of expenditure was observed in BP Koirala Institute of Health
Sciences (78.3%), National Academy of Medical Sciences (NAMS) Bir Hospital (84.6%) followed by
KantiChildren'sHospital(89.5%)in2067/68.
151
CurativeServices
Table5.10:AllocatedBudget,ReleasedandExpenditureinCentralHospitals,2065/66to2067/68
NationalAcademyof
MedicalSciences(NAMS)
BirHospital
ParopakarMaternityand
Women'sHospital
MentalHospital
SukrarajTropical&
ShahidGangalalNational
HeartCentre
BPKoiralaInstituteof
HealthSciences
Fiscal
Year
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
2065/66
2066/67
2067/68
Allocated
(Rs.)
519,850,000
642,563,100
585,836,873
51,563,000
95,095,000
268,566,000
53,153,641
92,500,000
94,747,649
14,000,000
14,301,773
26,808,850
41,900,000
50,500,000
58,895,351
NA
632,000,000
804,179,669
110,000,000
169,350,000
230,000,000
Released
(Rs.)
519,850,000
642,563,100
585,836,873
50,500,000
90,829,000
268,566,000
53,153,641
92,500,000
94,747,649
13,872,377
14,301,773
26,372,136
40,796,565
50,500,000
54,819,311
NA
632,000,000
804,179,669
110,000,000
169,350,000
230,000,000
Expenditure
(Rs.)
484,467,000
610,864,771
493629055
46,598,000
90,829,000
240,452,257
53,153,641
91,559,000
93,444,217
13,872,377
14,301,773
25,301,679
40,796,565
49,001,660
54,819,311
NA
610,833,000
988,262,435
110,000,000
169,350,000
180,054,204
Expenditure
(%)
93.0
95.1
84.6
92.3
95.5
89.5
100
98.9
98.6
99.0
100
95.9
97.0
97.0
100
NA
96.6
100
100
100
78.3
5.3
Manpowerretention&limitedinfrastructures.
Budgets:budgetforpoorpatientscareandothers.
Hospitalequipmentsandreplacement.
Procurementsystemandsecuritieschallenges.
LackofAmbulancesforservicedeliverytothepatients.
Expansionofhospitalbedsandbirthingcentres.
ImprovementofLaboratoryInformationSystem(LIS)andHospitalMedicalRecordkeeping.
Note:PleaseseeAnnexes3.12,3.13and3.14.
152
Chapter6
6.1
SupportingPrograms:HealthTraining
SUPPORTINGPROGRAMS
HEALTHTRAINING
6.1.1 Background
TheHealthCareDeliverySystemhasremainedcompetentinprovidinghealthcareservicesuptothe
communitypeoplethroughdevelopingskilledhumanresources.Butatthesametime,thetraining
system still needs to be improved to the proficient level to meet the international quality. Skilled
Human Resource for Health is the main component to meet its standard. Ministry of Health and
Populationaccordhighpriorityforthedevelopmentofcompetenthumanresourcethroughvarious
meansoftrainingactivitiesthroughdevelopingtrainedhumanresourceforbetterimprovementin
healthcareservicedelivery.TomaterialisethisfactNationalHealthTrainingStrategy(NHTS)2004
has been revised and updated. The NHTS2004 focused on development and management of
human resources at all levels for delivering quality health care services, for which national health
training centre has felt real need in quality training system through shared responsibility with
NGO/INGOandprivatesectorintrainingprograms.Atthesametime,ithasfocusedonoverseeing
all training need of MOHP through coordinated and complimentary efforts of all stakeholders of
MoHPandEDPs,privatesectortrainingresourcesunderthestewardshipofMoHP.Thestrategyalso
envisaged for an integrated national health training system to maximise quality training for all
resourcepersonsandtraineehealthworkers.
NationalHealthTrainingCentreisanapexbodyforhumanresourcedevelopmenttowardsmeeting
NHSP Outputs and millennium development goal 4, 5, and 6 for the Ministry of Health and
Population.Thus,itaimstocaterthetrainingneedsofvariousDivisions/CentresofDepartmentof
Health services (DoHS), Department of Drug Administration and Department for Ayurveda under
MoHP.
TrainingNetwork
The National Health Training system is an integrated and cross cutting efforts towards meeting
training needs to support the quality health care delivery throughout the country. It supports to
policies, plans and activities of MoHP to be addressed through training to contribute in achieving
nationalgoalsandtargets.NHTCisorganizedbytheDirectorwithateamofadministrators,senior
leveltrainingofficersandtrainersatthecentreandRegionalHealthTrainingCentres(RHTC)atthe
regionallevels.Theyprovidetechnicalaswellasmanagerialinputsatthenational,regional,district
and community level training programs with appropriate and quality training need assessment,
training delivery, monitoring, evaluation, post training follow up and research related activities on
publichealthandhealtheducation.
Training is delivered through the network of National Health Training Centre, 5 Regional Health
TrainingCentres,oneSubRegionallevelHealthtrainingcentre,districtleveltrainingfacilitiesin30
districts and 14 Training Health Posts in appropriate district sites. A team of 57 district training
teamprovidetrainingtotheconcerninghealthworkerofPHCC,HPandSHPs.Besidesthis,thereare
19 clinical training sites attached to Regional and Zonal hospitals for providing clinical competency
basedtrainingintheareaofFP,SM,andClinicalserviceManagement.
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Vision
The vision of NHTC is to develop as a National Health Training Academy to Institutionalize Training
System Thus the training system which will be sustained and capable of responding to training
requirements of all stakeholders being involved in health care delivery system up to the community
level.
Mission
The National Health Training Centre helps to develop Human Resources to facilitate Health System
Planners,Programmangers,Trainersinpreparingandimplementingtheirtrainingprogramsandtrain
serviceprovidersforsuccessfulimplementation.
Goal
TheoverallgoalofNHTCistoproduce/prepareefficienthealthserviceprovidersbymeansoftraining
tocontributetodeliverqualityhealthcareservicestowardsattainmentofthehighestlevelofhealth
status.
Objectives
AssesstrainingrequirementsofHealthWorkersandpreparetrainingplansbasedontheprograms
requirement.
Plan,implementandtrainhealthworkersasdemandedbyprograms.
Design, develop and refine teaching, learning materials to support implementation of training
programs.
Develop/improve capacity of trainers to deliver quality training at central, regional and district
level.
SupportRHDsandDHOsinorganizing,implementingandevaluatingthetrainingprograms.
Coordinate with all National and International, Governmental and NonGovernmental
Organizationstoavoidduplicationoftrainingandimprovequalityoftraining.
Orientnewlyrecruitedhealthworkersonhealthprograms.
Supervise,monitor,followupandevaluatetrainingprograms.
Conductoperationalstudiestoimprovetrainingefficiencyandeffectiveness.
OrganizeInternationalTrainingasperneed.
EstablishTIMSforthequalityrecordingandreportingsystemsofalltrainingprogramsatcentral,
regional,district,andcommunitylevels.
Strategies
NationalHealthTrainingCentreunderMoHPoperationalizestrainingactivitiesinlinewithNational
Health Training Strategy 2004. The NHTC is responsible for developing human resources of the
Department of Health, Department of Drug Administration and Department of Ayurveda. The
trainingactivitiescanbebroadlyclassifiedintotwothemesas:InServicetrainingandInternational
trainingcategories.
154
1.
Training
NHTCprovidesfollowingtrainingactivities:
Initial and Basic Training: Although Initial training for VHWs/MCHWs had been phased out if new
recruitmentisdonebyDoHSitwillmanagetoconductifnecessary.NHTCoffersbasictrainingfor
FCHVs,ANMbasictrainingwasconductedduringthereportingperiod.
UpgradedTraining:NHTChasbeenofferingseveralupgradedtrainingcoursese.g.,MCHWstobecome
ANMs,trainingofANMsandAHWstobecomeSeniorANMsandSeniorAHWsrespectively.
SpecialisedTraining:NHTCconductsspecialisedtrainingtoserviceproviderswiththehelpofclinical
training sites, to enable service providers to do additional responsibilities. For example after
receiving IUCD/Implant, VSC, Minilap, BEOC, SBA, USG training become able to provide services
specialisedinsuchareas.
Inservice Refresher Training: In service refresher training are short course training required by
ProgramDivisionsandCentresforimplementingnewprogramsandimprovingjobperformanceof
healthworkers.NHTCorganizessuchtrainingatcentre,regionandatthedistrictlevelaswell.
OrientationPrograms:NHTCsupportsthedivisionsandcentresindevelopingorientationpackages,
preparing master trainers for conducting various orientation of short duration for health workers
andnonhealthworkercategory.Allnewlyrecruitedhealthstaffofvariouscategoriesbeforejoining
theirworkareprovidedorientationprogramofshortdurationonhealthpolicy/healthcareservice
deliverysystemandtheirrolesandresponsibilities.NHTCalsoassistsdistrictsinconductingvarious
advocacy and orientation programs for Community Leaders and Health Management Committees,
Orientation to District Development Committee (DDC)/Village Development Committee (VDC)
membersonprogramslikeFCHV,PHC/ORCmanagement.
2.
CertificationandAccreditation
NHTC is responsible to accredit and certify institutions offering short non clinical, clinical
competency based training courses. The institutions should be accredited before providing such
training courses. Training courses of more than one month duration will be accredited as part of
careerdevelopment.NHTCprovidescertificatesaftercompletingabovetrainingprograms.
3.
InstitutionalDevelopment
Humanresourceneedsisreviewedregularly.AnInventoryofpotentialtrainersisbeingmaintained.
Eachdistricthasateamof57competenttrainerstoconductlocallyidentifiedtrainingneeds.One
healthlearningmaterialdevelopmentunithasalreadybeenestablishedunderNHTC.
PhysicalFacility
Existingphysicalfacilitiesincludingequipmentwillbereviewedandwillidentifyadditionalneeds
ifnecessarybasedonthenatureoftraining.
So far most of the in service training takes place at Regional Training Centres, district level,
trainingfacilitieswillbedevelopedgradually.
OneadditionalSubRegionalTrainingCentrewillbedevelopedatKarnaliZone.
155
A formal link is being maintained between Government National Health Training System and
otherprivate/autonomoushospitalsforclinicaltrainingpurposes.
HealthTrainingProgramDevelopmentandCoordination
Trainingisacrosscuttingsupportprogramtocontributeforeffectivehealthservicesdeliveryinthe
countrywithitsoptimallevelqualityoftraining.Infrastructureandlogisticssupportactivitieswere
managed with the help of GON/MoHP system. Planning, monitoring, supervision, followup and
evaluationfunctionsareinstitutionalizedatalllevelofthehealthtraining.Thereisalsoarrangement
ofbefore,duringandaftertrainingprogramevaluationincludingatthespotcoachingbyproviding
technical, human resource, logistics and financial support. Institutional/personnel performance is
being reviewed after end of the training. In this regard, the strengths, weaknesses, opportunities,
problems and constraints of training are assessed, at the end of each fiscal year, for improving in
planningnextyear'strainingprogramandactivities.
CapacityBuilding
The health service providers need competencies to provide specific services based on the service
protocols,programmodalitiestotheextentaspertheneedofthepeople.NHTCmakeseffortsto
meetthiscapacitybuilding,
CoordinationMechanism
NHTChasbeenplanning,implementingmanagingtrainingneedofvariousDivisions,Centreof
MoHP/DoHS and providing support for quality service improvement in coordination and
collaboration with the partnership of various institutions of MoHP including the EDPs and NGOs,
Privatesector,Medicalcolleges.
SupportfromUNandOtherInternationalDevelopmentPartners
Various EDPs are providing collaborative supports to National Health Training Centre in planning
andexecutionoftrainingprograms.TheEDPsandtheprogramstheyhavebeensupportingareas
follows:
USAID/NFHP: Family Planning, Logistic Training, HFOMC, FCHV, quality monitoring tools in
clinicaltraining.
DFID/SSMP:MaternalandneonatalhealthcareTraining:SBA,Anesthesia,Infectionprevention,
Clinicaltrainingsitedevelopment.
NSI:Anesthesia,BiomedicalEquipmentR/M.
MSI/SPN:ConductionofFPtraining,SupportonFamilyPlanningTraining,SAStraining.
CFWC/NFCC:ConductionofFPtraining,SupportonFamilyPlanningTraining.
FPAN:FPTraining,advocacy,ASRHtrainingResourcepersonsupport.
UNFPA:RHorientation,SBA,IUCD,ASRH,Genderandhealth,GenderBasedViolence,Behavior
ChangeCommunication,strengtheningtrainingcapacitybuilding,COPE/PLA.
WHO:PreserviceTrainingforGONhealthworkers,supportinCurriculumDevelopmentstudies.
UNICEF:SBATraining,TechnicalAssistance.
IPAS:SASTraining.
PSINepal:FPtraining,MedicalAbortion(MA)training,etc.
Recently NHTC, through a Training Working Group is undertaking several initiatives towards
strengthening its capacity in improving quality of training, package development, Preparing
156
Trainers,developmentofIntegratedworkplaninconsultationwithvarioussupportpartnerslike
NFHPII,PSINepal,FPAN,CFWC,UNFPA,NSI,MSI/SPN,IPASandNHTChasalsoassessedFPtraining
sitesandprovidedsupportforimprovingqualityandperformanceoftheFPrelatedtrainingsandRe
functionalizedFPtraininginMaternityHospital.AfterassessmentoftheFPTrainingSitesusingFPQI
(FP quality Improvement tools) support was provided to upgrade it, built capacity of its human
resource to conduct FP training. Also strengthened FP training sites (CFWC, ICTC Nepalgunj,
MaternityHospital,FPAN,KoshiZH)andreviewed,updatedandfinalizedTrainingPackagese.g.:CTS,
IUCD and Infection Prevention Training Package, Procurement Planning, Auctioning, Writeoff and
DisposalGuidelines(logistic)trainingpackages.
FinancialResources
AnnualProgrambudgetisallocatedtoEachRHTCandselecteddistrictsforimplementingcentral
anddistrictleveltrainingprogramsrespectively.Itisalsoenvisionedtoallocateannualgrants
forinitiatinglocallyorganizedtrainingbasedonthenumberandextentoftrainingneeds
Funding provision, in future, will be made on the basis of decentralized planning of the
respectivetraininginstitutions
Mechanism will be explored for generating/mobilizing local resources by each training
institutions
Coordinated financial planning with need based resource allocation is carried out with the
participationofallstakeholders.
PolicyMaking,Networking,LinkagesandCoordination
ACentrallevelNationalHealthTrainingCoordinationCommittee(NHTCC)chairedbysecretary
MoHP with the participation of Directors from National Administration Staff College (NASC),
Local Development Training Academy, Training Institutions from IOM, MOE, CTEVT, private
hospitals was formed and made functional for promoting intersectoral cooperation and
coordination.NHTCwillfunctionassecretariat
SimilarlylocallevelcoordinationcommitteewillalsobeformedatRegionalandDistrictLevel
StrengtheningtheTrainingInformationManagementSystem(TIMS)willensurecompliancewith
theNationalHealthTrainingstrategy2004.
Research
Atrainingresearchisneededtoidentifyproblemofhealthworkersandconductoperationaswellas
evidencebasedresearchontrainingtoexplorewaystoimprovethequalityoftraining.
4.
TrainingFunctions
TheNHTChasbeenundertakingthefollowingtrainingfunctions:
Assess Training Requirements of Health Workers: National and district training teams identify
trainingrequirementforeachcategoryofhealthworkersanddesigncoursesaccordingly.
TrainingMaterialsandHumanResourceDevelopment:Trainingmaterialsaredesigned,developed,
updatedandrevisedasperidentifiedtrainingrequirements.
Training Program Management and Implementation: Training programs are implemented in close
collaboration with the partner/stakeholders following the set policy, strategy, protocol and
157
guidelines. The management and implementation of local level training programs is managed at
local level institutions and updates through its national health training monitoring information
system.
Physical Assets Management and Implementation of Health Training Implementation Fund:

Physical assets management includes strengthening of existing training facilities, repair and
maintenance of medical equipment laboratory etc. The Health Training Implementation Fund
Procedure guideline 2059 facilitates to generate fund from the utilization of various training
facilities.
Supervise, Monitor, Followup and Evaluate the Training Activities: There is an established
mechanism of supervision, monitoring, followup and evaluation of the training activities in co
ordination with relevant stakeholders involved in training. The shared efforts provide feedback to
NHTCtoassertqualityoftrainingprograms.
5.
TrainingProcess
Allinservicetrainingscomplywithsystematictrainingcycle,
Training quality is maintained through use of standard training curriculum, lesson plans,
qualitymonitoringtool,
Major emphasis on competency based training approach following basic principles of clinical
qualityoftraining.
6.
HealthTrainingTargets
Indicatorsformeasuringachievementsarelistedbelow:
Indicator
NumberoftrainedHW
NumberoforientedHW
NumberoforientedLHFMOC
Numberoftrainedvolunteers
(FCHVs)
Description
Expresses the number of trained health personnel out of targeted
numbertobetrainedinthegivenfiscalyear
Expresses the number of oriented health personnel out of targeted
numbertobeorientedinthegivenfiscalyear
ExpressesthenumberoforientedLHFMOCoutoftargetednumberof
handoverofhealthfacilitiestothelocalbodiesinthegivenfiscalyear
Expressesthenumberoftrainedvolunteersoutoftargetednumberto
betrainedinthegivenfiscalyear
1.
CentralLevelTrainingPrograms
NationalTrainingSystemStrengtheningactivities
From above table it is seen that NHTC conducted some national training system strengthening
activities for central, Regional Trainers on training methodology, training of trainers to district
trainingTeam.
Basic Training: 32 women from various districts of Karnali Zone and Far Western Region received
basic ANM training course (100% achievement) continuation of last year program. This Training
wasaimedtosupportGovernment/sspecialprogramforpovertyalleviationforthissector.
InserviceTraining:Duringthereportingperiod,NHTCplannedandimplementedseveralInservice
trainingsinthegeneralcategoryforcentral/districtlevelprogramofficials,managersanddistrictand
158
below level health facility InCharges and service providers. The training programs were Gender
Based Violence (GBV), Adolescent Sexual Reproductive Health (ASRH), Behaviour Change
communication(BCC),LogisticsManagement.
In clinical training, key component training was training of ANMs/SN for Skilled birth attendants
(SBA) working at district hospitals, PHCC, HPs in districts. The achievement reported was 808
Doctors/ANMs/SNtrainedonSBAagainsttargetoftraining895ANMs/SNs(90%achieved).
ItwaspleasingtonotethatNHTCwasabletomeet90percentofthetargetedSBATraining.Thiswill
helpsignificantlyinfillingthegapofrequirednumberofSBAserviceprovidersinmanyPHCC/HPsof
the country. NHTC also was able to meet target of training Medical Officers in Non scalpel
Vasectomy,MinilapararatomyandIUCD,ImplanttrainingtoSN,ANMs.Achievementwasaround63
percentinvasectomy,MinilapwhileIUCD,Implant,had100percentachievement.Thisnumberof
trainedFPserviceproviderswillhelptoprovideVSCservicesinneedyareas.
OtherClinicaltrainingimplementedwere:
SafeAbortionServices(SAS)
Clinicaltrainingskills(CTS)
OperationTheatre(OT)Management
NursingClinicalservicemanagement
Infectionprevention
MinimumInitialServicesPackage(MISP)
EmergencyNursingManagement,ICCU,clinicalservicemanagement
Achievementinthesetrainingwasabove83percent.Thesetrainingwillalsohelpinstrengthening
ClinicalservicedeliverymanagementatHospitals.NHTCstartedtrainingserviceprovidersingender
basedViolence(GBV)totheserviceprovidersofHospital/PHCCwhichwillhelpinprovingmedicalas
wellassocialpsychologicalhelpvictimsofGBV.Themanagementstrengtheningtrainingprovidedto
Health Facility Operation Management Committee will help in improving the management of
handedoverHealthFacilitiesatcommunitylevel.
RefresherTraining:Refreshertrainingwasprovidedto35VHWsfor5weeks.
UpgradingTraining
NHTC provided upgrading training for MCHWs to receive ANM training to serve with ANMs job
responsibility,AHWstoreceiveSr.AHWtoservewithSr.AHWsresponsibilityandANMtoreceive
Sr. ANM to enable them to perform job of a senior ANM. The achievement in this category of
training was (100% for MCHW to ANM, 76% for ANM to Sr ANM, but AHW to Sr. AHW program
couldnotbelaunchedasselectionofparticipantscouldnotbedone).Itisexpectedthatwiththese
upgraded training the health Facilities at district and below level will have service of experienced,
trainedmidlevelserviceproviders.
CommunityInvolvement/MobilizationActivities
NHTC has also introduced training on COPE/PLA (Client Oriented Providers Efficient/Participatory
LearningAction),toolforincreasingqualityservicesathealthfacilitieswiththeactiveinvolvementof
serviceprovidersandserviceusersandcommunityleaders.OtherkeytrainingwasforHealthFacility
Operation Management Committee Members (HFOMCM) training on strengthening their
managementcapacitytomanagehandedoverhealthfacilities.Achievementwasnearly100percent
159
against the given target. However some training could not be conducted due to late release and
unavailabilityofFund.
NHTC has increased monitoring and supervision of training activities to assure maintenance of
quality of training delivered. 300 monitoring visits were targeted and by the end of the reporting
period100percentmonitoringvisitachievementwerereported.
2.
DistrictLevelTrainingPrograms
In efforts to promote district level training NHTC provided several training to be implemented by
districts using their own trainers and support provided by RHTCs as and when needed. Training
activitiescarriedoutatthedistrictlevelarepresentedinAnnex1.Duetothelatereleaseoffund
sometrainingcouldnotbeconductedontime.
Table6.1.1presentsthecomparisonofprogressof4FiscalYears'activities.
Table6.1.1:PhysicalandFinancialProgressofFY2064/65to2067/68
Achievement
2064/65
93
61
62
Physical(%)
Financial(%)
ClearanceofFinancialArrears(%)
2065/66
82
48
41
2066/67
88
74
45
2067/68
80
63
39
As in the previous year the national performance review meeting recommended to manage a
separatepooloftrainersfromvariousdisciplineslikepublichealth,nursing,clinicalhealtheducation
for which NHTC has been continuously advocating but still not been materialized. Some of the
specific issue/problems and opportunities identified during implementation of training activities
notedinrecentregionalreviewmeetingsandNationalReviewmeetingaresummarizedbelow:
Issues
NoskillMixPersonnelat
TrainingCentres
RetentionproblemofTrainers
andHealthWorkers
Inadequatetrainingallowances
TrainedSBAs,AATs,BMETsnot
optimallyutilized
Opportunities
ReorganizationofMoHPisexpectedtohelpin
thisissue
Strictlyfollowedtransferpolicywillhelptosolve
thisissue
Minimumallowancesbeallocatedtomaintain
basicneeds(lodgingandflooding)
Servicedeliverycentresareavailablewith
equipmentsforutilizingthem
Responsibility
NHTC/DoHs/MoHP
MoHP/DoHS/All
Divisions/Centres
MoHP/DoHS/MoF
RHD/DHO
Table6.1.2presentsthebroadheadingoftrainingactivitiestobeimplementedatcentralleveland
Table6.1.3presentstheactivitiestobeimplementedatdistrictlevelin2068/69.
160
Table6.1.2:TrainingActivitiesPlannedatCentralLevelfor2068/69
SN
A
1
2
3
4
5
6
7
8
9
10
11
12
13
B
C
Activities
TrainingCentreStrengthening
TOTfordistricttrainers
ASBA(C/S)training
RefresherSBAtrainingforANM/SN/Doctors
SBAtrainingforANM/SN/Doctors
SASRefresherTrainingfordoctorsandnurses
SASserviceOJT
InfectionpreventiontrainingforHealthWorkers
HealthInstitutionDecentralizationProgram Training
ToTforFCHV(Centre&RHTC)
Nursing/MedicalserviceMgmtTraining
BiomedicalEquipment&MaintenanceTrainingforAssistants
BehaviorChangecommunicationtrainingfordistrictsupervisors
COPE/PLATrainingforserviceproviders
GenderBasedViolenceandConflictManagementTraining
FamilyPlanningTraining
COFP/Counseling
MinilapforMedicalOfficer&NursingStaff
NonScalpelVasectomy
IUCDtrainingfornurses
Implant(Nurse/Paramedic)
MCHWtoANM
ANMtoSr.ANM
AHWtoSr.AHW
UpgradingTraining
MCHWtoANM
ANMtoSr.ANM
AHWtoSr.AHW
EmergencyServicemgtTrainingforMOsofDistrictHospital
MinimumInitialServicePackageTrainingforserviceproviders
RehabilitationTraining
AnesthesiaAssistantTraining
UltrasoundtrainingforMedicalofficers
MidLevelPracticumTrainingforHA/SN
ClinicalSkillsTrainingforSBAtrainers
Hospital/HealthFacilityManagementtrainingforHWs
TrainingMethodologyTraining(DTOT)
ICUmanagementtrainingforMO/Staffnurses
MedicoLegaltrainingforMedicalofficers
MentalHealthmgt.trainingfordistricthospitalserviceproviders
OTManagementtrainingforSNs
PublicProcurementtraining
InternationalTraining
Annualprogramreview,planningforSBAtraining
AnnualTrainingprogramreview/planning
SupervisionandfollowupforPostSBAtrainingfollowup
Monitoringandsupervision
Table6.1.3:TrainingActivitiesPlannedatDistrictLevelfor2068/69
SN
Programs/Activities
Unit
Person
Person
Person
Person
Person
Person
Person
Committee
Person
Person
Person
Person
Person
person
person
person
person
person
person
person
person
person
person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Batch
Time
times
Time
times
Target
15
30
200
950
100
50
420
100
190
60
48
25
175
120
120
100
100
80
100
60
100
295
60
100
295
40
40
20
18
36
60
16
120
150
40
30
40
36
15
2
1
1
300
300
Unit
Target
FemaleCommunityHealthVolunteerTraining
Persons
4200
Mothers'Group'sOrientation
Persons
4200
ToTforHWsonFCHVTraining
Persons
50
161
SupportingPrograms:HealthEducation,Information&Communication
6.2
HEALTHEDUCATION,INFORMATIONANDCOMMUNICATION
6.2.1 Background
In1991newhealthpolicywasinitiated.Followingthispolicy,NationalHealthEducation,information
andCommunicationCentre(NHEICC)wasestablishedundertheMinistryofHealthandpopulationin
1993, with the mandate to give high priority to information, education and communication in the
healthsector.
This centre is responsible for developing, producing and disseminating messages to promote and
support health programs and services in an integrated manner. For this purpose, all districts have
Health education, information and communication programs since FY 2051/52. The Health
education and communication units in the district Health Offices works to meet the increasing
demand for health education services by implementing IEC activities utilizing various media and
methods according to the needs of the local people in the district. Local media and languages are
used in the district for dissemination health messages so that people can understand health
messagesclearlyintheirlocalcontext.
Goal
ThegoaloftheNationalHealthEducation,informationandCommunicationCentreistocontribute
to attainment of the highest level of health of the people of the country and to contribute and
supportintheachievementofMDGs3,4,5,6and7;andgoalandobjectivesofotherprogramsand
services
Objectives
ThegeneralobjectiveofIECforhealthistoraisethehealthawarenessofthepeopleasameanto
promote improved health status and to prevent disease through the efforts of the people
themselvesandthroughfullutilizationofavailableresources.Thespecificobjectivesoftheprograms
areto:
Increaseawarenessandknowledgeofthepeopleonhealthissues
Increasepositiveattitudestowardshealthcare
Increasehealthybehavior
Increaseparticipationofthepeopleinthehealthinterventionprogramsatalllevelsofhealth
services
Increaseaccesstonewinformationandtechnologyonthehealthprogramsforthepeople
Promoteenvironmenthealthandhygiene
ControlthetobaccoandNonCommunicableDiseases(NCDs)
Strategies
Implementing IEC interventions in an effective manner at the national, regional, district and
communitylevel
Ensuring adequate supply of IEC/BCC materials to service outlets by using private and
governmentdistributionsystem
Ensuring and mobilizing the participation of community, INGOs, NGOs, local bodies, social
workersandindividuals
162
Building institutional capacities at various levels of interventions through training, orientation
andworkshop
Developing, producing and disseminating uniform, accurate, appropriate and adequate
messagesonhealthbasedonthelocalneedsandaudience
Usingmultimediaapproachestodisseminatehealthinformationtopeopleofcommunitylevel
Emphasizinginterpersonalcommunicationinthecommunitylevelinterventions
Establishingandstrengtheningcoordinationandcooperationwithrelatedgovernmental,non
governmentalandinternationalorganizationatalllevel
Strengtheningmonitoringandsupervisionactivitiesatdifferentlevelofinterventions
Conducting research on different discipline of IEC/BCC to determine the gaps in KAP among
targetaudiencesandgapsinKAPamongserviceproviders
Segmentingaudienceanddevelopingspecificmessageforspecificaudiencegroupbasedonthe
research
FunctioningNationalIEC/BCCCoordinationCommitteeandTechnicalCommitteesinthecentral
levelconsistingoftherepresentativesfromrelatedGOs,NGOsandINGOsforprovidingapproval
and guidance in order to disseminating uniform, accurate, appropriate and adequate health
messagestothepeople
Establishing national resource centre for proper management and dissemination of IEC/BCC
materialsandmessages
Strengthening recording and reporting system in community, district and regional level HIEC
activities
Conductingadvocacyatalllevelsthroughnationalandinternationalhealthrelatedevents
Emphasizingforsocialinclusionandgenderatalllevels
CentralLevel
Policy,strategyandprogramdevelopment
Programguidelineanddirectivedevelopment
Health Program and short messages development, production and airing through Radio,
TelevisionandFM
MessagesdevelopmentandpublicationthroughNewspaper
IECmaterialsdevelopment,productionanddistribution
Program orientation to regional and district level program manager and focal person in five
regions
AdvocacyGlobalHandWashingDay,WorldHealthDayandWorldNoTobaccoDayCelebration
CoordinationTechnicalcommitteesmeetings
Capacitybuildingonhealthcommunication
Conductionofhealthcommunicationresearches
Supervision,Monitoringandevaluationofhealthcommunicationprogram
RegionalLevel
RadioprogramairingfromregionalRadioNepal
supervisionandMonitoringofIECactivities
Orientationtojournalistandstakeholdersonhealth
Sensitizationprogramforpreventionandcontrolofepidemics
DistributionofIECmaterialsfromRegionalmedicalstore
163
DistrictLevel
StrengthendistrictIECcornerbysupportingelectronicequipments
Sensitizationprogramforpreventionandcontrolofepidemics
ProductionofneedbasedIECmaterials
DistributionofIECmaterialsinhealthfacilities
ProductionandairingofhealthradioprogramsandmessagesthroughlocalFMradio
Exhibitiontopromotehealthservices&program
Communityhealthpromotioncampaign
Communityinteractionprogramforhealthservicepromotion
Publicationofhealthmessagesinprintmedia
Essentialhealtheducationprograminschool
Sensitizationprogramagainstgenderbasedviolence
Orientationonhealthissuestomediapersons
Orientationtohealth&sociologyteacheronhealthissues
Orientationtojournalistandhealthcommunicatorsonhealth
IECprogramonantitobaccoandnoncommunicablediseases
Sensitizationprogramonenvironment&Occupationalhealth
ConductIECcornerineachhealthfacilities
EncourageFCHVstopromotehealtheducation
SupervisionandMonitoringofIECactivities
NewInitiatives
TobaccoProductControlandRegulatoryAct2011
LicensingofPicturesfromThailand,SingaporeandEU
AwarenessandActionsonSmokingBaninPublicPlacesSticker,Poster,HoardingBoard
TobaccoProductPictorialHealthWarningonTobaccoProduct'sPacketsandPackaging
SchoolBasedHandWashingwithSoapandWater
Climate Change and Health Activities in support from Ministry of Environment School and
Communityorientation,AwarenessKit,RadioandTVMessages
DevelopmentanddistributionofsetofBooklets(eightbookletsinaset)forAdolescents
6.2.3AnalysisofAchievement
The physical and financial progress of the regular IEC activities carried out by NHEICC in first two
fiscalyearswasinincreasingtrendbutinFY2067/68thephysicalandfinancialprogressdecreased
by6percentand2percentrespectively(Table6.2.1).Thiswasmainlybecausetherecommendations
of the formative research done in 2006 were not implemented. The delay in approval from the
MoHPforcostestimationwasoneofthereasonsfornotcompletingthisactivity.
Table6.2.1:TrendofPhysicalandFinancialAchievement
Program
RegularIECprogram(%)
IECprogramofTobacco
controlprogram(%)
IECprogramofAvian
Influenzacontrolprogram(%)
FY2065/66
Physical
Financial
89.8
81.1
97.7
99.9
92.5
71.9
FY2066/67
Physical
Financial
98.3
92.6
100
99.7
98.3
92.6
FY2067/68
Physical Financial
91.9
90.4
100
99.6
100
98.6
Source:NHEICCAnnualReport
164
ThephysicalandfinancialprogressofIECactivitiesonTobaccocontrolprogramwasaroundhundred
percentinthelasttwofiscalyearsandwasmaintainedintheFY2067/68.Similarly,thephysicaland
financialprogressofIECactivitiesonAvianInfluenzacontrolprogramisalsoinincreasingtrendover
thelastthreeyears.
According to NHSP2, Health education and communication is crosscutting to all health programs,
aimingtoincreaseknowledgeandimprovebehaviorsregardingkeyhealthissuesofallcastes,ethnic
groups, disadvantaged, and hardtoreach population. It also aims to create demand for quality
essential health services, thereby improving access, creating public trust in health services and
ultimately encouraging people to utilize the existing health services and mitigate public panic and
respondtocommunicationneedsduringemergencysituations.
NDHS 2011 preliminary report shows decrease in TFR, IMR, CBR and MMR. The report also shows
reductioninprevalenceofanaemiaamongpregnantwomenandchildren.Knowledgeofinformants
about HIV/AIDS has been found increased. Utilization rate of available health services has been
increasedaccordingtothereport.ThereiscorrelationwiththehealthindicatorsofNDHS2011and
impactofhealtheducation,informationandcommunicationprogram.
Table 6.2.2 presents the problems/constraints discussed during the regional and national reviews
2066/67andtheactionstakenin2067/68toovercometheseconstraints.
Table6.2.2:IssuesandActionTakenBasedonNationalandRegionalReviewsFY2066/67
LeastbudgetallocationforHEICprogram in
relationtoprogrambudget
ProgramspecificIEC/BCCinterventionneedto
strengthenforhardtoreachgroupandurbanslum
PositionofHealthEducationSupervisoratdistrict
levelwasdissolved
Weakmanagementofhealtheducationactivitiesin
districts
Actiontaken
RequestedformorebudgetprovisiontoDoHS,
MoHPandMoF
Planandbudgetpreparedandimplementedfor
hardtoreachandmarginalizedgroup
FileforwardedtoMoHPthroughDoHSforrevivalof
theposition
CreateHealthEducationOfficerposition
Table 6.2.3 presents the issues and recommendations based on the regional and national review
2067/68.
Table6.2.3:IssuesandRecommendationsBasedonRegionalandNationalReviews,FY2067/68
Actiontobetaken
Lessprioritytohealtheducationandcommunication Alldivisionsandcentrestogiveprioritytohealth
education,informationandcommunication
Focusonfreemedicinedistribution
FocusshouldbegiventoIEC/BCCactivities
BudgetallocatedforIIC/BCCisinadequate(0.7%of IncreasebudgetforIEC/BCCactivities
totalhealthbudget)
IEC/BCCactivitiesarenotintegrated(TB,Leprosy)
IntegrateIEC/BCCactivities
DumpingofIECmaterialsinthedistricts
RegularsupplyofIEC/BCCmaterials
InadequatetrainedmanpowerforHIEC
TrainingtoIEC/BCCprogram focalpersons
HETpostabolishedinAllDPHO/DHO
HETpostshouldberevivedbyMoHP
Outof20positionsofHEOatcentre,regionaland
PublicServiceCommissiontofulfilthevacantposts
districtlevel,13arevacant
165
SupportingPrograms:LogisticManagement
6.3
LOGISTICSMANAGEMENT
6.3.1 Background
Anefficientmanagementoflogisticsiscrucialforeffectiveandefficientdeliveryofhealthservicesas
well as ensuring rights of citizens of having quality of health care services. Logistics Management
Division (LMD) has been established under the Department of Health Services in 2050/51 (1993),
withanetworkofcentralandfiveregionalmedicalstoresaswellasdistrictlevelstores.Themajor
functionofLMDistoprocure,storeanddistributehealthcommoditiesforthegovernmenthealth
facilities. It also involves repair and maintenance of biomedical equipments, instruments and the
transportationvehicles.
In order to systematize the management of logistics information, the Logistics Management

Information System (LMIS) unit was established in LMD in 1994. LMIS Unit collects and analyses
quarterly (three monthly) LMIS reports from all the health facilities across the country; prepares
reportanddisseminatesitto:
estimateannualrequirementsofprogramcommoditiesincludingcontraceptives,vaccines,and
essentialdrugs;
help to make demand and ensure supply of drugs, vaccines, contraceptives, essential medical
suppliesatalllevels;and
monitorthenationalpipelineandstocklevelofkeyhealthcommodities.
OverallObjective
To plan and carry out the logistics activities for the uninterrupted supply of essential medicines,
vaccines, contraceptives, equipments, HMIS/LMIS forms and allied commodities (including repair
andmaintenanceofbiomedicalequipments)fortheefficientdeliveryofhealthcareservicesfrom
governmenthealthinstitutionsinthecountry.
Strategies
Logistics planning for procurement, storage and distribution of essential health care
commodities.
Introduce effective and efficient procurement mechanisms like multiyear procurement and
CentralBiddingLocalPayment(CBLP).
UseofLMISinformationinthedecisionmakingatalllevels.
Strengthen physical facilities at the central, regional, subregional and district level for the
storageanddistributionofhealthcommodities.
Promote webbased LMIS and Equipment/Expendable Items Inventory System in districts and
regions.
Repairandmaintenanceofbiomedicalequipments,instruments,coldstoreandtransportation
vehicles.
Capacitybuildingofrequiredhumanresourcesonlogisticsmanagementatalllevels.
Implement Pull System for year round availability of essential drugs and other health
commoditiesintheentirecountry.
166
Planfortheefficientmanagementonprocurement,storage,distributionandtransportationof
healthcommoditiesrequiredforthedeliveryofhealthcareservicestoallgovernmentalhealth
institutionsinthecountry.
Develop tender documents as per public procurement rules and regulations and procure
essentialmedicines,vaccines,contraceptives,equipments,differentformsincludingHMIS/LMIS
andalliedcommodities.
Store, repack and distribute medicines, vaccines, contraceptives equipments and allied
commodities.
Conducthealthlogisticsmanagementtrainings/orientationincollaborationwithNHTC,regions,
districtsandotherstakeholders.
ManagetoprintanddistributeHMIS/LMISforms,stockbooksanddifferentformsrequiredfor
allhealthinstitutions.
Support on implementation and functioning of webbased LMIS, webbased Equipment
InventorySystemandInventoryManagementSystemsoftware.
Managetomaintainthebiomedicalequipments,machineriesandtransportvehicles.
Implement and monitor Pull System for contraceptives, vaccines and essential drugs in the
districts.
Coordinatewithalldevelopmentpartnerssupportinghealthlogisticsmanagement.
Superviseandmonitorthelogisticsactivitiesofregion(RMS)anddistrictlevels(DPHO/DHO).
ImplementTelemedicineprograminthehillandmountaindistricts.
Procure,storeanddistributevarioushealthcommoditiesforProgramDivisionsoftheDoHS.
1.
LMISReportingStatus
Fig.6.3.1:LMISReportingStatus
The trend of total LMIS reporting from
healthfacilitiesisconsistentlyabove90%
overthreeyears(Figure6.3.1).TheLMIS
has helped to generate accurate and
reliable feedback reports, thereby
contributing to improved logistics
functions like budgeting, quantifying,
forecasting, procurement, storage,
transportation and distribution of MCH
commodities and essential drugs to be
procured by the centre. With closely
monitoring LMIS information, it has
played a key role in reducing stockout
rates and increasing yearround
Source:LMIS.
availabilityofkeyhealthcommodities.
Similarly,LMDhasimplementedwebbasedLMISandInventoryreportingsystemwiththesupport
fromDELIVER/NFHP.ThestoreassistantforthewebbasedLMISwerehiredsomemonthafterthe
beginning of the new fiscal year as a result total reporting through webbased LMIS was only 56
percent.
167
2.
AvailabilityofKeyHealthCommodities
Figure6.3.2:NationalStockout%ofHealthCommoditiesatHFs
Logistics Management Division aims
to make year round availability of
health commodities in all health
facilities. Availability of the key
commodities (Condom, Oral Pills, Inj.
DMPA, Tab. Iron, CotrimP, Caps. Vit.
A, ORS, Tab. Zinc sulphate) and
medicinesforfreehealthserviceshas
increased and the national stock out
of health commodities has been
steadily decreasing in every year
(Figure6.3.2).Theaverageavailability
of contraceptives, key MCH
commodities and selected essential
drugs has increased in HFs in
comparisonwithpreviousfiscalyears. FamilyPlanning=Condom,Injectables,andPills
MCHCommodities=ORS,VitaminA,Cotrim/p,andIronTablets
Thoughthedemandandconsumption EssentialDrugs=Albendazole,Paracetamol,Chloramphenarimine,Aluminium
of essential drugs has increased Hydroxide,Metronidazole,Chloramphenicol,GammaBenzene,Amoxycilline,
drastically after implementation of BenzoicAcid.(DataSource:LMIS(Stockoutinformationisquarterlyaverage
basedonover90%HealthFacilitiesreportingLMIS)
freehealthpolicyuptohospitallevel,
the stock out of the selected drugs has been reduced. However, there is a need to decrease the
stockout of essential drugs in the health facilities by the effective implementation of the Pull
System.
3.
MajorLogisticsActivitiestoStrengthenHealthCareServices
a.
Procurement
LMDcontinuedandaddedmorecommoditiesinthemultiyearprocurementinFY067/68.Condom,
Injectables, ORS, Iron Tablets, Essential Drugs are now being procured through multiyear
mechanism.Multiyearmechanismsavesbiddingandevaluationtime.LMDalsocompletedtheLIB
(limited international bidding) process in coordination with World Bank, in procuring Implants
directlyfromthemanufacturerandsavingahugeamountofmoney.
Adistrictwisebreakdownlistofessentialdrugsandquantitiestobeprocuredatthedistrictlevel,
basedonconsensusforecastwasdevelopedwithsupportfromNFHP.Thenthelistofessentialdrugs
and budget was sent to all districts by the Primary Health Care Revitalization Division (PHCRD).
Similarly, ebidding software, the terms of reference/guidelines was finalized and a workshop was
heldwithbiddersandDivisionpersonneltoreviewandsoftwareandtaketheirfeedback.
StandardSpecificationsforHealthCommoditiesandBiomedicalEquipment
LMDincoordinationandsupportfromNFHP/DELIVERProjectpreparedafinaldraftofthenational
standard list of biomedical equipment and instruments for different levels of health institutions.
Several workshops were held and inputs from all levels of health institutions like Zonal Hospitals,
DistrictHospitals,CentrallevelTertiaryHospitalsandProgramDivisionswereincluded.
ConsensusForecastingWorkshops
The 2day National Level workshop on Consensus Forecast and Quantification of RH/FP, MCH
commodities, Essential Drugs and Vaccines for coming 5 years was organized by Logistics
168
ManagementDivision,DepartmentofHealthServiceswiththetechnicalandfinancialsupportfrom
USAID|DELIVER/NFHP.
QuarterlyNationalPipelineReviewMeetings
LMDwiththesupportfromNFHPconductedquarterlyNationalPipelineStatusReviewmeetingsin
November2010andFebruary,MayandJuly2011.ThemeetingisparticipatedbyProgramDivisions
ofDoHS,ExternalDonorPartnersandstakeholders.Inthemeetingsshipmentschedules,shipment
status (planned, ordered and received), actual consumption and monthsofstockinhand of 19
health commodities were discussed. Specifically, issues related to condom distribution in high
HIV/AIDSprevalenceareas,procurementofvitaminA,monitoringthedistributionofcotrimoxazole
Ped.(Cotrim/P),irontablets,andORS,distributionofimplants,mandatorysubmissionofLMISforms
byNGOsandinclusionofvaccinedispensedatainthepipelinereportwerediscussedandresolved.
UpontherequestfromLMD,USAIDinitiatedsupplyof15millioncondomsinordertomanagecrisis
due to cancellation of LMD's multiyear procurement of condoms and retender which requires a
considerableperiodoftime.Themeetingalsotookadecisiontoexpediteshipmentscheduleorto
request suppliers for early partial supply of ORS, Zinc, Cotrim/P and Iron in order to maintain
nationalstocklevelatdesiredlevel.
b.
Storage,Distribution,TransportationofMedicine,EquipmentsandHealthCommodities
LMDconductedtheAnnualCommodityDistributionProgram(ACDP)incoordinationwithFHDand
help of NFHP. During this reporting period and supplied 24,583,000 pieces of condoms, 2,009,600
vialsofinjectbales,2,115,560cyclesoforalpills,23,000setsofImplantsand15,000setsofIUDsto
75 district stores. In addition,
42,525 kgs insecticides were also
sentto21malariaaffecteddistricts
for spraying. LMD supplied
4,300,000 capsules of vitamin A in
the country, in coordination with
CHD, RMS and NTAG for the
National Vitamin A campaign.
Similarly, LMD received the
medicineforfreehealthservicesas
well medicine/commodities and
printingsmaterialsfortheprogram
divisions and distributed to the
districts through the Regional
DeliveringStoreequipmentatFikkalHealthPost,Ilam
medicalstores.Italsoprovidedthe
biomedicalequipments,accessoriesandfurnituretothevariouslevelhealthfacilitiesofthecountry.
Upon the request from various District Health Offices, LMD coordinated with NFHP to strengthen
storagecapacityofdistrictstoresandhealthfacilitiesbyprovidingstoreequipmentrequiredatthe
storerooms thus enabling proper storage conditions for health commodities. NFHP and USAID/
DELIVER project provided 526 steel racks and 355 cupboards in 14 districts9 in order to proper
storageanddistributionofhealthcommodities.
LMDalsomanageddistributionoffollowingvaccinesinthereportingyear(Table6.3.1).
Ilam,Sarlahi,Makwanpur,Dhading,Gulmi,Baitadi,Bajura,Dang,Salyan,Surkhet,Banke,Sindhupalchowk,LamjungandOkhaldhunga
169
Table6.3.1:DistributionofVaccines(FY2067/68)
Vaccine
BCG
DPTHepBHib
Measles
Polio10dose
Polio20dose
TT10dose
TT20dose
JE
QuantityReceivedatCentral QuantitySuppliedto
Warehouse,Teku
RMSs
Remarks
160,000
159,820
2,262,100
2,123,250
190,000
178,100
188,000
272,220
591,150
544,625
MassCampaign
150,000
183,900
40,000
19,200
819,000
635,050
RegularandMass
Campaign
Source:DoHS/LMD
LMDwiththesupportfromNFHPprintedanddistributedquarterlyLMISformsandstockbookforFY
68/69 (2011/2012) for all regions, districts and HFs. NFHP also supported to prepare the annual
stock supervision report of the from all central stores (FP and program item stores, equipment
stores,epidemicandemergencystoresandcoldchainstores)oftheLMD.
c.
EmergencyTransportationofHealthCommodities
LMD managed emergency transportation of some health commodities. NFHP/DELIVER project

providedtechnicalandfinancialsupportforitandtransportedsomehealthcommodities,namely
2,489,000condoms,78,040cyclesoforalpills,64,400vialsofinjectables,850setsofimplants,500
sets of IUCD, 72,000 tablets of Cotrim/P, 850 ARI timers and 450 baby weighing scales to District
HealthOfficesChitwan,Morang,Dhankuta,Okhaldhunga,andParsa.Theemergencytransportwas
doneastransportationcontractwithprivatevendorhasexpiredandareinprocessofawardingthe
newcontract.
LMD also managed the internal movement of 1,824,000 tablets of Cotrim/P and 2,572 vials of
Gentamicin injections from districts10 with excess amount to districts11 in need. This has helped
preventtheexpirationoftheseessentialdrugsandcontributedintotimelyservicedelivery.
d.
StrengthenStorageCapacity
DistrictStoreConstruction
A significant progress has been made in the
Box 6.3.1: Key Achievements
infrastructure of District Warehouses. Till now,
construction of 53 district warehouses has been Increased total storage space from 21,223 sq. ft. in
1999 to 86,400 sq. ft. in 2011
completed (KfW43, DFID5, GoN5). One Cold Safe storage of valuable health commodities
maintaining storage standards
Chain Store has been constructed in Pathalaiya
Decreased wastage and expiry of drugs
TransitWarehousecomplexwithKfWfund.
Nine are under construction and 10 are planned from
GONs Fund, expected to be completed by 2011/12

and 2012/13
In FY 2067/68, GoN through Management
Division/DoHS funded 5 district warehouses
(Tehrathum, Makwanpur, Rupandehi, Gulmi, and Bajhang) and KfW funded 3 district warehouses
(Jajarkot, Sindhupalchowk, and Lamjung) were completed. JSI provides management support for
KfWfundedconstructionofdistrictwarehouses.
10
Udayapur,Makwanpur,Chitwan,Nuwakot,Bhaktapur,Lalitpur,KaskiandLamjung
Saptari,Siraha,Dhanusha,Mahottari,Sarlahi,RMSDhangadhi,RMSNepalgunj,DailekhandJumla
11
170
e.
DesigningofRegionalMedicalStore
LMD with support from the USAID/NFHP subcontracted architectural firm has prepared an
architectural design of new Regional Medical Store (RMS) buildings. The design was finalized in a
seriesofworkshopswithparticipationfromtheMD,theDGoffice,LMD,USAID,UNICEF,UNFPAand
KfW.
Proposed architectural design of new RMS building
f.
LogisticsDistributionNetworkProfile
TheMoHPLogisticsDistributionNetworkProfileisbeingrevisedforthesecondtimesinceitwasfirst
published in 1996. This profile provides the entire national transportation network information
including vehicle running cost, transportation cost and road situations. NFHP staff in coordination
with District Road Office, District Development Committee and District Technical Office, has
collected information of 29 districts and expects to complete all 75 districts by March 2012. LMD
usesthisprofileinpreparationoftransportationsbudgetsandplan.
171
g.
LogisticsSupervisionChecklist
LMDandNFHP/DELIVERdevelopedlogisticssupervisionchecklistwhichconsistof12setoflogistics
criteriaforthebetterlogisticsmanagementofstores.ThetoolwasusedduringsupervisionbyLMD
staffsaswellasNFHPstaffs.AcirculationwasalsosenttoallRegionaldirectorsandDPHO/DHOfor
the use of this newly developed checklist and included in the revised District level Basic Logistics
Managementtrainingcurriculumaswell.ThesechecklistsareusedbybothNFHPandGovernment
healthworkers.
h.
CapacityBuildinginLogisticsManagement
ProcurementTraining
LMD with support from USAID | DELIVER project and NHTC conducted District Level Procurement
Training to 15 participants from Rukum, Jajarkot and Mugu districts. The training imparted
knowledgeandskilltotheparticipantsinordertoimprovetheprocurementprocessinthedistrict.
NHTCandLMDdecidedtomonitordistrictprocurementbasedonfollowingfiveindicators:Setting
upofprocurementcommittee(evaluationcommittee)inthedistrict
DistrictProcurementPlan
Forecasting and quantification (also have district followed quantification provided by the
centre)
Costestimationofthehealthcommodities
Timelyprocurement
172
RegionalReviewMeetingandRefresherTrainingonWebbasedLMIS
According to the activities mentioned in the GoN Red Book, LMD conducted the Logistic Regional
Review meeting in all 5 development regions. The current logistics challenges and issues were
discussedwithdistricthealthofficersand Regional Directorsinthemeetings.LMDalsoconducted
refreshertrainingonwebbasedLMISandinventorymanagementsystemforstorekeepersofall75
districts, staff of Regional Medical Stores and Regional Directorate. NFHP and USAID | DELIVER
providedtechnicalandpartialfinancialsupporttoorganizetheseevents.
PullSystem
The District Level Basic Health Logistics Training manual, developed and printed in 2005, needed
revisionasnewlogisticsinterventions,suchasthe pullsystem, districtlevel procurementcapacity
trainingandwebbasedLMIShavematerializedsincethen.NFHPprovidedsupportinrevisingthe
package, which includes all of the new interventions and is expected to benefit the district
storekeepers.Trainingonthenewlyrevisedpackage,wasprovidedto15participantsfromregions
anddistrictstores.
Similarly, the pull system training on health logistics management was provided to 53 newly
transferred/dropouthealthpersonnelfromhealthfacilitiesinMugu,ParsaandBaradistricts.Both
thetrainingsbenefitstorekeepersandhealthfacilitypersonnelinbetterlogisticsmanagement.
Revision,OrientationandImplementationofSubDistrictLevelLogisticsCurriculum
LMD in coordination with NFHP/DELIVER conducted review and orientation on key health
commoditiesin8districts12to647participantsthisyear.ThetrainingpackageoriginallynamedSub
districtLevelLogisticsReviewandOrientationwasrevisedandrenamedReviewandOrientationon
Key Health Commodities Management at Health Facilities in January 2011. The program imparted
concepts,needsandimplementationofthepullsystemforessentialdrugsanddevelopedtheskills
ofdistrictlevelsupervisors,storekeepersandbelowdistrictlevelhealthpersonnelonsupplychain
management.
BasicLogisticsTrainingtoMCHWsandVHWs
LMD/NHTC/NFHP organized a TOT program to prepare twenty two trainers from 8 districts13 on
Basic Health Logistics for VHW/MCHWs. The trainers in turn trained 727 AHW/ ANMs (formerly
VHW/MCHWs) in their respective districts. It is
expectedthatthroughthetraining,therewillbea
better understanding of the supply chain
managementfromtheHFtothecommunitylevel.
BasicLogisticsTrainingtoFCHVs
LMDwiththesupportfromNFHPconductedbasic
logistics orientation for FCHVs in two remote
districts, Mugu and Kalikot because of their poor
logistics indicators. The training package,
consisting of a job aid and orientation guidelines
LogisticsorientationtoFCHVsinDolphuHP,Mugu
Khotang,Bhojpur,Sankhuwasabha,Dhanusha,Ramechap,Mugu,BaraandRukum
13
Sindhupalchowk,Makwanpur,Kapilbastu,Saptari,Jumla,Dailekh,RukumandJajarkot
12
173
were developed and printed this year. A pool of nine trainers were prepared in a regional ToT in
Nepalgunj,whointurnprepared30trainersinKalikotand24trainersinMuguatDistrictTrainers
Preparation Workshop in the districts. These trainers in turn provided logistics orientation to 257
FCHVs in Kalikot and 189 FCHVs in Mugu respectively. This program provided FCHVs with basic
concept of logistics management and is expected to significantly improve availability of health
commoditieswithFCHVs.
Auction,DisposalandWriteoff
GuidelineonAuctioning,DisposalandWriteoffhasbeenfinalizedandisreadyforprint.Basedon
the guideline, LMD with the assistance from
NFHP/DELIVER in carrying out auction, disposal
and write off processes. Each process has a
twofold benefit, one it creates space for storage
andtheotherisrevenuegeneration.
LMD auctioned off 36 four wheelers and 40 two

wheelers which were old and unfit for use, some
office equipment, instruments, furniture, freezers
andother commoditiesatCentralStoreTekuand
TWHPathalaiyathroughsealedbiddingprocessin
FY: 2067/068. The auction raised an amount of
NRs. 1,190,000 which was deposited in the
ClearingoldvehiclesatLMD,Teku
nationaltreasury.Asaresultoftheauction7,060
sq.ftspacewasfreedforvehicleparkingandcommoditystorage.
Recyclingmethodwasoptedforwriteoffofusedofficialpapers.23,170kgsofusedofficialpapers
were sold which generated an amount of NRs. 91,985. The amount was deposited in the national
treasury.LMDalsodisposedexpiredvaccinesatthecentralstore,Teku.Similarly,LMDreturnedof
1.3millionofPentavelentvaccinetothesuppliers.ThisvaccinewasprocuredthroughGAVI/UNICEF
fundandwasunusablebecauseofqualityissues.
j.
TelemedicineProgram
LMDinitiatedandimplementedRuralTelemedicineprogramin25hillandmountaindistricts14inFY
2065/66. The training on Telemedicine for these districts had completed and LMD had provided
necessaryTelemedicineequipmentsand
network accessories in the same year
forall25districts.
InFY2066/67,LMDhasinstalledVSATin
25 districts for high speed Internet
connectivity and video conference
system is developing in these districts.
Formally the telemedicine program was
inauguratedbyPrimeMinisterMadhava
KumarNepalonMagh7th,2068atPatan
InaugurationofTelemedicineProgram
6 Achham,Bajhang,Bajura,Darchula,Dolpa,Gorkha,Humla,Jajarkot,Jumla,Kalikot,Khotang,Manang,Mugu,Mustang,Okhaldhunga,
Pyuthan,Rasuwa,Rolpa,Rukum,Sankhuwasabha,Sindhuli,Sindhupalchowk,Dolakha,Solukhumbu,andTaplejung
174
Hospital. Patan Hospital is equipped with human resource and Tele medicine equipment and
accessories to function as centre for the rural telemedicine program and the SAARC Telemedicine
program.
k.
ImprovementofCommunicationTechnologyforLMIS
LMD established a wellequipped LMIS Learning Centre at the LMD with the support from
NFHP/DELIVER Project. The purpose of the
learningcentreistodemonstrateandprovidean
opportunityforGoNstaff,EDPsandthepublicto
learn about LMIS, webbased LMIS, inventory
management system and logisticsrelated
activities.
NFHP/DELIVER project provided financial

assistance to subcontract a private firm to
supportD/PHOsinall75districtstoassistinthe
operation of the webbased LMIS and inventory
management system. Their assistance to district
storekeepers and maintenance of logistics
database has resulted dramatically increase in
webbased LMIS reporting. Through web based
LMISLearningCentreatLogisticsManagementDivision
LMIS, now LMD can monitor stock status of
healthcommoditiesofthedistrictlevelstores.In
addition,NFHPprovidedsupportininstallingADSLconnectionsatD/PHOsin27districts15.
6.3.3Problems/Constraints
Issuesraisedduringtheregionalandnationalreviewsin2066/67andactionstaken:
SN
Problems/Issues
1 Nobudgetfortransportationof
fortifiedflour
2 LowreportingofWebbasedLMIS,
webbasedInventoryand
operationofTelemedicine
program
3 Insufficientstorecapacityof
Central,RMSsandDistricts
4
Lackoftechnicalhumanresources
forrepairandmaintenanceofbio
medicalequipmentintheCentral
andRMSs
Difficultyintransportationof
healthcommoditiesfromdistrict
tohealthfacilities
Insufficienthospitalequipmentin
Referralhospitals
ActionTaken
TransportedwiththesupportofUSAID/NFHPIIandUNICEF
Budgetprovisionplannedforcomingyear
SupportedcomputerassistantbyUSAID|DELIVERPROJECTin
75districtstostrengthenandreportingstatusisbetter.
RefresherTrainingdonebyLMDforTelemedicine&web
basedLMIS
CoordinatedwithMDtoincreasethestorespace
Programofbuildingcentralstoresand
SurveyconductedwiththeUSAID/NFHPforRMSWarehouse
Providedrequiredhumanresourcesoncontractforall
regions
Plannedtoestablishmaintenanceworkshopsinthree
regionsinFY06869
InstructiongiventoD/PHOs
Increasedbudgetalmostbydoubleforthesupply/
transportation
Anorganizedworkshoptodevelopthestandardequipment
listanditisinfinalstagenow.
PlannedfortheprocurementinFY068/69
15
Dhankuta, Ilam, Jhapa, Solukhumbu, Nuwakot, Sindhuli, Rautahat, Sarlahi, Gulmi, Gorkha, Syangja, Banke, Salyan, Bardiya, Achham,
Baitadi,Bajhang,Darchula,Dadeldhura,Doti,Kailali,Kanchanpur,Surkhet,Dang,Salyan,PyuthanandDailekh
175
Problemsandrecommendationsdiscussedinthenationalandregionalreviewsin2067/68:
SN
Issue/Problems
1 LackofmodernWarehousesat
CentreandRMS
2 Veryhighdemandofrepairand
maintenanceofmedicalequipment
3
Insufficientmedicalequipmentsfor
theupgradedHealthpostand
hospitals
Technicalmanpowerisrequiredfor
thebetterlogisticsmanagementat
districtlevel
IrregularityofWebbasedLMIS,
Inventoryreportandutilizationof
Telemedicineprogram
PossibleRecommendation/Suggestion
WarehousesatCentreandRMStobe
constructed
EstablishBiomedicalunit/manpowerat
centreandRMSforrepairand
maintenanceofmedicalequipment
Standardizeofbiomedicalequipment
foralllevelhealthfacilitiesandsupply
themonphasewise
Managementof2StoreKeepersat
leastonefromhealthbackground
Responsibility
MoHP,DoHS,LMD
Provisionofhumanresourceson
contracttoassistcomputerwork.
MoHP,DoHS,LMD
DoHS,LMD,RMS
MoHP,DoHS,LMD
MoHP,DoHS,LMD
6.3.4 ProgramforFY2068/69
SN
Activities
CentralLevel(BudgetSubheadNo.3701213/3701214)
1 ProcurementofofficeFurniture
2 ProcurementofPhotocopy,Fax,Scanner,ComputerforCentreandRMS
3 Biomedical Equipment Repair Workshop Establish in Centre and Regional Medical Store
(Biratnagar,Kathmandu,Pokhara/Butwal)
4 ProcurementofRuralTelemedicineInstrumentandEquipment
5 MasterPlanUpdate,ApprovedandConstructioninLMDCentreStoreandPathlaiyaStore
6 ProcurementandpaymentofHospitalFurniture,InstrumentandLabEquipment
7 WebbasedLMISandEPostandInventorySystemRefresherTraining
8 RuralTelemedicineRelatedBasicandRefresherTraining
9 ServiceContractforofficesecurity,helperanddriver
10 ConsultancyServiceprocurement(MechanicalEngineer,Biomedicaltechnician,ITPersonnel
forwebbasedLMISandEtender)
11 ContractManagementSoftwareforProcurement
12 RepackingofDrugandEquipmentforCentre
13 RepackingofDrugandEquipmentforRMS
14 TenderDocumentPreparation,TenderNoticePublicationandLogisticsRelatedWorks
15 TransportationofdrugsforCentre
16 TransportationofdrugsforRMS
17 ProcurementandpaymentofEssentialDrugs
18 InfrastructuredevelopmentforEtendering
19 PrintingofLMISandStockBook
20 LogisticsandpullsystemrelatedRegionalandCentralReviewworkshop
21 Supervisionandmonitoringoflogisticsprogram forCentre
22 Supervisionandmonitoringoflogisticsprogram forRMS
23 Inspection,TestandqualitycontrolofDrugsandInstrument
24 CapacityExtensionofVSAT,MonthlyInternetFeeandVSatInstallationfor25District
25 ReceivedofZithromaxforTrachomaprogram
26 PaymentofCustomdutiesforZithromax
27 MaintenanceofBiomedicalEquipment,Vehicle,Coldchainequipmentandother
DistrictLevel(BudgetSubheadNo.3708043)
1 Repacking,SupplyandotherserviceforDrugs,Instrument&Equipment
2 SupervisionandMonitoringofLogisticsProgram fordistrict
3 RuralTelemedicineProgramfor25District
4 TransportationandDistributionoffortifiedflourfromDistricttothehealthinstitutions
Target
1
1
3
1
2
1
180
75
18
14
1
200
100
1
200
200
1
1
1
5
300
300
1
1
2
2
150
225
375
25
7
176
SupportingPrograms:PublicHealthLaboratoryServices
6.4
PUBLICHEALTHLABORATORYSERVICES
6.4.1 Background
Under curative services, the Health policy aims to provide diagnostic laboratory services in all the
hospitalsfromcentraltotheperiphery.InaccordancewiththeEighthFiveYearPlanandtheHealth
Policy 1991 (2048 BS), the National Public Health Laboratory (NPHL) has been identified as the
central and specialised national referral public health laboratory for the country, which was
previouslybeenidentified ascentralhealthlaboratory.Beyondthisisalsothenationalfocalpoint
andprovidestechnicalsupportforlaboratoryservicerelatedactivitiesthroughoutthecountry.Apart
from the routine and specialized diagnostic facilities, various public health related laboratory
activities are ongoing. This is national the referral laboratory for HIV diagnostics and monitoring,
Japaneseencephalitis,Measles,Rubella,AntimicrobialdrugresistanceandInfluenzaalongwiththe
establishmentofNationalInfluenzaCentre.
NHSP II (20102015) envisages Public Health Laboratory Service strengthening at all levels. In this
regards, National Public Health Laboratory (NPHL) has be designated as nodal institute for Policy,
guidelinesandoverallframeworkforcapacitybuildingdevelopmentinlaboratorysector.Attention
willbegiventostrengthenlaboratoryprocedureandcommunicationbetweennational,regionaland
district levels and strengthening the systems ensuring the availability of essential equipment and
logistics.Italsogivescommitmenttonewrecruitmentofstaffaswellastrainingofexistingstaff.
History of laboratory services in Nepal is nearly half century old and a clinical lab was first
established at Bir Hospital. Now services have been expanded from central level to PHC Level in
government sector. At present there are central hospital based laboratories8, Regional hospital
basedlaboratory3,subregionalhospitalbasedlaboratory2,Zonalhospitalbasedlaboratories11,
Districthospitalbasedlaboratories66,andPHCCbasedlevellaboratories204.Intheprivatesector
there are above 1,300 laboratories. All these laboratories require significant strengthening with
respect to quality assurance, human resource recruitment, competency, development of service
rangeandphysicalinfrastructure.
NPHL has drafted national laboratory policy. NPHL is the nodal point for certifying private sector
laboratory based on the directives issued by MoHP. Coming to Quality control NPHL has been
organizing NEQAS with involvement of more than 300 health laboratories in public and private
sector.Toassurethequalitytoservicesprovided,NPHLitselfalsoparticipatesinEQAS,REQASand
IEQASorganizedbydifferentinternationalagenciesatIndia,Thailand,Hongkong,Australia,UKand
CDC,Atlantaondifferentdisciplinesoflaboratoryscience.
In2010,April19th,NPHLhasbeendesignatedasNationalInfluenzaCentre(NIC),thegoalofwhichis
to share the total influenza cases and the isolates of influenza virus prevailing in the country with
global influenza surveillance network, which might be useful for candidate vaccine development.
Nepal faced a few outbreaks of Highly Pathogenic Avain Influenza (HPAI) time to time. There is a
great possibility of transmission of such infection to human. So, the outbreak of such in poultry
should alert human component. Hence, a coordination committee has been deployed with
involvement of human (NIC, EDCD, WHO and WHO IPD, etc.) and animal component (Central
Veterinary Lab, Directorate of live stock and AICP). To collect representative samples of influenza
samples from all the regions of the country, National Influenza Surveillance Network (NISN) is
establishedwithidentificationof10sentinelsitesallocating1to3sentinelsitesforeachregion.
177
Diagnosisofemergingandreemerginghighlyinfectiousdiseasesisachallengeforthecountryfor
whichhighlycontainedlaboratory,BSL2plushasbeenconstructedthroughWorldBanksupportby
AICP (human). The lab needs to evaluated and then accredited by international agency more
appropriateifdonebyAmericanBioSafetyAssociation(ABSA).Thereisaneedoflotofresources
(humanaswellasfinancial)tomakethisBSL2pluslabfunctional.WHOSEAROhasalsoinitiatedto
formSEAROlabnetworkforcapacitybuildingoflaboratoriesatSEAROfordiagnosisofthesehighly
infectiousdiseases.
Major challenge of Health Laboratory service is shortage of human resource. There is no post of
microbiologist/virologist whose role is very crucial for diagnosis of infectious disease. Lab service
cannot be functional without use of biomedical equipments. Repair, maintenance of calibration of
equipment is very essential to provide quality laboratory service for which it needs adequate
numberofbiomedicalengineers.Unfortunately,thereisnopostofbiomedicalengineer/assistants.
Ministryofhealthandpopulationhasplanedtocarryoutorganizationandmanagementsurveyfor
creation of such unavailable but important posts. Besides the new posts creation of the human
resource, it is also essential to upgrade qualification of existing manpower. Through NHSP II,
fellowship scheme for Pathologist, Microbiologist/Virologist, MMLT, BMLT and Lab Technician
coursehavebeenintroducedsothathighlyqualifiedmanpowerwillbeavailableforthecountry.
Upgradement of Laboratory Management Information System is another challenge for health

laboratoryservice.Communicationbetweennational,regionalanddistrictandbetweendistrict,PHC
andhealthpostshouldbeliaisedthorougheffectivelinkingbyLaboratoryInformationManagement
System.NPHLalsoplanstodistributewebbasedlabresultsothatthecustomerscanretrievetheir
resultfromnetattheirconvenience.
NPHLisalsothefocalpointofbloodsafetyonbehalfofMoH&Pandforeffectiveimplementationof
NationalBloodprogramisworkingondevelopment/revisionofpolicy,guidelines,protocols,SOPsas
perneed.NPHLalsoservesasNationalReferencelaboratoryforTTIscreeningofalldonatedblood.
In this regards, NPHL will evaluate the TTI screening kits of HIV, Hepatitis B&C and syphilis. For
ExternalQualityAssessmentofBTSCs,NPHLdevelopsandsendsproficiencypanel.Besides,tocarry
outconfirmatorytestforpositiveinscreeningofblooddonorisresponsibilityofNPHL.Otherquality
relatedresponsibilitiesaretoconducttrainingoflaboratorystaff,carryoutsupervision&monitoring
ofdifferentlaboratoriesandBTSCsasperneedandsupplyofqualityequipmenttodistricthospital
andPHCbasedlaboratories.
Vision
Toprovidequalitylaboratoryserviceinthecountry
Goal
To provide quality health laboratory service which is accessible to every citizen of the country at
affordablecost.
Objectives
To affirm government commitment and support for the organization and management of
efficient,costeffectiveandsustainablehealthlaboratoryservices.
Tostrengthenlaboratoryservicesforsupportingdiagnosis,treatment,surveillance,prevention
andcontrolofdiseases.
Toestablishnationalstandardsforlaboratoryqualitysystems.
178
Toensurethequalityofthehealthlaboratorythroughanestablishedqualitysystem.
To empower the establishment, implementation and monitoring of the national health
laboratoryprogram,nationalregulatorymechanismforregulatingallhealthlaboratoriesinthe
country.
To ensure adequate financial and human resources to meet the requirements for the health
laboratoryservices.
Tocommenttoethicalvaluesinlaboratorypractice,includingpatientconfidentiality,adherence
toprofessionalcodesofconductandethicalresearchpractices.
Toencourageresearchandcollaborationtoinformandimprovethequalityofhealthlaboratory
services.
Strategies
PublichealthCapacitywillbestrengthenedatalllevels.
Policy,guidelinesandanoverallframeworkforcapacitybuildingwillbeprepared.
NationalPublicHealthLaboratory(NPHL)willbethenodalinstituteandwillalsobethenational
influenzacentre.
Attention will be given to strengthen laboratory procedures and communication between
different level, strengthen system and ensure the availability of essential equipment and
logistics.
NPHL is providing the routine and specialized laboratory service at affordable prices. The major
objectiveistoprovidetheroutineandspecialiseddiagnosticfacilitiesatreasonablepriceontimely
manner.
1.
LogisticsProcurementandSupply
NPHL has been procuring the test kits/reagents and biomedical equipments. Likewise some
equipment are provided by NGO/INGOs/Internal agencies. Among them, most of reagent/kits and
hugebulkofequipmentsareutilizedatNPHLandsomeequipmentdispatchedtootherlaboratory
which are in urgent need for those at different district. The main objective is to provide the
continuouslaboratoryserviceandminimizetheinterruptionofserviceoccurredduetologistics.
2.
LaboratoryRefurbishment
AsNPHLisdesignatedatthelaboratoryreferralcentre,andvariousdepartmentswiththeNPHLare
beingstrengthenedandsomearenewlyestablished.Toaddressthisissueandtomaintainthesound
workingenvironment,differentunitshavebeenrefurbishmentatNPHL.
Followingunitswererefurbishedinpasttwoyears:
Laboratoriessupervisedin2067/68
NationalInfluenzacentre
Region
Sites
NationalJE/Measles/Rubellalab
Easternregion
43
Collectionunit
Centralregion
57
Westernregion
24
Washingunit
Midwesternregion
12
Farwesternregion
National
14
150
179
3.
SupervisionandMonitoring
A team from NPHL goes for the supervisory and monitory visit in the different laboratories of the
country. The major objective is to access the laboratory standards, existing physical infrastructure
andcapability.
4.
NationalExternalQualityAssuranceScheme(NEQAS)
Toensurethetestingqualityandaccesstheexistingstatus,NPHLisconductingtheNEQASprogram
as a part of External quality assurance. NPHL dispatch the laboratory samples of different
parameters to various labs throughout the country and receives the test result from those labs
whereasinsomeNPHLreceivesthetestedsample(HIVDBS).Onthebasisoftheir,testresult,NPHL
compiles the report and send feedback to individual laboratories. This also helps to access the
testingcapabilityoflabpersonnel.Thetestingparameterrangesfrombiochemicaltest,malariaslide
andotherslikeDBSEQASwhereHIVtestingqualityismonitored.
5.
QualityControlTraining
Training
Inservicetraining
VCT/STITraining
AMR surveillance in selected infections pathogens in
Nepal
QualityControlTraining
BacteriologyTraining
Orientation Training for clinicians, nurses, lab staff and
statisticians
BiomedicalEquipmentTechnician(BMET)Training
EDR
4
23
2
Numberoftrainees
CDR
WDR MWDR
2
5
6
27
18
15
3
2
FWDR Total
17
70
2
24
4
6
5
5
32
2
1
33
12
10
77
2
6
94
25
28
236
15
16
1.
PerformanceofVariousDepartmentsofNPHL
ThecomparativeperformanceofvariousdepartmentsofNPHLinthelastthreefiscalyearsisshown
inthegraphsbelow:
Biochemistry
Immunology
180
Haematology
Parasitology
Virology(HIV,HepB/C/E)
Histo/Cyto
Endocrinology
2.
LaboratorybasedSurveillanceActivities
Beyond the routine diagnostic, NPHL is also conducting the laboratory surveillance activities on
various disease pathogens. These activities include Measles/Rubella surveillance, Japanese
encephalitissurveillance,InfluenzasurveillanceandAntimicrobialresistancesurveillance.Themajor
objective of these programs is to find out the burden of related diseases and provide background
informationfortheformulationofstrategytocontrolthesediseasesinthecountry.
Belowarethesamplesanalysedontherelatedactivities.
181
Bacteriology
Labbasedsurveillancevirology(June15,2010July15,2011)
OutbreakInvestigationReport(June15,2010July15,2011)
1,388
1,500
1,000
500
360
Total
Positive
PolicyConstraints
ApprovalofNationalLaboratorypolicy,licensingcriteriaandprocessofaccreditation.
Shortage of all levels and types of human resources including Pathologists, Microbiologists,
Technologists,Techniciansetc.
Difficulttoobtainthequalitychemicalsandreagentkitsfromdifferentsuppliers.
182
Lackofauthorityintransfer/training/upgradingoflaboratorystaffsofgovernmentofNepallabs
asperrequirements.
InstitutionalConstraints
Workloadincreased,howevermanpowerissameasofoldorganogram.
Lack of trained Manpower, i.e., MD Haematology, Microbiology, M.Sc. in Cytology,
Haematology,MedicalMicrobiology,Biochemistryandotherspecializedtraining.
Whentransfersaremade,NPHLisnotnotified.
OldLaboratoryequipmentnotmaintainedduetolackofbiomedicalengineer/technician.
Problemofwastedisposal.
ResourceConstraints
Skilledhumanresource
Financialresources/Budgetaryconstraints
SN
Activities
1 Preparationofnecessaryinfrastructurefortheconstructionofnewbuildingforthe
expansionandinvestigationofnewlyintroducedtestsinthelaboratory
2 Procurementofnecessaryequipmentandperformingotherassociatedactivitiesforthe
expansionofBTSin5differentlocations
3 Procurementofequipmentsandreagents/kitsfortheestablishedofreferencelab
4 Procurementofequipmentsfortheestablishmentoffoodmicrobiology/waterbacteriology
atNPHL
5 Procurementofnecessaryequipmentforestablishmentofhaematologyandcoagulation
studyatNPHL
6 Procurementofreagentforoutbreakinvestigation
7 Providing3weeksinservicetrainingfornewlyappointedLabAssistant/LabTechnician
8 Providing2daysWasteManagementTrainingforofficehelperoffivedifferent
developmentregion
9 ProvidingRefresherTrainingassociatedwithBacteriologytotheLabAssistant/Lab
Technicianfromdifferentpartofcountry
10 Providingqualitycontroltrainingtothelaboratorystaffofdifferentgovernmenthealthlab
11 ProvidingVCT/STItrainingtolabtechnician/labassistantworkingingovernmentlevelVCT
centres
12 ProcurementofnecessaryitemsforNICinordertoperformlaboratorytest.
13 Procurementofkits/reagentsnecessaryforantiepilepticdruglevelanalysisandtests
relatedtoendocrinology
14 Managementofkits/reagentsfortestingHIV/AIDS
15 Procurementofnecessarykits/reagentsfor68DHOandPHC
16 SupervisionandMonitoringoflaboperatedbyprivatemedicalcentre
17 Supervision,monitoringandevaluationofdifferentPHC,DHO,Zonalhospitalandregional
hospitalaswellasnewlyestablishedbloodtransfusioncentres
18 GivingcontinuitytothesecretariatestablishedforBloodTransfusionService.
19 Givingcontinuitytothequalitycontrolactivityofallthelaboratorieswithincountry
20 Contractinghumanresourcefcorsmoothoperationoflaboratory.Alsohiring3human
resourceincontractforareferencelab
21 Furnishingandmaintenanceofcoldroom,labsoftware,computers,etcinthelaboratory
22 Procurementofnecessarykits/reagentsforroutingandspecialtestsinlaboratory
Target
1
5
1
1
1
1
60
150
40
75
75
1
1
700
68
200
75
1
1,000
12
1
15,000
183
SupportingPrograms:PersonnelAdministrationManagement
6.5
PERSONNELADMINISTRATIONMANAGEMENT
6.5.1 Background
The Personnel Administration Section of the Department of Health Services is responsible for
organisingroutineandprogramadministrativefunction.Themajorfunctionsofthesectioninclude
upgradinghealthinstitutions,transferofhealthworkers,levelupgradingofhealthworkersupto6th
level,capacitybuildingofpersonnel,etc,.
Objectives
The main objective of the section is to mobilize human resource for delivery of quality health
services.Thespecificobjectivesinclude:
Transferandmanageallthepostsaccordingtothegovernmentpolicy;
Placementhealthstaffsatthesanctionedpostsinallthehealthinstitutions;
Managehumanresourcesatthedifferentlevels;
Takedisciplinaryactionaccordingtotheprofessionallaw;
Updatinghumanresourcebookkeepingofalllevelsandinstitutions;
Mange the posting and transfer of medical officers who had completed their study in
governmentscholarships;and
ExecutetheO&Msurveyasneededtoestablishandextendthestructureofhealthinstitutions/
organizationsinandundertheDepartmentofHealthServices.
DistributionofHealthWorkForce
MoHP has a total of 27,300 employees. Of them 21,000 are technical personnel and 6,300 are
administrativestaff.
Transfer
AspertheMoHPpolicy,DoHSisresponsiblefortransferofthehealthworkforceuptothe7thlevel.
DisciplinaryAction
Discipline may be considered as a force that prompts individuals and groups to observe the rules,
regulations and procedures which are deemed to be necessary for the effective functioning of an
organisation.DoHSworkstowardsmaintainingtheprofessionaldisciplinewithinitsemployees.
LevelUpgrading
FollowingasetofcriteriaDoHSmanagesupgradingofitsemployeesuptothe7thlevel.DoHSalso
providesitsemployeeswithappropriatePadnamasguidedbythenormssetbythecourt.
184
Leave
DoHSalsomanagesdifferenttypesofleavesofnongazetted/nonofficerlevelemployees.Following
theLawsandActs,italsomanagesspecialleaverequestsreceivedfromdifferentlevelsofstaffby
recommendingtheappropriatecasestotheMoHP.
Table6.5.1:TypeofInstitutions2067/68
TypesofInstitution
CentralHospital
RegionalHealthDirectorate
RegionalHealthTrainingCentre
RegionalMedicalStore
RegionalTBCentre
RegionalHospital
SubRegionalHospital
ZonalHospital
D(P)HO
DistrictHospital
InstitutionalClinic
PHC/HC
HP
SHP
Total
EDR
0
1
1
1
0
0
0
3
16
14
4
50
140
715
945
CDR
5
1
2
1
0
0
1
1
19
13
9
68
173
999
1292
WDR
0
1
1
1
1
1
0
2
16
17
2
42
145
692
921
MWDR
0
1
1
1
0
1
1
2
15
13
3
29
129
432
628
FWDR
0
1
1
1
0
0
0
2
9
8
1
19
88
289
419
Total
5
5
6
5
1
2
2
10
75
65
19
208
675
3,127
4,205
Source:HMIS/PersonnelAdministrationSection,DoHS
Table6.6.2:TypeofWorkforceDistributionsbyHealthInstitutions,2067/68
TypeofHealthInstitution
DepartmentofHealthServices(DoHS)
RegionalHealthDirectorateOffice(allfiveregions)
RegionalandSubregionalHospital(allfourhospital)
RegionalMedicalStore(allfivestores)
RegionalTrainingCentre(allsixtrainingcentres)
ZonalHospital(alltenzonalhospitals)
District/PublicHealthOffice(alldistricts)
Total
Sanctioned
184
227
444
60
79
1013
18,364
20,371
Fulfilled
165
134
341
53
66
745
15,887
17,391
Vacant
19
93
103
7
13
268
2,477
2,980
Source:PersonnelAdministrationSection,DoHS
185
SN Problems/Constraints
ActiontobeTaken
3.1 Needtoupdate
Eachandeverydistrictsandhealth
employeepersonnel
institutionsshouldmaintainpersonal
recordsinDoHSand
fileaccordingtotherulesand
HuRICunit
regulations.
Anychanges(e.g.transfer,trainingor
promotion)shouldbecommunicated
totheHuRICUnitforupdating.
ImplementEHURDISplan.Record
systemshouldbeimproved
systematically.
3.2 Frequenttransferand StrictlyfollowtheCivilServiceActand
notransfer
Healthactandregulations.
Transferpolicyshouldberevised.
3.3 Inadequatetrainingof Developandimplementinservice
administrativestaff
trainingpackages.Increaseefficiency
ofadministrationunit.Evaluation
performanceofadministrative
employees.Opportunitiesshouldbe
provideonthebasisofperformance.
3.4 Staffdutiesand
Theduties,responsibilities,and
authorityunclear
delegationofauthorityofemployees
shouldbedefinedclearly.There
shouldbecommitmentandbudget
allocationforeffectiveimplementation
oftheseactivities.
3.5 Fulfilmentofvacant
StrictlyfollowCivilServiceandHealth
postsanddeputation
ServiceActandRegulation.
3.6 NoHuRICunit
DevelopHuRICunitatRHDsand
connectionatregional
establishnetworkingbetweenRHDand
healthdirectorateand
centralhealthinformationsystem.
districthealthoffice
3.7 Performanceappraisal Performanceappraisalshouldbebased
systemwasnot
onjobdescriptions.
functioningproperly
Tieuprewardandpunishmentwith
performance.
3.8 Registrationofhealth Registrationofhealthinstitutionsin
institutions
CivilServiceRegistrationDepartment,
MinistryofGeneralAdministrationin
appropriatetime.
Responsibilities
Deadline
HuRICand
Ongoing
Personnel
Administration,
DoHS/MoHP
RHD/DoHS/
MoHP
Immediate
DoHS/MD,NHTC Assoonas
possible
DoHS/MD
Assoonas
possible
DoHS/RHD/
MoHP
DoHS/MoHP
Immediate
RHD/DoHS/
MoHP
Immediate
DoHS/MoHP
Assoonas
possible
Assoonas
possible
SN
1
2
3
4
5
6
7
Activities
Registrationofhealthinstitutions,postsandpersonnelinDepartmentofCivil
PersonnelRecord,MinistryofGeneralAdministration
UpdatingofpersonalrecordsinDoHSandHuRICunit
Superviseandmonitoradministrativework
UpdatehealthinstitutionsandcreatedpostsinCivilServiceRegistration
Department,MinistryofGeneralAdministration
AppointmentofMBBSgraduatesundergovernmentscholarship
Capacitybuildingofadministrativestaffofhealthinstitutions
O&Msurvey
Unit
1
AnnualTargets
Continued
1
1
1
Continued
Continued
Continued
1
30
Continued
Continued
Institutions
186
SupportingPrograms:FinancialManagement
6.6
FINANCIALMANAGEMENT
6.6.1 Background
An effective financial support system is imperative for efficient management of health services.
Preparationoftheannualbudget,timelydisbursementoffunds,accounting,reporting,andauditing
arethemainfinancialmanagementfunctionsthatarenecessarytosupporttheimplementationof
healthprograms.TheFinanceSectionoftheDoHSisthefocalpointforfinancialmanagementforall
programsundertheDoHS.AllhealthinstitutionshavetheirownFinanceSection,exceptPHCs,HPs
andSHPs.
Objectives
toprovidesupporttoallprogramsdivisions/centresduringannualbudgetpreparation
toobtainanddisburseprogrambudgets
tokeepbooksofaccountsandcollectfinancialreportsfromallinstitutions
toprepareandsubmitfinancialreports
tofacilitateinternalandexternalauditing
toprovidefinancialconsultation
Targets
The main target of financial management is to achieve 100 percent expenditure of all budgets in
accordancewithprogramworkplanswithinaspecifiedtimeasperfinancialrulesandregulationsof
governmentandtomaintaintherecordingandreportingsystemaccuratelyandtimely.
6.6.2 AnalysisofAchievementsbyMajorActivities
Out of total National Budget of Rs. 2,97,81,88,82,000 a sum of Rs. 23,81,39,93,000 (8%) was
allocatedforthehealthsectorduringthefiscalyear2067/68.Ofthetotalhealthsectorbudget,Rs.
15,03,53,90,000(63%)wasallocatedfortheexecutionofprogramsundertheDepartmentofHealth
ServicesNetwork(Table6.6.1).
Table6.6.1:HealthBudgetunderDoHS,2067/68(AmountinNRs.000)
NationalBudget
HealthBudget
HealthBudgetunderDoHS
Total
297,818,882
23,813,993
15,035,390
%
100
8.0
63.1
Recurrent
190,319,495
17,054,304
13,635,303
%
63.9
71.6
90.7
Capital
107,499,387
6,759,689
1,400,087
%
36.1
28.4
9.3
Source:FinanceSection,DoHS
Table6.6.2:AllocationofBudgetbySource,2067/68(AmountinNRs.000)
HealthBudgetunderDoHS
Total
15,035,390
GoN
7,747,379
%
51.52
Donor
7,288,011
%
48.47
187
Table6.6.3: RegularProgramRecurrentBudget,ReleasesandExpenditurebyProgramActivities,
2067/68(AmountinNRs.000)
Budget
CodeNo
ProgramBudget
703120* DepartmentofHealth
703121* RegionalHealth
Directorates
703122* DistrictHealthOffices
703128* HealthTrainingCentres
703150* DistrictsHospitals
Total
TotalBudget
(inRs.)
Amount
%
41,092 0.93
66,112 1.50
ReleaseBudget
(inRs.)
Amount
%
40,540 0.97
42,238 1.01
Expenditure
(inRs.)
Amount %(a) %(b)
40,540 100
0.97
42,238 100
1.01
3,838,785 87.10
26,617 0.60
434,782 9.86
4,407,388 100
3,660,364 87.62
21,897 0.52
412,516 9.87
4,177,555 100
3,660,364
21,897
412,516
4,177,555
100
100
100
100
87.62
0.52
9.87
100
Note:(a)withreferencetoreleasebudget,(b)withreferencetoallocatedbudget
Table6.6.4: RegularProgramCapitalBudget,ReleasesandExpenditurebyProgramActivities,
2067/68(AmountinNRs.000)
Budget
CodeNo
ProgramBudget
704122 DistrictHealthOffices
704150 DistrictsHospitals
Total
TotalBudget
Amount
%
7,500
23
25,200
77
32,700
100
ReleaseBudget
Amount
%
7,026
22
25,165
78
32,191
100
Expenditure
Amount %(a) %(b)
7,026
100
22
25,165
100
78
32,191
100
100
Table6.6.5:CentralLevelRecurrentBudgetAllocationbySourceandProgramActivities,2067/68
TotalBudgetAllocationbySource(AmountinNRs.000)
Budget
CodeNo
703303
703401
703402
703451
703470
703472
703500
703510
703512
703610
703611
703620
ProgramBudgetHeading
TuberculosisControlPrograms
NationalAidsControl
FP/MCHPrograms
EPIProgram
DiarrhoealDiseaseProgram
AvianInflunza
EpidemiologyProgram
LeprosyControlProgram
IndentProcurement
PrimaryHealthRD
HospitalConstruction/
ManagementInformation
System
703650 NHEICC
703660 NationalHealthTrainingCentre
703680 HealthLaboratoryServices
Total
GoN
40,920
41,740
44,316
133,156
75,999
96,712
490
61,905
10,736
426,130
205,692
68,677
%
3.21
3.28
3.48
10.45
5.96
7.59
0.04
4.86
0.84
33.44
16.14
5.39
29,420
13,381
25,219
1,274,493
2.31
1.05
1.98
100
Donor
0
529,307
192,247
421,127
942,861
468,864
205,460
217,827
6,593
715,805
264,640
96,618
%
0
12.53
4.55
9.97
22.31
11.10
4.86
5.15
0.16
16.94
6.26
2.29
Total
40,920
571,047
236,563
554,283
1,018,860
565,576
205,950
279,732
17,329
1,141,935
470,332
165,295
38,190
114,020
12,300
4,225,859
0.90
2.70
0.29
100
67,610
127,401
37,519
5,500,352
%
0
12.5
4.5
10.0
22.3
11.1
4.9
5.2
0.2
16.9
6.3
2.3
0.9
2.7
0.3
100
188
Table6.6.6:CentralLevelRecurrentBudgetReleasedbySource&Program,2067/68
ReleasedBudgetBySource(AmountinNRs.000)
Budget
CodeNo
703303
703401
703402
703451
703470
703472
703500
703510
703512
703610
703611
703620
ProgramsBudgetHeading
NationalAidsControl
FP/MCHPrograms
EPIProgram
AvenuInflunza
EpidemiologyProgram
IndentProcurement
PrimaryHealthRD
HospitalConstruction/Management
InformationSystem
703650 NHEICC
Total
GoN
%
40,549 3.65
37,926 3.41
42,836 3.86
130,114 11.71
68,061 6.13
82,045 7.38
233 0.02
49,997 4.50
6,209 0.56
344,312 30.99
200,330 18.03
54,539 4.91
28,782
12,165
13,015
1,111,113
Donor
0
440,396
92,622
321,128
831,432
230,335
68,736
149,358
3,875
344,524
124,576
34,689
2.59
32,203
1.09
77,147
1.17
12,202
100 2,763,223
Total
40,549
478,322
135,458
451,242
899,493
312,380
68,969
199,355
10,084
688,836
324,906
89,228
%
1.05
12.35
3.50
11.65
23.22
8.06
1.78
5.15
0.26
17.78
8.39
2.30
1.17
60,985
2.79
89,312
0.44
25,217
100 3,874,336
1.57
2.31
0.65
100
0
15.94
3.35
11.62
30.09
8.34
2.49
5.41
0.14
12.47
4.51
1.26
Table6.6.7:CentralLevelRecurrentBudgetExpenditurebySourceandProgram,2067/68
ExpenditureBudgetbySource(AmountinNRs.000)
Budget
CodeNo
703303
703401
703402
703451
703470
703472
703500
703510
703512
703610
703611
703620
NationalAidsControl
FP/MCHPrograms
EPIProgram
AvenuInflunza
EpidemiologyProgram
IndentProcurement
PrimaryHealthRD
ManagementInformationSystem
703650 NHEICC
Total
GoN
%
40,549 3.65
37,926 3.41
42,836 3.86
130,114 11.71
68,061 6.13
82,045 7.38
233 0.02
49,997 4.50
6,209 0.56
344,312 30.99
200,330 18.03
54,539 4.91
28,782
12,165
13,015
1,111,113
Donor
0
440,396
92,622
321,128
831,432
228,239
68,736
149,358
3,875
344,524
124,576
34,689
2.59
32,203
1.09
77,147
1.17
12,202
100 2,761,127
%
0
15.95
3.35
11.63
30.11
8.27
2.49
5.41
0.14
12.48
4.51
1.26
Total
%(a)
40,549
1.05
478,322 12.35
135,458
3.50
451,242 11.65
899,493 23.23
310,284
8.01
68,969
1.78
199,355
5.15
10,084
0.26
688,836 17.79
324,906
8.39
89,228
2.30
1.17
60,985
2.79
89,312
0.44
25,217
100 3,872,240
1.57
2.31
0.65
100
189
Table6.6.8:CentralLevelCapitalBudgetAllocationbySourcebyProgram,2067/68
TotalBudgetAllocationbySource
(AmountinNRs.000)
GoN
%
Donor
%
Total
1,600 1.38
0
0
1600
8,325 7.16
9,612
1.63 17,937
10,115 8.71
400
0.07 10515
0 0.00 65,050 11.06 65050
0 0.00 11,400
1.94 11400
7,940 6.83
1,960
0.33
9900
0 0.00 74,688 12.70 74688
0 0.00 28,350
4.82 28350
63,150 54.35 205,000 34.85 268150
21,500 18.50 85,950 14.61 107450
150 0.13 90,300 15.35 90450
Budget
CodeNo
704303
704401
704402
704451
704470
704472
704500
704510
704610
704611
704620
NationalAidsControl
FP/MCHPrograms
EPIProgram
HumanInflunza
EpidemiologyProgram
IndentProcurement
PreimryHealthRD
InformationSystem
704650 NHEICC
Total
415
1,000
2,000
116,195
0.36
0
0.86
2,500
1.72 13,000
100 588,210
0.00
415
0.43
3500
2.21 15000
100 704,405
%
0.23
2.55
1.49
9.23
1.62
1.41
10.60
4.02
38.07
15.25
12.84
0.06
0.50
2.13
100
Table6.6.9:CentralLevelCapitalBudgetReleasedbySourcebyProgram,2067/68
ReleasedBudgetbySource(AmountinNRs.000)
Budget
CodeNo
704303
704401
704402
704451
704470
704472
704500
704510
704610
704611
704620
NationalAidsControl
FP/MCHPrograms
EPIProgram
HumanInflunza
EpidemiologyProgram
IndentProcurement
PrimaryHealthRD
ManagementInformationSystem
704650 NHEICC
Total
GoN
1,206
5,788
0
0
0
4,764
0
0
5,362
414
145
%
3.06
14.68
0.00
0.00
0.00
12.08
0.00
0.00
13.60
1.05
0.37
Donor
18,758
990
2,000
39,427
47.58
2.51
5.07
100
0
2,497
13,000
207,668
0
8,821
11,140
6,776
3,784
1,303
3,737
1,648
53,590
76,238
25,134
Total
1,206
14,609
11,140
6,776
3,784
6,067
3,737
1,648
58,952
76,652
25,279
%
0.49
5.91
4.51
2.74
1.53
2.46
1.51
0.67
23.86
31.02
10.23
0.00 18,758
1.20
3,487
6.26 15,000
100 247,095
7.59
1.41
6.07
100
0
4.25
5.36
3.26
1.82
0.63
1.80
0.79
25.81
36.71
12.10
190
Table6.6.10:CentralLevelCapitalBudgetExpenditurebySourcebyProgram,2067/68
Budget
CodeNo
704303
704401
704402
704451
704470
704472
704500
704510
704610
704611
704620
NationalAidsControl
FP/MCHPrograms
EPIProgram
HumanInflunza
EpidemiologyProgram
IndentProcurement
PrimaryHealthRD
InformationSystem
704650 NHEICC
Total
GoN
%
1,206 3.06
5,788 14.68
0 0.00
0 0.00
0 0.00
4,764 12.08
0 0.00
0 0.00
5,362 13.60
414 1.05
145 0.37
Donor
0
8,821
11,140
6,776
3,784
1,303
3,737
1,648
53,590
76,238
25,134
0
4.25
5.36
3.26
1.82
0.63
1.80
0.79
25.81
36.71
12.10
18,758 47.58
990 2.51
2,000 5.07
39,427
100
0
2,497
13,000
207,668
0.00
1.20
6.26
100
Total
%(a)
1,206
0.49
14,609
5.91
11,140
4.51
6,776
2.74
3,784
1.53
6,067
2.46
3,737
1.51
1,648
0.67
58,952 23.86
76,652 31.02
25,279 10.23
18,758
3,487
15,000
247,095
7.59
1.41
6.07
100
Table6.6.11:DistrictLevelRecurrentBudgetAllocationbySourceandProgram,2067/68
Budget
CodeNo
703801 TBControlPrograms
703805 MCHPrograms
(Dolakha/Ramechhap)
703815 NHEICC
703855 IntegratedHealthServices
Total
GoN
41,367
48
28,000
4,995
1,603,909
1,678,319
%
2.46
0.00
Donor
97099
66,670
1.67
3,825
0.30
50,030
95.57 2,042,559
100 2,260,183
%
4.30
2.95
Total
138,466
66,718
%
3.52
1.69
0.17
31,825
2.21
55,025
90.37 3,646,468
100 3,938,502
0.81
1.40
92.59
100
Table6.6.12:DistrictLevelRecurrentBudgetReleasedbySourceandProgram,2067/68
Budget
CodeNo
703801 TBControlPrograms
703805 MCHPrograms
(Dolkha/Ramechhap)
703815 NHEICC
705855 IntegratedHealthProgram
Total
GoN
39,009
0
27,308
3,239
1,513,217
1,582,773
%
2.46
0.00
Donor
92,417
0
1.73
32,548
0.20
40,471
95.61 1,376,548
100 1,541,984
%
5.99
0.00
Total
131,426
0
%
4.21
0.00
2.11
59,856
2.62
43,710
89.27 2,889,765
100 3,124,757
1.92
1.40
92.48
100
191
Table6.6.13:DistrictLevelRecurrentBudgetExpenditurebySourceandProgram,2067/68
Budget
Program BudgetHeading
CodeNo
703801
703805
703815
703816
705855
TBControlPrograms
MCHPrograms
(Dolkha/Ramechhap)
NHEICC
NationalHealthTrainingCentre
IntegratedHealthProgram
Total
GoN
39,009
0
27,308
3,239
1,513,217
1,582,773
%
2.46
0.00
Donor
92,417
0
1.73
32,548
0.20
40,471
95.61 1,376,548
100 1,541,984
%
5.99
0.00
Total
131,426
0
%
4.21
0.00
2.11
59,856
2.62
43,710
89.27 2,889,765
100 3,124,757
1.92
1.40
92.48
100
Table6.6.14:DistrictLevelCapitalBudgetAllocationbySourceandProgram,2067/68
Budget
CodeNo
704815 NHEICC
Total
GoN
500
682,940
683,440
%
Donor
0.07
1,000
99.93 1,433,500
100 1,434,500
%
Total
0.07
1,500
99.93 2,116,440
100 2,117,940
%
0.07
99.93
100
Table6.6.15:DistrictLevelCapitalBudgetReleasedbySourceandProgram,2067/68
Budget
CodeNo
704815 NHEICC
Total
GoN
480
607,451
607,931
%
Donor
0.08
960
99.92 1,350,343
100 1,351,303
%
Total
0.07
1,440
99.93 1,957,794
100 1,959,234
%
0.07
99.93
100
Table6.6.16:DistrictLevelCapitalBudgetExpenditurebySourceandProgram,2067/68
Budget
CodeNo
704815 NHEICC
Total
GoN
480
584,050
584,530
%
Donor
0.08
950
99.92 1,316,832
100 1,317,782
%
Total
0.07
1,430
99.93 1,900,882
100 1,902,312
%
0.07
99.93
100
Note(a)withreferencetoreleasebudget,(b)withreferencetoallocatedbudget
Table6.6.17:CumulativeFinancialIrregularitiesupto2067/68
Irregularitytoberegularized
2,30,94,95,000
Irregularityclearance
1,05,06,46,000
Percent
45.5
Table6.6.18:IrregularityClearanceStatusofLastThreeYears
F/Y
2067/68
2066/67
2065/66
TotalIrregularityAmount
2,30,94
1,89,00
1,49,59
IrregularityClearance
1,05,06
61,84
42,67
(Rs.InLakh)
Clearance%
45.49
32.72
28.53
192
Difficultyinfinancialreporting
proceduresandreimbursementfrom
donorsduetothelackoftrained
manpowerandphysicalfacilities
Delayinbudgetdisbursementdueto
programsnotbeingapprovedon
time
Nonreleaseofcommitteddonor
budget
Difficultyinkeepingbooksof
accountsandreportingaccordingto
thedifferingformatsofthedifferent
donorssupportingthesameprogram
ActiontobeTaken
Provideinternalandexternaltraining
infinanceasappropriate
Responsibility
MoF,MoHP
Timelyactionsmustbetaken forthe
approvalofdevelopmentprograms
DoHS(especiallyconcerned
programdivisionsand
centres),MoHP,NPC
MoF,MoHP,Donors
PlanofActionandworkplan
agreementsmustbesignedbefore
budgetallocation,anddonorsshould
releasebudgetaspertheir
commitment
Accountstaffsshouldbe
thoroughlyorientedonbook
keepingandreportingformats
usedbyofdifferentdonors
Providecomputerstodistrictlevel
financesectionandprovide
computertrainingforthem
MoF,MoHPanddonors
193
SupportingPrograms:Management
6.7
MANAGEMENT
6.7.1 Background
General Management of Department of Health Services is assigned to Management Division, one

amongfivedivisionalwingsofDepartmentofHealthServices(DoHS).OperatingManual(Procedure)
for Department of Health Services describes the responsibility of this division for information
management, planning, coordination, supervision, monitoring and evaluation of the health
programs. The division is also responsible for monitoring the delivery of quality health services
throughalltypesofhealthinstitutions.Itisalsoresponsibleformonitoringthebuildingconstruction
and maintenance of public health institutions and providing supports for maintenance of medical
equipments.
Objectives
Tofacilitateandcoordinateamongconcernedprogramdivisionsandcentrestoprepareannual
plan, programs and make necessary arrangements to get approval from National Planning
Commission(NPC)andMinistryofFinance(MoF).
Makenecessaryarrangementsforpreparationandcompilationofannualbudgetandprograms
oftheRegionalHealthDirectoratesandDistrictsPublic/HealthOffices.
Tomonitorprogramimplementationstatusandcarryoutperiodicperformancereviews.
Tosupportqualityimprovementinthehealthsector.
To manage Health Management Information System (HMIS) and Health Sector Information
System(HSIS).
Manage and Coordinate for construction and maintenance of buildings and other
infrastructuresofPublicHealthInstitutions.
Toprocessforapprovalofestablishmentofprivateandnongovernmenthealthinstitutions.
Toprocessforapprovalofnewpublichealthinstitutionsandtheirupgrades.
Tomakearrangementsforcapacitybuildingofhumanresourcesinpublichealth.
Strategies
Make necessary arrangements to collect and analyze health information and use it to support
planning,monitoring,andevaluation(PME)ofhealthprograms.
Strengthen Bottomup planning process from VDC to the district level by optimum use of
availableresourcesincludinghealthserviceinformation.
Conductandexpandregularperiodicperformancereviewsanduseoutcomesforimprovement
downtocommunitylevel.
Strengthenmonitoring/supervisionsystemateachlevel.
Establish central data bank linking HMIS with HURDIS, LMIS, Finance, Surveys/ Censuses and
othersourcesofinformation.
Expandcomputerizedinformationsystematalllevels.
Monitoringofhealthservicesprovidedbystateownedandnonstatehealthinstitutions.
Developandimplementconstruction,repairandmaintenanceplanforhealthfacilities.
Capacity development of health workers as well as Management Committees in close
collaborationwithNHTCandconcernedagencies.
ConductHumanResourceDevelopmentprogramsforimprovementinqualityofhealthservices
RoutinemanagementofHealthServiceInformationroundtheyear.
194
Orientationonqualityhealthservicedelivery.
Upgradinghealthfacilitiesasperplanandpolicies.
Processforapprovalandrenewalofprivateandnongovernmentalhealthfacilitiesonthebasis
ofgivenservicestandards.
Developandimplementintegratedsupervisionandmonitoringplan.
Establishanddeveloprequiredinfrastructure,humanresourceandguidelinestoconductother
designatedandnonroutineworksassignedtoMD.
OrganizationalArrangement
The division has four sections and two units for overall management of functions and service
delivery as directed by operating manual, citizen charter and plan and policy documents of health
system.
1. HealthManagementInformationSection
2. Planning,Budgeting,BuildingConstructionandMaintenanceSection
3. ProgramMonitoringandEvaluationSection
4. QualityAssuranceSection
5. NursingUnit
6. OralHealthUnit
Thespecificfunctionsofsectionsandunitsareasfollows:
1. HealthManagementInformationSection(HMIS)
To collect and manage the health service delivery information from all levels of health service
deliveryoutlets.
Toverify,process andanalyzethecollecteddataanddrawindicatorsandrelevantinformation.
To provide feedbacks on achievements, coverage, continuity and quality of health services to
programdivisions/centres,hospitalsanddistrictpublic/healthoffices.
Toprovidenecessaryinformationforplanandpolicyformulation.
Todisseminatehealthinformationthroughefficientmethodsandtechnologies
TopublishacomprehensiveAnnualReportofDepartmentofHealthServices
TodevelopcompetenthumanresourceforHealthInformationManagementSystem.
To support for conducting National Performance Review of health programs and support to
regional,districtandbelowlevelreviews.
To improve the information management system and modify the tools, techniques and
methodologies.
ToestablishintegratedHealthSectorInformationSystem(HSIS).
2. Programming,Budgeting,BuildingConstructionandMaintenance Section
Tofacilitateplanning,programmingandbudgetingatcentral,regionalanddistrictlevel.
To process for approval of annual programs and budget of health programs of DoHS, Regions
anddistrictsfromNPCandMoF.
Tostrengthenandfacilitatebottomupplanningprocess.
Tosupportthemaintenanceofmedicalequipments.
To support the construction, repair and maintenance of infrastructure of public health
institutions.
Tosupportmentalandearhealthrelatedprograms.
195
3. ProgramMonitoring&EvaluationSection
Tomonitor,superviseandevaluatethehealthprogramsofDoHS.
To conduct integrated supervision in collaboration with Divisions, Centres and Regional Health
Directorates.
Facilitateconductionofmonthly,bimonthly,quarterly,halfyearly&annualperformancereview
meetingsofhealthprograms.
To monitor health care service delivery with special focus on essential health care services in
stateandnonstatesector.
To facilitate strengthening District Health Management System as well as health management
training.
Coordinatedecentralizationanddevolutionofhealthfacilitiesatdistrictlevel.
SupportDP/HOtostrengthenLocalHealthFacilityManagementCommittee.
Supporthealthcarewastemanagementactivities.
4. QualityAssurance Section
Strengthen national quality assurance system for health sector in close collaboration with
Divisions,Centres,RHDsandotherstakeholders.
Facilitateprocessforupgradinggovernmenthealthinstitutions.
Conduct supervision and monitoring for quality assurance as per standard guideline & service
protocolincoordinationwithprogrammonitoringandevaluationsection.
Toconductstudies&researchactivitiestoimprovequalityofhealthcare.
To process providing approval for opening new hospital under NGO/private sector including
nursinghomesof16to50bedsandtheirrenewal.
5. NursingUnit
Tosupportcapacitydevelopmentfornursingprofessionals.
Tosupportnursingleadershipprograms.
6. OralHealth Unit
Toconductoralhealthactivitiesasafocalpoint.
Activitiescarriedoutin2067/68
15thNationalAnnualPerformanceReviewMeeting,2067/68(2010/2011).
ArrangementsforprintingandsupplyofHMISrecordingandreportingtools.
Integratedcomputerizeddatabasesystemwasimplementedinthe45districts.
Preparation, printing and distribution of Annual Report of FY 2066/67 (2009/2010) of
DepartmentofHealthServices.
Health Sector Information System (HSIS) piloting extended and implemented in three districts:
Rupandehi,ParsaandLalitpur.
HealthGeographicalInformationSystem(HealthGIS)expanded.
Health Facility Mapping Survey (HFMS) with service availability mapping (SAM) has been
conductedinitiallyin15districts,reaching42districts.
196
RegularperiodicreviewmeetingofDoHSconducted.
Workshopandtrainingsconductedforhealthcarewastemanagement.
ConstructionofPHCs,HPs,birthingcentres,storebuilding,staffquarters,birthingunitsisbeing
continued.
Procurement of Dental sets, Computer accessories, Multimedia projectors, Printers, Fax
machines.
O&MSurveywasconductedforhealthfacilityupgrading.
Central/Regionallevelplanningworkshopconducted.
LeadershipDevelopmentOrientationforSeniorNurses.
AppreciativeInquiryOrientationtohealthworkers.
NursingJobdescriptiondevelopedforalllevelsofnurses.
CapacitybuildingprogramsforhealthworkersinOralHealth.
QualityAssuranceOrientationtostateandnonstatehealthworkers.
PerformanceBasedMonitoringSystemguidelineupdated.
MentalHealthTrainingiscontinued.
ManagementDivisionconducted71activitiesduring2067/68outofwhich59arelistedinAnnex1
andremainingwereminorprogramsorsimilartypesmergedtogether.Overallphysicalandfinancial
progressachievedwere85percentand70percentrespectively.
BuildingConstructionandMaintenance
Public health facility construction and

maintenanceworkisassignedtoManagement
Division and Department of Urban
Development and Building Construction
(DUDBC).Allthemaintenancewithinpremises
of DoHS and construction and maintenance
works in the districts and regions costing less
than one million is disbursed through
Management Division. All other construction
works costing more than one million is done
throughDUDBC.
Box6.7.1:SummaryofBuildingConstructionby
DUDBC(FY2061/0622067/068)
Totalnumberofprojects
973
Underconstruction
266
Near completion (Till the end of FY
286
2067/068)
Completed/handedover
421
BudgetallocatedtoDUDBC(in'000)
2935854
Expenditure(in'000)
2354719(80%)
HealthFacilityUpgradation
Management Division starts the processing for upgrading of public health facilities up to 15 bed
hospitals.InlinewithupgradingalltheSubHealthPoststoHealthPostsandotherhealthfacilities
accordingly up to 15 bed hospitals following certain procedures, division collects demand and
recommendations from concerned agencies and process for approval. The status of health facility
upgradationisgiveninTable6.7.1.
Table6.7.1:StatusofHealthFacilitiesupGradation
Year
2065/66
2065/66
2066/67
2067/68
2067/68
HFType
SHPtoHP
HFtoHospital
SHPtoHP
SHPtoHP
HPtoPHC
HFNumber
500
6
522
500
10
Status
ProcessingintheMoHP
Approved,Implementing
Approved,Implementing
O&Misgoingon
O&Misgoingon
197
ApprovaltoPrivateHealthFacilities
Management Division processes documents for approval to private health facilities. Among the
processed41privatehealthfacilitiesgotapprovaluptotheendoffiscalyear2067/68,sevenwere
approvedin2067/68.
Table 6.7.2 and Table 6.7.3 present the issues raised during the regional and national review
meetingsandactionstaken.
Table6.7.2:NationalReview,2067
Issues
Provisionofbuilding&
constructionthrough
interagencies
VacantPostsofSO,SA
andMRs
WeakSupervisionand
Monitoring
MotivationtoMedical
Recorders
Recommendations
Buildingsshouldbe
constructedbyconcerned
HealthOffice
RecruitmentthroughPSC
ActionsTaken
Putindiscussion
Putindiscussion
IntegratedSupervisionGuidelineisrevisedand
senttotheregionsanddistricts.
Interactioninregionstoimproveintegrated
supervisionandtoutilizefeedback.
Advocacyforthenecessityofintegrated
supervisionstressedatallforums.
Coordinationforsharingworks Program toestablishelectronicreportingsystem
andstrengthenHospital
in33publichospitalsandcapacitybuildingof
InformationSystem
medicalrecordersforoperation,inthisfiscalyear.
StrengthenIntegrated
supervision
Table6.7.3:RegionalandNationalReviews,2067/68
SN
Issues
1 DelayinHMISreporting
2
Underreportingfromprivatehealthfacilities
3
4
DegradingqualityofHMIStools
InadequateHMISdatautilization
InadequateHMIStrainingforproper
recordingandreporting
Stronganduserfriendlysoftwareisneeded
forreportinganddataanalysis
Lackoftrainingandotherinfrastructurefor
medicalrecordersinthehospitals
6
7
Noregulatoryactforprivatehealth
institutionforreportingservices
9 Lowpursuanceofissuesraisedinreviews
10 Lowinvolvementofdisadvantaged(DAG)in
healthmanagementandserviceutilization
11 Deathanalysisinthehospitalsisnotdone
12 Issueofqualityofservices
13 Lowqualityofconstructionworks,noproper
handovermechanismandpoorsupervision
Actiontobetaken
Ensuretimelyreportingfromdistrictsandmakeregions
moreresponsible
Makeproperarrangementsforactualandcomplete
reporting
Keepfocusonqualityofprinting
DatauseinPlanning,Monitoringandsupervisionateach
levelshouldbeenhanced
IncreasenumberoftrainingsforHFlevelstaffs
Developuserfriendlysoftware
ProvideICDandothertrainingstomedicalrecorders,
improveinfrastructureandpreparepolicytoclearold
documents
Privatehealthinstitutionregulatoryactshouldbe
formulated
Followissuesraisedandtakeproperactionforsolvingthem
Strengthengenderandsocialinclusioninpublichealth
systemsoftheregionthroughsituationanalysisand
forwardingthisagendaforimplementation
Deathaudittobeinitiatedanddocumented
Qualityservicedeliveryshouldbeimprovedandmonitored
well
Healthauthoritiesshouldtakeresponsibilityofbuilding
constructionandmaintenance
198
SupportingPrograms:PrimaryHealthCareRevitalization
6.8
PRIMARYHEALTHCAREREVITALIZATION
6.8.1 Background
InNepal,PHChashadalonghistorythatwasreinforcedbytheDeclarationatAlmaAta,andin1991
culminatedintheNationalHealthPolicyendorsingPHC.NationalHealthPolicy1991wasaturning
point in delivery of Primary health care services in the rural areas of Nepal. The most important
contribution of the Policy is that it increased the access to majority of people in Nepal by
establishing a total of 4,020 health institutions spread throughout the country. SubHealth Posts
(SHP)andHealthPosts(HP)deliverhealthservicesatVDClevel.PrimaryHealthCareCentres(PHCC)
with3bedsareestablishedineachelectoralconstituency.Hospitalsthathaveupto25bedsprovide
outdoor,indoor,diagnosticandemergencyservicesinthedistrict.
Currently, Nepal is undergoing a period of great political and social change. Nepal is one of the
poorest countries in the world. Annual gross domestic product per capita is below US$ 400 and
approximately50percentofitsadultpopulationisilliterate,withasharerisingtoover70percent
among some ethnic groups. Improving health for Nepal's people is a major challenge. Though the
progresshasbeenseeninsomecorehealthindicators,Nepalisstillatthelowerendincomparison
to other countries in Asia. Almost a quarter of the population lacks access to even the most basic
health care services, and almost half of Nepalese children under five suffer from undernutrition.
Everyhour,awomaninNepaldiesduetopregnancyandchildbirthrelatedcomplications,andonly
one in five births is attended by a Skilled Birth Attendants (SBA). Nevertheless new challenges for
optimalmanagementofthehealthsystemarewellidentified,particularlythegrowingdisparitiesin
healthandrapidlyexpandingandunregulatedprivatesector.Thesystemeffortsonselectivehealth
condition target as quick solution without comprehensively addressing the essential elements of
developingandstrengtheningsystemandfosteringintersectoralcoordinationhasproducedunequal
healthoutcomes.Recent,reformeffortsareexemplifiedbytheadoptionofahealthsectorstrategy
andImplementationPlanoftheNepalHealthSectorProgramII(20102015).ThePlanputsamajor
emphasis on an increased coverage and quality of 'essential health care services' with a special
attentiontoimprovedaccessforpoor,vulnerableanddisadvantagedgroups.
Rationale
The concern for the poor and marginalized people both in urban and rural areas has been the
priority of the government. In order to materialise the constitutional commitment (Interim
Constitution, 2007) of fundamental right of basic free health care, MoHP introduced a policy of
providing Free Health Care Services to the population in a phased manner to enhance access to
primaryhealthcareservicesforeverycitizenonanequalfootingwithspecialconsiderationforthe
safetynetforthepoor,ultrapoor,destitute,disabled,seniorcitizensandFemaleCommunityHealth
Volunteers(FCHV).Consequently,in2009(Jestha2065),MinistryofHealthandPopulation(MoHP)
embeddedinprinciplesofessentialcareandequityconstitutedanewdivisionPrimaryHealthCare
Revitalization (PHCRD) under the Department of Health Services. The new division is envisaged to
revitalize PHC in Nepal by addressing emerging health challenges in close collaboration with other
DoHSdivisionsandrelevantactors.Thedivisionhas3thematicfocuses:
SocialHealthProtection,and
UrbanandEnvironmentalHealth
199
And through it is expected to make inroads into translating the constitutionally stipulated
fundamental right of basic free health care into practice by addressing the disparities in health
servicedeliveryandhealthoutcomesandpromotingequitablehealthservices.
Vision
To contribute in improving the health status of the Nepali population, especially of the poor and
excluded.ItwillsupportMoHPtocontributetopovertyreductionbyprovidingequalopportunityfor
alltoreceivehighqualityandaffordablehealthcareservices.
Goal,ObjectivesandStrategy
Goal:Toreducemorbidityandmortalityespeciallyofpoor,marginalisedandvulnerablepeoplebysecuringtherightof
thecitizenstoqualityessentialhealthservices
Component1
Program
Objective1
Toincreaseaccesstoand
utilizationofqualityessential
healthcareservicesby
ensuringavailabilityof
essentialdrugsinbothurban
andruralhealthfacilities
throughouttheyear
Component2
SocialHealthProtection
Objective2
Toachieveuniversalcoverage
ofessentialhealthservicesby
developingamore
comprehensiveapproach
(structuresorsystems)with
theaimofprotectingthe
populationagainstthe
financialrisksofexpensive
healthcare
Strategy
1.Developandensure
1. SupporttheMoHPin
implementationof
Pilottestingof
comprehensiveessential
networking&
healthcareservices
expansionofsocial
packageconsideringthe
protectionmechanisms
below
asoutlinedinthe
NationalInsurance
Program
HealthInsurance
communication
Strategy
Rapidexpansionof
2. Mechanismstorevitalize
thepackage
CommunityDrugScheme
Community
areexploredand
participation
endorsed
Strengthening
3. Ensuretheservicesare
accountability,
sensitivetoGESIand
integration&reduce
usershaveequalaccess
verticality
toserviceswithout
2. Appointafocalpersonfor
regardtofinancialor
PRDwithinthedistrict
socialstatus
healthsystem
3. Outreachforunderserved
populationand
community
empowermentto
demandtheirrightsto
qualityservicesand
realizetheir
responsibilities
4. Ensurequalityofcareand
availabilityofessential
drugsthroughM&E
Component3
UrbanandEnvironmentalHealth
Objective3
Toprovidequalityessential
healthcareservicestothe
municipalpopulationat
accessibledeliverypoints
throughurbanhealthclinic
inpartnershipwithMoLD/
Municipality
Objective4
Topromoteenvironmental
healthspecificallyhygiene
andsanitationamongst
populationinconjunction
withotheressentialhealth
careservicesforimproved
hygienepracticesin
partnershipwithrelated
agencies
1. Developandendorse
1. Multisector
UrbanHealthStrategy
coordinationincluding
specifydivisions
2. Coordinatewithother
divisionsand
functionalitiesand
responsibilitieswith
MoLD/Municipalitiesto
establishurbanhealth
otherkeystake
centres
holders
3. Supportmunicipalities
indeployingtheFemale 2. IECforintegrated
CommunityHealth
messages(linkwith
Volunteers(FCHVs)as
behaviorchange)
MunicipalHealth
Volunteersindelivering 3. Institutional
EHCS
arrangementasbest
4. Supportmunicipalities
practiceforWASH
indeployingand
capacityenhancingof
clinicalhealthworkers
200
Thefollowingwerethemajoractivitiescarriedoutduringfiscalyear2067/68:
NationalFreeHealthCare(NFHC)
Monitoringcommitteedevelopedatalllevelsofthehealthsystem.
Information&communicationabouttheEHCSsimprovedbydisplayingcitizencharterinmostof
thehealthfacilities.
ReportingofNFHCincorporatedinHMIS.
Initiationofcentralbiddingandlocalpurchasing,andprocuringWHOGMPProducts.
InitiationofSocialAuditindistrictandbelowhealthfacilities.
Trainingconductedonrationaldrugprescriptionin75districts.
PeersgroupDiscussionconductedforrationaluseofdrugsin22districts.
IntegratedPublicHealthCampaignin8District
SocialHealthProtection
Policy draft on social health insurance is in progress to introduce social health insurance in
phasedmanner.
Social inclusion program specifically providing transportation costs incurred during referral,
targetedinterventionsformarginalizedcommunitiesandseniorcitizenimplemented.
Communityhealthinsurancepilotinterventionsareinprogressin6PHCCs(Table6.8.1).
Table6.8.1:CommunityHealthInsurancePilotInterventions
Districts
MangalabarePrimaryHealthCareCentre(PHCC)inMorang
District
DumkauliPHCC,Nawalparasi
Model
Highcostandlowfrequencyillness
(catastrophicspending)
Lowcost,highfrequencyillnessin
Katari
KatariPHCCinUdayapur,ChandranigahapurPHCCinRautahat,
LamahiPHCCinDang,andTikapurPHCCinKailali
UrbanHealth
DraftedUrbanHealthPolicyandStrategy.
DevelopedComprehensiveTrainingManualforMunicipalHealthWorkerandUrbanFCHV
83Urbanclinicestablishedin58Municipality.
FCHVfund,DressandKitboxes
IntegratedPublicHealthCampaign8LowHDIdistricts
6.8.3 KeyAchievements
1. 'Comprehensive' essential health care services package including Standard Operating

Procedures(SOP)of:
Eye,ENT,Oralandmentalhealth.
Prevention,managementandreferralofNonCommunicablediseases(NCD).
PreventionofPhysicaldisabilitiesdevelopedandimplemented.
201
2. Guideline on functional responsibilities reviewed and endorsed to address emerging health
conditions.
3. EmpowermentandIECpackagesforcommunitiestoawareabouttheirhealthrightsEHCS,free
medicineandmaketheserviceprovidersaccountable.
4. 83UrbanHealthCentresaredevelopedtoprovideEHCSinselectedmunicipalities.
5. Majorinterventionsrelatedtorehabilitation,WASH,NCD,socialhealthinsurance,mentalhealth
serviceswillbepilotedwithaviewthatlessonslearntwillbeextrapolatedatnationallevel.
SN
1 Poormechanismstoidentifyandissue
CardtotargetedgroupunderNFHCP
2
Lackofpolicyonsocialhealthprotection
Lackofclearpolicyandstrategyto
addressurbanhealthissues
DistrictreportunderPRDprogramshave
notyetincorporatedinHMIS
FewpostsarestillvacantinPHCRD
FunctionalcoordinationMOLDand
municipalitiesisstilllacking
4
5
6
Recommendations
Developsoundmechanismstoidentify
thetargetedgroup.
Reactivatemonitoringmechanisms.
Draftandendorseurbanheathpolicy
andstrategy
Responsibility
PHCRD
MoHPand
PHCRD
MoHPand
PHCRD
202
Chapter7
OtherPrograms:DrugAdministration
OTHERPROGRAMS
7.1 DRUGADMINISTRATION
7.1.1Background
Government of Nepal has promulgated the Drug Act 1978 to prohibit the misuse or abuse of
medicinesandalliedpharmaceuticalmaterialsaswellasthefalseormisleadinginformationrelating
toefficacyanduseofmedicinesandtoregulateandcontroltheproduction,marketing,distribution,
exportimport, storage and utilization of those medicines which are not safe for the use of the
people,efficaciousandofstandardquality.
ToimplementandfulfilltheaimofDrugAct1978andvariousregulationsunderitGovernmentof
NepalestablishedDepartmentofDrugAdministration(DDA)in1979.
InaccordancewiththeobjectivesoftheNationalHealthPolicy1991,theNationalDrugPolicy1995
hasbeenformulatedandimplemented.Itfocusesonestablishingcoordinationamonggovernment,
nongovernmentandprivateorganizationsinvolvedintheactivitiesrelatedtomedicineproduction,
import, export, storage, supply, sales, distribution, quality assessment, regulatory control, rational
use and information flow. Achieving the aims and objectives of National Drug Policy is another
importantareaforDDA.
UndertheDrugAct1978,thefollowingregulationsandcodeshavebeenimplementedassupporting
toolsfortheactiveenforcementofDrugAct:
Regulation on Constitution of Drug Consultative Council and Drug Advisory Committee,

(2037BS)
DrugRegistrationRegulation,(2038BS)
DrugStandardRegulation(2043BS)
EnquiryandInspectionRegulation(2040BS)
CodesonDrugProduction(2041BS)
DrugDonationguidelineshavebeenimplementedforthequalityassuranceofdonatedmedicines.
Objectives
The main objective of DDA is to regulate all functions relating modern, veterinary and traditional
medicines, like misuse and abuse of medicines and its raw materials, to stop false and misleading
advertisement and make available safe, efficacious and quality medicine to the general public by
controlling the production, marketing, distribution, sale, exportimport, storage and use of
medicines.
203
Strategies
Selectionofessentialmedicinetopromoterationaluseofmedicines
Establishmentofregionalofficesatallfiveregionsforeffectivedecentralization
Strengthening of National Medicines Laboratory (NML) as an Independent Medicine Control
Laboratory
Medicineregistrationbasedonscientificfacts
Promotionofrationaluseofmedicines
Developmentofanefficientdruginformationsystemtodisseminatetherelevantinformation
Encouragement to promote and establish pharmaceutical industries to achieve selfreliance in
theproductionofessentialmedicines
Effectiveinspectiontoensurethequalityofmarketedmedicines
Preventmisuseofantibiotictocombatantimicrobialresistance
StrengthennationalindustrytocomplywithWHOGoodManufacturingPractices(GMP)
SectionsandBranchOfficesandtheirFunctions
ImportandExportSection
Registertheforeigndrugmanufacturingcompanyandproductsinascientificmannerforimport
Issuetherecommendationletterforimport/exportofmedicines
Renewtherecommendationletterforimportexport
IndustrySection
IssuerecommendationletterfortheestablishmentofpharmaceuticalindustryandissueProduct
ManufacturingLicenseandrenewthem
Checkandapprovethepharmaceuticalmanufacturingplantlayout
Evaluatethenewproductsandissuemarketingpermissionforthesaleanddistribution
Issueletterofrecommendationfortheimportofrawmaterialsandrenewthem
PharmacyRegistrationSection
To register and issue registration certificates to open retail/wholesale pharmacy outlets and
renewthem
Issueandrenewcertificatesforpersonsauthorizedtosalemedicines
Updatetherecordofpharmacies
TrainingandDrugInformationSection
Conducttherefreshertrainingtomedicinesellers
Disseminate information about medicines particularly sideeffects, contraindication, drug
interaction,andstorageconditionandothernecessaryinformationregardingmedicines
Publish Drug Bulletin of Nepal (DBN) and distribute to health institutions, industries, medical
doctors,healthpersonnel's,pharmacistsandothersconcernedpersonandinstitutions
Revise National List of Essential Medicines, Standard Treatment Schedules and Nepalese
NationalFormularyperiodically
Recommend for import of narcotic, psychotropic, precursors substances and liaise with
InternationalNarcoticControlBoard
ConductactivitiesrelatedtoPharmacovigillanceandAdverseDrugMonitoringReporting
InspectionSection
Inspectdrugindustries,wholesaleandretailpharmaciesregularly
204
TakelegalandadministrativeactiononcasesofnoncomplianceaspertheprovisionofDrugAct
anditsRegulations
Regulatesalesanddistributionofpsychotropicandnarcoticdrugs
CoordinateGoodManufacturingPracticeAuditwithinandoutsidethecountry
BranchOffices
DDA has its branch offices at Biratnagar, Birgunj and Nepalgunj. These offices carry out the
responsibilityofinspectionaswellasPharmacyregistrationandrenewal.
BiratnagarOffice
BirgunjOffice
NepalgunjOffice
Adrshanagar,SurkhetRoad
MuraliBagaicha
Kanchanbari
Nepalgunj
Birgunj
Biratnagar
BankeDistrict
ParsaDistrict
MorangDistrict
email:nepalgunj@dda.gov.np
email:biratnagar@dda.gov.np email:birgunj@dda.gov.np
Tel./Fax082522074
Tel./Fax:051527753
Tel./Fax:021420849
NationalMedicinesLaboratory(NML)
NationalMedicinesLaboratoryistheprincipalbodyofGovernmentofNepalfortestingandanalysis
ofdrugs.Ithasvarioussectionslikechemicalanalysis,microbiology,pharmacologyandinstrumental
analysis.ThemainfunctionsofNMLareto:
TestandanalyzethequalityofmedicinesasempoweredaccordingtotheDrugAct1978.
IssueLotReleaseCertificateforvaccines.
DevelopSecondaryReferenceStandardandmakeavailabletothepharmaceuticalindustries
andlaboratories.
ConducttrainingonGoodLaboratoryPractices.
AuditlaboratoriesofNepalesepharmaceuticalindustries.
Majoractivitiescarriedoutin2067/2068include:
Awarenessontherationaluseofmedicinesthroughdifferentmedia
RegularpublicationofDrugBulletinofNepal(DBN)
AuditofdrugindustriesforGoodManufacturingPractice(GMP)
Inspectionofretailandwholesalepharmacies
DrugAnalysistocheckthequalityofmarketeddrugs
InspectionofForeignManufacturersbeforeregistrationfortheimportationpurposes
Conductingexaminationofveterinarydrugsellerstraining
Conductingrefreshertrainingsforretailersandwholesalers
RevisionofNepaleseNationalFormulary
DevelopmentofGoodManufacturingPracticeRegulation(Draft)
RevisionofNationalMedicinePolicy(Draft)
RevisionofNationalListofEssentialMedicines
205
7.1.3 FinancialAllocationandExpenditure
Budget
AllocatedBudget
Expenditure
RevenueCollection
Amount(NRs.)
3,99,37,724.00
3,94,30,367.21
2,31,89,633.50
7.1.4 WorkPlanfor2068/69
SN
1
2
3
4
5
6
7
Activities
Druginformationtothepublicbydifferentmedia
PublicationofDrugBulletin
InspectionofPharmaceuticalIndustries
Inspectiontodrugretailers&wholesellers
DrugAnalysis
AuditofPharmaceuticalAnalyticalLaboratories
Examinationofveterinarydrugsellerstraining
Unit
Number
Number/issue
Number
Number
Number
Number
Times
Target
45
15000(3issues)
100
1600
700
30
2
206
OtherPrograms:Ayurveda
7.2
AYURVEDA
7.2.1Background
Ayurvedaisthemostancientmedicalsystembasedontheherbal,mineralsandanimalproducts.At
presentAyurvedahealthservicesarebeingdeliveredthroughtwoAyurvedaHospitals(one100+18
cabin bedded at Naradevi, Kathmandu & other 30 beds Bijauri, Dang), 14 Zonal Ayurveda
Aushadhalayas,61DistrictAyurvedaHealthcentersand214AyurvedaAushadhalayasinthecountry.
Ayurveda and Alternative Medicine unit in the Ministry of Health and Populations (MoHP)
formulates policies and guidelines for the traditional medical system. Department of Ayurveda
(DoA),oneofthethreedepartmentswithintheMinistryofHealthandPopulation,wasestablished
in2038B.S.
Altogether 1,543 posts have been sanctioned within the Department of Ayurveda. Of which 817
postsaretechnical,101areadministrativeand625postsaresupportinglevel(officeassistance).
TheratiosbetweenpopulationandAyurvedainstitutionareasfollows:
PopulationperHospital:14.1million.
PopulationperDistrictAyurvedaHealthCenters:3.7million;and
PopulationperAyurvedaDispensaries:0.13million.
NRs.185,931,000wasallocatedfortheAyurvedrelatedactivitiesin2067/68.
Objectives
Toexpandanddevelopfunctional,physicalAyurvedahealthinfrastructure;
ToimproveaqualitycontrolmechanismforAyurvedahealthservicesthroughoutthecountry;
Todevelopandmanagetherequiredhumanresources;
Tomobilizetheadequateresourcesformedicinalplants;
To promote community participation in the management of the health facility & utilization of
localherbs;
Toprocure,storeanddistributetheAyurvedamedicine&otheralliedmaterials;
Topromotehealthstatus&sustainabledevelopmentofAyurvedasystemusinglocallyavailable
medicinalplants;
Topromotepositiveattitudestowardshealthcare&awarenessofhealthissues;
Strategies
Providepreventive,promotive&curativehealthservicesintheruralareas;
Establishment&developmentofAyurvedainstitutions;
Strengthen&expandtheAyurvedahealthservices;
Developskilledmanpowerrequiredforvarioushealthfacilities;
Strengtheningofmonitoring&supervisionactivities;
Developmentofinformation,education&communicationcenterintheDepartment;
Develop Inter sectored coordination with Education Ministry, Forestry, local development
sector&otherNGO's&INGO's;
EstablishmentofregionalAyurvedaHospitals&AyurvedaDispensaries;
Strengthening&expansionofresearch&trainingcenterofinternationallevel;
National&Internationalleveltrainingforthecapacitydevelopmentofitshumanresources
207
Establishmentandstrengtheningofruralpharmacies
Establishmentofmodelherbalgarden
Procurement&supplyoffurnitureandequipments(medical,surgicalandvehicle)
Procurement&supplyofAyurvedamedicinesindifferentAyurvedainstitutions
Preparation&publicationofAyurvedaPharmacopeia'sofNepal
Inservicetraining
ConductionoffreeAyurvedahealthcamps
Conductionoftraditionalhealerstraining(districtwide)
TrainingonPanchakarma,Hospitalmanagement&Ksharsutra
Construction,Maintenance&repairofAyurvedicinstitution
Productionofpowder(Churna)medicineinruralpharmacies&districtlevel
AyurvedahealtheducationforSchoolstudents
SupervisionandmonitoringofAyurvedainstitution
Regionalreview
FollowingactivitieswereconductedwithsupportfromGoNandWHOin2067/68:
GoNSupport
Constructionoftwentytwoofficebuildingspartiallycompleted.
RefreshertrainingforKavirajsandVaidyas.
Ayurvedamedicine,Firstaidandsurgicalequipmentssuppliedtoallhealthfacilities.
FreehealthcampsconductedonShivaratrifestival&twodistrictsoutsideKathmanduvalley.
Repairedexistingbuildingsandcompoundwallsindistrictandlocallevels.
PreparadNepalAyurvedaPharmacopoea(partwise).
Ayurveda medicine preparation were continued at rural Ayurveda Pharmacy and district
AyurvedaHealthCenterutilizingthelocallyavailablemedicinalherbsandsuppliedtoAyurveda
institutionintheregions.
Annualprogressreviewmeeting.
WHOSupport
TrainingforfarmerstoincreaseawarenessofGACP
AyurvedicDoctorstrainedonKshrasutra,Panchakarma&hospitalmanagement
GMPguidelinesdeveloped,disseminated&advocated
AnalysisandrevisionofessentialAyurvedicDrugListtosupportfreehealthcareservices
PreparationofcountrymonographonTM
StudyvisittosupportestablishmentofAyurvedicResearchCentreinNepal
BasedonthetreatmentreportofdifferentAyurvedainstitutionsfollowingdiseaseswereclassified
astoptendiseases:
Amlapitta(Gastritis)
Udarrog(Abdominaldiseases)
SwasanBikar(Respiratorydiseases)
Vatavyadhi(Arthritis,RheumaticArthritisetc.diseases)
Jwar(Pyrexia)
Balrog(Pediatricdiseases)
208
Karna,Nasa,Mukha,Danta&Kantharog(ENT,Oral,Dentaldiseases)
Strirog(Gynecologicaldiseases)
Brana(Wound,Abscess)
Atisar/Grahani(Diarrheadiseases)
Table7.2.1showsthenumberofpeopleservedatvariousregionsandzonesbysexin2067/68.The
highestnumberofpeoplewereservedinwesternregionwhereastheleastnumberofpeoplewere
servedinfarwesternregion.
Table7.2.1:ServiceStatistics
Adult
Region
Eastern
Zone
Mechi
Koshi
Sagarmatha
Total
Central
Janakpur
Bagmati
Narayani
Total
Western Gandaki
Lumbini
Dhawalagiri
Total
Mid
Rapati
western Bheri
Karnali
Total
Far
Seti
western Mahakali
Total
AyurvedicHospitalDang
AyurvedicHospitalNaradevi
GrandTotal
Male
18,450
16,060
13,776
48,286
29,511
30,720
20,793
81,024
35,954
14,258
27,727
77,939
12,691
12,957
8,866
34,514
21,811
10,621
32,432
9,632
13,412
297,239
Female
16,619
16,388
12,830
45,837
23,833
35,985
21,498
81,316
54,576
16,849
39,380
110,805
17,665
16,205
7,484
41,354
20,527
9,625
30,152
21,502
12,148
343,114
Children
Male
Female
5,566
4,997
3,402
3,052
6,762
6,656
15,730
14,705
9,300
8,682
5,539
5,634
3,471
3,445
18,310
17,761
9,366
9,439
1,741
2,177
3,799
3,929
14,906
15,545
3,253
3,292
5,044
5,537
1,852
1,521
10,149
10,350
6,857
6,243
5,857
5,507
12,714
11,750
720
725
586
518
73,115
71,354
Total
45,632
38,902
40,024
124,558
71,326
77,878
49,207
198,411
109,335
35,025
74,835
219,195
36,901
39,743
19,723
96,367
55,438
31,610
87,048
32,579
26,664
784,822
Table7.2.2showsthefinancialallocationandexpenditureofthefiscalyear2067/68.
Table7.2.2:FinancialAllocationandExpenditurein2067/68
Topic
DepartmentofAyurveda703165)
AyurvedaChikitsalaya2(703166)
AyurvedaAushadhalaya(703167)
Ayuvedchikitsalaya2(704166)
DepartmentofAyurveda(703756)
DepartmentofAyurveda(704756)
Allocation(NRs)
6,975,000.00
34,940,000.00
250,498,000.00
2,800,000.00
104,316,000.00
43,875,000.00
Expenditure(NRs)
6,637,068.94
30,438,196.68
229,692,750.15
2,795,277.50
98,323,890.78
40,569,257.57
%Expenditure
95.15
87.11
91.69
99.83
94.25
92.46
209
Noprovisionforhigherstudyfor
BAMSAyurvedadoctors
Lackofexpertsandinadequate
qualifiedmanpower.
Actionstobetaken
EstablishPGinstitutioninNepal
RecognitionofBAMScourseofNepal
byforeigncountry(India)
ProductionofQualifiedAyurvedic
manpower(BAMS,MD)
Inadequatefinancialsupportfor
AllocatesufficientBudget
districtlevelAyurvedainstitutionto
conductmonitoringsupervision&
publicityprogram.
Poorstorage&dispensing
Providegoodfurniture&dispensing
techniquesofmedicinesincurative
materials
aspectsofAyurvedainstitutions.
Trainingonstorage&dispensing.
Lackofintersectorcoordination.
Coordinationwithrelatedministries,
NGO's&INGO's
Increasequalifiedmanpower.
Lackofcommunitybasedprogram Increasemanpowerproduction.
forpublicityofAyurveda.
Allocatebudget.
Lackofworkshop,training&
seminaronplanningforAyurveda.
Lackofappropriaterecording&
reportingsystem.
Inadequatestaffingunder
DepartmentofAyurveda.
FormalJustificationaboutthe
successfultreatmentofcertain
incurablediseasewithAyurveda
therapyclaimedbypractitioners.
Allocatenecessarybudget,develop
longtermpolicy&planonAyurveda
Establishstatisticssectionunder
departmentofAyurvedawith
sufficientbudget.
Trainemployeeonrecording&
reporting.
Recruitment&placementasperneed.
Goalformation.
Allocatebudget.
Responsibility
MOHP
MOE
MOFA
DOA
MOHP
MOE
MOHP
MOE
DOA
MOHP
MOE
DOA
MOHP
MOE
DOA
MOHP
MOE
DOA
MOHP
MOE
DOA
MOHP
MOE
MOGA
PSC
DOA
MOHP
MOE
7.2.5 ProgramsProposedfor2068/69(2011/2012)
ProcurementanddistributionofAyurvedicMedicines.
Procurementoftreatmentequipment,furniture,diskmill.
ConstructionofcompoundwallinAyurvedicinstitutions.
Buildingconstructionof22Ayurvedicinstitutions.
Procurementofbooksandmagazine.
Panchakarma&YogatrainingforKaviraj&Vaidya.
Annualreviewmeetingineachdistrictandcenter.
Freehealthcamps.
PreparationofAyurvedapharmacopeias.
210
Powder(Churna)medicineproductioninZAD&DAHC.
Strengtheningofherbalgarden.
Workshopanddiscussionwithlocaltraditionalhealers.
Preparationofinformativebooks,pamphlets&brochurerelatedtoAyurveda.
SchoolAyurvedahealthprogram.
PromotivePanchakarma/Resayan/Yogaprogrammeforolderpopulation
Awarenessprogramformedicinalplants
Programforlactatingmother(Distributionofgalactogoguemedicine).
Observationtour.
Skilldevelopmenttraining.
AwarenessprogramonEpidemicdiseases&commonlyusedmedicinalplants.
Revision, evaluation, monitoring and update of Ayurvedic health policy and development of
codeofethics.
Evaluationandmonitoring.
TrainingforOfficerKavirajonprogramimplementation.
211
Chapter8
DevelopmentPartners
DEVELOPMENTPARTNERS
TheoutcomesdiscussedinthepreviouschaptersistheresultofcombinedeffortsofMoHP/GoNand
the development partners (multilateral, bilateral organizations and international and national
NGOs). Department of Health Services highly acknowledges partnership with these organizations
and their contribution in the health sector in Nepal. This section presents major program focus of
theseorganizationsandtheircontactdetailstohelpthereadersfindmoredetailsaboutthemand
theirprograms.
PooledFunding
World Bank, DFID, AusAID and GAVI have been providing pooled fund to support MoHP/GoN via
SectorWide Approach (SWAp). The pool funding supports the governments five year NHSP2
(2010/112014/15)toachieveitsthree objectives:(i)increasingaccesstoandutilizationofquality
essentialhealthservices(ii)reduceculturalandeconomicbarrierstoaccessinghealthcareservices
and harmful cultural practices in partnership with nonstate actors and (iii) to improve health
systems to achieve universal coverage of essential health care services. The current support is a
continuationofthepreviousHealthSWAp(NepalHealthSectorProgram2004/052009/10).
The coverage is nationwide and in alignment with the NHSP2. The areas of support include the
overall sector governance, child health, population and reproductive health, health system
performance,genderequalityandsocialinclusion,HIV/AIDSandnutrition.
During the last fiscal year 2010/11, the disbursements from the pooled funding partners were as
follows:
WorldBank:USD22.09million
DFID:GBP7million(USD11.2million)
AusAID:AUD5.20million(USD5.60million)
ApartfromthefullyflexiblepooledfundingtotheGoNinsupportofNHSP2,thesepooledfunding
partnersalsosupportedotherparallelactivitieswhichhavebeenpresentedintheTablebelow:
212
DevelopmentPartners
DevelopmentPartnersContributingtoHealthSectorinNepal
8.1
MULTILATERALORGANIZATIONS
Organization
UNFPA
UNICEF
WorldBank
WorldHealth
Organization(WHO)
Majorprogramfocus
Reproductivehealth
Populationanddevelopment
Gender
Supportdevelopment/updateofpolicy/
strategies,protocols,manuals,national
standards
Childhealth
MNCH
Nutrition
Immunization
WASH
HIV/AIDS
Strengtheningofhealthsystems
MCH
HIV/AIDS
Accesstoqualityhealthservices
Strengtheninghealthsystem
Controlandpreventionofdiseasesand
disability
Humanresourcedevelopment
Child,adolescentandreproductivehealth
Environmentalhealth
Emergencypreparednessandresponse
Budgetforhealth
Geographicalcoverage
sectorfor2010/11
Nationallevelandspecific Budget:
programsin18districts
US$7,923,000
Expenditure:
US$4,518,000
Contactdetails
Sanepa,Lalitpur
Tel:015523637,5523880
Fax:015523985
http://nepal.unfpa.org
Nationallevelandspecific
programsatsubnational
level
UnitedNationsHouse
Pulchowk,Lalitpur,Kathmandu
P.O.Box1187
www.unicef.org/infobycountry/nepal
Nationallevelandspecific US$22.09million
level
LalDurbar,
Yak&YetiHotelComplex
Kathmandu,Nepal
P.O.Box798
www.worldbank.org.np
UnitedNationsHouse
Pulchowk,Lalitpur,Kathmandu
PostBoxNo.108.
Tel:015523200,5523993
Fax:(9771)5527756
www.nep.searo.who.int
Nationallevelandspecific Program budget:US$

programsatsubnational 4,272,500
level
Voluntary
Contribution(VC)
fund:US$17,499,000
213
DevelopmentPartners
8.2
BILATERALORGANIZATIONS
Organization
Majorprogramfocus
Departmentfor
Maternal,newbornandreproductivehealth
International
Nutrition
Development(DFID) HIV/AIDS
Genderequityandsocialinclusion
Governance&accountability
GIZ
HarmReductionProgram
OpioidSubstitutionTherapy
HIV
HSSP
Socialhealthprotection
Sexualreproductivehealth
Decentralization
Developingpolicies,programs,strategiesand
guidelines
NepalFamilyHealth Familyplanning
Program(NFHP)
MNCH
Informationsystems
Healthfacilitiesstrengthening
FCHVs
Developmentofpolicies,standards,guidelines,
curricula
SwissAgencyfor
Maternalandchildhealth
Developmentand
Socialinclusion
Cooperation/Rural
Empowerment
HealthDevelopment Primaryhealthcare
Project(SDC/RHDP) Familyplanning
Healthinformation
Budgetforhealth
sectorfor2010/11
Nationallevelandspecific NHSP2:
programsatsubnational 57million
level
HIV/AIDS:
2.5million
KathmanduLalitpurand
Pokhara
Coreprogramin13
districts
Euro58,000
Euro1,493,843
Nationallevelandspecific
programsin22districts
Coreprogram:Dolakha,
Ramechapand
Okhaldhunga(162VDCs
&1Municipality)
Contactdetails
Ekantakuna,Lalitpur,Nepal
GPO:106
www.dfid.gov.uk/nepa
OasisComplex,PatanDhoka
P.O.Box1600,Kathmandu,Nepal
Tel:+97715524313,5526609
Fax:+97715526608
nfhp@nfhp.org.np
Budget:
Rs.71,606,000
Expense:
Rs.69,827,540
(97.5%)
www.sdc.org.np.
rhdppm@wlink.com.np
214
DevelopmentPartners
Organization
USAID
Majorprogramfocus
MNCH
FP&RH
Nutrition
HIV/AIDSandSTI
Neglectedtropicalandvaccinepreventable
diseases
LogisticsandsupplychainmanagementforFP
commodities
Environmentalhealth
DHSandothernationalpopulationbased
surveys
Budgetforhealth
sectorfor2010/11
Nationallevelandspecific OverUS$20million
level
Contactdetails
U.S.Embassy,Maharajgunj
G.P.OBox:295
Tel:014007200
Fax:014007285
http://nepal.usaid.gov
8.3
INTERNATIONALNONGOVERNMENTORGANIZATIONS(INGOs)
Organization
ActionAid
InternationalNepal
(AAIN)
Majorprogramfocus
Reproductivehealth
Safemotherhood
350VDCsand6
Municipalitiesof30
districts
ADRANepal
Safemotherhood
Uterineprolapse
VCT
15districts 5regions
BritainNepal
MedicalTrust
(BNMT)
Tuberculosis
Childhealth
Safemotherhood
Genderbasedviolence
Nutrition
Budgetforhealth
sectorfor2010/11
NRs.4,500,000
US$1069069
Contactdetails
ApsaraMarg,Lazimpat,Kathmandu,
Nepal
Tel:4436477
http://www.actionaid.org/nepal
POB:015555913/914
Fax:015554251
www.adranepal.org
>35districts 5regions
NRs.300million
simon.lewis@adranepal.org
Lazimpat,Kathmandu,Nepal
POB:20564
www.britainnepalmedicaltrust.org.uk
cd_po@bnmt.org.np
cd_era@bnmt.org.np
215
DevelopmentPartners
Organization
CAREInternational
Nepal
Majorprogramfocus
MNH
SRH
HIV/AIDS
Governance
Equity,inclusion
Schoolhealth
Nutrition
CCSItaliacentro
cooperzione
sviluppoonlus
CPCSInternational
Generalhealthandhygieneforstreetchildren
ChildProtection
CentresandServices
International
CWSChildWelfare Maternal&newborn
Scheme
Child&adolescent
7 districtsasdirect
programdistricts
Budgetforhealth
sectorfor2010/11
US$1,252,510
12VDCsof3districtsand GBP50,000
Kathmanduvalley
KathmanduandLalitpur
Cities
NRs.6million
5districts
US$900,000
FHI360Nepal
HIV/AIDS
Surveillance&research
Healthcarewastemanagement
30districts
US$4,690,586
FidaInternational
Preventivehealthcare
Healthscreeningcamps
36VDCsof18districts
NRs.1,080,000
FinnishEvangelical
LutheranMission
(FELMN)
Mentalhealth
Psychosocialsupport
Primaryhealthcare
19districts
NRs.25,270,274
Contactdetails
KrishnaGalli,Pulchowk,Lalitpur
POB:1661
www.carenepal.org
ChundeviMarg,Kathmandu,Nepal
Tel:014720048
IndrapuriMarg,Nagdhunga,Pokhara8,
Kaski,Nepal
Tel:061530002
health@cwsuk.org
Baluwatar,Kathmandu,Nepal
POB:8803
Tel:014437173
Fax:014417475
Maharajgunj,Bansbari,Kathmandu,
Nepal
Tel:014378788
palvi.leppanen@fidadevelopment.fi
Jhamsikhel,Lalitpur,Nepal
POB:8975
Tel:015529271
felmnepal@felm.org
216
DevelopmentPartners
Organization
GermanNepalese
HelpAssociation
Majorprogramfocus
Medicalequipmentsupplytoneedypatients,
community&governmenthospitals
4districts
Budgetforhealth
sectorfor2010/11
GBP73,000
GoodNeighbors
International
Nutrition
Medical/Disability
HousingandEnvironment
27VDCsof6districts
US$167,311
Handicap
International
HealthRight
International
19districts
NRs.22,645,133
Arghakhanchi42VDCs
Kapilvastu77VDCs
US$235,734
HelenKeller
International
Nutrition(Actionagainstmalnutritionthrough
Agriculture)
90VDCsof3districts
(Kailali,Baitadi,Bajura)
US$650,000
INFWorldwide
8districts
NRs.102,091,200
22districts
GBP300,000
InterplastGermany
Foundatione.V.
(SushmaKoirala
MemorialHospital)
IPAS
Physicalrehabilitation
Healthservicepreparednesstomajorcrisis
Maternalhealth
Childhealth
TB,Leprosy,HIV/AIDS
Spinalcordinjury
Disability
Nutrition
Specialhealthcamps
PlasticandReconstructiveSurgery
Safeabortioncare
Familyplanning
Reproductivehealth
Implementationresearch
inPHCCs&HPsof10
districts
Contactdetails
104JitJungMarga,ThapathaliHeight,
Kathmandu,Nepal
gnhanepal@wlink.com.np
dispensarydnh@gmail.com
Mahalaxmisthan,Lalitpur,Nepal
Tel:015538758
goodnn@wlink.com.np
gnnepal@gmail.com
Tel:0143278482
director@hinepal.org
Oasis49Dhara,Patan
Tel:015528843
hari.rana@healthright.org
Chakupat,Lalitpur,Nepal
POB:3752
ppandey@hki.org
www.hki.org
Kathmandu,Nepal
POB:1230
Tel:015521183
liason.officer@world.inf.org
Salambutar,Sankhu,Kathmandu,Nepal
Tel:014450826
skh@wlink.com.np
FamilyHealthDivision,
DoHS,Teku,Kathmandu
217
DevelopmentPartners
Organization
ISISFoundation
KarunaFoundation
Majorprogramfocus
Childnutrition
Safedrinkingwater
Mobilemedicalteam
Childdisabilityprevention
Communitybasedrehabilitation
Budgetforhealth
Geographicalcoverage sectorfor2010/11
15VDCsofHumladistrict NRs.3,447,448
17VDCsof3districts
(Sunsari,Kavre,Rasuwa)
NRs.34,607,215
LeprosyMission
Nepal
LutheranWorld
FederationNepal
Leprosy
15districts
NRs.36,064,523
Reproductivehealth
Sanitation/hygiene
HIV/AIDS
Healthfacilityimprovement
14districts
US$119,300
MedecinsDu
MondeFrance
(MDMFrance)
MedicalEmergency
ReliefInternational
(Merlin)
Safemotherhood
Neonatalhealth
Healtheducation
Masscasualtymanagement
Disasterpreparedness
DHOcapacitydevelopment
Humanresourceforhealth
Nutrition(MicronutrientsIronFolicAcid,Zinc
andORS,Wheatflourfortification,Cerealflour
fortification,VitaminA,multiplemicronutrient
powder)
12VDCsof
Sindhupalchowkdistrict
NRs.22,000,000
18districts
NRs.60,000,000
75districts
US$350,000
Humla 12VDCs
Kalikot5VDCs
EUR437,094
Micronutrient
Initiative
MissionEast
Healthpromotion
WatersupplyandHygiene
Contactdetails
Budhanilkantha,Kathmandu,Nepal
POB:8974
pralad.dhakal@isisgroup.org
NarayanGopalMarga,Lazimpat,
Kathmandu,Nepal
Tel:014410687,4413340
kimat@karunafoundation.com
Tikabhairav,LeleVDC,Lalitpur,Nepal
shovakhark@tlmnepal.org
ChundeviMarg,Maharjgunj,Kathmandu,
Nepal
POB:3330
Tel:014720152,4721271
sldc@lwf.org.np
Sanepa,Lalitpur,Nepal
Tel:015013023,
5521215medco.mdmnepal@gmail.com
Kupandole,Lalitpur,Nepal
cd@merlinnepal.org
C/OCanadianCooperationOffice,
Lazimpat,Kathmandu,Nepal
Tel:014415193
mi@canadanepal.org
mmaharjan@micronutrient.org
Jawalakhel,Lalitpur,Nepal
Tel:015538416,5538668
christophe.belperron@missioneast.org
218
DevelopmentPartners
Organization
NepalAssociation
fortheWelfareof
theBlind(NAWB)
Majorprogramfocus
Eyescreen/lowvision
14districts
Budgetforhealth
sectorfor2010/11
NRs.110,000
NepalLeprosyTrust
(UK)
Leprosy
7districts
NRs.40,000,000
NepalYouth
Foundation(NYF)
Nutrition(Nutritionalrehabilitationhomes)
19districts
US$303,497
AlldistrictsandVDCsof
easternandfarwestern
regions
11districts
NRs.39,015,125
7districts
NRs.158,333,000
75districts
US$31,825,413
(20112013)
6districts
NRs.3,200,000
NetherlandsLeprosy LeprosyandTBcontrol
Relief(NLR)
Disabilitymanagement
OxfamGBNepal
Publichealthpromotion
Waterandsanitation
PlanNepal
PopulationServices
International/Nepal
(PSI/Nepal)
MNH
PMTCT
Childdisability
Water&sanitation
Malaria
Women'shealth
HIV
WaterGuard
Restless
DevelopmentNepal HIV/AIDS
GBP500,000
Contactdetails
Tripureshwor,Kathmandu
POB:3255
Tel:014260583
nawbnepal@gmail.com
Satdobato,Lalitpur,Nepal
Tel:015521622,5523322
nlt@mail.com.np
Ekantakuna,Lalitpur,Nepal
Tel:015000276
som@nepalyouthfoundation.org.np
NewBaneshwor,Kathmandu,Nepal
Tel:016227564
kpdhakal2001@yahoo.com
Jawalakhel,Lalitpur,Nepal
POB:2500
afaiia@oxfam.org.uk
oxnepal@oxfam.org.uk
Shreedurbar,Pulchowk,Lalitpur,Nepal
Tel:015535580,5535560
sherbahadur.rana@plan
international.org
ShreeMahalaxmiSadan
GPOBox:21976
Mahalaxmisthan,Lagankhel
Lalitpur,Nepal
Tel:97715553190/5550620
info@psi.org.np
Jwagal,Lalitpur,Nepal
Tel:015538242
ravindra@restlessdevelopment.org
219
DevelopmentPartners
Organization
SavetheChildren
International
Terredeshommes
UnitedMissionto
Nepal(UMN)
WaterAidinNepal
(WAN)
Budgetforhealth
sectorfor2010/11
NRs.173,950,000
Majorprogramfocus
Maternal,Newborn&Childhealth
Nutrition
HRforhealth
Disability
Foodsafety/Nutrition
15districtsdirect
8districtsthroughNFHP
26districts
NRs.14,660,000
MNH
ASRH
Foodsecurity&nutrition
HIV/AIDS
WASH
10districts
NRs.30,810,322
28districts
GBP2.1million
(overallWAN)
WorldEducation,
Nepal
Maternalandchildhealth
8districts
US$331,665
WorldNeighbors
73VDCsof8districts
NRs.3,869,309
WorldVision
InternationalNepal
(WVIN)
12districts 83VDCs,3
Municipalities
NRs.150,511,104
Safemotherhood
RH&Familyplanning
Foodsecurity/nutrition
Capacitybuildingofhealthpersonneland
institutions
MCH
Nutrition
HIV/AIDS
WASH
Contactdetails
BagDurbar,Sundhara,Kathmandu,Nepal
Tel:014258140,4222272
www.savethechildren.org.au
POB:2430
Jason.squire@tdh.ch
Thapathali,Kathmandu,Nepal
Tel:014228118,4268900
netraprasad.bhatta@umn.org.np
Kupandole,Lalitpur,Nepal
Tel:015552764
wateraidnepal@wateraid.org
Ratopul,Kathmandu,Nepal
Tel:014422385
shyam@wei.org.np
62DochaMarg,Baluwatar,Kathmandu,
Nepal
Tel:014417272,4414715
infoasia@wn.org
Tel:015013570,5547177
http://nepal.wvasiapacific.org
Source:AIN,2011,AMappingofINGOsContributingtoHealthSectorinNepal,EffortstowardsreachingMDGsandNHSP2
220
DevelopmentPartners
8.4
NONGOVERNMENTALORGANIZATIONS
Organization
CRSCompany
Majorprogram focus
Maternalchildhealth
Familyplanning
HIVprevention
75districtsthroughits
productsandservices
FamilyPlanning
AssociationofNepal
(FPAN)
40districts
MarieStopes
International
(MSI)/Sunaulo
ParivarNepal(SPN)
NepalRedCross
Society(NRCS)
Familyplanning
Reproductivehealth
Safeabortion
HIV/AIDS/STI
Familyprogram
Safemotherhood
Safeabortion
Childimmunization
Emergencycumlifesurvivalservices
(Ambulance,firstaidandbloodtransfusion)
Familyplanning,HIV/AIDS,eye&earcare,
reproductivehealth,WATSAN
Communitybasedhealthpromotion
NepaliTechnical
AssistanceGroup
(NTAG)
Traininghealthpersonnel
Nutrition
Research,surveys
NickSimons
Institute(NSI)
Training
Ruralstaffsupport
Scholarship
Advocacy
M&E
Infrastructure
Budgetforhealth
sectorfor2010/11
Rs.91,292,265
NRs373.50millions
(FPAN:cash+
commodity)
41districts(52staticcentres)
75districtchapters1,339sub
chapters5160Junior&Youth
RedCrossCircles
Oneeyehospital
15eyecarecentres,77blood
transfusioncentres
137ambulanceservicestations
Staffsupportforsix
governmentdistricthospitals:
Bajhang,Kalikot,Salyan,
Kapilvastu,Gulmi,andDolakha
NRs.93,032,444
Contactdetails
TokhaRoad,MahadevTaar,Gongabu,
Kathmandu,Nepal
P.O.Box.842,Phone:4362097,4362098
mis@crs.org.np
Pulchowk,Lalitpur,P.O.Box486,
Kathmandu,Nepal
Phone97715010240,5010104
Fax97715010248
fpandg@fpan.org.np
Tel:014413976
msi@msinepal.org.np
RedCrossMarg,Kalimati
PostBoxNo.217,Kathmandu,Nepal
Phone:+97714272761(hunting)
Fax:+97714271915,4273285
nrcs@nrcs.org,
info@nrcs.org
Maitighar,Kathmandu,Nepal
GPOBox7518
Tel.#:97714224884,4223477
info@ntagonline.org
http://www.ntagonline.org
NickSimonsInstitute
Box8975;EPC1813,Sanepa,LalitpurNepal
Phone97715551978
Fax97715544179
nsi@nsi.edu.np
http://www.nsi.edu.np
221
References
REFERENCES
Department of Health Services. 2011. Annual Report 2066/67 (2009/2010). Ministry of Health and
Population,GovernmentofNepal.
FHD,2011,IncreasingAccesstoSASthroughANM(Implementationresearch),FHD.
Ministry of Health and Population (MOHP) (Nepal), New ERA, and Macro International Inc. 2007.
Nepal Demographic and Health Survey 2006. Kathmandu, Nepal: Ministry of Health and
Population,NewERA,andMacroInternationalInc.
Ministry of Health and Population (MOHP). 2010. Nepal Health Sector ProgramII (NHSPII) 2010
2015.GovernmentofNepal.
Ministry of Health and Population, New ERA, and Measure DHS 2011. Nepal Demographic and
Health Survey 2011 Preliminary Report, Kathmandu, Nepal: Ministry of Health and
Population,NewERA,andMeasureDHS.
NepalFamilyHealthProgramIIandNewERA.2010.FamilyPlanning,Maternal,NewbornandChild
HealthSituationinRuralNepal:AMidtermSurveyforNFHPII,Kathmandu,Nepal.
222
ANNEXES
Annexes
ANNEX1
ACTIVITIESCARRIEDOUTINFY2067/68
1.1CHILDHEALTH:IMMUNIZATION
SN
1
2
3
4
5
6
7
8
9
10
11
Activities
BCGvaccination
DPTHepBHib1vaccination
Polio1vaccination
Polio2vaccination
Polio3vaccination
Measlesvaccination
JEVaccination
TT2&TT2+vaccination
PolioMopupin8DistrictsIRound
(Bara,Parsa,Rautahat,Sarlahi,Mahottari,
Dhanusha,Siraha&Saptari)
12
PolioMopupin8DistrictsIIRound
(Bara,Parsa,Rautahat,Sarlahi,
Mahottari,Dhanusha,Siraha&Saptari)
13
(EDRandCDRTerai,InnerTeraiandValley
districts)
14
(Bara,Parsa,Rautahat,Sarlahi,Mahottari,
Dhanusha,Siraha&Saptari)
15 PolioMopupin3DistrictsIRound
(Bara,Rautahat,Sarlahi)
16 PolioMopupin3DistrictsIIRound
(Bara,Rautahat,Sarlahi
17 PolioMopupin3DistrictsIIIRound
(Bara,Rautahat,Sarlahi
18 Polio13thNIDin75DistrictsIRound
19 Polio13thNIDin75DistrictsIIRound
20 JECampaignin4Districts
(Sarlahi,Sindhuli,MakwanpurSurkhet)
21 SchoolImmunizationin11districts(Report
notreceivedfromBara)
Source:HMIS/MDandEPI/CHD,DoHS
Unit
Infants
Infants
Infants
Infants
Infants
Infants
Infants
Infants
1223Month
Pregnantwomen
Under5yrs
children
Targets
655,777
655,777
655,777
655,777
655,777
655,777
655,777
655,777
370,191
765,578
1,096,948
Achievement
637,526
585,467
590,905
627,654
581,284
584,875
623,015
574,790
201,282
597,518
1,073,315
%
97.2
89.3
90.1
95.7
88.6
89.2
95.0
87.7
54.4
78.0
97.9
<5yrschildren
1,096,948
1,078,402
98.3
<5yrschildren
2,015,085
1,939,249
96.2
<5yrschildren
1,096,948
1,101,668
100.4
<5yrschildren
436,617
443,198
101.51
<5yrschildren
436,617
452,106
103.6
<5yrschildren
436,617
442,995
101.5
<5yrschildren
<5yrschildren
Above1year
4,466,960
4,466,960
1,843,295
4,072,270
4,094,912
1,386,762
91.2
91.7
75
Grade1students
2,58,698
2,44,655
94.6
1.2CHILDHEALTH:CBIMCI
SN
1
2
3
4
5
Activities
PurchaseofLowOsmolarORS
PurchaseofZinctablets
CBIMCIDrugs
PurchaseofARISoundTimer
PurchaseofCotrim.Paed.Tablet
Source:IMCISection/CHD,LMD,DoHS
Unit
Pkts.
Tabs.
times
Units
Tabs
Targets
5,000,000
20,000,000
1
20,000
10,000,000
Achievement
5,000,000
20,000,000
1
20,000
10,000,000
%
100
100
100
100
100
224
Annexes
2.1FAMILYHEALTH:FAMILYPLANNING
SN
1
2
3
4
5
6
7
8
Activities
Currentusers
VSCexpected
IUDservice
Implantservice
VSCpreparatorymeetings
MicroplanninginlowCPRdistricts
IncreasepostpartumFPcounselingandservices
PreVSCmeetingwithFCHVsinlowperforming
districts
9 Conductsatelliteclinicsforlongactingmethods
10 FamilyplanningmanagementworkshopforFP
focalpersons
Unit
Couple
Couple
Number
Number
District
District
Site
District
Targets
2580000
85000
30,000
35,000
75
6
2
10
District
Time
75
1
Achievement* Achieved%
2425521
94
63053
73.6
28,037
93.5
23,334
66.7
74
98.7
4
66.7
2
100.0
10
100.0
75
1
100.0
100.0
2.2FAMILYHEALTH:FEMALECOMMUNITYHEALTHVOLUNTEER
SN Activities
Centrallevel
1 FCHVDaycelebration
Target
DisseminationofrrevisedFCHVStrategy
Districtlevel
1
2
3
4
5
6
FCHVsbiannualReview(AllVDC)
HFIReviewMeeting(llakaLevel)
FCHVsDayCelebration(AllVDC)
AdditionofFCHVsfund(AllVDC)
StrengtheningofHealthMother'sGroup
Rewardforvoluntaryretirement
Source:FCHV/FHD,DoHS
1Time
Achievement(%)
100
1Time
100
75District
75District
75District
75District
10District
1,848persons
100
100
100
100
100
49.2
2.3FAMILYHEALTH:PHCORC
Activities
Centrallevel
RevisionofPHC/ORCclinicsstrategy
OrientationonPHC/ORCclinicsMicroPlanning
DistrictLevel
PHC/ORCclinicReactivationandMicroplanning
PurchaseofDrugandEquipments
Target
1
1
1,305VDC
3,108Clinics
Achievements(%)
100
100
100
100
2.4ADOLESCENTANDSEXUALREPRODUCTIVEHEALTH
Activities
Target
Achievements(%)
No. of HFs with Adolescent Friendly health service

program
AdolescentBirthRate
1000
455*
70/1000women
(1519)
81/1000women**
Note:*416HFs:TheprocesswillbecompletedbythisFYand39HFswillbepartiallycompleted.(Source:FHD2068/99)
**Source:NDHS2011
225
Annexes
3.1DISEASECONTROL:LYMPATICFILARIASIS
SN
1
2
3
4
6
7
8
10
Activities
TOTforHWsandtrainingforVHWs/MCHWs/Volunteers
Districtlevelinteractionforsocialmobilization
Datacollection/updatingbydrugdistributors
MassDrugAdministrationonfilarialday(housetohousevisit)
SupervisionandmonitoringofMDA
IECactivitiesfocusingMDA
Mediainteractionprogram
ReviewandplanningmeetingforMDAin36districts
Unit
Persons
Time
Time
Time
Time
Days
Time
Time
Targets Achievement
70,000
70,000
36
36
1
1
1
1
1
1
10
10
1
1
2
2
3.2DISEASECONTROL:DENGUE
SN
Activities
1 DevelopmentofNationalDengueGuidelinesforClinical
Management,PreventionandControl
2 Onedayinteraction/trainingondengueforHWand
stakeholders
3 2daystrainingfordoctorsandparamedics
4 2daysTOTfordoctorsandfocalpersonondengueprevention
andaideslarvaesearchanddestroy
5 ProcurementofRDTandELIZAfordiagnosis
6 1daycentralleveladvocacymeeting
7 Denguesurveillanceofdenguepronedistricts
Unit
Time
Targets
1
Achievement
1
Districts
Times
Person
2
20
2
20
Pieces
times
Months
4,000
1
6
4,000
1
6
3.3DISEASECONTROL:LEPROSY
CentralLevel
Activities
Messagetelecastthroughtelevision
LeprosyBasicTraining
LeprosyBasicTraining
MDTmanagement
Purchase&distributionofsupportivedevicefordisable
leprosyaffectedpeople
Purchaseofcomplicationmanagementdrugs&
equipmentforreferralcenters
Transportationcostforpatients
Disabilitysurveyduetoleprosy
SpecialinterventionprograminPR>1endemicdistricts
Capacitybuildingtohealthworker&referralservices
MessagebroadcastingthroughRadio/FM
GrantforleprosypatientofKhokanaLeprosarium&
othergroups
Messagedisseminationthroughnewspaper
Poster,leaflet,chasecard,filipchartPrinting
WorldLeprosyDaycelebrationatcentre&regional
level
4monthlyperformancereviewmeetingcentral&
regional
4monthlycoordinationmeetingwithsupporting
partners
Followupofreferralservicebyexpertise
ProgramSupervision,monitoring&followupcentral&
regionallevel
Annualreportpublication
Units Target Achievement Budget Expenditure

Times
60
60
1000
1000
Times
3
3
500
500
Times
7
7
1000
1000
Times
3
3
210
180
Times
4
4
1462
933
1
1000
0
2
16
20
200
3
2500
1300
1500
400
500
1188
0
1222
1500
256
500
1100
6
1
1
6
1
1
100
300
500
100
300
500
1170
1170
30
30
Times
10
75
10
75
200
1500
180
1500
Copy
200
200
50
17329
50
2500
2
District 16
District 20
200
3
Copy
Times
226
Annexes
DistrictLevel
Activities
StreetDrama
Patients&patientsneighborfamily
examination
TransportationforRFTpatients
SkinCamp
FlexBoard
Supervision&Monitoring
Schoolhealtheducationprogram
District,PHC,HPlevelProgrammonitoring&
followup
Leprosymessagebroadcastingthroughlocal
FM
Units
Times
Times
Person
Target
150
10
195,000
Achievement
144
10
130000
Budget Expenditure
750
720
996
996
6,825
4550
Person
Times
Copy
Copy
School
Group
Times
Times
2,000
16
300
1,700
1,660
145
75
3
0
16
300
1700
1547
144
75
3
2,000
800
500
3,500
2,500
3,190
750
5,100
0
800
500
3500
2380
2700
750
4900
Times
2,000
2000
1,200
1200
3.4DISEASECONTROL:HIV/AIDSANDSTI
S.
N.
MajorActivities
1 HIV AIDS Training to Health worker at District and Health
postlevel
2 AnnualreviewofARTcenters
3 VCTTraining
4 RecordingReportingFormsandFormatprinting
5 Schooleducationprogramin75districts
6 CD4andlabtestsupportto4000HIVinfectedpeople
7 Blood bag and other support to 1000 HIV infected people
whocomesforCD4test
8 HIVAIDSorientationtoParamedical,Nursingandmedical
students
9 IECmaterialsdevelopment
10 STIMedicineprocurement
11 MARPs,TIprogramimplementationcost
12 DACCrunningcostin35district
13 IECmaterialsdevelopmentatlocallevel
14 HIVAIDStrainingtoclinicalstaffatworkplace
15 Costfor"HIVAIDSaffectedandinfectedsinglewomenand
children"studyteam
16 Monitoringandsupervisionvisit
17 ARTsiterunningcost
18 STImanagementtraining
19 HIVRapidtesttrainingtolabassistantantechnician
20 EnablingenvironmentcreationforCHBCteams
13 PMTCTguidelineupdateasperWHO'snewupdate
14 Develop'HIVAIDSOrientation'trainingmaterialforhealth
workers
15 MARPSTIprogramorientationforcentrallevel
stakeholders
16 Routinemonitoringofdistrictprogramfor5regions
17 VCTLabtraining(StaffrelatedtoCentrallabonly)
18 PMTCTprogrammonitoringandtechnicalsupport
Budget Expenditure Progress

(Rs.000) (Rs.000)
(%)
2700
2200
81
Unit
Times
Target
30
Times
Person
Times
Times
Times
Times
2
20
1
7500
4
1
2100
1000
1000
1875
1800
1000
1360
579
991
1875
1800
947
65
58
99
100
100
95
Times
30
900
900
100
Times
Times
Times
Times
Times
Times
Times
1
2
3
420
75
25
1
1000
10000
1500
5571
1502
806
400
850
9280
540
5430
1500
760
170
85
93
36
97
100
94
43
Times
Times
Person
Person
Times
Times
Times
92
292
40
50
2
1
1
3075
2796
600
750
57
135
600
2780
2480
600
750
57
135
600
90
89
100
100
100
100
100
Times
400
400
100
Times
Times
Times
12
40
1
500
600
400
500
600
400
100
100
100
227
Annexes
S.
N.
MajorActivities
19 Workshopon"StrengtheningcoordinationamongPMTCT,
Pediatricandreproductivehealth"
20 PMTCTtrainingforMedicaldoctorsandstaffnurse
21 STIsyndromiccasemanagementtraining
22 TIprogramrecordingandreportingforms,formatsprinting
23 WorldAIDScelebrationatdistrictlevel
24 TOT training on "HIV AIDS orientation for district level
healthworker"
25 TOT training on "HIV AIDS orientation for district level
healthworker"atregionallevel
26 WorkshoponintegratedSexualandReproductiveHealth
27 Routinemonitoringatdistrictlevel
28 DACCmeetingcostandcoordinationcost
29 WorldAIDScelebrationatcentrallevel
30 HIVandAIDSawarenessthroughnewspaper andmagazine
31 AiringofHIVandAIDSawarenessthroughradio,TVandFM
32 PMTCTonsitecoaching
33 OIandtestkitprocurementfor5000people
34 HIVAIDSorientationtoFCHV
35 "Orientation tool kit on high risk group" development and
printing
36 ART,STIandOIDrugprocurement
37 Bimonthly meeting between AIDS Management and
Hospitals
38 VCTandSTIcentersrunningcost(45sites)
39 PMTCTtrainingmaterialdevelopment
40 Bimonthlyreviewmeetingat30VCT/STIcenters
41 TBHIVCoInfectiontrainingatcentrallevel
42 PediatricARTTraining(50Person)
43 TwonewARTsitesestablishmentandrunningcost
44 Halfyearlyreviewmeetingat23ARTcenters
45 IECmaterialssupportforWorldAIDS
46 ARTsubcenter'srunningcost
47 Programrunningcostfor6NationalPublicHealth
Laboratoriesand5regionalmaintenancesites
48 AnnualreviewofHealthSectorindicatorforHIV
49 ExpansionofCBPMTCT
50 DevelopNationalEIDguideline
51 HIVsecondgenerationsurveillancesystemstrengthening
anddrugresistancemonitoring
52 TBHIVCoInfectiontrainingfordistricthealthprogram
implementers
53 IECmaterialprintinganddistribution
54 NewIECmaterialdevelopment,printinganddistribution
55 NutritionalsupporttopeopleonART,pregnantHIVpositive
women
Budget Expenditure Progress

(Rs.000) (Rs.000)
(%)
123
123
100
Unit
Times
Target
75
Times
Person
Times
Times
Person
75
160
1
75
25
1500
2000
500
3000
566
1400
1800
500
3000
550
93
90
100
100
97
Person
375
4935
3700
75
Times
Times
Times
Times
Times
Times
Times
Times
Person
Times
1
24
135
1
500
2000
13
1
2910
2
1000
1100
1173
250
500
2000
506
5000
10476
1950
545
1100
1173
250
560
1860
400
4800
10275
1450
55
100
100
100
112
93
79
96
98
74
Times
Times
1
138
16866
321
16866
305
100
95
Times
Times
Times
Times
Times
Times
Times
Times
Times
Times
597
1
324
1
2
24
46
1
4
4
812515
135
1132
588
1216
296
345
736
692
1080
2630
135
877
588
1200
260
300
730
450
200
0
100
77
100
99
88
87
99
65
19
Times
Times
Times
Times
1
3
1
3
736
399
156
1167
700
400
156
650
95
100
100
56
Times
588
580
99
Times
Times
Times
10000
30000
4200
250
750
16000
1000
750
15900
400
100
99
228
Annexes
4.1SUPPORTINGPROGRAMS:HEALTHTRAINING
CentralLevelTrainingPrograms
SN
ProgrammeComponent/Activities
Unit
1 Trainerscapacitybuildingactivities
TrainingMethodology(Dist.Trainingoftrainers)
Person
DTOTTrainingpackageprinting
copy
2 BasicTraining
BasictrainingforANM
person
RefreshertrainingtoVHWs
person
BMET/BMEATTraining
person
3 TrainingonReproductivehealthservices(SBA)
SBAtrainingforMedicalOfficer/Nurse
Person
SBAcoordinator
person
SBAsupervisor
person
SBAManual/LogbookPrinting
copy
SBAmaterialphotocopy
times
SBAReview/planningmeetings
times
SAStrainingforDoctors/Nurses
person
SASrefreshertrainingforserviceproviders
person
SASTrainingOJT
person
4 FamilyPlanningTraining
MinilapforMedicalOfficer
Person
MinilapforNursingstaff
Person
NonScalpelVasectomy
Person
IUCDtrainingfornurses
Person
Implant(Nurse/paramedic)
person
COFP/Counselingtrainingtoserviceproviders
person
5 MinimumInitialservicepackage(MISP/RH)duringEmergency
Servicepackageprinting
copy
M/TOTforMISP
person
6 Medical/NursingcareManagementTraining
ICU/CCUNursingCareManagementtrainingfor
Person
MO/NS
EmergencyservicemgtTrainingforDist.Hospitals
Person
MedicolegalTrainingforMO
Person
C/STrainingforMOofDistHospital
person
MentalHealthCareManagementTrainingforMo/NS
person
CTSTraining
Person
BasicUSGTraining
person
AppreciativeinquiryTraining
person
RehabilitationTraining
person
XRayrepairingTrainingforXRayTechnicians
person
OperationTheatreTrainingforNurses
person
ProcurementofBooksforLibrary
Times
7 InfectionPreventionTraining
Trainingtoserviceproviders
Person
8 BioMedicalEquipmenttraining
BioMedicalEquipment(BME)Training
Person
BMEATtraining
Person
9 FCHVTraining
Trainingmaterialprinting
Copy
10 HealthInstitutionDecentralizationProgram
TrainingPackagePrinting
Copy
HealthFacilityOperationManagementCommittee
Committee
trainingondecentralization
Target
Annual
Achievement
100
200
0
200
0
100
32
35
32
32
35
33
100
100
100
895
1
5
900
5
1
200
40
30
808
1
5
900
3
1
201
22
30
90
100
100
100
60
100
100
55
100
30
30
60
60
60
100
18
18
38
92
76
92
60
60
63
100
100
92
200
70
200
17
100
24
20
18
90
20
100
12
20
20
10
20
20
10
36
1
20
15
16
15
16
10
19
0
9
36
1
100
15
100
75
80
100
95
0
90
100
100
500
496
99
16
16
16
17
100
100
13500
13500
100
1200
100
1200
69
100
69
Achieved(%)
229
Annexes
Annual
Achievement
SN
Unit
Target
11 InternationalTraining
PreparationforInternationalTraining
Times
2
12 BehaviorchangeCommunicationtraining
TrainingforDistrictprogrammerassistants/HFIn
Person
20
charges
13 COPE/PLAtraining
COPE/PLAtrainingforHFStaff
Persons
125
14 ComputerSoftwareDevelopment
TrainingPackageDevelopment
Time
1
TrainingforTIMSestablishment(Trainers)
Person
15
15 GenderBasedViolenceandConflictManagementTraining(GBV)training
GBVpackageprinting
Copy
450
GBVtrainingtoDistrictandbelowlevelProgramme
Person
320
assistants/serviceproviders
16 UpGradingTraining
AHWtoSr.AHW
Person
70
ANWtoSr.ANW
Person
30
MCHWtoANM
Person
30
VHWRefresher
Person
35
17 Monitoring/Supervision
Trainingmonitoring/SupervisionbyTrainingofficers
Times
300
18 AnnualTrainingProgrammereviewplanningworkshop
Times
1
Achieved(%)
20
100
108
86
0
0
0
0
450
0
100
0
0
23
30
35
0
76
100
100
300
1
100
100
DistrictLevelTrainingPrograms
SN
1
2
3
FCHVkitbagprocurement
FCHVMothersGroupOrientation
FCHVBasicTraining
Unit
Boxes
Person
Person
Target
5000
5000
5000
Annual
Achievement
3562
4515
4515
Achieved(%)
71
90
90
4.2SUPPORTINGPROGRAM:LOGISTICSMANAGEMENT
CentralLevel
SN
Activities
Unit
Target
Achievement
(%)
Remarks
A.Capital
1
ProcurementofFurnitureforCentre
Time
100
ProcurementofInstrumentandEquipmentforRural
TelemedicineProgram
Time
100
InstallationofSolarBackupsystematdistricts
Dist
40
ProcurementofPhotocopy,Fax,ScannerandComputers
Time
100
ProcurementofTrainingequipmentsforRHTCs
Time
ProcurementofHospitalEquipment,Instrumentforall
HealthFacilitiesincludinglabequipments
Time
Underevaluation
(multiyear)
ProcurementofPickupforMedicine,Instrumentand
EquipmentTransportation
No.
15
Completedevaluation,
waitingforbudget
ProcurementofMotorcyclesforHealthFacilities
No.
76
Completedevaluation,
waitingforbudge
RepairandMaintenanceofBiomedicalEquipment,
Instrument,Vehicle,ColdChainEquipmentandOther
MaintenanceWorks
Time
150
100
Includedthe
achievementofrecurrent
budget(central)also
PaymentofMachineryandequipmentsprocuredin
066/67forallHealthInstructions
Time
100
Time
10.
Underevaluationprocess
B.Recurrent
1
ProcurementofDrugsandMedicalConsumablesforall
healthinstitutionsfromKfWfund
Budgetnotreceivedfrom
Kfw
230
Annexes
Unit
Target
Achievement
(%)
ProcurementofDrugsandMedicalConsumablesforall
healthinstitutions
Time
100
Repackingofdrugs,equipmentsandothermedical
consumablesforCentre
Time
200
100
Repackingofdrugs,equipmentsandothermedical
consumablesforRMSs
Time
100
100
TransportationofdrugsandequipmentsforCentre
Time
200
100
TransportationofdrugsandequipmentsforRMSs
Time
200
100
TenderDocumentPreparation,NoticePublicationand
Logisticsrelatedservices
Time
100
LMISandStockBookPrinting
Time
100
EBiddingProgram
Time
100
Physicalsetupcompleted
10.
RegionalandCentralReviewonLogisticsManagement
Program
Time
100
11.
TrainingonWebbasedLMIS,EPostandInventory
ManagementSystem
Person
80
100
12.
Inspectionandqualitytestofdrugandequipments
Time
100
Qualitytestperformed
fromKfw
13.
CentralLevelSupervisionofLogisticsManagement
Program
Time
200
100
14.
RegionalLevelSupervisionofLogisticsManagement
Program
Time
200
100
15.
ServicecontractforMechanicalEngineer,BioMedical
EngineerandTechnicians
Time
100
16.
ServiceContractforOfficeSecurityandDriver
17.
OutstandingPaymentofDrugsprocuredinFY066/067
18.
RuralDistrictandSAARCTelemedicineStrengthening
Program
19.
ReceiveZithromaxforNationalTrachomaProgram
20.
PaymentofCustom,DutiesofZithromaxMedicinefor
NationalTrachomaProgram
21.
RepackingandTransportationofZithromaxMedicinefor
NationalTrachomaProgram
SN
Activities
Time
Remarks
100
100
100
Time
100
Time
100
Time
100
Time
Time
OverallPhysicalAchievement
83
OverallFinancialAchievement
44
Districtlevel
SN
1
Activities
Drugs&EquipmentsRepackingandSupply
Unit
Time
Target
22
Achievement(%)
100
SupervisionOnLogisticsManagementProgram
Time
375
100
TelemedicineProgramInRuralDistricts
District
25
96
OverallPhysicalAchievement
99
OverallFinancialAchievement
97
ProcurementofDrugsandEquipmentforvariousDivisionsunderDoHS
SN
Activities
A.Epidemiology&DiseaseControlDivision
1 Malarial,Kalaazar,Denguetestkits
2 Tab.DiethylcarbamazineCitrate100mg
3 Insecticides:Alphacypermehrin5%WP
4 a)Inj.CellCultureAntiRabiesVaccines
b)Inj.AntiSnakeVenomSerum
5 MedicineformalariacontrolandchemicalforARV
6. MedicineandSurgicalGoodsforEpidemicandNatural
DisasterControl,MalariaandKalaazarControldrugs,Topical
applicationandsupportingmedicines
Unit
Number
Remarks
Package
Item
Item
1
1
1
Procured
Procured
Procured
Item
Procured
Package
Package
1
3
Notprocured
Notprocureddueto
noNOLfromWB
231
Annexes
SN
Activities
B.FamilyHealthDivision
1 SMNH(Siliconresuscitationsetandaccessoriesadultand
Infant.MVASetHandheldUSGset,Oxygencylinder,oxygen
concentrator,combinedpulseoxymeterandECGmonitor,
Vacuumextractorandotheraccessories
2 Contraceptives
Condom,OralPills,IUD,Implant3yrsand5yrs,Inj.DMPA
3 IECPrintingMaterials
BPPTrainingmanualandcard
FCHVIDcard
4 NSVkit,Minilabkit,IUCDkit,Implantkit,FPOTequipmentset
5. TabMifepristone+TabMisoprostol
C.ChildHealthDivision
1 ColdChainEquipments(Spareparts,Refrigerators,
Refrigerantsetc.
2 Syringes,WeighingMachineandARItimerandCBNCP
equipmentsetc
3 EPIVaccines
4 CBIMCIandNCPDrugs
(ORS,Iron,Cotrim/P,Albendazole,Zinc,VitA,Amoxycilline,
GentamycineInj.)
5 PrintingMaterials(Nutrition,CBIMCI,Zincetc.)
6 FortifiedFlour
D.ManagementDivision
1 HMISPrinting
2 AnnualReport
E.LeprosyControlDivision
1 Medicines
2 Leprosyequipmentfordisable
F.PrimaryHealthCareRevitalizationDivision
1 MedicineforFreeHealthServices
2 Purchaseofmotorbike
Unit
Number
Remarks
package
Completedcontract
Item
Package
IUDnotprocured
Restallprocured
Contractcompleted
Item
Item
Contractcompleted
exceptOTequipment
Contractcompleted
Item
19
Contractcompleted
Item
14
Contractcompleted
Item
Package
Procuredand
receivingasper
scheduled
Contractcompleted
(Multiyear)
Package
Item
1
2
Contractcompleted
Contractcompleted
Package
Item
1
2
Procured
Procured
Package
package
1
1
Notprocured
Procured
Package
Pcs
1
2
Completedcontract
Notprocured
4.3SUPPORTINGPROGRAM:LABORATORYSERVICES
SN
Activities
1 Newelectricitywiringlaboratorybuildinginanorganized
manner
2 Procurementofrequiredequipmentsfortheestablishmentof
5newbloodcenters
3 Paintthebuildingoflaboratoryandreconstructtheleakage
parts
4 ProcurementoftherequiredmachineryequipmentsforNPHL
5 ManagechemicalandkitsforthebloodtestofHIV/AIDS
patients
6 Givecontinuitytothequalitycontrolprogramofall
laboratorieswithinthecountry
7 SupervisionandmonitoringofdifferentPHC,Zonaland
RegionalHospitalaswellasnewlyestablishedBlood
TransfusionCenters
8 Prepareeducativebookletrelatedtotestsdoneinthe
laboratoryandadvertisethem.
9 Procurementofbook.
10 Procurementofrequiredkits,chemicalsandreagentforthe
routinetestandspecialtests
11 ProviderefreshertrainingforLabTechnician/LabAssistant
workingatLaboratoryandotherhospitalsofthecountry
12 Provide3weeksInservicetrainingfornewlyappointedlab
technician/labassistant.
Unit
Centre
Quantity
1
ReleasedBudget
(inthousands)
500
Exp.%
100
Centre
2000
100
Centre
400
100
Centre
Centre
1
700
7000
700
100
100
Place
500
100
Centre
24
1000
100
Place
2000
100
100
Region,
person
person
100
100
15000
8000
213
person
30
500
100
district
30
400
80
232
Annexes
13 Codinganddecodingofbooksoflibraryofthelaboratory
14 Supervisionandmonitoringoflaboratoryrunningprivate
medicalcenters
15 Hiringrequiredmanpowertoimplementlaboratoryservicein
wellmanagedway
16 ProcurementofrequiredequipmentsforNationalInfluenza
Centerforlabtest
17 Consultancyservicetobeundertakenforupdatinglaboratory
softwareandmaintenanceofcomputer
18 ProvidingVCT/STItrainingforlabtechnician/labassistant
workinginVCTofGovernmentsector(Biratnagar,Kathmandu,
PokharaandNepalgunj)
19 ProvidingqualitycontroltrainingtotheemployeeofPathology
DepartmentofLaboratoryofdifferentgovernmenthealth
institutions
20 Givingcontinuitytothesecretariatestablishedfor Blood
TransfusionService
21 Operationalcost(forchemical,kitsandmaintenanceof
laboratory)
Place
Place
1
200
50
200
100
100
Person
100
person
1200
400
100
Times
150
100
Person
60
1000
113
Person
30
500
80
Person
300
100
Times
4.4SUPPORTINGPROGRAM:MANAGEMENT
SN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
NameofActivities
Target
InserviceManagementTrainingto30HealthManagers(outsourcing)
30
Integratedsupervision
150
Quarterly&Bimonthlyprogressreviewprogramforcentrallevel
15
TOTonF.H.registerorientation(5District)
1
Orientationonrevisedsupervisionmanual
2
MTOTforlocallevelHealthinstitutionmanagement
25
TOTforhealthcarewastemanagementorientation
2
Awarenessprogramofmercuryeffecttohealthworkerandmaterial
1
development
DistricthealthServicesmanagementprogram(followup&supervision&OST
1
programforDHO/districthospital
Healthservicemanagementstrengthening(Highlevelmanagement
1
interaction)
CentrallevelAppreciativeInquiryMTOT
1
StrengtheningofHospitalservicemanagementprogram(Orientationfor
1
developmentboardmembers)
Buildingconstructioncontinuationfromcentral&regionallevelhealthfacilities
5
includingRMSButwal,NepalgungandSurkhet
ProcurementofFurnitureforcentralandRegionallevel building
1
PublicConstructionworkforCenterLevel
1
Building&repair&MaintenanceforDOHS
1
Regionallevelplanningworkshop
1
ManualPreparationofperformancebasedevaluation
1
Orientationonperformancebasedevaluationsystem
2
BudgetNorms,CalendarforOrientationandworkshopandDistrictLevel
3
guidelinepreparation
Health&Coldchainequipmentrepair&maintenanceforregional,zonel
2
district&PHClevel
Health&Coldchainequipmentrepair&maintenanceforregional,zonel,
2
district&PHClevel(Kfw)
MentalHealthTraining(OutSourcing)
3
MentalHealthTrainingandManualPrinting
4
DataAnnalist1,I.T.Export1,ComputerAssistant5Driver2OfficeAssistant3
15
Sweeper3incontractbasisservice
O&MSurvey
30
InternalmeetingexpenditureforKidneyTransplantCommittee
12
TrainingforAdministrationPersonnelofDistrict
1
GuidelinePreparationofUpgradingHealthInstitution
1
Achieved
(%)
100
100
100
100
100
85
100
100
100
100
100
100
100
100
100
100
100
100
50
66
50
100
100
100
100
87
66
100
100
233
Annexes
SN
NameofActivities
Target
30 Procurementofcomputerserver1,Laptopcomputer2,IPAQmachine(PDA)5,
58
GPSmachine50PCSforhealthGISProgram
31 Healthinstitution&servicesmappingplanin15districts
1
32 HealthGISTraining(5regionand75district)
1
33 Procurementofdesktopcomputers5pcs,laptopcomputer5Pcs,IPAQ
46
machine(PDA)5Pcs,externalharddisk5pcs,pendrive10pcs,UPS10pcs,
Scaner5pcs,Multimediaprojector5pcsforhealthGISProgram
34 ADSLModemprocurementforBroadbandinternetprogramfor75districts
103
healthofficeincludingcentral,regionalsubregional&zonalHospitals
35 RevisedHMISsoftwaretraining
1
36 HMIS/HSISrecordingreportingupdateandannualreportpreparation
1
37 PrintingofHMISrecordingreportingformsandmanual
1
38 Centralannualreviewworkshop
1
39 CDpublicationonNepalhealthinformation2010
1
40 UpdateEmail,internetwebhosting&websitecontentmanagementforDOHS
1
41 VarioussoftwarepackageprocurementforHMISprogram(e.g.windows,
1
Antivirusandstatisticalpackage)
42 Executionofvariousactivitiesin3HSISimplementingDistricts
2
43 RegionalFollowupandDataVerificationprogram
2
44 PreparationofDistrictLevelHealthProfile
1
45 ExecutionofVariousActivitiesforDecentralizingtheComputerizedHMIS
2
(MTOTCentralLevel2,TOTRegionalLevel 10)
46 InteractionandOrientationProgramonPublicPrivatePartnershipforHealth
1
InformationSharing
47 Orientatingonqualityassurancesystemforhealthfacilitylevel
2
48 OrientationonnursingHomeGuidelineforNGO&PrivatesectorInstitution
2
49 TrainingforqualityAssurance,Workshopofhospitalaccreditation&
2
preparationofguidelineforPatientSafety
50 PreparationandPrintingofQualityhealthserviceguideline
1
51 InteractionprogramonHEP,'B'vaccinewithconcernedagencies
3
(DDC/DPHO/DAO)
52 Conductionclientexitinterviewin2districtineveryregion(10HFineach)
1
53 OrientationonleadershipdevelopmentforNursingStaff
1
54 OrientationonAppreciativeinquiryprocessfornurses(centreanddistrict)
2
55 Orientation&followupprogramAccordingtonewnursingguidelineincentre
4
todistrictlevel
56 Revisionofnursingjobdescription
1
57 BasictrainingondentalExtractionforHA/AHW
200
58 RefreshertrainingforhealthworkeronOralHealth
24
59 IECMaterialsDevelopmentprogram
1
60 Otherminorandofficeoperationalactivities
Achieved
(%)
91
100
100
89
78
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
Source:MD,DoHS
Note:ManagementDivisionconducted71activitiesduringFY2067/68outofwhich59arelistedaboveandremaining
were minor programs or similar types merged together. Overall physical and financial progress achieved were 84
percentand70percentrespectively.
234
Annexes
5.1OTHERPROGRAMS:DRUGADMINISTRATION
SN
Activities
1 Druginformationtothepublicby
differentmedia
2 PublicationofDrugBulletinofNepal
3
4
5
6
7
8
9
InspectionofPharmaceuticalIndustries
Inspectiontodrugretailers&wholesalers
DrugAnalysis
AuditofPharmaceuticalAnalytical
Laboratories
InspectionofForeignCompanies
ExaminationofVeterinaryDrugSellers
Training
RefresherTraining
Unit
Number
Target
45
Number/
15000
issue
(3issues)
Number
100
Number
1575
Number
700
Number
26
Achievement
62
(%)
138
15,000
(3issues)
106
2046
760
25
100
106
130
109
96
Times
Times
5
4
5
4
100
100
Times
100
235
Annexes
ANNEX2
HEALTHINDICATORS
CHILDHEALTH:IMMUNIZATION
MainIndicators
Immunisationcoverage
NumeratorandDenominator
Numberofchildrenunderoneyearofageimmunised
withspecificdoseofantigen
x100
Totalestimatednumberofchildrenunderoneyearofage
ImmunisationcoverageforTT2+
NumberofpregnantwomenimmunizedwithTT2+
x100
vaccine
Totalestimatednumberofpregnantwomen
DPTdropoutrates(DPT1vs.DPT3) NumberofchildrenreceivedDPT1 Numberofchildren
receivedDPT3
x100
NumberofchildrenreceivedDPT1
HepatitisBdropoutrates(Hepatitis NumberofchildrenreceivedHepatitisB1 Numberofchildren
B1vs.HepatitisB3)
receivedHepatitisB3
x100
NumberofchildrenreceivedHepatitisB1
Measlesdropoutrates(BCGvs.
NumberofchildrenreceivedBCG Numberofchildren
Measlesvaccine)
receivedmeaslesvaccine
x100
NumberofchildrenreceivedBCG
VaccineWastageRate
Numberofvaccinedosesreceived Numberofvaccinedosesused x100
Numberofvaccinedosesreceived
ImmunizationSession
NumberofImmunizationSessionconductedinayear
x100
Numberoftotalimmunizationsessionplanedinayear
CHILDHEALTH:NUTRITION
MainIndicators
Growthmonitoringcoverage
Proportionofmalnourished
children(weightforage)
VitaminAmassdistribution
coverage
PostpartumVitaminAcoverage
Irondistributioncoverage
(women)
Dewormingcoverage
Iodisedsaltcoverage
Urinaryiodineexcretion(UIE)
Numberofvisits
Numberoftargetedvisits
x100
Numberofchildren(036months)underlowgrowthcurvefor
1stvisit
x100
Numberofchildren(036months)newcases
Numberofchildren(659months)whoreceivedvitaminA
capsules
x100
TargetPopulation(659months)
NumberofPostpartumwomensupplementedwithvitaminA
capsule
TotalnumberofExpectedpregnancies
Numberofpregnantwomenwhoreceiveall225iron
tablets
Targetpopulation(expectedpregnancies)
x100
x100
Numberofchildren(15years)receivingdewormingtablets
twiceayear
x100
Numberofchildrenof15years
NumberofHouseholdsusingadequatelyiodisedsalt(15ppm) x100
NumberofHouseholdsSurveyed
100microgramiodineperlitreofurine(Median)
236
Annexes
CHILDHEALTH:CBIMCI:CDD
MainIndicators
Morbidityrateduetodiarrhoea
Totaldiarrhoealnewcasesinspecifiedtime
Targetpopulation(underfives)
Totalnumberofdiarrhoearelateddeaths
Targetpopulation(underfives)
Totaldiarrhoealdeathsperyear
Totaldiarrhoealnewcasesinsameperiod
Mortalityrateduetodiarrhoea
Casefatalityratefromdiarrhoea
x1000
x1000
x1000
CHILDHEALTH:CBIMCI:ARI
MainIndicators
UnderfivechildmortalityduetoARI
relatedcauses
CaseFatalityRatefromARI
AnnualincidenceofARIamongunder
fivechildren
Annualincidenceofpneumoniaamong
underfives
TotaldeathsduetoARIinoneyear
Total<5yr.populationinthesameyear
TotaldeathsfromARIinaspecifictime
TotalARInewcasesinsameperiod
Totalno.ofARIcasesinoneyear
Totalno.of<5yr.populationinthesameyear
No.ofpneumoniacasesinaspecifiedyear
Totalno.of<5yr.populationinsameyear
x1000
x1000
x1000
x1000
FAMILYHEALTH:FAMILYPLANNING
MainIndicators
TotalFertilityRate
(TFR)
Contraceptive
PrevalenceRate
(CPR)
CoupleYearsof
Protection
(CYP)
Methodspecific
newacceptorsasa
percentofMWRA
Description
Expressestheaveragenumberofchildrenawomanwillbearbytheendofher
reproductivelifeunderprevailingfertilityconditions.WhiledataonTFRarenot
availablefromHMIS,NepalundertakesFertilityorDemographicandHealthSurveys
everyfiveyears,whichprovideanupdatedestimateofTFR.
ExpressesthepercentageofMWRAusinganymoderncontraceptivedeviceatapoint
oftime.
NumberofcurrentusersofmodernFPmethods
x100
MarriedWomenofReproductiveAge(MWRA)
Expressesthenumberofyearsforwhichacouplewouldbeprotectedfrombeing
pregnantbymoderncontraceptivemethodsprovidedduringtheyear.CYPiscalculated
asfollows:
(VSC=13CYPs,Norplant=5CYPs,IUCD=8CYPs,13pillcycles=1CYP,4dosesDepo=1CYP,
150Condoms=1CYP)
ExpressesthepercentageofMWRAusingspecificFPmethodsforthefirsttimein
specificperiod,whichiscalculatedasfollows:
NumberofmethodspecificNewAcceptors
x100
MarriedWomenofReproductiveAge(MWRA)
237
Annexes
FAMILYHEALTH:SAFEMOTHERHOOD
MainIndicators
ANCservicecoverage
ContinuityofANCservice
Percentageof4ANCvisit
Deliveryservicecoveragebyhealth
Workers
Pregnancycomplications
ProportionofbirthsinB/CEOCFacility
Postnatalservicecoverage
C/SRate(asproportionofexpectedbirths
inthepopulation)
Maternalmortalityratio
Maternaldeaths
Casefatalityrate(allmaternal
complications)
No.offacilitiesprovidingbasicEOCper
500,000population17(excludingbloodand
Csection)
No.offacilitiesprovidingcomprehensive
EOCper500,000Population18(including
bloodandCsection)
Irondistributioncoverage(Pregnant
women&PostnatalMother)
ImmunisationcoverageforTT2vaccine
amongpregnantwomen
No.ofANCfirstvisits
x100
Expectedno.ofpregnancies
Totalno.ofANCvisits
No.of1stANCvisits
No.of4timeANCvisit
x100
No.of1stANCvisits
Totalno.ofdeliveryservicesprovidedbyhealthworkers x100
Totalno.ofexpectedpregnancies
Totalno.ofpregnancycomplications(newvisits)
x100
Totalno.ofbirthsinB/CEOCfacilityinadistrict
x100
Totallivebirthinthatdistrict
Totalno.offirstpostnatalvisits
x100
TotalCsectionsperformedinadistrict
Totalno.ofexpectedbirthsinthatdistrict
Totalmaternaldeaths
x100,000
Totallivebirths
Annualno.ofmaternaldeaths
Deathsfromspecificmaternalcomplications16atafacility x100
Complicatedobstetriccasesinthefacility
No.offacilitiesprovidingbasicEOCservices
x500,000
Totalpopulation
No.offacilitiesprovidingcomprehensiveEOCservicesx500,000
Totalpopulation
Numberofpregnantwomenwhoreceived225irontabletsx100
Totalnumberofexpectedpregnancies
NumberofpregnantwomenimmunisedwithTT2
x100
Totalnumberofexpectedpregnancies
DISEASECONTROL:MALARIA
MainIndicators
AnnualBloodExaminationRate(ABER)
Totalnoofslidesexamined
x100
Totalpopulationatriskofmalaria
SlidePositivityRate(SPR)
Totalnoofpositiveslides
x100
Totalslidesexamined
AnnualParasiteIncidence(API)
Totalnoofconfirmedmalariacases
x1000
Populationatriskofmalaria
ProportionofP.falciparum(PFpercent)
TotalPFcases
x100
Totalconfirmedpositivecases
ClinicalMalariaIncidence(CMI)
Totalnoofclinicalmalariacases
x100
Totalpopulationatriskofmalaria
16 Deathsfrommaternalcomplicationsincludeantepartumhaemorrhage,prolonged/obstructedlabour,postpartumhaemorrhage
postpartumsepsis,complicationofabortions,pre/eclampsia,ectopicpregnancy,andruptureduterus.
17 4BEOCfacilitiesaredesirableper500,000populations.
18 1CEOCfacilityisdesirableper500,000populations.
238
Annexes
DISEASECONTROL:LYMPHATICFILARIASIS
Prevalenceofdisease
Prevalenceofinfectioninhuman
Coverageofdrugdistributionandcomplianceofintake
DISEASECONTROL:KALAZAR
MainIndicators
Kalaazarincidence(KAI)
Kalaazartreatmentfailurerate(KATFR)
CaseFatalityRate(CFR)
TotalKalaazarcases
Totalpopulationinareaatrisk
TotalnumberofcasesnotrespondingtoSAG
TotalKalaazarcases
Totaldeathcases
TotalKalaazarcases
x10,000
x100
x100
NTPIndicators
Indicator
Treatmentoutcomesfor
newsmearpositive
cases,relapses,failures,
andnewsmearnegative
andextrapulmonary
cases:
Curerates
Completionrates
Defaultrates
Failurerates
Fatalityrates
Transferrates
TARGET:
85percentcureratein
newsmearpositive
cases
Smearconversionrate
at2(3)monthsfornew
smearpositivecases,
relapses,andfailure
cases
TARGET:
Description
Cureratesof*newpulmonarysmearpositivecases the
numberofnewpulmonarysmearpositivecasescured
dividedbyallregisterednewpulmonarysmearpositive
casesforagivenquarter.Itshouldbeatleast85percent.
Cureratesfornewsmearpositivecasesandrelapsesare
themostimportanttreatmentoutcomeindicators.When
thesureratesarelessthan85percentitisusefulto
examineothertreatmentoutcomes:
Completionrateofnewsmearpositivecasesthenumber
ofnewpulmonarysmearpositivecaseswhocompleted
treatmentdividedbyallregisterednewpulmonary
smearpositivecasesforagivenquarter.
Defaultratefornewsmearpositivecases thenumberof
newpulmonarysmearpositivecaseswhodefaulted
dividedbyallregisterednewpulmonarysmearpositive
casesforagivenquarter.Thedefaultrateshouldbeless
than10percent.
Failureratefornewsmearpositivecasesthenumberof
failuresofnewpulmonarysmearpositivecasesdividedby
allregisterednewpulmonarysmearpositivecasesfora
givenquarter.Ifthereisnodrugresistance,arateof4
percentormorewouldbehighfornewsmearpositive
cases.Ifthereisknowtobedrugresistance,theratecould
beashighas10percentfornewsmearpositivecases.
Fatalityratefornewsmearpositivecases thenumberof
deathsofnewpulmonarysmearpositivecasesdividedby
allregisterednewpulmonarysmearpositivecasesfora
givenquarter.
Transferratefornewsmearpositivecasesthenumberof
newpulmonarysmearpositivecaseswhotransferto
anotherreportingunitdividedbyallregisterednew
pulmonarysmearpositivecasesforagivenquarter.
*NOTE:Thesameoutcomedefinitionsapplytorelapseand
failurecases.Theseoutcomesarealsomeasuredin
smearnegativeandextrapulmonarycases.Thedefinitions
arethesame,exceptcureratesdonotapply.
Conversionrateisaveryimportantindicator.Itisthe
numberofsmearpositivecaseswhichconvertfrom
smearpositivetosmearnegativein2(3)monthsof
treatment,outofallsmearpositivecasesregisteredduring
aquarter.Theconversionratefornewsmearpositive
casesandrelapsesshouldbeatleast85percentat2(3)
months.Itshouldbeatleast80percentforother
retreatmentcases.Ahighconversionrateisusually
Calculation
Numerator:
thenumberof*new
smearpositivecaseshaving
thatoutcome
Denominator:
thenumberof*new
smearpositivecases
registeredinthatquarter
Numerator:
thenumberofsmearpositive
cases(new,relapseorfailure
cases)whichare
smearnegativeat2(3)
monthsoftreatment
Denominator:
239
Annexes
Indicator
80percentsmear
conversionrateinnew
smearpositivecases
ProgramCoverage
TARGET:
100percentcoverage
withDOTSbytheendof
theyear1999
Casedetectionratioof
newpulmonary
smearpositivecases
TARGET:
70PERCENTCASE
DETECTIONRATIO
Description
followedbyahighcurerate,exceptinspecialsituations
(e.g.ifthereisahighmortalityrateduetoHIV).
Reportedincidencerate
fornewsmearpositive
cases(per100,000
population)
Thereportedincidencerateofnewsmearpositivecasesis
thenumberofnewlydetectedsmearpositivecasesper
100,000population.Thereportedincidencerateis
importantforobservingtrendsincasenotificationover
severalyears
Reportedincidenceby
ageandsexinnew
smearpositivecases
Thereportedincidenceofnewsmearpositivecasesbyage
andsexisthenumberofnewsmearpositivecases
detectedinspecificageandsexgroupsperpopulationof
100,000.ItprovidesinformationonthetrendofTB.Asthe
transmissionofTBdecreases,theincidenceinyoung
peoplefalls.Theincidenceinolderpeopledoesnotfallas
rapidly,becausemanyofthemwereinfectedyearsor
decadesearlier.InasuccessfulTBcontrolprogramhepeak
ofincidencegraduallymovesformyoungpeopletoold
people.
TheincidenceofTBisusuallysimilarinyoungmalesand
females.Inadulthood,theincidenceishigherinmales
thanfemales.Thisdifferenceisgreatestinoldpeople.A
bigdifferenceinincidencebetweenmalesandfemalesin
youngagegroupsmayindicateaweaknessincasefinding
servicesforwomen.
Thereportedincidencebyageandsexisusuallycalculated
onceayearforthewholecountry.Youcancalculateitfor
regionsanddistrictsifthecensusinformationisavailable.
Tocalculatethereportedincidencebyageandsex,
determinethenumberofcasesreportedinayearforthat
agegroupandsex.Thisinformationcomesfromthe3
FourmonthlyReportsonCaseFindingforthatyear.Divide
thisnumberbythetotalpopulationinthisspecificage
groupandsex.Thisinformationisavailableformthemost
recentnationalcensus.Multiplytheresultinganswerby
100,000.Thisgivesyouthereportedincidenceper100,000
populationforthatspecificagegroupandsex.
Thereshouldbeapproximatelya1to1relationship
betweenthenumberofnewsmearpositivecasesandthe
numberofnewsmearnegativecasesandextrapulmonary
casescombined.
Proportionofnew
smearpositivecasesto
newsmearnegativeand
extrapulmonarycases
Thisisanindicatorofthenumber andproportionof
reportingunitsinwhichTBcontrolactivitiesare
implemented.TherearethreelevelsofNTP
implementation.Thesearestandardchemotherapy,
unsupervisedshortcoursechemotherapy,andDOTS.
Thecasedetectionratioisthenumberofnewpulmonary
smearpositivecasesdetected,expressedasapercentage
oftheestimateofnewsmearpositivecases.Itprovidesa
measureofcasefindingcoverage.Thetargetistoachieve
acasedetectionratioof70percentbytheyear2000.
Calculation
cases(new,relapse,orfailure
cases)registeredduringthe
quarter
Numerator:
thenumberofreportingunits
implementingTBcontrol
activities
Denominator:
thetotalnumberofreporting
unitsinthecountry
Numerator:
thenumberofnew
smearpositivecases
registeredduringayearina
definedpopulation
Denominator:
thenumberofnew
smearpositivecases
estimatedtooccurduringthe
yearinthatpopulation.
Numerator:
thenumberofnew
smearpositivecases
registeredduringayearfrom
withinadefinedpopulation
(ofadistrict,regionor
country)
Denominator:
theestimatedtotalmidyear
populationofthatdistrict,
regionorcountry
Numerator:
thenumberofnew
smearpositivecases
registeredinayearineach
group,foreachsex
Denominator:
thenumberofpeopleofthat
agegroupandsexinthetotal
population
Numerator:
thenumberofnewpositive
casesregisteredduringa
quarter
Denominator:
thetotalnumberofnew
240
Annexes
Indicator
Positivityratefor
smearpositivecases
Qualityassuranceof
smearexamination:
PercentageAgreement
TARGET:
90percentagreement
StockOutFrequency
TARGET:
Zerostockouts
Agreementbetween
drugdistributionand
reportedcases
TARGET:
85130percent
SupervisoryVisits
Description
Thisisthenumberofsmearpositivecasesdetected,
dividedbythetotalnumberofTBsuspectsexamined.Ina
countrywhereTBiscommon,thereisusuallyone
smearpositivecasesfoundforevery10suspects
examined,i.e.apositivityrateof10percent.Aratemuch
lowerthan10percentmayindicatethatthemicroscopyis
notbeingdoneproperly,orthattoomanypatientsare
beingscreened.Aratemuchhigherthan10percentmay
alsoindicateaproblemwithmicroscopy,orthattoofew
patientsarebeingscreened.
Accuratesmearexaminationsareessentialtoensurethat
smearpositivepatientsarebeingdetected,andthat
patientswhodonothaveTBarenotbeingtreated
unnecessarily.DiagnosisofpatientswithTBisbysmear
examination.Qualityassuranceofsmearexamination
shouldbedoneroutinely.
Thepercentageagreementbetweenthesending
laboratoryandthereferencelaboratoryisthepercentage
ofslidessentforqualityassurancebythesending
laboratorywhicharegiventhesameresultbythe
referencelaboratory.
Theprovisionofanuninterrupteddrugsupplyisan
essentialfunctionoftheNTP.Thestockoutfrequencyis
thenumberoftimesinafourmonthlyperiodinwhich
therewerenostocksofanyantituberculosisdruginthe
districtmedicalstore,foranyperiodoftime.
DrugsintheNTParedistributedtodistrictsonthebasisof
thenumberofcasesreportedineachtreatmentcategory.
Thepercentageagreementbetweentheamountofdrugs
distributedandthenumberofpatientsreportedina
definedtimeperiodisanindicatoroftheappropriateuse
ofdrugs.
TheeffectivenessoftheNTPisdependentoncontinuous
supervisionoftreatmentcenters.Supervisoryvisitsshould
beonaregularbasisaccordingtoaplanofsupervision
Calculation
cases(smearpositive,
smearnegative,and
extrapulmonarycases)
registeredduringthequarter
Numerator:
casesdetectedduringa
quarter
Denominator:
thenumberofTBsuspects
examinedbysmear
microscopyinthatquarter
Numerator:
thenumberofsmearsread
thesamebythesending
laboratoryandthereference
laboratory
Denominator:
thenumberofslidessentby
thesendinglaboratorytothe
referencelaboratoryfor
qualityassurance
Numberoftimestherewere
nostocksofany
antituberculosisdruginthe
districtmedicalstore,forany
periodoftime
Numerator:
thequantityof
antituberculosisdrugs
suppliedtoadistrictina
definedtimeperiod(four
months)
Denominator:
thequantityofdrugs
requiredtotreatthenumber
ofpatientsreportedbythat
districtinthesameperiodof
time
Numerator:
thenumberofvisitsmadeto
treatmentcentreswithinthe
districtinadefinedperiodof
time(fourmonths)
Denominator:
thenumberofsupervisory
visitsplannedduringthe
sameperiodoftime
241
Annexes
HIV/AIDS
Mainindicators
HIVPositivityrateamongthosetested
Numeratoranddenominator
NumberofHIVpositivecases
Numberofpersonstested
AIDSincidence
STIincidence
NumberofnewAIDScasesreported
Populationof1545years
NumberofnewSTIcasesreported
Populationof1545years
MORBIDITY
MainIndicators
PercentageofOPDnew
TenleadingOPDcasesonnational,
regionalanddistrictbasis
TenleadingOPDcasesonanecological
basis
Tenleadingcausesofhospitalisation
Casefatalityrate
Averagelengthofstay
Bedoccupancyrate
Throughput
Bedturnoverinterval
Numerator/Denominator
TotalnumberofOPDnewvisits(cases)
Totalpopulationofcatchmentsareas
1st tenleadingOPDnewcases
x100
1st tenleadingOPDnewcasesbyecologicalzone
1st tenleadingcauseofhospitalisation
Casespecificdeaths
Totalnumberofspecificcases
TotalInpatientsdays
Totalno.ofdischarges
Totalinpatientsstayinahospital
365(days)xTotalno.ofbedsavailable
Totalnumberofadmissions
Totalno.ofbedsavailable
365(days) AveragelengthofstayxThroughput
Throughput
x100
x100
CURATIVESERVICES
MainIndicators
PercentageofOPDnewvisits
TenleadingcauseofOPDcasesonnational,
regionalanddistrictbasis
TenleadingcauseofOPDcasesonan
ecologicalbasis
Tenleadingcausesofhospitalization
Casefatalityrate
Averagelengthofstay
Bedoccupancyrate
Throughput
Bedturnoverinterval
Numerator/Denominator
TotalnumberofOPDnewvisits(cases)
Totalpopulationofcatchmentsareas
1st tenleadingcauseofOPDnewcases
x100
1st tenleadingcauseofOPDnewcasesbyecologicalzone
1st tenleadingcausesofhospitalization
Casespecificdeaths
Totalnumberofspecific cases
Totalinpatientsdaysstay
Totalno.ofdischarges
Totalinpatientsdaysstayinahospital
365(days)xTotalno.ofbedsavailable
Totalnumberofadmissions
Totalno.ofbedsavailable
365(days) Averagelengthofstayxthroughput
Throughput
x100
x100
242
Annexes
ANNEX3
HEALTHSERVICES
Annex3.1:TargetPopulation
Annex3.2:HealthInstitutions
Annex3.3:ChildHealth
Annex3.4:FamilyHealth
Annex3.5:Malaria
Annex3.6:Kalazar
Annex3.7:Tuberculosis
Annex3.8:Leprosy
Annex3.9:HIV/AIDS
Annex3.10:LogisticsManagementandCommunityDrugProgram
Annex3.11:LaboratoryServices
Annex3.12:OutpatientsMorbidity
Annex3.13:FreeHealthServices
Annex3.14:HospitalStatistics
Annex3.15:HospitalLaboratoryServices
Annex3.16:InpatientMorbidity
243
ANNEX 3.1: TARGET POPULATION FOR FY 2067/68

District
Code
Total
Population
District
EPI (0-11
month)
Nutrition
Nutrition (12(24-35
23 Month)
Month)
Nutrition (3659 Month)
Under 2
years
Under 3
years
6-35
months
6-59
months
25-59
months
Under 5
Expected
Married
years ARI/ Female Pop Female Pop
Female Pop Pregnancie
15-44 years 15-49 years
CDD/
s
15-49 years
Nutrition
Malaria
Risk Pop
Adolescent
Estimated
Population 10TB Cases
19 years
Expected
live birth
MOUNTAIN
2011580
45929
49509
49671
102453
95439
145109
122315
224845
152011
247562
471188
515802
387468
54090
613765
777
437600
48,685
HILL
12308087
289457
288010
288460
577815
577467
865927
721900
1301153
864000
1443743
2993627
3267259
2465944
337702
7615007
9226
2780044
303,931
TARAI
13679738
National Total
27,999,405
320952
656,339
319801
657,320
335769
673,900
673098
640753
976522
818653
1491750
1008864
1649620
3292886
3590951
2693213
374364 12128242
14017
2878359
336,929
1,353,366
1,313,659
1,987,558
1,662,868
3,017,748
2,024,875
3,340,925
6,757,702
7,374,013
5,546,625
766,156 20,357,013
24,020
6,096,003
689,545
TAPLEJUNG
Mountain
158,432
3,686
3,781
3,894
7,929
7,467
11,361
9,553
17,482
11,823
19,290
37,401
40,769
30,577
4,289
22,975
57
36,158
3,860
PANCHTHAR
Hill
239,205
5,525
5,683
5,831
11,930
11,208
17,039
14,324
26,254
17,761
28,969
56,795
61,808
46,356
6,438
54,291
134
56,442
5,794
ILAM
Hill
340,170
8,488
6,658
6,971
12,446
15,146
22,117
17,944
30,390
19,417
34,563
85,361
92,901
69,676
9,897
85,121
190
79,397
8,907
JHAPA
Flat
839,660
22,564
15,770
16,220
26,000
38,334
54,554
43,442
69,441
42,217
80,554 224,288 243,878 182,908
26,325 657,376
880
186,816
23,693
MORANG
Flat
1,017,282
25,893
20,390
21,420
37,739
46,283
67,703
54,953
92,692
59,159 105,442 263,550 286,419 214,814
30,237 814,946
1,067
222,762
27,213
SUNSARI
Flat
768,550
18,988
16,516
17,519
32,963
35,504
53,023
43,674
76,637
50,482
85,986 193,159 209,566 157,174
22,173 739,331
806
163,297
19,956
5,037
DHANKUTA
Hill
196,438
4,800
4,138
4,249
7,874
8,938
13,187
10,827
18,701
12,123
21,061
49,065
53,572
40,179
5,597
74,548
110
44,391
TERHATHUM
Hill
132,407
3,171
2,824
2,868
5,459
5,995
8,863
7,304
12,763
8,327
14,322
32,374
35,331
26,498
3,695
32,491
74
31,098
3,326
SANGKHUWASABH
Mountain
187,252
4,343
4,226
4,305
8,553
8,569
12,874
10,739
19,292
12,858
21,427
44,751
49,058
36,794
5,063
46,794
68
43,705
4,557
50,522
5,619
10
BHOJPUR
11
SOLUKHUMBU
12
OKHALDHUNGA
Hill
233,533
5,359
4,918
5,124
10,028
10,277
15,401
12,768
22,796
15,152
25,429
55,902
61,307
45,980
6,243
Mountain
126,287
2,855
2,837
2,897
5,843
5,692
8,589
7,188
13,031
8,740
14,432
29,886
32,765
24,574
3,324
130
55,531
46
29,098
Hill
184,376
4,070
4,484
4,520
9,507
8,554
13,074
11,076
20,583
14,027
22,581
42,455
46,830
35,122
2,992
4,738
18,806
193
42,540
4,264
6,272
13
KHOTANG
Hill
269,207
5,984
6,730
6,829
14,446
12,714
19,543
16,604
31,050
21,275
33,989
61,930
68,077
51,058
6,969
61,109
150
63,109
14
UDAYAPUR
Hill
350,325
8,054
8,481
8,682
17,951
16,535
25,217
21,258
39,209
26,633
43,168
82,402
89,475
67,106
9,389 315,493
196
82,391
8,450
15
SAPTARI
Flat
684,793
15,205
15,312
16,948
34,473
30,517
47,465
39,989
74,462
51,421
81,938 163,359 179,500 134,625
17,731 684,793
718
130,233
15,958
16
SIRAHA
Flat
Eastern
689,648
6417565
15,120
154105
16,211
138959
17,774
146051
37,041
280182
31,331
293064
49,105
439115
41,690
363333
78,731
643514
54,815
426230
86,146 160,826 176,651 132,488

719297
1583504
1727907
1295929
17,586 655,406
179694 4,314,003
723
5,543
130,958
15,827
1397926
161,725
17,926
17
DHANUSHA
Flat
807,388
17,076
19,641
21,153
45,019
36,717
57,870
49,471
94,490
66,172 102,889 184,362 202,674 152,006
19,918 768,915
847
151,923
18
MAKAWANPUR
Hill
473,302
11,014
11,230
11,381
23,109
22,244
33,625
28,204
51,313
34,490
90,910
12,857 410,474
496
108,667
11,571
19
SARLAHI
Flat
772,386
16,569
19,518
20,557
43,996
36,087
56,644
48,496
92,492
64,553 100,640 174,533 191,568 143,676
19,322 747,118
810
149,042
17,390
8,042
56,734 112,109 121,213
20
SINDHULI
Hill
337,437
7,666
8,737
8,927
18,937
16,403
25,330
21,562
40,499
27,864
44,267
77,712
84,482
63,362
8,935 317,872
188
77,285
21
RAMECHHAP
Hill
250,079
5,328
5,986
6,142
13,128
11,314
17,456
14,837
27,965
19,270
30,584
56,658
62,591
46,943
6,211 190,084
140
57,653
5,590
22
DOLAKHA
Mountain
242,911
5,181
5,357
5,167
10,115
10,538
15,705
13,014
23,129
15,282
25,820
57,531
63,277
47,458
6,383
20,948
136
55,902
5,745
23
SINDHUPALCHOK
Mountain
369,838
8,236
7,825
8,145
16,370
16,061
24,206
20,128
36,498
24,515
40,576
85,271
93,131
69,837
9,603
41,233
134
81,299
8,643
24
KAVRE
Hill
459,656
10,995
9,561
9,959
18,961
20,556
30,515
25,105
44,066
28,920
49,476 111,836 121,350
91,012
12,830 138,634
257
107,041
11,547
30,537 114,864 123,434
92,576
13,638 412,179
634
85,038
12,274
21,254
60,460
9,052
423
60,923
8,147
33,648
2,127
274,913
30,283
9,088 189,969
8,179
25
LALITPUR
Hill
412,179
11,692
5,900
6,153
6,792
17,592
23,745
17,995
24,787
12,945
26
BHAKATPUR
Hill
274,605
7,761
4,069
4,291
5,133
11,830
16,121
12,304
17,437
9,424
27
KATHMANDU
Hill
1,382,699
28,759
27,813
27,310
54,884
56,572
83,882
68,065 124,387
79,919 138,767 337,345 363,070 287,803
75,109
80,614
28
NUWAKOT
Hill
342,934
7,797
7,191
7,513
14,786
14,988
22,501
18,669
33,455
22,299
37,287
80,168
87,380
65,535
29
RASUWA
Mountain
53,614
1,176
1,187
1,227
2,481
2,363
3,590
3,013
5,494
3,708
6,071
11,966
13,127
9,845
192
79,259
19
10,976
30
DHADING
Hill
405,906
9,404
9,659
9,826
19,998
19,063
28,889
24,264
44,262
29,824
48,887
96,016 104,852
78,639
1,231
10,969 197,747
227
92,208
9,872
31
MOHOTTARI
Flat
668,471
13,788
16,526
17,614
37,985
30,314
47,928
41,147
79,132
55,599
85,913 150,311 165,926 124,444
16,083 618,943
373
125,290
14,475
32
RAUTAHAT
Flat
665,540
14,460
17,730
18,546
39,892
32,190
50,736
43,627
83,519
58,438
90,628 150,777 165,256 123,942
16,858 636,026
698
122,649
15,172
18,787
40,200
33,106
51,893
44,474
84,674
58,987
92,093 157,045 171,965 128,974
17,594 548,898
719
135,954
15,835
1,368
33
BARA
Flat
686,044
15,104
18,002
34
PARSA
Flat
608,992
13,411
15,432
16,177
34,254
28,843
45,020
38,430
72,684
50,431
79,274 141,228 154,682 116,012
15,627 608,992
639
121,330
35
CHITAWAN
Flat
577,794
15,078
11,450
11,711
20,087
26,528
38,239
30,814
50,901
31,798
58,326 150,156 162,328 121,746
17,610 577,794
606
131,795
15,849
2029147
231,835
Central
9791775
220495
222814
230586
466127
443309
673895
563619
1031184
694438
1140023
2324997
2532920
1915180
257594 6,425,825
9,665
14,064
36
GORKHA
Hill
340,159
7,848
7,490
7,567
14,990
15,338
22,905
19,052
34,042
22,557
37,895
83,598
92,200
69,150
9,136 225,996
190
78,105
8,222
37
LAMJUNG
Hill
209,634
4,908
4,341
4,411
8,394
9,249
13,660
11,254
19,648
12,805
22,054
51,816
57,296
42,972
5,707 209,634
117
47,516
5,136
9,501
38
TANAHU
Hill
374,805
9,055
8,370
8,463
16,451
17,425
25,888
21,436
37,887
24,914
42,339
93,458 102,856
77,142
10,557 338,708
209
89,501
39
SYANGJA
Hill
369,856
8,848
8,769
8,692
17,418
17,617
26,309
21,960
39,378
26,110
43,727
91,227 101,019
75,764
10,314 369,856
207
87,578
9,283
40
KASKI
Hill
463,151
11,987
8,740
8,883
14,679
20,727
29,610
23,706
38,385
23,562
44,289 121,400 132,323
99,242
14,001 311,709
259
105,291
12,601
41
MANANG
Mountain
12,565
300
142
147
152
442
589
441
593
299
741
3,115
3,475
2,606
350
2,591
315
42
MUSTANG
Mountain
17,335
381
258
278
442
639
917
731
1,173
720
1,359
3,937
4,361
3,271
440
2,941
396
3,378
43
MYAGDI
Hill
135,029
3,218
3,479
3,359
6,856
6,697
10,056
8,474
15,330
10,215
16,912
33,157
36,521
27,391
3,753 135,029
75
29,632
44
PARBAT
Hill
184,697
4,457
4,190
4,236
8,317
8,647
12,883
10,695
19,012
12,553
21,200
45,615
50,335
37,751
5,189 184,389
103
44,319
4,670
45
BAGLUNG
Hill
318,516
7,893
7,938
7,796
15,623
15,831
23,627
19,749
35,372
23,419
39,250
79,563
87,574
65,680
9,200 318,516
178
75,352
8,280
46
GULMI
Hill
348,214
8,166
8,748
8,756
18,299
16,914
25,670
21,656
39,955
27,055
43,969
84,609
93,398
70,048
9,521 347,729
195
83,723
8,569
47
PALPA
Hill
316,750
7,521
7,732
7,698
15,717
15,253
22,951
19,251
34,968
23,415
38,668
77,579
85,157
63,868
8,773 186,555
177
75,300
7,896
17,445
48
NAWALPARASI
Flat
684,035
16,620
15,860
16,268
31,986
32,480
48,748
40,575
72,561
48,254
80,734 168,055 183,129 137,347
19,383 638,276
717
155,441
49
RUPANDEHI
Flat
871,111
20,608
20,144
20,767
41,192
40,752
61,519
51,373
92,565
61,959 102,711 209,910 228,267 171,200
24,060 766,646
913
191,464
21,654
50
KAPILBASTU
Flat
586,409
12,942
14,434
15,283
32,154
27,376
42,659
36,298
68,452
47,437
15,085 458,383
615
122,884
13,577
51
ARGHAKHANCHI
Hill
Western
246,569
5478835
5,780
130532
6,183
126818
6,095
128699
12,715
255385
11,963
257350
18,058
386049
15,217
321868
27,932
577253
18,810
384084
74,813 133,781 146,712 110,034

30,773
641434
60,089
1340909
65,867
1470490
49,400
1102866
6,738
30,763
152207 4,522,190
138
4,104
59,642
6,064
1251280
136,987
52
PYUTHAN
Hill
254,534
5,861
7,485
7,325
16,134
13,346
20,671
17,788
33,922
23,459
36,805
60,597
66,507
49,880
6,836 254,218
142
57,802
6,152
53
ROLPA
Hill
249,496
5,779
7,383
7,143
15,569
13,162
20,305
17,466
33,035
22,712
35,874
58,691
64,332
48,249
6,734 249,496
139
53,946
6,061
54
RUKUM
Hill
225,756
5,492
5,469
5,469
10,923
10,961
16,430
13,731
24,654
16,392
27,353
55,140
60,189
45,142
6,401 224,243
126
50,414
5,761
55
SALYAN
Hill
253,925
5,971
8,476
8,148
18,334
14,447
22,595
19,694
38,028
26,482
40,929
58,893
64,541
48,406
6,880
142
55,303
6,192
56
DANG
Flat
563,679
14,132
13,954
14,003
27,864
28,086
42,089
35,136
63,000
41,867
69,953 139,846 151,824 113,868
16,488 412,551
591
132,719
14,839
57
BANKE
Flat
474,239
11,333
11,171
11,593
23,134
22,504
34,097
28,524
51,658
34,727
57,231 114,018 123,649
92,737
13,215 453,468
497
105,310
11,894
12,240
34,265
58
BARDIYA
Flat
467,603
11,659
10,632
11,409
22,177
22,291
33,700
27,966
50,143
33,586
55,877 113,970 123,298
92,474
13,600 382,304
490
110,153
59
SURKHET
Hill
350,038
8,744
9,492
9,167
18,471
18,236
27,403
23,016
41,487
27,638
45,874
86,860
94,010
70,508
10,403 264,452
196
82,120
9,363
60
DAILEKH
Hill
269,291
6,310
8,365
8,089
17,838
14,675
22,764
19,665
37,503
25,927
40,602
63,031
68,873
51,655
7,349 268,336
150
61,017
6,614
61
JAJARKOT
Hill
160,692
3,836
3,997
4,000
8,168
7,833
11,833
9,948
18,116
12,168
20,001
39,339
42,956
32,217
4,470 159,942
4,023
62
DOLPA
Mountain
35,184
807
915
896
1,870
1,722
2,618
2,224
4,094
2,766
4,488
8,598
9,331
6,998
63
JUMLA
Mountain
106,419
2,455
2,804
2,861
6,065
5,259
8,120
6,920
12,985
8,926
14,185
25,027
27,317
20,488
64
KALIKOT
Mountain
125,930
3,081
3,384
3,383
7,051
6,465
9,848
8,364
15,415
10,434
16,899
30,771
33,095
24,821
65
MUGU
Mountain
52,605
1,133
1,550
1,577
3,499
2,683
4,260
3,706
7,205
5,076
7,759
11,668
12,848
9,636
66
HUMLA
Mountain
Mid-western
48,568
3637959
1,549
1,438
1,348
88142
96515
96411
2,506
199603
2,988
184658
4,335
281068
3,483
237631
6,066
437311
3,741
295901
6,841
480671
11,117
877566
12,094
954864
9,697
716776
90
36,707
13
6,757
842
2,847 106,419
39
22,958
2,562
935
3,519 125,669
46
25,903
3,167
1,312
19
9,891
1,181
2,119
103108 2,935,363
18
2,698
8,812
1,909
819812
92,800
67
BAJURA
Mountain
129,460
2,815
3,917
3,849
8,568
6,732
10,581
9,189
17,757
12,417
19,149
29,541
32,607
24,455
3,301
47
26,758
2,971
68
BAJHANG
Mountain
199,497
4,510
6,135
5,916
13,144
10,645
16,561
14,346
27,490
19,060
29,705
46,016
50,698
38,024
5,254 199,497
72
42,048
4,729
69
ACHHAM
Hill
274,379
6,190
8,683
8,319
18,633
14,873
23,192
20,152
38,785
26,952
41,825
63,235
69,977
52,483
7,210 274,379
153
59,888
6,489
70
DOTI
Hill
249,146
5,678
6,988
6,729
14,432
12,666
19,395
16,601
31,033
21,161
33,827
57,351
63,159
47,369
6,626 249,146
139
52,939
5,963
71
KAILALI
Flat
773,136
18,873
18,970
19,802
40,026
37,843
57,645
48,364
88,390
59,828
97,671 185,943 200,700 150,525
22,010 611,597
811
179,138
19,809
72
KANCHANPUR
Flat
472,978
11,529
12,138
12,218
24,916
23,667
35,885
30,210
55,126
37,134
60,801 113,769 122,959
92,219
13,459 346,479
496
109,201
12,113
3,722
73
DADELDHURA
Hill
150,830
3,547
4,241
4,211
9,037
7,788
11,999
10,255
19,292
13,248
21,036
35,117
38,448
28,836
4,136 150,830
84
33,896
74
BAITADI
Hill
278,162
6,501
7,389
7,328
15,448
13,890
21,218
18,024
33,472
22,776
36,666
65,161
71,434
53,576
7,574 277,474
155
62,167
6,817
75
DARCHULA
Mountain
145,683
3,421
3,753
3,781
7,865
7,174
10,955
9,276
17,141
11,646
18,820
34,592
37,849
28,387
3,983
53
31,803
3,585
63064
72214
72153
597838
66,198
Far-western
DoHS, Annual Report 2067/68 (2010/2011)
2673271
152069
135278
207431
176417
328486
224222
359500
630725
687831
515874
50,229
73553 2,159,631
2,011
244
ANNEX 3.1: TARGET POPULATION FOR FY 2068/69

District
Code
Total
Population
District
Under 1
year EPI
Under 3
years
Under 2 years
Under 5
6-35 months 6-59 months 25-59 months years ARI/ CDD/
Nutrition
Female Pop
15-44 years
Female Pop
15-49 years
Married
Female Pop
15-49 years
Adolescent
Expected
Expected Live
Population 10Pregnancies
birth
19 years
MOUNTAIN
2050692
46325
94001
142754
119812
219985
149043
243207
482878
529141
397510
54459
441591
49004
HILL
12703005
293425
577435
866682
720648
1260731
866763
1446512
3093044
3382223
2552154
342570
2815517
308270
TARAI
13727117
National Total
28,480,814
319266
659,016
623027
1,294,463
946825
789804
1431064
1,956,261
1,630,264
2,911,780
965001
1,980,807
1588088
3,277,807
3327708
6,903,630
3629383
7,540,747
2722034
5,671,698
372670
769,699
2882256
6,139,364
335372
692,646
TAPLEJUNG
Mountain
161,528
3,696
7,340
11,152
9,330
17,096
11,578
18,918
38,316
41,810
31,353
4,319
36,476
3,887
PANCHTHAR
Hill
243,835
5,550
11,047
16,770
14,039
25,719
17,403
28,450
58,113
63,306
47,476
6,479
56,960
5,832
ILAM
Hill
346,206
8,517
14,929
21,752
17,558
29,658
18,923
33,852
87,151
94,950
71,211
9,945
79,903
8,948
JHAPA
Flat
864,917
22,915
38,281
54,483
43,214
68,556
41,487
79,827
231,198
251,647
188,737
26,748
190,164
24,077
MORANG
Flat
1,036,678
26,012
45,697
66,762
53,966
90,587
57,686
103,383
269,082
292,724
219,547
30,357
224,404
27,327
SUNSARI
Flat
780,265
19,032
34,922
52,101
42,740
74,648
49,087
84,009
197,003
213,936
160,451
22,216
163,938
19,991
DHANKUTA
Hill
198,906
4,821
8,782
12,916
10,546
18,146
11,734
20,516
50,154
54,821
41,120
5,626
44,442
5,063
TERHATHUM
Hill
135,265
3,184
5,907
8,716
7,148
12,515
8,176
14,083
33,123
36,187
27,141
3,716
31,427
3,344
SANGKHUWASABHA
Mountain
191,029
4,364
8,450
12,677
10,531
18,902
12,598
21,048
45,768
50,228
37,672
5,097
44,118
4,584
Hill
238,354
5,384
10,120
15,136
12,486
22,322
14,852
24,972
57,256
62,862
47,141
6,284
56,067
5,658
Mountain
128,497
2,860
5,586
8,410
7,003
12,718
8,539
14,125
30,595
33,578
25,183
3,339
29,292
3,008
10
BHOJPUR
11
SOLUKHUMBU
12
OKHALDHUNGA
Hill
188,043
4,083
8,399
12,813
10,805
20,154
13,763
22,162
43,476
48,012
36,011
4,764
42,941
4,283
13
KHOTANG
Hill
274,678
6,013
12,503
19,192
16,234
30,434
20,889
33,392
63,444
69,816
52,361
7,014
63,767
6,314
14
UDAYAPUR
Hill
356,030
8,087
16,265
24,775
20,798
38,280
25,992
42,257
84,250
91,575
68,679
9,435
82,896
8,489
15
SAPTARI
Flat
698,288
15,189
29,949
46,589
39,121
72,935
50,454
80,403
167,072
183,763
137,815
17,739
131,349
15,960
16
SIRAHA
Flat
Eastern
704,607
6547126
15,097
30,802
48,283
40,858
77,291
53,914
84,717
154804
288979
432527
356377
629961
417075
706114
164,785
1620786
181,178
1770393
135,881
1327779
17,623
180701
132,401
1410545
15,851
162616
17
DHANUSHA
Flat
823,150
17,074
36,047
56,847
48,456
92,554
64,898
100,945
188,645
207,579
155,687
19,934
153,287
17,937
18
MAKAWANPUR
Hill
681,140
13,786
29,757
47,089
40,316
77,472
54,488
84,245
153,808
169,950
127,466
16,098
126,339
14,485
19
SARLAHI
Flat
787,710
16,581
35,461
55,673
47,519
90,629
63,322
98,783
178,548
196,165
147,121
19,351
150,446
17,414
20
SINDHULI
Hill
344,304
7,701
16,160
24,948
21,158
39,721
27,351
43,511
79,501
86,514
64,885
8,989
78,100
8,092
21
RAMECHHAP
Hill
254,760
5,346
11,115
17,126
14,495
27,363
18,879
29,994
58,027
64,178
48,136
6,242
58,149
5,613
22
DOLAKHA
Mountain
248,155
5,506
10,395
15,466
12,753
22,653
14,971
25,366
59,028
64,992
48,740
6,430
56,482
5,785
23
SINDHUPALCHOK Mountain
376,088
8,261
15,764
23,758
19,698
35,635
23,931
39,695
87,138
95,278
71,467
9,628
81,842
8,667
24
KAVRE
Hill
466,594
11,038
20,197
29,907
24,480
42,880
28,110
48,307
114,178
124,010
93,007
12,881
107,480
11,593
25
LALITPUR
Hill
418,895
11,703
17,363
23,364
17,610
24,014
12,405
29,768
117,005
125,838
94,377
13,659
85,231
12,295
26
BHAKATPUR
Hill
278,778
7,785
11,693
15,884
12,053
16,886
9,024
20,717
76,570
82,251
61,687
9,087
61,038
8,181
27
KATHMANDU
Hill
1,383,881
28,756
56,586
83,923
68,094
83,278
79,955
138,853
337,604
363,354
288,020
33,646
275,117
30,254
28
NUWAKOT
Hill
348,809
7,823
14,743
22,091
18,236
32,640
21,752
36,495
81,968
89,434
67,073
9,137
79,749
8,222
29
RASUWA
Mountain
53,770
1,176
2,301
3,484
2,905
5,271
3,549
5,850
12,228
13,428
10,071
1,373
10,887
1,239
30
DHADING
Hill
412,649
9,452
18,782
28,422
23,775
43,213
29,078
47,860
98,170
107,313
80,488
11,031
92,783
9,926
31
MOHOTTARI
Flat
479,291
11,076
21,874
32,998
27,552
49,875
33,447
55,321
114,597
124,021
93,016
12,926
108,921
11,636
32
RAUTAHAT
Flat
678,117
14,459
31,607
49,828
42,718
81,776
57,279
88,886
154,216
169,191
126,889
16,883
123,693
15,191
33
BARA
Flat
697,812
15,108
32,492
50,917
43,484
82,759
57,700
90,192
160,585
176,010
132,007
17,629
136,887
15,863
14,069
34
PARSA
Flat
618,698
13,395
28,281
44,127
37,538
70,938
49,246
77,527
144,364
158,274
118,708
15,637
121,995
35
CHITAWAN
Flat
584,725
15,160
26,134
37,563
30,113
49,315
30,631
56,765
153,213
165,789
124,344
17,696
131,850
221186
436752
663415
552953
968872
680016
36
GORKHA
Hill
345,911
7,862
15,090
22,486
18,620
33,223
21,999
37,089
85,503
94,413
70,807
9,174
78,575
8,253
37
LAMJUNG
Hill
213,589
4,903
9,081
13,384
10,969
19,188
12,522
21,603
53,000
58,669
44,001
5,724
47,858
5,150
38
TANAHU
Hill
381,596
9,098
17,199
25,514
21,040
37,052
24,327
41,526
95,556
105,280
78,958
10,622
90,193
9,560
39
SYANGJA
Hill
377,450
8,900
17,400
25,936
21,557
38,628
25,607
43,007
93,377
103,526
77,649
10,385
88,501
9,345
12,635
Central
9937326
1119080
2369393
2583569
1953189
258257
2040276
15,924
232386
40
KASKI
Hill
469,359
12,029
20,401
29,056
23,139
37,229
22,745
43,146
123,772
135,048
101,288
14,042
105,423
41
MANANG
Mountain
12,663
297
431
569
424
559
273
704
3,171
3,545
2,659
348
2,563
312
42
MUSTANG
Mountain
17,263
378
622
883
698
1,098
661
1,283
4,038
4,481
3,360
438
2,887
397
43
MYAGDI
Hill
137,539
3,228
6,584
9,865
8,275
14,982
9,988
16,572
33,917
37,402
28,053
3,773
29,870
3,392
44
PARBAT
Hill
188,717
4,473
8,521
12,672
10,471
18,645
12,325
20,846
46,695
51,592
38,696
5,222
44,817
4,702
45
BAGLUNG
Hill
324,308
7,938
15,616
23,258
19,347
34,598
22,893
38,509
81,400
89,699
67,267
9,263
75,971
8,336
46
GULMI
Hill
354,897
8,213
16,657
25,238
21,198
39,150
26,533
43,190
86,618
95,729
71,797
9,583
84,522
8,631
18,853
34,241
22,935
37,959
79,319
87,170
65,371
8,822
75,973
7,938
48
NAWALPARASI
Flat
695,990
16,690
32,016
47,991
39,782
70,910
47,103
79,119
171,716
187,312
140,488
19,487
156,521
17,533
49
RUPANDEHI
Flat
883,845
20,665
40,058
60,410
50,248
90,171
60,275
100,333
214,175
233,130
174,847
24,128
192,201
21,710
50
KAPILBASTU
Flat
597,199
12,964
26,915
41,929
35,551
67,006
46,469
73,384
136,757
150,134
112,602
15,134
123,867
13,625
51
ARGHAKHANCHI
Hill
251,602
5,807
11,803
17,798
14,939
27,421
18,477
30,280
61,484
67,471
50,600
6,780
60,281
253418
379560
315111
564101
375132
628550
47
PALPA
Hill
Western
322,739
5574667
7,557
131002
15,024
22,571
1370498
1504601
1128443
152925
1260023
6,101
137620
52
PYUTHAN
Hill
258,737
5,887
13,137
20,320
17,422
33,222
22,983
36,120
61,973
68,091
51,068
6,872
58,219
6,186
53
ROLPA
Hill
253,949
5,810
12,974
19,982
17,129
32,384
22,263
35,237
60,106
65,950
49,460
6,779
54,384
6,102
54
RUKUM
Hill
230,000
5,512
10,805
16,167
13,453
24,148
16,057
26,862
56,410
61,634
46,227
6,435
50,825
5,790
55
SALYAN
Hill
260,198
6,044
14,303
22,278
19,306
37,060
25,729
40,032
61,194
67,144
50,357
7,050
56,313
6,344
56
DANG
Flat
572,618
14,216
27,723
41,482
34,485
61,542
40,816
68,539
142,868
155,266
116,450
16,589
133,492
14,929
57
BANKE
Flat
482,352
11,367
22,175
33,566
27,976
50,524
33,939
56,114
116,439
126,394
94,793
13,266
105,986
11,938
58
BARDIYA
Flat
475,731
11,719
22,002
33,249
27,480
49,053
32,820
54,822
116,395
126,043
94,533
13,678
110,944
12,312
59
SURKHET
Hill
353,105
8,902
17,855
26,782
22,405
40,254
26,775
44,632
88,010
95,351
71,512
10,388
82,028
9,351
60
DAILEKH
Hill
274,902
6,346
14,485
22,453
19,327
36,900
25,541
40,026
64,541
70,603
52,953
7,407
61,725
6,671
61
JAJARKOT
Hill
163,779
3,852
7,725
11,654
9,759
17,760
11,930
19,655
40,257
44,005
33,002
4,495
37,036
4,043
62
DOLPA
Mountain
35,500
803
1,677
2,542
2,148
3,948
2,665
4,342
8,824
9,586
7,190
937
6,748
842
63
JUMLA
Mountain
108,452
2,463
5,183
7,982
6,772
12,723
8,749
13,932
25,727
28,111
21,083
2,873
23,162
2,583
64
KALIKOT
Mountain
131,115
3,090
6,498
9,879
8,358
15,431
10,455
16,953
32,141
34,600
25,950
3,608
26,684
3,248
65
MUGU
Mountain
53,783
1,129
2,633
4,179
3,623
7,075
4,998
7,631
11,969
13,193
9,893
1,318
10,015
1,186
66
HUMLA
Mountain
49,418
3703639
Mid-western
1,517
88657
3,000
182175
4,387
276902
3,493
233136
11,303
12,291
427804
5,780
289511
3,791
471851
6,954
898157
978262
734344
9,873
2,162
103857
8,931
1,936
826492
93461
67
BAJURA
Mountain
131,374
2,825
6,588
10,352
8,961
17,335
12,138
18,726
30,067
33,223
24,918
3,297
26,901
2,966
68
BAJHANG
Mountain
203,477
4,530
10,482
16,285
14,056
26,977
18,724
29,206
47,143
51,996
38,997
5,285
42,495
4,759
69
ACHHAM
Hill
279,849
6,224
14,642
22,802
19,742
38,050
26,468
41,110
64,816
71,809
53,859
7,260
60,549
6,541
70
DOTI
Hill
252,607
5,706
12,438
18,996
16,189
30,226
20,595
33,033
58,647
64,657
48,496
6,661
53,131
5,993
KAILALI
Flat
784,757
18,953
37,265
56,699
47,378
86,197
58,253
95,518
189,868
205,137
153,850
22,117
180,072
19,907
72
KANCHANPUR
Flat
480,367
11,594
23,326
35,328
29,625
53,798
36,175
59,501
116,182
125,690
94,268
13,532
109,838
12,178
73
DADELDHURA
Hill
153,442
3,573
7,678
11,810
10,054
18,877
12,955
20,633
35,945
39,397
29,545
4,170
34,168
3,750
74
BAITADI
Hill
283,603
6,532
13,669
20,836
17,623
32,798
22,342
36,011
66,706
73,212
54,909
7,630
62,766
6,864
75
DARCHULA
Mountain
148,580
3,430
7,051
10,749
9,059
16,784
11,423
18,474
35,422
38,801
29,101
4,007
32,108
3,605
321042
219073
352212
644796
703922
527943
73959
602028
66563
71
Far-western
2718056
63367
133139
203857
172687
245
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
16
52
27
95
1
1
1
1
2
1
1
1
1
1
1
1
1
1
1
2
18
1
1
1
1
1
1
1
2
2
1
9
1
1
1
1
1
1
1
2
30
2
1
2
1
1
1
1
1
1
1
1
1
1
2
2
1
20
1
1
1
1
2
1
1
1
1
1
1
1
1
1
1
16
1
1
1
1
2
1
2
1
1
11
14
51
26
91
1
1
1
1
2
1
1
1
1
1
1
1
1
1
1
2
18
1
1
1
1
1
1
1
2
2
0
9
1
1
1
1
1
1
1
2
29
2
1
2
1
1
1
1
1
1
1
1
1
1
2
1
1
19
1
1
1
1
2
1
1
1
1
1
1
0
1
1
0
14
1
1
1
1
2
1
2
1
1
11
189
615
312
1116
12
12
12
12
24
12
12
12
12
12
12
12
12
12
12
16
208
12
12
12
12
12
12
12
24
24
3
108
12
12
12
12
12
12
12
24
351
24
12
24
12
12
12
12
12
12
12
12
12
8
24
24
12
236
12
12
12
12
24
12
12
12
12
12
12
9
12
12
12
189
12
12
12
12
24
12
24
12
12
132
315826
1678408
1599696
3593930
48271
45963
22210
74216
210586
44175
65008
23659
34532
27878
20493
11604
29504
35766
67474
36490
797829
160368
35901
30958
18891
18760
16653
27135
148172
0
5779
128013
44076
5962
42281
59469
30458
38285
0
201055
1012216
71222
54394
71825
41145
190252
6384
8682
24290
32721
43048
45816
10092
14602
0
40118
3569
658160
31641
16682
30735
37077
114965
208483
38505
52719
21774
33495
12253
9490
25009
16846
23740
673414
18975
17046
35551
18758
168501
84556
62538
22031
24355
452311
20
103
86
209
2
2
4
6
7
5
2
2
2
3
2
1
2
2
4
4
50
5
3
5
3
2
2
3
5
4
2
8
3
1
2
4
4
4
4
5
69
3
2
2
3
3
0
1
1
2
3
4
3
5
5
3
2
42
2
2
2
2
3
3
3
4
3
2
0
1
1
1
0
29
1
2
2
2
5
3
1
2
1
19
20
102
85
207
2
2
4
6
7
5
2
2
2
3
2
1
1
2
4
4
49
5
3
5
3
2
2
3
5
4
2
8
3
1
2
4
4
4
4
4
68
3
2
2
3
3
0
1
1
2
3
4
3
5
5
3
2
42
2
2
2
2
3
3
3
4
3
2
0
1
1
1
0
29
1
2
2
2
5
3
1
2
1
19
239
1229
1026
2494
24
24
48
71
84
60
24
24
24
36
24
11
18
24
48
48
592
60
36
60
36
24
24
36
60
48
24
96
36
12
24
48
48
48
48
55
823
36
24
24
36
36
0
12
12
24
36
48
36
60
60
36
24
504
24
24
24
24
36
36
36
48
36
24
0
12
12
12
0
348
12
24
24
24
60
36
12
24
11
227
212358
1088121
1306396
2606875
9087
13832
27846
117179
111624
75546
19106
12920
20894
21463
24764
4809
15284
45831
50940
57877
629002
76633
53443
86744
24081
19078
28153
44673
49383
0
17387
65395
20684
9126
53494
52884
50639
44364
0
106350
802511
27530
10657
35586
62844
21765
0
5310
12618
17887
43776
46873
36103
71919
0
47242
29729
469839
18991
28264
16036
23220
49122
49648
52302
78494
34378
9443
0
4395
4324
3361
0
371978
18289
20441
19607
7960
152961
51863
17626
25257
19541
333545
68
487
97
652
6
5
48
11
0
0
23
0
0
3
4
5
8
0
0
19
132
0
6
21
29
1
0
0
0
0
0
96
0
0
24
0
0
0
0
0
177
14
3
20
8
36
0
12
8
4
22
52
36
4
0
3
5
227
1
0
0
0
0
33
0
0
3
15
0
10
2
0
0
64
10
24
18
0
0
0
0
0
0
52
88
570
120
778
6
7
98
11
0
0
58
0
0
1
4
5
8
0
0
27
225
0
21
21
29
1
0
0
0
0
0
96
0
0
16
0
0
0
0
0
184
14
3
20
7
36
0
24
8
4
22
60
36
4
0
3
5
246
1
0
0
0
0
33
0
0
3
15
0
12
2
0
0
66
10
30
17
0
0
0
0
0
0
57
148
365
163
676
8
10
6
6
10
7
11
9
11
9
9
9
8
9
9
11
142
9
6
10
10
11
9
10
9
9
7
5
11
8
16
10
8
11
8
5
172
10
8
12
10
11
9
8
8
10
9
12
9
8
6
7
8
145
11
9
7
9
10
9
8
9
6
7
9
8
9
8
10
129
11
10
12
10
7
8
9
10
11
88
146
365
163
674
8
10
6
6
10
7
11
9
11
9
9
9
8
9
9
11
142
9
6
10
10
11
9
10
9
9
7
5
11
8
16
10
8
11
8
5
172
10
8
12
10
11
9
8
8
10
9
12
9
8
6
7
8
145
11
9
7
9
10
9
8
9
6
7
9
8
8
8
10
128
11
10
12
10
7
8
9
10
10
87
1733
4361
1957
8051
96
120
72
76
120
84
132
108
130
108
108
108
88
108
107
132
1697
108
71
120
120
132
108
120
108
108
84
60
129
96
192
120
96
132
96
60
2060
120
96
144
120
132
106
96
96
118
108
144
108
96
72
83
96
1735
132
108
83
108
120
108
96
108
72
84
106
89
102
95
120
1531
132
120
144
119
84
96
104
120
109
1028
603648
2335125
1879784
4818557
42661
46612
28287
91472
183138
117878
60819
48763
65563
47500
43937
79143
36172
64749
99334
125816
1181844
91461
74481
92016
41317
71674
42646
47135
73208
0
55212
59005
43893
28614
131049
72701
60147
105202
0
67380
1157141
42889
40310
62836
74824
68236
6607
13257
36171
62722
48496
93493
72651
82939
0
92113
56002
853546
85715
57795
61046
68313
127533
101981
138088
93307
46253
54164
13896
26348
42031
16025
33811
966306
76386
54924
79640
57527
99065
129740
54137
58494
49807
659720
Number of
visits
Integrated
Supervision
Total
Institution
Supervised
Service Provided to
Total Patients
(New+Old)
Total No. of Reports

Received
Current Month
Received Reports
Health Post
Total No. of Health
Post
Number of
visits
Total
Institution
Supervised
Service Provided to
Total Patients
(New+Old)

Received
Primary Health Care Center

Integrated
Supervision
Current Month
Received Reports
Total No. of PHCC
Service Provided to
Total Patients
(New+Old)

Received
Current Month
Received Reports
Total No. of Hospital
District Name
Received Reports
District Code
Hospital
346 312
1250 1287
255 288
1851 1887
18
18
16
16
72 133
14
16
0
0
4
4
106 140
3
2
0
0
0
0
7
7
21
23
28
26
0
0
0
0
63
76
352 461
0
0
12
28
34
36
109 111
1
1
0
0
0
0
0
0
0
0
0
0
60
60
5
4
0
0
102
38
0
0
0
0
0
0
0
0
0
0
323 278
35
34
6
6
60
60
34
47
132 132
17
17
72
75
44
44
17
10
52
52
124 144
92
92
12
12
0
0
12
12
23
23
732 760
7
7
34
34
0
0
0
0
0
0
104 104
0
0
0
0
0
0
22
20
17
5
96
69
5
5
0
0
0
0
285 244
41
41
73
75
45
28
0
0
0
0
0
0
0
0
0
0
0
0
159 144
246
67
68
69
70
71
72
73
74
75
12843677
105712
88804
116186
326250
324238
433483
81509
54943
89210
147184
88061
155679
167324
145558
467217
455870
3247228
457143
324117
403329
105316
116312
142610
154688
274511
0
66088
271682
107548
13483
150176
109224
323662
407936
0
194861
3622686
181254
132162
90726
163508
111530
1983
8735
80368
139162
192549
278191
170341
311596
0
411069
144454
2417628
145569
161071
119828
183761
239024
315871
261105
235507
232135
106760
13167
60210
39071
28158
55915
2197152
61954
102650
215252
138742
327889
137147
97476
195407
82466
1358983
4820
3916
3664
12400
101
67
65
103
8
77
199
44
12
96
9
268
100
3
131
764
2047
423
505
205
0
35
39
72
116
0
40
486
45
28
89
82
321
629
0
29
3144
94
111
174
213
217
14
57
114
39
229
84
124
294
0
38
131
1933
26
61
33
19
2
85
0
142
24
95
38
7
4225
14
0
4771
21
174
145
3
0
50
41
62
9
505
593 1564
1157 14517 260035
566
535 1924 1599
3704 6240
5307 65117 1341936 8503 6608 7846 7522
3154 4986
4293 52951 1169274 5913 5264 6809 6648
7451 12790 10757 132585 2771245 14982 12407 16579 15769
100
200
170
1964
31913
92
92
188
182
67
156
154
1815
43181
77
77
211
211
51
186
178
2146
61156
243
237
177
173
87
189
183
2218
61090
160
144
272
262
7
256
256
2984 111101
68
66
311
311
77
168
160
1972
44906
394
394
297
295
215
79
76
885
19658
17
13
150
149
44
68
51
742
12926
24
22
118
118
34
118
87
1119
17547
14
14
206
175
94
204
196
2376
35607
115
112
199
198
9
86
68
818
9025
20
20
123
108
114
168
168
2016
26151
63
37
168
168
96
223
172
1848
28525
92
99
233
205
9
156
133
1751
37521
22
23
210
199
75
407
398
4685 100917
338
200
459
459
705
289
254
3055
77827 1601 1607
497
489
1784 2953
2704 32394 719051 3340 3157 3819 3702
360
505
305
4008
87475
240
186
525
494
330
321
266
3254
98548 1188
970
373
361
205
308
155
2537
55022
133
138
425
370
0
195
123
1624
24894
7
7
205
184
35
139
134
1536
24379
8
8
187
184
27
149
139
1673
20141
15
7
169
168
74
240
196
2407
36289
55
55
254
223
113
307
298
3527
74555
553
488
324
317
0
61
61
732
0
0
0
110
110
41
50
41
524
7928
63
72
144
142
561
151
129
1612
33803
730
727
171
165
75
162
157
1928
35114
662
86
223
223
28
42
38
457
7675
72
65
57
56
66
180
166
1958
52519
375
265
216
213
82
156
128
1561
38761
47
56
238
214
318
353
346
3881
61910
203
198
461
442
512
297
249
2908
47270
594
466
492
481
0
330
330
3960
0
0
0
384
384
36
114
99
1196
23131
23
21
227
226
2863 4060
3360 41283 729414 4968 3815 5185 4957
84
240
209
2462
40154
438
351
257
231
111
165
156
1900
25743
98
98
197
193
174
170
141
1623
21992
296
296
235
228
220
214
170
2309
37818
585
649
240
240
224
158
143
1721
51937
477
483
203
190
13
13
13
132
648
40
40
20
18
60
25
13
211
1565
62
64
48
42
107
103
52
790
14388
165
127
109
99
40
104
91
1045
15603
112
112
163
155
142
124
91
1160
26021
355
149
184
148
71
236
181
2105
36760
830
684
311
310
124
180
168
2097
29476
155
155
260
260
263
228
188
2488
36428
497
438
343
343
0
229
229
2748
0
0
0
309
309
38
278
277
3226
85606
46
46
385
385
127
69
68
785
13421
226
213
185
178
1798 2536
2190 26802 437560 4382 3905 3449 3329
26
155
135
1540
28513
17
17
251
231
61
180
166
1790
36174
79
79
215
215
33
125
94
1119
26732
21
21
165
139
19
161
142
1640
35604
40
40
227
220
2
125
101
1240
33846
0
0
196
196
85
145
124
1549
40301
166
166
273
273
0
156
146
1762
67966
57
57
190
185
145
156
147
1727
42195
347
248
188
184
18
205
146
2198
47034
30
21
251
245
97
101
87
1133
28727
64
60
129
129
12
75
26
303
2396
17
4
69
38
10
94
68
968
12428
6
6
92
71
8
68
29
474
12076
8
8
111
74
10
78
30
484
5099
44
42
99
23
0
26
31
312
9090
0
0
79
62
526 1850
1472 18239 428181
896
769 2535 2285
20
64
45
602
25004
17
16
122
117
178
126
99
1078
30554
98
96
141
140
103
227
213
2469
68589
407
343
225
225
12
236
148
2215
69386
9
12
247
231
3
201
156
2297 104764
0
0
255
254
51
87
71
983
31166
205
167
135
129
41
84
71
799
44282
650
117
86
86
62
206
123
1909
44709
4
4
234
212
10
160
105
1515
38585
6
6
146
102
480 1391
1031 13867 457039 1396
761 1591 1496
279192
1449306
1981185
3709683
20397
34415
40767
153290
149135
118922
40494
14395
21483
25892
15728
19359
27049
50078
125538
121164
978106
125984
127295
126062
52546
24857
26177
34467
41443
0
49487
56217
39147
6440
62250
52213
141243
113949
0
73615
1153392
35265
25060
44230
42497
50815
517
1298
20055
18108
37449
48108
30477
107788
0
102933
30066
594666
42731
37358
33791
37769
82445
80207
67878
55239
46623
34045
4622
21708
26899
7092
9810
588217
24672
35564
49182
36799
104745
58992
19904
43126
22318
395302
Number of
visits
19314
88197
77469
184980
2181
2510
2083
3217
3720
3489
1673
1105
2050
2174
1131
2016
2172
2304
5297
5336
42458
5460
4388
4573
2005
2190
1993
2823
3680
1320
1664
2048
2667
655
2476
2593
5215
5787
4608
2163
58308
2875
2342
2624
2866
2331
199
432
1160
1730
1839
3708
3060
3982
3708
4493
2105
39454
2758
2283
1727
2542
2149
3167
2182
2193
2807
1477
444
987
927
520
667
26830
1352
1586
2700
2810
2979
1556
946
2634
1367
17930
Integrated
Supervision
Total
Institution
Supervised
Current Month
Received Reports
Number of
visits
Total No. of EPI

clinics
Service Provided to
Total Patients
(New+Old)
Total
Institution
Supervised
Total No. of
Reports Received
1048073
5673797
6121807
Current Month
Received Reports
4336
18996
13713
37045
496
353
456
502
588
480
288
240
296
612
262
531
628
420
1235
1116
8503
1040
800
1008
495
492
516
779
960
348
144
631
626
108
396
355
1004
996
852
372
11922
659
600
368
653
408
46
84
369
499
588
768
636
756
696
780
365
8275
419
480
395
432
312
420
264
456
600
300
116
237
197
158
161
4947
180
420
720
466
372
120
180
660
280
3398
Total No. of
PHC/ORC clinics
Received Reports
Current Month
Received Reports
363
1585
1142
3090
42
30
38
38
49
40
24
20
25
51
22
44
58
35
103
93
712
86
67
84
42
41
43
65
80
29
12
53
53
9
33
29
85
83
71
32
997
55
50
31
55
34
4
7
31
42
49
64
53
63
58
66
31
693
34
40
31
36
26
35
22
38
50
25
9
20
17
14
16
413
15
35
60
37
31
10
15
52
20
275
EPI Clinic
Integrated
Supervision
Service Provided to
Total Patients
(New+Old)
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
383
1603
1143
3129
43
30
38
38
49
40
24
20
25
51
23
45
65
35
103
93
722
88
67
84
42
41
43
65
80
29
12
53
53
9
33
30
85
83
71
31
999
55
50
31
55
34
4
7
31
42
49
64
53
63
58
66
31
693
35
40
34
36
26
35
22
38
50
25
14
20
19
16
16
426
15
35
60
39
31
10
15
55
29
289
Integrated
Supervision
Total No. of
Reports Received
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Service Provided to
Total Patients
(New+Old)
Total
Institution
Supervised
Number of
visits
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
PHC/Outreach Clinic
Total No. of
Reports Received
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Total No. of Sub

Health Post
District Code
Sub Health Post
759
702
9546 8326
9117 7940
19422 16968
117
117
114
114
229
218
295
186
82
89
433
433
47
35
54
52
21
21
128
126
33
33
65
33
110
116
20
22
427
217
2373 2363
4548 4175
285
209
1500 1228
284
284
5
5
13
13
14
7
62
62
615
518
0
0
65
69
858
853
191
74
83
69
517
373
147
146
312
312
1326 1012
0
0
59
50
6336 5284
502
426
128
128
451
451
772
843
540
570
72
72
109
111
103
98
170
170
540
261
1165
808
292
294
1063
984
0
0
40
40
466
385
6413 5641
16
16
96
96
43
43
39
40
2
2
272
272
68
68
307
277
38
31
76
69
15
3
22
13
17
14
6
7
0
0
1017
951
48
34
135
134
445
381
12
28
0
0
296
191
147
124
20
20
5
5
1108
917
247
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
5358
21821
16165
43344
790
385
811
495
581
926
247
345
229
555
253
605
696
149
846
885
8798
890
684
1249
479
663
932
646
934
369
187
1104
948
226
439
377
896
875
738
373
13009
573
660
409
599
853
73
136
335
422
802
897
508
661
1290
1032
627
9877
400
375
296
390
719
665
812
839
767
269
78
497
219
139
209
6674
246
406
858
564
878
670
374
711
279
4986
63498
688664 1712 1197
264564 4436770 32208 24491
197981 5479084 14342 11435
526043 10604518 48262 37123
8873
56037
274
274
4443
106196
151
151
10485
96515
878
808
6943
348977
443
290
7149
392256
154
192
11371
446250
41
41
3566
83871
148
109
4117
29584
105
87
2888
55305
18
18
6319
108524
776
779
3062
31041
32
32
7821
94077
239
73
8119
53163
387
388
4947
97555
23
32
11802
425702
778
216
11243
252424 4236 4134
113148 2677477 8683 7624
10492
266355
190
193
7712
322667 1997 1406
15038
195435
389
389
5554
82827
16
24
8313
121632
39
39
12378
66544
89
8
7283
82847
74
74
11004
170841 1425 1024
4428
0
0
0
2160
36775
147
156
12900
245686 3967 2998
10575
56879
191
109
2677
38658
349
216
5096
105821 1303
525
4861
177475
275
251
10380
215661
544
537
10357
257167 1388
785
8856
0
0
0
4633
186664
86
67
154697 2629934 12469 8801
6568
73289
833
611
7869
94193
176
176
4821
74314
602
602
7173
154902 3275 3541
10071
184467 5492 5624
970
1961
185
122
1412
3972
22
22
3903
55848
353
307
5364
97016
284
295
9778
114480 3275
113
11137
153239 2358 1094
6885
341070
748
748
8387
249462 3110 2444
15480
0
0
0
12022
171820
0
0
6922
73656
989
768
118762 1843689 21702 16467
4862
109672
79
75
4506
72940
195
195
3274
35561
88
88
4754
130641
187
187
8560
173419
0
0
7549
243106
373
373
9647
379842
228
228
10447
217536
572
388
9185
269452
185
175
3120
40315
143
104
719
2647
4
2
5515
64000
214
11
2515
55730
43
34
1912
14354
122
114
2232
14906
0
0
78797 1824121 2433 1974
2860
71391
52
27
4343
75527
216
225
10035
135485 1754 1422
6513
118657
48
55
12015
609302
21
18
8345
342575
364
122
4144
87810
461
329
8525
134806
41
41
3859
53744
18
18
60639 1629297 2975 2257
278
78103
1708 1144414
1447 485785
3433 1708302
27
11211
14
2913
24
31722
241 100575
56
33478
146
36209
24
14911
0
0
11
878
12
2380
36
18244
12
27117
0
0
34
7417
0
0
9
1121
646 288176
36
15913
70
16270
100
27911
3
333
12
17950
44
18066
107
20687
192
74709
130
0
195
64071
442 467611
17
2944
5
358
72
35144
63
20314
33
7215
24
36890
60
0
180
45957
1785 872343
41
8787
59
7934
33
9698
14
1506
36 102565
14
937
2
424
13
1581
11
1365
12
288
10
1168
48 159680
201
56139
120
0
10
2875
2
0
626 354947
0
0
0
0
0
0
0
0
13
21342
35
28764
81
39835
72
22625
10
4701
0
0
0
0
1
18
0
0
2
1813
16
3706
230 122804
12
1046
1
0
36
32059
4
225
17
10604
15
4687
29
17331
32
3365
0
715
146
70032
1
3746
60
3807
0
0
0
18
0
0
0
0
0
0
0
0
0
0
0
3
21
0
1
0
0
0
0
1
25
0
1
3581
0
0
0
0
0
0
0
3
3612
15
0
0
0
17
0
0
20
0
2
0
0
33
0
0
0
87
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
4
0
0
0
81
0
0
85
1
78
65
144
0
0
0
23
0
0
0
0
0
0
0
0
0
0
0
3
26
0
1
0
0
0
0
1
32
0
1
0
0
0
0
0
0
0
0
3
38
12
0
0
0
17
0
0
12
0
3
0
0
33
0
0
0
77
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
1
0
0
0
0
0
0
1
15
216
84
315
2
0
2
16
8
5
0
0
4
1
0
1
1
2
0
1
43
1
4
1
1
0
6
0
3
12
9
153
1
1
2
2
0
0
15
16
227
1
0
3
3
9
0
0
1
0
1
4
1
0
2
0
0
25
0
0
1
0
0
8
1
0
1
0
0
0
0
0
2
13
0
0
0
0
6
0
1
0
0
7
11
153
58
222
2
0
2
8
8
5
0
0
3
0
0
1
1
2
0
0
32
1
2
0
0
0
5
0
3
8
6
104
0
1
1
1
0
0
15
11
158
1
0
3
2
9
0
0
1
0
1
3
1
0
2
0
0
23
0
0
1
0
0
4
0
0
1
0
0
0
0
0
0
6
0
0
0
0
2
0
1
0
0
3
124
1742
670
2536
17
0
24
104
70
58
0
0
34
0
0
12
9
24
0
12
364
12
24
1
0
0
51
0
32
32
67
1233
5
11
20
20
0
0
180
92
1780
16
0
35
15
108
0
0
13
0
12
23
12
0
24
0
0
258
0
0
11
0
0
67
4
0
12
0
0
0
0
0
11
105
0
0
2
0
22
0
5
0
0
29
45469
1502936
923306
2471711
1620
0
12178
106694
227798
19899
0
0
13879
0
0
2147
261
10022
0
5561
400059
0
8706
673
0
0
23755
0
4556
0
69781
793119
121
2426
11915
31192
0
0
0
239042
1185286
16313
0
23690
2533
379257
0
0
6143
0
3000
10206
85874
0
0
0
0
527016
0
0
26481
0
155
311222
873
0
5216
0
0
0
0
0
3789
347736
0
0
568
0
2683
0
8363
0
0
11614
0
1450
4
1454
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
3
0
3
0
0
0
0
0
12
0
0
943
0
0
0
0
0
0
0
0
958
1
0
0
483
0
0
0
5
0
4
0
0
0
0
0
0
493
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Number of
visits
Total Institution
Supervised
Service Provided to
Total Patients
(New+Old)

Received
Private Health Institution

Integrated
Supervision
Current Month
Received Reports
Total No. of
Institution
Number of
visits
Integrated
Supervision
Total Institution
Supervised
28
166
122
316
2
1
2
19
8
11
2
0
1
1
3
1
0
3
0
0
54
3
5
7
0
1
5
10
16
33
13
40
1
0
7
5
4
2
5
14
171
3
5
3
0
3
1
0
1
0
1
1
4
17
10
2
0
51
0
0
0
0
3
3
5
6
1
0
0
1
0
1
3
23
1
0
3
1
2
2
5
3
0
17
Service Provided to
Total Patients
(New+Old)
40
236
169
445
2
3
2
24
8
13
2
0
1
4
4
1
0
3
0
0
67
3
5
15
2
1
4
12
29
40
20
60
4
1
7
7
5
2
5
29
251
6
5
3
3
3
3
1
2
2
1
1
4
18
10
2
0
64
0
0
0
0
3
4
16
6
3
0
0
2
0
4
4
42
1
1
3
1
4
3
5
3
0
21

Received
Number of
visits
Total Institution
Supervised
Service Provided to
Total Patients
(New+Old)

Received
Current Month
Received Reports
Total No. of FCHV
6489
24799
17392
48680
855
394
1065
527
585
1035
315
405
325
567
306
713
905
450
1074
952
10473
909
684
1351
495
752
1247
711
955
369
189
1153
1080
245
450
433
909
884
738
406
13960
621
669
434
612
922
118
144
369
495
972
996
585
713
1290
1054
842
10836
441
459
387
423
808
681
841
935
810
270
207
549
270
216
243
7540
261
423
941
635
1131
820
462
829
369
5871
NGO/INGO
Current Month
Received Reports
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Female Community Health Volunteers

Integrated
Supervision
Total No. of
NGO/INGO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
0
33
1
34
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
3
0
0
0
0
0
0
0
12
0
0
7
0
0
0
0
0
0
0
0
19
1
0
0
3
0
0
0
5
0
3
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
248
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
98.44
98.56
96.30
97.89
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
66.67
96.30
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
25.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
97.50
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
66.67
100.00
100.00
100.00
98.33
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
75.00
100.00
100.00
100.00
98.44
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
99.58
99.43
99.52
99.48
100
100
100
100
100
100
100
100
100
100
100
91.67
75
100
100
100
98.83
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
91.67
99.4
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
91.67
99.56
97.58
99.57
99.85
99.2
100
100
100
100
100
100
100
100
98.48
100
100
100
91.67
100
99.07
100
99.36
100
98.61
100
100
100
100
100
100
100
100
100
97.73
100
100
100
100
100
100
100
99.81
100
100
100
100
100
98.15
100
100
98.33
100
100
100
100
100
98.81
100
99.71
100
100
98.81
100
100
100
100
100
100
100
98.15
92.71
94.44
98.96
100
98.9
100
100
100
99.17
100
100
96.3
100
82.58
97.35
94.34
98.8
99.64
98.57
96.12
98.88
100
100
100
100
100
100
98.67
100
94.93
98.33
80.51
100
99.92
100
97.66
98.48
99.5
100
98.21
100
100
99.87
100
100
100
99.21
98.43
100
100
98.61
98.43
100
100
100
99.45
99.85
100
98.92
100
100
95.83
100
99.19
99.01
100
100
100
100
100
98.48
98.12
99.59
99.76
100
96.81
100
100
100
100
100
100
100
69.05
98.75
86.4
82.29
83.85
96.77
100
100
100
99.57
100
100
100
100
80.46
97.98
77.37
86.94
88.49
86.37
81.83
97.48
96.15
93.04
96.48
97.82
93.35
90.93
79.03
97.06
79.26
100
67.84
93.54
95.93
90.38
91.19
66.14
84.48
68.64
69.4
92.09
93.83
83.58
95.74
100
89.73
88.96
99.18
90.67
90.65
83.39
91.62
81.59
100
87.62
84.78
85.84
95.96
79.56
89.91
90.77
84.62
70.33
64.07
82.35
77.8
74.59
97.08
92.28
100
96.7
94.81
88.19
82.8
82.87
74.6
84.89
82.67
89.02
94.12
92.25
89.35
93.48
33.67
85.82
58.09
51.71
100
82.16
78.39
71.3
90.64
78.21
95.23
94.16
79.27
77.22
78.91
83.08
83.68
93.68
94.67
92.93
96.68
98.82
98.07
98.59
93.05
97.9
92.94
77.71
82.93
91.04
76.63
100
77.68
91.43
96.17
90.06
92.16
86.67
98.03
89.63
81.5
97.59
98.57
92.62
94.65
100
100
99.81
99.66
95.76
95.52
90.13
94.27
98.02
100
79.79
93.8
92.59
99.07
93.05
99.48
95.69
82.92
75
88.75
88.45
83.29
99.17
98.08
98.98
100
97.25
94.82
95.48
91.57
88.49
87.22
93.32
91.37
96.67
95.7
97.21
93.19
95.41
53.62
89.4
69.59
43.77
70.36
88.2
92.35
93.74
100
94.8
97.35
96.05
91.67
93.8
78.03
93.91
81.62
88.93
94.18
89.84
86.48
93.97
82.04
97.46
91.44
91.55
94.34
84.8
74.05
94.12
83.39
91.41
74.76
91.61
91.57
98.75
88.99
96.19
93.96
92.76
93.5
92.12
83.14
85.36
96.02
100
95.24
93.24
81.6
91.05
94.37
93.55
95.16
97.63
100
95.09
92.39
88.14
98.02
92.57
97.67
91.02
68.5
81.71
88.14
90.3
83.86
93.11
98.08
98.21
100
95.05
68.51
91.34
91.87
81.81
70.5
93.66
88.28
92.38
95.59
93.11
94.5
96.3
28.95
83.71
77.62
73.77
76.54
87.09
91.32
85.56
88.87
85.47
88.53
84.99
74.75
85.7
87.15
86.1
PHI
NGO
FCHV
EPI Clinics
PHC/outreach
clinics
SHP
HP
PHCC
Hospital
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
(Reported to Public
Health)
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Reporting Status (%)

District
District Name
Received Report
District Code
Annex3.2:ReportingStatusAnalysedData
59.78
61.53
71.6
65.24
93.1
38.89
100
86.69
71.79
93.59
100
91.67
50
75
100
94.44
100
84.33
100
78.65
58.48
12.5
100
97.78
74.31
55.17
27.08
86.67
61.39
35.42
41.67
85.71
75
55
100
100
53.25
59.42
56.94
98.33
91.67
38.89
100
38.89
28.57
86.67
52.38
100
83.33
100
89.73
100
50
100
82.69
72.09
68.64
70.08
69.18
85
100
61.9
82.35
96.67
70.83
0
100
81.82
100
92.31
77.61
100
77.42
20
0
70.83
88.89
22.22
98.53
67.16
45.45
91.67
83.33
83.33
0
100
54.44
67.5
94.12
97.22
68.18
100
100
100
47.92
100
0
100
88.05
91.67
38.24
72.92
42.19
100
27.78
0
69.79
33.33
100
4.17
4.17
34.78
45.91
100
50
100
100
35.42
41.67
48.33
88.89
62.39
55
58.66
50
30.56
41.67
32.95
249
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
70
114
214
134
168
160
77
258
366
153
226
82
120
97
71
40
102
124
234
95
160
557
125
107
66
65
58
94
257
0
80
49
153
21
147
206
106
133
0
349
120
124
189
125
143
661
22
30
84
114
149
159
35
76
0
70
12
116
110
58
107
129
200
724
134
183
76
116
43
44
87
58
82
148
66
59
123
65
293
294
109
76
85
143
37
37
53
44
16
24
24
69
55
52
33
22
36
25
43
18
35
80
44
50
44
53
62
60
28
33
49
52
34
0
30
28
24
32
93
46
44
39
0
81
41
32
19
62
73
25
18
44
31
51
41
42
50
0
55
52
39
33
49
28
40
57
57
61
68
40
16
15
15
12
45
64
35
34
14
106
60
61
44
74
61
15
22
40
25
19
16
16
50
64
58
19
19
21
18
17
31
17
25
39
40
29
35
44
32
14
23
16
16
28
0
27
41
14
12
28
25
26
33
0
47
23
15
17
18
26
22
3
6
16
22
19
27
28
36
0
46
24
20
27
22
31
26
44
39
60
36
27
27
5
12
17
7
12
26
24
19
23
20
49
56
22
20
19
27
10
12
19
14
9
10
11
27
23
38
12
10
13
10
14
12
11
14
16
17
16
18
17
17
9
10
12
8
12
0
19
18
7
5
16
13
13
17
0
22
13
11
9
10
10
11
2
4
9
12
14
15
11
17
0
22
16
12
14
14
13
18
32
31
41
22
16
15
5
11
8
7
14
19
14
10
12
12
37
48
23
12
12
17
18
21
22
21
16
24
28
28
37
23
22
17
16
15
11
13
15
21
22
25
22
22
30
22
15
16
12
15
21
0
15
21
18
17
27
25
16
16
0
19
18
16
14
14
16
30
5
7
18
15
22
17
14
15
0
27
17
16
19
20
24
22
27
26
39
24
21
25
8
13
25
11
29
23
42
28
28
31
46
32
55
23
25
33
14
16
26
20
9
14
20
48
40
34
24
13
10
12
14
10
12
22
24
23
23
23
29
28
26
11
13
12
11
0
30
27
15
10
25
20
27
20
0
34
20
12
11
17
15
22
3
3
17
10
20
13
10
27
0
23
14
15
15
16
20
15
38
25
31
25
17
23
10
22
29
14
15
22
18
22
18
13
35
38
21
16
16
22
11
17
28
20
6
24
9
50
55
39
24
7
19
17
10
12
7
20
36
22
24
25
42
13
15
15
5
11
16
0
17
19
5
14
21
37
21
25
0
40
17
11
12
15
22
18
2
3
14
18
12
14
50
30
0
14
11
16
23
16
11
27
20
32
39
21
29
13
4
12
22
8
7
23
25
17
14
18
51
41
21
16
14
27
12
28
14
21
17
9
55
17
25
10
26
3
8
21
94
9
5
19
18
10
12
5
62
17
8
16
0
14
44
7
3
20
13
9
64
0
11
20
9
6
12
4
119
3
9
5
5
1
5
139
12
0
12
0
24
15
36
57
41
4
21
43
136
14
17
7
1
17
19
46
0
15
28
19
6
0
43
27
1
9
25
65
0
108
28
42
28
7
146
20
10
18
298
0
85
100
68
34
20
13
20
194
9
18
1
38
10
22
4
0
37
2
26
13
25
4
20
14
138
12
5
70
17
1.55
2.31
2.76
2.38
2.33
2.23
1.34
2.29
0.14
1.93
8.96
2.2
1.36
1.84
0.39
2.53
1.48
0.26
0.73
7.58
2.47
4.09
4.93
2.44
0
0.85
0.63
1.14
1.41
0
3.42
10.58
1.42
3.11
2
2.73
3.74
6.17
0
1.16
2.87
1.53
2.22
5.61
4
6.59
3.25
8.57
3.45
0.95
2.9
1.11
2.34
4.17
0
0.58
4.1
2.59
0.74
1.53
0.97
0.53
0.08
2.43
0
3.82
0.36
3.88
0.86
0.5
0.42
0.63
0
1.23
1.33
5.09
1.72
0.31
0.1
5.1
2.73
1.13
0.34
1.66
0.34
1.06
1.06
0.97
0.46
0.49
1.27
0.76
0.26
2.35
0.16
0.32
0.12
0.55
0.23
0.22
0.44
0.15
0.49
5.56
1.07
0.37
3.02
0.45
0.04
0.06
0.05
0.23
1.59
0
1.44
4.81
0.53
1.55
1.47
0.36
0.56
1.57
0
0.18
0.94
1.46
0.59
1.74
3.03
3.06
3.08
2.56
1.23
1.08
1.2
2.9
0.86
1.92
0
0.17
3.09
1.54
0.11
0.44
0.17
0.25
0
1.14
0.37
1.59
0.1
0.59
0.05
0.06
0.12
0.54
0
0.42
0.25
0.76
1.51
0.05
0
1.92
1.39
0.02
0.04
0.55
0.36
1.06
1.17
1.02
0.62
0.54
1.23
0.68
0.29
1.46
0.23
0.44
0.1
0.63
0.27
0.2
0.5
0.1
0.47
4.75
1.09
0.4
3.29
0.67
0.02
0.07
0.04
0.24
1.6
0
0.48
4.99
0.33
1.21
1.73
0.61
0.68
2.06
0
0.22
1.02
1.66
0.65
1.92
3.51
2.81
3.6
2.31
0.9
1.04
1.42
2.6
1.13
2.87
0
0.1
2.08
1.64
0.06
0.45
0.26
0.18
0.01
1
0.36
1.47
0.12
0.53
0.04
0.14
0.13
0.07
0
0.38
0.28
0.95
1.69
0.11
0
1.41
1.44
0.09
0.03
0.58
0.18
0.99
0.66
0.76
0.32
0.38
0.76
0.55
0.33
0.04
0.35
0.21
0.06
1.37
0.1
0.1
0.43
0.07
0.2
4.34
0.73
0.21
2.06
0.29
0.05
0.05
0.01
0.1
1.07
0
0.83
2.6
0.1
0.88
1.17
0.58
0.59
0.89
0
0.17
0.63
0.98
0.26
1.39
5.79
6.1
1.03
0.15
0.83
0.6
0.12
1.1
1.28
3.43
0
0
0.91
1.52
0.17
0.42
0.23
0.44
0
0.55
0.27
0.41
0.22
0.39
0.01
0.02
0.13
0.53
0
0.26
0.1
0.53
1.51
0.09
0.02
0.15
0.71
0.05
0.05
0.38
PHI
NGO
FCHV
EPI clinics
PHC/ORC clinics
SHP
PHI
(per day)
NGO
(per day)
FCHV
(reporting period)
EPI Clinics
(per clinic)
PHC/ORC clinics
(per clinic)
SHP
(per day)
HP
(per day)
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
PHCC
(per day)
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Average no of Supervisory Visits in different

Health Institution
Average no of People Served
Hospital
(per day)
District Name
Received Report
District Code
Annex3.2:ReportingStatusAnalysedData
0.03
0.33
0.38
0.32
0
0
0
0.96
0
0
0
0
0.15
0.01
0.11
0
0
0
0
0
0
0
0.39
0
0.2
0
0
0
0
0.08
1.1
0
0.05
0
0
0
0
0
0
0
0
0.1
0.15
2
0
0
0
5.67
0
0
6
0
3
0
0
1.83
0
0
1.2
0
0
0.13
0
0
2
0
0
0.07
0
0
0
0
0
4
0
0
0.05
0
0
0
0
0
0
0.08
1
0
1
0
5
3
0
0
0
0.48
0
0
0
0.13
0
0
0
0
0
0
0
0
0.05
0
0
0.33
0
0
0
0
0
0.05
0
0
0
0
250
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
44195
266123
327651
637969
3240
4593
6977
21068
24142
18102
3835
2228
3614
3821
2606
3094
4491
7785
16284
17259
143139
21562
16582
20314
6469
3725
4031
5247
8000
10735
3436
36928
5492
1036
8239
9173
18673
17126
13247
11821
221836
5596
3716
6587
6195
13410
65
249
2606
2922
6481
7144
6530
13708
23788
14676
4675
118348
7073
6149
5530
5764
13771
12917
7894
8855
7417
5368
810
3197
4067
1673
1501
91986
3894
5638
8036
6375
15431
9286
4489
6184
3327
62660
44936
253819
287060
585815
3248
4680
6535
23107
21991
17508
3785
2330
3711
4006
2815
3228
4496
7783
15938
17230
142391
21532
16951
19845
6442
3850
4080
5862
8146
8836
4691
26261
5983
1077
8503
9539
18943
17587
0
10523
198651
5699
3854
6807
6876
9360
86
248
2808
3211
6555
7053
5601
13677
0
14680
4821
91336
7005
6232
5582
6241
13738
11030
8314
8827
7426
5573
814
3001
3956
1525
1483
90747
3941
5700
8172
6376
15201
9265
4183
6463
3389
62690
45311
258157
287789
591257
3290
4752
6722
23049
22328
17212
3949
2421
3759
4278
2811
3292
4561
7698
15756
17178
143056
21774
17013
19429
6413
3982
4136
6049
8406
7683
4871
26390
6052
1065
8602
9791
18828
18129
0
10402
199015
5679
3943
6776
6781
9666
117
236
2824
3366
6576
7320
5716
13647
0
14679
4931
92257
7053
6577
5913
6722
13486
11019
8328
8929
7954
5817
821
3093
3830
1250
1472
92264
4083
5758
8262
6626
15688
9844
4094
6769
3541
64665
45013
262925
320060
627998
3213
4860
6777
22519
22248
17384
3929
2431
3844
4359
2723
3621
4485
7554
15684
16492
142123
20799
16553
18057
6478
4262
4288
6073
8621
8667
5101
27637
5978
1090
8802
9736
18751
17819
14366
10683
213761
5737
4008
6964
7034
9958
125
228
2847
3476
6785
7463
5834
14036
20990
14361
5071
114917
6999
6642
5786
6738
13414
10805
8962
9064
7954
5645
772
3015
3791
1060
1416
92063
4099
5785
8183
6480
16242
9895
4112
6847
3491
65134
44793
252816
284023
581632
3268
4685
6535
21724
21991
17508
3783
2330
3711
4088
2815
3154
4428
7637
15261
17230
140148
21753
15848
19743
6306
3800
4097
5862
8145
8336
4686
26059
5983
1077
8439
9535
18909
17588
0
10615
196781
5684
3854
6804
6959
9358
86
248
2804
3209
6555
7056
5601
13677
0
14657
4866
91418
6987
6197
5684
6241
13736
11022
8303
8832
7426
5583
814
3100
3869
1445
1483
90722
3856
5673
8172
6376
15201
9257
4183
6456
3389
62563
44974
257744
282509
585227
3326
4755
6722
21247
22328
17212
3922
2421
3759
4349
2811
3259
4479
7558
14978
17177
140303
21499
15794
18483
6317
3974
4146
6002
8390
7983
4880
26320
6052
1065
8602
9768
18815
18129
0
10384
196603
5664
3943
6790
6778
9658
113
236
2829
3357
6576
7319
5716
13647
0
14458
4838
91922
7045
6544
5775
6722
13488
11019
8320
8929
7954
5817
811
3096
3682
1212
1472
91886
4013
5689
8260
6626
15688
9843
4094
6759
3541
64513
44949
262309
316101
623359
3235
4853
6777
21727
22248
17384
3915
2431
3844
4438
2723
3237
4450
7472
14788
16492
140014
20706
15594
18082
6361
4225
4290
6062
8601
8665
5106
27745
5978
1090
8802
9734
18585
17811
14448
9664
211549
5729
4008
6960
7034
9951
125
228
2827
3471
6785
7463
5834
14036
21010
14301
5085
114847
6985
6623
5731
6741
13414
10803
8863
9064
7954
5645
772
3035
3781
1057
1416
91884
4008
5765
8181
6489
16242
9903
4112
6847
3518
65065
40933
239647
294578
575158
3144
4476
6266
24648
21011
15760
3498
2174
3482
3775
2295
2716
4144
7000
14107
16626
135122
17232
15175
16969
5675
3888
4117
5525
7928
8016
4739
25952
5449
1017
8054
8293
16241
15924
11472
9658
191324
5227
3807
6366
6516
9223
102
192
2695
2898
6163
6967
5443
12683
19669
12979
4661
105591
6849
6077
5322
5898
13042
9552
7967
8401
7007
5081
791
2578
3349
1302
1410
84626
3702
4764
7634
5725
15125
8738
3691
5953
3163
58495
2067
4351
4914
11332
68
56
105
129
87
160
18
16
46
78
110
64
103
314
626
380
2360
593
118
450
395
92
44
110
32
0
296
245
62
14
57
228
632
359
0
51
3778
81
12
59
51
82
7
50
21
31
14
30
44
219
0
247
23
971
64
90
299
45
46
185
28
93
33
221
64
108
359
505
173
2313
222
127
202
309
403
201
152
234
60
1910
0
15110
186167
201277
0
0
0
13111
14946
10792
0
0
0
0
0
0
0
5678
9983
9753
64263
1854
9817
0
0
0
0
0
0
3585
3616
2130
0
0
0
101
6505
9372
8632
7849
53461
0
0
0
0
0
0
0
0
0
0
0
0
10407
16665
10974
0
38046
0
0
0
0
10537
7475
7988
0
0
0
0
0
0
0
0
26000
0
0
0
0
12175
7332
0
0
0
19507
21541
102953
158885
283379
1801
1850
1093
11339
5024
7332
1279
760
263
704
1078
1022
2278
3506
8500
9111
56940
15294
13632
12561
3342
1508
1991
1391
2542
5596
2843
21507
2467
157
1806
4460
17788
8402
0
3610
120897
2439
2084
3802
706
1614
36
46
1206
443
4126
921
477
5928
12725
3682
855
41090
2293
951
3069
2018
2978
6043
4276
2728
2421
3690
536
1890
3144
855
1007
37899
1421
4103
1986
2863
6467
4193
1687
2011
1822
26553
21412
116241
172632
310285
2112
1978
2026
12964
6827
6539
1541
1037
428
1101
1653
1610
2314
3570
7098
9147
61945
14968
16701
12295
2880
2046
2386
1908
2326
4642
2436
16686
2444
580
3904
4079
13858
7363
6251
3660
121413
3092
2681
3830
3935
4095
34
135
1220
1553
4034
4056
515
8504
12981
8505
2358
61528
3063
2249
2711
2541
7486
5175
3869
4226
2385
3472
412
1842
2110
625
758
42924
1569
3156
2287
2348
5475
2966
1108
1862
1704
22475
13798
104178
169550
287526
869
2980
5133
11194
12976
10038
2395
1400
2569
2621
1374
1287
2323
3571
9878
16066
86674
7989
3597
10341
1752
1314
1188
2308
3644
1106
861
2574
2040
388
4268
2158
4933
9050
5728
6367
71606
1662
695
806
4784
5431
14
112
1853
1839
701
5141
4491
5361
17904
13000
2290
66084
3933
3481
1645
2482
5657
5315
3081
4071
3744
1183
230
457
96
329
215
35919
1370
1090
4513
2796
6968
4107
1885
3325
1189
27243
TT Total
TT 2+
TT 2
TT Pregnant Women
TT 1
Japnese Encephalitis
Measles 12-23
months
Measles 9-11 months
Polio 3
Polio 2
Polio 1
DPT-Hep B-Hib 3
DPT-Hep B-Hib 2
DPT-Hep B-Hib1
BCG
District Name
Received Reports
District Code
Annex3.3:ChildHealthEPIRawData
56751
323372
501067
881190
4782
6808
8252
35497
24827
23909
5215
3197
3260
4426
4105
3919
6915
10647
25476
34324
205559
38251
33930
35197
7974
4868
5565
5607
8512
11344
6140
40767
6951
1125
9978
10697
36579
24815
11979
13637
313916
7193
5460
8438
9425
11140
84
293
4279
3835
8861
10118
5483
19793
43610
25187
5503
168702
9289
6681
7425
7041
16121
16533
11226
11025
8550
8345
1178
4189
5350
1809
1980
116742
4360
8349
8786
8007
18910
11266
4680
7198
4715
76271
251
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
286238
1615282
1154919
3056439
32770
42610
38130
60250
73583
69370
25360
22930
36354
34200
19420
35627
38410
41827
89720
79480
740041
85094
72740
61350
31874
35160
32980
44840
56790
0
20007
96325
47844
9298
47800
46995
55965
82519
0
51905
879486
49931
40450
43990
54650
52560
850
2430
18220
34630
32400
63712
66200
63464
0
72785
38083
634355
55540
41751
29760
42430
44820
53380
44530
44980
55180
28140
5000
15228
18232
4870
5290
489131
19970
25250
50060
43675
60724
33240
20841
46210
13456
313426
158426
877452
936293
1972171
10467
15985
21103
78246
73185
56887
13013
8454
12381
13313
9775
14314
15828
25610
51071
54877
474509
68562
54394
58483
24351
14015
15500
22311
28166
0
15927
98716
22333
3876
29325
31703
63310
57586
0
36883
645441
20596
15262
23025
25109
34360
331
845
9194
12680
23145
26875
24319
46266
0
46077
16966
325050
23153
22347
21875
21670
41738
36093
28907
31644
26752
21276
3789
10322
14277
4276
4815
312934
14209
19357
26744
21564
52150
31578
14046
22694
11895
214237
194911
1060360
1023075
2278346
15560
19423
24303
78243
77474
65900
16226
11804
16219
17820
12310
21048
23043
30795
61125
59460
550753
74950
53110
67383
26293
20500
21080
28020
32232
0
19166
103540
26254
5120
33020
37015
68070
66005
0
41555
723313
27268
23240
31320
32472
41385
1180
1730
11530
17660
25894
32222
32861
51033
0
50231
22464
402490
29175
25609
24840
27480
45370
38850
33194
33690
32738
21800
3986
11954
15042
4370
5960
354058
16800
22754
31963
26934
57986
33136
15957
29376
12826
247732
158850
850632
638443
1647925
17250
21750
19445
45090
38471
37650
13990
12530
18910
17209
10890
19100
20730
20529
48580
44910
407034
47551
40650
35240
18824
17900
17970
22910
31060
0
13390
56390
24385
4830
25380
24980
34171
45197
0
27115
487943
26875
22070
24210
27090
25470
730
1210
9647
16230
17410
30822
30200
33097
0
37795
20933
323789
27565
22703
19510
22280
24390
25730
22540
23160
28070
16171
3329
9035
10612
3440
3480
262015
12090
13053
24609
23465
32710
17556
11530
23020
9111
167144
50
20763
266112
286925
0
0
0
18816
22960
19320
0
0
50
0
0
0
0
10496
18262
16528
106432
3666
15401
0
0
0
0
0
0
0
6206
3623
0
0
0
438
9527
16507
0
16678
72046
0
0
0
0
0
0
0
0
0
0
0
0
18925
0
17553
0
36478
0
0
0
0
13680
11685
12801
0
0
0
0
0
0
0
0
38166
0
0
0
0
22641
11162
0
0
0
33803
124285
651547
660919
1436751
9870
11570
13350
42301
36119
38810
11060
7780
8333
9865
9020
10590
20104
20072
47630
45400
341874
53578
43150
45940
16853
11190
13970
14430
13998
0
10317
71286
15372
3210
17550
18964
47644
36834
0
23304
457590
17921
16480
19650
20270
17190
570
1320
7640
10374
14235
20011
19500
28544
0
68125
13240
275070
25460
12813
18110
18850
21650
22740
18491
19700
24060
15640
3011
8912
11187
3120
3550
227294
10120
15923
17740
18155
26568
14091
8297
16290
7739
134923
269470
1517422
1208469
2995361
31480
41288
36620
58080
66669
65090
25280
22172
33894
33700
19370
35351
38450
41330
89720
75840
714334
80478
71560
61310
31266
35100
32600
37160
49516
31471
17437
71189
46370
8790
47780
44951
54426
73479
56243
46606
897732
47224
36650
43730
47440
42800
850
2290
17130
26890
30990
50542
46040
57790
61129
66300
36895
614690
52570
40520
29080
39500
44090
51950
40661
43680
54390
27416
5000
14178
17569
4810
5290
470704
19970
24460
49380
41670
55228
31820
20294
43320
11759
297901
150098
829920
994764
1974782
10298
15785
20217
76133
67048
54293
12806
8227
11564
12931
9770
13964
15678
25331
51060
52445
457550
65182
53677
58739
23715
14015
15407
18140
25173
23211
14682
81935
21342
3571
29304
30609
61484
56363
43142
32407
672098
18928
11819
22162
21070
29325
327
732
8634
10752
21320
21906
17226
40895
60371
42930
16064
344461
21524
21609
21536
20275
41014
34728
25752
28829
26299
20950
3789
9722
14206
4276
4815
299324
14209
18671
26103
21268
47789
29312
12766
20630
10601
201349
189255
1054246
1093454
2336955
15250
18976
23937
75092
72196
63950
16156
11538
15784
17760
12290
20901
22987
30291
61125
58140
536373
72069
52830
63879
32935
20430
21214
25411
25769
30089
15791
88952
25415
4895
33020
35698
66958
65785
46476
37934
765550
26460
22384
31190
30302
36280
1148
1680
11246
15821
41244
29302
26413
47550
65024
47210
21913
455167
28695
25044
24560
26790
44940
37820
30676
32364
32488
21221
3986
11487
14792
4370
5960
345193
16800
22248
31815
26326
52850
30950
14509
27234
11940
234672
151344
819014
672229
1642587
16640
21720
18607
40545
34654
35280
13960
11954
17376
16870
10860
18940
20850
20281
48580
39030
386147
45876
39665
35270
18043
17810
17903
19119
25821
19919
11472
41828
23628
4667
25370
23860
33869
45155
28090
23655
501020
25284
20010
24100
24303
22510
730
1060
9287
24382
16460
25432
22940
29622
32976
34061
19343
332500
26780
21924
19270
21160
24150
25140
30063
22244
27650
15451
3329
8567
10512
3420
3480
263140
12090
13523
24274
22887
29813
16735
10670
21720
8068
159780
0
26379
306247
332626
0
20
0
17991
20028
18195
0
0
0
0
0
0
0
10312
18265
15476
100287
3305
14990
0
0
0
0
0
0
5845
5389
2925
0
0
0
408
33746
15696
16305
14220
112829
0
0
0
0
0
0
0
0
1430
0
0
0
16141
23213
15589
0
56373
0
0
0
0
13465
11155
11121
0
0
0
0
0
0
0
0
35741
0
0
0
50
16954
10392
0
0
0
27396
TT
JE
Measles
Polio
DPT - Hep BHib
BCG
TT
Vaccine Expenditure in Doses
JE
Measles
Polio
DPT - Hep BHib
Vaccine Received in Doses
BCG
District Name
Received Reports
District Code
Annex3.3:ChildHealthEPIRawData
118397
580754
606871
1306022
9510
11289
12638
40395
32373
37530
11240
6957
7829
9518
9000
8966
20094
18701
47630
43489
327159
51978
42480
45730
16561
11165
13901
11520
7814
0
7570
47077
14508
2867
17550
17859
48072
37058
10400
17661
421771
17055
16507
19536
18291
15640
591
1260
7338
7536
12649
16531
13250
25473
0
33596
12825
218078
24782
10989
17700
17840
21230
22220
14494
18390
23690
15060
3011
8405
10940
3120
3550
215421
10120
15408
17188
17625
22662
12400
6559
14266
7365
123593
252
Annex3.3:ChildHealth:EPIAnalysedData
67
68
69
70
71
72
73
74
75
5.22
58
30.67
58.11
57.72
56.84
70.5
65.66
64.5
41.7
10.86
71.2
30.66
46.59
7.41
0.92
44.99
62.05
64.37
52.06
24.25
62.62
80.87
84.79
29.15
74.56
65.96
68.51
29.5
64.51
63.6
30.93
39.82 39.59
30.49 34.42
42.44 46.11
36.99
40.5
41.99 49.24
28.74 30.72
11.04 20.47
43.07 49.25
16.62 22.58
33.07 29.49
22.85 27.53
20.57 28.06
5.19
8.45
11.28 17.64
32.43 49.73
21.57 33.98
32.69
33.2
37.34 38.02
47.94 40.03
51.81 52.01
31.69 34.47
76.78 75.15
84.76 103.84
65.01 63.63
37.4 32.23
24.28 32.94
31.19 37.38
14.49 19.87
19.81 18.13
41.03 34.04
31.41 26.91
63.92 49.59
27.15 26.89
11.48
42.4
16.46 35.59
34.69 31.73
105.52
82.2
47.75 41.85
0
40
20.5 20.78
46.93 47.13
26.7 33.84
36.52 46.98
36.01 36.28
6.85 38.15
11.53 29.25
10.29
9.71
10.45 30.68
32.13 32.51
8.54 29.93
44.85 43.85
9.67
42.6
5.44
5.87
30.58 43.87
52.89 53.95
24.41 56.38
12.69
35
27 40.42
33.54 44.81
14.12
33.4
47.95 42.35
29.33 36.93
18.06
45.4
45.73 39.16
31.44 28.45
26.22 40.62
32.94 32.45
82.55 77.67
57.33 44.06
66.39
64.7
89.34 59.96
65.17 47.64
47.52 35.77
36.76 41.63
43.05 47.53
78.09 60.07
27.55 31.72
43.21 35.44
29.38 24.88
31.15 22.04
40.79 26.79
26.55 24.58
45.74 42.78
36.1 30.56
25.51
30.85
45.29
37.53
20.26
46.29
51.86
42.52
42.91
45.27
42.79
37.89
50.74
41.98
41.34
27.16
33.33
38.03
55.71
91.36
48.23
40.11
22.37
53.52
19.61
21.16
18.61
24.03
28.4
8.11
9.51
7.65
22.45
28.36
38.91
16.78
29.26
51.44
36.65
36.16
27.8
18.19
12.18
7.63
46.38
38.79
4
25.45
49.37
35.44
7.62
54
51.19
27.66
74.41
86.18
33.99
43.42
57.53
51.69
25.7
36.08
34.31
40.22
22.65
39.13
50.95
26.47
24.6
16.05
2.73
25.08
10.15
34.84
41.5
20.75
62.59
42.2
31.66
30.51
45.58
43.9
29.85
37.04
7.38
9.95
10.09
9.85
2.96
2.55
10.19
-16.99
12.97
12.94
8.79
2.42
3.65
1.2
11.93
12.22
7.73
10.08
13.37
3.67
5.6
20.08
8.49
16.47
12.27
-4.38
-2.13
-5.3
0.9
25.33
-37.92
29.72
0.78
1.83
2.25
9.59
13.02
7.02
13.4
18.3
13.75
6.59
-2.45
3.36
-5.18
31.22
-56.92
22.89
-3.42
0.82
4.91
2.48
16.65
7.48
17.32
11.56
0.3
10.78
3.17
1.17
3.76
-2.32
5.29
26.05
-0.92
5.13
5.53
5.35
2.35
19.36
17.65
22.18
6.06
8
4.93
15.5
5
10.2
1.98
5.9
17.78
3.74
4.93
6.65
-0.17 -0.35 83.6

-3.59 -3.75 82.46
-11.5 -11.29 72.89
-7.2 -7.17 78.7
1.08
1.01 89.71
-3.85 -3.59 88.88
-3.7
-3.7 80.95
2.54 -0.01 63.73
-1.17 -1.17 63.79
0.71
0.71 72.19
-3.8 -3.49 84.83
-4.33 -4.33 89.95
-3.58 -3.58 89.34
-8.81 -8.56 88.66
3.27
3.27 86.55
-12.17 -2.63 91.25
0.24
-0.5 88.32
2.94
2.16 81.16
1.59
3.1 81.85
4.28
4.28 77.24
0.19
0.1 79.96
3.4
4.81 73.21
2.35
1.6 76.83
9.01
8.41 66.87
-0.56 -0.87 79.31
-10.7 -11.18 89.39
-5.1 -4.71 87.63
-3.6 -3.41 85.88
-5.83
-5.6 83.84
1.91 -3.95 65.89
-8.74 -8.96 80.29
-5.24 -6.47 48.13
0.08
0.08 88.16
-1.21 -1.21 88.21
-3.52
-4.3 82.76
-2.07 -2.09 79.59
1.01
1.71 65.69
-1.32 -1.27 76.69
76.45
-1.52
8.96 74.64
-7.61
-7.5 75.29
-0.67 -0.79 88.15
-4
-4 89.86
-2.31 -2.29 84.94
-2.3 -1.08 86.94
-6.39 -6.34 68.67
-45.35 -45.35 92.35
8.06
8.06 89.13
-1.39 -0.82 84.79
-8.25 -8.16 89.13
-3.51 -3.51 79.09
-5.81 -5.77 85.87
-4.16 -4.16 85.82
-2.62 -2.62 76.28
61.09
2.17
2.43 77.86
-5.19
-4.5 87.33
-25.82 -25.63 80.75
0.09
0.03 86.55
-6.58 -6.87 84.82
-3.65 -0.83 80.98
-7.96 -8.01 85.41
2.36
2.34 68.77
2.04
1.99 75.14
-7.79 -6.74 80.59
-2.68 -2.63 79.73
-7.11 -7.11 86.36
-1.29 -1.11 80.42
5.16
5.16 83.8
-0.47
2.1 77.45
4.17
2.27 76.85
30.49 26.85 65.22
4.52
4.52 71.63
-1.45 -1.28 80.46
-4.01 -3.94 80.5
-1.49 -1.62 76.95
-0.13 -0.11 83.73
-1.63 -1.77 84.7
-6.85 -6.85 72.06
-6.8 -6.98 70.82
1.7
1.7 77.88
-5.94 -6.06 85.72
-3.01 -3.81 71.71
-3.9
-4 78.97
9.89
6.63
10.04
8.59
5.31
9.46
0.91
9.8
0.72
4.03
8.93
12.7
2.16
2.23
14.54
27.38
13.62
9.06
7.21
2.95
6.55
1.65
5.89
2.4
18.48
13.71
18.84
0.86
0
-8.51
0.13
2.01
15.6
9.49
11.59
5.04
8.07
5.02
66.7
2.47
9.03
9.58
0.12
7.29
1.8
1.16
-0.31
2.73
1.8
6.5
6.59
0.32
0.44
-1.14
65.23
-1.84
7.73
13.34
2.17
9.99
19.76
2.83
0.92
5.4
0.57
6.97
11.27
18.69
36.47
6.31
18.51
10.31
9.22
8.1
14.68
7.65
5.69
8.4
1.38
1.05
2.95
2.67
1.7
4.4
28.82
26.69
19.28
23.4
35.55
24.68
16.31
13.84
7.8
18.52
28.08
37.75
28.32
27.51
32.07
53.83
41.89
25.17
26.34
12.45
21.61
11.25
10.59
11.85
42.36
41.27
40.92
29.46
2.46
16.97
7.09
9.92
29.12
33.97
21.74
18.66
15.9
18.63
68.91
19.17
20.98
35.46
47.26
34.1
31.45
20.16
71.78
57.62
24.77
36.56
51.71
25.47
35.07
13.02
67.69
8.04
32.51
34.49
26.76
22.68
30.01
26.45
9.57
13.16
16.92
17.11
28.18
19.68
39.86
19.64
23.39
15.01
26.66
20.48
29.3
23.02
22.64
25.96
10.82
6.29
14.61
26.33
12.5
18.12
71.59
70.21
55.45
64.29
80.7
79.13
65.76
38.89
39.12
54.88
74.81
81.68
79.7
77.16
77.85
85.32
79.63
63.94
69.67
56.43
64.4
61.15
61.44
50.61
66.36
77.65
76.76
70.53
69.17
59.76
56.11
37.37
76.68
77.91
68.03
64.29
50.18
63.94
59.16
58.96
61.06
79.01
80.91
73.34
72.98
58.66
85.07
77.17
70.75
87.99
62.47
72.49
76.08
56.44
40.35
61.17
75.78
67.95
74.19
71.87
70.83
71.91
45.81
61.27
73.41
61.81
74.54
65.69
74.32
68.65
64.73
47.16
54.51
66.96
67.54
63.83
67.72
73.64
47.92
46.59
63.98
71.51
60.05
62.19
42.72
39.21
39.49
100
27.12
25.37
40.69
44.94
45.34
36.98
35.92
43.9
34.51
38.67
32.9
27.18
75.25
80.72
40.29
47.06
44.8
52.62
100
35.52
28.21
29.6
32.51
21.75
32.99
28.17
27.25
100
28.19
29.45
28.8
TT
JE
Measles
Polio
DPT-Hep B-Hib
BCG
Polio 3
Polio 1 Vs
DPT-Hep B-Hip 1 Vs
DPT-Hep B-Hip 3
BCG Vs Measles
89.12
82.79
91.78
87.63
85.3
81.01
73.82
109.24
81.15
83
72.88
68.56
80.17
70.44
80.39
66.73
69.25
86.91
92.78
109.96
87.68
100.91
110.06
102.41
74.03
72.97
79.46
67.08
72.11
68.56
61.06
90.24
69.89
86.48
85.64
75.3
112.32
105.43
85.54
64.05
86.77
66.6
77.57
70.3
73.64
76.94
34
50.39
83.75
65.02
78.08
85.32
72.37
76.31
95.44
100.29
80.64
80.89
116.86
105.16
96.9
98.78
92.29
84.28
68.33
96.08
111.05
132.46
98.02
105.01
108.7
114.92
91.03
96.01
131.51
105.63
123.33
100.83
80.14
75.79
104.06
91.57
92.46
92.75
TT2+
97.87
90.62
98.49
94.98
87.76
87.84
79.84
96.29
85.92
91.55
81.56
76.66
88.51
82.81
95.38
79.53
74.36
92.77
97.26
109.07
90.86
121.26
113.1
109.13
82.98
79.3
82.8
73.6
78.23
74.11
65.79
96.47
76.67
92.69
93.6
88.38
128.53
117.92
107.73
64.09
95.94
73
81.66
76.86
79.5
83.01
41.67
59.84
87.85
77.88
85.96
91.39
77.57
84.45
101.95
110.5
87.98
87.98
119.18
114.6
104.35
112.9
94.92
95.32
76.02
103.66
126.05
147.16
95.66
123.63
122.72
93.29
91.41
104.25
142.38
127.83
132.16
114.28
86.06
85.9
115.93
105.32
102.84
103.17
TT2
98.01
90.83
99.72
95.68
87.17
87.96
79.84
99.8
85.92
91.55
81.85
76.66
88.51
81.34
95.38
88.97
74.95
93.79
103.15
109.07
92.22
121.8
120.05
108.98
84.5
79.99
82.76
73.74
78.41
74.13
65.73
96.1
76.67
92.69
93.6
88.4
129.67
117.98
107.12
70.85
96.95
73.1
81.66
76.91
79.5
83.07
41.67
59.84
88.47
77.99
85.96
91.39
77.57
84.45
101.85
110.96
87.73
88.04
119.42
114.93
105.35
112.85
94.92
95.34
76.87
103.66
126.05
147.16
95.66
122.81
123.04
93.56
91.41
104.45
145.61
128.27
132.2
114.12
86.06
85.83
115.93
105.32
102.05
103.28
Wastage Rate (%)
Drop Out Rate (%)
TT1
96.22
91.94
102.09
97.2
87.9
83.13
82.2
93.37
93.24
95.33
79.9
70.26
83.21
71.3
91.28
76.02
75.05
96.66
107.1
114.15
92.88
126.27
120.26
122.6
84.39
69.91
77.8
63.71
72.76
91.81
44.27
128.41
70.44
88.1
87.61
83.28
129.14
113.39
98.78
78.4
100.61
71.3
75.71
72.74
70.02
111.87
21.67
65.35
80.98
65.56
82.11
87.48
86.82
82.48
115.43
113.4
80.88
90.67
120.68
106.4
100.69
96.53
97.45
113.98
67.71
101.27
117.54
139.94
100.37
130.22
132
147.66
96.9
104.36
138.33
125.01
129.82
112.28
81.76
80.54
126.56
95.12
97.25
99.36
JE
Measles
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
Polio 3
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
DPT-Hep B-Hib 3
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
BCG
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Report
District Code
Coverage (%)
52.07
44.32
17.43
32.53
49.72
39.69
34.7
12.13
23.31
36.29
53.6
54.05
58.36
53.5
54.39
56.29
65.59
43.07
46.51
21.07
37.17
26.41
20.13
23.03
51.85
56.4
59.97
51.33
-8.93
18.89
13.4
52.09
60.76
43.15
40.1
23.91
33.04
-15.18
22.78
25.57
57.82
66.92
56.81
48.47
28.77
85.79
76.75
41.69
49.11
29.95
38.79
58.62
22.3
25.03
57.09
22.64
62.52
39.2
58.05
60.53
24.07
25.59
22.55
40.05
63.91
44.59
60.88
50.16
51.1
42.02
44.23
45.81
56.92
45.81
48.88
54.57
16.56
9.15
28.65
49.54
35.98
38.29
253
District Name
Low
Normal
Normal
Low
Low
Normal
Weighing Status according to age group (Repeated Visit)

12-23
24-35
36-59
Total
Months
Months
Months
Normal
Mountain
192
2211
56243
2507
27204 1379
18157
7804
119235
127039
1665
94660
Hill
468
4517
274929
3443 109215 2778
82158 2920 100718 13658
567020
580678
5910 522218
8859 196333
9436 155299
4228 155364 28433
Terai
240
7538
258127
5950 112508 4681
95949 4696 101335 22865
567919
590784
6309 362273
8501 185141
6214 133756
5145 138484 26169
National Total
900 14266
911
Normal
Low
33339
Normal
1647
Low
40185
Normal
1729
Low
Normal
Grand Total
0-11 Months
Low
17631 1707
Normal
Low
Normal
Low
Low
0-11 Months
24718
5952
Grand Total
Weighing Status according to age group (New Visit)

12-23
24-35
36-59
Total
Months
Months
Months
Received Reports
District Code
Annex3.3:ChildHealthNutritionRawData
589299 11900 248927 8838 195738 9323 220210 44327 1254174 1298501 13884 979151 19089 421659 17297 322394 10284 318566 60554
192902
198854
1029214 1057647
819654
845823
2041770 2102324
Taplejung
12
3208
221
206
18
137
22
3772
3794
9944
3473
2702
2662
15
18781
18796
Panchthar
12
67
5036
22
1629
16
1047
1363
114
9075
9189
72
7433
71
4344
44
3157
28
3192
215
18126
18341
Ilam
12
83
8014
53
2504
43
1628
63
2721
2442
173
Jhapa
12
195
20804
153
7878
139
5915
120
6562
607
41159
41766
122
36912
91
15703
114
8497
907
7516
1234
68628
69862
Morang
12
613
24274
422
3066
289
2122
329
2621
1653
32083
33736
355
50707
271
19486
129
10190
128
14250
883
94633
95516
Sunsari
12
312
14128
211
3771
128
3110
176
3501
827
24510
25337
378
21226
754
12759
642
10966
303
12238
2077
57189
59266
Dhankuta
12
18
3900
395
178
160
23
4633
4656
20
10127
2887
1767
2155
26
16936
Teharthum
12
31
2552
360
233
200
40
3345
3385
19
3963
10
1982
1433
1736
42
9114
9156
Sankhuwasabha
12
18
4214
11
891
574
685
39
6364
6403
30
10795
15
3639
2269
14
3267
68
19970
20038
12
3853
2921
2323
3102
11
12199
12210
18
17741
64
3785
31
2591
57
3428
170
27545
27715
10 Bhojpur
242
14867
15109
82
11328
60
2818
17
1948
14
18536
18709
16962
11 Solukhumbu
12
18
3717
31
2460
10
1982
41
2095
100
10254
10354
27
6797
111
6851
123
6472
24
3668
285
23788
24073
12 Okhaldhunga
12
107
5785
102
3575
68
2453
83
3541
360
15354
15714
130
7908
101
2516
43
3262
114
2760
388
16446
16834
13 Khotang
12
56
5428
43
1299
18
1056
13
977
130
8760
8890
47
8483
24
3427
24
2518
34
2278
129
16706
16835
14 Udaypur
12
85
6731
72
3444
42
2422
40
2632
239
15229
15468
42
12092
109
7330
49
4547
18
5141
218
29110
29328
4753
90
218
17461
3738
30
4078
454
30354
30808
1414
25682
33740 1029
38785
5527
261334
266861
15 Saptari
16 Siraha
12
267
14260
149
5953
160
4410
666
29376
30042
157
10000
7822
632
2724
15631
1605
12472
1170
16698
6913
70483
77396
4571 116631
2987
148
82129
7338
2933
109
91253 13468
548612
42621
562080
43253
229
9247
289
9083
1112
40916
42028
194
12585
176
12522
900
60370
61270
7995
158
7716
138
7339
543
32579
33122
2837
42
2292
58
2032
303
16268
16571
63
1841
42
1347
17
1860
194
12297
12491
14
1906
14
1224
31
1448
88
16500
16588
17992
26
1573
14
993
26
1259
130
21817
21947
26024
263
9026
158
6864
69
7341
612
49255
49867
12
338
17819
51
4719
35
192
2217
143723
1329
45086
952
17 Dhanusha
12
483
12698
460
9911
380
9108
425
10065
1748
41782
43530
335
13263
259
9323
18 Mahottari
12
454
15319
313
9316
255
8681
264
8582
1286
41898
43184
283
20196
247
15067
19 Sarlahi
12
367
14258
590
11413
639
10986
588
11166
2184
47823
50007
77
9529
170
20 Sindhuli
12
94
7971
49
3739
45
3012
46
3364
234
18086
18320
101
9107
102
21 Ramechhap
12
12
4948
24
1852
11
1382
18
1931
65
10113
10178
72
7249
22 Dolkha
12
10
5916
1771
1254
34
1370
55
10311
10366
29
11922
23 Sindhupalchowk
12
66
7356
40
2204
34
1514
45
1908
185
12982
13167
64
24 Kavre
12
102
6754
57
3800
49
3142
52
4768
260
18464
18724
122
25 Lalitpur
12
26 Bhaktapur
12
128
4910
385
203
287
153
5785
5938
310
8334
73
2215
22
785
27
958
432
12292
12724
27 Kathmandu
Eastern
2977 258599
12
482
20589
815
9064
633
7296
745
9113
2675
46062
48737
411
32933
1393
10298
1330
8595
75
3175
3209
55001
58210
28 Nuwakot
12
107
5749
63
2144
83
1625
66
1843
319
11361
11680
129
9053
110
1616
53
1199
38
1527
330
13395
13725
29 Rasuwa
12
35
1639
28
917
30
678
27
726
120
3960
4080
27
1452
42
905
37
703
18
629
124
3689
3813
30 Dhading
12
95
9866
22
1541
17
987
40
1060
174
13454
13628
194
26297
246
9579
167
7006
180
9062
787
51944
52731
31 Makawanpur
12
150
11190
101
1942
81
1376
67
1645
399
16153
16552
180
20890
114
2999
86
1698
74
1833
454
27420
27874
32 Rautahat
12
445
10583
531
10138
516
10441
613
11426
2105
42588
44693
179
4681
470
3119
334
2569
328
2901
1311
13270
14581
33 Bara
12
788
12512
661
8601
486
7632
567
8387
2502
37132
39634
175
11304
252
6178
222
5294
250
5897
899
28673
29572
34 Parsa
12
1440
29
959
26
1174
290
14126
14416
442
22415
435
10425
387
7347
146
5901
1410
46088
47498
78815 14754
392080
406834
3130 252641
4279
96902
3489
77464
1940
74767 12838
501774
514612
26293
35 Chitwan
12
166
10553
69
Central
228
3984
162811
3834
80178 3304
70276 3632
36 Gorkha
12
99
6993
64
2580
40
1959
51
2445
254
13977
14231
91
14717
86
4098
47
3166
35
4053
259
26034
37 Lamjung
12
22
6545
2922
2640
3593
42
15700
15742
11340
4465
4327
86
5744
101
25876
25977
38 Tanahu
12
47
9727
25
4349
23
2863
26
3528
121
20467
20588
27
16287
40
3149
36
2061
23
1812
126
23309
23435
39 Syangja
12
20
6570
16
3914
15
3415
10
4557
61
18456
18517
37
22981
103
5079
19
4052
23
5850
182
37962
38144
40 Kaski
12
75
14401
42
5904
22
2565
38
3281
177
26151
26328
110
30106
25
7094
11
4138
14
5312
160
46650
46810
41 Manang
12
212
122
79
103
516
516
182
88
53
82
405
405
42 Mustang
12
413
84
68
93
658
660
1019
363
267
425
2074
2076
43 Myagdi
12
50
3951
42
2142
25
1644
28
2169
145
9906
10051
60
9006
26
2968
17
2086
23
2865
126
16925
17051
44 Parbat
12
4472
15
1992
16
1476
21
2210
60
10150
10210
12
11343
2485
1759
2652
30
18239
18269
45 Baglung
12
83
7751
46
3056
23
2633
16
2963
168
16403
16571
70
19358
17
3898
14
2814
11
3412
112
29482
29594
46 Gulmi
12
56
10804
53
5726
40
4530
33
6376
182
27436
27618
37
19122
79
5219
22
3778
28
6086
166
34205
34371
47 Palpa
12
221
6371
12
395
154
156
240
7076
7316
33
19927
32
4758
17
3325
23
4762
105
32772
32877
48 Nawalparasi
12
282
14095
107
2601
62
1707
149
2289
600
20692
21292
506
28504
756
13342
785
8423
159
3368
2206
53637
55843
49 Rupandehi
12
50 Kapilvastu
12
716
12699
621
7955
469
5725
323
4991
2129
31370
33499
449
15316
405
8770
357
6808
353
8482
1564
39376
40940
51 Arghakhanchi
12
49
6155
21
2503
11
2118
26
2470
107
13246
13353
23
8792
1371
1049
11
1189
49
12401
12450
1463 228000
Western
192
1729
111159
1073
46245
749
33576
737
41224
4288
232204
236492
1591
67147
1338
48106
796
56094
5188
399347
404535
52 Pyuthan
12
207
7546
94
2851
78
2098
101
2471
480
14966
15446
165
14478
87
3608
51
2513
92
3313
395
23912
24307
53 Rolpa
12
62
7754
86
3861
63
2743
66
3109
277
17467
17744
55
7298
53
3914
45
3103
67
3670
220
17985
18205
54 Rukum
12
152
7805
147
4645
169
3358
105
3731
573
19539
20112
87
3868
143
1979
49
1420
65
2428
344
9695
10039
55 Salyan
12
121
6736
123
4400
101
3354
160
3731
505
18221
18726
74
7070
244
5215
260
4467
107
2389
56 Dang
12
532
19007
187
6880
198
6950
262
5049
1179
37886
39065
156
15238
265
8531
157
8319
165
7163
743
39251
39994
57 Banke
12
553
13510
421
6460
308
4733
315
5448
1597
30151
31748
493
13259
453
6012
320
3766
192
3599
1458
26636
28094
190
7719
141
6107
73
7148
551
33343
33894
58 Bardiya
12
289
685
19141
19826
9742
407
6970
171
5735
113
6973
980
29420
30400
147
12369
59 Surkhet
12
113
9033
122
4111
104
3492
88
3830
427
20466
20893
74
10341
66
6365
87
5427
90
6558
317
28691
60 Dailekh
12
128
6921
26
767
14
499
20
666
188
8853
9041
180
15076
163
6296
124
4690
111
5792
578
31854
32432
61 Jajarkot
12
336
5231
350
3712
247
3210
237
3368
1170
15521
16691
218
5128
210
3480
193
3082
175
2938
796
14628
15424
62 Dolpa
12
25
1382
24
761
22
349
64
566
572
63 Jumla
12
349
5756
422
2585
143
925
86
883
1000
10149
11149
350
5819
247
2360
72
920
104
610
773
9709
10482
64 Kalikot
12
463
4494
873
5827
267
2150
183
1844
1786
14315
16101
108
972
136
1848
68
378
36
432
348
3630
3978
549
485
79
3177
3256
100
53
29008
65 Mugu
12
254
951
273
1113
219
785
176
736
922
3585
4507
86
442
116
690
136
580
80
377
418
2089
2507
66 Humla
12
210
1413
341
1597
267
1516
264
1779
1082
6305
7387
28
275
49
234
14
204
18
209
109
922
1031
180
3794
107281
3896
44103 12245
250021
262266
2221 111982
2422
58351
1723
45040
1375
46679
7741
262052
269793
Mid Western
56540 2371
42097 2184
67 Bajura
12
338
4159
231
1729
187
1463
286
1703
1042
9054
10096
422
5076
431
3243
338
3157
259
2597
1450
14073
68 Bajhang
12
363
7666
160
2723
108
2030
97
1952
728
14371
15099
409
13322
364
7125
629
6981
137
2809
1539
30237
31776
69 Achham
12
225
8100
134
1126
95
900
31
629
485
10755
11240
953
24429
1529
20066
2025
19747
947
16859
5454
81101
86555
563
11806
70 Doti
316
5113
654
13805
71 Kailali
12
167
13464
83
1745
90
961
49
1096
389
17266
17655
253
33957
241
10835
68
3519
46
3272
608
51583
52191
72 Kanchanpur
12
571
8402
514
3691
327
2693
257
3517
1669
18303
19972
327
10254
361
4246
224
2593
213
3285
1125
20378
21503
73 Dadeldhura
12
206
5432
215
2843
153
2314
179
2955
753
13544
14297
878
8926
2256
12462
3597
10944
976
5195
7707
37527
45234
3225
311
2423
290
308
11687
4194
805
2199
81
1858
433
1658
642
9462
10104
82
8302
170
5787
186
6372
159
4191
597
24652
25249
16049 1741
17283
7513
118535
126048
4093 127929
6226
82628
7760
69655
3240
49773 21319
329985
351304
74 Baitadi
75 Darchula
Far Western
12
12
299
8242
159
201
12
57
3747
71
108
2542
64325
1768
1597
110
20878 1462
1407
119
1324
2449
704
1101
9441
16339
10145
17440
461
11976
220
5059
130
4536
356
147
7371
2034
44958
15523
25476
46992
26281
254
1696
4206
7154
13056
20
59
69
201
57
276
3
5
16
14
32
38
61
57
165
105
1178
272
90
737
78
35
25
95
76
29
2
38
42
7
157
80
690
428
162
25
3068
58
7
5
13
3
0
2
8
23
175
51
17
39
237
1152
4
1794
72
185
179
117
141
284
628
169
97
742
7
278
199
381
160
3639
274
102
923
56
129
1336
256
203
98
3377
4356 20065
10797 71368
19619 84308
34772 175741
62
1821
135
941
143
2568
634
9855
227
3110
482
4136
33
696
31
649
69
988
63
1011
141
1893
296
1422
488
2426
150
3185
701
5391
1346
4940
5001 45032
1441
7217
569
5798
1542
4827
304
2388
92
92
167
1276
263
701
303
568
78
0
38
2186
206
3062
319
1608
14
380
449
2410
246
1612
2116
7586
948
5083
550
0
60
1456
9705 48250
173
2855
35
585
116
1505
121
1075
18
276
0
26
4
27
69
672
60
377
677
2063
169
1455
26
461
81
1816
374
0
3441
7808
25
2006
5389 23007
205
2415
368
2214
674
3497
372
1725
462
4586
1736
3919
782
2918
335
4008
137
1384
1310
5607
109
1068
527
1112
641
1514
668
2836
626
1718
8952 40521
525
1407
358
2244
1261
5317
222
2274
701
1940
1426
1922
554
805
496
1968
182
1054
5725 18931
285876
1423869
1512615
3222360
10929
26424
62313
22723
249
190178
20884
11691
18806
29034
24211
4303
17821
7038
69020
111269
626893
66273
44560
130998
21234
44970
29251
38298
0
0
5658
147428
15851
2688
58155
65607
55377
241784
0
35713
1003845
31198
36983
55745
46795
88892
520
1657
17020
11639
7694
44286
52339
92472
0
60582
38
547860
44292
46215
22193
41487
59018
46456
90802
92314
64060
20519
5098
31812
28166
10693
2236
605361
40135
33877
68033
18772
122636
72505
21003
53941
7499
438401
44651
194707
256258
495616
2997
3946
4708
20613
20752
14969
2913
1970
3095
2926
2737
2932
4309
5391
17216
17566
129040
4296
16975
17855
5555
3556
3974
4761
5950
0
2214
6270
4684
762
8335
7202
16547
14651
0
8238
131825
4811
3499
5153
5975
9832
78
179
2938
2902
5640
7057
5272
13250
0
14259
3516
84361
5320
4983
4609
5216
16388
11008
9444
9158
6616
4300
893
3540
3768
2210
1867
89320
3741
6070
7554
6715
13623
8608
5122
5658
3979
61070
49175
222873
286527
558575
3066
4073
5166
23322
23841
15123
2949
1939
3214
3214
3303
3758
5226
5841
21607
17025
142667
7125
18609
20555
5760
3793
4466
5305
6975
0
3098
11287
5263
783
8335
8134
22016
17297
0
9788
158589
4980
3516
7804
6210
10649
93
182
3109
3185
7403
7349
5735
12797
0
16576
3692
93280
6008
5427
5606
6340
12290
12263
10416
10110
7400
4700
1029
4383
4290
2292
1867
94421
3955
6899
7608
7322
15004
10873
7328
6581
4048
69618
43231
314400
386897
744528
1780
5030
5391
19974
32795
32851
5590
1991
3880
4149
1873
2616
4892
8608
32027
34595
198042
7439
21237
22832
7541
6260
3795
7656
16174
0
3660
6942
2707
958
11212
22263
12450
23011
0
13982
190119
4017
9961
6644
13234
19523
37
278
2966
5293
4841
11947
11292
19073
0
14152
3608
126866
9401
5097
2585
9918
12458
12496
22533
16240
17983
2656
237
2336
1913
1935
1416
119204
4220
6282
10770
12844
36841
16151
8022
10532
4635
110297
22399
121930
199346
343675
1813
1759
3102
12152
10405
7843
1697
665
1438
932
2025
1849
2666
3314
10456
12444
74560
6688
22132
8364
3266
1927
2035
1785
1965
12589
436
7099
1577
482
6329
3175
10531
8395
12406
1904
113085
2277
2506
2692
4707
3369
20
104
1865
2002
3572
4264
3378
6691
24155
8278
1775
71655
2045
2086
1188
2090
7800
7090
5564
5380
4160
1779
246
2402
1147
937
1156
45070
1256
3214
3553
4111
10098
5950
5382
3402
2339
39305
27933
145847
215359
389139
1828
2404
4124
14327
11774
10203
2397
1035
2298
2753
2110
1898
2804
4099
10447
11508
86009
10084
10900
10777
3971
2186
2638
3031
4267
10220
2075
4148
3157
527
6150
4109
10550
14362
9298
5474
117924
3230
2485
3963
4247
3705
49
146
2076
2098
4281
4872
5120
6810
23795
8552
2817
78246
3340
2761
2514
3674
8591
11517
7583
7819
5494
2156
271
2343
1778
1045
933
61819
2685
3688
5479
4632
11512
7295
3364
3923
2563
45141
Vitamin 'A'
Iron (45 Tabs)
Iron (180 Tabs)
Iron (Repeated)
110286
264710
184109
559105
12662
162
6355
7579
38789
0
0
46
12663
799
12825
1043
4745
1702
5554
3394
108318
5278
5003
8372
2312
0
4393
24090
0
0
236
1085
1369
104
5322
1224
2895
3885
0
15242
80810
5478
33455
1440
16672
0
17
340
415
0
1467
16742
0
2193
0
2824
128
81171
0
10
13836
49608
3836
1138
2
0
150
2768
1126
0
94
120
3712
76400
9215
1950
5847
1282
61862
16263
34126
54886
26975
212406
Iron (New)
251368
986662
1035696
2273726
10062
24235
55622
21360
398
169996
19112
10436
16939
17770
21487
3240
17763
5424
45162
56088
495094
45089
18569
71598
16047
25026
25758
22867
0
0
2800
33442
8064
2328
32416
59551
21138
86094
0
34143
504930
16530
21559
48037
31910
46288
464
1491
10706
7623
6156
40140
30305
83618
0
39391
67
384285
28181
31194
11401
25106
39400
33907
81912
82333
55348
17702
5586
27548
23520
11039
1802
475979
35054
28571
59823
16558
104894
82939
19052
49695
16852
413438
No of Postpartum
mother within 6
No. of Pregnant Women

Antihelmenthis
Vitamin A
Antihelmenthis
Total
1180
2149
3848
7177
9
17
9
195
8
62
2
3
11
10
55
49
153
30
169
68
850
165
140
284
60
46
43
72
49
13
1
36
96
2
82
33
684
153
121
21
2101
36
4
43
7
3
0
2
8
1
123
19
4
18
111
1277
2
1658
67
109
298
80
100
135
63
65
22
241
14
139
144
229
216
1922
117
104
149
48
57
17
46
85
23
646
Severe
Malnourish
233
1426
2572
4231
7
12
17
44
3
9
1
7
26
18
5
96
34
24
18
23
344
705
39
38
41
0
18
50
103
21
30
40
100
1
45
40
92
48
27
13
1451
19
20
6
30
10
0
0
43
36
143
76
3
6
9
138
2
541
24
10
11
63
42
808
50
16
1
5
14
0
60
1
19
1124
3
10
8
32
433
27
208
31
19
771
Students received
Antihelmenthis Tabs.
67
68
69
70
71
72
73
74
75
1247
3016
6045
10308
26
47
48
194
159
135
27
16
16
21
49
113
240
39
349
1150
2629
299
300
483
125
11
81
46
75
15
5
92
81
4
165
93
650
319
240
1
3085
60
4
62
71
2
0
0
10
0
236
23
2
18
17
874
17
1396
42
64
186
112
179
509
41
85
17
322
74
110
238
57
231
2267
131
142
181
86
82
46
44
177
42
931
Mass Distribution
Program (<5 Yrs)
Antihelmenthi
s
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
Diarrhoea
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Measles
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Treated (<5 Yrs)

Vitamin A
Eye
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
Annex3.3:ChildHealthNutritionRawData
28378
157131
234980
420489
1850
2419
4405
13813
24385
21057
2600
1320
2330
2753
2032
1825
2963
4108
10954
11554
110368
11623
12265
11161
3949
2324
2575
2974
6421
10217
1976
6614
3910
530
6381
5368
12318
12610
9451
5543
128210
3644
2757
3962
4351
3481
51
147
2289
2088
4560
5209
5233
7426
15686
8643
2905
72432
3530
2885
2273
3806
8340
11812
7634
8445
5674
2545
295
2474
1735
997
933
63378
2626
3946
5711
4935
11238
7467
3413
3882
2883
46101
255
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
51.32
40.22
35.81
38.87
19.67
31.72
43.71
51.85
31.99
29.47
22.11
23.63
29.88
48.02
71.74
69.59
26.16
35.83
36.66
35.76
37.1
42.31
50.26
49.69
41.39
33.28
40.15
32.45
37.84
0
27.94
35.12
31.32
67.2
27.88
29.17
49.31
43.04
0
24.72
35.69
37.55
71.38
48.63
42.35
59.45
69.64
48.57
59.43
48.16
42.22
62.81
18.92
26.37
0
44.78
43.39
36.87
41.97
49.46
73.53
45.75
55.84
55.47
54.41
45.54
22.27
83.45
72.55
78.6
95.28
58.09
107.98
54.56
52.72
50.83
26.87
29.99
18.08
32.85
67.96
47.56
53.69
35.06
2.58
5.49
2.73
2.94
1.28
2.41
4.71
6.31
96.6
94.49
97.6
96.75
98.51
98.37
91.01
96.96
3.4
5.51
2.4
3.25
1.49
1.63
8.99
3.04
2.72
2.58
2.57
1.88
3.66
2.86
1.44
1.86
6.81
2.18
1.78
2
7.29
2.52
1.34
1.69
4.84
2.25
1.73
2.05
8.14
2.22
1.26
1.68
4.33
1.33
1.82
1.86
9.4
2.11
1.27
1.69
97.99
96.37
98.22
99.73
99.41
99.67
99.33
100
99.7
98.56
99.41
98.99
99.34
96.72
97.18
2.01
3.63
1.78
0.27
0.59
0.33
0.67
0
0.3
1.44
0.59
1.01
0.66
3.28
2.82
97.03
97.51
99.01
99.61
99.46
99.52
99.66
100
99.9
99.26
99.84
99.62
99.52
99.68
96.05
2.97
2.49
0.99
0.39
0.54
0.48
0.34
0
0.1
0.74
0.16
0.38
0.48
0.32
3.95
3.13
2.53
3.09
2.73
2.67
4.49
3.09
1.86
3.46
3.27
3.53
3.48
2.76
4.03
3.02
8.2
2.2
2.58
2.53
1.73
2.32
2.2
1.72
5.33
2.37
2.24
2.26
1.92
12.77
6.21
8.83
2.1
2.61
2.64
1.73
2.19
2.6
1.67
4.93
2.26
2.18
2.06
1.83
22.56
6.21
6.04
1.93
2.64
2.62
1.52
2.29
2.6
1.8
5.53
2.31
2.19
2.15
1.95
30.54
2.45
93.64
99.2
98.19
96.89
98.44
97.15
97.3
96.98
94.97
96.78
97.96
97.92
92.99
97.57
91.03
88.91
79.54
85.35
95.33
89.68
95.18
95.69
93.06
97.8
91.64
94.73
93.69
93.65
94.04
6.36
0.8
1.81
3.11
1.56
2.85
2.7
3.02
5.03
3.22
2.04
2.08
7.01
2.43
8.97
11.09
20.46
14.65
4.67
10.32
4.82
4.31
6.94
2.2
8.36
5.27
6.31
6.35
5.96
96.18
99.61
98.72
98.37
98.79
96.57
96.54
98.14
94.81
98.37
98.91
98.22
94.84
98.95
92.63
91.25
83.33
89.43
97.13
90.66
95.16
93.7
95.67
98.84
94.77
82.96
96.94
97.64
93.93
3.82
0.39
1.28
1.63
1.21
3.43
3.46
1.86
5.19
1.63
1.09
1.78
5.16
1.05
7.37
8.75
16.67
10.57
2.87
9.34
4.84
6.3
4.33
1.16
5.23
17.04
3.06
2.36
6.07
2.18
2.42
3.03
2.89
1.94
1.5
2.04
1.79
1.98
2.25
2.14
3.16
1.96
1.25
2.01
1.22
1.44
1.19
2.03
2.22
2.71
4.05
3.29
3.51
2.18
2.74
2.4
3.2
2.97
2.07
1.55
2.45
2.25
2.01
1.44
2.21
2.24
1.94
2.07
2.52
9.15
1.91
1.13
1.87
1.3
1.58
1.15
2.01
2.87
3.6
18.14
9.23
7.06
2.1
5.81
2.54
3.62
4.92
2.16
1.5
2.44
2.18
2.12
1.42
2.37
2.19
1.81
2.06
2.53
10.38
1.95
1.12
1.93
1.18
1.71
1.12
2.05
3.12
4.56
22.88
9.15
4.41
1.93
6.89
2.71
4.38
5.42
2.66
1.48
2.36
2.32
2.18
1.65
1.64
2.38
1.66
2.02
2.7
9.6
1.86
1.11
1.74
1.23
1.5
1.11
2.04
2.44
2.44
27.98
6.35
3.9
1.93
2.97
2.58
3.08
3.79
0.09
0.1
0.16
0.13
0.04
0.04
0.05
0.05
0
0.01
0
0.05
0.12
0.07
0.03
0.43
0.1
0.06
0.02
0.03
0.05
0.69
0.05
0.04
0.09
0
0.07
0.12
0.21
0.07
0.14
0.03
0.27
0.02
0.09
0.07
0.1
0.05
0.03
0.02
0.13
0.05
0.09
0.01
0.07
0.02
0
0
0.25
0.17
0.36
0.17
0.01
0.01
0.01
0.18
0.01
0.08
0.07
0.03
0.04
0.15
0.06
1.41
0.09
0.03
0
0.02
0.31
0
0.36
0.01
0.28
0.23
0.02
0.03
0.02
0.09
0.44
0.04
0.99
0.08
0.1
0.21
0.48
0.15
0.23
0.21
0.05
0.06
0.03
0.24
0.01
0.07
0.01
0.02
0.05
0.04
0.38
0.22
0.45
0.07
0.21
0.08
0.12
0.16
0.16
0.28
0.14
0.15
0.17
0.18
0.1
0.04
0
0.03
0.26
0.03
0.17
0.06
0.75
0.17
0.15
0.04
0.18
0.09
0.02
0.1
0.02
0.01
0
0.15
0.05
0
0.31
0.04
0.01
0.02
0.11
1.71
0.01
0.26
0.18
0.3
1.09
0.2
0.14
0.24
0.11
0.14
0.05
1.2
0.31
0.98
0.85
2.95
3.16
0.4
0.61
0.35
0.36
0.14
0.06
0.03
0.22
0.23
0.12
0.18
0.69
0.29
0.43
0.39
0.1
0.2
0.2
0.25
0.05
0.32
0.01
0.03
0.07
0.06
0.22
0.17
0.18
0.13
0.2
0.12
0.16
0.26
0.1
0.73
0.18
0.11
0.1
0.23
0.15
0.09
0.01
0.03
0.11
0.12
0.32
0.14
0.76
0.46
0.2
0.04
0.27
0.15
0.03
0.01
0.03
0.01
0
0.15
0.05
0.11
0.45
0.12
0.04
0.05
0.23
1.54
0.01
0.28
0.2
0.52
0.65
0.29
0.2
0.5
1.12
0.37
0.24
3.71
0.16
1.96
1.18
4.91
2.34
0.76
1.43
0.34
2.21
0.17
0.13
2.2
1.22
0.55
0.52
0.94
Children Treated for

Antihelmenthis (%)
97.42
94.51
97.27
97.06
98.72
97.59
95.29
93.69
0.5
0.21
0.37
0.31
0.13
0.16
0.14
0.24
0.15
0.16
0.13
0.11
0.07
0.08
0.34
0.5
0.71
0.09
0.43
1.33
0.37
0.29
0.35
0.48
0.28
0.04
0.31
0.11
0.15
0.05
0.02
0.07
0.22
0.07
0.34
0.16
0.72
0.35
0.3
0
0.27
0.16
0.02
0.15
0.16
0
0
0
0.06
0
0.6
0.05
0.01
0.02
0.02
1.17
0.06
0.22
0.11
0.18
0.68
0.27
0.26
0.89
0.07
0.19
0.04
1.61
1.65
0.78
1.41
0.73
3.38
0.47
0.68
0.48
0.43
0.25
0.08
0.08
0.21
0.48
0.22
0.26
Severe
Malnutrition
2.29
2.54
2.35
2.43
18.2
3.35
1.88
2.26
5.87
4.41
14.32
9.67
5.73
2.12
2.73
1.79
3.34
2.93
2.76
5.35
3.37
1.89
2.44
1.64
1.61
1.96
2.05
1.66
2.54
Chronic
Diarrhoea
2.84
2.94
2.39
2.66
14.12
4.01
2.18
2.42
5.28
4.58
10.88
7.15
4.95
2.13
4.31
2.31
3.37
2.87
2.52
4.73
3.45
2
2.43
1.68
1.76
2
1.98
1.65
3.2
Measles
2.41
2.82
2.63
2.69
16.75
3.67
2.13
2.97
6.66
4.39
8.28
6.43
5.05
2.32
3.79
1.71
3.57
3.12
2.66
4.85
3.61
1.92
2.59
1.68
1.78
2.01
2.08
1.71
3.41
0-11 Months
2.65
2.89
2.39
2.65
4.1
2.47
2.41
2.76
3.05
2.5
3.59
2.54
3.56
5.6
2.83
2.36
2.56
2.78
2.22
2.49
2.79
2.03
2.3
1.66
2.14
2.48
3.02
3.43
4.81
Malnourished
2.99
2.69
3.09
2.88
0.08
1.17
0.92
1.77
0.92
3.5
0.15
0.46
0.34
0.61
1.18
2.3
0.77
0.74
1.46
8.93
2.4
2.65
1.47
1.64
1.83
1.55
0.53
0.59
1.23
Normal
97.01
97.31
96.91
97.12
99.92
98.83
99.08
98.23
99.08
96.5
99.85
99.54
99.66
99.39
98.82
97.7
99.23
99.26
98.54
91.07
97.6
97.35
98.53
98.36
98.17
98.45
99.47
99.41
98.77
Malnourished
6.14
2.35
3.87
3.41
0.58
1.24
1.6
1.45
4.9
3.26
0.49
1.18
0.61
0.09
0.97
2.29
1.46
1.55
2.22
1.47
2.07
4.02
2.98
4.37
1.28
0.64
0.53
1.41
1.39
Children Treated With Vitamin A

(%) for
Eye
Avg. no of Growth Monitoring

Visits made by
93.86
97.65
96.13
96.59
99.42
98.76
98.4
98.55
95.1
96.74
99.51
98.82
99.39
99.91
99.03
97.71
98.54
98.45
97.78
98.53
97.93
95.98
97.02
95.63
98.72
99.36
99.47
98.59
98.61
Normal
Under 5 Yrs
Under 1 Yrs
127.27
96.54
82.77
91.96
87.14
92.36
95.39
93.06
96.11
76.05
81.63
81.46
97.44
71.99
130.82
144.77
91.64
84.63
95.54
120.09
94.7
77.19
114.4
88.27
105.2
93.09
114.38
90.12
62.36
0
64.91
73.27
75.11
142.35
105.92
102.96
76.27
88.06
0
71.09
75.65
90.37
133.8
107.94
74.48
120.76
70.67
108.66
124.33
100.52
99.25
132.99
87.65
86.5
0
103.65
107.34
86.48
132.28
135.25
144.88
114.84
138.26
124.09
86.04
104.6
111.71
145.13
174.35
248.68
160.89
106.35
104.78
126.02
159.75
178.03
134.49
95.61
72.22
77.83
158.95
131.38
111.2
106.03
Children among
Repeated visits
(%)
36-59 Months
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Children among
New visits (%)
24-35 Months
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
New Growth
Monitoring(%)
12-23 Months
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Report
District Code
Annex3.3:ChildHealthNutritionAnalysedData
8.11
4.94
5.11
5.26
9.44
3.25
7.43
12.23
2.95
4.81
3.3
4.53
4.61
3.98
13.12
6.3
7.14
7.38
6.58
5.73
6.26
7.01
6.75
4.8
5.39
0.3
4.94
1.73
1.15
0
10.29
2.21
4.31
6.26
4.93
2.84
8.37
5.52
0
2.5
4.23
7.53
2.65
3.55
2.46
0.62
3.51
1.99
3.97
1.78
5.26
3.31
1.19
2.25
0
10.44
6.52
3.59
6.56
6.17
12.78
4.21
6.56
6.85
5.22
8.74
3.41
28.03
23.8
7.84
8.96
36.55
25.11
8.43
7.35
7.55
12.71
6.72
1.99
3.16
3.83
5.37
5.6
5.27
256
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
82.55
57.66
68.45
64.69
69.88
61.29
47.57
78.3
68.63
67.51
52.05
53.32
61.13
46.87
82.34
61.88
61.83
57.42
97.1
99.89
71.81
21.57
105.55
92.41
62.17
57.25
62.26
49.58
46.38
0
24.46
18.63
51.54
55.7
75.99
56.02
98.16
83.27
0
46.78
51.18
52.66
61.31
48.81
57.93
70.22
22.29
40.68
78.28
55.93
61.3
74.12
60.09
68.36
0
94.52
52.18
55.43
77.82
74
72
75.81
99.39
83.3
69.44
88.03
90.03
96.2
95.51
124.34
107.08
168.45
88.11
86.63
113.33
115.53
104.77
101.34
61.89
63.96
123.84
74.7
99.9
83.03
90.91
66
76.54
72.91
71.49
63.26
52.2
88.59
78.85
68.2
52.69
52.48
63.48
51.48
99.37
79.32
74.99
62.21
121.86
96.81
79.39
35.77
115.71
106.38
64.47
61.07
69.97
55.24
54.36
0
34.22
33.54
57.91
57.24
75.99
63.27
130.6
98.31
0
55.58
61.57
54.51
61.61
73.92
60.21
76.06
26.57
41.36
82.84
61.38
80.47
77.19
65.37
66.02
0
109.88
54.79
61.28
87.89
80.59
87.58
92.15
74.54
92.8
76.59
97.18
100.69
105.15
110.05
153.95
121.91
174.7
88.11
91.57
119.81
131.31
105.52
110.5
68.17
80.79
177.18
86.89
101.63
94.65
79.92
93.1
103.35
97.18
41.5
78.13
54.47
75.87
108.46
148.16
99.87
53.88
76.63
66.46
56.35
55.21
70.2
91.68
180.63
196.72
110.21
37.35
132.05
118.17
84.4
100.79
59.45
79.73
126.06
0
40.43
20.63
29.79
70.03
102.22
173.16
73.85
130.79
0
79.4
73.81
43.97
174.54
62.93
128.31
139.44
10.57
63.18
79.03
102
52.62
125.48
128.71
98.4
0
93.82
53.55
83.35
137.52
75.69
40.38
144.16
75.56
94.56
165.68
156.11
244.7
59.42
25.35
82.05
54.36
147.48
66.82
115.61
127.84
119.57
149.38
193.84
167.38
120
193.96
139.05
116.37
149.96
51.64
43.19
57.53
50.79
42.62
37.34
41.67
54.42
38.94
46.02
42.83
28.01
45.39
44.1
63.48
40.06
40.24
43.66
58.92
65.44
47.86
50.63
67.77
55.78
44.44
35.2
41.33
31.56
33.26
74.94
22.92
12.33
34.74
38.52
56.07
31.96
62.58
81.63
59.5
31.08
45.78
35.35
43.54
37.54
41.18
26.46
14
33.18
55.32
40.43
46.53
51.17
58.36
35.13
98.9
56.69
41.81
51.41
48.86
41
39.28
53.4
52.1
87.15
55.76
75.16
74.76
48.23
28.98
82.3
50.53
79.65
44.03
59.96
81.34
70.19
75.99
69.91
52.3
54.2
81.33
51.8
64.35
61.37
52.46
46.53
62.77
54.88
43.13
37.57
44.51
52.47
80.65
94.97
46.45
35.72
46.02
44.1
61.13
38.52
42.52
43.75
61.78
65.7
61.42
58.35
76.26
57.76
44.2
37.42
40.34
30.97
50.05
74.92
21.83
19.66
43.02
38.74
58.17
41.75
73.07
71.67
60.48
31.48
49.77
39.89
48.31
37.53
42.19
24.86
14.57
33.41
60.99
40.24
49.57
54.71
59.65
38.31
65.2
57.3
43.11
47.59
51.64
42.84
35.51
55.32
50.58
89.38
56.13
81.18
77.21
56.94
31.55
86.9
49.3
75.99
44.03
61.47
79.55
75.1
79.21
74.48
51.06
55.48
82.52
51.25
72.38
62.68
Iron Compliance
Vitamin A
% of postpartum mothers receiving
Iron Tabs
Repeated
% of pregnant woman receiving Iron

Tabs
New
% of pregnant woman
receiving
Antihelmenthis
District Name
Received Report
District Code
Annex3.3:ChildHealthNutritionAnalysedData
41.41
36.11
53.25
44.86
42.27
27.32
31.34
46.16
34.41
35.37
30.32
18
28.4
14.93
60.92
39.02
38.26
35.3
58.97
70.76
41.49
33.58
137.61
43.29
36.55
31.03
31.88
18.59
15.32
92.31
4.82
21.1
17.35
35.23
57.7
24.69
62.47
47.72
79.39
10.81
43.9
24.92
43.91
25.5
45.64
24.06
5.71
23.64
49.69
38.58
38.83
44.79
38.5
34.52
100.39
54.88
26.34
47.08
29.92
30.98
18.56
30.38
47.31
53.65
40.91
51.72
56.61
39.8
26.31
84.37
32.59
71.42
54.55
43.71
38.05
61.17
49.28
62.04
45.88
44.21
130.13
44.92
58.72
53.44
257
Annex3.3:ChildHealthIMCIRawData
Health Facility Level
594
14489
29647
7227 1086
302
8399
8714
32935
45029
17583
861
42878
Other Classification
ORS & Jinc Treatment
IV Fluid Treatment for

Diahorrea
Other antibiotic
Total
Cotrim
Diahorrea
Pnumonia
Total Reffer
Total followup
Ear Problem
Malaria
Other Fever
Severe Fever
Total
Reffer
329
66
149107
1614
569
22 24
90
197
705077
5422 162994 186728 1717
42864 130907 29086 4215
8119 39506
39391 124012 1471
65 16
96 193625
92817 2177 168205 161338
199
736170
3994 156327 169325 3395
49318 127169 27590 3132
40578 24123
57318 135084 1666
26
4 106 233231
91013 2989 182533 172968
462 1590354
11030 356285 395708 6249
106671 287723 63903 8433
944
39655 1137
Medicine
9320 3067 1094
568 146 2083 11507 4339
36964
Death
Dysantry/Blood
900 48669 9108 21305 1672 460 5380 22503 8000 2367
1676
No Dedehydration
National Total
795
Some Dehydration
97
No Pneumonia
177
927 217 2502
Sever Dehydration
1990
8326
Pneumonia
638
240 22553 4815 10989
Very Severe
Disease/Severe
Pneumonia
4782
468 21334 3655
Terai
Classification and Treatment for Greater than 2 Months and Less than 5 years
Death Cases
192
Hill
Treatment by
Zentamycine
Hyperthermia
Treatment by Cotrim
Jundice
Feeding Problem/Low
Weight
SBI
Mountain
District Name
LBI
Total
Received Reports
District Code
Classification and Treatment for Less than 2 Months
23905
48999 72028 105423 292031 3706 113 44 292 471885 201413 6027 393616 358211
1 Taplejung
12
438
42
187
34
37
181
64
45
13327
72
3798
3751
36
1460
2037
353
42
25
1843
1087
3935
17
4474
1104
141
3121
1498
2 Panchthar
12
240
32
144
21
59
23
11
15383
147
4452
3741
1267
1391
231
188
389
588
3508
18
4559
2451
18
2932
3724
3 Ilam
12
237
13
138
12
24
86
49
16
11816
92
4450
2653
14
840
979
191
80
369
399
579
3359
41
4907
2512
25
1996
1807
4 Jhapa
12
683
46
481
22
103
379
79
45
17723
67
4646
5131
25
1137
3014
430
79
1897
453
1255
4516
11
6163
2289
30
4208
2945
5 Morang
12
2820
938
702
49
131
1337
881
47
49768
262
9887
16852
26
1434
5675
740
228
7437
589
3174
8084
74
15409
4967
81
7187
15865
6 Sunsari
12
1914
414
823
17
277
902
409
77
60375
297
18839
14811
14
4648
5119
1583
165
147
3188
3643
12658
182
21072
9056
86
8999
13573
7 Dhankuta
12
614
98
251
14
85
258
77
11
16774
302
4557
4908
304
2441
517
19
314
754
3503
69
5121
2118
2628
5024
8 Teharthum
12
660
27
193
11
72
24
7039
40
1606
2417
463
800
155
50
377
1201
1670
799
1269
1856
9 Sankhuwasabha
12
900
72
236
15
108
70
45
41
16299
159
4429
3408
29
438
2514
327
15
20
532
775
2281
21
4 16
30
3241
3364
56
2715
5215
10 Bhojpur
12
347
96
184
16
51
113
55
38
20978
141
5171
4586
1352
2288
838
185
682
1194
4321
58
5926
2628
63
3527
4535
2160
11 Solukhumbu
12
342
25
170
10
36
202
18
45
11823
108
3235
3371
21
1305
2227
260
17
277
701
2702
38
4445
1006
72
3099
12 Okhaldhunga
12
415
100
214
81
136
46
16661
80
4747
5448
14
1744
2575
141
90
335
416
2919
34
4442
2120
32
4039
13 Khotang
12
357
24
237
15
42
162
60
26
9797
80
2846
3333
62
1561
1923
662
62
531
746
4338
12
6475
1542
50
3343
1090
14 Udaypur
12
783
69
330
43
56
151
43
23
19743
66
3534
6258
57
1833
3759
734
111
75
544
1589
3797
14
5274
2192
81
4905
3608
140
290
107
957
142
52
252
120
40
61492
253
11494
17547 1945
5088
4650 2091
500
76
402680
2258
96072
99172 2403
31366
15 Saptari
16 Siraha
Eastern
12
983
39
12
562
58
409
192 12295 2093
5284
585
263
36 1255
45
53682
92
8381
6492
8545
1797
623
6854
2046
174
52141 11005 2083
708
2997
2371
5578
15762
10698 15494
27249
4793
82232
5348
603
17613
10
72
17078
29 18 118 127869
974
5491
177
14819
7328
5966
152
11951
15113
49605 1071
80738
86315
17 Dhanusha
12
697
164
2293
69
46
19
135
110
15
45859
141
9162
12940
50
2316
9121
1148
61
3340
325
4753
8977
14708
3952
147
12339
8771
18 Mahottari
12
474
132
286
58
354
138
13
25686
136
6974
8466
138
3204
3836
985
49
2191
543
2529
7487
10281
2569
133
10360
4202
19 Sarlahi
12
250
41
172
12
58
94
41
34182
173
7520
8499
127
2699
6967
1292
53
46
1007
3690
8309
29
11127
3048
401
8551
8422
20 Sindhuli
12
147
45
86
10
56
27
11
10557
108
2958
2495
44
862
1872
312
42
471
530
698
2479
42
3515
1192
64
2630
1710
21 Ramechhap
12
426
36
128
12
25
48
17
21
16221
97
4204
5043
18
419
2590
497
66
618
748
2029
38
4475
1691
18
2816
4595
22 Dolkha
12
303
18
164
57
148
22
28
13741
57
3354
4075
45
1280
2568
695
46
17
803
638
2431
16
25
4319
1326
32
3872
1337
23 Sindhupalchowk
12
453
54
207
38
25
52
165
23
41
18057
158
4744
4251
85
1324
2615
1000
268
80
1297
826
3530
397
6183
2372
112
4160
2678
24 Kavre
12
598
75
218
28
32
196
61
22
22572
50
5331
5777
36
886
3587
682
71
12
793
952
3981
64
5638
2947
27
4405
5695
25 Lalitpur
12
3229
14
106
4339
7001
63
1169
4445
893
19
42
4628
26 Bhaktapur
12
169
41
15
17
8643
48
1713
2938
20
109
1847
261
74
427
254
712
1964
787
22
2081
1567
27 Kathmandu
12
327
39
172
22
84
14
41
24044
83
4905
6222
117
1093
4917
550
15
29
628
915
2596
5160
1153
25
5765
2100
28 Nuwakot
12
446
52
220
46
14
34
146
46
59
11139
132
2546
3154
20
901
2425
366
135
287
598
2285
19
3179
1145
72
2964
1320
29 Rasuwa
12
24
3499
30
1137
853
225
639
110
68
159
985
912
397
861
400
30 Dhading
12
951
154
421
94
161
253
102
129
12
27692
236
7246
5639
54
1746
4680
2175
180
36
2299
1607
6242
195
7945
4895
99
6551
6796
31 Makawanpur
12
416
30
233
20
54
126
49
34
15654
97
3485
2921
16
1176
2113
464
137
39
515
689
2089
3916
2082
46
32 Rautahat
12
627
268
275
11
11
155
98
61
36450
261
7244
6528
230
3670
6053
1497
337
282
1529
4039
10389
185
12715
3158
253
8923
8582
33 Bara
12
476
65
311
46
205
83
37
44316
239
6950
8568
44
3047
5516
1506
58
134
2400
5281
7699
49
14005
7785
122
10485
13305
6181
4752
86
122
6708
4454
191
2265
12
96701 104576 1202
28824
34 Parsa
12
35 Chitwan
12
2121
263
353
Central
228
8905 1449
5588
51
53
425 116
805
404
155
48
30935
44
5628 1042
570
103
400511
11264
2527
331
2507
6683
3340
982
28
75814 14522 1622

44
24
1351
1476
6709 15420
29852
75378 1199
19 11
5137
8033
38 123212
3300
2172
1738
97
6614
5349
27
3913
9595
47586 1741 105218
83247
36 Gorkha
12
532
23
277
67
70
115
11
30
18798
66
5216
4096
23
1034
2689
1138
40
960
1135
4900
90
5355
3765
49
4137
37 Lamjung
12
274
42
60
11
23
15
43
15194
83
3635
3548
333
2309
200
1557
610
2016
3248
1606
19
2614
38 Tanahu
12
300
28
137
37
58
67
14
15
11704
30
2063
3453
578
1765
186
79
587
570
1037
2311
1126
71
2099
2756
39 Syangja
12
293
21
164
38
32
76
44
16
18622
61
3119
5972
19
478
2843
391
58
1104
948
3289
26
3755
1900
36
3219
6177
40 Kaski
12
173
16
119
17
22
33
12
14369
2546
5578
242
1687
333
27
18
533
535
1909
11
14
2300
1442
10
1976
2942
41 Manang
12
30
18
23
545
132
220
47
117
10
13
17
149
136
44
125
42 Mustang
12
36
21
2343
401
873
112
322
46
44
226
63
739
493
422
430
109
43 Myagdi
12
217
29
89
10
68
85
20
21
11854
56
2781
3324
10
842
2333
478
61
1386
529
2555
17
3704
1143
19
3113
2621
1023
4372
4482
31
44 Parbat
12
217
47
62
27
23
11
59
11618
23
4024
2787
38
209
1471
160
37
499
1956
28
3576
1988
13
1711
2630
45 Baglung
12
663
102
352
42
22
144
122
60
33
20050
235
4548
6166
31
1779
4035
724
356
801
988
5447
4869
2678
65
4045
2653
46 Gulmi
12
778
50
297
53
75
166
42
29115
188
6192
7100
75
1148
4167
1259
556
68
2448
1667
5004
31
11
8761
3267
48
4883
6009
47 Palpa
12
700
32
141
64
115
119
28
21
21343
117
3977
4480
164
723
3231
415
100
19
1114
1118
2228
32
4824
1575
113
3860
6506
48 Nawalparasi
12
1065
113
541
45
16
136
338
52
94
40484
129
7890
8215
22
419
5936
1285
100
272
1031
2287
4227
9297
5136
43
8571
11507
49 Rupandehi
12
2915
92
6502
10873
1387
12344
3502
59
5933
748
180
11297
50 Kapilvastu
12
1481
85
398
33
34
307
356
82
79
33950
273
4410
9910
204
3262
8011
2135
528
1013
2103
3091
5383
395
11952
3274
315
10257
4261
51 Arghakhanchi
12
238
28
150
25
98
48
14255
44
3377
3273
911
2138
629
197
70
1296
946
2859
19
4483
2073
21
2512
2320
Western
192
6997
625
2826
433
97 1103
4558
460
412
23
264244
1410
60813
79868
601
13504
55398
1524 16182
15003
47200
730
25
40
74997
32187 1011
64849
59376
9381 2197
52 Pyuthan
12
432
67
209
19
13
40
72
48
53
20170
115
4775
4942
916
4693
1049
43
122
879
1369
1995
41
6007
3264
54
5583
53 Rolpa
12
683
136
245
10
142
194
113
97
25171
172
6041
4384
20
1185
6107
903
56
87
2062
1800
3656
73
8156
3729
7288
7300
54 Rukum
12
793
94
312
14
34
86
241
144
25
21342
353
5155
4588
132
2092
4695
1349
175
46
1041
1256
3162
39
5944
2580
182
6248
4923
55 Salyan
12
849
271
254
10
15
63
387
265
18
18155
311
4132
3573
46
964
4568
961
65
212
1329
1226
1805
40
11
4748
3162
69
5118
5906
56 Dang
12
1540
349
578
103
10
130
676
365
52
33853
122
5553
7378
59
1243
6484
1439
237
4373
659
2204
5601
109
9915
6438
238
8184
9166
57 Banke
12
1000
122
275
28
44
181
52
65
33107
134
6773
8164
39
2002
6833
1728
81
3535
592
2518
4468
87
9860
4086
149
8254
5293
58 Bardiya
12
2877 1136
790
47
170
1694 1150
43
10
38911
261
7950
8487
22
1702
6004
2032
26
4705
427
2136
7855
160
9426
5311
55
8025
9767
59 Surkhet
12
1341
686
435
71
77
5224
1346
2659
5279
35
10604
6594
8515
10595
60 Dailekh
12
799
280
310
49
286
261
28
25994
201
4796
5448
58
2158
5251
1028
41
1746
1665
2578
42
6696
3133
76
7178
7305
61 Jajarkot
12
899
166
385
29
11
179
204
191
26
10
19728
405
3099
4733
151
2541
4300
1046
292
1317
1586
2625
19
5630
2743
242
5907
4045
62 Dolpa
12
106
65
21
501
13
271
118
426
12
14
687
101
117
63 Jumla
12
287
61
112
11
96
50
35
8906
332
2657
2656
68
1223
1840
602
49
15
324
748
2777
2996
1361
64
2939
1607
64 Kalikot
12
267
61
122
14
69
86
78
22
6805
112
765
1403
592
756
1100
926
118
110
209
443
805
1800
817
44
2637
1602
119
22
358
69
234
20
41
37973
2183
214
6971
9830
768
38
1521
6317
642
2226
45
26
32
71
688
7138
48
65 Mugu
12
97
24
64
23
42
19
12
4678
49
944
1634
68
704
1125
201
13
99
244
985
15
1239
332
34
1775
397
66 Humla
12
476
56
188
27
37
168
186
81
20
8099
100
1220
2622
21
825
2227
421
54
277
616
1476
2269
423
20
2820
474
180 12446 3511
4344
4772 3071
537
55
305075
2902
61332
70610 1335
20103
18435 12339
44074 1424
20588
45493
675
27
56
85977
81159
75566
67 Bajura
12
418
94
207
103
204
66
33
15688
157
3587
2626
91
2369
3428
1044
302
18
1445
908
4675
13
5031
1631
83
6227
1994
68 Bajhang
Mid Western
12
392
94
173
14
84
160
83
18
15379
178
3693
4069
54
1474
4569
687
49
473
888
2730
17
4044
1654
39
4980
2769
69 Achham
12
1281
285
601
268
444
246
62
41863
279
6435
11004
77
2078
8973
2497
313
25
2912
2205
11783
189
9129
4186
172
12809
8456
70 Doti
383 144 1315
62186 15956 1353
12
978
146
161
63
405
208
40
13971
136
3244
3823
138
897
4157
1114
60
206
1357
870
1788
38
4749
1980
62
4882
4184
71 Kailali
12
2059
427
1064
61
162
634
236
69
45894
460
6506
1685
163
1800
5592
2583
255
4273
1183
2794
6891
28
10354
4403
199
10569
14084
72 Kanchanpur
12
924
154
653
88
397
128
64
150
38239
227
6757
5108
51
1070
5242
2382
50
6193
1375
2077
5663
144
22
13153
6249
104
9027
11189
73 Dadeldhura
12
1468
6139
133
233
53
26
74
549
298
51
20406
245
3764
5423
57
532
4676
978
91
888
2238
1497
1848
42
5218
4307
41
5314
74 Baitadi
12
293
77
123
16
14
37
69
41
31
18669
182
5014
4669
67
1978
3870
1246
27
14
1129
1009
4041
15
5392
2322
44
5415
75 Darchula
12
213
20
48
23
33
30
13
7735
69
2367
3075
10
676
1677
508
31
481
483
2309
13
2760
1229
36
2429
1586
8026 1430
3263
168
67
902
2895 1336
348
205
217844
1933
41367
41482
708
12874
11633 12593
12731
41728
499
13
40
59830
27961
780
61652
53707
Far Western
108
42184 13039 1178
3306
258
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
39198
191186
244439
474823
5078
4038
4836
6206
11377
9045
3483
1751
2292
5162
2289
4245
3870
4685
13898
13885
96140
15371
10706
15293
5804
3036
3953
4446
5883
8821
1596
5082
4613
939
5842
3717
10418
10593
36468
4887
157468
5792
3521
2830
7040
3131
50
156
3349
4627
5350
5467
3729
6398
39945
11002
2652
105039
4990
5643
4129
4187
4161
7875
5501
6302
6684
7274
427
2307
2644
866
1696
64686
3721
5614
8160
7121
8344
3066
4541
8203
2720
51490
14251
54103
57122
125476
2272
1394
2120
1545
3138
3628
1009
707
688
1731
872
1380
1354
1370
2577
4174
29959
2928
2895
3265
1723
1249
1647
1881
1569
1083
248
955
1816
241
1824
985
3722
2816
10146
1247
42240
1852
669
729
1250
592
19
28
1046
1256
2002
2057
916
1659
3379
3525
1355
22334
1741
2193
2016
1209
1112
2103
1230
1860
1300
1812
267
967
938
298
656
19702
1184
1366
1634
1647
1500
533
771
1679
927
11241
11451
43570
54079
109100
1892
1343
1705
1374
2995
3418
989
517
532
1432
676
324
1211
1110
2502
4174
26194
2830
2829
3211
1579
1107
1123
1340
1409
920
203
911
1438
191
1409
750
3590
2876
9435
1134
38285
1655
661
556
1214
447
4
25
959
1109
1918
1616
775
1426
2603
3273
715
18956
1651
1596
627
1087
1030
2071
1274
1672
1222
839
154
933
568
269
438
15431
1154
1254
1402
1437
1518
516
560
1495
898
10234
201
492
316
1009
29
0
16
2
17
43
1
64
0
4
28
8
20
17
17
6
272
2
18
2
2
14
22
50
5
0
2
5
35
1
40
14
30
12
0
10
264
8
0
2
2
4
0
1
8
2
12
26
2
1
0
63
12
143
18
9
9
4
4
7
67
11
6
83
3
9
5
5
42
282
4
0
7
6
15
0
5
9
2
48
1124
3239
2560
6923
222
11
134
37
40
120
11
5
7
77
155
112
79
91
259
33
1393
27
180
15
63
58
96
294
65
0
58
242
233
1
322
23
77
26
320
36
2136
112
3
28
11
39
0
3
38
16
83
86
24
0
644
563
287
1937
60
68
130
8
25
64
49
62
25
311
27
68
48
33
108
1086
20
6
79
94
40
5
25
66
36
371
4970
10980
9075
25025
996
22
446
285
446
658
85
225
73
397
155
265
713
453
1199
98
6516
874
163
629
311
189
455
663
260
0
159
474
948
20
410
113
793
249
171
102
6983
516
23
147
161
51
15
13
493
115
148
516
102
136
814
1462
274
4986
156
447
183
9
144
543
72
415
70
312
113
254
284
115
155
3272
1159
159
849
73
180
57
61
389
341
3268
31255
134815
187602
353672
2987
2598
2712
4722
8224
5691
2462
1118
1616
3579
1555
2550
2398
3192
11006
9210
65620
12368
9708
11929
4088
1884
2538
2662
3953
9974
1362
4153
3043
691
3982
2699
6741
7744
22519
3678
115716
3801
2853
2151
5817
2534
33
128
2303
3331
3241
3527
2813
4693
39448
7749
1431
85853
3209
3540
2276
2969
2874
5737
4404
4523
5388
3322
242
1288
1847
6510
864
48993
2534
4199
6633
5430
6637
2520
1837
6139
1561
37490
19
123
29
171
2
0
0
0
0
0
0
0
0
0
0
0
0
9
15
0
26
0
0
5
1
0
0
9
1
0
1
10
15
0
1
1
0
0
0
0
44
0
0
0
0
0
0
0
1
0
0
0
0
0
0
2
2
5
0
0
1
0
0
0
0
0
0
46
0
4
0
0
3
54
0
0
2
24
5
2
8
0
1
42
27893
114178
168198
310269
3303
2188
2794
4128
6220
7064
1868
825
1108
2551
1611
2413
2201
3390
9844
9378
60886
9890
8681
10209
4284
1431
2742
2834
3647
1140
1319
4506
3400
817
4119
2547
6434
7942
21399
3928
101269
3050
1968
1647
2852
1794
17
73
2210
1904
2361
2933
2202
4123
32016
9230
1500
69880
2700
3820
2695
3020
3514
4662
3607
5067
4986
3904
359
1775
1807
675
1490
44081
2228
4083
6234
5729
4458
1471
1812
5167
2971
34153
25234
110612
137582
273428
2946
2186
2602
4039
5684
5581
1858
783
1076
2457
1307
1332
2011
3077
8408
9306
54653
9448
7547
9401
4217
1396
3322
2538
3573
5731
1280
4173
3265
706
3895
2437
6113
7114
16389
3708
96253
2835
1968
1511
2867
1591
16
74
1957
1723
2169
2803
2194
4114
16894
8301
1188
52205
2602
3606
2695
2933
3345
3756
3181
4809
4509
3174
326
1613
1642
539
1241
39971
2205
2843
6074
4689
3849
1404
1735
4707
2840
30346
383
1725
1294
3402
24
4
23
12
75
86
10
0
14
41
27
47
69
25
69
50
576
15
142
76
27
34
46
116
68
5
8
52
13
2
87
68
104
44
131
15
1053
26
1
34
20
7
0
5
5
44
13
93
0
6
86
126
89
555
35
118
22
7
18
41
102
53
1
246
4
30
12
27
27
743
22
16
68
176
91
5
31
55
11
475
Zinc
Expenditure
ORS
Expenditure
Diahhorea
Cases
Treatment
ORS & Jinc

Treatment
Diahhorea total
Death reported
No Pneumonia
>2 M. & <5

Yrs.
Reffer:
Infection/Pnumonia
<2
months
Followup
Treatment
by Cotrim
Cotrim Treatment
Follow up
VHW/MCHW
Total ARI
Treated
District Name
Received Reports
District Code
46710
191051
194425
998682
178070
921890
419205 2111623
5805
27051
3678
21790
5227
21717
6988
38173
9479
56275
11001
55020
3095
18101
1607
8045
1956
11570
4418
19435
2914
9095
3090
11162
3623
16575
5794
30934
16166
66815
14514
68693
99355
480451
14550
94489
13025
61749
14477
58039
7064
41142
2262
13155
5326
22433
4215
18916
6850
35688
0
0
2432
13024
9906
41040
6115
29501
1485
6235
6801
39627
4154
22629
9711
49656
11541
77930
0
0
6421
34560
126335
659813
5507
26101
3022
19680
2940
14785
4495
33870
2898
15854
28
170
140
691
3929
19218
3274
17368
5161
20771
4985
21751
3542
22020
6038
40970
2359
0
15261
79396
2777
12297
66356
344942
3817
22642
7204
31130
5104
27540
4234
27140
5976
34610
7317
28558
4333
29770
7142
44770
7623
43820
7226
33533
548
2470
3211
11264
3777
17025
1215
5290
2465
8940
71192
368502
3457
17960
6264
20096
11845
61309
10670
46890
6020
32020
2893
15167
2794
17647
8120
34981
3904
11845
55967
257915
259
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192 130318
468 705715
240 678387
900 1514420
12
8781
12
18213
12
17776
12
28161
12
57472
12
39846
12
14670
12
5581
12
10940
12
20630
12
7288
12
13358
12
9605
12
16085
12
47092
12
50456
192 365954
12
47328
12
33168
12
55979
12
23434
12
20241
12
12264
12
11209
12
20945
12
0
12
4333
12
22513
12
10277
12
3163
12
20477
12
21786
12
27142
12
38611
12
0
12
24579
228 397449
12
15508
12
16529
12
10753
12
33036
12
23891
12
188
12
374
12
7716
12
16960
12
15840
12
24893
12
17904
12
28466
12
0
12
14094
12
8610
192 234762
12
24938
12
17054
12
8212
12
22984
12
26476
12
30362
12
44760
12
40090
12
43556
12
10791
12
604
12
12660
12
11432
12
3292
12
3245
180 300456
12
17943
12
17284
12
27194
12
20743
12
51299
12
33096
12
13901
12
24688
12
9651
108 215799
41636
153626
134299
329561
3393
3502
3826
7207
16578
10936
3851
1136
2905
5070
2746
3861
2795
4256
3420
9349
84831
6823
5497
8229
6785
4522
4338
2336
3462
0
204
1393
2425
515
4911
5085
7338
7944
914
5824
78545
4252
2307
2431
5443
2219
45
27
1512
3477
3258
5005
4861
5624
0
2664
1962
45087
9067
5137
2965
5808
7471
6423
7213
11139
7689
3453
360
5604
3505
1408
1512
78754
6605
5078
4465
3968
9940
4905
2286
3838
1259
42344
35398
138621
132524
306543
2868
3369
3036
7134
16809
10400
3719
1041
2483
4460
2347
3054
2618
3845
3081
9349
79613
6718
5397
8683
6442
3486
2333
1698
3158
68
105
1581
1881
466
4122
4469
7842
7888
753
5645
72735
3704
2260
2226
5208
2115
35
26
1324
3312
3107
4599
4523
5248
0
2695
1387
41769
8747
4616
1427
5651
6941
6205
7490
10697
7538
1960
157
5541
2650
1223
1052
71895
6410
4831
4448
3540
9421
4825
2125
3653
1278
40531
385
1865
2310
4560
9
8
23
37
169
684
11
10
19
25
14
11
29
24
46
90
1209
4
39
30
7
37
64
73
177
0
2
22
78
0
94
72
4
48
0
81
832
18
8
3
28
97
0
0
0
2
14
463
12
18
0
92
27
782
51
27
34
52
189
66
400
79
13
134
0
47
26
4
109
1231
7
4
67
50
234
79
26
30
9
506
3307
12641
9855
25803
309
129
949
815
657
1679
93
109
43
394
507
386
252
506
729
430
7987
120
402
68
109
329
534
627
377
0
362
889
521
3
743
359
98
81
0
306
5928
411
45
88
156
659
5
29
161
46
168
267
86
501
0
858
442
3922
210
286
349
268
620
471
353
344
155
778
68
366
202
60
271
4801
44
127
490
200
1175
492
267
258
112
3165
15782
88712
32067
541221
24846
531273
72695 1161206
1255
5622
137
14471
1032
12912
1701
20598
2184
40459
2162
27421
224
10715
591
3798
348
8035
1172
16024
764
4607
998
8339
1284
6018
1512
11688
1829
41542
720
40092
17913
272341
1726
40713
532
25303
1806
46031
1165
13729
337
16373
974
8872
868
8783
679
16511
0
0
145
3976
1441
20945
1435
7744
348
2703
1680
15433
998
16524
1272
18972
915
30435
935
0
587
17654
17843
310701
1418
11313
139
14183
571
8204
876
27297
284
21336
69
149
36
308
711
6273
359
13738
289
12520
1376
20281
466
13043
624
22962
0
0
2043
10821
847
6573
10108
189001
934
16158
1597
11618
540
4470
170
17026
791
18127
1730
22867
632
37249
1570
28899
522
35703
727
6124
144
412
1042
7022
977
7852
578
1811
407
1331
12361
216669
6437
11274
713
12097
2696
22372
245
16843
1885
40699
772
29328
188
11250
712
20797
822
7834
14470
172494
51
283
28
362
2
0
0
0
10
1
2
0
0
8
0
1
0
56
0
1
81
0
0
1
0
0
5
10
2
0
0
0
0
0
1
2
0
0
0
6
27
1
1
1
0
0
0
0
0
0
0
1
0
1
0
0
0
5
3
0
0
1
0
0
2
0
1
32
0
31
0
2
0
72
0
1
4
166
3
3
0
0
0
177
76327
442412
442290
961029
4383
9934
9537
16763
29701
31311
7139
2655
3983
9934
3579
5762
3611
12488
28726
23757
203263
22950
15268
20102
11035
12025
7591
7314
13448
0
3999
21230
6347
3033
12299
19289
14408
23172
1939
15152
230601
6827
10408
5737
10870
11889
138
278
5463
6236
5698
11402
10181
22493
0
10732
4542
122894
12290
12252
4898
17049
23911
26263
26431
32133
42118
6385
442
8399
7648
1443
3140
224802
9656
10007
17100
18637
47697
41514
12036
17529
5293
179469
64363
394028
399436
857827
3852
9922
7708
16332
28081
27790
7118
2523
3832
9822
2532
3688
3116
11975
19912
23389
181592
21641
13596
18333
10658
10360
6553
6343
13270
0
3630
16793
5803
2268
11606
17116
14255
22720
1431
14262
210638
6271
10087
5177
10824
10418
135
269
4472
5773
4979
10165
10206
25162
0
9614
3160
116712
11667
11094
4898
16871
23395
19918
23640
31050
33636
5624
260
7537
7008
1332
2154
200084
9649
6441
13543
13615
37409
38556
10530
14860
4198
148801
1772
108623
9813
612632
12746
540643
24331 1261898
62
7588
97
12677
192
14086
432
22796
776
38347
2733
39469
23
8712
11
4159
19
5767
250
12938
166
5234
184
7303
86
5780
115
18850
391
33717
80
28101
5617
265524
54
29166
138
20374
124
24373
236
16043
138
13471
334
11711
509
9195
223
21227
0
0
82
6436
578
33988
102
10364
10
4305
404
17616
554
23229
125
15309
226
28334
0
0
188
20248
4025
305389
143
11183
28
12789
90
9292
242
15204
617
17495
3
270
4
493
5
8828
73
9325
124
9757
421
16585
6
14305
84
28114
0
0
319
16814
354
6934
2513
177388
357
15061
242
17482
146
7612
305
21912
615
29471
955
34557
689
29244
960
43414
376
52786
603
10077
17
772
310
11482
183
11978
21
2497
33
5359
5812
293704
10
11873
59
13218
341
24663
501
24163
3150
51666
1667
50543
513
15486
91
21400
32
6881
6364
219893
Zinc Expenditure
ORS Expenditure
Diahhorea Cases
Treatment
ORS & Jinc

Treatment
Diahhorea total
Death reported
No Pneumonia
>2 M. & <5

Yrs.
Reffer:
Infection/Pnumonia
< 2 months
Followup
Treatment
by Cotrim
Cotrim Treatment
Follow up
FCHV
Total ARI Treated
District Name
Received Reports
District Code
439111
3561740
3457052
7457903
37252
105090
56320
134738
274357
259664
70031
23478
36872
61183
4130
25073
21945
123101
132380
147530
1513144
223185
114070
110442
115862
90083
62384
32746
131304
0
36340
153886
54461
16257
115130
170031
114830
226770
0
137959
1905740
60157
123870
47115
107702
98144
1410
2820
36597
55480
47640
52075
101810
252480
0
88002
16131
1091433
98986
60637
47380
153190
234810
102812
224676
297474
318620
51458
3380
47442
69947
13330
4130
1728272
73100
25295
99856
136150
303673
374674
107120
90830
8616
1219314
260
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
1000.76
867.22
759.25
823.8
1113.53
1055.99
862.4
548.84
909.03
963.39
1325.67
795.63
990.71
1403.52
1128.81
1234.58
580.6
709.51
859.43
1086.93
917
825.57
691.98
869.08
786.12
1066.6
918.01
611.4
767.77
663.69
500.05
279.64
555.74
1008.4
806.76
564.14
569.28
705.38
602.11
697.32
665.53
809.55
1238.6
451.81
1125.8
793.58
802.97
1332.6
1018.57
1340.61
818.83
997.07
781.19
632.92
558.97
530.51
583.5
751.27
1080.29
928.08
820.28
859.71
624.56
931.45
1198.33
1382.2
1494.63
1315.03
517.16
1453.08
967.87
874.47
1298.49
1040.18
1463.99
1038.14
1268.91
1036.66
699.22
793.64
1325.06
1166.09
950.16
979.34
381.58
260.53
213.23
246.15
494.3
327.76
303.45
167.15
283.24
391.92
461.47
243.61
381.81
476.35
482.33
445.86
208.16
213.72
176.6
293.34
296.29
185.19
180.44
190.65
261.46
329.32
363.9
224.74
210.45
181.03
104.12
52.87
185.56
316.75
290.81
170.13
204.85
194.9
221.66
237
192.99
300.46
303.53
124.07
225.79
120.98
271.26
340.69
319
414.15
255.87
305.72
255.28
189.54
97.1
145.32
218.96
202.12
426.52
377.52
383.47
280
203.82
269.66
298.05
439.99
344.47
438.43
256.02
673.95
314.81
347.85
509.87
338.46
602.28
347.25
306.35
265.91
188.45
204.31
335.9
292.18
245.59
269.5
6.52
3.76
2.42
3.3
3.73
5.07
2.66
0.83
2.48
3.45
14.34
2.79
7.42
5.54
7.48
3.54
2.35
1.53
1.12
2.94
3.14
1.37
1.58
1.72
2.44
3.17
2.21
3.89
1.01
3.47
2.26
0.6
3.54
4.94
4.83
1.71
2.88
2.6
4.18
0.75
2.22
1.74
3.76
0.71
1.4
0.02
6.75
5.15
3.31
1.08
5.99
4.28
3.03
1.6
0.9
3.65
1.43
2.2
3.12
4.79
12.91
7.6
1.74
2.34
4.67
4.66
4.95
20.25
4.68
23.41
6.63
6.32
14.62
6.04
8.2
5.99
6.67
4.02
4.71
3.73
11.65
4.96
3.67
5.38
38.13
30.04
28.08
29.88
44.39
31.04
35.19
30.46
31.16
40.68
34.81
30.62
38.54
33.94
42.73
36.11
35.85
30.12
20.55
26.99
32.31
22.43
26.08
21.94
33.26
30.88
39.64
36.76
27.41
27.28
20.82
18.9
33.39
31.41
36.05
30.16
35.98
27.63
36.81
33.99
29
37.11
24.51
27.46
20.06
15.24
33.78
25.57
31.32
30.89
31.25
30.66
32.68
29.95
17.37
27.39
37.53
26.9
39.48
40.68
46.75
32.57
32.63
28.95
24.87
31.83
23.05
33.34
49.5
46.38
32.53
39.78
39.27
32.54
41.14
33.45
24.14
25.65
26.95
25.74
25.35
25.06
25.85
27.52
0.65
0.43
0.32
0.4
0.34
0.48
0.31
0.15
0.27
0.36
1.08
0.35
0.75
0.4
0.66
0.29
0.41
0.22
0.13
0.27
0.34
0.17
0.23
0.2
0.31
0.3
0.24
0.64
0.13
0.52
0.45
0.21
0.64
0.49
0.6
0.3
0.51
0.37
0.69
0.11
0.33
0.22
0.3
0.16
0.12
0
0.84
0.39
0.33
0.08
0.73
0.43
0.39
0.25
0.16
0.69
0.25
0.29
0.29
0.52
1.57
0.88
0.28
0.25
0.39
0.34
0.33
1.54
0.9
1.61
0.68
0.72
1.13
0.58
0.56
0.58
0.53
0.39
0.67
0.47
0.88
0.43
0.39
0.55
47.83
39.47
41.17
41
52.34
38.92
44.84
38.91
41.83
53.95
43.33
37.84
48.04
43.02
55.67
42.34
61.65
42.75
41.32
39.05
44.31
33.45
35.73
29.35
37.98
36.59
49.07
51.48
35.84
5.34
30.14
22.32
41.33
33.73
49.63
37.71
52.2
50.11
37.57
50.29
38.43
49.63
28.66
34.49
25.08
18.64
41.01
53.56
42.99
36.23
39.85
43.54
40.31
42.5
17.52
53.96
54.98
36.23
50.5
57.71
60.19
42.42
57.07
42.16
34.62
47.62
31.01
51.85
60.97
53.02
43.16
48.3
54.71
45.7
51.55
39.37
36.58
35.2
38.36
51.48
45.14
30.95
34.53
40.16
ARI Case Fatality/1000

0.03
0.02
0.01
0.01
0
0
0
0
0
0
0
0
0.05
0.04
0
0.01
0.06
0
0.04
0.03
0.01
0
0.01
0.01
0.04
0
0.03
0.02
0.02
0
0
0
0
0
0.02
0
0
0.03
0
0
0.01
0.02
0.03
0.05
0
0
0
0
0
0.12
0
0.03
0.05
0
0
0.01
0.01
0.02
0.07
0.01
0.01
0
0
0
0.01
0.01
0.02
0.06
0.16
0.09
0
0.04
0.03
0.02
0
0.04
0.01
0.03
0
0
0.03
0.02
0.04
0.02
31.58
28.37
26.32
27.72
35.48
27.26
24.14
22.27
28.17
40.98
34.98
35.66
37.67
27.73
41.21
36.86
31.72
32.19
13.39
31.29
29.94
26.19
26.2
18.51
15.98
28.64
31.58
36.9
29.37
56.48
44.21
28.89
28.14
33
33.27
20.32
27.2
24.26
23.6
27.55
26.86
30.57
26.6
28.99
18.59
23.12
60
70.73
35.77
24.05
34.07
30.75
28.38
31.77
30.42
36.77
37.28
29.49
24.73
31.83
45
22.78
29.88
28.27
24.94
26.83
17.21
31.32
55.58
27.39
13.94
38.72
44.38
26.97
22.72
25.75
33.38
20.54
12.67
25.06
33.84
23.07
30.82
24.08
FCHV
VHW/MCHW
% of ARI Cases at
HF
% Treated with
Antibiotic
% of Severe
Pneumonia among
new ARI cases
% of Pneumonia (Mild
and Severe) among
new ARI cases
Incidence of Severe
Pneumonia per 1000
Incidence of
Pneumonia (Mild and
Severe) per 1000
ARI Incidence per

1000
District Name
Received Report
District Code
Annex3.3:ChildHealthAnalysedDataIMCI
15.82
15.27
19.52
17.25
23.64
13.2
16.22
14.04
11.87
10.92
12.47
15.37
10.8
14.46
14.05
15.23
19.61
15.3
19.74
14.83
14.58
18.1
18.01
17.48
16.68
9.31
16.68
17.92
15.49
43.52
15.02
13.1
22.26
15.34
14.81
11.61
20.19
16.31
76.4
12.02
20.75
18.88
12.89
14.79
14.3
8.91
8.4
8.61
19.44
16.28
16.65
12.47
12.34
12.52
69.58
27.72
14.77
21.8
12.55
16.95
18.4
11.9
9.52
14.77
8.22
9.94
11.01
27.66
18.4
11.19
16.17
12.76
19.09
12.94
13.27
18.2
15.38
20.31
12.22
6.35
16.29
19.19
15.21
14.62
52.6
56.36
54.16
55.02
40.88
59.54
59.64
63.7
59.96
48.1
52.54
48.98
51.54
57.8
44.74
47.92
48.67
52.52
66.87
53.89
55.48
55.72
55.79
64
67.34
62.05
51.74
45.18
55.14
0
40.77
58.02
49.59
51.67
51.92
68.07
52.61
59.44
0
60.43
52.38
50.55
60.51
56.21
67.11
67.97
31.6
20.65
44.79
59.67
49.29
56.78
59.27
55.71
0
35.51
47.95
48.72
62.72
51.22
36.6
65.32
60.6
56.96
66.85
63.23
71.77
41.03
26.02
61.42
69.89
48.52
36.53
60.09
64
56.05
51.24
59.15
75.11
68.59
49.87
57.74
53.97
61.29
261
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
603.86
507.07
479.12
500.44
581.6
510.51
409.8
311.18
408.34
560.04
558
331.52
376.72
634.28
605.81
553.92
275.32
498.68
655.97
545.84
486.67
430.82
362.31
398.49
408.81
538.94
550.97
349.27
436.66
223.24
343.18
229.62
351.14
776.64
468.39
443.14
339.8
431.31
411.41
387.8
383.95
359.49
681.15
229.74
390.19
352.5
430.5
579.84
642.03
465
354.24
448.61
426.74
408.66
445.4
420.23
295.68
408.89
559.9
651.84
530.55
626.62
503.35
695.41
675.88
982.6
1344.05
864.01
384.8
937.96
704.36
517.46
1126
733.36
928.09
679.58
823.96
873.8
611.34
811.63
908.59
780.31
564.67
749.34
70.39
75.02
74.61
74.42
73.93
90.5
78.82
85.9
81.81
78.98
78.97
79.49
66.59
84.54
59.08
54.19
72.13
78.7
65.03
84.49
77.13
75.47
78.66
76.2
87.2
73.97
78.73
72.61
82.23
102.14
69.08
69.6
76.29
67.87
75.56
82.51
78.81
82.89
62.59
80.33
76.97
74.6
82.49
74.7
83.16
78.47
62.07
58.12
67.06
78.55
64.43
71.94
80.52
90.07
39.96
68.01
57.89
69.78
73.73
68.02
67.65
81.16
79.64
64.61
75.58
83.01
73.96
66.49
50.38
78.47
84
65.83
55.06
74.18
80.54
53.56
63.18
65.43
72.38
83.25
67.25
75.54
72.68
71.54
98.03
98.72
98.39
98.49
95.68
99.39
98.76
99.29
98.89
99.05
99.92
99.61
97.98
98.25
97.73
99.21
98.53
98.38
98.82
98.74
98.69
98.82
98.73
95.52
97.62
99.36
99.18
97.38
99.39
99.1
98.95
99.57
97.63
99.77
98.51
98.63
97.24
98.85
98.55
99.31
98.37
98.83
99.28
96.73
98.89
99.5
100
97.95
99.39
99.25
98.42
99.03
97.16
99.5
98.43
97.02
99.17
98.46
99.04
99.88
97.17
98.67
97.17
98.23
99.32
99.17
98.95
96.06
85.47
97.87
98.36
98.12
99.3
98.28
98.68
99.22
98.67
98.75
98.15
98.86
99.23
99.19
98.54
98.75
1.97
1.28
1.61
1.51
4.32
0.61
1.24
0.71
1.11
0.95
0.08
0.39
2.02
1.75
2.27
0.79
1.47
1.62
1.18
1.26
1.31
1.18
1.27
4.48
2.38
0.64
0.82
2.62
0.61
0.9
1.05
0.43
2.37
0.23
1.49
1.37
2.76
1.15
1.45
0.69
1.63
1.17
0.72
3.27
1.11
0.5
0
2.05
0.61
0.75
1.58
0.97
2.84
0.5
1.57
2.98
0.83
1.54
0.96
0.12
2.83
1.33
2.83
1.77
0.68
0.83
1.05
3.94
14.53
2.13
1.64
1.88
0.7
1.72
1.32
0.78
1.33
1.25
1.85
1.14
0.77
0.81
1.46
1.25
0.02
0
0
0
0
0
0
0
0
0
0
0
0.2
0
0.01
0
0
0
0
0
0.01
0
0
0
0
0
0
0
0
0
0
0
0.06
0
0
0
0
0.01
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.01
0
0
0
0.01
0
0
0
0.01
0
0
0
0
0
0
0
0
0
0
0.02
0.01
0
0.01
0.02
0
0
0
0
0
0
0
0
30.28
23.97
22.76
23.96
31.49
18.03
12.94
16.66
16.57
20.31
23.36
26.71
36.93
22.59
40.64
34.64
37.89
26.24
28.24
29.53
24.54
25.91
23.06
24.42
15.35
18.36
27.37
28.39
20.87
83.28
27.09
19.23
25.56
18.35
28.3
13.15
32.32
21.67
28.44
15.65
24.18
27.5
17.61
24.09
19.58
12.36
51.41
55.46
29.33
17.43
42.04
27.33
24.96
19.33
30.02
36.51
33.6
26.5
27.26
31.27
47.68
21.75
22.11
22.3
20.46
17.47
13.68
40.46
53.62
23.53
20.57
47.25
39.89
23.72
33.13
30.2
32.29
17.57
12.65
12.89
27.55
20.67
22.24
20.7
FCHV
VHW/MCHW
IV Fluid
ORS
0.76
0.23
0.43
0.37
0.32
0.06
0.1
0.1
0.06
0.03
0
0.11
0.36
0.02
0.24
0.11
0.66
0.26
0.26
4.14
0.69
0.11
0.44
0.32
0.24
0.11
0.32
0.6
0.17
0.92
0.27
0.37
0.15
0.02
0.24
0.06
0.75
0.11
0.26
0.04
0.27
0.17
0.03
0
0.11
0
0
0.38
0.09
0.39
0.22
0.38
0.99
0.07
0
0.65
0.09
0.23
0.04
0.09
0.91
0.18
0.17
0.1
0.06
0.08
0.11
0.87
0.75
0.51
4.97
1.69
0.27
0.38
0.51
0.27
0.22
0.47
0.27
0.1
0.3
0.23
0.09
0.26
% of CDD Cases at
CDD Case Fatality
% Treated With
HF
Severe Dehydration
among new Cases
Dehydration (Mild and

Severe) among new
Cases
CDD Incidence per

1000
District Name
Received Report
District Code
Annex3.3:ChildHealthAnalysedDataIMCI
18.66
15.6
21.28
18.56
29.44
14.79
19.73
16.47
14.45
14.67
15.9
17.38
13.73
15.82
18.43
19.29
23.52
15.75
18.31
19.94
17.39
22.31
27.89
25.46
23.67
8.68
19.27
20
16.88
16.72
18.08
14.14
25.97
17.33
17.99
10.13
20.89
19.99
65.61
17.37
23.14
22.39
13.1
16.93
16.72
11.49
5.33
9.26
20.35
19.31
16.98
14.87
13.34
12.5
69.98
29.36
16.49
26.64
13.1
16.34
18.57
11.78
9.98
11.71
9.55
11.24
9.14
22.59
20.79
13.34
15.18
16.81
19.34
12.5
12.54
20.23
18.09
19.38
7.47
2.98
9.48
18.06
27.96
12.68
51.06
60.43
55.96
57.48
39.07
67.17
67.33
66.87
68.98
65.02
60.75
55.92
49.34
61.59
40.94
46.07
38.59
58.01
53.44
50.52
58.07
51.77
49.05
50.12
60.98
72.95
53.36
51.61
62.25
0
54.83
66.63
48.48
64.33
53.71
76.72
46.79
58.34
5.95
66.99
52.68
50.11
69.29
58.98
63.71
76.15
43.26
35.28
50.31
63.26
40.98
57.8
61.7
68.18
0
34.14
49.92
46.86
59.64
52.39
33.75
66.48
67.91
65.99
69.99
71.29
77.18
36.95
25.59
63.13
64.25
35.94
40.76
63.77
54.33
49.57
49.62
63.05
79.88
84.12
62.97
61.27
49.81
66.62
262
Annex3.4:FamilyHealthSafeMotherhoodRawData
9316 1356
3927 5494
16166 5479
298
3779
243 15
352 22384 13572 3166
42
537 1219 21283
Still Birth
Neonatal death
1st checkup of Neonatal
Maternal death
pac
No. of FP Long lasting method

users after Abortion care
Treatement of Abortion
complication
3 Times PNC Visits
Total no. CAC service received
First PNC Visits
C/S Delivery
Forcep Delivery
Vacuum Delivery
Mountain
192
Hill
468 56584 211093 267677 153733 97797 5432 103229 5079 15769 20848 124077 22100
Terai
240 60812 279678 340490 195616 129173 6832 136005 11409 39200 50609 186614 16158 3681 73372 12039 100068 7935 577 19316 205996 128350 41548 1062 5948 14609 176619 202 1226 2281
969 32257
674 13891
Maternal &
Neonatal death
Safe Abortion Care
Delivery Types
Spontaneous Delivery
Treatment of Obstetric
complications at BEOC/CEOC
centers
At BEOC/CEOC centers
Treatment of obstetric
complications at Birthing centers
Total Delivery
Total
Home
10672 1567
Birthing Center (HP/SHP)
Conducted by
Health worker
Health Institution
Total
36047 45318 21214
Home
9271
Health Institution
Four Time Visits
Total
=> 20 Years
Received Reports
Conducted by SBA
First Visits
< 20 Year
District Code
District Name
Postnatal
Services
Delivery Services
Antenatal Services
54 300 326
3074 72917 2318 283 14421 158821 104611 50592 646 5277 24482 141250 178 1073 1334
National Total
900 126667 526818 653485 370563 236286 13620 249906 18055 58896 76951 326857 43737 4948 109408 15787 186876 10496 875 34089 387201 246533 95306 1750 11762 40310 339152 434 2599 3941
1 Taplejung
12
593
2377
2970
1571
412
23
435
121
671
792
1227
310
28
244
46
1214
2 Panchthar
12
618
3241
3859
2114
1197
48
1245
53
206
259
1504
485
28
705
322
1166
36
84
2145
750
298
60
1928
23
44
3 Ilam
12
1229
4137
5366
3405
1503
16
1519
48
650
698
2217
257
11
1293
316
1874
72 29
217
4205
1761
1788
957
155
612
4031
20
40
4 Jhapa
12
4709
19418 24127 15896 12294
287
187 2070 11158
4105
7030 5167
793 1525
9220
10
5 Morang
12
4986
19059 24045 12210 13253
1589
9630
413 15 3205 21611
6376 2249
6 Sunsari
12
3640
13816 17456
349 11857
296 20 2521 15857
6066 3572
23
7 Dhankuta
12
560
2769
8 Teharthum
12
448
1574
9 Sankhuwasabha
12
747
10 Bhojpur
12
610
0 3760 10925
1224
402
8144 8400 451
27
39
1625
11
14
12581 2661
826 3487
16068
101
13354
13
243
256
13610
18
2 13106
9693 14360
57
14417
20
204
224
14641 1761
90 10437
3329
1895
572
43
615
36
346
382
997
179
194
27
714
13
2361
1295
855
20
66
159
1955
13
2022
1008
409
83
492
61
180
241
733
115
39
14
425
19
1075
535
37
17
1097
16
2514
3261
1498
1127
42
1169
138
60
198
1367
535
18
351
37
809
61
30
1738
978
568
92
176
1658
12
50
2614
3224
1430
397
11
408
156
344
500
908
166
11
816
1685
1014
115
12
41
1701
11
23
21
20 15
607
970 20560
241 1944 15728
26 118
15 131 353
19 138
43
12
11 Solukhumbu
12
450
2398
2848
2332
638
156
794
38
397
435
1229
72
53
195
134
1193
1730
1466
196
90
1702
18
19
12 Okhaldhunga
12
625
2449
3074
1477
692
157
849
132
540
672
1521
115
11
484
77
1422
50
1924
1599
13
49
1779
14
30
13 Khotang
12
981
3699
4680
3269
872
326
1198
171
652
823
2021
235
92
20
1074
574
1734
1612
131
11
2162
13
14 Udaypur
12
1249
5123
6372
3894
1574
151
1725
137
663
800
2525
554
61
817
84
1389
99
3820
2924
80
50
57
3434
12
28
461
87
3061
13
7566 10179
85
7305
15 Saptari
16 Siraha
Eastern
17 Dhanusha
12
1991
16009 18000 12463
3108
12
3212
15523 18735 11753
6953 1009
192 26648 116720 143368 85908 59361 2971

12
4969
5437 2053
11774
374
188
924
123
5805
77779 7416 2730 45830
11939
18514
6569
103
41
852
20
292
346 13034
15
1997
518
2515
629
6570 7199
9714
118
11
2962
1 95
7816
3052
305
3357
103
3819 3922
7279
282
16
59
5519
26 80
20 Sindhuli
12
894
3942
4836
2147
981
267
1248
164
998 1162
2410
586
1974
17
3213
21 Ramechhap
12
707
2991
3698
2524
887
199
1086
117
399
516
1602
830
28
131
1596
1915
22 Dolkha
12
884
3937
4821
2557
872
76
948
110
637
747
1695
213
39
414
34
842
31
29
2121
23 Sindhupalchowk
12
964
4128
5092
2326
1135
90
1225
97
342
439
1664
536
80
701
212
1617
28
2728
1150
24 Kavre
12
1710
8349 10059
5241
4093
83
4176
70
156
226
4402
933
45
1854
2007
45
410
5177
25 Lalitpur
12
1099
12753 13852
9747
8784
8798
330
231
0 3700
9709 11475 3361
1781
792
46
838
103
104
942
322
21
1062
29
1914
186
558
1679
26434 32118 23550 22993
654
23647
221
230
23877
630
48
106
31
4060
4 5813 25375 22670 18353 255 1622 12942 21955
1794
220
333
86
36
340
507
2792 1195
35
678
123
2018
18
6422
16
85
3557
28 Nuwakot
12
1271
3788
5059
2166
1072
14
189
1261
176
137
357
467
533
9265
10
22
15
976
125
0 1720 10155
53 14
8716 1153
0 10949 13144
17 10460
66
12
3420
121
36
40
466
60
1925
73
24
821
264
46
1097
875
45
374
46
4211 1351
109
6890
651 1311
94
548
8890
42
70
15759 18899 14849
3765
290
21
30
15564 20614
2955
1
4
95 495 910
3140
810
151
129 13668
5050
5684
6353 6575
49 39
12
12
222
407 10860
7608 54534 6860 135 10011 93805 52519 18828 572 2569 5967 88919
12
12
549
1745 1868
2976 3812
19 Sarlahi
27 Kathmandu
9491 11390
123
836
18 Mahottari
26 Bhaktapur
15194 20163
3569
7962
62332 4744 10703 15447
9 10475
23
45
9761
17
59
89
40
3036
24
28
24
1817
16
28
470
2046
21
299
2592
43
32
673
5898
34
36
389
2944
695
29
504
103
628
5917
34
49
671
846
557
170
22
192
56
85
141
2123
6169
8292
4885
2167
74
2241
232
319
551
31 Makawanpur
12
1842
5907
7749
3991
2831
14
2845
96
28
124
2969
510
413
242
2904
32 Rautahat
12
3329
15625 18954 11060
2692
660
3352
594
6041 6635
9987
506
126
1605
229 18
31 10724
9965
57
18
33 Bara
12
3598
13199 16797
9155
3591
740
4331
989
4978 5967
10298
789
46
5779
123 21
52 10013
7565
733
10
192
481
9355
Central
12
12899 12899
7626
867
25
12
4235
12355 16590
8581 10701
173
228 42484 182619 225103 130050 81067 4698
892 3197
10874
44
0 3197
161
205
4089
11079
379
85765 7338 31602 38940 124705 7964
22
9608
2522
8170
635 14311
13
1373 2097
5936
3353 1913
436 70 2197 13009
2605 7697
143
948
18
3460
24
32
12 10227
14
37
15
47
901 2849 11953
3394 43721 1187 320 14149 137304 103047 42029 303 3756 21068 112509
0
8
72 149
75 498 1047
36 Gorkha
12
1124
4470
5594
2566
1275
60
1335
132
409
541
1876
314
1036
187
1433
119
3174
1035
763
49
104
435
3084
31
43
37 Lamjung
12
1082
3698
4780
3002
1571
104
1675
99
285
384
2059
382
79
402
141
1372
125
161
2465
2601
632
87
201
2453
26
32
38 Tanahu
12
1820
4395
6215
3243
1292
81
1373
67
147
214
1587
168
546
77
906
3348
1580 1693
27
23
259
2931
18
23
39 Syangja
12
1186
6022
7208
4343
1339
75
1414
42
442
484
1898
218
11
458
1566
54
14
2907
45
291
2953
11
18
40 Kaski
12
3229
11707 14936 11235 11298
97
11395
35
173
208
11603
198
2 11040
85
8435
320 2874 12846
18
41 Manang
12
20
13
13
26
16
59
79
33
12
12 21
330
175
12
1927
12
30 Dhading
35 Chitwan
3179 1191
29 Rasuwa
34 Parsa
6 110 416
189
366 23 2405 12132

0
29
643
6014 6202
2397
18
28
96 109
0
42 Mustang
12
29
158
187
105
91
100
16
22
122
24
46
112
141
95
40
13
137
43 Myagdi
12
807
2250
3057
1726
669
193
862
17
442
459
1321
144
205
785
1596
1384
210
38
90
1571
19
23
453
44 Parbat
12
668
2293
2961
2270
719
209
928
36
489
1417
131
390
40
1233
1787
1047 1246
33
89
1703
12
13
45 Baglung
12
1607
5329
6936
3960
1751
410
2161
263
1252 1515
3676
250
1365
105
3488
48
25
4437
3567
198
133
206
4702
15
14
46 Gulmi
12
1329
5587
6916
4597
1453
541
1994
141
1090 1231
3225
471
19
979
122
3028
53
53
4256
2916
725
45
108
159
3831
21
7750
9796
3883
3356
62
3418
126
338
464
3882
295
2822
34
2670
102 16
535
3943
21
583
193
4037
38
61
10952 13699
8283
1984
129
2113
224
381
605
2718
399
138
1139
97
2028
32
5076
690
11
109
398
4976
33
31
27374 27374 15483
9102
63
9165
644
644
9809
756
117
0 2731 13002
8375 4197
387
9770
859 1039
1898
80
4161 4241
6139
223
121
263
2447
7868
6807 1614 295
171 1069
7195
20
31
1878
713
892
65
1344
178
13
28
13
632
44 30
1881
1077
1870
13
24
47 Palpa
12
2046
48 Nawalparasi
12
2747
49 Rupandehi
12
50 Kapilvastu
12
1322
51 Arghakhanchi
12
764
Western
14461 15783
2799
3563
179
192 19780 109304 129084 76377 37484 3252
40736 1992
387
452
9974 11966
52702 3399 1039 20577
1296 30151
866 1370
3777
596
27
112
853 102 6052 68042 43556 20827 452 1784 6390 54704
58 341 443
52 Pyuthan
12
1447
4767
6214
3237
947
76
1023
11
670
681
1704
239
22
689
14
1638
3058
1328
555
180
147
2782
53 Rolpa
12
1361
3971
5332
2831
1244
94
1338
129
182
311
1649
999
335
1270
2308
1297
33
30
40
2245
37
34
54 Rukum
12
2026
4204
6230
2109
970
223
1193
117
477
594
1787 1124
10
10
1671
47
41
1888
1302
104
16
44
1779
19
29
55 Salyan
12
1630
3768
5398
2197
1351
39
1390
170
162
332
1722
957
32
1071
2411
657
118
32
2350
56 Dang
12
4120
7938 12058
6554
5072
214
5286
233
137
370
5656 1373
17
1997
28
4465
203 25
104
7270
4576 1110
40
373
609
7262
57 Banke
12
2461
9891 12352
5709
9232
170
9402
39
196
235
9637
11
8137
714
7717
212 130 1375 11066
2433 2260
41
543
188 11223
58 Bardiya
4803
83
23
2279
147
4992
13
14
5982
2839
605
31
159
287
5851
99 121
3480
6572 10052
6504
5270
102
5372
91
436
527
5899 1892
17
3394
742
5472
124
297
6428
2918 2212
18
280
861
6569
13
65 120
5438
7096
4226
3750
42
3792
426
128
554
4346 3271
19
888
43
4514
10
19
4479
2858
407
41
56
396
4381
71
61 Jajarkot
12
1426
3385
4811
1993
646
136
782
181
521
702
1484
473
990
1929
1094
59
43
60
1711
13
45
62 Dolpa
12
109
554
663
325
132
40
172
32
98
130
302
23
227
20
208
195
265
63 Jumla
12
1126
2645
3771
1476
514
175
689
63
239
302
991
577
465
64
1023
1933
1661
204
37
80
1809
36
28
64 Kalikot
12
921
3467
4388
994
504
169
673
106
226
332
1005
383
11
251
11
669
20
1280
434
131
34
1229
15
20
135
53
60
12
482
371
1318
1800
745
529
89
1417
1788
1035
548
254
66295 91317 46017 35512 1906
4886
95
618
56
802
54
37418 1803
38
133
257
313
229
283
3996 5799
5019 2617
15
91
1658
12
6082
40
32
12
180 25022
9364
4
0
23 227 352
12
Mid Western
6960
40
14
60 Dailekh
66 Humla
2404
22
59 Surkhet
65 Mugu
12
929
931
199
1085
513
43217 15569
218 18640
520
890
753
22
15
892
744
672
70
23
539
531
3207
3738
1317
1037
73
1110
299
159
458
1568
740
1172
4564
5736
2280
1011
83
1094
265
356
621
1715
958
18
1704
11
272
2857
1520
78
31
16
2774
75
59
1511
6761
8272
4646
1684
154
1838
138
754
892
2730 1507
77
344
62
1888
14
32
5401
4328
461
41
96
107
5307
39
69
7182
3243
2013
72
2085
281
286
567
2652 1107
25
50
1333
10258 13286
8146
8993
245
9238
598
289
887
10125 2201
157
5558
1121
8178
4996
4870
4874
65
82
147
5021 1798
3077
308
3478
2822
2176
35
2211
264
35
16
1349
12
3028
12
1871
7424
9295
73 Dadeldhura
6032
7799
75 19
792
103
1558
30
3569
2581
7951 3171
5076
2020
670
292
366
4544
56
53
30
124
581
2233
33
71
192 63
249
3752
83
28
9783
77
86
34
38
78
562 48 1359
31
485
8
16
12
72 Kanchanpur
1635
5
27
12
71 Kailali
2
0
93 741 967
12
6081
1561
0
0
69 Achham
1101
0
16
684 182 1866 51874 25017 7880 217 1841 2762 50887
68 Bajhang
12
345
793
22
67 Bajura
70 Doti
10
1787 37032
92
272
3192
20
88 1029 2734
8673
63 120 193
38
12
1767
299
2510
561
28
924
517
74 Baitadi
12
1055
4920
5975
2698
494
73
567
157
503
660
1227
211
23
188
27
696
19
2021
1091
181
50
1927
74
41
75 Darchula
12
697
2633
3330
2063
584
54
638
111
157
268
906
306
518
108
1251
21
2082
1187
76
26
12
1925
14
22
51880 64613 32211 22862
793
Far Western
108 12733
23655 2178
2621 4799
28454 9389
326 10050
1702 21438
912 136 2011 36176 22394 5742 206 1812 4123 32133 113 524 574
263
10.16
9.23 14.46
6.17
6.74 94.90
13.52 23.82 114.66
10.04 15.26 98.87
18.47
7.94
0.00
4.02 37.05 29.00
7.05 23.65 48.73
13.25 115.51 317.39
0.85 38.93 235.55
1.01 11.66 252.66
6.83
3.57
2.38
6.52
1.60
0.00
3.91
5.41 13.17
8.01
0.00
0.00
13.09 29.86
2.67
14.18 12.04 23.45
11.81
2.13
0.00
8.52
6.63
0.00
10.54
3.63
0.63
21.68 17.14 16.30
8.6 110.74 437.14
33.01
0.00 191.90
44.76
0.00
0.00
20.3
2.26
1.96
13.01
0.08
0.00
8.31
0.12
0.00
11.7
3.95 10.10
4.57 16.35
0.00
1.76
0.35 71.01
3.42
0.00 602.90
1.15
1.72 16.20
0.68
0.68 383.91
5.86
1.22
2.93
10.31
0.54
0.00
5.02
8.31
0.81
0.96 11.15 11.74
39.36
5.54
4.09
33.91
0.00
6.57
20.46
0.00
1.85
1.16 106.08 277.24
15.12 15.01 187.72
5.92 15.16 28.95
6.73 18.30 62.69
2.03
5.40
0.21
4.69
0.65
3.02
1.49
4.50 381.72
3.71
0.00
0.00
5
8.42
0.00
12.23
0.20
0.00
9.42
5.71
0.00
16.47
8.45
6.04
12.93
9.49 12.37
5.29
2.87 135.51
3.12
3.71
0.69
2.68
3.60 252.24
28.11 12.91
0.00
6.71
1.43
0.66
7.86 11.38 159.43
9.96
1.52
0.00
4.62
0.22
0.33
9.28
0.00 14.23
4.83
0.54
0.00
2.24
1.26 14.02
1.78 40.02 231.21
0.98
8.01
2.29
5.07 52.83 63.44
7.54
4.33
5.75
15.7
0.83
0.00
13.9
0.00 14.25
10.61 16.65
7.03
9.43
2.32
0.00
23.86
5.64
0.00
13.36
0.70
0.00
5.62 12.84 40.22
13.87
1.35
0.00
11.82
0.56 115.03
12.37
6.37
9.86
8.56
5.59
0.34
4.03 37.73 137.21
1.09 16.95 12.71
7.23
2.87 133.80
8.71
2.64
5.57
6.73 20.08
1.12
6.52 17.14 60.76
0.72
4.74
5.73
4.94
0.00
1.45
2.44
15.87
11.78
12.63
0.12
0.00
0.66
0.00
0.13
1.17
0.00
0.00
0.03
0.82
21.86
9.60
0.00
0.10
0.00
0.00
0.50
0.00
3.55
30.15
0.81
19.20
0.15
0.00
0.04
0.59
0.20
0.33
0.09
13.86
9.39
1.45
3.13
0.01
0.15
19.09
0.00
0.00
0.00
0.00
0.30
0.62
6.78
0.03
12.61
0.00
0.03
7.97
0.00
0.02
0.71
0.00
0.70
11.56
0.11
3.17
0.29
0.00
0.71
0.35
0.00
0.00
0.00
2.01
0.00
5.75
0.49
0.02
6.86
0.64
6.69
0.28
0.06
3.04
34.72
31.36
52.19
43.02
45.78
56.4
83.37
74.61
98.79
72.58
31.91
2.98
27.75
1.99
28.85
58.74
8.82
47.75
28.6
74.53
71.49
0.13
0.42
0
0
13.05
42.16
56.9
44.54
0
35.98
0.46
1.76
15.93
28.26
14.11
0
0
0
89.42
16.19
73.63
24.07
40.18
33.16
97.41
0
42.99
29.88
51.66
67.78
61.42
81.05
51.59
0
12.89
3.6
52.13
71.92
24.4
0.92
0
37.64
87.77
46.53
63.31
21.26
0
0
80.59
41.15
23.08
9.97
49.95
25.82
1.41
18.88
0.04
57.95
62.35
0.04
28.88
74.53
40.14
4.17
2.48
6.45
4.83
3.75
21.41
14.25
25.55
11.68
2.38
2.71
1.09
2.71
0
10.9
5.06
0.99
3.33
1.6
3.46
9.78
0
0
0.81
0.04
0.06
2.01
12.74
0.14
0
2.23
0.13
0.84
0.3
4.41
8.15
1.26
0
0
22.76
2.72
9.97
6.85
4.85
0.47
0.73
0
4.1
0.08
2.82
2.86
3.78
0.88
3.57
1.19
4.28
0.97
2.46
0.82
0.12
0
0.29
0.5
7.41
2.93
12.58
0.99
0.34
0
6.46
1.09
1.07
0.18
4.13
0.38
0.23
2.27
1.89
11.07
6.13
0.64
2.2
11.92
5.98
3.23
14.02
13.74
13.4
0
6.72
13.99
25.14
24.16
17.53
0.99
0
2.37
0
0.59
6.07
0
0
0.15
1.66
15.62
14.81
0
0.54
0
0
2.95
0
9.85
40.6
7.37
25.27
0.96
0
0.17
2.9
0.94
1.14
0.32
20.45
16
8.46
9.64
0.07
1.01
21.22
0
0
0
0
1.24
3.32
15.36
0.27
28.02
0
0.26
15.33
0
0.07
3.77
0
1.96
14.83
0.29
5.54
0.45
0
3.66
1.56
0
0
0
5
0
21.32
1.76
0.04
14.17
1.56
10.2
2.92
0.29
8.03
22.4
33.8
41.7
36.9
13.8
21.6
17.4
63.1
48.7
72.1
12.1
14.1
27.8
9.8
22.6
19.3
16.6
20.2
20.2
49.2
39.6
64.8
22.7
18.1
14.2
18.0
17.1
14.3
36.1
74.3
11.0
76.0
15.3
18.4
24.3
20.2
21.7
28.9
28.9
67.8
38.1
17.1
32.5
14.3
14.9
89.9
5.4
27.0
20.3
16.2
24.3
18.6
44.1
12.7
45.0
6.9
12.8
28.8
15.6
22.7
18.9
24.6
35.8
77.9
40.0
57.3
63.1
20.6
19.5
22.5
19.3
49.5
31.5
40.2
45.0
27.0
28.1
38.5
48.4
40.7
65.6
9.5
19.4
37.8
41.38
47.03
55.03
50.54
41.06
33.32
42.49
41.5
71.47
71.51
42.18
29.09
34.33
26.99
52.05
40.61
24.88
40.69
42.67
77.72
52.2
50.98
68.08
54.14
35.96
30.83
33.23
28.41
40.35
71.19
21.14
75.41
37.63
37.06
58.55
27.67
63.61
56.91
37.99
73.87
53.3
34.74
43.19
31.71
28.18
86.65
8.29
32.05
42.53
34.44
48.23
44.7
44.94
26.19
54.04
52.16
27.92
44.7
44.73
34.27
29.5
35.04
44.09
83.74
43.99
61.79
60.95
43.15
22.25
67.9
36.37
67.84
35.11
50.31
49.53
54.38
74.91
53.86
44.45
37.71
90.72
26.68
52.27
49.18
% of neonatal first time checkup
% of FP acceptors after abortion care
PNC first Visits
Institutional Deliveries as % of live

birth
% of C/S among total

Institutional deliveries
% of obstetric complication
among total delivery
7.26
4.67
10.47
7.69
15.64
3.2
6.57
3.14
0.8
0.92
6.18
4.87
1.19
5.51
11.94
11.4
9.36
7.06
9.84
16.92
5.96
31.9
40.85
19.77
11.17
6.42
9.98
3.56
1.22
1
0.01
0.66
3.93
6.21
2.91
0.22
35.83
28.29
0
0.91
12.27
4.48
4.99
1.39
4.29
1.24
2.29
1.36
11.78
8.73
13.61
11.45
3.85
1.97
0
27.58
5.74
6.55
9.8
2.7
7.45
2.35
0.83
1.48
0.28
4.19
1.74
11.66
10.48
8.39
6.42
19.59
10.81
3.88
4.82
6.78
10.46
4.32
1.31
0.61
0.85
6.64
3.94
3.56
Delivery Conducted at
B/CEOC among total HF
delivery
2.9
1.5
3.05
2.36
2.82
0.82
0.48
10.11
0.04
0.09
0.64
1.65
2.73
2.5
1.14
2.79
2.45
1.46
0.69
4.75
2.64
1.11
3.91
0.53
1.84
1.88
1.72
1.01
0.55
2.42
1.14
0.03
1.94
4.09
2.12
0.75
3.52
5.62
20.46
0.25
2.85
1.44
1.73
0.63
0.41
0.25
1.43
3.64
0.45
0.69
2.86
1.48
1.44
1.16
2.68
0.53
0.96
1.31
0.16
1.92
1.83
2.47
1.41
0.3
0.7
0.87
5.8
4.05
3.42
2.21
3.01
4.27
2.55
1.75
9.06
5.04
1.91
4.24
2.72
0.48
6.38
2.07
2.79
2.96
CS Rate as % of
(BEOC/CEOC Delivery)
19.73
30.57
36.33
32.62
10.14
19.34
15.35
47.79
44.16
65.02
10.99
13.32
23.09
6.54
23.89
17.92
17.19
18.37
20.13
45.27
34.69
59.94
15.64
17.37
13.97
17.49
14.85
12.76
32.55
64.51
9.26
70.28
13.88
14.04
20.43
22.13
19.88
24.62
5.71
61.75
33.29
14.61
29.35
13.01
13.71
81.39
3.71
22.73
22.97
17.88
23.49
20.94
38.96
10.9
38.09
12.58
13.24
26.76
14.96
19.87
18.64
20.2
32.06
71.15
35.93
51.64
51.6
17.49
18.4
24.2
19.12
47.1
37.85
36.29
33.63
20.82
25.49
31.47
41.97
36.21
53.46
7.49
16.02
32.16
Met Need of CS
2.51
1.61
1.82
1.78
0.54
0.75
0.16
1.09
0.33
0.26
0.77
2.25
0.83
0.18
4.69
3.31
4.68
1.61
2.6
5.74
1.65
2.76
3.22
1.58
2.99
3.2
1.19
0.94
0.65
0.1
0.51
1.94
2.08
1.61
0.67
0.11
3.92
4.21
0.16
0.98
1.82
0.66
1.82
0.77
0.73
0.69
0.29
2.05
5.14
4.03
4.46
5.68
0.71
0.67
0.26
6.89
2.66
2.14
1.11
1.4
3.48
0.57
1.3
1.29
0.61
0.98
0.57
3.04
4.28
6.15
4.8
6.78
11.99
1.85
2.21
1.58
2.14
1.09
1.11
0.03
0.85
0.96
1.36
1.08
Met need of EOC
17.22
28.96
34.5
30.84
9.61
18.59
15.19
46.7
43.83
64.76
10.22
11.07
22.26
6.36
19.19
14.61
12.51
16.76
17.53
39.54
33.03
57.18
12.42
15.8
10.98
14.28
13.66
11.82
31.9
64.41
8.75
68.33
11.8
12.43
19.76
22.02
15.97
20.41
5.55
60.77
31.47
13.96
27.53
12.24
12.98
80.69
3.43
20.68
17.83
13.86
19.03
15.26
38.25
10.24
37.83
5.69
10.58
24.63
13.85
18.47
15.15
19.64
30.76
69.86
35.32
50.66
51.03
14.45
14.12
18.05
14.32
40.32
25.86
34.44
31.41
19.24
23.36
30.38
40.86
36.18
52.61
6.52
14.66
31.08
Total
Both (<20 and >20) Yrs
Home
39.22
45.52
52.25
48.37
36.63
32.84
34.4
60.38
40.38
43.72
33.86
27.28
29.59
22.91
70.16
31.17
46.91
41.47
70.29
66.83
47.81
47.65
92.33
40.45
24.03
40.64
40.06
24.22
40.85
71.47
19.68
69.99
23.83
40.72
44.53
31.04
65.61
52.03
48.8
48.73
50.49
28.09
52.6
30.72
42.11
80.24
9.43
23.86
45.99
43.75
43.04
48.28
44.26
42.73
64.35
64.77
27.87
50.18
47.35
42.04
32.95
31.93
39.75
43.2
44.72
62.52
57.5
44.59
34.76
51.84
28.25
56.78
48.84
44.63
39.9
43.4
64.44
48.94
37.01
37.12
68.23
35.62
51.8
43.79
HF
67
68
69
70
71
72
73
74
75
83.78
79.26
90.95
85.29
69.25
59.94
54.22
91.65
79.52
78.73
59.48
54.72
64.41
51.64
85.68
64.88
67.15
67.87
101.52
106.53
79.78
101.23
117.51
106.69
54.12
59.54
75.53
53.03
78.4
101.57
41.59
95.45
55.67
61.84
75.59
60.27
112.43
95.47
82.54
94.21
87.39
61.23
83.76
58.87
69.89
106.68
22.57
42.5
81.45
57.06
75.39
72.64
111.66
70.68
113.77
104.63
52.88
84.81
90.9
79.18
97.33
78.46
73.13
93.47
68.85
96.63
96.56
107.63
70.91
132.46
124.69
137.2
84.38
88.56
113.24
109.17
114.73
108.39
60.36
69.06
188.56
78.89
83.61
87.85
by other than SBA at
Total
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
17.14
16.76
16.24
16.53
13.83
9.6
12.42
17.89
16.49
16.42
10.01
12.12
14.75
9.77
13.54
13.19
14.08
13.3
11.23
18.26
14.83
24.95
19.52
26.14
10.01
11.38
13.85
10.04
13.33
8.06
8.95
16.89
13.99
12.79
19.35
14.33
19.75
20.45
0
24.05
16.49
12.3
18.96
17.24
11.5
23.06
5.71
6.59
21.5
12.87
17.47
13.96
23.32
14.17
0
8.76
11.34
13
21.17
20.21
31.65
23.69
24.99
18.62
17.68
33.45
22.56
31.9
11.66
39.55
26.17
36.74
17.51
24.27
16.09
22.31
20.96
16.62
13.76
13.9
42.72
13.93
17.5
17.31
by SBA at
Home
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Delivery Conducted as % of Expected Pregnancy
HF
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
<20 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Report
District Code
1st ANC Visit as %

of Expected
Pregnancy
4th ANC Visit as % of Expected

Pregnancy
Annex3.4:FamilyHealthSafeMotherhoodAnalysedData
32.92 46.34
43.82
48.8
30.76 55.03
37.65 51.67
9.09 44.09
0.84
34.9
55.04 47.49
16.59 40.86
33.96
79.4
50.98 82.83
17.26 40.73
3.7 34.59
26.67 38.18
32.28 31.74
2.8 59.61
0 43.71
0 36.13
43.85 42.64
77.27 48.04
30.24
86.2
27.89
57.7
43.01 52.06
11.84 75.97
35.93 58.91
41.24
39.6
7.74
34.1
51.09 39.49
71.19 31.47
46.1 53.64
0
0
37.27 21.63
64.79 76.34
49.3 37.76
25.71 42.86
48.53 62.92
42.32 31.41
16 70.73
52 61.94
0
0
33.14 79.27
46.02 51.03
50.17
39.3
27.96 49.98
15.09 32.37
42.3 33.37
44.07 107.17
9.09
9.33
32.5 35.96
36.29 48.82
6.96 38.21
62.24 59.57
19.09 46.91
9.88 53.68
49.81 29.94
0
1.88
59.89 55.59
17.98 32.35
28.26 41.91
20 47.47
63.49 38.85
0 32.39
20.25 39.36
41.07 51.39
6.71 99.03
37.57 50.18
34.55 75.13
85.53 69.43
58.82
44.6
44.44 32.84
33.2 73.69
24.64 39.89
51.72 78.73
9.68
34.8
28.41 57.73
18.78 55.35
14.68 61.51
19.21 85.74
47.64 56.22
65.1 45.95
38.05 39.41
90.64 62.95
0.43 29.64
11.76 56.27
54.58 50.95
264
Maternal death as % of expected

Pregnancy
0.1
0.05
0.05
0.06
0.12
0.02
0.06
0.04
0.05
0.09
0
0.16
0.1
0.08
0.12
0.13
0
0.09
0.01
0.02
0.05
0.03
0.04
0.09
0.03
0.05
0.11
0.06
0.02
0
0
0
0.02
0
0.02
0.03
0.03
0.01
0
0.05
0.03
0.02
0.07
0.03
0
0.13
0
0
0.03
0
0.05
0.05
0.03
0.02
0
0.03
0.12
0.04
0
0.06
0.03
0.06
0
0.17
0.07
0.12
0.12
0.29
0
0.28
0.17
0.15
0
0.09
0.15
0.06
0.1
0.3
0.29
0.04
0.05
0.07
0.08
0.15
265
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
District Name
Received
Reports
District Code
Annex3.4:FamilyHealthPHCOutreachClinicRawData
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
PHC/outreach clinics
Conduction (Times)
12991
59889
43205
116085
1870
1768
2041
1394
2898
1958
964
561
1021
2375
537
1195
1026
1311
4699
2982
28600
3588
4005
2098
1104
1536
1468
2202
3229
0
811
1503
1652
566
1944
1302
3881
2666
0
1031
34586
2233
1858
1202
2215
1763
72
194
701
965
1671
2009
1924
2080
0
2598
773
22258
1542
2792
1101
1440
658
1492
1694
1706
2211
866
91
853
323
414
310
17493
488
1028
2338
1812
2504
979
810
1635
1554
13148
Primary Treatment
(Persons)
117265
499056
371175
987496
16911
12730
15700
13703
35261
12074
8751
4423
6875
16022
2544
9285
5098
10876
24755
24568
219576
42681
36052
24975
12664
8814
10499
13192
26831
0
2404
12437
16285
3674
24538
11513
20473
19508
0
9226
295766
20232
16442
9204
19458
18801
332
996
6841
7361
14464
14562
16014
14545
0
23466
9647
192365
14204
13254
7632
10614
6387
13939
15641
15280
9665
8091
668
5561
3984
2320
5575
132815
6488
17499
26655
16236
21694
12227
9374
16654
20147
146974
Depo Service Provide

(Persons)
22655
115832
86233
224720
2217
6381
11523
3695
14818
4985
3112
726
1693
3316
775
1656
567
2790
7191
3988
69433
2696
8264
1571
1836
3200
1935
11476
9610
0
789
4755
3581
705
8493
9269
2820
2889
0
2417
76306
3137
698
1355
1195
1664
2
26
425
257
1501
2049
2107
1393
0
2955
599
19363
8044
1754
1201
4077
6224
3104
3941
3544
2072
2162
184
657
185
251
736
38136
854
321
3214
1214
10321
2961
708
1251
638
21482
ANC Checkup
14911
76972
149375
241258
1714
1952
3163
2799
10421
11030
1057
418
979
1157
510
892
703
2598
18315
8887
66595
12036
16140
5053
1655
1619
1306
1816
3856
0
161
1085
1504
619
4105
2805
8618
7639
0
2891
72908
2077
1332
1156
2991
2425
1
56
898
1347
1773
3787
2102
5257
0
10235
880
36317
2503
2091
802
1776
1353
9107
8891
4055
3187
2074
119
1881
687
431
755
39712
1254
1516
4284
2331
8409
2294
2362
2009
1267
25726
PNC Serice (Persons)
6179
29488
40135
75802
994
807
1707
963
3781
1573
588
205
423
750
325
290
452
1175
4149
2701
20883
4013
3869
2400
1095
424
408
916
1073
0
78
350
814
411
2818
507
2553
2933
0
518
25180
964
329
715
824
511
3
7
251
165
553
994
405
852
0
4557
197
11327
1037
874
282
672
417
995
1448
1060
651
913
56
797
181
180
225
9788
318
459
1922
1126
2082
331
1149
761
476
8624
Growth Monitoring <5

yrs
85664
500181
445998
1031843
11538
9742
18110
13642
45353
11283
7052
2518
8206
12291
1994
3842
5140
8783
34012
40212
233718
26082
36848
36275
7530
6518
3727
9075
27303
0
948
5305
7515
2296
22126
13955
10411
15587
0
6882
238383
15061
9365
6882
14655
19928
52
210
4612
4739
3909
14094
6298
13551
0
30786
2880
147022
10765
16415
5754
15259
7575
16474
33331
19102
30031
11112
578
7789
2732
1444
2899
181260
8893
9836
39587
31121
53758
13936
33271
26663
14395
231460
266
10841
50515
95102
156458
904
703
896
2582
8992
10470
1116
158
376
641
470
391
559
1428
6604
7488
43778
4171
3215
5461
1070
615
722
1267
3660
0
114
839
753
280
1872
1704
3646
8095
0
4642
42126
939
976
607
2104
961
4
24
690
604
865
2114
2251
1975
0
3048
984
18146
1727
1404
379
1860
6014
5248
6572
3000
3277
829
92
1725
614
281
416
33438
974
1777
3073
3115
3666
3213
896
1341
915
18970
11978
55921
45294
113193
2530
1515
2161
1099
3045
3614
831
360
542
2508
273
1034
607
1168
4820
3257
29364
3274
2204
2029
1002
1162
1469
1797
2868
0
245
1124
1305
555
1744
1571
1948
2429
0
971
27697
1988
1646
676
2516
2534
51
121
625
689
585
2465
1585
1869
0
2716
604
20670
1597
1385
529
1831
1145
2087
3431
2623
3063
904
49
933
308
213
543
20641
651
1098
2944
1765
3969
1387
609
1553
845
14821
1072
6699
2802
10573
242
285
259
134
326
71
154
100
97
339
68
147
466
159
253
393
3493
251
0
289
241
192
118
196
444
0
12
119
113
2
139
113
179
154
0
96
2658
273
332
130
137
39
10
34
69
218
99
138
259
169
0
39
42
1988
224
56
129
187
118
120
129
384
177
40
13
89
0
17
14
1697
52
86
260
93
57
24
62
69
34
737
Total Investment by
Fund (Rs)
13419
54027
98862
166308
916
1323
1150
2735
8545
10381
1127
143
418
726
509
415
580
1613
6881
7717
45179
4472
3006
5832
2023
713
752
1419
3044
0
80
729
807
308
2015
1515
3642
8285
0
4413
43055
997
981
716
2147
954
1
30
737
698
1025
2126
2105
2340
0
3118
1062
19037
1842
1580
466
1882
6039
6593
6387
3166
3429
928
47
1842
1012
372
477
36062
1112
2407
3453
3171
3952
4524
1040
1519
1797
22975
Total Loan Received

(Persons)
14915
65280
105581
185776
1027
1553
1292
3255
8296
9240
1302
255
602
1141
591
460
620
2014
6747
8152
46547
5188
4389
6916
2303
1012
1016
1624
2647
0
115
1182
1170
313
2831
2459
4020
8617
0
3363
49165
1496
1058
1024
2488
954
2
31
862
869
1261
2805
1755
3028
0
3833
1335
22801
2246
1976
517
2359
5772
7261
5654
3830
3974
1364
74
1936
1566
528
550
39607
1356
2643
3935
3003
6076
5774
1577
2236
1056
27656
FCHV Participated in
PHCC/ORC
36579
232342
138912
407833
4447
3584
4862
3384
6579
9504
3235
1955
1703
5838
1232
6151
2851
2835
10532
10888
79580
8378
6181
9992
3516
7266
5719
5423
9954
0
1077
7294
5241
1558
4228
4366
7689
9752
17
4011
101662
4258
6693
2491
6600
7829
451
491
2934
3724
3514
9011
5589
6888
0
7210
5939
73622
4423
3366
1236
3992
6262
6204
7414
9365
8479
2192
382
3785
1355
746
1898
61099
1982
2984
7863
49490
10497
7530
3807
5294
2423
91870
7 Days
Confirm no Neonatsl
bath within 24 hours
4 Times
1st
ORS Distribution (Pkts)
Iron Tablet Distribution
Condom Distribution to
(Pcs)
5801
39854
56438
102093
224
1678
825
2190
5184
6553
689
155
231
1004
233
404
1085
922
3965
4075
29417
1685
969
2601
585
1427
544
1472
1414
0
419
2155
563
245
1228
3308
1359
2806
83
2324
25187
726
548
461
1341
2033
2
44
431
412
450
1016
647
2910
0
1854
398
13273
2221
954
554
1743
1920
3570
2952
2352
1251
709
243
536
437
58
108
19608
422
714
1324
779
6799
2639
997
646
288
14608
Neonatal and
Postnatal Mother
(Vitis/Check)
3 Days
67
68
69
70
71
72
73
74
75
393147 1044380
140823 25893 11807 16028
2554811 6346159
705968 103582 58370 80232
3957574 8851990
640822 166014 120359 119490
6905532 16242529 1487613 295489 190536 215750
37944
12115
13077
1462
817
1191
50337
92029
12192
3576
989
1929
43071
32952
14671
3213
1168
2281
77639
289878
43277
6477
3809
3806
177974
560292
39143 10989
8895
9313
246346
680593
39566
7682 13150
9617
32866
40279
8812
2889
730
1617
18009
564
4825
588
272
341
20442
21297
5904
1199
576
817
65497
57541
13571
1911
740
1458
14382
31070
5398
873
665
645
6889
102305
8115
1246
485
730
27486
58663
9476
1413
686
829
40044
127188
22575
4461
2355
2583
229608
463900
40621 13711
8396
7564
284441
715381
28263 13824
9527
8685
1372975 3286047
309486 75514 53260 53406
154120
350298
29101
9009
4289
6125
133243
308588
23138
8977
5970
4896
131123
492047
30682 11370
5493
7225
64664
244278
20958
2922
1712
2523
31159
169786
14645
2559
1027
1508
26897
88518
13681
1927
919
1227
22758
122262
12660
2702
1276
2063
68889
232682
22796
3004
2697
2876
7735
0
6561
0
0
0
5853
24670
5193
682
208
350
57327
93526
38294
2799
1425
2122
43791
55871
11407
1955
964
1470
40002
30035
4310
1323
353
371
97447
126047
20676
3401
2663
3477
103684
268464
24572
5062
2208
3695
183434
207376
27235
6866
5408
4195
275562
711686
33041 11762
8754
9466
11444
0
5048
0
0
0
131491
279978
23331
6305
3926
4057
1590623 3806112
367329 82625 49292 57646
38706
111789
14778
2412
1305
2070
47872
103381
12569
1715
1294
1244
31836
69833
12879
1641
813
1309
66756
223472
16633
4059
2568
2998
86921
208055
20939
820
1005
1072
853
287
348
7
4
3
2262
852
976
60
35
50
37069
93216
11256
1493
810
1082
43631
115910
10687
1977
898
1281
36048
87779
14468
2123
1233
1509
89834
205585
19929
3711
2251
3179
60756
249688
14616
2814
1527
2076
203604
269030
32657
7554
2801
4664
9968
0
3380
0
0
0
154750
323498
32950
6903
5082
4208
92386
155978
11328
1956
1137
1531
1003252 2218353
230393 39245 22763 28276
136934
261284
14926
2890
2048
2765
99014
116144
20829
2488
1294
2192
18648
97588
9982
1215
470
1097
100287
302189
22272
2687
1660
2560
149189
430608
33777
8034
6798
6057
167755
316362
38606 10146
5727
7466
368285
873079
31139
7996
5792
6123
224784
411082
51181
4477
4119
4461
195834
420660
51696
4340
3392
4606
30484
93139
20603
2880
1045
1756
3758
4572
1577
327
135
69
31991
71385
13614
3085
1270
1878
25994
132582
14115
2216
930
1403
7995
29855
3809
632
393
724
24331
47291
9146
912
646
517
1585283 3607820
337272 54325 35719 43674
53284
184601
13536
3353
1102
1440
59139
197885
14542
4563
1767
2563
72722
279802
27418
6052
3139
4366
97704
373843
26000
4763
2576
3196
633311 1143961
54716 11266
9394
9977
234287
435435
51151
7143
7148
6046
56949
195759
17624
2098
1702
1597
124888
443138
24016
3290
1755
2496
21115
69773
14130
1252
919
1067
1353399 3324197
243133 43780 29502 32748
Confirmed Breast
Feeding withn 1 hour
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
42100
260387
382214
684701
4877
7787
8285
33606
41002
37206
7307
2151
3375
7275
1528
4778
5091
13046
17827
19590
214731
8535
18517
10574
9532
5047
4999
3245
6530
3869
1871
13373
4501
1187
8906
18531
11236
8496
201
3576
142726
5915
3876
5707
7557
5992
37
46
3121
3833
6340
6820
7421
16704
1873
11229
4078
90549
11026
6396
3754
7272
20585
20161
21680
14815
9673
4511
920
2641
2054
888
4319
130695
7129
2390
3153
4208
57016
22600
1672
5367
2465
106000
Mothers Group
Meeting
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
ANC Services
Confirm
Reffer Cough Patients

(2 weeks) to HFs
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Pills Distribution
(Cycle)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
Annex3.4:FamilyHealthFCHVRawData
8203747
38272006
17911771
64387524
616425
527800
972642
997100
2206100
331500
1108589
0
906255
1717952
753250
835466
1222804
1056681
1145253
2902685
17300502
856125
0
3835079
323200
946749
923875
1797495
2572621
0
320000
1120000
1304445
60000
1092675
950798
692526
0
0
860000
17655588
0
2013286
1071650
881052
1044500
0
308017
401660
2152749
507070
1205391
1489004
1334128
0
162000
86420
12656927
1955287
471690
1208558
2112260
442900
861788
889208
191345
1087617
628100
175000
556254
0
299000
202500
11081507
428876
976800
1851130
709674
292179
103200
599761
531380
200000
5693000
267
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
12389
78463
79520
170372
750
1109
1868
3062
3800
3972
1354
991
1200
1329
926
332
684
948
3809
4173
30307
4012
3487
2324
1479
886
766
957
2378
2017
610
4496
1354
560
6303
2693
3209
3634
2398
3790
47353
1066
1534
1937
1742
2772
105
162
1507
1081
1439
2556
2288
4436
3102
2974
1644
30345
4530
3908
1082
2019
5305
3933
4806
4003
3156
740
661
1001
1050
333
385
36912
1147
1505
2681
2551
7410
5875
1102
2275
875
25421
921
5436
2982
9339
65
54
128
213
191
88
150
24
29
52
64
78
142
157
86
385
1906
241
116
206
103
20
122
60
142
0
43
471
1005
33
196
163
46
53
0
136
3156
130
25
70
137
177
1
9
26
45
83
76
62
80
0
81
33
1035
105
113
181
75
475
140
45
419
264
315
41
70
34
12
150
2439
36
62
43
65
133
267
19
45
133
803
8990
49755
42542
101287
571
855
1664
4880
2575
1254
1462
471
709
531
919
949
1011
1087
2440
2294
23672
1966
1759
2353
1353
365
1431
868
1765
1479
810
5029
940
168
1969
1391
1374
837
1467
1692
29016
1440
521
1255
905
2188
37
127
440
459
1450
2027
977
1348
3183
2561
408
19326
1732
941
1545
854
3284
1749
817
1715
2425
1188
548
410
468
147
607
18430
680
597
1068
1238
2945
1764
476
1372
703
10843
9911
55191
45524
110626
636
909
1792
5093
2766
1342
1612
495
738
583
983
1027
1153
1244
2526
2679
25578
2207
1875
2559
1456
385
1553
928
1907
1479
853
5500
1945
201
2165
1554
1420
890
1467
1828
32172
1570
546
1325
1042
2365
38
136
466
504
1533
2103
1039
1428
3183
2642
441
20361
1837
1054
1726
929
3759
1889
862
2134
2689
1503
589
480
502
159
757
20869
716
659
1111
1303
3078
2031
495
1417
836
11646
1841
9780
5906
17527
121
129
331
618
447
345
146
68
153
91
304
226
156
222
244
89
3690
343
240
366
162
100
262
186
381
0
201
1296
368
83
478
641
61
156
0
500
5824
178
442
178
286
312
4
44
84
113
66
113
129
274
0
106
66
2395
128
339
341
267
603
450
357
826
236
423
67
93
55
24
180
4389
78
54
65
87
338
369
82
23
133
1229
24327
108643
97167
230137
1492
2089
2866
7650
7366
4493
2419
1200
2223
1450
3231
2135
2204
2628
4947
5147
53540
5700
3509
3984
2042
1675
3796
2916
3729
5820
2598
11578
4397
660
4850
5419
2774
3356
2845
4864
76512
2598
1293
2028
1397
3181
68
311
1055
867
1931
3215
1770
3788
6651
4868
974
35995
2246
2729
3303
2364
4405
5653
4024
3737
3166
2718
793
831
909
496
773
38147
1278
1445
2453
2595
6965
4178
1532
2392
3105
25943
26168
118423
103073
247664
1613
2218
3197
8268
7813
4838
2565
1268
2376
1541
3535
2361
2360
2850
5191
5236
57230
6043
3749
4350
2204
1775
4058
3102
4110
5820
2799
12874
4765
743
5328
6060
2835
3512
2845
5364
82336
2776
1735
2206
1683
3493
72
355
1139
980
1997
3328
1899
4062
6651
4974
1040
38390
2374
3068
3644
2631
5008
6103
4381
4563
3402
3141
860
924
964
520
953
42536
1356
1499
2518
2682
7303
4547
1614
2415
3238
27172
29
372
394
795
2
0
19
19
4
3
6
2
1
2
0
0
0
15
2
11
86
25
5
5
15
0
9
6
38
0
2
43
1
0
12
0
0
2
0
4
167
0
0
7
2
11
0
0
3
0
0
0
14
28
0
0
0
65
2
14
0
3
53
64
63
59
2
3
0
0
9
0
0
272
1
1
11
15
105
1
71
0
0
205
2010
13041
12185
27236
313
120
630
1739
1193
237
98
58
203
94
23
45
22
166
165
179
5285
286
82
697
145
124
660
335
1262
2296
281
2940
251
12
716
60
864
158
134
335
11638
69
117
262
63
319
9
63
72
89
80
297
283
951
1777
202
102
4755
86
322
35
125
794
835
1055
573
178
113
11
27
31
52
11
4248
85
39
66
158
300
202
171
153
136
1310
2039
13413
12579
28031
315
120
649
1758
1197
240
104
60
204
96
23
45
22
181
167
190
5371
311
87
702
160
124
669
341
1300
2296
283
2983
252
12
728
60
864
160
134
339
11805
69
117
269
65
330
9
63
75
89
80
297
297
979
1777
202
102
4820
88
336
35
128
847
899
1118
632
180
116
11
27
40
52
11
4520
86
40
77
173
405
203
242
153
136
1515
40
288
205
533
0
1
0
11
18
14
5
0
12
0
1
5
0
1
0
5
73
18
1
4
14
5
0
8
28
0
0
25
0
0
13
8
9
5
0
40
178
2
0
1
1
6
1
0
10
1
0
0
15
11
0
0
0
48
4
50
1
18
3
6
48
31
2
4
0
6
5
4
0
182
3
0
26
1
7
5
3
7
0
52
2156
12807
7838
22801
14
172
118
634
907
172
186
101
263
213
109
87
14
222
132
400
3744
205
207
544
356
281
144
218
635
666
248
1507
11
101
474
553
409
417
216
234
7426
94
145
126
25
312
30
54
150
138
25
420
271
181
395
206
119
2691
266
1524
127
568
236
410
660
356
619
482
2
94
184
80
91
5699
270
257
358
169
631
642
239
430
245
3241
Total
=>20
Years
<20
Years
Implant
Total
=>20
Years
<20
Years
IUCD
Total
=>20
Years
<20
Years
Depo
Total
=>20
Years
<20
Years
Pills
2196
13095
8043
23334
14
173
118
645
925
186
191
101
275
213
110
92
14
223
132
405
3817
223
208
548
370
286
144
226
663
666
248
1532
11
101
487
561
418
422
216
274
7604
96
145
127
26
318
31
54
160
139
25
420
286
192
395
206
119
2739
270
1574
128
586
239
416
708
387
621
486
2
100
189
84
91
5881
273
257
384
170
638
647
242
437
245
3293
Total
(Temporary
Methods)
New Acceptors
Temporary Methods
Condom
District Name
Received Reports
District Code
Annex3.4:FamilyHealthFamilyPlanningRawData
52703
278591
248739
580033
3328
4529
7624
18826
16501
10578
5826
2915
4793
3762
5577
3857
4233
5446
11825
12683
122303
12796
9406
10483
5669
3456
7190
5554
10358
12278
4793
27385
8327
1617
15011
10928
8746
8618
7060
11595
181270
5577
4077
5864
4558
9278
255
770
3347
2793
5074
8704
5809
11097
15108
10998
3352
96661
9099
9940
6615
6293
15158
13240
11875
11719
10048
5986
2123
2532
2745
1148
2197
110718
3578
3960
6771
6879
18834
13303
3695
6697
5330
69047
268
67
68
69
70
71
72
73
74
75
58
267
46
371
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
3
7
0
0
0
0
0
0
0
0
181
1
8
0
1
14
0
0
0
0
212
0
0
0
2
47
0
0
0
2
0
0
0
31
0
0
0
82
0
0
0
0
0
6
0
0
0
0
0
25
0
0
0
31
0
0
0
0
2
0
8
0
33
43
251
1987
4157 10390
43420
2395
47828 14772
0
25
1
13
84
12
2901
208
3371
69
1441
49
0
21
0
19
2
43
1
103
0
0
5
123
0
72
105
260
2787
1
3807
24
14505
1042
4567
11
2552
19
3064
31
123
173
0
133
95
169
54
273
172
429
28
493
106
190
630
1140
556
111
53
24
38
557
38
1508
3996
8
2907
112
4125
75
347
765
23451
6221
207
234
111
208
60
146
169
58
288
451
0
3
13
5
0
160
6
110
61
192
174
86
222
386
1214
145
675
61
600
12
88
65
3888
2322
157
123
14
233
0
146
1
268
729
127
480
173
1196
75
454
880
1
507
0
162
0
64
0
262
0
44
0
190
0
147
3032
3401
0
216
0
405
44
139
15
144
2044
367
617
63
145
158
53
177
34
117
2952
1786
2238
14547
45815
62600
25
14
96
3109
3440
1490
21
19
45
104
0
128
72
365
2788
3831
15547
4578
2571
3095
296
133
264
327
601
521
296
1770
667
77
595
1546
4004
3019
4200
1112
29672
441
319
206
227
739
3
18
160
116
253
260
608
1359
736
612
153
6210
280
247
146
269
856
653
1271
1334
508
162
64
262
44
190
147
6433
216
405
183
159
2411
680
303
230
151
4738
54941
293138
294554
642633
3353
4543
7720
21935
19941
12068
5847
2934
4838
3866
5577
3985
4305
5811
14613
16514
137850
17374
11977
13578
5965
3589
7454
5881
10959
12799
5089
29155
8994
1694
15606
12474
12750
11637
11260
12707
210942
6018
4396
6070
4785
10017
258
788
3507
2909
5327
8964
6417
12456
15844
11610
3505
102871
9379
10187
6761
6562
16014
13893
13146
13053
10556
6148
2187
2794
2789
1338
2344
117151
3794
4365
6954
7038
21245
13983
3998
6927
5481
73785
1858386
11769472
11928091
25555949
112590
166420
280281
459391
570084
595800
203228
148713
180003
199412
138904
49863
102667
142333
571411
625960
4547060
601804
523181
348686
221895
133001
114919
143553
356729
302637
91581
674475
203114
84126
945541
404099
481457
545150
359772
568548
7104268
159949
230199
290614
261362
415925
15857
24341
226066
162292
215950
383522
343251
665543
465317
446124
246727
4553039
679503
586237
162357
302861
795881
590082
721017
600514
473408
111098
99298
150184
157529
50002
57779
5537750
172090
225872
402175
382700
1111631
881252
165430
341343
131339
3813832
Depo
Pills
Condom
Total All
Methods
Total
Strerilization
Male
2
212
4596
4810
0
0
0
0
0
485
0
0
0
0
0
0
0
0
0
0
485
2961
0
652
0
0
0
0
0
0
104
0
8
0
0
2
0
0
0
8
3735
0
1
0
2
17
0
0
0
0
0
0
0
384
0
0
0
404
0
7
0
0
78
28
0
0
0
0
0
0
0
0
0
113
0
0
0
0
0
0
71
0
2
73
Female
118
2126
1310
3554
0
0
0
204
50
43
0
0
0
0
0
41
0
0
1
24
363
4
19
29
0
0
9
25
325
0
0
449
36
0
46
517
0
97
0
528
2084
6
15
0
0
309
0
0
0
7
0
0
47
81
0
1
0
466
18
0
0
0
1
12
0
228
0
0
0
84
0
0
0
343
0
0
0
0
170
46
82
0
0
298
Male
Female
Female
Male
Female
Male
1747
1
5630
541
452 15108
7829 15650
25
0
11
0
12
0
4
2402
17
2106
0
320
21
0
16
0
34
0
101
0
0
0
82
5
72
0
142
0
0
44
0
2478
537
7355
0
965
0
772
0
1310
156
0
133
0
160
0
248
1
90
109
0
0
8
0
105
63
67
42
24
0
510
11
876
36
8
0
11
2313
0
0
55
210
2451
5832
169
4
178
18
146
0
27
0
70
53
3
0
5
0
0
0
99
1
120
0
86
0
55
150
33
642
0
0
11
339
60
0
1062
1207
105
1
231
0
0
146
268
0
121
7
28
172
53
4
540
2
429
0
162
0
49
0
128
0
34
0
185
0
147
0
2626
186
216
0
405
0
132
0
139
0
96
831
15
193
66
46
0
0
84
0
1153
1070
97304 120669
668359 702313
776745 651543
1542408 1474525
10799
19412
50991
70640
68081
67347
17538
6709
7471
16049
10624
15324
10888
22410
53005
36321
483609
20842
39221
23908
16618
8983
12793
16412
25317
19997
14199
59756
9168
1777
27323
19376
15925
19112
14981
28156
393864
10662
7897
12985
19077
23338
312
1070
4496
6006
9813
16926
19556
39915
48012
35953
6780
262798
43716
12413
10239
11553
39220
18878
20722
31677
21633
9273
2780
3121
4676
1955
5094
236950
8742
3969
7678
9829
79969
36537
3902
8852
5709
165187
11414
17183
38217
55924
53304
52781
17031
7334
11028
16452
14263
15292
9426
19239
40189
32923
412000
27498
35595
17456
16364
19308
16088
35471
36549
36855
23711
89161
18498
3098
34405
43735
13001
22777
17818
21382
528770
13898
7597
10883
9084
13129
371
890
4573
4488
6697
12597
14107
25023
40815
34169
4961
203282
21537
14020
12569
18348
38723
28265
21453
21206
14122
8304
2428
2429
2516
2050
2856
210826
5284
5683
8805
7856
44882
27565
6809
7963
4800
119647
Implant
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
64
246
2367
1783
587 13943
3018 15972
0
0
2
0
0
84
0
446
2
1262
6
0
0
0
0
0
9
0
2
0
0
0
0
0
0
0
118
77
0
2701
0
1246
139
5816
0
212
0
45
2
0
17
116
0
0
0
95
0
53
14
63
493
0
1
0
585
48
0
36
0
53
0
27
101
0
0
3996
4
309
75
0
182
49
1474
5102
59
99
15
63
0
60
29
97
25
69
0
0
0
13
160
0
2
5
72
44
0
171
284
72
0
156
61
0
0
261
5
88
712
1198
0
156
2
7
0
0
0
1
5
644
127
180
22
1170
112
317
78
0
0
0
15
0
25
0
10
0
5
0
0
0
401
2475
0
0
0
0
7
40
5
15
99
955
2
311
2
28
177
0
0
32
292
1381
Total
Camp
IUCD
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
2
468
1621
240
9773
900 11396
12
0
12
1
12
0
12
53
12
3
12
636
12
0
12
0
12
2
12
1
12
0
12
0
12
0
12
28
12
42
12
83
192
849
12
429
12
1735
12
1102
12
7
12
0
12
0
12
0
12
0
12
28
12
2
12
519
12
470
12
0
12
0
12
0
12
0
12
285
12
4125
12
80
228
8782
12
104
12
29
12
0
12
70
12
149
12
0
12
0
12
0
12
0
12
17
12
3
12
0
12
32
12
675
12
0
12
0
192
1079
12
0
12
0
12
0
12
0
12
0
12
100
12
22
12
135
12
1
12
0
12
0
12
0
12
0
12
0
12
0
180
258
12
0
12
0
12
4
12
0
12
258
12
113
12
0
12
53
12
0
108
428
Institutions
Female
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Camp
Institutions
Distribution
New Acceptors
Sterilization
Non-government
Government
Male
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
2968
15374
13207
31549
315
120
949
1877
1197
240
104
96
1016
158
25
47
23
559
432
212
7370
311
87
702
160
124
714
342
1334
2622
285
2984
252
19
728
62
864
167
202
339
12298
69
117
281
65
536
9
63
123
94
80
513
311
979
1778
288
102
5408
88
367
35
128
856
920
1118
632
180
329
32
65
40
52
11
4853
86
40
77
237
405
233
242
161
139
1620
2264
13844
8216
24324
14
173
118
670
925
191
193
101
312
213
110
99
14
230
132
423
3918
223
208
548
370
286
144
226
719
778
251
1532
11
101
487
561
418
422
286
274
7845
186
145
127
26
318
31
54
160
170
25
427
309
197
414
206
119
2914
270
1693
128
586
239
446
708
424
621
497
2
127
191
84
91
6107
273
257
384
300
638
648
242
551
247
3540
269
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Current Users
Defaulter
12389
78463
79520
170372
750
1109
1868
3062
3800
3972
1354
991
1200
1329
926
332
684
948
3809
4173
30307
4012
3487
2324
1479
886
766
957
2378
2017
610
4496
1354
560
6303
2693
3209
3634
2398
3790
47353
1066
1534
1937
1742
2772
105
162
1507
1081
1439
2556
2288
4436
3102
2974
1644
30345
4530
3908
1082
2019
5305
3933
4806
4003
3156
740
661
1001
1050
333
385
36912
1147
1505
2681
2551
7410
5875
1102
2275
875
25421
9701
79048
78023
166772
1118
1878
6440
6843
5551
6126
2155
620
699
1519
1573
1498
6623
2290
4994
3018
52945
1879
3674
2198
1670
696
1059
1495
2323
3770
2216
6106
1023
141
3895
1476
2771
1841
928
2934
42095
844
633
1149
1821
2689
41
107
503
538
1081
1755
1453
2941
4304
5829
659
26347
3956
1215
1323
1045
8476
2101
1932
2579
1865
1134
294
380
437
144
463
27344
769
431
751
782
6523
3160
291
4784
550
18041
38362
223502
191756
453620
3839
4995
12182
15934
17452
13349
4950
1893
3051
4661
6208
5189
12725
6193
11795
9193
133609
7219
10201
5602
4739
4768
4526
10253
10606
18535
6905
26049
5806
1095
12467
9732
6836
8390
4272
5565
163566
3605
2339
2864
2407
3820
117
342
1449
1116
2146
4297
3274
7817
11442
10999
1421
59455
6322
4142
3571
4430
13600
7949
5792
4883
3737
4290
800
821
886
610
994
62827
1414
1908
2550
2538
12131
6218
2109
3797
1498
34163
4845
51905
40327
97077
710
791
1612
3637
3402
1612
461
278
974
592
122
387
286
180
866
1574
17484
4185
1282
2397
775
1078
651
1063
3987
6146
1894
15514
339
49
1781
604
2540
1088
355
2504
48232
65
329
1235
334
2232
9
84
770
368
800
1524
501
1731
2000
885
271
13138
658
1028
164
818
3052
1464
3774
2028
899
244
35
111
114
107
43
14539
443
136
137
468
1257
722
193
134
194
3684
6827
60027
34105
100959
24
917
1358
2496
2449
1552
859
413
1035
571
385
795
710
333
0
1688
15585
3967
607
1704
908
1004
643
1323
7902
6475
1761
10637
846
357
2975
3972
1678
987
370
1486
49602
111
333
676
51
1324
113
135
375
423
145
1374
1237
1383
1826
663
326
10495
426
3668
212
1246
990
2509
3088
1057
1600
822
2
566
593
91
217
17087
361
436
772
376
2872
1790
345
692
546
8190
72124
492945
423731
988800
6441
9690
23460
31972
32654
26611
9779
4195
6959
8672
9214
8201
21028
9944
21464
19646
249930
21262
19251
14225
9571
8432
7645
15091
27196
36943
13386
62802
9368
2202
27421
18477
17034
15940
8323
16279
350848
5691
5168
7861
6355
12837
385
830
4604
3526
5611
11506
8753
18308
22674
21350
4321
139780
15892
13961
6352
9558
31423
17956
19392
14550
11257
7230
1792
2879
3080
1285
2102
158709
4134
4416
6891
6715
30193
17765
4040
11682
3663
89499
41988
247055
96617
385660
2089
1946
2100
9427
5473
3357
2053
1885
2979
2787
878
2405
2631
4453
3324
1243
49030
1808
456
2860
4631
3571
4868
7798
9094
24601
3826
19202
7871
1915
9438
29190
827
1989
3240
26724
163909
6166
6025
8673
4473
12954
209
331
3146
4391
6338
3737
5447
8816
2573
1899
3192
78370
3104
3619
3209
5714
4136
6374
3221
11811
6113
3470
752
5248
2202
1617
1237
61827
3183
4299
2844
4061
4502
4368
3107
3777
2383
32524
7732
49720 121844
171050
418105 911050
872279
968896 1392627
1051061 1436721 2425521
3
2092
8533
389
2335
12025
7316
9416
32876
53498
62925
94897
89840
95313 127967
39678
43035
69646
1810
3863
13642
150
2035
6230
55
3034
9993
137
2924
11596
186
1064
10278
287
2692
10893
215
2846
23874
4230
8683
18627
56533
59857
81321
57632
58875
78521
311959
360989 610919
81261
83069 104331
52460
52916
72167
63790
66650
80875
4932
9563
19134
199
3770
12202
3165
8033
15678
2124
9922
25013
9641
18735
45931
11724
36325
73268
8648
12474
25860
32782
51984 114786
7436
15307
24675
694
2609
4811
1614
11052
38473
3967
33157
51634
57984
58811
75845
39506
41495
57435
72753
75993
84316
12807
39531
55810
467487
631396 982244
6568
12734
18425
2140
8165
13333
7030
15703
23564
9560
14033
20388
11204
24158
36995
18
227
612
270
601
1431
921
4067
8671
1053
5444
8970
3479
9817
15428
6059
9796
21302
8373
13820
22573
29660
38476
56784
28793
31366
54040
13546
15445
36795
2818
6010
10331
131492
209862 349642
2054
5158
21050
110
3729
17690
220
3429
9781
838
6552
16110
19880
24016
55439
16440
22814
40770
25048
28269
47661
10106
21917
36467
63
6176
17433
219
3689
10919
12
764
2556
225
5473
8352
8
2210
5290
30
1647
2932
56
1293
3395
75309
137136 295845
394
3577
7711
167
4466
8882
301
3145
10036
669
4730
11445
40517
45019
75212
20653
25021
42786
833
3940
7980
955
4732
16414
325
2708
6371
64814
97338 186837
6538
49769
22102
78409
296
2381
1860
4005
2327
2372
773
410
673
821
748
389
4006
1103
830
959
23953
345
958
785
527
510
625
991
933
0
1292
5026
1151
125
1054
1007
180
403
0
1230
17142
1131
1462
565
1512
1415
19
93
361
325
568
1879
1003
680
0
1010
182
12205
4203
1008
1694
1286
1062
876
237
1489
2189
1026
157
131
388
667
181
16594
655
382
747
657
2173
1670
973
851
407
8515
19370
123140
64711
207221
848
4927
3714
7435
6743
7702
1793
1184
2316
2211
2703
865
5948
4342
2495
3788
59014
1326
1921
2189
1403
2964
2575
3737
4285
0
3745
15740
5951
480
3172
5196
365
1328
0
3632
60009
2935
4199
1356
1946
2311
67
245
738
594
770
3262
1826
2461
0
2596
621
25927
4007
2446
4329
5894
3032
4050
1120
3766
3388
2162
349
422
521
1506
676
37668
1092
1175
2233
2052
5119
7409
3056
1809
658
24603
223
1952
1612
3787
5
20
213
573
62
81
14
29
55
0
1
14
7
124
79
38
1315
0
0
19
9
18
0
121
75
0
12
845
5
0
48
0
53
25
0
104
1334
2
4
50
64
28
2
0
8
1
0
11
14
124
0
0
0
308
35
48
141
29
21
115
180
2
22
22
4
9
2
0
2
632
4
3
7
9
104
34
10
12
15
198
Implant
IUCD
Depo
Pills
Total all
Methods
Total
Sterilization
Female
Male
Total
(Temporary
Methods)
Strerilization
Implant
IUCD
Depo
Pills
Temporary Methods
Condom
District Name
Received Reports
District Code
245
2839
1492
4576
13
38
142
261
90
127
28
10
62
3
0
83
11
1
21
15
905
0
0
21
1
12
0
55
823
0
91
796
54
0
67
93
108
35
0
93
2249
1
4
42
3
70
12
0
0
0
0
1
32
109
0
0
6
280
6
127
131
71
1
121
327
0
22
12
0
0
15
0
0
833
2
13
17
22
90
73
10
9
73
309
270
18.61
19.99
15.73
17.83
21.06
20.9
33.67
17.48
15.2
16.93
24.34
15.83
18.91
18.86
37.49
23.35
41.18
14.82
15.94
14.83
19.29
13.99
15.47
9.9
15.11
17.96
16.11
21.61
29.88
39.91
22.14
21.82
14.29
22.37
34.87
20.32
13.74
12.36
7.17
13.37
18.32
8.23
12.03
10.19
8.39
12.94
14.77
25.37
16.81
9.34
8.54
16.43
13.7
13.33
13.24
19.4
8.75
12.67
31.86
28.94
14.07
19.75
27.6
19.36
20.97
20.64
21.79
22.44
25.61
14.05
12.41
13.34
21.68
22.14
16.9
11.61
13.13
14.18
20.06
19.26
14.01
21.8
12.9
17.35
31.45 12389.24
36.95 78463.15
51.71 79520.61
43.73 170372.99
27.91
750.6
25.94
1109.47
47.18
1868.54
51.88
3062.61
59.57
3800.56
44.31
3972
33.95
1354.85
23.51
991.42
27.16
1200.02
25.22
1329.41
41.82
926.03
31.01
332.42
46.76
684.45
27.76
948.89
60.41
3809.41
59.27
4173.07
47.14 30313.73
68.64
4012.03
57.99
3487.87
56.29
2324.57
30.2
1479.3
25.99
886.67
33.04
766.13
35.82
957.02
50.47
2378.19
79.14
2017.58
42.77
610.54
39.88
4496.5
37.65
1354.09
48.87
560.84
48.92
6303.61
56.8
2693.99
61.19
3209.71
44.53
3634.33
72.68
2398.48
45.84
3790.32
51.29 47361.79
26.64
1066.33
31.03
1534.66
30.55
1937.43
26.91
1742.41
37.28
2772.83
23.48
105.71
43.75
162.27
31.66
1507.11
23.76
1081.95
23.49
1439.67
30.41
2556.81
35.34
2288.34
41.34
4436.95
31.57
3102.11
33.44
2974.16
20.91
1644.85
31.7 30353.59
42.2
4530.02
36.66
3908.25
21.67
1082.38
33.28
2019.07
48.69
5305.87
43.96
3933.88
51.54
4806.78
51.72
4003.43
33.75
3156.05
33.89
740.65
36.52
661.99
40.77
1001.23
21.31
1050.19
30.43
333.35
35.01
385.19
41.28 36918.33
31.53
1147.27
23.36
1505.81
19.12
2681.17
24.16
2551.33
49.97
7410.87
46.4
5875.01
27.67
1102.87
30.64
2275.62
22.44
875.59
36.22 25425.55
7484.92 30167.25
51412.23 175578.25
59749.62 162885.75
118646.77 368631.25
830.69
2853.5
1493.23
4295.75
3922.38
9554.25
5433.85
13981
5237
13326
5180.54 13195.25
1349.08
4257.75
516.08
1833.5
574.69
2757
1234.54
4113
817.23
3565.75
1178.77
3823
837.54
2356.5
1723.85
4809.75
4077.31 10047.25
2793.92
8230.75
37200.69
103000
1603.23
6874.5
3017
8898.75
1839.08
4364
1278.31
4091
691
4827
984.08
4022
1262.46
8867.75
1947.46
9137.25
1538.23
9213.75
1092.23
5927.75
4596.62 22290.25
705.23
4624.5
136.69
774.5
2101.77
8601.25
1490.46 10933.75
1225
3250.25
1470.15
5694.25
1152.38
4454.5
2165.85
5345.5
30297.23 132192.5
820.15
3474.5
607.46
1899.25
998.85
2720.75
1467.46
2271
1795.23
3282.25
24
92.75
82.31
222.5
345.85
1143.25
462
1122
754.85
1674.25
1302
3149.25
1504.31
3526.75
3070.38
6255.75
3693.23 10203.75
2765.62
8542.25
521.54
1240.25
20215.23
50820.5
3362.77
5384.25
954.85
3505
787.62
3142.25
888.69
4587
3016.92
9680.75
1452.15
7066.25
1594
5363.25
2436.69
5301.5
1664.08
3530.5
713.31
2076
213.85
607
240.08
607.25
359.69
629
150.38
512.5
391.85
714
18226.92
52706.5
672.46
1321
305.31
1420.75
590.62
2201.25
756.08
1964
6151.46
11220.5
2810.54
6891.25
300.15
1702.25
680.92
1990.75
439.15
1200
12706.69 29911.75
23744
122992
105656
252392
2520
960
7592
15016
9576
1920
832
768
8128
1264
200
376
184
4472
3456
1696
58960
2488
696
5616
1280
992
5712
2736
10672
20976
2280
23872
2016
152
5824
496
6912
1336
1616
2712
98384
552
936
2248
520
4288
72
504
984
752
640
4104
2488
7832
14224
2304
816
43264
704
2936
280
1024
6848
7360
8944
5056
1440
2632
256
520
320
416
88
38824
688
320
616
1896
3240
1864
1936
1288
1112
12960
Implant
IUCD
Depo
Pills
Condom
1.76
2.43
1.27
1.82
0.08
1.98
1.95
1.36
1.14
0.99
2.14
1.56
2.81
1.24
1.57
2.26
1.39
0.5
0
1.27
1.2
2.61
0.49
1.19
1.43
2.14
1.35
1.89
8.68
6.99
2.91
3.7
1.29
3.63
3.78
4.37
1.35
0.77
0.32
1.22
2.59
0.16
0.77
0.88
0.07
1.33
4.34
4.13
1.37
1.12
0.22
1.96
1.94
1.01
1.07
0.6
0.66
0.95
0.85
7.6
0.47
2.57
0.87
2.71
3.34
1.5
3.1
2.55
0.03
2.76
2.39
0.94
2.24
2.38
1.48
1.15
1.47
0.79
1.91
1.94
1.2
1.29
1.92
1.59
CPR
1.25
2.1
1.5
1.75
2.32
1.71
2.31
1.99
1.58
1.03
1.15
1.05
2.65
1.29
0.5
1.1
0.56
0.27
0.64
1.19
1.35
2.75
1.03
1.67
1.22
2.3
1.37
1.52
4.38
6.64
3.13
5.39
0.52
0.5
2.26
0.66
2.05
0.84
0.31
2.06
2.52
0.09
0.77
1.6
0.44
2.25
0.35
2.57
2.81
0.97
1.22
2.18
0.78
1.26
1.17
0.8
0.55
1.19
1.32
2.13
0.36
1.69
2.68
1.58
4.08
2.88
1.74
0.76
0.5
0.54
0.46
1.11
0.44
2.03
1.81
0.36
0.26
0.99
0.84
0.78
0.67
0.25
0.68
0.71
Total
Depo
3.2
2.5
9.9
3.18 3.21 9.06
2.95
2.9 7.12
3.07 3.01 8.18
2.45 3.66 12.56
2.39 4.05 10.78
2.68 9.24 17.48
1.67 3.74 8.71
1.77 2.58 8.12
2.53
3.9 8.49
3.37 5.36 12.32
3.74 2.34 7.14
3.26
1.9 8.29
2.89
3.3 10.14
3.77
6.4 25.26
0.95 4.27 14.77
1.34 12.97 24.92
1.41 3.41 9.23
2.83 3.71 8.76
3.15 2.28 6.94
2.34 4.09 10.31
2.64 1.24 4.75
2.8 2.95
8.2
1.62 1.53
3.9
2.33 2.64 7.48
1.89 1.48 10.16
1.61 2.23 9.54
1.37 2.14 14.68
2.61 2.55 11.65
2.18 4.07 20.02
1.01 3.67 11.42
1.56 2.12 9.05
2.07 1.56 8.86
5.7 1.43 11.12
8.02 4.95 15.85
2.96 1.62 10.71
2.59 2.24 5.52
2.82 1.43 6.51
2.07
0.8 3.68
3.11 2.41 4.57
2.47
2.2 8.54
1.54 1.22 5.21
3.57 1.47 5.44
2.51 1.49 3.71
2.3
2.4 3.18
2.79 2.71 3.85
4.06 1.57 4.49
4.96 3.27 10.46
5.5 1.84 5.29
2.87 1.43 2.96
2.19 1.65 3.27
3.65 2.51 6.13
3.58 2.28 5.13
3.23 2.14 5.69
1.81 2.51 6.68
2.7
5.3
10
3.33 1.33 2.88
2.75 2.39 5.39
9.08 7.93 12.67
8.1 2.52 8.58
2.4 2.93 7.91
4.17 2.16 9.15
4.66 7.44 11.94
4.24 2.27 8.57
5.2 2.09 6.26
5.68 3.66 6.93
6.11 3.61 7.23
2.3 3.52 13.32
9.46
4.2 11.43
4.89 1.85 4.01
4.23 1.76 3.57
3.46 1.49 6.33
3.97 4.77 10.25
5.15 3.81 8.77
4.69 3.14 5.78
3.96 1.13 5.02
5.11 1.43 4.86
5.39 1.65 5.36
4.92 4.33 8.06
6.37 3.43 6.74
3.82 1.01 7.31
4.25 8.93 7.09
3.08 1.94 5.28
4.93
3.5 6.62
Implant
13.6
11.3
9.24
10.46
10.88
9.77
10.94
10.29
7.68
6.73
14.5
11
13.03
8.18
22.69
10.98
8.29
8.12
8.78
9.57
9.44
8.42
7.56
7.3
8.95
7.36
15.15
7.95
11.38
13.26
7.93
9.52
12.71
16.42
19.09
12.02
7.06
6.68
6.09
9.52
9.47
8.07
9.49
7.6
6.02
9.35
9.79
23.54
12.22
7.4
7.73
12.43
9.1
8.08
8.82
10
6.79
8.77
18.24
20.6
14.65
13
13.31
14.28
12.84
16.62
19.45
18.58
30.34
12.36
11.06
11.91
22.66
15.45
14.63
10.41
12.9
14.52
12.51
14.43
12.81
12.5
18.78
13.39
Pills
0.57
0.53
0.3
0.42
0.05
0.37
0.17
0.35
0.43
0.12
0.48
0.38
0.75
0.46
0.45
0.26
0.03
0.33
0.1
0.31
0.29
0.15
0.17
0.38
0.58
0.61
0.3
0.32
0.73
0.72
0.41
0.53
0.02
1.03
0.62
0.62
0.34
0.33
0.19
0.23
0.4
0.14
0.34
0.16
0.03
0.32
1.19
1.65
0.58
0.37
0.04
0.6
0.45
0.14
0.23
0.19
0.24
0.25
0.54
3.26
0.28
1.21
0.21
0.45
0.77
0.55
1.2
1.51
0.03
0.49
0.76
0.87
0.94
0.82
1.12
0.68
0.73
0.36
0.42
0.7
0.84
0.82
0.86
0.64
Condom
0.53
0.54
0.47
0.51
1.03
0.26
0.93
0.96
0.56
0.15
0.26
0.23
0.55
0.21
0.09
0.13
0.04
0.27
0.12
0.14
0.41
0.2
0.07
0.49
0.25
0.26
1.41
0.49
1.43
2.48
0.47
1.04
0.38
0.12
0.93
0.07
0.7
0.12
0.12
0.28
0.62
0.1
0.27
0.35
0.09
0.33
0.35
1.93
0.27
0.24
0.12
0.42
0.47
0.71
1.04
0.18
0.22
0.44
0.18
0.7
0.08
0.26
0.74
0.97
1.21
0.9
0.35
0.36
0.16
0.13
0.16
0.54
0.11
0.63
0.35
0.11
0.15
0.37
0.27
0.22
0.84
0.29
0.48
0.29
Current Users as % of MWRA

Total
Depo
6.75
4.8
3.83
4.47
5.28
4.78
4.59
4.52
3.64
3.08
6.38
4.79
6.46
3.35
14.39
6.72
4.62
4.25
3.86
3.95
4.42
3.98
3.01
3.03
3.48
3.78
8.55
4.44
4.52
6.29
4.63
4.47
7.27
7.55
6.78
6.67
2.29
2.72
2.45
4.41
4.3
4.01
4.04
2.86
2.22
3.52
2.76
10.85
4.16
2.6
3.04
4.75
2.97
2.96
3.88
4.52
2.11
3.48
4.76
6.36
8.07
5.44
4.4
6.58
4.74
6.47
6.59
9.75
12.29
4.51
3.88
5.4
9.83
5.93
5.54
3.94
4.8
5.66
4.85
4.93
5.6
4.51
11.41
5.27
CYP
IUCD
67
68
69
70
71
72
73
74
75
2.56
2.24
1.69
1.99
2.08
1.96
2.57
2.78
1.29
0.85
4.01
1.87
2.01
1.27
4
2.92
2.26
1.85
1.88
2.02
1.97
1.45
1.51
1.78
2.3
0.82
3.27
1.33
2.1
1.6
1.41
1.91
2.97
2.04
2.75
1.71
1.15
0.69
1.26
1.5
1.68
2.27
1.27
1.72
1.38
2.38
1.46
4.16
1.7
1.34
2.33
3
1.63
1.04
1.86
2.4
0.89
1.85
3.68
2.18
3.82
1.92
3.3
2.04
0.93
3.03
5.21
4.67
8.42
2.34
2.02
1.65
7.81
2.91
2.93
1.73
2.12
2.75
2.04
2.2
1.72
2.64
2.95
2.26
Implant
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
3.2
3.18
2.95
3.07
2.45
2.39
2.68
1.67
1.77
2.53
3.37
3.74
3.26
2.89
3.77
0.95
1.34
1.41
2.83
3.15
2.34
2.64
2.8
1.62
2.33
1.89
1.61
1.37
2.61
2.18
1.01
1.56
2.07
5.7
8.02
2.96
2.59
2.82
2.07
3.11
2.47
1.54
3.57
2.51
2.3
2.79
4.06
4.96
5.5
2.87
2.19
3.65
3.58
3.23
1.81
2.7
3.33
2.75
9.08
8.1
2.4
4.17
4.66
4.24
5.2
5.68
6.11
2.3
9.46
4.89
4.23
3.46
3.97
5.15
4.69
3.96
5.11
5.39
4.92
6.37
3.82
4.25
3.08
4.93
IUCD
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
New Acceptors as % of MWRA

Pills
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Temporay Method
Condom
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Report
District Code
Annex3.4:FamilyHealthAnalysedDataFamilyPlanning
11320
69220
41080
121620
70
865
590
3350
4625
955
965
505
1560
1065
550
495
70
1150
660
2115
19590
1115
1040
2740
1850
1430
720
1130
3595
3890
1255
7660
55
505
2435
2805
2090
2110
1430
1370
39225
930
725
635
130
1590
155
270
800
850
125
2135
1545
985
2070
1030
595
14570
1350
8465
640
2930
1195
2230
3540
2120
3105
2485
10
635
955
420
455
30535
1365
1285
1920
1500
3190
3240
1210
2755
1235
17700
271
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
0.58
0.59
1.7
1.13
0.08
0.03
0.14
1.7
1.6
0.95
0.05
0.07
0.12
0.23
0
0.36
0.14
0.54
2.07
2.89
1.2
3.01
2.07
2.15
0.47
0.28
0.56
0.47
0.66
0.56
0.49
0.62
1.02
0.78
0.76
1.7
3.23
2.34
3.62
0.91
1.55
0.64
0.74
0.27
0.3
0.74
0.12
0.55
0.58
0.31
0.39
0.37
0.95
0.99
0.43
0.56
0.31
0.56
0.56
0.51
0.32
0.56
0.75
0.7
1.37
1.89
0.98
0.5
0.91
1.28
0.18
1.97
1.52
0.9
0.88
1.07
0.35
0.34
1.6
0.74
1.05
0.43
0.53
0.92
12.83
16.96
35.98
25.9
6.84
5.04
13.51
34.4
44.37
27.38
9.61
7.68
8.25
6.36
4.33
7.66
5.57
12.94
44.46
44.44
27.86
54.65
42.52
46.39
15.09
8.03
16.93
14.21
20.59
39.24
20.63
18.06
23.36
26.5
14.05
36.47
47.45
32.17
65.5
32.47
32.97
18.42
19
20.36
18.52
24.34
8.71
18.37
14.85
14.42
14.95
13.98
21.64
28.01
18.32
14.04
12.17
19.03
10.34
7.73
7.6
13.54
21.09
24.6
30.57
31.08
11.96
11.45
10.92
26.71
8.9
17.09
13.33
19.13
14.63
11.75
5.99
9.99
29.91
27.13
13.66
8.83
9.54
18.87
11.22
28.58
94.77
76.4
0
7.14
87.5
93.31
97.99
96.71
0
0
4.44
0.96
88.78
71.42
5.23
23.6
100
92.86
12.5
6.69
2.01
3.29
100
100
95.56
99.04
8.27
45.75
58.45
53.7
0
21.43
0
85.53
62.82
67.45
0
0
24.44
2.88
91.73
54.25
41.55
46.3
100
78.57
100
14.47
37.18
32.55
100
100
75.56
97.12
92
78.37
54.03
61.05
100
100
100
16.18
37.33
43.09
100
84.21
100
100
8
21.63
45.97
38.95
0
0
0
83.82
62.67
56.91
0
15.79
0
0
3.91
0
28.77
99.96
99.37
93.3
99.76
99.26
99
41.55
0
35.98
16.51
28.62
5.37
35.81
35.59
83.36
68.83
6.39
2.46
99.8
96.29
98.21
31.21
79.03
46.94
34.8
29.13
74.45
38.97
0
72.22
0
5.17
24.11
66.92
36.51
89.33
91.71
98.04
57.52
62.61
56.07
5.67
0
0.37
85.16
73.51
94.1
34.03
0.2
0
0
0
0
0
0
47.13
0
0
24.04
9.43
84.78
90.74
47.85
23.04
22.52
62.3
96.09
100
71.23
0.04
0.63
6.7
0.24
0.74
1
58.45
100
64.02
83.49
71.38
94.63
64.19
64.41
16.64
31.17
93.61
97.54
0.2
3.71
1.79
68.79
20.97
53.06
65.2
70.87
25.55
61.03
100
27.78
100
94.83
75.89
33.08
63.49
10.67
8.29
1.96
42.48
37.39
43.93
94.33
100
99.63
14.84
26.49
5.9
65.97
99.8
100
100
100
100
100
100
52.87
100
100
75.96
90.57
15.22
9.26
52.15
76.96
77.48
37.7
35.94
0
40
3.12
67.48
56
30.54
98.25
78.93
8.11
0
3.41
7.95
74.54
100
1.01
91.3
82.16
0
9.58
42.3
0
89.4
100
89.93
61.24
39.23
24.14
0
43.61
72.53
0
0
100
8.62
35.18
1.15
79.11
55.56
100
55.56
3.27
55.78
6.79
0.81
0
0
1.52
62.94
3.78
35.76
15.55
0
23.44
41.6
22.73
2.63
0
18.47
0
0
6.01
3.14
56.33
52.06
42.9
100
0
44.07
64.06
100
60
96.88
32.52
44
69.46
1.75
21.07
91.89
100
96.59
92.05
25.46
0
98.99
8.7
17.84
100
90.42
57.7
100
10.6
0
10.07
38.76
60.77
75.86
100
56.39
27.47
100
100
0
91.38
64.82
98.85
20.89
44.44
0
44.44
96.73
44.22
93.21
99.19
100
100
98.48
37.06
96.22
64.24
84.45
100
76.56
58.4
77.27
97.37
100
81.53
100
100
93.99
96.86
43.67
47.94
57.1
0
100
55.93
64.06
100
100
98.39
34.69
47.22
14
69.23
35.67
100
100
96.59
92.05
27.79
100
3.72
71.02
85.91
100
90.25
63.2
100
20.17
100
32.91
60.02
97.73
89.34
100
98.24
42.35
100
100
100
91.38
100
100
67.6
16.26
100
44.44
100
65.23
93.21
97.17
100
100
89.95
66.62
99.69
82.76
100
100
100
58.4
100
100
100
89.54
100
100
100
100
58.4
64.85
31.68
100
76.82
68.68
35.94
0
0
1.61
65.31
52.78
86
30.77
64.33
0
0
3.41
7.95
72.21
0
96.28
28.98
14.09
0
9.75
36.8
0
79.83
0
67.09
39.98
2.27
10.66
0
1.76
57.65
0
0
0
8.62
0
0
32.4
83.74
0
55.56
0
34.77
6.79
2.83
0
0
10.05
33.38
0.31
17.24
0
0
0
41.6
0
0
0
10.46
0
0
0
0
41.6
35.15
68.32
0
23.18
31.32
99.95
90.85
95.69
94.01
79.75
72.88
93.93
90.38
91.41
82.91
77.95
75.98
86.9
79.42
110.52
77.81
106.11
85.84
101.65
103.32
91.66
102.99
96.22
98.63
82.47
87.16
91.15
90.96
90.95
100.37
71.83
80.27
91.39
96.22
122.14
96.51
114.92
103.49
91.15
80.3
94.16
81.89
88.89
98.18
90.61
75.5
87.43
95.4
90.32
89.7
79.12
109.24
81.49
92.33
83.78
99.45
80.71
88.01
95.68
119.53
95.89
100.69
100.8
90.6
100.34
101.3
108.96
114.94
116.18
114.41
146.94
108.59
154.32
102.02
118.63
104.49
118.07
109
98.96
101.87
53.2
156.32
115.84
102.1
as % of VSC new
Cases
NGO
Government
Camp
HF
Male
Target Vs Achievement
Proportion of VSC
provided by
as % of Current
Users
Permanent Method
Proportion of VSC new
acceptors at
% of VSC new Cases

Female
Current Users as
% of MWRA
New Acceptors
as % of MWRA
District Name
Received Report
District Code
Annex3.4:FamilyHealthAnalysedDataFamilyPlanning
62.17
73.1
74.5
73.65
25
14
32
69.09
61.43
99.33
14
19
30
104
0
64
72
91.25
79.66
95.78
74.39
70.43
57.13
88.43
74
88.67
66
65.4
85.86
57.89
59.2
88.5
66.7
51.33
85
61.84
78.51
100.63
84
61.78
75.5
88.2
106.33
29.43
56.75
92.38
6
36
80
58
84.33
74.29
121.6
104.54
40.89
51
51
69.39
70
61.75
73
33.63
57.07
54.42
79.44
83.38
101.6
81
64
65.5
12.57
63.33
98
66.32
108
101.25
91.5
53
80.37
48.57
121.2
115
75.5
77.04
272
67
68
69
70
71
72
73
74
75
0
10
15
25
0
1
0
0
0
0
0
0
0
2
0
0
0
0
1
0
4
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
2
0
0
1
0
12
0
4
0
0
17
0
9
19
28
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
2
5
0
1
4
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
2
1
1
0
0
0
0
0
0
4
0
0
0
0
6
0
3
0
0
9
0
17
26
43
0
0
0
2
0
1
0
0
0
0
0
0
0
0
0
1
4
6
0
1
7
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
40
0
0
0
1
0
0
0
0
0
0
0
0
3
0
0
0
4
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
3
1
8
0
5
0
0
17
1
262
721
984
0
0
0
54
15
2
1
0
0
3
0
1
0
0
1
7
84
45
49
6
32
0
0
0
1
0
0
0
0
0
0
17
21
9
0
6
275
0
0
0
1
6
0
0
0
2
0
0
4
15
38
25
0
91
0
0
0
0
7
23
62
59
10
0
0
0
1
0
0
162
0
0
44
1
294
74
48
0
0
461
0
6
8
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
4
1
4
0
0
9
Male
0
146
373
519
0
0
1
30
13
1
1
0
0
0
0
0
0
1
2
4
53
35
35
5
19
0
0
0
0
0
0
0
0
0
0
12
16
8
0
0
212
0
0
0
0
5
0
0
0
0
0
0
0
12
32
16
0
65
0
0
0
0
2
3
45
33
5
0
0
0
0
0
0
88
0
0
4
0
111
26
42
0
0
183
Total
Female
1
245
695
941
0
0
0
52
15
1
1
0
0
3
0
1
0
0
1
6
80
39
49
5
25
0
0
0
1
0
0
0
0
0
0
17
19
8
0
6
235
0
0
0
0
6
0
0
0
2
0
0
4
12
38
25
0
87
0
0
0
0
7
23
61
59
10
0
0
0
1
0
0
161
0
0
41
0
286
74
43
0
0
444
5 Years &
Above
Male
Total
Male
0
137
354
491
0
0
1
30
11
1
1
0
0
0
0
0
0
1
2
4
51
30
35
4
15
0
0
0
0
0
0
0
0
0
0
11
15
8
0
0
196
0
0
0
0
5
0
0
0
0
0
0
0
12
32
15
0
64
0
0
0
0
2
3
43
32
4
0
0
0
0
0
0
84
0
0
4
0
105
26
39
0
0
174
PV Imported
Under 5
Years
Female
5 Years &
Above
Female
Male
Female
Treatment Total
Pregnamnet Women
Treatment
Total
RDTs
Microscope
Total
Microscope
RDTs
Total
PCDH
ACD
192
127
1762
1889 1162
534 1696
2
2
4
4
468 5237 31758 36995 9434 26580 36014 195 507 700 643
240 13771 108213 121984 18169 79484 97653 865 1670 2535 2330
900 19135 141733 160868 28765 106598 135363 1062 2179 3239 2977
12
0
285
285
40
200
240
1
0
1
1
12
30
1355
1385
41 1327 1368
6
0
6
6
12
1
3968
3969 1833 2136 3969
12
5
17
17
12
814
9812 10626 1713 10084 11797
30 275 305 305
12
789
8246
9035 1546 4874 6420
38
38
76
76
12
0
3460
3460
134 1717 1851
3
8
11
11
12
452
296
748
10
269
279
0
2
2
2
12
148
225
373
130
371
501
1
2
3
3
12
58
1082
1140 1069
13 1082
0
0
0
0
12
28
680
708
3
588
591
0
18
18
18
12
0
0
0
0
0
0
0
0
0
0
12
25
190
215
35
210
245
1
9
10
10
12
0
13
13
16
0
16
0
0
0
0
12
143
471
614
48
345
393
1
6
7
7
12
645
2682
3327
243
826 1069
1
3
4
4
12
22
3905
3927
866 1680 2546
3
20
23
23
192 3155 36670 39825 7727 24640 32367
97 386 483 483
12 2647
5940
8587 2130 3064 5194
41
57
98
98
12 2615
7519 10134 2409 7121 9530
19
76
93
93
12 2971
1188
4159
5 4159 4164
0
54
54
54
12
463
1984
2447 2406
54 2460
6
56
62
62
12
0
455
455
0
455
455
0
0
0
0
12
27
0
27
0
0
0
0
0
0
0
12
41
276
317
53
238
291
1
0
1
1
12
15
1978
1993 1000 1483 2483
1
2
3
3
12
0
894
894
0
894
894
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
87
131
218
0
186
186
0
0
0
0
12
49
2401
2450
431 1449 1880
16
23
39
39
12 1032
3056
4088
577
349
926
2
45
47
47
12 1005
3872
4877
475 2953 3428
4
17
21
21
12
25
2150
2175
0
971
971
0
0
0
0
12
633
2580
3213
174 2670 2844
7
18
25
25
228 11610 34424 46034 9660 26046 35706 191 400 443 724
12
227
376
603
4
599
603
0
6
6
6
12
0
789
789
0
779
779
0
3
3
3
12
94
573
667
8
659
667
1
2
3
3
12
0
331
331
0
281
281
0
1
1
1
12
53
1379
1432
6 1384 1390
1
41
42
42
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
166
166
0
166
166
0
0
0
0
12
26
174
200
0
200
200
0
2
2
2
12
0
173
173
0
173
173
0
3
3
3
12
0
776
776
203
776
979
2
8
10
10
12
35
1314
1349
9 1349 1358
0
19
19
19
12
55
7891
7946 2556 5267 7823
41
53
94
94
12
0 13305 13305
0 11934 11934
0 156 156 156
12
0
2329
2329
0 2019 2019
0
83
83
83
12
16
191
207
0
207
207
0
0
0
0
192
506 29767 30273 2786 25793 28579
45 377 422 422
12
371
1
372
0
371
371
0
0
0
0
12
160
151
311
97
39
136
3
0
3
3
12
0
46
46
0
46
46
0
0
0
0
12
24
7
31
7
0
7
0
0
0
0
12
156
1526
1682
321
716 1037
1
8
9
9
12
30
2852
2882 1342 1596 2938
21
27
48
46
12
322
7153
7475 2436 5599 8035
32 120 152 139
12
3
3247
3250
732 2515 3247
3
94
97
97
12
4
710
714
0
703
703
0
18
18
18
12
0
3
3
0
3
3
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
0
61
61
0
46
46
0
1
1
1
12
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
180 1070 15757 16827 4935 11634 16569
60 268 328 313
12
0
0
0
0
10
10
0
0
0
0
12
1
58
59
0
27
27
0
1
1
1
12
0
253
253
124
129
253
33
41
74
74
12
6
5
11
5
4
9
1
1
2
2
12 2576 15239 17815 2728 9423 12151 588 493 1081 931
12
0
8626
8626
492 8134 8626
37 172 209 169
12
99
909
1008
308
669
977 104
92 196 139
12
112
25
137
0
89
89
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
108 2794 25115 27909 3657 18485 22142 763 800 1563 1316
PV Indigenous
Under 5
Years
Male
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
Positive Cases
Male
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
Examined
Female
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Slide Collection
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
Annex3.5:MalariaRawData
0
0
1
0
1
9 35 111 40 120
19 135 547 143 566
28 170 659 183 687
0
0
0
0
0
0
0
1
0
1
0
3
1
3
1
7 26 67 26 74
0
3
5
3
5
0
0
2
0
2
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
2
3 10
3 12
0
0
0
0
0
0
2
5
2
5
0
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
0
2
0
2
9 37 96 37 105
0
7 11
7 11
0
1
1
1
1
3
2 33
4 36
0
1
5
1
5
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
2
4
2
0
0
0
0
0
0
1
1
1
1
0
0
0
0
0
1
2
9
3 10
7 16 98 17 105
0
3
3
3
3
0
1
2
1
2
0
1
2
1
2
0
0
0
0
0
0
9 18
9 18
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
1
0
2
5
2
5
0
1 14
1 14
3 14 31 14 34
1 10 10 10 11
0
0 34
0 34
0
0
0
0
0
4 42 120 42 124
0
0
0
0
0
0
0
3
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
5
0
8 16
8 16
0
0
0
2
0
0
0
3
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8 27 10 27
0
0
0
0
0
0
0
0
0
0
0
3 16
2 16
0
0
1
0
1
4 49 276 53 280
0
9 43 10 43
7
4 15
8 22
0
0
0
0
0
0
0
0
0
0
11 65 351 73 362
273
67
68
69
70
71
72
73
74
75
0
5
69
74
0
0
4
24
3
1
0
0
0
0
0
0
0
0
0
5
37
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
2
10
0
0
12
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
15
6
1
0
0
22
0
16
134
150
0
0
5
41
6
4
0
0
0
0
0
0
0
0
0
1
57
4
2
0
2
0
0
0
0
0
0
0
0
0
0
1
0
1
0
1
11
0
0
0
0
0
0
0
0
0
0
0
0
2
11
3
0
16
0
0
0
0
0
6
3
3
0
0
0
0
0
0
0
12
0
0
1
0
46
4
3
0
0
54
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
2
2
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
2
0
4
41
45
0
1
2
6
3
0
0
1
0
0
0
0
0
0
0
0
13
6
0
0
0
0
0
0
0
0
0
0
0
0
0
2
3
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
2
3
1
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
15
1
21
200
222
1
0
1
51
3
0
0
1
0
0
0
0
0
1
1
1
60
5
4
3
2
0
0
0
0
0
0
0
0
0
0
2
7
1
0
4
28
0
0
0
0
3
0
0
0
0
1
3
0
7
7
4
0
25
0
0
0
0
0
3
4
0
0
0
0
0
0
0
0
7
0
0
3
0
93
4
2
0
0
102
PM Indigenous
0
0
4
4
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
3
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
16
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
11
0
0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
2
0
1
22
23
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
11
0
0
14
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
0
0
0
0
3
0
0
0
0
3
PM Imported
0
0
20
20
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
13
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
3
0
4
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
4
0
3
1
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
3
1
3
17
21
0
2
0
1
10
0
0
0
0
0
0
0
0
1
0
2
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
3
0
9
39
48
0
2
0
0
11
1
0
0
0
0
0
1
0
2
0
1
18
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
6
0
0
7
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
4
0
0
3
0
14
1
0
0
0
18
1
7
17
25
0
2
0
1
10
0
0
0
0
0
0
0
0
1
0
2
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
0
4
0
0
7
Male
Total
Female
Male
Female
5 Years &
Above
Male
Male
0
1
25
26
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
13
0
0
16
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
0
0
0
0
3
0
0
0
0
3
Female
Under 5
Years
Total
Female
Male
1
23
202
226
1
0
1
51
3
0
0
1
0
0
0
0
0
1
1
1
60
6
5
3
2
0
0
0
0
0
0
0
0
0
0
2
7
1
0
4
30
0
0
0
0
3
0
0
0
0
1
3
0
7
7
4
0
25
0
0
0
0
0
3
4
0
0
0
0
0
0
0
0
7
0
0
3
0
94
4
3
0
0
104
Female
0
5
41
46
0
1
2
6
3
0
0
1
0
0
0
0
0
0
0
0
13
6
0
0
0
0
0
0
0
0
0
0
0
0
0
2
3
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
2
3
1
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
1
0
0
16
5 Years &
Above
Male
Total
Under 5
Years
Female
Male
Female
0
18
138
156
0
0
5
42
7
4
0
0
0
0
0
0
0
0
0
1
59
4
2
0
2
0
0
0
0
0
0
0
0
0
0
1
0
1
0
1
11
0
0
0
0
0
0
0
0
0
0
0
0
2
11
3
0
16
0
0
0
0
0
6
3
3
0
0
0
0
0
0
0
12
0
0
2
0
48
4
4
0
0
58
Male
0
9
72
81
0
0
4
26
4
1
0
0
0
0
0
1
0
0
0
5
41
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
2
10
0
0
12
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
15
6
4
0
0
25
Female
Male
Female
Female
Male
0
2
4
6
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
1
0
0
4
Total
5 Years &
Above
Male
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
0
4
3
7
0
0
0
2
1
0
0
0
0
0
0
1
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
3
PF Imported
Under 5
Years
Female
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
5 Years &
Above
Male
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
PF Indigenous
Under 5
Years
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
0
12
40
52
0
2
0
0
11
1
0
0
0
0
0
1
0
2
0
1
18
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
6
0
0
8
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
4
0
0
3
0
14
1
3
0
0
21
274
Male
Female
Male
1
2720
6713
9434
6
2319
6976
9301
73
3302
24790
28165
63
4055
32507
36625
74
6022
31503
37599
69
6376
39483
45928
1
2720
6713
9434
6
2319
6976
9301
73
3302
24790
28165
63
4055
32507
36625
74
6022
31503
37599
69
6376
39483
45928
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
0
6
10
123
18
21
15
2
0
20
0
0
0
2
45
15
277
1290
551
18
3
0
0
1
13
0
0
0
0
0
8
37
107
32
0
19
2079
0
0
0
0
0
0
0
0
0
0
7
0
113
20
56
0
196
0
4
0
9
1009
586
1832
2002
1
0
0
0
0
0
0
5443
0
0
1
6
1358
14
60
0
0
1439
0
8
15
154
96
30
9
0
0
0
0
0
0
3
42
10
367
1311
54
28
3
1
0
6
14
0
0
0
0
0
10
29
88
50
0
7
1601
0
0
0
0
0
0
0
0
0
0
11
0
108
28
108
0
255
0
3
0
12
853
619
1951
2151
0
0
0
0
0
0
0
5589
0
0
0
1
1450
14
24
0
0
1489
0
16
148
1484
617
1033
69
12
0
21
0
0
0
75
1183
1516
6174
4591
1023
799
64
0
0
68
121
0
0
0
2
0
11
220
1035
1850
0
117
9901
283
0
9
0
0
0
0
0
0
0
42
24
1565
1485
1165
13
4586
0
15
0
13
1606
740
2464
1315
1
0
0
0
0
0
0
6154
0
5
7
0
1252
68
18
0
0
1350
1
33
184
2144
3905
1143
75
7
0
41
0
2
0
121
1054
1598
10308
6257
1517
1278
65
0
0
53
122
0
0
0
3
0
28
201
1268
2712
0
156
13660
314
0
2
4
0
0
0
0
0
0
104
66
1660
1695
1384
23
5252
0
16
0
23
1554
791
2375
1211
9
0
0
0
0
0
0
5979
0
9
36
1
1252
80
48
0
0
1426
0
22
158
1607
635
1054
84
14
0
41
0
0
0
77
1228
1531
6451
5881
1574
817
67
0
0
69
134
0
0
0
2
0
19
257
1142
1882
0
136
11980
283
0
9
0
0
0
0
0
0
0
49
24
1678
1505
1221
13
4782
0
19
0
22
2615
1326
4296
3317
2
0
0
0
0
0
0
11597
0
5
8
6
2610
82
78
0
0
2789
1
41
199
2298
4001
1173
84
7
0
41
0
2
0
124
1096
1608
10675
7568
1571
1306
68
1
0
59
136
0
0
0
3
0
38
230
1356
2762
0
163
15261
314
0
2
4
0
0
0
0
0
2
115
66
1768
1723
1492
23
5509
0
19
0
35
2407
1410
4326
3362
9
0
0
0
0
0
0
11568
0
9
36
2
2702
94
72
0
0
2915
0
6
10
123
18
21
15
2
0
20
0
0
0
2
45
15
277
1290
551
18
3
0
0
1
13
0
0
0
0
0
8
37
107
32
0
19
2079
0
0
0
0
0
0
0
0
0
0
7
0
113
20
56
0
196
0
4
0
9
1009
586
1832
2002
1
0
0
0
0
0
0
5443
0
0
1
6
1358
14
60
0
0
1439
0
8
15
154
96
30
9
0
0
0
0
0
0
3
42
10
367
1311
54
28
3
1
0
6
14
0
0
0
0
0
10
29
88
50
0
7
1601
0
0
0
0
0
0
0
0
0
0
11
0
108
28
108
0
255
0
3
0
12
853
619
1951
2151
0
0
0
0
0
0
0
5589
0
0
0
1
1450
14
24
0
0
1489
0
16
148
1484
617
1033
69
12
0
21
0
0
0
75
1183
1516
6174
4591
1023
799
64
0
0
68
121
0
0
0
2
0
11
220
1035
1850
0
117
9901
283
0
9
0
0
0
0
0
0
0
42
24
1565
1485
1165
13
4586
0
15
0
13
1606
740
2464
1315
1
0
0
0
0
0
0
6154
0
5
7
0
1252
68
18
0
0
1350
1
33
184
2144
3905
1143
75
7
0
41
0
2
0
121
1054
1598
10308
6257
1517
1278
65
0
0
53
122
0
0
0
3
0
28
201
1268
2712
0
156
13660
314
0
2
4
0
0
0
0
0
0
104
66
1660
1695
1384
23
5252
0
16
0
23
1554
791
2375
1211
9
0
0
0
0
0
0
5979
0
9
36
1
1252
80
48
0
0
1426
0
22
158
1607
635
1054
84
14
0
41
0
0
0
77
1228
1531
6451
5881
1574
817
67
0
0
69
134
0
0
0
2
0
19
257
1142
1882
0
136
11980
283
0
9
0
0
0
0
0
0
0
49
24
1678
1505
1221
13
4782
0
19
0
22
2615
1326
4296
3317
2
0
0
0
0
0
0
11597
0
5
8
6
2610
82
78
0
0
2789
1
41
199
2298
4001
1173
84
7
0
41
0
2
0
124
1096
1608
10675
7568
1571
1306
68
1
0
59
136
0
0
0
3
0
38
230
1356
2762
0
163
15261
314
0
2
4
0
0
0
0
0
2
115
66
1768
1723
1492
23
5509
0
19
0
35
2407
1410
4326
3362
9
0
0
0
0
0
0
11568
0
9
36
2
2702
94
72
0
0
2915
Male
Female
192
468
240
900
Male
Mountain
Hill
Terai
National Total
Female
Total
Female
67
68
69
70
71
72
73
74
75
5 Years & Above
Male
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
Under 5 Years
Total
Female
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
Total Treatment
5 Years & Above

Male
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Clinical Malaria
Under 5 Years
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
275
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
1
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
4
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
4
0
1
2
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
5
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
5
0
2
5
7
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
3
Death
0
0
7
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Male
Female
Male
Female
Confirmed PF
5 Years &
Above
Male
Female
Under 5
Years
Male
Female
Male
Female
Male
Male
0
2
6
8
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
4
Female
Suspected/Possible
Under 5
5 Years &
Total
Years
Above
Total
Female
Male
Female
5 Years &
Above
Male
Female
Male
Male
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
Confirmed Serious Malaria

Under 5
Years
Total
Female
Female
5 Years &
Above
Male
Received Reports
District Name
Suspected/Possible Malaria
Under 5
Years
Female
District Code
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
276
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
0.28
0.47
0.81
0.66
1.04
2.52
4.66
1.79
0.79
0.25
0.37
1.54
2.31
1.17
0.00
1.30
0.03
0.12
0.16
0.39
0.75
0.68
2.32
0.56
0.77
0.24
0.00
0.71
1.79
0.22
0.00
0.00
0.00
0.00
0.09
0.30
0.15
0.62
0.16
0.49
0.56
0.27
0.37
0.20
0.08
0.45
0.00
0.00
0.12
0.11
0.05
0.28
0.73
1.23
1.56
0.44
0.67
0.63
0.15
0.05
0.02
0.02
0.25
0.65
2.10
1.23
0.26
0.00
0.00
0.00
0.04
0.00
0.00
0.56
0.00
0.01
0.09
0.00
1.99
2.49
0.65
0.03
0.00
1.03
Male
0.24
1.94
2.60
2.39
0.42
0.44
0.43
2.59
1.18
0.59
0.72
0.60
0.00
3.05
0.01
0.09
0.21
0.16
0.04
0.11
0.20
0.46
0.09
0.01
0.03
0.09
0.00
0.36
0.23
1.63
5.85
4.10
0.04
1.16
4.19
5.94
5.69
3.01
2.25
0.65
0.00
1.62
25.00
7.86
17.87
15.71
100.00
16.67
70.59
40.98
22.37
45.45
0.00
66.67
0.00
0.00
75.00
29.57
39.80
37.64
100.00
100.00
41.18
51.80
46.05
27.27
0.00
100.00
0.00
8.14
3.51
4.51
0.00
0.00
0.00
4.26
6.58
9.09
0.00
0.00
100.00
83.86
89.51
88.30
100.00
100.00
100.00
99.34
92.11
90.91
100.00
100.00
25.00
29.57
26.27
26.98
0.00
50.00
58.82
29.51
44.74
18.18
50.00
33.33
75.00
62.29
66.75
65.79
100.00
50.00
41.18
74.10
53.95
81.82
50.00
66.67
83.33
11.11
88.89
16.67
83.33
4.08
0.00
1.78
0.37
0.90
1.49
1.89
0.98
1.30
2.52
0.00
0.11
0.00
0.64
3.39
4.79
3.97
17.49
7.66
2.84
0.42
0.01
0.00
3.10
1.95
0.00
10.00
0.00
14.29
25.00
30.43
35.82
17.35
7.53
5.56
6.45
0.00
0.00
0.00
0.00
0.00
80.00
10.00
90.00
30.00
70.00
85.71
25.00
26.09
51.55
30.61
7.53
79.63
14.52
0.00
0.00
4.35
4.76
12.24
1.08
12.96
17.74
100.00
100.00
95.65
97.31
105.10
98.92
87.04
82.26
28.57
50.00
47.83
33.54
50.00
38.71
16.67
32.26
71.43
50.00
52.17
68.53
67.35
61.29
83.33
67.74
0.34
0.12
0.00
0.53
0.00
0.02
0.01
0.04
0.11
0.13
0.23
0.07
0.20
0.00
0.00
0.02
0.02
0.00
100.00
66.67
0.00
0.00
100.00
100.00
0.00
0.00
100.00
100.00
0.00
0.03
0.00
0.00
2.07
5.08
0.61
0.00
0.88
1.24
1.00
0.39
0.45
0.36
3.02
0.00
0.06
0.07
0.04
0.00
0.04
0.07
0.03
0.01
0.01
0.00
0.13
0.29
0.79
3.93
8.46
0.00
0.52
4.24
2.64
0.00
0.03
0.01
0.00
25.64
21.28
14.29
2.56
6.38
4.76
100.00
93.62
95.24
46.15
40.43
42.86
56.41
59.57
57.14
68.00
37.02
100.00
100.00
100.00
0.00
71.43
8.00
14.90
0.00
0.00
0.00
100.00
0.00
92.00
134.99
100.00
100.00
100.00
0.00
100.00
16.00
54.63
50.00
33.33
33.33
0.00
33.33
84.00
95.26
50.00
66.67
66.67
100.00
66.67
0.00
1.00
1.73
1.02
1.40
1.20
1.31
4.11
0.00
1.48
0.00
2.21
0.00
0.00
0.87
1.63
1.89
2.99
2.56
0.00
0.00
0.01
0.01
0.03
0.10
0.15
0.20
0.18
0.00
0.09
0.00
0.01
0.00
0.00
0.02
0.11
0.40
0.37
0.07
0.00
0.00
0.00
0.01
0.47
0.48
5.40
4.21
5.92
1.17
2.28
0.00
0.15
0.00
1.66
12.17
6.03
22.55
25.26
0.04
0.00
0.00
100.00
100.00
78.95
62.77
25.00
46.99
0.00
0.00
0.00
0.00
7.45
3.21
1.20
100.00
100.00
100.00
100.00
92.55
96.79
98.80
0.00
33.33
20.00
5.26
34.04
44.87
20.48
100.00
66.67
80.00
94.74
65.96
55.13
79.52
2.17
0.00
0.01
0.00
0.00
1.98
0.11
7.89
3.70
29.25
22.22
8.90
2.42
20.06
0.00
0.01
0.27
0.01
1.77
0.60
1.30
0.00
0.00
0.72
0.07
0.16
0.03
8.69
0.51
0.99
0.00
0.00
2.64
0.00
12.82
21.28
9.52
0.00
24.00
12.19
0.00
0.00
0.00
0.00
100.00
0.00
0.00
0.00
0.00
100.00
100.00
0.00
86.67
83.78
100.00
0.00
13.98
0.00
0.00
0.00
0.00
0.00
18.75
5.26
3.09
0.00
0.00
0.00
0.00
0.00
0.00
0.00
6.10
0.00
0.00
6.76
0.00
15.91
6.70
6.12
0.00
0.00
12.99
7.06
Blood Slide Collection

Achievement (%)
Proportion of Malaria
Cases by Sex among
total +ve cases
Female
Above 5 Yrs
Proportion of Malaria cases

by Age among total positive
cases
Under 5 yrs
Proportion of imported
cases among total +ve
Proportion of PF
Clinical Malaria among

1000 population
Annual parisite
incidence among 1000
population
Slide positivity rate
Blood slide examination

rate
District Name
Received Report
District Code
Annex3.5:AnalysedDataMalaria
37.04
87.77
118.72
107.25
47.50
153.89
101.77
107.33
91.26
76.89
99.73
49.73
190.00
94.40
28.67
2.17
15.74
79.21
100.69
86.76
104.72
168.90
115.53
54.38
75.83
9.00
17.61
51.10
119.20
36.33
81.67
113.56
162.57
90.63
82.38
98.47
100.50
131.50
88.93
44.13
238.67
55.33
66.67
23.07
103.47
224.83
176.58
369.58
64.69
23.00
162.76
124.00
103.67
15.33
10.33
50.21
73.90
146.57
108.33
238.00
1.00
49.05
3.32
96.68
33.65
66.35
100.00
0.00
100.00
0.00
100.00
0.00
25.00
18.42
2.06
16.67
0.00
0.00
1.97
3.09
5.56
100.00
95.83
89.47
96.91
94.44
22.22
6.25
35.53
36.08
27.78
77.78
89.58
55.92
63.92
72.22
0.00
0.00
100.00
0.00
100.00
0.00
20.33
14.63
2.13
93.29
30.18
65.24
93.22
100.00
32.43
50.00
42.37
27.75
20.92
0.00
5.41
50.00
2.41
0.48
16.33
100.00
95.95
50.00
83.72
80.38
54.59
100.00
8.11
0.00
18.32
20.57
30.10
0.00
91.89
100.00
67.81
60.29
40.82
37.30
4.09
80.17
19.64
64.56
19.67
42.17
1.83
219.94
115.01
42.00
22.83
0.00
134.83
277
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
4
36
298
338
0
0
0
12
68
33
0
0
0
0
1
3
1
9
31
43
201
15
31
48
0
0
0
0
0
0
0
15
0
1
1
1
6
7
1
0
126
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
1
1
1
1
1
0
1
2
0
0
0
0
9
0
0
1
0
0
0
0
0
0
1
0
0
23
23
0
0
0
0
1
8
0
0
0
0
0
0
0
0
5
4
18
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
31
0
0
0
0
1
6
0
0
0
0
0
0
0
0
4
3
14
2
8
1
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
60
569
633
0
0
0
22
175
95
0
0
0
0
1
13
1
11
66
68
452
27
50
45
0
0
0
0
0
0
0
25
0
1
1
1
8
9
1
0
168
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
1
1
1
1
3
0
1
2
0
0
0
0
11
0
0
1
0
0
0
0
0
0
1
2
10
220
232
0
0
0
11
5
0
0
0
0
0
1
2
1
0
42
42
104
24
48
45
0
0
0
0
0
0
0
0
0
1
0
0
0
3
0
0
121
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
0
0
0
0
3
0
1
0
0
0
0
0
5
0
0
1
0
0
0
0
0
0
1
2
1
123
126
0
0
0
2
0
94
0
0
0
0
0
0
0
0
18
0
114
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
0
0
0
2
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
11
344
359
0
0
0
13
5
94
0
0
0
0
1
2
1
0
60
42
218
26
48
45
0
0
0
0
0
0
0
0
0
1
0
0
0
8
1
0
129
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
1
1
0
1
3
0
1
2
0
0
0
0
10
0
0
1
0
0
0
0
0
0
1
0
11
244
255
0
0
0
13
175
0
0
0
0
0
0
11
0
0
23
24
246
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
192
205
0
0
0
2
0
94
0
0
0
0
0
0
0
11
24
12
143
0
1
45
0
0
0
0
0
0
0
0
0
0
0
1
3
8
1
0
59
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
41
41
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
40
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
41
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24
477
501
0
0
0
15
175
94
0
0
0
0
0
11
0
11
47
36
389
1
50
45
0
0
0
0
0
0
0
0
0
0
0
1
3
8
1
0
109
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
Male
Female
No of Deaths
Total
Others
Total
Other
Sp
BM
RK 39
3
38
354
395
0
0
0
20
146
50
0
0
0
0
1
7
1
7
26
33
291
15
22
35
0
0
0
0
0
0
0
15
0
1
1
1
1
4
1
0
96
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
3
0
1
1
0
0
0
0
7
0
0
1
0
0
0
0
0
0
1
Total
1
22
161
184
0
0
0
2
27
31
0
0
0
0
0
6
0
4
31
28
129
8
18
9
0
0
0
0
0
0
0
10
0
0
0
0
1
4
0
0
50
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
0
1
0
1
0
0
0
1
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
Fungizone
No of Patients Treated
SAG/
Miltefosine
Diagnosis Method
>=5 Yrs
Male
<5 Yrs
Female
No of
Village/Tole
No of VDCs
4
26
223
253
0
0
0
11
45
32
0
0
0
0
1
4
1
7
24
36
161
13
22
23
0
0
0
0
0
0
0
6
0
1
1
1
6
7
1
0
81
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
1
1
1
1
1
0
1
2
0
0
0
0
9
0
0
1
0
0
0
0
0
0
1
Native Cases
No of Patients
Male
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Affected
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
Annex3.6:KalazarRawData
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
4
0
0
0
0
3
1
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
278
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
0
0
5
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
72
72
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
5
40
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
71
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
93
93
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
55
33
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
93
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
173
173
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
15
95
62
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
172
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
154
154
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
15
76
62
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
153
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
156
156
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
15
76
64
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
155
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
74
74
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
60
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
74
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Female
No of Deaths
Total
Others
Fungizone
SAG/
Miltefosine
Total
Other
Sp
BM
RK 39
Total
Male
Male
0
0
3
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
No of Patients Treated
>=5 Yrs
Female
<5 Yrs
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
85
85
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23
62
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
85
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Male
Foreigner Cases
Diagnosis Method
No of Patients
Female
District Name
Received Reports
District Code
Annex3.6:KalazarRawData
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
279
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Male
Female
Case Fatality
Deaths (%)
Fungizone
% Treated by
SAG
% of Patients by sex
Female
Under 5 yrs
Above 5 yrs
% of Patients by age
Male
Incidence of Kalaazar
/10000*
District Name
Received Report
District Code
Annex3.6:AnalysedDataKalaazar
2.4
0.69
0.75
0
0
9.49
8.53
100
100
90.51
91.47
25
36.67
32.34
32.7
75
63.33
67.66
67.3
0
18.33
42.88
40.28
0
21.67
33.74
32.39
0
0
0
0
0
0
1.04
0.94
0
0
0.7
0.63
0.26
1.72
1.24
0
1.14
14.74
100
98.86
85.26
9.09
16
41.05
90.91
84
58.95
59.09
100
0
9.09
0
98.95
0
0
0
0
2.04
1.79
0
1.71
1.05
0.44
0.96
0.99
1.06
0.34
0.75
0.58
0
0
0
0
13.64
10.29
7.08
14.81
20
2.22
100
100
100
100
86.36
89.71
92.92
85.19
80
97.78
0
46.15
0
36.36
54.55
47.06
32.52
37.04
40
20
100
53.85
100
63.64
45.45
52.94
67.48
62.96
60
80
0
84.62
0
0
34.85
35.29
54.42
0
18
0
0
0
0
100
36.36
17.65
31.64
0
2
100
0
0
0
0
0
0
0
0
0
0
0
0
0
1.31
0
0
0
0
0
0
0
0
0
0.88
0
0
0
100
40
60
0.12
0.13
0.02
0
0
0
75
11.11
0
100
100
100
25
88.89
100
0
0
0
12.5
55.56
0
100
100
100
87.5
44.44
100
0
0
0
0
0
0
0
0
100
37.5
88.89
100
0.4
13.1
86.9
32.74
67.26
5.36
35.12
100
100
0
0
100
100
100
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
100
100
100
100
0
100
0
100
0
100
0
100
0
100
0
0
0
0
0
100
100
0
100
0
0
0
100
100
0
50
100
50
0
0
0
0
100
36.36
63.64
27.27
100
100
100
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
280
District Code
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Smear Positive
New
District
F
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchok
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitawan
Central
Gorkha
Lamjung
Tanahun
Syangja
Kaski
Manang
Mustang
Mygadi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilbastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid-Westen
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far-Western
Relapse
M
4741 10259
14
17
16
43
16
37
230
450
188
444
146
320
9
33
3
20
13
33
12
30
14
8
11
14
13
28
36
104
79
217
113
261
913 2059
110
261
111
273
153
327
36
97
19
56
10
20
33
81
39
100
83
188
66
129
421
636
32
81
6
11
29
103
100
207
101
230
170
328
120
278
137
305
1776 3711
47
107
14
51
65
109
38
90
66
129
0
0
0
5
15
20
9
30
27
42
37
106
49
114
125
300
208
481
94
298
24
66
818 1948
50
81
46
77
36
60
31
70
166
329
155
332
108
241
58
123
20
50
19
29
0
1
14
17
17
9
3
6
0
5
723 1430
19
29
25
37
42
73
29
88
178
395
139
333
18
36
37
80
24
40
511 1111
582
2
0
2
20
18
12
1
0
2
1
4
4
0
3
1
5
75
12
5
17
3
3
0
10
6
22
16
66
3
1
5
11
5
11
8
30
234
7
5
11
7
10
0
0
0
4
1
5
6
28
26
8
3
121
5
11
5
2
35
15
10
1
0
3
2
1
1
0
1
92
1
5
3
4
23
18
2
2
2
60
1780
3
0
9
61
64
45
4
1
5
3
0
3
0
17
13
35
263
41
28
56
25
7
6
14
15
35
37
130
29
1
23
49
20
37
30
68
651
30
10
30
31
28
0
0
3
5
12
16
14
71
113
37
18
418
25
19
13
18
71
52
38
23
2
4
0
2
1
0
0
268
2
5
11
7
78
57
5
9
6
180
Failure
F
92
0
0
2
3
1
3
0
0
0
0
0
0
0
2
0
0
11
0
0
3
1
0
0
0
3
4
1
13
0
0
2
5
0
3
0
8
43
0
0
2
0
2
0
0
0
0
0
0
1
0
5
1
1
12
0
1
1
0
0
5
3
0
1
0
0
0
2
0
0
13
0
0
2
0
5
4
0
0
2
13
M
187
0
1
2
10
3
5
0
0
0
0
0
0
1
1
4
6
33
3
3
7
0
0
1
1
5
4
1
16
0
0
2
5
4
3
2
5
62
2
1
3
0
4
0
0
2
0
3
0
2
8
9
5
0
39
0
1
1
0
2
6
3
5
4
0
0
0
1
0
0
23
0
1
1
2
15
7
1
3
0
30
Smear
Negative
RAD
F
33
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
1
3
0
0
0
0
1
0
0
0
0
0
2
0
0
0
1
0
2
3
2
11
0
0
0
0
0
0
0
1
0
0
0
0
0
4
1
0
6
0
1
0
0
1
2
1
0
0
0
0
0
0
0
0
5
0
1
0
1
3
0
0
1
2
8
208 3402 6260

1
4
7
0
11
10
2
8
24
4
115
227
6
97
202
12
74
144
0
5
8
0
2
6
1
6
12
0
1
6
0
4
3
0
1
2
0
6
14
2
21
30
3
143
271
2
79
190
33
577 1156
6
130
290
5
355
605
5
211
344
1
29
73
0
8
17
2
5
23
3
17
36
1
19
44
2
50
91
1
29
41
15
198
331
1
8
20
0
0
2
2
13
36
2
82
105
4
185
275
6
166
281
8
98
185
10
103
186
74 1706 2985
3
7
22
2
12
25
4
19
42
1
25
43
0
26
51
0
0
0
0
2
1
4
2
4
1
2
11
1
14
25
1
12
44
0
35
61
5
93
171
15
110
191
4
36
111
1
16
42
42
411
844
2
19
38
0
15
35
0
27
33
0
22
65
2
121
191
15
131
179
7
55
72
4
55
100
1
4
33
1
20
33
0
0
1
0
4
14
1
12
7
0
1
1
1
4
3
34
490
805
0
1
6
4
2
19
3
7
21
1
17
26
8
84
185
6
72
135
0
8
39
1
15
26
2
12
13
25
218
470
Extra
Pulmonary
F
3362
4
12
16
127
204
165
17
7
12
18
6
8
4
23
31
23
677
26
25
44
26
19
22
31
45
143
102
622
21
5
35
43
43
38
60
97
1447
33
11
26
35
64
2
0
11
11
18
40
52
79
112
37
26
557
25
43
32
24
70
60
46
110
18
15
2
6
12
7
2
472
14
12
15
8
68
64
9
12
7
209
Proportion
Others
Total
4122
11
11
18
132
209
154
23
10
11
17
3
10
16
36
50
47
758
59
38
56
23
43
38
48
70
134
102
699
31
9
41
62
67
51
83
130
1784
41
20
34
56
74
0
0
14
14
28
47
61
115
134
66
54
758
18
55
29
28
103
64
58
122
18
17
1
12
16
4
0
545
12
18
13
13
93
62
21
27
18
277
326
1
0
2
11
7
10
0
0
1
0
2
0
0
2
1
0
37
3
0
13
1
0
2
2
5
7
10
80
0
0
5
2
5
2
3
10
150
1
0
10
0
12
0
0
0
1
0
2
0
1
7
0
3
37
4
2
1
1
7
16
19
10
1
0
0
2
1
0
0
64
2
4
3
0
21
4
0
4
0
38
610 12538 23426

0
25
39
1
39
66
3
46
95
10
507
894
16
515
944
31
411
711
2
32
70
0
12
37
1
34
63
2
32
58
0
30
14
1
24
30
0
23
59
1
87
191
8
255
566
1
221
542
77 2293 4379
7
281
667
3
496
955
11
441
806
4
96
223
2
50
125
3
39
93
9
93
192
8
117
243
19
309
473
9
224
320
105 1402 1932
2
64
164
0
12
23
9
89
216
8
244
438
5
339
605
2
392
708
6
292
592
43
387
747
255 5367 9522
5
95
210
0
42
109
10
133
232
0
105
221
20
180
306
0
2
0
0
2
6
3
29
50
3
27
64
0
60
111
6
96
220
7
143
259
2
326
672
15
472
958
4
177
525
6
73
187
81 1962 4130
8
103
172
4
119
191
0
102
136
3
80
184
17
400
715
24
384
672
30
242
449
20
234
397
3
44
111
2
57
86
0
4
3
0
27
45
2
45
37
0
11
11
0
7
9
113 1859 3218
1
37
50
8
49
92
5
72
127
7
59
144
32
382
806
15
301
615
6
37
108
9
71
155
1
49
80
84 1057 2177
S+ve/all New
Re Tx / S+ve
%
47
54
57
45
53
47
46
44
48
53
50
58
54
51
56
37
52
48
42
27
42
47
46
25
46
44
39
42
36
59
52
51
51
37
48
48
46
41
60
48
59
45
61
49
63
53
51
45
50
44
48
56
61
39
52
57
45
44
42
51
53
60
32
49
36
20
46
36
41
36
48
59
55
67
65
57
59
41
59
56
58
16
16
2
24
13
13
14
11
4
15
9
15
22
2
15
7
12
12
14
10
15
18
13
23
20
18
20
22
19
23
11
20
19
9
11
11
22
16
21
18
22
23
13
22
0
22
20
20
13
12
21
20
13
20
19
20
21
17
17
18
16
15
15
10
14
67
9
19
0
29
17
6
21
15
11
19
16
13
12
18
16
281
Dist Code
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
District
Treatment regimen
Male and Female together
All
treated
New
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchok
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitawan
Central
Gorkha
Lamjung
Tanahun
Syangja
Kaski
Manang
Mustang
Mygadi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilbastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid-Westen
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far-Western
I
32327
59
108
131
1322
1355
1038
95
50
95
93
61
50
86
262
733
700
6238
818
1358
1139
300
179
123
247
326
698
477
3075
194
30
260
595
903
1024
815
980
13541
259
139
316
279
440
4
8
47
78
164
292
365
916
1245
641
229
5422
242
262
199
237
959
832
561
509
142
126
11
74
76
25
16
4271
87
121
177
191
1004
815
132
206
122
2855
II
0-8years
3192
1570
6
1
2
2
18
2
96
22
93
51
88
34
5
4
1
2
9
4
4
2
3
0
9
0
1
2
28
5
23
75
47
21
433
227
65
72
43
58
93
37
32
9
14
7
9
12
38
10
34
14
86
35
69
16
298
147
35
2
2
3
44
10
79
19
39
18
59
22
51
34
160
36
1250
561
44
10
19
3
53
5
43
12
51
15
0
0
0
0
11
0
13
4
20
0
23
7
28
10
121
22
186
25
57
10
25
8
694
131
36
6
33
28
23
21
20
24
123
62
97
146
68
81
45
116
9
10
9
11
3
2
3
2
6
4
1
0
2
0
478
513
4
0
16
10
21
6
15
1
135
94
106
12
11
9
16
5
13
1
337
138
Cases
37089
66
112
151
1440
1499
1160
104
53
108
99
64
59
89
295
831
768
6898
955
1459
1269
341
200
144
295
374
819
562
3520
231
35
314
693
960
1105
900
1176
15352
313
161
374
334
506
4
8
58
95
184
322
403
1059
1456
708
262
6247
284
323
243
281
1144
1075
710
670
161
146
16
79
86
26
18
5262
91
147
204
207
1233
933
152
227
136
3330
M+F
15000
31
59
53
680
632
466
42
23
46
42
22
25
41
140
296
374
2972
371
384
480
133
75
30
114
139
271
195
1057
113
17
132
307
331
498
398
442
5487
154
65
174
128
195
0
5
35
39
69
143
163
425
689
392
90
2766
131
123
96
101
495
487
349
181
70
48
1
31
26
9
5
2153
48
62
115
117
573
472
54
117
64
1622
Smear Positive
Relapse Failure
M+F
2362
5
0
11
81
82
57
5
1
7
4
4
7
0
20
14
40
338
53
33
73
28
10
6
24
21
57
53
196
32
2
28
60
25
48
38
98
885
37
15
41
38
38
0
0
3
9
13
21
20
99
139
45
21
539
30
30
18
20
106
67
48
24
2
7
2
3
2
0
1
360
3
10
14
11
101
75
7
11
8
240
M+F
279
0
1
4
13
4
8
0
0
0
0
0
0
1
3
4
6
44
3
3
10
1
0
1
1
8
8
2
29
0
0
4
10
4
6
2
13
105
2
1
5
0
6
0
0
2
0
3
0
3
8
14
6
1
51
0
2
2
0
2
11
6
5
5
0
0
0
3
0
0
36
0
1
3
2
20
11
1
3
2
43
RAD
M+F
241
1
0
2
5
6
13
0
0
1
0
0
0
0
2
3
3
36
6
5
5
1
1
2
3
1
2
1
17
1
0
2
3
4
8
11
12
85
3
2
4
1
0
0
0
5
1
1
1
0
5
19
5
1
48
2
1
0
0
3
17
8
4
1
1
0
0
1
0
1
39
0
5
3
2
11
6
0
2
4
33
Smear
Negative
M+F
9662
11
21
32
342
299
218
13
8
18
7
7
3
20
51
414
269
1733
420
960
555
102
25
28
53
63
141
70
529
28
2
49
187
460
447
283
289
4691
29
37
61
68
77
0
3
6
13
39
56
96
264
301
147
58
1255
57
50
60
87
312
310
127
155
37
53
1
18
19
2
7
1295
7
21
28
43
269
207
47
41
25
688
Extra
Pulmonary
M+F
7484
15
23
34
259
413
319
40
17
23
35
9
18
20
59
81
70
1435
85
63
100
49
62
60
79
115
277
204
1321
52
14
76
105
110
89
143
227
3231
74
31
60
91
138
2
0
25
25
46
87
113
194
246
103
80
1315
43
98
61
52
173
124
104
232
36
32
3
18
28
11
2
1017
26
30
28
21
161
126
30
39
25
486
O'ther
Total
M+F
936
1
1
5
21
23
41
2
0
2
2
2
1
0
3
9
1
114
10
3
24
5
2
5
11
13
26
19
185
2
0
14
10
10
4
9
53
405
6
0
20
0
32
0
0
3
4
0
8
7
3
22
4
9
118
12
6
1
4
24
40
49
30
4
2
0
2
3
0
0
177
3
12
8
7
53
19
6
13
1
122
M+F
35964
64
105
141
1401
1459
1122
102
49
97
90
44
54
82
278
821
763
6672
948
1451
1247
319
175
132
285
360
782
544
3334
228
35
305
682
944
1100
884
1134
14889
305
151
365
326
486
2
8
79
91
171
316
402
998
1430
702
260
6092
275
310
238
264
1115
1056
691
631
155
143
7
72
82
22
16
5077
87
141
199
203
1188
916
145
226
129
3234
Case detection
per population
(100 T)
New S+
All
M+F
54
20
25
16
81
62
61
21
17
25
18
17
14
15
40
43
54
46
46
57
62
39
30
12
31
30
66
71
76
33
32
33
65
50
73
65
76
56
45
31
46
35
42
0
29
26
21
22
41
51
62
79
67
37
50
51
49
43
40
88
103
75
52
26
30
3
29
21
17
10
59
37
31
42
47
74
100
36
42
44
61
M+F
128
40
44
41
167
143
146
52
37
52
39
35
29
30
79
120
111
104
117
217
161
95
70
54
77
78
190
198
241
66
65
75
144
142
160
145
196
152
90
72
97
88
105
16
46
59
49
54
91
127
146
164
120
105
111
108
124
105
104
198
223
148
180
58
89
20
68
65
42
33
140
67
71
73
81
154
194
96
81
89
121
282
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
F
102
0
0
1
0
5
6
0
0
1
0
0
0
0
0
0
2
15
4
9
8
0
0
0
0
0
0
1
7
3
0
0
5
1
3
7
2
50
2
1
0
0
0
0
0
0
0
0
0
0
0
3
0
1
7
1
0
2
0
0
8
0
1
0
0
0
2
2
0
0
16
0
0
0
2
2
3
0
3
4
14
284 69
2
0
0
0
4
0
9 10
8
1
11
2
0
0
0
0
1
0
1
0
0
0
0
0
1
0
3
0
0
0
4
0
44 13
10
1
22
0
9
3
2
0
0
0
2
0
2
1
3
1
0
3
1
2
29
9
3
0
2
0
2
0
17
5
4
0
14
2
6
0
5
2
133 29
5
1
0
1
2
1
5
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
1
2
3
0
4
4
0
1
1
0
21 12
6
0
2
0
3
0
0
0
3
0
13
3
1
2
2
0
7
0
1
1
0
0
5
0
3
2
0
0
0
0
46
8
0
0
4
0
3
1
10
1
7
1
7
3
3
0
3
1
3
0
40
7
F
149
0
1
1
4
5
5
0
0
0
2
0
0
0
1
2
6
27
8
1
8
0
0
1
0
0
0
2
9
1
1
2
3
4
6
6
4
56
0
0
1
2
3
0
0
1
0
0
1
2
7
7
6
2
32
3
2
0
2
8
3
5
0
0
0
0
0
0
0
0
23
0
0
0
0
5
2
0
4
0
11
365 85
1
1
2
0
2
0
7
3
18
5
9
6
0
0
0
0
2
0
1
0
0
0
1
0
1
0
0
0
5
0
12
0
61 15
10
3
5
7
9
7
3
1
1
0
2
0
3
0
3
0
3
1
2
0
17
6
1
0
0
0
0
0
9
1
13
3
17
1
8
1
13
3
119 34
1
0
3
0
2
0
5
0
11
0
0
0
0
0
1
0
2
0
1
0
3
0
5
0
15
1
9
2
19
4
1
0
78
7
6
1
3
1
4
0
2
0
14
3
23
7
10
1
5
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
71 13
1
0
3
2
8
3
5
4
9
1
8
2
2
2
0
1
0
1
36 16
No result
Transferred out
Defaulted
Died
M
134
0
0
2
3
3
4
0
1
0
0
0
0
0
2
3
4
22
2
3
5
0
0
0
1
0
1
1
6
0
0
0
1
2
1
2
4
29
2
4
5
0
5
0
0
2
0
2
0
1
2
12
10
0
45
0
0
1
0
1
1
3
6
2
0
0
1
0
0
0
15
0
3
2
4
8
4
1
1
0
23
364 114 236

1
0
0
0
1
3
3
1
1
6
8
10
22
5
18
34
4
9
0
0
1
0
0
0
2
0
0
0
0
2
0
0
0
0
0
2
0
0
0
0
0
0
2
0
2
3
0
2
73
19
50
30
1
3
16
2
3
10
6
2
5
2
0
0
0
0
3
2
0
1
0
1
1
0
2
4
1
4
2
4
6
25
27
68
1
0
0
1
0
2
1
0
1
5
5
7
1
1
2
5
0
6
2
1
0
12
3
8
125
55 115
2
2
2
0
0
2
4
2
2
2
1
0
1
0
3
0
0
0
1
0
0
1
0
1
2
1
0
3
1
0
1
1
3
0
0
0
14
5
3
16
1
5
18
0
1
2
2
1
67
16
23
7
0
1
7
0
0
0
1
0
0
0
0
10
4
4
17
4
13
12
3
4
6
1
10
6
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
65
13
33
0
1
1
3
0
1
1
1
0
12
0
0
8
2
7
5
7
5
2
0
0
3
0
1
0
0
0
34
11
15
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
3
1
0
0
0
0
1
1
0
0
0
0
0
0
1
0
1
5
0
0
2
0
0
0
0
1
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
5
0
0
0
0
0
0
4
0
0
0
0
0
0
2
0
0
6
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
88%
74%
85%
81%
92%
86%
83%
97%
94%
86%
83%
100%
92%
94%
96%
95%
92%
89%
85%
85%
89%
93%
98%
79%
91%
93%
94%
88%
81%
92%
76%
96%
83%
90%
90%
91%
88%
87%
88%
86%
88%
90%
88%
0%
14%
84%
88%
91%
93%
94%
90%
89%
86%
90%
89%
81%
87%
87%
96%
90%
81%
88%
84%
74%
95%
100%
70%
79%
100%
100%
86%
92%
77%
79%
72%
90%
90%
85%
78%
86%
86%
90%
84%
85%
87%
93%
88%
86%
97%
94%
91%
86%
100%
92%
97%
98%
95%
94%
91%
88%
91%
92%
94%
98%
83%
93%
95%
94%
89%
84%
97%
84%
97%
89%
91%
93%
95%
89%
90%
93%
87%
89%
94%
88%
0%
14%
84%
88%
91%
93%
94%
90%
90%
86%
92%
90%
87%
89%
92%
96%
91%
85%
88%
86%
83%
98%
100%
96%
94%
100%
100%
89%
92%
83%
82%
81%
92%
92%
90%
86%
98%
90%
1%
0%
0%
3%
2%
1%
1%
0%
6%
0%
0%
0%
0%
0%
1%
1%
1%
1%
1%
1%
1%
0%
0%
0%
2%
1%
1%
2%
1%
0%
0%
0%
2%
1%
1%
1%
1%
1%
2%
6%
4%
0%
3%
0%
0%
5%
0%
3%
0%
2%
0%
3%
3%
0%
2%
0%
0%
1%
0%
0%
1%
2%
3%
3%
2%
0%
4%
6%
0%
0%
1%
0%
4%
3%
4%
2%
2%
1%
3%
0%
2%
3% 3% 2%
5% 11% 0%
6% 0% 8%
4% 4% 3%
2% 1% 2%
4% 4% 4%
3% 8% 2%
0% 0% 3%
0% 0% 0%
5% 5% 0%
9% 0% 6%
0% 0% 0%
3% 0% 5%
3% 0% 0%
1% 0% 0%
2% 1% 1%
4% 1% 0%
3% 3% 2%
4% 7% 1%
1% 5% 1%
3% 3% 1%
2% 3% 1%
2% 0% 0%
6% 6% 4%
3% 1% 1%
2% 1% 1%
1% 2% 2%
2% 1% 6%
2% 3% 9%
2% 1% 0%
4% 4% 8%
1% 1% 1%
4% 2% 4%
6% 1% 1%
4% 1% 1%
4% 1% 0%
4% 3% 2%
3% 3% 3%
1% 1% 3%
4% 0% 3%
2% 3% 3%
5% 1% 1%
7% 0% 1%
0% 0% 0%
0% 14% 0%
5% 3% 3%
5% 5% 2%
1% 4% 1%
3% 1% 3%
4% 0% 0%
5% 3% 2%
3% 3% 1%
6% 5% 0%
3% 2% 3%
4% 3% 1%
7% 6% 1%
4% 7% 0%
4% 0% 1%
4% 0% 0%
5% 3% 2%
5% 5% 4%
5% 4% 2%
2% 3% 5%
5% 8% 1%
0% 0% 0%
0% 0% 0%
0% 0% 0%
0% 0% 0%
0% 0% 0%
0% 0% 0%
4% 4% 2%
3% 0% 6%
4% 7% 1%
9% 4% 1%
4% 12% 0%
3% 2% 2%
2% 2% 3%
3% 6% 0%
5% 5% 1%
0% 2% 0%
3% 3% 2%
Defaulted Rate
4,369 9,273
8
6
14
27
26
38
221
444
144
407
146
290
10
25
4
11
11
26
11
18
18
7
12
22
10
23
52
102
81
208
114
269
882
1923
132
286
133
268
219
314
57
114
13
46
7
30
22
71
42
84
87
172
58
99
304
573
32
80
7
12
36
100
90
185
96
177
144
336
116
236
123
270
1718
3453
36
99
24
43
45
90
38
101
66
123
0
0
0
1
8
23
11
26
22
48
39
85
38
125
123
310
156
398
99
267
31
73
736
1812
33
76
37
63
32
57
33
60
157
265
134
259
90
197
54
133
11
47
13
27
0
2
6
13
11
15
7
8
3
2
621
1224
13
20
32
22
20
52
31
65
145
305
113
284
16
42
21
41
21
30
412
861
Ttranfered out Rate
M
10,670
10
32
50
479
476
357
26
12
31
22
7
25
25
107
220
294
2173
342
319
349
124
47
37
79
93
184
112
718
86
17
104
224
199
379
254
312
3979
111
52
105
113
143
0
6
28
30
54
92
132
347
446
315
78
2052
96
75
65
62
297
326
227
165
67
28
2
19
18
8
2
1457
22
36
66
96
344
313
50
49
33
1009
Failure
Completed
Cured
F
4,899
9
16
29
246
165
169
10
4
12
13
18
12
10
53
83
122
971
149
154
251
60
13
10
23
43
92
67
363
36
8
38
109
105
156
131
137
1945
42
26
49
41
71
1
1
9
12
23
41
42
136
174
110
37
815
38
40
37
35
172
159
101
57
11
14
0
8
15
7
3
697
14
34
25
38
156
130
18
30
26
471
Died Rate
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchok
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitawan
Central
Gorkha
Lamjung
Tanahun
Syangja
Kaski
Manang
Mustang
Mygadi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilbastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid-Westen
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far-Western
Failed Rate
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
District
Cure Rate
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Registered
District Code
New Smear Positive
Treatment Success
Rate
Annex3.7:TuberculosisTreatmentOutcomeReport
283
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolakha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
1409
0
4
7
119
96
86
0
3
1
0
0
0
1
10
39
39
405
73
56
64
15
7
4
3
6
9
2
1
2
0
6
5
54
51
33
43
434
9
11
11
11
37
1
4
11
6
3
8
14
53
61
24
6
270
1
11
18
8
19
17
25
9
10
11
0
5
2
1
3
140
7
2
22
12
72
32
4
5
4
160
1644
1
3
2
127
119
74
2
4
2
4
20
3
3
35
42
3
1
4
2
3
1
19
43
44
444
72
66
69
16
1
3
2
3
7
1
1
1
7
14
65
79
63
52
522
9
7
14
9
28
0
0
6
10
8
3
17
37
79
29
6
262
5
9
17
8
26
63
43
8
7
11
1
7
6
0
4
215
6
8
12
11
95
39
8
14
8
201
6
0
5
2
11
5
4
1
16
0
2
5
0
2
2
1
1
1
1
2
0
0
1
0
0
2
3
0
0
0
0
0
0
0
0
6
1
5
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
2
9
0
0
0
0
1
2
1
0
1
0
0
0
0
0
0
5
1
1
1
0
0
1
8
1
1
1
12
4
3
1
1
10
3150
1
7
9
253
221
163
2
7
4
4
0
3
2
29
91
86
882
150
122
133
32
8
7
5
9
16
3
1
3
1
13
19
119
134
96
97
968
20
18
25
20
69
1
4
17
16
12
11
32
91
145
54
13
548
6
20
37
16
47
84
72
17
18
22
1
12
8
1
7
368
14
10
35
23
180
75
14
20
13
384
1507
1
2
4
128
106
93
1
3
2
1
0
1
13
50
47
452
85
63
68
18
6
4
3
7
5
1
1
0
7
10
58
38
41
45
460
9
9
13
7
42
0
4
12
8
5
7
15
57
63
22
8
281
1
11
17
10
16
31
23
12
9
7
0
5
5
0
3
150
6
2
19
7
79
32
4
10
5
164
19
1
3
23
90
6
5
17
1
1
4
3
35
5
3
4
1
4
1
1
15
3
1
2
1
4
3
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
1
0
1
0
0
0
0
0
0
4
1
2
1
3
1
3
6
4
1
15
12
0
0
8
0
5
0
1
0
0
0
0
0
0
0
0
14
1
0
2
5
4
2
14
1639
1
2
4
134
112
114
1
3
2
1
0
0
1
13
54
50
492
91
66
72
18
6
4
3
7
5
1
0
1
0
7
10
59
38
48
46
482
12
9
14
7
48
0
4
12
8
5
7
16
57
67
22
8
296
1
11
25
11
23
31
25
12
10
7
0
5
5
0
3
169
7
2
21
12
92
41
8
10
7
200
1511
0
5
5
119
109
49
1
4
2
3
0
3
1
16
37
36
390
59
56
61
14
2
3
2
2
11
2
1
2
1
6
9
60
96
48
51
486
8
9
11
13
21
1
0
5
8
7
4
16
34
78
32
5
252
5
9
12
5
24
53
47
5
8
15
1
7
3
1
4
199
7
8
14
11
88
34
6
10
6
184
Female among new
Disability Grade 2
New Child
Positive
Smear Tested
Total child
Patients at the End of

this Fiscal Year
Total deduction
Other Deduction
Defaulter
Transferred Out
RFT
Total
Transferred In
Re-starter
Relapse
New Patients
District
Patients at end
previous year
Dist Code
Annex3.8:LeprosyStatisticsMBRawData
59
525
196
53
94
5
5
1
78
96
63
1
21
30
18
4
10
4
5
7
6
1
1
404
0
1
34
37
25
1
1
1
1
0
13
1
1
2
1
20
8
269
30
46
20
9
4
82
19
10
12
0
0
18
3
2
4
1
3
22
11
13
5
0
2
5
5
17
7
1
105
9
6
10
5
28
45
5
6
4
3
14
1
1
0
0
1
11
3
0
5
3
9
20
17
17
110
2
2
3
2
6
0
38
1
2
3
1
1
1
1
1
0
6
0
0
1
0
0
4
9
0
0
2
0
0
0
0
0
16
1
0
1
72
36
0
6
0
5
5
4
32
17
7
3
5
79
3
1
16
4
2
3
0
0
0
0
2
4
7
0
0
0
0
0
0
0
0
13
9
0
1
0
0
0
5
5
1
0
0
0
0
0
0
0
12
2
0
1
5
1
4
13
5
120
19
13
10
2
2
33
1
4
1
2
1
4
0
5
1
0
13
1
1
9
5
30
8
1
71
1
4
3
0
4
23
11
2
1
0
0
0
0
0
1
50
2
3
4
2
18
14
5
5
0
53
Source:LeprosyControlDivision
284
12
2
0
0
9
35
46
406
169
96
117
6
1
1
0
0
3
0
0
0
1
1
92
64
47
47
645
3
3
6
3
10
0
0
2
1
1
2
4
50
85
30
1
201
1
3
2
3
6
43
51
0
1
1
0
1
1
0
0
113
1
1
3
1
102
24
0
1
133
0
1
2
4
1
0
0
0
1
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
2
2
0
0
0
0
0
0
0
0
4
1
1
0
0
0
0
0
0
0
6
41
53
402
173
113
128
4
1
0
0
32
5
5
0
0
2
12
3
0
1
3
1
0
3
5
70
63
49
41
654
3
4
4
2
10
0
1
2
1
0
0
3
65
69
36
1
201
0
3
2
3
8
22
39
0
4
1
0
1
0
0
0
83
0
1
2
1
102
26
0
132
0
0
1
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
2
0
0
1
0
0
1
2
0
0
0
0
0
0
0
0
4
1
0
4
1
9
1
0
10
1513
0
4
0
100
127
78
0
1
1
0
1
0
0
6
41
55
414
176
113
129
4
1
0
0
0
3
1
0
0
0
3
5
70
64
49
41
659
3
4
4
2
12
0
1
2
1
0
0
3
65
69
36
1
203
0
3
3
3
8
24
41
0
4
1
0
1
0
0
0
88
0
1
3
1
116
28
0
0
0
149
699
1
0
3
32
63
32
0
0
0
1
0
0
0
5
12
19
168
79
37
53
3
1
1
0
0
1
0
0
0
0
0
0
53
34
23
29
314
3
1
4
1
2
0
0
0
0
1
2
1
15
46
20
0
96
1
1
0
2
3
29
26
0
0
0
0
0
1
0
0
63
1
0
2
0
43
11
0
0
1
58
Female among new
Disability Grade 2
New Child
Positive
Smear Tested
Total child
Patients at the End of

this Fiscal Year
Total deduction
1472
0
4
0
95
122
78
0
1
1
0
1
Other Deduction
2212
1
4
3
132
190
110
0
1
1
1
1
0
0
11
53
74
582
255
150
182
7
2
1
0
0
4
1
0
0
0
3
5
123
98
72
70
973
6
5
8
3
14
0
1
2
1
1
2
4
80
115
56
1
299
1
4
3
5
11
53
67
0
4
1
0
1
1
0
0
151
1
1
5
1
159
39
0
0
1
207
Defaulter
Transferred Out
Transferred In
Re-starter
Relapse
0
RFT
1498
1
4
3
97
130
78
0
1
1
1
Total
National Total
695
Taplejung
0
Panchthar
0
Ilam
0
Jhapa
33
Morang
60
Sunsari
32
Dhankuta
0
Terhathum
0
Sankhuwasabha
0
Bhojpur
0
Solukhumbu
1
Okhaldhunga
0
Khotang
0
Udayapur
2
Saptari
18
Siraha
26
Eastern
172
17 Dhanusha
85
18 Mahottari
53
19 Sarlahi
65
20 Sindhuli
1
21 Ramechhap
1
22 Dolakha
0
23 Sindhupalchowk
0
24 Kavre
0
25 Lalitpur
1
26 Bhaktapur
1
27 Kathmandu
0
28 Nuwakot
0
29 Rasuwa
0
30 Dhading
2
31 Makawanpur
4
32 Rautahat
31
33 Bara
32
34 Parsa
25
35 Chitwan
22
Central
323
36 Gorkha
3
37 Lamjung
2
38 Tanahu
2
39 Syangja
0
40 Kaski
4
41 Manang
42 Mustang
1
43 Myagdi
0
44 Parbat
0
45 Baglung
0
46 Gulmi
0
47 Palpa
0
48 Nawalparasi
30
49 Rupandehi
27
50 Kapilvastu
26
51 Arghakhanchi
0
Western
95
52 Pyuthan
0
53 Rolpa
1
54 Rukum
1
55 Salyan
2
56 Dang
4
57 Banke
8
58 Bardiya
14
59 Surkhet
0
60 Dailekh
3
61 Jajarkot
0
62 Dolpa
0
63 Jumla
0
64 Kalikot
0
65 Mugu
0
66 Humla
0
Mid Western
33
67 Bajura
0
68 Bajhang
0
69 Achham
2
70 Doti
0
71 Kailali
56
72 Kanchanpur
14
73 Dadeldhura
0
74 Baitadi
0
75 Darchula
0
Far Western
72
Source: Leprosy Control Division
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
New Patients
District
Patients at end
previous year
Dist Code
Annex3.8:LeprosyStatisticsPBRawData
87
384
110
15
3
11
6
55
98
65
8
19
10
0
3
2
488
1
1
35
59
38
0
1
1
22
13
5
8
1
7
8
234
25
53
14
0
2
0
2
2
41
24
12
5
2
1
6
0
3
12
6
156
70
32
22
2
1
3
0
2
9
7
0
44
1
5
7
95
0
0
4
0
9
56
0
0
0
0
0
0
0
0
0
2
3
0
0
0
0
0
6
2
0
0
0
0
0
0
0
0
8
1
0
9
0
10
10
25
13
21
198
3
1
1
1
5
0
0
0
4
15
11
0
41
0
0
0
0
2
15
21
0
0
0
0
0
0
0
0
38
1
1
1
0
40
11
0
1
8
1
55
0
2
0
14
0
0
0
0
0
38
2
0
0
0
0
1
41
0
0
3
0
0
0
0
0
4
1
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
5
0
0
7
285
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern
17 Dhanusha
18 Mahottari
19 Sarlahi
20 Sindhuli
21 Ramechhap
22 Dolakha
23 Sindhupalchowk
24 Kavre
25 Lalitpur
26 Bhaktapur
27 Kathmandu
28 Nuwakot
29 Rasuwa
30 Dhading
31 Makawanpur
32 Rautahat
33 Bara
34 Parsa
35 Chitwan
Central
36 Gorkha
37 Lamjung
38 Tanahu
39 Syangja
40 Kaski
41 Manang
42 Mustang
43 Myagdi
44 Parbat
45 Baglung
46 Gulmi
47 Palpa
48 Nawalparasi
49 Rupandehi
50 Kapilvastu
51 Arghakhanchi
Western
52 Pyuthan
53 Rolpa
54 Rukum
55 Salyan
56 Dang
57 Banke
58 Bardiya
59 Surkhet
60 Dailekh
61 Jajarkot
62 Dolpa
63 Jumla
64 Kalikot
65 Mugu
66 Humla
Mid Western
67 Bajura
68 Bajhang
69 Achham
70 Doti
71 Kailali
72 Kanchanpur
73 Dadeldhura
74 Baitadi
75 Darchula
Far Western
Source: Leprosy Control Division
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
1.12
0.13
0.29
0.15
2.67
2.45
1.98
0.10
0.38
0.16
0.21
0.00
0.00
0.00
0.80
1.14
1.31
1.32
2.98
2.42
2.41
0.65
0.08
0.16
0.05
0.07
0.24
0.04
0.00
0.03
0.19
0.20
0.32
2.36
2.08
1.81
1.71
1.19
0.35
0.48
0.53
0.32
0.82
0.00
0.00
0.59
0.60
0.28
0.14
0.66
1.27
1.88
1.01
0.28
0.85
0.24
0.48
0.84
0.43
0.57
2.24
2.01
0.23
0.30
0.75
0.28
0.75
0.56
0.00
0.82
0.90
0.54
0.45
0.55
0.48
2.55
1.33
0.53
0.50
0.62
1.25
0.79
0.06
0.21
0.24
1.80
1.69
1.05
0.05
0.30
0.11
0.17
0.00
0.16
0.04
0.60
0.72
0.80
0.87
1.71
1.39
1.48
0.50
0.12
0.16
0.05
0.04
0.29
0.07
0.01
0.06
0.19
0.15
0.19
1.70
1.89
1.17
1.38
0.82
0.32
0.48
0.40
0.38
0.50
0.80
0.00
0.37
0.43
0.25
0.17
0.54
0.72
1.42
0.89
0.20
0.64
0.24
0.40
0.53
0.28
0.48
1.73
1.56
0.14
0.30
0.93
0.28
0.66
0.32
0.19
0.82
0.72
0.62
0.40
0.58
0.44
1.69
0.95
0.40
0.36
0.48
0.91
52.32
50.00
42.86
40.00
56.70
47.79
48.68
100.00
80.00
66.67
80.00
0.00
0.00
0.00
67.86
55.13
48.89
52.24
29.88
40.74
37.10
72.73
50.00
75.00
100.00
100.00
70.00
0.00
0.00
100.00
100.00
87.50
93.33
41.40
55.24
57.27
52.53
44.73
75.00
70.00
70.00
75.00
73.68
0.00
0.00
75.00
90.91
88.89
60.00
80.95
42.53
48.17
49.15
85.71
56.59
83.33
75.00
89.47
72.73
81.25
59.43
45.74
100.00
87.50
91.67
100.00
87.50
85.71
0.00
100.00
65.55
85.71
88.89
80.00
91.67
48.22
61.90
100.00
100.00
88.89
60.18
5.19
0.00
0.00
0.00
5.36
11.65
9.21
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2.56
2.22
6.94
11.20
8.64
4.84
13.64
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.64
3.50
7.27
0.00
5.74
0.00
10.00
0.00
0.00
7.89
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.61
3.39
0.00
1.30
0.00
0.00
0.00
0.00
6.25
7.55
8.51
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
5.49
0.00
22.22
0.00
8.33
4.57
1.59
0.00
0.00
0.00
3.89
3.47
0.00
0.00
0.00
2.23
4.02
5.26
0.00
0.00
0.00
20.00
0.00
0.00
0.00
0.00
5.13
0.00
3.29
4.56
8.02
2.69
0.00
0.00
0.00
0.00
0.00
10.00
0.00
0.00
0.00
0.00
0.00
0.00
3.18
2.10
0.00
0.00
3.26
0.00
10.00
0.00
16.67
7.89
0.00
0.00
0.00
0.00
11.11
0.00
4.76
1.15
0.00
0.00
0.00
1.94
0.00
8.33
0.00
0.00
0.00
4.72
6.38
12.50
0.00
0.00
0.00
0.00
0.00
0.00
0.00
3.96
0.00
0.00
13.33
8.33
5.58
0.00
62.50
7.14
11.11
6.29
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.58
0.00
0.00
0.00
0.00
0.00
0.37
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.07
0.25
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.43
1.19
0.00
0.21
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
4.76
1.72
0.73
0.72
0.00
4.55
0.00
0.00
0.00
0.00
0.00
0.00
0.96
0.00
0.00
5.00
12.50
2.95
4.39
7.14
0.00
0.00
3.55
Female
proportion
among new
Defaulter
proportions
Regularity
proportions
G II proportion
among new
Child
proportions
among new
MB proportions
among New
Prevalence Rate
District
New Case
Detection Rate
District code
Annex3.8:LeprosyStatisticsAnalysedData
28.39
50.00
0.00
40.00
30.80
38.55
41.45
0.00
0.00
66.67
0.00
0.00
0.00
0.00
25.00
32.05
12.22
32.47
36.93
27.78
17.20
18.18
0.00
25.00
0.00
0.00
50.00
0.00
0.00
0.00
0.00
0.00
0.00
12.10
31.47
27.27
38.38
26.39
41.67
30.00
20.00
25.00
28.95
0.00
0.00
12.50
0.00
11.11
20.00
42.86
10.34
27.44
32.20
14.29
24.19
16.67
33.33
15.79
0.00
18.75
35.85
34.04
25.00
12.50
0.00
0.00
0.00
0.00
0.00
25.00
26.83
42.86
44.44
33.33
16.67
29.44
39.68
62.50
35.71
11.11
32.34
286
Annex3.9:HIV/AIDSRawData
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Male
Female
25+ years
29
522
821
508
994
900 10539 13495 12584 20318
914 11483
7399 13266 13352
1843 22544 21715 26358 34664
0
2
5
14
3
0
10
74
17
64
1
25
555
26
371
23
906
344
748
489
88
515
279
608
399
45
966
446
848
484
0
34
232
33
111
1
7
125
20
125
2
2
39
2
13
Female
3
7
66 647
90 661
159 1315
0
0
0
0
1
1
7
24
6
41
15
50
1
1
0
0
1
0
Male
1
67
92
160
0
0
0
3
3
9
0
0
0
Male
1
105
111
217
0
0
0
1
8
1
0
0
0
15-24 year
Children 0-14 years
7
380
377
764
0
0
2
10
24
15
0
0
0
25+ years
15-24 year
HIV Post Test Counseled (Persons)
Female
139
501
949
750 12935 20605
846 13488 13513
1735 26924 35067
2
14
3
11
17
64
14
28
372
74
774
495
40
608
399
55 1010
589
6
33
111
6
20
125
11
2
13
Children 0-14 years
Male
Female
25+ years
15-24 year
Female
Male
59
511
970 10747
909 11575
1938 22833
0
2
0
10
1
34
23
906
88
515
45 1000
0
34
1
7
2
2
Female
140
546 1162
750 13884 21664
846 14281 13792
1736 28711 36618
2
14
3
11
47
68
14
28
372
74
785
521
40
611
401
55 1066
543
6
33
111
6
22
157
11
2
13
Children 0-14 years
Male
Female
25+ years
15-24 year
Female
Male
38
545
995 11573
967 12542
2000 24660
0
2
0
10
1
34
23
916
88
522
60 1172
0
34
1
7
2
2
HIV Positive (persons)
HIV Tested (persons)
Male
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolakha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Children 0-14 years
District Code
HIV Pre Test Counseled (Persons)
71
17
16
66
17
15
66
113
17
15
1
13
6
195
87
1
21
0
0
0
2
64
5
3
246
6
0
16
30
4
2820
572
62
875
7
2
10
6
291
663
368
4387
128
6
12
8
9
253
36
24
56
12
11
11
18
19
40
30
105
12
11
35
60
8
2728
736
66
1259
18
11
26
18
332
447
350
5777
90
10
96
47
6
2354
506
65
1319
29
6
69
29
979
72
740
2800
76
14
1
13
6
180
87
1
21
16
0
0
2
62
5
3
224
6
0
16
28
4
2624
535
61
805
102
2
10
3
266
549
361
3936
101
6
12
8
9
253
36
24
56
12
11
11
18
19
40
30
105
12
11
35
62
8
2628
686
66
1202
154
11
26
8
311
401
350
4900
68
10
96
60
6
2348
470
64
1309
135
6
69
15
936
71
740
2320
70
14
0
2
1
13
10
0
1
0
0
0
0
0
0
1
44
0
0
0
0
0
15
3
0
11
0
0
0
0
0
4
1
33
0
0
0
4
0
35
11
0
1
0
2
0
0
0
1
2
24
0
0
0
7
2
126
51
1
10
0
2
0
0
4
16
11
249
4
1
0
3
3
57
29
1
7
0
0
0
2
2
2
7
129
5
0
1
13
6
180
98
1
21
0
0
0
2
62
5
3
196
3
0
8
28
4
2573
528
61
805
15
2
10
3
266
549
361
3883
71
5
55
55
8
2330
348
40
356
75
7
57
25
503
50
287
1586
71
19
20
62
8
2423
675
66
1209
30
11
26
8
311
400
350
4754
55
10
39
60
6
2179
470
64
1309
39
6
69
15
936
71
740
2249
61
13
14
3
3
54
100
609
20
7
12
26
58
2
0
4
3
31
33
35
12
114
22
28
407
4
10
14
24
42
75
52
41
59
0
5
498
98
469
748
751
9941
21
35
21
122
1759
6
3
6
5
205
158
94
592
892
584
123
4626
161
290
34
127
531
1425
502
121
140
2
15
33
549
11
58
31
454
32
929
53 1006
545 12136
15
65
14
89
12
39
26
145
57 1322
12
4
7
7
6
14
8
8
34
417
20
272
18
423
46
560
79 1260
49
723
35
237
438 5585
19
194
22
188
9
52
18
139
38
496
68 1472
32
457
16
178
16
139
3
3
5
16
210
42
141
297
1140
8534
187
664
169
383
406
7
8
7
3
2214
1403
154
244
1537
415
1067
8868
1127
1065
81
566
743
1247
1292
473
332
1
116
14
3
3
53
77
577
20
7
12
24
58
2
0
4
3
26
33
35
14
113
22
22
395
3
10
14
19
29
74
52
41
55
0
5
491
98
435
733
441
8935
21
35
21
120
1597
5
1
6
5
190
158
94
580
838
583
117
4371
157
248
34
125
488
1324
475
118
138
2
14
33
538
11
58
31
425
32
904
53
696
545 10814
15
64
14
82
12
39
26
135
57 1240
11
3
7
3
6
14
8
8
34
400
20
272
18
423
46
551
79 1183
49
720
35
220
437 5357
19
187
22
250
9
52
18
124
38
473
68 1408
32
488
16
177
16
133
3
3
5
14
206
42
141
292
1032
7932
187
638
169
307
402
7
0
7
3
1980
1403
150
235
1524
415
962
8389
1008
1276
81
503
591
1231
1430
469
324
1
92
10
0
0
3
12
81
3
1
2
3
14
0
0
1
2
2
2
2
1
17
6
1
57
1
1
0
2
4
8
2
5
1
0
0
9
0
0
7
4
72
0
0
0
4
8
0
0
0
0
5
0
5
6
6
5
0
39
1
0
1
0
1
8
0
1
2
0
0
0
0
0
7
5
53
3
0
1
1
13
1
0
0
0
3
1
1
1
9
0
1
35
0
1
1
1
3
11
2
1
0
0
0
18
2
1
53
66
489
14
6
10
7
77
0
0
1
2
13
11
45
10
81
36
11
324
3
4
3
0
5
64
22
25
5
0
0
4
1
0
23
39
251
8
7
9
6
54
0
0
1
1
6
10
20
9
57
27
8
223
5
3
2
0
3
40
14
17
3
0
0
14
3
3
53
75
539
20
7
12
24
58
0
0
4
3
23
33
30
11
111
22
22
380
3
8
14
19
30
74
52
41
55
0
5
491
98
433
733
440
8754
21
35
21
120
1593
3
1
6
5
196
158
84
572
803
583
115
4316
157
240
34
125
488
1324
475
118
136
2
14
173
538
19
58
55
424
172
904
430
688
4273 10517
417
64
1100
82
427
39
160
135
552
1239
9
3
0
3
0
14
3
8
726
400
662
272
71
385
151
544
924
1178
240
714
686
218
6128
5298
570
187
761
242
41
52
521
124
354
473
568
1406
980
488
277
179
310
130
0
3
78
14
206
42
141
292
1022
7745
187
638
169
307
403
7
1
7
3
1980
1403
144
202
1521
415
962
8349
1006
1225
81
503
591
1232
1429
468
330
1
92
2
3
0
331
10
8
151
52
144
34
4
51
4
458
50
82
40
3520
113
123
887
683
496
865
134
365
87
3753
4
4
12
266
15
15
31
23
46
50
17
24
13
234
70
117
43
7273
225
283
2208
2244
1662
1479
619
704
165
9589
0
3
0
305
9
8
146
52
143
29
11
55
28
481
52
82
34
3291
109
123
835
683
486
810
133
365
68
3612
4
4
12
266
15
15
31
23
46
50
17
24
13
234
45
117
31
7199
211
283
2325
2242
1618
1428
374
669
49
9199
0
0
0
24
1
0
7
3
21
3
4
3
0
42
0
0
0
14
0
1
1
0
15
2
0
1
0
20
1
0
0
21
0
0
3
2
6
2
0
2
0
15
0
0
0
131
5
1
48
40
97
21
14
19
0
245
0
0
0
87
3
0
27
30
62
7
7
8
2
146
0
3
0
304
9
8
146
52
143
29
4
49
0
440
52
82
34
3281
109
123
834
683
486
805
133
365
82
3620
32
74
32
4598
128
257
1102
712
840
657
162
462
66
4386
45
117
30
7150
211
271
2325
2242
1618
1424
374
669
107
9241
43
48
40
3465
154
61
880
1077
809
983
195
535
103
4797
41
48
27
3425
145
61
909
1077
802
892
185
530
99
4700
41
48
26
3413
145
73
909
1077
802
891
185
530
95
4707
287
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
234390
586111
342779
1163280
125060
13067
28214
28065
12255
20065
6388
6703
11324
7135
9473
5156
15391
7769
15044
9065
320174
29942
10783
28807
16577
8846
13960
22307
18204
0
13800
75407
15375
6089
19115
9948
84130
10179
0
12865
396334
12382
11211
10910
24717
26200
0
2098
6535
13398
18178
20260
25357
6744
0
5745
0
183735
7031
20510
7532
11010
7833
13465
10547
13646
10583
20090
1928
6592
2506
4834
3848
141955
8056
9053
15255
18221
7870
29375
7061
18929
7262
121082
877506
4924464
2909238
8711208
62602
100176
214021
230575
194440
100010
70890
50391
45570
75640
31059
42640
50249
44440
160250
150655
1623608
297720
8473
202890
97310
86989
82582
203254
165990
0
56650
1177590
92600
32800
167551
110491
84130
121310
0
223770
3212100
218129
93693
139370
204044
129650
0
24150
138538
86952
113796
118710
236790
192830
0
73790
0
1770442
48782
135360
67450
106070
288640
61230
101150
77597
103060
23940
5720
94410
54050
14449
20480
1202388
69100
84890
63050
76900
302675
114700
72700
66265
52390
902670
93456
486506
428079
1008041
6749
7540
22199
9425
140051
9761
9241
5125
7696
11191
13456
3545
16123
9975
6390
18595
297062
14276
7619
6521
9873
23875
10677
19621
59593
0
5299
9661
9602
2320
13468
21466
8144
15053
0
25946
263014
10065
7429
10671
22226
9257
0
1278
5034
7131
18326
26396
25000
27916
0
26720
0
197449
7420
16239
5206
9828
20387
18668
21495
7641
8717
5989
595
2602
2265
2303
450
129805
4439
15878
3531
14216
25767
25345
7440
20968
3127
120711
1090096
7112114
10270597
18472807
3892
180900
158530
379250
378820
258080
106860
88589
68033
130725
63395
98000
124630
85825
601752
644600
3371881
563550
356910
694600
83207
148730
119277
222448
266260
0
74050
450470
264000
88100
376166
190981
411535
306700
0
206410
4823394
160460
192141
105250
498815
156695
0
28250
412200
152622
182093
295340
444690
490925
0
162545
0
3282026
233095
136210
79332
133470
157350
367585
37600
186588
184260
109657
9910
117810
57090
16545
20386
1846888
103590
116260
122340
181370
4039840
212545
190700
126863
55110
5148618
377948
1320598
743543
2442089
72925
20530
39795
23413
17885
21141
9648
9756
22350
31355
19059
21421
39693
21343
43120
39004
452438
73412
31005
72861
52600
35175
33333
58532
32880
0
10040
59190
28235
5630
49560
20070
23016
49781
0
31619
666939
68467
25503
36014
59579
34364
0
1868
99004
25635
41663
81840
114435
51310
0
57233
0
696915
38035
36916
36089
28749
54125
74220
31700
12716
12237
25777
1930
94280
1855
11216
3365
463210
13270
31145
13312
21657
19591
29107
17780
9535
7190
162587
1770975
10203420
9458190
21432585
380370
159470
419948
679920
1055700
505100
100835
217558
176984
302079
57557
103750
208520
239030
593000
703668
5903489
768750
564946
922300
209485
143950
187300
372735
252492
0
219800
1356150
286400
84300
506994
162625
319695
309650
0
214500
6882072
310565
294120
205780
234314
328815
0
38060
432843
143941
349721
443530
635690
537466
0
246985
0
4201830
344400
154150
104860
225130
308850
569070
543300
174000
157910
124760
9555
81810
16265
35590
28645
2878295
148200
95600
112150
228140
346480
268810
200625
108890
58004
1566899
109073
279860
392530
781463
31900
8600
10150
37860
30040
13290
14610
8295
16290
700
400
4470
80
15280
25550
3731
221246
31962
5870
10485
8625
4100
12220
3250
34010
0
550
16100
4950
0
25140
21443
0
8935
0
6550
194190
10
1880
1200
16210
1000
0
0
3150
100
0
400
500
3507
0
25700
0
53657
1720
3970
9792
550
12400
115050
28850
13400
4885
6750
1075
6000
7552
280
7176
219450
15185
2300
10010
13700
4740
28010
3440
10090
5445
92920
1428
2985
7141
11554
100
20
33
44
107
189
56
27
351
19
6
20
0
39
130
58
1199
1340
31
163
135
55
89
173
114
0
91
250
10
13
166
308
14
23
0
60
3035
30
60
50
111
19
0
0
367
9
12
27
88
1073
0
52
0
1898
80
185
0
117
261
3124
316
119
97
0
0
540
11
50
0
4900
59
36
55
149
65
91
58
9
0
522
Implant
IUCD
Tetracyclin (250
mg)
Cetamol
Albendazole
Iron
Vitamin A
97230
380437
216816
694483
17897
10772
19510
16290
7320
14704
4670
4275
11472
18120
4244
5747
8729
7885
14580
27421
193636
13504
14268
8817
13577
14882
8483
25594
18071
0
4190
27288
16270
2401
18999
14397
8516
887
0
10389
220533
13187
5366
6072
1055
5621
0
803
10679
4671
5997
14921
16670
19805
0
6126
0
110973
19431
13712
10748
12898
16927
11124
9481
8932
7362
3667
505
2567
1805
6422
1229
126810
5987
4356
1420
5004
13432
3225
2433
3209
3465
42531
Cortim (120 mg)
132079
351986
229566
713631
17792
8642
22247
29788
8935
21702
4229
5743
47185
12793
4964
6065
6990
7204
12772
24757
241808
4930
11554
16713
14007
4629
9669
12649
16496
0
4841
37173
13852
1301
12999
10137
6206
13513
0
11846
202515
15349
6501
6347
17080
5786
0
734
10197
4762
7373
13874
7392
13562
0
7406
0
116363
18497
7795
7512
6005
7620
9096
7876
8074
5494
4379
1071
16358
2169
2256
3192
107394
6159
3724
1478
3780
15449
5841
3717
2547
2856
45551
ORS
Condom
633468
3362297
2554786
6550551
133140
80740
306889
154669
236080
177666
42430
26130
122230
110404
25964
28360
42526
30529
158318
233694
1909769
197075
59095
97395
80357
51447
35330
68977
120161
0
19050
147120
81610
50830
139089
82580
98409
97640
0
120778
1546943
94285
64812
38533
261728
99996
0
11975
231415
51581
49738
172249
199830
216612
0
34640
0
1527394
179950
116337
34800
46165
49140
155900
190200
86488
60563
18250
4970
42958
9782
30904
4321
1030728
40435
31702
21701
46425
161175
116300
71625
26404
19950
535717
Depo
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Stock at the End of Month of Asadh (July)
Pills
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
Annex3.10:LogisticManagementRawData
266
2397
1096
3759
0
41
0
48
185
63
54
12
118
0
13
37
0
10
100
42
723
2
1
2
47
54
2
25
101
0
47
260
0
6
93
784
0
33
0
45
1502
4
0
0
42
0
0
0
90
8
25
0
18
47
0
0
0
234
22
192
0
123
52
90
181
152
8
0
0
29
14
10
0
873
17
32
62
57
114
91
54
0
0
427
288
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
6
260
304
570
3
71
1
5
102
0
2
0
3
10
0
4
1
24
46
30
302
2
0
0
0
3
0
0
0
0
6
1
0
0
0
8
0
5
0
20
45
3
68
5
2
0
0
0
0
8
0
0
0
0
0
0
0
86
12
0
0
0
0
34
0
0
0
0
0
0
0
0
0
46
0
0
0
15
44
16
7
9
0
91
0
7
637
644
0
0
0
0
171
0
0
0
0
1
0
0
0
0
5
0
177
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
3
0
0
0
0
0
0
0
0
0
4
0
0
0
0
457
1
0
4
0
462
131094
95492
449414
676000
128364
29571
0
1221
3987
0
1903
0
1687
8392
0
141
0
4522
107788
106888
394464
10608
0
0
0
441
0
1043
0
0
4406
0
0
0
0
0
0
17955
0
17427
51880
829
9755
8910
5460
0
0
0
0
8574
0
0
0
0
0
0
0
33528
1653
0
0
0
0
43797
0
0
0
0
0
0
0
0
0
45450
0
0
0
8852
96270
43473
2083
0
0
150678
435
11347
12304
24086
0
0
0
0
582
0
0
0
435
0
0
0
0
175
5688
0
6880
0
0
0
0
0
0
0
0
0
2188
0
0
0
0
0
0
0
0
0
2188
0
0
0
8984
0
0
0
0
0
0
0
0
0
0
0
0
8984
0
0
0
0
0
648
0
0
0
0
0
0
0
0
0
648
0
0
0
0
2020
3366
0
0
0
5386
90648
406569
95610
592827
760
8395
0
4095
30
0
66450
0
38531
0
0
3455
0
42240
0
0
163956
57920
0
0
0
17881
0
39510
0
0
0
0
0
0
0
0
0
1400
0
0
116711
8068
141058
65795
21748
0
0
0
0
0
0
0
0
0
0
0
0
236669
5479
0
0
0
0
11000
0
0
0
0
0
0
11847
0
0
28326
0
0
0
26000
5675
15490
0
0
0
47165
42803
674894
138135
855832
0
0
0
0
52
0
0
0
42803
174469
0
157174
0
308881
1
0
683380
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4200
0
0
4200
0
34370
0
0
0
0
0
0
0
0
0
0
0
0
0
0
34370
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
133882
0
0
0
133882
1433241
4871843
2189426
8494510
0
148288
0
133386
2
0
270625
0
1386864
88230
0
20925
0
55000
54000
1213786
3371106
0
0
0
0
143221
0
46377
33360
0
0
66000
0
0
0
17000
0
3145
0
0
309103
16220
166554
0
593635
0
0
0
0
0
0
0
0
0
0
0
0
776409
266738
0
0
0
0
24000
0
2964195
0
0
0
0
0
0
0
3254933
0
0
0
21552
188835
572272
300
0
0
782959
Total Collection
of this month
Others
Medicine Sale
Income of this month

Registration
Fee
Total patients
partially exempted
this month
Total patients full

exempted this
month
Program
Implemented
Health Facilities
Meeting (CDP
Committee)
District Name
Received Reports
District Code
Annex3.10:CommunityDrugProgramRawData
1566692
5953306
2423171
9943169
760
156683
0
137481
84
0
337075
0
1468198
262699
0
181554
0
406121
54001
1213786
4218442
57920
0
0
0
161102
0
85887
33360
0
0
66000
0
0
0
17000
0
8745
0
0
430014
24288
341982
65795
615383
0
0
0
0
0
0
0
0
0
0
0
0
1047448
272217
0
0
0
0
35000
0
2964195
0
0
0
0
11847
0
0
3283259
0
0
0
47552
194510
721644
300
0
0
964006
289
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
51490
2128447
108562
2288499
0
22236
0
0
84
0
94008
0
32950
130999
0
690176
0
239026
5422
16975
1231876
2740
0
0
0
0
0
18540
0
0
0
5045
0
0
0
0
0
0
0
0
26325
7567
35945
0
121954
0
0
0
0
0
0
0
0
0
0
0
0
165466
145753
0
0
0
0
21000
0
635738
0
0
0
0
0
0
0
802491
0
0
0
0
6029
56312
0
0
0
62341
0
150661
225356
376017
0
0
0
15000
11
0
20000
0
0
76691
0
5785
0
15040
0
15600
148127
780
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
780
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
33015
0
0
0
0
0
0
0
33015
0
0
0
130
43304
150661
0
0
0
194095
1010101
6611203
1988489
9609793
247291
400716
0
133767
24
0
226743
0
703521
158246
0
278459
0
182258
37241
1256461
3624727
46496
0
0
0
0
0
59289
86088
0
75680
16969
0
0
0
2800
0
32800
0
945
321067
203964
406435
1580
1684736
0
0
0
0
47858
0
0
0
0
0
0
0
2344573
47063
0
0
0
0
39740
0
2742093
0
0
0
0
0
0
0
2828896
0
0
0
47515
64841
376174
2000
0
0
490530
1061591
8890311
2322407
12274309
247291
422952
0
148767
119
0
340751
0
736471
365936
0
974420
0
436324
42663
1289036
5004730
50016
0
0
0
0
0
77829
86088
0
75680
22014
0
0
0
2800
0
32800
0
945
348172
211531
442380
1580
1806690
0
0
0
0
47858
0
0
0
0
0
0
0
2510039
192816
0
0
0
0
60740
0
3410846
0
0
0
0
0
0
0
3664402
0
0
0
47645
114174
583147
2000
0
0
746966
25150287
81398676
44807295
151356258
16813029
6082907
0
5918703
0
0
6225685
0
8175423
4131415
0
5931836
0
119704
1216967
35036800
89652469
81508
0
1382306
0
210000
0
74607
1295773
0
17752366
0
0
0
0
210070
0
546894
0
0
21553524
942082
8793482
1124946
4563357
0
0
0
0
1621167
0
0
0
0
0
0
0
17045034
5195565
0
0
0
0
196271
0
16734430
0
0
0
0
87228
0
0
22213494
0
0
0
436372
364952
62894
27519
0
0
891737
54857398
61701160
25424433
141982991
48737933
4950422
0
2499303
6
0
6586522
0
6009353
2883179
0
1632745
0
63040
1087621
21433002
95883126
89732
0
0
0
63000
0
97120
1168283
0
1801138
0
0
0
0
3232
0
47024
0
0
3269529
817548
8185016
0
4651100
0
0
0
0
2030962
0
0
0
0
0
0
0
15684626
5105514
0
0
2705
0
70910
0
21470278
0
0
0
0
12992
0
0
26662399
0
0
0
280159
164384
32451
6317
0
0
483311
447901
17275471
4812212
22535584
132680
1649413
0
88779
0
0
470821
0
235635
1880978
0
1075373
0
39251
1050640
3512321
10135891
119377
0
0
0
0
0
17807
53481
0
1128272
0
0
0
0
26750
0
25850
0
0
1371537
132850
3004603
0
2691251
0
0
0
0
150490
0
0
0
0
0
0
0
5979194
782919
0
0
0
0
0
0
3824265
0
0
0
0
61779
0
0
4668963
0
0
0
364554
3000
12245
200
0
0
379999
Total balance
Total Balance at
Cash box at the of
this month
Total Balance at
the end of this
month (bank)
Total Balance at
the end of last
month
Total
Expenditure of
this month
Exempted
Health Facility
Conduction
expenditure
Expenditure of this month

Medicine
District Name
Received Reports
District Code
Annex3.10:CommunityDrugProgramRawData
80455587
160375309
75043940
315874836
65683643
12682742
0
8506785
6
0
13283028
0
14420411
8895572
0
8639954
0
221995
3355228
59982123
195671487
290617
0
1382306
0
273000
0
189534
2517537
0
20681776
0
0
0
0
240052
0
619768
0
0
26194590
1892480
19983101
1124946
11905708
0
0
0
0
3802619
0
0
0
0
0
0
0
38708854
11083998
0
0
2705
0
267181
0
42028973
0
0
0
0
161999
0
0
53544856
0
0
0
1081085
532336
107590
34036
0
0
1755047
290
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
20
516
160
696
6
3
1
2
0
0
0
0
0
0
1
251
0
0
0
0
264
0
0
1
0
0
7
2
0
0
18
30
7
0
15
0
0
0
0
7
87
3
0
6
0
0
0
0
0
3
0
26
0
0
0
0
0
38
0
1
0
41
0
5
0
0
6
0
0
0
2
0
0
55
2
0
39
10
145
0
27
29
0
252
8
814
165
987
0
0
2
4
0
0
0
0
0
0
0
249
0
0
0
0
255
0
0
0
0
0
2
0
0
0
191
268
0
0
3
0
0
0
0
99
563
0
0
0
0
0
0
6
0
0
0
29
0
0
0
0
0
35
0
0
0
42
0
1
0
0
0
0
0
0
0
0
0
43
0
0
0
0
61
0
0
30
0
91
30
946
857
1833
0
0
57
20
0
0
0
0
0
0
27
88
0
0
0
0
192
0
0
0
0
0
0
0
0
0
220
525
0
0
2
0
0
0
0
104
851
0
0
0
0
0
0
3
0
0
0
26
0
0
0
0
0
29
0
0
0
0
0
733
0
0
0
0
0
0
0
0
0
733
0
0
0
0
0
0
0
28
0
28
6
3464
558
4028
5
0
4
1
0
7
0
0
0
0
1
309
0
0
0
0
327
0
0
0
0
0
0
0
0
0
6
3132
0
0
0
0
0
0
0
8
3146
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
542
0
0
10
0
0
0
0
0
0
552
0
0
0
0
0
0
2
1
0
3
2
10
5
17
0
0
0
0
0
5
0
0
0
0
0
3
0
0
0
0
8
0
0
0
0
0
0
0
0
0
1
6
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
21
0
21
0
0
0
0
0
0
0
0
0
0
0
21
0
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
69
21
90
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
38
26
0
0
0
0
0
0
0
15
79
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
6
16
813
2842
3671
0
0
25
2599
0
0
0
0
0
30
0
0
0
0
0
0
2654
0
0
0
0
0
0
0
21
0
1
12
0
0
0
0
0
0
0
1
35
391
0
0
0
0
0
1
0
0
0
0
0
61
0
0
0
453
0
0
0
0
0
39
0
0
111
0
15
0
0
0
0
165
0
0
222
0
0
142
0
0
0
364
8
141
30
179
0
0
2
0
0
0
0
0
0
2
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
80
0
0
0
0
0
0
13
93
37
0
0
0
0
8
0
0
0
0
0
0
6
0
0
0
51
0
0
0
0
0
4
0
0
4
0
0
0
0
0
0
8
0
0
16
0
0
7
0
0
0
23
2160
19539
12890
34589
268
601
209
2800
0
3789
125
0
13
243
160
580
181
142
0
0
9111
0
0
165
239
266
91
335
27
0
79
208
406
0
760
0
0
0
0
378
2954
678
0
985
1023
0
23
0
79
400
0
623
0
1078
0
0
0
4889
3228
608
0
1149
0
389
1743
0
930
554
159
67
132
58
14
9031
462
211
1605
1310
192
2356
1487
814
167
8604
127
1759
955
2841
13
32
13
138
0
358
3
0
0
13
12
59
3
20
0
0
664
0
0
0
16
12
2
23
2
0
2
25
21
0
119
0
0
0
0
33
255
51
0
92
188
0
0
0
5
13
0
52
0
80
0
0
0
481
252
57
0
125
0
40
216
0
50
30
6
2
6
4
0
788
25
19
119
201
30
60
66
118
15
653
2340
16652
7415
26407
332
1831
650
87
0
1285
86
0
14
297
134
23
29
196
0
0
4964
0
0
796
116
54
99
574
5
0
121
412
661
0
685
0
0
169
0
203
3895
607
0
1117
1850
0
2
8
15
375
0
1048
0
307
0
0
188
5517
934
316
0
239
0
908
1665
0
556
327
67
409
52
60
0
5533
404
0
1648
592
36
1959
729
945
185
6498
1
325
5
331
0
0
0
0
0
5
0
0
0
4
0
65
0
0
0
0
74
0
0
0
0
0
1
0
0
0
0
2
0
0
73
0
0
0
0
0
76
14
0
0
103
0
0
0
0
0
0
29
0
0
0
0
0
146
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
35
0
0
35
0
6
0
6
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Others
CSF Culture
Leptospira
Fungus
Widal Test
+ve
Sputum AFB
Total
ENT culture
Sputum
Culture
Pus Culture
Water Culture
Stool Culture
Body Fluid
Culture/US/AF
B
Urine Culture
Blood Culture
BACTERIOLOGY
Gram stain
District Name
Received Reports
District Code
Annex3.11:HealthLaboratoryServices
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
116
95
221
0
0
4
15
0
0
0
0
0
0
0
49
0
0
0
0
68
0
0
46
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
29
78
0
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
4
0
40
0
0
0
0
5
0
0
2
10
0
0
0
0
57
0
0
7
0
0
0
7
0
0
14
291
0
3
84 140
5 21
89 164
0
0
0
0
3 91
5
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8 96
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
14
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 16
16 23
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
3
0
0
0
0
65 39
0
0
0
0
0
0
0
0
0
0
0
0
65 39
0
105
0
105
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
24
80
0
1
0
0
0
0
0
105
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
48
336
2
386
0
0
326
0
0
0
0
0
0
0
28
0
0
0
0
0
354
0
0
0
0
0
16
4
0
0
0
4
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
6
0
0
0
0
0
0
6
0
14
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
1
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
8
10
52
6
68
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
1
0
0
1
0
0
0
0
6
18
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
Others
24 Hrs Urinary
Protein
Creatinine
Clearance
S.
troponin-I
24 hours urinary
Uric Acid
0 55
79 97
0
0
79 152
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 55
0
0
0
0
0
0
0
0
0
0
0 55
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
72 97
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
79 97
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
CPK
0
239
46
285
0
0
16
5
0
2
0
0
0
0
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
10
158
0
0
21
0
0
0
0
39
228
2
0
0
0
0
0
0
0
0
0
22
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
0
10
CPK MB
0
36
0
36
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
31
0
0
0
0
0
0
0
0
34
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
GGT
Calcium
1514
57 154 30
10685 893 3204 224
5055 159 1173 60
17254 1109 4531 314
859
0
2
0
201
0
33
0
1864
47 108 24
1615
28 300
0
0
0
0
0
242
12
25
0
12
0
14
0
0
0
0
0
31
0
0
0
124
7
16
2
375
29 130 26
694
27
46
0
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6036 150 674 52
0
0
0
0
0
0
0
0
161
7
16
0
39
0
0
0
112
0
0
0
91
20
10
0
107
8
12
4
1
0
0
0
0
0
0
0
444
61
93
1
1395 484 2773 138
674
80
0
0
0
0
0
0
358
16
36 14
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
1204
56 297 60
4600 732 3237 217
149
3
6 24
0
0
0
0
405
6
14
0
489 106
10
0
0
0
0
0
17
0
0
0
14
0
0
0
15
0
5
0
154
0
0
0
227
0
0
0
691
19
0
4
0
0
0
0
57
0
0
0
0
0
0
0
0
0
0
0
24
0
0
0
2242 134
35 28
481
0
0
7
48
0
1
0
0
0
0
0
47
0
0
0
0
0
0
0
1413
33 405
0
17
0
0
0
0
0
0
0
394
14
0
0
8
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
2411
47 406
7
6
0
0
0
11
0
0
0
986
0
0
0
51
1
1
0
34
0
0
0
298
23 130
0
401
0
42
0
178
22
6 10
0
0
0
0
1965
46 179 10
Phosp horus
LDH
1461
7832
4157
13450
550
219
743
431
0
161
24
0
52
190
215
161
38
0
0
0
2784
0
0
92
60
85
139
224
3
0
219
635
570
0
656
0
0
19
0
482
3184
272
0
222
805
0
38
11
14
283
165
625
0
202
0
0
40
2677
324
69
0
70
0
2303
216
0
260
67
13
2
26
0
0
3350
25
45
306
111
23
228
266
330
121
1455
Acid Phosphatese
134
1109
1179
2422
0
32
129
288
0
30
10
0
0
27
89
61
0
0
0
0
666
0
0
5
0
0
29
15
0
0
82
612
0
0
11
0
0
0
0
450
1204
6
0
13
0
0
0
1
2
0
0
16
0
26
0
0
0
64
0
0
0
0
0
380
0
0
0
0
0
0
0
0
0
380
0
0
107
0
0
0
1
0
0
108
SGOT
135
2209
1090
3434
0
34
19
278
0
30
0
0
0
19
81
35
0
0
0
0
496
0
0
0
0
0
14
40
0
0
98
870
0
0
7
0
0
0
0
429
1458
19
0
10
220
0
0
0
5
0
0
24
0
0
0
0
0
278
0
18
0
0
0
222
0
0
0
0
0
0
0
0
0
240
0
0
805
1
0
131
25
0
0
962
Cholesterol
2846
15652
3558
22056
1622
1933
909
508
0
449
114
0
52
168
324
658
65
57
0
0
6859
0
0
150
109
49
136
304
14
0
159
1148
885
0
416
0
0
36
0
386
3792
525
0
986
1281
0
28
16
18
167
210
765
0
342
0
0
144
4482
1231
126
0
122
0
515
595
0
473
209
15
44
39
18
0
3387
170
33
1818
385
51
526
236
272
45
3536
Ceatinine
Uric Acid
155 158 195

4273 753 622
515 380 482
4943 1291 1299
0
28
37
4
32
21
504
5
19
100 205 202
0
0
0
2
23
83
0
2
2
0
0
0
0
0
0
0
36
35
38
70 109
0
21
18
0
11
8
0
0
0
0
0
0
0
0
0
648 433 534
0
0
0
0
0
0
16
10
5
0
0
0
0
0
0
103
48
32
13
2
0
0
0
0
0
0
0
298
4
19
1113 270 279
0
0
0
0
0
0
84
1
13
0
0
0
0
0
0
0
0
0
0
0
0
361
72
72
1988 407 420
897
11
3
0
0
0
4
4
11
158
27
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
185
5
37
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1245
47
53
0
0
0
0 177
15
0
0
0
0
0
0
0
0
0
0
32
18
0
32 102
0
0
0
0
60
20
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1 301 155
0
10
17
0
0
0
958
81 120
0
1
0
0
0
0
36
6
0
67
5
0
0
0
0
0
0
0
1061 103 137
Alk. Phosphatase
Albumin
Total Protein
1
426
347
774
1
0
110
47
0
0
0
0
0
1
0
16
0
0
0
0
175
0
0
0
0
0
0
0
0
0
34
167
0
0
38
0
0
0
0
253
492
2
0
2
26
0
0
0
0
0
0
18
0
0
0
0
0
48
0
0
0
0
0
47
0
0
0
0
0
0
0
0
0
47
0
0
0
0
0
0
12
0
0
12
NA K+
956
9231
7298
17485
222
150
2326
1478
0
180
9
0
39
128
414
40
40
2
0
0
5028
0
0
141
32
171
112
76
0
0
415
1002
684
0
377
0
0
2
0
1809
4821
66
0
344
616
0
29
10
15
152
271
299
0
53
0
68
21
1944
283
46
0
47
0
3291
20
0
355
3
0
0
16
0
0
4061
4
1
896
67
20
236
128
246
33
1631
GPT
67
68
69
70
71
72
73
74
75
3994
29764
14867
48625
1549
1194
4095
2250
0
1559
76
0
144
364
899
790
69
70
0
0
13059
0
0
929
76
333
332
652
33
0
1687
3878
1197
0
1941
0
0
31
0
3016
14105
666
0
1334
2375
0
83
44
33
473
1180
2433
0
777
0
65
88
9551
1364
225
0
174
0
5418
439
0
639
85
12
5
44
2
0
8407
46
43
1285
245
18
365
806
556
139
3503
Bilirubin T&D
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Amylase
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Urea
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
District Name
BIOCHEMISTRY
Sugar
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Received Reports
District Code
0
77
3
80
0
0
8
0
0
0
14
0
0
0
0
4
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
14
0
0
36
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
3
0
0
0
3
292
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
District Name
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Received
Reports
District
Code
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Virology
HIV
Total
638
11506
5360
17504
86
188
930
908
0
2527
34
0
0
28
150
480
5
76
0
0
5412
0
0
193
370
3
57
111
3
0
148
409
315
0
102
0
0
14
0
296
2021
165
0
452
81
0
32
0
6
25
29
168
0
41
0
0
0
999
402
156
0
528
0
691
281
0
558
29
11
1
48
0
0
2705
95
39
3831
464
4
405
342
1179
8
6367
Western Bloot
HCV
+Ve
5
275
28
308
1
1
0
1
0
2
2
0
0
0
0
0
0
0
0
0
7
0
0
5
0
0
1
0
1
0
0
5
8
0
0
0
0
0
0
0
20
10
0
20
14
0
0
0
2
5
1
6
0
3
0
0
0
61
0
0
0
2
0
12
1
0
9
0
0
0
1
0
0
25
2
0
110
52
3
1
3
24
0
195
Total
76
1335
155
1566
24
6
115
71
0
18
0
0
0
0
0
141
3
0
0
0
378
0
0
0
0
0
39
6
0
0
22
113
43
0
30
0
0
0
0
66
319
4
0
6
13
0
0
0
0
0
6
49
0
0
0
0
5
83
384
0
0
0
0
0
0
0
48
0
0
0
0
0
0
432
7
0
124
5
0
0
211
7
0
354
+Ve
Total
6
10
0
16
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
4
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
3
18
106
6
130
0
0
102
1
0
0
0
0
0
0
1
0
0
0
0
0
104
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
1
0
0
1
0
0
0
0
3
0
5
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
HBsAg
+Ve
Total
10
3
1
14
0
0
0
1
0
0
0
0
4
0
0
0
0
0
0
0
5
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
2
428
6022
2942
9392
94
81
838
441
0
92
9
0
1
112
136
296
5
0
0
0
2105
0
0
57
0
0
68
70
12
0
144
422
266
0
68
0
0
18
0
534
1659
32
0
27
508
0
5
0
3
0
78
83
0
253
0
0
4
993
407
90
0
4
0
780
58
0
546
5
2
0
16
1
0
1909
21
2
1431
13
76
633
362
176
12
2726
HEV
+Ve
4
170
24
198
3
0
0
1
0
0
0
0
0
0
1
1
1
0
0
0
7
0
0
4
0
0
0
0
0
0
4
18
10
0
4
0
0
0
0
1
41
1
0
1
71
0
0
0
1
0
0
4
0
0
0
0
0
78
0
0
0
2
0
11
5
0
11
0
0
0
0
0
0
29
0
0
36
0
1
1
5
0
0
43
Total
6
19
0
25
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
5
0
0
0
6
2
0
2
0
0
0
0
0
15
0
0
0
5
0
0
0
0
0
0
4
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
CD4
count
+Ve
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
674
161
835
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
111
0
0
0
0
0
0
0
0
0
111
0
0
412
262
0
0
0
0
0
674
Viral
Load
Others
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
62
51
113
0
0
3
0
0
0
0
0
0
0
0
48
0
0
0
0
51
0
0
0
0
0
0
0
0
0
7
1
3
0
0
0
0
0
0
8
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
3
0
0
0
0
0
40
0
0
0
40
293
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
192
468
240
900
12
12
12
12
12
12
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
191
153
6
159
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
32
121
0
0
0
0
0
0
0
6
159
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
201
7
208
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
185
0
0
0
0
0
0
0
7
208
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
688
663
1542
23
0
75
0
0
173
0
0
0
11
0
0
61
0
0
0
343
0
0
0
0
29
23
144
0
0
0
6
0
0
16
0
0
0
0
3
221
9
0
0
0
0
0
1
0
0
0
16
0
26
0
0
0
52
0
0
0
0
0
23
52
0
59
0
0
0
0
0
0
134
0
0
375
0
16
370
31
0
0
792
133
7
140
0
0
6
0
0
0
0
0
0
0
0
1
120
0
0
0
127
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
2
0
9
9
8
17
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
8
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Others
Cytokeratin
Vimention
S100
PR
ER
Other
GFAP
Immunohistochemistry
Bodyfluid
smear
Sputum
smear
Biopsy
District Name
Cytology
Pap smear
Histology
Received
Reports
District Code
0
0
6
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
6
13
0
0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
0
13
294
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
3163
14534
4863
22560
1203
824
451
439
0
1159
65
0
260
412
396
660
168
164
0
0
6201
0
0
379
394
378
216
461
17
0
387
707
280
0
922
0
0
30
0
746
4917
729
0
361
667
0
25
5
37
145
495
972
0
234
0
19
32
3721
446
696
0
31
0
475
753
0
746
122
33
144
105
4
12
3567
128
108
964
399
78
551
1313
550
63
4154
207
1186
662
2055
116
18
21
22
0
316
0
0
0
19
27
86
3
0
0
0
628
0
0
15
289
0
33
18
0
0
14
78
0
0
187
0
0
0
0
83
717
27
0
37
33
0
1
0
1
1
0
108
0
3
0
0
0
211
5
16
0
0
0
200
6
0
76
0
0
0
0
0
0
303
3
4
68
16
5
12
33
50
5
196
229
2334
1248
3811
0
0
0
610
0
5
0
0
0
0
221
0
0
0
0
0
836
0
0
496
93
0
0
0
0
0
0
89
0
0
0
0
0
0
0
7
685
0
0
0
9
0
0
0
0
98
1055
855
0
10
0
0
0
2027
0
0
0
0
0
120
0
0
0
0
0
0
0
0
0
120
8
0
0
0
0
0
0
135
0
143
9627
63929
23971
97527
2911
4573
4743
1479
0
5288
129
0
284
1222
2207
2543
412
346
0
0
26137
0
0
2573
356
851
299
1952
31
0
1179
3275
1028
0
2917
0
0
358
0
3606
18425
3521
0
2225
5412
0
91
32
138
824
1473
6079
0
1454
0
88
386
21723
2990
1514
0
628
0
3852
2165
0
2600
656
44
197
284
27
24
14981
598
244
4723
1673
484
2624
4346
1136
433
16261
9
1069
25
1103
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
5
0
0
0
285
0
0
0
1
0
0
84
0
0
9
0
0
0
0
20
399
0
0
0
0
0
0
0
0
0
0
77
0
0
0
0
0
77
5
0
0
0
0
0
0
0
0
0
0
9
0
0
0
14
0
0
608
0
0
0
0
0
0
608
11
1144
20
1175
7
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
285
0
4
0
1
0
0
168
0
0
78
0
0
0
0
20
556
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
608
0
0
0
0
0
0
608
0
1674
20
1694
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
285
0
0
0
1
0
0
168
0
0
0
0
0
0
0
20
474
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1214
0
0
0
6
0
0
1220
0
450
1
451
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
202
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
202
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
248
0
0
0
0
0
0
248
2
1369
37
1408
2
0
6
26
0
0
0
0
0
0
0
1
0
0
0
0
35
0
0
0
202
0
0
0
0
0
24
238
0
0
3
0
0
1
0
10
478
2
0
0
1
0
0
0
0
0
0
34
0
0
0
0
0
37
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
858
0
0
0
0
0
0
858
2
212
1
215
0
0
0
0
0
1
0
0
0
1
2
0
0
0
0
0
4
0
0
0
200
0
0
0
0
0
9
2
0
0
0
0
0
0
0
0
211
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
88
513
175
776
3
9
7
0
0
1
1
0
1
1
6
34
0
0
0
0
63
0
0
0
5
0
9
30
0
0
4
40
19
0
99
0
0
0
0
39
245
3
0
21
4
0
1
0
1
2
10
7
0
0
0
0
0
49
0
29
0
5
0
131
1
0
46
5
5
7
16
0
0
245
10
0
33
37
0
3
47
44
0
174
11
3
100
114
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
0
11
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
437
199
636
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
168
0
0
0
0
0
0
0
0
168
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
199
0
0
0
0
0
0
0
0
0
199
0
0
250
0
0
0
0
0
0
250
Others
Specific gravity
Bence John's
Protein
Semen
Analysis
Chyle
Acetone
Porpho
bilinogen
Urobili nogen
Bile Pigments
Bile salts
Urine test
Reducing
sugar
Occult blood
PARASITOLOGY
Stool Test
District Name
Received Reports
District Code
0
186
69
255
0
0
5
0
0
0
1
0
0
0
0
56
0
0
0
0
62
0
0
0
0
0
0
0
0
0
0
8
80
0
7
0
0
0
0
0
95
6
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
20
4
0
0
0
0
17
2
0
0
0
0
0
0
0
0
23
0
0
0
0
0
50
5
0
0
55
295
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhul
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192 3641
468 17493
240 5384
900 26518
12
657
12
466
12
507
12
715
12
0
12 1516
12
78
12
0
12
42
12
207
12
792
12
595
12
31
12
146
12
0
12
0
192 5752
12
0
12
0
12
171
12
70
12
433
12
357
12
430
12
58
12
0
12
364
12
403
12
335
12
0
12 1138
12
0
12
0
12
99
12
0
12
377
228 4235
12
592
12
0
12
678
12 1266
12
0
12
46
12
2
12
72
12
300
12
195
12
651
12
0
12
399
12
0
12
0
12
63
192 4264
12
957
12
469
12
0
12
184
12
0
12
695
12
627
12
0
12 1339
12
361
12
2
12
107
12
148
12
192
12
6
180 5087
12
463
12
114
12 3032
12
405
12
174
12
611
12 1321
12
777
12
283
108 7180
895
4543
2723
8161
109
99
410
59
0
293
14
0
29
29
358
99
13
0
0
0
1512
0
0
214
19
26
137
111
1
0
78
275
97
0
211
0
0
89
0
86
1344
152
0
146
403
0
12
7
3
196
112
633
0
24
0
0
22
1710
244
113
0
37
0
1686
99
0
384
14
0
14
38
0
0
2629
23
30
352
194
44
129
114
53
27
966
52
664
152
868
28
12
33
30
0
1
2
0
0
14
6
1
1
0
0
0
128
0
0
19
4
0
10
1
0
0
50
22
3
0
27
0
0
0
0
45
181
41
0
21
51
0
0
0
0
15
10
30
0
1
0
0
13
182
0
15
0
2
0
51
2
0
81
0
0
0
0
0
0
151
0
0
104
9
0
3
76
27
7
226
56 1973
1316 16518
1531 8182
2903 26673
55
459
1
850
157 1545
18
555
0
0
145 2722
0
92
0
0
0
28
103
189
1
708
0
818
0
90
0
85
0
0
0
0
480 8141
0
0
0
0
6
350
0
101
0
200
0
125
0
240
0
15
0
0
92
318
209
478
0
312
0
0
136
562
0
0
0
0
0
109
0
0
48
536
491 3346
165
622
0
0
7
613
21 1243
0
0
0
52
0
4
0
33
0
299
10
237
268 1034
0
0
0
351
0
0
0
51
59
23
530 4562
0
883
14
307
0
0
3
143
0
0
1298 1709
0
637
0
0
0 1334
0
72
0
1
0
77
0
136
0
2
0
0
1315 5301
0
99
0
30
27
982
0
84
0
132
16 1030
22 2631
22
323
0
12
87 5323
24
785
248
1057
0
0
0
8
0
51
0
0
0
0
5
85
0
0
0
0
149
0
0
0
0
0
0
0
0
0
1
24
0
0
8
0
0
0
0
22
55
33
0
0
268
0
0
0
0
0
6
6
0
0
0
0
0
313
0
0
0
0
0
145
6
0
5
0
0
0
0
0
0
156
19
0
34
0
16
0
315
0
0
384
0
69
42
111
0
0
0
2
0
5
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
7
1
0
0
59
0
0
0
0
0
0
0
0
0
0
0
0
60
0
0
0
0
0
35
0
0
0
0
0
0
0
0
0
35
0
0
0
0
0
0
2
0
0
2
0
15
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
14
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
7
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
107
0
113
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
14
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
92
0
0
0
0
0
0
0
0
0
0
0
0
92
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
6
0
868
41 9052
42 4530
83 14450
0
97
0
475
0
907
0 1964
0
0
28
624
0
82
0
0
0
12
4
86
0
474
0
690
0
54
0
93
0
0
0
0
32 5558
0
0
0
0
14
52
0
62
0
20
0
96
0
57
0
12
0
0
0
118
0
422
0
118
0
0
0
200
0
0
0
0
0
54
0
0
0
25
14 1236
0
268
0
0
0
457
0
809
0
0
0
36
0
0
0
3
0
144
0
289
0
155
0
0
0
146
0
0
0
0
0
18
0 2325
0
781
0
318
0
0
0
93
0
0
0
513
0
438
0
0
0
539
1
33
0
0
0
3
0
12
0
2
0
0
1 2732
0
26
0
39
36 1459
0
38
0
16
0
698
0
229
0
80
0
14
36 2599
4
263
11
278
0
1
0
5
0
1
0
0
0
0
0
0
0
0
0
0
7
0
0
1
11
0
0
3
0
0
3
18
30
0
0
0
0
1
0
0
67
0
0
112
40
0
0
0
0
0
2
10
0
1
0
0
0
165
7
1
0
0
0
0
1
0
10
0
0
0
0
0
0
19
0
0
16
0
0
1
2
0
1
20
0
16
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
7
0
0
0
0
0
0
0
0
13
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
4
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
14
137
6
157
0
0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
0
0
0
105
0
0
18
0
0
0
0
0
123
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
6
0
0
0
20
9
85
6
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
48
0
0
0
0
0
0
0
0
55
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
31
0
6
6
0
0
43
0
8
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
5
0
0
6
0
9
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
5
0
7
7
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
7
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
177
529
33
739
0
0
1
0
0
0
0
0
0
0
0
0
14
0
0
0
15
0
0
0
0
0
0
16
0
0
2
2
0
0
0
0
0
0
0
0
20
0
0
0
300
0
0
0
0
0
0
0
0
33
0
0
0
333
87
0
0
0
0
0
0
0
0
0
0
0
161
0
0
248
0
0
15
0
0
0
104
4
0
123
0
110
0
110
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
109
0
0
0
0
0
0
0
0
0
0
0
0
109
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
53
418
471
0
0
0
0
0
207
0
0
0
0
0
27
0
8
0
0
242
0
0
202
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
203
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
0
0
0
0
0
17
0
4
33
37
0
0
0
0
0
5
0
0
0
0
0
4
0
0
0
0
9
0
0
28
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
22
53
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
15
0
0
0
0
0
0
22
0
0
0
0
0
0
0
0
22
0
0
0
0
0
0
0
0
0
0
Rapid MP Test
+ve
0
4
2
6
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
15
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total
+ Ve
Total
Dengue
+ Ve
Total
JE
+ Ve
K-39
Total
CA 15.3
B.HCG
Electrophoresis
Brucella
Thyroglobulin
Ferritine
9
11
0
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
6
0
0
11
Cysticercos
is
PSA
F. Protein
Amoe
biasis
Echino
cocus
Rubella IgG
Measles/
IgG
TORCH IgG,
IgM
CA-125
0
14
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
8
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
CA 19-9
CEA
+ Ve
Total
VDRL
+ Ve
Total
DNA
+ Ve
Total
ANA
+ Ve
TPHA
Total
CRP
Blood
Group
ASOT
Rh Factor
District Name
Pregnancy
test
IMMUNOLOGY
Received
Reports
District Code
0
0
4
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
88
1130
2593
3811
59
25
25
20
0
463
0
0
0
63
0
15
0
0
0
0
670
0
0
500
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
160
663
12
0
21
67
0
0
0
0
0
0
58
0
13
0
0
0
171
0
46
0
0
0
28
934
0
1
0
17
0
0
0
0
1026
12
0
616
96
0
475
24
58
0
1281
PV
0
177
46
223
0
2
0
0
0
2
0
0
0
3
0
1
0
0
0
0
8
0
0
5
0
0
0
0
0
0
0
1
15
0
0
0
0
0
0
0
21
7
0
2
17
0
0
0
0
0
0
2
0
1
0
0
0
29
0
0
0
0
0
1
18
0
0
0
0
0
0
0
0
19
0
0
114
2
0
19
4
7
0
146
PF
1
24
9
34
1
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
3
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
3
0
0
23
0
0
2
1
0
0
26
296
ALC
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4 0
0 125 44
0 28 0
0 157 44
0
0 0
0
0 0
0 25 0
0
0 0
0
0 0
0
2 0
0
0 0
0
0 0
0
0 0
0
0 0
0
3 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0 30 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
1 0
0
0 0
0
0 0
0 16 0
0 67 44
0
0 0
0
0 0
0
5 0
0
0 0
0
0 0
0
0 0
0
0 0
0 26 0
0 115 44
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
3 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
3 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
0 0
0
1 0
0
0 0
0
0 0
0
0 0
0
8 0
0
0 0
0
0 0
0
9 0
0
8
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
HbA1c
HB Elec.
phorosis
Others
7 0 0 137 0
190 11 16 739 7
168 3 0 1160 19
365 14 16 2036 26
7 0 0
71 0
0 0 0
33 0
0 0 0
29 0
0 0 0 103 0
0 0 0
0 0
0 0 0
3 0
0 0 0
2 0
0 0 0
0 0
0 0 0
0 0
0 0 9
34 0
0 0 0
26 0
0 0 0
36 0
0 0 0
4 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
7 0 9 341 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
15 0 0
3 0
0 0 0
1 0
0 0 0
0 0
0 0 0
32 0
0 0 0
0 0
0 0 0
0 0
0 0 0
31 0
0 0 7
43 2
0 0 0
0 0
0 0 0
0 0
5 0 0
26 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
18 0 0 246 0
38 0 7 382 2
0 0 0
21 0
0 0 0
0 0
0 0 0
17 0
0 0 0
38 0
0 0 0
0 0
0 0 0
5 0
0 0 0
0 0
0 0 0
1 0
0 0 0
13 0
0 0 0
34 0
0 0 0
53 5
0 0 0
0 0
92 2 0
0 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
92 2 0 182 5
0 0 0
0 0
2 2 0
3 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
0 0 0 772 19
0 0 0
0 0
0 0 0
0 0
0 0 0 173 0
0 0 0
0 0
0 0 0
0 0
0 0 0
0 0
0 0 0
3 0
0 0 0
0 0
0 0 0
0 0
2 2 0 951 19
0 0 0
0 0
0 0 0
0 0
168 9 0
47 0
0 0 0
9 0
0 0 0
0 0
58 1 0
36 0
0 0 0
43 0
0 0 0
45 0
0 0 0
0 0
226 10 0 180 0
Factor IX
2
259
135
396
1
1
0
0
0
2
0
0
0
1
0
3
0
0
0
0
8
0
0
46
36
0
0
0
0
0
1
3
3
0
1
0
0
0
0
1
91
3
0
1
0
0
0
0
0
0
0
48
0
4
0
0
0
56
0
4
0
0
0
14
17
0
17
0
0
0
0
0
0
52
0
1
100
2
14
37
7
28
0
189
Factor VIII
416
6098
8858
15372
186
1174
100
0
0
657
116
0
0
84
3
34
0
24
0
0
2378
0
0
823
42
455
2
113
4
0
20
107
141
0
255
0
0
20
0
261
2243
86
0
177
101
0
6
0
2
0
4
216
0
516
0
45
32
1185
374
19
0
21
0
907
1328
0
704
91
4
0
37
0
0
3485
17
13
389
100
314
3987
154
1072
35
6081
FDP/ D-dimer
1
0
78
79
0
0
0
2
0
13
0
0
0
0
0
0
0
0
0
0
15
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
49
12
0
0
0
0
0
0
0
0
61
0
0
0
0
0
0
0
0
0
0
PT
77
321
312
710
0
4
0
134
0
4
0
0
0
4
36
9
0
0
0
0
191
0
0
0
5
0
4
0
0
0
0
235
0
0
15
0
0
0
0
54
313
0
0
1
18
0
10
0
0
0
0
21
0
0
0
0
6
56
0
0
0
0
0
120
0
0
0
0
0
0
0
0
0
120
0
0
1
0
0
0
0
2
27
30
APTT
0
1234
143
1377
0
0
0
134
0
0
0
0
0
0
0
0
0
0
0
0
134
0
0
0
10
0
0
0
0
0
0
284
0
0
0
0
0
0
0
3
297
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
939
0
0
6
0
0
0
945
Spleenic Asp.
0
295
137
432
0
0
0
134
0
0
0
0
0
0
0
0
0
0
0
0
134
0
0
0
10
0
0
0
0
0
0
284
0
0
0
0
0
0
0
3
297
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
CSF
0
304
137
441
0
3
1
134
0
0
0
0
0
0
0
0
0
0
0
0
138
0
0
0
10
0
0
0
0
0
0
284
0
0
0
0
0
0
0
3
297
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
Bone Marrow
377
3024
2420
5821
131
54
94
183
0
37
7
0
0
27
105
314
1
0
0
0
953
0
0
8
0
0
15
50
0
0
171
735
48
0
17
0
0
1
0
1158
2203
56
0
16
33
0
24
0
0
3
48
373
0
55
0
0
0
608
13
0
0
0
0
909
0
0
54
1
0
0
6
0
0
983
1
0
881
22
0
69
5
51
45
1074
LE
0
50
1
51
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
0
19
0
0
0
0
0
0
0
0
0
1
20
0
0
0
0
0
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
1
0
0
0
11
BTCT
RBC
Aldehyde
42
2021
73
2136
0
0
2
0
0
0
0
0
0
0
2
299
0
0
0
0
303
0
0
0
15
0
25
15
0
0
11
401
0
0
0
0
0
2
0
59
528
61
0
1
0
0
0
0
0
1
0
50
0
0
0
0
0
113
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
10
0
0
1110
0
0
2
2
68
0
1182
MF
MCHC
6555
28306
13229
48090
2929
943
745
1442
0
2517
147
0
161
295
481
1261
153
92
0
0
11166
0
0
2731
127
665
391
1636
8
0
618
1068
1136
0
2356
0
0
98
0
1422
12256
607
0
710
1646
0
45
3
73
267
1182
2754
0
408
0
55
69
7819
1046
1086
0
306
0
2148
946
0
1717
471
20
180
294
15
30
8259
116
60
3601
622
166
1296
1313
1222
194
8590
MCH
8642
54815
26686
90143
3110
4092
5004
2734
0
5233
203
0
199
444
1771
2533
215
118
0
0
25656
0
0
1486
159
634
476
1634
21
0
1560
2772
1419
0
2694
0
0
548
0
4586
17989
1286
0
1473
4564
0
102
10
95
604
1273
4246
0
1083
0
75
152
14963
2428
966
0
205
0
6324
1879
0
2988
412
28
131
375
39
19
15794
404
186
5275
1469
300
2438
4034
1477
158
15741
MCV
MP
Platelet
8763
58317
27658
94738
3053
4108
4236
2268
0
4092
196
0
184
740
1460
2290
198
257
0
0
23082
0
0
4801
111
729
517
2000
10
0
1457
2428
1501
0
3033
0
0
626
0
4177
21390
1409
0
2115
4994
0
111
16
119
964
3942
5808
0
999
0
53
521
21051
2231
1451
0
443
0
5147
2429
0
1890
580
38
214
353
17
30
14823
314
166
3522
1252
303
2763
4134
1648
290
14392
Reticulocyte
8775
60087
27747
96609
3053
4108
4228
2267
0
4096
196
0
187
822
1460
2187
198
258
0
0
23060
0
0
4801
111
729
509
2014
10
0
1484
2973
1501
0
3034
0
0
625
0
4128
21919
2521
0
2115
4994
0
112
16
119
965
3942
5807
0
999
0
53
521
22164
2231
1361
0
443
0
5286
2421
0
1893
580
39
214
354
17
30
14869
314
166
3522
1252
303
2768
4334
1648
290
14597
PCV
67
68
69
70
71
72
73
74
75
ESR
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
Hb
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
DC
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
HAEMATOLOGY
TC
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
0
85
5
90
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
76
0
0
0
0
0
0
0
5
90
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
68
34
103
0
0
16
0
0
1
0
0
0
0
0
10
0
0
0
0
27
0
0
0
0
0
0
0
0
0
2
10
0
0
0
0
0
0
0
30
42
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
3
1
0
0
0
0
0
2
25
0
28
297
67
68
69
70
71
72
73
74
75
0
100
0
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
52
0
52
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
52
0
0
0
0
0
0
0
0
52
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
131
0
131
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
130
0
0
0
0
0
0
0
0
131
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
0
0
0
0
0
0
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Others
Digoxine
Phenytoin
2
2317
51
2370
0
0
0
13
0
12
0
0
0
2
2
0
0
0
0
0
29
0
0
0
0
0
0
0
0
0
22
2234
0
0
16
0
0
0
0
26
2298
5
0
0
20
0
0
0
0
0
0
0
0
0
0
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
16
0
18
Valporic Acid
0
4495
14
4509
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
4476
0
0
0
0
0
0
0
14
4509
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Cyclosporine
0
1709
90
1799
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
1690
0
0
0
0
0
0
0
90
1799
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Carbamazepin
0
942
90
1032
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
923
0
0
0
0
0
0
0
90
1032
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Microalbumin
Testerone
Prolactin
FSH
LH
0
103
1
104
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
103
0
0
0
0
0
1
0
0
104
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Lipid Profile
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
0
76
0
76
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
73
0
0
0
0
0
0
0
0
73
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TSH
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
T4
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
ENDOCRINOLOGY
T3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
170
0
170
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
22
0
0
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
147
0
147
298
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
1802074
9263406
8643320
19708800
157878
131868
155930
508752
555109
500338
141445
113358
183011
201732
151450
230035
201147
242637
536916
628397
4640003
591971
420591
766689
145391
193266
238970
240790
377336
0
148877
560387
167256
48205
304434
195146
408665
507095
0
459548
5774617
295081
212196
210063
298335
419348
13715
31690
130465
209596
272168
403684
398303
401357
0
471030
214647
3981678
226987
195276
210456
255119
406184
382438
419940
384639
299743
161795
25905
74894
85373
47091
94268
3270108
145622
156499
320577
190367
404599
273701
194830
249486
106713
2042394
294
1459
606
2359
72
19
76
28
12
6
1
31
37
29
6
35
21
74
12
11
470
29
13
65
22
38
45
85
129
0
74
205
112
0
63
19
42
50
0
45
1036
46
4
14
43
70
0
2
71
45
7
7
8
22
0
13
2
354
17
14
0
49
32
35
65
8
1
5
0
0
0
0
3
229
2
4
7
2
57
69
81
10
38
270
0
67
27
94
0
0
0
0
0
1
0
0
0
2
0
12
0
0
2
0
17
0
0
10
0
0
0
0
0
0
0
25
9
0
0
0
0
0
0
0
44
0
0
0
0
7
0
0
0
5
0
0
1
0
0
7
0
20
0
2
0
0
0
4
0
0
0
3
0
0
0
0
0
9
0
0
1
0
3
0
0
0
0
4
41
1119
573
1733
1
1
1
22
4
4
5
0
0
17
0
52
51
3
28
4
193
3
33
87
25
28
7
23
118
0
69
217
146
0
124
8
20
165
0
60
1133
1
1
8
2
132
0
1
3
8
0
14
8
0
0
107
7
292
5
1
0
0
2
27
1
3
4
39
0
0
2
0
0
84
5
2
5
8
2
4
3
2
0
31
1
62
32
95
1
0
0
0
0
0
0
0
0
0
0
0
5
0
0
1
7
0
10
18
1
0
0
0
0
0
8
7
0
0
0
0
2
0
0
0
46
0
0
0
0
3
0
0
0
2
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
32
0
37
11
108
74
193
1
0
0
2
0
0
0
2
0
0
0
0
0
7
3
13
28
7
5
0
3
0
1
0
0
0
11
43
0
0
1
7
8
2
0
3
91
0
2
1
3
1
0
0
1
16
0
0
2
21
0
0
0
47
1
2
0
0
0
2
0
0
0
1
0
0
2
0
0
8
0
7
1
0
2
6
1
2
0
19
569
6759
9018
16346
19
15
54
939
996
201
31
35
88
29
19
190
14
230
103
365
3328
323
408
385
299
22
215
70
135
0
210
667
122
11
135
235
211
523
0
949
4920
353
22
348
239
156
0
0
70
34
81
116
1358
904
0
50
95
3826
215
177
211
47
943
254
503
317
63
10
0
0
4
0
0
2744
26
117
93
29
244
717
146
156
0
1528
42
115
171
328
13
3
3
72
8
2
3
2
0
1
0
1
5
14
1
8
136
0
0
13
2
0
28
0
1
0
9
17
1
0
3
4
4
5
0
7
94
3
0
2
4
4
0
0
0
2
0
11
3
6
0
13
2
50
1
1
1
0
0
7
3
0
1
0
0
0
0
0
0
14
0
1
2
0
19
3
5
4
0
34
74
839
262
1175
22
18
16
16
22
11
21
14
8
13
1
8
29
1
0
6
206
29
50
10
22
36
11
19
33
0
40
36
9
0
52
9
0
2
0
12
370
83
2
21
33
27
0
1
14
10
58
54
41
4
0
0
14
362
0
25
0
44
5
6
61
4
0
4
0
0
0
0
0
149
0
2
0
1
15
13
2
45
10
88
4061
22181
12781
39023
533
378
510
1411
926
737
407
580
668
741
447
735
788
677
433
350
10321
108
381
312
695
910
785
870
1103
0
325
808
583
135
1894
491
354
1080
0
952
11786
1522
304
566
670
870
1
31
518
409
543
899
500
686
0
684
613
8816
310
512
103
520
1533
290
1083
436
386
282
0
48
70
17
91
5681
188
129
64
112
697
764
122
295
48
2419
1989
9016
4758
15763
449
222
192
437
515
85
230
302
185
103
199
261
313
95
4
52
3644
24
171
189
95
213
153
509
341
0
272
617
105
58
501
136
138
231
0
675
4428
507
246
191
261
436
1
20
246
189
235
501
186
482
0
72
74
3647
134
378
164
157
496
114
359
244
181
55
0
44
50
1
43
2420
40
186
165
53
293
421
178
237
51
1624
Hepatitis B
Chicken pox
Mumps
Rubella
Acute Flacid
Paralysis
(AFP)
Tuberculosis
Tetanus
Neonatal
Tetanus
Whooping
Cough
Diptheria
Measles
Communicable, Immunizable
Total
District Name
Received Reports
District Code
115
1150
106
1371
7
10
4
0
6
0
1
0
1
0
18
2
19
1
7
4
80
0
1
0
0
0
22
29
10
0
1
733
41
0
3
0
0
6
0
59
905
3
16
1
28
79
0
0
2
0
1
7
105
6
0
0
42
290
1
0
16
0
0
0
0
1
0
4
0
0
5
0
0
27
1
2
8
0
12
5
4
7
30
69
299
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
17
254
216
487
5
5
0
0
47
0
0
1
3
0
0
4
0
4
0
2
71
0
0
36
7
2
1
8
0
0
77
39
16
0
9
0
17
10
0
12
234
0
0
1
9
4
0
0
0
0
0
0
36
1
0
0
0
51
8
4
1
0
46
0
0
5
0
0
0
0
0
0
0
64
0
0
0
0
9
36
22
0
0
67
5
298
728
1031
0
0
2
63
6
4
0
0
2
0
0
1
1
1
5
17
102
31
26
12
0
0
3
0
3
0
108
95
23
0
33
2
65
4
0
3
408
0
8
4
0
0
0
0
0
2
0
0
2
8
0
445
2
471
0
0
4
0
1
12
10
1
0
1
0
0
0
0
0
29
0
0
4
0
15
1
1
0
0
21
389
12534
82754
95677
9
157
357
3206
4807
2105
174
77
43
152
0
3
19
794
2708
3216
17827
15327
8555
3752
1023
30
7
185
300
0
16
92
23
0
116
692
5948
3871
0
524
40461
123
13
20
12
24
0
0
0
1
0
231
94
3783
0
3230
90
7621
106
140
1
210
5134
2736
8611
6998
23
0
0
18
13
0
1
23991
50
60
106
125
4571
670
143
49
3
5777
1
126
1194
1321
0
2
12
148
134
1
0
0
0
3
0
0
2
11
0
136
449
193
5
5
14
0
1
0
0
0
0
9
0
0
0
0
100
21
0
12
360
7
0
6
2
20
0
0
0
0
0
1
2
19
0
0
0
57
0
0
0
0
0
12
6
1
0
0
0
0
0
0
0
19
0
0
14
0
380
22
12
8
0
436
1
489
1568
2058
0
2
5
107
61
3
0
0
0
12
0
6
0
63
5
56
320
38
24
65
37
1
1
0
1
0
0
39
0
0
0
19
2
3
0
3
233
5
1
2
1
10
0
0
0
0
6
8
19
60
0
0
1
113
1
4
0
0
0
34
123
23
11
0
0
0
0
0
0
196
0
0
90
0
845
139
122
0
0
1196
0
67
101
168
0
0
0
0
27
0
0
0
0
0
0
0
0
0
0
0
27
0
0
0
0
0
0
0
0
0
0
12
18
0
0
5
0
0
0
73
108
0
0
0
0
28
0
0
0
0
0
0
0
1
0
0
0
29
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
1
107
755
863
0
0
0
6
3
0
0
0
0
0
0
1
0
7
12
47
76
3
1
633
2
0
1
0
0
0
0
47
2
0
0
1
2
37
0
0
729
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
42
0
0
0
0
0
42
0
0
0
0
11
0
0
0
0
11
38642
26630
257729 135969
209812 133435
506183 296034
3610
2596
1954
713
2150
1193
16555
9611
14622
9899
4934
3235
3052
560
2259
1026
5493
1365
3195
1920
1761
2878
4152
2830
3486
6491
7404
4554
8144
12480
17724
10824
100495
72175
19633
7616
11429
6848
17684
10575
7457
3150
2884
1171
4687
2489
6898
3239
9531
2239
0
0
4068
3903
10333
13793
6078
2620
1051
939
10497
2771
3267
1501
8154
4769
10589
7907
0
0
8869
5961
143109
81491
7142
4047
3104
1543
5745
1384
12276
3309
6499
5536
163
391
93
623
2366
1103
6054
2311
11003
4762
13702
7176
11025
2814
7847
4537
0
0
10887
10963
8644
3962
106550
54461
8259
2947
6810
4334
9831
2084
10826
8413
14601
6675
8434
9576
13335
5781
15302
8294
16101
4377
5665
6413
520
472
928
1724
1010
1487
529
532
1255
2062
113406
65171
3551
2440
5901
1884
4190
3357
2731
2038
9497
4218
6874
1960
4399
2121
4288
3209
1192
1509
42623
22736
60522
29975
278686 115763
274964 120428
614172 266166
3895
1448
3033
1121
2493
645
13724
6529
10532
4609
15501
5139
3981
972
2773
938
3440
1076
6051
2836
3775
1872
5336
2498
6455
3434
11490
3249
20526
6927
15530
7476
128535
50769
15504
7983
13918
6655
24747
10596
4690
2072
4095
1636
5818
2706
8021
3038
9838
3293
0
0
3957
1137
11111
4622
4496
2022
1347
794
11624
4153
4326
2217
14761
6630
21681
6939
0
0
6363
2720
166297
69213
9050
3530
5162
1942
3823
1775
7057
3015
6290
1983
589
198
635
195
3394
1766
5192
1295
7673
3244
14268
3865
9205
3312
9240
3978
0
0
24741
13418
7377
3204
113696
46720
6823
3179
7411
3240
7659
4272
12580
6311
15845
5573
16747
6646
16770
9681
12089
6093
8562
5487
6784
3776
1146
763
2267
1400
3746
2693
2317
1462
3952
2701
124698
63277
6737
3590
7678
4051
15345
7367
10318
3635
9557
4354
9277
4575
5501
2927
11374
3700
5159
1988
80946
36187
56786
284099
285844
626729
3455
3991
3666
6557
13506
17800
3997
1476
5640
6746
3712
7109
3007
7930
31607
23837
144036
25779
13018
15686
3454
7459
9493
9257
14420
0
3307
10694
6373
1919
11179
10324
19482
18424
0
5020
185288
8751
6660
5130
4351
7057
228
622
4603
3435
6780
6728
9375
20241
0
14215
5660
103836
12027
5297
8922
6715
10050
13089
12801
9006
23628
5268
1182
1880
1564
702
2125
114256
6900
6320
18219
10053
14776
9956
5136
6166
1787
79313
830
2267
1480
4577
247
0
22
109
0
0
0
103
397
0
0
367
0
244
343
269
2101
0
75
1
3
35
0
59
0
0
42
380
44
0
55
0
0
131
0
0
825
0
0
13
0
132
0
0
0
37
0
2
4
53
0
96
106
443
0
0
438
0
0
391
0
0
4
1
29
0
0
0
0
863
0
42
2
0
0
12
79
154
56
345
107124
350256
435437
892817
14240
8846
9161
28860
22040
31812
9126
6921
12230
10487
11067
14558
17024
17582
41058
39209
294221
47738
28870
34524
8048
6918
11522
7774
6613
0
2458
10770
5236
2079
9916
4378
32055
25899
0
8836
253634
10837
6653
6379
7686
8393
592
1222
5245
5833
10799
19886
8345
11829
0
17739
10423
131861
6686
6964
8706
8214
12362
15347
18586
16125
10534
8724
2893
7273
5608
4088
6824
138934
6609
9337
13269
10459
11252
7421
4336
7718
3766
74167
Jaundice and
Infective Hepatitis
Intestinal Worms
Cholera
Presumed non
infectious
diarrhoea
Baccilary Dysentry
Ameobic Dysentry
Acute gastro
enteritis
Typhoid (Enteric
Fever)
Kala-azar
Communicable, Water/Food Borne

Dangue Fever
Malaria (PV)
Malaria (PF)
Clinical Malaria
Filariasis
Received Reports
District Name
Communicable, Vector Borne

Acute Encephalitis
like syndrome
(AES)
District Code
3508
23438
15890
42836
627
459
445
1676
1826
285
403
838
378
426
291
207
1434
499
375
732
10901
505
649
828
269
391
525
407
653
0
272
2865
364
151
622
342
400
970
0
1158
11371
911
428
611
986
1106
4
68
194
275
1091
1757
1047
716
0
653
514
10361
939
244
313
338
1720
219
1326
447
334
269
169
68
236
11
165
6798
201
176
395
176
1212
640
351
223
31
3405
300
67
68
69
70
71
72
73
74
75
123
337
1112
1572
0
4
0
175
89
36
0
20
44
0
19
5
0
12
28
33
465
94
35
56
14
2
2
1
4
0
0
51
0
0
2
4
78
87
0
34
464
9
4
13
5
35
0
0
3
3
0
4
47
74
0
61
1
259
2
6
9
19
14
51
48
7
3
1
27
3
7
0
1
198
6
12
19
6
103
16
18
5
1
186
42151
212655
177514
432320
4083
5341
4825
15070
11831
18968
4747
2900
5618
6665
3015
5922
6068
4311
10172
12706
122242
11404
8034
8697
3755
4035
3687
5744
7667
0
2073
12004
3180
820
9175
4628
7517
6251
0
9457
108128
7495
4086
2417
5205
4655
165
292
2296
5525
6632
10246
6236
10309
0
8081
6266
79906
6529
5977
5931
5891
7474
8976
7375
9005
7114
3352
634
2353
2040
1421
2426
76498
4358
3913
6270
3493
7343
7849
4503
6235
1582
45546
2153
11042
8324
21519
129
193
230
541
663
363
84
104
76
273
182
199
1037
275
213
763
5325
406
478
516
134
131
143
202
79
0
53
616
277
37
393
204
425
354
0
299
4747
244
144
86
238
208
2
0
105
139
400
519
123
209
0
1036
168
3621
420
167
646
638
475
347
280
351
300
522
36
155
237
151
257
4982
250
239
406
154
754
202
467
315
57
2844
22796
128705
142426
293927
1020
1412
1515
9626
9610
4135
2542
2497
783
2857
1871
3012
2206
3903
11194
13884
72067
12836
8966
13142
1738
2761
3153
3340
4739
0
1070
4758
2623
440
3709
2919
6988
9128
0
4120
86430
3675
3138
2301
5640
5468
197
63
1321
3121
4671
9200
6685
5083
0
9069
4876
64508
4366
2528
4310
3411
5494
3038
8434
4133
4196
2191
227
1112
1886
1010
1394
47730
1431
1881
2624
2002
3744
3935
1340
3247
2988
23192
34355
171774
149985
356114
2021
1548
1733
7747
6518
5465
1598
1435
2187
3429
2470
3522
2971
2974
9531
8691
63840
11399
9304
14048
2792
3072
4002
4712
7856
0
2586
15610
5970
581
6534
3113
8805
10105
0
9072
119561
4437
4667
3707
7034
6290
142
121
1413
3525
2500
6439
6813
7379
0
9102
4299
67868
4727
3040
3303
6136
9412
5445
6625
6222
5758
3631
371
1688
2299
1346
2340
62343
3223
3049
6146
4779
6235
5102
3773
6392
3803
42502
26363
126650
112130
265143
1893
1244
1845
9867
14727
4224
1298
1531
2250
2285
2309
2687
2172
2838
6063
10278
67511
5368
5975
5627
1769
2306
3579
3334
3235
0
1965
9287
1776
660
3100
1458
2696
4739
0
5296
62170
4193
2681
2650
4953
4537
134
250
1669
2069
4099
7084
8072
4429
0
6042
3278
56140
2951
2754
3667
4232
4886
3395
7256
6197
3648
3674
388
981
1629
1171
1395
48224
2115
2972
4745
2387
6580
4682
3607
2707
1303
31098
Viral Influnenza
Urinary Track
Infections (UTI)
Asthama
Bronchitis
Sever
Pneumonia
95243
470093
394712
960048
6936
6145
7829
27279
29018
27773
5271
6777
8109
6594
10470
13765
8259
6384
19502
32129
222240
26743
18398
22587
4642
7747
11350
13088
23520
0
6709
22107
7344
2177
13947
7795
11710
16408
0
16963
233235
14914
6546
8656
16691
22342
645
3350
8676
19342
22163
19391
13082
25136
0
20758
7581
209273
12117
9638
10467
12816
16331
22316
25377
23551
17611
10432
1391
6350
3719
2565
4182
178863
5747
9251
22092
12834
18795
17489
11226
13090
5913
116437
Pneumonia
153
97072
820 494403
579 425324
1552 1016799
40
7408
0
8288
0
8961
9
22843
292
31641
0
35300
0
7215
2
5078
68
9506
1
11552
2
7549
3
13666
1
9560
94
9000
0
27960
23
38460
535 253987
0
36659
7
22343
24
23203
14
5474
8
8658
4
16534
15
14444
10
23475
0
0
3
6355
74
15289
4
6896
10
3203
5
18367
14
7058
42
10374
2
16742
0
0
28
15552
264 250626
0
12663
0
7244
6
10454
5
22932
195
25316
0
659
0
2141
0
8385
1
17935
4
17466
25
26328
194
15285
2
22699
0
0
10
15969
0
9668
442 215144
0
9817
0
11114
7
11619
24
13642
0
17187
7
20410
2
19076
4
19185
1
24385
19
6480
9
1117
0
5034
0
3335
3
2880
0
4064
76 169345
2
5186
0
7484
6
21794
40
11224
131
31224
0
17682
44
11811
12
14764
0
6528
235 127697
Confirmed
Meningitis
Leprosy
STD/STI
HIV/AIDS
199
1595
446
2240
0
0
0
10
23
0
0
7
113
0
3
0
4
16
15
0
191
1
43
83
18
1
2
0
0
0
7
483
2
0
15
9
12
56
0
38
770
17
0
6
9
9
0
0
0
5
26
7
103
1
0
3
0
186
17
0
3
253
0
77
47
1
5
2
67
0
12
0
0
484
1
1
551
5
10
27
13
1
0
609
17305
104951
86465
208721
1237
942
5121
16283
3954
4060
2522
1458
256
2740
264
1901
1008
1807
8019
4541
56113
4820
3077
1750
848
2541
3795
4414
4328
0
1712
5721
1379
1378
7485
3337
2036
2212
0
7346
58179
6120
3012
2834
3510
4972
52
244
3916
3408
2544
7713
4094
1964
0
2523
2442
49348
103
384
164
677
2659
5671
4252
5287
109
856
97
133
674
41
957
22064
1793
620
769
699
2509
8789
2236
4252
1350
23017
Reproductive
Tract Infection
(RTI) female
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
3353
18324
21315
42992
63
137
126
1545
1257
176
155
141
482
80
45
35
158
673
882
308
6263
565
1330
503
200
91
354
488
811
0
195
2184
308
151
1156
526
915
850
0
1104
11731
179
38
255
478
426
27
55
123
37
493
811
251
93
0
1442
129
4837
198
389
635
804
1989
1460
4837
1590
679
437
154
100
404
177
297
14150
122
210
1357
378
1143
916
1034
627
224
6011
Reproductive
Tract Infection
(RTI) male
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Other Infectious Disease

Upper
respiratory tract
Infection
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Other Communicable
ARI/Lower
respiratory tract
Infection
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Reports
District Code
624
4334
3479
8437
10
20
33
460
267
44
18
82
37
720
35
43
268
126
53
124
2340
166
88
152
55
17
84
97
43
0
44
467
18
18
81
22
192
103
0
640
2287
144
28
68
94
218
8
0
39
35
58
144
60
71
0
331
548
1846
31
11
121
61
123
39
366
120
72
156
52
16
38
72
97
1375
8
38
91
25
167
93
114
39
14
589
1254
6557
6411
14222
50
28
105
613
437
113
23
76
87
214
115
225
154
230
177
242
2889
251
198
238
82
8
175
222
129
0
74
834
75
17
343
92
292
388
0
1006
4424
264
27
87
265
290
13
5
54
69
88
328
104
119
0
733
687
3133
132
47
158
260
143
115
649
178
137
324
68
23
95
127
115
2571
24
65
106
9
443
254
187
64
53
1205
301
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
3049
10873
19433
33355
79
95
128
779
740
752
15
63
50
35
105
191
271
208
978
1030
5519
1605
698
1635
188
87
73
130
153
0
71
474
138
5
487
122
1629
1254
0
226
8975
105
131
61
216
1116
4
4
160
64
247
224
350
430
0
3001
224
6337
162
145
463
372
689
685
935
474
281
1159
119
295
446
425
446
7096
487
297
1494
315
851
1516
179
205
84
5428
8619
57218
86872
152709
769
649
797
3217
4728
6779
1277
438
692
1613
330
906
1020
1349
5235
9722
39521
8308
3243
6506
880
1019
727
745
2746
0
1009
3298
1265
603
1858
969
4670
7217
0
2402
47465
1040
2167
812
4050
3643
80
267
499
2098
1462
1982
2991
4133
0
5750
1563
32537
838
790
1992
1369
1378
3627
4045
2399
1390
827
85
417
743
521
735
21156
1108
541
1558
1017
3404
2508
1168
470
256
12030
3626
28849
24090
56565
181
246
354
1767
2062
891
331
327
120
166
118
35
357
840
961
1560
10316
1258
837
589
119
612
398
740
932
0
189
666
449
40
1341
512
249
1691
0
873
11495
1336
635
271
1046
1026
9
12
204
811
1174
2333
783
968
0
2255
1090
13953
513
606
1248
1783
1290
928
3750
3136
947
461
7
60
473
118
201
15521
402
637
858
370
1657
504
380
362
110
5280
6740
38216
67551
112507
613
614
821
2773
2892
2438
155
343
453
890
699
395
844
1302
4454
4942
24628
5987
3999
5307
848
409
628
940
2166
0
178
2081
608
145
2503
1052
6417
5875
0
2846
41989
1207
746
625
1410
1279
29
60
168
1034
1200
2092
1550
2210
0
5418
912
19940
618
743
948
1247
1020
1972
2727
1217
669
1069
130
144
805
189
349
13847
655
618
1540
735
4136
2138
616
1382
283
12103
241
3776
998
5015
1
5
8
92
114
6
8
37
2
5
6
10
175
9
50
12
540
109
19
63
7
19
67
26
51
0
9
467
30
1
8
0
64
67
0
26
1033
112
7
81
36
1762
0
0
0
20
26
144
400
17
0
0
6
2611
22
22
30
36
0
34
18
7
1
117
1
2
24
9
44
367
27
3
43
7
305
2
45
4
28
464
834
20826
16275
37935
45
51
395
795
5398
125
3
171
176
55
144
184
117
402
91
110
8262
38
179
621
47
131
332
65
599
0
677
6342
65
8
254
82
124
336
0
6744
16644
484
795
503
242
5058
11
12
75
155
149
274
2556
430
0
50
149
10943
26
7
23
103
496
76
136
18
34
19
0
1
0
0
1
940
12
18
176
20
434
92
270
115
9
1146
250
1868
1596
3714
25
11
4
48
97
19
4
5
18
2
71
12
197
5
43
144
705
68
47
88
3
6
16
8
7
0
79
418
87
0
24
29
42
124
0
43
1089
111
8
158
14
218
0
1
9
4
65
101
6
20
0
242
26
983
23
2
12
10
188
227
26
60
14
18
0
7
0
0
75
662
15
10
57
2
126
4
49
8
4
275
9413
33272
43183
85868
414
659
429
2062
2230
2689
470
133
446
612
937
924
1100
872
4412
4912
23301
1865
2377
3397
1416
227
558
949
1143
0
65
1851
523
142
1113
596
4413
3279
0
586
24500
696
475
214
364
298
33
191
217
284
690
858
1686
1026
0
1711
844
9587
309
858
652
1064
1663
2496
1187
2711
2373
1619
174
399
639
1024
528
17696
1419
1277
2179
981
1507
1371
792
975
283
10784
Night blindness
Dehydratioin
Obesity
Diabetic mellitis
Goitre, Cretinism
Anaemia
Polyneuritis
Avitaminoses and
other nutri
deficency
Nutrional and Metabolic Disorder

Malnutrition
District Name
Received Reports
District Code
1129
3243
12782
17154
5
49
21
545
309
177
10
58
14
29
101
81
253
88
940
935
3615
999
881
1739
143
38
196
48
42
0
11
228
134
3
124
7
1389
1531
0
81
7594
38
13
84
127
53
10
1
7
21
58
121
27
221
0
1245
43
2069
29
33
86
167
456
432
577
124
93
237
8
126
82
112
16
2578
129
188
203
122
162
163
49
192
90
1298
302
34582
144113
242044
420739
3333
2163
2490
9102
9230
11989
1960
1874
3459
3799
3987
2902
4552
5125
20650
21749
108364
18711
10244
21435
3555
1827
2705
2888
2995
0
1187
5192
2636
636
3805
2583
17732
26059
0
4994
129184
3829
3367
4108
4649
3048
251
227
2422
2641
4831
6176
4514
9089
0
23611
6396
79159
3975
3556
4764
6915
8061
9715
8203
7215
6295
2105
576
1796
3688
1154
2119
70137
1965
2721
4426
3417
7866
3604
3115
3704
3077
33895
2886
17261
12230
32377
401
330
385
1370
1372
471
409
490
564
695
158
327
753
530
498
785
9538
361
386
606
319
469
378
356
344
0
262
519
382
94
773
285
373
830
0
566
7303
448
517
251
512
847
5
16
220
536
498
1261
662
378
0
1223
609
7983
614
499
335
214
761
202
1282
556
291
171
0
25
208
50
229
5437
124
187
130
112
267
499
287
419
91
2116
33086
181763
244330
459179
2866
2356
3415
10688
15325
17104
2527
2426
3271
3873
2548
3844
3496
5980
20501
19013
119233
21232
12845
13152
2893
3934
4016
4374
7314
0
2498
8370
3388
1019
6145
4166
12700
15569
0
15629
139244
5636
3559
3961
5594
10229
169
405
2596
4104
4752
6273
5552
10548
0
8380
3817
75575
5001
4373
4413
5969
10112
11638
9342
9200
6152
3769
377
1754
1389
771
1789
76049
2924
3293
5734
4106
11112
9440
4127
6221
2121
49078
14288
83326
53578
151192
1195
1033
1306
6301
5001
1775
812
1078
1096
1099
1421
1680
1682
1662
2413
2925
32479
2766
2434
3122
1192
1063
1715
2888
2105
0
1857
5705
1446
443
2012
1072
1198
1829
0
7686
40533
3166
1379
2176
7072
8173
137
335
1355
3901
3539
4733
3993
4244
0
3679
2548
50430
2061
1110
1316
2233
2887
851
2268
2366
937
1562
328
480
580
461
1180
20620
471
713
780
359
1171
1028
924
839
845
7130
43974
234698
105869
384541
10016
9766
9919
14141
11387
8198
11463
6804
6229
14155
4982
7768
8472
5953
4630
5493
139376
5945
3824
4833
4252
6441
4792
6833
11197
0
4278
14267
4054
1362
5214
3626
2117
3885
0
11765
98685
8434
5030
3774
9374
14671
379
1314
3774
6974
7547
7831
6527
5497
0
5046
3697
89869
3047
2249
2842
2687
4786
2358
6028
5568
2878
1878
475
571
759
626
1760
38512
1109
1083
1901
1215
3048
2888
1683
3488
1684
18099
20622
105557
56445
182624
2839
2053
2867
9906
6675
2756
4044
4005
2844
4920
3037
4007
3471
4695
3210
2717
64046
2225
1618
2622
1325
2822
3019
4376
3743
0
2388
6625
1618
481
2653
1829
1000
1091
0
6957
46392
3708
1170
1501
3285
7861
95
429
1427
2461
3820
3911
3532
2238
0
2619
1987
40044
2334
1893
1737
2812
2664
1106
3519
2173
1181
1238
178
171
455
223
790
22474
695
477
1562
463
1947
1575
1198
1238
513
9668
Foreign body in
respiratory tract
1081
5203
3948
10232
123
148
40
261
135
11
0
67
71
56
31
111
183
60
386
232
1915
89
421
117
41
50
380
71
43
0
175
716
97
13
269
56
416
68
0
674
3696
62
49
112
294
500
0
1
96
156
98
125
171
85
0
375
95
2219
120
139
231
40
169
44
371
401
87
35
8
6
210
34
23
1918
14
60
72
45
59
35
131
32
36
484
Pharyngities/ Sore
throat
1209
8988
9020
19217
53
63
86
195
1291
74
18
83
10
44
98
163
594
141
293
383
3589
324
233
330
71
82
263
83
46
0
205
491
55
16
90
74
782
694
0
465
4304
199
100
114
312
3662
0
5
183
69
268
285
145
111
0
2278
136
7867
70
102
101
133
345
174
532
127
89
79
0
34
68
76
33
1963
19
123
150
24
373
143
225
109
328
1494
Tonsilitis
30451
175748
207862
414061
3946
2414
3469
15680
13711
12633
2865
3032
2668
3719
2773
4171
3836
5498
9630
14522
104567
13926
8065
10954
2969
3383
2808
3762
6059
0
2662
8736
3505
844
6266
3935
8171
16182
0
12386
114613
5251
5194
4374
6373
8603
360
265
2447
3601
4535
7431
6463
10083
0
13810
5167
83957
4366
3440
4134
6805
10846
10523
11716
8826
4629
3149
290
794
1588
1043
1656
73805
2818
2368
4269
2923
8273
6751
3035
4214
2468
37119
Scabies
Fungal Infection
Abscess
Impegtigo/ Boils/
Furunculosis
Eczema/
Dermatatis
30935
174429
166256
371620
1824
4411
2308
9759
9012
9225
3895
3095
3311
5388
3505
3442
3880
4441
8605
9917
86018
8416
5761
7779
2393
3457
3844
4677
6143
0
2763
10038
3228
991
6209
3858
6036
11442
0
10715
97750
5630
4703
4542
6297
7606
308
781
2525
4004
5913
7509
6289
11983
0
11792
5003
84885
3579
4546
4020
5110
9922
8716
9522
7394
4571
2699
181
1567
1755
672
851
65105
2471
1913
3693
1871
8949
8705
3360
4616
2284
37862
Sinusitis
67
68
69
70
71
72
73
74
75
32527
167629
240780
440936
3312
2884
2736
10461
11191
9552
3347
1772
2631
6297
2802
4051
4138
6056
19375
21320
111925
33823
12765
20015
4583
3236
3355
6159
6324
0
1964
7480
3712
1063
7024
4783
15716
17930
0
8951
158883
5208
4675
3968
5149
6416
138
194
2363
3419
2939
7959
6502
9603
0
12760
3244
74537
4320
2942
3893
4253
9040
9761
8742
5888
6131
2767
307
1093
1927
976
1679
63719
2153
2459
5314
2554
5556
4219
2585
4753
2279
31872
Lymphadenitis
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
43957
262440
464968
771365
6075
5189
4302
17473
24927
29154
4936
4351
5266
6385
4467
6809
5199
8870
27699
40733
201835
29450
25107
29424
8521
6669
5867
5827
12179
0
3385
10284
6189
1751
11621
9502
26214
65473
0
17179
274642
7928
5512
6099
9911
4487
147
210
3189
3899
5449
12974
9532
20871
0
19688
6115
116011
10001
6057
5480
8652
17096
23788
24017
12776
8112
2532
259
1066
2674
963
1310
124783
2445
3399
5420
4046
15963
10712
5136
4742
2231
54094
Psoriasis
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Leukoderma
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Received Reports
District Code
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Acute/ Chronic
Suppurative Otitis
Media (ASOM)
Ear, Nose and Throat Infection and Oral Health related

problems
Skin Diseases
1148
5453
3887
10488
116
132
52
78
371
23
22
21
45
81
106
178
341
229
225
123
2143
343
141
304
67
111
155
143
64
0
108
962
107
5
106
21
335
120
0
630
3722
74
80
124
72
609
6
9
70
49
231
299
67
89
0
564
124
2467
38
44
63
39
36
49
116
104
49
115
3
37
103
105
136
1037
63
38
106
67
146
194
102
325
78
1119
303
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
46532
207237
148373
402142
3868
2165
3223
8576
8247
8806
1987
2645
4042
4055
3683
4818
4062
4421
11128
12937
88663
15600
9438
10883
2914
5694
6625
4589
9001
0
8001
23415
3515
863
6395
3207
7621
10193
0
7521
135475
6793
4333
4630
6730
9006
405
781
3200
4602
7391
7212
6754
4730
0
7695
3515
77777
3867
3764
4412
5745
6244
6614
4825
5990
5245
4081
771
2608
2116
1666
2184
60132
3098
4791
4584
4490
3691
3624
3117
8258
4442
40095
8084
36912
30103
75099
673
573
890
2682
1447
1784
375
437
462
555
544
883
791
886
1478
1567
16027
2504
1383
2003
542
687
2691
749
1820
0
2799
7709
713
131
1078
614
1322
1451
0
3864
32060
969
626
278
852
1920
26
20
515
499
833
901
1375
898
0
2592
700
13004
445
365
837
1004
1616
1356
949
862
507
645
145
339
335
177
473
10055
195
320
364
229
827
380
418
416
804
3953
5285
33044
19019
57348
653
238
426
1071
784
1038
210
205
385
319
440
643
419
531
1298
1218
9878
1943
1182
1577
259
92
1801
315
1830
0
1521
6799
494
52
512
203
1197
1000
0
2498
23275
636
368
337
496
8412
14
8
180
251
501
530
2399
256
0
1295
577
16260
230
119
522
612
1083
339
356
460
325
291
143
116
240
88
278
5202
258
232
249
295
530
354
181
372
262
2733
10709
57389
48076
116174
885
734
1503
2961
3264
3839
893
721
1355
998
723
1530
873
1680
2417
2492
26868
2787
1538
1943
896
1007
2742
1413
3309
0
1539
6726
1434
400
2367
2094
984
1624
0
4101
36904
1823
1139
791
1489
5578
77
142
645
749
1239
1440
938
1906
0
2625
1011
21592
941
849
674
1544
2378
4776
3770
2275
1210
822
72
251
517
105
579
20763
485
630
959
656
2305
2366
777
1536
333
10047
44385
227665
158476
430526
4830
3687
4371
8729
12744
11298
4503
3345
4210
4424
3719
5407
5276
6208
8910
11345
103006
11503
5460
7924
3018
9837
5888
6738
16656
0
3069
10563
5028
1444
9716
12093
5618
9241
0
8443
132239
8222
4913
4182
6081
7847
589
741
3939
4928
5517
6564
9559
10946
0
9028
3812
86868
5071
4764
3776
5729
6694
10741
6847
8194
4390
3253
807
1592
1057
1173
2585
66673
2322
3917
6953
5130
8351
4654
2243
5397
2773
41740
Blindness
Cataract
Trachoma
Conjuntivitis
Oral ulcer,
mucosa and
other related
diseases
Eye Problem
Other disorder
of teeth
Periodontal
diseases (gum
diseases)
Oral Health
Dental Carries/
Toothache
District Name
Received Reports
District Code
997
3044
3118
7159
48
39
2
20
68
21
4
16
31
32
51
46
266
198
114
123
1079
126
37
75
28
43
73
168
21
0
9
302
32
4
91
248
191
220
0
1343
3011
72
409
55
4
125
0
3
62
91
57
99
53
66
0
514
32
1642
32
36
113
68
51
35
24
28
16
64
0
58
58
41
44
668
10
75
136
73
73
17
32
10
333
759
487
6482
38120
45089
13
0
10
1296
34697
8
1
21
14
5
50
31
27
20
36
30
36259
122
65
93
77
384
99
133
126
0
21
326
72
8
120
1267
108
385
0
782
4188
188
105
140
49
1395
1
1
1
22
5
12
1494
29
0
25
94
3561
10
71
4
57
64
128
77
29
40
158
4
0
12
16
68
738
23
43
24
28
164
11
18
30
2
343
855
4878
9905
15638
30
34
23
4564
937
79
7
54
17
78
157
48
63
46
257
97
6491
220
275
398
90
19
133
97
1451
0
42
603
207
28
105
405
197
411
0
1492
6173
130
96
147
37
244
0
0
8
13
27
23
63
58
0
186
120
1152
7
16
12
121
283
60
250
81
34
162
16
30
37
32
26
1167
40
172
93
94
102
39
24
51
40
655
304
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
193
613
489
1295
6
9
6
23
40
0
2
0
10
2
16
4
19
6
44
14
201
11
74
30
48
8
6
6
6
0
7
61
5
1
20
6
22
56
0
23
390
8
1
12
18
30
0
2
3
9
36
2
27
10
0
62
1
221
0
21
7
17
20
4
20
57
4
61
1
19
27
8
26
292
19
38
26
42
33
3
6
16
8
191
327
1131
727
2185
15
23
12
51
47
6
0
6
29
2
23
7
16
9
28
50
324
21
88
19
28
3
11
9
33
0
3
103
5
2
34
8
35
70
0
14
486
11
0
1
5
121
0
0
8
4
14
7
36
27
0
45
1
280
28
23
47
22
44
21
56
106
85
110
1
36
53
4
39
675
28
64
90
69
88
17
29
22
13
420
43
324
166
533
2
3
0
1
42
0
0
0
1
0
2
0
8
0
5
4
68
3
4
5
0
0
7
0
2
0
4
82
0
1
2
0
18
1
0
52
181
5
0
3
19
143
0
0
0
0
0
0
20
0
0
1
4
195
1
2
0
2
14
1
0
0
6
0
0
0
0
1
0
27
3
6
3
2
15
0
2
11
20
62
98
967
508
1573
2
0
1
20
77
4
11
1
8
10
20
1
0
99
94
21
369
18
74
7
10
1
48
10
0
0
13
299
3
0
7
1
39
22
0
43
595
1
0
7
188
202
1
0
0
5
11
7
24
14
0
15
19
494
0
4
26
1
14
7
19
2
2
0
0
0
2
0
0
77
2
4
6
1
13
7
3
1
1
38
130
1599
832
2561
24
11
14
31
198
1
29
13
25
20
5
1
1
8
14
94
489
82
20
10
4
5
27
45
4
0
8
872
1
0
35
0
2
23
0
65
1203
0
0
4
64
264
2
0
2
12
23
37
19
43
0
156
7
633
1
1
104
0
25
4
32
2
9
6
0
0
1
0
0
185
1
0
5
0
32
0
7
6
0
51
26
151
215
392
1
1
2
40
66
0
0
0
1
0
3
0
1
2
13
13
143
1
6
3
1
0
10
1
4
0
0
43
0
0
7
10
9
5
0
18
118
1
0
4
15
16
0
0
2
2
2
0
21
1
0
12
0
76
1
1
0
0
11
2
6
4
3
2
0
1
0
0
4
35
1
4
3
0
9
0
3
0
0
20
26
99
83
208
1
0
0
5
5
0
0
0
0
1
3
0
1
1
7
13
37
2
8
3
0
0
8
3
0
0
6
16
1
0
5
6
15
7
0
9
89
2
0
2
0
9
0
0
0
0
4
0
20
1
0
0
4
42
0
0
7
0
3
2
0
0
0
7
0
0
5
0
0
24
1
5
1
1
3
0
5
0
0
16
71
855
606
1532
8
42
28
105
41
11
4
2
2
4
13
14
5
26
23
35
363
12
81
42
18
2
9
8
12
0
0
79
0
1
72
4
16
31
0
40
427
16
1
13
1
73
0
0
48
0
36
5
90
21
0
14
23
341
22
9
7
18
64
15
37
10
6
21
0
0
6
9
7
231
1
4
14
87
18
0
38
5
3
170
64
638
1100
1802
0
13
3
543
66
0
0
4
31
0
9
1
0
10
10
19
709
15
33
6
2
0
6
2
19
0
1
43
0
0
15
1
292
5
0
47
487
3
0
2
1
80
0
0
15
0
5
1
353
2
0
3
18
483
1
3
3
2
15
0
29
6
3
5
0
0
2
0
2
71
7
1
11
1
14
1
10
3
4
52
23
465
74
562
0
1
1
2
2
0
0
0
9
2
6
0
1
0
0
21
45
2
3
7
4
0
1
0
1
0
2
19
2
0
1
0
6
1
0
18
67
0
0
2
0
394
0
0
0
0
0
0
3
0
0
0
4
403
0
0
0
0
0
1
4
0
3
2
0
4
0
0
0
14
2
0
3
0
7
0
1
19
1
33
45
414
181
640
3
8
4
5
7
0
1
0
2
5
5
0
1
10
24
15
90
6
1
8
2
5
7
3
8
0
1
104
83
0
12
8
14
6
0
9
277
4
0
4
5
25
0
0
3
0
13
1
19
15
0
14
2
105
0
1
5
2
13
4
18
8
3
25
0
0
4
0
10
93
5
3
12
7
16
6
7
16
3
75
311
1207
495
2013
32
30
26
32
69
7
19
7
13
21
52
27
17
126
11
28
517
1
26
21
33
10
37
34
24
0
9
105
164
2
76
31
32
52
0
26
683
17
0
14
31
10
1
2
12
8
62
10
77
13
0
31
38
326
16
17
11
12
75
5
28
34
4
58
0
6
45
8
40
359
11
18
13
6
34
4
12
20
10
128
1801
7455
7272
16528
26
56
12
747
222
65
103
39
809
287
59
6
18
75
38
316
2878
36
52
33
2
6
99
688
23
0
15
760
118
1
55
167
48
33
0
61
2197
20
1
32
113
4243
0
1
4
7
65
20
151
12
0
11
330
5010
9
2
48
7
50
30
67
79
28
47
0
19
8
7
18
419
6
53
390
18
1930
3521
54
45
7
6024
Abortion
Complications
Other
Complicatiob\ns
/ Condition
Retained
Placenta
Postpartum
Sepsis
Ruptured Uterus
Obstructed
Labour
Prolonged
Labour
Postpartum
Eclampsia
Anteparturm
Eclampsia
Hyperemesis
Grivaduram
Pregnancy
included
Hypertension
Ectopic
pregnancy
Heamorrhage:
Post-partum
Obstetrics Complications
Heamorrhage:
Antepartum
District Name
Received Reports
District Code
307
3769
1202
5278
14
19
35
50
29
10
19
4
28
21
7
6
43
58
57
109
509
37
135
43
9
11
42
43
65
0
49
501
33
5
101
17
63
86
0
187
1427
15
8
37
92
1152
0
3
30
27
19
20
190
16
0
28
55
1692
11
26
164
18
58
27
134
91
68
70
0
5
26
6
26
730
33
63
231
118
80
53
116
220
6
920
305
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
1449
14504
7717
23670
60
108
87
627
917
56
116
48
91
60
71
188
63
297
931
221
3941
42
352
168
67
347
317
293
1271
0
173
2123
196
22
483
127
268
104
0
2325
8678
647
144
309
345
1122
0
1
88
137
374
510
956
251
0
294
274
5452
188
312
596
428
207
73
144
253
181
419
6
19
105
13
120
3064
70
109
221
142
241
496
380
724
152
2535
8193
53769
28875
90837
341
456
344
2291
1741
514
300
373
1160
346
277
507
772
1122
1362
704
12610
590
1123
651
310
892
1456
1138
2448
0
599
3509
947
255
1881
684
954
652
0
3570
21659
2580
992
1740
1673
2689
26
158
438
1026
1828
2720
3526
1523
0
1757
1610
24286
1708
1593
1173
2230
2855
1035
1984
3094
1304
1357
137
483
571
86
499
20109
726
378
972
566
2467
3102
1857
1603
502
12173
3698
33655
35373
72726
288
119
368
1967
1475
1034
240
139
357
230
176
181
374
891
2854
1359
12052
1329
1816
1302
407
301
327
665
2389
0
519
2365
743
86
1317
866
1349
1130
0
1421
18332
1595
855
1216
1592
1630
12
31
419
659
1024
1568
1502
3388
0
3322
701
19514
725
591
802
1378
2280
1312
3277
1693
776
789
60
228
142
65
458
14576
239
355
646
252
2404
2354
1291
502
209
8252
4168
24637
22989
51794
304
231
584
1923
3214
1162
283
225
500
372
395
513
489
680
1230
788
12893
933
1226
760
328
718
1057
665
1804
0
348
2243
560
149
1093
397
901
519
0
1513
15214
1148
408
469
680
1514
15
20
603
290
579
721
1458
1296
0
2043
417
11661
226
478
651
613
929
425
1887
700
392
347
15
25
209
35
189
7121
197
199
689
168
1590
650
607
611
194
4905
2515
14977
12085
29577
165
236
243
1105
1208
419
257
216
302
282
161
172
220
319
242
514
6061
504
322
344
180
293
330
402
751
0
222
1416
383
78
879
399
247
185
0
1400
8335
505
205
333
237
691
6
20
171
206
242
453
680
672
0
562
252
5235
198
373
371
429
702
427
1022
752
693
314
0
28
134
18
183
5644
277
268
572
192
1484
726
284
356
143
4302
1214
8889
8516
18619
79
103
103
2644
622
148
110
55
123
193
116
118
212
390
435
357
5808
305
281
246
128
149
180
178
330
0
127
428
224
34
565
144
256
293
0
957
4825
427
148
262
262
879
4
6
164
92
222
277
419
317
0
181
203
3863
429
224
168
139
426
170
348
283
214
133
2
39
98
20
124
2817
83
63
196
102
390
140
93
174
65
1306
644
4338
4305
9287
64
26
66
2253
388
65
53
50
62
68
64
52
131
73
117
123
3655
72
84
74
32
93
123
81
633
0
58
273
72
25
340
51
80
54
0
118
2263
247
80
59
160
61
4
5
102
60
150
174
101
81
0
98
160
1542
73
127
118
74
247
53
171
103
70
91
0
29
37
10
45
1248
29
48
106
33
135
92
67
51
18
579
568
14776
6965
22309
28
42
167
449
1720
70
25
17
82
31
42
1269
122
118
113
152
4447
72
116
183
30
175
148
32
96
0
72
1714
50
5
272
159
148
152
0
2292
5716
2816
185
124
345
2009
5
7
36
133
313
735
1622
176
0
453
447
9406
68
50
135
146
409
69
132
105
83
98
0
9
29
21
8
1362
33
115
346
78
250
9
383
160
4
1378
325
5842
1968
8135
5
24
7
23
300
3
0
2
6
5
17
340
14
45
13
52
856
46
17
49
16
12
248
13
26
0
9
747
4
9
142
170
40
16
0
1036
2600
25
63
43
48
2996
0
0
14
9
95
550
117
234
0
20
38
4252
5
21
59
32
19
36
9
26
13
29
0
0
8
0
1
258
0
16
48
10
53
2
35
3
2
169
777
18118
6005
24900
221
15
190
607
1683
39
21
126
80
111
32
584
179
115
85
76
4164
40
205
98
43
147
9
111
140
0
51
1839
56
26
105
168
124
127
0
1176
4465
627
311
115
423
3235
6
10
57
326
748
898
3773
17
0
260
428
11234
500
119
349
477
694
60
344
116
248
217
0
24
60
14
9
3231
6
143
257
58
329
41
829
117
26
1806
129
995
1557
2681
4
4
2
14
734
0
0
1
12
3
11
3
8
42
14
34
886
13
26
29
8
5
88
4
1
0
4
67
85
0
58
2
17
8
0
505
920
15
62
15
18
164
0
0
5
26
64
60
138
50
0
31
34
682
1
5
22
4
1
5
17
5
0
20
0
2
4
0
0
86
0
3
16
9
59
0
9
10
1
107
405
2500
1944
4849
120
10
41
65
820
0
1
0
23
16
13
2
20
33
18
19
1201
2
9
55
6
9
139
55
14
0
65
467
98
0
69
6
9
16
0
627
1646
104
5
23
150
762
2
1
17
7
31
95
50
21
0
43
37
1348
82
3
42
15
87
10
22
21
8
27
0
1
33
0
5
356
0
13
60
9
102
19
92
3
0
298
666
4979
2647
8292
104
7
57
165
830
20
7
59
23
30
39
63
120
68
11
100
1703
18
69
92
5
15
355
33
235
0
145
1969
42
7
139
29
67
61
0
713
3994
40
144
68
75
443
2
1
18
28
107
96
368
19
0
86
73
1568
18
43
126
60
302
15
22
25
14
41
19
10
12
8
34
749
1
18
32
11
49
8
123
36
0
278
Epilesy
Alcoholism
Conversive
disorder
(Hysteria)
Mental
retardation
Anxiety
(Neurosis)
Psychosis
Dipression
Mastitis
(Ingorged
breast)
Breast lumps /
Breast Abscess
Mental Health related problems

Disfunctional
uterine bleeding
Menstrual
disorder
Leukerrhoea
(Veginal
discharge
Pelvic
Inflamatory
Disease (PID)
Gyne Problems
Prolapsed uterus
District Name
Received Reports
District Code
549
5756
2020
8325
18
3
16
21
855
10
4
4
21
101
370
388
54
33
2
40
1940
0
3
70
5
34
4
39
42
0
23
630
11
1
66
636
8
38
0
467
2077
475
237
20
53
1011
1
0
12
38
53
115
1104
2
0
40
43
3204
104
23
57
39
136
28
87
48
28
3
8
19
4
18
9
611
2
25
161
5
190
23
70
7
10
493
306
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
4
795
75
874
0
0
0
12
10
9
0
78
2
0
0
0
0
28
0
1
140
0
0
0
0
1
1
0
0
0
3
51
0
0
24
0
0
6
0
33
119
2
1
0
5
571
0
0
0
0
0
2
18
0
0
0
0
599
0
0
6
0
0
3
0
0
0
0
0
0
0
0
1
10
0
0
3
0
0
1
0
2
0
6
40
777
147
964
0
9
1
0
36
0
0
0
6
1
1
0
0
23
0
4
81
0
0
0
0
2
19
0
0
0
6
75
3
0
15
0
6
25
0
65
216
0
1
1
3
556
0
0
0
4
2
0
55
1
0
0
1
624
0
0
7
0
0
10
0
1
0
0
0
0
0
0
1
19
0
0
4
7
0
0
0
0
13
24
49
7479
3366
10894
4
390
0
0
424
0
2
98
5
3
5
3
0
785
1488
0
3207
20
1
36
686
27
0
2
5
0
4
995
0
25
1587
1
24
12
0
1242
4667
7
12
3
272
2304
5
0
2
2
15
5
213
0
0
39
2
2881
0
0
25
6
0
71
0
1
0
2
0
0
0
3
0
108
0
0
17
4
7
2
1
0
0
31
11208
78713
53036
142957
1110
977
2577
4315
6769
2203
753
759
1163
851
3189
1688
1045
1002
2208
4535
35144
4196
2970
2729
1178
1306
1933
1296
1588
0
2479
13373
1094
125
1288
1254
2248
2670
0
5055
46782
3435
2678
2245
4175
8304
454
787
622
1845
2418
4377
6618
2997
0
2736
2379
46070
1229
358
431
424
2002
609
2096
804
578
230
31
66
207
15
225
9305
143
232
753
340
2074
624
916
342
232
5656
909
9497
7088
17494
51
242
21
106
607
32
18
135
55
27
43
278
65
927
2014
205
4826
37
20
365
455
86
103
47
132
0
60
841
119
119
1637
24
100
591
0
1449
6185
120
193
37
331
802
0
0
35
62
113
326
1260
61
0
82
91
3513
6
25
224
89
49
648
57
7
33
76
71
24
139
8
10
1466
187
51
74
52
587
78
333
141
1
1504
18534
100191
61040
179765
568
564
1009
3779
3954
3473
621
466
1346
793
1837
2189
1648
1290
2902
5042
31481
3768
2852
4017
576
1465
2873
3298
4315
0
2266
10208
2458
286
1230
1645
2425
3082
0
4628
51392
5347
1862
3027
3021
5378
164
40
984
1662
3462
4557
6612
2354
0
4705
4172
47347
2705
1093
1296
3251
3070
2154
2787
2997
2572
1640
174
1019
992
442
1657
27849
1790
929
2408
1138
2905
3143
3552
4712
1119
21696
1607
5965
4781
12353
54
18
44
311
255
12
43
16
5
76
78
149
232
208
251
296
2048
491
302
1345
2
30
252
124
168
0
67
336
91
0
59
89
267
75
0
273
3971
81
120
158
113
412
10
0
58
475
62
563
158
25
0
273
932
3440
60
148
64
32
99
121
142
128
43
273
26
64
118
87
77
1482
119
82
97
156
214
29
119
85
511
1412
573
4628
1720
6921
17
0
33
23
610
2
41
15
56
25
137
122
57
21
4
27
1190
35
28
87
1
171
104
113
341
0
49
196
28
0
60
21
116
15
0
50
1415
869
196
71
41
940
0
0
32
34
57
23
582
36
0
16
54
2951
4
17
188
10
168
26
42
67
6
39
3
4
22
4
8
608
8
13
66
6
373
62
129
16
84
757
166
4190
735
5091
2
18
0
1
297
0
0
120
12
1
4
4
3
36
4
3
505
0
4
5
14
9
45
1
105
0
43
2391
8
0
38
1
93
4
0
23
2784
1
2
4
10
1052
0
0
8
1
13
25
161
1
0
0
14
1292
0
3
14
10
27
12
1
0
0
31
19
14
1
0
0
132
0
1
15
6
254
6
28
1
67
378
Other
cardiovascular
problems
Ischemic heart
disease
Rheumatic
heart disease
Acute
rheumatic fever
COPD
(Corpormonale
)
Cardiac failure
(CCF)
Hypertension
Lung Cancer
Cervical
Cancer
14
703
118
835
4
0
0
2
11
8
1
104
2
2
0
1
0
2
0
2
139
16
0
2
0
8
1
0
2
0
5
48
0
1
0
1
4
5
0
64
157
0
2
3
0
462
0
0
0
0
0
4
20
0
0
0
2
493
0
2
3
18
0
4
0
2
2
1
0
2
0
0
0
34
0
4
4
0
0
0
3
1
0
12
Cardiovascular related problems

Other Cancer
Malignancy
Breast Cancer
District Name
Received Reports
District Code
712
6696
2792
10200
17
202
9
43
379
39
11
179
30
31
6
65
3
378
350
18
1760
0
25
60
71
14
592
6
126
0
28
2692
20
5
749
43
11
28
0
1111
5581
76
30
51
99
1336
0
3
7
6
12
9
140
33
0
0
27
1829
1
6
15
31
106
290
24
4
22
28
0
3
10
7
6
553
0
27
20
27
248
27
110
18
0
477
307
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
66761 106898
326957 543627
163379 368636
557097 1019161
4336
7537
4510
4237
5755
6969
5425
22780
12133
22590
8917
20635
6298
6935
3925
5019
6977
12974
5369
11757
5469
9281
5041
12983
3887
11663
10306
8150
14733
13422
7553
28621
110634 205553
9415
27806
5293
20341
7466
23862
1721
5831
6750
12313
13650
4352
10439
14687
16782
20792
0
0
6104
7805
16765
28542
4643
10760
2558
2766
16175
9553
6112
8468
6089
18189
6545
20155
0
0
15659
16403
152166 252625
10161
20877
6951
15845
8251
14131
15455
18142
13689
19746
467
1968
2021
2425
5829
6709
9965
13145
10960
16763
14460
28483
16148
24339
10554
22212
0
0
6511
23180
6220
14105
137642 242070
8682
13370
7524
13740
6758
14238
6030
19070
7345
20485
9727
14549
9647
20097
9514
25722
10617
19449
3317
11323
550
1822
2210
5258
1812
7387
607
3673
2055
7022
86395 197205
3810
9962
5734
9726
13320
22815
6431
11097
10623
21285
9744
12024
6502
12616
10030
16125
4066
6058
70260 121708
7907
20593
19213
47713
195
617
154
725
1525
70
115
155
153
139
532
409
730
1944
5667
695
13825
855
468
1330
270
255
3378
313
461
0
363
1058
352
244
2905
394
491
743
0
1660
15540
229
202
285
959
412
38
8
371
257
307
2032
291
357
0
955
638
7341
258
187
889
342
821
1575
520
309
287
445
264
261
203
355
281
6997
298
475
595
303
583
173
374
300
909
4010
41275
187582
199791
428648
2371
1900
3354
10673
13994
11126
2500
1845
2476
3577
3040
6435
3817
3902
11539
17979
100528
14397
11213
12874
4267
3454
3087
4144
8231
0
2475
10189
3300
695
5580
4011
10338
12218
0
5923
116396
6032
3405
5643
5207
4812
617
510
1502
3267
4206
5689
5414
8207
0
11980
4185
70676
5950
4639
4898
7564
11285
8955
10442
9179
7488
5734
1046
2260
3139
1750
3908
88237
4468
4781
8461
3851
10759
5889
4622
6997
2983
52811
23348
119222
115552
258122
1092
931
1126
4092
7504
9811
1225
1251
2547
2109
2673
1945
1990
1436
6667
14679
61078
9632
5628
6675
1228
2670
718
3734
4505
0
1937
6505
1762
738
2743
1997
5189
5538
0
5074
66273
7268
3154
3487
4968
5874
270
624
1347
2787
4215
8567
7470
5314
0
7815
4718
67878
3163
3326
1605
2338
4836
2924
6028
3157
3398
859
202
828
1456
853
2362
37335
1544
2391
2885
2617
4622
3524
3005
3654
1316
25558
1402
4421
3745
9568
46
121
7
167
287
6
35
50
69
8
221
24
121
444
686
270
2562
278
102
428
27
19
418
90
116
0
28
557
69
28
542
26
125
187
0
226
3266
24
45
23
254
88
0
0
99
45
77
492
139
74
0
228
128
1716
33
28
332
55
86
237
91
56
17
49
8
35
61
46
27
1161
24
39
96
42
251
16
73
32
290
863
5401
24849
18833
49083
383
333
278
755
972
769
347
344
424
558
608
403
458
871
922
1489
9914
876
1369
1289
416
417
541
722
970
0
396
1059
507
123
569
482
1580
1360
0
553
13229
725
338
537
741
954
30
89
371
453
733
1213
944
886
0
1369
734
10117
837
657
624
580
1048
588
1144
1516
1056
700
25
255
269
170
654
10123
406
377
922
637
829
1035
410
759
325
5700
2142
13035
11289
26466
249
160
161
255
631
94
189
162
329
318
127
329
311
337
79
1147
4878
198
608
1350
745
1294
150
333
308
0
369
1088
229
39
203
260
392
1257
0
114
8937
420
220
456
398
284
37
42
133
149
388
410
487
432
0
110
166
4132
299
297
510
180
995
302
558
179
360
285
8
46
181
61
152
4413
134
162
277
113
1621
1146
306
255
92
4106
159
1070
968
2197
7
15
17
19
46
15
1
13
22
10
1
5
36
23
3
10
243
54
114
52
22
66
22
24
18
0
47
176
33
2
28
0
109
37
0
27
831
37
38
76
48
19
5
1
5
6
4
83
10
55
0
24
19
430
4
5
40
3
119
14
13
14
11
13
0
3
11
2
7
259
5
2
37
16
243
14
49
23
45
434
96
384
312
792
35
1
2
3
0
0
0
5
2
6
4
0
10
57
125
23
273
6
15
2
4
3
19
23
3
0
10
10
8
5
56
2
43
15
0
12
236
6
5
4
10
57
0
0
10
6
3
21
18
14
0
25
7
186
1
5
10
6
6
1
1
13
10
0
0
1
1
0
0
55
3
2
3
7
16
5
5
0
1
42
302
1634
1131
3067
32
14
7
15
8
3
10
17
88
25
10
18
59
143
105
129
683
0
241
135
53
39
71
66
73
0
13
9
30
5
56
29
221
28
0
23
1092
70
32
55
121
95
0
0
50
68
83
29
225
63
0
18
37
946
14
17
27
8
65
14
0
42
26
2
0
1
4
0
0
220
15
10
9
4
30
33
11
14
0
126
Physical
Disability
(Disable Person)
Snake Bite: Non

Poisonous
Snake Bite:
Poisonous
Other Rabies
susceptibile
animal bites
Dog Bite
Burns and
Scalds
Cirrhosis of liver
Arthritis,
Rheumatism and
Gout
Abdominal Pain
Insect/Wasp Bite
Gastritis (APD)
Falls/Injuries/
Fractures
13173 121478
50276
41407 545079 282763
46551 372028 713974
101131 1038585 1047013
115
13936
3251
2601
8485
5806
355
9539
5829
1997
18212
14181
4893
20460
11452
623
22977
46358
272
8310
7730
493
6451
3150
380
13008
2762
215
16135
7020
115
9920
3000
445
20828
5942
28
15603
2348
4347
11411
10037
10756
31648
20838
2340
23882
53766
29975 250805 203470
1347
22967
15895
1816
19471
34551
1831
24738 282491
179
9463
9783
248
15815
10170
10069
7885
7325
1028
17785
9449
1288
19646
9664
0
0
0
961
4426
6493
6216
20381
15859
315
10795
4216
800
2220
1894
10562
12682
10255
452
9537
11437
1237
16633
42176
1561
19886
35626
0
0
0
6659
14382
15487
46569 248712 522771
133
17834
7342
437
14060
15821
811
11130
9978
1574
13611
5568
1168
14039
8646
1
702
713
44
1898
661
1493
8883
3308
251
13988
5637
373
13217
3721
1263
24624
8504
849
17528
6801
1723
22868
22568
0
0
0
1880
18801
40494
540
10581
5276
12540 203764 145038
503
16363
3456
77
16313
4918
111
13485
7732
171
18334
7092
1028
16611
3743
3952
23744
26248
1573
21157
17800
457
16630
1519
76
25330
5521
252
10452
3465
0
2345
444
365
5537
1353
145
5553
1545
0
2823
0
0
5956
1491
8710 200633
86327
0
11399
7221
63
12020
7107
567
27391
16076
255
16089
9744
1099
23059
23908
236
10532
6392
503
8724
7874
566
16966
9025
48
8491
2060
3337 134671
89407
Pyrexia of
Unknown Origin
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Headache
(Migrain)
RTA (Road
Traffic Accident)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Other Diseases & Injuries
Received Reports
District Code
521
2275
1350
4146
27
11
32
23
18
21
88
12
36
2
3
3
3
13
24
611
927
154
27
16
16
253
68
157
40
0
15
211
2
1
103
3
23
5
0
223
1317
54
7
51
48
67
0
0
4
117
198
7
342
8
0
6
47
956
33
69
10
0
28
4
2
4
63
10
0
5
114
19
23
384
2
66
5
0
15
142
34
298
0
562
308
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
339
2661
3616
6616
22
10
25
516
283
33
10
17
26
33
14
8
38
51
32
32
1150
66
67
212
17
30
40
75
91
0
23
459
95
34
81
13
54
70
0
755
2182
104
26
35
32
540
0
3
83
14
52
51
158
14
0
261
35
1408
15
58
54
41
293
299
278
62
65
24
0
13
38
16
19
1275
12
23
88
14
292
59
68
41
4
601
179
1617
1391
3187
11
6
9
98
119
5
2
8
15
13
9
0
20
94
30
12
451
20
41
71
15
15
66
17
55
0
8
228
84
4
70
13
12
30
0
642
1391
57
14
8
22
403
0
0
15
2
33
29
109
62
0
22
16
792
2
5
89
17
62
13
34
17
18
13
1
1
21
1
4
298
9
14
36
10
97
21
54
8
6
255
1147
7995
7291
16433
74
59
77
691
550
159
43
47
103
124
61
81
170
148
76
154
2617
279
237
330
97
92
98
122
242
0
78
1332
68
41
172
51
105
328
0
1878
5550
209
131
104
161
1325
2
12
93
63
139
172
438
157
0
436
174
3616
109
136
165
185
391
87
762
233
172
132
1
29
153
55
80
2690
55
187
219
44
369
302
334
376
74
1960
305
1484
1799
3588
31
3
10
198
106
14
11
21
26
19
17
3
19
17
11
25
531
20
11
53
11
22
37
42
55
0
17
139
19
15
44
17
0
26
0
650
1178
54
38
14
55
298
0
1
25
13
26
16
83
29
0
60
62
774
9
36
83
48
237
59
172
23
10
23
0
2
62
2
8
774
15
39
37
10
54
74
75
19
8
331
Others
Prostatism
(BEP/BPH)
Epedidymitis/Orc
hitis
Phimosis/Para Phimosis
Hydrocelle
440
4460
3440
8340
40
15
28
320
327
44
12
8
31
52
8
11
112
54
24
28
1114
31
101
129
36
91
53
73
170
0
59
1220
143
28
165
8
25
62
0
1292
3686
92
24
29
44
652
0
1
37
20
89
100
363
101
0
173
40
1765
88
121
112
36
130
119
154
60
43
19
54
7
30
11
38
1022
14
39
81
17
324
56
102
107
13
753
Haemorhoids/(Pil
es)
Surgical Problems
Hernia
District Name
Received Reports
District Code
772
3751
1990
6513
24
8
25
65
176
3
8
3
27
17
3
5
15
16
3
2
400
128
0
49
11
24
662
11
111
0
28
529
20
2
24
8
7
8
0
913
2535
68
13
33
915
835
0
1
38
45
24
7
487
25
0
31
39
2561
10
3
50
22
305
29
37
17
19
9
0
1
13
0
0
515
3
9
144
10
53
156
97
14
16
502
178419
1080887
632804
1892110
14931
8963
15948
53603
40944
42996
9221
9398
29422
15636
12839
27221
20575
23598
23001
24367
372663
30533
21498
17909
9889
21764
33510
17126
51286
0
23448
84358
18593
4121
18982
26198
20983
18098
0
82529
500825
27183
32416
36331
26136
57735
651
5782
15889
20267
31795
39310
87385
36729
0
17268
19552
454429
29630
21636
18364
12780
77521
22429
24479
62395
25517
11522
1286
4784
4208
2257
7406
326214
19631
11641
33211
21792
51193
26724
35057
29906
8824
237979
309
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
Oral Health
related
Problems
Ear, Nose and

Throat Infection
Skin Diseases
Nutritional and
Metabolic
Disorder
Other Infected
Diseases
Other
Communicable
Diseases
Male
Communicable,
Water/Food
Borne
89.59
75.26
63.18
70.39
99.65
55.13
45.84
60.59
54.57
65.1
72
85.61
97.74
86.38
119.93
124.76
74.72
69.26
78.41
91.12
72.3
73.32
62.92
99.26
43.09
77.28
98.38
65.11
82.09
0
54.21
40.53
48.77
89.91
75
41.23
61.4
73.92
0
79.53
58.97
86.75
101.22
56.05
80.66
90.54
109.15
182.81
96.62
113.48
85.45
115.93
125.75
58.67
0
80.32
87.05
72.67
89.18
78.27
93.22
100.47
72.06
80.64
89.81
109.88
111.31
100.69
73.63
70.38
67.79
89.52
194.09
89.89
112.48
78.45
116.84
76.41
52.33
57.87
129.17
89.69
73.25
76.4
Female
% of OPD Visits for

Communicable,
Vector Borne
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Proportion by sex among

total OPD Visit
Communicable,
Immunizable
% of new OPD Visits

of Total Population
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
District Name
Received Report
District Code
Annex3.12:OutpatientsMorbidityAnalysedData
53.02
56.07
55.76
55.65
52.85
54.71
56.81
52.72
55.45
56.42
55.6
53.68
55.81
54.73
54.47
56.78
52.57
54.92
53.86
55.28
54.81
53.42
52.89
66.42
52.56
56.71
56.54
56.31
58.41
46.98
43.93
44.24
44.35
47.15
45.29
43.19
47.28
44.55
43.58
44.4
46.32
44.19
45.27
45.53
43.22
47.43
45.08
46.14
44.72
45.19
46.58
47.11
33.58
47.44
43.29
43.46
43.69
41.59
0.4
0.46
0.33
0.4
0.71
0.51
0.55
0.58
0.45
0.21
0.49
0.85
0.54
0.46
0.46
0.56
0.62
0.45
0.11
0.13
0.4
0.09
0.25
0.14
0.8
0.65
0.53
0.67
0.5
0.02
0.15
1.01
0.52
0.01
0.13
0.24
0.69
0.92
0.42
0.12
0.07
0.03
0.08
0
0.01
0.01
0.36
0.51
0.55
0.41
2.63
2.05
0.59
0.74
0.02
0.01
0.08
0.08
17.98
15.63
17.09
16.49
19.08
15.26
12.68
16.44
13.88
15.73
15.62
14.41
16.4
15.69
16.74
16.11
20.55
21.82
22.62
18.4
17.31
21.08
19.37
14.95
20.04
12.72
15.58
16.07
12.35
0.21
0.23
0.27
0.25
0.07
0.11
0.08
0.34
0.3
0.04
0.11
0.15
0.39
0.04
0.05
0.02
0.08
0.33
0.17
0.06
0.16
0.11
0.34
0.09
0.17
0.05
0.15
0.21
0.22
18.83
18.69
17.43
18.15
15.7
19.08
20.65
21.69
19.58
20.08
17.9
19.35
15.8
18.5
18.67
19.54
16.76
13.13
17.3
19.39
18.72
18.59
18.27
11.73
14.64
16.18
19.46
20.6
19.9
1.88
2.14
3.16
2.56
1.35
1.8
1.9
2.37
3.35
2.77
1.61
1.39
1.08
1.69
1.66
1.19
2.15
2.09
3.2
3.72
2.51
3.42
2.92
2.6
2.51
1.32
1.25
1.52
2.08
9.86
10.32
15.59
12.59
12.08
13.35
10.14
12.64
12.77
14.61
12.32
13.02
9.82
13.08
11.77
9.55
11.5
12.66
16.23
17.45
13.53
17.75
14.97
11.82
15.44
9.92
8.2
9.89
9.05
6.28
6.59
5.37
6.03
10.79
11.63
11.26
8.08
6.98
5.97
13.34
12.64
7.37
11.96
7.99
7.6
8.68
7.63
5.77
4.82
7.7
5.49
4.96
3.13
6.69
7.44
5.73
7.73
6.47
3.92
3.61
2.84
3.3
3.85
2.81
3.87
3.01
2.48
3.09
2.45
3.54
3.41
2.94
3.56
3.42
3.05
3.1
3.04
2.9
3.05
3.86
3.22
2.14
3.17
3.87
5.8
2.93
4.23
57.79
55.89
54.39
53.4
57.37
56.19
50.08
48.3
42.21
44.11
45.61
46.6
42.63
43.81
49.92
51.7
0.68
0.6
0.67
0.42
0.91
0.47
0.19
0.41
0.14
0.06
0.05
0
0.05
0.37
1.5
0.78
12.86
11.52
16.28
17.18
16.69
13.51
21.11
18.25
0.14
0.5
0.19
0.33
0.39
0.28
0.26
0.2
15.21
15.47
17.66
19.36
20.74
15.69
12.49
13.1
1.54
2.82
1.97
1.96
2.53
1.73
4.65
4.21
8.47
7.75
11.84
11.22
11.84
12.85
18.46
27.35
7.48
6.41
6.35
6.87
5.3
5.49
4.25
4.44
9.31
7.97
3.68
3
3.4
3.14
2.72
2.81
53.24
55.75
58.37
56.42
57.35
58.34
54.73
47.38
50.65
55.24
55.9
57.3
57.61
57.53
57.87
46.76
44.25
41.63
43.58
42.65
41.66
45.27
52.62
49.35
44.76
44.1
42.7
42.39
42.47
42.13
0.6
0.43
0.85
0.28
0.55
0.43
0.43
0.01
0.17
0.71
0.34
0.34
0.4
0.56
0.53
0.14
0.74
0.05
0.01
0.02
0.01
0.02
0
0
0
0
0
0.06
0.04
0.96
8.47
15.78
15
12.01
11.83
12.97
8.82
15.79
10.91
14.31
11.66
16.66
16.69
11.33
14.56
0.26
0.23
0.07
0.02
0.13
0.17
0.16
0.2
0.17
0.1
0.02
0.19
0.21
0.15
0.04
15.18
16.1
18.35
14.88
15.83
22.31
17.72
14.71
20.4
21.37
26.32
22.27
21.65
15.2
19.28
3.01
2.78
1.74
2.35
1.34
2.52
3.45
1.28
1.73
1.03
2.14
1.86
2.01
2.6
2.36
12.17
13.69
9.68
11.37
11.22
11.23
8.39
8.82
5.36
10.31
8.74
9.01
10.83
8.61
15.5
9.28
5.69
7.12
5.29
5.49
8.51
9.91
5.73
7.86
7.07
8.34
7.31
5.71
4.94
5.63
3.91
3.94
3.46
3.05
2.87
3.21
5.94
3.81
3
3.48
2.91
3.66
2.5
2.88
1.94
55.43
56.27
56.75
56.36
56.07
53.93
58.16
58.46
55.17
56.75
59.19
54.7
53.04
50.14
49.49
49.48
50.6
50.4
55.87
51.52
48.86
54.04
53.42
59.68
58.81
55.67
51.51
49.92
54.79
44.57
43.73
43.25
43.64
43.93
46.07
41.84
41.54
44.83
43.25
40.81
45.3
46.96
49.86
50.51
50.52
49.4
49.6
44.13
48.48
51.14
45.96
46.58
40.32
41.19
44.33
48.49
50.08
45.21
0.2
0.4
0.44
0.3
0.57
0.24
0.32
0.74
0.19
0.49
0.26
0.21
0.25
0
0.12
0.16
0.04
0.15
0.35
0.18
0.29
0.11
0.11
0.33
0.73
0.28
0.32
0.17
0.3
0.78
0.04
0.21
0.05
0.08
0
0.08
1.28
0.73
2.08
1.83
0.01
0.03
0
0.02
0.02
0
0
0.74
0.03
0.04
0.07
0.07
1.44
0.32
0.15
0.02
0
0.37
19.68
18.58
14.26
18
17.56
20.06
20.93
16.45
18.42
18.64
17.51
23.03
22.81
27.69
20.75
19.14
20.47
20.24
19.19
20.62
22.61
19.39
20.7
13.56
14.88
12.75
14.76
14.51
16.63
0.32
0.06
0.14
0.1
0.2
0.31
0.43
0.49
0.42
1.17
0.42
0.23
0.28
0.99
0.14
0.5
0.38
0.32
0.46
0.09
0.14
0.6
0.23
0.34
0.35
0.57
0.26
0.21
0.34
15.63
18.55
18.86
18.15
18.26
19.19
18.72
15.8
18.24
18.98
19.3
21.13
19.54
16.91
23.83
18.69
22.9
18.27
18.78
16.57
18.86
20.29
19.75
19.23
24.14
20.15
20.48
22.11
20.28
4.18
2.26
2.49
1.12
1.64
2.59
2.41
1.77
2.74
3.19
2.64
1.94
3.42
2.02
1.94
3.76
5.09
2.54
2.44
2.92
2.29
2.53
1.87
3.11
3.03
1.82
1.49
1.07
2.39
18.16
12.47
11.47
11.91
10.9
10.91
12.59
13.85
16.45
15.33
11.23
10.08
8.37
6.26
8.52
14.19
10.55
8.38
12.44
8.25
8.45
7.32
7.88
11.69
12.67
9.17
9.05
11.99
9.74
4.31
5.67
6.49
5.5
4.95
4.93
5.39
5.04
4.18
5.07
5.05
3.74
5.29
5.25
4.02
3.85
4.64
6
4.85
3.61
3.58
3.15
3.26
4.31
5.53
4.12
4.85
4.91
4.17
3.02
2.7
3.23
2.42
2.61
3.06
3.49
2.79
3.42
2.36
2.49
2.43
3.61
4.37
4.42
3.76
4.32
3.73
2.94
2.77
3.82
1.92
2.98
1.82
2.46
2.31
4.24
5.47
2.78
310
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Surgical
Problems
Other Diseases
and Injuries
Cardiovascular
related problem
Malignancy
Mental Health
related
problems
Obstetrics
Complications
Gyne Problems
% of OPD Visits for

Eye Problem
District Name
Received Report
District Code
Annex3.12:OutpatientsMorbidityAnalysedData
2.59
2.61
2.43
2.53
3.12
2.85
2.83
2.87
8.73
2.28
3.19
3.03
2.33
2.25
2.63
2.4
2.8
2.67
1.74
1.85
3.16
2.02
1.39
1.11
2.21
5.32
2.59
2.96
4.84
0.19
0.21
0.16
0.19
0.08
0.16
0.09
0.33
0.16
0.02
0.13
0.07
0.53
0.19
0.15
0.03
0.07
0.18
0.07
0.12
0.15
0.04
0.14
0.03
0.11
0.03
0.13
0.35
0.05
1.21
1.67
1.39
1.5
0.82
0.97
1.15
2.52
1.72
0.68
0.96
0.98
1.42
0.77
0.83
0.75
1.12
1.55
1.34
0.65
1.23
0.64
1.24
0.46
1
1.45
1.59
1.42
2.55
0.19
0.57
0.27
0.4
0.32
0.08
0.31
0.26
1.25
0.03
0.04
0.18
0.13
0.15
0.35
1.15
0.26
0.19
0.05
0.08
0.33
0.03
0.11
0.08
0.08
0.21
0.41
0.12
0.15
0.01
0.11
0.04
0.07
0.01
0.3
0
0
0.09
0
0
0.25
0.01
0
0
0
0
0.35
0.28
0
0.08
0.01
0
0
0.47
0.02
0.01
0
0
1.87
2.27
1.52
1.9
1.15
1.53
2.37
1.69
2.32
1.15
1.05
1.49
1.46
0.89
3.5
1.95
1.52
1.59
1.44
1.61
1.66
1.44
1.47
1.12
1.58
1.59
2.47
2.03
1.8
24.48
22.83
23.56
23.3
21.29
22.55
21.54
15.59
17.39
24.27
24.08
20.19
23.08
23.42
23.11
23.83
20.41
22.02
21.83
24.38
21.45
17.55
24.07
47.55
23.4
27.82
21.66
26.16
21.97
10.08
11.91
7.55
9.83
9.59
6.87
10.34
10.91
7.66
8.64
6.58
8.38
16.2
7.88
8.55
11.88
10.41
9.88
4.32
3.92
8.17
5.25
5.22
2.45
6.93
11.4
14.42
7.25
13.78
2.11
2.1
3.19
3.08
3.3
7.18
1.5
2.02
0.08
0.55
0.25
0.03
0.15
0.13
0.15
0.08
1.37
2.21
1.87
1.35
2.15
1.37
0.99
0.58
0.25
1.33
0.21
0.1
0.28
0.6
0.1
0.08
0.01
0.21
0
0.05
0.53
0
0.01
0.01
3.35
5.36
2.28
1.11
1.66
1.58
1.29
1.27
21.12
19.38
22.13
25.14
23.65
22.14
25.16
20.74
15.89
15.75
11.37
8.81
6.42
13.48
5.18
3.67
2.62
2.52
2.92
2.6
2.15
2.07
2.29
4.3
2.35
3.07
2.41
2.06
1.66
2.8
2.77
0.13
0.15
0.03
0.01
0.07
0.19
1.61
0.03
0.03
0.1
0.04
0.11
0.03
0.26
0.04
2.46
1.37
2.42
1.33
2.09
1.66
2.05
0.49
0.76
1.52
1.18
1.62
1.59
2.17
1.88
1.48
0.37
1.39
0.47
0.19
0.37
2.53
0.12
0.06
0.12
0.27
0.52
0.63
1.8
0.13
0.31
0.09
0
0.01
0
0.09
0.93
0.04
0
0
0
0.01
0
0.08
0
2.74
2.05
3.36
2.39
2.66
2.61
4.35
4.58
2.62
1.34
1.95
2.25
2.45
3.9
1.37
17.94
25.11
24.13
28.54
26.14
22.49
16.68
35.35
26.26
23.08
23.92
20.3
23.75
20.34
23.75
19.29
8.96
9.41
15.39
17.4
9.17
14.73
4.76
18.3
12.4
9.74
11.82
9.83
22.35
9.25
2.07
1.89
2.34
2.26
2.5
1.86
2.34
1.75
2.87
1.71
2.17
1.49
2.25
3.19
2.24
1.36
2.68
2.89
2.12
1.64
2.69
2.25
2.8
2.15
1.72
1.19
2.2
2.95
2.13
0.08
0.24
0.26
0.04
0.06
0.2
0.04
0.1
0.03
0.11
0.1
0.07
0.26
0.01
0.12
0.21
0.09
0.18
0.1
0.08
0.17
0.25
0.18
0.57
1.32
0.15
0.15
0.07
0.4
1.75
1.69
1.8
1.56
1.89
1.84
2.07
1.88
0.91
2.1
1.79
1.21
2.13
0.85
1.14
1.52
0.52
1.72
1.67
1.11
0.91
1.06
0.76
2.15
2.76
2.35
1.61
1.2
1.67
0.2
0.51
0.8
0.34
0.14
0.38
0.3
0.41
0.06
0.15
0.09
0.13
0.27
0.1
0.09
0.18
0.13
0.07
0.2
0.03
0.21
0.29
0.09
0.26
0.04
0.79
0.13
0.04
0.22
0.01
0
0.12
0
0
0.02
0.01
0
0.02
0
0
0
0
0
0
0
0.01
0
0.01
0
0
0.01
0.01
0
0
0
0
0.01
0
1.66
3.57
2.67
1.76
0.84
1.06
1.51
1.36
1.01
1.23
1.04
1.09
1.43
1.25
1.59
1.74
1.2
2.1
1.27
1.54
0.85
1.07
0.91
1.64
1.45
2.66
2.13
1.89
1.56
24.07
22.08
22.74
23.33
26.53
24.36
24.21
16.86
24.27
21.21
17.76
24.59
22.81
25.92
24.59
25.63
22
25.39
22.28
26.98
27.45
29.15
26.9
24.45
18.6
23.15
26.07
25.01
25.15
3.87
9.28
11.69
13.16
11.26
8.99
5.15
19.43
6.02
6.17
16.33
8.62
7.26
5.18
6.46
5.3
4.97
8.01
10.18
13.55
7.64
10.55
11.5
12.95
10.01
18.37
12.21
8.38
11.87
311
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
'LVWULFW1DPH
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
5HFHLYHG
5HSRUWV
'LVWULFW
&RGH
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
OPD
Hospital
8OWUDSRRU
'HVWLWXWH
34471
163509
59279
257259
177
22
0
4249
2290
0
1067
2917
759
12668
0
561
0
2114
3909
21917
52650
374
0
11846
2071
680
0
1008
0
41
68
0
4498
271
29042
8605
0
0
0
0
58504
5772
406
36333
1476
0
0
135
0
2
0
5956
25
3590
397
0
657
54749
687
7310
0
8860
72
0
1838
0
2984
8609
92
0
4517
3205
0
38174
13446
0
13430
1302
4552
4245
5301
45
10861
53182
3RRU
43051
38850
50943
132844
21223
13
0
5097
9101
0
1930
14
6
0
0
371
0
0
3301
12677
53733
397
0
4546
4221
0
0
1056
0
203
0
0
24
0
471
12123
0
0
0
0
23041
33
186
1
1659
0
0
150
0
0
0
430
0
9376
352
0
0
12187
165
5014
0
0
51
0
0
0
1708
0
111
0
11894
4556
0
23499
0
0
397
2158
2306
3739
7581
148
4055
20384
'LVDEOH
2556
4653
32790
39999
13
0
0
151
4
0
91
33
18
0
0
87
0
113
643
752
1905
485
0
689
280
32
0
473
0
0
0
0
0
6
17
77
0
0
0
0
2059
3
67
102
315
0
0
468
0
0
0
602
106
0
56
0
34
1753
125
473
0
101
4
0
9
0
44
48
30
0
226
761
0
1821
0
0
32
389
29588
409
1433
49
561
32461
6HQLRU&LWL]HQ
12956
43550
16168
72674
161
372
0
4991
1925
0
104
2262
1617
418
0
42
603
622
695
2913
16725
417
0
1188
568
489
0
3078
0
15
0
238
3532
57
564
2606
0
0
0
0
12752
1649
1381
5766
6470
0
0
396
0
107
0
4429
1186
163
353
0
747
22647
1124
859
0
557
859
0
172
0
1192
433
25
0
1430
1082
0
7733
975
0
3983
657
2046
446
375
200
4135
12817
3+&
)&+9
5174
6803
8786
20763
19
262
0
85
3443
0
0
535
7
0
0
3
141
114
19
76
4704
265
0
143
127
15
0
156
0
0
0
1246
99
10
208
187
0
0
89
0
2545
27
27
32
270
0
0
494
0
0
0
415
2083
1852
36
0
53
5289
82
125
0
12
7
0
25
0
75
20
11
0
127
259
0
743
0
0
156
437
2543
203
48
4
4091
7482
58715
326588
898467
1283770
0
6968
0
12825
39052
0
12237
3509
0
19551
8123
0
2193
4
30220
33966
168648
10485
23758
38292
8718
629
0
23777
13716
0
4407
0
10784
3625
1133
10759
0
27933
13
10611
188640
17676
677
13511
7346
0
0
4055
2953
934
951
22975
7371
24522
574080
0
12189
689240
15287
14150
0
2067
13270
0
37796
66626
7036
0
0
1160
2496
0
0
159888
6621
8851
13019
1785
5476
16168
4854
20573
7
77354
7RWDO
156923
583953
1066433
1807309
21593
7637
0
27398
55815
0
15429
9270
2407
32637
8123
1064
2937
2967
38787
72301
298365
12423
23758
56704
15985
1845
0
29548
13716
259
4475
1484
18937
3969
31435
34357
0
27933
102
10611
287541
25160
2744
55745
17536
0
0
5698
2953
1043
951
34807
10771
39503
575274
0
13680
785865
17470
27931
0
11597
14263
0
39840
66626
13039
9110
269
1160
20690
9863
0
231858
21042
8851
31017
6728
46511
25210
19592
21019
23710
203680
312
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
'LVWULFW1DPH
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
5HFHLYHG
5HSRUWV
'LVWULFW
&RGH
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Emergency
Hospital
8OWUDSRRU'HVWLWXWH
2787
23115
10965
36867
57
23
0
309
478
0
51
555
440
1098
0
1
45
82
42
4980
8161
1102
0
801
306
458
0
168
0
0
11
0
155
43
2571
919
0
0
0
0
6534
525
0
3210
393
0
0
2
1032
191
0
2460
18
715
462
0
94
9102
1056
484
0
325
68
0
9
0
1963
841
7
0
267
365
0
5385
1029
0
3421
278
1242
757
516
33
409
7685
3RRU
'LVDEOH
5690
4206
4372
14268
2363
83
0
387
644
0
65
0
16
0
0
5
37
4
37
26
3667
12
0
38
258
0
0
126
0
0
7
0
123
0
0
780
0
0
0
0
1344
244
0
0
778
0
0
2
9
0
0
106
68
1766
419
0
0
3392
217
329
0
0
44
0
1
0
78
0
4
0
817
458
0
1948
0
0
0
269
519
479
641
105
1904
3917
6HQLRU&LWL]HQ
220
1104
296
1620
1
0
0
25
18
0
12
0
9
2
0
0
6
3
1
0
77
14
0
27
48
0
0
13
0
0
0
0
0
0
4
12
0
0
0
0
118
62
0
348
4
0
0
63
0
16
0
106
15
0
58
0
22
694
47
17
0
13
13
0
0
0
32
14
3
0
24
107
0
270
0
0
12
252
79
61
34
23
0
461
1333
9855
3083
14271
33
42
0
598
135
0
8
318
383
224
0
7
189
58
0
87
2082
15
0
32
52
205
0
376
0
0
3
1492
843
8
131
175
0
0
0
0
3332
381
0
1910
455
0
0
18
0
252
0
604
69
51
469
0
17
4226
1052
151
0
38
915
0
5
0
312
46
3
0
224
106
0
2852
149
0
247
267
663
113
152
155
33
1779
3+&
)&+9
125
2243
796
3164
1
63
0
6
318
0
0
20
1
2
0
0
14
17
0
0
442
19
0
6
36
0
0
15
0
0
21
1570
20
4
25
15
0
0
0
0
1731
30
0
0
20
0
0
12
0
19
0
21
24
320
43
0
0
489
27
41
0
7
26
0
0
0
26
3
1
26
23
38
0
218
0
0
13
170
15
43
37
2
4
284
7RWDO
3435
15409
24994
43838
0
1536
11
361
3573
0
538
69
0
1001
393
0
505
0
1023
1179
10189
132
7192
2509
585
501
0
1536
487
0
516
19
362
85
172
960
0
3703
0
58
18817
1124
50
63
0
0
0
55
13
0
194
2643
94
3322
0
0
20
7578
885
333
0
74
901
0
532
1764
68
0
0
196
152
0
0
4905
261
754
10
43
0
509
291
478
3
2349
13590
55932
44506
114028
2455
1747
11
1686
5166
0
674
962
849
2327
393
13
796
164
1103
6272
24618
1294
7192
3413
1285
1164
0
2234
487
0
558
3081
1503
140
2903
2861
0
3703
0
58
31876
2366
50
5531
1650
0
0
152
1054
478
194
5940
288
6174
1451
0
153
25481
3284
1355
0
457
1967
0
547
1764
2479
904
18
222
1507
1074
0
15578
1439
754
3703
1279
2518
1962
1671
796
2353
16475
313
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
'LVWULFW1DPH
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
5HFHLYHG
5HSRUWV
'LVWULFW
&RGH
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Inpatients
Hospital
8OWUDSRRU'HVWLWXWH
1713
10972
4527
17212
49
0
0
20
0
0
0
584
495
1257
0
231
70
44
0
2761
5511
0
0
89
156
252
0
69
0
9
0
0
137
30
1234
24
0
10
0
0
2010
133
80
1464
564
0
0
15
0
129
0
163
0
149
92
0
90
2879
296
310
0
570
11
0
2
0
996
431
0
2
266
267
0
3151
440
0
1245
136
962
431
280
87
80
3661
3RRU
'LVDEOH
3079
2475
562
6116
2053
0
0
0
0
0
0
33
8
0
0
176
28
0
6
0
2304
0
0
5
108
0
0
38
0
6
0
0
13
0
0
70
0
2
0
0
242
48
81
0
867
0
0
30
0
0
0
36
16
288
22
0
0
1388
89
173
0
0
11
0
39
0
0
0
0
0
630
305
0
1247
0
0
0
116
0
189
171
444
15
935
6HQLRU&LWL]HQ
149
422
47
618
1
0
0
0
0
0
0
0
3
0
0
23
1
0
0
0
28
0
0
0
44
1
0
16
0
0
0
0
29
0
8
5
0
3
0
0
106
7
7
7
0
0
0
28
0
0
0
75
1
0
8
0
0
133
25
13
0
6
14
0
15
0
0
4
0
0
8
81
0
166
0
0
0
140
0
7
23
3
12
185
1008
4195
920
6123
37
70
0
0
4
0
0
160
376
361
0
12
48
14
0
0
1082
0
0
0
29
156
0
334
0
0
0
27
285
4
43
13
0
8
0
0
899
136
144
314
632
0
0
32
0
213
0
175
91
1
53
0
33
1824
534
44
0
68
630
0
13
0
154
29
0
0
57
62
0
1591
93
0
158
124
171
40
77
51
13
727
3+&
)&+9
76
276
173
525
4
2
0
0
86
0
0
9
35
0
0
0
1
14
0
0
151
0
0
0
24
1
0
5
0
0
0
32
1
0
14
0
0
2
0
0
79
5
1
7
1
0
0
18
0
3
0
0
7
60
1
0
1
104
9
6
0
9
14
0
6
0
6
0
0
11
0
3
0
64
0
0
7
104
0
4
12
0
0
127
7RWDO
1349
4652
5249
11250
0
90
0
230
416
0
0
20
0
891
313
0
0
0
1642
804
4406
0
560
237
324
38
0
420
106
0
19
0
105
24
95
190
0
190
0
30
2338
464
65
0
0
0
0
52
0
0
0
1139
0
635
0
0
0
2355
72
267
0
7
96
0
166
554
0
0
0
40
0
0
0
1202
0
500
0
0
186
57
0
206
0
949
7374
22992
11478
41844
2144
162
0
250
506
0
0
806
917
2509
313
442
148
72
1648
3565
13482
0
560
331
685
448
0
882
106
15
19
59
570
58
1394
302
0
215
0
30
5674
793
378
1792
2064
0
0
175
0
345
0
1588
115
1133
176
0
124
8683
1025
813
0
660
776
0
241
554
1156
464
0
53
961
718
0
7421
533
500
1410
620
1319
728
563
791
120
6584
314
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
'LVWULFW1DPH
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
5HFHLYHG
5HSRUWV
'LVWULFW
&RGH
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
Reffer
Hospital
8OWUDSRRU
'HVWLWXWH
123
1590
269
1982
17
14
0
73
13
0
0
40
24
0
0
4
0
14
5
85
289
0
0
2
91
0
0
0
0
0
0
0
9
2
754
31
0
0
0
0
889
43
0
19
159
0
0
2
0
0
0
0
0
42
0
0
8
273
68
52
0
0
0
0
0
0
0
100
15
0
22
37
0
294
4
0
66
21
17
32
91
6
0
237
3RRU
'LVDEOH
115
793
166
1074
50
6
0
51
9
0
9
0
1
0
0
5
0
0
3
54
188
0
0
4
50
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
254
0
0
0
415
0
0
2
0
0
0
0
0
27
0
0
0
444
14
2
0
0
0
0
0
0
0
0
2
0
38
22
0
78
0
0
1
7
0
18
62
22
0
110
6HQLRU&LWL]HQ
13
92
32
137
0
0
0
6
0
0
0
0
0
0
0
0
0
0
8
16
30
0
0
2
29
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
44
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
6
4
0
0
0
0
0
0
0
0
13
8
0
0
5
0
30
0
0
1
14
0
0
12
0
0
27
89
2006
205
2300
9
18
0
142
7
0
0
9
43
9
0
0
0
0
0
52
289
0
0
1
31
0
0
27
0
0
0
1510
4
1
60
11
0
0
0
0
1645
9
0
3
194
0
0
1
0
0
0
0
0
0
0
0
0
207
92
0
0
0
0
0
0
0
0
12
3
0
4
1
0
112
0
0
10
11
2
1
20
3
0
47
3+&
)&+9
4
1600
36
1640
1
0
0
0
6
0
0
0
0
0
0
0
0
0
0
7
14
0
0
0
14
0
0
0
0
0
0
1543
3
0
23
0
0
0
0
0
1583
0
0
0
5
0
0
1
0
0
0
0
0
21
0
0
0
27
0
0
0
0
0
0
0
0
0
8
2
0
0
0
0
10
0
0
0
2
0
2
2
0
0
6
7RWDO
1149
1456
1991
4596
0
56
0
206
152
0
11
105
0
47
1084
0
0
3
249
399
2312
0
535
30
201
5
0
37
30
0
56
0
78
0
77
6
0
80
0
0
1135
44
242
24
0
0
0
8
0
0
0
3
4
174
0
0
17
516
182
18
0
0
2
0
119
144
0
0
0
0
4
1
0
470
2
13
7
2
0
45
0
94
0
163
1493
7537
2699
11729
77
94
0
478
187
0
20
154
68
56
1084
9
0
17
265
613
3122
0
535
39
416
5
0
64
30
0
56
3053
94
3
927
248
0
80
0
0
5550
96
242
46
779
0
0
14
0
0
0
3
4
264
0
0
25
1473
360
72
0
0
2
0
119
144
0
133
30
0
68
66
0
994
6
13
85
57
19
98
187
125
0
590
315
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
150340
949969
764586
1864895
4926
8095
9372
49405
28378
33226
26042
8764
11609
26291
7294
12509
11644
14841
45033
45367
342796
33261
32232
47359
8443
20923
21154
23329
242024
0
12027
33053
19725
3188
33165
14219
11795
39258
29070
81084
705309
17536
21251
16277
36715
29223
507
1349
22856
25254
25616
38112
24579
44597
65726
33594
22803
425995
14349
11697
7204
13881
25058
37745
27642
26999
18271
8327
298
4213
19204
2697
5314
222899
10041
9090
22584
16437
29532
25224
17705
11156
26127
167896
967365
3901 25416
5374247 49300 152252
5714598 65150 157771
12056210 118351 335439
84457
305 1347
127565
2797
887
123136
396 1409
184224
952 14719
340299
4093 5844
451003
2436 5060
100579
95 4767
74978
2813
731
130394
333 2173
148850
209 1921
64667
637
573
133323
307
447
110200
7524
529
176360
624 1149
437115
3789 3713
451776 10967 17681
3138926 38277 62950
365291
8691 11708
315326
1305 4117
363954
602 13802
87504
604 3343
141989
108 1535
140292
33 3432
144930
331 4268
57690
763 23415
0
0
0
49582
370 1787
184935
1648 9737
106673
764 2132
31229
3
345
222690
638 2880
129852
3349 5431
87994
1810 2786
371169
912 4178
272561
11
0
151667
260 28025
3225328 22202 122921
121675
531 10895
96690
37 6357
88302
823 3586
178324
1229 15665
131412
340 2833
3870
27
0
13361
17
274
84679
74
385
150411
3879 2367
171941
261 2077
286425
661 5651
169595
161 3007
294187 10602 8686
0
0
0
236412
1651 5961
131234
477 4462
2158518 20770 72206
155189
156 3680
179120
2505 1630
75806
99
677
158167
3317 4106
281013
1074 8352
279519
3592 4710
332956
308 3040
251582
1112 6316
224428
157 3681
124396
3623
413
3277
6
0
49920
1871
936
2868
41 1172
24898
24
257
27401
92
0
2170540 17977 38970
112328
47 1190
112827
131 2493
230029
289 1177
144325
2574
427
286807
7737 11441
211325
4358 3948
121818
3368 3460
122793
618 7300
20646
3 6956
1362898 19125 38392
154722 98208 10155 6025

854868 257365 40523 18340
788603 167966 19512 6229
1798193 523539 70190 30594
19824 21593 2455 2144
12632
669 211
72
19852
0
0
0
64935 14573 1325
20
58685 16763 1593
90
51926
0
0
0
12360 3192 136
0
10095 5761 893 786
17286 2407 849 917
18034 13086 1326 1618
5690
0
0
0
4847 1064
13 442
3890
744 291 148
14103 2963 164
72
22412 8567
80
6
46564 38335 5093 2761
383135 129717 14429 9076
51585 1938 1162
0
28900
0
0
0
58823 18412
904
94
12606 7267 700 361
15051 1216 663 410
22971
0
0
0
32747 5771 698 462
6488
0
0
0
0
259
0
15
6334
68
42
0
71722 1484 3062
59
11592 8153 1141 465
1543
344
55
34
27867 30302 2731 1299
31389 23598 1901 112
7465
0
0
0
40375
0
0
25
0
89
0
0
52678
0
0
0
480136 98901 13059 3336
84769 7484 1242 329
25465 2067
0 313
26598 42234 5468 1792
56576 10190 1650 2064
14480
0
0
0
0
0
0
0
3580 1643
97 123
5991
0 1041
0
15222
109 478 345
10940
0
0
0
26616 11832 3297 449
29365 3400 194 115
82813 14981 2852 498
0 1194 1451 176
27422
0
0
0
25184 1491 133 124
435021 96625 17903 6328
15035 2183 2399 953
20499 13781 1022 546
9532
0
0
0
18646 9530 383 653
33513
993 1066 680
20670
0
0
0
38576 2044
15
75
61703
0
0
0
25674 6003 2411 1156
4868 9110 904 464
0
269
18
0
2625
0
26
13
87 18194 1355 961
2305 9863 1074 718
0
0
0
0
253733 71970 10673 6219
15994 14421 1178 533
23293
0
0
0
16274 17998 3693 1410
6467 4943 1236 620
68194 41035 2518 1133
33067 9042 1453 671
3939 14738 1380 563
72163
446 318 585
6777 23703 2350 120
246168 126326 14126 5635
344
58715
3435 1349 1149 1117705 1274628 13590 7374
Total
Refer
Emergency
OPD
OPD
Refer
Indoor
7RWDO
+36+3
Indoor
Emergency
OPD
3+&
Refer
Indoor
Emergency
OPD
+RVSLWDO
<60 Yrs
>60 Yrs
3+&
Refer
192
468
240
900
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
228
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
192
12
12
12
12
12
12
12
12
12
12
12
12
12
12
12
180
12
12
12
12
12
12
12
12
12
108
<60 Yrs
Mountain
Hill
Terai
National Total
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Teharthum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udaypur
Saptari
Siraha
Eastern
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolkha
Sindhupalchowk
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Central
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
Mid Western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Far Western
+36+3
>60 Yrs
'LVWULFW1DPH
5HFHLYHG5HSRUWV
'LVWULFW&RGH
5394 1300986
6081 326588 15409 4652 1456 6324216 6908169 55932 22992 56837 7043930
708 898467
7133 1283770
77
0
38
6968
0
0
272 12825
35 39052
0
0
9 12237
49
3509
68
0
9 19551
0
8123
9
0
0
2193
14
4
16 30220
214 33966
810 168648
0 10485
0 23758
9 38292
215
8718
0
629
0
0
27 23777
0 13716
0
0
0
4407
3053
0
16 10784
3
3625
850
1133
242 10759
0
0
0 27933
0
13
0 10611
4415 188640
52 17676
0
677
22 13511
779
7346
0
0
0
0
6
4055
0
2953
0
934
0
951
0 22975
0
7371
90 24522
0 574080
0
0
8 12189
957 689240
178 15287
54 14150
0
0
0
2067
0 13270
0
0
0 37796
0 66626
0
7036
133
0
30
0
0
1160
64
2496
65
0
0
0
524 159888
4
6621
0
8851
78 13019
55
1785
19
5476
53 16168
187
4854
31 20573
0
7
427 77354
24994
43838
0
1536
11
361
3573
0
538
69
0
1001
393
0
505
0
1023
1179
10189
132
7192
2509
585
501
0
1536
487
0
516
19
362
85
172
960
0
3703
0
58
18817
1124
50
63
0
0
0
55
13
0
194
2643
94
3322
0
0
20
7578
885
333
0
74
901
0
532
1764
68
0
0
196
152
0
0
4905
261
754
10
43
0
509
291
478
3
2349
5249 1991
11250 4596
0
0
90
56
0
0
230 206
416 152
0
0
0
11
20 105
0
0
891
47
313 1084
0
0
0
0
0
3
1642 249
804 399
4406 2312
0
0
560 535
237
30
324 201
38
5
0
0
420
37
106
30
0
0
19
56
0
0
105
78
24
0
95
77
190
6
0
0
190
80
0
0
30
0
2338 1135
464
44
65 242
0
24
0
0
0
0
0
0
52
8
0
0
0
0
0
0
1139
3
0
4
635 174
0
0
0
0
0
17
2355 516
72 182
267
18
0
0
7
0
96
2
0
0
166 119
554 144
0
0
0
0
0
0
40
0
0
4
0
1
0
0
1202 470
0
2
500
13
0
7
0
2
186
0
57
45
0
0
206
94
0
0
949 163
6479184 7545617 44506 11478

13921105 15728414 114028 41844
89383 110976 2455 2144
135660 143297 1747 162
132508 132508
11
0
233629 261027 1686 250
368677 424492 5166 506
484229 484229
0
0
126621 142050
674
0
83742
93012
962 806
142003 144410
849 917
175141 207778 2327 2509
71961
80084
393 313
145832 146896
13 442
121844 124781
796 148
191201 194168
164
72
482148 520935 1103 1648
497143 569444 6272 3565
3481722 3780087 24618 13482
398552 410975 1294
0
347558 371316 7192 560
411313 468017 3413 331
95947 111932 1285 685
162912 164757 1164 448
161446 161446
0
0
168259 197807 2234 882
299714 313430
487 106
0
259
0
15
61609
66084
558
19
217988 219472 3081
59
126398 145335 1503 570
34417
38386
140
58
255855 287290 2903 1394
144071 178428 2861 302
99789
99789
0
0
410427 438360 3703 215
301631 301733
0
0
232751 243362
58
30
3930637 4218178 31876 5674
139211 164371 2366 793
117941 120685
50 378
104579 160324 5531 1792
215039 232575 1650 2064
160635 160635
0
0
4377
4377
0
0
14710
20408
152 175
107535 110488 1054
0
175665 176708
478 345
197557 198508
194
0
324537 359344 5940 1588
194174 204945
288 115
338784 378287 6174 1133
65726 641000 1451 176
270006 270006
0
0
154037 167717
153 124
2584513 3370378 25481 8683
169538 187008 3284 1025
190817 218748 1355 813
83010
83010
0
0
172048 183645
457 660
306071 320334 1967 776
317264 317264
0
0
360598 400438
547 241
278581 345207 1764 554
242699 255738 2479 1156
132723 141833
904 464
3575
3844
18
0
54133
55293
222
53
22072
42762 1507 961
27595
37458 1074 718
32715
32715
0
0
2393439 2625297 15578 7421
122369 143411 1439 533
121917 130768
754 500
252613 283630 3703 1410
160762 167490 1279 620
316339 362850 2518 1319
236549 261759 1962 728
139523 159115 1671 563
133949 154968
796 791
46773
70483 2353 120
1530794 1734474 16475 6584
67849 7669450
130080 16014366
382
2891
396
1430
4280
2436
115
2967
401
265
1721
316
7524
641
4054
11580
41399
8691
1840
641
1020
113
33
395
793
0
426
4701
858
6
1565
3597
1810
992
11
260
27752
627
279
869
2008
340
27
31
74
3879
261
664
165
10866
0
1651
502
22243
516
2577
99
3317
1076
3592
427
1256
157
3756
36
1871
109
90
92
18971
53
144
374
2631
7756
4456
3555
743
3
19715
115957
148097
132915
264393
434444
486665
142839
97747
146577
212879
82511
147667
133249
195045
527740
590861
3859586
420960
380908
472402
114922
166482
161479
201318
314816
274
67087
227313
148266
38590
293152
185188
101599
443270
301744
243710
4283480
168157
121392
168516
238297
160975
4404
20766
111616
181410
198963
367536
205513
396460
642627
271657
168496
3426785
191833
223493
83109
188079
324153
320856
401653
348781
259530
146957
3898
57439
45339
39340
32807
2667267
145436
132166
289117
172020
374443
268905
164904
157298
72959
1777248
316
SN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
Hospital Name
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Aawadnarayan Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Sukraraj Tropical and I. D.
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Lumbini Medical College
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Surkhet Regional Hospital
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Received
Average Length of
Reports
Stay
1163
3.3
12
2.8
12
2.8
12
2.6
12
2.2
12
3.1
12
2.8
12
3.5
12
1.8
12
2.9
8
2.0
12
4.0
12
2.5
12
6.6
12
1.2
12
2.1
12
3.3
12
2.6
12
1.8
12
1.9
12
0.1
11
2.8
12
1.9
12
2.2
12
1.9
12
2.0
295
3.0
12
1.2
12
3.7
11
3.0
12
2.4
12
2.9
12
3.2
12
8.9
12
7.4
12
3.2
12
3.5
12
3.2
12
4.1
12
2.3
12
2.7
0
12
2.9
12
2.8
12
2.5
12
3.6
12
1.8
12
3.8
239
3.9
11
2.3
12
1.8
12
2.2
12
4.5
11
3.6
12
2.2
12
1.4
12
1.1
12
2.8
12
6.4
12
2.9
12
3.7
12
2.4
12
1.9
12
1.9
12
2.5
12
2.7
12
4.3
11
4.3
12
2.4
12
1.9
12
2.8
12
1.9
273
3.5
12
3.4
12
2.0
12
2.8
11
5.1
12
2.1
12
1.3
12
2.6
12
3.1
12
2.4
12
2.1
12
3.1
12
2.6
12
1.2
12
4.3
12
2.9
12
2.4
12
2.9
203
2.8
9
2.0
12
3.1
12
2.3
12
2.4
12
2.2
12
2.4
12
3.6
12
3.1
12
2.0
12
2.2
12
2.2
12
1.7
12
2.2
153
2.3
Bed Occupancy
Rate
56.6
65.1
31.5
73.0
16.0
57.5
57.1
62.3
9.4
59.4
12.0
64.3
4.4
100.0
17.7
67.2
100.0
63.9
32.4
47.9
1.3
5.6
84.2
46.1
49.5
40.6
58.0
36.5
33.1
77.9
67.9
65.3
53.8
53.2
55.2
34.3
83.8
41.7
53.8
46.5
90.1
40.5
8.8
57.7
80.1
33.8
75.3
76.0
50.5
50.8
100.0
51.7
12.1
100.0
25.5
19.6
65.9
49.0
68.6
16.2
18.5
40.5
44.1
22.5
20.4
77.8
19.0
67.8
56.2
53.0
32.3
43.0
81.0
36.2
39.5
83.8
64.0
27.6
9.0
36.7
58.6
25.4
44.8
33.6
28.4
43.3
68.7
39.4
78.5
58.1
19.3
81.0
29.6
74.8
30.1
36.0
45.1
77.3
31.6
5.3
57.9
60.3
45.7
45.6
Bed Turnover
Interval
Throughput
% of Inpatients
% of Emergency
% of OPD
2.5
1.5
5.9
1.0
10.8
2.3
1.5
2.0
17.4
1.6
15.4
2.2
58.2
2.6
10.3
1.0
0.5
1.2
3.8
1.5
2.4
49.3
0.3
2.6
1.8
3.0
2.0
2.5
7.0
0.5
1.0
1.8
2.1
6.6
4.2
2.7
0.7
4.5
3.5
2.7
0.3
63.2
85.1
42.6
100.0
28.7
68.7
85.2
66.4
19.4
81.4
21.4
58.7
6.5
90.7
32.5
100.0
100.0
98.5
65.1
100.0
100.0
7.3
100.0
76.8
99.9
74.0
74.2
100.0
34.4
100.0
100.0
77.7
69.2
23.8
31.7
61.3
87.4
47.8
48.8
73.0
100.0
9.1
10.3
3.2
10.2
6.6
11.8
4.6
9.8
1.6
16.1
7.0
28.9
4.4
11.3
4.8
8.7
10.2
13.8
6.2
14.6
7.3
1.8
7.4
8.2
7.8
8.3
10.0
7.5
4.5
16.5
3.8
19.3
7.0
2.8
5.2
14.2
17.8
11.1
3.4
6.1
12.1
74.5
81.6
77.1
62.1
73.3
69.5
74.6
75.7
81.3
76.6
91.5
66.7
95.6
85.1
89.1
56.7
77.3
63.1
68.7
56.6
83.7
94.6
70.4
82.5
76.5
69.1
73.4
55.4
69.6
62.8
76.9
56.2
78.3
81.4
65.1
81.6
82.2
76.9
81.2
62.9
74.1
16.4
8.2
19.7
27.7
20.1
18.7
20.8
14.4
17.1
7.3
1.4
4.4
0.0
3.7
6.1
34.6
12.5
23.2
25.1
28.8
9.0
3.6
22.2
9.4
15.7
22.7
16.6
37.1
25.9
20.8
19.2
24.5
14.7
15.8
29.8
4.2
0.0
12.0
15.4
31.0
13.8
4.2
27.6
1.6
0.9
3.5
1.2
1.0
2.3
1.7
0.2
4.3
26.6
0.1
4.1
4.7
0.9
6.6
1.4
20.4
11.0
2.6
2.4
7.9
10.3
1.0
18.4
0.8
1.6
2.5
3.9
5.0
0.9
3.6
4.1
1.3
1.1
3.0
27.6
5.4
1.4
6.0
3.7
5.1
3.0
5.2
1.1
3.6
0.7
2.0
9.0
0.7
5.6
0.7
4.5
3.8
4.1
0.7
4.1
43.3
1.9
1.1
2.5
2.9
51.1
12.1
87.7
81.7
68.6
74.3
76.0
79.6
100.0
100.0
41.5
12.8
100.0
66.5
63.5
100.0
28.1
85.6
15.9
27.9
82.7
84.8
35.0
28.5
68.8
16.5
100.0
100.0
69.7
62.4
43.1
85.5
65.6
53.0
57.1
100.0
86.8
12.9
43.1
95.2
45.8
54.4
47.9
87.5
38.7
91.0
61.1
100.0
76.5
33.6
94.9
46.5
100.0
55.1
59.0
47.8
95.7
60.1
8.5
89.2
100.0
76.5
70.3
4.3
2.8
6.8
3.9
6.8
5.4
8.7
19.2
11.3
6.6
8.7
1.9
6.5
4.9
3.6
13.4
7.3
8.3
1.8
5.0
9.2
6.2
13.9
4.1
12.0
7.8
7.5
5.5
6.9
3.4
9.3
13.0
5.2
7.7
11.0
10.6
10.2
1.8
3.4
6.0
8.9
4.6
6.0
7.2
4.5
7.6
6.2
9.7
8.7
3.2
4.9
3.7
10.7
3.2
3.4
8.2
6.2
5.4
6.5
15.5
5.4
12.2
8.4
81.6
89.8
80.4
57.3
72.5
86.8
73.2
61.2
60.9
68.2
88.7
60.6
81.1
86.1
94.3
66.7
87.4
81.3
92.1
84.0
74.8
72.6
56.4
91.1
73.8
83.3
70.1
78.3
81.6
74.9
76.3
80.7
81.8
79.9
81.1
62.1
78.6
95.1
86.2
83.8
64.6
88.8
84.8
80.5
80.8
84.9
89.9
79.3
79.7
82.6
81.5
82.0
80.6
89.5
89.1
74.9
66.6
77.7
77.2
51.9
75.0
53.6
70.1
14.1
7.4
12.7
38.7
20.7
7.8
18.1
19.7
27.8
25.3
2.6
37.5
12.5
9.1
2.1
19.9
5.2
10.4
6.2
11.0
16.1
21.2
29.7
4.8
14.2
8.8
22.4
16.2
11.5
21.6
14.4
6.3
13.0
12.4
8.0
27.3
11.2
3.0
10.4
10.2
26.5
6.6
9.2
12.4
14.7
7.6
3.9
11.1
11.6
14.2
13.6
14.3
8.7
7.3
7.6
16.8
27.1
16.9
16.4
32.6
19.6
34.2
21.5
317
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
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19
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8
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14
0
168
323
0
0
193
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0
239
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0
0
0
0
0
0
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0
0
0
0
0
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0
0
0
0
0
0
0
0
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0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
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2216
479
5261
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6446
6483
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8676
442
6380
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107382
12516
414
1010
3399
2894
1642
1116
46865
20756
3713
3076
2904
2713
319859
44341
3305
4320
12235
11673
3530
492
2010
3209
2687
2940
1838
2692
2368
6269
2159
14328
120396
1410
4435
1620
4095
1100
1972
8227
4232
1732
962
26413
4840
14183
75221
Neonatal
Services
Provided
Examined in
Laboratory
Safe Motherhood
service provided
CT-Scan / MRI
ECG /
Ecocardiograp
h
Endoscopy /
Colonoscopy
Ultra Sound
X-Ray
Others
Services Provided in hospital

Total (OPD +
Emergency +
Others)
Total Preventive
Total Emergency
Total OPD
Total Inpatient
Discharged
Total Inpatients
Stay (Days)
Total no of
Inpatient
Total no of Bed
available
Hospital Name
Total no of Bed
Sanctioned
SN
Received Reports
423809 4500100 141353

463
10105
159
2832
11891
537
1224
28407
7
258
14314
985
3537
56782
1713
1882
9555
252
10883 167284
845
155
8119
0
280 286653
534
0
24778
4
0
0
0
1476
5970
77
1652
27052
389
182
1419
50
2478
24226
606
1186
25029
461
5437
7070
210
41
1588
1
2694
17260
1822
0
0
0
293
212
80
0
1246
20
1615
19730
284
1017
7580
159
2423
10501
804
42008 766771
9999
2015
7981
728
3292
58388
5216
8816 194508
778
1237
19478
487
17768
75128
1313
807
6891
149
110292 286238
0
0 226395
20912
0
65022
0
79649 358600
2841
1393
67414
1072
928 113443
903
1704
52322
1711
806
14025
801
674
2755
209
668
1275
6520
1063
24814
312
8493
259
8376
232499 1597459
218
6001
3114
18067
988
23207
1097
9284
0
2306
3207
17995
587
0
1120
3026
35195 240766
3857 561828
4518
36409
55
614
165
3191
2655
13270
2067
18628
1
2963
233
7148
1791 183803
1360 139189
2787
11667
1080
18867
291
6032
2519
19520
68905 1343781
8685 108829
4343
11102
2891
20612
503
28648
2297
28838
3051
6133
695
567
122
1873
2254
1653
525
6042
2081
5266
1996
801
2581
11220
281
12336
2360
11478
1742
12726
5499
52160
41906 320284
320
20007
1849
31376
420
15285
1483
10635
1107
2683
1087
5460
6899
36285
1136
4463
983
13390
1238
3386
4377 258740
3063
13201
14529
56894
38491 471805
120
34
1219
0
309
255
38848
228
1108
919
229
0
694
0
320
9925
1954
1089
10
48
539
172
0
30
1769
758
417
468
101
538
70414
1200
911
380
280
2410
1265
133
20
161
450
309
221
552
77
278
217
282
9146
90
602
217
303
164
131
2316
857
420
187
4681
1058
1920
12946
318
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
286
2
0
2
0
16
1
28
0
17
1
0
0
0
0
4
1
5
0
1
0
0
1
1
0
2
82
0
0
55
2
14
1
0
2
0
0
2
0
0
3
98
0
0
0
0
7
0
1
0
2
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
12
0
0
5
0
11
1
0
1
0
0
0
0
0
0
127
0
1
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0
10
0
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0
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13
0
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9
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0
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0
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0
0
0
0
0
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5
0
0
8
0
7
0
0
0
0
0
0
0
0
0
46
0
0
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0
0
0
1
0
0
0
0
0
0
0
0
0
13
0
1
0
0
0
0
0
0
15
0
0
3
0
8
0
0
2
0
0
0
0
0
0
141
1
0
0
0
2
0
12
0
0
0
0
0
1
0
2
0
1
0
0
1
0
0
0
0
0
20
0
0
7
0
15
0
0
0
0
0
2
0
0
0
202
6
0
0
0
0
0
21
0
3
0
0
0
4
0
6
0
3
0
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1
0
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0
0
0
44
0
0
9
0
22
0
0
0
0
0
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0
0
0
90
0
0
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0
0
8
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
6
0
0
31
0
0
0
0
0
0
152
0
0
0
0
0
0
14
0
0
0
0
0
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0
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0
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0
0
0
16
0
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0
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0
0
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6
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1
225
11
280
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170
7
0
0
24
3
9
9
59
2
16
64
14
13
4
5
5
936
1
1
392
4
545
7
0
403
0
0
66
0
0
26
6977
14
2
4
2
267
8
565
0
299
13
0
0
33
3
15
10
171
2
8
61
7
21
10
1
8
1524
0
0
389
4
608
6
1
650
0
0
53
2
2
30
11988
20
5
10
3
492
19
845
0
469
20
0
0
57
6
24
19
230
4
24
125
21
34
14
6
13
2460
1
1
781
8
1153
13
1
1053
0
0
119
2
2
56
1
0
25
0
0
0
1312
5
15
9
10
0
7
1
0
337
858
49
0
1
21
13
1
1
52
14
3
2
1
3
1403
359
8
2
12
35
7
1
1
61
5
3
0
3
0
5
5
118
625
6
0
0
5
1
0
32
8
3
0
114
45
40
254
0
0
33
0
1
2
1563
27
31
9
8
0
26
3
0
520
1015
76
0
0
17
11
2
1
87
41
7
5
0
0
1886
603
11
5
26
67
7
0
1
66
3
10
2
6
1
18
10
127
963
2
3
1
7
2
2
70
5
3
1
171
54
58
379
1
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
2
0
0
0
0
0
8
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
3
0
0
0
0
3
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
1
6
0
0
0
0
2
0
0
1
0
0
0
0
0
10
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
1
0
0
0
1
2
0
0
4
0
0
0
66
2
4
0
2
0
1
1
0
3
0
6
0
1
6
3
0
0
0
0
2
1
0
0
32
13
0
1
1
1
1
0
0
1
1
0
0
3
0
0
0
1
23
0
0
0
0
0
0
0
0
0
0
2
8
3
13
0
0
5
0
0
0
84
3
2
5
2
0
0
1
0
5
2
6
0
0
2
6
0
0
0
0
2
0
0
0
36
19
3
0
0
7
0
0
0
1
0
1
0
3
0
1
7
2
44
0
0
0
1
0
0
8
1
1
1
6
15
7
40
0
0
7
0
0
0
25
0
0
0
0
0
0
0
0
2
0
4
0
0
0
0
0
0
0
0
0
0
0
1
7
23
2
0
3
1
0
0
0
0
0
0
0
0
2
0
0
6
37
0
0
1
2
0
0
2
0
0
0
10
2
0
17
0
0
9
0
0
0
33
0
0
1
0
0
0
2
0
2
1
4
0
0
0
1
0
0
0
1
0
0
0
0
12
34
3
0
2
1
0
0
0
0
0
1
0
1
0
0
0
7
49
1
0
1
0
0
0
3
0
0
0
10
3
2
20
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
19
0
0
0
0
0
0
0
0
4
0
0
1
1
6
0
0
0
0
1
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
13
0
0
0
0
0
0
0
0
0
0
2
1
0
3
1
0
1
0
0
0
26
0
0
0
0
0
0
1
0
6
16
3
0
0
1
0
0
0
7
2
0
0
0
0
36
28
1
0
3
2
0
0
0
0
0
0
0
1
1
0
0
3
39
0
1
0
0
1
0
5
0
1
0
1
4
7
20
1
0
0
0
0
0
34
0
0
1
1
0
1
0
0
10
10
0
0
0
0
0
0
0
2
1
0
0
0
0
26
59
0
0
1
5
0
0
0
0
0
1
0
0
1
2
0
7
76
0
1
0
2
0
0
4
0
2
0
5
3
5
22
0
0
0
0
0
0
37
1
0
0
1
0
0
0
0
7
12
2
0
0
1
0
0
0
2
1
0
0
0
0
27
12
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
2
16
1
0
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
66
1
0
0
0
0
0
0
0
2
27
0
0
0
0
0
0
0
6
1
0
0
0
0
37
19
0
0
1
1
0
0
0
0
2
0
0
0
0
0
0
3
26
2
0
0
0
0
0
3
0
0
0
1
1
0
7
3
0
37
0
0
0
1485
8
19
9
13
0
8
3
0
355
892
64
0
2
29
16
1
1
63
18
5
3
1
4
1514
451
11
4
19
41
8
1
1
62
6
3
1
7
3
5
5
133
761
7
1
1
7
2
0
40
8
11
0
127
60
51
315
1
0
47
0
2
2
1797
31
33
16
11
0
27
6
0
540
1061
86
0
0
19
20
2
1
96
44
10
5
0
0
2008
747
17
5
30
82
7
0
1
67
5
13
2
10
2
21
17
149
1175
5
4
2
10
2
2
88
6
7
2
195
77
73
473
4
0
84
0
2
2
3282
39
52
25
24
0
35
9
0
895
1953
150
0
2
48
36
3
2
159
62
15
8
1
4
3522
1198
28
9
49
123
15
1
2
129
11
16
3
17
5
26
22
282
1936
12
5
3
17
4
2
128
14
18
2
322
137
124
788
Male
Female
180
0
0
2
0
17
0
14
0
6
0
0
0
0
0
1
2
1
0
0
0
0
2
0
0
1
46
0
0
38
4
14
0
0
1
0
0
1
0
0
4
Male
Female
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
2
0
0
0
0
0
0
Male
Female
18
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
2
0
0
0
Male
Female
6145
6
1
2
2
241
7
500
0
278
12
0
0
29
3
5
9
149
2
6
60
6
20
9
1
6
1354
0
0
311
2
538
5
1
593
0
0
46
2
2
27
Male
Female
Total
4438
5
3
4
1
199
10
245
0
162
6
0
0
23
3
6
7
52
2
16
62
14
11
4
5
4
844
1
1
334
0
492
6
0
369
0
0
61
0
0
22
Male
Female
Dead after 48 hrs
Male
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Dead within 48
hrs
Absconded
Female
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Received
Reports
Lama
Male
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
Referral
Female
SN
Not Improved
All Total
<28 days
Recovered
319
29 days - <1 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
Male
Total
Female
Male
Male
Female
Male
Female
Dead after 48 hrs

Female
Dead within 48
hrs
Absconded
Male
Male
Male
Lama
Female
Referral
Female
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
5546
28
33
18
12
171
32
633
6
51
8
0
0
63
1
74
43
185
4
20
18
0
70
40
27
23
1560
6
0
622
40
72
14
8
632
0
0
70
0
5
36
10623
43
63
38
8
334
61
1440
9
155
23
0
0
125
9
145
79
548
7
19
25
0
113
53
30
42
3369
5
0
842
52
88
23
17
1521
0
0
97
0
25
41
21
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
2
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
2
0
0
1
0
0
0
40
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
6
0
0
0
0
0
0
243
1
0
0
1
7
3
12
0
3
1
0
0
2
0
4
3
3
0
0
1
0
0
2
5
2
50
1
0
58
1
3
2
0
4
0
0
1
0
1
7
421
5
1
1
2
23
1
29
2
12
0
0
0
0
0
5
4
1
0
3
3
0
0
1
3
3
99
0
0
115
9
6
0
0
3
0
0
1
0
1
1
116
0
1
0
0
5
0
1
0
0
0
0
0
1
0
2
1
0
0
1
2
0
0
0
1
0
15
1
0
7
0
4
0
1
7
0
0
0
0
1
0
206
1
1
0
0
11
1
4
0
1
1
0
0
0
0
1
1
0
0
1
1
0
0
0
0
0
24
1
0
20
0
3
0
1
15
0
0
1
0
1
0
48
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
13
0
0
0
0
0
0
0
0
15
0
0
9
0
1
0
0
2
0
0
0
0
0
0
91
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
27
0
0
0
0
0
0
1
0
30
0
0
9
0
3
0
0
5
0
0
0
0
0
0
43
1
0
1
0
0
0
4
0
1
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
11
0
0
6
0
0
0
0
0
0
0
0
0
0
0
53
0
0
1
0
2
1
4
0
2
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
12
0
0
1
0
0
0
0
0
0
0
1
0
0
0
37
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
14
0
0
0
0
0
0
66
1
0
0
0
1
0
5
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
1
2
0
21
0
0
0
0
0
0
6054
30
34
19
13
184
35
651
6
55
9
0
0
71
1
81
51
201
6
21
21
0
70
42
33
25
1659
8
0
702
41
81
16
9
661
0
0
72
0
7
43
11500
50
65
40
10
371
64
1483
11
170
25
0
0
133
10
152
85
576
7
23
29
0
113
54
34
45
3550
6
0
987
61
101
25
18
1571
0
0
100
0
27
42
17554
80
99
59
23
555
99
2134
17
225
34
0
0
204
11
233
136
777
13
44
50
0
183
96
67
70
5209
14
0
1689
102
182
41
27
2232
0
0
172
0
34
85
8
0
4
0
11
5
1533
85
93
40
42
4
36
10
12
337
158
56
2
1
43
49
10
1
266
38
44
7
5
11
1350
119
25
18
54
91
22
1
8
35
24
17
7
61
10
63
15
60
630
14
26
10
24
6
16
68
17
10
5
116
57
104
473
17
1
2
0
27
27
2785
136
144
52
82
5
90
30
7
724
305
98
2
5
63
66
8
0
441
86
40
5
6
9
2404
254
41
43
106
203
17
0
10
39
52
47
14
131
13
97
18
125
1210
33
41
11
42
13
13
172
28
14
19
227
76
166
855
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
5
0
0
0
2
1
0
0
3
0
0
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
12
0
0
0
0
1
0
0
9
0
0
0
0
0
22
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
1
0
2
0
82
7
10
1
2
0
5
1
1
2
1
4
0
1
3
2
0
0
0
0
1
1
0
2
44
3
1
2
2
10
2
0
0
2
1
1
0
21
1
3
2
0
51
0
1
1
0
0
1
2
0
0
0
8
3
0
16
1
1
1
0
2
0
141
8
14
2
1
0
9
5
0
0
2
3
0
0
4
2
0
0
0
0
5
4
0
1
60
16
4
2
1
4
4
0
0
5
3
0
1
37
3
1
2
1
84
0
0
3
1
0
3
5
3
0
0
10
8
4
37
0
0
0
0
2
1
24
1
0
1
2
0
0
2
0
1
0
0
0
0
1
3
0
0
0
1
1
1
0
0
14
12
2
0
1
3
0
1
0
5
0
0
1
1
1
3
1
1
32
0
4
1
2
0
2
5
1
0
1
6
5
4
31
1
1
3
0
2
1
50
0
0
3
1
0
0
3
0
3
0
6
0
0
0
5
0
0
0
1
0
0
0
1
23
24
5
1
3
11
0
0
0
3
2
3
0
4
0
3
0
6
65
1
3
2
2
0
3
3
0
0
8
15
3
4
44
0
0
0
0
0
0
12
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
8
0
0
0
3
0
0
0
0
1
0
0
0
0
0
0
1
13
0
1
0
2
0
0
0
0
0
0
1
3
0
7
0
0
0
0
1
0
18
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
11
0
0
0
7
0
0
0
4
3
1
0
0
0
0
0
1
27
1
1
0
0
0
0
1
0
0
0
3
2
6
14
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
2
2
1
0
0
0
0
0
0
5
0
0
1
0
0
11
6
0
0
0
1
0
0
0
0
0
2
0
0
0
0
1
0
10
0
0
0
0
1
0
1
0
0
0
0
2
1
5
0
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
5
0
0
0
0
0
0
0
6
0
0
0
0
0
12
8
0
0
0
2
0
0
0
0
1
1
0
0
0
2
0
1
15
1
1
0
1
1
0
2
1
1
0
2
2
0
12
0
0
0
0
0
0
15
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
7
0
0
0
0
0
9
3
0
0
1
0
0
0
0
0
2
0
0
0
0
1
0
1
8
0
0
0
0
0
0
2
0
0
0
1
1
0
4
0
0
0
0
0
0
24
1
0
0
0
0
0
0
0
0
7
0
0
0
0
3
0
0
7
0
0
0
0
0
18
8
0
0
0
0
0
0
0
0
2
1
1
0
0
0
0
2
14
0
0
0
0
0
0
1
0
0
0
0
1
0
2
9
0
5
0
15
6
1675
94
103
42
46
4
41
14
13
342
167
61
2
2
49
55
10
1
281
39
46
10
5
13
1440
151
28
20
58
108
24
2
8
42
28
20
8
83
12
70
19
63
744
14
32
12
28
7
19
78
18
10
6
132
71
109
536
19
3
6
0
32
28
3026
145
158
57
85
5
100
39
7
727
331
107
2
5
67
77
8
0
463
87
45
9
6
11
2541
322
51
46
110
227
21
0
10
51
63
53
16
172
16
103
20
136
1417
38
46
16
46
14
19
184
32
15
27
257
92
180
966
28
3
11
0
47
34
4701
239
261
99
131
9
141
53
20
1069
498
168
4
7
116
132
18
1
744
126
91
19
11
24
3981
473
79
66
168
335
45
2
18
93
91
73
24
255
28
173
39
199
2161
52
78
28
74
21
38
262
50
25
33
389
163
289
1502
320
1 - 4 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
Total
Female
Male
Female
Male
Female
Male
Female
Dead after 48 hrs
Male
Dead within 48
hrs
Absconded
Male
Male
Male
Lama
Female
Referral
Female
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
7081
30
52
36
16
186
54
583
4
72
11
0
0
73
4
102
90
151
13
29
36
1
73
48
41
43
1748
4
7
862
57
66
19
37
589
1
0
118
2
20
68
11184
54
61
40
22
271
88
1105
6
194
21
0
0
119
8
133
114
356
11
69
32
0
139
68
41
55
3007
7
7
1038
66
119
37
35
1095
1
0
125
12
57
70
22
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
36
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
0
0
0
0
0
0
3
5
0
0
0
0
0
0
247
4
0
0
0
8
3
7
1
1
0
0
0
0
0
9
5
3
0
1
3
0
1
1
3
4
54
0
0
45
6
2
0
0
3
0
0
0
0
5
11
399
6
2
1
1
14
3
20
0
7
0
0
0
5
0
7
1
3
0
1
5
0
3
0
3
2
84
1
0
93
1
5
1
0
3
0
0
2
2
5
5
166
3
2
0
0
3
1
3
1
2
0
0
0
0
1
1
2
0
0
0
1
0
0
0
0
1
21
1
0
21
0
3
1
2
10
0
0
1
0
2
1
232
0
1
1
0
7
0
3
1
4
0
0
0
0
0
1
8
0
0
0
1
0
0
0
2
0
29
5
0
25
0
6
2
1
6
0
0
2
0
2
1
76
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
10
0
0
0
0
0
0
0
0
14
0
0
4
1
4
1
0
2
0
0
0
0
1
2
99
0
0
0
0
3
1
0
0
0
0
0
0
0
0
1
0
23
0
0
0
0
0
0
1
0
29
0
0
11
0
3
0
0
4
0
0
0
0
0
0
25
0
0
0
0
1
0
3
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
5
0
0
2
0
2
0
0
0
0
0
0
0
0
0
25
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
2
0
0
0
0
0
1
0
0
0
17
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
0
0
4
0
0
0
0
0
0
32
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
1
0
1
16
0
0
0
0
0
0
7634
37
54
36
16
198
58
600
6
75
11
0
0
73
5
114
97
165
13
30
40
1
74
49
44
48
1844
5
7
934
64
78
21
41
609
1
0
119
2
28
82
12007
60
64
43
23
295
92
1135
7
205
21
0
0
124
8
142
123
382
11
70
39
0
142
68
47
57
3158
13
7
1168
67
136
40
40
1129
1
0
130
14
64
76
19641
97
118
79
39
493
150
1735
13
280
32
0
0
197
13
256
220
547
24
100
79
1
216
117
91
105
5002
18
14
2102
131
214
61
81
1738
2
0
249
16
92
158
17
0
5
4
20
15
1911
125
95
45
63
4
51
17
15
488
248
116
3
4
53
38
12
2
261
63
62
16
7
13
1801
97
21
36
44
115
53
4
21
53
31
41
8
93
9
88
17
70
801
18
39
15
39
6
20
53
27
9
3
296
84
211
820
23
1
7
6
26
17
2749
161
129
70
103
5
106
25
31
784
433
182
0
11
82
79
29
3
507
121
53
23
15
19
2971
211
36
37
99
189
39
5
39
75
38
64
9
83
22
123
23
112
1204
24
56
20
79
16
23
141
43
15
13
408
106
309
1253
0
0
1
0
0
0
4
1
0
0
0
0
0
0
4
0
9
0
0
0
0
2
0
0
0
0
0
0
0
0
16
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
10
2
0
0
0
0
0
0
0
0
18
1
0
0
0
1
0
0
0
0
0
0
0
0
22
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
1
2
0
1
0
2
0
77
9
3
1
3
0
4
2
1
0
1
2
0
1
8
2
0
0
0
0
3
0
0
2
42
4
0
2
3
3
3
1
1
2
2
2
2
16
0
4
0
1
46
0
0
1
1
0
4
2
1
0
0
10
8
1
28
1
0
0
0
4
1
124
11
4
2
3
0
8
3
0
2
3
6
0
1
5
4
0
0
0
0
1
2
1
1
57
8
3
7
3
3
5
0
0
2
7
1
2
23
3
11
2
0
80
0
4
1
3
1
2
11
2
0
0
13
12
5
54
2
0
2
0
0
2
48
0
1
1
0
0
0
0
0
2
0
3
0
0
3
4
1
0
0
3
0
0
0
2
20
10
6
0
0
3
0
3
0
5
0
0
2
2
0
1
1
2
35
2
1
1
4
0
2
1
1
0
4
15
5
6
42
2
0
1
0
2
0
55
1
0
1
1
0
1
2
0
1
0
2
0
0
0
3
0
0
0
1
1
2
0
1
17
28
6
0
2
6
0
0
0
5
2
2
1
3
0
5
0
1
61
1
3
4
7
0
6
9
5
0
6
15
5
9
70
0
0
0
0
0
0
15
0
0
0
0
0
0
2
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
3
14
0
0
0
2
1
0
0
3
0
0
0
0
1
2
0
2
25
0
2
0
0
0
0
1
0
0
0
6
2
8
19
0
0
0
0
1
0
19
1
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
3
8
0
2
0
6
0
0
0
5
0
1
1
0
0
1
0
1
25
1
1
0
2
0
1
0
0
0
0
2
1
15
23
0
0
0
0
0
0
4
0
0
0
0
0
0
1
0
1
2
0
0
0
0
1
0
0
2
0
0
0
0
0
7
3
1
0
0
1
0
0
0
0
2
0
0
0
0
0
0
0
7
0
0
0
1
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
3
0
0
0
0
0
6
1
0
0
1
1
0
0
0
2
0
1
0
0
0
0
1
0
7
0
0
0
0
1
0
1
0
0
0
1
1
0
4
0
0
0
0
0
0
5
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
4
0
0
0
0
0
2
6
0
0
0
0
0
0
18
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
0
1
0
0
0
0
0
4
1
0
0
0
1
0
0
1
0
1
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
1
0
0
2
0
0
3
21
0
9
4
22
17
2064
136
99
47
66
4
55
22
20
491
261
121
3
5
65
47
13
2
263
66
65
16
7
17
1891
129
28
39
47
125
57
8
23
63
35
43
12
111
10
95
18
75
918
20
42
17
45
6
26
61
29
9
7
328
99
228
917
26
1
9
6
33
19
2979
176
133
73
108
5
115
30
31
790
457
192
0
12
87
87
29
3
511
122
55
27
16
21
3080
257
45
46
105
206
44
5
40
89
48
69
13
110
25
140
26
114
1382
26
64
25
91
18
32
162
51
15
19
441
125
339
1408
47
1
18
10
55
36
5043
312
232
120
174
9
170
52
51
1281
718
313
3
17
152
134
42
5
774
188
120
43
23
38
4971
386
73
85
152
331
101
13
63
152
83
112
25
221
35
235
44
189
2300
46
106
42
136
24
58
223
80
24
26
769
224
567
2325
321
5 - 14 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
Male
Total
Female
Male
Male
Female
Male
Female
Dead after 48 hrs

Female
Dead within 48
hrs
Absconded
Male
Female
Male
Lama
Male
Referral
Female
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
9383
52
28
63
19
114
72
376
5
136
23
180
0
119
22
107
146
121
24
61
51
1
28
90
84
42
1964
15
39
911
58
155
36
163
919
40
13
212
21
51
114
14086
63
50
64
22
160
73
635
5
221
49
216
0
171
29
132
193
167
15
100
80
2
37
78
79
54
2695
26
52
1254
64
205
49
301
1808
63
0
281
27
87
107
51
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
1
0
0
0
0
0
3
0
0
0
0
0
0
3
7
0
0
0
0
0
0
72
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
12
7
0
0
0
0
0
0
471
9
3
8
3
8
7
14
1
3
1
0
0
4
2
13
15
5
3
1
9
0
2
2
11
6
130
0
4
47
7
12
4
0
2
0
0
1
0
18
17
663
12
1
9
5
24
9
21
0
9
0
3
0
11
1
16
19
3
2
4
11
0
1
2
8
6
177
0
5
62
5
4
8
0
7
0
0
5
3
8
16
200
2
0
0
0
3
3
2
0
3
0
6
0
0
0
0
6
0
0
0
4
0
0
0
1
1
31
0
0
29
1
13
0
1
6
0
0
0
1
3
0
292
2
0
0
0
4
0
3
0
1
0
15
0
0
1
1
2
0
0
0
4
0
0
0
0
4
37
0
0
56
0
14
0
4
19
1
0
6
0
3
1
81
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
18
0
0
12
1
10
0
0
5
0
0
0
0
2
0
121
0
0
0
0
1
3
0
0
0
0
0
0
0
0
1
0
22
0
1
0
0
0
0
0
0
28
0
0
17
1
8
0
0
2
0
0
0
0
1
0
31
0
1
0
0
0
0
6
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
8
0
0
3
0
0
2
1
0
0
0
0
0
0
0
33
1
0
0
0
0
0
7
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
10
0
0
1
0
0
2
1
0
0
0
0
0
0
0
40
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
1
0
0
1
0
1
16
1
0
0
0
0
0
51
1
0
0
0
0
0
5
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
3
21
0
0
0
0
0
0
10257
64
32
71
22
125
83
403
6
142
24
186
0
125
24
121
167
142
27
62
65
1
30
92
96
49
2159
15
44
1002
67
191
42
169
955
41
13
213
22
74
131
15318
79
51
74
27
189
85
671
5
231
49
234
0
184
31
152
214
192
17
105
96
2
38
80
87
64
2957
26
57
1390
70
231
59
321
1864
64
0
292
30
99
124
25575
143
83
145
49
314
168
1074
11
373
73
420
0
309
55
273
381
334
44
167
161
3
68
172
183
113
5116
41
101
2392
137
422
101
490
2819
105
13
505
52
173
255
27
4
16
19
36
46
2895
156
101
109
118
0
108
10
34
514
352
168
2
23
55
17
35
6
477
176
50
43
39
40
2633
199
26
42
113
120
119
1
15
48
30
41
17
62
16
101
8
95
1053
29
26
26
66
20
28
54
38
9
16
321
62
143
838
27
4
11
25
49
49
4489
155
148
124
153
5
130
22
51
925
592
325
2
13
66
35
42
19
1051
270
59
43
43
54
4327
351
34
49
192
158
82
3
32
52
23
49
20
84
32
100
24
152
1437
32
43
25
129
20
35
119
56
9
25
346
75
224
1138
0
0
0
0
0
0
10
1
0
1
0
0
0
0
0
0
21
0
0
0
2
0
1
0
7
0
0
0
0
0
33
2
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
4
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
19
3
0
0
0
0
0
0
0
2
24
0
0
0
2
0
0
0
7
0
0
0
0
0
38
3
0
0
0
2
0
0
0
0
0
0
1
0
0
0
1
0
7
0
0
0
0
0
0
0
0
0
4
0
1
0
5
3
2
1
0
2
5
125
13
8
9
2
0
15
3
0
2
4
6
0
2
9
2
0
0
0
0
1
5
0
2
83
14
1
4
2
7
1
0
1
5
7
3
2
3
0
14
4
3
71
1
7
2
13
2
2
7
2
0
3
12
6
5
62
7
1
2
1
9
2
145
23
6
12
0
0
19
2
0
1
1
7
0
3
6
6
4
0
0
0
1
4
0
5
100
29
0
10
15
5
3
0
0
6
7
6
6
25
2
23
4
3
144
3
13
2
22
0
7
18
4
0
3
12
6
7
97
0
0
2
0
5
0
61
1
2
0
1
0
1
2
0
1
0
5
0
0
3
2
2
1
0
4
2
1
0
1
29
11
2
0
3
3
3
1
0
0
0
0
0
1
1
4
0
1
30
1
1
3
6
0
1
6
3
0
6
17
2
3
49
1
1
4
0
3
1
114
0
0
2
9
0
0
2
0
1
0
5
0
0
3
1
0
0
0
2
0
0
1
0
26
18
0
0
2
8
4
1
0
4
0
1
1
3
1
2
0
9
54
0
0
2
6
0
3
8
4
0
11
14
3
10
61
1
0
2
0
0
0
33
0
0
0
2
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
3
12
0
1
1
2
0
0
0
1
0
0
0
0
0
0
0
1
18
0
1
0
2
0
0
1
0
0
0
3
0
2
9
0
0
0
0
0
1
30
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
1
3
22
0
4
0
3
4
0
0
7
0
0
1
0
2
1
0
3
47
0
1
0
2
0
0
0
0
0
0
3
0
7
13
0
0
0
0
1
0
7
0
0
0
0
0
0
2
0
1
1
0
0
0
0
0
0
0
3
0
0
0
0
1
8
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
2
1
0
3
0
0
0
0
0
0
4
0
0
0
0
0
0
1
0
1
7
0
0
0
0
0
0
0
0
1
0
0
0
0
10
1
1
0
0
1
0
0
0
1
0
1
0
0
0
2
0
0
7
0
1
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
20
2
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
0
3
1
0
0
0
0
10
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
1
0
0
0
1
0
0
0
0
1
3
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
3
6
0
0
0
0
0
0
0
3
1
0
0
0
0
13
2
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
1
0
0
0
2
0
0
3
31
6
21
19
44
51
3151
173
111
119
123
0
124
17
34
520
380
180
2
25
69
21
38
7
490
181
53
49
39
44
2799
244
29
48
119
133
123
2
16
54
38
44
19
66
17
119
12
100
1183
32
35
31
88
22
31
68
44
9
25
355
71
154
965
35
6
17
26
61
53
4825
181
154
138
162
5
149
27
51
933
630
338
2
16
77
42
46
19
1061
275
60
47
44
60
4517
426
35
63
210
177
93
4
32
71
30
57
29
112
37
128
29
167
1700
35
58
29
159
20
45
147
64
9
43
377
85
248
1319
66
12
38
45
105
104
7976
354
265
257
285
5
273
44
85
1453
1010
518
4
41
146
63
84
26
1551
456
113
96
83
104
7316
670
64
111
329
310
216
6
48
125
68
101
48
178
54
247
41
267
2883
67
93
60
247
42
76
215
108
18
68
732
156
402
2284
322
15 - 19 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
Male
Total
Female
Male
Male
Female
Male
Female
Female
Dead within 48
Dead after 48 hrs
hrs
Absconded
Male
Male
Male
Lama
Female
Referral
Female
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
30766
95
74
274
13
490
157
1748
44
212
37
225
0
211
37
224
308
631
69
376
77
6
342
175
95
167
6087
133
175
1804
102
3358
37
280
72
166
4094
308
97
339
283
6550
35
19
36
8
93
48
206
4
131
27
256
0
64
11
75
113
58
8
36
45
4
30
82
43
39
1471
13
86
402
45
180
31
451
167
248
0
249
10
48
80
55
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
0
0
0
0
0
0
5
0
0
0
0
0
0
5
0
0
0
1
0
0
0
43
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
7
2
0
0
0
0
0
0
946
11
6
15
0
62
11
29
6
8
0
6
0
6
2
14
16
10
6
21
5
0
52
3
23
14
326
3
50
22
19
22
1
0
0
0
5
2
9
35
46
320
7
1
3
0
7
5
4
0
4
1
7
0
9
2
13
2
1
2
3
3
0
1
4
3
1
83
2
16
5
3
19
1
2
0
0
0
4
2
5
21
347
0
1
1
1
3
4
21
0
6
0
11
0
0
0
2
8
0
1
11
2
0
1
0
1
0
74
2
13
12
0
40
0
2
1
0
33
5
0
8
1
171
0
0
1
0
2
3
2
0
6
0
8
0
0
1
0
0
0
0
0
3
0
0
1
0
0
27
2
3
6
0
35
0
4
4
0
0
4
0
0
0
178
0
0
1
0
1
3
3
1
0
0
0
0
0
0
0
2
66
0
0
0
0
0
0
0
0
77
0
1
9
1
15
0
0
0
0
10
0
0
1
1
70
1
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
1
10
0
0
7
0
13
0
0
0
0
0
0
0
0
0
38
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
4
0
0
18
1
0
0
0
1
0
0
0
22
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
1
0
1
4
3
0
0
0
0
0
0
0
37
0
0
0
0
0
1
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
3
0
13
0
0
0
0
7
2
1
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
1
0
2
3
1
0
0
0
0
0
32367
107
81
291
14
556
176
1802
51
226
37
242
0
218
39
240
335
707
79
408
84
6
395
178
120
181
6573
138
252
1851
122
3435
56
295
75
167
4142
317
106
383
331
7191
44
20
40
8
102
59
212
4
141
28
271
0
73
14
88
115
65
11
39
51
4
31
87
46
41
1594
17
109
421
48
249
36
469
176
249
0
257
12
53
101
39558
151
101
331
22
658
235
2014
55
367
65
513
0
291
53
328
450
772
90
447
135
10
426
265
166
222
8167
155
361
2272
170
3684
92
764
251
416
4142
574
118
436
432
59
17
73
148
104
104
11753
173
259
301
159
5
239
38
64
1911
592
378
10
29
160
107
37
20
542
412
113
170
76
208
6003
994
202
194
172
772
366
37
45
100
179
150
70
211
43
201
102
739
4577
42
98
50
97
61
55
103
102
37
14
1020
288
379
2346
12
4
10
6
18
33
2093
80
95
60
75
6
51
4
70
307
304
93
5
9
37
22
37
9
284
117
32
35
31
28
1791
156
11
20
64
57
82
1
20
22
11
13
16
34
14
33
19
40
613
11
23
17
39
10
10
42
25
14
7
240
32
112
582
0
0
0
0
0
0
6
2
0
1
0
0
0
0
0
1
22
0
0
0
1
0
0
0
6
0
0
0
0
0
33
0
0
0
0
7
0
0
0
0
0
0
1
0
0
0
1
0
9
1
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
21
0
0
1
1
0
0
0
8
0
0
0
0
0
31
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
1
4
2
5
0
15
4
244
17
14
6
3
0
11
8
0
0
3
5
0
1
10
15
1
1
0
1
12
11
6
12
137
13
3
11
5
24
13
0
1
6
8
5
4
23
7
17
12
4
156
0
5
2
6
3
7
5
2
3
2
13
18
17
83
1
0
1
0
5
5
92
5
5
5
0
0
5
0
1
0
1
11
0
3
2
1
3
0
0
0
3
2
0
1
48
6
0
4
7
3
7
0
0
0
0
3
2
5
0
7
3
2
49
1
2
4
3
4
1
6
4
0
0
9
2
12
48
0
0
9
0
4
2
132
1
2
2
2
0
0
3
0
1
2
2
0
1
0
4
2
0
0
1
0
1
2
0
26
19
11
1
1
8
6
0
0
2
3
0
0
1
0
4
4
8
68
0
2
3
5
1
2
1
3
0
1
18
3
8
47
0
0
2
0
1
0
61
0
0
1
3
0
0
1
0
1
0
1
0
0
0
1
1
0
0
2
1
0
2
1
15
13
1
0
4
0
3
0
0
1
0
0
0
1
1
0
0
0
24
1
1
1
5
0
0
2
0
0
4
20
1
9
44
0
0
6
0
0
1
45
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
11
0
5
0
6
2
0
0
3
2
0
0
0
1
0
0
4
34
0
1
0
2
0
0
0
0
0
0
10
4
4
21
0
0
0
0
0
1
21
0
0
0
1
0
0
1
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
2
7
8
0
2
0
1
3
0
0
1
0
0
0
0
0
0
0
0
15
0
0
0
3
0
0
0
0
0
0
4
2
8
17
0
0
1
0
0
0
25
0
0
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
1
1
0
0
0
0
5
4
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
5
0
0
0
0
0
0
1
0
0
0
1
0
0
2
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
1
0
0
0
0
0
4
2
0
0
0
2
0
1
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
2
0
1
0
0
0
0
0
1
0
0
0
0
0
4
4
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
6
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
1
0
0
0
0
3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
63
19
94
148
123
111
12228
193
275
310
164
5
251
49
64
1913
623
385
11
31
172
126
40
21
550
415
125
182
84
220
6209
1045
216
211
179
817
387
37
46
111
192
155
75
235
51
223
119
756
4855
43
106
55
110
65
65
110
107
40
17
1063
313
408
2502
13
4
13
6
24
39
2296
85
100
66
79
6
56
6
71
311
329
107
5
13
40
24
41
9
293
120
36
37
33
32
1899
187
12
26
75
64
95
2
20
24
11
16
18
40
15
40
22
42
709
13
26
22
50
14
12
50
29
14
11
273
37
142
693
76
23
107
154
147
150
14524
278
375
376
243
11
307
55
135
2224
952
492
16
44
212
150
81
30
843
535
161
219
117
252
8108
1232
228
237
254
881
482
39
66
135
203
171
93
275
66
263
141
798
5564
56
132
77
160
79
77
160
136
54
28
1336
350
550
3195
323
20 - 29 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
Male
Total
Female
Male
Male
Female
Male
Female
Dead after 48 hrs

Female
Dead within 48
hrs
Absconded
Male
Female
Male
Lama
Male
Referral
Female
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
115621
290
334
935
71
1941
408
8675
135
910
97
296
65
465
92
695
678
4362
489
2584
225
11
1661
458
309
675
26861
1910
1253
8476
443
4560
78
624
0
528
20330
1620
751
1657
633
10521
82
20
59
23
127
67
385
3
280
73
235
0
116
21
92
122
121
20
63
58
2
55
130
63
40
2257
16
155
628
41
240
34
967
1
551
0
725
19
57
114
153
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
1
0
1
0
0
0
0
0
0
0
5
3
0
0
0
0
1
14
0
0
0
1
0
0
0
81
1
0
1
0
0
0
0
0
0
0
6
0
0
0
0
0
0
1
0
1
0
0
0
0
0
10
0
0
0
0
0
0
22
0
0
0
0
0
0
0
2899
42
32
60
3
253
20
121
20
23
4
7
0
11
4
51
24
31
18
72
31
0
217
2
39
63
1148
34
77
44
54
27
3
0
0
0
14
10
41
117
79
615
15
5
6
1
16
13
4
0
25
1
11
0
10
2
16
11
11
3
3
11
0
1
3
14
3
185
0
2
29
3
22
4
0
0
0
0
4
1
9
17
1127
6
6
1
1
16
1
112
4
24
0
10
0
0
1
2
4
0
4
33
5
0
4
1
2
4
241
53
34
40
1
49
3
7
0
0
113
10
4
40
5
318
1
1
2
0
9
2
1
0
12
1
9
0
0
0
1
3
0
3
1
2
0
0
2
0
1
51
2
11
10
1
42
2
19
0
0
0
5
0
2
0
599
0
0
2
0
5
6
25
0
0
0
0
0
0
0
4
0
329
2
2
0
0
0
0
1
1
377
3
3
12
0
8
1
0
0
0
15
1
0
6
3
119
0
0
0
0
1
0
2
0
0
0
0
0
0
0
0
0
13
0
1
0
0
0
0
0
0
17
0
1
15
0
10
0
0
0
0
0
1
0
1
0
60
0
0
0
0
0
0
5
0
3
0
0
0
1
0
0
1
3
0
0
0
0
0
0
0
0
13
1
1
4
0
3
2
5
0
0
3
0
0
0
0
49
0
0
0
0
0
0
4
0
1
0
0
0
1
0
1
2
1
0
0
0
0
0
0
0
0
10
0
1
4
0
1
4
11
0
0
0
1
0
0
0
76
0
0
0
0
2
0
6
0
1
0
0
0
2
0
0
0
3
0
0
1
0
0
0
0
0
15
0
2
4
0
2
0
18
0
6
0
1
0
0
0
56
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
3
0
5
1
0
0
0
15
0
9
0
0
0
0
0
120535
338
372
998
75
2217
435
8944
159
961
101
313
65
481
97
753
708
4728
514
2691
262
11
1882
461
351
743
28660
2004
1370
8580
498
4649
88
668
0
534
20475
1643
796
1820
720
11759
99
26
68
24
154
82
397
3
318
75
261
0
127
23
110
138
147
27
68
72
2
56
135
77
44
2533
18
175
687
45
315
44
1034
1
560
0
736
20
69
131
132294
437
398
1066
99
2371
517
9341
162
1279
176
574
65
608
120
863
846
4875
541
2759
334
13
1938
596
428
787
31193
2022
1545
9267
543
4964
132
1702
1
1094
20475
2379
816
1889
851
169
40
1193
820
336
322
45743
702
1195
866
271
14
801
422
302
8126
1834
1099
13
83
415
525
82
59
2081
830
441
448
115
506
21230
3610
772
432
444
1893
763
54
118
197
372
214
170
494
100
357
251
1999
12240
134
347
228
352
163
165
390
444
400
29
3802
1041
2052
9547
19
16
18
7
43
38
3689
124
141
59
51
7
58
9
44
513
542
121
6
28
72
20
51
19
363
209
51
29
31
34
2582
294
18
30
117
63
119
11
55
58
22
20
29
52
23
70
39
73
1093
31
42
19
67
16
32
72
34
34
23
246
59
225
900
0
0
3
0
0
0
22
5
0
0
0
0
0
0
0
1
72
0
0
3
8
4
0
0
14
0
0
0
0
0
107
5
0
0
0
9
0
0
0
0
0
0
1
1
0
0
0
0
16
0
0
0
0
0
0
1
0
0
2
0
0
0
3
0
0
0
0
0
0
22
1
0
0
0
0
0
0
0
1
28
0
0
0
0
0
0
0
12
0
0
0
0
0
42
3
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
1
0
0
0
1
14
5
36
0
50
29
634
50
50
20
2
1
33
80
4
1
6
13
0
5
22
54
2
1
0
2
40
41
6
12
445
22
8
26
7
70
43
1
5
13
30
9
11
49
19
30
27
10
380
2
5
19
18
2
23
19
16
25
8
20
52
83
292
4
2
2
0
2
1
102
23
5
9
2
1
4
2
0
2
2
9
0
11
5
4
5
1
0
0
8
3
1
0
97
18
0
13
13
4
5
5
4
13
9
3
7
12
1
15
2
5
129
1
10
4
9
1
5
12
5
8
2
23
7
15
102
3
1
96
0
10
3
472
2
3
7
3
0
0
9
0
8
13
18
0
1
2
24
2
1
0
8
0
3
3
2
109
47
46
3
9
29
5
4
0
3
1
2
2
2
6
8
3
33
203
1
4
3
20
0
3
10
3
0
5
37
6
10
102
3
0
15
0
7
1
120
2
1
2
4
0
0
3
0
2
1
4
0
1
2
1
2
1
0
4
0
0
2
0
32
24
2
2
1
3
7
0
0
1
1
2
2
2
0
3
0
2
52
0
0
0
1
0
2
3
4
0
9
40
3
1
63
0
0
22
0
0
2
76
1
0
1
1
0
0
3
0
0
0
3
0
0
0
0
0
0
0
0
0
2
1
3
15
21
0
9
0
18
5
0
0
2
0
0
3
1
0
1
0
10
70
1
1
0
3
0
0
0
0
0
0
13
9
34
61
1
0
5
0
2
1
37
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
5
20
0
1
0
6
3
0
0
3
1
0
0
0
0
2
0
0
36
0
1
0
1
0
0
0
0
0
0
13
0
9
24
0
0
1
0
0
0
20
0
0
1
1
0
0
0
0
4
3
0
0
0
0
0
0
0
3
1
0
0
0
0
13
2
0
0
0
3
1
0
0
0
0
0
0
0
0
0
0
2
8
0
0
0
3
0
0
1
0
0
0
2
0
0
6
0
0
0
0
0
1
23
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
1
0
0
0
0
0
3
1
0
0
1
0
0
0
0
0
0
0
0
1
0
0
1
1
5
0
0
0
0
0
1
2
0
0
0
3
0
2
8
0
0
0
0
1
0
34
0
0
0
0
0
0
0
0
3
8
0
0
0
0
0
0
0
3
0
0
0
0
0
14
6
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
9
0
0
0
0
0
0
0
0
0
0
2
0
2
4
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
5
3
0
0
0
0
0
0
0
1
3
0
0
0
0
12
6
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
1
9
0
0
0
0
0
0
1
0
0
0
0
0
1
2
186
46
1351
820
397
356
47001
760
1248
895
278
15
834
514
306
8143
1936
1133
13
92
447
607
86
61
2101
841
481
494
125
523
21933
3713
826
471
460
2022
817
59
123
215
403
225
187
547
125
396
281
2056
12926
138
357
250
396
165
191
421
463
425
44
3876
1108
2181
10015
27
18
40
7
54
42
4023
151
147
70
58
8
62
14
44
523
577
134
6
41
79
25
58
21
377
216
59
35
34
34
2773
366
20
47
132
78
134
16
59
75
33
25
40
67
24
90
42
82
1330
32
53
23
78
17
40
90
43
42
35
325
69
253
1100
213
64
1391
827
451
398
51024
911
1395
965
336
23
896
528
350
8666
2513
1267
19
133
526
632
144
82
2478
1057
540
529
159
557
24706
4079
846
518
592
2100
951
75
182
290
436
250
227
614
149
486
323
2138
14256
170
410
273
474
182
231
511
506
467
79
4201
1177
2434
11115
324
30 - 39 Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
27637
97
82
249
21
470
99
1553
18
855
136
523
16
199
33
242
220
485
107
388
78
13
196
223
100
117
6520
150
199
895
106
2546
55
593
0
435
3657
519
126
222
201
8703
45
21
40
16
119
30
375
2
283
78
425
0
75
12
55
89
105
16
54
51
5
14
91
38
30
2069
6
75
460
33
329
22
808
0
405
0
363
14
54
77
104
1
0
1
0
0
0
0
0
0
0
7
0
1
0
1
0
0
3
0
2
0
0
0
0
0
16
0
0
0
0
0
1
13
0
0
0
0
0
0
0
87
0
0
0
0
0
0
0
0
0
0
5
0
0
0
1
1
0
1
0
0
0
0
0
0
0
8
0
0
0
0
0
0
28
0
0
0
0
0
0
0
924
21
4
14
4
73
14
32
3
15
2
10
0
1
0
22
11
5
8
14
15
3
19
6
13
12
321
4
65
15
13
27
5
0
0
0
9
2
6
29
25
473
11
3
4
1
20
6
2
0
10
4
17
0
4
1
12
9
7
2
1
4
1
1
7
4
1
132
4
7
11
3
21
1
2
0
0
0
11
1
9
15
404
5
0
1
0
7
3
18
0
10
0
11
0 ``
0
0
1
5
0
0
1
3
0
0
14
3
1
83
5
6
9
1
56
1
4
0
0
32
0
2
8
1
43
10
191
127
75
75
10225
169
219
151
102
6
189
131
125
1500
770
256
8
41
141
74
52
42
605
330
80
123
67
117
5298
784
142
131
155
408
224
13
72
108
104
71
81
117
34
143
57
387
3031
59
166
62
160
57
76
170
105
97
18
936
176
481
2563
11
10
9
11
26
39
2752
64
80
51
36
3
45
12
57
409
621
94
11
18
49
17
42
19
355
142
41
37
45
26
2274
251
13
26
80
73
116
8
40
33
10
24
15
31
17
41
26
62
866
16
44
12
32
11
14
56
25
48
7
318
45
114
742
0
0
0
0
0
1
15
1
0
1
0
0
0
0
0
0
40
0
0
1
0
0
2
0
12
0
0
0
0
0
57
3
0
0
0
5
0
0
0
0
0
0
1
0
0
0
0
0
9
3
1
0
0
0
0
0
0
0
3
0
0
0
7
0
0
0
0
0
0
28
1
0
0
0
0
0
0
0
0
34
0
0
0
0
0
1
0
9
0
0
0
0
0
45
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
2
0
0
0
2
6
3
5
0
5
5
224
13
15
8
1
1
13
24
0
0
3
8
0
3
6
15
0
0
0
0
10
14
2
2
138
18
5
7
4
18
15
3
1
5
6
6
6
24
7
16
4
10
155
3
5
6
7
3
15
10
4
10
1
1
4
17
86
4
1
6
0
7
1
104
11
7
10
0
0
7
1
0
4
5
9
0
3
2
6
2
0
0
1
3
2
2
0
75
15
0
5
16
4
12
2
2
3
4
2
6
5
0
11
3
1
91
0
4
2
7
2
2
11
2
11
1
11
7
11
71
1
0
17
0
4
1
148
1
2
0
6
0
1
4
0
2
3
7
0
1
1
2
0
0
0
4
0
3
2
0
39
30
10
0
4
10
5
0
0
3
3
1
1
1
0
7
0
7
82
2
1
1
7
0
2
5
0
0
12
14
2
6
52
All Total
Male
Total
Female
Male
Male
Female
Male
Female
236
0
0
0
0
1
1
3
0
8
0
21
Dead after 48 hrs

Female
Dead within 48
hrs
Absconded
Male
Female
Male
Lama
Male
Referral
Female
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
1
0
1
0
0
0
0
3
0
0
0
1
2
42
4
0
11
0
47
1
15
0
0
0
8
0
2
1
167
0
0
1
0
2
2
9
0
0
0
0
0
0
0
1
0
46
0
3
0
0
0
0
0
2
66
0
0
8
0
12
0
0
0
0
6
0
1
5
0
72
0
0
0
0
3
0
2
0
0
0
0
0
0
0
1
0
7
0
0
0
0
0
0
0
2
15
0
0
6
0
7
0
0
0
0
0
0
0
1
0
67
0
1
0
0
2
0
2
0
2
0
0
0
1
0
1
1
0
0
0
0
0
0
0
0
0
10
0
0
9
0
2
4
6
0
0
2
1
0
0
0
73
0
1
0
0
2
0
3
0
1
0
3
0
0
0
0
0
1
0
0
0
0
0
0
0
0
11
0
0
9
0
3
3
8
0
0
0
3
0
1
0
79
0
0
0
0
1
0
3
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
6
0
0
1
0
4
0
25
0
9
1
0
0
0
0
90
0
0
0
1
3
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
2
0
0
0
23
0
21
0
1
0
0
0
29382
124
87
266
25
555
118
1617
21
882
138
551
16
203
33
268
237
537
118
406
98
16
215
243
116
132
7022
159
270
937
120
2647
66
641
0
444
3707
522
135
264
227
9734
56
25
44
18
148
37
390
2
302
82
471
0
80
13
70
99
120
19
55
58
6
15
98
43
35
2286
14
82
499
36
407
27
884
0
426
0
386
15
67
93
39116
180
112
310
43
703
155
2007
23
1184
220
1022
16
283
46
338
336
657
137
461
156
22
230
341
159
167
9308
173
352
1436
156
3054
93
1525
0
870
3707
908
150
331
320
0
0
5
0
2
1
97
0
2
1
0
0
0
0
0
0
0
5
0
0
2
0
1
0
0
1
1
3
1
1
18
18
0
2
3
3
4
2
0
1
0
1
0
0
0
2
0
2
38
1
0
1
5
1
2
1
0
0
6
18
3
3
41
0
0
11
0
1
1
45
2
1
0
1
0
0
3
0
0
0
1
0
0
1
0
0
0
0
0
0
1
0
1
11
9
0
5
0
10
3
0
0
2
0
0
0
0
0
1
0
1
31
0
3
0
1
0
0
0
0
0
0
3
1
6
14
0
0
1
0
0
0
15
0
0
0
1
0
0
0
0
1
0
2
0
0
0
0
0
0
0
0
0
1
0
0
5
12
0
1
0
2
2
0
0
2
0
0
1
0
1
0
0
1
22
0
0
0
1
0
0
1
0
0
0
3
0
10
15
1
0
0
1
0
0
26
0
0
0
0
0
0
1
0
5
2
0
0
0
0
0
0
0
3
2
0
0
0
0
13
7
0
0
1
1
0
0
0
0
1
1
0
0
0
0
0
0
11
0
2
0
0
0
0
2
0
0
0
2
0
1
7
0
0
0
0
1
0
28
0
0
0
0
0
0
0
0
4
2
0
0
1
1
0
0
0
4
0
0
0
0
0
12
6
1
0
0
3
0
1
1
1
0
0
0
0
0
1
0
0
14
0
2
0
0
0
0
1
1
0
0
2
0
2
8
0
0
0
0
0
0
40
0
0
0
0
0
0
0
0
8
5
0
0
0
0
0
0
0
7
2
0
0
0
0
22
7
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
1
0
0
0
0
0
0
0
2
0
0
3
0
0
0
0
0
0
47
0
0
0
0
0
0
0
0
5
6
0
0
0
0
0
0
0
4
0
0
0
0
0
15
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
8
0
2
3
0
0
0
2
0
0
0
3
0
1
11
51
13
224
128
85
83
10723
186
237
160
110
7
203
163
125
1515
823
272
8
46
149
91
54
42
627
338
90
141
71
120
5578
858
157
143
164
453
247
16
73
118
114
79
89
142
41
167
61
405
3327
67
178
70
175
60
93
187
109
107
34
958
183
511
2732
15
11
21
11
36
41
3071
76
89
62
37
3
52
13
57
423
668
110
11
22
54
23
46
19
372
144
45
43
48
27
2444
312
14
34
99
86
134
13
43
40
14
27
22
36
18
55
29
67
1043
17
52
18
45
14
18
72
28
59
16
355
55
141
890
66
24
245
139
121
124
13794
262
326
222
147
10
255
176
182
1938
1491
382
19
68
203
114
100
61
999
482
135
184
119
147
8022
1170
171
177
263
539
381
29
116
158
128
106
111
178
59
222
90
472
4370
84
230
88
220
74
111
259
137
166
50
1313
238
652
3622
325
40 - 49 Yrs
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
436
10
0
1
0
17
11
3
0
15
2
13
0
6
2
17
14
7
1
3
6
0
1
5
6
1
141
1
0
20
3
5
2
3
0
0
0
5
1
11
9
240
5
0
0
0
4
2
5
0
4
1
12
0
0
0
0
1
0
0
4
5
0
0
0
0
1
44
5
0
8
0
33
1
9
0
0
2
6
0
5
0
241
1
0
1
0
6
1
3
0
9
0
15
0
1
0
0
1
0
0
2
6
0
0
1
0
2
49
3
0
7
0
36
0
11
0
0
0
7
0
1
0
78
0
0
1
0
2
0
1
0
0
0
0
0
0
0
2
0
13
0
0
0
0
0
0
0
0
19
1
0
2
0
7
0
0
0
0
1
0
0
1
0
64
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
9
0
0
10
0
4
0
0
0
0
0
1
0
1
0
71
0
0
1
0
0
0
1
0
2
0
5
0
1
0
0
2
0
0
0
1
0
0
1
0
0
14
0
0
3
0
4
3
9
0
0
0
1
0
0
0
113
1
0
0
0
1
0
4
0
3
0
6
0
2
0
0
1
0
0
0
1
0
0
0
0
0
19
0
0
11
0
3
2
15
0
0
0
3
0
0
0
68
1
0
0
0
3
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
6
0
0
2
0
2
0
17
0
4
0
1
0
0
0
130
0
0
0
0
2
1
12
0
0
0
0
0
2
0
0
0
3
1
1
2
0
0
0
0
0
24
0
0
1
0
2
0
32
0
15
0
1
0
0
1
13275
113
37
83
9
229
81
597
5
872
127
460
13
90
22
118
151
160
29
115
73
9
45
114
72
53
3677
45
43
713
54
323
50
615
0
270
604
397
12
117
162
9202
62
19
46
17
148
38
407
10
272
58
514
0
98
17
58
93
104
20
77
52
9
18
63
40
28
2268
13
29
451
32
308
39
877
0
297
0
308
15
62
88
22477
175
56
129
26
377
119
1004
15
1144
185
974
13
188
39
176
244
264
49
192
125
18
63
177
112
81
5945
58
72
1164
86
631
89
1492
0
567
604
705
27
179
250
28
12
28
12
45
65
3376
137
124
88
90
13
87
10
34
515
647
150
9
21
56
28
29
32
431
290
33
56
49
45
2974
340
23
61
150
142
103
2
38
48
49
36
35
49
17
102
30
121
1346
27
73
15
59
21
34
104
69
26
12
363
48
263
1114
19
7
10
9
28
35
2375
75
77
65
51
6
41
3
41
430
476
84
17
14
37
15
38
38
390
153
35
33
44
22
2185
266
16
32
76
67
124
3
21
34
10
23
13
25
16
32
20
54
832
11
39
17
35
10
15
76
28
26
10
309
35
111
722
0
0
0
0
0
0
23
1
0
0
0
0
0
0
0
0
24
0
0
0
1
0
0
0
9
0
0
0
0
0
35
3
0
0
0
3
1
0
0
0
0
0
1
0
1
0
0
0
9
0
0
0
0
0
0
0
0
0
1
0
0
2
3
0
0
0
0
0
0
25
1
0
1
0
0
0
0
0
1
21
0
0
0
0
1
1
1
19
0
0
0
0
0
46
3
0
0
0
2
0
0
0
0
0
0
1
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
1
0
0
0
1
3
1
2
0
9
1
85
19
10
3
1
0
8
3
0
2
5
6
0
2
5
4
0
1
0
1
4
8
5
5
92
23
2
11
6
11
3
0
2
3
3
1
3
14
1
11
5
3
102
1
1
5
10
1
2
9
9
0
0
10
5
12
65
3
2
0
0
7
2
74
8
4
4
2
0
7
2
0
0
3
8
0
3
4
6
0
1
0
2
2
5
4
5
70
17
1
7
5
3
4
2
2
5
9
4
0
7
1
8
3
3
81
2
4
4
8
1
3
11
7
5
2
5
5
13
70
1
0
6
0
2
2
80
0
0
1
3
0
0
1
0
2
4
5
0
1
2
2
1
1
0
3
0
2
2
0
30
28
1
3
7
3
5
0
0
1
0
0
0
2
0
1
1
3
55
1
1
1
3
1
3
3
3
0
2
10
0
3
31
0
0
4
0
3
3
75
1
0
3
1
0
0
0
0
3
3
4
0
0
0
0
1
0
0
6
0
1
1
0
24
30
1
0
1
0
11
0
0
1
0
0
2
0
1
4
1
2
54
0
2
0
3
0
2
4
2
0
2
17
3
4
39
0
0
3
0
0
0
15
0
0
0
0
0
0
0
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
3
15
0
1
0
1
3
0
0
1
0
0
0
0
3
0
0
6
30
0
1
0
2
0
0
0
0
0
0
3
3
2
11
0
0
0
0
1
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
17
0
2
0
2
1
0
0
2
0
0
0
0
0
1
0
0
25
0
0
0
3
0
0
1
0
0
0
2
2
4
12
0
0
0
0
0
0
20
0
0
1
0
0
0
1
0
7
9
0
0
0
0
1
0
0
7
0
0
0
0
0
26
5
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
1
8
1
0
0
0
0
0
0
0
0
0
1
0
1
3
1
0
0
0
0
0
35
0
0
1
0
0
0
0
1
6
6
0
0
0
0
0
0
0
15
2
0
0
2
0
33
8
0
0
1
2
0
0
0
0
0
0
1
0
1
1
1
1
16
0
1
0
0
0
0
2
0
2
0
4
1
0
10
0
0
0
0
0
0
26
1
0
0
0
0
0
0
0
5
9
0
0
0
0
0
0
0
7
1
0
0
0
0
23
4
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
6
1
0
0
0
0
0
0
0
1
0
3
0
2
7
0
0
0
0
0
0
52
0
0
0
0
0
0
0
0
6
13
0
0
0
0
0
0
0
6
3
0
0
0
0
28
11
0
1
0
1
0
1
0
0
1
0
0
0
1
0
0
1
17
0
1
0
0
0
0
1
0
0
0
5
0
2
9
32
13
39
12
56
68
3625
158
134
93
94
13
95
15
34
532
698
163
9
24
64
35
30
34
454
295
37
66
56
50
3183
418
26
76
165
162
115
2
40
53
52
37
39
65
22
114
36
134
1556
31
76
21
74
23
39
116
81
27
15
390
56
285
1234
23
9
14
9
39
40
2653
85
81
74
54
6
48
5
42
446
522
96
17
17
41
22
40
40
430
166
37
39
51
28
2387
352
18
42
83
77
140
6
23
42
20
27
17
32
20
46
25
61
1031
13
47
21
49
11
20
95
37
33
15
342
46
134
863
55
22
53
21
95
108
6278
243
215
167
148
19
143
20
76
978
1220
259
26
41
105
57
70
74
884
461
74
105
107
78
5570
770
44
118
248
239
255
8
63
95
72
64
56
97
42
160
61
195
2587
44
123
42
123
34
59
211
118
60
30
732
102
419
2097
Male
Female
537
20
3
6
0
25
16
13
1
15
2
16
0
6
0
11
15
10
0
3
4
0
3
3
12
9
193
0
2
12
5
9
1
1
0
0
3
3
1
16
16
Male
Female
90
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
0
0
0
0
1
0
0
0
0
0
12
2
0
0
0
0
0
23
0
0
0
0
0
0
0
Male
Female
83
1
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
23
0
0
0
0
0
0
0
Male
Female
Total
8128
50
19
44
17
122
25
384
10
245
56
469
0
87
15
41
77
86
18
71
36
9
17
57
34
25
2014
7
29
402
29
258
35
793
0
282
0
291
14
49
78
Male
Female
Dead after 48 hrs
12198
86
34
75
9
195
63
576
4
851
124
415
13
83
21
105
133
137
29
108
63
9
42
110
60
43
3388
39
41
686
49
268
45
556
0
266
598
386
11
95
146
Male
Female
Dead within 48
hrs
Absconded
Male
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Lama
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
Referral
Male
SN
Received
Reports
Not Improved
Female
Recovered
326
50 - 59 Yrs
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
473
15
1
9
0
17
10
5
0
18
3
16
0
3
3
7
13
8
0
2
9
0
1
4
8
6
158
3
0
23
0
3
2
1
0
0
0
5
1
10
9
201
5
0
0
0
5
1
2
0
13
1
11
0
0
0
0
3
0
0
0
3
0
0
0
0
0
44
5
0
8
0
15
0
12
0
0
1
4
0
2
0
230
0
0
1
0
1
0
5
0
10
0
16
0
0
0
0
3
0
0
0
2
0
0
0
0
2
40
4
0
13
1
18
2
14
0
0
0
9
0
2
1
44
0
0
0
0
1
0
1
0
0
0
0
0
0
0
1
0
10
0
2
0
0
0
0
0
0
15
0
0
3
0
2
0
0
0
0
0
0
0
0
1
53
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
9
0
2
0
0
0
0
0
0
12
0
0
5
0
0
5
0
0
0
0
0
0
0
0
87
0
0
0
0
1
0
4
0
6
0
5
0
1
0
0
1
0
0
0
1
0
1
0
0
0
20
1
0
12
0
1
4
8
0
0
0
0
0
0
0
127
0
0
1
0
2
0
5
0
5
0
10
0
2
0
1
0
0
0
0
0
0
0
0
0
1
27
0
0
10
0
1
1
16
0
0
0
2
0
0
0
85
0
0
0
0
0
0
5
0
0
0
0
0
2
0
0
0
1
0
0
0
0
0
0
0
0
8
0
0
0
0
2
0
26
0
3
0
1
0
0
0
113
1
1
0
0
0
0
8
0
0
0
0
0
1
0
0
1
2
0
0
1
0
0
0
0
0
15
0
0
3
0
3
0
41
0
5
0
0
0
0
0
10178
81
21
77
19
165
58
438
3
676
69
489
1
88
24
97
102
141
9
75
71
4
15
83
62
31
2899
41
19
549
41
295
49
540
0
182
190
299
4
78
126
8732
67
13
74
14
136
41
450
0
266
50
470
0
84
20
54
74
110
9
63
46
5
27
76
28
37
2214
31
34
501
43
208
46
801
0
140
0
244
9
62
89
18910
148
34
151
33
301
99
888
3
942
119
959
1
172
44
151
176
251
18
138
117
9
42
159
90
68
5113
72
53
1050
84
503
95
1341
0
322
190
543
13
140
215
21
7
22
4
22
50
2351
83
97
80
64
3
69
9
22
380
797
131
5
11
45
27
27
18
361
313
23
61
35
31
2692
233
11
21
75
97
86
1
13
22
36
17
28
46
10
54
30
66
846
27
44
9
42
9
22
78
41
5
2
264
33
152
728
22
5
12
7
35
43
2098
68
39
53
62
8
70
5
25
332
719
82
2
11
37
20
22
36
372
167
39
34
17
20
2240
240
18
27
51
84
94
3
28
28
21
10
12
30
23
26
19
46
760
12
43
8
38
7
22
52
22
16
9
269
23
72
593
0
0
0
0
0
0
20
1
0
0
0
0
0
0
0
0
30
0
0
0
0
2
0
0
18
0
0
0
0
0
51
2
0
1
0
5
7
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
21
0
0
1
0
0
0
0
0
4
22
0
0
0
0
0
0
0
27
0
0
1
0
0
55
1
0
0
0
1
4
0
0
0
0
0
0
0
0
0
1
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
0
4
2
66
18
3
4
0
0
6
1
0
1
2
7
0
2
11
5
1
1
0
1
8
4
2
0
77
8
2
2
4
4
4
1
0
3
7
1
1
8
7
9
3
4
68
1
0
2
2
2
2
9
4
0
0
4
4
5
35
2
0
2
0
3
3
67
21
15
7
1
1
6
1
0
3
3
5
0
3
4
5
0
0
0
0
2
4
4
2
87
23
0
3
7
4
5
0
1
4
14
3
4
15
3
14
3
4
107
1
3
1
7
0
3
11
4
2
1
15
2
4
54
1
0
2
0
2
1
53
2
2
1
1
0
0
0
0
0
1
4
0
0
1
0
1
0
0
7
0
3
0
1
24
21
2
0
2
3
8
0
0
0
2
1
0
1
0
5
0
0
45
0
1
0
5
0
1
2
1
0
4
13
5
3
35
0
0
6
0
6
1
77
0
0
3
1
0
1
2
0
4
15
7
0
0
1
4
1
1
0
4
0
0
2
0
46
27
1
0
1
4
1
1
0
1
0
0
0
0
1
1
0
0
38
0
0
0
1
0
0
6
2
0
6
13
0
1
29
1
0
1
0
0
0
8
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
4
0
0
1
0
1
2
0
0
1
0
0
0
0
1
1
0
2
9
0
0
0
0
0
0
0
0
0
0
4
0
4
8
0
0
2
0
1
1
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
2
2
0
0
2
0
0
1
0
0
0
0
2
20
0
0
0
2
0
0
0
0
0
0
2
0
3
7
1
0
0
0
0
0
27
0
1
0
1
0
0
0
1
5
11
0
0
0
0
0
0
0
7
0
0
0
0
0
26
2
0
0
0
4
1
0
0
0
2
0
0
0
0
0
0
0
9
0
0
0
1
0
0
1
1
0
0
2
0
0
5
0
0
1
0
0
3
34
0
0
2
1
0
0
1
0
7
14
2
1
0
0
1
0
0
8
5
0
0
1
1
44
5
0
0
1
0
0
0
0
0
1
0
0
0
1
1
0
0
9
0
1
0
1
0
1
2
0
2
0
5
1
0
13
0
0
0
0
0
0
32
0
1
0
0
0
0
0
0
9
19
1
1
0
0
0
0
0
3
1
0
0
0
0
35
2
1
0
1
1
1
0
0
0
0
1
0
0
0
0
0
1
8
0
0
0
0
0
0
0
0
0
0
1
1
0
2
0
0
0
0
0
0
52
0
0
0
0
0
0
0
0
5
17
0
1
0
0
0
0
0
9
8
0
0
0
0
40
2
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
3
0
0
3
25
8
26
4
28
53
2557
105
104
85
67
3
75
10
23
395
860
143
6
13
58
34
29
19
389
322
32
68
37
32
2909
268
16
25
82
115
109
2
13
26
47
20
29
55
18
69
33
73
1000
28
45
11
50
11
25
90
47
5
6
288
43
164
813
24
5
23
7
45
51
2363
89
54
66
65
9
77
9
25
355
790
96
4
14
42
30
23
37
416
184
41
39
24
23
2512
309
19
30
61
95
106
4
29
35
36
13
17
45
28
42
23
52
944
13
47
9
49
7
26
71
28
20
16
307
26
80
699
49
13
49
11
73
104
4920
194
158
151
132
12
152
19
48
750
1650
239
10
27
100
64
52
56
805
506
73
107
61
55
5421
577
35
55
143
210
215
6
42
61
83
33
46
100
46
111
56
125
1944
41
92
20
99
18
51
161
75
25
22
595
69
244
1512
Male
Female
393
14
0
3
3
20
12
3
0
21
0
14
0
3
1
13
8
4
2
2
9
0
0
6
7
2
147
1
0
12
2
4
5
2
0
0
1
8
2
12
8
Male
Female
93
0
0
0
0
0
0
0
0
0
0
7
0
0
0
3
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
0
0
21
0
0
0
0
0
0
0
Male
Female
100
2
0
2
0
0
0
0
0
0
0
8
0
1
0
0
0
0
0
0
1
0
0
0
0
0
14
0
0
0
0
0
0
19
0
0
0
1
0
0
0
Male
Female
Total
7643
51
11
63
14
115
31
427
0
233
47
421
0
78
17
43
57
91
9
59
34
5
26
72
20
28
1952
24
34
447
42
183
36
708
0
135
0
228
8
50
79
Male
Female
Dead after 48 hrs
9268
60
21
72
16
138
45
423
3
636
68
451
1
81
23
83
90
126
7
71
57
4
14
77
55
29
2651
34
19
514
39
271
40
473
0
179
188
285
2
64
117
Male
Female
Dead within 48
hrs
Absconded
Male
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Lama
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
Referral
Male
SN
Received
Reports
Not Improved
Female
Recovered
327
60 + Yrs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
All Total
Male
Total
Female
Male
Male
Female
Male
Female
Dead after 48 hrs

Female
Dead within 48
hrs
Absconded
Male
Female
Lama
Male
Referral
Female
Male
Not Improved
Female
Hospital Name
Male
SN
Received
Reports
Female
Recovered
16056
116
50
138
39
265
176
682
3
636
80
507
0
164
26
110
255
158
29
92
73
1
39
123
108
56
3926
47
25
827
71
133
91
713
0
280
127
461
5
134
209
16267
138
53
108
33
238
135
725
3
466
95
613
0
144
24
101
154
204
10
113
52
1
34
111
59
43
3657
37
22
727
66
56
88
1059
0
211
0
451
4
141
164
244
3
0
1
0
0
0
0
0
1
0
29
0
2
0
0
5
0
0
0
0
0
0
0
0
0
41
0
0
0
0
0
1
18
0
0
0
1
0
0
0
291
1
0
1
0
0
0
0
0
0
0
34
0
1
0
0
3
0
0
0
1
0
0
0
0
0
41
1
0
0
0
0
0
42
0
0
0
0
0
0
0
846
39
4
7
2
39
24
7
0
42
5
30
0
5
5
27
31
14
1
7
16
0
1
8
17
4
335
1
0
24
9
1
6
1
0
0
2
13
0
34
29
994
36
5
18
5
36
27
13
3
48
3
38
0
7
3
25
37
18
1
2
20
0
0
16
21
7
389
0
0
42
14
1
7
1
0
0
0
20
0
16
27
388
7
2
3
0
10
2
4
1
14
2
25
0
2
0
0
4
0
0
1
4
0
0
1
0
1
83
5
0
23
1
1
2
34
0
0
0
17
0
7
2
425
9
0
3
1
5
6
7
0
24
1
32
0
2
0
0
4
0
1
1
2
0
0
0
0
0
98
7
0
29
0
4
2
33
0
0
0
23
0
4
2
71
0
0
0
0
0
3
0
0
0
0
0
0
0
0
2
0
17
0
0
0
0
0
0
0
0
22
0
0
4
0
0
0
0
0
0
0
0
0
0
1
70
1
0
0
0
1
2
0
0
0
0
0
0
0
0
2
1
13
0
0
0
0
0
0
0
0
20
0
0
3
0
1
3
0
0
0
0
0
0
2
0
228
3
0
2
1
4
2
12
0
5
0
9
0
0
0
0
4
1
0
1
2
0
0
0
2
1
49
0
0
13
0
12
1
29
0
0
0
6
0
0
0
351
1
0
0
1
3
1
22
0
16
1
15
0
1
0
1
4
2
0
1
1
0
0
0
2
0
72
0
0
30
0
7
1
41
0
0
0
6
0
2
4
279
3
0
0
0
0
0
16
0
1
0
0
0
2
0
0
0
4
0
0
0
0
0
0
0
0
26
0
0
9
0
7
1
72
0
1
0
1
0
2
3
355
2
0
0
2
3
1
16
1
1
1
0
0
0
0
0
0
3
0
1
0
0
0
0
0
0
31
0
0
13
1
7
0
61
0
9
0
3
0
0
1
18112
171
56
151
42
318
207
721
4
699
87
600
0
175
31
139
299
194
30
101
95
1
40
132
127
62
4482
53
25
900
81
154
102
867
0
281
129
499
5
177
244
18753
188
58
130
42
286
172
783
7
555
101
732
0
155
27
129
203
240
12
118
76
1
34
127
82
50
4308
45
22
844
81
76
101
1237
0
220
0
503
4
165
198
36865
359
114
281
84
604
379
1504
11
1254
188
1332
0
330
58
268
502
434
42
219
171
2
74
259
209
112
8790
98
47
1744
162
230
203
2104
0
501
129
1002
9
342
442
67
8
22
2
59
200
3481
265
253
254
141
9
110
10
53
881
1935
263
4
26
118
51
42
24
668
461
94
85
90
71
5908
411
23
79
86
171
146
3
26
45
50
20
26
113
21
84
45
170
1519
45
71
20
79
7
52
108
61
14
11
285
128
341
1222
56
8
16
7
88
162
3363
298
226
185
123
12
94
23
50
993
2458
188
6
8
128
60
52
47
737
404
90
110
97
53
6442
467
34
70
113
210
201
0
20
50
44
29
26
100
27
72
31
131
1625
29
54
29
61
25
57
93
64
15
13
400
98
242
1180
0
0
0
0
0
0
20
2
0
0
2
0
0
0
0
7
93
1
0
1
4
1
0
1
51
0
0
2
0
0
165
5
0
0
0
11
0
0
0
0
0
0
1
0
1
0
0
0
18
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
44
5
0
0
2
0
0
0
0
6
115
0
0
0
2
0
0
0
55
0
0
0
0
0
185
8
0
0
0
5
0
0
0
0
0
0
0
1
0
1
0
0
15
1
0
0
0
1
0
1
0
0
0
0
0
3
6
8
1
3
0
9
8
149
28
16
13
3
2
9
1
0
1
11
15
0
4
20
4
0
1
0
0
9
19
8
6
170
24
3
8
7
8
6
1
0
7
3
1
1
22
4
16
1
5
117
2
5
4
6
2
3
11
8
1
3
9
13
8
75
8
2
3
1
12
9
163
25
29
18
8
3
10
3
0
2
11
19
0
7
13
5
1
2
0
0
12
31
4
4
207
35
4
13
5
7
6
0
1
5
5
1
0
24
5
22
3
3
139
1
6
5
14
2
5
14
7
2
4
8
11
17
96
6
0
6
0
6
6
116
1
3
4
4
0
0
4
0
11
2
2
0
0
1
4
0
0
0
17
0
9
4
0
66
29
2
3
3
7
2
0
0
3
5
2
1
0
1
3
1
5
67
0
2
3
4
0
4
5
2
0
5
16
8
7
56
7
1
1
0
6
4
123
1
1
6
5
0
0
2
0
7
9
1
0
0
4
2
1
1
0
21
0
4
5
2
72
46
2
0
2
10
3
0
0
1
1
0
0
3
3
2
0
5
78
1
1
3
4
0
3
5
2
0
6
19
5
5
54
0
0
2
0
1
2
10
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
1
3
12
0
1
0
1
1
0
0
4
0
0
0
0
0
0
0
2
21
0
2
0
2
0
0
0
0
0
0
8
0
3
15
0
0
2
0
2
0
13
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
13
0
3
0
7
1
0
0
2
0
0
0
0
0
0
1
1
28
0
0
0
0
0
0
0
0
0
0
4
0
4
8
0
1
0
0
1
2
65
2
0
6
2
1
0
1
0
19
36
0
0
0
0
0
0
0
12
4
0
0
0
2
85
13
1
1
1
2
0
0
0
0
0
1
0
0
0
0
0
2
21
0
0
0
2
0
2
2
0
0
0
1
1
0
8
0
0
1
0
1
7
100
0
0
4
4
0
0
0
0
30
40
1
0
0
3
1
0
0
23
12
0
4
0
1
123
22
2
0
0
3
1
0
0
1
1
1
0
0
1
4
1
1
38
0
1
0
1
0
1
4
1
0
0
3
6
1
18
1
0
0
0
1
0
98
2
1
4
1
0
1
0
0
33
50
0
0
0
0
0
0
0
21
8
0
0
0
0
121
11
2
2
1
2
0
0
0
1
1
0
0
0
0
0
0
5
25
0
1
0
0
0
0
1
0
1
0
1
0
5
9
0
0
0
0
0
0
95
4
0
4
1
0
0
0
0
47
84
1
0
0
1
0
0
1
21
23
0
1
1
1
190
9
0
0
0
1
1
0
0
0
0
1
0
0
0
0
0
5
17
1
1
1
0
0
1
4
0
0
0
5
3
6
22
82
10
33
2
77
218
3939
300
273
281
153
12
120
16
53
952
2127
281
4
31
144
61
42
26
752
490
103
115
102
80
6518
505
31
94
98
202
155
4
26
60
59
24
29
135
27
103
47
189
1788
47
81
27
93
9
61
127
71
16
19
320
150
364
1385
72
11
23
8
109
182
3901
333
256
217
143
15
104
28
50
1085
2718
210
6
15
151
68
54
51
836
460
102
150
107
61
7220
600
42
86
120
243
213
0
21
59
51
32
26
128
36
101
36
146
1940
33
63
38
80
28
67
121
74
17
23
439
123
278
1384
154
21
56
10
186
400
7840
633
529
498
296
27
224
44
103
2037
4845
491
10
46
295
129
96
77
1588
950
205
265
209
141
13738
1105
73
180
218
445
368
4
47
119
110
56
55
263
63
204
83
335
3728
80
144
65
173
37
128
248
145
33
42
759
273
642
2769
328
Total
All Total
7686
161
52
115
16
512
110
252
32
137
15
83
0
38
14
165
130
86
38
121
93
3
297
33
130
117
2750
44
198
317
120
121
27
4
10
0
34
41
59
267
242
5080
119
19
54
15
190
86
129
5
165
15
105
0
55
14
122
111
64
11
23
72
1
10
43
70
32
1530
11
30
455
43
100
27
9
15
0
0
59
11
74
123
3287
33
12
6
2
63
17
169
6
78
5
86
0
3
2
8
34
0
5
51
30
0
5
16
8
9
648
77
53
162
4
225
9
72
25
0
181
43
7
76
10
2478
14
4
9
1
56
14
32
1
76
3
116
0
4
2
5
22
0
4
5
24
0
0
4
3
11
410
28
14
186
2
215
9
102
48
1
0
66
0
17
6
1388
1
0
5
0
12
15
41
1
0
0
0
0
0
0
13
2
525
2
7
0
0
0
0
1
3
628
4
4
71
3
66
2
0
9
0
32
1
1
16
8
805
2
0
0
0
10
8
7
0
0
0
0
0
0
0
6
1
141
0
5
0
0
0
0
2
3
185
0
1
86
1
57
8
0
13
0
0
2
0
6
0
791
5
2
4
1
10
2
49
0
19
0
19
0
5
0
4
13
6
0
1
5
0
1
1
3
1
151
2
1
63
0
39
34
59
0
0
5
11
0
0
0
1048
10
1
2
1
10
3
74
0
31
1
34
0
10
1
10
8
7
0
1
4
0
0
0
2
1
211
0
2
77
0
40
17
95
0
0
0
19
0
3
4
808
4
0
0
0
6
1
48
0
2
0
0
0
8
1
0
0
9
0
0
1
0
0
0
0
0
80
0
16
16
0
26
1
166
67
25
1
4
0
2
3
1060
5
1
0
3
10
2
69
1
1
0.14
0
0
4
0
0
1
10
1
2
3
1
0
0
0
0
116
0
8
21
1
31
2
178
108
60
0
7
0
0
2
252805
1071
777
1998
236
4772
1262
16053
261
4758
610
2841
95
1548
279
1940
2156
7034
827
3925
873
63
2779
1398
1026
1329
59911
2469
2031
16560
1092
12398
497
3845
2703
1920
29260
4147
1082
2948
2092
111173
719
343
563
185
2096
678
6493
49
2759
502
2953
0
1091
166
970
1154
2107
135
626
580
36
495
798
485
409
26392
183
515
7337
487
2639
423
5682
5391
1957
0
3009
121
670
972
363978
1790
1120
2561
421
6868
1940
22546
310
7517
1112
5794
95
2639
445
2910
3310
9141
962
4551
1453
99
3274
2196
1511
1738
86303
2652
2546
23897
1579
15037
920
9527
8094
3877
29260
7156
1203
3618
3064
440
98
1579
1136
708
882
84580
1900
2451
1943
1060
58
1697
658
661
14989
8191
2666
56
240
1107
929
327
205
5744
2927
943
1011
484
1045
51292
7146
1253
1016
1305
3844
1889
117
357
717
880
610
442
1249
260
1198
560
3825
26668
401
890
435
923
351
468
1160
912
610
110
7517
1962
4166
19905
206
56
128
78
341
445
27956
1188
1110
728
744
57
711
136
376
5937
7465
1343
51
117
588
345
323
191
4587
1710
447
354
329
265
29102
3093
232
339
924
1171
881
34
266
457
234
289
156
576
188
612
229
922
10603
201
388
159
529
130
223
893
330
194
127
2934
603
1633
8344
1
0
4
0
0
1
127
14
0
3
2
0
0
0
4
9
322
1
0
5
18
10
3
1
122
0
0
2
0
0
516
20
0
3
0
44
8
0
0
0
0
0
5
1
2
0
1
0
84
5
1
0
0
0
1
1
0
3
6
0
0
2
19
1
0
1
0
0
1
187
13
0
2
2
0
0
0
0
15
301
1
0
1
5
5
2
1
147
0
0
1
0
0
496
25
1
0
0
14
4
0
0
0
0
0
4
2
0
1
2
0
53
3
0
0
0
1
1
1
0
1
8
0
1
5
21
42
15
59
0
98
54
1752
176
133
65
19
4
105
124
6
12
36
72
0
22
100
106
4
5
0
5
90
104
29
43
1260
142
25
74
41
156
91
7
11
47
68
29
30
183
46
120
58
41
1169
10
29
42
63
15
59
74
46
39
17
89
121
151
755
31
9
22
2
51
24
1096
138
91
74
19
5
75
20
1
19
33
83
0
34
47
45
15
4
0
3
39
57
16
19
837
186
15
64
72
44
51
9
10
44
58
24
28
156
18
113
32
24
948
9
46
26
75
11
31
107
39
29
14
112
75
95
669
14
1
147
0
35
18
1159
9
15
17
22
0
2
25
0
30
25
50
0
4
14
45
9
3
0
48
3
23
13
7
364
230
84
10
33
70
34
9
0
22
14
6
7
11
11
36
11
66
654
7
17
17
58
2
20
40
17
0
40
156
38
50
462
14
3
50
0
32
12
805
5
4
23
25
0
2
17
0
24
29
39
0
1
12
18
7
3
0
43
3
10
14
6
285
262
21
5
21
46
33
4
0
18
6
10
6
17
7
22
1
34
513
6
10
14
34
1
21
44
19
0
58
181
29
48
465
2
0
47
0
2
6
274
4
1
1
5
0
0
9
0
1
0
7
0
0
5
1
0
0
0
1
1
3
1
5
45
118
0
23
1
44
17
0
0
17
3
0
3
1
6
5
0
32
270
1
12
0
14
0
0
2
0
4
0
51
23
64
171
1
0
10
0
9
4
198
2
0
0
5
0
0
2
0
2
1
6
0
0
0
0
0
0
0
1
1
4
0
4
28
132
0
15
0
36
16
0
0
28
4
2
4
0
3
5
1
12
258
2
4
0
14
0
1
3
0
0
0
38
8
66
136
3
1
3
1
2
2
226
2
1
8
4
1
1
7
1
50
84
4
0
0
1
2
0
0
50
10
0
1
0
3
230
75
3
1
5
16
2
0
0
0
5
4
0
1
1
1
1
8
123
1
3
0
7
2
2
13
1
1
0
13
8
10
61
2
0
2
0
2
11
274
0
0
8
6
0
2
2
1
59
90
3
1
2
4
2
0
0
63
21
0
4
3
2
273
113
4
0
5
19
1
2
1
5
3
5
1
1
4
13
4
11
192
1
8
0
5
2
3
19
3
7
0
25
14
11
98
1
0
0
0
2
0
330
8
2
4
2
0
1
0
0
67
109
3
2
0
1
0
0
0
54
14
0
0
0
0
267
51
3
4
6
4
1
0
1
1
4
1
1
0
0
1
0
12
90
2
1
1
1
0
0
8
1
2
0
11
2
12
41
0
0
0
0
0
0
418
6
0
4
1
0
0
0
0
77
164
1
1
0
1
3
0
1
58
40
0
1
1
1
360
67
0
2
3
5
1
1
1
1
6
2
1
0
1
0
0
13
104
3
4
4
0
0
1
13
1
0
0
21
5
10
62
503
115
1839
1137
847
963
88448
2113
2603
2041
1114
63
1806
823
672
15158
8767
2803
58
271
1246
1093
343
214
5970
3005
1037
1144
527
1103
53974
7782
1368
1131
1391
4178
2042
133
369
804
974
650
488
1446
326
1361
631
3984
29058
427
953
495
1066
370
550
1298
977
659
173
7837
2154
4455
21414
255
68
213
80
435
497
30934
1352
1205
839
802
62
790
177
378
6133
8083
1476
53
155
657
418
347
200
4855
1818
490
431
363
297
31381
3878
273
425
1025
1335
987
50
278
553
311
332
200
752
221
766
269
1016
12671
225
460
203
657
145
281
1080
392
231
207
3311
735
1868
9795
758
183
2052
1217
1282
1460
119382
3465
3808
2880
1916
125
2596
1000
1050
21291
16850
4279
111
426
1903
1511
690
414
10825
4823
1527
1575
890
1400
85355
11660
1641
1556
2416
5513
3029
183
647
1357
1285
982
688
2198
547
2127
900
5000
41729
652
1413
698
1723
515
831
2378
1369
890
380
11148
2889
6323
31209
Male
Female
852
2
0
4
0
0
0
0
0
0
0
63
0
10
0
5
4
0
3
0
4
0
0
0
0
0
95
3
0
1
0
0
0
158
22
0
0
0
0
0
0
Male
851
8
0
4
0
0
1
0
0
1
0
56
0
13
0
2
7
0
9
0
4
0
0
0
0
0
105
3
0
0
0
0
3
97
11
0
0
7
0
0
0
Male
Female
Total
99850
567
318
494
165
1820
565
6182
42
2486
481
2635
0
1008
149
822
1007
1885
116
590
473
34
485
751
408
362
23845
141
460
6511
440
2196
360
5140
5185
1896
0
2856
110
570
837
Male
Female
Dead after 48 hrs
237994
859
711
1864
217
4169
1116
15494
222
4521
590
2597
95
1481
262
1748
1970
6408
773
3745
740
60
2476
1348
884
1199
55549
2339
1759
15931
965
11921
421
3447
2581
1895
29007
4040
1015
2587
1829
Male
Female
Dead within 48
hrs
Female
87
88
89
90
91
92
93
94
95
96
97
98
99
Absconded
Male
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
Lama
Female
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Referral
Male
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Not Improved
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
Male
SN
Received
Reports
Female
Recovered
329
87
88
89
90
91
92
93
94
95
96
97
98
99
60
116
9
30
58 1147
150
932
13
297
59
253
2819 43055
49
511
237
911
130
769
111
124
9
0
317
606
0
498
0
367
716 7061
145
894
231
585
4
10
12
48
0
469
71
536
24
4
9
29
862 1344
134
526
74
381
210
432
0
56
122
542
3467 16703
147 3111
76
880
282
359
159
244
64 1971
17 1211
0
72
6
101
31
160
0
433
146
177
0
181
151
395
7
68
107
253
11
208
0 1963
1204 11787
8
122
176
258
205
215
315
300
2
161
134
120
402
942
194
426
96
403
48
152
0 3385
92 1148
19 1616
1691 9248
1
0
8
20
3
2
291
5
22
18
3
0
10
3
4
128
5
1
0
0
0
0
0
0
6
5
7
6
3
0
226
83
19
6
10
39
10
1
2
1
17
5
1
107
1
21
0
52
375
0
5
4
8
4
5
42
1
2
2
5
38
34
150
0
0
57
21
0
1
7137
4
19
63
57
0
53
0
0
1846
392
174
0
0
6
2
0
0
349
191
0
13
0
0
3169
618
11
20
39
117
0
0
0
0
9
0
0
0
0
0
0
297
1111
5
30
0
9
0
0
270
2
0
8
621
87
93
1125
98
22
17
1
73
102
4488
447
197
66
0
0
79
0
0
354
117
0
7
19
151
1
4
98
1
91
134
377
39
63
2245
21
63
406
0
34
57
6
17
72
27
124
3
0
17
93
130
251
1321
225
158
131
86
103
38
0
63
479
0
457
177
42
1959
Other Deaths
Total Deaths in
Hospital
5
1
33
0
4
7
1050
13
38
8
2
0
31
6
20
300
9
9
0
0
0
0
0
1
69
20
4
7
0
0
537
186
3
4
3
133
33
0
2
1
2
12
0
0
3
32
5
90
509
0
9
0
6
3
0
98
17
33
0
338
34
36
574
512
73
85
0
0
212
9081
8
218
3631
0
0
357
0
0
0
0
259
0
0
0
160
8
502
1864
0
0
645
0
0
7652
587
38
3
226
69
105
0
33
133
0
5
0
173
2
109
63
0
1546
76
266
0
647
0
166
4
353
11
72
0
376
126
2097
Post-operative
deaths (excluding
maternal, neonatal)
0
0
9
5
6
0
210
9
0
17
0
0
0
0
0
53
14
5
0
0
0
0
0
0
10
1
0
0
0
0
109
10
3
3
0
0
11
0
0
0
0
0
0
0
1
2
0
6
36
0
0
0
0
0
0
33
0
0
1
28
10
6
78
413
80
62
0
0
155
8743
5
204
1410
0
0
336
0
0
0
0
154
0
1
0
97
5
370
1486
0
0
456
0
0
4524
715
18
1
187
60
142
0
32
113
0
2
0
157
3
121
76
0
1627
81
282
0
632
0
160
0
319
19
41
0
179
104
1817
Maternal Death (all)
68
4
38
83
3
50
2032
46
186
95
76
3
329
0
0
479
115
163
2
11
0
51
13
17
571
89
46
148
0
104
2544
91
75
214
98
37
16
0
4
9
0
74
0
119
7
105
16
0
865
4
130
173
285
1
106
351
235
43
38
0
95
15
1476
0
35
26
0
0
41
3639
142
0
116
437
0
0
0
1
912
432
264
0
32
0
0
0
0
569
50
0
54
0
0
3009
162
0
8
12
594
37
0
69
31
0
16
0
0
0
67
3
724
1723
30
0
0
72
0
150
1099
69
23
30
465
128
6
2072
Late Neonatal death
0
38
20
0
0
96
1296
199
0
106
470
0
0
0
2
793
488
315
0
76
0
0
0
0
687
62
0
13
0
0
3211
179
0
17
23
623
45
0
55
32
0
13
0
0
1
60
1
520
1569
23
0
0
89
0
179
1193
98
21
31
293
144
8
2079
0
2
0
0
0
10
612
60
0
38
127
0
0
0
0
237
151
29
0
0
0
0
0
0
198
0
0
1
0
0
841
105
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
38
168
0
0
0
36
0
55
644
0
0
0
7
3
7
752
C/S
0
2
0
0
0
7
1084
91
0
45
86
0
0
0
0
330
334
30
0
0
0
0
0
0
468
0
0
0
0
0
1384
242
0
0
23
0
0
0
0
0
0
0
0
0
0
0
0
66
331
20
0
0
40
0
81
790
0
0
0
6
4
7
948
0
0
0
0
0
0
993
0
0
12
85
0
0
0
0
431
717
34
0
0
0
0
0
0
957
595
0
0
0
0
2831
225
0
0
100
34
0
0
0
0
0
0
0
0
0
0
0
160
519
0
0
0
0
0
11
83
0
3
0
44
4
15
160
Normal
1285 16585 12438

5
1
90
4
6
148
10
199
84
0
15
0
15
482
22
2
0
319
113 2259
138
0
0
0
23
147
13
5
5
0
0
46
9
0
36
0
39
23
4
0
10
5
14
84
212
2
24
544
0
637
64
0
0
1
2
67
3
0
2
194
0
0
0
3
0
30
1
0
396
2
0
79
3
0
70
243 4043 2425
8
56
6
1
57
156
56 1402
316
9
4
554
0
379
11
0
19
130
0
0
0
0
0
6
0
0
0
144 4857 2874
13
156
0
2
26
19
18
85
1
6
17
102
Male
3402
6
17
65
0
15
41
329
0
0
35
0
0
19
0
32
56
0
0
78
2
0
1
3
3
30
732
0
0
199
8
0
3
0
0
0
709
4
12
16
49
Female
515
0
3
17
0
6
1
15
0
8
26
0
0
2
0
0
0
0
0
0
1
0
2
0
1
0
82
0
0
145
7
0
0
0
0
0
9
25
2
0
2
Male
7989 10814 101050

0
0
148
2
1
295
80
86
722
30
39
24
1
2 1213
59
65
259
474
771 6410
2
3
143
20
59
113
20
21
32
0
0
61
0
0
26
4
3
302
2
4
60
33
65
453
65
97
329
4
2 3651
0
0
571
39
47 2484
56
134
140
2
6
17
0
0 1578
71
81
256
91
129
151
17
18
819
1072 1633 20257
0
0 1886
317
383 1262
227
235 6127
552
634
463
122
187 9144
112
125
97
0
0
0
113
453
0
0
0
0
0
0 17407
246
337
865
30
45
849
17
7 1448
50
64
732
Female
9454 18324 22500

0
0
0
1
77
92
27
14
11
41
1
1
72
208
201
321
16
11
98
370
557
0
7
24
124
0
0
164
17
23
0
0
0
0
0
0
308
127
164
23
20
27
5
124
252
0
91
88
13
0
0
0
0
0
0
0
0
0
34
49
0
0
0
0
0
0
99
96
157
0
398
458
3
13
9
1299 1613 2124
0
0
0
121 3589 3216
248 3471 3637
19
23
14
14
98
123
125
146
162
0
0
0
123
176
530
0
0
0
0
250
147
387
277
362
34
3
8
71
0
0
0
0
0
Male
4399 12096
0
0
0
18
8
22
0
35
33
77
3
261
236
389
5
0
170
242
123
155
4
0
0
0
29
227
0
25
0
116
0
0
15
6
0
0
0
0
0
0
0
0
0
0
26
75
0
0
0
5
652 1653
0
0
15
122
144
305
30
31
2
116
49
123
0
0
469
64
0
0
0 2363
356
322
0
22
10
69
0
0
PAC
CAC
Forceps
Total Deliveries in Hospital
OPD Plaster
2810
0
0
7
0
6
5
71
0
124
163
1
0
27
2
0
0
12
0
0
0
0
0
19
0
0
437
0
22
148
47
77
50
0
76
0
0
177
0
3
0
5506
0
70
6
8
17
0
380
0
265
76
138
5
35
1
1
0
1
0
0
0
0
0
0
0
0
1003
0
3
384
17
12
11
0
351
0
0
191
0
24
0
Female
Male
OPD Surgery
Breech
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
Minor
Vaccum
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163 22503
12
0
12
66
12
85
12
75
12
530
12
0
12 2881
12
0
12 1641
8
185
12
58
12
59
12
84
12
11
12
85
12
30
12
0
12
0
12
0
12
0
11
0
12
0
12
4
12
0
12
0
295 5794
12
31
12
66
11 1820
12
10
12 1654
12
25
12
0
12
143
12
0
12 3553
12
549
12
0
12
90
12
0
0
12
0
12
0
12
47
12
17
12
0
12
0
239 8005
11
38
12
0
12
66
12
97
11
0
12
10
12
0
12
0
12 1955
12 1240
12
229
12
0
12
0
12
0
12
2
12
0
12
0
12 1040
11
854
12
0
12
14
12
0
12
0
273 5545
12
980
12
10
12
23
11
125
12
142
12
0
12
0
12
0
12
0
12
0
12
0
12
0
12
0
12
0
12
0
12
0
12
570
203 1850
9
0
12
30
12
0
12
11
12
0
12
13
12
275
12
0
12
4
12
0
12
540
12
52
12
384
153 1309
Intermediate
Male
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Major
Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
Female
SN
Received Reports
Inpatient Surgeries
6961
11
22
115
4
255
34
350
3
85
0
0
0
53
4
55
77
215
1
92
27
0
10
27
23
29
1492
26
47
191
64
2
6
0
0
0
1812
143
26
96
92
886
7
0
1
0
2
0
56
0
1
0
0
0
5
0
10
0
5
0
1
0
0
0
0
0
0
94
0
10
9
0
62
6
0
72
0
261
6
0
0
0
46
0
0
0
0
0
0
6
0
0
0
0
0
1
0
0
0
4
0
0
0
0
0
0
1
0
12
0
0
4
0
0
0
0
0
0
4
0
0
0
0
57
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
1
1
0
0
0
0
0
0
0
0
2987
17
4
6
6
34
8
177
1
48
3
59
0
25
2
6
22
29
0
4
6
1
1
1
2
2
464
1
11
165
1
62
12
378
96
71
1
36
0
5
9
3976
24
4
7
6
36
8
239
1
49
3
59
0
31
2
16
22
38
0
5
6
1
1
1
3
2
570
1
24
178
1
125
19
378
168
71
266
42
0
5
9
13
7
3
4
20
13
2565
18
110
54
0
0
64
0
12
220
24
70
3
0
32
30
4
14
169
45
34
33
1
11
948
178
69
56
86
203
98
2
18
45
43
6
16
43
12
47
35
150
1107
14
45
42
24
25
29
98
18
81
0
265
104
104
849
0
0
1
0
0
0
427
0
0
2
1
0
1
1
0
21
80
10
0
0
2
0
0
0
18
2
0
0
0
0
191
102
1
0
6
7
1
0
0
0
1
1
1
0
2
2
0
2
126
1
2
0
2
1
3
12
0
0
1
6
8
12
48
0
0
0
1
0
0
9
0
0
0
0
0
1
0
0
2
8
0
0
0
0
0
0
0
0
0
0
0
0
0
13
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
8
0
0
0
0
0
0
0
0
0
0
2
0
2
4
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
21
0
0
0
0
0
0
0
8
0
0
0
0
0
40
8
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
0
0
1
0
0
0
0
0
0
1
3
1
3
0
5
12
872
13
3
20
12
0
5
9
2
234
310
7
0
0
5
7
0
1
206
85
0
6
1
6
1088
172
9
6
17
37
4
2
3
7
17
9
3
0
4
13
4
38
345
4
15
2
11
3
8
43
6
7
0
60
30
29
218
3
1
4
1
5
12
1313
13
3
22
13
0
7
10
2
257
419
17
0
0
7
7
0
1
232
87
0
6
1
6
1332
286
10
6
23
44
8
2
3
7
18
10
4
0
6
15
4
44
490
5
17
2
13
4
11
56
6
7
1
68
38
43
271
330
Late Neonatal
Death
28460
56
130
355
0
613
132
3458
21
58
0
14
0
155
6
239
172
0
0
669
0
5
637
153
68
288
7229
12
1
3469
212
0
62
0
0
0
921
27
206
0
279
546
2
0
0
0
5
3
96
0
0
0
0
0
0
0
2
11
0
0
1
0
0
0
0
0
1
121
0
0
12
0
0
1
0
0
0
30
0
0
2
3
26
2
0
0
0
0
0
0
0
0
0
0
0
0
0
2
3
0
0
0
0
0
0
0
0
0
7
0
0
4
0
0
0
0
0
0
0
0
0
0
0
11 3296 2696
0
3
0
0
10
8
0
32
18
0
0
0
0
34
20
0
2
2
0 165
99
0
7
7
0
4
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
27
13
0
11
23
0
0
0
0
0
0
0
91 120
0
0
0
0
0
0
0
0
0
0
10
4
0
6
5
0
6
8
0 409 328
0
0
0
0
0
0
0 154 114
0
3
1
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0 1096 981
0
0
0
0
0
0
0 922 791
0
17
10
78
0
0
0
0
0
0
3
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
5
0
0
1
0
0
0
0
0
0
41
0
5
8
0
35
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
3
0
0
1
0
0
0
0
0
0
30
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
12
2
2
3
64
1
3
5
1
0
6
9
3
47
0
1
0
0
0
0
0
0
16
3
1
1
1
1
99
38
7
8
2
18
1
0
1
0
7
2
0
0
0
3
0
20
107
0
7
2
5
0
1
26
1
2
0
12
5
14
75
0
0
0
0
0
0
12
0
0
0
1
0
0
0
0
0
99
0
0
0
0
0
0
0
4
0
0
0
0
0
104
0
0
4
0
0
1
0
1
0
0
0
0
0
0
0
4
0
10
0
0
0
0
0
0
0
0
0
0
0
1
8
9
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
109
0
0
0
0
0
0
0
2
1
0
0
1
0
114
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
1
0
4
56
4
307
433
131
125
6753
168
411
442
78
0
337
232
177
4656
0
108
5
21
14
8
0
13
720
372
172
209
19
244
8406
1393
407
184
92
1040
548
36
47
68
208
85
10
266
40
142
93
1161
5820
36
141
90
132
78
82
313
204
224
16
316
445
809
2886
52
4
244
436
92
103
6120
149
448
368
85
0
269
168
116
4084
0
87
0
21
32
6
0
11
554
282
174
192
24
214
7284
1271
425
158
95
869
525
36
43
66
171
88
7
245
31
135
85
960
5210
49
111
100
134
81
77
275
182
184
18
308
379
719
2617
0
0
18
12
2
1
81
7
3
5
2
0
2
10
1
39
0
1
2
0
0
0
0
0
6
3
3
2
1
3
90
68
7
5
10
3
0
1
3
0
2
5
1
0
0
10
0
33
148
0
10
0
6
2
0
16
6
2
0
5
59
0
106
0
0
0
0
0
0
4
0
0
2
1
0
0
0
0
0
0
1
0
0
0
0
0
0
3
1
0
0
0
0
8
0
0
3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
1
1
0
0
0
0
0
0
0
0
2
0
4
1
0
0
0
0
78
54
0
7
4
0
0
0
0
3
2
0 2285 1959
0
0
0
0
22
18
0
58
54
0
5
1
0
0
0
0
5
0
0
0
0
0
10
11
0 149
91
0
0
0
0
3
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
7
8
5
0
7
5
0
4
0
0
3
6
0
0
0
0
1
1
7 277 192
0
50
21
0
7
4
0
2
1
0
2
0
0
9
7
0
31
33
0
0
0
0
1
0
0
3
0
0
3
1
1
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
43
23
2 151
91
0
1
0
0
1
0
0
2
0
2
3
1
0
0
0
0
1
1
0 110 102
0
3
2
0
0
0
0
1
0
0
11
9
0
24
5
0
17
6
2 174 126
0
0
5
0
0
0
60
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
5
0
0
0
0
0
0
6
0
0
0
0
0
0
6
0
0
0
0
0
0
31
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
3
5
0
44
3
33
12
789
26
33
35
6
0
51
58
37
175
74
18
1
2
0
0
0
3
128
32
13
26
3
34
755
183
25
19
28
146
53
1
4
4
26
8
0
8
0
6
19
83
613
1
10
14
12
0
25
190
14
14
2
42
59
117
500
2
0
49
4
23
7
746
13
33
31
9
0
42
48
37
174
69
16
1
2
0
0
0
2
151
30
4
18
1
34
715
180
34
12
29
157
59
1
4
8
35
9
0
12
0
5
19
92
656
1
24
11
17
3
27
186
36
13
0
40
66
128
552
Still Birth
Early Neonatal
Death
31955
64
161
316
0
782
157
4013
27
82
0
15
3
172
8
270
169
0
0
572
0
2
707
202
69
299
8090
20
3
3801
231
0
53
0
0
0
1070
26
195
0
298
Male
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
1
0
2
120
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
Live Birth
Female
2
0
1
0
0
2
31
0
4
2
0
0
0
3
3
28
0
0
0
0
0
0
0
0
7
3
0
0
0
2
52
10
2
4
2
32
2
1
0
0
3
0
0
0
1
0
0
9
66
0
2
0
5
2
0
1
0
0
0
4
8
4
26
143
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
8
0
0
12
0
0
0
0
0
0
0
0
0
0
0
Late Neonatal
Death
0
0
0
0
0
1
94
0
4
1
0
0
0
1
2
14
0
1
0
0
0
0
0
0
4
1
0
0
0
5
33
15
1
0
3
7
6
1
0
0
2
0
0
0
0
0
0
3
38
0
2
0
0
0
8
14
1
0
0
6
12
0
43
538
0
1
0
0
9
2
119
0
9
0
0
0
2
1
11
3
8
0
1
0
0
8
2
15
2
193
0
0
34
2
0
3
0
0
0
0
3
1
0
2
Still Birth
0
0
0
0
0
1
61
0
2
3
0
0
7
4
0
9
0
0
0
0
0
0
0
0
4
1
0
1
0
5
36
9
0
3
1
8
2
0
0
0
2
0
0
0
0
0
0
2
27
0
0
0
0
0
5
16
0
0
0
5
15
0
41
3 3881 4178
0
3
4
0
3
10
0
89 109
0
0
0
0
46
43
0
7
2
0 534 784
0
8
8
0
27
19
0
0
0
0
0
0
0
0
0
2
29
21
0
1
3
0
20
21
0
8
12
0
12
22
0
0
0
0 327 343
0
0
0
0
2
1
0
70
60
0
22
23
0
4
3
0
12
21
2 1224 1509
0
0
0
0 302 258
0 196 195
0
15
22
0
0
0
0
10
9
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
90 101
0
0
0
0
77
76
Live Birth
Early Neonatal
Death
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
2
Male
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
0
0
0
0
0
0
0
0
0
4
0
0
0
1
0
0
0
0
1
0
0
0
1
3
Female
0
1
0
0
0
3
66
0
0
1
0
0
1
1
2
10
0
0
0
0
0
0
0
0
3
2
0
2
0
0
22
10
1
3
0
7
6
0
0
0
1
0
0
0
0
0
0
6
34
0
0
0
5
0
0
0
0
0
0
1
4
2
12
4000+g
2500-3999g
Late Neonatal
Death
13
3
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
4
0
0
3
0
0
0
0
0
0
0
0
0
0
1
Still Birth
251
2
1
2
0
3
3
35
1
0
0
0
0
8
0
4
1
0
0
12
0
0
0
1
3
0
76
0
1
18
0
0
3
0
0
0
0
4
0
0
0
Male
237
1
2
1
0
3
2
12
0
1
0
0
0
0
0
1
0
0
0
4
0
1
0
1
0
0
29
0
78
6
0
0
2
0
0
0
0
0
5
0
2
Live Birth
Female
211
3
0
2
0
4
0
26
0
2
0
0
0
1
0
1
1
0
0
4
0
0
1
1
0
0
46
0
52
1
1
0
1
0
0
0
0
0
2
0
3
Late Neonatal
Death
4
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Still Birth
Early Neonatal
Death
34
0
0
2
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
3
0
0
0
0
0
0
21
0
0
0
0
Still Birth
Male
201
0
0
22
0
13
0
21
0
0
0
0
0
1
0
2
1
0
4
2
0
0
0
0
0
1
67
11
0
5
0
0
4
0
0
0
41
0
0
1
0
Live Birth
Early Neonatal
Death
87
88
89
90
91
92
93
94
95
96
97
98
99
Male
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
Female
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163 1804 1720

12
0
0
12
0
0
12
0
0
12
0
0
12
0
0
12
0
0
12
3
5
12
1
0
12
0
0
8
0
0
12
0
0
12
0
0
12
0
0
12
10
6
12
0
0
12
0
0
12
0
0
12 102
91
12
1
0
12
0
0
11
0
0
12
2
1
12
0
0
12
0
0
12
0
0
295 119 103
12 598 632
12
2
1
11
1
0
12
0
0
12
0
0
12
1
0
12
0
0
12
0
0
12
0
0
12 1026 940
12
0
0
12
0
0
12
0
0
12
0
1
0
12
0
0
12
7
3
12
0
0
12
0
0
12
0
0
12
0
0
239 1635 1577
11
0
0
12
0
3
12
1
1
12
0
0
11
0
0
12
0
0
12
0
0
12
0
0
12
2
2
12
0
0
12
0
0
12
0
0
12
0
0
12
0
0
12
0
0
12
0
0
12
0
0
12
0
1
11
1
2
12
0
0
12
0
0
12
0
0
12
0
0
273
4
9
12
1
4
12
0
0
12
0
0
11
1
0
12
4
0
12
2
0
12
0
0
12
0
1
12
0
0
12
1
1
12
0
0
12
26
18
12
0
0
12
0
0
12
0
0
12
0
0
12
0
2
203
35
26
9
0
0
12
0
0
12
0
0
12
0
1
12
0
0
12
2
1
12
4
2
12
0
0
12
1
0
12
0
0
12
1
1
12
3
0
12
0
0
153
11
5
Late Neonatal
Death
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Live Birth
Number of Babies at Birth

1500-2499g
1000-1499g
Early Neonatal
Death
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
500-999g
Female
SN
Received Reports
331
Grand Multi
<20 Year
20-34 Year
35+ Year
None
Public
Private
1-3 ANC
4+ ANC
3724
7
2
0
0
89
0
442
32
27
0
0
0
11
0
42
16
0
0
0
0
0
0
0
11
18
697
0
0
406
38
0
1
0
0
0
0
0
2
130
123
32370
81
341
0
0
1276
0
26
47
150
0
0
0
270
22
506
359
0
0
0
0
11
0
0
124
209
3422
0
0
4122
463
0
141
0
0
0
0
0
17
14
585
2317
12
16
0
0
63
0
0
0
21
0
0
0
29
1
49
31
0
0
0
0
0
0
0
23
12
257
0
0
114
3
0
4
0
0
0
0
0
129
4
81
766
1
0
13
0
12
0
68
3
5
0
0
0
2
0
17
3
0
0
11
0
0
4
4
1
7
151
9
0
8
5
0
2
0
0
0
206
0
1
11
4
40
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
0
0
0
0
30347
71
156
40
0
845
0
0
21
60
0
0
0
121
3
366
230
0
0
0
0
8
93
0
79
433
2526
0
0
3041
221
0
76
0
0
0
8643
0
136
0
470
18528
30
119
52
0
617
0
0
49
102
0
0
0
137
2
240
155
0
0
0
0
3
81
0
68
336
1991
0
0
2893
241
0
65
0
0
0
846
0
89
0
261
3684
12
11
7
0
101
0
0
2
37
0
0
0
55
0
29
26
0
0
0
0
0
22
0
12
14
328
0
0
95
54
0
10
0
0
0
0
0
0
0
66
10243
26
51
24
0
249
23
0
7
22
0
0
0
60
3
104
85
0
0
202
0
3
228
0
24
77
1188
206
0
1091
76
0
22
0
0
0
273
1
19
364
197
45993
86
291
160
0
1263
64
0
73
153
0
0
0
233
29
497
304
0
0
1628
0
7
1327
0
133
462
6710
1053
0
5787
407
0
109
0
0
0
1914
24
177
999
471
2580
4
18
14
0
51
3
0
1
25
0
0
0
80
3
45
19
0
0
91
0
0
29
0
3
15
401
43
0
73
22
0
8
0
0
0
106
0
29
96
52
3116
26
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
30
0
0
1996
0
0
0
0
0
0
0
0
0
0
0
8682
66
0
0
0
0
0
0
0
0
0
0
0
0
0
451
0
0
0
0
0
1
0
0
0
0
518
0
0
3734
0
0
2
0
0
0
0
0
0
0
0
4967
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
17548
40
831
0
0
0
0
0
0
80
0
0
0
303
14
404
0
0
0
0
0
0
0
0
35
0
1707
0
0
792
31
0
19
0
0
0
3963
0
0
168
0
12467
26
410
0
0
0
0
0
0
44
0
0
0
312
18
102
0
0
0
0
0
11
0
0
41
0
964
80
0
3260
135
0
98
0
0
0
2772
0
0
0
0
0
0
16
17
0
1
87
0
6
1
0
0
10
0
0
20
0
0
0
0
0
0
0
0
13
116
0
2
0
0
168
0
0
7
1
0
0
0
0
1
2
0
0
0
0
0
0
0
11
1
0
1
10
1
0
8
0
1
0
35
2
1
60
9
0
78
309
4
24
1124
0
66
43
7
0
30
0
3
258
0
5
1
3
0
0
0
6
172
195
12
25
9
50
885
0
86
29
25
0
12
0
8
2
54
0
0
0
9
4
20
0
249
3
32
22
21
6
7
427
15
21
0
47
45
123
769
134
7
200
585
17
221
6506
95
878
660
150
0
455
0
375
8683
0
107
8
37
0
0
0
18
1377
196
371
419
38
327
14194
0
812
351
189
0
209
59
94
151
280
157
0
89
60
270
183
0
2904
66
244
192
281
144
107
607
405
415
0
580
693
1610
5344
9
4
13
1
19
15
396
0
35
140
8
0
22
0
13
385
0
6
0
0
0
0
0
0
48
20
7
12
0
50
746
0
18
12
14
0
6
6
3
7
21
8
0
364
4
1
14
0
478
5
26
4
11
3
3
207
26
1
0
58
28
68
440
0
0
6
7
2
3
264
2
8
11
1
0
2
6
2
72
17
1
0
0
0
0
0
0
13
8
0
2
1
43
189
29
5
2
6
11
2
0
1
0
2
2
0
10
0
6
3
29
108
0
7
0
1
0
1
10
2
0
0
13
4
16
54
0
0
0
0
0
0
2
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
32
0
0
0
0
0
0
32
58
3
0
0
0
145
12793
0
519
518
97
0
258
0
237
4732
0
54
0
13
0
0
0
8
877
56
199
204
30
253
8055
0
480
88
119
1229
396
2
25
43
322
24
0
109
45
162
103
1149
4296
47
116
70
114
55
48
303
187
139
0
354
462
782
2677
57
5
0
0
0
102
4559
0
380
351
55
0
233
0
185
3764
0
59
0
22
0
0
0
16
501
50
191
145
14
131
6097
0
321
142
90
722
357
4
53
37
108
63
0
168
25
135
94
1115
3434
40
144
122
158
58
60
287
253
203
0
204
215
703
2447
6
0
0
0
0
12
243
0
100
34
13
0
99
0
46
904
0
6
0
3
0
0
0
0
26
7
0
19
3
4
1264
0
14
41
19
346
54
0
20
15
8
20
0
0
3
0
18
146
704
1
42
27
51
10
5
333
54
83
0
135
90
314
1145
22
5
31
107
52
47
2513
0
227
200
62
0
99
8
0
1319
0
25
3
7
0
0
0
2
239
138
64
102
18
132
2645
629
156
103
62
595
157
24
16
41
174
23
0
103
21
101
66
588
2859
24
59
32
37
38
23
264
58
33
1
126
160
183
1038
93
9
151
674
226
206
12300
95
730
676
120
0
435
82
283
7702
0
84
5
37
0
0
0
20
1304
572
322
302
29
355
13153
2825
727
276
129
1481
550
42
80
87
272
134
0
187
51
180
139
1752
8912
53
208
176
268
114
89
627
376
361
17
471
578
1580
4918
7
0
23
40
3
7
509
0
32
17
5
0
99
11
25
220
0
10
1
4
0
0
0
2
57
20
4
15
0
15
537
128
37
20
8
221
45
6
9
5
15
8
0
20
1
16
9
70
618
10
35
11
18
3
1
209
12
43
0
96
40
37
515
0
0
0
0
0
22
2018
0
0
0
10
0
165
0
18
0
0
0
0
2
0
0
0
0
0
0
0
0
4
0
199
0
0
0
0
0
0
0
1
0
0
3
0
0
15
0
7
0
26
15
10
0
163
15
4
0
0
230
0
0
0
406
843
0
0
0
0
0
193
3929
0
0
0
91
0
63
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
46
200
0
0
433
0
0
0
0
0
52
0
0
0
0
23
297
67
0
872
41
250
245
160
140
48
0
0
170
0
693
0
1416
3163
0
0
0
0
0
30
37
0
0
0
8
0
4
0
0
0
0
0
0
0
0
0
0
0
158
0
0
0
0
0
170
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
2
12
0
1
0
0
405
4297
0
41
1
0
0
1
4758
4
14
0
0
0
85
5076
0
0
335
107
0
115
0
199
0
0
0
8
5
0
0
0
0
796
588
0
121
106
0
2380
0
0
931
0
0
646
0
99
60
0
109
0
333
38
65
47
0
2328
106
265
292
115
81
385
3473
0
247
0
390
0
703
6057
56
16
0
0
0
126
6543
0
0
290
50
0
105
0
90
0
0
4
3
32
0
0
0
0
426
57
0
103
34
46
1240
0
0
374
0
0
561
0
30
46
0
32
0
247
19
245
34
0
1588
28
35
108
45
59
73
817
0
141
0
136
0
690
2132
Triplet
757
1
4
0
0
11
0
403
2
0
0
0
0
3
0
3
3
0
0
0
0
0
0
0
1
0
431
0
0
19
0
0
6
0
0
0
0
0
0
20
8
Twin
Multi
87
88
89
90
91
92
93
94
95
96
97
98
99
Mrimi
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
Antenatal Care
42+ Weeks
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Maternal Age
37-41 Weeks
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Neonate From
28-36 Weeks
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Hospital Name
Multiple
Pregnancy
Maturity Status
22-27 Weeks
SN
Received Reports
332
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Sputum Culture
Body Fluid
Culture/US/AFB
2779
0
0
0
0
0
58
1
0
63
4
30
0
0
0
0
0
0
0
0
0
0
0
35
37
0
228
0
1
11
0
0
0
0
1
0
30
0
0
0
0
707
0
0
0
0
0
3
435
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
438
0
0
72
0
0
0
0
0
0
0
0
0
0
0
59062
237
658
378
43
0
582
1498
207
378
91
288
0
752
121
412
458
0
183
1199
68
0
918
318
227
665
9681
40
587
6
910
0
137
0
586
686
64
453
0
0
456
4642
18
41
9
0
4
26
57
15
32
0
0
0
71
11
24
35
0
7
120
5
0
73
13
19
55
635
0
11
0
45
0
5
0
4
52
0
4
0
0
21
62832
664
717
562
7
165
174
1931
276
1560
35
263
0
24
59
1578
1252
0
16
398
66
0
589
247
44
894
11521
622
57
1072
635
0
203
0
1194
943
126
1862
0
1593
733
1659
0
0
0
0
0
0
0
0
1
0
0
0
74
0
0
0
0
0
0
0
0
0
0
0
0
75
8
0
12
0
0
0
0
0
9
0
23
0
0
0
70
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1118
0
0
0
0
7
0
167
0
22
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
208
0
0
0
0
0
0
0
636
0
14
6
0
0
0
2159
0
0
0
0
35
0
444
0
0
0
0
0
81
0
0
9
0
0
0
0
0
0
0
0
0
569
0
8
25
0
0
0
0
0
11
0
3
0
105
3
0
4
0
0
0
4
508
0
0
3
0
0
7
0
0
11
841
28
0
0
0
0
0
0
329
274
3
0
0
0
1496
0
51
6
52
0
0
10
1
0
0
8
0
0
1
0
0
5
134
34
0
34
10
0
0
120
0
17
0
467
0
0
682
0
0
0
0
0
0
8516
0
0
0
0
0
0
0
0
2773
2511
144
0
0
0
0
0
0
1347
668
0
0
0
0
7443
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
45
54
0
0
30
0
0
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
7122
0
0
0
0
0
0
0
0
2988
2997
252
0
0
0
0
0
0
2110
521
0
0
0
0
8868
0
105
0
0
0
0
0
0
0
0
0
0
0
0
0
0
36
141
0
0
28
0
0
0
0
0
0
0
0
0
0
28
0
0
0
0
0
0
107
0
0
0
0
0
0
0
0
17
134
7
0
0
0
0
0
0
94
125
0
0
0
0
377
45
0
10
5
0
0
0
0
0
0
0
0
0
0
0
0
26
86
0
0
1
1
0
0
4
0
0
0
47
0
13
66
0
0
0
0
0
0
1866
0
0
0
0
0
0
0
0
44
136
0
0
0
0
0
0
0
0
0
0
0
0
0
180
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
603
0
0
0
0
0
0
0
0
2834
1006
43
0
0
0
0
0
0
473
172
0
0
0
0
4528
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
43
0
25
0
0
4
117
0
30
0
576
0
0
1
136
0
0
0
0
141
0
30
18
0
1078
0
0
0
137
881
0
0
11
0
0
34
15
0
0
0
0
0
1078
0
0
0
0
0
0
0
65
287
0
0
0
0
352
0
0
0
0
0
0
72
0
1
0
0
2
11
0
5
0
0
0
0
0
12
0
0
0
0
30
0
0
3
0
64
0
0
0
16
67
0
0
0
0
0
2
1
0
0
0
0
1
87
0
0
0
0
0
0
0
5
41
0
0
0
0
46
0
70
0
0
457
176
4628
0
383
1080
188
49
600
0
238
0
1383
555
29
144
765
1034
15
772
4634
806
443
594
262
1006
14980
99
552
903
855
9288
1321
24
42
539
330
365
71
2839
573
774
1722
1066
21363
65
1077
587
1198
285
151
1827
631
1510
7
0
1072
0
8410
0
6
0
0
25
9
182
0
27
111
18
5
38
0
21
0
102
32
0
10
47
120
0
61
538
13
16
23
29
90
1301
10
129
52
92
753
129
3
3
30
6
60
3
206
58
65
150
44
1793
6
72
71
103
23
9
104
46
166
1
0
130
0
731
0
72
0
2072
555
227
11966
505
1361
1050
0
131
364
0
170
1580
80
1240
5
95
396
787
158
559
0
562
1171
898
484
2736
14332
3293
728
498
847
494
987
22
2
369
1136
179
97
697
385
883
243
543
11403
0
1555
1062
147
259
694
220
764
554
72
4128
823
3332
13610
0
0
0
0
0
0
52
0
16
0
0
0
0
0
0
0
215
71
0
0
0
0
0
0
458
16
75
1
0
0
852
0
0
0
198
0
0
0
0
0
0
320
0
0
0
0
49
38
605
0
0
0
0
31
0
44
0
0
0
0
0
0
75
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
2
0
1
38
0
0
0
47
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23
0
23
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
656
0
0
0
0
0
0
0
0
23
193
1
0
0
0
0
0
0
0
37
0
0
0
0
254
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
46
0
0
201
39
0
0
0
0
0
0
0
15
223
18
0
9
2
0
0
0
872
6
0
7
0
1
1192
0
3
0
18
0
0
10
0
2
0
0
0
0
49
0
0
31
113
0
10
0
0
0
0
6
0
0
0
0
33
35
84
Leptospira
Total
Pus Culture
Others
5636
0
0
0
6
0
0
257
0
44
70
124
0
0
0
0
0
0
0
0
0
0
0
0
0
0
501
0
4
53
0
0
0
0
243
0
118
185
0
0
0
CSF Culture
30
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Fungus
2244
0
0
0
0
0
0
2
0
46
0
10
0
70
70
0
0
0
0
0
0
0
0
0
0
0
198
0
118
164
0
0
0
0
952
606
26
0
0
0
0
Widal Test
797
0
0
2
0
4
0
120
0
29
0
0
0
0
0
0
0
0
0
0
1
0
0
5
0
0
161
0
0
83
0
0
0
0
0
0
24
0
0
0
0
+ve
19990
0
0
0
401
65
0
1303
0
1006
180
226
18
316
316
0
0
0
0
0
0
0
0
0
0
0
3831
0
546
230
0
0
0
0
2271
343
2781
951
0
0
0
ENT culture
16746
0
0
0
9
8
0
569
0
33
58
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
703
0
403
301
0
0
0
0
3394
1693
860
1865
0
0
0
Water Culture
3942
1
0
0
0
20
1
371
0
71
121
521
0
2
4
3
0
0
0
0
1
0
0
6
0
0
1122
0
22
53
0
0
16
0
28
3
369
9
0
0
0
Stool Culture
Urine Culture
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Sputum AFB
Blood Culture
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
District Name
BACTERIOLOGY
Gram stain
SN
Received Reports
333
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
Alk. Phosphatase
0
0
0
0
0
0
253
0
0
0
0
0
0
0
0
0
229
0
0
0
0
0
0
0
41
205
0
0
0
0
564
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Others
Creatinine
Clearance
24 Hrs Urinary
Protein
CPK
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
2136
0
0
0
0
0
0
0
594
0
0
0
0
0
3650
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
11
26
0
0
0
0
0
0
2
0
0
0
0
3
128
133
CPK MB
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
GGT
0
0
0
0
0
0
65
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
78
79
0
0
0
0
157
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7556 101
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
119
0
3653 993
133
0
0
0
0
0
30
0
0
0
31
0
0
0
1121
0
1773
58
0
0
0
0
20
0
0
0
6880 1051
1724
0
0
0
0
0
109
0
0
0
0
0
0
0
35
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
165
0
2034
0
0
0
0
0
0
18
0
0
0
0
0
0
64
0
0
0
0
0
1
0
300
0
0
0
412
0
777
18
Calcium
0
0
0
0
0
0
178
0
0
0
0
0
0
0
0
0
2058
0
0
0
0
23
0
0
21
0
0
0
0
0
2102
0
2
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
335
0
0
335
0
16
0
0
6
0
1642
0
0
7
0
0
0
0
0
412
3239
25
0
0
0
0
1
19
96
346
0
3
6
0
4154
467
0
14
3
0
0
0
0
0
0
0
0
0
0
0
0
0
484
0
0
22
2
0
0
3
0
0
1
1128
0
90
1246
Phosp horus
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
35
0
0
0
0
0
0
0
0
21
17
0
0
0
0
73
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
29
0
0
42
66
33106
60
558
242
90
11
385
0
0
3964
19494
811
17
86
107
207
244
127
6232
4526
190
395
210
309
38265
2128
16
394
313
301
0
0
18
12
1
43
0
424
75
260
103
531
4619
515
299
196
117
6
98
450
82
64
16
4453
206
1013
7515
LDH
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 76
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 104 711
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
58 278
0
0
0
0
0
0
0
0
0
0
0
0
0
58 382 713
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 27
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 27
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
5
0
0
0
0
0
0
12
0
5
0
0
0
0
0
69
0
0
0
0
0
8
0
8
88
0
0
141
5653 8519 11865
0
25
143
0
0
284
0
0
681
12
0
52
0
0
254
0
0
361
0
0
0
0
0
23
5433 5993 3044
0 2871 4875
122
92
505
0
0
38
19
0
118
33
18
220
0
0
284
0
31
60
0
0
243
1088 1102
485
2201 1991 1686
0
0
358
0
0
397
16
19
60
0
0
180
8924 12142 14351
1755 1103
894
0
0
140
0
0
260
100
68
207
0
0
244
0
0
568
0
0
0
35
12
34
0
0
70
0
0
23
0
0
61
0
0
0
0
0
280
1
0
93
0
0
179
0
0
106
192
123
528
2083 1306 3687
91
91
66
735
0
190
0
0
344
0
0
210
0
0
36
0
0
68
35
5
434
0
0
570
0
0
131
0
0
18
750
831 2365
0
13
168
413
0
722
2024
940 5322
Acid
Phosphatese
0
0
0
0
0
0
0
0
0
0
0
0
0 744
19
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
822 1292
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0 238
0 833
0
0
0
0
0
0
0
0
841 2372
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
76
0
0
0
0
0
85
0
0
0
83
0
0
44
89
0
140
0
227
1830 18716
63
283
0 1004
0
737
1
160
0
31
0
536
0
0
6
18
276 6016
4569 4107
10
940
0
28
0
226
0
258
0
179
0
66
282
423
226 2878
468 1612
0
207
44
489
15
180
7 1573
5967 21951
175 2076
0
226
14
467
37
361
0
917
0
451
0
2
0
48
0
240
0
201
0
139
0
29
0 1027
26
153
0
238
0
180
29
494
281 7249
70
124
0 1489
0
305
0
239
0
236
0
54
0
275
0
377
0
459
0
8
322 5247
0
361
0 1347
392 10521
SGOT
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1320 10882 1099
5
0
0
0
1
0
24
186
0
0
0
4
0
0
0
0
0
0
0
0
0
6
0
0
1340 4200 5993
562 7742 3749
113
685
15
0
0
0
0
0
0
0
0
0
0
0
0
8
26
0
0
0
0
197 3774
266
1131 2518
621
0
0
0
0
197
2
3
0
6
0
0
0
3389 19329 10656
401
0
269
0
0
0
0
0
66
3
92
48
0
0
0
1
0
0
0
0
0
12
5
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
242
0
0
0
0
0
0
21
0
37
438
98
662
0
774
43
0
0
2
0
0
0
0
0
0
0
0
0
1
0
0
25
51
7
0
0
0
0
0
0
0
0
0
276
0
605
0
0
0
0
235
0
302 1060
657
Cholesterol
4075
0
92
0
6
29
0
65
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
0
0
216
0
8
12
0
0
0
0
0
30
0
0
0
0
0
Ceatinine
79
0
0
0
0
0
5
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
0
10
0
0
0
0
0
0
0
0
Uric Acid
258
0
0
0
0
0
0
28
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
36
0
0
65
0
0
0
0
0
0
0
0
0
0
0
GPT
5267
0
0
0
38
0
0
2588
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2626
0
0
0
0
0
28
0
0
0
0
0
0
150
0
Bilirubin T&D
89
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
2
0
0
0
0
0
0
5
0
0
0
0
Albumin
70 409 880 911

0
0
0
0
0
0
0
0
0
0
0
8
0
0
1
0
0
0 14 13
0
0
0
0
0
0 71
0
0
0
0
0
0
0
0 38
0
0
0
0
0
0
0 25
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 86 91
0
0
0
0
0
0
0
0
0
0 29 52
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 47 201
0
0
0
0
0
0
0
0
0
0
0
0
Total Protein
858 4170
0
0
0
0
0
0
0
0
10
0
0
0
0 278
0
0
0 144
0
9
0 530
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17 961
0
0
0
0
0 108
0
0
0
0
0
0
0
0
0 314
0
0
0
25
0 297
0
0
0
0
0
0
NA
K+
6585 33931 21098 16578 74851 19859 31153 46246 105118 12167 23242 1606
1
0
54
44
338
30
44
323
172
13
39
2
5
0
38
51
432
0
71
115
188
0
104
0
39
220
3
0
686
19
19
743
1914
30
0
10
89
8
6
10
477
0
156
71
626
17
48
0
154
239
72
69 1012
299
284 1035
2336
68
293
10
0
0
30
29
210
0
0
157
173
0
0
0
139
446
893
895 2159
727
702 2550
4223
543 1274 402
0
0
0
0
319
0
0
0
0
0
0
0
513
258 4524 4479 1987
0 4530 1329
5055 1685 1747
0
129
0
345
325
399
0
350
342
681
372
170
0
36 1250 1960 2118 2375
0 1910 2664
3184 1878 2168
0
2
0
0
0
0
0
0
33
0
0
0
0
25
66
32
27
799
56
92
152
777
33
83
0
2
71
8
3
113
0
18
44
82
2
24
12
0
4
31
21 1933
34
32
219
193
0
33
0
0
0
0
0
682
0
0
299
788
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
184
0
28
207
82
0
0
0
0
0
0
0
89
0
0
44
74
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
153
0
0
0
122
0
0
0
1
0
28
37 1622
0
0
550
859
0
2
0
1
0
0
0
327
10
10
142
84
0
10
0
0
0
0
0
118
0
0
2
0
0
0
0
1136 2562 8024 8108 16414 1175 8246 11021 21613 4641 5995 436
12
10
0
2
125
0
0
55
30
0
0
0
166
0
44
0
244
0
510
374
1151
154
138
0
445 3047
176
189 2283 2643 1680 1756
6460
210 1446
77
0
0
0
0
662
0
0
417
288
0
0
0
0
0
67
0 1076
0
0
255
673
0
75
0
0
186
96
79
255
34
56
271
190
20
10
0
0
0
0
0
0
0
0
0
0
0
0
0
189 1327
339
584 1131
0
19
509 13293
249
2
0
10
710
65
545 2203 1881 1615 1097
1938
476 1423
0
0 2997
178
113 6713 1095 3462 4566
6765
222 3304
24
498 2315
134
274 1358
0 1169
710
571
289 1158
0
0
0
0
0
0
0
0
0
0
0
0
0
0
290
0
0 1346
0
0
979
936
0
0
0
0
0
0
0
781
0
0
570
674
0
0
0
Amylase
Urea
1163 225147 107160

660
168
12
12
496
199
12
3583
2109
12
965
547
12
3394
2429
12
352
194
12 17507 14977
12
464
0
12 10630
3067
8
1982
1286
12
4663
2890
12
902
84
12
937
31
12
146
30
12
1124
150
12
1566
712
12
0
0
12
0
0
12
485
253
12
185
85
11
0
0
12
633
113
12
1549
216
12
344
23
12
282
6
295 52849 29569
402
12
12
12
3359
1374
11 10873
6180
12
792
311
12
2480
685
12
571
202
12
0
0
12 13913 14653
12
1922
2483
12 22541
7782
12
8646
141
12
0
0
12
3223
570
12
1172
680
0
12
0
0
12
99
27
12
0
0
12
999
0
12
116
44
12
499
0
239 71607 35144
210
40
11
12
1323
637
12
1925
151
12
160
0
11
241
11
12
2090
165
12
1333
1203
12
76
26
12
9773
5322
12 24433 18104
12
2717
263
12
83
29
12
388
101
12
409
105
12
1328
157
12
1454
195
12
894
22
12 10193
536
11
9890
4509
12
594
161
12
1365
379
12
287
207
12
1258
255
273 72424 32578
5721
2985
12
12
329
18
12
633
355
11
628
72
12
650
347
12
1817
480
12
0
0
12
54
16
12
102
6
12
37
1
12
137
46
12
13
0
12
1177
276
12
286
46
12
408
257
12
246
83
12
2043
265
203 14281
5253
590
390
9
12
347
302
12
590
274
12
278
20
12
33
4
12
266
106
12
1068
57
12
552
152
12
241
76
12
64
6
12
7315
2260
12
601
159
12
2041
810
153 13986
4616
24 hours urinary
Uric Acid
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
S.
troponin-I
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
District Name
BIOCHEMISTRY
Sugar
SN
Received Reports
334
SN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
District Name
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Received
Reports
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
HIV
Total
HCV
+Ve
Total
Virology
HBsAg
Western Bloot
+Ve
Total
+Ve
Total
HEV
+Ve
Total
CD4 count Viral Load
+Ve
Others
79078
60
706
1013
72
1768
46
787
0
367
130
780
0
235
42
174
120
0
1
40
6
0
984
86
0
298
7715
0
669
2029
159
40
80
0
488
629
20542
1757
0
1807
315
1200
0
7
1
1
0
0
43
0
16
15
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
85
0
0
0
7
0
1
0
0
148
33
1
0
0
8
10484
4
0
91
32
5
12
236
0
364
84
984
0
195
25
0
0
0
0
0
0
0
6
29
0
0
2067
0
0
458
0
0
68
0
19
290
44
65
0
86
23
111
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
29
5
0
0
0
0
107
0
0
102
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
102
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
62907
192
61
927
79
1220
38
1801
0
594
201
1401
0
266
42
43
402
0
1
403
5
0
21
84
5
5
7791
12
613
3068
124
35
96
0
504
514
20644
3025
0
1832
266
900
0
0
0
0
2
3
143
0
57
17
0
0
2
0
0
5
0
0
0
0
0
0
3
0
0
232
5
0
0
1
0
0
0
0
97
68
2
0
0
4
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
3
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2705
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
304
0
0
0
0
0
0
0
0
0
0
0
31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
541
0
0
0
1
15
0
44
0
0
0
0
0
28
0
0
0
0
0
0
0
0
0
0
0
0
88
0
0
8
0
0
0
0
0
0
0
10
0
122
0
0
54
0
165
497
43
29274
2
118
957
117
13
109
664
0
3002
4161
1582
28
19
53
67
10
34
3265
3151
32
51
32
531
17998
2058
11
554
308
745
0
26
21
29
6
99
0
376
229
274
829
1382
6947
385
954
1198
288
0
23
675
115
543
6
10475
489
1993
17144
0
1
0
9
0
0
208
3
1
25
18
0
5
4
0
24
26
12
0
0
8
0
0
0
144
211
5
4
2
21
513
87
0
9
2
6
0
0
0
0
0
2
0
0
0
8
3
21
138
5
66
29
1
0
1
2
1
66
0
45
31
9
256
0
0
0
0
0
6
1059
14
18
3
0
0
18
0
0
646
2927
26
0
0
0
2
4
0
978
1144
0
4
7
0
5791
0
0
48
158
0
0
0
0
0
0
6
0
376
0
10
0
0
598
25
6
5
33
0
0
543
3
17
0
337
0
0
969
0
0
0
0
0
0
34
1
0
0
0
0
1
0
0
4
20
2
0
0
0
0
0
0
1
0
0
0
0
0
29
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
30
0
0
0
0
0
5
0
0
0
3
0
0
38
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
15
0
10
0
31
0
33
30807
18
118
15
2
10
16
0
0
3789
4115
118
6
20
21
28
26
23
1059
3067
1
32
14
12
12510
2493
46
542
283
233
0
1
13
5
3
39
1
376
140
168
5
178
4526
53
1262
39
115
3
15
597
67
10
5
2513
397
2197
7273
0
3
0
7
0
0
187
0
0
0
0
0
1
0
0
22
65
3
0
0
6
0
0
0
14
4
0
0
0
1
116
157
4
11
3
3
0
0
1
0
0
0
0
0
0
11
1
59
250
0
30
0
2
0
3
4
0
1
0
58
9
8
115
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
3
0
12
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
304
0
0
0
0
0
0
0
0
608
0
0
0
0
0
0
0
0
0
0
0
0
0
0
608
727
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
146
873
0
412
0
0
0
0
0
0
308
0
200
0
0
920
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
0
0
0
0
0
0
0
0
0
0
0
0
0
31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
140
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
153
0
0
0
0
0
153
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
8
0
0
0
0
0
0
0
0
0
0
0
33
119
152
335
Annex3.15:HospitalLaboratoryServicesHISTOLOGY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Others
Cytokeratin
Vimention
S100
PR
ER
Other
Sputum smear
GFAP
Immunohistochemistry
Bodyfluid smear
Cytology
Pap smear
Biopsy
District Name
Received Reports
SN
Histology
338
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
88
0
0
0
0
943
0
0
0
0
0
0
113
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
113
0
0
70
0
0
0
0
0
0
89
0
0
0
0
2136
0
0
75
0
0
0
18
0
0
0
0
0
0
0
0
1294
0
0
0
0
0
0
23
0
0
1410
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
4
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
15
0
0
0
0
0
0
4
0
0
0
0
315
0
0
0
0
0
0
25
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
26
0
0
0
4
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
138
0
0
0
0
0
0
67
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
67
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
88
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
238
0
0
0
0
238
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
159
0
0
0
0
0
0
0
0
92
199
0
0
0
0
0
0
0
0
327
0
0
0
0
618
0
0
0
53
0
0
0
0
0
0
0
0
0
0
0
0
0
53
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
90
0
0
0
0
90
72
0
0
49
0
0
0
0
0
233
0
0
0
0
0
0
0
354
0
0
0
101
0
31
0
150
0
0
0
0
0
282
0
0
0
0
0
0
19
0
0
0
0
0
0
0
0
6
0
2
0
0
0
0
0
0
52
33
0
0
0
0
93
45
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
46
0
0
0
1
0
0
0
0
0
0
0
0
36
37
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
277
0
0
0
0
0
0
0
0
0
0
0
0
0
0
277
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18
18
0
0
0
0
0
0
0
0
0
0
0
0
53
53
336
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
Specific gravity
Semen Analysis
Reducing sugar
18227
0
0
0
0
0
0
95
0
1478
0
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1593
0
0
39
0
412
0
0
0
0
0
9660
0
0
0
2221
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7171
0
0
0
0
62
2
182
0
1361
0
0
0
1
0
0
0
0
0
0
0
0
0
2
0
0
1610
0
0
122
0
50
0
0
0
0
269
1013
0
0
0
223
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
4
0
0
0
0
0
0
0
0
0
0
0
3796
5
2
7
1
0
6
202
0
190
88
57
113
47
20
9
5
0
0
0
4
0
0
3
0
0
759
1
12
113
45
169
12
0
0
0
1052
20
0
0
19
4719
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
9
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3422
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17862
0
5
0
0
0
0
0
0
0
0
0
0
54
0
0
69
0
0
0
0
0
0
0
0
0
128
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
99
0
297
507
182
45329
108
346
878
1199
122
206
642
68
3716
1906
1170
25
287
363
122
237
454
4077
1333
286
372
157
384
18458
2632
710
718
1976
704
369
5
102
122
495
328
14
380
901
283
48
896
10683
94
742
550
385
108
242
1336
541
240
973
12910
143
1393
19657
0
7
0
3
285
2
4252
0
10
57
0
13
16
0
0
246
385
49
1
7
2
6
8
15
760
681
2
16
25
21
2320
795
4
76
44
18
0
0
0
0
8
0
0
10
17
1
1
150
1124
225
0
50
7
0
0
56
18
19
3
545
10
57
990
0
0
0
347
166
0
1155
0
0
0
0
0
547
0
0
146
37
0
0
0
0
0
0
0
0
0
0
0
0
1
731
589
0
0
1020
0
0
0
0
0
0
0
0
0
0
0
0
0
1609
360
0
0
0
0
0
0
0
78
0
86
0
0
524
0
305
721
2432
586
1077
116669
795
2925
5074
2474
898
3036
878
220
24579
15808
5196
91
713
1701
1933
774
1668
18398
11668
1721
2628
725
2471
106374
9882
1463
2502
6116
2337
1985
11
164
695
1034
930
61
2118
2007
1781
974
4037
38097
811
2956
1205
1791
520
1344
5545
1691
1397
548
12836
2567
7778
40989
0
0
0
0
515
0
10213
0
2
0
0
0
5
0
0
10
74
0
0
0
0
0
0
0
338
4
0
0
0
119
552
20
0
0
1726
0
0
0
24
0
0
0
0
0
0
0
0
0
1770
360
0
0
0
0
0
0
0
0
0
0
0
0
360
0
0
0
0
598
0
10454
0
3
1
0
0
0
0
0
9
88
104
0
0
0
0
0
0
301
4
0
0
0
0
510
19
0
0
2029
0
0
0
24
0
0
0
0
0
0
0
0
0
2072
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
495
0
10606
0
0
0
0
0
0
0
4
28
1763
3
0
0
0
0
0
0
0
7
0
0
0
0
1805
10
0
0
3374
0
0
0
24
0
0
0
0
0
0
0
0
0
3408
800
0
0
0
0
6
0
0
0
0
9
0
0
815
0
0
0
0
117
0
117
0
0
0
0
0
0
0
0
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
0
0
2067
0
0
0
0
0
0
0
0
0
0
0
0
0
2067
0
0
0
0
0
0
0
0
0
0
20
0
0
20
0
0
0
0
245
0
1699
0
0
14
0
0
37
0
0
65
79
11
0
0
0
0
1
0
25
204
0
0
0
0
436
1
0
0
3374
0
0
0
24
0
0
0
0
0
0
0
0
14
3413
1
0
0
1
0
0
0
0
0
0
10
0
1
13
0
0
0
0
200
0
204
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
12
0
0
12
0
2
0
0
11
25
1481
0
19
23
0
3
1
0
20
173
54
20
1
0
9
0
0
9
65
52
4
4
4
22
483
248
0
42
78
0
0
0
6
5
22
31
0
4
30
36
10
12
524
2
13
37
7
12
11
84
16
38
6
310
4
9
549
0
0
0
0
122
0
122
0
0
0
0
0
0
0
0
3
4
60
0
0
0
0
0
0
0
0
0
0
0
0
67
0
0
0
4401
0
0
0
0
0
0
0
0
0
0
0
0
0
4401
0
115
0
0
0
0
0
0
0
0
0
0
0
115
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
3374
0
0
0
34
0
0
0
0
0
0
0
0
0
3408
0
10
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
18
0
0
0
2
0
0
38
17325
0
0
0
0
0
17383
106
2
0
0
87
0
0
0
0
0
0
0
0
0
0
0
36
231
0
0
0
0
0
0
10
0
0
0
0
0
104
114
Others
16546
0
0
4
0
0
0
94
0
3405
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
3510
0
0
34
0
157
4
0
1
0
0
9660
0
0
0
Bence John's
Protein
16498
0
0
0
0
0
0
94
0
3484
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3603
0
0
34
0
4
0
0
0
0
0
9660
0
0
0
Chyle
369959
1647
1092
3976
960
6736
1620
10691
455
13997
955
4778
174
2892
572
3584
2845
0
30
1929
719
0
2559
2911
1235
1473
67830
943
3427
13270
3152
6419
541
0
21819
2271
20275
9660
17972
10610
1189
Acetone
4143
0
0
0
0
0
3
48
0
67
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
124
4
0
47
0
449
8
0
119
2
13
0
0
0
0
Porpho
bilinogen
11268
23
1
7
13
78
11
718
0
1012
93
281
0
104
6
15
14
0
0
42
8
0
0
116
40
0
2582
0
121
169
34
407
66
0
244
54
28
2832
0
0
0
Urine test
114405
446
398
210
228
1505
735
5488
199
3804
588
1415
130
687
163
683
505
0
10
299
118
0
302
1203
273
889
20278
38
2079
2767
1196
3490
373
0
5156
1927
5441
2832
15901
2769
275
Occult blood
Urobili nogen
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Bile Pigments
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
Bile salts
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
District Name
PARASITOLOGY
Stool Test
SN
Received Reports
Annex3.15:HospitalLaboratoryServicesPARASITOLOGY
337
Annex3.15:HospitalLaboratoryServicesIMMUNOLOGY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86 Surkhet Regional Hospital
Mid Western
87 Bail Pata
88 Achham
89 Baitadi
90 Bajhang
91 Bajura
92 Dadeldhura
93 Team
94 Darchula
95 Doti
96 Sujan
97 Seti Zonal
98 Tikapur
99 Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
48902 21513 8446 17794 69116 2293 16 186
+ Ve
+ Ve
Dengue
Total
+ Ve
Total
Total
B.HCG
CA 15.3
Electrophoresis
Brucella
Thyroglobulin
Cysticercosis
PSA
Ferritine
F. Protein
Measles/ IgG
Rubella IgG
Echino cocus
Amoe biasis
CA 19-9
TORCH IgG, IgM
CEA
CA-125
+ Ve
+ Ve
Total
+ Ve
JE
Rapid MP Test
+ve
Total
PV PF
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
33
0
24
0
0
0
1 357
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 54
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 54
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 50379 715
0
214 2
0
611 0
0
895 0
0
79 0
0 1354 0
0
303 0
0 1336 354
0
600 16
0
167 0
0
121 0
0
260 0
0
242 0
0
771 0
0
110 0
0
420 1
0
525 0
0
0 0
0
3 1
0
678 0
0
173 0
0
0 0
0
200 0
0
76 0
0
90 5
0
227 0
0 9455 379
0
77 0
0
488 0
0 1325 0
0
513 0
0 1368 0
0
125 0
0
0 0
0
252 0
0
470 42
0 10357 15
0 1090 0
0
0 0
0 2017 0
0
163 3
8 11
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
8 11
0 0
0 0
0 0
0 0
0 25
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 14
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 14
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 167 128 42 23 251 7

0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 17 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 26 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 43 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 54 5 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 231 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 17 0 0 0
0
0 0 0 0 0 0
0 2727 2 1652 142 124

0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0 148 10
0
0
0 0
5
0
0
0
0 0
1
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
60
7
0
0
0 0
21
2
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
5
0
0
0
0 0 187 29
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
69
2
0
0 31 0
0
0
0
0
0 0
0
0
0
0
0 0 198
3
0
0 31 0 694 53
0
0
6 2
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
80
0 65
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0 154 23
0
0 35 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0
0 0
0
0
0
0 1192 224 10052 427 124

0
0
0
13 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0 1330 0 0
0
0
0
0 0 0
0
0
0
0 69 69
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
47 1 0
0
0
0
46 2 1
0
0
0
1 0 0
0
0
0 1005 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
554 8 19
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
216 1 0
0
0
0
31 0 1
0
0
0
147 4 0
0
0
0
141 0 0
0
0
0 3531 85 90
0
0
0
3 0 0
0
0
0
0 0 0
0 1059 218 1520 0 0
0
25
0
46 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0 0 0
0
34
3
125 4 1
0
0
0
0 0 0
0
0
0
0 51 21
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
30 0 0
0
0
65
0
0
0
254
0
143
0
112
0
13016 139
109
0
402
29
1214
11
333
0
34
0
935
0
65
0
43
0
7387
22
0
18
2183
0
75
0
61
1
310
0
0
0
0
0
137
0
3892
0
3199
0
376
0
746
0
128
0
554
0
22183
81
3087
0
268
6
1287
5
1408
0
573
0
114
0
1
0
6
6
69
0
78
0
368
0
2
0
641
0
366
1
132
0
209
0
1527
0
10136
18
121
0
786
15
180
0
253
0
62
0
59
12
3476 1006
114
0
92
0
11
0
1985 614
528
0
2896
0
10563 1647
0
0
0
0
0
0
9
0
0
3
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
3
0
0
0
0
0
0
57
0
0
0
0
0
0
0
0
0
66
0
0
0
0
0
0
0
0
47
0
0
0
0
113
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 300
0
0
0
0
0 300
0
0 0
0
50 4
0
0 0
0
25 0
0
135 29
0
38 3
0 18493 96
0
12 0
0
389 4
0
879 0
0
245 0
0
83 0
0
51 0
0
0 0
0
15 0
0 1481 1
0
882 13
0 1537 3
0
40 0
0
16 1
0
53 3
0
301 1
0
13 0
0
36 0
0
157 0
0 1225 0
0
310 0
0
582 2
0
77 2
0
562 0
0 8946 30
0 2444 91
0
254 0
0
535 8
0
210 11
0
102 2
0
288 0
0
0 0
0
10 0
0
34 1
0
32 0
0
49 0
0
5 0
0
641 6
0
401 1
0
170 5
0
132 0
0 1081 6
0 6388 131
0
102 0
0 1409 21
0
78 0
0
256 0
0
13 0
0
21 1
0
189 1
0
97 1
0
37 0
0
7 0
0 2661 51
0
540 4
0 1687 0
0 7097 79
0 0
0 0
0 0
0 0
0 0
0 0
8 11
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 11
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 11
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 1118 221
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
2
0
32
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
40
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
1
0
14
1
0
149
0
161
116
91
1313
126
329
708
303
90
574
0
284
840
0
769
46
137
666
168
83
638
775
623
322
563
155
553
8752
896
132
1216
748
451
261
5
66
361
373
924
227
632
467
410
296
514
7979
730
1359
777
557
399
583
879
1193
463
76
2490
395
1002
1090
0
6
0
176
38
82
3512
21
233
151
90
23
540
0
16
4773
357
303
16
29
45
47
34
49
238
1302
223
239
41
217
8987
576
36
343
312
100
265
0
4
17
47
89
0
147
169
52
57
400
2614
146
161
53
233
20
30
164
120
195
19
1352
160
476
3129
K-39
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
1
0
0
0
0
64
17
38 343
27
10
0 676
345
31
82 1429
17
0
0
0
155
83
43 1678
58
17
5 442
1299 391 137 1646
0
0
0 386
101
12
20
0
0
0
0
0
161 399 133
0
0
0
0
0
120
0
0 1254
30
2
0
48
59
12
1 705
201
68
67 650
0
0
0
0
0
0
0
0
382
49
0 872
27
0
0 211
0
0
0
0
24
0
0 1886
109
28
0 514
92
24
27 143
0
1
0 335
3271 1144 553 13218
94
3
8
94
0
0
0
0
483 383 421 3043
205
13
9 577
161 521 573 260
206
12
0 283
0
0
0
0
50 165 1519 3074
85
17
43 262
922
50 4651 865
569 297 705 1798
0
0
0
0
368 129 146 1889
67
0
0 297
0
0
0
0
0
10
8085
0
17
7
37
66
82
0
0
4354
1925
138
0
0
32
0
4
0
63
1066
0
1
9
0
7801
662
0
0
13
0
0
0
0
0
0
0
0
0
15
0
6
200
896
18
0
21
4
0
0
28
0
13
7
327
0
41
459
VDRL
0
88
0
0
0
0
266
0
36
0
0
0
0
0
0
0
0
0
17
1
0
0
0
0
0
408
0
0
94
0
0
0
0
0
34
11
0
0
0
0
633
487
349
101
617
220
547
486
132
217
153
81
679
224
377
643
0
2
408
180
0
308
657
202
433
8136
171
514
1133
1187
1075
472
0
0
18
6001
641
0
1146
257
0
1
0
0
10
0
1601
19
18
59
27
15
15
0
0
1883
499
46
0
6
0
0
1
16
45
834
15
9
8
17
3532
534
2
81
184
28
0
0
7
0
2
0
0
2
16
84
3
88
1031
55
11
27
4
0
0
109
79
21
1
817
1
13
1138
DNA
Total
+ Ve
ANA
Total
Total
CRP
Blood Group
ASOT
Rh Factor
Received Reports
District Name
Pregnancy test
SN
IMMUNOLOGY
TPHA
0
0
0
0
0
0
54
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
70
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
70
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
20 20 20 20 0
0 0 0 0 0
25 37 20 251 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
72 0 2 0 0
31 5 1 0 7
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
103 5 3 0 7
0
0
0
0
0
26
67
0
0
0
0
0
0
0
0
1454
0
0
0
0
0
0
0
0
0
205
0
193
0
0
1852
0
0
0
94
47
264
0
0
0
0
83
0
193
0
0
0
0
681
0
0
0
0
0
0
96
0
0
0
0
0
0
96
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
661
0
0
900
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
26
41
14
0
0
0
0
0
0
0
0
0
3
0
0
17
0
0
0
65
0
0
88
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
65
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
40
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
57
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
963
0
0
2718
0
0
0
20
0
189
0
10
0
0
3
0
0
0
0
0
18
0
0
0
20
24
105
389
1060
130
0
251
108
14
0
0
0
0
0
0
0
60
2
5
252
1882
189
181
65
0
5
28
189
8
67
28
300
0
472
1532
0
0
2
8
0
0
65
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
148
0
2
0
152
12
2
0
39
6
0
0
0
0
0
0
0
0
0
0
0
7
66
14
21
9
0
0
0
10
0
1
1
3
0
0
59
0
0
0
3
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
1
0
0
0
0
0
3
0
0
0
0
0
0
4
338
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86 Surkhet Regional Hospital
Mid Western
87 Bail Pata
88 Achham
89 Baitadi
90 Bajhang
91 Bajura
92 Dadeldhura
93 Team
94 Darchula
95 Doti
96 Sujan
97 Seti Zonal
98 Tikapur
99 Mahakali Zonal
Far Western
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211 66
0 0
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23 0
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18 0
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1
71
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1
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3
33
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17
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0
0
43
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191
133
0
0
0
APTT
0 11342
0
0
0
0
0
0
0
3
0
8
0
0
0
147
0
0
0
91
0
0
0
172
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0
485
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0
0
0
0
0
0
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0
0
0
912
0 3298
0
392
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0
0
0
0
0
CSF
LE
0
5
12
709
37
45
2435
61
15
205
28
0
233
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40
0
141
33
6
5
73
21
48
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601
165
0
100
19
276
3009
3600
910
699
24
470
246
0
3
211
2
118
2
0
28
24
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520
6878
186
104
952
63
13
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11
0
1913
187
3752
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1
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1 121 0
48 165 0
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90 293 0
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4 0
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0 0
0 70 0
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14
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Bone Marrow
165
0
0
0
0
0
0
0
0
0
0
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0
0
0
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0
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0
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0
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0
0
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BTCT
0
0
0
0
0
5
5
0
0
0
0
0
5
0
0
0
0
0
0
0
0
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21164 634 710 6 302 16675 653
377
225
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0
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2
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1
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362
139
0
222
5090
5
0
517
227
285
0
0
3
183
10
289
0
0
108
Spleenic Asp.
MF
MP
0
2
0
0
1
0
958
0
0
0
0
0
0
0
0
1039
2309
10
10
0
0
0
0
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53
380
0
0
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550
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0
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0
0
0
4
628
0
1
2
1
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1
36
0
0
600
0
0
641
Aldehyde
MCH
MCHC
MCV
Platelet
PCV
Reticulocyte
ESR
Hb
DC
RBC
824
0
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
24
0
0
2
0
0
0
0
0
18
11
0
0
0
0
ALC
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
8
0
0
0
6
1
942
0
1365
267
1580
0
11
0
13
0
0
0
0
20
0
0
0
0
0
1650
2
0
241
606
50
0
0
9
29
18
0
0
0
0
43313
Factor IX
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
1163 417060 383068 372880 178566 48265 1759 117699 41551 43834 44779
1169
1169
555
371
1
0
57
0
0
0
12
12
1223
1224
1168
502
0
0
52
0
0
0
12
3983
3992
5196
602
0
0
15
0
0
0
12
1134
1133
1040
355
0
0
20
0
0
0
12
7285
7285
8891
4969
0
0
116
0
0
0
12
867
869
782
587
0
0
21
0
0
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12 19547 19547 28821
5074 679
8 1355
0
0
0
12
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643
590
439
0
0
0
0
0
0
12 13650 13717 14238
1251 13651
1 11036 1309 13650 1365
8
2041
2041
1685
645 363
0
392 374
363 363
12
6338
6338
4656
3919 3186 13 2018 1580 2740 2740
12
0
0
227
338
0
0
0
0
0
0
12
2195
2195
2543
1051
0
0
371
0
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0
12
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533 299
0
321
0
0
0
12
3726
3726
3314
504
0
0
57
0
0
0
12
3003
3003
3218
2268
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12
40
44
51
11
0
0
0
0
0
0
12
2185
2185
2322
352
0
0
74
0
0
0
12
397
397
469
136
0
0
22
0
0
0
11
0
0
0
0
0
0
0
0
0
0
12
1783
1783
3198
682
0
0
15
0
0
0
12
3053
3053
3110
3029
0
0
96
0
0
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12
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809
979
658
0
0
13
0
0
0
12
1394
1390
911
881
0
0
0
0
0
0
295 77208 77274 88683 29157 18179 22 16051 1504 16753 1675
1551
1552
1482
1146
0
0
5
0
0
0
12
12
3170
3170
2603
1969
58
0
166
0
0
0
11 17244 17244 20729
7821 118
0 6775 1126
7
7
12
2480
2480
2908
2309
0
0
618
0
0
0
12
7860
7365
6655
3140
0 40 1067 250
0 300
12
1045
1055
1059
885
24
0
10
0
0
0
12
0
0
0
0
0
0
0
0
0
0
12 28331
5001
1333
2519 112 51 16236
79
43
79
12
5283
5276
5269
4197 204 14 2717
20
19
18
12 11552 11552 31183
1360 481 247 6308
32
32
32
12 12442 12319 13493
2956
11 26 12358
1
0
0
12 18224 18208 18194 18219
0
0
0
0
0
0
12
9002
9002
8836
4291
0
0
0
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0
0
12
1495
1485
1362
1208
0
0
48
0
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0
0
12
0
0
0
0
0
0
0
0
0
0
12
152
152
211
127
0
0
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12
1375
1364
1510
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0
0
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12
5923
5833
1107
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0
0
0
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12
179
179
255
190
1
0
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12
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1289
1177
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10
0
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239 128597 104526 119366 58206 1019 378 46356 1508
101 436
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270
0
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11
12
3591
3591
1706
906
0
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52
0
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0
12
2814
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1908
785
5
0
71
0
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12
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112
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242
61
0
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0
0
0
11
1057
1057
1079
1057
0
0
2
0
0
0
12
2485
2486
1919
805
10
0
68
0
0
0
12
1008
1040
1437
1326
0
0
0
0
0
0
12
365
365
338
288
0
0
0
0
0
0
12 29802 29802 11408
7051 1603 135 8975 1067 1067 1067
12 26334 24820 23472
9399 12564
0 25874 2382 25820 2582
12
4260
3890
2739
601
0
0
116
0
0
0
12
129
129
119
62
0
0
24
0
0
0
12
335
335
200
252
0
0
0
0
0
0
12
1348
1348
1179
814
0
0
3
0
0
0
12
2108
2208
1250
1144
0
0
0
0
0
0
12
1160
1160
3984
853
0
0
14
0
0
0
12
1236
1236
459
367
0
0
6
0
0
0
12 13700
8090
0
5230 11906
6 1326
0
0
0
11
7785
7785
9135
3513 1943
0 2705
33
20
24
12
1755
1737
850
290
1
0
3
0
0
0
12
2362
2362
2262
1090
0
0
28
0
0
0
12
789
789
420
330
1
0
16
0
0
0
12
3724
3724
1719
676
0
0
0
0
0
0
273 111276 102010 68557 37351 28094 135 39343 2492 26907 2691
4588
61
0 2983
0
0
0
12 13596 13596 12760
12
1661
1661
1057
665
0
0
0
0
0
0
12
1844
1844
2932
1690
0
0
56
0
0
0
11
5243
4177
3243
2324
0
0
80
0
0
0
12
2669
2669
2639
1630
0
0
60
0
0
0
12
2528
2478
2110
1130
0
0
0
0
0
0
12
20
20
1
2
0
0
0
0
0
0
12
169
169
165
128
34
0
67
67
63
38
12
580
580
456
404
0
0
2
0
0
0
12
619
619
409
424
0
0
0
0
0
0
12
1006
981
990
723
0
0
10
0
0
0
12
44
44
52
31
0
0
0
0
0
0
12
1517
1517
1641
761
0
0
8
0
0
0
12
1708
1708
975
1311
2
0
0
0
0
0
12
2233
2233
456
1738
0
0
0
0
0
0
12
648
648
344
449
0
0
0
0
0
0
12
4001
4001
3463
1825
0
0
112
0
0
0
203 40086 38945 33693 19823
97
0 3378
67
63
38
815
815
890
196 812
0
520
0
0 641
9
12
3300
3600
4065
3585
0
0
41
0
0
0
12
1426
1426
1297
1025
62
0
46
2
10
0
12
1111
1236
1228
632
0
0
29
0
0
0
12
266
266
274
90
0
0
1
0
0
0
12
2125
2125
667
616
0
0
8
0
0
0
12
5176
5176
6140
1867
2
0
0
0
0
0
12
1323
1318
845
1076
0
0
119
0
0
0
12
918
918
1150
694
0
0
47
0
0
0
12
560
560
593
91
0
0
12
0
0
0
12 32410 32410 36355 18789
0
0 11489
0
0
0
12
2744
2744
2359
1762
0
0
0
0
0
0
12
7719
7719
6718
3606
0
1
259
0
0
0
153 59893 60313 62581 34029 876
1 12571
2
10 641
Factor VIII
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
FDP/ D-dimer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
District Name
HAEMATOLOGY
TC
SN
Received Reports
Annex3.15:HospitalLaboratoryServicesHAEMATOLOGY
339
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
National Total
Bhojpur
Dhankuta
Ilam
Dr.MBPCH
Mechi Zonal
Khotang
Koshi Zonal
Rangeli
Birat Nursing Home
Life Guard
Neuro Hospital
Okhaldhunga UMN
Rumjhatar Hospital
Panchthar
Sankhuwasabha
Sagarmatha Zonal
Siraha
Lahan
Solukhumbu
Khunde Hospital
Sunsari Hospital
Taplejung
Tehrathum
Udayapur
Eastern
Kalaiya
Bhaktapur
Bharatpur
Dhading
Janakpur Zonal
Jiri
Bir
Kanti
Maternity
Shir Memorial
Mahottari (PH)
Hetauda
Trishuli
Narayani zonal
Ramechhap
Rasuwa
Gaur
Sarlahi
Sindhuli
Sindhupalchowk
Central
Argakhanchi
Baglung
Gorkha
Amp Pipal UMN
Ama-Ba Hospital
Tamghans
P. Bir
Shiva Raj
Western Regional
Manipal Teaching
Lamjung
Manang
Mustang
Beni
P.Chandra
Kali Gandaki
Palpa
Palpa UMN
Parbat
Syangja
Bandipur
Damauli
Western
Bheri Zonal
Bardiya
Dailekh
HDCS-Chaurjahari
Dang
Dang Zonal Hospital
Dolpa
Humla
Jajarkot
Jumla
Kalikot
Mugu
Pyuthan
Rolpa
Rukum
Salyan
Mid Western
Bail Pata
Achham
Baitadi
Bajhang
Bajura
Dadeldhura
Team
Darchula
Doti
Sujan
Seti Zonal
Tikapur
Mahakali Zonal
Far Western
1163
12
12
12
12
12
12
12
12
12
8
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
295
12
12
11
12
12
12
12
12
12
12
12
12
12
12
0
12
12
12
12
12
12
239
11
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
11
12
12
12
12
273
12
12
12
11
12
12
12
12
12
12
12
12
12
12
12
12
12
203
9
12
12
12
12
12
12
12
12
12
12
12
12
153
Others
Digoxine
Phenytoin
Valporic Acid
Cyclosporine
Carbamazepin
Microalbumin
Lipid Profile
TSH
T4
T3
Testerone
Prolactin
LH
District Name
ENDOCRINOLOGY
FSH
SN
Received Reports
Annex3.15:HospitalLaboratoryServicesENDOCRINOLOGY
9
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
5
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
3482
0
0
0
0
0
0
0
0
194
0
169
0
0
0
0
0
0
0
0
0
0
0
0
0
0
363
0
0
465
0
0
0
0
0
0
68
174
0
0
0
2325
0
0
0
0
0
0
0
0
194
0
169
0
0
0
0
0
0
0
0
0
0
0
0
0
0
363
0
0
465
0
0
0
0
0
0
68
174
0
0
0
3022
0
0
0
0
0
0
0
0
194
0
169
0
0
0
0
0
0
0
0
0
0
0
0
0
0
363
0
0
389
0
0
0
0
0
0
60
174
0
0
0
6015
6
1
2
0
19
0
168
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
196
0
0
223
0
0
0
0
0
79
0
272
0
0
0
31
0
0
0
0
0
0
0
0
0
0
31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
509
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
929
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
707
0
0
0
0
0
0
0
0
934
1310
0
0
0
0
0
0
0
85
83
0
0
0
0
2412
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
707
0
0
0
0
0
0
0
0
934
0
0
0
0
0
0
0
0
238
83
0
0
0
0
1255
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
623
0
0
0
0
0
0
0
0
1160
0
0
0
0
0
0
0
0
793
83
0
0
0
0
2036
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
574
0
0
0
0
0
0
0
0
357
4557
0
0
0
0
0
0
0
65
214
0
0
0
0
5193
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
0
0
0
2
0
0
0
28
0
0
52
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
509
0
0
0
0
0
0
0
0
0
0
0
0
0
509
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
910
0
0
0
0
0
910
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
4
0
0
0
0
0
0
1
0
0
0
0
0
0
1
340
Annex 3.16: Inpatient Morbidity

Inpatient Morbidity
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
17467
21322
35031
117396
33628
18228
15103
29550
223132
91485
314617
1254
1691
0.94
14
30
14
26
51
77
0.00
29 days 1 Yrs
5 - 14 Yrs
Cholera
Total
1 - 4 Yrs
National Total
A00
<28 days
ICD Code
Total Deaths
Diseases
10861 16031
Grand
Total
CFR
%
A01
Typhoid and paratyphoid fevers
10
165
700
2373
1535
2346
1341
950
579
705
5769
4935
10704
0.15
A01.0
Typhoid fever
31
32
64
25
25
20
25
110
122
232
0.43
A02
Other salmonella infections
14
34
95
25
17
37
141
99
240
0.00
A03
Shigellosis
34
82
61
42
60
41
27
35
47
222
209
431
0.00
A03.9
Shigellosis, unspecified
13
10
23
0.00
A04
Other bacterial intestinal infections
15
15
34
32
66
0.00
A05
Other bacterial foodborne intoxications, not elsewhere

classified
55
81
13
21
10
95
113
208
0.00
A06
Amoebiasis
25
25
13
35
20
24
24
35
123
85
208
0.00
A06.0
Acute amoebic dysentery
100.00
A06.4
Amoebic liver abscess
0.00
A06.9
Amoebiasis, unspecified
0.00
A07
Other protozoal intestinal diseases
11
0.00
A08
Viral and other specified intestinal infections
14
19
0.00
A08.4
Viral intestinal infection, unspecified
14
12
19
21
40
0.00
64
2108
2688
1497
1024
2100
1334
1067
844
1569
7276
7019
14295
18
24
0.29
24
24
91
82
96
112
187
246
379
625
20
4.32
14
23
0.00
0.00
26
57
35
135
156
139
191
326
433
636
1069
22
2.81
0.00
0.00
0.00
11
15
39
41
31
32
67
77
162
239
14
9.21
A17.0+ Tuberculous meningitis ( G01* )
0.00
A17+
Tuberculosis of nervous system
20.00
A18
Tuberculosis of other organs
A09
A15
A15.0
A15.9
A16
A16.1
A16.2
A16.5
A16.9
Diarrhoea and gastroenteritis of presumed infectious

origin
Respiratory tuberculosis, bacteriologically and
histologically confirmed
Tuberculosis of lung, confirmed by sputum microscopy
with or without culture
Respiratory tuberculosis unspecified, confirmed
bacteriologically and histologically
Respiratory tuberculosis, not confirmed
bacteriologically or histologically
Tuberculosis of lung, bacteriological and histological
examination not done
Tuberculosis of lung, without mention of bacteriological
or histological confirmation
Tuberculous pleurisy, without mention of
bacteriological or histological confirmation
Respiratory tuberculosis unspecified, without mention
of bacteriological or histological confirmation
63
25
28
10
14
15
13
11
15
78
123
201
2.49
A18.0+ Tuberculosis of bones and joints
0.00
A18.2
Tuberculous peripheral lymphadenopathy
0.00
A18.3
Tuberculosis of intestines, peritoneum and mesenteric

glands
10
15
17
32
3.13
A18.4
Tuberculosis of skin and subcutaneous tissue
0.00
A19
Miliary tuberculosis
50.00
A19.9
Miliary tuberculosis, unspecified
12
8.33
A22
Anthrax
0.00
A23
Brucellosis
0.00
A23.9
Brucellosis, unspecified
12
0.00
A27
Leptospirosis
0.00
A30
Leprosy [Hansen's disease]
11
14
0.00
A33
Tetanus neonatorum
66.67
A34
Obstetrical tetanus
0.00
A35
Other tetanus
11
12
18
16
52
68
10
20.59
A36
Diphtheria
0.00
A37
Whooping cough
12
11
20
0.00
A37.9
Whooping cough, unspecified
0.00
A40
Streptococcal septicaemia
11
15
25
40
22.50
A40.9
Streptococcal septicaemia, unspecified
A41
Other septicaemia
A41.0
Septicaemia due to Staphylococcus aureus
A41.9
Septicaemia, unspecified
A46
A48
10
10
13
0.00
36
126
17
21
13
10
25
113
151
264
15
8.33
123
10
15
44
112
156
5.13
417
37
15
11
15
215
317
532
13
4.14
Erysipelas
0.00
Other bacterial diseases, not elsewhere classified
0.00
A48.1
Legionnaires' disease
0.00
A49
Bacterial infection of unspecified site
11
18
0.00
A51.4
Other secondary syphilis
0.00
A52
Late syphilis
0.00
A52.3
Neurosyphilis, unspecified
0.00
341

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
A54
Gonococcal infection
0.00
A55
Chlamydial lymphogranuloma (venereum)
0.00
A64
Unspecified sexually transmitted disease
0.00
A67.1
Intermediate lesions of pinta
0.00
A69
Other spirochaetal infections
0.00
A70
Chlamydia psittaci infection
0.00
A75.3
Typhus fever due to Rickettsia tsutsugamushi
0.00
A80
Acute poliomyelitis
0.00
A80.9
Acute poliomyelitis, unspecified
0.00
A81
Atypical virus infections of central nervous system
0.00
A82
Rabies
10
18
10
28
14.29
A83
Mosquito-borne viral encephalitis
0.00
A85
Other viral encephalitis, not elsewhere classified
0.00
A86
Unspecified viral encephalitis
16
27
88
26
25
16
16
17
120
118
238
11
6.72
A87
Viral meningitis
50.00
A87.9
Viral meningitis, unspecified
0.00
A90
Dengue fever [classical dengue]
29
45
125
87
45
22
16
134
238
372
0.54
A92
Other mosquito-borne viral fevers
11
48
104
65
96
42
30
22
27
273
172
445
0.22
A92.2
Venezuelan equine fever
0.00
A92.8
Other specified mosquito-borne viral fevers
0.00
A92.9
Mosquito-borne viral fever, unspecified
0.00
A94
Unspecified arthropod-borne viral fever
11
18
33
24
26
13
56
84
140
0.00
A99
Unspecified viral haemorrhagic fever
18
20
17
34
10
64
59
123
0.00
B00
Herpesviral [herpes simplex] infections
0.00
B00.1
Herpesviral vesicular dermatitis
0.00
B01
Varicella [chickenpox]
24
13
18
33
51
84
0.00
B01.9
Varicella without complication
13
0.00
B02
Zoster [herpes zoster]
15
14
29
0.00
B02.9
Zoster without complication
12
0.00
B03
Smallpox
0.00
B04
Monkeypox
0.00
B05
Measles
17
15
22
24
46
0.00
B05.9
Measles without complication
0.00
B06
Rubella [German measles]
0.00
B06.9
Rubella without complication
0.00
B08
Other viral infections characterized by skin and

mucous membrane lesions, not elsewhere classified
0.00
B15
Acute hepatitis A
12
14
18
32
0.00
B15.9
Hepatitis A without hepatic coma
36
11
35
41
76
1.32
B16
Acute hepatitis B
24
13
11
42
35
77
2.60
B16.9
Acute hepatitis B without delta-agent and without

hepatic coma
12
21
4.76
B17
Other acute viral hepatitis
24
33
33
66
0.00
B17.2
Acute hepatitis E
11
18.18
B18
Chronic viral hepatitis
0.00
B18.9
Chronic viral hepatitis, unspecified
0.00
B19
Unspecified viral hepatitis
14
62
31
42
20
18
11
11
110
104
214
2.34
B19.0
Unspecified viral hepatitis hepatic with coma
12
10
22
9.09
B19.9
Unspecified viral hepatitis without hepatic coma
13
7.69
0.00
0.00
50.00
14
13
136
339
199
67
54
286
544
830
25
62
10.48
B20
B22
B23
B24
Diseases
Human immunodeficiency virus [HIV] disease resulting

in infectious and parasitic diseases
in other specified diseases
in other conditions
Unspecified human immunodeficiency virus [HIV]
disease
Grand
Total
CFR
%
B26
Mumps
42
75
25
27
39
152
191
0.00
B26.9
Mumps without complication
23
19
34
53
0.00
B34
Viral infection of unspecified site
11
14
16
30
0.00
B34.1
Enterovirus infection, unspecified
20.00
B35
Dermatophytosis
0.00
B35.0
Tinea barbae and tinea capitis
0.00
B36
Other superficial mycoses
0.00
342

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
B36.9
Superficial mycosis, unspecified
0.00
B37
Candidiasis
0.00
B46
Zygomycosis
0.00
B46.5
Mucormycosis, unspecified
0.00
B49
Unspecified mycosis (Fungaemia NOS)
0.00
B50
Plasmodium falciparum malaria
17
13
36
15
22
52
73
125
0.00
B50.8
Other severe and complicated Plasmodium falciparum

malaria
0.00
B50.9
Plasmodium falciparum malaria, unspecified
13
0.00
B51
Plasmodium vivax malaria
22
12
33
11
24
46
80
126
0.00
B51.9
Plasmodium vivax malaria without complication
0.00
B52
Plasmodium malariae malaria
0.00
B53
Other parasitologically confirmed malaria
0.00
B54
Unspecified malaria
11
34
28
75
54
33
13
97
162
259
0.00
B55
Leishmaniasis
35
150
47
85
61
57
34
23
226
267
493
0.81
B55.0
Visceral leishmaniasis
11
9.09
B55.1
Cutaneous leishmaniasis
0.00
B56
African trypanosomiasis
0.00
B56.0
Gambiense trypanosomiasis
0.00
B67
Echinococcosis
11
0.00
B67.9
Echinococcosis, other and unspecified
11.11
B68.9
Taeniasis, unspecified
0.00
B69
Cysticercosis
10
12
0.00
B69.0
Cysticercosis of central nervous system
0.00
B69.9
Cysticercosis, unspecified
0.00
B71
Other cestode infections
0.00
B73
Onchocerciasis
0.00
B74
Filariasis
0.00
B74.9
Filariasis, unspecified
0.00
B76
Hookworm diseases
0.00
B76.9
Hookworm disease, unspecified
0.00
B77
Ascariasis
0.00
B77.9
Ascariasis, unspecified
0.00
B80
Enterobiasis
0.00
B81
Other intestinal helminthiases, not elsewhere classified
0.00
B82
Unspecified intestinal parasitism
14
0.00
B83
Other helminthiases
11
13
14
27
0.00
B83.9
Helminthiasis, unspecified
10
13
17
30
0.00
B85
Pediculosis and phthiriasis
0.00
B86
Scabies
14
0.00
B88
Other infestations
12
11
13
33
26
67
93
8.60
B90.0
Sequelae of central nervous system tuberculosis
0.00
B91
Sequelae of poliomyelitis
100.00
B92
Sequelae of leprosy
0.00
0.00
B95
B96
Diseases
Streptococcus and staphylococcus as the cause of

diseases classified to other chapters
Other bacterial agents as the cause of diseases
classified to other chapters
Grand
Total
CFR
%
0.00
B99
Other and unspecified infectious diseases
0.00
C02
Malignant neoplasm of other and unspecified parts of

tongue
0.00
C02.9
Tongue, unspecified
0.00
C09.9
Tonsil, unspecified
0.00
C11.9
Nasopharynx, unspecified
0.00
C13.9
Hypopharynx, unspecified
0.00
C14
Malignant neoplasm of other and ill-defined sites in the

lip, oral cavity and pharynx
0.00
C15
Malignant neoplasm of oesophagus
0.00
C15.9
Oesophagus, unspecified
10
13
15.38
C16
Malignant neoplasm of stomach
24
15
25
40
0.00
C16.9
Stomach, unspecified
22
15
24
39
2.56
C17
Malignant neoplasm of small intestine
0.00
C17.8
Overlapping lesion of small intestine
0.00
C18
Malignant neoplasm of colon
11
9.09
343

Inpatient Morbidity
50 - 59 Yrs
40 - 49 Yrs
30 - 39 Yrs
13
20
16
27
43
6.98
12
19
15
10
28
35
63
3.17
C21
Malignant neoplasm of anus and anal canal
0.00
C21.0
Anus, unspecified
0.00
C22
Malignant neoplasm of liver and intrahepatic bile ducts
12
18
22.22
C22.0
Liver cell carcinoma
10
0.00
C22.7
Other specified carcinomas of liver
0.00
C22.9
Liver, unspecified
0.00
C23
Malignant neoplasm of gallbladder
14
21
9.52
C25
Malignant neoplasm of pancreas
0.00
C25.9
Pancreas, unspecified
0.00
C30
Malignant neoplasm of nasal cavity and middle ear
0.00
C32
Malignant neoplasm of larynx
0.00
C32.0
Glottis
10
0.00
C32.1
Supraglottis
0.00
C32.9
Larynx, unspecified
10
12
0.00
C34
Malignant neoplasm of bronchus and lung
15
97
60
65
125
4.00
C34.1
Upper lobe, bronchus or lung
15
32
17
43
60
11.67
C34.9
Bronchus or lung, unspecified
14
11
18
11.11
C40
Malignant neoplasm of bone and articular cartilage of

limbs
0.00
C43
Malignant melanoma of skin
0.00
C44
Other malignant neoplasms of skin
0.00
C44.5
Skin of trunk
0.00
C49
Malignant neoplasm of other connective and soft tissue
0.00
C50
Malignant neoplasm of breast
14
25
10
58
59
0.00
C50.9
Breast, unspecified
23
23
0.00
C53
Malignant neoplasm of cervix uteri
13
26
34
41
119
119
0.84
C53.9
Cervix uteri, unspecified
12
27
27
0.00
C54.1
Endometrium
0.00
C56
Malignant neoplasm of ovary
11
28
28
7.14
C57.4
Uterine adnexa, unspecified
0.00
C57.8
Overlapping lesion of female genital organs
0.00
C60.9
Penis, unspecified
25.00
C61
Malignant neoplasm of prostate
0.00
C62
Malignant neoplasm of testis
0.00
C64
Malignant neoplasm of kidney, except renal pelvis
0.00
C67
Malignant neoplasm of bladder
0.00
C67.9
Bladder, unspecified
12
12
18
0.00
C71
Malignant neoplasm of brain
0.00
C71.3
Parietal lobe
11
0.00
C71.9
Brain, unspecified
0.00
C72
Malignant neoplasm of spinal cord, cranial nerves and

other parts of central nervous system
0.00
C73
Malignant neoplasm of thyroid gland
16.67
C74
Malignant neoplasm of adrenal gland
0.00
C74.9
Adrenal gland, unspecified
0.00
C76
Malignant neoplasm of other and ill-defined sites
0.00
C76.2
Abdomen
0.00
C76.5
Lower limb
0.00
C78.0
Secondary malignant neoplasm of lung
0.00
C80
Malignant neoplasm without specification of site
22
32
34
54
178
162
178
340
1.18
C81
Hodgkin's disease
0.00
C81.9
Hodgkin's disease, unspecified
0.00
C83
Diffuse non-Hodgkin's lymphoma
0.00
C85
Other and unspecified types of non-Hodgkin's

lymphoma
10
17
0.00
C85.9
Non-Hodgkin's lymphoma, unspecified type
10
22
22
44
6.82
C90
Multiple myeloma and malignant plasma cell

neoplasms
0.00
C90.0
Multiple myeloma
0.00
C91
Lymphoid leukaemia
0.00
Male
Grand
Total
Female
Malignant neoplasm of rectum
Male
Colon, unspecified
C20
Female
C18.9
60+ Yrs
5 - 14 Yrs
20 - 29 Yrs
1 - 4 Yrs
15 - 19 Yrs
29 days 1 Yrs
Total
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
344

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
C92
Myeloid leukaemia
10
15
6.67
C92.0
Acute myeloid leukaemia
13
0.00
C92.1
Chronic myeloid leukaemia
0.00
C92.2
Subacute myeloid leukaemia
25.00
C92.3
Myeloid sarcoma
10
19
10
19
29
10.34
C94.0
Acute erythraemia and erythroleukaemia
0.00
C95
Leukaemia of unspecified cell type
10
13
23
4.35
C95.0
Acute leukaemia of unspecified cell type
0.00
C95.9
Leukaemia, unspecified
0.00
D00
Carcinoma in situ of oral cavity, oesophagus and

stomach
0.00
D00.1
Oesophagus
0.00
D00.2
Stomach
0.00
D01
Carcinoma in situ of other and unspecified digestive

organs
0.00
D01.5
Liver, gallbladder and bile ducts
0.00
D02.2
Bronchus and lung
0.00
D05
Carcinoma in situ of breast
0.00
D06
Carcinoma in situ of cervix uteri
0.00
D06.9
Cervix, unspecified
0.00
D07.3
Other and unspecified female genital organs
0.00
D09
Carcinoma in situ of other and unspecified sites
0.00
D11
Benign neoplasm of major salivary glands
0.00
D14.1
Larynx
0.00
D17
Benign lipomatous neoplasm
11
0.00
D17.9
Benign lipomatous neoplasm, unspecified
0.00
D18
Haemangioma and lymphangioma, any site
0.00
D21.3
Connective and other soft tissue of thorax
0.00
D23
Other benign neoplasms of skin
0.00
D23.2
Skin of ear and external auricular canal
0.00
D23.4
Skin of scalp and neck
11
15
0.00
D23.9
Skin, unspecified
0.00
D24
Benign neoplasm of breast
0.00
D25
Leiomyoma of uterus
10
19
40
79
79
0.00
D25.1
Intramural leiomyoma of uterus
0.00
D25.9
Leiomyoma of uterus, unspecified
37
123
114
117
36
433
433
0.00
D26
Other benign neoplasms of uterus
0.00
D27
Benign neoplasm of ovary
0.00
D32
Benign neoplasm of meninges
0.00
D32.9
Meninges, unspecified
10
12
0.00
D33.3
Cranial nerves
0.00
D36
Benign neoplasm of other and unspecified sites
0.00
D36.7
Other specified sites
0.00
D39
Neoplasm of uncertain or unknown behaviour of

female genital organs
36
109
11
173
173
0.58
D39.0
Uterus
13
12
10
49
49
0.00
D39.1
Ovary
0.00
D41

urinary organs
0.00
D41.1
Renal pelvis
0.00
D41.4
Bladder
0.00
D42

meninges
0.00
D46
Myelodysplastic syndromes
0.00
D46.9
Myelodysplastic syndrome, unspecified
0.00
D48
Neoplasm of uncertain or unknown behaviour of other

and unspecified sites
0.00
D50
Iron deficiency anaemia
10
10
0.00
D50.9
Iron deficiency anaemia, unspecified
0.00
D53.1
Other megaloblastic anaemias, not elsewhere

classified
0.00
D56
Thalassaemia
10
70
315
73
158
313
471
0.00
D56.9
Thalassaemia, unspecified
19
13
23
36
0.00
D58
Other hereditary haemolytic anaemias
11
0.00
D58.9
Hereditary haemolytic anaemia, unspecified
0.00
D59
Acquired haemolytic anaemia
11
14
7.14
Diseases
Grand
Total
CFR
%
345

Inpatient Morbidity
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Other autoimmune haemolytic anaemias
0.00
D59.9
Acquired haemolytic anaemia, unspecified
13
0.00
D60
Acquired pure red cell aplasia [erythroblastopenia]
16
13
16
6.25
D61
Other aplastic anaemias
13
15
33
23
56
1.79
D61.0
Constitutional aplastic anaemia
0.00
D61.9
Aplastic anaemia, unspecified
10
16
22
38
5.26
D62
Acute posthaemorrhagic anaemia
0.00
D64
Other anaemias
63
102
205
151
308
180
180
152
351
965
731
1696
15
13
1.65
D64.0
Hereditary sideroblastic anaemia
11
45
26
37
24
22
35
30
125
108
233
1.72
D64.9
Anaemia, unspecified
21
36
45
66
60
52
47
65
225
173
398
2.51
D65
Disseminated intravascular coagulation [defibrination

syndrome]
0.00
D66
Hereditary factor VIII deficiency
13
33
39
0.00
D69
Purpura and other haemorrhagic conditions
10
18
58
40
55
95
0.00
D69.0
Allergic purpura
0.00
D69.3
Idiopathic thrombocytopenic purpura
12
19
10
29
0.00
D69.6
Thrombocytopenia, unspecified
75.00
D69.9
Haemorrhagic condition, unspecified
0.00
D70
Agranulocytosis
100.00
D71
Functional disorders of polymorphonuclear neutrophils
0.00
D72
Other disorders of white blood cells
0.00
D72.1
Eosinophilia
0.00
D73
Diseases of spleen
0.00
D73.1
Hypersplenism
0.00
D73.3
Abscess of spleen
0.00
D75
Other diseases of blood and blood-forming organs
0.00
D81.1
Severe combined immunodeficiency [SCID] with low Tand B-cell numbers
0.00
D84
Other immunodeficiencies
0.00
E03
Other hypothyroidism
0.00
E03.9
Hypothyroidism, unspecified
0.00
E04
Other nontoxic goitre
18
16
20
36
0.00
E04.1
Nontoxic single thyroid nodule
16
17
0.00
E04.2
Nontoxic multinodular goitre
0.00
E04.9
Nontoxic goitre, unspecified
11
13
0.00
E05
Thyrotoxicosis [hyperthyroidism]
0.00
E05.9
Thyrotoxicosis, unspecified
0.00
E06
Thyroiditis
0.00
E06.3
Autoimmune thyroiditis
0.00
E07
Other disorders of thyroid
0.00
E10
Insulin-dependent diabetes mellitus
11
18
5.56
E11
Non-insulin-dependent diabetes mellitus
10
19
61
87
141
157
171
328
3.66
E11.1
Non-insulin-dependent diabetes mellitus With

ketoacidosis
0.00
E14
Unspecified diabetes mellitus
14
21
39
106
186
298
588
557
701
1258
25
2.70
E16
Other disorders of pancreatic internal secretion
15
12
18
37
28
65
4.62
E16.1
Other hypoglycaemia
0.00
E16.2
Hypoglycaemia, unspecified
14
10
28
38
2.63
E20
Hypoparathyroidism
0.00
E24.2
Drug-induced Cushing's syndrome
0.00
E27.1
Primary adrenocortical insufficiency
0.00
E27.8
Other specified disorders of adrenal gland
11
25
25
0.00
E27.9
Disorder of adrenal gland, unspecified
0.00
E32
Diseases of thymus
0.00
E34.3
Short stature, not elsewhere classified
0.00
E40
Kwashiorkor
0.00
E41
Nutritional marasmus
0.00
E42
Marasmic kwashiorkor
0.00
E46
Unspecified protein-energy malnutrition
194
296
79
314
278
592
1.35
E50
Vitamin A deficiency
12
0.00
E56
Other vitamin deficiencies
0.00
E58
Dietary calcium deficiency
0.00
Male
1 - 4 Yrs
D59.1
Grand
Total
Female
29 days 1 Yrs
Total
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
346

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
E64
Sequelae of malnutrition and other nutritional

deficiencies
0.00
E66.9
Obesity, unspecified
0.00
E72
Other disorders of amino-acid metabolism
0.00
E72.3
Disorders of lysine and hydroxylysine metabolism
0.00
E75
Disorders of sphingolipid metabolism and other lipid

storage disorders
0.00
E77
Disorders of glycoprotein metabolism
0.00
E77.8
Other disorders of glycoprotein metabolism
0.00
E80
Disorders of porphyrin and bilirubin metabolism
0.00
E83
Disorders of mineral metabolism
0.00
E83.5
Disorders of calcium metabolism
10
0.00
E85
Amyloidosis
0.00
E86
Volume depletion
10
72
56
18
18
20
11
12
23
111
137
248
0.81
E87
Other disorders of fluid, electrolyte and acid-base

balance
0.00
E87.6
Hypokalaemia
11
15
6.67
E88.0
Disorders of plasma-protein metabolism, not

elsewhere classified
0.00
E89.1
Postprocedural hypoinsulinaemia
0.00
F03
Unspecified dementia
0.00
F07
Personality and behavioural disorders due to brain

disease, damage and dysfunction
0.00
F07.1
Postencephalitic syndrome
0.00
F09
Unspecified organic or symptomatic mental disorder
13
19
0.00
F10
Mental and behavioural disorders due to use of alcohol
41
88
120
95
72
64
361
425
0.71
0.00
0.00
10
14
35
40
5.00
0.00
0.00
0.00
F10.0
F10.2
F10.3
F10.5
F13
F16
Diseases

- Acute intoxication
- Dependence syndrome
- Withdrawal state
- Psychotic disorder
Mental and behavioural disorders due to use of
sedatives or hypnotics
Mental and behavioural disorders due to use of
hallucinogens
Grand
Total
CFR
%
F19
Mental and behavioural disorders due to multiple drug

use and use of other psychoactive substances
0.00
F20
Schizophrenia
15
0.00
F23
Acute and transient psychotic disorders
13
0.00
F23.9
Acute and transient psychotic disorder, unspecified
0.00
F25
Schizoaffective disorders
0.00
F28
Other nonorganic psychotic disorders
0.00
F29
Unspecified nonorganic psychosis
15
36
54
42
20
11
14
115
77
192
0.00
F30
Manic episode
0.00
F30.9
Manic episode, unspecified
0.00
F31
Bipolar affective disorder
12
0.00
F32
Depressive episode
15
34
55
44
27
41
170
52
222
0.45
F32.2
Severe depressive episode without psychotic

symptoms
0.00
F32.9
Depressive episode, unspecified
12
14
0.00
F33
Recurrent depressive disorder
0.00
F39
Unspecified mood [affective] disorder
0.00
F40
Phobic anxiety disorders
0.00
F40.9
Phobic anxiety disorder, unspecified
21
21
42
0.00
F41
Other anxiety disorders
37
65
58
42
18
16
184
61
245
0.00
F41.0
Panic disorder [episodic paroxysmal anxiety]
0.00
F41.1
Generalized anxiety disorder
11
20
27
0.00
F41.9
Anxiety disorder, unspecified
0.00
F43
Reaction to severe stress, and adjustment disorders
0.00
F44
Dissociative [conversion] disorders
20
84
88
31
17
215
38
253
0.40
F44.9
Dissociative [conversion] disorder, unspecified
21
25
0.00
F45
Somatoform disorders
0.00
F45.3
Somatoform autonomic dysfunction
0.00
F45.9
Somatoform disorder, unspecified
0.00
F48
Other neurotic disorders
16
14
30
3.33
347

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
F48.9
Neurotic disorder, unspecified
0.00
F50.5
Vomiting associated with other psychological

disturbances
0.00
F51.9
Nonorganic sleep disorder, unspecified
0.00
F53
Mental and behavioural disorders associated with the

puerperium, not elsewhere classified
11
11
0.00
F53.1
Severe mental and behavioural disorders associated

with the puerperium, not elsewhere classified
0.00
F65.0
Fetishism
0.00
F72
Severe mental retardation
0.00
F79
Unspecified mental retardation
0.00
F84.5
Asperger's syndrome
0.00
F99
Mental disorder, not otherwise specified
12
24
16
40
2.50
G00
Bacterial meningitis, not elsewhere classified
0.00
G00.9
Bacterial meningitis, unspecified
0.00
G03
Meningitis due to other and unspecified causes
18
103
104
248
52
68
27
24
17
33
321
373
694
10
10
2.88
G03.9
Meningitis, unspecified
12
11
29
17
21
12
55
65
120
9.17
G04
Encephalitis, myelitis and encephalomyelitis
33
15
45
32
77
7.79
G04.2
Bacterial meningoencephalitis and meningomyelitis,

not elsewhere classified
13
16
21
0.00
G04.8
Other encephalitis, myelitis and encephalomyelitis
0.00
G04.9
Encephalitis, myelitis and encephalomyelitis,

unspecified
35
52
15
20
15
14
16
76
104
180
13
14
15.00
G06
Intracranial and intraspinal abscess and granuloma
40.00
G06.0
Intracranial abscess and granuloma
0.00
G06.1
Intraspinal abscess and granuloma
0.00
0.00
13
12
17
0.00
G08
G09
Diseases
Intracranial and intraspinal phlebitis and

thrombophlebitis
Sequelae of inflammatory diseases of central nervous
system
Grand
Total
CFR
%
G10
Huntington's disease
0.00
G20
Parkinson's disease
0.00
G25
Other extrapyramidal and movement disorders
0.00
G31.9
Degenerative disease of nervous system, unspecified
0.00
G35
Multiple sclerosis
0.00
G37.3
Acute transverse myelitis in demyelinating disease of

central nervous system
0.00
G40
Epilepsy
14
24
24
33
14
10
72
72
144
2.08
0.00
13
15
34
49
6.12
0.00
G40.0
G40.1
G40.2
Localization-related (focal)(partial) idiopathic epilepsy

and epileptic syndromes with seizures of localized
onset
Localization-related (focal)(partial) symptomatic
epilepsy and epileptic syndromes with simple partial
seizures
Localization-related (focal)(partial) symptomatic
epilepsy and epileptic syndromes with complex partial
seizures
Generalized idiopathic epilepsy and epileptic
syndromes
0.00
G40.9
Epilepsy, unspecified
0.00
G41.1
Petit mal status epilepticus
0.00
G41.9
Status epilepticus, unspecified
0.00
G43
Migraine
0.00
G43.8
Other migraine
0.00
G43.9
Migraine, unspecified
11
16
0.00
G44
Other headache syndromes
16.67
G44.2
Tension-type headache
0.00
G45
Transient cerebral ischaemic attacks and related

syndromes
33
25
24
49
12.24
G45.9
Transient cerebral ischaemic attack, unspecified
11
16
0.00
G47.9
Sleep disorder, unspecified
0.00
G50
Disorders of trigeminal nerve
0.00
G51
Facial nerve disorders
0.00
G54
Nerve root and plexus disorders
0.00
G56.2
Lesion of ulnar nerve
0.00
G58
Other mononeuropathies
0.00
G58.9
Mononeuropathy, unspecified
0.00
G61
Inflammatory polyneuropathy
0.00
G61.0
Guillain-Barr syndrome
0.00
G62
Other polyneuropathies
0.00
G40.3
348

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
G62.9
Polyneuropathy, unspecified
0.00
G71
Primary disorders of muscles
0.00
G72.3
Periodic paralysis
0.00
G80
Cerebral palsy
0.00
G80.9
Cerebral palsy, unspecified
0.00
G81
Hemiplegia
13
17
27
29
43
72
6.94
G81.9
Hemiplegia, unspecified
12
14
17
31
3.23
G82
Paraplegia and tetraplegia
12
12
18
30
48
2.08
G82.2
Paraplegia, unspecified
11
16
0.00
G82.5
Tetraplegia, unspecified
12
14
7.14
G83
Other paralytic syndromes
14
16
19
27
46
0.00
G83.1
Monoplegia of lower limb
0.00
G83.3
Monoplegia, unspecified
0.00
G83.9
Paralytic syndrome, unspecified
16.67
G90
Disorders of autonomic nervous system
0.00
G90.0
Idiopathic peripheral autonomic neuropathy
100.00
G91
Hydrocephalus
14
14
25
39
5.13
G91.9
Hydrocephalus, unspecified
0.00
G92
Toxic encephalopathy
0.00
G93
Other disorders of brain
11
15
13.33
G93.4
Encephalopathy, unspecified
10
18
11.11
G93.5
Compression of brain
0.00
G93.8
Other specified disorders of brain
0.00
G93.9
Disorder of brain, unspecified
0.00
G95
Other diseases of spinal cord
0.00
G95.9
Disease of spinal cord, unspecified
0.00
G96
Other disorders of central nervous system
11
0.00
G97.8
Other postprocedural disorders of nervous system
0.00
G98
Other disorders of nervous system, not elsewhere

classified
11
0.00
H00
Hordeolum and chalazion
0.00
H02
Other disorders of eyelid
0.00
H05
Disorders of orbit
0.00
H10
Conjunctivitis
15
0.00
H10.9
Conjunctivitis, unspecified
0.00
H16
Keratitis
0.00
H18.7
Other corneal deformities
0.00
H20
Iridocyclitis
0.00
H26
Other cataract
12
164
85
113
198
0.00
H40
Glaucoma
0.00
H44
Disorders of globe
0.00
H57
Other disorders of eye and adnexa
0.00
H57.8
Other specified disorders of eye and adnexa
0.00
H58*
Other disorders of eye and adnexa in diseases

classified elsewhere
0.00
H60
Otitis externa
0.00
H61
Other disorders of external ear
0.00
H61.2
Impacted cerumen
0.00
H65
Nonsuppurative otitis media
15
0.00
H65.0
Acute serous otitis media
0.00
H65.2
Chronic serous otitis media
20
40
57
25
61
93
154
0.00
H66
Suppurative and unspecified otitis media
16
55
33
50
21
114
89
203
0.00
H66.9
Otitis media, unspecified
0.00
H68
Eustachian salpingitis and obstruction
0.00
H70
Mastoiditis and related conditions
0.00
H70.0
Acute mastoiditis
0.00
H70.9
Mastoiditis, unspecified
0.00
H72
Perforation of tympanic membrane
0.00
H74
Other disorders of middle ear and mastoid
0.00
H81
Disorders of vestibular function
0.00
H81.1
Benign paroxysmal vertigo
0.00
H83
Other diseases of inner ear
0.00
Diseases
Grand
Total
CFR
%
349

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
H83.0
Labyrinthitis
0.00
H92
Otalgia and effusion of ear
0.00
H92.1
Otorrhoea
0.00
H93
Other disorders of ear, not elsewhere classified
16
0.00
I00
Rheumatic fever without mention of heart involvement
24
19
29
33
62
1.61
I01
Rheumatic fever with heart involvement
11
12
19
0.00
I02
Rheumatic chorea
0.00
I02.9
Rheumatic chorea without heart involvement
0.00
I05
Rheumatic mitral valve diseases
10
16
11
27
0.00
I05.0
Mitral stenosis
0.00
I05.9
Mitral valve disease, unspecified
0.00
I08
Multiple valve diseases
0.00
I09
Other rheumatic heart diseases
14
20
89
30
38
43
45
34
58
224
148
372
0.81
I09.9
Rheumatic heart disease, unspecified
25
10
19
19
14
18
19
75
53
128
9.38
I10
Essential (primary) hypertension
16
39
115
254
414
561
1597
1436
1572
3008
15
10
0.83
I11.9
Hypertensive heart disease without (congestive) heart

failure
0.00
I12
Hypertensive renal disease
0.00
I12.0
Hypertensive renal disease with renal failure
0.00
I13
Hypertensive heart and renal disease
0.00
I15
Secondary hypertension
0.00
I20
Angina pectoris
25
24
24
48
2.08
I20.0
Unstable angina
0.00
I20.9
Angina pectoris, unspecified
14
12
20
0.00
I21
Acute myocardial infarction
20
12
16
28
10.71
I21.0
Acute transmural myocardial infarction of anterior wall
0.00
I21.4
Acute subendocardial myocardial infarction
0.00
I21.9
Acute myocardial infarction, unspecified
0.00
I22
Subsequent myocardial infarction
12
0.00
I23.3
Rupture of cardiac wall without haemopericardium as

current complication following acute myocardial
infarction
0.00
I24
Other acute ischaemic heart diseases
10
18
99
64
70
134
0.00
I24.9
Acute ischaemic heart disease, unspecified
0.00
I25
Chronic ischaemic heart disease
10
30
36
25
61
1.64
I25.1
Atherosclerotic heart disease
15
27
25
59
60
79
139
4.32
I25.4
Coronary artery aneurysm
10
16
6.25
I25.5
Ischaemic cardiomyopathy
10
0.00
I25.9
Chronic ischaemic heart disease, unspecified
20
36
46
22
68
7.35
I26
Pulmonary embolism
17
14
11
25
12.00
I26.9
Pulmonary embolism without mention of acute cor

pulmonale
66.67
I27
Other pulmonary heart diseases
47
40
29
69
0.00
I27.9
Pulmonary heart disease, unspecified
17
15
22
13.64
I30
Acute pericarditis
12
20
0.00
I30.1
Infective pericarditis
0.00
I31
Other diseases of pericardium
0.00
I31.1
Chronic constrictive pericarditis
0.00
I31.2
Haemopericardium, not elsewhere classified
0.00
I31.3
Pericardial effusion (noninflammatory)
0.00
I31.9
Disease of pericardium, unspecified
0.00
I33
Acute and subacute endocarditis
0.00
I33.0
Acute and subacute infective endocarditis
0.00
I35.9
Aortic valve disorder, unspecified
0.00
I38
Endocarditis, valve unspecified
20.00
I40
Acute myocarditis
25
20
25
45
4.44
I40.0
Infective myocarditis
18
14
17
31
19.35
I42
Cardiomyopathy
33
17
22
48
41
89
10.11
I42.0
Dilated cardiomyopathy
14
0.00
I42.5
Other restrictive cardiomyopathy
0.00
I42.9
Cardiomyopathy, unspecified
16.67
I44
Atrioventricular and left bundle-branch block
0.00
I45
Other conduction disorders
0.00
Diseases
Grand
Total
CFR
%
350

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
I45.2
Bifascicular block
0.00
I45.9
Conduction disorder, unspecified
100.00
I46
Cardiac arrest
100.00
I46.9
Cardiac arrest, unspecified
77.78
I47.1
Supraventricular tachycardia
0.00
I48
Atrial fibrillation and flutter
0.00
I49
Other cardiac arrhythmias
0.00
I49.2
Junctional premature depolarization
0.00
I49.3
Ventricular premature depolarization
0.00
I49.4
Other and unspecified premature depolarization
22
28
29
0.00
I49.5
Sick sinus syndrome
0.00
I49.9
Cardiac arrhythmia, unspecified
0.00
I50
Heart failure
17
11
32
58
95
321
328
225
553
15
16
5.61
I50.0
Congestive heart failure
14
0.00
I50.1
Left ventricular failure
0.00
I50.9
Heart failure, unspecified
10
11
13
25
61
70
69
139
5.76
I51
Complications and ill-defined descriptions of heart

disease
10
19
26
80
82
74
156
5.13
I51.4
Myocarditis, unspecified
0.00
I51.5
Myocardial degeneration
11.11
I51.6
Cardiovascular disease, unspecified
14
20
15
28
43
0.00
I51.7
Cardiomegaly
0.00
I51.8
Other ill-defined heart diseases
0.00
I60
Subarachnoid haemorrhage
11
27.27
I60.1
Subarachnoid haemorrhage from middle cerebral

artery
14
30
32
39
71
15.49
I60.9
Subarachnoid haemorrhage, unspecified
0.00
I61
Intracerebral haemorrhage
50.00
I61.5
Intracerebral haemorrhage, intraventricular
0.00
I61.9
Intracerebral haemorrhage, unspecified
0.00
I63
Cerebral infarction
0.00
I63.9
Cerebral infarction, unspecified
0.00
I64
Stroke, not specified as haemorrhage or infarction
10
40
105
160
542
359
504
863
45
48
10.78
I65
Occlusion and stenosis of precerebral arteries, not

resulting in cerebral infarction
0.00
I65.2
Occlusion and stenosis of carotid artery
14
0.00
I67
Other cerebrovascular diseases
10
18
22.22
I69
Sequelae of cerebrovascular disease
0.00
I71.4
Abdominal aortic aneurysm, without mention of rupture
0.00
I72
Other aneurysm
0.00
I73
Other peripheral vascular diseases
12
13
0.00
I73.1
Thromboangiitis obliterans [Buerger]
12.50
I73.9
Peripheral vascular disease, unspecified
0.00
I77
Other disorders of arteries and arterioles
0.00
I80
Phlebitis and thrombophlebitis
0.00
I80.2
Phlebitis and thrombophlebitis of other deep vessels of

lower extremities
14
23
0.00
I80.9
Phlebitis and thrombophlebitis of unspecified site
0.00
I81
Portal vein thrombosis
0.00
I82
Other venous embolism and thrombosis
0.00
I82.2
Embolism and thrombosis of vena cava
0.00
I83
Varicose veins of lower extremities
14
19
0.00
I83.9
Varicose veins of lower extremities without ulcer or

inflammation
11
15
26
0.00
I84
Haemorrhoids
29
30
42
19
44
60
113
173
1.16
I84.9
Unspecified haemorrhoids without complication
11
25
36
0.00
I85
Oesophageal varices
0.00
I85.9
Oesophageal varices without bleeding
0.00
I86
Varicose veins of other sites
0.00
I86.0
Sublingual varices
0.00
I86.1
Scrotal varices
0.00
I87.1
Compression of vein
0.00
I88
Nonspecific lymphadenitis
12
15
13
32
45
0.00
I88.9
Nonspecific lymphadenitis, unspecified
0.00
Diseases
Grand
Total
CFR
%
351

Inpatient Morbidity
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
0.00
Hypotension
11
12
23
0.00
I95.9
Hypotension, unspecified
0.00
I99
Other and unspecified disorders of circulatory system
0.00
J00
Acute nasopharyngitis (common cold)
0.00
J01
Acute sinusitis
0.00
J02
Acute pharyngitis
16
21
24
62
18
22
10
98
83
181
0.00
J02.9
Acute pharyngitis, unspecified
0.00
J03
Acute tonsillitis
10
28
170
86
170
56
36
30
334
260
594
0.34
J03.9
Acute tonsillitis, unspecified
13
27
16
37
33
70
0.00
J04
Acute laryngitis and tracheitis
12
21
0.00
J04.2
Acute laryngotracheitis
0.00
J05
Acute obstructive laryngitis [croup] and epiglottitis
0.00
J05.0
Acute obstructive laryngitis [croup]
0.00
J05.1
Acute epiglottitis
0.00
13
230
307
262
155
279
198
187
168
325
1081
1043
2124
10
14
1.13
0.00
J06
J06.8
Acute upper respiratory infections of multiple and

unspecified sites
Other acute upper respiratory infections of multiple
sites
Male
15 - 19 Yrs
I95
Grand
Total
Female
5 - 14 Yrs
Noninfective disorder of lymphatic vessels and lymph

nodes, unspecified
Male
1 - 4 Yrs
I89.9
Female
29 days 1 Yrs
Total
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
J06.9
Acute upper respiratory infection, unspecified
21
12
10
18
12
16
38
62
79
141
1.42
J09
Influenza due to identified avian influenza virus
0.00
J10
Influenza due to other identified influenza virus
0.00
J11
Influenza, virus not identified
10
17
0.00
J13
Pneumonia due to Streptococcus pneumoniae
0.00
J14
Pneumonia due to Haemophilus influenzae
11
22
10
13
10
19
48
54
102
0.00
2.73
J15
Bacterial pneumonia, not elsewhere classified
66
619
477
116
11
16
11
24
541
814
1355
15
22
J15.7
Pneumonia due to Mycoplasma pneumoniae
0.00
J15.9
Bacterial pneumonia, unspecified
16
11
11
17
28
21.43
J16
Pneumonia due to other infectious organisms, not

J18
Pneumonia, organism unspecified
J18.0
J18.1
J18.9
Pneumonia, unspecified
J20
J20.9
20
18
10
28
40
68
4.41
392
3787
2731
970
141
199
144
149
135
368
3532
5484
9016
36
52
0.98
Bronchopneumonia, unspecified
18
17
11
12
35
47
0.00
Lobar pneumonia, unspecified
13
15
28
3.57
171
1184
667
165
32
76
52
48
51
142
893
1695
2588
18
30
1.85
Acute bronchitis
58
33
18
17
13
11
29
93
102
195
0.00
Acute bronchitis, unspecified
80
27
40
81
121
0.00
J21
Acute bronchiolitis
17
24
30
3.33
J21.9
Acute bronchiolitis, unspecified
10
186
55
75
198
273
1.83
J22
Unspecified acute lower respiratory infection
317
3451
2794
1083
176
299
200
203
200
419
3820
5322
9142
0.16
J30
Vasomotor and allergic rhinitis
0.00
J31
Chronic rhinitis, nasopharyngitis and pharyngitis
0.00
J31.2
Chronic pharyngitis
0.00
J32
Chronic sinusitis
15
11
12
10
37
29
66
0.00
J32.4
Chronic pansinusitis
0.00
J32.9
Chronic sinusitis, unspecified
0.00
J33
Nasal polyp
13
12
25
0.00
J33.8
Other polyp of sinus
10
0.00
J33.9
Nasal polyp, unspecified
15
24
0.00
J34
Other disorders of nose and nasal sinuses
21
10
21
32
53
0.00
J34.2
Deviated nasal septum
17
10
29
39
0.00
J34.8
Other specified disorders of nose and nasal sinuses
0.00
J35
Chronic diseases of tonsils and adenoids
0.00
J35.8
Other chronic diseases of tonsils and adenoids
0.00
J36
Peritonsillar abscess
0.00
J37
Chronic laryngitis and laryngotracheitis
0.00
J38.2
Nodules of vocal cords
0.00
J38.7
Other diseases of larynx
0.00
J39
Other diseases of upper respiratory tract
11
22
13
16
11
50
56
106
0.00
J39.0
Retropharyngeal and parapharyngeal abscess
0.00
J40
Bronchitis, not specified as acute or chronic
247
100
70
14
13
19
14
44
212
323
535
0.75
J42
Unspecified chronic bronchitis
0.00
J43
Emphysema
13
0.00
352

Inpatient Morbidity
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Chronic obstructive pulmonary disease with acute

lower respiratory infection
Chronic obstructive pulmonary disease with acute
exacerbation, unspecified
5 - 14 Yrs
J44.1
Other chronic obstructive pulmonary disease
1 - 4 Yrs
J44.0
29 days 1 Yrs
J44
Total
<28 days
ICD Code
Total Deaths
Diseases
11
13
38
109
259
585
1333
5881
4468
3769
8237
135
126
3.17
13
50
147
115
97
212
15
11.32
19
70
360
247
210
457
14
14
6.13
Grand
Total
CFR
%
J44.8
Other specified chronic obstructive pulmonary disease
41
67
257
212
163
375
3.20
J44.9
Chronic obstructive pulmonary disease, unspecified
21
60
55
43
98
3.06
J45
Asthma
30
77
104
42
80
90
98
78
164
419
346
765
0.52
J45.9
Asthma, unspecified
15
15
23
24
11
25
73
56
129
2.33
J46
Status asthmaticus
0.00
J47
Bronchiectasis
0.00
J62
Pneumoconiosis due to dust containing silica
0.00
J64
Unspecified pneumoconiosis
0.00
J65
Pneumoconiosis associated with tuberculosis
0.00
0.00
0.00
15
14
33
39
0.00
J67.8
J68
J68.3
J68.9
Hypersensitivity pneumonitis due to other organic

dusts
Respiratory conditions due to inhalation of chemicals,
gases, fumes and vapours
Other acute and subacute respiratory conditions due to
chemicals, gases, fumes and vapours
Unspecified respiratory condition due to chemicals,
gases, fumes and vapours
0.00
J69
Pneumonitis due to solids and liquids
13
7.69
J69.0
Pneumonitis due to food and vomit
0.00
J80
Adult respiratory distress syndrome
11
14
14.29
J81
Pulmonary oedema
14
14.29
J82
Pulmonary eosinophilia, not elsewhere classified
11
16
18
34
0.00
J84.1
Other interstitial pulmonary diseases with fibrosis
0.00
J85
Abscess of lung and mediastinum
16.67
J85.2
Abscess of lung without pneumonia
20.00
J86
Pyothorax
11
15
0.00
J86.0
Pyothorax with fistula
0.00
J86.9
Pyothorax without fistula
15
20
0.00
J90
Pleural effusion, not elsewhere classified
19
51
129
35
94
67
67
69
177
260
448
708
1.69
J93
Pneumothorax
17
10
12
22
20
57
77
2.60
J93.8
Other pneumothorax
0.00
J93.9
Pneumothorax, unspecified
17
21
4.76
J94
Other pleural conditions
0.00
J94.2
Haemothorax
16.67
J94.8
Other specified pleural conditions
0.00
J95
Postprocedural respiratory disorders, not elsewhere

classified
0.00
J95.8
Other postprocedural respiratory disorders
0.00
J96
Respiratory failure, not elsewhere classified
12
33.33
J96.0
Acute respiratory failure
100.00
J96.9
Respiratory failure, unspecified
33.33
J98
Other respiratory disorders
15
12
19
10
19
29
35
78
71
149
2.68
J98.4
Other disorders of lung
0.00
J98.8
Other specified respiratory disorders
10
11
17
28
3.57
J98.9
Respiratory disorder, unspecified
27
16
30
46
2.17
K01
Embedded and impacted teeth
0.00
K02
Dental caries
14
21
0.00
K03.4
Hypercementosis
0.00
K03.5
Ankylosis of teeth
0.00
K04
Diseases of pulp and periapical tissues
0.00
K04.6
Periapical abscess with sinus
0.00
K04.7
Periapical abscess without sinus
0.00
K05
Gingivitis and periodontal diseases
16
21
0.00
K05.2
Acute periodontitis
100.00
K06
Other disorders of gingiva and edentulous alveolar

ridge
0.00
K07
Dentofacial anomalies [including malocclusion]
0.00
K07.0
Major anomalies of jaw size
0.00
K08
Other disorders of teeth and supporting structures
11
24
17
41
0.00
K09
Cysts of oral region, not elsewhere classified
0.00
353

Inpatient Morbidity
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Cyst of oral region, unspecified
0.00
K10
Other diseases of jaws
12
0.00
K10.9
Disease of jaws, unspecified
0.00
K11
Diseases of salivary glands
13
0.00
K11.2
Sialoadenitis
0.00
K11.5
Sialolithiasis
0.00
K11.6
Mucocele of salivary gland
0.00
K12
Stomatitis and related lesions
43
16
38
39
77
0.00
K12.1
Other forms of stomatitis
0.00
K12.2
Cellulitis and abscess of mouth
10
0.00
K13
Other diseases of lip and oral mucosa
13
14
52
53
55
108
0.00
K13.0
Diseases of lips
0.00
K14
Diseases of tongue
0.00
K20
Oesophagitis
0.00
K21.9
Gastro-oesophageal reflux disease without

oesophagitis
0.00
K22
Other diseases of oesophagus
0.00
K22.0
Achalasia of cardia
0.00
K22.2
Oesophageal obstruction
0.00
K25
Gastric ulcer
16
6.25
K26
Duodenal ulcer
19
14
15
22
30
57
87
1.15
K27
Peptic ulcer, site unspecified
14
36
13
13
20
52
53
105
0.00
K28
Gastrojejunal ulcer
10
11
11
21
30
28
58
0.00
K29
Gastritis and duodenitis
16
157
371
805
639
534
371
673
2311
1263
3574
0.17
K29.0
Acute haemorrhagic gastritis
10
11
17
43
34
67
101
1.98
K29.1
Other acute gastritis
0.00
K29.7
Gastritis, unspecified
11
10
15
25
40
0.00
K29.8
Duodenitis
0.00
K29.9
Gastroduodenitis, unspecified
0.00
K30
Dyspepsia
0.00
K31
Other diseases of stomach and duodenum
27
64
57
72
46
63
209
130
339
0.29
K31.0
Acute dilatation of stomach
10
15
13.33
K31.1
Adult hypertrophic pyloric stenosis
10
10.00
K31.2
Hourglass stricture and stenosis of stomach
0.00
K31.8
Other specified diseases of stomach and duodenum
15
0.00
K31.9
Disease of stomach and duodenum, unspecified
16
24
23
20
13
28
92
36
128
1.56
K35
Acute appendicitis
290
362
526
298
173
101
77
891
947
1838
0.00
K35.0
Acute appendicitis with generalized peritonitis
11
16
6.25
K35.1
Acute appendicitis with peritoneal abscess
0.00
K35.9
Acute appendicitis, unspecified
81
88
139
122
79
42
36
275
316
591
0.17
K36
Other appendicitis
11
16
27
0.00
K37
Unspecified appendicitis
17
130
20
37
30
17
10
108
159
267
0.00
K38
Other diseases of appendix
13
11
32
26
58
0.00
K38.1
Appendicular concretions
15
15
17
32
0.00
K40
Inguinal hernia
44
53
146
27
67
71
95
75
130
124
585
709
0.28
0.00
0.00
K40.0
K40.3
Bilateral inguinal hernia, with obstruction, without

gangrene
Unilateral or unspecified inguinal hernia, with
obstruction, without gangrene
Male
1 - 4 Yrs
K09.9
Grand
Total
Female
29 days 1 Yrs
Total
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
K40.4
Unilateral or unspecified inguinal hernia, with gangrene
38
16
55
24
87
111
0.00
K40.9
Unilateral or unspecified inguinal hernia, without

obstruction or gangrene
22
41
21
29
21
34
52
24
204
228
0.00
K41
Femoral hernia
11
16
6.25
0.00
21
21
0.00
K41.2
K41.3
K41.9
Bilateral femoral hernia, without obstruction or

gangrene
Unilateral or unspecified femoral hernia, with
obstruction, without gangrene
Unilateral or unspecified femoral hernia, without
obstruction or gangrene
0.00
K42
Umbilical hernia
0.00
K42.9
Umbilical hernia without obstruction or gangrene
0.00
K43
Ventral hernia
0.00
K43.9
Ventral hernia without obstruction or gangrene
12.50
K44
Diaphragmatic hernia
0.00
K45
Other abdominal hernia
0.00
354

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
42
41
133
36
56
52
43
43
95
84
462
546
0.55
0.00
12
17
20
0.00
K50
Crohn's disease [regional enteritis]
0.00
K51
Ulcerative colitis
0.00
K51.9
Ulcerative colitis, unspecified
0.00
K52
Other noninfective gastroenteritis and colitis
37
45
20
15
36
21
20
16
109
107
216
0.46
K55
Vascular disorders of intestine
20
18
38
2.63
K55.0
Acute vascular disorders of intestine
0.00
K56
Paralytic ileus and intestinal obstruction without hernia
10
14
20
55
11
36
37
41
46
70
130
210
340
3.24
K56.1
Intussusception
17
11
10
16
24
40
2.50
K56.2
Volvulus
0.00
K56.4
Other impaction of intestine
0.00
K56.5
Intestinal adhesions [bands] with obstruction
25.00
K46
K46.0
K46.9
Diseases
Unspecified abdominal hernia

Unspecified abdominal hernia with obstruction, without
gangrene
Unspecified abdominal hernia without obstruction or
gangrene
Grand
Total
CFR
%
K56.6
Other and unspecified intestinal obstruction
15
12
23
25
46
51
47
94
133
227
10
8.37
K56.7
Ileus, unspecified
0.00
K57
Diverticular disease of intestine
21
22
9.09
0.00
12.50
0.00
K57.8
K57.9
Diverticular disease of intestine, part unspecified, with

perforation and abscess
Diverticular disease of intestine, part unspecified,
without perforation or abscess
K58
Irritable bowel syndrome
K58.9
Irritable bowel syndrome without diarrhoea
0.00
K59
Other functional intestinal disorders
14
25
24
22
20
31
95
46
141
0.00
K59.0
Constipation
15
0.00
K60
Fissure and fistula of anal and rectal regions
19
14
18
31
49
0.00
K60.0
Acute anal fissure
0.00
K60.1
Chronic anal fissure
0.00
K60.2
Anal fissure, unspecified
0.00
K60.3
Anal fistula
17
17
13
25
55
80
6.25
K61
Abscess of anal and rectal regions
10
0.00
K61.1
Rectal abscess
0.00
K61.3
Ischiorectal abscess
0.00
K62
Other diseases of anus and rectum
11
10
21
0.00
K62.0
Anal polyp
0.00
K62.1
Rectal polyp
10
17
0.00
K62.2
Anal prolapse
0.00
K62.3
Rectal prolapse
17
0.00
K62.4
Stenosis of anus and rectum
0.00
K62.5
Haemorrhage of anus and rectum
0.00
K62.8
Other specified diseases of anus and rectum
0.00
K63
Other diseases of intestine
22
29
6.90
K63.1
Perforation of intestine (nontraumatic)
12.50
K63.2
Fistula of intestine
0.00
K65
Peritonitis
17
18
15
21
39
56
95
9.47
K65.9
Peritonitis, unspecified
10
27
17
23
15
22
35
81
116
7.76
K66
Other disorders of peritoneum
13
0.00
K66.0
Peritoneal adhesions
11
12
16.67
K66.1
Haemoperitoneum
14.29
K66.8
Other specified disorders of peritoneum
0.00
K70
Alcoholic liver disease
22
92
150
162
165
195
399
594
28
5.89
K70.1
Alcoholic hepatitis
11.11
K70.3
Alcoholic cirrhosis of liver
0.00
K70.4
Alcoholic hepatic failure
0.00
K70.9
Alcoholic liver disease, unspecified
36
64
40
44
37
157
194
7.73
K71.9
Toxic liver disease, unspecified
0.00
K72
Hepatic failure, not elsewhere classified
12
21
33
15.15
K72.0
Acute and subacute hepatic failure
K72.9
Hepatic failure, unspecified
K73
K73.9
0.00
37
72
83
47
130
11
11.54
Chronic hepatitis, not elsewhere classified
0.00
Chronic hepatitis, unspecified
0.00
355

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
K74
Fibrosis and cirrhosis of liver
18
21
46
48
57
90
147
5.44
K74.0
Hepatic fibrosis
33.33
Diseases
K74.6
Other and unspecified cirrhosis of liver
K75
Other inflammatory liver diseases
K75.0
Grand
Total
CFR
%
11
19
32
23
25
65
90
11
16.67
18
28
109
33
70
60
40
38
59
190
270
460
3.04
Abscess of liver
11
10
11
25
36
5.56
K75.9
Inflammatory liver disease, unspecified
11
11
38
33
22
15
10
67
75
142
1.41
K76
Other diseases of liver
17
13
21
37
58
12.07
K76.0
Fatty (change of) liver, not elsewhere classified
10
10.00
K76.1
Chronic passive congestion of liver
12
18
0.00
K76.6
Portal hypertension
0.00
K76.7
Hepatorenal syndrome
0.00
K76.8
Other specified diseases of liver
0.00
K76.9
Liver disease, unspecified
44
54
67
37
77
136
213
10
21
14.55
K80
Cholelithiasis
28
177
219
176
185
171
713
254
967
0.00
K80.0
Calculus of gallbladder with acute cholecystitis
10
10
0.00
K80.1
Calculus of gallbladder with other cholecystitis
18
21
0.00
K80.2
Calculus of gallbladder without cholecystitis
21
22
241
253
205
165
138
835
211
1046
0.00
K80.5
Calculus of bile duct without cholangitis or cholecystitis
13
22
0.00
K80.8
Other cholelithiasis
16
14
32
15
47
2.13
K81
Cholecystitis
11
29
63
66
58
43
61
239
105
344
0.00
K81.1
Chronic cholecystitis
15
15
0.00
K81.9
Cholecystitis, unspecified
13
11
16
12
13
44
22
66
1.52
K82
Other diseases of gallbladder
0.00
K82.9
Disease of gallbladder, unspecified
0.00
K83
Other diseases of biliary tract
17
10
27
0.00
K83.0
Cholangitis
0.00
K83.1
Obstruction of bile duct
0.00
K85
Acute pancreatitis
14
20
36
35
25
26
69
97
166
1.20
K85.0
Idiopathic acute pancreatitis
11
21
24
45
4.44
K85.2
Alcohol-induced acute pancreatitis
0.00
K86
Other diseases of pancreas
0.00
K86.1
Other chronic pancreatitis
0.00
K86.3
Pseudocyst of pancreas
0.00
K91
Postprocedural disorders of digestive system, not

13
17
0.00
K91.1
Postgastric surgery syndromes
0.00
K91.4
Colostomy and enterostomy malfunction
17
23
14
14
23
47
70
2.86
K92
Other diseases of digestive system
12
23
32
48
45
83
87
170
257
0.39
K92.0
Haematemesis
0.00
K92.1
Melaena
0.00
K92.2
Gastrointestinal haemorrhage, unspecified
19
27
32
54
54
69
88
172
260
4.62
K92.9
Disease of digestive system, unspecified
0.00
L00
Staphylococcal scalded skin syndrome
0.00
L01
Impetigo
12
22
37
59
0.00
L02
Cutaneous abscess, furuncle and carbuncle
88
151
254
495
211
298
171
127
98
116
992
1017
2009
0.10
L02.1
Cutaneous abscess, furuncle and carbuncle of neck
16
0.00
L02.2
Cutaneous abscess, furuncle and carbuncle of trunk
10
0.00
L02.3
Cutaneous abscess, furuncle and carbuncle of buttock
11
20
0.00
L02.4
Cutaneous abscess, furuncle and carbuncle of limb
11
25
13
12
36
53
89
0.00
12
14
20
0.00
28
11
10
34
53
87
1.15
L02.8
L02.9
Cutaneous abscess, furuncle and carbuncle of other

sites
Cutaneous abscess, furuncle and carbuncle,
unspecified
L03
Cellulitis
24
32
78
182
71
91
96
83
75
90
412
410
822
0.36
L03.1
Cellulitis of other parts of limb
12
0.00
L03.8
Cellulitis of other sites
0.00
L03.9
Cellulitis, unspecified
11
10
21
35
56
1.79
L04
Acute lymphadenitis
11
19
13
32
0.00
L04.1
Acute lymphadenitis of trunk
0.00
L04.9
Acute lymphadenitis, unspecified
0.00
L05
Pilonidal cyst
0.00
L05.9
Pilonidal cyst without abscess
0.00
356

Inpatient Morbidity
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
L08.9
Other specified local infections of skin and

subcutaneous tissue
Local infection of skin and subcutaneous tissue,
unspecified
1 - 4 Yrs
L08.8
Other local infections of skin and subcutaneous tissue
29 days 1 Yrs
L08
Total
<28 days
ICD Code
Total Deaths
Diseases
13
10
20
28
48
0.00
0.00
0.00
Grand
Total
CFR
%
L10
Pemphigus
0.00
L10.0
Pemphigus vulgaris
0.00
L10.9
Pemphigus, unspecified
0.00
L13
Other bullous disorders
0.00
L20.9
Atopic dermatitis, unspecified
0.00
L21.9
Seborrhoeic dermatitis, unspecified
0.00
L23
Allergic contact dermatitis
10
12
12
10
22
27
49
0.00
L23.9
Allergic contact dermatitis, unspecified cause
0.00
L24
Irritant contact dermatitis
11
0.00
L24.8
Irritant contact dermatitis due to other agents
0.00
L30
Other dermatitis
16
26
14
16
13
15
23
82
58
140
0.00
L30.3
Infective dermatitis
0.00
L30.8
Other specified dermatitis
0.00
L30.9
Dermatitis, unspecified
10
28
18
46
0.00
L40
Psoriasis
0.00
L40.8
Other psoriasis
0.00
L50
Urticaria
27
21
25
40
65
0.00
L50.9
Urticaria, unspecified
13
0.00
L51
Erythema multiforme
0.00
L51.1
Bullous erythema multiforme
0.00
L52
Erythema nodosum
15
42
116
97
92
189
0.53
L53
Other erythematous conditions
0.00
L53.9
Erythematous condition, unspecified
0.00
L56.1
Drug photoallergic response
16
16
15
31
22.58
L57
Skin changes due to chronic exposure to nonionizing

radiation
0.00
L63
Alopecia areata
0.00
L64
Androgenic alopecia
0.00
L72
Follicular cysts of skin and subcutaneous tissue
0.00
L73
Other follicular disorders
0.00
L73.2
Hidradenitis suppurativa
0.00
L80
Vitiligo
0.00
L84
Corns and callosities
0.00
L88
Pyoderma gangrenosum
0.00
L89
Decubitus ulcer
10
11
21
0.00
L90
Atrophic disorders of skin
11
12
13
25
0.00
L91
Hypertrophic disorders of skin
0.00
L92
Granulomatous disorders of skin and subcutaneous

tissue
0.00
L92.2
Granuloma faciale [eosinophilic granuloma of skin]
0.00
L92.9
Granulomatous disorder of skin and subcutaneous

tissue, unspecified
50.00
L94
Other localized connective tissue disorders
0.00
L94.9
Localized connective tissue disorder, unspecified
0.00
L97
Ulcer of lower limb, not elsewhere classified
12
0.00
L98
Other disorders of skin and subcutaneous tissue, not

10
12
12
14
10
18
50
46
96
0.00
L98.4
Chronic ulcer of skin, not elsewhere classified
0.00
L98.8
Other specified disorders of skin and subcutaneous

tissue
12
30
35
0.00
L98.9
Disorder of skin and subcutaneous tissue, unspecified
0.00
M00
Pyogenic arthritis
18
11
19
30
0.00
M00.9 Pyogenic arthritis, unspecified
10
10
10
20
0.00
M05
Seropositive rheumatoid arthritis
0.00
M06
Other rheumatoid arthritis
0.00
M06.9 Rheumatoid arthritis, unspecified
0.00
M08
0.00
M08.0 Juvenile rheumatoid arthritis
0.00
M10
Gout
0.00
M12
Other specific arthropathies
0.00
Juvenile arthritis
357

Inpatient Morbidity
50 - 59 Yrs
40 - 49 Yrs
30 - 39 Yrs
20 - 29 Yrs
15 - 19 Yrs
5 - 14 Yrs
0.00
15
60
43
45
47
50
63
91
228
193
421
0.00
M13.0 Polyarthritis, unspecified
0.00
M13.9 Arthritis, unspecified
10
18
0.00
M16
Coxarthrosis [arthrosis of hip]
0.00
M17
Gonarthrosis [arthrosis of knee]
0.00
M19
Other arthrosis
0.00
M19.9 Arthrosis, unspecified
0.00
M21
Other acquired deformities of limbs
0.00
M22
Disorders of patella
0.00
M23.9 Internal derangement of knee, unspecified
0.00
M24
0.00
M24.4 Recurrent dislocation and subluxation of joint
0.00
M24.5 Contracture of joint
0.00
M24.6 Ankylosis of joint
0.00
M25
15
0.00
M25.3 Other instability of joint
0.00
M25.4 Effusion of joint
0.00
M25.5 Pain in joint
10
0.00
M25.8 Other specified joint disorders
0.00
M30
0.00
M30.0 Polyarteritis nodosa
0.00
M32
0.00
M32.9 Systemic lupus erythematosus, unspecified
14
15
0.00
M33.1 Other dermatomyositis
0.00
M34.9 Systemic sclerosis, unspecified
0.00
M35
Other systemic involvement of connective tissue
0.00
M43
Other deforming dorsopathies
0.00
M43.9 Deforming dorsopathy, unspecified
0.00
M45
Ankylosing spondylitis
0.00
M46
Other inflammatory spondylopathies
0.00
M46.4 Discitis, unspecified
0.00
M47
11
9.09
M47.1 Other spondylosis with myelopathy
0.00
M47.8 Other spondylosis
11
16
22
18
24
59
35
94
0.00
M47.9 Spondylosis, unspecified
0.00
M48.5 Collapsed vertebra, not elsewhere classified
0.00
M50
Cervical disc disorders
13
22
22
0.00
M51
Other intervertebral disc disorders
0.00
M51.2 Other specified intervertebral disc displacement
15
16
20
29
49
0.00
M53
Other dorsopathies, not elsewhere classified
0.00
M54
Dorsalgia
20
17
14
18
51
37
88
0.00
M54.1 Radiculopathy
0.00
M54.3 Sciatica
0.00
M54.5 Low back pain
0.00
M54.9 Dorsalgia, unspecified
0.00
M60
Myositis
20
18
24
42
0.00
M60.0 Infective myositis
14
7.14
M60.2 classified
0.00
M60.9 Myositis, unspecified
0.00
M62
Other disorders of muscle
0.00
M62.8 Other specified disorders of muscle
0.00
M65
0.00
0.00
Other specific joint derangements
Other joint disorders, not elsewhere classified
Polyarteritis nodosa and related conditions
Systemic lupus erythematosus
Spondylosis
Foreign body granuloma of soft tissue, not elsewhere
Synovitis and tenosynovitis
M65.9 Synovitis and tenosynovitis, unspecified
Male
Grand
Total
Female
Male
Other arthritis
Female
M13
60+ Yrs
M12.0 Chronic postrheumatic arthropathy [Jaccoud]
1 - 4 Yrs
29 days 1 Yrs
Total
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
M70
Soft tissue disorders related to use, overuse and

pressure
0.00
M71
Other bursopathies
0.00
M71.2 Synovial cyst of popliteal space [Baker]
0.00
M72
11.11
M75.8 Other shoulder lesions
0.00
M77.9 Enthesopathy, unspecified
0.00
Fibroblastic disorders
358

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
15
14
10
40
32
72
0.00
M79.1 Myalgia
0.00
M79.2 Neuralgia and neuritis, unspecified
0.00
M79.6 Pain in limb
0.00
M79.8 Other specified soft tissue disorders
0.00
M79.9 Soft tissue disorder, unspecified
0.00
M80
Osteoporosis with pathological fracture
23
19
54
45
56
92
116
208
6.25
M80.5 Idiopathic osteoporosis with pathological fracture
0.00
M81
11
0.00
M81.4 Drug-induced osteoporosis
0.00
M83
0.00
M83.9 Adult osteomalacia, unspecified
0.00
M84.1 Nonunion of fracture [pseudarthrosis]
0.00
M84.2 Delayed union of fracture
0.00
M84.4 Pathological fracture, not elsewhere classified
0.00
M85
0.00
M85.6 Other cyst of bone
0.00
M86
40
14
14
42
58
100
0.00
M86.1 Other acute osteomyelitis
0.00
M86.9 Osteomyelitis, unspecified
12
15
0.00
M88
Paget's disease of bone [osteitis deformans]
14
0.00
M89
Other disorders of bone
0.00
M89.4 Other hypertrophic osteoarthropathy
0.00
M89.9 Disorder of bone, unspecified
0.00
M91
0.00
M91.1 Calv-Perthes]
0.00
M91.8 Other juvenile osteochondrosis of hip and pelvis
0.00
M93
Other osteochondropathies
14
19
0.00
M93.8 Other specified osteochondropathies
40.00
M94
0.00
100.00
0.00
M79
Diseases
Other soft tissue disorders, not elsewhere classified
Osteoporosis without pathological fracture
Adult osteomalacia
Other disorders of bone density and structure
Osteomyelitis
Juvenile osteochondrosis of hip and pelvis

Juvenile osteochondrosis of head of femur [Legg-
Other disorders of cartilage
M94.0 Chondrocostal junction syndrome [Tietze]
Grand
Total
CFR
%
M95
Other acquired deformities of musculoskeletal system

and connective tissue
10
17
M99
Biomechanical lesions, not elsewhere classified
0.00
N00
Acute nephritic syndrome
15
61
11
11
10
74
64
138
0.00
N00.9
Acute nephritic syndrome - Unspecified
16
0.00
N02
Recurrent and persistent haematuria
11
16
25
41
0.00
N02.0
Recurrent and persistent haematuria - Minor

glomerular abnormality
19
15
13
11
28
43
71
0.00
N03.9
Chronic nephritic syndrome - Unspecified
0.00
N04
Nephrotic syndrome
15
72
211
15
23
20
13
10
173
220
393
0.76
N04.9
Nephrotic syndrome - Unspecified
0.00
N05
Unspecified nephritic syndrome
45
169
26
46
34
18
10
15
176
192
368
0.27
N05.1
Unspecified nephritic syndrome - Focal and

segmental glomerular lesions
0.00
N05.9
Unspecified nephritic syndrome - Unspecified
0.00
N07
Hereditary nephropathy, not elsewhere classified
0.00
N10
Acute tubulo-interstitial nephritis
0.00
N11.1
Chronic obstructive pyelonephritis
0.00
N12
Tubulo-interstitial nephritis, not specified as acute or

chronic
22
38
17
13
81
22
103
0.00
N13
Obstructive and reflux uropathy
11
10
29
23
52
0.00
N13.3
Other and unspecified hydronephrosis
12
25
20
45
0.00
N13.5
Kinking and stricture of ureter without hydronephrosis
11
0.00
N13.6
Pyonephrosis
0.00
N14
Drug- and heavy-metal-induced tubulo-interstitial and

tubular conditions
0.00
N15
Other renal tubulo-interstitial diseases
0.00
N15.1
Renal and perinephric abscess
14.29
N17
Acute renal failure
25.00
N17.9
Acute renal failure, unspecified
10
12
23
26
39
65
13.85
N18
Chronic renal failure
10
11
10
10
23
32
55
16.36
N18.0
End-stage renal disease
13
18
33.33
359

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
N18.8
Other chronic renal failure
10
17
20
27
44
71
N18.9
Chronic renal failure, unspecified
10
16
25
24
42
66
4.55
N19
Unspecified renal failure
11
11
12
20
29
49
49
98
9.18
N20
Calculus of kidney and ureter
10
14
52
48
139
126
83
55
48
287
288
575
0.00
N20.0
Calculus of kidney
27
28
17
58
35
93
0.00
N20.1
Calculus of ureter
17
76
58
37
12
12
88
129
217
0.00
N20.9
Urinary calculus, unspecified
0.00
N21
Calculus of lower urinary tract
13
20
10
10
11
10
31
50
81
0.00
N21.0
Calculus in bladder
17
24
0.00
N21.1
Calculus in urethra
20
13
33
0.00
N23
Unspecified renal colic
15
31
90
53
27
17
17
129
123
252
0.00
18
30
30
0.00
0.00
N25
N28
Diseases
Disorders resulting from impaired renal tubular

function
Other disorders of kidney and ureter, not elsewhere
classified
Grand
Total
CFR
%
8.45
13
10
23
N28.8
Other specified disorders of kidney and ureter
0.00
N28.9
Disorder of kidney and ureter, unspecified
10
15
24
39
10.26
N30
Cystitis
10
17
19
24
43
0.00
N30.0
Acute cystitis
0.00
N30.9
Cystitis, unspecified
11
0.00
N32
Other disorders of bladder
10
16
0.00
N32.0
Bladder-neck obstruction
0.00
N32.1
Vesicointestinal fistula
10
22
28
7.14
N32.4
Rupture of bladder, nontraumatic
0.00
N34
Urethritis and urethral syndrome
0.00
N34.2
Other urethritis
14
14
0.00
N35
Urethral stricture
18
13
44
52
0.00
N35.9
Urethral stricture, unspecified
15
19
0.00
N36
Other disorders of urethra
20
12
32
0.00
N36.0
Urethral fistula
0.00
N36.2
Urethral caruncle
0.00
N36.8
Other specified disorders of urethra
0.00
N39
Other disorders of urinary system
14
160
354
630
673
1484
775
540
445
838
3927
1986
5913
0.10
N39.0
Urinary tract infection, site not specified
19
31
17
47
32
23
27
36
125
114
239
2.51
N39.3
Stress incontinence
0.00
N39.9
Disorder of urinary system, unspecified
10
32
38
2.63
N40
Hyperplasia of prostate
40
189
242
242
0.00
N41
Inflammatory diseases of prostate
13
174
194
194
0.00
N41.0
Acute prostatitis
0.00
N41.2
Abscess of prostate
0.00
N41.9
Inflammatory disease of prostate, unspecified
13
13
0.00
N42
Other disorders of prostate
0.00
N43
Hydrocele and spermatocele
13
69
108
26
45
47
54
44
54
460
460
0.00
N43.3
Hydrocele, unspecified
11
38
38
0.00
N44
Torsion of testis
0.00
N45
Orchitis and epididymitis
10
51
51
0.00
0.00
10
43
45
0.00
N47
Redundant prepuce, phimosis and paraphimosis
10
37
135
18
12
10
13
243
244
0.00
N48
Other disorders of penis
0.00
N49
Inflammatory disorders of male genital organs, not

0.00
N49.2
Inflammatory disorders of scrotum
0.00
N49.9
Inflammatory disorder of unspecified male genital

organ
0.00
N50
Other disorders of male genital organs
15
15
0.00
N50.1
Vascular disorders of male genital organs
0.00
N50.8
Other specified disorders of male genital organs
0.00
N60
Benign mammary dysplasia
12.50
N60.0
Solitary cyst of breast
13
0.00
N60.3
Fibrosclerosis of breast
0.00
N61
Inflammatory disorders of breast
25
51
10
106
110
0.00
N62
Hypertrophy of breast
18
18
0.00
N45.0
N45.9
Orchitis, epididymitis and epididymo-orchitis with

abscess
Orchitis, epididymitis and epididymo-orchitis without
abscess
360

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
N63
Unspecified lump in breast
48
97
19
12
11
180
18
198
0.00
N64
Other disorders of breast
16
18
0.00
N64.5
Other signs and symptoms in breast
0.00
N70
Salpingitis and oophoritis
0.00
N70.9
Salpingitis and oophoritis, unspecified
0.00
N71
Inflammatory disease of uterus, except cervix
0.00
N71.9
Inflammatory disease of uterus, unspecified
0.00
N72
Inflammatory disease of cervix uteri
14
11
39
39
0.00
N73
Other female pelvic inflammatory diseases
13
112
114
81
30
14
367
367
0.00
N73.0
Acute parametritis and pelvic cellulitis
0.00
N73.9
Female pelvic inflammatory disease, unspecified
16
19
12
56
56
0.00
N75
Diseases of Bartholin's gland
11
16
39
39
0.00
N75.1
Abscess of Bartholin's gland
0.00
N76
Other inflammation of vagina and vulva
0.00
N76.0
Acute vaginitis
0.00
N80
Endometriosis
43
10
72
72
0.00
N80.0
Endometriosis of uterus
0.00
N80.1
Endometriosis of ovary
0.00
N80.8
Other endometriosis
0.00
N80.9
Endometriosis, unspecified
16
16
0.00
N81
Female genital prolapse
114
441
797
672
645
2674
2674
0.00
N81.1
Cystocele
0.00
N81.2
Incomplete uterovaginal prolapse
14
14
0.00
N81.3
Complete uterovaginal prolapse
37
120
20
187
187
0.00
N81.4
Uterovaginal prolapse, unspecified
24
66
93
135
321
321
0.00
N81.9
Female genital prolapse, unspecified
0.00
N82
Fistulae involving female genital tract
0.00
N82.0
Vesicovaginal fistula
0.00
N83
Noninflammatory disorders of ovary, fallopian tube and

broad ligament
15
47
45
28
11
10
160
160
0.00
N83.1
Corpus luteum cyst
0.00
N83.2
Other and unspecified ovarian cysts
10
52
43
25
14
153
153
0.00
N83.4
Prolapse and hernia of ovary and fallopian tube
0.00
N84
Polyp of female genital tract
25
25
0.00
N84.0
Polyp of corpus uteri
0.00
N84.1
Polyp of cervix uteri
18
33
14
72
72
0.00
N85
Other noninflammatory disorders of uterus, except

cervix
34
12
65
65
0.00
N85.2
Hypertrophy of uterus
0.00
N85.3
Subinvolution of uterus
0.00
N85.7
Haematometra
0.00
N86
Erosion and ectropion of cervix uteri
0.00
N88
Other noninflammatory disorders of cervix uteri
10
32
32
0.00
N89
Other noninflammatory disorders of vagina
19
19
0.00
N89.8
Other specified noninflammatory disorders of vagina
0.00
N90
Other noninflammatory disorders of vulva and

perineum
0.00
N90.5
Atrophy of vulva
0.00
N90.8
Other specified noninflammatory disorders of vulva

and perineum
12
12
0.00
N91
Absent, scanty and rare menstruation
15
15
0.00
N91.1
Secondary amenorrhoea
0.00
N92
Excessive, frequent and irregular menstruation
10
40
59
52
36
20
220
220
0.45
N92.0
Excessive and frequent menstruation with regular

cycle
22
22
0.00
N92.2
Excessive menstruation at puberty
41
10
72
72
0.00
N92.6
Irregular menstruation, unspecified
15
32
40
119
36
13
259
259
0.00
N93
Other abnormal uterine and vaginal bleeding
14
150
633
335
235
66
11
1445
1445
0.00
N93.8
Other specified abnormal uterine and vaginal bleeding
24
37
53
15
135
135
0.00
N93.9
Abnormal uterine and vaginal bleeding, unspecified
19
33
33
0.00
N94
Pain and other conditions associated with female

genital organs and menstrual cycle
24
47
47
0.00
N94.1
Dyspareunia
0.00
N94.6
Dysmenorrhoea, unspecified
0.00
Diseases
Grand
Total
CFR
%
361

Inpatient Morbidity
N94.9
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
CFR
%
Male
20 - 29 Yrs
Grand
Total
Female
15 - 19 Yrs
Male
5 - 14 Yrs
Female
1 - 4 Yrs
Other specified conditions associated with female

genital organs and menstrual cycle
Unspecified condition associated with female genital
organs and menstrual cycle
29 days 1 Yrs
N94.8
Total
<28 days
ICD Code
Total Deaths
Diseases
0.00
0.00
N95
Menopausal and other perimenopausal disorders
13
13
0.00
N96
Habitual aborter
0.00
N97
Female infertility
0.00
N97.8
Female infertility of other origin
0.00
N97.9
Female infertility, unspecified
18
15
35
35
0.00
N98
Complications associated with artificial fertilization
0.00
N99
Postprocedural disorders of genitourinary system, not

12
31
31
3.23
N99.3
Prolapse of vaginal vault after hysterectomy
0.00
O00
Ectopic pregnancy
12
76
31
124
124
0.00
O00.1
Tubal pregnancy
0.00
O00.9
Ectopic pregnancy, unspecified
71
48
130
130
0.00
O01
Hydatidiform mole
50
12
76
76
1.32
O01.9
Hydatidiform mole, unspecified
29
116
15
174
174
0.00
O02
Other abnormal products of conception
22
104
42
11
182
182
0.00
O02.0
Blighted ovum and nonhydatidiform mole
15
22
22
0.00
O02.1
Missed abortion
11
63
16
91
91
0.00
O03
Spontaneous abortion
17
58
28
112
112
0.00
O03.0
Spontaneous abortion - Incomplete, complicated by

genital tract and pelvic infection
23
106
39
177
177
0.00
O04
Medical abortion
37
209
87
12
345
345
0.00
19
23
23
0.00
O04.3
O04.9
Medical abortion - Incomplete, with other and

unspecified complications
Medical abortion - Complete or unspecified, without
complication
0.00
O05
Other abortion
39
143
54
243
243
0.00
O06
Unspecified abortion
24
1015
4523
1276
229
21
7095
7095
0.04
42
204
59
14
320
320
0.00
0.00
0.00
O06.3
O06.7
Unspecified abortion - Incomplete, with other and

unspecified complications
Unspecified abortion - Complete or unspecified,
complicated by embolism
O06.8
Unspecified abortion - Complete or unspecified, with

other and unspecified complications
O06.9
Unspecified abortion - Complete or unspecified,

without complication
0.00
O07
Failed attempted abortion
17
78
27
135
135
0.74
O07.4
Failed medical abortion, without complication
0.00
0.00
0.00
14
61
14
93
93
0.00
0.00
21
33
33
0.00
O07.5
O07.9
O08
O10
O13
O14
Other and unspecified failed attempted abortion,

complicated by genital tract and pelvic infection
Other and unspecified failed attempted abortion,
without complication
Complications following abortion and ectopic and
molar pregnancy
Pre-existing hypertension complicating pregnancy,
childbirth and the puerperium
Gestational [pregnancy-induced] hypertension without
significant proteinuria
Gestational [pregnancy-induced] hypertension with
significant proteinuria
24
60
18
105
105
0.95
O14.9
Pre-eclampsia, unspecified
0.00
O15
Eclampsia
17
83
111
111
1.80
O15.0
Eclampsia in pregnancy
0.00
O15.2
Eclampsia in the puerperium
10
16
16
0.00
O15.9
Eclampsia, unspecified as to time period
16
23
23
8.70
O16
Unspecified maternal hypertension
0.00
O20
Haemorrhage in early pregnancy
38
142
31
219
219
0.00
O20.0
Threatened abortion
14
14
0.00
O21
Excessive vomiting in pregnancy
53
238
28
322
322
0.00
O21.0
Mild hyperemesis gravidarum
18
109
12
140
140
0.00
O22
Venous complications in pregnancy
100.00
O22.3
Deep phlebothrombosis in pregnancy
0.00
O23
Infections of genitourinary tract in pregnancy
18
48
12
80
80
0.00
O23.4
Unspecified infection of urinary tract in pregnancy
16
31
51
51
0.00
O23.9
Other and unspecified genitourinary tract infection in

pregnancy
0.00
O24
Diabetes mellitus in pregnancy
0.00
O26.8
Other specified pregnancy-related conditions
0.00
362

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
O26.9
Pregnancy-related condition, unspecified
0.00
O30
Multiple gestation
0.00
O32
Maternal care for known or suspected malpresentation

of fetus
11
20
20
0.00
O33
Maternal care for known or suspected disproportion
15
21
21
0.00
O33.9
Maternal care for disproportion, unspecified
0.00
O34
Maternal care for known or suspected abnormality of

pelvic organs
0.00
O34.5
Maternal care for other abnormalities of gravid uterus
0.00
0.00
0.00
0.00
0.00
12
17
17
0.00
O36.4
Maternal care for intrauterine death
16
68
98
98
0.00
O40
Polyhydramnios
0.00
O41
Other disorders of amniotic fluid and membranes
13
20
20
0.00
O41.0
Oligohydramnios
0.00
O42
Premature rupture of membranes
33
46
46
0.00
O42.2
Premature rupture of membranes, labour delayed by

therapy
0.00
O42.9
Premature rupture of membranes, unspecified
0.00
O43
Placental disorders
12
12
0.00
O44
Placenta praevia
25
35
35
0.00
O44.1
Placenta praevia with haemorrhage
0.00
O46
Antepartum haemorrhage, not elsewhere classified
15
137
29
191
191
0.52
O46.9
Antepartum haemorrhage, unspecified
10
11
11
0.00
O47
False labour
513
2317
336
28
45
3241
3241
0.00
O47.1
False labour at or after 37 completed weeks of

gestation
0.00
O47.9
False labour, unspecified
14
44
17
75
75
0.00
O48
Prolonged pregnancy
18
54
13
87
87
0.00
O60
Preterm labour
68
277
38
389
389
0.00
O62
Abnormalities of forces of labour
20
25
25
0.00
O62.0
Primary inadequate contractions
0.00
O63
Long labour
70
377
41
492
492
0.00
O63.0
Prolonged first stage (of labour)
0.00
O63.9
Long labour, unspecified
0.00
O64
Obstructed labour due to malposition and

malpresentation of fetus
20
30
30
0.00
O65
Obstructed labour due to maternal pelvic abnormality
0.00
O65.1
Obstructed labour due to generally contracted pelvis
0.00
O66
Other obstructed labour
103
364
68
540
540
0.00
O66.9
Obstructed labour, unspecified
0.00
0.00
0.00
O34.9
O35
O35.1
O35.9
O36
O67
O68
Diseases
Maternal care for abnormality of pelvic organ,

unspecified
Maternal care for known or suspected fetal abnormality
and damage
Maternal care for (suspected) chromosomal
abnormality in fetus
Maternal care for (suspected) fetal abnormality and
damage, unspecified
Maternal care for other known or suspected fetal
problems
Labour and delivery complicated by intrapartum

haemorrhage, not elsewhere classified
Labour and delivery complicated by fetal stress
[distress]
Grand
Total
CFR
%
23
71
11
106
106
O70
Perineal laceration during delivery
11
55
72
72
0.00
O70.9
Perineal laceration during delivery, unspecified
41
124
11
176
176
0.00
O71
Other obstetric trauma
21
21
0.00
O71.1
Rupture of uterus during labour
0.00
O71.5
Other obstetric injury to pelvic organs
0.00
O72
Postpartum haemorrhage
104
469
88
11
679
679
0.29
O72.0
Third-stage haemorrhage
15
26
26
0.00
O72.1
Other immediate postpartum haemorrhage
11
11
0.00
O72.2
Delayed and secondary postpartum haemorrhage
74
15
97
97
0.00
O73
Retained placenta and membranes, without

haemorrhage
129
693
162
21
1005
1005
0.00
O73.0
Retained placenta without haemorrhage
29
41
41
0.00
0.00
194
540
92
11
842
842
0.00
0.00
O74
O75
O75.2
Complications of anaesthesia during labour and

delivery
Other complications of labour and delivery, not
Pyrexia during labour, not elsewhere classified
363

Inpatient Morbidity
50 - 59 Yrs
40 - 49 Yrs
30 - 39 Yrs
0.00
25
55
29
109
109
0.00
O75.9
Complication of labour and delivery, unspecified
133
102
85
320
320
0.00
O80
Single spontaneous delivery
79
12467
59105
7199
316
15
210
79391
79391
0.00
O80.0
Spontaneous vertex delivery
18
24
24
0.00
O80.1
Spontaneous breech delivery
0.00
O80.9
Single spontaneous delivery, unspecified
3297
7061
2517
15
12891
12891
0.00
O81
Single delivery by forceps and vacuum extractor
387
1266
172
12
1843
1843
0.00
O81.0
Low forceps delivery
19
21
21
0.00
O81.1
Mid-cavity forceps delivery
0.00
O81.3
Other and unspecified forceps delivery
18
27
27
0.00
O81.4
Vacuum extractor delivery
122
619
76
824
824
0.12
O81.5
Delivery by combination of forceps and vacuum

extractor
0.00
O82
Single delivery by caesarean section
813
4638
691
30
45
6223
6223
0.06
O82.1
Delivery by emergency caesarean section
0.00
O82.9
Delivery by caesarean section, unspecified
1104
2903
709
17
4735
4735
0.15
O83
Other assisted single delivery
93
331
42
476
476
0.00
O83.0
Breech extraction
0.00
O83.1
Other assisted breech delivery
69
306
42
426
426
0.00
O84
Multiple delivery
19
185
38
247
247
0.00
O84.0
Multiple delivery, all spontaneous
10
11
11
0.00
O84.1
Multiple delivery, all by forceps and vacuum extractor
100.00
O84.2
Multiple delivery, all by caesarean section
0.00
O84.8
Other multiple delivery
0.00
O84.9
Multiple delivery, unspecified
42
53
53
0.00
O85
Puerperal sepsis
53
193
86
335
335
0.30
O86
Other puerperal infections
11
35
53
53
0.00
O86.4
Pyrexia of unknown origin following delivery
0.00
O88.3
Obstetric pyaemic and septic embolism
0.00
O89
Complications of anaesthesia during the puerperium
0.00
O90.3
Cardiomyopathy in the puerperium
0.00
O91
Infections of breast associated with childbirth
0.00
O95
Obstetric death of unspecified cause
100.00
O96
Death from any obstetric cause occurring more than 42

days but less than one year after delivery
0.00
O97
Death from sequelae of direct obstetric causes
0.00
O98.6
Protozoal diseases complicating pregnancy, childbirth

and the puerperium
0.00
O99
Other maternal diseases classifiable elsewhere but

complicating pregnancy, childbirth and the puerperium
335
1376
156
75
14
11
1967
1967
0.00
0.00
0.00
0.00
O99.0
O99.5
O99.6
Anaemia complicating pregnancy, childbirth and the

puerperium
Diseases of the respiratory system complicating
pregnancy, childbirth and the puerperium
Diseases of the digestive system complicating
Male
Grand
Total
Female
Vaginal delivery following previous caesarean section
Male
Other infection during labour
O75.7
Female
O75.3
60+ Yrs
5 - 14 Yrs
20 - 29 Yrs
1 - 4 Yrs
15 - 19 Yrs
29 days 1 Yrs
Total
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
O99.8
Other specified diseases and conditions complicating

12
16
16
0.00
P01
Fetus and newborn affected by maternal complications

of pregnancy
0.00
P01.5
Fetus and newborn affected by multiple pregnancy
50.00
P01.6
Fetus and newborn affected by maternal death
0.00
0.00
0.00
0.00
P01.7
P02
P03
Fetus and newborn affected by malpresentation before

labour
Fetus and newborn affected by complications of
placenta, cord and membranes
Fetus and newborn affected by other complications of
labour and delivery
P03.2
Fetus and newborn affected by forceps delivery
0.00
P03.4
Fetus and newborn affected by caesarean delivery
0.00
433
14
186
280
466
12
20
6.87
25.00
31
11
20
31
12.90
0.00
110
50
60
110
15
16
28.18
P07
Disorders related to short gestation and low birth

weight, not elsewhere classified
P07.0
Extremely low birth weight
P07.1
Other low birth weight
P07.2
Extreme immaturity
P07.3
Other preterm infants
364

Inpatient Morbidity
Male
Grand
Total
Female
Male
Female
Total
60+ Yrs
50 - 59 Yrs
40 - 49 Yrs
30 - 39 Yrs
20 - 29 Yrs
15 - 19 Yrs
5 - 14 Yrs
1 - 4 Yrs
29 days 1 Yrs
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
P08
Disorders related to long gestation and high birth

weight
0.00
P11.1
Other specified brain damage due to birth injury
15
10
16
6.25
P12
Birth injury to scalp
0.00
P12.0
Cephalhaematoma due to birth injury
0.00
P15
Other birth injuries
0.00
P15.9
Birth injury, unspecified
0.00
P20
Intrauterine hypoxia
10
16
0.00
P20.9
Intrauterine hypoxia, unspecified
P21
Birth asphyxia
P21.0
Severe birth asphyxia
P21.1
Mild and moderate birth asphyxia
P21.9
Birth asphyxia, unspecified
P22
P22.0
0.00
417
180
247
427
15
25
9.37
30
21
30
16.67
0.00
620
263
365
628
22
33
8.76
Respiratory distress of newborn
11.11
Respiratory distress syndrome of newborn
0.00
P23
Congenital pneumonia
0.00
P24
Neonatal aspiration syndromes
66
28
38
66
12.12
P24.0
Neonatal aspiration of meconium
P24.9
Neonatal aspiration syndrome, unspecified
P25.1
Pneumothorax originating in the perinatal period
P28
P29
P29.9
Other respiratory conditions originating in the perinatal

period
Cardiovascular disorders originating in the perinatal
period
Cardiovascular disorder originating in the perinatal
period, unspecified
P35.8
Other congenital viral diseases
P36
Bacterial sepsis of newborn
25.00
16
11
16
0.00
0.00
0.00
0.00
20.00
0.00
3049
208
21
27
1331
1990
3321
42
75
3.52
178
12
83
109
192
3.65
0.00
592
223
384
607
22
4.61
P36.0
Sepsis of newborn due to streptococcus, group B
P36.8
Other bacterial sepsis of newborn
P36.9
Bacterial sepsis of newborn, unspecified
P37
Other congenital infectious and parasitic diseases
18
14
21
0.00
P38
Omphalitis of newborn with or without mild

haemorrhage
0.00
P39
Other infections specific to the perinatal period
0.00
P39.1
Neonatal conjunctivitis and dacryocystitis
0.00
P39.4
Neonatal skin infection
0.00
P39.9
Infection specific to the perinatal period, unspecified
88
18
62
53
115
6.96
P50.9
Fetal blood loss, unspecified
0.00
P54.3
Other neonatal gastrointestinal haemorrhage
0.00
P55
Haemolytic disease of fetus and newborn
0.00
P59
Neonatal jaundice from other and unspecified causes
582
26
293
324
617
1.62
P59.9
Neonatal jaundice, unspecified
116
50
71
121
1.65
P74
Other transitory neonatal electrolyte and metabolic

disturbances
0.00
P74.1
Dehydration of newborn
67
33
34
67
0.00
P76
Other intestinal obstruction of newborn
0.00
P77
Necrotizing enterocolitis of fetus and newborn
0.00
P78
Other perinatal digestive system disorders
0.00
P78.1
Other neonatal peritonitis
0.00
P78.3
Noninfective neonatal diarrhoea
0.00
P80
Hypothermia of newborn
33.33
P80.9
Hypothermia of newborn, unspecified
50.00
0.00
14
10
15
0.00
0.00
P81
P81.9
P83
Other disturbances of temperature regulation of

newborn
Disturbance of temperature regulation of newborn,
unspecified
Other conditions of integument specific to fetus and
newborn
P83.5
Congenital hydrocele
0.00
P90
Convulsions of newborn
12
0.00
P91
Other disturbances of cerebral status of newborn
0.00
P92
Feeding problems of newborn
16
16
0.00
P92.0
Vomiting in newborn
0.00
P92.5
Neonatal difficulty in feeding at breast
0.00
P92.9
Feeding problem of newborn, unspecified
0.00
365

Inpatient Morbidity
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
10
37
55
56
1.79
16
12.50
Anencephaly and similar malformations
0.00
Microcephaly
0.00
Q03
Congenital hydrocephalus
0.00
Q03.1
Atresia of foramina of Magendie and Luschka
0.00
Q04.9
Congenital malformation of brain, unspecified
0.00
Q05
Spina bifida
0.00
Q05.9
Spina bifida, unspecified
33.33
Q12
Congenital lens malformations
0.00
Q18
Other congenital malformations of face and neck
0.00
Q18.1
Preauricular sinus and cyst
0.00
Q21
Congenital malformations of cardiac septa
0.00
Q21.1
Atrial septal defect
0.00
Q28
Other congenital malformations of circulatory system
0.00
Q32.1
Other congenital malformations of trachea
0.00
Q35
Cleft palate
0.00
Q35.9
Cleft palate, unspecified
0.00
Q36
Cleft lip
0.00
Q37.9
Unspecified cleft palate with unilateral cleft lip
0.00
Q38
Other congenital malformations of tongue, mouth and

pharynx
20.00
Q38.1
Ankyloglossia
0.00
Q39
Congenital malformations of oesophagus
0.00
Q40
Other congenital malformations of upper alimentary

tract
0.00
Q40.0
Congenital hypertrophic pyloric stenosis
0.00
Q40.1
Congenital hiatus hernia
0.00
0.00
0.00
0.00
25
24
15
11
27
48
75
10.67
Other conditions originating in the perinatal period
Q00
Q02
Q41
Q42
Q42.3
Congenital absence, atresia and stenosis of small

intestine
Congenital absence, atresia and stenosis of large
intestine
Congenital absence, atresia and stenosis of anus
without fistula
1 - 4 Yrs
0
1
Fetal death of unspecified cause
P96
29 days 1 Yrs
0
13
P95
<28 days
15 - 19 Yrs
Total
5 - 14 Yrs
ICD Code
Total Deaths
Diseases
Grand
Total
CFR
%
Q43.1
Hirschsprung's disease
Q44
Congenital malformations of gallbladder, bile ducts

and liver
0.00
Q44.4
Choledochal cyst
0.00
Q51
Congenital malformations of uterus and cervix
0.00
Q52
Other congenital malformations of female genitalia
21
21
0.00
Q52.1
Doubling of vagina
0.00
Q52.8
Other specified congenital malformations of female

genitalia
12
33
33
0.00
Q53
Undescended testicle
0.00
Q53.1
Undescended testicle, unilateral
0.00
Q53.9
Undescended testicle, unspecified
0.00
Q54
Hypospadias
13
16
36
37
0.00
Q54.0
Hypospadias, balanic
0.00
Q54.4
Congenital chordee
0.00
Q55
Other congenital malformations of male genital organs
18
18
5.56
14
20
20
0.00
11
29
29
0.00
10
16
16
0.00
Q55.4
Q55.8
Q55.9
Other congenital malformations of vas deferens,

epididymis, seminal vesicles and prostate
Other specified congenital malformations of male
genital organs
Congenital malformation of male genital organ,
unspecified
Q56
Indeterminate sex and pseudohermaphroditism
0.00
Q60
Renal agenesis and other reduction defects of kidney
23
12
37
33
23
34
76
92
148
240
0.00
Q64
Other congenital malformations of urinary system
0.00
Q66
Congenital deformities of feet
0.00
Q66.0
Talipes equinovarus
0.00
Q67
Congenital musculoskeletal deformities of head, face,

spine and chest
0.00
Q67.4
Other congenital deformities of skull, face and jaw
19
24
0.00
Q68.2
Congenital deformity of knee
0.00
Q69
Polydactyly
0.00
Q70
Syndactyly
0.00
366

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
Q72
Reduction defects of lower limb
0.00
Q76.1
Klippel-Feil syndrome
0.00
Q76.5
Cervical rib
0.00
Q78
Other osteochondrodysplasias
50.00
Q78.4
Enchondromatosis
0.00
Q78.6
Multiple congenital exostoses
0.00
Q79
Congenital malformations of the musculoskeletal

system, not elsewhere classified
0.00
Q79.3
Gastroschisis
0.00
Q82
Other congenital malformations of skin
0.00
Q83
Congenital malformations of breast
0.00
Q89
Other congenital malformations, not elsewhere

classified
0.00
Q89.2
Congenital malformations of other endocrine glands
0.00
Q90
Down's syndrome
0.00
Q90.9
Down's syndrome, unspecified
0.00
Q99
Other chromosome abnormalities, not elsewhere

classified
0.00
R00
Abnormalities of heart beat
0.00
R00.1
Bradycardia, unspecified
0.00
R00.8
Other and unspecified abnormalities of heart beat
0.00
R02
Gangrene, not elsewhere classified
11
12
21
34
55
0.00
R03
Abnormal blood-pressure reading, without diagnosis
0.00
R04
Haemorrhage from respiratory passages
15
11
45
38
36
58
65
132
141
273
1.83
R04.0
Epistaxis
13
12
10
15
39
54
0.00
R04.2
Haemoptysis
39
29
28
31
78
71
149
2.68
R04.9
Haemorrhage from respiratory passages, unspecified
0.00
R05
Cough
12
21
0.00
R06
Abnormalities of breathing
13
15.38
R06.2
Wheezing
0.00
R06.4
Hyperventilation
0.00
R06.5
Mouth breathing
0.00
R06.6
Hiccough
20
29
0.00
R06.8
Other and unspecified abnormalities of breathing
10
15
22
18.18
Diseases
Grand
Total
CFR
%
R07
Pain in throat and chest
35
29
20
23
34
80
70
150
0.67
R07.0
Pain in throat
0.00
R07.1
Chest pain on breathing
0.00
R07.4
Chest pain, unspecified
11
17
28
7.14
R09
Other symptoms and signs involving the circulatory

and respiratory systems
14
50.00
R09.1
Pleurisy
0.00
R10
Abdominal and pelvic pain
31
84
343
351
732
356
222
142
246
1557
957
2514
0.48
R10.0
Acute abdomen
29
20
25
12
14
15
77
54
131
0.76
R10.1
Pain localized to upper abdomen
26
12
28
27
55
1.82
R10.2
Pelvic and perineal pain
0.00
R10.3
Pain localized to other parts of lower abdomen
0.00
R10.4
Other and unspecified abdominal pain
35
65
47
119
81
63
45
48
293
221
514
0.58
R11
Nausea and vomiting
16
38
54
38
46
41
20
12
28
172
124
296
0.00
R12
Heartburn
0.00
R13
Dysphagia
12
0.00
R14
Flatulence and related conditions
17
24
55
62
4.84
R15
Faecal incontinence
0.00
R16
Hepatomegaly and splenomegaly, not elsewhere

classified
20
13
28
35
63
1.59
R16.0
Hepatomegaly, not elsewhere classified
0.00
R16.1
Splenomegaly, not elsewhere classified
12
0.00
R16.2
Hepatomegaly with splenomegaly, not elsewhere

classified
0.00
R17
Unspecified jaundice
135
15
33
23
41
34
18
13
27
167
178
345
0.29
R18
Ascites
13
10
17
27
45
38
59
122
87
209
4.31
R19
Other symptoms and signs involving the digestive

system and abdomen
10
15
0.00
R19.0
Intra-abdominal and pelvic swelling, mass and lump
14.29
R20
Disturbances of skin sensation
0.00
367

Inpatient Morbidity
R21
Rash and other nonspecific skin eruption
R22
Localized swelling, mass and lump of skin and

subcutaneous tissue
R22.0
R22.1
Male
Grand
Total
Female
Male
Female
Total
60+ Yrs
50 - 59 Yrs
40 - 49 Yrs
30 - 39 Yrs
20 - 29 Yrs
15 - 19 Yrs
5 - 14 Yrs
1 - 4 Yrs
29 days 1 Yrs
<28 days
ICD Code
Total Deaths
Diseases
CFR
%
0.00
111
12
12
13
18
85
106
191
2.09
Localized swelling, mass and lump, head
11
16
21
37
8.11
Localized swelling, mass and lump, neck
0.00
R22.4
Localized swelling, mass and lump, lower limb
0.00
R22.9
Localized swelling, mass and lump, unspecified
0.00
R23.8
Other and unspecified skin changes
25
11
15
26
0.00
R25
Abnormal involuntary movements
0.00
R30
Pain associated with micturition
0.00
R31
Unspecified haematuria
12
14
23
37
2.70
R32
Unspecified urinary incontinence
0.00
R33
Retention of urine
19
20
58
22
34
32
75
109
162
271
0.00
R34
Anuria and oliguria
0.00
R36
Urethral discharge
0.00
R39
Other symptoms and signs involving the urinary

system
12
17
15
32
0.00
R40
Somnolence, stupor and coma
0.00
R40.0
Somnolence
0.00
R40.2
Coma, unspecified
0.00
R41
Other symptoms and signs involving cognitive

functions and awareness
11
22
33
3.03
R42
Dizziness and giddiness
33
26
24
33
31
112
43
155
0.00
R47
Speech disturbances, not elsewhere classified
0.00
R49
Voice disturbances
0.00
R50
Fever of other and unknown origin
68
350
628
957
661
1144
642
483
354
578
3027
2838
5865
13
0.32
R50.9
Fever, unspecified
54
43
62
83
57
117
53
40
31
31
302
269
571
0.70
R51
Headache
29
55
108
70
48
22
26
232
127
359
0.00
R52
Pain, not elsewhere classified
0.00
R52.9
Pain, unspecified
0.00
R53
Malaise and fatigue
44
38
90
105
51
15
47
217
178
395
0.25
R55
Syncope and collapse
18
19
10
41
28
69
11.59
R56
Convulsions, not elsewhere classified
15
150
301
180
67
77
20
19
11
20
372
488
860
0.81
R56.0
Febrile convulsions
20
47
97
14
69
116
185
0.54
R56.8
Other and unspecified convulsions
37
121
105
33
45
34
27
20
32
170
291
461
0.43
R57
Shock, not elsewhere classified
15
13.33
R57.0
Cardiogenic shock
0.00
R57.9
Shock, unspecified
0.00
R58
Haemorrhage, not elsewhere classified
12
21
26
32
53
73
81
154
4.55
R59
Enlarged lymph nodes
12
25
23
48
0.00
R59.0
Localized enlarged lymph nodes
12
15
22
0.00
R59.1
Generalized enlarged lymph nodes
10
10
12
22
0.00
R59.9
Enlarged lymph nodes, unspecified
108
44
29
19
46
45
46
40
34
23
224
210
434
0.69
R60
Oedema, not elsewhere classified
13
7.69
R60.1
Generalized oedema
0.00
R60.9
Oedema, unspecified
10
30.00
R62
Lack of expected normal physiological development
0.00
R62.8
Other lack of expected normal physiological

development
0.00
R63
Symptoms and signs concerning food and fluid intake
R63.3
Feeding difficulties and mismanagement
0.00
11
13
17
0.00
R63.5
Abnormal weight gain
100.00
R64
Cachexia
0.00
R68
Other general symptoms and signs
0.00
R68.1
Nonspecific symptoms peculiar to infancy
26
15
13
28
0.00
R68.8
Other specified general symptoms and signs
R69
Unknown and unspecified causes of morbidity
R73
R73.9
0.00
1331
270
422
700
718
1554
798
713
681
1417
4776
3828
8604
132
194
3.79
Elevated blood glucose level
45
52
52
0.00
Hyperglycaemia, unspecified
0.00
R74
Abnormal serum enzyme levels
0.00
R75
Laboratory evidence of human immunodeficiency virus

[HIV]
0.00
R79.8
Other specified abnormal findings of blood chemistry
0.00
R80
Isolated proteinuria
0.00
368

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
R81
Glycosuria
0.00
R90.0
Intracranial space-occupying lesion
0.00
R99
Other ill-defined and unspecified causes of mortality
0.00
S00
Superficial injury of head
0.00
S00.5
Superficial injury of lip and oral cavity
0.00
S01
Open wound of head
0.00
S02
Fracture of skull and facial bones
18
26
0.00
S02.1
Fracture of base of skull
17
22
0.00
S02.2
Fracture of nasal bones
11
0.00
S02.4
Fracture of malar and maxillary bones
0.00
S02.6
Fracture of mandible
11
23
26
0.00
S03
Dislocation, sprain and strain of joints and ligaments of

head
0.00
S05
Injury of eye and orbit
0.00
S06
Intracranial injury
13
17
5.88
S06.2
Diffuse brain injury
100.00
S06.4
Epidural haemorrhage
14
19
15
10
60
70
1.43
S06.5
Traumatic subdural haemorrhage
12
44
18
74
92
3.26
S06.9
Intracranial injury, unspecified
0.00
S08
Traumatic amputation of part of head
0.00
S09
Other and unspecified injuries of head
20
65
20
51
41
30
22
34
83
204
287
2.44
S09.0
Injury of blood vessels of head, not elsewhere

classified
18
24
0.00
S09.7
Multiple injuries of head
0.00
S09.9
Unspecified injury of head
14
57
33
55
46
28
21
24
77
204
281
18
7.83
S10
Superficial injury of neck
0.00
S11
Open wound of neck
0.00
S12
Fracture of neck
23
10
30
32
62
3.23
S12.7
Multiple fractures of cervical spine
0.00
S12.9
Fracture of neck, part unspecified
0.00
S14.2
Injury of nerve root of cervical spine
0.00
S14.5
Injury of cervical sympathetic nerves
0.00
S18
Traumatic amputation at neck level
0.00
S19
Other and unspecified injuries of neck
12
13
7.69
S19.9
Unspecified injury of neck
0.00
S20
Superficial injury of thorax
14
19
11
43
54
1.85
S20.8
Superficial injury of other and unspecified parts of

thorax
0.00
S22
Fracture of rib(s), sternum and thoracic spine
12
15
18
26
44
0.00
S22.3
Fracture of rib
21
29
0.00
S22.4
Multiple fractures of ribs
0.00
S27
Injury of other and unspecified intrathoracic organs
0.00
S27.1
Traumatic haemothorax
0.00
S27.9
Injury of unspecified intrathoracic organ
0.00
S30
Superficial injury of abdomen, lower back and pelvis
24
27
3.70
S30.2
Contusion of external genital organs
0.00
0.00
S30.7
S30.8
Diseases
Multiple superficial injuries of abdomen, lower back

and pelvis
Other superficial injuries of abdomen, lower back and
pelvis
Grand
Total
CFR
%
0.00
S31
Open wound of abdomen, lower back and pelvis
0.00
S31.4
Open wound of vagina and vulva
0.00
S31.8
Open wound of other and unspecified parts of

abdomen
0.00
S32
Fracture of lumbar spine and pelvis
13
10
23
0.00
S32.0
Fracture of lumbar vertebra
0.00
S32.2
Fracture of coccyx
0.00
S32.4
Fracture of acetabulum
0.00
S32.5
Fracture of pubis
0.00
13
7.69
0.00
S36
Injury of intra-abdominal organs
0.00
S36.8
Injury of other intra-abdominal organs
0.00
S37
Injury of urinary and pelvic organs
0.00
S32.8
S33
Fracture of other and unspecified parts of lumbar spine

and pelvis
lumbar spine and pelvis
369

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
S37.3
Injury of urethra
0.00
S38.2
Traumatic amputation of external genital organs
0.00
S39
Other and unspecified injuries of abdomen, lower back

and pelvis
10
0.00
S39.9
Unspecified injury of abdomen, lower back and pelvis
16
21
4.76
S40
Superficial injury of shoulder and upper arm
0.00
S41
Open wound of shoulder and upper arm
0.00
S42
Fracture of shoulder and upper arm
26
186
25
20
19
14
19
26
130
208
338
0.00
S42.0
Fracture of clavicle
0.00
S42.1
Fracture of scapula
0.00
S42.2
Fracture of upper end of humerus
0.00
S42.3
Fracture of shaft of humerus
51
11
28
73
101
0.99
S42.4
Fracture of lower end of humerus
13
17
23
0.00
S42.9
Fracture of shoulder girdle, part unspecified
0.00
S43

shoulder girdle
0.00
S45
Injury of blood vessels at shoulder and upper arm level
0.00
S50
Superficial injury of forearm
0.00
S51
Open wound of forearm
0.00
S52
Fracture of forearm
22
164
43
37
30
25
26
33
134
251
385
0.00
S52.0
Fracture of upper end of ulna
0.00
S52.1
Fracture of upper end of radius
0.00
S52.2
Fracture of shaft of ulna
0.00
S52.4
Fracture of shafts of both ulna and radius
0.00
S52.5
Fracture of lower end of radius
0.00
S52.6
Fracture of lower end of both ulna and radius
0.00
S52.7
Multiple fractures of forearm
12
0.00
S52.8
Fracture of other parts of forearm
14
22
37
59
0.00
S52.9
Fracture of forearm, part unspecified
13
19
0.00
S53

elbow
15
22
0.00
S53.1
Dislocation of elbow, unspecified
0.00
S58
Traumatic amputation of forearm
0.00
S59
Other and unspecified injuries of forearm
0.00
S61
Open wound of wrist and hand
0.00
S62
Fracture at wrist and hand level
36
179
33
27
28
22
33
42
165
235
400
0.00
S62.3
Fracture of other metacarpal bone
0.00
S62.5
Fracture of thumb
0.00
S62.6
Fracture of other finger
0.00
10
16
26
3.85
S62.8
S63
Diseases
Fracture of other and unspecified parts of wrist and

hand
Dislocation, sprain and strain of joints and ligaments at
wrist and hand level
Grand
Total
CFR
%
0.00
S64
Injury of nerves at wrist and hand level
0.00
S65.4
Injury of blood vessel(s) of thumb
0.00
S65.5
Injury of blood vessel(s) of other finger
0.00
S65.9
Injury of unspecified blood vessel at wrist and hand

level
0.00
S66
Injury of muscle and tendon at wrist and hand level
0.00
S67
Crushing injury of wrist and hand
0.00
S68
Traumatic amputation of wrist and hand
0.00
S68.1
Traumatic amputation of other single finger

(complete)(partial)
0.00
S69
Other and unspecified injuries of wrist and hand
0.00
S69.9
Unspecified injury of wrist and hand
0.00
S70
Superficial injury of hip and thigh
12
14
0.00
S71
Open wound of hip and thigh
0.00
S72
Fracture of femur
40
114
41
46
31
31
22
98
149
283
432
1.16
S72.0
Fracture of neck of femur
14
0.00
S72.1
Pertrochanteric fracture
10
13
17
30
35
65
0.00
S72.2
Subtrochanteric fracture
0.00
S72.3
Fracture of shaft of femur
20
11
17
44
61
1.64
S72.4
Fracture of lower end of femur
0.00
S72.8
Fractures of other parts of femur
0.00
S72.9
Fracture of femur, part unspecified
20
71
13
22
27
20
32
71
111
168
279
1.08
370

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
S73
Dislocation, sprain and strain of joint and ligaments of

hip
0.00
S73.0
Dislocation of hip
0.00
S74
Injury of nerves at hip and thigh level
0.00
S77
Crushing injury of hip and thigh
0.00
S79
Other and specified injuries of hip and thigh
0.00
S79.9
Unspecified injury of hip and thigh
0.00
S81
Open wound of lower leg
0.00
S82
Fracture of lower leg, including ankle
15
53
51
53
54
56
22
39
122
221
343
0.00
S82.0
Fracture of patella
22
31
0.00
S82.1
Fracture of upper end of tibia
10
19
11
18
50
68
0.00
S82.2
Fracture of shaft of tibia
11
30
41
0.00
S82.3
Fracture of lower end of tibia
0.00
S82.4
Fracture of fibula alone
11
16
0.00
S82.5
Fracture of medial malleolus
0.00
S82.7
Multiple fractures of lower leg
0.00
S82.8
Fractures of other parts of lower leg
12
17
0.00
S82.9
Fracture of lower leg, part unspecified
10
15
0.00
S83

knee
0.00
S83.0
Dislocation of patella
0.00
S88
Traumatic amputation of lower leg
0.00
S88.9
Traumatic amputation of lower leg, level unspecified
0.00
S89
Other and unspecified injuries of lower leg
0.00
S89.9
Unspecified injury of lower leg
0.00
S91
Open wound of ankle and foot
0.00
S91.0
Open wound of ankle
0.00
S92
Fracture of foot, except ankle
13
21
0.00
S92.0
Fracture of calcaneus
0.00
S92.1
Fracture of talus
0.00
S92.3
Fracture of metatarsal bone
0.00
S92.4
Fracture of great toe
0.00
S92.5
Fracture of other toe
0.00
S92.9
Fracture of foot, unspecified
0.00
S93
Dislocation, sprain and strain of joints and ligaments at

ankle and foot level
0.00
S95.8
Injury of other blood vessels at ankle and foot level
0.00
S97
Crushing injury of ankle and foot
0.00
S97.8
Crushing injury of other parts of ankle and foot
0.00
S98
Traumatic amputation of ankle and foot
0.00
S99
Other and unspecified injuries of ankle and foot
0.00
S99.9
Unspecified injury of ankle and foot
0.00
T01
Open wounds involving multiple body regions
0.00
T01.9
Multiple open wounds, unspecified
10
14
21
0.00
T02
Fractures involving multiple body regions
12.50
T02.4
Fractures involving multiple regions of both upper

limbs
0.00
T02.9
Multiple fractures, unspecified
0.00
T03
Dislocations, sprains and strains involving multiple

body regions
11
17
28
0.00
T03.4
Dislocations, sprains and strains involving multiple

regions of upper limb(s) with lower limb(s)
0.00
T04
Crushing injuries involving multiple body regions
0.00
0.00
10
0.00
T04.3
T06
T06.0
Diseases
Crushing injuries involving multiple regions of lower

limb(s)
Other injuries involving multiple body regions, not
Injuries of brain and cranial nerves with injuries of
nerves and spinal cord at neck level
Grand
Total
CFR
%
50.00
T07
Unspecified multiple injuries
0.00
T08
Fracture of spine, level unspecified
11
10
21
9.52
T09
Other injuries of spine and trunk, level unspecified
13
18
31
3.23
T09.2
Dislocation, sprain and strain of unspecified joint and

ligament of trunk
0.00
T09.3
Injury of spinal cord, level unspecified
10
10.00
T09.9
Unspecified injury of trunk, level unspecified
0.00
371

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
T10
Fracture of upper limb, level unspecified
17
25
0.00
T11
Other injuries of upper limb, level unspecified
0.00
T12
Fracture of lower limb, level unspecified
10
0.00
T13
Other injuries of lower limb, level unspecified
0.00
T13.9
Unspecified injury of lower limb, level unspecified
0.00
T14
Injury of unspecified body region
36
239
908
378
644
487
442
374
473
1634
2356
3990
0.20
T14.0
Superficial injury of unspecified body region
14
31
40
2.50
T14.1
Open wound of unspecified body region
11
35
12
12
10
53
48
101
0.00
T14.2
Fracture of unspecified body region
25
81
30
71
41
61
35
66
149
263
412
0.24
T14.3
Dislocation, sprain and strain of unspecified body

region
13
30
43
6.98
T14.4
Injury of nerve(s) of unspecified body region
0.00
T14.5
Injury of blood vessel(s) of unspecified body region
0.00
13
17
0.00
0.00
T14.6
T14.7
Diseases
Injury of muscles and tendons of unspecified body

region
Crushing injury and traumatic amputation of
unspecified body region
Grand
Total
CFR
%
T14.8
Other injuries of unspecified body region
0.00
T14.9
Injury, unspecified
16
70
53
113
106
70
43
56
199
330
529
0.38
T15
Foreign body on external eye
0.00
T16
Foreign body in ear
0.00
T17
Foreign body in respiratory tract
14
17
31
0.00
T17.2
Foreign body in pharynx
0.00
T17.9
Foreign body in respiratory tract, part unspecified
100.00
T18
Foreign body in alimentary tract
11
18
29
0.00
T18.1
Foreign body in oesophagus
0.00
T18.3
Foreign body in small intestine
0.00
T18.8
Foreign body in other and multiple parts of alimentary

tract
0.00
T18.9
Foreign body in alimentary tract, part unspecified
0.00
T19
Foreign body in genitourinary tract
19
27
0.00
T19.3
Foreign body in uterus [any part]
0.00
T19.8
Foreign body in other and multiple parts of

genitourinary tract
0.00
T19.9
Foreign body in genitourinary tract, part unspecified
0.00
T20
Burn and corrosion of head and neck
0.00
T22
Burn and corrosion of shoulder and upper limb, except

wrist and hand
0.00
T23
Burn and corrosion of wrist and hand
0.00
T24
Burn and corrosion of hip and lower limb, except ankle

and foot
0.00
T28.0
Burn of mouth and pharynx
0.00
T29
Burns and corrosions of multiple body regions
0.00
T30
Burn and corrosion, body region unspecified
139
387
308
73
125
123
96
61
71
616
773
1389
14
18
2.30
T30.0
Burn of unspecified body region, unspecified degree
11
18
0.00
0.00
17.14
T30.4
T31
Corrosion of unspecified body region, unspecified

degree
Burns classified according to extent of body surface
involved
18
17
35
T31.0
Burns involving less than 10% of body surface
33.33
T31.1
Burns involving 10-19% of body surface
34
19
15
52
58
110
23
26.36
T31.2
14
21
0.00
T31.3
12
17
5.88
T31.4
11
9.09
T31.5
75.00
T31.6
0.00
T31.7
33.33
T31.8
33.33
100.00
0.00
0.00
0.00
13
11
17
0.00
17
88
70
50
120
0.00
T32
T35
T36
T39
T40
T44
Corrosions classified according to extent of body

surface involved
Frostbite involving multiple body regions and
unspecified frostbite
Poisoning by systemic antibiotics
Poisoning by nonopioid analgesics, antipyretics and
antirheumatics
Poisoning by narcotics and psychodysleptics
[hallucinogens]
Poisoning by drugs primarily affecting the autonomic
nervous system
372

Inpatient Morbidity
T50.9
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
22
12
34
CFR
%
Male
20 - 29 Yrs
Grand
Total
Female
15 - 19 Yrs
Male
5 - 14 Yrs
Female
1 - 4 Yrs
Poisoning by diuretics and other and unspecified

drugs, medicaments and biological substances
Other and unspecified drugs, medicaments and
biological substances
29 days 1 Yrs
T50
Total
<28 days
ICD Code
Total Deaths
Diseases
0.00
0.00
T52
Toxic effect of organic solvents
26
10
13
38
27
65
0.00
T52.0
Petroleum products
0.00
T52.9
Organic solvent, unspecified
12
23
34
26
60
0.00
T54.2
Corrosive acids and acid-like substances
0.00
T56.2
Chromium and its compounds
17
25
0.00
T57
Toxic effect of other inorganic substances
16
0.00
T57.1
Phosphorus and its compounds
0.00
T60
Toxic effect of pesticides
47
96
42
22
145
93
238
2.52
T60.0
Organophosphate and carbamate insecticides
11
18
0.00
T60.1
Halogenated insecticides
0.00
T60.3
Herbicides and fungicides
0.00
T60.4
Rodenticides
13
15
6.67
T60.9
Pesticide, unspecified
0.00
T61
Toxic effect of noxious substances eaten as seafood
0.00
T61.9
Toxic effect of unspecified seafood
11
11
20
0.00
T62
Toxic effect of other noxious substances eaten as food
23
29
11
34
15
10
70
68
138
0.72
T62.0
Ingested mushrooms
12
0.00
T62.2
Other ingested (parts of) plant(s)
0.00
T62.9
Noxious substance eaten as food, unspecified
0.00
T63
Toxic effect of contact with venomous animals
16
22
43
21
17
75
64
139
2.16
T63.0
Snake venom
12
8.33
T63.2
Venom of scorpion
0.00
T63.3
Venom of spider
0.00
T63.4
Venom of other arthropods
0.00
T64
Toxic effect of aflatoxin and other mycotoxin food

contaminants
0.00
T65
Toxic effect of other and unspecified substances
11
91
106
301
513
247
142
66
62
1024
515
1539
13
16
1.88
T65.9
Toxic effect of unspecified substance
54
69
54
28
13
145
99
244
4.51
T66
Unspecified effects of radiation
0.00
T67
Effects of heat and light
0.00
T67.0
Heatstroke and sunstroke
0.00
T68
Hypothermia
10
12
26
17
43
4.65
T71
Asphyxiation
0.00
T74
Maltreatment syndromes
0.00
T74.2
Sexual abuse
0.00
T75
Effects of other external causes
22
10
21
27
46
73
0.00
T75.1
Drowning and nonfatal submersion
0.00
T75.4
Effects of electric current
0.00
T78
Adverse effects, not elsewhere classified
15
10
15
10
47
38
85
0.00
T78.2
Anaphylactic shock, unspecified
0.00
T78.4
Allergy, unspecified
0.00
T78.9
Adverse effect, unspecified
0.00
T79
Certain early complications of trauma, not elsewhere

classified
14
42
29
43
29
21
27
33
118
126
244
0.00
T79.2
Traumatic secondary and recurrent haemorrhage
0.00
T79.3
Post-traumatic wound infection, not elsewhere

classified
14
25
19
44
0.00
T79.6
Traumatic ischaemia of muscle
0.00
T79.7
Traumatic subcutaneous emphysema
0.00
T80
Complications following infusion, transfusion and

therapeutic injection
0.00
T81
Complications of procedures, not elsewhere classified
19
28
13
41
0.00
0.00
0.00
25
10
15
10
46
33
79
0.00
0.00
0.00
11
0.00
0.00
T81.2
T81.3
T81.4
T81.8
T81.9
T82
T83.1
Accidental puncture and laceration during a procedure,

not elsewhere classified
Disruption of operation wound, not elsewhere
classified
Infection following a procedure, not elsewhere
classified
Other complications of procedures, not elsewhere
classified
Unspecified complication of procedure
Complications of cardiac and vascular prosthetic
devices, implants and grafts
Mechanical complication of other urinary devices and
implants
373

Inpatient Morbidity
T86
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Other complications of internal orthopaedic prosthetic

devices, implants and grafts
Failure and rejection of transplanted organs and
tissues
29 days 1 Yrs
T84.8
Total
<28 days
ICD Code
Total Deaths
Diseases
0.00
Grand
Total
CFR
%
100.00
T86.0
Bone-marrow transplant rejection
0.00
T87.3
Neuroma of amputation stump
0.00
T88
Other complications of surgical and medical care, not

10
18
0.00
T88.5
Other complications of anaesthesia
0.00
T88.7
Unspecified adverse effect of drug or medicament
0.00
0.00
0.00
50.00
11
15
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
10
15
0.00
0.00
0.00
0.00
0.00
18
93
148
266
193
151
88
74
424
609
1033
0.10
0.00
T88.8
T94
T96
T98
V02
V29
V29.9
V30
V47
V50.9
V56
V56.0
V59
V59.9
V69.9
V79.9
V87
V87.2
V89
V89.0
V89.2
Other specified complications of surgical and medical

care, not elsewhere classified
Sequelae of injuries involving multiple and unspecified
body regions
Sequelae of poisoning by drugs, medicaments and
biological substances
Sequelae of other and unspecified effects of external
causes
Pedestrian injured in collision with two- or threewheeled motor vehicle
Motorcycle rider injured in other and unspecified
transport accidents
Motorcycle rider [any] injured in unspecified traffic
accident
Occupant of three-wheeled motor vehicle injured in
collision with pedestrian or animal
Car occupant injured in collision with fixed or stationary
object
Occupant of pick-up truck or van injured in collision
with pedestrian or animal - Unspecified occupant of
pick-up truck or van injured in traffic accident
with other nonmotor vehicle
with other nonmotor vehicle - Driver injured in
nontraffic accident
Occupant of pick-up truck or van injured in other and
unspecified transport accidents
Occupant [any] of pick-up truck or van injured in
unspecified traffic accident
Occupant [any] of heavy transport vehicle injured in
unspecified traffic accident
Bus occupant [any] injured in unspecified traffic
accident
Traffic accident of specified type but victim's mode of
transport unknown
Person injured in collision between car and pick-up
truck or van (traffic)
Motor- or nonmotor-vehicle accident, type of vehicle
unspecified
Person injured in unspecified motor-vehicle accident,
nontraffic
Person injured in unspecified motor-vehicle accident,
traffic
10
12
22
0.00
V89.9
Person injured in unspecified vehicle accident
0.00
V93
Accident on board watercraft without accident to

watercraft, not causing drowning and submersion
0.00
V99
Unspecified transport accident
11
18
26
0.00
W03
Other fall on same level due to collision with, or

pushing by, another person
100.00
W13
Fall from, out of or through building or structure
0.00
W14
Fall from tree
100.00
W17
Other fall from one level to another
0.00
W18
Other fall on same level
0.00
W19
Unspecified fall
13
60
195
82
168
94
93
70
90
428
437
865
0.12
W34
Discharge from other and unspecified firearms
0.00
W40
Explosion of other materials
0.00
W50
Hit, struck, kicked, twisted, bitten or scratched by

another person
0.00
W54
Bitten or struck by dog
13
27
24
51
1.96
W55
Bitten or struck by other mammals
11
0.00
W57
Bitten or stung by nonvenomous insect and other

nonvenomous arthropods
24
22
21
23
19
11
15
73
67
140
0.71
W59
Bitten or crushed by other reptiles
49
61
115
104
85
60
55
296
239
535
0.37
W74
Unspecified drowning and submersion
0.00
W76
Other accidental hanging and strangulation
0.00
W89
Exposure to man-made visible and ultraviolet light
0.00
X16
Contact with hot heating appliances, radiators and

pipes
0.00
X21
Contact with venomous spiders
0.00
374

Inpatient Morbidity
29 days 1 Yrs
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Total
<28 days
ICD Code
Total Deaths
X23
Contact with hornets, wasps and bees
X36
Victim of avalanche, landslide and other earth

movements
0.00
X59
Exposure to unspecified factor
21
18
54
76
58
58
10
138
163
301
0.00
X61
Intentional self-poisoning by and exposure to

antiepileptic, sedative-hypnotic, antiparkinsonism and
psychotropic drugs, not elsewhere classified
0.00
0.00
X68
X70
Diseases
Intentional self-poisoning by and exposure to

pesticides
Intentional self-harm by hanging, strangulation and
suffocation
Grand
Total
CFR
%
0.00
0.00
X87
Assault by pesticides
0.00
Y00
Assault by blunt object
17
23
0.00
Y04
Assault by bodily force
52
149
381
369
263
140
101
649
814
1463
0.14
Y05
Sexual assault by bodily force
0.00
Y09
Assault by unspecified means
15
11
18
25
43
0.00
0.00
0.00
Y14
Y20
Y23
Poisoning by and exposure to other and unspecified

drugs, medicaments and biological substances,
undetermined intent
Hanging, strangulation and suffocation, undetermined
intent
Rifle, shotgun and larger firearm discharge,
undetermined intent
0.00
Y28
Contact with sharp object, undetermined intent
16
53
30
72
53
39
20
34
106
218
324
0.00
Y29
Contact with blunt object, undetermined intent
0.00
Y30
Falling, jumping or pushed from a high place,

undetermined intent
0.00
Y36
Operations of war
0.00
Y40
Systemic antibiotics
0.00
0.00
0.00
Y45.9
Y50
Analgesic, antipyretic and anti-inflammatory drug,

unspecified
Central nervous system stimulants, not elsewhere
classified
Y51.2
Ganglionic blocking drugs, not elsewhere classified
0.00
Y52.4
Angiotensin-converting-enzyme inhibitors
0.00
Y54
Agents primarily affecting water-balance and mineral

and uric acid metabolism
0.00
Y65
Other misadventures during surgical and medical care
0.00
Y79
Orthopaedic devices associated with adverse incidents
0.00
Z00
General examination and investigation of persons

without complaint and reported diagnosis
0.00
Z03
Medical observation and evaluation for suspected

diseases and conditions
0.00
Z03.4
Observation for suspected myocardial infarction
0.00
Z03.8
Observation for other suspected diseases and

conditions
0.00
Z31
Procreative management
0.00
Z32
Pregnancy examination and test
19
37
68
68
0.00
Z34
Supervision of normal pregnancy
70
339
62
473
473
0.00
Z34.9
Supervision of normal pregnancy, unspecified
10
10
0.00
Z35
Supervision of high-risk pregnancy
31
157
31
222
222
0.00
Z36.2
Other antenatal screening based on amniocentesis
Z38.2
Singleton, unspecified as to place of birth
Z39
Z41
0.00
238
97
141
238
0.00
Postpartum care and examination
0.00
Procedures for purposes other than remedying health

state
0.00
Z42
Follow-up care involving plastic surgery
0.00
Z43.2
Attention to ileostomy
0.00
Z43.3
Attention to colostomy
0.00
Z43.6
Attention to other artificial openings of urinary tract
0.00
Z45
Adjustment and management of implanted device
0.00
Z46.5
Fitting and adjustment of ileostomy and other intestinal

appliances
0.00
Z46.6
Fitting and adjustment of urinary device
0.00
Z47
Other orthopaedic follow-up care
16
14
25
39
0.00
Z47.0
Follow-up care involving removal of fracture plate and

other internal fixation device
0.00
Z47.9
Orthopaedic follow-up care, unspecified
12
15
27
0.00
Z51.2
Other chemotherapy
0.00
Z52.4
Kidney donor
0.00
Z73
Problems related to life-management difficulty
0.00
375

Inpatient Morbidity
Z76.2
1 - 4 Yrs
5 - 14 Yrs
15 - 19 Yrs
20 - 29 Yrs
30 - 39 Yrs
40 - 49 Yrs
50 - 59 Yrs
60+ Yrs
Female
Male
Female
Male
Persons encountering health services in other

circumstances
Health supervision and care of other healthy infant and
child
29 days 1 Yrs
Z76
Total
<28 days
ICD Code
Total Deaths
Diseases
0.00
Grand
Total
CFR
%
0.00
Z89
Acquired absence of limb
0.00
Z91
Personal history of risk-factors, not elsewhere

classified
0.00
Z93
Artificial opening status
0.00
Z93.3
Colostomy status
0.00
Z93.5
Cystostomy status
0.00
Z94
Transplanted organ and tissue status
0.00
Z98
Other postsurgical states
0.00
376

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A n nual

DEPARTMENT OF HEALTH SERVICES

 

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         &' 

 +  2 +  

  

  7/07/0*  1 

Atotalof160,868bloodsmearswerecollectedagainstthetargetof collecting150,000. However,

R o u tin e H e a lth In fo rm a tio n S y s te m s

DEPARTMENT OF HEALTH SERVICES

Management Information Section

Regional / Zonal Hospitals

HMIS 32 PHC/HP/SHP Reporting Form

Sub HP / Non -Ilaka HP

HMIS 32 PHC/HP/SHP Reporting Form

HMIS 31 VHW / MCHW Reporting Form

Measles Vaccination and Coverage

Source: HMIS/MD, DoHS

The NationalImmunizationProgram (NIP)isahighpriority program(P1)of Government ofNepal.

Currently NIP provides vaccination against TB (BCG), diphtheriapertussistetanushepatitis B and

Bhojpur, Dhankuta, Ilam, Khotan, Okhaldhunga, Terhathum, Bhaktapur, Chitwan,

BCG vs. Measles Drop-out Rates

Acute Flaccid Paralysis (AFP), Nepal, 2067-68

AFP cases = 575

Confirmed Measles and Rubella Cases, Nepal, 2003-2011

A successful completion of measles catchup

Data as of 27 Dec 2011

Reported Neonatal Tetanus (NT) Cases, Nepal, 2067-68

Growth Monitoring New Visits as

Sank huwa s abha

Source: HMIS/MD, DoHS

New Growth Monitoring Coverage

Table 2.2.1 presents the trend in growth

Source: HMIS/MD, DoHS

Trends in Total Growth Monitoring Visits

Total Grow th M onitor ing V is its

Growth Monitoring Visits

Figure2.2.3 presentsthe nutritionalstatus

Proportion of Sev ere Dehydration

Source: HMIS/MD, DoHS

COMMUNITY BASED INTEGRATED MANAGEMENT OF

Table 2.3.1 and Figure 2.3.1 show the national

Table2.3.4: Treatment of Diarrhea at Different

Figure 2.3.2: Incidence of Diarrhoea /1,000 <5 Children

Source: HMIS/MD, DoHS

Figure 2.3.4 shows the three years trend of

Figure 2.3.5: Reported ARI New Cases/1,000 <5 Children

Source: HMIS/MD, DoHS

Source: HMIS/MD, DoHS

Target Vs Achiev ement

Fig. 3.1.2: Female VSC Acceptors

Table 3.1.5 and Figure 3.1.3 show the VSC

VSC Expected Cases vs. Achievement

Source: HMIS/MD & FHD, DoHS

Source: HMIS/MD, DoHS

Figure 3.1.8 shows trend in method mix of CPR

As estimated by the 2006 NDHS the CPR

% of Deliv ery (including SBA)

Sank huw as a bha

* *

+

&'

+ 2 +

7/07/0* 1