Annual Report FY 2071 72

Annual
Report
Department of Health Services
2071/72 (2014/2015)
Government of Nepal
Ministry of Health

Kathmandu

Contents
Acronyms
National Health Policy 2071 i-xv
Executive Summary xvi-xxiv

Health Services Coverage Fact-sheet

Chapters
Chapter 1: INTRODUCTION----------------------------------------------------------------------------------------------------------------------1-8
1.1 Background ---------------------------------------------------------------------------------------------------------------------------- 1
1.2 Department of Health Services (DoHS) ----------------------------------------------------------------------------------------- 2
1.3 Source of information --------------------------------------------------------------------------------------------------------------- 5
1.4 Structure of the Report ------------------------------------------------------------------------------------------------------------- 5
Chapter 2: CHILD HEALTH ------------------------------------------------------------------------------------------------------------------- 9-68
2.1 Immunization ------------------------------------------------------------------------------------------------------------------------- 9
2.2 Nutrition ------------------------------------------------------------------------------------------------------------------------------ 26
2.3 CB-IMCI and Newborn Care ------------------------------------------------------------------------------------------------------ 50
Chapter 3: FAMILY HEALTH --------------------------------------------------------------------------------------------------------------- 71-108
3.1 Family Planning ---------------------------------------------------------------------------------------------------------------------- 71
3.2 Safe Motherhood and Newborn Health --------------------------------------------------------------------------------------- 80
3.3 Female Community Health Volunteer (FCHV) ------------------------------------------------------------------------------- 91
3.4 Primary Health Care Outreach (PHC/ORC) ------------------------------------------------------------------------------------ 95
3.5 Demography and Reproductive Health Research --------------------------------------------------------------------------- 98
3.6 Adolescent Sexual and Reproductive Health -------------------------------------------------------------------------------- 103
Chapter 4: DISEASE CONTROL ---------------------------------------------------------------------------------------------------------- 111-190
4.1 Malaria -------------------------------------------------------------------------------------------------------------------------------- 111
4.2 Kala-azar ----------------------------------------------------------------------------------------------------------------------------- 118
4.3 Lymphatic Filariasis (LF) ---------------------------------------------------------------------------------------------------------- 123
4.4 Dengue ------------------------------------------------------------------------------------------------------------------------------- 127
4.5 Zoonoses -------------------------------------------------------------------------------------------------------------- -------------- 130

4.6 Epidemiology and Disease Outbreak Management-------------------------------------------------------------------------133
4.7 Disaster Management ----------------------------------------------------------------------------------------- ------------------- 135
4.8 Surveillance and Research ----------------------------------------------------------------------------------------- ------------- 140
4.9 Tuberculosis ------------------------------------------------------------------------------------------------------------------------ 144
4.10 Leprosy ------------------------------------------------------------------------------------------------------------------------------- 156
4.11 HIV/AIDS and STI ------------------------------------------------------------------------------------------------------------------- 174
4.12 Eye Care ------------------------------------------------------------------------------------------------------------------------------ 186
Chapter 5: CURATIVE SERVICES (Inpatients/OPD services) ---------------------------------------------------------------------- 191-204
Chapter 6: SUPPORTING PROGRAMS -------------------------------------------------------------------------------------------------- 207-262
6.1 Health Training --------------------------------------------------------------------------------------------------------------------- 207

6.2 Health Education, Information and Communication ---------------------------------------------------------------------- 216
6.3 Logistic Management ------------------------------------------------------------------------------------------------------------- 223
6.4 Public Health Laboratory Services --------------------------------------------------------------------------------------------- 235
6.5 Personnel Administration Management ------------------------------------------------------------------------------------- 239
6.6 Financial Management ----------------------------------------------------------------------------------------------------------- 243
6.7 Management ----------------------------------------------------------------------------------------------------------------------- 250
6.8 Primary Health Care Revitalization -------------------------------------------------------------------------------------------- 257
Chapter 7: MONITORING AND EVALUATION ---------------------------------------------------------------------------------------- 263-276
Chapter 8: OTHER DEPARTMENT ------------------------------------------------------------------------------------------------------- 279-290
8.1 Drug Administration -------------------------------------------------------------------------------------------------------------- 279
8.2 Ayurveda ---------------------------------------------------------------------------------------------------------------------------- 284
8.3 Homeopathic ----------------------------------------------------------------------------------------------------------------------- 289
Chapter 9: DEVELOPMENT PARTNERS ------------------------------------------------------------------------------------------------- 293-302

ANNEXES
Annex 1: Activities carried out in FY 2071/72 by programs ----------------------------------------------------------------------- 305
Annex 2: Target for 2072/73 by programs --------------------------------------------------------------------------------------------- 319
Annex 3: Health Services (Estimated Target Population, Raw/Analyzed data sheets) ------------------------------------- 331
ACRONYMS
ACT
AEFI
AES
AFP
AI
AIDS
AMR
AMTSL
AR
BMI
BPCR
CBIMCI
CBNCP
CMAM
DOTS
DSS
DST
EQA
GFATM
HPAI
IDA
IDD
IDU
IFA
IMAM
IMNMP
IPD
IRS
JE
LF
LLIN
MARP
MCV
MDVP
MIYCN
MMNP
NEQAS
NHP
NHSP
NHTS
NIC
NISN
NML
NMR
NNSC
ArtemisininbasedCombinationTherapy
AdverseEventsFollowingImmunization
AcuteEncephalitisSyndrome
AcuteFlaccidParalysis
AvianInfluenza
AcquiredImmunodeficiencySyndrome
AntiMicrobialResistant
ActiveManagementofThirdStageofLabor
AntiRetroviralTherapy
BodyMassIndex
BirthPreparednessandComplicationReadiness
CommunityBasedIntegratedManagementofChildhoodIllness
CommunityBasedNewbornCareProgram
CommunitybasedManagementofAcuteMalnutrition
DirectlyObservedTreatmentShortCourse
DengueShockSyndrome
DrugSusceptibilityTesting
ExternalQualityAssurance
GlobalFundagainstAIDS,TBandMalaria
HighlyPathogenicAvianInfluenza
IronDeficiencyAnaemia
IodineDeficiencyDisorder
InjectingDrugUsers
IronandFolicAcid
IntegratedManagementofAcuteMalnutrition
IntensificationofMaternalandNeonatalMicronutrientProgram
ImmunizationPreventableDiseases
IndoorResidualSpraying
JapaneseEncephalitis
LymphaticFilariasis
LonglastingInsecticideTreatedbedNet
MostAtRiskPopulation
MeaslesContainingVaccine
MultiDoseVialPolicy
Maternal,InfantandYoungChildNutrition
MultipleMicronutrientPowder
NationalExternalQualityAssuranceScheme
NationalHealthPolicy
NepalHealthSectorProgram
NationalHealthTrainingStrategy
NationalInfluenzaCentre
NationalInfluenzaSurveillanceNetwork
NationalMedicinesLaboratory
NeonatalMortalityRate
NationalNutritionSteeringCommittee
NQC
NTAGM
OPV
ORS
ORT
OTP
PAL
PEM
PEP
PHC/ORC
PHCRD
PLAMAHS
PLHA
PLHIV
PMTCT
PPH
PPM
PR
PSBI
PWID
RBM
REACH
REC
RED
RHCC
SAM
SAS
SLTHP
SMART
SOP
STI
SUN
Td
TTI
VAD
VAS
VBD
VCT
VPD
VSC
WASH
NationalQualityControlCentre
NationalTechnicalAdvisoryGroupforMalaria
OralPolioVaccine
OralRehydrationSolution
OralRehydrationTherapy
OutpatientTherapeuticProgram
PracticalApproachtoLung
ProteinEnergyMalnutrition
PostExposureProphylaxix
PrimaryHealthCareOutreachClinics
PrimaryHealthCareRevitalization
PlanningandManagementofAssetsinHealthCareSystem
PeopleLivingwithHIV/AIDS
PeopleLivingwithHIV
PreventionofMothertoChildTransmission
PostpartumHaemorrhage
PublicPrivateMix
PrevalenceRate
PossibleSevereBacterialInfection
PeopleWhoInjectDrugs
RollBackMalaria
ReachingtoEndChildHungerandMalnutrition
ReachingEveryChild
ReachingEveryDistrict
ReproductiveHealthCoordinationCommittee
SevereAcuteMalnutrition
SafeAbortionServices
SecondLongTermHealthPlan
StandardizedMethodologyofNutritionAssessmentduringReliefandTransition
StandardOperatingProcedures
SexuallyTransmittedInfection
ScalingUpNutrition
Tetanusdiphtheria
TransfusionTransmissibleInfection
VitaminDeficiencyDisorder
VitaminASupplementation
VectorBorneDiseases
VoluntaryCounselingandTest
VaccinePreventableDiseases
VoluntarySurgicalContraception
Water,SanitationandHygiene
Government of Nepal
4262063
4251242
Fax: 4252483
Management Division
Pachali, Teku
Kathmandu, Nepal
Ministry Of Health
Acknowledgement
Tel:
National Health Policy-2071
National Health Policy- 2071
1. Background

The relationship between health of general population and overall development of country is
intertwined. Progresses made in the health sector are considered the main indicators of
development. Despite poverty and conflict in past decades, Nepal has achieved remarkable success
in the health sector.

In the context of health as a fundamental right of the people established by Nepals constitution, it is
the responsibility of the nation to maintain the achievement made in controlling communicable
diseases, to reduce infant and maternal mortality rate to the desired level, to control the ever
increasing prevalence of non-communicable diseases and timely management of unpredictable
health disasters, and to provide quality health services to senior citizens, physically and mentally
impaired people, single women especially poor and marginalized and vulnerable communities.

This national health policy 2071, a complete revision of the national health policy 2048, has been
introduced to promote, preserve, improve and rehabilitate the health of the people by preserving
the earlier achievement, appropriately addressing the existing and newly emerging challenges and
by optimally mobilizing all necessary resources through a publicly accountable efficient
management.

2. Past Attempts
In Nepal, only limited people had access to ayurvedic and modern health care services at
Singhadarbar Vaidyakhana established nearly 300 years ago, and Bir Hospital established in 1947;
most ordinary people had to rely on traditional healers such as dhamijhakri, jharphuke, guvaju etc.

After the introduction of the periodic developmental plan in the country from B.S. 2013, a planned
development process began also in the health sector. In this process the first 15 year long-term
health plan and the second 20 year long-term health plan were introduced in B.S.2032 and 2054
respectively.

People actively and remarkably participated in health programs such as Smallpox Eradication,
Malaria Control, Tuberculosis Control, Polio Eradication, Filariasis Elimination, Leprosy Elimination,
as well as regular administration of vitamin A to the children. Female Community Health Volunteer
program started from B.S. 2045 in Nepal has been a model program for the whole world.
Meanwhile, a policy for integrating vertical health programs from the perspective of cost
effectiveness and ease of implementation was adopted and the integration of malaria, leprosy,
tuberculosis, smallpox, and family planning / maternal child health programs was completed by B.S.
2047.

After the opening for private-sector investment in the health sector through the enactment of The
National Health Policy 2048, Institutes for the study of health sciences as well as private health
facilities were established in massive scale. The involvement of private sector in health has been
mainly in curative services, production of medicines and equipment, and they are concentrated in
urban areas. At the same time, Nepal Health Sector Program-1 (2060-2065) and Nepal Health Sector
Program-2 (2066-2071) have been formulated and implemented in order to enhance the
effectiveness of the investment of Government, Non-Government and Donor agencies.

3. Current Situation
Due to concerted efforts of past sixty years, significant achievements have been made in the health
sector. Network of health facilities providing primary health care services have been accessible to all
people. Though concentrated in urban centers and confined to curative services only, the
participation of private sector has been increased. Human resources required for almost all levels of
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health care are being produced within the county. Country is increasingly becoming capable to
producing high and medium level human resources. About four dozens of pharmaceutical companies
currently operating in the country have developed the capacity of producing 40 percent of medicine
required by the country.

Likewise, though the services are not widely available, a number of specialized care facilities relating
to eye, cancer, heart, kidney, neurology, orthopedic, and plastic surgery have been established
under Government and Non-Government sector. Diagnostic centers and lab services have been
strengthened and expanded. The major health problems of past decades that have been Malaria,
Tuberculosis, Diarrhea, respiratory diseases, Typhoid, Chickenpox, Whopping Cough, Diphtheria,
Tetanus, Filariasis, Kala Ajar, Trachoma, HIV, are in control and burden of these diseases are in
descending trend. Smallpox has been eradicated and polio is down to zero in Nepal. Leprosy is in
state of elimination. Maternal and neonatal tetanus has been eliminated and trachoma is in process
of elimination. Campaign for control of filarial disease is ongoing.

Various regulatory bodies (Medical Council, Nursing Council, Pharmacy Council, Health Council,
Ayurvedic Council, National Health Research Council) responsible for ensuring quality of production
of human resource for health, health care, drug supply and researches, several institutions have
been established and are operational.

Collaboration and partnership with health related international organizations, donor communities,
and countries have been developed. Health awareness in general public has been increased.
Considerable development in education, communication, agriculture, and food supply has
contributed to the development of health.
As the result of above Decade of B.S. B.S. 2048 B.S. 2068 Source
(A.D.
(A.D.
2007 (A.D.
efforts,
remarkable
2011)
1991)
1950)
progress has been
made in the health
sector which is justified
by the indicators in
table below. Indicator
200
107
46
Nepal Health and Demographic
a) Infant mortality rate
Survey, 2011
(per thousand live
births)
b) Maternal mortality
1800
850
170
Millennium Development Goal
rate (Per 100,000 live
Progress Report, 2011
births)
c)Average
life
32
53
68.8 (A.D. Nepal Human Development
expectancy (year)
2011)
Index Report, 2014
280
197
54
d) Under 5 children
Survey, 2011
mortality
(per
thousand)
e)Total fertility rate
7
5.8
2.6
Survey, 2011
f) Fully immunized
70
88/87
children (Percentage)
Survey, 2011

4. Issues and Challenges
In spite of considerable achievement in the health sector and country progressing towards positive
direction, there are still many problems and challenges that need to be addressed. Some major
problems and challenges are as follows:

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Major Issues:
Citizens of all localities, levels, classes, groups and communities do not have yet easy and
affordable access to health care as aspired by the constitution.
Despite the continuous effort of the state, about a half of under 5 children and women of
reproductive age are undernourished whereas the problem of obesity is growing among urban
population.
Health problems created by the situations like climate change, raising food insecurity and
natural disasters are on the rise.
Prevalence of cancer, hypertension, diabetes, and illnesses related to heart, kidneys, liver, lungs,
along with other non communicable diseases like mental illnesses, dental problems are on the
rise. Likewise, deaths due to road and injuries are increasing day after day.
State has not been able to provide adequate priority on primary health care programs in urban
areas, health of senior citizens, mental disorders, genetic and congenital diseases,
environmental health, occupational hazard, sexual and reproductive health of adolescents and
health promotion on school-age children, etc.
Access to quality medicine for people, right use of medicine, production and distribution of
essential drugs and medical equipments within the country are not effective and people
oriented.
Laboratory services and medical equipments are not yet up to the quality standard.
The issues such as complexities seen in rational production of various skilled health professionals
that take social responsibility, brain drain of health professionals, transfer of health and other
personnel, continuous presence of health personnel in health facilities, security of health
personnel, etc., have not yet been addressed in a planned way.
Not been able to mobilize private-sector investment in health for the benefit of the people and
divert their investment to appropriate areas.
Not been able to effectively regulate health sector according to law and rules. There is a lack of
sufficient harmony between the organizations producing health personnel and the organizations
utilizing them.

Major Challenges:
There is a need for appropriate implementation of a two way referral system in order to improve
the quality standard of health care services.
There is a need for immediate management of highly infectious diseases (like Bird-flu) or
potential new diseases, controlling of epidemic, emergency preparedness for minimizing human
casualty due to earthquake and other natural disasters and retrofitting of hospitals and other
health institutions.
In order to reduce new born, child and maternal mortality rate, there is a need for maximizing
the effectiveness of controlling Diarrhea, acute respiratory infection, Malaria, Kala Azar,
Encephalitis, Filariasis, Dengue, Tuberculosis, Leprosy, HIV, and other diseases that can be
prevented through immunization.
It has been difficult to control the spread of human and animal related diseases due to the open
border with neighboring countries.
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There is a need for creating opportunities by strengthening health institutions down to the grass
root level and establishment of a social health insurance system so that health services, health
education and information are equally available for all citizens.
There is a need for increasing states investment to the health sector in proportion to population
growth.
There is a need for urgently addressing regional disparity in health indicators.
There is a need for implementing health-related acts, rules, policies, strategies and action plan in
a comprehensive and integrated manner. Likewise, country is committed to the international
treaties and agreements, and therefore, it should continue actively participating for their
successful implementation.
The nation being a party to a convention on the Rights of Persons with Disabilities, it needs to
increase investment for providing all necessary health services to the people with blindness,
visual impairment, hearing impairment, mental impairment, and physical impairment.
There is a need for empowering local government and holding them accountable for health
services along with improving people participation in rural health programs.
5. Need for new policy, guiding principles and vision
As the existing health policy 2048 is insufficient to ensure citizens right to quality health care
through appropriate response to the above problems and challenges, this new national health policy
had to be promulgated. While preparing this policy, a few guiding principles were formulated and
based on those guiding principles, policies, and strategies have been proposed. The National Health
Policy 2071 will be implemented based on the guiding principles presented below:
As a fundamental right of citizens, provision for obtaining quality health care will be ensured.

Right to information related to the health services provisioned for citizens will be ensured.
In order to ensure the health services provisioned by the state is accessible to poor,
marginalized, and vulnerable communities; based on equality and social justice, programs will be
designed and implemented accordingly.
People will be participated in every kind and level of health services.
Policies and programs related to health promotion, protection, improvement, and rehabilitation
will be gradually incorporated into states other policies.
Participation of private sector will be promoted ensuring citizens easy access to quality health
services at fair price.
Resources obtained from internal and external agencies will be mobilized for effective
implementation of this policy and the programs formulated under this policy.
All health services, provided by government or organized differently through a network of

government and private sector, will be regulated.
Flow of health services will be made fully accountable.
This policy has been deemed necessary for successful implementation of the above guiding
principles.

5.1 Vision
All Nepalese citizens would be able to live productive and quality life; being physically, mentally,
socially, and emotionally healthy.

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5.2 Mission
Ensure the fundamental right of citizens to remain healthy through a strategic collaboration among
service provider, beneficiaries, and stakeholders and optimum utilization of available resources.

5.3 Goal
To ensure health for all citizens as a fundamental human right by increasing access to quality health
services through a provision of just and accountable health system.

5.4 Objectives
1.
To make available free the basic health services that existed as citizens fundamental
right.
2.
To establish an effective and accountable health system with required medicines,

equipments, technologies and qualified health professional for easy access to acquire
quality health services by each citizen.
3.
To promote peoples participation in extending health services. For this, promote

ownership of the private and cooperative sector by augmenting and managing their
involvement.
6. Policies
1.
To make available in an effective manner the quality health services, established as a

fundamental right, ensuring easy access within the reach of all citizens (universal health
coverage) and provision of basic health services at free of cost.
2.
To plan produce, acquire, develop, and utilize necessary human resources to make health
services affordable and effective.
3.
To develop the ayurvedic medicine system through the systematic management and
utilization of available herbs in the country as well as safeguarding and systematic
development of other existing complementary medicine systems.
4.
To aim at becoming self-sufficient in quality medicine and medical equipment through

effortless and effective importation and utilization with emphasis on internal production.
5.
To utilize in policy formulation, program planning, medical and treatment system, the
proven behaviors or practices obtained from researchers by enhancing the quality of
research to international standard.
6.
To promote public health by giving high priority to education, information, and

communication programs for transforming into practice the access to information and
messages about health as a right to information.
7.
To reduce prevalence of malnutrition through promotion and usage of quality healthy

foods.
8.
To ensure availability of quality health services through competent and accountable

mechanism and system for coordination, monitoring and regulation.
9.
To ensure professional and quality service standard by making health related

professional councils capable, professional, and accountable.
10.
To mainstreaming health in every policy of state by reinforcing collaboration with health-

related various stakeholders.
11.
To ensure the right of citizens to live in healthy environment through effective control of
environmental pollution for protection and promotion of health.
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12.
To maintain good governance in the health sector through necessary policy, structure
and management for delivery of quality health services.
13.
To promote public and private sectors partnership for systematic and quality
development of health sector.
14.
To increase the investment in the health sector by state to ensure quality and accessible
health services and to provide financial security to citizens for medical cost and as well as
effectively utilize and manage financial resources obtained from private and non
government sector.
7. Strategies
1. Following strategies (related to policy 1) will be adopted to make available in an effective

manner the quality health services, established as a fundamental right, ensuring easy access
within the reach of all citizens (universal health coverage) and provision of basic health
services at free of cost.
1.1.
Basic health service will be provided at free of cost by making acts relating to basic health
service.
1.2.
As Nepal is the signatory of international convention on Rights of Persons with

Disabilities, all necessary health services needed for people who are blinds, visually
impaired, hearing impaired as well as mentally, cognitively and physically disabled will be
included in urgent health service category.
1.3.
National health guidelines and protocols will be prepared and implemented to ensure all
citizens have received standard quality health care by reforming basic health program of
state for fulfilling basic health needs of citizens.
1.4.
Impartial service will be delivered on the basis of equality by strengthening programs

delivering health services in rural areas as well as including marginalized groups in urban
areas.
1.5.
Quality health treatment care of national standard will be catered by keeping priority on
preventive and promotive service and by using proper medicine and technology.
1.6.
Nepal will be developed as regional hub for health tourism and medical science studies
by confirming areas delivering highly specialized and international standard services and
developing those areas.
1.7.
Integrated program of health service, care and support will be formulated and
implemented according to the need of senior citizens.
1.8.
Current situation of managing infectious diseases will be modified and implemented

under periodic plan on timely basis with essential additional immunization service.
Respective services are implemented effectively on the basis of policies related to
prevention and control of non communicable diseases, prevention and treatment of
accidents and injury, and mental health.
1.9.
Affordable health services will be made available all over the country through
telemedicine (ehealth).
1.10.
Arrangement of a doctor and a nurse along with other health technicians will be made
available in every VDC and one nurse midwife in every ward according to population.
Necessary number of health promotion and monitoring officer will be mobilized in every
constituency to monitor quality of health service and make promotive health service
available widely in local level.
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1.11.
Laboratory and x-ray service will be expanded respectively in VDC level health
institutions.
1.12.
Blood transfusion service will be made systematic in coordination with non-government

sector by regulating through government sector.
1.13.
Institutions providing specialized and highly specialized service will be established and
expanded gradually for providing services accessible to the residents of all regions in
country. Intensive care facility with specialists will be expanded to district level hospitals
gradually on the basis of criteria. Effective two-way communication system will be
arranged between health institutions at community level to highly specialized service
providers to make treatment service systematic.
1.14.
Arrangements will be made to provide pharmacy service owned itself by hospital and to
distribute medicines to patients through qualified pharmacy personnel.
1.15.
Periodic health related programs and action plans will be implemented by stating target
based on important health and development indicators such as maternal mortality rate,
infant mortality rate, under-five child mortality rate, average age. Reports from health
institutions will be made more scientific, timely, reliable and periodic.
1.16.
Primary Health care service will be decentralized gradually by making local government
authorized and accountable for health services by increasing technical capability of local
government.
1.17.
Arrangement will be made to contact ambulance service using one symbol number
throughout the country. Arrangement of service with essential medicines, oxygen, and
skilled health personnel will be ensured in ambulance. Air ambulance service will be
operated by making certain criteria for providing medical care by rescuing those in crisis.
1.18.
Network of health personnel capable of making first aid treatment with essential drugs
and equipment will be arranged within the distance of one hour maximum in major
highways for treating injured people quickly.
1.19.
At least one-village-one-health-institution will be established in the distance of 30

minutes maximum on the basis of geographical location and population ratio. Programs
in periodic plans will be included to establish one primary health care center in every 20
thousand population and one 25-bed-hospital for every one hundred thousand
population. Likewise one primary health care center will be established in every industrial
area.
1.20.
Mental health care service from the level of community to hospitals providing specialized
service will be implemented gradually by including in periodic plan.
1.21.
Family planning including sexual and reproductive health will be included as integrated
form of service. Concept of Youth and adolescent friendly health service will be
incorporated in all organizations delivering health services. Reproductive health act will
be introduced.
1.22.
Integrated child health program managing diseases relating to child will be implemented
continuously through strengthening on timely basis.
1.23.
Flow of health service related to oral, eye and ear care will be actively implemented
throughout the country.
1.24.
Establishment of referral hospitals on various subjects of medicines including dental and

ear, nose, throat will be done.
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1.25.
Development of international standard referral laboratory will be done by increasing

capacity of national public health laboratory and national drug laboratory.
1.26.
Country being signatory to International treaty, agreements and commitments including

treaty related to controlling tobacco will be implemented actively.
2. Following strategies (related to policy 2) will be adopted to plan, produce, acquire, develop,
and utilize necessary human resources to make health services affordable and effective.

2.1
Master plan will be implemented for managing and developing human resources in
health sector along with projection of necessary workforce required within and outside
the country. Expenditure in human resources will be considered an investment.
2.2
Minimum integrated national curriculum will be implemented to produce human

resources of various kinds at various levels in health sector having appropriate skills and
knowledge capable of taking social responsibility according to national need. Educational
institutions operating under private and government investment will be supported and
regulated by creating high level mechanism with authority for monitoring educational
institutions and quality of human resources produced there.
Active and continuous presence of human resource in health sector will be ensured by
creating an environment to make them work compulsorily in assigned duty. Special
facility and opportunity will be created for health workers and their dependent families
working in remote areas.
2.3
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2.4
Quality health services will be ensured by creating new positions of human resources by
having skills mixed on the basis of population.
2.5
Arrangement of one doctor along with 23 health workers will be ensured for every 10
thousand population gradually. Special arrangement will be made for remote and
mountainous areas.
2.6
Arrangements for encouragement of health workers including doctor will be done for
enhancing their capacity by creating opportunity of higher education, in-service training,
and participating them in research and study.
2.7
Regional and zonal hospitals are included in specialization course provided by

government academy.
2.8
Brain drain of human resources is discouraged by taking effective measures such as

career development and various kinds of financial and non-financial incentives to stop
currently visible brain drain and to create conducive working environment.
2.9
Skilled human resource will be produced for safe motherhood by initiating midwifery
education. Opportunity of midwifery education will be provided for enhancing capacity
of working nurses.
2.10
Transparent and scientific rotation transfer system will be developed and implemented
to systematize transfer of health workers and staffs.
2.11
Policy will be adopted for utilizing skilled private sector workers into government service
according to need. Likewise arrangement will be made for utilizing health workers
produced in private sectors into governmental entities according to need.
2.12
Study, research and training center of international standard will be set up by utilizing
outstanding achievements obtained in Nepals health sector.
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2.13
3
Capacity of female community health volunteers will be developed with necessary

incentives to improve their quality of services.
Following strategies (related to policy 3) will be adopted to develop the ayurvedic medicine
system through the systematic management and utilization of available herbs in the country
as well as safeguarding and systematic development of other existing complementary
medicine systems.
3.1
Ayurveda will be developed gradually. Development and reformation will be done by

assessing quality of service in this area from research. Long term plan will be developed
and implemented for the safeguard, development, and expansion of homeopathy, unani
(Greek), and other complimentary medicine system.
3.2
Development and expansion of appropriate structure will be done gradually for

implementation of ayurveda system effectively.
3.3
Emphasis is given for production and commercialization by ensuring quality of herbal

medicine produced by government and private ayurveda medicine manufacturer with
special plan and programs for the safeguard and proper use of locally available herbs.
3.4
Study and research of ayurveda, and development of skilled human resources related to
research will be operated as a priority program by arranging and developing appropriate
human resources for national ayurveda research and training center.
3.5
Special focus will be given to enhance the quality of ayurveda health service by regulating
inappropriate activities in the name of ayurveda and herbs.
4. Following strategies (related to policy 4) will be adopted to aim at becoming self-sufficient in

quality medicine and medical equipment through effortless and effective importation and
utilization with emphasis on internal production.

4.1
Country will be made self sufficient in production of medicine. Arrangement will be made
for production and supply of all essential medicines.
4.2
Supplied to private and government sector, manufactured either within country or

imported, system will be developed according to the criteria for ensuring quality of
medicines, medical tools, equipments, and items used in laboratory.
4.3
Special arrangement will be done for controlling misuse of freely distributed drugs and
will increase gradually the types and numbers of freely distributed essential drugs from
every health institutions.
4.4
Making estimates, purchases, and distribution of drugs more effective and making
current arrangement of purchase and supply system strong, procedural reform including
participation of skilled pharmacist will be done in this process.
5. Following strategies (related to policy 5) will be adopted to utilize in policy formulation,

program planning, medical and treatment system, the proven behaviors or practices obtained
from researchers by enhancing the quality of research to international standard.

5.1
Current organizational, institutional and procedural state of affair of Nepal health

research council will be improved timely to increase quality of health research to
international standard. Special programs will be launched to enhance the capacity of
council for the promotion and facilitation of health research.
5.2
Health research will be regulated for providing new findings and suggestions for
promoting, safeguarding, improving and rehabilitating health of citizens and
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arrangement will be made for using suggestions from research more effectively in policy
making, planning and implementation.
5.3
Report and conclusion obtained from research will be made further accessible to all.
5.4
Encouragement will be done to include health in research of other sectors.
5.5
Health researcher and scientist will be encouraged to do research in various subjects of

health and environment will be created to respect their expertise.
5.6
Network of national and international organizations related to study and research will be
established.
5.7
Universities related to health and governmental and nongovernmental educational

institutions will be encouraged and facilitated to participate in research.
5.8
Special priority will be given for scientific exploration and research of herbs available in
country.
6. Following strategies (related to policy 6) will be adopted to promote public health by giving
high priority to education, information, and communication programs for transforming into
practice the access to information and messages about health as a right to information.

6.1
National health information system will be developed to provide information of works

done in health sector in simple and easy manner to the access of all citizens.
6.2
Wide use of health education information and communication will be put in high priority
to promote health by increasing awareness of individual or community, to control
diseases, to obtain health gain in time and to change behavior.
6.3
Advertisement and promotion of items having adverse effect on health of citizens such as
tobacco, substance with tobacco, alcohol, and other alcoholic beverages will be banned.
Likewise any kind of medium of communication that affects the sexual life of citizens
directly or indirectly will be banned.
6.4
Governmental and nongovernmental sectors will be mobilized to disseminate user

friendly and acceptable information in local languages that are informative, promotive
and able to raise awareness among public.
6.5
All citizens will be encouraged to obtain health information using all medium of
communication including electronic in optimum manner.
6.6
School health program that is recognized as effective and capable of providing high
return will be implemented in all schools of country in coordination with ministry of
education. For this, action plan with detail working procedure will be developed for all
programs ongoing currently in schools by unifying them and health programs will be
carried out by arranging one health worker at least in secondary school.
6.7
Arrangement will be done to provide all kinds of information of health service

particularly related to the treatment of patient for establishing a right to information to
the respective consumer.
7. Following strategies (related to policy 7) will be adopted to reduce prevalence of malnutrition

through promotion and usage of quality healthy foods.

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7.1
Necessary arrangement will be made to free from the condition of malnutrition in the
long run by emphasizing promotion, production, and usage of food items available and
could be produced locally through the means of educational program in nutrition based
in community.
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7.2
Current multi-sector policy and programs related to nutrition including food security will
be implemented with high priority by updating them to improve the situation of
malnutrition.
7.3
Regular feedback will be given to agriculture development and other ministries to

increase the self sufficiency in food as there is direct relationship between food security
and nutrition, under the community health program backyard garden will be promoted
with the involvement of local body, and daily consumption of green vegetable and fruits
will be increased up to 400 grams.
7.4
Necessary act, procedure, and human resources will be arranged to discourage the usage
of processed and readymade food (junk food) that damage the body, alcohol and
beverages, and to monitor the quality of food distributed and sold from hotels and
restaurants.
7.5
Coordinate with respective stakeholders will be done to eliminate chemical substances

and poisons used in food and meat items which have adverse effect on human health.
7.6
Appropriate life style will be promoted to control food related diseases and overweight.
7.7
Arrangement will be made to bring within legal domain to control food adulteration that
has adverse effect on health.
8. Following strategies (related to policy 8) will be adopted to ensure availability of quality health
services through competent and accountable mechanism and system for coordination,
monitoring and regulation.
8.1
Receipt of quality health services will be ensured provided by government and private
sectors by arranging legal institution for regulating all health services.
8.2
Current legal arrangement will be amended to regulate drugs used in modern, ayurveda,
and alternative method of treatment used in human and animals to make it more
effective. Arrangement of drug inspectors in right numbers will be placed in every district
by restructuring department of drug administration.
8.3
National directives and protocols will be prepared for ensuring receipt of quality health
services. Arrangement will be made to implement protocols according to the local need
of hospitals for treating diseases.
8.4
Regular monitoring and regulation will be done to ensure delivery of high quality health
service to citizens with criteria to keep the quality of human resources providing services,
technologies used, medicines, equipments including supplies.
8.5
Laboratory/blood transfusion centers along with services provided by such

laboratory/centers will be regulated for standardization according to criteria.
Arrangement of legal provision will be made for laboratories to function only after the
accreditation.
8.6
Provision of punishment and penalty will be done on regular basis by monitoring and
evaluating health services provided by government and non-government sector in any
geographical region of the country.
8.7
Necessary organizational structure will be arranged to listen grievances and complaints

of patients or health service user for providing legal remedy. Consultation will be
provisioned for using technology to the availability in the process of treatment.
8.8
Necessary strategy will be adopted to make investment of private sector to the benefit of
public by legal arrangement and to increase investment in appropriate place.
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8.9
Legal arrangement will be made under the Infectious disease act 2020 to compulsorily
inform the designated entity in specified time for the diseases likely to become
pandemic. Infectious disease act, 2020 will be amended.
8.10
Arrangement will be made for mentioning generic name of medicine by doctor to be

understandable clearly by all.
9. Following strategies (related to policy 9) will be adopted to ensure professional and quality
service standard by making health related professional councils capable, professional, and
accountable.
9.1
Work of various established councils will be made effective, transparent and accountable
to ensure the quality of varieties of education related to health and health services
provided.
9.2
Current act and rules will be implemented through amendment to bring uniformity on
the services provided by health institutions and councils.
9.3
Health institutions and councils will be strengthened more through legal and physical
means.
9.4
Collaboration will be promoted with professional association /organizations established

in private and non government sector to deliver health services and doing study and
research.
10. Following strategies (related to policy 10) will be adopted to mainstreaming health in every
policy of state by reinforcing collaboration with health-related various stakeholders.

10.1
Current multilateral cooperation will be made stronger by accepting health as a main

agenda of development. Issues of health will be included in all associated acts.
10.2
Action plans will be implemented in coordination with multi sector as various aspects
such as safe drinking water, hygiene, energy, food security, climate, environment,
education, accommodation, road including physical development impact the receipt of
health services.
10.3
Sustaining the progress made in millennium development goal set for 2015 by Nepal,
goal set thereafter will be addressed effectively.
10.4
Coordination with all the stakeholder entities will be done for making multi sectoral
action plan by utilizing national network and mechanism and opportunities for
addressing negative effect on health due to climate change for overall management.
10.5
Proper arrangement will be done for effective coordination and collaboration with
stakeholders entities for managing diseases communicated through animals and insects.

11. Following strategies (related to policy 11) will be adopted to ensure the right of citizens to live
in healthy environment through effective control of environmental pollution for protection
and promotion of health.
11.1 Collaboration for leadership will be taken for regulation by developing mechanism for
controlling adverse effect of environmental pollution and climate change for health
safeguarding and promotion.
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Effective arrangement will be done for managing waste generated from the entities
providing health services in scientific manner. Current legal system for managing waste
will be implemented strictly.
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Act will be implemented to manage radioactive materials used in health sector according
to national and international standards.
12. Following strategies (related to policy 12) will be a dopted to maintain good governance in the
health sector through necessary policy, structure and management for delivery of quality
health services.
12.1 Changes will be made to acts and rules according to need after reviewing them to make
health services in operation more effective and trustworthy. Integrated public health
service act will be implemented by integrating health related acts and rules according to
need by timely revising them.
12.2

12.3
System of result oriented utilization and management will be adopted for effectively
mobilizing foreign aid in health sector by integrating all partner entities.
All physical infrastructure constructed will be made friendly to disable people, children,
and will be made earthquake resistant. Infrastructures that are being used currently but
at risks will be strengthened using available technology to make earthquake resistant. To
provide service to all physical infrastructures additional necessary infrastructure like
store etc will be added and systematized.
12.4
Health institutions are constructed according to the prevailing building standard on the
basis of physical location and population.
12.5
Modern information technology will be used at maximum for health management.
12.6
Multi-sectoral action plan will prepared and implemented to address emergency health
issues instantly arising from natural disaster and other causes.
12.7
Individuals having social prestige and respect, and individuals regarding health service as
charity, professionals, and local community will be involved in forming development
committees of various hospitals and operations and management committees of health
institutions. Community involvement is encouraged in management of health service,
easy access and continuation.
12.8
Act will be implemented for management and regulation of hospital management

committee including other committees.
12.9
Good governance action plan will be prepared and implemented for ensuring qualitative
service by incorporating government, private, community and cooperative in health
service delivery. Local cooperatives having many consumers will be participated in
management of local level health institutions by developing criteria for delivering health
service.

12.10 Health good-governance action plan will be prepared and implemented for making
health service delivery transparent, responsive and publicly accountable.
12.11 Action of withdrawing tissues or blood related substance, or transplanting or action of
human organ transplanting will be systematized by law.
12.12 Action of organ donation will be eased by defining brain dead in scientific and
professional manner, in relation to selecting appropriate organ recipient with the goal of
providing organs for transplanting will be systematized by law.
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12.13 Arrangement will be made to have only one official professional trade union in relation
to current situation of many trade unions present in one health institution.
12.14 Infertility is systematized by the law of surrogacy.

13. Following strategies (related to policy 13) will be adopted to promote public and private
sectors partnership for systematic and quality development of health sector.
13.1 Public and private partnership will be developed complimenting each other to promote
further the concept of public and private partnership.

13.2
Arrangement of legal system will be made to encourage and manage the concept of
cooperative needed for health sector.
13.3
Grant will be providing to health institutions in nongovernmental sector by making clear

criteria.
14. Following strategies (related to policy 14) will be adopted to increase the investment in the
health sector by state to ensure quality and accessible health services and to provide financial
security to citizens for medical cost and as well as effectively utilize and manage financial
resources obtained from private and non government sector.
14.1 Arrangement will be done for allocating budget on the basis of population by
determining per capita investment in health sector by acknowledging spending made in
health is not expenditure but an investment. Per capita investment will be increased
gradually.

14.2
As current personal expenditure of individual is 55 percent of gross expenditure made in

health, such percentage will be reduced gradually.
14.3
Amount appropriated for health sector will be distributed equitably by making criteria.
14.4
Nationwide insurance plan will be rolled out by making law and directives for ensuring
delivery of affordable health service by making financial management sustainable.
Arrangement will be made to provide discount for Incapable and financially poor.
14.5
Vaccine fund set up with the aim of preventing fund scarcity will be systematized through
law to conduct immunization program without interruption.
14.6
Action will be encouraged to find or help others to find new ways to manage finance of
health sector. Other funds of health sector will be made systematic and effective.
14.7
Arrangement will be made to use local level program and fund for health service and
infrastructures.
14.8
Production and sales and distribution of substance with tobacco and other substance
harmful to health will be discouraged with high taxes. Sources of fund obtained this way
are spent in health service.
15. Miscellaneous
15.1 Current sectoral policy and newly made such policies will be helpful and complementary
to implement provisions contained in this national policy.
15.2
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Partnership and collaboration will be done with private, commercial groups,

cooperatives, communities and development partner organizations and not for profit
service providers with the aim of providing quality, sufficient, relevant, timely service of
appropriate kind.
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8. Structural arrangements
For effective implementation of this policy, departments, divisions, branches, subdivision etc of
current organizational structure from center to rural level along with additional regulating bodies,
and employee positions according to these levels will be added or reduced according to need under
the ministry of health and population by taking care of state restructuring.

9. Financial resources
Government sources, foreign loans and assistance, and investments of private sector in this
sector in totality will be the sources of implementation of this national health policy.
10. Monitoring and evaluation

1.
Responsive and effective mechanism will be arranged to monitor and evaluate health
programs at every level regularly. For this, effective monitoring and evaluation system
will be developed by taking into account of the result based monitoring and evaluation
model formulated and practiced by national planning commission as well as monitoring
and evaluation system implemented by the ministry of local development.
2.
Health management information system will be amended timely and will be upgraded to
complete computerized system.
11. Risks
1.
In the absence of overall resource mobilization strategy in health sector, chances of

difficulty in resource mobilization will be present.
2.
Health policy may need to be readjusted by segregating programs to be included in the

domain of center and federation after the country is transformed into the federal
structure.
12. Revocation
National health policy 2048 has been revoked.
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ExecutiveSummary
A.INTRODUCTION
TheAnnualReportoftheDepartmentofHealthServices(DoHS)forfiscalyear2071/72(2014/2015)
is the 21st consecutive report of its kind. The report focuses on the objectives, targets, strategies
adopted by the programs and analyses the achievements of the major activities and attempts to
highlight trends in the service coverage over the preceding three fiscal years. This report also
identifies issues, problems, constraints and suggests actions to be taken by the related health
institutions for further improvements. The executive summary highlights the key issues and
observationsemergingfromtheanalysisofeachprogram.Detailprograminformationisavailablein
specificreportsfollowingthissummary.
The information and statistics used in this report are based on the data collected by the Health
Management Information System (HMIS) under the Department of Health Services (DoHS) from
health institutions including Public/Private Hospitals, Primary Health Care Centres (PHCC), Health
Posts(HP),PrimaryHealthCare/outreachClinics(PHC/ORC),ExpandedProgrammeofImmunisation
(EPI) clinics, Female Community Health Volunteers (FCHV) NGO/INGOs and Private Health
Institutionsinfiscalyear2071/72acrossthecountrythroughtheHMISsystem.
B.CHILDHEALTH
IMMUNIZATION
Nationalimmunizationprogramisthepriority1(P1)program.Sincetheinceptionofimmunization
programtothedateithasbeenanestablishedandsuccessfullypublichealthintervention.Nepalis
one of the countries recognized for the wellfunctioning immunization system. The accessibility of
immunization has reached to the 97% population and serves equally, successfully to the poor and
rich, also does not discriminate child's sex. New antigen PCV and MRS has introduced during this
fiscalyear.Nepalhasdeclared6fullyimmunizeddistrictsanddirectedtoachievefullyimmunized
countryby2017.ThecontributionofimmunizationinachievingtheMDG4goalisimmense.Nepal
has achieved polio free status in 27th March 2014, sustained maternal and neonatal tetanus
eliminationsince2005,andJapaneseencephalitisisincontrolstatusandconductingmeaslescase
basedsurveillancetomeetthetargetofeliminationby2019.
ThenationalcoverageofBCGisthehighestofallantigensindicatesthatalmost94%motherhave
accessinimmunizationservices,whileDPTHepBHibandOPV3coveragearemorethan90%.The
measles/rubella vaccine coverage is 85% and Td2 and Td2+ coverage is 52%. The JE coverage (32
districts)is53%.
NUTRITION
The national nutrition programme is priority programme of Government of Nepal to achieve
nutritional wellbeing of all people to maintain a healthy life to contribute in the socioeconomic
development of the country, through improved nutrition programme implementation in
collaborationwithrelevantsectors.Commitmentathighlevelfornutritioninthecountryhasshown
anincreasedinteresttoimprovethenutritionalstatusofwomenandchildrenfocusingonfirst1,000
days.
Infiscalyear2071/72,averagenumberofgrowthmonitoringvisitsof0to24monthschildrenis2.5
whichislowercomparedtolastfiscalyear2070/71.Theproportionofunderweightchildrenaged0
24 months is 3.3 which is increased by 1.5 percent compared to fiscal year 2070/71. Reporting of
exclusivebreastfeedingupto6monthsamong0to12monthsisonly28.5percent.Similarly,only
27.5 percent of children aged 68 months were received solid foods. In 11 IMAM districts have
admitted 4,680 severely acute malnourished children at out patients therapeutic program and
discharged5,483children.Amongthem,74percentchildrenhaverecoveredanddefaulterrateis15
percentanddeathrateis1percent.Infiscalyear2071/70,2188childrenwereprovidednutritional
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ExecutiveSummary
care through 16 Nutrition Rehabilitation Homes and got recovered 2126 children. Coverage of
Vitamin A supplementation to 659 months age children is 85 percent which is 14 percent higher
compared to fiscal year 2070/71. The coverage of 1st time iron and Folic Acid distribution for
pregnantwomenis84percent.
COMMUNITY BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (CBIMCI) AND

NEWBORNCARE(CBNCP)
CBIMNCIis an integrated package of childsurvival interventions and addresses mainly three age
groupse.g.newbornofage028daysand2959daysinfantfortheproblemslikebirthasphyxia,
bacterialinfection,jaundice,hypothermia,lowbirthweight,counselingofbreastfeedingetc.Among
theagegroupof2monthsto59monthschildren,itaddressesmajorchildhoodkillerdiseaseslike
Pneumonia,Diarrhoea,Malaria,MeaslesandMalnutritioninaholisticway.
In FY 2071/72, a total of 32,109 (028 days) infants were treated at health facilities and PHC/ORC
clinics. Out of the total 5,171 cases were treated for the infection (PSBI). In FY 2070/71 FCHV
checked20,565cases,outofwhich11,041sickbabiesreferredtohealthfacilitiesaftergivingcotrim.
Similarly,atotalof47,179casesof2959daysinfantsweretreatedathealthfacilitiesandPHC/ORC
clinics.Outofthetotal3,915casesweretreatedforinfection(PSBI).FCHVschecked50,284cases,
outofwhich27,685sickbabiesreferredtohealthfacilitiesaftergivingcotrim.
In FY 2071/72, a total of 1,413,111 diarrhoeal cases were reported. The reported number of new
diarrhoealcaseshasslightlydecreasedinFY2071/72comparedtoFY2069/70andFY2070/71.At
thenationallevel,percentageofseveredehydrationhasdecreasedto0.2inFY2071/72compared
to FY 2069/70 and FY 2070/71. Similarly, the national incidence of diarrhoea per 1,000 underfive
years'childrenhasconsiderablydecreasedto501/1,000under5yearchildreninFY2071/72from
528/1,000in2069/70and629/1,000in2070/71.
Regarding to ARI Cases, in FY 2071/72, a total of 2,208,221 ARI cases has been reported. At the
national level, reported ARI cases per 1,000 underfive population has decreased to 783 in FY
2071/72comparedtoFY2069/70and2070/71.Percentageofseverepneumoniaremainedconstant
inFY2071/72atNationallevel(0.4%)comparedtoFY2069/70andFY2070/71.
C.FAMILYHEALTH
FAMILYPLANNING
Inordertoprovidethereproductivepopulationwithoptionstolimitorspacebirths,variousmodern
contraceptivemethodsaremadeavailableunderthenationalhealthservicesdeliverysystem.Family
planning services are provided through different health institutions at various levels through static
clinics as well as mobile outreach services. The Contraceptive Prevalence Rate (CPR) is one of the
main indicators for monitoring and evaluating the National Family Planning Program. The
contraceptiveprevalencerate(CPR)formodernfamilyplanningmethodis43%atnationallevelin
fiscalyear2071/72.ThereiswidevariationinCPRattheregionallevelinthereportingyear.
SAFEMOTHERHOOD
In the fiscal year 2071/72 national level ANC first visit as percentage of expected pregnancy has
increased to 96 percent. Similarly Institutional delivery at nationallevel has been increased to 57
percentinFY2071/72ascompareto50%oftheFY2070/71level.However,percentageofmothers
who received first postnatal care at the health facility among expected live births has been
decreased to 48 percent in the reporting year.. In fiscal year 2071/72, among 78,611 total service
usersin2071/72,50%receivedmedicalabortion(MA).About15.3%ofthesafeabortionclientsin
FY2071/72wereadolescents(aged<20)andmorethanahalf(59.6%)ofthesafeabortionclients
received postabortion family planning service. Share of long term family planning among post

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ExecutiveSummary
abortionfamilyplanninguserswas19.2%.Outofallabortionserviceusers,10%ofmedicalabortion
serviceusersand13%ofsurgicalabortionserviceusersreceivedLARCmethods.
FEMALECOMMUNITYHEALTHVOLUNTEERS
The major role of the Female Community Health Volunteers (FCHVs) is promotion of safe
motherhood,childhealth,familyplanning,andothercommunitybasedhealthservicestopromote
health and healthy behavior of mothers and community people with support from health workers
andhealthfacilities.Atpresentthereare51,470FCHVs(47,328FCHVsatrural/VDCleveland4,142
aturban/municipalitylevel)activelyworkingalloverthecountry.FCHVscontributedsignificantlyin
the distribution of oral contraceptive Pills, Condoms and Oral Rehydration Solution (ORS) packets
andcounselingandreferringtomothersinthehealthfacilitiesfortheserviceutilization.
FCHVshavecontributedindistributionof866,881cycleoralpillsand1,411,438ORSpacketsatthe
national level. Furthermore, FCHVs distributed a total of 10,512,449 packets of condoms in the FY
2071/72.ServicestatisticsalsoshowsthatmorethanonehalfofthediarrhoeaandARIcaseswere
treatedbyFCHVs.
PRIMARYHEALTHCAREOUTREACHCLINICS
Based on the local needs PHC/ORCs are conducted every month at fixed locations of the VDC on
specific dates and time. The clinics are conducted within half an hour's walking distance for the
populationresidinginthatarea.Primaryhealthcareoutreachclinics(PHC/ORC)extendbasichealth
careservicestothecommunitylevel.
About 50,000 PHC/ORCs were expected to be conducted every year. However, only 47,397 (95
percent) clinics were conducted in the reporting year. On an average, 20 clients were served per
clinic during the fiscal year 2071/72 which has been decreased by 2 percent compared to the
previousfiscalyear2070/71.
ADOLESCENTSEXUALANDREPRODUCTIVEHEALTH
National ASRH program is being gradually scaled up and met the NHSP II target of making 1,000
public health facilities adolescentfriendly by 2015. However, all public health facilities have been
providingregularservicestoallincludingadolescentsbeforeequippingthemtobecomeAFS.
DEMOGRAPHYANDREPRODUCTIVEHEALTHRESEARCH
Planning, monitoringand evaluationofreproductivehealth (RH) activitiesare the keyfunctionsof
Program, Budget and Demography Section. This section conducts periodic and ad hoc studies and
alsocoordinatesreproductivehealthrelatedresearchandstudiescarriedoutbyotherorganisations
in Nepal. Major activities such as (a) Annual program and Budget (b) Target population setting,
monitoring and research/study (c) Guideline/ documents development and (d) other major Family
Health related studies were conducted in the fiscal year 2071/72. Implementation of Maternal and
PerinatalDeathSurveillanceandResponse(MPDSR)in5districts(Okhaldhunga,Dhading,Kaski,Banke
&Kailali),Birthdefectsurveillanceinselectedreferralhospitalsandongoingsupportforhospitalbased
MaternalandPerinatalDeathReview(MPDR)weremajorinitiativesdonethroughthesectionduring
FY2071/72.
D.DISEASECONTROL
MALARIA
Nepal has surpassed the Millennium Development Goal #6 by reducing malaria morbidity and
mortality ratesby more than 50% in 2010 as compared to 2000. Therefore, Government of Nepal
hassetavisionofMalariafreeNepalin2025.
Confirmed cases dropped from 2092 in FY 2069/70 to 1,352 in 2071/72. The proportion of P.
falciparum infections has sharply increased and reached 20.26% in reporting year. There is a
decreasingtrendofconfirmedcase,caseseveritywithsustainingzerodeathduetoscalingupaccess
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toRDTandACTtopublichealthfacilities,highcoverageofLLINsinendemicdistrictsandincreased
socioeconomic status of community people. There is rapid decreasing trend of indigenous PF,
whereas slow decreasing trend of indigenous Plasmodium vivax cases indicates that P vivaxmay
remainachallengeformalariaeliminationinNepal.
KALAAZAR
Kalaazarisamajorpublichealthproblemin12districtsinEasternandCentralTarai.ThetrendofKA
caseshasbeendecreasingsignificantlyforthelastseveralyears.Inthefiscalyear2071/72,atotalof
220caseswerereported,ofwhichallarenativecases.Among220nativecases,148casesreported
from 12 programme districts and remaining 72 were reported from other nonprogram
districts.IncidenceofKalaazaratnationalaswellasdistrictlevelislessthan1/10,000population.At
districtlevelincidenceper10,000inareasatriskpopulationsrangedfrom0.47inMorangto0.01in
Barareflectingtheincidenceof0.25per10,000in12programmedistricts(excludingforeigncases).
LYMPHATICFILARIASIS
LymphaticFilariasis(LF)isapublichealthprobleminNepal.Allendemicdistrictswillcompletethe
recommended six rounds of MDA by 2018. The LF elimination programme has also indirectly
contributedtostrengtheningofhealthsystemthroughtrainingsandcapacitybuildingactivities.AS
done in 21 districts has revealed that the prevalence of LF infection has significantly reduced and
contributedinpreventingdisabilitiesandsufferingsduetoLF.Overtheperiodoflast12years,more
than 90 million populations at risk have been treated with MDA medicines. In this fiscal year,
15,981,384 people living in 41 districts were targeted for MDA, of which 11,117,624 (69.6%) were
treated.
DENGUE
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
early as 2005. In the fiscal year 2071/72 total number of dengue case reported from 12 districts
were 302. Among them, 119 cases were reported from Chitwan and 114 cases from Parsa district
where outbreak was recorded. Remaining 69 cases were reported from Jhapa, Rupandehi,
Kathmandu,Nawalparasi,Kailali,Kanchanpur,Makawanpur,Doti,DadeldhuraandBhaktapur.
ZOONOSES
Nepal has dual burden of disease and zoonotic diseases of epidemic, endemic and pandemic
potentialsaremajorpublichealthconcerns.Globallymorethan300Zoonoticdiseasesareidentified
amongwhichabout60havebeenidentifiedinNepalasemergingandreemergingdiseases.Thesix
zoonoses like Taeniosis/cysticercosis /Neurocysticercosis, Leptospirosis, Hydatidosis, Brucellosis;
ToxoplasmosisandAvianInfluenzahasbeenidentifiedasPrioritiesZoonoticDiseasesinNepalwhich
epidemic potentials. Annually about 15,000 to 18,000 cases of snake bites occur in Nepal. Though
only10%ofbitesarevenomous.
DISASTERMANAGEMENT
This collaborative programme between MoH/DoHS/EDCD and WHOEHA has been committed to
enhancing health sector emergency preparedness, disaster response and epidemiology and
outbreak management capabilities in close coordination & collaboration with key players in the
country. To fulfill of its objectives such activities (a) Expediting the process of health sector
contingency planning (b) Providing training to the health workers in emergency preparedness and
disaster response and (c) Strengthening the mechanism for multisectoral coordination and
collaborationinrelationtohealthsectordisastermanagementhasbeencarriedoutinthefiscalyear
2071/72.
SURVEILLANCEANDRESEARCH
Diseasesurveillanceand researchisanintegralpartofEpidemiologyandDiseaseControlDivision.
This section came into existence in August 12, 2013 (Shrawan 28, 2070 BS). The mission of the

xix
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ExecutiveSummary
communicable diseases Surveillance program is to protect and improve the health of Nepalese
citizens by tracking and responding to the occurrence of disease in the population across the
country.Surveillanceofreportablediseasesisresponsibleforcollecting,analyzing,interpreting,and
reporting information for infectious diseases. Maintains a high level of data accuracy and quality,
monitors disease trends for early detection and prompt response in case of any outbreak. It also
assists in the development of public health policies, programme planning and implementation
relatedtocommunicablediseases.
TUBERCULOSIS
Tuberculosis(TB)isstillamajorpublichealthprobleminNepal.In2014/15,totalof34,121casesof
TB were registered. Among them, 54.1% were pulmonary bacteriological confirmed (PBC). Most
caseswerereportedamongthemiddleagedgroupwiththehighestamong1524yearofage(20%).
ThechildhoodTB(newandrelapse)was7%.TheCaseNotificationRate(CNR)allformswas123per
100,000population.Whereasinecoterrain,CNRswerehighestinTeraizonesfollowedbyhillthen
mountainzoneswithratesof139,112and69per100,000populationsrespectively.
The overall treatment success rates (all forms) nationally of drug susceptible TB was 91.5%. The
treatmentsuccessratesofPulmonaryBacteriologicalConfirmed(PBC)were90%comparedto72%
inretreatmentcases(losttofollowup+failure),93.6%innewPulmonaryClinicallyDiagnosed(PCD)
and 93.01% Extra Pulmonary cases. Failure rate in new PBC was 1.3% compared to 2.06% in
retreatmentcases,0.23%innewPCDcasesand0.28%inEPcases.TBprograminNepalwasableto
save32,973livesthisyearnationally,butstill978deathswerereportedamonggeneralTBcases
LEPROSY
During the reporting year 2071/72, a total number of 3053 new leprosy cases were detected and
were put under multi drug therapy (Multi Drug Therapy). 2461 cases were under treatment and
receiving MDT at the end of the fiscal year. This year reported the registered prevalence rate of
0.89/10,000 populations at national level which is well below the cutoff point of <1 /10,000
populationthestandardsetbyWHO.135(4.42%)newleprosycasesofGrade2Disability(G2D),236
newleprosychildcases,1100newleprosyfemalecaseswererecordedduringthereportingyear.
Leprosy Post Exposure Prophylaxis (LPEP) which aims to test the feasibility and effectiveness of a
single dose rifampicin (SDR). SDR is given to contacts of newly diagnosed leprosy patients to
decreasetheirriskofdevelopingleprosy.LPEPprogrammehadbeenimplementedinMorang,Jhapa
and Parsa districts and planned to be extended in Dhanusa, Kapilvastu and other districts in the
yearstocome.
HIV/AIDSANDSTI
Makingup5%ofthetotalestimatedpopulationof39,249,thereareabout1,968childrenagedupto
14yearsarelivingwithHIVinNepalin2014,whiletheadultsaged15yearsandaboveaccountfor
95%.Thereare8,413infectionsestimatedamongpopulationaged50yearsandabove(21.4%).By
sex,malesaccountfortwothirds(64.8%)oftheinfectionsandtheremainingmorethanonethird
(35.2%)ofinfectionsareinfemales,outofwhicharound82%areinthereproductiveagegroupof
1549years.Themaletofemalesexratiooftotalinfectioncamedownfrom2.15of2006to0.54for
theyear2014.
E.SUPPORTINGPROGRAMMES
HEALTHTRAINING
TheNationalHealthTrainingCentre(NHTC)operationalisesitstrainingactivitiesinlinewithNational
Training Strategy. Inservice training is delivered through a network of National Health Training
Programmes which provide technical as well as managerial training at all levels. There are five
regionaltrainingcentre,onesubregional,75districttrainingunits.Inaddition,therearetwentyone
SBA,twoASBA,fifteenFamilyplanning,sevensafeabortion,elevenmidlevelpracticum,fourUSG,
xx
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ExecutiveSummary
twoOTTM,sixanaesthesiaassistant,twopaediatrictrainingsitesunderNHTC.Atrainingworking
group(TWG)comprisingvarioussupportingpartnerswasformedunderleadershipofNHTCwiththe
purpose of ensuring the efficient running of national health training programs, maintaining the
qualityofthetrainingandimprovingthecoordinationofalltrainingprovidedunderNHTC.NHTCis
theapexbodyforthedevelopmentofhumanresourcesforthehealthsector.
HEALTHEDUCATION,INFORMATIONANDCOMMUNICATION
TheNationalHealthEducation,InformationandCommunicationCenter(NHEICC)wasestablishedin
1993withthemainresponsibilityofplanning,implementation,monitoringandevaluationofhealth
promotion,educationandcommunicationprogramforallhealthservicesandprogramswithinthe
Ministry of Health (MoH). It is also responsible for demand creation on health care services and
playedsignificancerolesasabackboneforallhealthprogramsundertheMoH.
The physical and financial achievement was 68.9 percentages and 57.7 percentages during the FY
2070/71 and 85.5 percentages and 78.7 percentages achievement was in 2071/72 respectively.
Similarly,thephysicalandfinancialachievementonHealthTaxfundsTobaccocontrolactivitieswas
81.4percentagesand71.6percentagesinFY2070/71and96.1percentagesand74.7percentagesin
FY2071/72respectively.
LOGISTICSMANAGEMENT
The main role of Logistics Management Division is to support in delivering quality health care
servicesprovidingbyprogramdivisionsandcentersthroughlogisticssupplyofessentialequipments,
vaccines, family planning commodities and free health drugs to all regional /district stores and
health facilities. The major function of LMD is to forecast, quantify, procure, store and distribute
health commodities, equipments, instruments and repairing & maintaining of the biomedical
equipments/instruments and transportation vehicles. The quarterly LMIS and monthly Webbased
LMIS have facilitated evidence based logistics decision making and initiatives in annual logistics
planning, quarterly national pipeline review meetings, the consensus forecasting of health
commoditiesandtheimplementationofthepullsystem.LMDimplementedWebbasedLMISupto
the HFs level in three districts: Jumla, Arghakhanchi and Bardiya to make real time inventory
management system gives realtime information of stock status of health commodities at service
deliverysite.
LMD carried out Regional Logistics Review Meeting in all regions of the country to address the
problemsandissuesfacedbythedistrictsinsupplychainmanagementofhealthcommoditiesinthe
region and district. LMD has initiated supply chain intervention by empowering private partners
throughPPPmodeltohandleoverallsupplychainmanagementbelowdistrictlevelintwodistricts:
Kapilvastu and Udayapur. To avoid delay and constraints in procurement and supply chain,
procurement reform committee is working on procurement reform and restructuring of Logistics
ManagementDivisionincludingdistrictstore.
HEALTHLABORATORYSERVICES
National Public Health Laboratory (NPHL) has been designated as nodal institute for Policy,
guidelines and over all frameworks for capacity building &development in laboratory sector.
Attention will be given to strengthen laboratory procedure and communication between national,
regional and district levels and strengthening the systems ensuring the availability of essential
equipmentandlogistics.Italsogivescommitmenttonewrecruitmentofstaffaswellastrainingof
existingstaff.
Atpresenttherearecentralhospitalbasedlaboratories8,Regionalhospitalbasedlaboratory3,sub
regional hospital based laboratory3, Zonal hospital based laboratories10, District hospital based
laboratories62, and District level Hospital Based16 and PHCCbased level laboratories204. In the
private sector there are above 1,500 laboratories. All these laboratories require significant

xxi
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ExecutiveSummary
strengthening with respect to quality assurance, human resource recruitment, competency,
developmentofservicerangeandphysicalinfrastructure.
PERSONNELADMINISTRATIVEMANAGEMENT
The Personnel Administration Section is responsible for managing Nepals health workforce to
deliverqualityhealthservices.Thissectionmanagestheposting,transfer,upgradesanddisciplinary
actiontohealthworkers.MinistryofHealth(MoH)hasatotal30,703employeesofthem24,403are
technicalpersonneland6,300areadministrativestaff.DepartmentofHealthServices(DoHS)hasa
total23,886workforceincludingallfivedevelopmentregion'shealthfacilitiesandofthem196post
(technicalandadministrative)foralldivisionsandsectionsundertheDoHS.
FINANCIALMANAGEMENT
An effective financial support system is imperative for efficient management of health services.
Preparationoftheannualbudget,timelydisbursementoffunds,accounting,reporting,andauditing
arethemainfinancialmanagementfunctionsthatarenecessarytosupporttheimplementationof
healthprograms.TheFinanceSectionoftheDoHSisthefocalpointforfinancialmanagementforall
programsundertheDoHS.
Out of total National Budget of Rs. 618,100,000,000 a sum of Rs. 33,517,102,000 (5.42%) was
allocatedforthehealthsectorduringthefiscalyear2071/72.Ofthetotalhealthsectorbudget,Rs.
23,472,963,597 (70.03 %) was allocated for the execution of programs under the Department of
HealthServicesNetwork.
PRIMARYHEALTHCAREREVITALIZATION
The Primary Health Care Revitalization Division (PHCRD) aims to revitalize primary health care in
Nepal by addressing emerging health challenges. More than two third of the population of Nepal
usedpublichealthservicesin2071/72.AmongSeventyEightPercentofregisteredmorbiditycases
Ninetytwopercentofthepopulationusedfreeoutpatient(OPD)healthcareservices.
Key achievements in 2071/72 are free health care services in all districts, Increment of Budget of
DrugandNumberofEssentialFreeDruglistinto70,socialauditofhealthinstitutionin45districts
(752HFs),regularreportingofurbanhealthcenterinHMIS,supportfor100CommunityHealthUnit
(CHU)and128UrbanHealthCentre.
MANAGEMENT
More activities are assigned as directed by NHSP, Policies and Plans that include: information
management, planning, coordination, supervision, monitoring and evaluation of the health
programs. This division is also responsible for monitoring the delivery of quality health services
through all types of health institutions. Furthermore, it monitors the building construction and
maintenance of public health institutions and provides supports for maintenance of medical
equipment, Mental Health, Oral Health, Health Care Waste Management (HCWM), Health Facility
Upgrading/renewals, Nursing program and treatment facilities to impoverished Nepalese Citizens
from the listed diseases such as Kidney (Dialysis, Transplant & Post Renal Treatment) Cancer, Heart,
Head/Spinalinjuries,Alzaimers/ParkinsonsandSickleCellAnaemiafromlistedhospitals.
As in the previous year Health Management Information System (HMIS) Section continued to
providefeedbackofinformationontheactivitiesundertakenbythedistrictstoallDivisions/Centers
of the DoHS, Regional Directorates, and the 75 District Health/Public Health Offices. Annual
PerformanceReviewworkshopswereconductedinallDistricts,RegionsandNationallevel.Several
trainings were conducted in programme management to improve the skills of heath workers. The
annualtargetedactivitiesoffiscalyear2071/72underthisdivisionwerealmostachieved.
xxii

xxii
HealthServiceCoverageFactSheet
FiscalYear2069/702071/72(2012/20132014/2015)
PROGRAMINDICATORS
REPORTINGSTATUS
%ofPublicHospitalreportingtoHMIS
%ofPrimaryHealthCareCenterreportingtoHMIS
%ofhealthpostreportingtoHMIS
%ofPHCORCclinicsreportingtoHMIS
%ofEPIclinicsreportingtoHMIS
%ofFemaleCommunityHealthVolunteers(FCHVs)reportingtoHMIS
%ofPrivatehealthfacilitiesreportingtoHMIS
IMMUNIZATION
%ofchildrenunderoneyearimmunizedwithBCG
%ofchildrenunderoneyearimmunizedwithDPTHepBHib3
%ofchildrenunderoneyearimmunizedwithOPV3
%ofoneyearoldchildrenimmunizedagainstMeasles/Rubella(90)*
%ofchildren1223monthsimmunizedJapaneseEncephalitis
%ofchildrenunderoneyearfullyimmunizedasperNIPschedule
%ofplannedimmunizationclinicsconducted
NUTRITION
%ofchildrenaged012monthsregisteredforgrowthmonitoring
Averagenumberofvisitsamongchildrenaged024monthsregistered
forgrowthmonitoring
%ofchildrenaged06monthsregisteredfor growthmonitoring,
exclusivelybreastfedforthefirstsixmonths
%ofchildrenaged68monthsregisteredforgrowthmonitoring
receivedsolid,semisolidorsoftfoods
%ofchildrenaged623months,whoreceived1stdoseofBaalVita
(MNP)in15programdistricts
ACUTERESPIRATORYINFECTION(ARI)
Incidenceofacuterespiratoryinfection(ARI)per1,000childrenunder
fiveyears(newvisits)
Incidenceofpneumoniaamongchildrenunderfiveyears(per1,000)
%ofchildrenunderfiveyearswithARIsufferingpneumonia
%ofchildrenunderfiveyearswithpneumoniacounseledforhomecare
management(facilitylevel)
management(outreachlevel)
management(communitylevel)
DIARRHEA
Incidenceofdiarrheaper1,000underfiveyearschildren(newcases)
%ofchildrenunderfiveyearswithdiarrheasufferingfromdehydration
(facility,outreach&communitylevel)
%ofchildrenunderfiveyearswithdiarrheasufferingfromdysentery
(bloodinstool)
%ofchildrenunder5withdiarrheatreatedwithZincandORS(40)*
%ofchildrenunderfiveyearswithdiarrhoeatreatedwithIVfluid
SAFEMOTHERHOOD
xxiii
2069/70
(2012/13)
2070/71
(2013/14)
2071/72
(2014/15)
83
95
98
87
94
88
71
99
93
93
88
47
92
99
99
81
92
87
68
94
91
90
85
53
73
92
81
100
100
85
91
89
70
99
92
92
88
43
2.5
29
28
79
918
951
765
188
25
35
56
578
629
502
21
12
97
98
93
0.64
97
xxiii
2069/70
(2012/13)
89
55
2070/71
(2013/14)
86
59
2071/72
(2014/15)
52
96
52
75
72
52
%ofpostpartummotherswhoreceivedVitaminAsupplements
%ofinstitutionaldeliveries(40)*
57
45
53
50
49
52
%ofdeliveriesconductedbyaskilledbirthattendant(60)*
45
50
51
45
3.6
3.3
8.0
2.1
2.2
26.2
50,007
51
45
3.7
3.1
7.6
2.5
2.4
25.7
51,470
53
48
20
43
3.5
3.0
6.9
2.6
2.8
23.8
51,470
54
62
64
64
57
58
57
0.67
0.11
49,550
0.27
78
90
90
11.9
0.82
22,994
88
3.2
0.94
0.12
26,526
0.34
83
90
90
11.8
0.83
25,222
79
3.3
0.75
0.10
20,861
0.25
83/123
91.5
89
11.0
0.89
26,702
73
3.0
PROGRAMINDICATORS
%ofpregnantwomenwhoreceivedTd2&2+
%ofpregnantwomenattendingfirstANCvisit
%ofpregnantwomenattendingfourANCvisits(80)*
%ofpregnantwomenreceivingIFAtabletsorsyrupduringtheirlast
pregnancy(90)*
%ofpostpartumwomenreceivedPNCcheckupwithin24hours
%ofwomenwhohadthreePNCcheckupsasperprotocol
FAMILYPLANNING
Contraceptiveprevalencerate(CPR)(unadjusted)(67)*
CPRMethodMixCondom
CPRMethodMixPills
CPRMethodMixDepo
CPRMethodMixIUCD
CPRMethodMixImplant
CPRMethodMixSterilization
FEMALECOMMUNITYHEALTHVOLUNTEERS(FCHV)
TotalnumberofFCHVs(53,514)*
%ofpillsdistributedbyFCHVsamongtotaldistribution
%ofdiarrhealcasestreatedwithORSandZincbyFCHVsamongdiarrhea
casesinchildrenunderfiveyears
%ofARIcasesmanagedbyFCHVsamongARIcasesinchildrenunder
fiveyears
MALARIA/KALAAZAR
Annualbloodslideexaminationrate(ABER)per100
Annualparasiteincidence(API)per1,000populationatrisk*
Clinicalmalariacases
IncidenceofKalaazarper10,000populationatrisk
TUBERCULOSIS
TBcasefindingrate(85)*/CaseNotificationRate
Treatmentsuccessrate(90)*
Sputumconversionrate
LEPROSY
Newcasedetectionrate(NCDR)per100,000population
Prevalencerate(PR)per10,000*
HIV/AIDSANDSTI
CumulativeHIVreportedcases
CURATIVESERVICES
%ofpopulationutilizingoutpatient(OPD)services*
Averagelengthofstay
Source:HMIS,FHD,EDCD,NTC,NCASC,LCS/DoHS,
Note:*TheseindicatorsarefromNHSP2,ResultsFramework;andthefiguresinparenthesisindicatetargetfor2015.
%ofchildrenunderfiveyearswithdiarrheasufferingfromdehydration(facility,outreachandcommunity)
DoHS,AnnualReport2069/70(2012/2013
xxiv
xxiv
Chapter1
Introduction
INTRODUCTION
1.1BACKGROUND
This is the Annual Report of Department of Health Services (DoHS) for the fiscal year 2071/72
(2014/2015),anditisthe21stconsecutivereportofitskind.Thisreportanalysestheperformance
andachievementsofDepartmentofHealthServicesinthefiscalyear2071/72.Thisdocumentnot
onlyfocusesontheperformanceofthefiscalyear2071/72butcoversthefollowingareas,whichwill
bethebasisfortheanalysisforactionstobetakentoimproveperformanceforthenextyear.
Programmespecificpolicystatements,includinggoals,objectives,strategiesmajoractivitiesand
achievement,
Programmespecificindicatorsforthemonitoring&evaluationofprogrammeperformanceona
regularbasis,and
Problems/Issues/constraints and recommendation for actions to be taken in order to improve
performanceandtagetforthenextfiscalyear.
Furthermore, this report also provides information on contributions from other departments,
partners and stakeholders, contemporary issues in the health sector as well as progress status of
majorprogramsimplementedthroughDoHS,RHDs,D/PHOsandhealthinstitutionsunderDoHS.
PreparationofthisreportfollowedtheRegionalAnnualPerformanceReviewWorkshopsconducted
in all five development regions which culminated in the National Annual Performance Review
Workshop.ThesereviewWorkshopswereattendedbytheRegionalDirectorates,Divisions/Centers
and Section of DoHS, Central hospitals, and representatives from External Development Partners
(EDPs)andNGOs/INGOsateachlevel.
Duringtheworkshop,policystatementsofeachprogramwerereviewedinthelightofthepresent
contextandanalysedtoanextent.ThedatageneratedfromtheHMISOnlinesustemintheformof
rawnumbers,werecarefullyandcriticallyanalysedutilisingtheselectedindicatorsalongwithdata
availablefromothersources.Thesedatawereinterpretedduringthepresentationsanddiscussions.
TheNationalAnnualPerformanceReviewWorkshopachievedthefollowingobjectives:
Reviewthestatusofachievementagainstthetargetwithrespecttobudgetreleasedand
expenditure.
Analysedtheservicecoverage,continuityandquality.
AssesstheimplementationstatusofrecommendationsmadeduringpreviousNationalAnnual
PerformanceReviewMeeting(2070/71).
Identifiedproblems,constraintsandmanagementissuesinimplementingthehealthprograms
Recommendspecificstrategiesandactionplantoaddressthehealthissues.
Generatespecificstrategiesforlowcoverageregionanddistrictstoboostupcoverage.
InteractionbetweenRHDs/DepartmentofHealthServices/Hospitals/MainistryofHealthand
Partners.
DoHS,
Annual Report 2071/72 (2014/2015)
1
1
Introduction
TheoutcomeofthisworkshopcanbeseenintheprogramspecificchaptersofthisAnnualReport.
DetaileddistrictspecificrawandanalyseddatabyprogrammeareavailableinAnnex.
Ministry of Health has been delivering promotional, preventive, diagnostic, curative, and palliative
healthcareservicesandotherhealthsystemrelatedfunctionssuchaspolicyandplanning,human
resource development and mobilisation, financing and financial management, and monitoring and
evaluation.IthassixDivisions:(1)AdministrationDivision,(2)CurativeServicesDivision,(3)Policy,
Planning and International Cooperation Division, (4) Public Health Administration and Monitoring
and Evaluation Division, (5) Population Division, and (6) Human Resources and Financial
ManagementDivision.
There are five Centres with a degree of autonomy in personnel and financial management (1)
NationalTuberculosisCentre(NTC),(2)NationalHealthTrainingCentre(NHTC),(3)NationalPublic
Health Laboratory (NPHL), (4) National Centre for AIDS and STD Control (NCASC) and (5) National
Health Education, Information and Communication Centre (NHEICC). The NHTC coordinates all
training programs of the respective Divisions and implements training by sharing common inputs
and reducing the travelling time of care providers. Similarly, all IEC/BCCrelated activities are
coordinatedbyNHIECC.ThesecentressupportthedeliveryofEHCSandworkinclosecoordination
with the respective Divisions. In addition to these, there are five professional councils to provide
accreditation to healthrelated schools/training centres and to regulate care providers such as: (i)
Nepal Medical Council (ii) Nepal Health Research Council (iii) Health Professional Council (iv)
AyurvedaCouncil,and(v)NursingCouncil.
TherearethreeDepartmentsundertheMoH:DepartmentofHealthServices(DoHS),Departmentof
Ayurveda (DoA) and Department of Drug Administration (DDA). The DoHS and other departments
areresponsibleforformulatingprogramsasperpolicyandplans,implementation,useoffinancial
resources and accountability, and monitoring and evaluation. DDA is the regulatory authority for
assuring the quality and regulating the import, export, production, sale and distribution of drugs.
DepartmentofAyurvedaofferAyurvediccaretothepeopleandalsoimplementhealthpromotional
activities.
1.2
DEPARTMENTOFHEALTHSERVICES(DoHS)
DepartmentofHealthServices(DoHS)isresponsiblefordeliveringpreventive,promotive,diagnostic
andcurativehealthservicesthroughoutNepal.DirectorGeneral(DG)istheorganisationalheadof
theDoHS.ThecurrentorganizationalstructureoftheDoHSincludessixDivisions:(1)Management
Division with infrastructure, budget & planning, monitoring and supervision (M&E) quality of care,
management information system, information technology (IT), nursing services, oral and mental
health, PAM activities, and free medication & treatment for very severe disease to impoverished
Nepalisecitizens.(2)ChildHealthDivisioncoveringEPI,NutritionandCBIMCIandNewborncare.(3)
FamilyHealthDivisionwiththeresponsibilityofreproductivehealthcare,includingsafemotherhood
andneonatalhealth,familyplanningandFemaleCommunityHealthVolunteers(FCHVs).(4)Logistics
Management Division covers procurement, supplies and management of logistics, equipment and
services required by DoHS and below level (5) Epidemiology and Disease Control Division with the
responsibility of controlling epidemics, pandemic and endemic diseases as well as treatment of
animal bites. (6) Primary Health Care Revitalization Division with the responsibility of carrying out
activitiesforprimaryhealthcareasshowninFigure1.1.
2
2
DoHS,
Annual Report 2071/72 (2014/2015)
Introduction
MajorfunctionsofDoHSinclude:
ProvideGoNwithnecessarytechnicaladviceinformulatinghealthrelatedpolicies,developand
expandhealthinstitutionsestablishedinlinewiththesepolicies;
Determine requirement of human resource for health institutions and develop such human
resourcebypreparingshortandlongtermplans;
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;
Manage free medication & treatment for very severe disease: Cancer, Heart, Alzaimers,
Parkinsons,Headinjuries,Spinalinjuries,Renalfailure(KidneyDisease)andSicklecellAniemia
toimpoverishedNepalisecitizens.
Manage information systems regarding health facilities, health services, logistics, training and
financetosupportplanning,monitoring,andevaluationofhealthprograms,
Systematicallymaintaindata,statementsandinformationregardinghealthservices,updateand
publishthemasrequired;
FinancialmanagementofDoHS,RHDs,D/PHOsandsettlementofirregularities.
At the regional level there are five Regional Health Directorates (RHDs) providing technical
backstoppingaswellasprogrammonitoringtothedistricts.TheRHDsaredirectlyundertheMoH.
Thereareregional,subregionalandzonalhospitals,whichhavebeengivendecentralisedauthority
through the formation of Hospital Development Boards. In addition, there are training centres,
laboratories,TBcentres(insomeregions)andmedicalstoresattheregionallevel.
At the district level, the structure varies between districts managed by the District Health Office
(DHO) and District Public Health Office (DPHO). The DPHOs and DHOs are responsible for
implementing essential health care services (EHCS) and monitor activities and outputs of District
Hospitals,PrimaryHealth CareCentres(PHCCs)andHealthPosts(HPs). Thepublicservice delivery
outlets in the country include HPs, PHCC/HC, district/other hospitals, zonal hospitals, subregional
hospitals,regionalhospitals,andcentrallevelhospitals.
A Health Post is the first institutional contact point for basic health services and it's monitor the
activitiesofFCHVsaswellascommunitybasedactivitiesbyPHCoutreachclinicsandEPIclinics.In
addition,HPalsofunctionsasthereferralcentreofFCHVsaswellasavenueforcommunitybased
activitiessuchasPHC/ORCandEPIclinics.EachlevelabovetheHPisareferralpointinanetwork
fromtoPrimaryHealthCareCentre(PHCC),ontodistrict,zonalsubregionalandregionalhospitals,
and finally to tertiary level hospitals. This referral hierarchy has been designed to ensure that the
majorityofpopulationreceivepublichealthandminortreatmentinplacesaccessibletothemandat
apricetheycanafford.Inversely,thesystemworksasasupportingmechanismforlowerlevelsby
providing logistical, financial, monitory supervisory and technical support from the centre to the
periphery.
DoHS,
Annual Report 2071/72 (2014/2015)
3
3
Introduction
Fig.1.1:OrganogramofDepartmentofHealthServices(DoHS)
MINISTRYOFHEALTH
DEPARTMENTOFHEALTHSERVICES
NHEICC
NCSAC
NPHL
CENTRE
NHTC
NTC
PHCRD
EDCD
LMD
FHD
CHD
MD
DIVISION
REGIONALTBCENTRE1
REGIONALMEDICALSTORE5
REGIONALTRAININGCENTRE5
SUBREGIONALHOSPITAL3
REGIONALHOSPITAL3
REGIONALHEALTHDIRECTORATE5
CENTRALHOSPITALS6
ZONALHOSPITAL10
DISTRICTPUBLICHEALTH
OFFICE20
DISTRICT/OTHERS
HOSPITAL75
DISTRICTHEALTH
OFFICE55
PRIMARYHEALTHCARECENTRE/HEALTH
CENTRE202
HEALTHPOST3,805
FCHV
51,470
PHC/ORCCLINIC
12,908
EPIOUTREACHCLINIC
16,355
Source:HMIS,DoHS
4
4
DoHS,
Annual Report 2071/72 (2014/2015)
Introduction
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. The MIS within the health sector include the Health Management Information System
(HMIS); Logistics Management Information System (LMIS); Financial Management Information
System(FMIS);HealthInfrastructureInformationSystem(HIIS);PlanningandManagementofAssets
in Health Care System (PLAMAHS); Human Resource Information System (HuRIS); Training
Information Management System (TIMS); Ayurveda Reporting System (ARS); and Drug Information
Network(DIN).
1.4
STRUCTUREOFTHEREPORT
This report has nine chapters. Chapter one briefly presented the background to the practice of
annualreportpreparation,organogramoftheDoHS,andsourcesofinformationinhealthsectorin
Nepal.ChaptertwotosixcoverthedifferentprogramswithintheDoHS;Chaptersevenpresentsthe
Monitoring and Evaluation (M&E) program of health sector, Chapter eight presents programs of
other departments (Drug Administration (DDA), Ayurveda DoA) and Homeopathic within the
MinistryofHealth;andChapterninepresentsabriefsummaryofdevelopmentpartnerscontributing
tohealthsectorinNepal.
Annexone presents the target vs. achievement of the major activities carried out in the last fiscal
year 2071/72 by different programs; Annex two shows the program targets for next fiscal year
2072/73; and Annex three provides the raw and analyzed data by health indicators of different
programmsdisaggregateddatabyecological,developmentregionsanddistricts.
DoHS,
Annual Report 2071/72 (2014/2015)
5
5
Child Health Programme

2.1 Immunization........................................................... 9
2.2Nutrition................................................................ 26
2.3CBIMCIandNewbornCare.................................. 50
Measlesvaccination&coverage
No.ofinfantsimmunized
Source:HMIS
FiscalYear207172(2014/2015)
Coverage
Chapter 2
ChildHealth:Immunization
CHILDHEALTH
2.1NationalImmunizationProgramme
1BACKGROUND
National Immunization Programme (NIP) is the priority 1 (P1) program of Nepal. National
ImmunizationProgramthenknownasExpandedProgramonImmunizationlaunchedin2034BS,
has been a successful public health intervention. It has met several milestones during the past
decades.Morethan97%populationhastheaccessofimmunizationservicedeliveryoutlet.National
immunization program provides equitable services to the geographically, economically hard to
reach,marginalizedcommunity.Currently;thereare11antigensinnationalimmunizationschedule
(IPV& PCV added in RI). The comprehensive multiyear plan (cMYPoA for 201116) with costing for
activities for each year is in place. NIP contribution in reduction of under 5 mortality related with
MDG4goalisimmense.
Nepalispoliofreesince2010.Nepalwasawardedaspoliofreecountryon27thMarch 2014.The
countryhasbeenabletosustainmaternalandneonataltetanuseliminationstatussince2005.The
burden of Japanese encephalitis and measles/ rubella disease has been successfully reduced.
Measleseliminationandcontrolofrubella/congenitalrubellasyndromeby2019hasreceivedhigh
level commitment. Several rounds of measles supplementary immunization activities have been
completedandmeaslescasebasedsurveillancehasbeeninitiatedtomeetthetargetofelimination.
ChildHealthDivision,identifies,implementandmonitorstheannualactivitiestargetedtoeradicate,
eliminate and control of vaccine preventable diseases. The division also ensures the adequacy of
vaccine and cold chain. Logistic management division involves in supply chain management and
NHEICC supports in advocacy and IEC material production for immunization. The Regional Health
Directorate (RHD) monitors immunization the districts level activities and reports to CHD. District
Public Health offices which are the implementers of immunization through the health facilities,
locatedineachVDCandmunicipalities,inclosecoordinationoflocalgovernmentandcivicsociety.
Immunization services are delivered through static immunization clinics in the health facilities,
outreachsessions(establishedatdifferentlocationsofVDC,allocatedinconsensusoflocalleaders,
stakeholders and health facilities staffs) are the main outlets of immunization service delivery.
Mobileclinicsdesignedespeciallyforgeographicallyremotedistrictswhereregularservicescantbe
deliveredduetorainandsnowprovideimmunizationservicesinappropriatemonths.Thesessions
sitesareidentifiedforthebetteraccessofpopulationandareusually35inaVDCbutmaybemore
in municipalities. Almost 16,000 immunization sessions are held in each month and1, 92,000
sessions per annum nationwide. In addition immunization services are delivered through different
PrivatehealthfacilitiesorHospitals,NGO/INGOclinicsandmedicalcolleges.
At the end of immunization sessions, the health facilities generate data on usage rate of vaccine
(total vaccine doses given to the target population) expressed as coverage. Once the eligible
population enrolled for vaccination are encouraged, counselled to complete the scheduled doses
andthosedropsthedosesaretrackedforthecompletionofmissingdose.Vaccinewastagerateis
for each antigen. Multi dose vial policy is in practice in almost all fixed sessions and few outreach
sessions to reduce the vaccine wastage. HMIS section of Management Division in DoHS collects
DoHS,
Annual Report 2071/72 (2014/2015)
69
Child Health: Immunization

reportsmonthly,analysesagainsttheindicatorssetforandsendstoimmunizationsectionofCHD
forreviewandfeedbacktothedistricts.ChildHealthDivisionalsoreceivesVPDsurveillancedata
through HMIS and WHO/IPD. WHO/IPD through its extensive reporting networks in all districts
collectsdataonAcuteFlaccidParalysis,Measleslikeillnesses,MaternalandNeonatalTetanusand
AcuteEncephalitisSyndrome.FieldofficesofWHO/IPDlocatedin11placescollectsinformationon
weeklybasisandverifytheinformationphysicallyonregularbasis.
2.GUIDINGDOCUMENTSOFNATIONALIMMUNIZATIONPROGRAM
2.1NepalHealthSectorSupportProgramII(NHSPIPII):
NHSP2 focuses on increasing access and utilisation of essential health care services, especially to
reducedisparitiesbetweenthewealthierandthepoor,vulnerableandmarginalisedpopulations.It
hasgivenhighpriorityforimmunizationprogramme.
2.2ComprehensiveMultiYearsPlanofAction(20112016)
Thecomprehensivemultiyearplan(cMYPoA)isafiveyearsplan(201116)ofnationalimmunization
programme has clearly mentions the immunization goal, objectives, strategies and activities. The
reflectedactivitiesaretimeframedbyitscost.ReviewofcMYPoAactivitiesisdoneannuallytoalign
the government annual priority. The cMYPoA has been aligned with various policy documents on
nationalimmunizationprograms,theMillenniumDevelopmentGoals(MDGs),GlobalImmunization
VisionandStrategy(GIVS)andWorldHealthAssembly(WHAs)resolutionsandlastlyvaccineaction
plan.
TheGoal,ObjectivesandmilestonesofcMYPoA(20112016)areasfollows:
2.2.1 GOAL: To reduce child mortality, morbidity and disability associated with vaccine
preventablediseases.
2.2.2 Objectivesandstrategies
Objective1:Achieveandmaintainatleast90%vaccinationcoverageforallantigensatnationaland
districtlevelby2016
Keystrategies:
IncreaseaccessandutilizationtovaccinationbyimplementingREDstrategiesineverydistrict
Enhancehumanresourcescapacityforimmunizationmanagement
Strengthenimmunizationmonitoringsystematalllevels
Strengthencommunication,socialmobilization,andadvocacyactivities
Strengthenimmunizationservicesinthemunicipalities
Objective2:Ensureaccesstovaccinesofassuredqualityandwithappropriatewastemanagement
Keystrategies:
10
7
Strengthenthevaccinemanagementsystematalllevels
DoHS,
Annual Report 2071/72 (2014/2015)
Objective3:Achieveandmaintainpoliofreestatus
Keystrategies:
AchieveandmaintainhighimmunitylevelsagainstPoliobystrengtheningroutineimmunization
andconductinghighqualitynationalpolioimmunizationcampaigns.
Respondadequatelyandtimelytooutbreakofpoliomyelitiswithappropriatevaccine
AchieveandmaintaincertificationstandardAFPsurveillance
Objective4:Maintainmaternalandneonataltetanuseliminationstatus
Keystrategies:
Achieveandmaintainatleast>80%TT2+coverageforpregnantwomenineverydistricts
ConductTdfollowupcampaignsinhighriskdistricts
Expandschoolbasedimmunizationprogram
ContinuesurveillanceofNT
Objective5:Initiatemeasleselimination
Keystrategies:
Achieveandsustainhighpopulationimmunitytoreducemeaslesincidencetoeliminationlevel
Investigateallsuspectedmeasleslikeoutbreakswithprogramresponse
UseplatformofmeasleseliminationforRubella/CRScontrol
Continuecasebasedmeaslessurveillance
Objective6:Acceleratecontrolofvaccinepreventablediseasesthroughintroductionofnewand
underusedvaccines
Keystrategies:
Introductionofnewandunderusedvaccines(rubella,pneumococcal,typhoid,rota)basedon
diseaseburdenandfinancialsustainability
Objective7:StrengthenandexpandVPDsurveillance
Keystrategies:
ExpandVPDsurveillancetoincludevaccinepreventablediseasesofpublichealthconcern.
Strengthenandexpandlaboratorysupportforsurveillance.
Objective8:Continuetoexpandimmunizationbeyondinfancy
Keystrategies:
Considerforboosterdoseofcurrentlyusedantigenbasedonevidenceandprotectionofadult
frompotentialVPDs.
DoHS,
Annual Report 2071/72 (2014/2015)
11
8

Table1:MilestonesofNIP20112016areasfollows
Objectives
1. Achieve and maintain
at least 90% vaccination
coverage for all antigens
atnational&districtlevel
by2016
2011/12
Achieve
and
sustain
90%
DPT3 coverage
in 35 districts
andallantigens
in20districts
2. Ensure access to
vaccine of assured quality
and with appropriate
wastedisposal
3. Achieve and maintain
poliofreestatus
4. Maintain maternal and
neonatal
tetanus
eliminationstatus
At least 20
district
with
AEFI monthly
zeroreporting
Zero cases of
WPV
Conduct
Td
campaign in 10
high
risk
districts
5. Initiate measles 1..Achieve and
eliminationstatusby2016 sustain at least
95% MCV1
coverage in 35
districts
6. Expand VPD Continue

surveillance
with penumo
and
possibilityofintegration
rota
sentinel
sites,
initiate
typhoid
&
cholera sentinel
surveillance
7. Accelerate control of
vaccinepreventable
diseases
through
introduction of new and
underusedvaccines
8. Continue to expand
immunization
beyond
infancy
Expand school
based
Td
vaccination in 2
additional
districts
with
school health
program,
Expand
Td
vaccination to
grade 1 & 8
students
2012/13
Achieve and
sustain 90%
DPT3coverage
in 50 districts
and
all
antigens in 30
districts
At least 60
districts with
AEFI monthly
zeroreporting
Zero cases of
WPV
Conduct
Td
campaign in
10 high risk
districts
1..Achieve and
sustainatleast
95% MCV1
coverage in 50
districts
2013/14
Achieve and
sustain 90%
DPT3 coverage
in 60 districts
and
all
antigens in 50
districts
All 75 districts
with
AEFI
monthly zero
reporting
Zero cases of
WPV
Conduct
Td
campaignin10
high
risk
districts
1..Achieve and
sustain at least
95%
MCV1
coverage in 60
districts
2014/15
Achieve and
sustain 90%
DPT3coverage
in 75 districts
and
all
antigens in 65
districts
2015/16
Sustain 90% DPT3
coverage in 75
districts
and
achieve
90%
coverage for all
antigens in 75
districts
Eradicationofpoliomyelitis
Conduct
Td
campaign in 10
high
risk
districts
1..Achieve and
sustain at least
95%
MCV1
coverage in 70
districts
1.Achieve and
sustain
95%
MCV1 coverage
in75districts
2. Achieve and maintain elimination standard

surveillanceperformanceindicator
3.Achievev a measles incidence of less than one
confirmedcasepermillionpopulationperyear
Continue
Continuepenumo, Continue
Continue penumo,
penumo,
typhoid, cholera, penumo,
typhoid, cholera
typhoid,
rota
&
CRS typhoid,
rota
&
CRS
cholera and sentinel
cholera,
sentinel
rota sentinel surveillance
rota & CRS surveillance
sites, initiate
sentinel
CRS
surveillanc
surveillance,
e
conduct
HepBsero
survey
Introduce
Introduce
Introduce
Rota
rubellavaccine pneumococcal
vaccineintoRI
intoRI
vaccineintoRI,
Consider
HepB
birthdose
Expand school Expand
school Expand
Expand
school
based
Td based
Td school
based
Td
vaccination in vaccination in 2 based Td vaccination in 4
2 additional additionaldistricts vaccination districts
districts,
in
3
additional
districts
3.TARGETPOPULATION
3.1 Under1yearchildrenforBCG,DPTHepBHib,OPV,IPV,PCVandMeasles/Rubellavaccine.
3.2 TwelvemonthschildrenforJEand15monthschildrenforMRSD
3.3PregnantwomenforTetanusToxoidcontaining(Td)vaccine.
12
9
DoHS,
Annual Report 2071/72 (2014/2015)
4.NATIONALIMMUNIZATIONSCHEDULE.
TABLE2:NationalImmunizationSchedule
SN
Numberof
TypeofVaccine
Doses
1
BCG
1
2
OPV
3
3
DPTHepBHib
3
4
IPV
1
5
PCV
3
6
MeaslesRubella
2
7
Td
2
8
JE
1
RecommendedAge
Atbirthoronfirstcontactwithhealthinstitution
6,10,and14weeksofage
6,10,and14weeksofage
14weekofage
6,10weeksand9monthofage
MR1at9monthsand2at15monthsofage
Pregnantwomen(2dosesofTd)
12monthsofage
5.ANALYSISOFACHIEVEMENTSBYMAJORACTIVITIES
5.1 MajoractivitiescarriedoutinFY2071/72
5.1.1
Procurementofcoldchainequipment
5.1.2
Trainingtonewhealthworkers(GoN200,Private/NGO100)
5.1.3
Establishmentoftrainingcentresandcapacitydevelopmentonimmunizationandvaccine
safety36healthworkersastrainers.
5.1.4
TrainingtoRHDfocalpoint/DHO/DPHO/EPIO/CCOonnewvaccinesfor75districts
5.1.5
Resource mobilization in immunization in 12 districts through appreciative Inquiry

approach for the VDC secretaries, Local Development Officers and health facility in
charges.
5.1.6
DataQualitySelfAssessmentin15districts
5.1.7
Immunizationexpenditureanalysisin7districts
5.1.8
OrientationontheprocessofachievingFullImmunizationDeclarationVDC/municipality
andDistrictstoLDO/DHOandEPISupervisorsin20districts
5.1.9
Production, printing of guideline and IEC materials on pneumococcal conjugate

vaccine(PCV)
5.1.10 AEFIcases'investigationandmanagement
5.1.11 ProcurementandsupplyofFreezetag(30dayslogger)in75district
5.1.12 EstablishmentofImmunizationtrustfund
5.1.13 SubnationalImmunizationpoliocampaignsin27highriskdistricts
5.1.14 PilotingofElectronicImmunizationRegistrationSystem(EIRS)in2districts
5.1.15 Advocacy/IEC/BBC/documentationandoperationalstudiesinimmunization
DoHS,
Annual Report 2071/72 (2014/2015)
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10
5.1.2 TARGETvs.ACHIEVEMENT,FY2071/72
5.1.2.1ImmunizationcoveragebyantigensdosesFY2071/72
ImmunizationcoverageofdifferentantigensduringtheFY2071/72isanalysedasgivenbelow.
TABLE3:ImmunizationcoveragebyantigensdosesFY2071/72
SN Antigens
Targetpopulation
Targets
Achievement %Achieved
1
BCG
under1year
608,802
571,420
93.86
2
DPTHepBHib1
under1year
608,802
570,453
93.70
3
DPTHepBHib2
under1year
608,802
555,333
91.22
4
DPTHepBHib3
under1year
608,802
552,289
90.71
5
Polio1
under1year
608,802
569,585
93.55
6
Polio2
under1year
608,802
555,866
91.30
7
Polio3
under1year
608,802
550,434
90.41
8
IPV
under1year
608,802
359,604
59.07
9
PCV1*
under1year
87,660
95,352
108.77
10 PCV2*
under1year
87,660
65,469
74.69
11 PCV3*
under1year
87,660
32,891
37.52
12 Measles/Rubella
under1year
608,802
5173,49
84.97
13 JE
12months
407,303
302,291
74.42
14 Td2&Td2+
Pregnantwomen
724,839
522,200
72.04
Source:HMIS/MDandEPI/CHD,DoHS
*PCVintroducedinphasedmanner
Theabovetable3showsthenationalcoverageofBCGishighestofallantigensindicatesthatalmost
94%haveaccessonimmunizationservices.Thecoverageof1st,2ndand3rddoseofDPTHepBHib
and OPV aremore than 90% while the coverage ofMeaslesRubella is 85%.Pneumonia Conjugate
Vaccine (PCV) & Inactivated Poliovirus Vaccine (IPV) has incorporated in national immunization
scheduledprogramsinceFY2071/72andintroducedinphasedmannerinJanuary2015(Magh2071
BS) only in WDR districts and IPV in September (Ashoj 2071 BS) in all districts at once. Thus, the
coverage of PCV has been analysed against the target population of 6 months of WDR and of 3
monthsforEDR.ThePCV1coverageishigherthan2ndand3rddose,reflectsthatallchildreneligible
to get vaccine at the age of 6 weeks, 10 weeks as well as 9 months were vaccinated during the
launch.TheJEcoverage(31districts)is74%.TheTd2+coverage(Td2andTd2+)coverageis72%.
Theimmunizationcoverageforlastthreeyearsofdifferentantigensatnationallevelispresentedin
figure1.Itshowsthat,coverageofBCG,DPTHepBHib3,OPV3,MR1andJEisindecreasingtrendby
23%exceptinBCGfor5%.CoverageofIPVwhichwasintroducedinSeptember2015attheageof
14 weeks (with 3rd dose of DPTHepBHib and OPV) does not match with DPTHebHib3 because it
wasnotusedfor12months(GovernmentfiscalyeardoesnotcorrespondtoEnglishcalendaryear).
Regarding the PCV which was introduced in January 2015 in phased manner the graph shown is
analysedagainsttotaltargetpopulationandthecoverageseenapparentlylow.
14
11
DoHS,
Annual Report 2071/72 (2014/2015)
5.1.2.2TRENDOFNATIONALIMMUNIZATIONCOVERAGE(FY2069/702071/72)
Figure1:Immunizationcoverageatnationallevel,FY2069/70to2071/72
100
99 99
94 93 92 91 93 92
90
88 88 85
80
71
76 74
59
60
40
2070/71
2071/72
Source: HMIS
JE
PCV 3
5
Measles -Rubella
2069/70
PCV1
IPV
OPV 3
DPT-HepB-Hib 3
BCG
11
PCV2
16
20
5.1.3EQUITYINIMMUNIZATIONCOVERAGE:
Themilestonestoachieve90%coverageforallantigensby2015in65districtsandDPTHepBHib3
in75%toaddressequityinimmunizationhaveyetnotmet.
Figure2:Districtwith>90%forallantigensandDPTHepBHib3
ThecoverageofDPTHepBHib3ismorethan90%in42districtsandforallantigensin18districts.
The decreased number of districts achieving 90% coverage for DPTHepBhib3 and all antigens is
linkedtodenominatorsofHMISi.e.theprojectedVSactualdenominatorsvariesdistricttodistricts
but the administrative and survey coverage (MICS 2014) are almost same. Full immunization
DoHS,
Annual Report 2071/72 (2014/2015)
15
12

declarationofVDCs/municipalityanddistrictsinitiatives(wherelinelistofchildrenof1223months
andlessthan1iscreated)willbeonlysolutionandwillalsogivetruepictureofequity.
Figure 3: Region wise DPTHepBHib3 coverage

has decreased in EDR and WDR by 16 and 5%
respectively. The coverage of DPTHepBHib3
coverage in CDR, MWDR and FWDR has
increased by 6, 14 and 3% respectively. The
dataqualityselfassessmentaswellascapacity
builtup in vaccine and cold chain safety
training which also includes recording and
reporting has helped in improved data quality.
Thus these administrative and coverage data
doesnotfluctuatesmuch.
5.1.4ACCESSANDUTILIZATIONOFIMMUNIZATIONSERVICE:
Table4:DistrictsCategorizedbasedonthe80%coverageofDPTHepBHib1(Access)anddropout
lessthan10%ofDPTHepBHib1VSDPTHepBHib3(Utilization)2071/72
Category1
(lessProblem)
Category2
(Problem)
LowDropOut(<10%)
HighDropout(10%)
HighCoverage(80%)
HighCoverage(80%)
Taplejung,Panchthar,Ilam,Jhapa,
Siraha,Sarlahi,
Morang,Sunsari,Djamlita,Terhathum, Rautahat
Sankhuwasabha,Bhojpur,Okhaldhunga,
Khotang,Udayapur,Saptari,Dhanusha,
Mahottari,Sindhuli,Kavre,Nuwakot,
Rasuwa,Dhading,Makwanpur,Bara,
ParsamChitwan,Gorkha,Lamjung,
Tanahu,Syangja,Kaski,Myagdi,Parbat,
Baglung,Gulmi,Palpa,Nawalparasi,
Rupandehi,Kapilbastu,Arghakhanchi,
Pyuthan,Rolpa,Rukum,Salyan,Dang,
Banke,Bardiya,Surkhet,Dailekh,
Jajarkot,Jumla,Kalikot,Mugu,Humla,
Bajura,Bajhang,Achham,Doti,Kailali,
Kanchanpur,Dadeldhura,Baitadi,
Darchula
(62Districts)
(3districts)
Category3
(Problem)
Category4
(Problem)
LowDropout(<10%) HighDropout(10%)
LowCoverage(<80%) LowCoverage(<80%)
Solukhumbu,
Ramechhap,Dolkah,
Sindhupalchowk,
Lalitpur,Bhaktapur,
Kathmandu,
Manang,Mustang,
Dolpa
(10districts)
(0districts)
Table4shows62districtsfallsinCatagory1,3districtsinCategory2,10districtsinCategory3and
thereisnodistrictsinCategory4in2071/72.
Theaccessandutilizationofimmunizationserviceswhichisanalysedintable4showsthatSiraha,
sarlahi,Rautahat(CAT2)hastheproblemofdropouti.e.ChildrenthosereceivingDPTHepBHib1,
more than 10% of them did not complete DPTHepBHib3 dose. In the same way, Solukhumbu,
Ramechhap, Dolakha, Sindhupalchowk, Lalitpur, Bhaktapur, Kathmandu, Manang, Mustang, Dolpa
(CAT 4) districts have the accessibility problem though they have good utilization of immunization
services.
16
DoHS,
Annual Report 2071/72 (2014/2015)
13
5.1.5NUMBEROFUNIMMUNIZEDCHILDRENINFISCALYEAR2071/72:
In FY 2071/72 the total unimmunized children against DPTHepBHib3 are 56,513.0 i.e. has
increasedcompareto52,060inFY2070/71.
5.1.6MEASLESRUBELLACOVERAGE:
The national measles Rubella1 coverage is 85

%forincurrentfiscalyear2071/72,whereasin
the last 2 fiscal years (Figure 4) the MCV1
coveragewas88%.Thehighestcoverage(91%)
inMWDRinFY2071/72andthelowest(78.%)
isinEDR.
5.1.7Td2andTd2+COVERAGE:
Figure 5 shows the coverage of Td2+ (Tetanus

Toxoid and low dose of diphtheria) containing
vaccine coverage in pregnant women has
increased in MWDR and FWDR by 12% and
10% but has decreased in EDR, CDR and WDR
by7%,11%and7%respectively.Thecoverage
ofTd2andTd2+islessthan80%foryearsand
hassignificantlyreducedinCDR.
5.1.8DROPOUTRATES:
Figure 6: The dropout rate for BCG VS MR is

close to 9% and has decreased from previous
years. Dropout rate of DPTHepBHib 1 VS 3 is
3.2% which indicates the better utilization of
immunizationservices.
Figure5:Trendof3yearsTd2&Td2+coverage
byRegions
100
83 86 79
75
77 75
87 90 83
69
64
58
70
65
59
69
50
25
0
EDR
CDR
2069/70
WDR
MWDR
FWDR
2070/71
2071/72
Figure6:Trendof3yearsdropoutrate
20
15
11.2
10
10.8
9.3
3.2
0
5
1.6
BCGvsMeaslesRubella
2069/70
DPTHpeBHib1vs3
2070/71
2071/72
5.1.9VACCINEWASTAGERATE:
Figure7:ThewastagerateofDPTHepBHiband
OPV are 22% and 23% respectively, and is
decreasing in trend compare to previous years
and is higher than accepted wastage rate
because there are remote areas where multi
dose vial policy cannot be practiced. The
wastage rate of BCG, MR and JE (non MDVP
vaccine) is high because the sessions size are
smallbutthepresentationofBCGandMRvialis
big.IncaseofhighwastagerateofJEvaccine,it
isdiscardedwithin1hourofdilution.
Figure7:Trendof3yearsvaccinewastagerate
100
80
79.580.377.3
64.964.363.6
60
39.435.541.1
40
24.5
19.522.8 22.2 22.8 23.3
20
0
BCG
DPTHpeB
Hib
OPV
2069/70
Measles/
Rubella
2070/71
JE
2071/72
DoHS,
Annual Report 2071/72 (2014/2015)
17
14
6.SUPPLEMENTARYIMMUNIZATIONACTIVITIES
6.1NATIONALIMMUNIZATIONDAYSFORPOLIOERADICATION:
Figure8:CoverageofNationalImmunizationcampaignforPolio1997to2014
Figure 8 shows, Polio (NID) campaign coverage from 1997/1998 to 2013/2014 in number and
percentage of children immunized in each round. The NID coverage in both round (each year)
remainedabout90%.
6.2.SUBNATIONALIMMUNIZATIONDAY(NID):
Thereare27PoliohighriskdistrictsandoutofthatSNIDwasheldin22earthquakeaffected
districtswithonlyOPVintheFY2071/72.
Program
Date
TargetPopulation
Achievements
%Coverage
DistrictsCovered
SNID
6Jun15
2,427,411
2,210,771
91.08
22Districts
6.3.FULLYIMMUNIZEDDISTRICTDECLARATION:
Full immunization VDC/Municipality and Districts declaration by 2017 is the new and
innovativeapproachtoaddressreachingeverychildrenaswellasequityissueswhichhad
beenindicatedinsurvey.In2015total 8districts,700VDCsand5municipalitiesweredeclared
fullyimmunized.
7.VACCINEPREVENTABLEDISEASESURVEILLANCE
7.1ACUTEFLACCIDPARALYSISSURVEILLANCE:
Acuteflaccidparalysissurveillancenetworkhasbeenexpandedthroughoutthecountryandincludes
all hospital (public, private, medical colleges), selected PHC, HP feasible for VPD surveillance,
totalling735zeroreportingsitesand79activesurveillancesites.
18
15
DoHS,
Annual Report 2071/72 (2014/2015)
Figure9:MapshowingreportedAcuteFlaccidParalysis(AFP)inFY2071/72
AFP cases have been reported from 71/75 districts in 2071/72. Total 431 AFP cases have been
reported during the period. Four sparsely populated districts have not reported AFP cases. (There
shouldbe50,000below15yrspopulationfor1AFP).
Figure10:MapshowingNonPolioAFPRatebydistricts
The non AFP rate is the most sensitive indicators of AFP surveillance (polio eradication initiatives)
andmapshowsthatmostofthedistrictshaveachievedcertificationlevelnonAFPrate.
DoHS,
Annual Report 2071/72 (2014/2015)
19
16

The non polio AFP rate at national level is 5.06 (standard 2 per 1, 00,000 below 15 yrs of age
population). Most of the district's non AFP rate is more than 2 except 4 districts where the
populationissparse.
Figure11:Adequatestoolcollectionrate
AdequatestoolcollectionrateisverycriticalcriteriaofAFPsurveillance.Themapaboveshowsthat
only 5 districts among the AFP reported districts have not met this criterion. Over the entire
adequatestoolcollectionrateis96%.
7.1.2SUSTAINEDTHEPOLIOFREESTATUS:
NepalispoliofreesinceAugust2010butofficiallySEAR(SouthEastAsianRegion)membercountries
weredeclaredpoliofreein2014(Aquarteroftheworldpopulationlivesinthe11countriesofthe
Region Bangladesh, Bhutan, Democratic Peoples Republic of Korea, India, Indonesia, Maldives,
Myanmar,Nepal,SriLanka,ThailandandTimorLeste.Withthiscertificationon27March2014,80%
of the worlds population now lives in poliofree certified Regions).All the activities and efforts are
continuedforitssustainabilityanddirectedtoeradication.
20
17
DoHS,
Annual Report 2071/72 (2014/2015)
7.2MEASLESLIKEILLNESSSURVEILLANCE:
Figure12:linediagramshowingConfirmedMeasles&RubellaCases,Nepal20032014
140
Lab confirmed Measles Cases

Lab confirm Rubella cases*
120
100
80
60
40
20
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
Jan
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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
2012
2013
2014
2015
YearandMonth
Figure 12 shows laboratory confirmed measles, rubella cases from 2003 to 2014. Successful
completion of catchup (2004/05), Follow up measles campaigns (2008) and catch up campaign of
measles rubella (2011/12) have remarkably reduced measles and rubella cases by 2013/14. The
incidencerateofmeaslesandrubellaremained0.26/1,000,000and0.06/100,000respectivelyinFY
2070/2071.
7.3.ACUTEENCEPHALITISSYNDROMESURVEILLANCE:
AESsurveillanceisdonethroughthesameAFPsurveillancenetworkandtheJEcaseshavereduced
dramatically in the JE endemic districts after the mass campaign which was initiated in 2006 and
completedin2011covering31districts.
Figure13:TrendofreportedAESandLabconfirmedJEcases
1200
No.ofCases
1000
800
AES
LabconfirmedJE
600
400
May
Jul
Sep
Nov
Jan
Mar
May
Jul
Sep
Nov
Jan
Mar
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200
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
MonthsandYear
Figure13showsthetrendofreportedAESandlaboratoryJEcasessince2004to2015.Abovefigure
showsthattheJEcaseshavereducedandhasbeendetectedmostlyinearlyJulyanddecreaseby
September.
DoHS,
Annual Report 2071/72 (2014/2015)
21
18

Figure14:mapshowingreportedAESandlaboratoryconfirmedJEcasesbydistrictsinFY
2071/2072
Figure14showsthat71districtshavereportedAEScasesandonly35districtshave159laboratory
JEcases.
7.4.NEONATALTETANUSSURVEILLANCE:
Figure15:Neonataltetanuscases
Figure 15 shows neonatal tetanus cases distribution by the districts. Total of 6 NT cases were
reportedfrom6districtsin2071/72.NepalhassustainedMNTeliminationstatusvalidatedin2005
(lessthan1caseper1000livebirths).
22
19
DoHS,
Annual Report 2071/72 (2014/2015)
8.ADVERSEEVENTSFOLLOWINGIMMUNIZATION
Surveillance of Adverse Events Following

Immunization (AEFI) is in place throughout
the country since 2004. In 2071/72 total 13
AEFI cases were reported from 14 districts
compareto22AEFIcasesfrom12districtsin
previousyear.3deathsoccurredduring2015.
All the cases were fully investigated and
causality association wasdone by the central
AEFIcommitteemembers.
Figure14:Trendof3yearsreported AEFI
casesanddeath
30
20
22
19
17
13
13
11
10
0
2012
2013
2014
Reportedcases
2015
Death
9.PROBLEMS/CONSTRAINTSANDACTIONSTOBETAKEN
Regionalperformancereviewmeetingin2070/71identifiedthefollowingproblemsandconstraints
andrecommendedactiontobetakenatdifferentlevelsofimmunizationdeliverysystem.
Problems/Constraints
Actiontobetaken
Inadequate HRH and ill Provision for alternative vaccinators for
definedJDofAHW&ANM
thevacantposts
Incorporate responsibility of delivering

immunizationserviceinJobDescriptionof
all HA, SAHW, AHW/ANM to conduct
immunizationsessions
Illdefinedprovisionoffield Provisionoffieldallowancewhoever
allowanceforVaccinators
performsimmunizationsessions
Poor quality immunization SupportivesupervisionofImmunizationas
data: Under and over perHMIS.
reporting
Strengthen supportive supervision at all
levels
Quarterlyreviewofperformanceofdataat
HF/DHOlevelasHMIS31,HMIS5.
Provision of DQSA to the RHDS and
districts
Poor Inventory keeping and Updateinventoryofcoldchainequipment
distributionsystem
withtheircoldchaincapacityandvaccine,
syringes, diluents etc. and use of stock
control register. Maintain maximum and
minimumstocklevel.Alwaysmakevaccine
requisitionbydeductingthestockathand
from maximum stock level of
vaccine/syringes/diluents
In effective immunization Utilize immunization month as an
monthcelebration
opportunity
to
intensify
routine
immunization activities especially all
DoHS,
Annual Report 2071/72 (2014/2015)
Responsibility
MoH/DoHS/DHO
MOF/MoH/DoHS/
CHD
HF/DHO/RHD/
CHD/HMIS
RMS/District
Store
Cold
Districts
23
20

Actiontobetaken
Responsibility
sessions be held, reallocate inappropriate
sessionsiteatappropriateplace.Guideline
of immunization is followed and plan of
activitiesandachievementsbereviewed.
Givemoreemphasistoreachthe
unreachedbasedonprioritization.
IncreasetheaccessinCat3and4
VDCs/municipalitiesandreducethe
dropoutrateinCat2VDCs
Reporttheimmunizationmonths
achievementseparatelytoseethe
additionallyofimmunizationperformance
ofimmunizationmonth
PoorColdChainandVaccine Effective implementation of EVM training LMD/CHD/NHTC/
management
DHO
atalllevel
Supervisors checks the proper vaccine
storage
Strengthenbundling
Inadequate CC Equipment Supplyofcoldchainspareparts
DoHS/LMD/CHD
and no repair, maintenance Replacementofageingequipment
andreplacement
regularrepairofcoldchainequipment
24
21
DoHS,
Annual Report 2071/72 (2014/2015)
ChildHealth:Nutrition
2.2
NUTRITION
2.2.1 Background
Nutrition interventions have been proved as one of the most cost effective investments for overall
socioeconomic development by enhancing human capital through improved productivity of the
population.Hence,nutritionalwellbeingofthepopulationiscrucialforacceleratedattainmentofmany
of the Sustainable Development Goals. In an alignment with several international and national
declarationsandNationalHealthPoliciesincludingInternationalConferenceonNutrition,Government
ofNepaliscommittedtoitscitizensforadequatefood,healthandnutritiontomaintaintheirnutritional
wellbeing. The Constitution has also ensured the right to food, health and nutrition to all citizens in
Nepal.Failingtoensureprotectionofthepopulationfromthehungerandundernutritionoftenresults
intheviciouscycleofmalnutritionandinfectionsleadingtopoorcognitiveandintellectualdevelopment
adversely affecting which, in turn, lead to less productivity leading to compromised socioeconomic
development. When combined with household food insecurity, frequent illness and infections,
inadequatedietaryintake,poorhygiene,careandpractices,thecycleofintergenerationalmalnutrition
comesintoexistenceandcontinues.
2.2.1.1CurrentDevelopmentsandFocusinNutrition
Nutrition has become a development agenda globally recognizing a need of multisectoral efforts to
enhance the nutritional wellbeing of the population. In the years 2000s, several global movements
advocated prioritization of nutrition for development through increased resources and building
partnership for nutrition. ScalingUpNutrition (SUN) is one of them calling for greater 'multisectoral'
action for improved nutrition during the first critical 1000 days of life. Nepal Government, being an
early member of SUN has demonstrated a high commitment in nutrition with an adaptation of Multi
Sector Nutrition Plan (MSNP) in 2012 based on the recommendations by multisectoral Nutrition
Assessment and Gap Analysis (NAGA). MSNP envisions leading the country on the path towards
significantly reduction of chronic nutrition that it will no longer remain an impending factor for
enhancing human capital and for overall socioeconomic development. Recently, in an alignment of
InternationalConferenceonNutrition2(ICN2),UNGeneralAssemblyhasdeclaredtheperiodof2016
2025 as the Decade of Action on Nutrition. Nepal as highly committed for nutrition will also need to
focusonprioritizedactionsfornutritiontoachievethegoalasenvisionedbyMSNP.
2.2.1.2SummaryofPolicyInitiatives
National Nutrition Policies and Strategies was formulated and approved in 2004 providing policy
guidancetoaddressallformsofmalnutritionamongthepopulationNepalincludingundernutritionand
over nutrition. This policy document provides the strategic and programmatic directions within the
health sector. The MSNP provides broader policy framework within and beyond health sector with a
Food and Nutrition Security Secretariat under National Planning Commission that coordinate with all
sectoral ministries for its implementation. National Health Policy 2071 has also made important
26
22
ChildHealth:Nutrirtion
directions towards nutritional wellbeing via utilization and promotion of quality and nutritious foods
generatedfromcommunityleveltofightagainst malnutrition.Tosupport thehealthsectorformulit
sectoralcoordinationprovidingtechnicalsupportinnutritionprogramdevelopment,NutritionTechnical
Committee has been establishment in Child Health Division in 2011 under Department of Health
Services.
Aligning with the MSNP and current global initiatives, Department of Health Services, Child Health
Division has developed different strategies and plan of actions for maternal infant and young child
nutritionwithtechnicalsupportofNutritionTechnicalCommittee(NuTEC).Moreover,asrecommended
by NAGA and guided by MSNP, Ministry of Health has conducted an Organization and Management
SurveyfortheestablishmentofNationalNutritionCenterforeffectiveimplementationofMSNPunder
healthsector.
2.2.2ProblemofMalnutritioninNepal
Theprevailinghighrateofchildundernutritioninthecountryisoneofthemajornutritionalproblems
despite a steady decline in past several years. Alike maternal malnutrition is also prevailing with 18.2
percentprevalenceofchronicenergy deficiencyandincreasing trendofoverweight.AlthoughNepal's
effort in micronutrient supplementation including National Vitamin A Program has been globally
recognizedasoneofthesuccessfulpublichealthinterventions,nutritionalanemiaisstillaseriouspublic
health issue among women and children. Anemia prevalence among the women of reproductive age
andpregnantwomenis35and48percentrespectivelywhichisstill.Itisevenhigheramongthechildren
aged659monthswith46percentwiththehighestamongthechildrenaged623monthsataround69
percent(NDHS,2011).
2.2.3EffortstoAddressUndernutritioninNepal
In an effort of addressing existing problems in nutrition, Ministry of Health has been implementing
several nutrition intervention programs since more than last two decades. Aligning with the global
developments and movements in nutrition, Ministry of Health has been adopting new initiatives in
nutrition programs including evidencebased interventions and strategies. Initiated with Growth
MonitoringProgramandBreastfeedingPromotionthroughhealthfacilitiesduringearlyyears,Ministry
has then adopted communitybased approach via micronutrient supplementation program in later
years. Foodbased approach with improved dietary behaviors among the nutritionally vulnerable
populationincludinghardtoreachgrouphasbeentherecentfocusofnationalnutritionprogramsalong
the already existing programs. With that view, Child Health Division, Nutrition Section has been
implementingprogrammes:
A. NationwideProgrammes:
GrowthMonitoringandcounseling
PreventionandcontrolofIronDeficiencyAnemia(IDA)
Prevention,ControlandTreatmentofVitaminAdeficiency(VAD)
PreventionofIodineDeficiencyDisorders(IDD)
ControlofParasiticInfestationbydeworming
Flourfortificationvialargerollermills
23
27
B.ScaleupProgrammes
Maternal,Infant,andYoungChildrenNutrition(MIYCN)Program
IntegratedManagementofAcuteMalnutrition(IMAM)
MicronutrientPowder(MNP)distributionlinkedwithIYCF
SchoolHealthandNutritionProgram
VitaminASupplementationtoaddressthelowcoveragein611months
MultisectoralNutritionPlan(MSNP)
2.2.4NationalNutritionProgramme
Goal
ThegoalofNationalNutritionProgrammeistoachievenutritionalwellbeingofallpeopletomaintaina
healthylifetocontributeinthesocioeconomicdevelopmentofthecountry,throughimproved
nutritionprogrammeimplementationincollaborationwithrelevantsectors.
GeneralObjective
ThegeneralobjectiveoftheNationalNutritionProgrammeistoenhancenutritionalwellbeing,reduce
childandmaternalmortalityandtocontributeforequitablehumandevelopment.
SpecificObjectives:
To reduce proteinenergy malnutrition in children under 5 years of age and women of

reproductiveage
Toimprovethematernalnutrition
Toreducetheprevalenceofanemiaamongadolescentgirls,womenandchildren
To virtually eliminate iodine deficiency disorders and vitamin A deficiency and sustain the
elimination
Toreducetheinfestationofintestinalwormsamongchildrenandpregnantwomen
Toreducetheprevalenceoflowbirthweight
To improve household food security to ensure that all people can have adequate access,
availabilityandutilizationoffoodneededforhealthylife
Topromotethepracticeofgooddietaryhabitstoimprovethenutritionalstatusofallpeople
To prevent and control infectious diseases to improve nutritional status and reduce child
mortality
To control the incidence of lifestyle related diseases (coronary artery disease, hypertension,
tobaccoandsmokerelateddiseases,cancer,diabetes,dyslipidemia,etc.)
Toimprovehealthandnutritionalstatusofschoolchildren
Toreducethecriticalriskofmalnutritionandlifeduringexceptionallydifficultcircumstances
Tostrengthenthesystemforanalyzing,monitoringandevaluatingthenutritionsituation
ToalignthehealthsectorprogrammesonnutritionwithMultiSectoralNutritionInitiative
28
24
2.2.5Targets
a.SustainableDevelopmentGoal
Goal 2. End hunger, achieve food security and improved nutrition and promote sustainable
agriculture
By2030,endhungerandensureaccessbyallpeople,inparticularthepoorandpeople
invulnerablesituations,includinginfants,tosafe,nutritiousandsufficientfoodallyear
round
By2030,endallformsofmalnutrition,includingachieving,by2025,theinternationally
agreedtargetsonstuntingandwastinginchildrenunder5yearsofage,andaddressthe
nutritionalneedsofadolescentgirls,pregnantandlactatingwomenandolderpersons
By 2030, double the agricultural productivity and incomes of smallscale food
producers, in particular women, indigenous peoples, family farmers, pastoralists and
fishers,includingthroughsecureand equalaccesstoland,otherproductive resources
andinputs,knowledge,financialservices,marketsandopportunitiesforvalueaddition
andnonfarmemployment
b.GlobalNutritionTargetby2025WHO
Reductionoftheglobalnumberofchildrenunderfivewhoarestuntedby40percent
Reductionofanaemiainwomenofreproductiveageby50percent
Reductionoflowbirthweightby30percent
Noincreaseinchildhoodoverweight
Increase the rate of exclusive breastfeeding in the first six months up to at least 50
percent
Reduceandmaintainchildhoodwastingtolessthan5percent
c.NationalNutritionalStatusandTarget
Indicators
StuntingamongU5children
WastingamongU5children
UnderweightamongU5children
AnemiaamongU5children
Anemia among children under 623
months
BMI(<18.5kg/m2)amongwomen
Anemiaamongpregnantwomen
NDHS
2001
57
11
43
26
Status(%)
NDHS
NDHS
2006
2011
49
41
13
11
39
29
48
46
78
69
24
42
18
48
NMICS
2014
37
11
30
Target(%)
MDG2015
28
5
27
<40
<40
25
29
2.2.6ProgrammeStrategies
OverallStrategy
Promotionoffoodbasedapproach
Foodfortification
Supplementationoffoods
PromotionofPublicHealthMeasures
SpecificStrategy
ControlofProteinEnergyMalnutrition(PEM)
Promotionofearlyinitiationofbreastfeedingwithinonehourofbirth,avoidanceofprelacteal
feeding
Promotion of exclusive breastfeeding for the first 6 months and timely introduction of
complementaryfood
Ensure continuation of breast feeding for at least 2 years and introduction of appropriate
(quantityandquality)complementaryfeedingafter6months.
Strengthen the capacity of health workers/ medical professionals for nutrition/breast feeding
managementandcounselling
Improve skills and knowledge regarding growth monitoring and nutrition counseling among
healthworkers
Strengthenthesystemofgrowthmonitoringanditssupervision/monitoring
PromotetheuseofappropriateandadequatelocallyavailablecomplementaryfoodslikeJaulo
andSarbottamPitho
Createawarenessregardingtheimportanceofappropriateandadequatenutritionforchildren,
pregnantandlactatingmothers
Strengthen the ability of health personnel in dietary and clinical management of severely
malnourishedchildren
Distribute fortified foods to pregnant, lactating women and children aged 6 to 23 months in
fooddeficientareas
Improve maternal and adolescent nutrition and low birth weight through improved maternal
nutritionpractices.
Createawarenessoftheimportanceofadditionaldietaryintakeduringpregnancyandlactation
StrengthentheactivitiesofnutritioneducationandCounseling
ControlofIronDeficiencyAnaemia(IDA)
Advocacytopromotedietarydiversitiesamongpolicymakers
IronFolicAcidsupplementationforpregnantandpostpartummothers.
Ironfortificationofwheatflouratrollermills.
IntermittentIronFolicAcidsupplementationforadolescentgirls
Multiplemicronutrientsupplementationforthechildrenaged623months.
30
26
Nutrition education to create awareness on importance of iron in nutrition, promote

consumptionofironrichfoodsandpromotedietarydiversitiesindailydiet.
Parasitic infestation control among nutritionally vulnerable groups through deworming among
pregnantwomenandchildrenaged1223months.
ControlofIodineDeficiencyDisorders
Strengthen the implementation of Iodized Salt Act, 2055 for regulation and monitoring of
iodizedsalttradetoensurethatallediblesaltisiodized
Universalsaltiodization
Socialmarketingofgovernmentcertifiedtwochildlogoadequatelyiodizedsalt.
Ensuresystematicmonitoringofiodizedsaltdistribution
Increasetheaccessibilityandmarketshareofiodizedpacketsaltwithtwochildlogo
Create awareness about the importance of use of iodized salt for the control of IDD through
socialmarketingcampaign
ControlofVitaminADeficiency(VAD)
BiannualsupplementationofhighdosevitaminAcapsuletothechildrenaged659months.
PostpartumvitaminAsupplementationwithin42daysofdelivery.
StrengthenimplementationofVitaminAtreatmentprotocolforseveremalnutrition,persistent
diarrhea,measles,Xerophthalmia
Nutritioneducationtopromotedietarydiversification,consumptionofvitaminArichfood
EnsureavailabilityofVAcapsulesathealthfacilities
IncreaseawarenessofimportanceofVAcapsulessupplementation
BiannualdistributionofvitaminAcapsuletochildrenbetween6and59monthsthroughFCHVs
Advocateforincreasedhomeproduction,consumptionandpreservationofVitaminArichfoods
atthecommunitylevel
StrengthentheusageofVitaminATreatmentprotocol
PromotetheconsumptionofVArichfoodsandbalanceddietthroughnutritioneducation
SupplementationofVitaminAcapsule(200,000IU)topostpartummothersthroughhealthcare
facilitiesandcommunityvolunteers
LowBirthWeight
Reducematernalmalnutrition(PEM,VAD,IDD,IDA)
Reduceworkloadofpregnantwomen
IncreaseawarenessofrisksofsmokingandalcoholtoLBW
Increaseawarenessofrisksofearlypregnancytoinfantandmaternalhealth
Promotionofactivitiesfornutritionmonitoring/counselingatantenatalclinics
HouseholdFoodSecurity
Promotekitchengardenandagriculturalskills
27
31
Promoteraisingofpoultry,fishandlivestockforhouseholdconsumption
Advocateamongcommunitypeopleastohowtostoreandpreservetheirfoodsathome
Improvetechnicalknowledgeoffoodprocessingandpreservation
Promoteactivitiesofwomensgroupswhichareinterestedinincomegeneration
Improveddietarypractices
Conductastudytoclarifytheproblemsofculturallyrelateddietaryhabits
Promotenutritioneducationactivitiesandadvocateforgooddietsanddietaryhabits
Develop and strengthen programs that focus on behavior change as the means of improving
dietaryhabits
Strengthen the activities of nutrition education/advocacy which seek to eliminate the food
taboosaffectingnutritionalstatus
Promotetheprogramofhouseholdfoodsecurity
InfectiousDiseasePreventionandControl
Promoteknowledge,attitudesandpracticeswhichwillpreventinfectiousdiseases
Ensureaccesstoappropriatehealthservices
Improvenutritionalstatustoraiseresistanceagainstinfectiousdisease
Improvesafewatersupply,sanitationandhousing
Improvefoodhygienepractices
SchoolHealthandNutritionProgram
BuildcapacityofthepolicyandworkinglevelStakeholders
Biannualdistributionofdewormingtabletstoschoolchildrenfromgrade1to10
CelebrationofSHNweekinthemonthofJunetoraiseawarenessonmalnutritionfocusingat
thecommunitylevelthroughthemediumofschoolchildrenandhealthworkers
DistributionofFirstAidkitboxtothepublicschools
Enhanceknowledge,skills,andlearningability
Introducechildtochildandchildtoparentapproaches
IntegratedManagementofAcuteMalnutrition
Capacity building of all levels of health workers for the management of acute malnutrition
throughregularhealthservicesandofothercommunityworkersforthescreeningandreferral
ofthecasesfortheirmanagement
Effective establishment and implementation of 4 key structures of IMAM programme:
Community mobilization, Inpatient therapeutic care, Outpatient therapeutic care and
managementofMAM
Effective implementation of IMAM programme based on 4 principles: Maximum coverage &
access,Timelinessofservice,Appropriatecare,andCareaslongasitisneeded
Integration of the management of acute malnutrition across the sectors to ensure that the
treatment is linked to support for continued rehabilitation of cases and to wider malnutrition
preventionprogrammeandservices
32
28
SupportandpromoteIYCF,WASH,ECD,socialprotectionandchildhealth&carealongwiththe
managementofacutemalnutrition
AdvocateIMAMprogrammeasthebridgebetweenemergencyanddevelopmentprogramme:
DisasterRiskReduction
SupportivesupervisionandmonitoringofIMAMprogrammeactivitiesforbetterresult
Harmonizebothcommunityaswellfacilitybasedmanagementofacutemalnutrition
StrengthencoordinationandfunctionalcapacityofNutritionRehabilitationHomes
NutritioninEmergencies
Develop adequate capacity and predictable leadership in the nutrition sector for managing
humanitarianresponse
Formulate an emergency nutrition in emergency preparedness, nutrition in emergency
response,includingcontingencyplansandDRR,forthenutritionsector
Establish and strengthen stronger partnerships and coordination mechanisms between
government,UNandnonUNagencies(I/NGOs,donorsandnonstatesector)
Responseduringemergenciesthroughtheactivatednutritioncluster
LifeStyleRelatedDiseases
Createawarenessamongadultsabouttheimportanceofmaintaininggoodfoodhabits
Developcapacityforcounselingathealthfacilities
Createawarenessabouttheimportanceforadolescentsandadultstocontrolsmokingandbody
weight
Createawarenesstoincreasephysicalactivityandimprovestressmanagementtechniques
2.2.7 MajorAchievements
2.2.7.1GrowthMonitoringandPromotion
Growth monitoring of children less than 2 years of
age is one of the key strategy of Government of
Nepal for prevention and control of protein energy
malnutrition. It is recognized as an effective means
of evaluating a child's growth pattern, providing a
critical opportunity for taking the preventive or
curative actions needed. Currently, health workers
of all public health facilities monitor the growth of
children once a month by taking their weight in 75
districts. Based on the WHO new growth standard,
MoH has developed and used a new growth
monitoringcard.
Figure 2.2.7.1 shows thepercent of newborns with low birth weight (<2.5 kg) of fiscal year 2071/ 72.
There is no significantly a difference of low birth weight among regions. By regions, 11 percent off
29
33
newbornswerereportedlowbirthweightfrommidwesternregionwhichisthehighestcomparedto
otherregions.Thereis9percentofnewbornswithlowbirthweightinnationallevel.
Figure 2.2.7.2 shows the average number of

growth monitoring visits of last three fiscal
years. Looking at regional level, there is 2.9
averagenumberofgrowthmonitoringvisitsin
easternandfarwesternregionwhichishigher
as compared to others regions in fiscal year
2071/72. In all regions, it is decreasing trend
compared to fiscal year 2070/71. At the
nationallevel,thereisonly2.5visitsforgrowth
monitoring. This reflects that proper
counsellingtomothersorcaretakersbyhealth Source:HMIS
workersisnecessarytoincreasethegrowthmonitoringvisitsofchildren.
Figure2.2.7.3showspercentofchildrenaged
0 to 12 months registered for growth
monitoring from FY 2069/70 to 2071/72. In
FY 2071/72, the registration of growth
monitoring is slightly decreased in eastern,
center and western regions compared to
fiscal year 2070/71. In western region, 120
percent children were registered for growth
monitoringwhichisthehighestcomparedto
others regions in FY 2071/72. In center
region, there is only 79 percent of children
wereregisteredforgrowthmonitoringwhich
is the lowest as compared to other regions. At national level, 97 percent of that aged group was
registeredforgrowthmonitoringinthisfiscalyearwhichis9percentlowcomparedtoFY2070/71.
Figure 2.2.7.4 shows that 3.3 percent of

underweight children 0 24 months were
reported at national level which is 1.5
percent higher in FY 2071/ 72 compared to
FY 2070/71 among new growth monitored.
By regions, there is slightly increased of
underweight children in all regions in this
fiscal year. Highest cases of underweight
children were reported from mid western
regioninallthreefiscalyears.
34
30
2.2.7.2InfantandYoungChildFeeding(IYCF)
Appropriate feeding practice is essential for enhancement of nutrition, survival, growth and
developmentofinfantsandyoungchildren.Thisfeedingpractice,collectivelyisknownasIYCFpractices,
includesexclusivebreastfeedingfor6monthsandnutritionallyadequateandcomplementaryfeeding
starting from the age of 6 months with continued breastfeeding up to 2 years of age or beyond.
Improvingcareandpracticesrelatedtoinfantandyoungchildfeeding(IYCF)isakeyprioritystrategyof
MoH. IYCF programme has been scaled up in 60 districts and has planned to cover throughout the
country by next year; however, effective counseling and monitoring mechanism is an essential to
improveits'status.
Figure 2.2.7.5 shows that the percent of

children aged 06 months who were
exclusively breastfed for the first six
months, who registered for growth
monitoring in fiscal year 2071/72. There
is huge difference of exclusively breast
feeding status by regions. About 57
percent children were exclusively
breastfed for the six months in far
westernandmidwesternregionswhichis
the highest compared to others regions.
In center region, only 10.7 percent
children were exclusively breastfed for
the first six months. At national level,
exclusivebreastfeedingisonly28.5percentwhichisverylowascomparedtoNDHS2011(70percent).
Figure2.2.7.6showsthat58.1percentof
childrenaged68monthsamongchildren
age
611
months
received
complementary foods, who were
registered for growth monitoring in far
western region which is the highest as
compared to other regions. In center
region, only 9.9 percent children of that
agegroupreceivedcomplementaryfood.
Looking at national level, only 27.5
percent of children of that age group
Source:HMIS
received complementary food which is
verylowascomparedtoNDHS2011(70percent).Itreflectsthattimelyintroductionofcomplementary
foodisverypoorinourcommunity.Therefore,needtoprovideappropriatecounsellingtomothersor
caretakerstoimprovethefeedingpracticesandnutritionalstatusofinfantsandyoungchildren.
31
35
2.2.7.3IntegratedManagementofAcuteMalnutrition
Integrated Management of Acute Malnutrition (IMAM) Programme (previously CMAMCommunity
based Management of Acute Malnutrition) manages acute malnutrition in children age 059 months
through inpatient and outpatient services at the facility and community level. This program has been
implementingin11districts(Achham,Kanchanpur,Bardiya,Jajarkot,Jumla,Mugu,Kapilbastu,Sarlahi,
Dhanusa,SaptariandOkhaldhunga)andintheplanofscaleupinmoredistricts.AlongwiththeMIYCN
promotion and support, it aims to integrate the programme across the sectors (Health, ECD, WASH,
Socialprotection)toensurethatthetreatmentislinkedtosupportforcontinuedrehabilitationofcases
and to wider malnutrition prevention programme and services. The programme also acts as a bridge
betweenemergencyanddevelopment.i.e.moreDRR(DisasterRiskReduction).Themaingoalofthis
programistopreventmortalityandmorbidityduetoacutemalnutritionamong059monthschildrenat
thefacilityandcommunitylevel.
InthisFiscalyear2071/72,11IMAMdistrictshaveadmitted4680severelyacutemalnourishedchildren
at out patients therapeutic program and discharged 5483 children. Among them 74 percent children
have recovered and similarly, defaulter rate is 15 percent and death rate is 1 percent which if we
compare with SPHERE standard (recovery rate >75percent, defaulter rate <15percent and death rate
<10percent)programisjustneartoachievethespherestandard.Butyes,ifwegoindividualdistrictin
some districts (Mugu, Sarlahi and Kapilbastu) we should have to focus and give attention to improve
programperformance.Thedetailsperformanceofindividualdistricthasgivenbelow.
Table2.2.7.1:DistrictwiseIMAMPerformance
Total
Admission
Total
Discharge
Total
Recover
Recovery
rate
Total
Death
Death
rate
Total
Defaulter
Defaulter
rate
1 OKHALDHUNGA
52
63
45
71
0.00
11
2 SAPTARI
801
1493
1293
87
0.00
115
0.00
4 SARLAHI
246
288
180
63
0.00
77
27
5 KAPILBASTU
1090
1014
691
68
0.00
252
25
6 BARDIYA
561
628
595
95
0.00
10
7 JAJARKOT
164
140
99
71
0.71
21
15
8 JUMLA
215
292
214
73
11
3.77
38
13
9 MUGU
303
298
152
51
0.00
84
28
10 ACHHAM
441
528
388
73
0.38
59
11
11 KANCHANPUR
807
739
626
85
0.27
44
Total
4680
5483
4283
TotalAchievementin%
SN
Districts
3 DHANUSA
Spherestandard
16
707
74
15
>75 %
<10%
<15 %
Source:HMIS
In some district, number of discharged children seemed higher than admission. Its normal in IMAM
programbecausechildrenmaycomeascarryoverfromnextfiscalyear.InSaptaridistrict,numberof
36
32
dischargedchildreniscomparativelyveryhigh(1493)thantotaladmission(801).Itshowsthat692SAM
caseswerecarriedoverfrompreviousfiscalyear.
2.2.7.4NutritionRehabilitationHome(NRH)
ThefirstNutritionRehabilitationHomewasestablishedin1998inKathmanduandnowthere
are 18 NRHs in Nepal located in different Regional/Sub regional, Zonal and districts hospital.
TheaimifNRHsistoreducethechildmortalityratecausedbymalnutritioninNepalandithas
twospecificobjectiveaswell;torestorehealthofseverelymalnourishedchildrenandeducate
theguardian,andmostoftenmothersonnutritionandfamilyhealth.Thetotalcapacityof16
NRHs is 181 beds. With an average of 30 children staying days and a 90 percent occupancy
target,theseNRHshaveacapacitytoserve1981malnourishedchildrenperyear.
Table2.2.7.2:AdmissionanddischargestatusofNRH
SN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
NRHs
NRHKtm
NRHJanakpur
NRHRajbiraj
NRHBharatpur
NRHDailekh
NRHBaglung
NRHDang
NRHButwal
Nepalgunj
Bhadrapur
Biratnagar
Birgunj
Kanchanpur
Dhangadi
Pokhara
Surkhet
Total
Achievement
Admission
Discharge
259
164
147
147
46
151
152
108
133
92
83
155
139
159
108
145
2188
253
163
146
141
44
155
150
105
131
87
79
148
134
153
99
138
2126
Source:Annualreport20142015,NepalYouthFoundation
This fiscal year 2071/72, total 2188 children were provided nutritional care through NRH and got
recovered 2126. Similarly, all the care takers were provided counselling on food, nutrition, health
hygiene,andsanitation.Thesessionsweremadelivebyfooddemonstrationsandpracticalsessions.
33
37
2.2.7.5PreventionandControlofIronDeficiencyAnemia
Ministry of Health has been supplementing Iron and Folic Acid (IFA) to pregnant and postpartum
womenthroughPrimaryHealthCareServicessince1998toaddresshighmaternalanemiaprevalence
underpolicyofIronFolicAcidSupplementation(60mgelementaliron+400microgramfolicacid)tothe
pregnantwomenfor225daysfromthesecondtrimester.Initially,thesupplementationwasprovidedto
the pregnant women from the health facilities. In 2003, Intensification of Maternal and Neonatal
Micronutrient Program (IMNMP) was initiated to improve coverage and compliance of IFA
supplementationviabringingtheserviceclosertobeneficiariesthroughincreasingaccesstoIFAtablets.
In this program, the IFA supplementation was distributed from the Female Community Health
Volunteersatwardlevel.Thisprogramwasimplementedinphasewisemannercoveringall75districts
by the year 2014. The intensification program has helped to improve the coverage of maternal IFA
supplementationprogram;howeverthecomplianceoftaking180tabletsduringpregnancyandtaking
45tabletsforpostpartumperiodisstillanissue.Thecoverageof1sttimeIFAdistributionisconsistently
high with over 80 percent, but the continuation till 180 days and till 45 days of delivery needs to be
improved.
Figure 2.2.7.7 shows the overall trend of

supplementation of IFA tablets of last three
fiscal years at national level. The coverage of
IFA supplementation with 1st time distribution
isconsistent over80percentsinthelastthree
years.Yet,thedistributionfor180daysand45
days postpartum is low compared to the 1st
timedistribution.
Byregions,thetrendfollowsthesamepattern
asforthenationalcoverageasshowninfigures
2.2.7.8 and 2.2.7.9. The coverage for the 1st
time distribution is maintained at around 80
percents for the last three years, while the
coveragefor180daysdistributionislownationallyandbyregions.Nevertheless,coveragebyindividual
regionsvarieswiththeCentralRegionwiththelowestcoverageforboth1sttimedistributionandthe
distributionfor180daysaswell.Thereisnogreatdifferencein1sttimedistributionanddistributionfor
180daysinotherregionsexceptinMidWesternregion.IntheMidWesternregion,thecoverageof1st
time IFA distribution has increased to 105 percent in FY 2071/072 from 77 percent in FY 2070/071
38
34
2.2.7.6 Integrated Infant and Young Child Feeding MicroNutrient Powder (IYCFMNP)
CommunityPromotionProgram
Consideringthecriticallyhighlevelsofanemiatogetherwithothermicronutrientdeficiencies,situation
analysis and strategic review was done in 2003 which highlighted the severity and implication of the
highprevalenceofanemiainyoungchildrenandlackofanyeffectiveinterventioninplacetoaddress
theproblemandwarrantedurgencytoaddresstheproblem.TheNationalNutritionPolicyandStrategy
2004andAnemiaPlanofAction2005wasendorsed.TheNDHS2006revealedthattheanemiasituation
among623monthschildrentobe78%withpoorIYCFpractices.Foodbasedapproachesarethebest
andsustainableapproachtoimprovethesituation;however,thefeedingofinfantsandyoungchildren
was far from optimal. The need for innovative approaches to address anemia in young children and
othervulnerablegroupswasunderscoredandthePlanofActionendorsedSprinklesaskeyintervention
to address anemia in young children. Later in 2007, National Nutrition priority workshop was held at
Kathmandu which endorsed piloting of sprinkles supplementation as preventive measure. The Lancet
2008 further recommended the IYCFMNP interventions as one of the effective and cost efficient
intervention.In2008,feasibilitystudywasinitiatedin2districtstodesignlargescalepilotprogramme.
LaterinJune2009,MoHpilotedthehomefortificationofcomplementaryfoodwithMNPsamongthe
children aged 623 months in 6 districts (Parsa, Makawanpur, Gorkha, Plapa, Rupandehi, Rasuwa)
integrating with the Community Infant and Young Child Feeding Program. After the successful
completionofthepilotprogram,MoHexpandedthisprograminadditional9districts(Sankhuwasabha,
Morang,Sunsari,Kapilbastu,Dang,Rukum,Bardiya,DadeldhuraandAchham)in2012;thisprogramis
currentlyimplementedin15districtsofNepal.
Promotion of MNP is linked with improved complementary feeding; while introducing MNPs mothers
andcaregiversarealsocounseledtotimelyintroducecomplementaryfoodsattheageofsixmonths,for
age appropriate feeding frequency, improving dietary quality of complementary foods by making
nutrient and calorie dense (e.g. by adding milk, oil, ghee, peanuts etc.) as well as hand washing with
soap before feeding. Furthermore, mothers/caregivers are trained to prepare Poshilo Jaulo (pulses,
riceandgreenvegetablescookedinoil)andLito(mixtureofblendedandroastedcerealandlegume
flours).
Thefeasibilitystudycarriedoutin2districtsinvolvedformativeandethnographicresearchtoidentify
existingfeedingpracticesandpotentialbarriersthatmighthinderacceptanceofMNP,brandingofthe
product, and development of a behavior change communication strategy, etc. As part of the study,
FCHVs were trained to counsel mothers on IYCF and care issues as well as to distribute MNP in eight
VDCs of two districts. Evaluation was conducted to gather information on coverage, acceptability,
compliance in utilization, including any constraints and logistical issues related to delivery of the
intervention.Thefeasibilitystudyhasshownastrongcommunityacceptancewithaveryhighcoverage
andcomplianceontheuseofMNP.Withpromisingimpactstudiesglobally,theIYCFMNPwasinitiated
inNepalandthepilotingin6districtswasdesignedtostudytheoperationalefficacyandeffectiveness
in terms of coverage, compliance and mode of distribution. The coverage survey of the pilot study
showscoveragerangingfrom53%to83%andcompliancerangingfrom40%to56%.ThelinkingofIYCF
35
39
with MNPs has contributed to significant improvement in IYCF practices as revealed by the process
monitoring and coverage surveys. Table 2.2.7.3 shows that 78.8 percent of children aged 6 to 23
months were taken first dose of Multiple Micronutrient Power (MNPBaal Vita) from 15 programme
districts, whereas only 4.6 percent were taken third dose of MNP of that age group in fiscal year
2071/72.Propercounsellingandfollowupisessentialtoimproveitscompliance.
Table2.2.7.3:MicronutrientPowder(MNPBaalVita)distributionstatus
Morang
31573
7021
5684
3368
1097
671
338
671
192
57.6
3rd
dos
e
(%)
3.9
Sunsari
25427
4518
3363
2548
1032
863
433
590
307
50.2
5.6
Sankhuwasabha
4948
1752
1278
554
657
230
131
124
94
93.0
4.0
Rasuwa
1376
416
223
217
243
132
69
31
32
94.5
4.0
Makawanpur
13641
3867
2124
706
1343
1100
667
130
45
71.9
1.7
6
7
Parsa
Gorkha
21113
8179
495
2684
654
2225
422
1239
138
842
140
471
85
236
18
450
32
125
9.2
2.4
94.1
5.8
Palpa
8075
2723
1036
380
501
229
70
301
40
61.2
5.4
9
10
Rupandehi
Kapilbastu
29590
20102
6071
6082
5206
5105
3736
4608
546
1325
300
917
204
854
418
1311
93
681
54.3
2.7
94.0
8.1
5.5
SN
District
Target
Popn.
FirstTime
ThirdTime
611
12_17
18_23
6_11
12_17
18_23
18_23
18_23
1st
dose
(%)
FCHV
HF
FCHV
HF
11
Rukum
7248
1461
1130
1338
437
293
252
212
124
67.8
12
Dang
18712
6883
3830
1910
1698
1022
504
730
289
84.7
5.0
13
Bardiya
14086
7991
4293
3225
162
42
20
367
28
111.7
1.8
14
Achham
9663
6126
4553
2453
533
295
135
1013
160
145.9
6.0
15
Dadeldhura
5093
2376
1353
700
139
105
44
486
50
92.6
7.9
TOTAL
218826
78.8
4.6
Source:HMIS
2.2.7.7 Prevention and Control of

IodineDeficiencyDisorder
Ministry of Health adopted a policy to
fortify all edible salt in 1973 to
eliminate Iodine Deficiency Disorders
(IDD) among the population. Universal
SaltIodization(USI)istheonlystrategy
underthispolicytoaddressIDDinthe
country.Underthispolicy,SaltTrading
Corporation is responsible for iodine
fortification of all edible salt and their
distribution throughout the country,
while Ministry of Health is responsible
40
36
for the promotion of adequately iodized salt and its social marketing to
increase consumption of optimum iodized salt at the household level.
Government uses TwoChildLogo (TCL) to certify the adequately iodized salt
and Department of Health Services has been implementing Social Marketing
Campaign of this certified iodized salt to create awareness on use of
adequately iodized salt household level. The HMIS has yet not incorporated
anyindicatorsinregardstouseofTCLadequatelyiodizedsalt.However,other
national surveys have reported the coverage of adequately iodized salt at
householdshowingthatinthelastthirteenyears,thepercentofthehouseholdsusingtheadequately
iodizedsalthasincreasedfrom55percentin1998(NepalNationalMicronutrientStatusSurvey,1998)to
80percentin2011(NepalDemographicHealthSurvey,2011).
Although the national coverage on use of

adequately iodized salt has reached to 80 percents
in the year 2011, there are great subregional
variationsonit(fig.2.2.7.10).WesternTerairegion
hasthehighestcoverageat92percentsandtheFar
Western region has the lowest coverage at 43
percents. To address this problem, Child Health
Division has planned to implement Iodized Salt
SocialMarketingCampaign(ISMAC)Programinthe
region with lowest coverage. This program is being
pilotedin2districtsoftheregion,namelyDadeldhuraandBaitadiasinterventiondomainwithAchham
andDotiascomparisondistrictsfortheintervention.
AbaselinesurveyofISMACprogramwascarriedoutinthisFY,whichshows(fig.2.2.7.11)thathalfof
the households in intervention domain (Dadeldhura and Baitadi) use adequately iodized salt. In the
comparisondomain(AchhamandDoti),42percent
householdsuseadequatelyiodizedsalt.Amongall
the salts used, 50 percent in intervention domain
and 37 percent in comparison domain use
government certified TCL adequately iodized salt
(fig.2.2.7.12).
Asusualinpreviousfiscalyears,IodineMonthwas
celebrated in February month of International
Calendar in all 75 districts to raise awareness on
useofTCLadequatelyiodizedsaltfortheoptimumiodineintaketocombatiodinedeficiencydisorders.
37
41
2.2.7.8ControlofVitaminADeficiencyDisorders
Government has initiated National Vitamin A
2.2.7.8ControlofVitaminADeficiencyDisorders
Program
(NVAP)
1993 toNational
improveVitamin
vitamin A
Government
hasininitiated
A
status
of(NVAP)
the children
659 months
and
Program
in 1993aged
to improve
vitamin
A
reduce of
child
has been
status
themortality.
children This
aged program
659 months
and
recognized
as
a
global
success
story
of
public
reduce child mortality. This program has been
healthinterventionswithconsistentcoverageover
recognized as a global success story of public
85 percents. With 8 districts in its first phase, the
healthinterventionswithconsistentcoverageover
program
wasWith
scaled
up nationwide
byphase,
the year
85 percents.
8 districts
in its first
the
2002.
FCHVs,
the
frontline
community
health
program was scaled up nationwide by the year
volunteers
supplement
the capsules
to thehealth
target
2002. FCHVs,
the frontline
community
children
twice
a
year
(in
Baisakh
and
Kartik)
volunteers supplement the capsules to the target
throughanationalcampaign.ThetrendinthecoverageofVitaminAsupplementationtothechildren
children twice a year (in Baisakh and Kartik)
aged659monthsisdemonstratedbelow.
throughanationalcampaign.ThetrendinthecoverageofVitaminAsupplementationtothechildren
aged659monthsisdemonstratedbelow.
As
shown in the figure 2.2.7.13, the national
coverage
A 2.2.7.13,
supplementation
has
As shown of
in vitamin
the figure
the national
decreased of
fromvitamin
91 percent
in FY 2069/70 tohas
71
coverage
A supplementation
percentinFy2070/071.However,ithasincreased
decreased from 91 percent in FY 2069/70 to 71
to
85 percent in FY 2071/072. By regions as well,
percentinFy2070/071.However,ithasincreased
the85trend
follows
same By
pattern
except
in
to
percent
in FYthe
2071/072.
regions
as well,
Central
Region,
where
the trend
is decreasing
the
trend
follows
the same
pattern
except in
despite
of
having
consistent
higher
coverage
over
Central Region, where the trend is decreasing
80percents.
despite
of having consistent higher coverage over
Agewise
coverage of the program is illustrated in
80percents.
thefigure2.2.7.14.Atthenationallevel,thecoverageamongthechildrenaged611monthsishigh(104
Agewise coverage of the program is illustrated in
percent)
compared to that among the children aged 1259 months (82 percent). Similar pattern is
thefigure2.2.7.14.Atthenationallevel,thecoverageamongthechildrenaged611monthsishigh(104
reportedinallregions.However,thedifferencesinthecoveragebyagegroupsvaryintheregions.The
percent) compared to that among the children aged 1259 months (82 percent). Similar pattern is
CentralRegionshowsthegreaterdifferencewith126percentamongthechildrenaged611monthsand
reportedinallregions.However,thedifferencesinthecoveragebyagegroupsvaryintheregions.The
77 percent among the children aged 1259 months. The difference in the coverage by agegroup is
CentralRegionshowsthegreaterdifferencewith126percentamongthechildrenaged611monthsand
lowest
in the
Western
In this region,
the coverage
among
the 611
months old
77 percent
among
theDevelopment
children agedRegion.
1259 months.
The difference
in the
coverage
by agegroup
is
childrenis85percentandthatamong1259monthsoldchildrenis82percent.
the 611 months old
lowest in the Western Development Region. In this region, the coverage among
childrenis85percentandthatamong1259monthsoldchildrenis82percent.
2.2.7.9SchoolHealthandNutritionProgramme
SchoolHealthandNutritionStrategy(SHNS)wasdevelopedin2006bytheMinistryofHealth(MoH)and
2.2.7.9SchoolHealthandNutritionProgramme
Ministry of Education (MoE) reflecting the need to address the high burden of diseases in school age
SchoolHealthandNutritionStrategy(SHNS)wasdevelopedin2006bytheMinistryofHealth(MoH)and
children.of
In
2008, a five
year
Joint Action
Planto(JAP)
wasthe
endorsed
by both
ministries
orderage
to
Ministry
Education
(MoE)
reflecting
the need
address
high burden
of diseases
inin
school
effectively In
implement
theyear
minimum
package
of (JAP)
schoolwas
health
and nutrition
under
four
children.
2008, a five
Joint Action
Plan
endorsed
by bothbased
ministries
in the
order
to
strategicobjectivesoftheSHNstrategywhichareasfollows:
effectively implement the minimum package of school health and nutrition based under the four
1)ImproveuseofSHNservicesbyschoolchildren
strategicobjectivesoftheSHNstrategywhichareasfollows:
2)Improvehealthfulschoolenvironment
1)ImproveuseofSHNservicesbyschoolchildren
2)Improvehealthfulschoolenvironment
38
38
42
3)Improvehealthandnutritionbehaviourandhabits
4)Improveandstrengthencommunitysupportsystemandpolicyenvironment
Improveduseofschoolbasedhealthandnutritionservices,betterandimprovedaccesstosafewater
and sanitation and skillsbased health education, community support and policy environment, are the
coreelementsoftheSchoolHealthandNutritionprogramme.
TheGovernmentofNepalimplementedapilotSHNprojectinprimaryschoolsbasedontheJointAction
Plan (JAP) in Sindhupalchowk and Syangja districts for four years from 2008 to 2012.On the basis of
findings, SHN programme was scaled up into 54 districts and has planned to cover all districts by F/Y
2075. New Joint Action Plan (JAP) 2071/072 to 2075/76 was endorsed from Ministry of Health and
Ministry of Education which recommends of the following minimum package of SHN progrmme to
improvethehealthandnutritionstatusofschoolchildren:
1) AnnualHealthScreening
2) BiannualSupplementationofDewormingTabletstoSchoolChildren(Grade110)
3) ProvisionofFirstAidKitBoxanditsrefillingmechanisminallprimarypublicschools
4) IronfolateSupplementationtoadolescentSchoolChildren(Grade610)
5) Provisionofhandwashingfacilitywithsoap
6) Toiletsineachschool
7) Useofnewattendanceregisterinallschools
8) StrengthenSMCforSHNrelatedactivities
9) ChildClubmobilization
2.2.7.10NutritioninEmergency(NiE)
The earthquake on 25 April 2015 and the subsequent aftershock on 12th May 2015 have had a
devastating impact in Nepal affecting 35 of the countrys 75 districts. Among these, 14 districts were
identified as most affected districts. Nutrition Cluster under NEOC did response having developed 5
building blocks to make nutrition intervention more systematic. These 5 building blocks are based on
UNICEF,WFPjointstatementforemergencynutritionresponse:
Promotion,protectionandsupportforBreastfeeding023monthsagedchildren
Promotionofcomplementaryfeedingfor623monthsagedchildren
Managementofmoderateacutemalnutritionthroughsupplementaryfeedingprogrammefor6
59monthsagedchildren
Managementofsevereacutemalnutritionprogrammethroughtherapeuticfeedingprogramme
for659monthsagedchildren
Micronutrientforchildrenandwomensuchas;MNPandVitaminAforthechildrenage659
months,IFAforpregnantandpostnatalwomen.
The total achievement of emergency nutrition response in the 14 Earth quake affected districts is as
follows:
39
43
Table 2.2.7.4: Achievement of Emergency Nutrition response in 14 Earth quake affected

districts
SN
2
3
4
5
6
InterventionAreas
Mothers/caretakers of children age 023
months received counselling on breast
feedingandrisksofartificialfeeding
Mothers/caretakers of children age 623
months
received
counselling
on
complementaryfeeding
Children age 659 months screened using
MUAC
Children age 659 months with moderate
acute malnutrition who are identified
throughscreening
Childrenage659monthswithsevereacute
malnutrition who are admitted to
therapeuticcare
Blanket Supplementary Feeding Program to
thechildrenaged623months
Total
Targeted
Population
TotalAchievements
#ofBeneficiary Percentofthe
Reached
Reached
225,708
152,697
68
167,757
137,719
82
476,842
373,546
78
2,500
1,564
63
2,500
1,328
53
46,484
26,160
56
Children age 659 months who received

multiplemicronutrientpowders(BaalVita)
451,512
326,091
72

VitaminAcapsules
476,842
365,871
77

dewormingtablets
418,544
385,972
92
10
Pregnant & lactating women who received

IFAtablets
252,043
173,998
69
Source:NutritionClusterreport2071/72
Now the nutrition cluster already shifted in the recovery phase which also depends on the 5 building
blocksandimplementingaccordingly.
Similarly,nutritioninemergencytrainingandcontingencypreparationworkshoporganizedfocusingto
floodpronedistrictswhere18floodpronedistrictsDHO,NutritionFocalPersonswereparticipated.All
thedistrictshavepreparedcontingencyplan.
44
40
2.2.7.11MotherandChildHealthandNutritionProgramme
NepalhasbeenprovidingfoodassistancetoPregnantandLactatingMothers(PLM)andchildrenaged6
to23monthsthroughtheMotherandChildHealthandNutritionCare(MCHN)activityoftheCountry
Programme (CP) since 2001 in alignment with the Governments long term and interim strategic plan
under the nutrition and safer motherhood programme of the MoH. Under the MCHN Programme, a
monthlytakehomeratiooffortifiedsupplementaryfoodisprovidedalongwithhealthservices,growth
monitoring and counseling from government and community health staff in 6 programme districts;
Humla,Jumla,Dolpa,Kalikot,MuguandSolukhumbu.
2.2.7.12NewProjectsonNutritionProgramme
a.Suaahara:AnIntegratedNutritionProgram
Suaahara,afiveyearproject(August2011August2016)USAIDfundedintegratednutritionprogram
aims to improve the nutritional status of women and children in 41 Districts of Nepal influencing
behaviorofindividualsandcommunitythroughcommunitybasedbehaviorchangeprogrammingwitha
focusonreachingthemostdisadvantagedgroups(DAG).
TheSuaaharaprojectfocusesonfourprimaryresults:
1. Householdhealthandnutritionbehaviorsimproved
2. Womenandchildrenincreasetheiruseofqualitynutritionandhealthservices
3. Womenandtheirfamiliesincreasetheirconsumptionofdiverseandnutritiousfood
4. Coordinationonnutritionbetweengovernmentandothersectorsisstrengthened
Additionally,Suaaharaengagesin4crosscuttingthemes:genderandsocialinclusion(GESI),socialand
behavior change communication (SBCC), social mobilization and governance, and monitoring and
evaluation.
During the period July 2014 to June 31, 2015, Suaahara efforts focused on coordinating with
government bodies, particularly the Child Health Division (CHD) to execute the integrated nutrition
programintheprojectdistrictsusingmultipleentrypointstoreinforcehealthandnutritionbehaviorsof
1,000daysmothersandtheirfamilymembers.Suaaharaalsoconcentratedonrollingoutitsactivitiesin
its16expansiondistricts;Kanchnapur,Kailali,Bardiya,Banke,Surkhet,Dailekh,JajarkotDang,Rolpa,
Puythan,Rukum,Salyan,Gulmi,Arghakhachi,Kapilbastu&Palpa.
41
45
KeyAchievementduringJuly2014 June2015
627,655womenandfamilymembersreachedthrough31,070fooddemonstrationssessions
99,847womenandfamilymembersreachedthroughwardlevelinteractions
69,358homevisitsconductedto1000dayhouseholdswith19,525inDAGHouseholds
14,9370thousanddayswomenandtheirfamilymembersreacheddirectlyindifferentnutrition
relateddayscelebration
12,062frontlineworkers(health&nonhealthpersonnel)includingFCHVstrainedinMIYCN
52VDCsdeclaredODFmakingatotalof106VDC
18,882 participants participated in 673 community level interaction events toincrease the
PHC/ORCservices
2,604 persons trained as Village Model Farmers ( VMF) and 1,080 VMF sprovided start up
materialstoestablishmodelHFPatcommunitylevelbasedonneedandactionplan
21,857mothers(1000dayandFCHVs)and1,552malemembersprovidedHFPbasictraining
530VDCsand11municipalitiescommittedatotalofNPR56,133,589VDCblockgrantbudgeton
integratednutritionpromotionrelatedactivitiesinthefiscalyear2071/72BS
33,206 mothers and caregivers, and 83,580 children reached during child nutrition week in
earthquakeaffecteddistricts
b.AgricultureandFoodSecurityProject
The Agriculture and Food Security Project (AFSP) is a five years project which is designed to
comprehensively address food and nutrition security issues in the most effective way possible. It is
implementedthroughthecollaborationofMinistryofAgriculturedevelopmentandMinistryofHealth
in19hillandmountaindistrictsofthefarandmidwesternregions(Darchula,Baitadi,Bajhang,Bajura,
Doti, Achham, Dadeldhura, Salyan, Pyuthan, Rolpa, Rukum, Surkhet, Dailekh, Jajarkot, Humla, Jumla,
Mugu,DolpaandKalikot).
TheobjectiveofAFSPisto:
To enhance household food security through increased agricultural productivity, household
incomesandimprovednutritionalpractices.
Food security will be realized through increased food availability, made possible by increasing
productivity of agriculture, both crop and livestock. Nutrition security will be realized through
improveddietaryintake,madepossiblebypromotionofdiversifieddiets,andimprovedfeeding
andcaringpracticesforpregnantandnursingwomenandchildrenupto2yearsofage
Majorexpectedoutputforhealthsector
Numberofpregnantand/ornursingmothersandchildren(624months)withimprovedietary
intakewillhavebeenincreasedby15%and30%respectively.
45,000householdswithPregnantandlactatingmotherswillhavebeenreceivedproject
supportedBehaviorChangeCommunication(BCC).
54,000 children will have been received appropriate Infant and Young Child Feeding (IYCF)
practices.
46
42
C.Golden1000daysProject
Golden1000daysProjectisimplementedbyMinistryofFederalAffairandLocalDevelopmentin
15districtsofeasternandcentralregionofNepaltoimproveattitudesandpracticestoenhance
nutritionaloutcomesamongpregnantwomenandchildrenunderageof2in15districts.Itis
fiveyearsprojectfundedbyWorldBank
d.SABALProject
SABALprojectisimplementedinsixdistricts(Makawanpur,Okhaldhunga,Khotang,Udayapur,
Ramechhap and Sindhuli) of eastern and central regions of Nepal to improve health and
nutrition.ItisfundedbyUSAID.
2.2.7.14Issues,challengesandRecommendations
Table2.2.7.5:IssuesandRecommendations
Issues/Problems/Constraints
Recommendation
Responsibility
Institutionalstrengtheningfor
nutritionandcapacitybuildingof
healthworkersatalllevels
Developmentofbasicnutritiontraining
packageandcapacitybuildingofhealth
workersatalllevels
DoHS/CHD,
NHTC
Slowscaleupofevidencebased
andcosteffectiveinterventionsof
IYCF,IMAM,IYCFMNP,SHNPdue
toresourcegap
Increaseresourcestofulfillgapand
gradualexpansion
DoHS/CHD
Changingthebehaviorofthe
peopletopromoteconsumptionof
localindigenousfood,dietdiversity
andnutritionrichfood
FocusonBCCforlocalfoodbased
approach
DoHS/CHD
Numberofstafffornutritionunder
DoHSisverylimitedandno
designatedpersonnelfornutrition
atregionanddistrictlevel
EstablishmentofNationalNutrition
Centre
MoH/
DoHS/CHD
Qualityofnutritiondata:under
reportingandoverreporting
Regular supportive supervision and

monitoringatalllevels
Regularfeedbackmechanism
Districtlevel
Periodically review of reported
datawithlocalhealthfacilities
Increase supervision in the health
facilities where under and over
reportinghasbeenaproblem
Healthfacility/
District/RHD
andCHD/HMIS
43
47
Issues/Problems/Constraints
Recommendation
Responsibility
Centrallevel
Provision of DQSA to the RHDS
anddistricts
Regularfeedbackmechanism
Delayprocurementofnutrition
commodities
Timelyprocurement
CHD/LMD
2.2.7.15:Newinitiativesinnutritionprogramme:
NationalMicronutrientStatusSurveyongoing
ImplementationofMIYCNactionplan
ImplementationofbasicpackageofSHNasdesignedinnewJAPandupdatedguideline
AdolescentIronandFolicAcid(IFA)supplementation
Revision/UpdatingofNationalNutritionPolicyandStrategyinlinewithHealthPolicy2071,
NHSSandMSNP
EstablishmentofNationalNutritionCentre(NNC)
48
44
ChildHealth:CBIMNCI
2.3 COMMUNITYBASEDINTEGRATEDMANAGEMENT
OFNEONATALANDCHILDHOODILLNESSES(CBIMNCI)
2.3.1
Background
CBIMCI,CBNCPandCBIMNCI:achronologicaldevelopment
In Nepal, Child survival intervention began when Control of Diarrheal Disease (CDD) Program was
initiatedin1983.Likewise,AcuteRespiratoryInfection(ARI)ControlProgramwasinitiatedin1987.
TomaximizetheARIrelatedservicesatthehouseholdlevel,referralmodelandtreatmentmodelat
community level was piloted. An evaluation of this intervention in 1997 revealed that treatment
model was more effective and popular in the community than referral model. In 1997/98,ARI
interventionwascombinedwithCDDandnamedasCBACprogram,afteroneyearlater,twomore
components, nutrition and immunization, were also incorporated in the CBAC program. IMCI was
piloted in Mahottari district and was extended to the community level as well. Finally government
has decided to merge the CBAC into IMCI in 1999 and named as Community Based Integrated
ManagementofChildhoodIllness(CBIMCI).CBIMCIincludedthemajorchildhoodkillerdiseaseslike
pneumonia, diarrhoea, malaria, measles, and malnutrition. The strategies adopted in IMCI were
improvingknowledgeandcasemanagementskillsofhealthserviceproviders,overallhealthsystems
strengthening and improving community and household level care practices. After piloting of low
osmolar ORS and Zinc supplementation, incorporated in CBIMCI program in 2005. Nationwide
implementation of CBIMCI was completed in 2009 and revised in 2012 incorporating important new
interventions.
Uptothe2005,Nepalhadmadehugeprogressinreductionofunderfiveandinfantmortalitybut
the reduction of neonatal mortality was observed very sluggish because country had not
implemented targeted interventions for newborns. Nepal state of world report had showed that
majorcausesofmortalitywereinfections,asphyxia,lowbirthweightandhypothermia.Government
of Nepal formulated the National Neonatal Health Strategy 2004 based on this 'Community Based
NewBornCareProgram(CBNCP)'wasdesignedin 2007,andpilotingstartedin2009.CBNCPhad
incorporated seven strategic interventions as behavior change communication, promotion of
institutional delivery, postnatal care, management of neonatal sepsis, care of low birth weight
newborns, prevention and management of hypothermia and recognition and resuscitation of birth
asphyxia.InSeptember2011MinistryofHealth(MoH)decidedtoimplementtheChlorhexidine(CHX)
Digluconate(7.1%w/v)aimingtopreventumbilicalinfectionofnewborn.Governmenthaddecided
toscaleuptheCBNCPandsimultaneously,programwasevaluatedin10piloteddistricts.Upto2014,
CBNCPwasimplementedin41districtscovering70%population.
Impact evaluation of CBIMCI and CBNCP focusing on neonatal mortality and under five mortality
reductionshasnotbeendocumentedinNepal.But,duetoCBIMCIprogramstrategy,theprevalence
of pneumonia and diarrhea has reduced significantly over the last decades. The care seeking
practicesandhouseholdlevelpracticeshavebeenimproved.CBIMCIprogramhasbecometheone
oftherolecommunitybasedprograminNepal.Otherinterventionswhichhashighcontributionin
reduction of postneonatal child mortality reduction biannual supplementation of Vitamin A
program,expandedprogramonimmunization.Ontheotherhand,essentialnewborncarepractices
50
45

ChildHealth:CBIMNCI
wereimprovedinCBNCPimplementeddistricts.
In both of the programs (CBIMCI and CBNCP), FCHVs were considered as front line health services
providersbutqualityandcoverageofserviceisverylow.Forinstance,only1.5%oftotalsepsiscasesare
seen by FCHVs, and only 33% of FCHVs can use thermometer correctly (Assessment report2014).
According to NDHS 2011, only 3% of under five children sought services from FCHVs, and none of ARI
casesaresoughttoFCHVs.About86%ofmotherdirectlygoestotrainedhealthworkersduringneonatal
sepsistreatment.ImportantlearninginCBNCPimplementationwasverylow(7%withintwodaysof
home delivery) PNC home visit. Low PNC home visits by FCHVs even incentive provided. Also met
need of asphyxia management (1.5%) by paramedics and ANMs working in nonbirthing centers,
wereusedtheseskillsveryrarely.
CBNCPandCBIMCIhavesimilaritiesininterventions,programmanagement,servicedeliveryandtarget
beneficiaries. Both programs had duplicated interventions like management of neonatal sepsis,
promotion of essential newborn care practices, infection prevention, and management of low birth
weight.Although,FCHVsaredoingverygooddistributionandpromotionofhealthybehaviorsbutpoorly
performinginservicedelivery.Moreover,theywereoverburdenedwithworkloadsandmassiveresource
was used in fragmented manner in the same purpose. Also, inequity in quality service delivery and
utilizationisbeingmajorchallengesinnewbornandchildhealthprogramming.Healthgovernanceissueis
alsoaffectingtobetterfunctioningofthehealthsystem.Consideringthemanagementandmaintenance
challengesinCBNCPandIMCIprogramMoHhaddecidedtomergethebothoftheprogramintoCB
IMNCI.
DistrictcoverageofCBIMCIprogram(19972014)
S.No. FiscalYear
1.
3.
4.
5.
6.
7.
8.
9.
10.
11.
2054/55
2056/57
2057/58
2058/59
2059/60
2060/61
2061/62
2062/63
2063/064
2064/65
12
2065/66
13
2066/67
Districts
No.of
Districts
Mahottari
1
Nawalparasi,Bardiya,andKanchanpur
3
DhanushaandNuwakot
2
RupandehiandKaski.
2
Dhankuta,Makwanpur,Banke,KailaliandBara
5
Jhapa,Morang,Sunsari,Saptari,Kavre,Tanahu,andDang
7
Sarlahi,Dadeldhura,Doti,BajhangandHumla
5
Udayapur, Sankhuwasava, Sindhuli, Gorkha, Parbat, Kapilvastu,
10
Jumla,Surkhet,PalpaandLamjung.
Panchthar,Siraha,Chitwan,Parsa,Dhading,Syngja,Gulmi,Mugu,
13
Rukum,Pyuthan,Jajarkot,AchhamandBaitadi.
Bhojpur, Ilam, Solukhumbhu, Rasuwa, Rautahat, Dolakha,
16
Ramechhap, Arghakhanchi, Baglung, Myagdi, Dailekh, Dolpa,
Kalikot,Bajura,Salyan,Lalitpur
Bhaktapur, Kathmandu, Khotang, Okhaldhunga, Taplejung,
11
Tehrathum, Sindhupalchowk, Manang, Mustang, Rolpa and
Darchula
TheremainingtrainingofthecommunityleveloftheBhaktapur,
Kathmandu, Khotang, Okhaldhunga, Taplejung, Tehrathum,
Sindhupalchowk,Manang,Mustang,RolpaandDarchula

51
46
ChildHealth:CBIMNCI
CommunitybasedNewborncareprogram(CBNCP)(2008/092014)
FiscalYear
Districts
Supports
CBNCP(PilotingPhase)
2010
Dhankuta,Morang,Palpa
Dang,Chitwan,Kavre
Parsa,Sunsari
Bardiya
Doti
CBNCP(ScallingupPhase)
2011
Terhathum, Sankhuwasabha, Sarlahi, Myagdi,
Kailali
Mahottari,Salyan,Dailekh,Jumla
Kapilvastu,Argakhachi
Banke
Nawalparasi
2012
Lamjung, Humla, Kanchanpur, Taplejung,
Bara
Baglung,Dolpa
Rautahat
Baitadi
2013
Bajura,Udayapur
Rupandehi,Pyuthan
Dadeldhura
2013
CBNCPrevision
2014
Makwanpur,Sindhuli
CHD
UNICEF
PlanNepal
SavetheChildren
CareNepal
CHD
Noof
district
3
3
2
1
1
NFHP
HRI
PlanNepal
SavetheChildren
CHD
4
2
1
1
5
OneHeart
PlanNepal
SavetheChildren
SavetheChildren
CNCP
CareNepal
PlanNepal
2
1
1
2
2
1
CBIMNCI
On 2071/6/28 (October 14, 2015) MOH had decided to integrate the CBIMCI and CBNCP into CB
IMNCI. It is implemented in 30 districts in FY 2071/72. It is comprised of the childsurvival
interventionsincludingessentialnew borncareandnewborncomplications suchasbirthaxphyxia,
neonatal sepsis, jaundice, hypothermia, low birth weight and preterm conditions, counseling of
breastfeeding. The role of FCHVs is to identify and refer for the sick young infants and underfive
children. Among the age group of 2 to 59 months children, it addresses major childhood killer
diseaseslikepneumonia,diarrhea,malaria,measlesandmalnutritioninaholisticway.
In CBIMNCI programFCHVs are expected to do counselling in different conditions of maternal,

newbornandchildhealthanddispensingofessentialcommoditieswhichdonotrequireassessment
and diagnostic skills like distribution of iron, zinc, ORS, chlorhexidine and referralin case of any
danger signs appear. And health workers will counsel, and provided the health service like
managementofnonbreathingcases,kangaroomothercareandmanagementofneonatalsepsisand
common childhood illness. Also program has provisioned the postnatal visits by trained health
workers through primary health care outreach clinic. For treatment of neonatal sepsis, treatment
regimenwillbetheoralamoxicillinandinjectiongentamycine.Institutionalizationandaccreditation
52
47

ChildHealth:CBIMNCI
oftraininghasbeenstarted.ProgramhasenvisionedthatCHDrolewillbethequalityassuranceand
monitoring of the CBIMNCI program and NHTC will be the lead agency for training. NHTC will
producethemaster'strainersanddistrictwillbefullyresponsibleforprogramimplementation.Now
CBIMNCI program will not be limited to completing training and will be implemented and
strengthenedtomakeitoneofthesuccessfulprograms.Theprocessofrapidneedassessmentwhich
will helpful for contextual planning and customization of the implementation approach in the
districts.
The core objectives of the CBIMNCI programmeis to reduce the morbidity,mortality and disability
among new borns, infants and children aged under five and to improve the nutritional status of
children.
Source:CHD
Vision
Contributetosurvival,healthygrowthanddevelopmentofunderfiveyearschildrenofNepal.
Goals
Improvenewbornandchildsurvivalandhealthygrowthanddevelopment.
Targets
Toreduceunderfivemortalityfromthecurrentrateof38/1,000andIMR33/1000livebirths
to32/10000livebirths
To reduce neonatal mortality from the current rate of 23/1,000 live births (NMICS) to
16/1000livebirths

53
48
ChildHealth:CBIMNCI
Objectives
Toreduceneonatalmorbidityandmortalitybypromotingessentialnewborncareservices.
Toreduceneonatalmorbidityandmortalitybymanagingmajorcausesofillness
Toreducemorbidityandmortalitybymanagingmajorcausesofillnessamongunder5years
children
Strategies
Rapidexpansion,phasewiseimplementationandonsitecoaching
Carryout contextspecific decentralized planning and phase wise implementation of CB
IMNCI interventions with additional focus on underserved children (urban slums,
marginalized,disadvantagedgroupsandhardtoreachareas).
Strengthen the provision and quality integrated neonatal and child health services at the
communityandhealthfacilitylevels
Strengthenmanagementoflogisticssupply
Improvecollaborationwithpublicandprivatesectors(stateandnonstate)forstandardized
newbornandchildhealthservices
Researchandinnovationforprogramimprovement
Strengthenhomeandcommunitybasedpracticesandpromotecommunityparticipation
MajorstrategicinterventionsincludedinofCBIMNCIProgram
NewbornSpecificInterventions
Promotionofbirthpreparednessplan
Promotionofessentialnewborncarepracticesandpostnatalcaretomothersandnewborns
Identificationandmanagementofnonbreathingbabiesatbirth
Identificationandmanagementofpretermandlowbirthweightbabies
Managementofsepsisamongyounginfants(059days)includingdiarrhea
ChildSpecificInterventions
Case management of children aged between 259 months from 5 major childhood killer
diseases(pneumonia,diarrhoea,malnutrition,measlesandmalaria)
CrossCuttingInterventions
Behaviorchangecommunicationsforhealthypregnancy,safedelivery,healthynewbornand
U5children
ImprovedknowledgerelatedtoEssentialNewbornCare,Nutritionandcareofsickchildren
Timelyreferralofsickchildren
ImprovedinterpersonalcommunicationskillsofHWsandFCHVs
Achievehigheffectivecoverageofinterventions
2.3.2
MajorActivities
MajoractivitiescarriedoutinFY2071/72includethefollowing:
CBIMNCITraining(ToT,DistrictPlanning,HFandFCHVLevelTraining)andonsitecoachingin
8districts(Nuwakot,Nawalparasi,Mugu,Kalikot,Jajarkot,Rukum,SurkhetandDadeldhura).
Reviewreflectionandplanningworkshopwasorganizedtofinalizethecurrentmodalitywith
thedirectionofChiefspecialists,DirectorGeneral,involvementofMoH,Policy,Planningand
54
49

ChildHealth:CBIMNCI
2.3.3
InternationalCoordinationDivisions,CurativeDivision,differentdivisionsofDoHS,regional
directors,districtchief,focalpersonsandprofessionalorganizationsandallthepartners.
CHX intervention in seven districts (Panchthar, Rasuwa completed), Okhaldhunga, Kalikot,
Dhading,Mugu,Gorkha(Started)
WorkshoponCBIMNCIpackagedevelopment
CBIMNCIToT(5batches)byGoNandwithsupportofUNICEF,WHO,H4L
ProgressanalysisandimprovementofCBIMNCIprogramat87disadvantagedVDCsinHealth
for Life project (H4L) districts: ward and caste wise data recorded on IMCIOPD register were
analyzedforimprovementofCBIMNCIprogram
ToTonCBIMNCIPackagebyGoNandpartners.
Communitycareofpretermandlowbirthweightbabiesbornathomeusingfootlengthcard
2districts(NuwakotandRasuwa)
SupervisionandMonitoringoftheprograminCBIMNCIprogramimplementeddistricts
IMNCI handbook and Bal swasthya Manjari are our publication to support this program
effectivelyfromdifferentsector.
AnalysisofAchievement
Since FY 2064/65, CBIMCI services data (as received from Health Facilities, VHWs/MCHWs and
FCHVs) has been incorporated into HMIS. Therefore, from FY 2064/65 onwards, service provided
atcommunity level (VHW/MCHW and FCHVs) is considered as community level data whereas total
serviceprovidedfromHealthFacilitylevelinadditionwithcommunitylevelconstitutesthenational
aggregateddataforthisprogram.
CBIMNCIprogrammehasbeeninitiatedfromFY2071/72.FromFY2071/72HealthFacilityLeveland
Primary Health Care and Out Reach Clinics (PHC/ORC) data has been incorporated into HMIS.
Consequently, the role of FCHV at community level has been redefined for counseling parts for
newborn care.Obviously, the treatment protocol also has been changed and role of FCHVs at the
community level has been assigned as health promoters/counselors rather than health service
providers.
1.Managementofnewbornsaged028days
Thestatusofthe028daycasesregisteredathealthfacilitiesPHC/ORCandFCHVinFY2071/72has
beenpresentedinTable2.3.1.
Table2.3.1ClassificationandTreatmentof028dayNewbornCasesbyregioninFY2071/72
Indicators
EDR
CDR WDR MWDR FWDR National
%
Total028dayNewbornCases
6,801 7,196 4,339 8,536
5,237
32,109
(HF+PHC/ORC
PossibleSevereBacterial
903
829
447
1,923
1069
5,171
16.10%
Infection(PSBI)
LocalBacterialInfection(LBI)
3,659 3947 1,966 3,181
2,567
15,320 47.71%
Hypothermia
86
126
57
180
117
566
1.76%
Jaundice
399
503
554
538
189
2,183
6.80%
LowWeightorBreastFeeding
313
326
300
429
361
1,729
5.38%

55
50
ChildHealth:CBIMNCI
Indicators
Problem
TreatmentandReferral
TreatmentbyCotrim
Refer
Deaths
FCHV
Sickbaby
TreatedwithCotrim.&referred
toHF
Deaths
Source:HMIS
EDR
CDR
WDR
MWDR
FWDR
National
3,147 2,480
476
582
24
31
1,429
311
17
4,207
274
81
2,430
223
69
13,693
1,866
222
42.65%
5.81%
0.69%
3,765 3,574
2,319
4,230
6,677
20,565
2,791 2,064
243
295
884
179
2,998
419
2,304
466
11,041
1,602
53.69
7.79
InFY2071/72,atotalof32,109newbornscaseswereregisteredandtreatedathealthfacilitiesand
PHC/ORC.Outoftotalregisteredcases5,171(16.10%)wereclassifiedandtreatedasPossibleSevere
BacterialInfection(PSBI).
At the regional level, MWDR have treated highest percentage of PSBI cases (22.53%), followed by
FWDR(20.40%),EDR(13.30%),CDR(11.50%),andWDR(10.30%).Seefigure2.3.1.
Among the total registered 228 days new born cases at national level, LBI 15,320 (47.71%),
Hypothermia 566 (1.76%), Jaundice 2,183 (6.80%), Low weight or Breast Feeding Problem 1,729
(5.38%)wereclassifiedandtreated.Outofthetotalcases13,693(42.66%)weretreatedbycotrim
pediatrictablet.Total1,866(5.81%)caseswerereferredand222(0.69%)werereportedasdeathat
HF.
The Table 2.3.1 also shows that 20,565 sick babies were checked by FCHVs. Out of the total cases
11,041(53.69%)weretreatedbyCotrim.andreferredtoHFsand1,602(7.79%)caseswerereported
deadbyFCHVsattheircommunity.
Figure2.3.1:028daysagednewborncasesregistered
andPercentageofPSBICasesTreatedatHFs
2. Management of 2959
daysNewbornCases
The status of the 2959 day 10,000

cases registered at health 8,000
facilities PHC/ORC and FCHV
from FY 2069/70 to FY 6,000
2071/72 has been presented 4,000
inTablebelow(Table2.3.2)
56
51
TotalCases
%
6,801
NationalTatal :32,109(16.1%)
7,196
22.53
4,339
13.30
11.50
2,000
25.00
8,536
20.40
20.00
5,237
15.00
10.00
10.30
5.00
0.00
0
EDR
CDR
WDR
MWDR
FWDR

ChildHealth:CBIMNCI
Table2.3.2.ClassificationandTreatmentof<2months(2959days)InfantsCasesbyregionfrom
FY2069/70to2071/72andsickbabytreatedbyFCHVinFY2071/72.
Indicators
TotalCases(HF+PHC/ORC
PossibleSevereBacterial
Infection(PSBI)
LocalBacterialInfection(LBI)
Hypothermia
Jaundice
LowWeightorBreastFeeding
Problem
Year
EDR
CDR WDR MWDR FWDR National
2069/70 13,400 10,899 7,076 12,523 9,363 53,261
2070/71 12,167 11,539 7,389 13,352 9,793 54,240
2071/72 11,455 11,882 6,789
8,864 8,189 47,179
2069/70 1,808 1,442 591 3,052 1,331
8,224
2070/71
1,463 1,250
383
2,853 1,579
7,528
2071/72
779
804
526
1,117
689
3,915
2069/70
6,407
5,147 2,861
4,531 3,759
22,705
2070/71
6,436
4617 3,078
4,616 4,114
22,861
2071/72
6,675
6930 3,086
4,433 3,539
24,663
2069/70
78
127
98
202
52
557
2070/71
125
78
89
153
231
676
2071/72
136
232
136
177
207
888
2069/70
489
577
591
609
243
2,509
2070/71
416
672
561
508
150
2,307
2071/72
248
384
221
218
88
1,159
2069/70
1,205
946
939
1,158
1004
5,252
2070/71
960
1125
942
1120
1164
5,311
2071/72
572
560
372
600
444
2,548
15.4%
13.9%
8.3%
42.6%
42.1%
52.3%
1.0%
1.2%
1.9%
4.7%
4.3%
2.5%
9.9%
9.8%
5.40%
TreatmentandReferral
TreatmentbyCotrim
TreatmentbyGentamicin
2069/70
2070/71
2071/72
2069/70
2070/71
FY2071/721st.Dose
2071/72
CompleteDose
OtherAntibiotic
2071/72
2069/70
Refer
2070/71
2071/72
Followup
2071/72
2069/70
Deaths
2070/71
2071/72
FCHV
Sickbaby
2071/72
TreatedwithCotrim&referred
2071/72
toHF
2069/70
2070/71
Deaths
2071/72
5,843
5681
6658
1,969
1,638
1070
974
1929
613
562
400
5918
117
27
10
3,976 2,163
3583 2244
5431 2639
1,672
689
1,378
651
911
310
1176
325
2269 1111
733
292
426
275
429
215
6035 2408
357
52
10
34
9
7
6,294
6324
5236
3,340
3,330
2558
2420
1250
317
318
179
4806
117
25
28
4,389
4099
3639
2,128
1,608
1212
1214
1006
293
277
252
3938
222
37
21
22,665
21,931
23,603
9,798
8,605
6,061
6,109
7,565
2248
1858
1475
23105
865
133
75
42.55%
40.43%
50.03%
18.40%
15.86%
12.85%
12.95%
16.03%
0.04
0.03
0.03
0.49
0.016
0.002
0.002
11051
11556
6337
10841
10499
50284
7864
5107
3036
6235
5443
27685
55.06
117
27
24
357
10
33
52
34
11
117
25
51
222
37
33
865
133
152
0.30
Source:HMIS
In FY 2071/72, a total of 47,179 infants of 2959 days cases were treated at health facilities and
PHC/ORC clinics which is slightly low in comparison to FY 2069/70 and 2070/71 (Table 2.3.2).The
table also shows that there has been significant decrease in the number of cases treated for PSBI
(3,915cases)inFY2071/72.WhereascasestreatedforLBIhasslightlyincreasedatnationallevelin

57
52
ChildHealth:CBIMNCI
FY 2071/72 compared to FY 2069/70 and FY 2071/72. Treatment for jaundice has decreased more
than 50 percent in FY 2071/72 compared to FY 2069/70 and 2070/71. Treatment of Hypothermia
caseshasslightlyincreasedinFY2071/72thanthatofpreviousfiscalyears.Treatmentandreferralof
babieswithlowweightandfeedingproblemshasdecreasedsignificantlyinFY2071/72comparedto
FY2069/70andFY2070/71.ReporteddeathsareindecreasingtrendoversinceFY2069/70.
The Table 2.3.2 also shows that 50,284 sick babies were checked by FCHVs. Out of the total cases
27,685 (55.06%) were treated by cotrim. and referred to HFs. Reported number of deaths in
communityisslightlyincreasedinFY2071/72incomparisonofpreviousFiscalYear.
3.Diarrhoea
CBIMNCI program has imparted positive impact on the skills and knowledge of health workers,
enabling them for better identification, classification and treatment of diarrhoeal diseases. Health
workers classify the three categories of dehydration of all the diarrheal cases as 'No Dehydration',
'SomeDehydration',andSevereDehydration'asperthetreatmentprotocolofCBIMCI.
Thereportednumberoftotalnewdiarrhoealcases(healthfacility,PHC/ORCClinicsandFCHVs)and
classificationofdehydrationbyregionoverthelastthreeyearshavebeenpresentedinTable2.3.3.
In FY 2071/72, a total of 1,413,111 diarrhoeal cases were reported. The reported number of new
diarrhoealcaseshasslightlydecreasedinFY2071/72comparedtoFY2069/70andFY2070/71.
Atthenationallevel,percentageofseveredehydrationhasdecreasedto0.2inFY2071/72compared
toFY2069/70andFY2070/71.Amongsttheregionsitcontinuedtoconstantat0.2inEDRoverlast
threeyears.ComparedtoFY2070/71,verynominalincreaseisseeninMWDRbutremainedconstant
inWDRanddecreasedinCDRandFWDRinFY2071/72.
Figure 2.3.2: Percentage of Severe Dehydration

among new diarrhoeal cases (<5 Children)
2069/70
2070/71
2071/72
EDR
0.2
0.1
0.1
0.2
0.2
0.2
NATIONAL
0.2
0.3
0.3
0.4
0.2
0.4
0.4
0.6
0.3
0.3
0.2
0.8
0.3
0.2
0.3
0.8
1.0
MWDR
FWDR
0.0
58
53
CDR
WDR

ChildHealth:CBIMNCI
Table2.3.3:Classificationofdiarrhoealcasesbyregion,FY2069/70to2071/72
Region
Indicators
Year
EDR
CDR
WDR MWDR
FWDR
2069/70 381,039 467,809 282,303 324,144 298,463
TotalCases
2070/71 379,550 473,097 259,520 337,542 317,194
(HF+Community)
2071/72 290,640 384,635 210,179 276,462 251,195
351,416 435,760 271,529 307,646 286,067
2069/70
92.2%
93.1%
96.2%
94.9%
95.8%
352,202 443,657 250,585 321,347 305,207
NoDehydration
2070/71
92.8%
93.8%
96.6%
95.2%
96.2%
261,533 354,172 199,633 259,130 238,486
2071/72
90.0%
92.1%
95.0%
93.7%
94.9%
28,879 30,147 10,230 15,530 11,571
2069/70
7.6%
6.4%
3.6%
4.8%
3.9%
26,573 25,797 8,649
15,367 11,083
SomeDehydration
2070/71
7.0%
5.5%
3.3%
4.6%
3.5%
28,459 29,450 10,286 16,531 12,206
2071/72
8.1%
6.8%
3.8%
5.4%
4.3%
744 1,902
544
968
825
2069/70
0.2%
0.4%
0.2%
0.3%
0.3%
775 3,643
286
828
904
SevereDehydration 2070/71
0.2%
0.8%
s0.1%
0.2%
0.3%
648 1,013
260
801
503
2071/72
0.2%
0.3%
0.1%
0.3%
0.2%
Note:*Casesreportedfromhealthfacilityandcommunity;Source:HMIS
National
1,753,758
1,766,903
1,413,111
1,652,418
94.2%
1,672,998
94.7%
1,312,954
92.9%
96,357
5.5%
87,469
5.0%
96,932
5.9%
4,983
0.3%
6,436
0.5%
3,225
0.2%
Table2.3.4:IncidenceandCaseFatalityofDiarrhoeaamongchildrenunder5yearsofage,by
region,FY2069/70to2071/72
Region
Indicators
Year
National
EDR
CDR
WDR MWDR FWDR
2069/70 636,830 1,120,978 564,053 468,742 337,322 3,127,925
Total<5Popufor
2070/71 579,372
981,253 482,756 450,398 314,400 2,808,179
CDD/ARI
2071/72 604,096 1,019,943 508,025 400,118 287,878 2,820,060
2069/70
381,039 467,809
282,303 324,144 298,463 1,753,758
TotalCases
259,520 337,542 317,194 1,766,903
(HF+Community) 2070/71 379,550 473,097
2071/72 290,640 384,635 210,179 276,462 251,195 1,413,111

2069/70
4
19
30
50
13
116
DiarrhoealDeaths 2070/71
3
4
7
16
6
36
2071/72
26
16
3
24
11
80
2069/70
615
427
515
717
921
528
Incidenceof
diarrhoea/1,000
2070/71
655
482
538
749
1,009
629
<5yrs.Popn.
2071/72
481
377
414
693
873
501
2069/70
0.01
0.04
0.11
0.15
0.04
0.07
CaseFatalityRate/
2070/71
0.01
0.01
0.03
0.05
0.02
0.02
1,000<5yrs.Popn.
2071/72
0.09
0.04
0.01
0.09
0.04
0.06
Note:*Casereportedfromhealthfacilityandcommunity;Source:HMIS
The national incidence of diarrhoea per 1,000 underfive years' children has considerably
decreasedto 501/1,000 under 5 years children in FY 2071/72 from 528/1,000 in 2069/70 and

59
54
ChildHealth:CBIMNCI
629/1,000in2070/71(Table2.3.4).Theincidenceofdiarrhoeahasdecreasedinallregionscompared
topreviousfiscalyears.ThehighestincidenceofdiarrhoeaoccurredatFWDR(873/1,000underfive
children)followedbyMWDR(693),EDR(481),WDR(414)andCDR(377).
DiarrhoealdeathshasslightlyincreasedinFY2071/72atnationallevelaswellasinall theregions
except in WDR as compared to FY 2070/71. Consequently, Diarrhoea case fatality rate also has
increased. It has increased in EDR followed by MWDR, CDR, FWDR but remained low in WDR,
comparedtoFY2070/71.
Table2.3.5:Treatmentofdiarrhoealdiseases,byregion,FY2069/70to2071/72
Region
Indicators
Year
National
EDR
CDR
WDR MWDR
FWDR
2069/70 381,039 467,809 282,303 324,144 298,463 1,753,758
TotalCases
2070/71 379,550 473,097 259,520 337,542 317,194 1,766,903
(HF+Community)
2071/72 290,640 384,635 210,179 276,462 251,195 1,413,111
354,395 463,676 245,352 323,305 284,882 1,671,610
2069/70
93.0%
99.1%
86.9%
99.7%
95.4%
95.3%
368,329 454,822 249,012 332,100 298,211 1,702,474

ORS+Zinc
2070/71
97.0%
96.1%
96.0%
98.4%
94.0%
96.4%
256,479 365,274 194,465 269,839 229,205 1,315,262

2071/72
88.2%
95.0%
92.5%
97.6%
91.2%
93.1%
2,455
3345
1687
1712
3295 12,494
2069/70
0.6%
0.7%
0.6%
0.5%
1.1%
0.7%
1,038
2,655
1,209
2,385
1,695 8,982
TreatedwithIVFluid
2070/71
0.3%
0.6%
0.5%
0.7%
0.5%
0.5%
1,652
3,032
1,038
2,025
1,428 9,175
2071/72
0.6%
0.8%
0.5%
0.7%
0.6%
0.6%
Source:HMIS
ThetreatmentsofdiarrhoeabyORSandZincandIVfluidhavebeenpresentedinTable2.3.5.InFY
2071/72, the proportion of diarrhoeal cases treated by ORS and Zinc at national level has been
slightly decreased to 93.1 percent compared to FY 2069/70 and FY 2070/71 but it remained more
than90percent.Further,theproportionof
Figure 2.3.3 Diarrhoeal Cases Treated at
case treated by IV Fluid has slightly
different level in FY 2071/72
increased to 0.6 percent in FY 2070/71
from 0.5 percent of FY 2070/71.
Significantly, treatment of diarrhoea with
HF
ORS and Zinc is near to 90 percent. This
25.88%
canbeattributedtotheeffectofCBIMNCI
program.
PHC/ORC
FCHV
8.32%
Out of the total 1,413,111 diarrhoeal
65.81%
cases, 25.88 percent were treated at HFs,
8.32 percent were treated at PHC/ORC
clinics and 65.81 percent cases were
treatedbyFCHVs(Figure2.3.1).
60
55

ChildHealth:CBIMNCI
4.AcuteRespiratoryInfection
InFY2071/72,atotalof2,208,221ARIcaseshavebeenreported(Table2.3.6).Thereportednumber
ofNewARIcasessignificantlydecreasedinFY2071/72comparedtoFY2069/70andFY2070/71.
Table2.3.6:TotalARINewCases,byRegion,fromFY2069/70to2071/72
Region
EDR
CDR
WDR
MWDR
2069/70 636,830 1,120,978 564,053 468,742
Target
population<5 2070/71 579,372 981,253 482,756 450,398
years
2071/72 604,096 1,019,943 508,025 400,118
2069/70 701,690 769,128 490,965 471,322
TotalCases
(HF+
2070/71 671,550 713,746 441,255 453,127
Community)
2071/72 536,774 566,442 352,136 402,000
2069/70
1,102
686
870
1,006
ARINew
2070/71
1,159
727
914
1,006
Cases/1000
2071/72
889
555
693
1,005
2069/70
70.7%
74.2%
78.8%
72.0%
%ofNo
2070/71
69.2%
71.1%
71.0%
70.3%
Pneumonia
2071/72
70.4%
74.0%
79.6%
69.4%
2069/70
30.4%
26.1%
21.3%
29.7%
%of
2070/71
29.1%
24.2%
20.6%
29.3%
Pneumonia
2071/72
29.3%
25.6%
20.2%
30.1%
2069/70
0.3%
0.4%
0.2%
0.5%
%ofSevere
2070/71
0.3%
0.4%
0.2%
0.5%
Pneumonia
2071/72
0.4%
0.4%
0.2%
0.5%
Note:*Casesreportedfromhealthfacilityandcommunity;Source:HMIS
Indicators
Year
National
FWDR
337,322
314,400
287,878
394,654
392,244
350,869
1,170
1,248
1,219
76.6%
76.4%
76.9%
23.0%
21.2%
22.7%
0.5%
0.5%
0.4%
3,127,925
2,808,179
2,820,060
2,827,759
2,671,922
2,208,221
904
951
783
74.1%
71.2%
73.6%
26.5%
25.3%
26.0%
0.4%
0.4%
0.4%
Atthenationallevel,reportedARIcasesper1,000underfivepopulationhasalsodecreasedto783in
FY 2071/72 compared to FY 2069/70 and 2070/71 (Table 2.3.6). Reported incidence of ARI has
decreasedinallregionsduringFY2071/72withsharpdeclineinEDR,WDRandCDRascomparedto
previousFY2070/71.ThehighestrateofnewARIcasesperthousandU5childrenoccurredinFWDR
(1,219)followedbyMWDR(1,005),EDR(889),WDR(693)andCDR(555)inFY2071/72.
Figure2.3.4:PercentageofSeverePneumoniaamongNewARICases(<5Children)FY2069/70to
2071/72
0.3
0.3
0.4
0.4
0.4
0.4
National
EDR
CDR
2071/72
0.4
MWDR
FWDR
0.2
0.2
0.2
0.6
0.5
0.5
0.4
2070/71
0.5
0.5
0.5
2069/70
0.4
0.4
0.4
Figure 2.3.4: Percentage of Severe Pneumonia Among New ARI Cases (<5
Children)
0.2
0

WDR
61
56
ChildHealth:CBIMNCI
PercentageofseverepneumoniaremainedconstantinFY2071/72atNationallevel(0.4%)compared
toFY2069/70andFY2070/71(Figure2.3.4).AttheregionallevelalsoitremainedconstantinCDR
(0.4)andWDR(0.2)andMWDR(0.5),butitslightlydecreasedinFWDR(0.4)comparedtoprevious
fiscal years. Severe Pneumonia has been slightly increased in EDR (0.4) in 2071/72 compared
previous fiscal years. The low prevalence of severe pneumonia can be attributable to the early
detectionandpropermanagementofARIcasesbyhealthworkers,andFCHVsinCBIMNCIdistricts.
InFY2071/72,outofthetotal2,208,221NewARIcasesregistered,581,929casesweretreatedfor
pneumonia(Pneumonia+SeverePneumonia),whichaccountedfor26.4percentatNationallevel.It
hasslightlyincreasedinFY2071/72comparedtoFY2070/71andremainedstilllowfromthatofFY
2069/70. On the other hand, the incidence of pneumonia (Pneumonia and Severe Pneumonia) has
been increased in FY 2071/72 compared to previous years. The incidence of pneumonia per 1,000
under5years'childrenis264inFY2071/72atnationallevel.
Table2.3.7:TotalPneumoniaCases,PercentageofPneumoniaandSeverePneumonia,Incidenceof
ARI,Incidenceofpneumonia,Deaths,andCaseFatalityRatebyRegionFY2069/70to2071/72
Region
Indicators
EDR
CDR
WDR MWDR FWDR
%
Year
National
2069/70 636,830 1,120,978 564,053 468,742 337,322 3,127,925
Target
2070/71 579,372 981,253 482,756 450,398 314,400 2,808,179
population
<5years
2071/72 604,096 1,019,943 508,025 400,118 287,878 2,820,060
2069/70 701,690 769,128 490,965 471,322 394,654 2,827,759
TotalCases
(HF+Community 2070/71 671,550 713,746 441,255 453,127 392,244 2,671,922
)
2071/72 536,774 566,442 352,136 402,000 350,869 2,208,221
2069/70 495,875 570,636 386,773 339,342 302,259 2,094,885 74.1

NoPneumonia 2070/71 464,745 507,521 313,136 318,461 299,645 1,903,508 71.2
2071/72 377,820 419,155 280,284 279,164 269,869 1,626,292 73.6
2069/70 213,157 200,392 104,567 139,915 90,661
748,692 35.7
Pneumonia
2070/71 195,619 173,057
90,784 132,786 83,217
675,463 25.3
2071/72 157,053 145,032
71,071 120,824 79,498
573,478 26.0
2069/70 2,348
2,785
1,027
2,591
2,075
10,826
0.4
Severe
2070/71 2,073
2,542
878
2,170
1,907
9,570
0.4
Pneumonia
2071/72 1,901
2,255
781
2,012
1,502
8,451
0.4
2069/70
215,505
203,177
105,594
142,506
92,736
759,518
27
Total
Pneumonia
2070/71 197,692 175,599
91,662 134,956 85,124
685,033
26
Cases
2071/72 158,954 147,287
71,852 122,836 81,000
581,929
26
2069/70
338
181
187
304
275
243
Incidenceof
Pneumonia
2070/71
341
179
190
300
271
244
/1,000<5children 2071/72
296
260
204
306
231
264
30.7
26.4
21.5
30.2
23.5
26.9
%ofPneumonia 2069/70
2070/71
29.4
24.6
20.8
29.8
21.7
25.6
(Pneumonia+
Severe)
2071/72
29.6
26.0
20.4
30.6
23.1
26.4
2069/70
185
872
308
129
299
1,793
ARIreported
2070/71
27
23
19
51
48
168
deaths
2071/72
45
36
10
37
27
155
ReportedARI
2069/70
0.26
1.13
0.63
0.27
0.76
0.63
case
2070/71
0.04
0.03
0.04
0.11
0.12
0.06
Fatality
2071/72
0.08
0.06
0.03
0.09
0.08
0.07
rate/1,000
Source:HMIS
62
57

ChildHealth:CBIMNCI
ThereportedtotalARIrelateddeathsincreasedto337intheFY2071/72.Itwas168inFY2070/71
but remained low 1,793 of FY 2069/70. Consequently, the ARI case fatality rate among underfive
childrenalsoincreasedto0.15inFY2071/72butremainedlowthanofFY2069/70.InFY2069/70it
was0.63and0.06inFY2070/71.AmongsttheregionsARIcasefatalityslightlyincreasedinEDR(0.42)
and CDR (0.06), but decreasing tendency is seen in WDR (0.03), MWDR (0.09) and FWDR(0.08)
comparingtoFY2070/71.
Treatment of ARI at home has decreased to 54.6 percent in FY 2071/72 in comparison with FY
2069/70 and 2070/71. Treatment by cotrimoxazole has slightly increased to 33.6 percent in FY
2071/72comparedtoFY2069/70and2070/71.Furthermore,treatmentofARIbyotherantibiotics
has also slightly increased to 11.8 percent in FY 2071/72 which is highest percentile of previous FY
2069/70andFY2070/71(Table2.3.7).
Table2.3.8:TreatmentofARIcasesbyregionfromFY2069/70to2071/72
Region
Indicators
Year
National
EDR
CDR
WDR MWDR FWDR
2069/70 701,690 769,128 490,965 471,322 394,654 2,827,759
TotalCases
2070/71 671,550 713,746 441,255 453,127 392,244 2,671,922
(HF+
Community)
2071/72 536,774 566,442 352,136 402,000 350,869 2,208,221
2069/70 381,119 440,217 316,715 250,248 237,582 1,625,881
54.3%
57.2%
64.5%
53.1%
60.2%
57.5%
379,751 427,442 286,523 243,484 245,617 1,582,817
Home
2070/71
Treatment
56.5%
59.9%
64.9%
53.7%
62.6%
59.2%
284,045 314,351 199,018 203,189 204,326 1,204,929
2071/72
52.9%
55.5%
56.5%
50.5%
58.2%
54.6%
2069/70 258,160 261,277 133,523 174,728 120,731 948,419
36.8%
34.0%
27.2%
37.1%
30.6%
33.5%
231,861 220,110 118,867 162,805 112,841 846,484
Antibiotic
2070/71
(Cotrim)
34.5%
30.8%
26.9%
35.9%
28.8%
31.7%
194,680 184,192 105,856 147,620 110,216 742,564
2071/72
36.3%
32.5%
30.1%
36.7%
31.4%
33.6%
2069/70 62,411 67,634 40,727 46,346 36,341 253,459
8.9%
8.8%
8.3%
9.8%
9.2%
9.0%
59,938
66,194
35,865
46,838
33,786
242,621
Other
2070/71
8.93%
9.27%
8.13% 10.34%
8.61%
9.08%
Antibiotics
58,049 67,899 47,262 51,191 36,327 260,728
2071/72
10.8%
12.0%
13.4%
12.7%
10.4%
11.8%
Source:HMIS
Figure2.3.5ARICasesTreatedatdfferent
InFY2071/72atotalof2,208,221New
levelFY2071/72
ARI Cases among underfive children
weretreatedinFY2071/72.Outofthe
totalARIcases,34.28%weretreatedat
HF
HFs, 8.61% cases were treated at
34.28%
PHC/ORC clinics and 57.11% were
FCHV
57.11%
treatedbyFCHVs.
PHC/ORC
8.61%
TotalCasestreated
2,208,221

63
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ChildHealth:CBIMNCI
5.Othercommonchildhoodillnesses
Other
Anaemia
Severe
malnutrition
Otherfever
Earinfection
Measles
Non
falciparum
Falciparum
Dysentery
Malaria
VerySevere
Febriledisease
Table2.3.9ClassificationandtreatedcasesunderCBIMNCIProtocol
Regions
Eastern
10461
99 1,994 1,586
306 24,315 34,942
849 1,072 75,241
Central
18356 304 3,225 1,316
432 32,052 48,095 1,404 2,176 91,580
Western
11547
50
319 1,240
80 16,804 38,258 1,172 1,057 69,605
Midwestern 14481
42
632 1,038
187 18,751 34,487 2,487 1,441 65,480
Farwestern 12047
42
445 1,044
174 12,250 37,166 1,975 1,615 51,515
Total
66892
537 6,615 6,224 1,179 104,172 192,948
7,887
7,361 353,421
CBIMNCIProgrammealsofocusesonidentifyingmalaria,malnutrition,measles,andothercommon
illnessesamongchildren.Theinterventionstoaddressmalnutritionamongchildrenarebeingledby
NutritionSection and interventions to address measles and other vaccine preventable diseases are
beingledbyEPISectionwithinChildHealthDivision.MalariaisledbytheEDCD.IMNCISectionwould
actively collaborate with EPI and Nutrition Sections for the reduction of Malnutrition and Measles
andothercommonchildhooddiseasesthroughgeneratingevidencesrelatingtochangingpatternof
childhood disease epidemiology and strengthening the integrated approach to childhood disease
prevention.
In the course of <5 children case assessing at health facilities and PHC/ORC clinics under the CB
IMNCI Protocol, health workers identified 66,892 Dysentry, 537 Malaria Falciparum, 6,615 Non
FalciparumMalaria,6,224VerySevereFebriledisease,1,179Measles,104,172EarInfection,192,948
OtherFever,7,887SevereMalnutrition,7,361Anaemiaand353,421Otherdiseases.
6.KeyCBIMNCIProgramMonitoringIndicators:
CBIMNCIprogramhasidentified6majorindicatorstomonitortheprogramthatislistedbelow:
1. %ofInstitutionaldelivery
2. %ofnewbornwhohadchlorhexidinegelappliedimmediatelyafterbirth(withinonehour)
3. %ofinfants(02months)withPSBIreceivingcompletedoseofGentamycin
4. %ofunder5childrenwithpneumoniawhoreceivedantibiotics
5. %ofunder5childrenwithdiarrheatreatedwithORSandZinc
6. Stockoutofthe5keyCBIMNCIcommoditiesinafacility(ORS,Zinc,Amoxicillin/Cotrim,CHX)
Vision 90 by 20: CBIMNCI program has a vision to provide targeted service to 90% of the target
populationby2020thatisshowninthediagrambelow.
64
59

ChildHealth:CBIMNCI
All program monitoring indicators except 1
and 6 numbers are presented in the table
below 2.3.10. District wise institutional
delivery is presented in Safe Motherhood
programsection.Itisexpectedthatifhealth
facility delivery is high, program envisioned
thattherewouldbegoodessentialnewborn
care and immediate management of
complications like birth asphyxia. Another
important indicator, stock out of the 5 key
CBIMNCI commodities, ORS, Zinc,
Amoxicillin/Cotrim, Gentamycin and CHX) in
a facility. This information can be obtained
fromLMISreport.
Institutional
Delivery
Under 5
children with
Pneumonia
treated with
Antibiotics
To provide service
to 90% of targeted
group by 2020
Newborn
who had
CHX gel
applied
Under five
children with
Diarrhea
treated with
ORS and
Zinc
Table2.3.10:DistrictwiseProgramMonitoringbyCBIMNCIIndicators
S.N
.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
District
%ofnewbornswho
hadchlorhexidine
ointmentapplied
immediatelyafter
birth
aged02months
withPSBI
receivinga
completedoseof
Gentamycin
%ofchildren
underfiveyears
withpneumonia,
whoreceived
antibiotics
%ofchildren
underfiveyears
withdiarrhea
treatedwith
zincandORS
National
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Dhanusa
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolakha
Sindhupalchok
Kavre
75.16
58.28
50
NoProgram
NoProgram
54.42
39.38
39.18
66.15
64.05
55.94
NoProgram
86.71
91.53
65.74
74.45
NoProgram
NoProgram
97.35
83.56
32.72
NoProgram
70.91
62.51
76.11
67.24
75
52
5.88
17.07
93.76
74
37.7
20
57.89
18
60
24.53
36.99
25.47
17.33
36.51
66.67
105.28
239.68
56.38
28
10.53
42.86
37.93
189.23
175.03
149.26
153.68
154.53
126.52
114.08
181.95
187.75
153.47
257.25
208.89
254.05
184.76
178.96
147.52
180.66
163.34
200.88
173.92
138.42
177.86
190.78
249.85
197.61
93.08
86.84
96.17
90.64
91.71
86.91
79.27
87.4
81.27
100.04
89.55
89.57
78.9
91.3
92.15
84.02
97.17
101.77
97.46
95.13
119.95
86.82
118.66
73.62
98.7

65
60
ChildHealth:CBIMNCI
S.N
.
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.
66
61
District
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makwanpur
Rautahat
Bara
Parsa
Chitawan
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilbastu
Arghakhanchi
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
%ofnewbornswho
hadchlorhexidine
ointmentapplied
immediatelyafter
birth
aged02months
withPSBI
receivinga
completedoseof
Gentamycin
%ofchildren
underfiveyears
withpneumonia,
whoreceived
antibiotics
%ofchildren
underfiveyears
withdiarrhea
treatedwith
zincandORS
15.96
NoProgram
10.81
63.59
29.79
45.01
48.88
116.76
56.64
56.92
111.52
70.66
62.68
31.62
NoProgram
32.12
NoProgram
NoProgram
84.46
NoProgram
80.15
NoProgram
105.55
45.09
135.27
70.29
52.56
85.38
77.75
NoProgram
77.53
80.38
111.35
62.74
1.76
99.14
76.87
34.81
89.62
18.1
66.49
61.54
10.53
0
0
21.28
22.22
30.34
32.93
114.88
76.47
63.74
35.9
5.56
11.76
0
33.33
12.5
0
100
31.58
13.16
32.81
117.39
5.39
31.15
3.03
64.81
53.85
37.8
50
53.04
82
65.74
76.43
92.28
65.15
85.76
73.65
32.47
153.73
102.94
28.85
129.79
135.13
529.27
203.07
182.7
153.45
169.61
206.53
209.47
155.62
106.32
182.86
219.88
185.28
171.36
226.57
192.53
202.52
326.19
248.29
167.36
196.84
228.31
199.88
211.18
330.24
472.93
320.05
174.15
191.34
159.24
162.88
244.71
171.88
178.99
211.59
241.91
299.71
179.51
127.48
168.85
135.38
161.95
98.01
83.11
71.54
94.22
88.14
94.36
90.55
99.2
93.59
87.57
103.54
95.46
97.11
90.02
98.04
82.67
108.68
97.11
99.38
95.53
104.51
95.18
93.86
95.43
93.99
85.03
72.15
100.79
96.3
87.92
95.89
112.41
92.62
99.19
87.07
101.05
100.61
88.88
117.44
93.88
84.17
79.04

ChildHealth:CBIMNCI
S.N
.
District
%ofnewbornswho
hadchlorhexidine
ointmentapplied
immediatelyafter
birth
aged02months
withPSBI
receivinga
completedoseof
Gentamycin
%ofchildren
underfiveyears
withpneumonia,
whoreceived
antibiotics
%ofchildren
underfiveyears
withdiarrhea
treatedwith
zincandORS
82.44
67. Bajura
224.55
189.08
107.09
98.27
68. Bajhang
87.5
155.9
91.51
NoProgram
69. Achham
63.95
399.45
98.8
102.07
70. Doti
71.43
244.25
93.18
75.07
71. Kailali
36.59
463.85
71.65
69.11
72. Kanchanpur
50.88
212.76
93.1
83.99
73. Dadeldhura
48.85
215.63
97.8
81.21
74. Baitadi
90.3
195.51
91.04
71.36
75. Darchaula
64
194.14
119.26
CHX program has been fully implemented (upto community level)in 45 districts. Likewise, in four
districtsithasbeenimplementedonlyuptothehealthfacilitylevel.Inaddition,alongwithCBIMNCI
program, CHX program is just initiated in 12 districts. In FY 2071/72, HMIS data shows that CHX
coverageinnationallevelamongtheprogramimplementeddistrictsis75.16%withhighestcoverage
inRupandehiandlowestcoverageinSurkhetasthetrainingforHWswasdoneinthelastmonthof
thisFY2071/72.
ComplianceofInjectionGentamicinatnationallevelforPSBIcasesamongundertwomonthschildis
67.24%.Duetothedataqualityissue,fewdistrictshavemorethan100%gentamycincompliance.As
aresultofmixingofantibiotictreatmentotherthanpneumoniacasesinHMISdata,percentageofU
5 children with pneumonia treated with antibiotics is 189.23%. As per CBIMNCI protocol, all
diarrhealcasesshouldbetreatedwithORSandZinc.BasedonHMISdata,U5childrensufferingfrom
diarrheatreatedwithORSandZincatNationallevelis93.08%andishigherthantargetinvision90
by 20 however, 13 districts have lower than 90% coverage. Like the data error in Gentamycin
compliance, some districts have reported that ORS and Zinc treatment is higher than the diarrheal
cases i.e. ORS and Zinc treatment is more than 100%. To improve the data quality of CBIMNCI
program, IMNCI section has started to provide feedbacks on reported data to all districts through
HMISsection.

67
62
Family Health Programme

3.1 FamilyPlanning........................................................................................ 71
3.2 SafeMotherhoodandNewbornHealth................................................... 80
3.3 FemaleCommunityHealthVolunteer(FCHV)...........................................91
3.4 PrimaryHealthCareOutreach(PHC/ORC)................................................ 95
3.5 DemographyandReproductiveHealthResearch.....................................98
3.6 AdolescentSexualandReproductiveHealth...........................................103
69
70
Chapter 3
FamilyHealth:FamilyPlanning
FamilyHealth:FamilyPlanning
FAMILYHEALTH
3.1
3.1
FAMILYPLANNING
FAMILYPLANNING
3.1.1 Background
3.1.1 Background
TheGovernmentofNepalcommitstoequitableaccesstovoluntaryFamilyPlanning(FP)services
TheGovernmentofNepalcommitsto
basedoninformedchoiceforallindividualsandcouples,inparticularthepoor'vulnerableand
basedoninformedchoiceforallindivi
marginalizedgroups.
marginalizedgroups.
The main aim of the National Family Planning Program is to ensure thatThe
individuals
main aim
andofcouples
the National
are Family Pl
able to fulfill their reproductive needs by using appropriate family planning
able tomethods
fulfill their
based
reproductive
on
need
informed choice. Family planning can reduce unmet need for contraceptives
informed choice.
and unintended
Family planning can
pregnancywhichultimatelyhelpstoimprovematernalandchildhealth,empowerswomenbyallowing
pregnancywhichultimatelyhelpstoimp
them to invest more in their children and earn wages outside the home.
them
In addition,
to investitmore
also in
helps
their children
communitiesandcountrytoboosteconomicgrowthbyexpandinghealthyandskillfullaborforceand
communitiesandcountrytoboostecon
allowingthemtoinvestmoremoneyinschool,healthcareandinfrastructuredevelopment.Overall,
allowingthemtoinvestmoremoneyin
NationalFamilyPlanningProgramhelpstoimprovethequalityoflifeofpeopleanddevelopanation.
NationalFamilyPlanningProgramhelps
FamilyplanningisoneofthepriorityprogramsofGovernmentofNepal,MinistryofHealth.Itisalso
Familyplanningisoneoftheprioritypr
consideredasacomponentofreproductivehealthpackageandessentialhealthcareservicesofNepal
consideredasacomponentofreproduc
Plan 2015
Health Sector Program
II (20102015),
Health Sector Program II (20102015), National Family Planning Costed Implementation
2021,NepalHealthSectorStrategy20152020(NHSS)andtheGovernmentofNepalscommitmentsto
2021,NepalHealthSectorStrategy2015
FP2020. InNepal,family planninginformationandservicesare being providedthroughgovernment,
FP2020. InNepal,family planninginfor
,
socialmarketing,nongovernmentalorganizationsandprivatesectors.Ingovernmenthealthsystem
socialmarketing,nongovernmentalorg
currently,temporaryfamilyplanningmethods(malecondoms,oralpillsandinjectable)areprovided
currently,temporaryfamilyplanningm
on a regular basis through health posts, sub health posts, PHC Outreachon
clinics.
a regular
Female
basis
Community
through health posts
Health Volunteers are providing information to community people, and
Health
distribute
Volunteers
condom
are and
providing infor
resupply of pills. Long acting reversible contraceptive (LARC) services such
resupply
as IUCDof
and
pills.
Implants
Long acting
are reversible
availableonlyatlimitednumberofPrimaryHealthCareCentersandhealthpostswheretrainedhealth
availableonlyatlimitednumberofPrim
care providers are available. Sterilization services are provided at static care
sitesproviders
or through
are
scheduled
available. Sterilizatio
seasonal or mobile outreach services. Almost all district FP MCH clinics
seasonal
are providing
or mobile
all types
outreach
of
services
temporaryFPmethodsregularly.
temporaryFPmethodsregularly.
Objective:
Objective:
GoNstrivestoimprovethehealthstatusofallpeople,regardlessoftheirsex,casteandethnicity,or
GoNstrivestoimprovethehealthstatu
socioeconomicstatus.
socioeconomicstatus.
OverallobjectiveoftheFPprogramistoimprovedhealthstatusofallpeoplethroughaccountable
OverallobjectiveoftheFPprogramis
andequitablehealthservicedeliverysystemthroughinformedchoicetoaccessandusevoluntary
andequitablehealthservicedeliverysy
FP(throughincreasedandequitableaccesstoqualityFPinformationandservices).
FP(throughincreasedandequitablea

63
71
63
Family Health: Family Planning
Specific Objectives:
To increase access to and utilization of quality FP services which are safe, effective and
acceptable to individuals and couples. Special focus is given to increasing access to services
in places where the rural, poor, Dalit, other marginalized people and those with high unmet
need live.
To create an enabling environment for increasing access to quality family planning services
to men and women.
To increase demand of family planning services by implementing various behavior change
communication activities.

Policies and Strategies:

Enabling Environment:
- Strengthen enabling environment for family planning
- Establish family planning as reproductive rights of females and males.
Demand Generation: Increase health care seeking behavior among population with high
unmet need for modern contraception.
Service Delivery:
- Enhance FP service delivery including commodities to respond to the needs of
marginalized, rural residents, migrants, adolescents and other special groups.
- Increase availability of broader range of modern contraceptives and improved method
mix.
- Effective integration of family planning services with other health services.
- Strengthen effective procurement and logistics management system to ensure regular
availability of family planning commodities.
- Promote family planning services delivery through government, private, non-
governmental organization and social marketing approaches.
Capacity Building: Strengthen capacity of service providers to expand FP service delivery
network.
Research and Innovation: Strengthen evidence base for effective programme implementation
through research and innovations.
3.1.2 Major Activities

In order to provide the reproductive population with options to limit or space births, various modern
contraceptive methods are made available under the national health services delivery system. Family
planning services are provided through different health institutions at various levels through static
clinics as well as mobile outreach services. The major activities implemented during fiscal year 2071/72
are described briefly in following sections.

1. Voluntary Surgical Contraception (VSC)

VSC services include vasectomy and minilap including postpartum tubal ligation. At least one type of
VSC service was made available in all districts except Manang, Sankhuwasabha, Dhankuta, Ilam and
Panchthar through health institution or at camp setting. VSC mobile outreach program was conducted
in 70 districts in fiscal year 2071/72.

72

64


2. Spacing Methods

Spacing methods such as Depo-Provera (injectable), oral pills and condoms were made available up to
the community level. Distribution of oral pills and condoms were done through FCHVs at the ward
level. In addition, implant and IUCD services were offered through selected HPs, PHCCs and hospitals.
Spacing methods were also made available through private practitioners, contraceptive retail sales
outlets, pharmacies, and other NGOs and INGOs.

3. FP Counseling

Counseling is an important activity for assisting clients to make an informed choice for appropriate
family planning method. Family planning counseling services were provided to potential clients by
front-line FP providers.

4. Referral

Referral is one of the main approaches for increasing access to family planning services. At community
level, condoms and pills were re-supplied, through a network of FCHVs, while requests for other family
planning services were referred to the PHC Outreach clinics, HPs or to mobile camps. Health facilities
referred the clients to other appropriate health institutions or mobile camps for those FP services
which were not available in their own institution.

3.1.3 Achievement

1. Current Users
Overall achievement of FP current users at national level has slightly declined from 91.3 percent in
FY 2070/71 to 91.08 percent in FY 2071/72 as compared to projected number of users. However,
there was slight variation in achievement across the development regions. The achievement in
FWDR and MWDR was highest whereas it is lower in other regions i.e. in Central and western region
(Table 3.1.1). Comparative achievement in current users compared to projected number is almost
static during last three program years. Percentage of Family Planning current users is in decreasing
trend in last three years from 93.8 percent in FY 2069/70 to 91.3 percent in FY 2070/71 to 91.1
percent in FY 2071/72 (Table 3.1.1).

Table 3.1.1: Trend in family planning current users (all modern methods)

Fiscal Years

2069/70
2070/71
Region
Projected Achievem
%
Projected Achievem
ent
ent
2071/72
%
Projected
Achievem
ent
EDR
671,500
624,657
93.0
699,000
628,053
89.9
691,000
630,808
91.3
CDR
1,062,000
972,244
91.5
1,101,500
959,435
87.1
1081,000
953,850
88.2
WDR
387,500
359,964
92.9
418,000
374,405
89.6
426,000
372,647
87.5
MWDR
307,500
306,865
99.8
332,000
332,683
100.2
356,000
342,963
96.3
FWDR
196,500
197,970
100.7
204,500
219,432
107.3
221,000
227,112
103.
National
2,625,000
2,461,739
93.8
2,755,000
2,514,044
91.3
2,775,000
2,527,380
91.1

65
73

2. New Acceptors in Voluntary Surgical Contraception (VSC)

National achievement for VSC new acceptor was 61.5 percent in FY 2071/72, which has reduced
from 67.6 percent in FY 2070/71. There was marked difference in the achievement of VSC services
throughout the country. Percentage of VSC new acceptors against projected number is highest
(81.7%) in FWDR while it is lowest in CDR (45.9%) in the current FY 2071/72 (Table 3.1.2).

Proportion of minilap new acceptors against projected VSC numbers has decreased from 70.5%
percent in FY 2069/70 to 53.1% in FY 2070/71 to and 45.8% in FY 2071/72. Similarly, proportion of
vasectomy new acceptors against projected VSC numbers has decreased from 20.5% in FY 2069/70
to 14.5% in FY 2070/71 and slightly increased to 15.7% in FY 2071/72.

Overall enrollment of new VSC users in absolute number is declining from FY 2069/70 to FY 2071/72
at National level. There were a total of 46,415 new VSC users in FY 2069/70 which declined
subsequently to 30,728 users in FY 2071/72 (Table 3.1.2). Decline in total VSC users was noticed in all
five regions. Projected numbers of VSC was decreased from 58,000 in FY 2070/71 to 50,000 in FY
2071/72.

New VSC acceptors by procedure i.e. male and female declined in FY 2071/72 compared to the
previous years. There is a slight increase in male new VSC acceptor in CDR (2,849 in FY 2070/71 to
2,921 in FY 2071/72) and WDR (1,234 in FY 2070/71 to 1,499 in FY 2071/72).

Overall performance in total VSC users compared to projected number was not up to the expected
level. National achievement is in declining trend. The total VSC achievement in FY 2070/71 was
39,213 in number, which declined to 30,728 in FY 2071/72 (Table 3.1.2).

Table 3.1.2: Trend of VSC new acceptors by procedure and region FY 2069/70 to 2071/72

Region
Procedure
Projected
Cases
Year
2069/70
2070/71
2071/72
2069/70
Minilap
2070/71
2071/72
2069/70
Vasectomy 2070/71
2071/72
Total new 2069/70
2070/71
VSC
acceptors
2071/72
Procedure as a % of
projected total VSC
2071/72
EDR
CDR
WDR
MWDR
FWDR
National
total VSC
13,900
14,600
13,200
12,389
9,235
8,652
621
288
284
13,010
9,523
8,936
20,850
25,600
20,950
15,117
12,004
6,694
4,270
2,849
2,921
19,387
14,853
9,615
6,050
6,900
6,150
3,858
3,778
3,237
1,692
1,234
1,499
5,550
5,012
4,736
5,650
6,300
5,600
2,204
2,162
2,015
2,532
2,684
2,075
4,736
4,846
4,090
4,550
4,600
4,100
2,386
3,637
2,280
1,346
1,342
1,071
3,732
4,979
3,351
51,000
58,000
50,000
35,954
30,816
22,878
10,461
8,397
7,850
46,415
39,213
30,728
67.7%
45.9%
77.0%
73.0%
81.7%
61.5%
Procedure
as a % of
projected
VSC

70.5
53.1
45.8
20.5
14.5
15.7
91.0
67.6
61.5

3. New Acceptors of Spacing Methods

New acceptors are defined as the number of MWRA who adopted any FP method for the first time
in their life. A total of 623,857 new users were recruited in FY 2070/71 which increased to 668,777 in

74
66
FY 2071/72 (Table 3.1.3). Districts reported that the high spousal separation among the MWRAs due
to out-migration of their male counterpart in search of employment opportunity has made low
demand for temporary FP methods particularly in rural areas of Nepal.

Out of five temporary FP methods supplied by public health system, there has been a slight decline
in use of IUCD whereas users of all four methods Condom, Depo, Pills, and implant has increased.
Number of implant users has significantly increased from (37,823 in FY 2070/71 to 61,343 in FY
2071/72) (Table 3.1.3) showing increasing popularity and acceptance of implant services by Nepalese
women.

Regional variations have been noticed in new IUCD users. The number of new IUCD users declined in
CDR and WDR. While the number of new IUCD users significantly increased in EDR, MWDR and
FWDR. Similarly, new implant users has increased in all five regions in FY 2071/72 when compared to
previous years. Number of implant users increased by more than twice in WDR in 2071/72 compared
to 2070/71.New condom users decreased in EDR, CDR and MWDR. New pills users decreased in EDR,
WDR and FWDR. New Depo users increased in all five regions except in MWDR.

Table 3.1.3: Trend in Number of New Acceptors of Spacing Methods by Region FY 2069/70 to
2071/72
Method
Pills
Depo
IUCD
Implant
Condoms
Total
Year
2069/70
2070/71
2071/72
2069/70
2070/71
2071/72
2069/70
2070/71
2071/72
2069/70
2070/71
2071/72
2069/70
2070/71
2071/72
2069/70
2070/71
2071/72
EDR
25,289
25,372
24,047
53,152
54,359
62,188
5,506
6,147
6,211
6,354
6,479
9,811
34,439
34,250
33,523
124,740
126,607
135,780
CDR
32,959
29,083
32,414
78,267
68,082
75,791
13,811
15,297
11,322
15,441
13,594
21,764
55,678
50,784
46,585
196,156
176,840
187,876
Region
WDR
21,414
23,482
23,219
37,108
38,769
42,678
4,773
6,170
5,107
4,134
4,517
11,050
39,595
38,973
41,612
107,024
111,912
123,666
MWDR
19,914
18,897
19,197
44,324
46,876
45,376
5,041
4,285
5,320
6,041
8,341
11,934
38,513
45,517
45,036
113,833
123,916
126,863
FWDR
13,060
13,462
13,000
27,434
27,465
29,276
2,134
3,243
4,469
3,714
4,892
6,784
28,867
35,484
41,063
75,209
84,546
94,592
Note: New acceptors of condom are estimated by dividing total condoms distributed by 150.
National
112,636
110,297
111,877
240,285
235,551
255,309
31,265
35,142
32,429
35,684
37,823
61,343
197,092
205,044
207,819
616,962
623,857
668,777

Out of the total 668,777 new acceptors in spacing methods in FY 2071/72, the percentage share of
new acceptors by method type shows a dominance of injectable constituting 38.2%, followed by
condom 31.1%, oral pills 16.7%, implant 9.2% and IUCD 4.9% (Fig 3.1.1). New acceptors of all spacing
methods constitute 11.3% of MWRA (data not shown).

67
75
Fig 3.1.1 FP spacing method mix (new acceptors) FY 2071/72

Pills (n=111,877),
16.7%
Condom
(n=207,819),
31.1%
Pills
Depo
IUCD
Implant
Condom
Implant
(n=61,343), 9.2%
Depo
(n=255,309),
38.2%
IUCD (n=32,429),
4.9%

4. Family Planning Current Users and Contraceptive Prevalence Rate (CPR)
The trend (in number) of current users has increased during FY 2071/72 compared to previous years
(Table 3.1.4). Total number of current users was 2,461,700, 2,514,044 and 2,527,380 in FY 2069/070,
2070/2071 and 2071/72 respectively. The number of current users has slightly declined in CDR and
WDR while the number of current users in EDR, MWDR and FWDR has increased. While the total
number of current FP users has increased in National level, there has been a decrease in number of
current users of permanent methods (VSC). Among total current users, the proportion of users of
spacing methods is in increasing trend while the proportion of permanent method users is
decreasing.

Table 3.1.4: Trend in current users in spacing and limiting methods by region, FY 2069/70 to
2071/72

Method
Year
EDR
Spacing
methods
2069/70
2070/71
2071/72
Permanent 2069/70
methods
2070/71
2071/72
Total users 2069/70
2070/71
2071/72
266,501
266,176
274,084
358,156
361,877
356,724
624,657
528,053
630,808
Development Region
CDR
WDR
MWDR
348,461
33,7009
342,184
623,783
622,426
611,666
972,244
954,774
953,850
153,480
165,479
169,123
206,484
208,926
203,524
359,964
374,030
372,647
167,782
197,272
203,744
139,083
135,411
139,219
306,865
332,683
342,963
FWDR
National
Total
100,016
112,029
126,737
97,954
107,403
100,375
197,970
216,555
227,112
1,036,240
1,078,001
1,115,872
1,425,460
1,436,043
1,411,508
2,461,700
2,514,044
2,527,380
Share of
methods as
% of total
users
42.1
42.9
44.2
57.9
57.1
55.8


76

68

The Contraceptive Prevalence Rate (CPR) is one of the main indicators for monitoring and evaluating
the National Family Planning Program. The number of current users in permanent method to
calculate the CPR is adjusted based on the age exit and the mortality of males and females in the
reproductive age group every year.

CPR for modern family planning method, as shown in Figure 3.1.2 is computed based on service data
reported to HMIS. HMIS do not capture all private sector service data. The Figure 3.1.2 also indicates
that CPR of modern method over the three fiscal year period is fluctuating. One of the reasons for
such decrease in CPR for modern methods could be high spousal separation due to migration for
employment reason. Couples who are not living together for long duration are less likely to use
family planning methods as they usually have infrequent sex and hence do not have an immediate
need. These data indicate that more efforts are needed if the program has to increase the share of
spacing methods especially LARCs in the contraceptive method mix.

There is wide variation in CPR at the regional level. CPR has been decreased in all 5 regions. National
level CPR has also decreased from 45 in FY 2070/71 to 43 in FY 2071/72. It is the highest in EDR
(49%) and the lowest in WDR (33%) (Figure 3.1.2).

CPR by district reveals a distinct pattern (Fig 3.1.3). A total of 5 districts namely Morang, Saptari,
Siraha, Parsa and Mustang have CPR greater than or equal to 60%. Eleven districts including
Dhanusa, Mahotari, Sarlahi, Kavre, Rasuwa, Makwanpur, Manang, Palpa, Dang, Bardia and Surkhet
have CPR in between 50-60%. These districts can achieve more if programs are intensified. Fourteen
districts: Ilam, Jhapa, Sunsari, Dhankuta, Sindhupalchok, Lalitpur, Dhading, Rautahat, Bara, Chitawan,
Banke, Jumla, Kailali and Kanchanpur have CPR level between 40-49%. More than one-third districts
(28 districts) have CPR between 30-40%, while 17 districts have substantially low CPR-below 30%.
Thus the FP program needs more attention in districts with low and moderate level of CPR.


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Fig3. 1.3 Contraceptive Prevalence Rate by Districts
5. Availability of LARCs services in public health facilities

Table 3.1.5 shows proportion of health facilities offering long acting reversible contraceptive
methods by type of health facilities. In fiscal year 2071/72, only 9% of SHPs (n=191), 22% of
HPs(n=363), 65% of PHCCs (n=132) and 62% of district hospitals (n=32) provided both implant and
IUCDs indicating a substantial need for expanding LARCs services in all tiers of health facilities.
Service tracking survey conducted in 2013 showed that 18% HPs provided all 5 temporary FP
methods.
Table 3. 1.5 Availability of LARCs services by type of Health Facility

Service availability
SHPs
HPs
PHCCs
HFs Providing Implant
(%)
HFs Providing
IUCD service (%)
HFs Providing
Both Implant
and IUCD (%)
Total
542
25%
699
42%
160
79%
36
69%
297
14%
493
30%
147
73%
33
63%
191
9%
363
22%
132
65%
32
62%
2139

78

District Hospitals
1666
202
52
70

Issues / constraints
Issues / constraints
Low or stagnant
CPR
High unmet
need
High
discontinuation
Underutilized
LARCs
Stock out and
inadequate FP
commodities
and equipment
Inadequate
trained HR in
LAPM and
supervision and
follow up of
trained HR
Recommendation
Responsibility
Improve FP education, information and services for

adolescents
FHD/CHD
Conduct and follow up of FP micro- planning in low CPR

areas and districts
FHD/DHO
Expand comprehensive VSC approach (VSC+) of service

delivery
FHD/DHO
Strengthening FP services in Urban health

FP integration with EPI clinic, postpartum and post abortion
services
FHD/PHC/RD
FHD/CHD
Strengthen Satellite clinics for long acting reversible

contraceptive (LARC) methods
FHD/DPHO
Systematic forecasting and annual procurement of FP

commodities
FHD/LMD
Regular need assessment and supply of FP implant, IUCD

insertion/removal sets
Ensure training are based on local need
FHD/LMD/DHO
FHD/NHTC/RHTC/DHO
Strengthen/expand capacity of FP training sites

Regular follow up and supervision/onsite coaching of
trained HR is needed.
Strengthening FP services in Private hospital
Misuse of abortion
services
FHD/MD/RHD
Knowledge update to FCHVs on LARC
FHD/DPHO
Focus on awareness raising campaign and activities for the

rational use of abortion services
FHD/DPHO

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FamilyHealth:SafeMotherhoodandNewbornHealth
3.2 SAFEMOTHERHOODANDNEWBORNHEALTH
3.2.1 Background
The goal of the National Safe Motherhood Program is to reduce maternal and neonatal morbidity
andmortalityandtoimprovethematernalandneonatalhealththroughpreventiveandpromotive
activities as well as by addressing avoidable factors that cause death during pregnancy, childbirth
and postpartum period. Evidences suggest that three delays are important factors behind the
maternalandnewbornmorbidityandmortalityoutcomeinNepalscontext:
(i) Delayinseekingcare,
(ii) Delayinreachingcare,and
(iii) Delayinreceivingcare.
Toreduce therisksduringpregnancy andchildbirthandaddressfactorsassociatedwith mortality

andmorbiditythreemajorstrategieshavebeenadoptedinNepal:
Promoting birth preparedness and complication readiness including awareness raising and
improvingtheavailabilityoffunds,transportandbloodsupplies.
AamaSurakshaProgramtopromoteantenatalcheckupsandinstitutionaldelivery
Expansion of 24hour emergency obstetric care services (basic and comprehensive) at
selectedpublichealthfacilitiesineverydistrict.
Since its initiation in 1997, the Safe Motherhood Program has made significant progress. Service
coveragehasgrownalongwiththedevelopmentofpolicies,programsandprotocols.Thepolicyon
skilled birth attendants endorsed in 2006 by MoH specifically highlights the importance of skilled
birth attendance at every birth and embodies the Governments commitment to train and deploy
doctors and nurses/ANMs with the required skills across the country. Similarly, endorsement of
revised National Blood Transfusion Policy 2006 was also a significant step towards ensuring the
availabilityofsafebloodsuppliesintheeventofanemergency.
InordertoensurefocusedandcoordinatedeffortstheNationalSafeMotherhoodPlan(20062017)
has been revised, with wide participation of partners. The revised plan has recognized the
importanceofaddressingneonatalhealthasanintegralpartofsafemotherhoodprogram.NHSP2
committedtoachieveanumberofmaternalandnewbornhealthindicatorsinlinewithMDGgoals
andtargets.
Strategies
Followingstrategieshavebeenadoptedtoachievethegoalsofsafemotherhoodprogram:
1. Promoting intersectoral coordination and collaboration at central, regional, districts and
community levels to ensure the commitment and action for the promotion of safe motherhood
withespecialfocusonpoorandexcludedgroups.
2. Strengthening and expanding delivery by skilled birth attendant, basic and comprehensive
obstetriccareservicesatalllevels.Interventionsinclude:
Developingtheinfrastructurefordeliveryandemergencyobstetriccare.
Standardizingbasicmaternitycareandemergencyobstetriccareatappropriatelevelsofthe
healthcaresystem;
Strengthening human resource management; DGO, ASBA, SBA, Anesthesia Assistant training
anddeployment
Establishing functional referral system: Airlifting for emergency referral from remote areas,
provisionofstretchersin wards,emergencyreferral fundsinremotedistricts. Strengthening
communitybased awareness on birth preparedness and complication readiness through
FCHVs,increasingaccessofallrelevantmaternalhealthinformationandservice.
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3. Supportingactivitiesthatraisethestatusofwomeninsociety;
4. Promoting research on safe motherhood to contribute to improved planning, higher quality
services,andmorecosteffectiveinterventions.
3.2.2 MajorActivities
1. BirthPreparednessPackageandMNHActivitiesatCommunityLevel
FamilyHealthDivision(FHD)continuessupportforexpansionandmaintenanceofMNHactivitiesat
communitylevelwhichincludedBirthPreparednessPackage(JeevanSurakshaFlipChartandJeevan
SurakshaCard)andMatriSurakshaChakki(Misoprostol)distributionforpreventionofPPHathome
delivery.
Thisactivitypromotes
birthpreparednessandcomplicationreadiness(preparednessofmoney,healthfacilitiesfor
thedelivery,transportandblooddonors).
keyANC/PNCservices(Iron,TT,Albendazole,etc),selfcare(food,rest,nosmokingandno
drinking alcohol, including pregnancy and postpartum period), essential new born care,
identification and prompt care seeking for danger signs during pregnancy, delivery, post
partumandnewbornperiod.
InFY2066/67,GoNapprovedPPHeducationandMatriSurakshaChakki(MSC)distributionthrough
FCHVswiththeobjectiveofpreventingPPHathomedelivery.Threemisoprostoltablets(600mcg)
aregiventopregnantmotherduring8thmonthofpregnancyandareinstructedtotakethosethree
tabletsimmediatelyafterthedeliveryofbabybeforeplacentaisexpelled,ifdeliveryoccursathome.
Ifwomengetdeliveredinhealthfacilitiestheyhavetoreturnthosegiventabletstohealthfacilities.
Altogether 42 districts have been currently implementing the program by 2071/72. Family Health
Divisionhasbudgetedtoscaleupthisprogramin4districtsin2072/73.
2. RuralUltraSoundProgram
Theobjectiveofruralultrasoundprogramistimelyidentificationofpregnantwomenwithrisksof
obstetric complication and refer them to the CEON centers for the appropriate complication
management.Atrainednurse(SBA)withskillonuseofportableultrasoundmachineforantenatal
scan provides service at defined rural PHCC/HP sites on a regular basis. If any abnormality is
detected such as abnormal lie and presentation, pregnant women are referred to a facility where
appropriate services are available. This program is being implemented in 10 remote districts of
NepalnamelyMugu,Dhading,Darchula,Rukum,Solukhumbu,Bajhang,Achham,Dhankuta,Humla,
andBaitadi.Altogether20SBAsfromvariousdistrictsreceived3weekslongtrainingonultrasound
usetoperformantenatalultrasonographyinFY2071/72.
3. ReproductiveHealthMorbidityPreventionandmanagementProgram:
FHD is currently implementing various reproductive health (RH) morbidity prevention and
management activities such as management of pelvic organ prolapse (POP), cervical cancer
screeningandCryotherapy,andobstetricfistulascreeningandmanagement.
a) Management of Pelvic Organ Prolapse: Pelvic Organ Prolapse is one of the most common
reproductive health morbidities in Nepal contributing for high DALYs and social consequences.
Multiparity,maternalmalnutrition,toofrequentpregnancies,andheavyworkafterdeliveryare
risk factors for POP. The root causes identified include Gender inequity, low women status,
povertyetc.EveryyeargovernmenthasallocatedfundsformanagementofPOPincludingfree
screening,thesiliconringpessary,andKegellsexercisetrainingatdistrictlevel,andfreesurgical
services at designated hospitals. Since the beginning of free surgical care of POP in 2066/67
73
DoHS,
Annual Report 2071/72 (2014/2015)
81
more than 41,500 women received surgery for repair of POP. In 2071/72 more than 37,000
women received screening. Among them the prevalence of 1st degree POP was 8%, second
degreewas6%and3rddegreewas8%.Morethan1000womenreceivedsurgicaltreatmentand
4800womenreceivedmanagementusingringpessaryin2071/72.
b)
Cervical cancer screening and prevention training: Cervical cancer is the most common
cancer among women in Nepal. It accounts for 21.4% of all the cancer among women of 3464
yearsagegroup.Anationalguidelineoncervicalcancerscreeningandpreventionwasdevelopedin
the year 2010 which aimed to screen at least 50% women of 3060 years of age and reduce
mortality due to cervical cancer by 10% with recommended screening among this group every 5
years.
Thecervicalcancerscreeningisdonebyvisualinspectionofcervixusingaceticacidbytrainednurses
anddoctors.Ifanysignsofprecancerouslesionseen,womenarereferredforaCryotherapy,using
compressed carbon dioxide to cure the lesion. This approach is considered costeffective as it
detectsearlylesion,managementatearlystagebyCryotherapywillpreventprogressiontocervical
cancer,andthecostforscaleupislow.Familyhealthdivisionhasplannedtoscaleupthisverycost
effectiveapproachtoall75services.Todate,162nurses/doctorsaretrainedtoprovidescreening
servicesand14centershaveCryotherapyservices.
(c) Obstetric Fistula management: Obstetric Fistula affects women from poorer communities and
significantly impairs the quality of life of women suffering this condition by social stigmatization
making womens life harder in family and society besides her physical suffering. Government of
Nepalhasallocatedfundsforthefreescreeningofobstetricfistulacurrentlybeingintegratedwith
POP screening and surgical services at BPKIHS (Dharan), Kathmandu Model Hospital (Kathmandu),
andMidWesternregionalhospital(Surkhet).
4. HumanResource
AsignificantshareoffamilyhealthdivisionsbudgethasbeenallocatedfortherecruitmentofANMs
in short term contract to ensure the 24 hour birthing services at PHCC/HP levels. FHD has also
providedfundatlocalleveltorecruithumanresourcemixneededtoprovidesurgicalmanagement
forobstetriccomplicationsatdistricthospitals.
FHDhasbeencoordinatingwithNationalHealthTrainingCenter(NHTC)andNationalAcademyfor
MedicalSciences (NAMS)forpreserviceandinservicetraining ofhealthworkers. NHTCprovides
trainingonSBA,ASBA,OTmanagement,FamilyPlanningtrainingincludingImplantsandIUCD,and
antenatalUSG.Morethan7100SBAsand140ASBAshavealreadybeentrainedsinceSBAtraining
began.In2071/72,fiveanesthesiaassistant(AA)and6DGOgraduatedfromNAMSandaredeployed
atCEONCsites.ProperplacementoftrainedstaffsuchasSBA,AAhasbeenacontinuouschallenge
forthesystem.PlacementofSBAsattrainingsitesfor2weekstorefreshtheirknowledgeandskills
andimprovetheirconfidenceinmanagingcomplicateddeliverywastestedinthreedistricts(Dang,
RupandehiandDailek).
5. Expansionandqualityimprovementofservicesdeliverysites
FHDcontinuestoexpand24/7servicedeliverysiteslikebirthingcenters,BEONCandCEONCsitesat
existingPHCC/HPandhospitals.Expansionofservicesitesispossiblemostlyduetoprovisionoffund
tocontractshorttermstafflocally.BytheendofFY2071/72CEONCserviceswereestablishedin67
districts,howeveronly56districtswereabletoprovideservicesonaregularbasis.Atotalof1621
BCand166BEONCsitesarefunctioningbytheendof2071/72.Expansionandqualityimprovement
ofMNHservicedeliveryatremoteareasisbeingtestedinTaplejungdistrict.FHDisalsotestingon
site coaching of MNH service providers in 10 districts for improving continuity of services and the
qualityofcare.
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Since2060/70,FHDalsoprovidedfundto14referralhospitalstoexpandbedsformaternitywards,
recruit nurses and doctors including OBGYN and anesthetist in order to cope with current
overcrowding at maternity wards and developing longterm strategies to overcome this problem.
Overcrowdingatthesehospitalshasresultedinpoorqualityofcare.
5. EmergencyReferralFund
Itisestimatedthat15percentofthepregnantwomenwilldevelopcomplicationduringpregnancy
andchildbirth,and5to15percentofthem needCSfordelivery(WHO,2009)toavoiddeathsor
longterm morbidity. In case of difficult geographical terrain and unavailable CEONC services, it is
veryimportanttoreferthesewomentoappropriatecenters.ToaddressthisissueFHDhasallocated
emergency referral fund to facilitate referral services in sixteen districts in last fiscal year namely
Bhojpur, Taplejung, Khotang,Rasuwa, Manang, Mustang, Dolpa, Humla, Jajarkot, Mugu, Rolpa,
Rukum,Bajura,Darchula,Ramechap,andTeharthum.Atotaloftwohundredthousandrupeeshas
beenallocatedasseedmoneyforeachdistricttobemanagedbyalocallyformedcommitteeasper
the operational guidelines. The main objective of this program is to support emergency referral
transport to women from poor, Dalit, Janjati, geographically disadvantaged, socially and
economicallydisadvantagedcommunitieswhoneedemergency Caesareansectionorcomplication
managementduringpregnancyandchildbirth.Fundisalsoprovidedatregionaldirectoratelevelto
provide airlift to women where motorable service is not available or for situation requiring
immediatetransferofpatient.FHDistestingthefeasibilityofimplementingnationalMNHreferral
guidelinesatdistrictslevelwiththesupportofGIZintwodistricts(AchhamandJumla).
7. SafeAbortionServices
Accordingtoglobalandnationalevidence,womenfaceunwantedpregnancyduetovariousreasons
includingthelimitedaccesstofamilyplanninginformationandservices.Suchwomenifdonotget
accesstosafeabortionservicesintimelymannerareathighriskofdevelopingcomplicationsdueto
unsafeabortionorinworstcasescenariosuicideduetosocialpressure.Thus,thereisanecessityto
makethisserviceavailable,accessibleandaffordabletoallwomenwithunwantedpregnancies.FHD
hasdefinedfourkeycomponentsofcomprehensiveabortioncare(CAC)andtheyare;i)pre&post
counselingonabortionmethodsandaswelloncontraceptivemethods,ii)terminationofpregnancy
as per national protocol iii) diagnosis and treatment of existing RTIs and iv) provide contraceptive
methodsasperinformedchoiceandfollowupforpostabortioncomplicationmanagement.
CAC(MVAandMA)serviceshasbeenexpandedtoall75districtshospitalandtoover50%ofPHCCs.
Additionally,2ndtrimesterabortionservicesareavailablein22hospitalswhereCEONCServiceisalso
available and Medical abortion services being expanded at health post with additional training to
SBA.By2071/72,Medicalabortionservicehasbeenexpandedto39districtswiththesupportfrom
variouspartners.BeginningfromFY2070/71asperNHSPIP2direction,safeabortionprogramhas
beengivenprioritytoensuretheavailabilityoffivemoderncontraceptivemethodsinallSASsites.
8.ObstetricFirstAidorientation:
Since 2070/71, FHD started orientation of paramedics on first aid management of obstetric
complicationsinordertoimproveimmediatemanagementofwomenwithobstetriccomplications
athealthfacilitieswithoutBCandalsoenablethemtosupporttheSBA/ANMintimesofemergency,
starting from two districts. In 2071/72, training of trainers was conducted for trainers from 19
districts.
9.NyanoJholaProgram:
TheNyanoJholaProgramwaslaunchedwiththeobjectiveofprotectingnewbornfromhypothermia
andinfectionaswelltoincreasetheutilizationofperipheralhealthfacilities(birthingcenters)inFY
2069/70.Asetofclothes(twosetsofbhoto,daura,napkin,cap,andonesetofwrapper,matfor
babyandgownformother)fornewbornandmotherisprovidedifthewomengavebirthatbirthing
centersordistricthospitals.Theprogramisbeingimplementedinall75districtsofNepal.
75
DoHS,
Annual Report 2071/72 (2014/2015)
83
10.AamaProgram:
TherevisedAamaguidelinehasbeenimplementedsincethestartofFY2069/70.TheAamaguideline
specifiesthe servicestobefunded,thetariffsforreimbursementandthesystemforclaimingand
reportingonfreedeliverieseachmonth.Afterrevision,Aamaprogramhasfourcomponents:(I)the
SafeDeliveryIncentiveProgram(SDIP),acashincentivescheme,whichwasinitiatedinJuly2005,(2)
free institutional delivery care, which was launched in midJanuary 2009, (3) incentive to health
workerforhomedeliveryand(4)incentivetowomenfor4ANCvisits.TheAamaprogramprovisions
are:
Incentivestowomenoninstitutionaldelivery:Acashpaymentismadetowomenimmediately
following institutional delivery: NRs. 1,500 in mountain, NRs. 1,000 in hill and NRs. 500 in
Teraidistricts.
Free institutional delivery services: A payment to the health facility for the provision of free
deliverycare.Foranormaldeliveryhealthfacilitieswithlessthan25bedsreceiveNRs.1,000;
healthfacilitieswith25ormorebedsreceiveNRs.1,500.
For complicated deliveries health facilities receive NRs. 3,000; for CSections (surgery) NRs.
7,000.Tencomplicationsi.e.APHrequiringbloodtransfusion,PPHrequiringbloodtransfusionor
MRP or exploration, severe preeclampsia, eclampsia, MRP for retained placenta, puerperal
sepsis, instrumental delivery, multiple delivery, AntiD administration for RH negative, and
management of abortion complications requiring blood transfusion and admission longer than
24 hours with IV antibiotics for sepsis are included as complicated deliveries. Laparotomy for
perforationduetoabortionhasalsobeenaddedtothecriteriaforsurgery(receiving7000NRs)
alongwithC/S,laparotomyforectopicpregnancyandruptureduterus.
Incentive to women for 4ANC visits: A cash payment of NRs. 400 is made to women on
completionoffourANCvisitsatthe4,6,8and9monthsofpregnancyandinstitutionaldelivery.
Incentivestohealthworkersforhomedeliveries:AcashpaymentofNRs.100ismadetohealth
workerforhomedeliveries.Copiesofbirthregistrationordeathcertificateneedtobeproduced
toclaimincentiveforhomedeliveries.
A significant increase has been observed in the number of facilities providing delivery service and
numberofinstitutionaldeliveryafterthelaunchofAamaprogram.Attheendoffiscalyear,Aama
programwasimplementedin64nonstatehealthfacilities.FHDsAamaadministrativerecordshows
that 87 health facilities functioning at the level of providing CEONC service, 161 health facilities
functioningatthelevelofprovidingBEONCservice,1621healthfacilitiesfunctioningatthelevelof
birthing centers are currently providing Aama Surakshya Program (These numbers need
confirmation).
3.2.3 Achievement
1.
AntenatalCare
WHOrecommends minimumfourantenatal checkupsataregularinterval toall pregnant women
firstat4thmonth,secondat6thmonth,thirdat8thmonthandfourthat9thmonthofpregnancy.During
thesevisitsshewillreceivethefollowingservicesontopofthegeneralhealthcheckup:
Monitorbloodpressure,weightandfetalheartrate;
Provide information, education and communication (IEC) and behavior change communication
(BCC)oncareduringpregnancy,childbirth,earlynewborncareandfamilyplanning;
Provide information on danger signs during pregnancy, childbirth and postpartum period, and
timely referral to the appropriate health facilities using birth preparedness and complication
readiness (BPCR) for both normal and obstetric emergencies (plan of delivery by skilled birth
attendants,money,transportationandblood);
Earlydetectionandmanagementofcomplicationsduringpregnancy;and
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76
Provision of tetanus toxoid and Diphtheria (Td) immunization, iron folic acid tablets and
dewormingtabletstoallpregnantwomenandmalariaprophylaxiswherenecessary.
Service statistics of the last three years shows that the national average of first ANC visit as
percentageofexpectedpregnancyhasincreasedfrom86to96percentin2071/7072.
Fig3.2.1:4thANCvisit(asperprotocol)asapercentageofFirstANC
Mothers are encouraged to make atleast
80
four antenatal checkups and monitoring
67
70
system is in place to track the timing of
63
62
62 62
59
ANC visits as per the ANC protocol since
57
57
57
56
56
56
60
55
54
53
51
2066/67.Figure3.2.1showstheproportion
50
50
50
of pregnant women attending at least 4
ANC visits as per protocol among women
40
who had first antenatal visits has declined
30
in2071/72incomparisontopreviousyears
20
in all regions. Performance on ANC four
visits, one of the quality indicators, shows
10
the need to focus on the quality of ANC
0
consultationprocessasitisexpectedthata
EDR
CDR
WDR
MWDR
FWDR
National
satisfied and well informed pregnant
2069/70
2070/71
2071/72
women will complete the recommended
fourvisits.
Figure 3.2.2 shows district level performance on coverage of 4 ANC according to protocol among
expectedpregnantwomen.Asshowninthefigure,only4districtshave4ANCcoverageofabove80
percentandatotalof50districtshavea4ANCcoveragebetween40to80percent,whileatotalof21
districtshave4ANCcoverageofbelow40percent.
Figure3.2.2:ANC4visitsbydistrict,2071/72
Legend
<40%
4080%
>80%
77
DoHS,
Annual Report 2071/72 (2014/2015)
85
DeliveryCare
Deliverycareservicesinclude:
Skilledbirthattendantsatdeliveries(eitherhomebasedorfacilitybased);
Early detection of complicated cases and management or referral, after providing obstetric first
aid,toappropriatehealthfacilitywhere24hoursemergencyobstetricservicesareavailable;
Registrationofbirthsandmaternalandneonataldeaths.
Although women are encouraged to deliver at the health facility, home delivery using Emergency
ObstetricCareKit(EmOCkit),andobstetricfirstaidathomeifcomplicationsoccurisalsoconsidered
asimportantcomponentofdeliverycareinsettingswhereinstitutionaldeliveryserviceisnotavailable.
Nepalhadcommittedinachieving60percentdeliveriesbySBAby2015(2071/72)inlinewithMDG
target.Deliveriesattendedbyskilledbirthattendanthavebeeninincreasingtrendoverthelastthree
years with seven percent increase in 2071/72 at national average. Significant increment in SBA
deliverywasnotedinallregionsexceptinEDR.UnderreportingcouldbethecauseofdeclineinEDR
wheremanyprivatehospitalsareinoperation.
Nepal aims to achieve institutional
Fig3.2.4:Institutionaldeliveryaspercentageof
delivery at 60% by 2015 (NHSP2, 2010
expectedlivebirths
2015).Institutionaldeliveryaspercentage
100
of expected live births increased from 45
90
80
to 57 percent over the last three years,
66
66
70
with notable seven percent increment
58
58
57
57
57
60 51 52
52
51
50
47
from last fiscal year. MWDR and FWR
46
45
45
44
50
39
have achieved more than the national
40
30
targetof60%institutionaldelivery.
20
10
Fig 3.2.5 shows that 21 districts have
0
EDR
CDR
WDR
MWDR
FWR
National
already achieved the 2015 target of 60
percent institutional delivery, while 33
069/70
070/71
071/72
districts achieved less than 40%
institutionaldeliveries.(note:institutionalandSBAdeliverydatafromBPKIHSandTUTHisbasedon
their presentations at national annual review and data from Janakpur and Narayani subregional
hospitalsarefromAamareporting.ThereforethefigurespresentedabovedonotmatchwithHMIS
raw and analyzed data, as the delivery information from few government and nongovernment
hospitalsarenotincludedinHMISreport).
Proportion of institutional deliveries taking

placeatbirthingcenters(HP)increasedfrom InstitutionalandSBAdeliveriesfromNepal
27% of all institutional deliveries in 2070/71 MultipleIndicatorClusterSurvey2014
to 29% in 2071/72. This increase is not
Indicators
Finding
significantwhennumberofBCatHPlevelsis Skilledbirthattendantatdelivery
55.6%
compared over years (Table 3.2.3).Share of Institutionaldeliveries
55.2%
district hospitals and BEONC centers is 20%,
whilethatofreferralandteachinghospitalsis34%andprivatehospitalsis17%oftotalinstitutional
deliveries.
Table3.2.3:StatusofBC/BEONC/CEONCexpansion
86
78
significantwhennumberofBCatHPlevelsis Skilledbirthattendantatdelivery
55.6%
compared over years (Table 3.2.3).Share of Institutionaldeliveries
55.2%
district hospitals and BEONC centers is 20%,
whilethatofreferralandteachinghospitalsis34%andprivatehospitalsis17%oftotalinstitutional
deliveries.
2070/71
2071/72
Table3.2.3:StatusofBC/BEONC/CEONCexpansion
Region
District
BC
BEONC CEONC* Total
BC
BEONC CEONC* Total
78
2070/71
Eastern
16
277
41
16
330
281
31 2071/72
16
332
Region
District
BC
BEONC
CEONC*
Total
BC
BEONC
CEONC*
Total
Central
19
349
51
16
432
366
41
17
431
Eastern
16
277
41
16
330
281
31
16
332
Western
16
261
43
12
316
278
40
13
334
Central
19
349
51
16
432
366
41
17
431
Midwestern
15
342
43
12
389
399
28
13
444
Western
16
261
43
12
316
278
40
13
334
FarWestern
9
227
28
8
259
297
26
9
334
Midwestern
15
342
43
12
389
399
28
13
444
Total
75
1456
206
64
1726
1621
166
67
1875
FarWestern
9
227
28
8
259
297
26
9
334
*numberofdistrictswithCEONCserviceestablishedinthedistrict
Total
75
1456
206
64
1726
1621
166
67
1875
*numberofdistrictswithCEONCserviceestablishedinthedistrict
Fig:3.2.5:Institutionaldeliveryratebydistricts
Fig:3.2.5:Institutionaldeliveryratebydistricts
Legend
<30%
Legend
3060%
<30%
>60%
3060%
>60%
2. PostnatalCare
Postnatalcareservicesinclude:
PostnatalCare
Threepostnatalcheckup:firstwithin24hoursofdelivery,secondonthethirddayandthirdon
2.
seventhdayafterdelivery;
Postnatalcareservicesinclude:
Identification and management of complications of both mother and newborn during postnatal
Threepostnatalcheckup:firstwithin24hoursofdelivery,secondonthethirddayandthirdon
periodandreferraltoappropriatehealthfacilityasandwhenneeded;
seventhdayafterdelivery;
Promotionofexclusivebreastfeeding;
Identification
and management of complications of both mother and newborn during postnatal
periodandreferraltoappropriatehealthfacilityasandwhenneeded;
Personalhygieneandnutritioneducation,postnatalvitaminAandironsupplementationforthe
mother;
Promotionofexclusivebreastfeeding;
Personalhygieneandnutritioneducation,postnatalvitaminAandironsupplementationforthe
Immunizationofnewborns;and
Postnatalfamilyplanningcounselingandservices.
mother;
Immunizationofnewborns;and
Postnatalfamilyplanningcounselingandservices.
79
DoHS,
Annual Report 2071/72 (2014/2015)
87
79
Percentageofmotherswhoreceived
first postnatal care at the health
Fig:3.2.6:ThreeyeartrendfirstPNCwithin24hourof
facility among expected live births
deliveryaspercentageoflivebirths,206973,and
has decreased in last fiscal year.
ThreePNCvisitasperprotocol,2071/72
Institutional delivery was 57%, 100
90
nationally whereas PNC within 24
hours was lower at 48%, this could
80
66
be due to the lack of proper
65
65
65
70
61
60
59
59
57
57
recording and reporting of
56
55
60
53
5153
50
48
information. The figure has shown
50
the decline in PNC in EDR, CDR and
40
WDR whereas significant increment
29
27
30
in MWDR and FWR corresponding
20
20
20
18
17
20
with high institutional deliveries in
10
thesedistricts.
0
EDR
CDR
WDR
MWDR
FWR
National
Withtheintroductionoftherevised
HMIS,monitoringofthreePNCvisits
069/70
070/71
071/72
3PNCvisitsperprotocol
according to national protocol was
introduced in 2071/72. Mothers attending three PNC visits as per the national protocol was not
satisfactoryinallregions.Culturalandgeographicalfactorsaffectingmovementofpostnatalmother
couldbethereasonsforthislowcoveragewhileperceivedlowimportanceofcareduringpostpartum
periodcouldalsoplayanimportantrole.InNepal,thereisaneedofastrategythatpromotesaccess
to and use of postnatal service especially in geographically challenging districts and is culturally
sensitive.
3. NewbornCare
Newborncareincludes;
deliverybyskilledbirthattendantbothathomeandhealthfacilitywithimmediatenewborn
care (warmth, cleanliness, immediate breast feeding, cord care, eye care and immunization)
forallnewbornandresuscitationtonewbornwithasphyxia;
healtheducationandbehaviorchangecommunicationonearlynewborncareathome;
identification of neonatal danger signs and timely referral to the appropriate health facility;
and
CommunitybasednewborncareprogramwhichisreportedinChapter2,ChildHealth.
4. EmergencyObstetricCare
Fig:3.2.7:C/Saspercentageoflivebirths
Basic emergency obstetric care
20
(BEONC) covers management of
pregnancy complications by assisted
16
vaginal delivery (vacuum or forceps),
12.8
manual removal of placenta, removal
11
12
10.5
10
of retained products of abortion
9
9
8.7
8
(manual vacuum aspiration), and
7
7
8
6
6
administration of parental drugs (for
4.2
4
postpartum hemorrhage, infection and
3
2.7
4
2 2
preeclampsia/eclampsia),
resuscitation of newborn and referral.
0
Comprehensive emergency obstetric
EDR
CDR
WDR
MWDR
FWR
National
care (CEONC) includes surgery
069/70
070/71
071/72
(caesarean section), anesthesia and
88
80
bloodtransfusionalongwithBEONCfunctions.SafebloodtransfusionisanessentialpartofCEONC
andfreebloodtransfusionwasprovidedfrom2069/70.
Proportion of Caesarean section among

TrendsofproportionofCaesareansectionsamong
expected live births has gradually
totalexpectedlivebirths(Csrate)
increasedatnationalaverageis8.7%with
one percent increment in 2071/72
2069/70 2070/71 2071/72

comparedtopreviousyear.Atpopulation Mountaindistricts
0.4
0.7
1.0
level 515% of Caesarean section among Hilldistricts
6.3
8.3
9.3
alllivebirthsisacceptedasminimumand Teraidistricts
7.1
8.0
9.8
maximum standard by the WHO. While Nepal
6.3
7.6
8.7
EDR, CDR and WDR are within the
accepted range, MWDR and FWDR are still lag behind the national average and at below the
acceptedminimumlevel.ProportionofCSamongtotalexpectedbirthsinmountaindistrictsisstill
verylowat1%,althoughithasincreasedcomparedtopreviousyears.
EmOCmetneedslightlydecreasedto25.6%from28.9%inlastfiscalyearbasedonAamamonitoring
report(table:3.2.4).AllwomenwhoneededobstetriccomplicationshouldreceiveEmOCservices;
therefore the aim is to attain 100%. The proportion of major direct obstetric complications
throughout pregnancy, childbirth and immediate postpartum period is estimated to be 15% of
expectedbirths(WHO).
Table3.2.4:MetneedforEOCbasedonAamareporting*
15%ofexpected Numberofobstetric
MetneedforEOC
Totalexpected
livebirths
complications
Fiscalyear
services
livebirths
requiringEOC
managed
2069/70
2070/71
2071/72
662,446
662,285
614,666
99,367
99,343
92,200
*PreviousyearsreportingwerebasedonHMISdata
81
DoHS,
Annual Report 2071/72 (2014/2015)
28,717
28,495
23,611
28.9
28.7
25.6
89
5. Safeabortion
Sincetheimplementationofsafeabortionservicesin2060/61,atotalof819,690womenreceived
safe abortion services from certified service sites. Utilization of safe abortion services has been
plateauedinthelastfouryears.Among78,611totalserviceusersin2071/72,50%receivedmedical
abortion,15.3%areadolescents(aged<20),59.6%receivedfamilyplanningservice.Shareoflong
termfamilyplanningamongpostabortionfamilyplanningusersis19.2%.Outofallabortionservice
users, 10% of medical abortion service users and 13% of surgical abortion service users received
LARCmethods.
3.2.5 ProblemsandRecommendations
Table3.13:Problems/constraintsandactionstobetaken
Issues/Constraints
Recommendations
Responsibility
Referralmechanismtobe
Pilotrecommendationsfromreferral
FHD
established
guidelineandimplementaccordingly
Qualityservicefrom
Continueneedbasedtemporary
maternitycareathospitals
MoH/DoHS
hiring.
andbirthingcentre
Introducequalityimprovement
24/7availabilityof
processinallmaternitycareservices
services
FHD(QoC)
Qualitymonitoringandmentoringof
Skillsandknowledge
providers.
ofstaff
Monitoringprocessindicatorfor
FHD
Enabling
qualityserviceatmaternitycare
environmentand
Upgradingstrategicallylocated
motivation
birthingcenterstoprovide
FHD,DHO/DPHO
Overcrowdingat
comprehensivequalityprimary
FHD/DoHS
referralhospitals
healthcareservices

RaisethequalityofANCcounseling
Districts,
Plateau4ANCuse
service
FHD
Developaspecialpackagefor4ANC
RecruittrainedANM/StaffNurse
Strengtheninserviceskillsassessment,
LowutilizationofBirthing
SBAandnewborncaretraining
D(P)HO
Centers
Innovateprogramstoencourage
deliveryatbirthingcenters
Increasingnumberofbirthing shouldbeStrategicupgradingofhealth
MoH,D(P)HO
centers
facilitiesintobirthingcenters
Strategytoreachunreachedsub
LowutilizationoffourANC,
population.
institutionaldeliveryandC
Rapidassessmentandexpansionof
FHD/DHO
sectionservicesinmountain
ruralUSG.
districts
Expansionofservicesinremoteand
difficultaccesslocations
YearlycontractofMDGP,SN,
Exploremultiyearcontractsystem
MoH
AA,ANM,SMcoordinator
90
82
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
was to select one FCHV per ward regardless of the population size. Later in 2050 (1993/94)
populationbasedapproachwasintroducedinselected (28) districts.All togetherthereare51,470
FCHVsinthecountry(47,328FCHVsatrural/VDCleveland4,142aturban/municipalitylevel).
FCHVsareselectedbymembersofMothers'GroupforHealth(MGH)withthehelpoflocalhealth
facilitystaff.Theyareprovided18daysbasictrainingintwophases(9+9days)onselectedprimary
health carecomponents.Aftercompletionofbasictraining,FCHVsareprovidedwithacertificate
andmedicinekitboxconsistingofnecessarydrugsandsuppliesfreeofcost.Theyarealsoprovided
withmanuals,flipchart,wardregister,IECmaterials,FCHVbag,signboardandidentitycard.Family
Planning devices (pills and condoms only to FCHVs) Iron tablets, Vitamin A, and ORS are supplied
regularlythroughlocalhealthfacility.
ThemajorroleoftheFCHVistoadvocatehealthybehaviorsofmothersandcommunitypeopleto
promote safe motherhood, child health, family planning, and other community based health
promotion and service delivery. FCHVs distribute condoms and pills, ORS packets and vitamin A
capsules, treat pneumonia cases and refer and serious cases to health institution along with
motivation and education to community people. Similarly, they also distribute iron tablets to
pregnantwomen.
Various policies, strategies and guidelines have been developed to strengthen the FCHV program.
Numerous factors influence the program including national health sector reform, decentralization
andhandingoverofhealthfacilitiestoVDCs,experiencegainedfromprogramimplementation,and
therecognitiontoFCHVsinreductionofmaternalandchildmortalityandgeneralfertilitythrough
continuousimplementationofcommunitybasedhealthprogramsinNepal.
The FCHV program strategy has been revised in 2067 (2010) which gave strategic directions and
critical approaches to ensure a strengthened national program for consistency and continuous
supporttoeachFCHV.
Government of Nepal (GoN) is committed to increase the moral & participation of FCHV in
community health development. In fiscal year 2064/65 MoH established FCHVs fund by providing
cash support of Rs. 50,000 to each VDC. The mobilization of this fund for income generation
activitiesisexpectedtobenefittheFCHVsandthecommunityatlarge.
Goal
ThegoalofFCHVprogramistosupportnationalgoalofhealththroughinvolvementofcommunityin
public health activities. This includes imparting knowledge and skills for empowerment of women,
increasing awareness on health related issues and involvement of local institutions in promoting
healthcare.
83
DoHS,
Annual Report 2071/72 (2014/2015)
91
Objective
FCHVprogramhasthefollowingobjectives:
Toprepareapoolofselfmotivatedvolunteersasafocalpersontobridgehealthprograms
withcommunity
Toprepareapoolofvolunteerstoprovidecommunitybasedhealthservices
Toactivatewomentotacklecommonhealthproblemsbyimpartingrelevantknowledgeand
skills
Toincreasethecommunityparticipationinimprovinghealth
TodevelopFCHVasamotivatorforhealth
Toincreaseutilizationofhealthcareservicesthroughdemandcreation
MajoractivitiescarriedoutduringtheFY2071/72includethefollowing:
DressallowancestoFCHV
BiAnnualFCHVReviewmeeting
FCHVDaycelebration
FCHVDatabaseupdate
FarewellofLongactingFCHV
Additionalbudget(Rs.10,000)inFCHVFund
Training,orientationandmobilizationofFCHVforvariousnationalprogramsimplemented
3.3.3 Achievement
Therearealtogether51,470FCHVsservingpeopleofNepaloutofwhich47,328areinruralareasand
4,142inurbanhealthcenters.However,thereportswerereceivedonlyfrom49,451FCHVs.Therefore,
analysisforthisreporthasbeenbadedfrom49451FCHVsandpresentedhereaccordingly..According
tocurrentprogramguidelineUrbanFCHVsaremobilizedthroughmunicipalities,whiletheruralFCHVs
aremobilizedbyconcernedHPsorPHCCs.Table3.3.1presentsthetrendofvariousservicesprovided
by FCHVs during FY2069/70 to FY2071/72, which suggests that the service provided by FCHVs (Pills,
CondomandORSdistribution)hasslightlydecreasedinFY2071/72thaninFY2070/71.Thenumberof
mothersparticipatingintheHealthMother'sGroupMeetinghasbeenincreased.
Table3.3.1.TrendofservicesprovidedbyFCHVs
Services
Pillsdistribution(cycles)
Condomdistribution(pieces)
ORSdistribution(packets)
Irontabletsdistribution*
HealthMother'sGroupmeeting
Source:HMIS
2069/70
9,00,424
98,65,035
16,48,343
2,47,02,035
4,33,503
2070/71
9,13,530
1,45,06,525
17,02,330
2,32,87,380
4,18,936
2071/72
8,66,881
1,05,12,449
14,11,438
9,32,945
7,02,823
*Iron tablets district distribution: 2069/70 and 2070/71 data is on Iron tablets; 2071/72 data is on number of persons
providedIrontablets.
92
84
23287
24702
Figure3.3.1:FCHVContributioninSelectedHealthServices
FY2069/70to2071/72(.000)
703
419
434
933
1411
1648
867
914
5,300
900
10,300
1702
9865
15,300
10512
14507
20,300
300
Pillsdistribution
(cycles)
Condom
distribution
(pieces)
2069/70
ORSdistribution
(packets)
2070/71
Irontablets
distribution
HealthMother's
Groupmeeting
2071/72
Source:HMIS
SummaryofserviceprovidedbyFCHVshasalsoshowninFigure3.3.1forselectedservicesoverthe
lastthreefiscalyears.Thefigurealsoindicatesthatparticipantsofhealthmother'sgroupmeeting
are in increasing trend over the last three fiscal years. Similarly, distribution of oral contraceptive
Pills,Condoms,andORShavebeendeclinedinFY2071/72incomparisontothelastFY2070/71.
3.3.4Providedsupportinhomedeliverycases
FCHVhadalsoprovidedsupportinhomedelivery.Theirsupportsweremainlyfocusedoninitiating
skin to skin contact after birth, ensure uptake of misoprostol, and application of chlorhexidine in
cordafterdelivery.ContributionofFCHVinhomedeliveryhasbeenshowninTable3.2.
Table3.3.2.SupportprovidedbyFCHVinhomedelivery
Region
EnsureMisoprostolTaken
(Tablet)
SkintoSkincontact
afterbirth
Chlorhexidineappliedin
Cord
Eastern
Central
Western
MidWestern
FarWestern
National
31,979
55,523
14,292
9,995
5,688
1,17,477
25,659
55,713
18,882
16,496
13,644
1,30,394
20,343
45,672
14,560
13,135
10,968
1,04,678
Source:HMIS
Table3.3.2showsthatFCHVhavebeenactivetoincreasebestpracticesincludingSkintoskincontact
after birth, Chlorhexidine application in umbilical cord and ensuring uptake of misoprostol after delivery for
PPHpreventionatcommunityinFY2071/72.
85
DoHS,
Annual Report 2071/72 (2014/2015)
93
3.3.5InvolvementinCBIMCIProgram
Inadditiontothematernalandnewbornhealthcareshownabove,FCHVshavebeenproactively
counselingandreferringmotherandchildrentothehealthfacilitiesforvariousserviceswhichare
showninTable3.3.3.
Table3.3.3.CBIMCIserviceprovidedbyFCHVsatthecommunitylevel
Services
Cotrimtreatment(cases)
ORS&ZincTreatment(pieces)
TotalDiahhoreacasesreportedbyFCHV
TreatedwithORS&Zinc
Source:HMIS
2069/70
3,17,804
10,36,651
12,28,204
10,36,651
2070/71
3,02,876
10,88,979
11,36,165
10,88,979
2071/72
2,77,095
8,52,928
9,31,376
853,924
The Table 3.3.3 indicates that the CBIMCI service provided by FCHV at the community has slightly
declined in FY 2071/72 compared to FY 2070/71. For example In FY 207172, a total of 743349
children were treated by Cotrim, among of them FCHV served 2,77,095 children. That means
contribution of FCHV in treatment of children by Cotrim was 37.27% of total children treated.
Besides that FCHVs had supported for polio immunization to children below 5 years during NID;
community based management and treatment of ARI and CDD; community based nutrition
programsandotherpublichealthactivitiesincludingcontrolofneglectedtropicaldiseases.
Issues/constraints
Issues/constraints
IncreaseddemandofFCHVS
FCHVsareinactive
Increasedworkload
IlliterateFCHVs
Uninterestedinfarewell
LowutilizationofFCHVfund
Recommendations
Addresstheissueatpolicylevel
Capacitybuildup,needmotivation
Minimizeworkload
KnowledgeupdatetoFCHVs
Rethinkonfarewellpackage
Strictlyimplementguideline
94
Responsibility
MoH
FHD/CHD/DHO
FHD/CHD/DHO
FHD/DHO
FHD/DHO
FHD/DHO
86
FamilyHealth:PrimaryHealthCareOutreach
3.4 PRIMARYHEALTHCAREOUTREACH
3.4.1 Background
As envisage in the national health policy 1991, health facilities were extended up to village level.
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
services should be expanded closer to the community. Thus Primary Health Care Outreach
(PHC/ORC)serviceswasinitiatedandestablishedin1994(2051BS).
The aim of PHC/ORC is to improve access to some basic health services including family planning,
childhealthandsafemotherhoodclosertoruralhouseholds.Theseclinicsaretheserviceextension
sites of PHCCs, HPs and SHPs up to community level. The primary responsibility to conduct these
clinicslieswithMCHWsandVHWsatSHPlevelandANMs,AHWsandVHWsatPHCCandHPlevel.
OtherstaffsofHP/PHCCshelptoconductthePHC/ORC.WiththeupgradingofMCHWandVHW,and
with upgrade of all SHP the responsibility is being shared with all ANM and AHWs. Female
Community Health Volunteers (FCHVs) and other local NGOs/CBOs support health workers to
conducttheclinicsandalsosupportinrecording/reportingandothersupportactivities.
Based on the local needs PHC/ORCs are conducted every month at fixed locations of the VDC on
specific dates and time. The clinics are conducted within half an hour's walking distance for the
population residing in that area. VHWs and MCHWs or ANMs/AHWs provide basic PHC services.
AccordingtoPHC/ORCstrategy,followingservicesareprovidedfromtheclinic.
1. SafeMotherhood&NewbornCare
Antenatal,postnatal,andnewborncare
Irondistribution
Referralifdangersignsidentified
2. FamilyPlanning
DMPA,(DepoProvera)pillsandcondom
Monitoringofcontinuoususers
EducationandcounselingonFPmethodsandemergencycontraception
CounselingandreferralforIUCD,implantandVSCservice
Tracingdefaulter
3. ChildHealth
Growthmonitoringofunder3children
Pneumoniatreatment
Diarrhoeatreatment
4. HealthEducationandCounseling
Familyplanning
Maternalandnewborncare
Childhealth
STI,HIV/AIDS
Adolescents'sexualandreproductivehealth
Others
5. Firstaidtreatment
Minortreatment
Referralforcomplicatedcases
87
DoHS,
Annual Report 2071/72 (2014/2015)
95
3.4.2 MajorActivitiesofFY2071/72
FinancialsupporttorunPHC/ORC
3.4.3 Analysisofservicecoverage
1) Outreachclinicsconductedandpeopleservedin2071/72ispresentedbelow:
Table3.4.1.Outreachclinicsconductedandpeopleservedin2071/72bydevelopmentregion
Region
TotalNo.ofclinics
Serviceprovidedtovisitors(New+Old)
2917
597824
Eastern
4118
685202
Central
2520
508007
Western
1899
391326
MidWestern
1458
388627
FarWestern
12912
2570986
National
Source:HMIS
Altogether2.6millionpeopleservedthrough12912ORCsconducted124747times.
Note:
Target:Totalnumberofclinicsexpectedtoruninayear(12912PHC/ORCclinicsX12times=
154944)
Achievement:Totalnumberofclinicsreportedtohavebeenconductedis124747(81%)
2) The average number of people served by ORCs explains the performance of clinics on
coverage.
Table3.4.2.Averagenumberofpeopleservedperclinicperdaybydevelopmentregion
AveragenoofPeopleServedbyclinic
Region
PHC/Day
National
EasternRegion
CentralRegion
WesternRegion
MidwesternRegion
FarwesternRegion
50
39
65
39
41
59
HP/Day
20
SHP/Day
14
PHCORC/Clinic
20.6
20
14
19.5
18
13
20.2
18
13
18.9
23
17
22.2
25
14
25.0
Source:HMIS
Average number of clients, served per day per outreach clinic was 20.6 at national level in
FY2071/72.Thisnumberhasslightlydecreasedfrom22duringFY2070/71.Table3.4.2showsthatthe
average clients served per clinic per day was highest in Farwestern development region (25)
followed by Midwestern region, Cental region, Eastern region and Western region respectively.
Table3.4.2furtherindicatesthattheaverageclientsservedperdayishigherinoutreachclinicsthan
theaverageclientsservedperdayinHPandSHPs.
96
88
3) ServicesprovidedbyPHC/ORC
Table3.4.3.TrendofserviceprovidedinPHCoutreachclinics
ServiceTypes
Primarytreatment
Depo(times)
ANC(times)
PNC(Times)
Growthmonitoring
Source:HMIS
2069/70
10,63,636
2,47,299
2,83,247
77,474
11,96,189
2070/71
10,03,924
2,38,067
2,70,991
73,567
12,45,345
2071/72
7,54,413
2,14,370
2,58,979
56,917
9,31,097
Table3.4.3 shows that the trend of average number of people served in PHC/ORC. The table
indicatesthattheaveragepeopleservedinPHC/ORChasslightlydecreasedinFY2071/72compared
to the last two fiscal years. The declining trend of average number of people served in PHC/ORC
suggeststhatthePHC/ORCneededtobestrengthenedsoastostepupthemtoincreasefunctional
infuture.
3.4.4 Issues/Gaps
Issues/constraints
Recommendation
Responsibility
Servicecoverageof
PHC/ORC
UpgradedANM/AHWare
notinterestedtoconduct
PHC/ORCclinicsdueto
lackofFieldallowance
PHC/ORCcommittee
meetingnotfunctional
Lackofplace
(infrastructure)to
conductPHC/ORC
LowreportingofPHCORC
MobilizationofANM/AHWinPHC/ORCclinics FHD/DHO
withfieldallowance
Supportingsupervisionandmonitoring
Reformandreorientmgtcommittee
members
DHO/DPHO
RevisestrategiesforPHC/ORC
FHD
Improvereportingmechanismand
monitoring
MD
89
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97
FamilyHealth:DemographyandReproductiveHealthResearch
3.5
DEMOGRAPHYANDREPRODUCTIVEHEALTHRESEARCH
3.5.1 Background
Planning, monitoring and evaluation of reproductive health (RH) activities are the key functions of
Program, Budget and Demography Section. This section conducts periodic and ad hoc studies and
alsocoordinatesreproductivehealthrelatedresearchandstudiescarriedoutbyotherorganisations
inNepal.
Majorresponsibilitiesofthissectioninclude:
Estimate annual national targets for family planning, safe motherhood and adolescent
reproductivehealthservicesincludingfamilyplanningacceptorsandRHcommodities.
CarryoutregularmonitoringofRHandEOCactivities
Provide supportive supervision to DHO/DPHO and all levels of health facilities regarding RH
services.
Conductperiodicandadhocresearchesandstudiesonreproductivehealthfocusingonfamily
planning, maternal and neonatal health, safe abortion services, adolescent sexual and
reproductivehealthandfemalecommunityhealthvolunteerservices.
Conductandsupportpilotingofmaternalandnewbornhealthinitiatives.
Majoractivitiescompletedinthefiscalyear2071/72include:
3.5.2.1AnnualprogramandBudget
AnnualprogramandbudgetwaspreparedforFamilyHealthDivisiononthebasisofprogram
continuation, district, regional and national RH review recommendation, subcommittee
recommendations,districtandregionalofficedemands,researchandstudyfindingsandHMIS
providedinformation.
3.5.2.2Targetpopulationsetting,monitoringandresearch/study
Target population revisionfor RH programs was led by HMIS andsupported bythe division.
Thetargetwassetfornext10yearsonthebasisofpopulationcensus2011.
Estimation of contraceptive requirement: Forecasting for contraception and other RH
commoditieswasdoneincoordinationofLogisticsManagementDivisionandHMIS.
Reviewmeetings:
Regional and national reviews of Department of Health Services were supported by
documentingandpresentingprogressofRHprograms.AnationalRHReviewMeetingwas
conducted to review the progress, partnership effectiveness and plan for annual program
andbudget.NepalHealthSectorProgram(NHSPIII)developmentprocesswassupportedby
designingperiodicplanofRHactivities.EOCmonitoringreviewmeetingswereconductedat
regionalandnationallevels.
Internal monitoring was done from the division to various district offices and hospitals. The
monitoringwasfocusedonthefinanceflowofAamaProgram,UterineProlapsemanagement
and family planning services. The CEONC strengthening was done through mentor and FHD
officials.
Maternal and perinatal death review exercise was scaled up to 44 hospitals by capacitating
concerned staffs and providing supportive budget for meeting conduction. However, some
hospitalscouldntfunctionMPDRverywell,needfeltforfurthersupports.
98
90
RapidAssessmentofDemandSideFinancing(Aamaand4ANC)roundVIXwasconductedin
10 districts. Additionally, exit client interview in seven private health institution was also
incorporatedintherapidassessment.
Coordination in research activities was conducted through partner organizations and
researcherstheycomeincontacttoFHD.
3.5.2.2Guideline/documentsdevelopment
MaternalandPerinatalDeathSurveillanceandResponseGuidelineandImplementationPlan
(201519) have been finalized and approved by MoH. Birth defect surveillance, prevention
and control plan (201519) has been finalized and approved by MoH. Which has been
instrumental to initiate or integrate birth defect surveillance, prevention and control
activities within WHO regional framework for Southasia. Information recording and
reportingoncongenitalanomalieswasincorporatedinHMIS.
Safe Motherhood Policy revised draft has been prepared to incorporate maternal death
notificationandnewbornhealthaswellascontemporaryissuesofsafemotherhood.
RevisionofUterineProlapseGuidelinehasbeeninitiated
MajorFamilyHealthRelatedStudiesapprovedbyNHRCin2015and2016
RHrelatedstudiesapprovedbyNHRCduring2015and2016(Source:NHRC)
ParentalHelthcareAmongLowerCasteWomeninRuralNepal:ACaseof
1
Gautam,D.S.,2015
StudyofSiganaVillage,Baglung,Nepal
ExperiencesofSocialStigmaandDomesticViolenceAmongInfertile
2
Aryal,Y.,2015
Women:AQualitativeStudy
3
Sijapati,K.,2015
SuicidalIdeationandRiskySexualBehaviorAmongLGTinKathmandu
PrevalenceofPostpartumDepressionandAnxietyinParopakar
4
Shrestha,N.,2015
MaternityandWomen'sHospital
Rajbhandary,R.,
AssessingClient'sSatisfactionandPreceptionofQualityWithServices
5
2016
ReceivedFromMarieStopesCentersThroughExitInterview
AssessingProviderandSitePerformanceintheProvisionofQualitySafe
6
Shrestha,D.R.,2015
AbortionServiceinIpasInterventionDistrictsofNepal
UnmetNeedforFamilyPlanningAmongMarriedWomenLivingwithHIV
7
Pokhrel,B.R.,2015
inNepal
AnalysisofMenstrualHygienePractices:TheRoleofWASHinSchools
8 Morrison,J,2016
ProgrammeinGirlsEducationinNepal
BaselineSurveyonKnowledge,PerceptionandPracticeofReproductive
9
Tamang,A.,2016
andSexualHealthAmongMarriedandUnmarriedAdolescentsinEight
DistrictsofNepal
SterilizationandReuseofMedicalDevicesinNepal:APatientSafety
10 Pant,G.,2016
Concern
SituationAnalysisonManagementofSevereInfectioninYoungInfants
11 Pant,B.P.,2016
withaFocusonPrivateSector
KnowledgeandSocioculturalPracticesofMenstruationAmong
12 Dahal,S.,2016
AdolescentGirlsinRuralSettingofNepal
EffectivenessofFCHV EarlyPregnancyDetectionandReferral
13 Sharma,S.K.,2016
InterventiononWomen'sUseofSafeAbortionServicesinNepal
SituationAssessmentonSexualandReproductiveHealthandRightsof
14 Acharya,A.,2015
YoungPeopleinIllam,Nepal
ACrosssectionalSurveyonCoverageofIFASupplementsamong
15 Pant,P.R.,2016
PregnantWomeninFourDistrictsofNepal
16 Khadka,D.B.,2016
EconomicBurdenforSeekingSafeDeliveryServiceatPublicandPrivate
91
DoHS,
Annual Report 2071/72 (2014/2015)
99
HospitalsHavingSaferMotherhoodPrograminKathmanduMetropolitan
City
Rajbhandary,R.,
AnOperationalResearchtoMeasureImpactofVideoLibraryonFamily
17
2016
PlanningUptakeandMethodWomeninMarieStopesCenters
18 Bhattarai,S.,2016
FactorsAssociatedwithEarlyMenarche;ACaseControlStudy
KnowledgeandPracticeRegardingBirthPreparednessandComplication
19 Paudel,B.,2015
ReadinessPlanAmongPregnantWomenAttendingAntenatalClinicat
NorvicInternationalHospital,Thapathali
RHrelatedstudiesapprovedbyNHRCduring2015and2016Contd.(Source:NHRC)
FertilityBehaviorandItsSocioeconomicandDemographicDeterminants
20 Ghimire,A.,2015
inDalitCommunityofSindhuli,Nepal
PrevalenceofAnemiaAmongPregnantWomenAttendingAntenatal
21 Rimal,B.M.,2015
ClinicatLamjungDistrictCommunityHospital
PracticeandCulturalBeliefsRelatedtoMenstrualManagementAmong
22 Khadka,S.,2015
AdolescentGirlinAranikoSchool,Gamcha
EffectivenessofEducationalInterventiononKnowledgeRegarding
23 KC,P.,2015
UterineProlapseAmongReproductiveAgeGroupWomenof
BudhanilkanthaMunicipalityWardNo7ofKathmanduDistrict
AcceptabilityandWillingnesstoPayforCycleBeadsinSelectedDistricts
24 Shattuck,D.,2015
ofNepal:BankeandBardiya
ARandomized,APlaceboControlledStudyofTwoProphylactic
25 GautamJ.,2015
MedicationApproachesinAdditiontoPainControlRegimenforearly
MedicalAbortionWithMifepristoneandMisoprostol
AnInvestigationoftheRelationshipsAmongWomen'sExperiencesofthe
26 Khatri,G.,2015
2015Earthquake,MentalHealthStatusandPregnancy
KnowledgeandAttitudesofMarriedWomenof ReproductiveAge
27 Karki,D.K.,2015
TowardsIntrauterineDevicesandMedicationAbortioninNepal
CoverageandQualityofMedicationAbortionDrugsinSafeAbortion
28 Karki,D.K.,2015
Sites(SAS)andPrivatePharmaciesinNepal
MedicationAbortionDrugDispensingPracticesofPrivateChemists
29 Karki,D.K.,2015
ThroughMysteryClientsinNepal(RoundI)
IntraUterineContraceptiveDevice(IUD)RecommendingPracticesand
30 Karki,D.K.,2015
ClientCounselingBehaviorofProvidersinNepal(RoundII)
MonitoringandEvaluationofFamilyPlanningInterventionsto
31 Baral,S.C.,2015
StrengthenDeliveryofFamilyPlanningServicesinNepal
GapsandBarrierstoFamilyPlanningServicesAmongMuslimPopulation
32 Baral,S.C.,2015
inRupandehiDistrict,Nepal
FormativeResearchonMenstrualHyegineManagementinUdaypurand
33 Morrison,J.,2015
Siraha
TraffickedintotheSexIndustry:YoungNepaleseWomenand
34 Patricia,O.M.,2015
ReproductiveHealth
ExplorationofFactorsInfluencingtheUseoftheReproductiveHealth
35 Maharjan,B.,2015
CareServiceAmongtheEarlymarriedBridesinNepal
ConductingGapandPotentialityAnalysisandMarketAppraisalofSRH,
36 Rajbhandari,R.,2015
MainlyFamilyPlanningServicesinProjectCatchments
AComparativeStudyonMenstrualHygienePracticesandSchool
Bhochhibhoy,S.,
37
AbsenteeismAmongSchoolGirlsFromPublicandPrivateSchoolsof
2015
Kathandu
StigmaandIntimatePartnerViolenceAmongWomenLivingWithHIVin
38 Dhakal,S.,2015
Nepal
Bajracharya,D.C.,
Explorationofinfluencesandtreatmentseekingbehaviorspecificto
39
2015
familyplanningandresponsivenessofexistingservicesandprograms
100
92
amongyoungurban,unmarriedwomenandmarriedurbanslum
dwellers
Knowledge,AttitudesandBeliefsofPregnantWomenandTheirFamilies
DuringandAftermathofMajorEarthquakeinNepal:AQualitative
Assessment
40
Rajbhandary,R.,
2015
41
Upreti,A.,2015
ResearchonSexualViolenceAmongGirlsinTenDistrictsofNepal
42
Basnett,I,2015
DocumentationofSecondTriServiceUtilization
43
Shrestha,H.K.,2015
StudyonEndometrialPathologybyTransvaginalUltrasonographyandits
CorrelationwithHistopathologyinPostmenopausalWomen
RHrelatedstudiesapprovedbyNHRCduring2015and2016Contd.(Source:NHRC)
44
Underwood,C.R.,
2015
HC3NepalBaselineSurvey:FamilyPlanningKnowledge,Attitude,Norms,
andPractices
45
Sapkota,B.P.,2015
BaselineSurveyforAdolescentSexualReproductiveHealthProjectin
SelectedVDCsofBajhang,Doti,MuguandRukumDistricts
46
Paudel,M.,2015
AssessmentofProviderKnowledgeandAttitudestowardsIUDandMA
(RoundII)
47
Puri,M.C.,2015
StudyingtheImpactandPerformanceofInstitutionalizingImmediate
PostpartumIUDServicesasaRoutinePartofAntenatalCounsellingand
DeliveryRoomServiceinepal
48
Velcoff,J.,2015
DevelopingStrategiestoDiffuseFertilityAwarenessThroughCommunity
NetworksinNepal
49
Thapa,K.,2015
PromotingKangarooMotherCareinSelectedHospitalofNepalThrough
TrainingandProvisionofaBabyWrap
93
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101
50
Saville,N.M.,2015
ExploringInterviewersandParticipatinngWomen'sPerspectivesonthe
PlanninngofPregnancyandtheLondonnMeasureofUnplanned
PregnancyquestionnaireinDhanushaandMahottariDistricts,Southern
Nepal:AProcessEvaluation
51
Suvedi,B.K.,2015
BaselineStudyofPregnantWomen'sGroupsinNepal
Kukuczka,A.,2015
FactorsImpactingtheUptakeandAcceptabilityofandAttitudesTowards
MenstrualCupsinaComparativeCohortof50adolescentgirlsand50
womeninSisneriVDC,MakawanpurDistricts,Nepal
52
MajorIssues
Research in RH is crucial for program design, planning, monitoring and evaluation. However,
adequate coordination is not made from nongovernment partners during different stages of
study(design,implementation,analysisanddissemination)asprovisionedinReproductiveHealth
ResearchStrategy,whichhasledtogapandredundancy.Eventhough52RHrelatedstudieswere
approvedbyNHRCduringtwoyearperiodbetween2015and2016veryfewstudieswereshared
with DoHS, Family Health Division. As a result, study findings and recommendations were not
incorporatedintheRHprogramplanningandimplementation.Inordertobeabletomonitorand
appraisetheRHresearchandstudiesconductedinNepal,DoHSshouldhaveclearplantoenhance
monitoringandresearchcapacityforFHDstaffs.to
102
94
FamilyHealth:AdolescentSexualandReproductiveHealth
3.6
ADOLESCENTSEXUALANDREPRODUCTIVEHEALTH
3.6.1 Background
NepalendorsedandpublishedtheNationalAdolescentHealthandDevelopment(NAHD)Strategyin
2000. An implementation guideline on Adolescent Sexual and Reproductive Health (ASRH) was
developed in 2007 to support district health managers in operationalizing this strategy. In 2008, a
draftnationalASRHprogramwasdevelopedwiththesupportofGIZ.Thisprogramwassuccessfully
piloted in 2009 in 26 public health facilities. Based on the findings from the pilot intervention, a
NationalASRHProgramwasdesignedin2011whichconsistsof4differentorientationmanualsfor
districthealthmanagers,districtstakeholders,healthserviceprovidersandHealthFacilityOperation
andManagementCommittees(HFOMCs)/localstakeholders.
NationalASRHprogramisbeinggraduallyscaledupandhasbeenabletomeettheNHSPIItargetof
making1,000publichealthfacilitiesadolescentfriendlyby2015.Thecriteriaofadolescentfriendly
services(AFS)include,amongothers,theavailabilityoftrainedstaffaswellasinformationmaterials
on adolescent sexual and reproductive health, the delivery of services in a confidential way,
adolescentfriendly opening hours, the display of the AFS logo as well as the inclusion of two
adolescents in the HFOMC. By end of 2071/72, a total of 1140 health facilities in 63 districts are
providing adolescentfriendly services (AFS) in support of different stakeholders (UNFPA, UNICEF,
WHO,GIZ,SavetheChildren,IPASandADRA).
TheASRHsecretariatlocatedatFamilyHealthDivisionsupportedbySavetheChildrenNepalandan
ASRH subcommittee meeting are well functioning for facilitating effective implementation of
adolescenthealthprograminthecountry.
Goal
The overall goal of the National ASRH Program is to promote the sexual and reproductive health
statusofadolescents.
Objectives
To increase the availability of and access to quality information on adolescent health and
development, and provide opportunities to build the respective knowledge and skills of
adolescents,serviceprovidersandeducators.
Toincreaseaccessibilityandutilizationofadolescenthealthandcounselingservices.
Tocreatesafeandsupportiveenvironmentforadolescentsinordertoimprovetheirlegal,
socialandeconomicstatus,and
TocreateawarenessthroughBCCcampaignsandatnational,districtsandcommunitylevel
throughFCHVsandmothersgroups.
Targets
Themajortargetoftheprogramwastomake1,000healthfacilitiesadolescentfriendlyby2015in
linewithNationalHealthSectorProgramII.Accordingtohealthpolicyandnationalhealthstrategy
government envisioned to make all health facilities adolescent friendly health services. Through
improving access to family planning information and devices, the program aims to reduce the
AdolescentFertilityRate(AFR).
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103
ThefollowingaretheactivitiesthathavebeenimplementedaspertheNAHDStrategy2000:
1. InformationandSkills
Informationdisseminationthroughhealthfacilities
PrintedanddistributedIEC/BCCbooklets,ASRHposter,ASRHcomics
DistributedASRHflipchart
PrintedanddistributedadolescentjobaidinNepali
2. ProgramorientationtoHealthServiceProvidersandstakeholdersonASRH
ProgramorientationstoDistrictHealthManagersofprogramdistricts
OrientationstodistrictstakeholdersincludingReproductiveHealthCoordinationCommittee
(RHCC)membersintheprogramdistricts
Orientationtoserviceproviders in the programdistricts
OrientationtolocalstakeholdersincludingHFOMCmembersinprogramHFs.
3. HealthServicesandCounseling
Makinghealthfacilitiesadolescentfriendly.
IntegratingAFSintotheexistinghealthcaredeliverysystem.
Involving and establishing links with youth clubs, child clubs, Village Child Protection
Committees (VCPCs), NGOs and the private sector to expand and improve service delivery
foradolescents.
4. SafeandSupportiveEnvironment
FunctionalASRHSubcommitteeunderthechairofFHDDirector
DisplayAFSlogoandinformationboardatAFSHFs
Wallpainting,messagethroughlocalFMinAFSHFs
Communitymobilizationandawarenessactivitiesthroughexistinghealthsystemsandlocal
NGOs
The National ASRH Program achieved the following in FY 2071/72 (2014/2015): National ASRH
program equipped health facilities in districts in the following areas to provide quality AFS and
increaseaccesstoanduseoftheseservices:
Improved capacity of health workers through orientation program to provide adolescent
friendlySRHservicesthroughtheuseofspecificcounselingtoolsandIECmaterialsaswellas
anopenandappreciativeattitude.
Improved capacity of district health managers and HFOMCs to respond to adolescents
healthneeds.
ProvisionofappropriateSRHservicestoadolescents(familyplanning,HIVandSTIservices,
safeabortion,counselingetc.)
EquippinghealthfacilitieswithminimumnecessarylogisticsandequipmenttoprovideSRH
servicestoadolescentsinaprivateandconfidentialenvironment.
Ensuring participation of adolescents in decisionmaking processes in health facilities by
involvingthemasinviteemembersinHFOMC.
Improvedrecordingandagedisaggregatedreportingonserviceutilizationbyadolescents.
Supporting in increasing the demand for the services through distribution of ASRH related
IEC materials to schools and communities as well as the mobilization of different
stakeholdersandstructuresatcommunitylevel.
SupervisionandmonitoringofAFShealthfacilities.
104
96
3.6.3CurrentStatus
National ASRH program is being gradually scaled up and met the NHSP II target of making 1,000
public health facilities adolescentfriendly by 2015. However, all public health facilities have been
providingregularservicestoallincludingadolescentsbeforeequippingthemtobecomeAFS.InFY
2071/72, out of total clients served 20 percent were adolescents aged 1019 years (girls18% and
boys22%). Similarly, out of total referred cases, 19 percent adolescents (girls19% and boys20%)
werereferred.Likewise,20percentofnewTuberculosiscaseswereyouthaged1524years(female
24% and male18%). Furthermore, 3686 schools have run peer education program and counseled
122,467adolescents.Servicespecificanalyseshavebeengiveninthefollowingsections.
12
Proportionofadolescentsnewacceptorsamongtotalnewacceptorsof
modernspacingcontraceptives,2068/69to2071/72,Nepal
Percent
9.6
10.4
10
9.6
9.4
7.4
7.2
6.4
6.3
7.9
7.7
4.4
4.5
2
2068/69
Depo
IUCD
Implant
4.4
3.6
3
2069/70
Pills
2070/71
2071/72
Source:HMIS
The above figure shows the trend of proportions of adolescent new acceptors of spacing modern
contraceptivesfromFY2068/69to2071/72inNepal.Pillsnewacceptorsrankhighestfollowedby
DeponewacceptorswhereascomparativelyIUCDandimplantusersarelessinnumber.Totalsumof
data shows that slightly more than one fourth of new acceptors of modern contraceptives are
adolescents among total new acceptors of spacing modern contraceptives. The proportion of
adolescentnewacceptorsusingDepo,ImplantandIUCDareallinincreasingtrendswhileproportion
ofPillsusersremainedconstantinthelasttwoyears.
Table6.3.1:ProportionofAdolescentsNewAcceptorsamongtotalnewacceptorsofSpacing
ModernContraceptivesbyRegions
Method
Pills
Depo
IUCD
Implant
FiscalYear
2068/69
2069/70
2070/71
2071/72
2068/69
2069/70
2070/71
2071/72
2068/69
2069/70
2070/71
2071/72
2068/69
2069/70
2070/71
2071/72
EDR
CDR
Regions
WDR
MWDR
FWDR
8.1
14.6
8.9
8.6
6.9
7.6
7.5
7.4
3.2
8.0
6.3
6.6
2.1
2.7
2.3
2.6
6.7
8.1
9.2
11.0
7.4
7.9
7.9
9.3
5.1
4.3
3.6
6.4
2.0
2.0
2.9
4.3
4.6
5.4
10.7
7.9
5.0
5.2
5.4
11.7
2.4
3.9
4.2
4.8
4.6
2.9
2.6
6.3
12.3
16.7
13.0
13.1
11.3
11.5
12.1
13.0
15.5
15.7
7.8
7.8
12.0
6.8
6.8
5.4
5.3
6.3
5.5
6.2
4.2
4.5
5.3
4.9
9.6
8.0
4.4
6.6
1.1
1.7
3.0
2.8
Source:HMIS
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105
Table6.3.1showsthetrendofproportionofadolescentnewacceptorsamongtotalnewacceptors
of spacing modern contraceptives by development regions from FY 2068/69 to 2071/72. The
proportionofadolescentnewacceptorsofshorttermspacingmethods(Depo)isinincreasingtrend
with the highest proportion of adolescent new acceptors in midwestern development region and
thelowestinfarwesterndevelopmentregion.Althoughtheproportionofadolescentnewacceptors
ofIUCDslightlyincreased/stabilizedincurrentfiscalyearinFWDRandMWDR,theproportionhas
decreased compared to fiscal year 2068/69 and 2069/70, however, its trend is increasing in other
developmentregions.Whilelessnumbersofadolescentnewacceptorsareusingimplant,overallits
trendisincreasinginotherregionsexceptMWDR.
Table6.3.2:ProportionofAdolescentsAntenatalcheckupamongtotalAntenatalcheckupvisits
byRegions
Fiscal
Year
National
20.7
2071/72
19.0
16.7
Indicator
FirstANCVisit(anytime)
FirstANCvisitasperprotocol
FourANCvisitsasperprotocol
EDR
19.6
18.3
14.6
CDR
19.5
16.3
17.6
Regions
WDR
18.1
17.2
13.3
MWDR FWDR
28.7
20.5
29.0
19.7
24.9
15.4
Source:HMIS
Table 6.3.2 depicts the proportion of adolescent Antenatal checkup visits among total Antenatal
checkupvisitsbydevelopmentregionsofinthereportingyear2071/72presentthat,theproportion
ofANCcheckupvisitsbothanytimeandasperprotocolisconsistentlyhigherthannationalaverage
inMWDR.ItindicatesthatchildmarriagepreventionactivitiesandprogramneedtotargetinMWDR
and side by side adolescent friendly health services and or any innovative intervention for better
outcomeofbothadolescentmotherandbabyshouldbetargetedinthisregioncomparedtoother
regions as the literatures suggest that adolescent pregnancy is risky. It is a concern that the
proportionofadolescentsamongtotalfourANCvisitsislessthantheproportionofthemamongthe
firstvisit.Lessadolescentsamongfirstvisitaccordingtoprotocolcomparedtofirstvisitatanytime
couldbeduetopoorinformationamongthisgroup,indicatingtheneedtoemphasisinformationon
earlyANCvisitamongadolescents.
Table6.3.3:ProportionofAdolescentsSafeAbortionServiceuseamongtotalSafeAbortion
ServiceusersbyRegions
Fiscal
Year
Indicators
MedicalSafeAbortionService(Noof
women)
SurgicalSafeAbortionService(Noof
women)
TotalSafeAbortionService(Noof
women)
National
Regions
WDR
MWDR
EDR
CDR
2071/72
13.9
(5541)
11.4
(1009)
18.2
(2301)
11.5
(1163)
16.4
(635)
10
(433)
2071/72
16.7
(6489)
13.2
(839)
18.2
(2524)
13.5
(1454)
36.5
(1372)
7.4
(300)
12.1
(1848)
18.2
(4825)
12.6
(2617)
26.4
(2007)
8.7
(733)
2071/72
15.3
(12030)
FWDR
Source:HMIS
Table 6.3.3 presents proportion of adolescents Safe Abortion Service users (number) among total
Safe Abortion Service users by regions and it is highest in MWDR. As shown in the table, the
proportion of adolescents using medical safe abortion service is the highest in CDR followed by
MWDRandsurgicalsafeabortionserviceamongadolescentsishighestinMWDRfollowedbyCDR
andlowestinFWDR.
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98
3.6.4 ImplementationStatusofASRH/AFSProgram
Table3.6.2:ImplementationStatusofASRHProgram
2065/66(piloting)
Bardia,Surkhet,Dailekh,Jumla,Baitadi(5piloting)
2066/67
Bara,Dhading,Morang,Gulmi,Parbat(5)
2067/68
Jhapa,Dolakha,Kavrepalanchowk,Kaski,Nawalparasi(5)
2068/69
Udayapur,Rautahat,Baglung,Rolpa,Dadeldhura,Humla,Jajarkot,Rukum,
Bajura,Darchula,Banke,Bardiya,Jumla,Dang,Dailekh,Surkhet,Achham,
Baitadi,Doti,Kailali,Pyuthan,Kapilbastu,Arghakhanchi,Bajhang,Mahotari,
Sindhuli,Kathmandu,Bhaktapur(28)
2069/70
Taplejung,Shankhuwasabha,Rasuwa,Gorkha,Lamjung,Salyan,Mugu,
Kalikot,Kanchanpur,Siraha(10)
2070/71
Panchthar,Ilam,Dhankuta,Teharthum,Bhojpur,Saptari,Dhanusha,Parsa,
SunsariandSarlahi(9)
2071/72
Okhaldhunga,Solukhumbu,Nuwakot,Ramechhap,MyagdiandPalpa(6)
ThedistrictsandnumberofhealthfacilitiesidentifiedforthescaleupofASRHProgramin2072/73
andthesupportagenciesaregivenintable3.6.3.
Table3.6.3:ASRHProgramProposedPlanforFY2072/73
ASRHPrograminNew
SN
Source
GoN
UNFPA
UNICEF
HFs
Districts
ASRH ProgramExtension
NewHFs
Districts
13
Kaski
39
Dadeldhura13,Dang13andUdaypur13
38
Baitadi10,Bajhang10,Parsa10and
Mahottari8
Savethe
Children
30
Saptari
Total
120
3.6.4 Issues
Some of the specific issue/problems identified during implementation of program noted in recent
regionalreviewmeetingsandnationalreviewmeetingaresummarizedinTable3.6.4.
99
DoHS,
Annual Report 2071/72 (2014/2015)
107
Table3.6.4:Issuesandrecommendations
Issues
Recommendations
QualityassuranceofASRH CertifyAFShealthfacilitiesusingcertificationcriteria
Program
andtools,ensuretheavailabilityofessential
commodities,equipmentandenvironment
Inadequatetrainedhuman Developcapacityofserviceprovidersfromeach
resourceonASRHinHFs
healthfacility
Inadequatemonitoring
IncreasenumberofmonitoringvisitstoAFSsites
fromdifferentlevels
Lowresourceallocation
Allocatesufficientresourcesforthisprogramat
forprogramatcenterand center,districtandlocallevels
locallevel
Inadequatelinkagewith
AdvocateforfunctionalintegrationofASRHissues
otherprograms(FP,SM,
andservicesinotherthematicareas
HIVetc.)
InadequateIEC/BCC
EnsuresupplyofASRHrelatedIEC/BCCmaterialsup
materials
toHFlevel
108
Responsibility
FHD
NHTC
FHD,MDand
DHOs
FHD/DHO
FHD
FHD,NHEICC,
DHO&Partners
100
Disease Control
4.1 Malaria
.................................................................................................... 111
4.2 Kalaazar................................................................................................. 118
4.3 LymphaticFilariasis(LF).......................................................................... 123
4.4 Dengue................................................................................................... 127
4.5 Zoonoses................................................................................................. 130
4.6 EpidemiologyandDiseaseOutbreakManagement................................133
4.7 DisasterManagement............................................................................. 135
4.8 SurveillanceandResearch....................................................................... 140
4.9 Tuberculosis............................................................................................. 144
4.10 Leprosy.................................................................................................... 156
4.11 HIV/AIDSandSTI...................................................................................... 174
4.12 EyeCare.................................................................................................. 186
Curative Services
5.
CURATIVESERVICES(Inpatients/OPDservices)...............................191204
109
Chapter4
4.1
DiseaseControl:Malaria
DISEASECONTROL
MALARIA
4.1.1 Background
Malaria control project in Nepal was first initiated in 1954 with the support from USAID (the then
USOM),withtheobjectiveofcontrollingmalaria,mainlyinplainregion(Teraibelt)ofcentralNepal.
In 1958, national malaria eradication program was launched with the objective of eradicating
malaria from the country. Due to various reasons the eradication concept reverted to control
programin1978.Followingthecallof WHOtorevampthemalariacontrolprogramsin1998,Roll
Back Malaria (RBM) initiative was launched to control malaria transmission in hardcore forests,
foothills,innerTeraiandhillrivervalleys,whichaccountedformorethan70%ofthetotalmalaria
casesinthecountry.Thehighriskofacquiringthediseaseisattributedtotheabundanceofvector
mosquitoes, mobile and vulnerable population, relative inaccessibility of the area, suitable
temperature, environmental and socioeconomic factors. The recent microstratification, based on
number of malaria cases, geoecology, vector breeding and vulnerability due to migration and
population movements, further narrowed down the essentials to VDC level risks as compared to
earlierdistrictasunitsofrisks.Ithasclearlyshownthatonly54VDCsareathighrisk,201VDCsat
moderateriskand999VDCsatlowrisk.
Basedonthemicrostratificationreport2013,approximately13.02millionpopulation(47.9%)livein
malariaendemicareas(VDCS);outofwhich~1million(3.62%)liveinhighriskVDCs,2.66million
(9.8%)liveinmoderateriskVDCs,and9.38million(34.52%)liveinlowriskVDCs.Atotalpopulation
of14.13(52.1%)isestimatedtoliveinVDCswherethereisnomalariatransmission.Thehighrisk
areas consist of foothills with river belts, forest fringe areas in terai, hill river valleys, inner terai
areas.LowriskVDCslieinplaincultivatedouterTerai,mountain,andvalleysinthemountains.
Map44.1.1:Malariamicrostratification
ThemapbelowclearlyshowsthedifferentclustersofVDCsatdifferentriskofmalaria
The Global Fund has been continuously supporting malaria control program in the risk areas since
2004.
DoHS,
Annual Report 2071/72 (2014/2015)
101
111
Nepals current National Malaria Strategic Plan (NMSP20142025) has identified following vision,
mission,goalsandobjectives:
Vision
MalariafreeNepalin2025
Mission
Toempowerthehealthstaffandthecommunitiesatriskofmalariatocontributetowardsthevision
ofmalariafreeNepalin2026.
Goals:
Tosustainzerodeathduetomalariafrom2012onwards;
Toreducetheincidenceofindigenousmalariacasesby90%by2018(relativeto2012);
Toreduceno.ofVDCshavingindigenousmalariacasesby70%by2018(relativeto
2012);
ToreceiveWHOcertificationofmalariafreestatusby2025.
Objective1: To enhance strategic information for decision making towards malaria

elimination.
Keytargets/milestones:
Wardwiseriskstratifiedandappropriate/rationalinterventionsexecuted
o By the end of 2015, wardwise malaria risk microstratification will be, so the
interventionunitscouldbewardsinplaceofcurrentVDCsandearlierdistricts.
Development and roll over of SMS and web based recording and reporting system for
strengtheningmalariasurveillance,includingsuspectedandconfirmedcasesreporting.
o IntroductionofCasebasedsurveillanceinalldistrictsbytheendof2014.
o AllmalariacaseswillberecordedandreportedthroughSMSandWebbasedMDIS,
bytheendof2015.
o Establishment and expansion of Border check posts: 2 in 2014, 2 in 2015 and 3 in
2016andcontinuedthereafter.
Quarterlyreviewoftherecordeddataandplaninterventionsaccordingly
o Threequarterlyreviewswillbeconductedandvalidationofdatacompletedbythe
endofeachyear.
Fociinvestigationrolledoutbytheendof2014
o Atleast54fociwillbeinvestigatedin2014,160in2015and100eachyearafter.
o Investigatedfociwillbeeliminatedgraduallyandbytheendof2016atotalof214
foci will be eliminated, sustained thereafter and gradually increased as per above
target.
Numberofoperationalresearchwillbecarriedoutgeneratingevidenceforpolicymaking.
Objective2:Tofurtherreducemalariatransmissionandeliminatethefoci.
102
112
GuidelineforIVMdevelopedandrolledoverbytheendof2014forimplementation.
Prevention using LLIN: Coverage of high risk VDC population through mass campaign and
pregnantwomeninhighandmoderateriskVDCsthroughANCvisits.
o 471,747LLINsin2014;149,969LLINsin2015;252,440LLINsin2016;491,112LLINs
in2017and155,851LLINsin2018.
DoHS,
Annual Report 2071/72 (2014/2015)
PreventionusingIRS:Regularannualspraycoveringpeoplelivinginhighriskeveryyearand
responsivesprayingasindicatedbyfociinvestigation.
o 88,444 households in 2014; 60,000 households in 2015 and 30,000 households in
2016.
Focieliminationanddocumentationoflessonslearntforprospectiveactivities.
o 54in2014;160in2015and100everyyearthereafter.
Objective3:Toimprovequalityofandaccesstoearlydiagnosisandeffectivetreatmentof
malaria.
Updatethemalariadiagnosisandtreatmentpolicy,manualandrolloveritsapplicationby
theendof2014
Developmentoftrainingpackageonmalariacasemanagement:developmentandrolloutby
2015
Trainingoncasemanagementofmalariaby2015
o FCHVsinremoteVDCstodetectmalariausingRDTs,
o Training on malaria case management for public & private sector health care
providers
Expandandimprovequalityofmalariamicroscopyservicecontinuedannually
o FinalizeandrolloveroftheSOPonmalariamicroscopy
o Establishslidebanksfortrainingandreferenceinmalariamicroscopy
o Conductinternalcompetencyassessmentofmalarialabtechniciansandassistant
o Conductexternalcompetencyassessmentlabtechniciansandassistants
o Conductinstructionalskillsdevelopmenttrainingfortrainersinmalariamicroscopy
o Basicandrefreshertraininginmicroscopy
o traininginmalariamicroscopy
o Trainingonpreventivemaintenanceofmicroscopes
o Supportivesupervisionandmonitoringofmalariamicroscopists
o Crosschecking/validationofbloodsmears
ExpandtheuseofRDTsandsetupQAQCofcomboRDTsbytheendof2015
Procurementandsupplyofantimalarialdrugsanddiagnosticstoavoidstockout
o RegularmonthlyrecordingandreportingthroughFMIS/MDIS.
o Annualhealthfacilitysurveyconductedtodocumentnostockoutoflogistics.
Objective4: To sustain support from the political leadership and the communities
towardsmalariaelimination.
DevelopandrolloutofcomprehensiveBCCstrategybytheendof2015
o Developcommunicationpackagetomobilizecommunitiesformalariaprevention
Developspecificmaterials(print,audioandvideo)toimprovethefollowingbehaviors:sleep
under nets every night; seek early diagnosis and treatment for malaria, and adhere to
treatmentonmalaria.
Organize Multisector advocacy meetings at national / district levels to support malaria
elimination
o CommemorateWorldMalariaDay:April25.
o Crossborder collaboration meetings annually for sharing the information and
harmonizinginterventions.
DoHS,
Annual Report 2071/72 (2014/2015)
103
113
Objective5: To strengthens programmatic technical and managerial capacities towards

malariaelimination
Training key program staffs in malariology, case management, entomology, health

informatics,GISmapping,malariamicroscopyetc.annualtargetsinannexbudgetsheet
ConveneMalariaTechnicalWorkingGroup;
o atleast3/yr
Periodicallyupdatethenationalmalariastrategicplan
o bytheendof2018,reviewandreviseasnecessary
Supervision,monitoringandevaluation
o AnnuallyasperM&EPlan.
StrengthenVBDRTCcapacityinmalariatrainingandresearch
o Equipmentprovidedandstaffsdeployedasnecessary
RecruitandfillvacantpositionsatEDCD,VBDRTC,RegionsandDistricts
o Bytheendof2014,vacantpositionswillbefilledandsustainedthereafter
StrengthenpartnershipwithWHOandothernational/internationalinstitutions
o Collaborativemeetings,activitiesimplemented
MajoractivitiesconductedduringFY2071/72
In addition to the regular annual malaria program activities and interventions, the below
mentionedactivitieshavebeencarriedoutasmajoractivities:
104
114
Introductionofthecasebasedsurveillancesystem,includingwebbasedrecordingand
reportingsystemforthedistricts.
Orientation of the health workers from districts and peripheral level on case based
surveillanceandresponse.
Revitalization of the malaria microscopy quality assurance system as a collaborative
activityofEDCDandVBDRTC,withWHOTA.
OrientationofhealthworkersandFCHVsatdistrictlevelonmalariaeliminationinitiative
of the Govt. of Nepal and their role in detecting every cases and facilitation for early
treatment.
Quarterlyandannualreviewmeetingparticipatedbydistrictandcentrallevelstaffswho
reviewedthedatafedbytheperipherallevelandrevisedbasedonsuggestions.
Operationalresearchonmalariavectorbehaviorsandinsecticideresistancestatus.
Regular intervention (Indoor Residual Spraying) program conducted biannually at
malariahighandmoderatedriskdistricts.
Regularcasebasesurveillanceconductedbasedonmalariapositivecaserecord.
Integrated entomological surveillance in Kathmandu valley and other districts after
earthquake.
Bioassay test on LLIN in Malaria high risk district Kailali. Study was conducted in
moderate risk area of Attariya municipality ward no 4 situated in forest fringe. Study
findingsshowsthatnetdistributionsinyear2013havebeenusedformorethan2years
and have no functional residual effect to kill mosquito. After five washes mortality
reached to the level of 56% in case of Anopheles fluviatilis and 16% with suspected
vectorAnophelesculicifacies.
DoHS,
Annual Report 2071/72 (2014/2015)
DistributionofLLINinearthquakeandfloodaffecteddistrictsincoordinationwithother
stakeholders.
CommemorateWorldMalariaDay(25thApril)
4.1.2 AnalysisofAchievement
Nepal has surpassed the Millennium Development Goal #6 by reducing malaria morbidity and
mortalityratesbymorethan50%in2010ascomparedto2000.Despitethepoliticalinstabilityand
current restructuring of administrative set up towards increasing federalism, the Nepal has been
successfully implementing the interventions to eliminate the remaining active foci (VDCs) where
malaria transmission remains. The Ministry of Health and Population, with the support of its
partners especially WHO which is coordinating the technical assistance, has implemented a strong
malaria control program, steadily improving the coverage and quality of Indoor Residual Spraying
(IRS),introducinglonglastinginsecticidetreatednets(LLIN),andincreasingaccesstorapidmalaria
diagnosis(RDTs)andpowerfulartemisininbasedcombinationtreatments(ACTs).
Data generated by public health care facilities and computerized through the Health Management
InformationSystem(HMIS),EWARSandfromadditionalstudiessuchasmalariamicrostratification,
theoverallmalariatrendsinNepalforthelast6yearsclearlyindicateasubstantialdeclineinboth
clinical and laboratory confirmed P. falciparum and P vivax cases. The recently conducted micro
stratification exercise shows that there are less districts classified as high and moderate risk (25
instead of 31) and that the overall population living in at risk Village Development Committees
(estimatedat1,254VDCsoutof3,972)isdeclining.Thisgiveshopethatanincreasingnumberoffoci
(VDCs)willbecomefreeofmalariainthecomingyearswithcontinuedshrinkingofmalariamap.
Table1:MalariaEpidemiologicalInformation,FY2069/702071/72
S.N.
Items/indicators
2069/70
2070/71
2071/72
1
Totalpopulationin'000
26,852
13025
13455
113382
101377
2
Totalslidecollection
152,538
3
Totalpositivecases
2092
1674
1352
4
Totalindigenouscases
1,106
865
683
5
Totalimportedcases
986
585
669
6
TotalP.falciparumcases*
428
224
274
7
%ofPfofthetotalcases*
20.45
13.38
20.26
8
TotalindigenousPfcases*
184
82
101
9
%indigenousPfcases*
43
36.60
36.86
10
TotalimportedPfcases*
244
142
173
11
%importedPfcases
57
63.40
63.13
12
TotalP.vivaxcases
1,664
1325
1078
13
TotalindigenousPvcases
872
821
570
14
%indigenousPvcases
52.40
62
42
15
TotalimportedPvcases
792
504
508
16
%importedPvcases
47.60
38.03
37.57
17
AnnualBloodExaminationRate
0.57
0.94
0.75
18
Annualparasiteincidence
0.15
0.12
0.10
19
Annualfalciparumincidence
0.01
0.017
0.020
DoHS,
Annual Report 2071/72 (2014/2015)
105
115
S.N.
Items/indicators
2069/70
2070/71
2071/72
20
Slidepositivityrate
1.37
1.36
0.33
21
SlidePfpositivityrate*
0.27
0.18
0.27
Clinicallysuspectedmalariacases
22
(nottestedbuttreatedbyCQ)
49,550
26,526
20,861
Source:EDCD,DoHS
Confirmed cases dropped from 2092 in FY 2069/70 to 1352 in 2071/72. The proportion of P.
falciparum infections has slightly increased and reached 20.26 %in current FY as compared to the
previous year. In FY 2071/72 pf cases are high which may be due to high number of imported P.
falciparum cases (out of 274 pf cases173 cases are imported). No Malaria deaths have been
recordedafter2012tilldate.
During 20042007, the Malaria Parasite Incidence (API) has remained stable (0.260.27 per 1000
population countrywide), andthereafterhasbeen graduallydecliningfrom2008onwardstobeat
the lowest level ever recorded in FY 2071/72 0.10 /1000 risk population(calculated based on the
denominatorsetafterMicrostratification2013)
The trend of clinically suspected malaria case is also decreasing year by year, mainly due to
increasedcoverageofRDTandmicroscopiclaboratoryserviceatperipherallevel,Atotalof20861
clinicalsuspectedmalariacasestreatedbychloroquinewerereportedinFY2071/72;
Theabovetableclearlyshowedthatthereisdecreasingtrendofconfirmedcase,caseseveritywith
sustainingzerodeath.ThereissharpdecreaseinnoofindigenousPFwithslowlydecreasingtrendof
indigenousPlasmodiumvivaxcasesindicating thatPvivaxmalariamaystillremainachallengefor
eliminationofmalariainNepaldemandingneweffectivestrategiesforelimination.
AbovetrendofthenationalmalariometricindicatorslistedaboveshowsthatNepalhasenteredin
preelimination phase. But district level indicator varies from one district to another district
including number of case, API and SPR. Highest number of confirmed case reported from Kailali
district (268), followed by Rupandehi (107), and Kapilvastu (100), Kanchanpur(85) and Mahottari
(80).ZeroindigenouscasesreportedfromKavreandSindhupalchokdistrictforlast3years.
TheabovefindingsareratherpositiveandindicativeofsubstantialprogressinNepaltowardspre
eliminationtargetsbearinginmindthatdataaregeneratedbypublichealthcarefacilitiesonlyand
arestillrequiringcontinuousattentionforimprovement.
Many factors might have contributed to the recorded significant decline of clinical and confirmed
malaria cases and decline of endemic districts (and most probably number of active foci). Among
themwemightassumethatthefollowingelementshaveplayedamajorrole:
a) Overall improvement of social determinants of health (for example less than 20% of Nepalese
peoplearebelowpovertylinethresholdin2010againstmorethan40%in2000),
b)Scalingupaccesstosimplediagnostictoolslike(combo)RDTs,
c)Availabilityofpowerfulantimalarialmedicine,ACTsinallpublichealthcarefacilities,
d) Distribution of more than 4 million LLINs leading to an exceptionally high coverage of LLINs (in
additiontohighusageoftraditionalnets)intargetedendemicareas.
Tothatextent,thesignificantfinancialsupportfromtheGFATMfrom2004continuedtilldatehasto
beacknowledgedtohaveplayedasignificantrolebyallowingtheprogramandpartnerstoscaleup
essentialcosteffectiveinterventionsandmalariacontroltoolstothemostperipherallevel.
106
116
DoHS,
Annual Report 2071/72 (2014/2015)
Data reported by the districts via HMIS and report received by the programme may vary due to
various reasons, which includes but not limited to validation of the HMIS data by the program
throughDPHOdataandlinelistingverification,addition/verificationofprogrammeticdatareceived
through EWARS and MDIS. However efforts have been made to eliminate the data difference by
verifyingthedataatdistrictlevel.
Based on the assessment of current epidemiological data, there are still crucial concerns to be
addressedbytheprograminordertoimprovethereliabilityandprecisionofthedata.Inparticular,
there is a need to increase the capacity of EDCD and district teams to analyse data generated by
public health facilities and progressively include and analyse data generated by all private health
institutionsincludingNGOs(e.g.inchargeofcommunityactivities,refugeesandmigrants).
4.1.3 IssuesandRecommendations
Table4.1.2: Recommendations Made During Regional and National Reviews in 2070/71 and Actions Taken in
2071/72
Confirmationof
suspected/
probablemalaria
cases
Orientationon
malariaprogramto
healthworkers
Malariacase
reportingandcase
investigation
Insufficient
variablesinHMIS
tool(fore.g.slide
andRDT
classification)
Actiontobetaken
Actiontaken
IncreasednumberofMalaria
Microscopytrainings,
microscopytrainingsat
RDTavailability
VBDRTC.
Validationofprobable
ValidationofHMISdataby
malariacases
EDCDincoordinationwith
DPHOs
Basic/refreshertrainingson
Trainingprograms
malariamicroscopyforlab
throughGFATM
tech/Asstconducted,
support
Peripherallevelsorientations
ongoing
Districtandperipheral
Districtandperipheral
levelstaffshavebeenoriented
levelstaffsshouldbe
oncaseinvestigation,case
orientedoncase
basedsurveillance,foci
investigationand
investigationandreporting.
reporting.
EDCDshouldaddress
DiscussedwithHMIS
duringHMIStools
section
revision.
DoHS,
Annual Report 2071/72 (2014/2015)
107
117
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 which is divided into three phases:
Preparatory Phase: 20052008; Attack Phase: 20082015 and Consolidation Phase: 2015 onwards.
TheoverallgoaloftheplanisTocontributetoimprovingthehealthstatusofvulnerablegroupsand
atriskpopulationslivinginKalaazarendemicareasofNepalthroughtheeliminationofKalaazarso
thatitisnolongerapublichealthproblem.Thetargetis:ToreducetheannualincidenceofKala
azartolessthan1per10,000populationsatthedistrictlevelby2015.ExpectedoutputsofthePlan
are six related to the different components of the system that has to be strengthened in order to
achieve the elimination goal. One of the outputs is to develop a functional network that provides
diagnosisandcasemanagementwithspecialoutreachtothepoorest.
The national plan was revised in 2010 as National Strategic Guideline on KalaAzar Elimination in
Nepal that recommended rK39 as a rapid diagnostic test kit and Miltefosine as the first line of
treatment in Kalaazar except in some situations. Kalaazar is a vectorborne disease caused by
parasiteLeishmaniadonovani,transmittedby thesandfly,Phlebotomus argentipes.The diseaseis
characterized by fever for more than two weeks with spleenomegaly, anaemia, and progressive
weightlossandsometimesdarkeningoftheskin.Intheendemicareas,childrenandyoungadults
are its principal victims. The disease is fatal if it is not treated timely. Kalaazar and HIV/TB co
infectionshaveemergedasahealthprobleminrecentyears.
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 easily applicable serologicaltest has
beenwidelyusedintheIndiansubcontinentincludingNepal.Thenationalprogrammetoeliminate
KA in Nepal has made this test kit available up to PHCC level ofprogramme districts. The recently
revised national guideline has recommended introducing Liposomal Amphotericin B and
combination regimen for KA and PKDL treatment in Nepal and MIltefosine, the only available oral
drugandcurrenttreatmentofchoiceinthecountry,willbegraduallyphasedout.
Goal
ReduceincidenceofKalaazartolessthan1caseper10,000populationsatdistrictlevelby2015.
Objectives
Reducing the incidence of Kalaazar in the endemic communities including the poor, vulnerable
andunreachedpopulation;
ReducingcasefatalityratesfromKalaazar;
TreatmentofPKDLtoreducetheparasitereservoir;and
PreventionandtreatmentofKalaazarandHIVTBcoinfections.
108
118
DoHS,
Annual Report 2071/72 (2014/2015)
Strategies
BasedontheregionalstrategyproposedbySouthEastAsiaKalaazartechnicaladvisorygroupand
theadjustmentsproposedbytheNepalexpertgroupdiscussions,GovernmentofNepal,Ministryof
Health has adopted the following strategies in the implementation of the Kalaazar elimination
programinNepal.
ImproveProgramManagement
EarlyDiagnosisandCompleteTreatment
IntegratedVectorManagement
EffectiveDiseaseandVectorSurveillance
SocialMobilizationandPartnershipsand
Clinical,ImplementationandOperationalResearch
CaseDetectionandTreatment
Early case detection and complete and timely treatment is the mainstay of Kalaazar elimination.
Kalaazarrelateddiagnosticandtreatmentservicesareprovidedatprimaryhealthcarecentreand
above level where as awareness, health education, follow up for treatment compliance,
identificationandreferralofsuspectedcasesarealsoofferedathealthpost/subhealthpostlevel.
Duringthisfiscalyear,activecasedetectionactivitywascarriedoutin5mostendemicVDCseachof
Morang, Saptari and Sarlahi districts. The case detection activities were done through camp
approach. The VDCs were selected based on the number of new KA cases reported in the
previous/running fiscal year. Meetings were organized at district level involving DPHOs/DHOs,
programfocalpersons;medicalofficers,labpersonsandhealthworkersfollowedbyorientationto
FCHVsandhealthworkersatlocallevel.Communitybasedhousetohousesearchwascarriedoutby
the FCHVs for suspected kalaazar (KA) and Post Kalaazar Dermal Leishmaniasis (PKDL) cases.
SuspectedcasesofKAandPKDLwerethenscreenedclinicallyandbyrapiddiagnostickits(rK39)at
healthfacilitybymedicaldoctors,laboratorypersonandotherhealthworkers.rK39positivecases
werereferredtodistrict/zonalhospitalforfurtherconfirmationandmanagement.SuspectedPKDL
caseswerealsoscreenedforleprosybytrainedhealthworkers.
IndoorResidualSprayinginPriorityselectedKalaazarAffectedAreas
Two rounds of selective Indoor Residual Spraying (IRS) was carried out in prioritised Kalaazar
affected areas of 12 kalaazar indemic districts based on the national guideline on IRS. IRS for the
preventionandcontroliscarriedoutonlyinthosevillageswhereKalaazarcaseswererecordedin
previous year or in areas with an outbreak in the recent past. Collateral benefit for the Kalaazar
eliminationprogramhasbeengainedfromtheIRSusedforthepreventionandepidemicresponse
formalariainKalaazarendemicandKalaazarnonendemicdistrictstoo.
ContinuationofTreatmentthroughMiltefosineandAmphotericineB
Asinthepreviousfiscalyear,Miltefosine(oraldrug)asfirstlinedrugandAmphotericinBassecond
linedrughavebeencontinuallyutilisedforthetreatmentofKalaazarinendemicdistricts,SukraRaj
TropicalHospitalandotherhospitalsaccordingtonationalguidelineinthisfiscalyear.
DoHS,
Annual Report 2071/72 (2014/2015)
109
119
TrainingonrevisednationalGuidelineandtreatmentProtocol
TrainingforMedicalofficers,nursingstaffs,Laboratorystaffsandotherparamedicswasconducted.
TrainingwasfocusedonrevisednationalKalaazarguidelinesandtreatmentprotocol.
KalaazarReviewMeeting
Review meeting with District health office, District Hospitals and focal persons of all endemic and
nonendemic (disticts with Kalaazar cases) districts was conducted. The meeting was focused on
dataverification,linelistingupdateandrevisedkalaazartreatmentprotocol.
Fig4.2.1TrendofKalaazarcases(Source:EDCD)FY2064/65to2071/72
2064/65 2065/66 2066/67 2067/68 2068/69 2069/70 2070/71 2071/72
Districts
Jhapa
36
76
21
22
21
10
12
6
Morang
55
60
107
175
111
55
84
48
Sunsari
46
54
34
30
32
13
14
18
Saptari
197
135
113
66
57
62
44
9
Siraha
109
47
61
11
11
3
42
17
Udayapur
35
13
5
69
25
37
1
2
Dhanusha
112
58
30
42
102
48
29
16
Mahottari
162
162
160
145
96
12
26
18
Sarlahi
449
223
61
107
73
55
38
13
Rautahat
26
31
38
8
6
4
4
0
Bara
34
18
7
9
5
6
1
1
Parsa
1
0
1
1
0
0
0
0
Totalcases
1262
877
638
685
537
305
295
148
Other
72
10
12
24
22
20
46
44
districts
The trend of Kalaazar cases has been decreasing significantly for the last several years. Three
hundredandsixtysevencasesofKalaazarwerereportedintheFY2070/71,andoutofthese339
(80%) cases were native case of 12 program district and the rest were foreign reported from
different districts. In FY 2071/72, a total of 220 cases were reported, of which all the cases were
native cases(no foreign cases). Among 220 native cases, 148 cases reported from 12 programme
districtsandremaining72werereportedfromothernonprogramdistricts.Thehighestnumberof
case was reported from Morang (48), followed by Sunsari (18) Mahottari (18), Siraha (17), and
Dhanusha(16). These five districts together reported about (n=117) 53% of total cases. Thirty one
nonprogrammedistricts,mostlyhilly,fromallregionsreported72casesinthisFY.Nonprogramme
districtreportingKalaazarcasesareSurkhet,Doti,,Bajhura,Bardiya,Dailekha,Arghakhanchi,Dang,
Pyuthan, Palpa Okhaldhunga a Kailali, Kanchanpur, Bhojpur, Sankhuwasabha, Panchthar, Darchula,
Salyan, Rukum, Banke, Dhankutta, Palpa, Kapilvastu, Syangja, kaski, Nuwalot, Gulmi, Rolpa,
Darchula,Jajrkot,Ramechhap,Makwanpur.SixofthesenonprogrammedistrictsarereportingKala
azarcasesconsecutivelyforlastfouryears(Surkhet,Okhaldhunga,BhojpurMakwanpur,Kailaliand
Kanchanpur). This epidemiological shifting urges the programme to conduct vector survey to
establishpresenceofvectorandindigenoustransmissionofthedisease.In2070/71epidemiological
aswellasentomologicalandmolecularstudywasconductedinthisfiscalyearinOkhaldhungaand
Bhojpur districts to validate the reported cases and to rule out indigenous transmission. Similarly
EDCDhasextendedprogramtothesedistrictfromFY2071/72.
110
120
DoHS,
Annual Report 2071/72 (2014/2015)
Table4.2.2:Kalaazarcasesandincidence:FY2069/70to2071/72
2071/72
2070/71
2069/70
2071/72
2070/71
Incidence/10,000
2069/70
Native
2071/72
2070/71
2069/70
2071/72
2070/71
Foreign
Jhapa
11
12
10
12
0.12
0.14
0.07
Morang
55
84
48
55
84
48
0.56
0.84
0.47
Sunsari
13
14
18
13
14
18
0.17
0.17
0.22
Saptari
63
46
62
44
0.94
0.67
0.14
Udayapur
37
37
42
0.09
0.03
0.06
Siraha
42
17
17
0.56
0.6
0.26
Dhanusha
48
31
16
48
29
16
0.61
0.37
0.20
Mahottari
29
36
18
17
10
12
26
18
0.18
0.4
0.27
Sarlahi
66
48
13
11
10
55
38
13
0.69
0.47
0.16
Rautahat
0.06
0.05
0.00
Bara
0.08
0.013
0.01
Parsa
Otherdistricts
(18)
Total
0.00
46
46
72
46
44
72
382
367
220
30
28
349
339
220
0.39
0.34
0.25
Districts
2069/70
TotalCases(including
Foreign)
Source:HMIS,EDCD,DoHS
KalaazarIncidence
Incidenceofkalaazaratnationalaswellasdistrictlevelislessthan1/10000population.Atdistrict
levelincidenceper10,000inareasatriskpopulationsrangedfrom0.47inMorangto0.01inBara
reflectingtheincidenceof0.25per10,000in12programmedistricts(excludingforeigncases).
Outofthe12endemicdistricts,only10districtshavereportedKalaazarcasesduringthisFYandall
thereportingdistrictshaveanincidenceoflessthan1per10,000populations.Table4.2.2shows
thedistrictwiseincidenceinprogrammedistrictsforFY2071/72.However,EDCDstartedtolinelist
theallKalaazarcasesfrom2012.
KalaazarcasesreportedbythedistrictviaHMISandcasereportreceivedbytheprogrammemay
vary due to various reasons. Generally the HMIS received raw data from district and programme
proactively collect data from hospital and other health facility and DPHO through EWARS and
DPHO. EDCD verified data with the help of line listing report of each and every case. EDCD also
receivedcasereportofactivecasedetectiondonebycentreanddistrictwithlinelistingofcase.
DoHS,
Annual Report 2071/72 (2014/2015)
111
121
Table4.2.2: Recommendations Made During the Regional and National Reviews of 2070/71 and Actions Taken
During2071/72
Issues
Earlycasedetectionand
completetreatmentofKala
azar
Earlydetectionandcase
investigation
Casesincreasinginnon
endemicdistrict
112
122
Recommendations
Orientation/Trainingofhealth
workers
RegularsupplyofKAtest
kits/drugs
ActivecasedetectioninKala
azarendemicdistricts
Casebasesurveillance
Reportingwithlinelistingof
case.
Programshouldbeextend
toothernonendemic
districtalso
Responses
Orientationonnewguide
line
Reactivecasedetection
baseonindexcase
implementedinendemic
district.
Allocatedbudgetforcase
basesurveillanceandcase
investigationstodistricts.
Linelistingofcases
initiated
EDCDhasextended
programtothesedistrict
fromFY2071/72
DoHS,
Annual Report 2071/72 (2014/2015)
DiseaseControl:LYMPHATICFILARIASIS
4.3
LYMPHATICFILARIASIS
4.3.1 Background
Lymphatic Filariasis (LF) is a public health problem in Nepal. Nepal conducted LF mapping in 2001
and2005andremappingin2012byusingICT(ImmunochromatographyTestcard)whichrevealed
13%averageprevalenceofLFinfectioninthecountry,rangingfrom<1%to39%.BasedontheICT
survey,morbidityreportingandgeoecologicalcomparabilitysixtyonedistrictsofthecountrywere
mappedasendemicforLF.Thediseasehasbeendetectedindifferenttopographicalareasrangingin
altitudefrom300feetabovesealevelintheplainteraiecologicalzoneto5,800feetabovesealevel
inhighhillareas.Comparatively,moreLFcasesareseenintheteraithaninthehills,butvalleysand
riverbasinareasofhillydistrictshavealsohighdiseaseburden.Thediseaseismoreprevalentinthe
ruralareasofthecountry,predominantlyaffectingthepoorersectorofthecommunity.Wuchereria
bancrofti is the only recorded parasite in Nepal and the mosquito, Culex.quinquefasciatus, an
efficientvectorofthediseasehasbeenrecordedinalltheendemicareasofthecountry.
Progresstowardselimination
EpidemiologyandDiseaseControlDivisionundertheDepartmentofHealthServiceshasformulated
a National Plan of Action (20032020 AD) for the Elimination of Lymphatic Filariasis in Nepal by
establishing a National Task Force under the Chairmanship of DirectorGeneral, Department of
HealthServices.
The division initiated the implementation of Mass Drug Administration (MDA) in Parsa district in
2003whichwasgraduallyscaleduptoallendemicdistrictsachieving100%geographicalcoverageby
FY2069/70(2013).ThetargetofscalingupMDAtoallendemicdistrictswasachievedin2013.By
thisfiscalyear,MDAhasbeenstopped(phasedout)in20districts,postMDAsurveillancehasbeen
initiatedinatleastfivedistrictsandmorbiditymanagementhasbeeninitiatedinselecteddistricts
andhighendemicareas.AllendemicdistrictswillcompletetherecommendedsixroundsofMDAby
2018. The LF elimination programme has also indirectly contributed to strengthening of health
system through trainings and capacity building activities. Between these periods of twelve years,
varioussurveyshavebeencarriedoutincludingmapping,baselinesurveys,followupsurveys,post
MDA coverage survey and transmission assessment surveys (TAS). TAS done in 21 districts has
revealedthattheprevalenceofLFinfectionhassignificantlyreducedandcontributedinpreventing
disabilitiesandsufferingsduetoLF.Overtheperiodoflast12years,morethan90milliondoseshas
beenadministratedtoatriskpopulation.
Map4.3.1:LymphaticFilariasisEndemicityNepal
ProgrammeGoal
123
113
ProgrammeGoal
DiseaseControl:L
PeopleofNepalnolongersufferfromLF
YMPHATICFILARIASIS
113
Objectives
PeopleofNepalnolongersufferfromLF
ToeliminateLFasapublichealthproblemby2020
Objectives
Tointerruptthetransmissionoflymphaticfilariasis;
ToeliminateLFasapublichealthproblemby2020
Toreduceandpreventmorbidity;
ToprovidedewormingbenefitthroughuseofAlbendazoletoendemiccommunityespeciallyto
Tointerruptthetransmissionoflymphaticfilariasis;
thechildren;and
Toreduceandpreventmorbidity;
To reduce mosquito vectors through application of suitable and available vector control
ToprovidedewormingbenefitthroughuseofAlbendazoletoendemiccommunityespeciallyto
measures(IntegratedVectorManagement).
thechildren;and
To reduce mosquito vectors through application of suitable and available vector control
measures(IntegratedVectorManagement).
Strategies
Interruption of transmission by yearly Mass Drug Administration using two drug regimens
Strategies
(DiethylcarbamazineCitrateandAlbendazole)forsixyears.
Morbiditymanagementbyselfcareandwithsupportsusingintensivebutsimple,effectiveand
Interruption of transmission by yearly Mass Drug Administration using two drug regimens
localhygienictechniques.
(DiethylcarbamazineCitrateandAlbendazole)forsixyears.
Morbiditymanagementbyselfcareandwithsupportsusingintensivebutsimple,effectiveand
Target
localhygienictechniques.
ToscaleupMDAtoallLFendemicdistrictsby2014
Target
Aachieve<1%prevalence(microfilaraemiarate)inallendemicdistrictsafter6yearsofMDAby
2018
ToscaleupMDAtoallLFendemicdistrictsby2014
Aachieve<1%prevalence(microfilaraemiarate)inallendemicdistrictsafter6yearsofMDAby
2018
Majoractivitiesandanalysis,FY2071/72
Massdurgadministration(MDA)campaign
Majoractivitiesandanalysis,FY2071/72
During
this fiscal year MDA was continued in 41 districts. Four cohorts of 10 districts each
Massdurgadministration(MDA)campaign
completed
6, 5, 4 and 3 MDA rounds respectively in this fiscal year. Kapilvastu district underwent
During
this fiscal
year
MDA
was
in 4115,981,384
districts. Four
cohorts
10 districts were
each
eigth round
of MDA
this
year.
In continued
this fiscal year,
people
living of
in 41
completed
6,MDA,
5, 4 and
3 MDA
rounds respectively
in this
fiscalAs
year.
Kapilvastu
district underwent
targeted for
of which
11,117,624
(69.6%) were
treated.
compared
to previous
year, this
eigth
round of MDA this year. In this fiscal year, 15,981,384 people living in 41 districts were
yearsMDAachievementishigher.Thecampaignwasconductedintwophases:38districtsinfirst
targeted for MDA, of which 11,117,624 (69.6%) were treated. As compared to previous year, this
phaseinFalgun2325,2071(0709March2015)andsecondphasein3districtsinFalgun30,Chaitra
yearsMDAachievementishigher.Thecampaignwasconductedintwophases:38districtsinfirst
01
and 02, 2071 (14 16 March 2015). The campaign mobilized 12,832 health workers and 81,204
phaseinFalgun2325,2071(0709March2015)andsecondphasein3districtsinFalgun30,Chaitra
trainedvolunteerstoreachthetargetpopulationsandmonitoringofcampaignactivities.
01
and 02, 2071 (14 16 March 2015). The campaign mobilized 12,832 health workers and 81,204
trainedvolunteerstoreachthetargetpopulationsandmonitoringofcampaignactivities.
Adverseeventsandmorbidityreporting:overeighteenthousandsonehundredandfortysixcasesof
adverse events, mostly mild like headache, dizziness, stomach ache etc, were reported after the
MDA. Health workers and volunteers mobilized during this years campaign reported nearly 15
Adverseeventsandmorbidityreporting:overeighteenthousandsonehundredandfortysixcasesof
thousandevents,
cases mostly
of morbidity
due
to or suspected
of LF. More
30 thousand
casesthe
of
adverse
mild like
headache,
dizziness, stomach
ache than
etc, were
reported after
lymphedemaoflowerandupperlimbs,breastswellingandhydrocelehavebeenreportedfromall
MDA. Health workers and volunteers mobilized during this years campaign reported nearly 15
endemicdistrictsduringpreviousMDAcampaigns.
thousand
cases of morbidity due to or suspected of LF. More than 30 thousand cases of
lymphedemaoflowerandupperlimbs,breastswellingandhydrocelehavebeenreportedfromall
endemicdistrictsduringpreviousMDAcampaigns.
124
114

114
MDArelatedmajoractivitiescarriedoutatdifferentlevel,FY2071/72
ActivitiesatNationallevel:
o
o
o
o
o
o
ActivitiesatRegionallevel:
o
o
o
Regionallevelplanningmeetingsatthreeplaces(Biratnagar,PokharaandNepalgunj),
Regionalcoordinationmeetings,and
Monitoringandsupervision.
ActivitiesatImplementationunitlevel:
o
o
o
o
Planningmeetings,
Trainingofhealthworkers,
Advocacy/socialmobilization/IEC/BCC,and
ActivitiesatCommunitylevel:
o
o
o
o
Volunteersorientation,
Advocacy/socialmobilization/IEC/BCC,
ImplementationofMDAactivities,and
Socialmobilizationactivities:
o
o
o
o
NationalTaskForceCommitteemeeting,
MDAlaunchinginPokhara,Kaskidistrict,
Interactionswithmedia,professionals,organizations,civilsociety,etc,
Monitoringandsupervision,
Logisticsprocurementandsupply,and
Advocacy,IEC/BCCactivities.
Production of revised IEC material, checklist, reporting, recording, and guidelines for MDA
campaign,
MediamobilizationandadvertisementduringMDA,
Coordinationandcollaborationwithallstakeholders,and
SchoolhealthprogrammeinteractionsinschoolsonLFandMDA.
Monitoringactivities:
o PostMDAcoveragesurveyin22districts,
o MonitoringandmanagementofPostMDAcomplications/adverseevents.
o Followupsurveyin10districts.
Otheractivities
o
Morbidity management hydrocele surgery camps in various districts (done by RHDs), self
caretrainingandmaterialdistributiontolymphedema(elephantiasis)casesofSalyantarand
KhalteVDC'sofDhadingdistrict,MagragadhiVDCofBardiyadistrictandMaharajgunjVDCof
Kapilvastudistrict.
MorbidityorientationtoMedicaldoctorsinBPKIHS,DharanandPAHS,Lalipur.

125
115
ThetablebelowshowsscalingupandcoverageofMDAcampaigns.
Table4.3.1:ScalingUpandCoverageofMDACampaigns
MDA
MDA
Year districts
2003
1
2004
3
2005
5
2006
3
2007
21
2009
21
2010
30
2011
36
2012
46
2013
56
2014
41
2015
41
Source:EDCD
Atriskpop
505,000
1,541,200
3,008,131
2,075,812
10,906,869
10,907,690
14,162,850
15,505,463
20,017,508
21,852,201
15,874,069
15,981,384
Treated
Epidemiological
Remarks
Population
Coverage%
412,923
81.77
1,258,113
81.63
2,509,306
83.42
1,729,259
83.31
8,778,196
80.48
8,690,789
79.68
11,508,311
81.26
MDAstoppedin1district
12,276,826
79.18
MDAstoppedin4districts
13,546,889
67.68
16,116,207
73.75
TASdonein16districts
10,929,305
68.90
MDAstoppedin15districs
11,117,624
69.60
Challengesandwayforward
TheprogrammebynowhasadecadelongexperienceonMDAoperations/implementationsandhas
made significant achievement; however, ensuring quality MDAs including adverse event
management, sustaining low prevalence in phased out districts, expansion of morbidity
management and surveillance, achieving higher coverage in urban areas, and improving social
mobilization and coordination are some of the major challenges and areas which need to be
addressedtofurtherconsolidatetheachievementsmadesofarandtoachievethesettargets.
MDAs should be continued at least till next 3 years to complete recommended six rounds in all
endemic districts, and surveys like transmission assessment surveys, periodic surveys (for
surveillance), follow upsurveys are required to be carried out as planned to monitor the progress
towards elimination. Capacity building activities should be done to further strengthen the health
systemandserviceproviderstoaddresstheneedsofmorbiditymanagementandsurveillance.The
programme has felt the needs of some operational research/studies and programme review. All
documents related to the programme should be consolidated as dossier which is required for
verificationofelimination.
126
116

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
earlyas2005.Thesporadiccasescontinuedandoutbreaksoccurredin2006and2010.Initiallymost
ofthereportedcaseshadtravelhistorytoneighbouringcountry(India),howeverlatelyindigenous
caseswerealsoreported.
The affected districts were Chitwan, Kanchanpur, Kailali, Banke, Bardiya, Dang, Kapilvastu, Parsa,
Rupandehi, Rautahat, Sarlahi, Saptari and Jhapa, indicating spread throughout the country from
westtoeastlyingintheplainTerairegion.During2011,79confirmedcaseswerereportedfrom15
districtswiththehighestcaseincidenceinChitwan(n=55).
Aedes aegipti (mosquitovector) has been identified in 5 periurban areas of Terai 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
ToreducethemorbidityandmortalityduetoDengueFever(DF),DengueHemorrhagicFever(DHF)
andDengueShockSyndrome(DSS)
Objectives
TodevelopanIntegratedVectorManagement(IVM)approachforpreventionandcontrol.
TodevelopcapacityondiagnosisandcasemanagementofDF/DHF/DSS
Tointensifyhealtheducation/IECactivitiesand
To strengthen the surveillance system for prediction, early detection, preparedness and early
responsetooutbreakofdengue.
Strategies
Earlycasedetection,diagnosis,managementandreportingoftheDF,DHF&DSS
RegularmonitoringofDF/DHF/DSScasesandsurveillancethroughtheEWARS
Mosquitovectorsurveillanceindifferentmunicipalities.
Integrated vector control approach: A combination of several approaches directed towards
containermanagementandsourcereduction
Toachievethegoalofcontrollingdengue,thefollowingactivitieswerecarriedoutduring2071/72.
Trainingondenguecasedetection,diagnosis,managementandreportinginHetauda,Chitwan,
ParsaandMakawanpurdistrictforphysicians,nurses,paramedicsandlabpersons.
Orientationtostakeholdertodifferentmunicipalitiesof19programdistricts.
Rapiddiagnostictestkit(IgM)supply.
Denguecasemonitoringandvectorsurveillance.
DoHS,
Annual Report 2071/72 (2014/2015)
117
127
Denguevectorlarvae(Aedesaegypti)searchanddestroywasdonein19programdistricts.
HealthEducationMessagedevelopmentanddissemination
DengueVectormappingwasdone.
Diseaseburdenin2014
In 2014, a total of 356 confirmed

dengue cases were reported. More
than forty percent (n=149) of these
cases were reported from Chitwan
districtaloneandfollowedbyParsa29
%(n=105)andMakwanpur7%(n=28)
but no confirmed deaths were
reported. Dengue cases have
decreasedby50%Ascomparedtothe
previous year data (642 cases).No
outbreakoccurredinthisperiod.
DenguePositiveCasesFY2070/71to2071/72
SN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Districts
TotalPositive
2070/71
202
8
371
1
11
1
5
35
3
99
2
43
1
1
2
0
0
0
0
785
Jhapa
Makwanpur
Chitwan
Kapilbastu
Rupandehi
KAthmandu
Kailali
Bara
Rauthat
Parsa
Kaski
Nawalparasi
Ilam
Mahottari
Palpa
Kanchanpur
Dadeldhura
Bhaktapur
Doti
Total
2071/72
8
20
119
0
10
1
9
0
0
114
0
3
0
0
0
15
1
1
1
302
SourceDHO/DPHO/EDCD,DoHS
During the FY 2071/72 total number of dengue case reported from 12 districts were 302. Among
them, 119 cases were reported from Chitawan and 114 from Parsa. Remaining 69 cases were
reportedfromJhapa,Rupandehi,Kathmandu,Nawalparasi,Kailali,Kanchanpur,Makawanpur,Doti,
DadeldhuraandBhaktapur.
118
128
DoHS,
Annual Report 2071/72 (2014/2015)
Table4.4.1: Recommendations Made During the Regional and National Reviews of 2070/71 and Actions Taken
During2071/72
Issues
Inadequate
denguecontrol
interventionsin
districts
QualityofRDT
Vectorcontrol
Involvementof
Stakeholderfor
vectorsearchand
destroy
Recommendations
Responses
Increasethebudget
Incrementinthedistrictand
Strategydevelopmentand
regionalbudgetweremade
planning
AntigenbaseRDT(NS1)
Orientationtodoctorsand
healthworkersconducted
vectorsurveillanceandIntegrated Strategydevelopmentand
Vectormanagement
planningworkshopdone
CoordinationwithMunicipality
Advocacymeetingsorganized
shouldbedone
Vectorlarvaesearchand
destroyactivitydone
DoHS,
Annual Report 2071/72 (2014/2015)
119
129
DiseaseControl:Zoonoses
4.5ZoonosesControlProgramme
The Department of Health Services, Epidemiology and Disease Control Division (EDCD) responds
timely to reduce human sufferings and deaths due to poisonous snake bites, control and prevent
rabies and other zoonoses in coordination and collaboration with public, nongovernmental and
privatepartners.
Goal
NoNepalese willdieofrabiesandpoisonoussnakebitesdue tounavailabilityofARV/ASVSas

wellastimelyhealthcareservices;
Toprevent,controlandmanageoutbreaksandepidemicsofzoonoses.
Objectives
1. To strengthen the response and capacity of health care service providers for prevention and
2.
3.
4.
5.
6.
7.
8.
9.
controlofzoonoses
Toimprovecoordinationamong/betweenthekeystakeholdersatdifferentlevelforprevention
andcontrolofzoonoses
ToenhancejudicioususeoftissuecultureARV/ASVSintheHospitals/PHC/HP
To reduce burden of zoonotic diseases (especially rabies and other six priorities zoonoses)
throughpublicawarenessprograms
ToprovidetissuecultureARVasapostexposuretreatmenttoallvictims,bittenbysuspiciousor
rabidanimals
ToreducemortalityrateinhumanbyprovidingASVS/ARV
Totrainmedicalofficersandparamedicsonsnakebitemanagement
Toreducethenumberofrabidandothersuspiciousanimals'bite
Toreducethedeathrateduetorabiesperannum
A. Rabiessituation:
Almost half of the countrys population is at high risk and a quarter at moderate risk of
Rabies.
Around30,000PETcasesoccurperannum
Morethan100Humanrabiescasesoccurperannum
Latentinfectionindogsandcatsreported
Batrabiesalsoreported
ArcticFoxGenometypevirusisolated
Surveillance:Passive
VeryfewpatientstakeRIG
Lab.StrengthenedforCCOARVproduction
120
130
DoHS, Annual
Report 2071/72 (2014/2015)
Riskzonesofrabies
Activitiesconductedinthefiscalyear2071/72
Procured and supplied around 273,000 of ARV through 5 Regional Medical Stores and
hospitalsannuallyforthemanagementofdogbitessuspectedinfectionwithrabies
Orientationtomedicalofficersandparamedicsonzoonoticdiseasesofhighriskdistricts
350personincludingmedical/seniorwereTrainedonjudicioususeofARV.
DevelopmentanddistributionofEICmaterialstostakeholders.
Celebratedworldrabiesday.
Developmentanddistributionofanimalbitemanagementguidelineandtreatmentprotocol
formedicalprofessionalsofthecountry.
StatusofRabiesinNepal
Fiscalyear
2065/66
2066/67
2067/68
2068/69
2069/70
2070/71
2071/72
Source:HMIS/EDCD
No.ofcases
Animal
bites(Dog+
otheranimal)
26,574
25,662
26,466
31,313
34,933
34,516
20,610
No.ofcases
Otherbites
No,ofARVvials
consumed
Death
2,571
2,145
2,197
2,211
2,996
2,540
3,290
145,978
168,194
167,663
229,851
219,651
195,868
273,000
97
89
83
76
68
10
13
B. Snakebitesituation
79speciesofsnakesarefoundinNepal
DoHS,
Annual Report 2071/72 (2014/2015)
121
131
Amongthem21speciesarepoisonous(5sp.OfKraits,3ofCobras,1sp.ofCoral,1sp.Of
Russelsviperand11sp.ofpitvipers)
Around1,5000snakebitecasesoccurannually
Around10%ofthesecasesarepoisonousbites
Mortalityis10%amongpoisonousbite
26districtofteraiincludinginnerteraiarehighlyaffected
Everyyear85120peopledieduetopoisonoussnakebiteinNepal
ASVSfreedistributionpolicyimplementedsinceFY2056/57
IndianQuadrivalentASVSisused
ActivitiesconductedinFY2071/72
350personincludingmedical/seniorwereTrainedonjudicioususeofAntiSnakevenom.
FreedistributionofASVSforthevictimsofpoisonoussnakebite.
Annually around 2,6000 vials of ASVS are supplied for the treatment and management of
snakebiteinhighriskzonesofthecountry,throughregionalmedicalstoresandhospitals.
DevelopanddistributionofIECmaterialstostakeholders
Snakebitecasesanddeaths
Fiscalyear TotalCase NonPoisonous
2065/66
13,017
2066/67
17,163
2067/68
18,204
2068/69
14,768
2069/70
14,329
2070/71
5,143
2071/72
4,128
Source:HMIS/EDCD
11,883
15,844
17,121
13,789
13,462
4,145
3461
Poisonous
Cure
No.ofDeath
%ofDeath
1,134
1,319
1,083
979
867
998
667
1,006
1,188
965
890
788
988
666
128
131
118
89
79
10
1
11.3
9.9
10.9
9.1
9.1
1.0
0.14
Problems/Issues
Issues
Underreportingofcasesand
deathsofdogandsnakebite
Poorcompliancesoftreatment
protocolofsnakebiteanddog
bite
Recommendations
Regularreportingmechanismshould
bedeveloped
Trainingandorientationfornew
healthcareprovidershouldbe
providedondogandsnakebite.
Workshoponsharingexperienceof
casetreatingphysicianoncompliance
oftreatmentprotocol
Action
Increasesupervisory
visittoreportingsites
Allocatebudgetfor
trainingand
workshop.
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DoHS, Annual
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DiseaseControl:EpidemiologyandOutbreakManagement
4.6EpidemiologyandDiseaseOutbreakManagement
Objective
To reduce the burden of communicable diseases (morbidity and mortality) through effective
preparedness, planning and response to the disease outbreaks by utilizing primary health care
services
Strategies
Effectivesurveillance,outbreakpreparednessandresponse
MajorActivities
Rumorverificationandsituationupdate
OutbreakInvestigationandresponse
o Responseatlocallevel:
Awarenessprograms
Casemanagement
Communitymobilization
Preparednessforoutbreak
o Prepositioningofemergencyhealthkitsandmedicines
o Provisionofbufferstockofmedicinesatcenter,region,district&
communitylevel
o Coordinationmeetingwithstakeholders
MajorOutbreaksinFY2071/72
InNepal,communicablediseaseoutbreaksarecommonandoccurindifferentdistricts.Therewere
19suchoutbreaksoccurredinthisfiscalyear.
Disease
No.of
Outbreaks
Diarrhoea
No.
Affected
Districts
4
Influenza
Food
Poisoning
Alcohol
adulteration
Mushroom
Poisoning
AffectedDistricts
Total Deaths
cases
116
1445
31
Kanchanpur,Sarlahi,Nuwakot,
Sindhupalchowk
Jajrkot,Rukum,Kalikot,
Sindhupalchowk
Chitwan,Dhading,Mahottari
64
Siraha
Dailekh,Morang,Kavre,Dhading,Kailali
19
Viral
1
HepatitisA
Total
19
Source:EWARS,EDCD
Gorkha
147
18
1701
50
DoHS,
Annual Report 2071/72 (2014/2015)
123
133
DiseaseControl:EpidemiologyandOutbreakManagement
Major outbreaks reported during FY 2071/72 are diarrhea, influenza, food poisoning, alcohol
adulteration, mushroom poisoning, and viral hepatitis A. The average case fatality rate is 3%. The
numberofoutbreaksisdecreasedfrom50outbreaksinFY2070/71to19outbreaksinthisfiscalyear
2071/72. Among 19 outbreaks, influenza outbreak in Jajarkot is the largest. In Jajarkot influenza
outbreaks 15 VDC are affected with 1135 cases and 14 deaths. Water and food borne disease
outbreaks are common in this fiscal year. Alcohol adulteration has very high case fatality rate (i.e.
83%).Similarlymushroompoisoninghasclaimed4livesinthisfiscalyear.
Responseactivitiesundertaken
Rumorverificationandsituationupdates
Prepositioningofemergencyhealthkitsandmedicines
Provisionofbufferstockofmedicinesatcenter,region,district&communityLevel
Coordinationmeetingwithstakeholders
Responseatlocallevel:awarenessprograms,casemanagementandcommunity
mobilization
IntegratedentomologicalsurveillanceinKathmanduvalleyandSindupalchokdistrict.
Problem/Constraints
Issues
Inadequatebudgetfor
outbreakresponse
Recommendations
NonfreezingEmergencyfund
shouldbeestablishedforoutbreak
response
Action
Allocateadequatebudget
Repeatedoutbreaksoffood
andwaterbornedisease
Improvewatersupplies,hygiene
andsanitation
WaterqualitySurveillanceshouldbe
expandedtoall75districts
Inadequatehumanresource
atEpidemiologyandDisease
ControlDivision(EDCD)
OrganizationandManagement
surveyisrequiredtofindthegapof
humanresourceatEDCD
Vacantpositionsshouldfulfilledin
time
EarlyWarningandReportingSystem
(EWARS)shouldbeexpandedto
coverall75districts
DistrictPublic/HealthOfficesshould
establishdistrictlevelEWARS
Coordinationwith
departmentofwatersupply
andsanitationfor
interventions
Establishmentofwater
qualitysurveillancein75
districts
Organizationand
Managementsurveyfor
humanresourcegapanalysis
Fulfillingvacantposts
InadequateSurveillance
SystemCoverage
Inadequateoutbreak
investigation
Properoutbreakinvestigation
shouldbecarriedout
ExpansionofEWARSin75
districts
Establishmentofdistrictlevel
EWARS
OutbreakInvestigation
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DoHS, Annual
Report 2071/72 (2014/2015)
DisasterManagement
4.7DisasterManagement
Background
DisasterManagementSectionisanotherimportantprogrammeimplementationunitofEDCD.This
programmeisacollaborativeunitbetweenMoH/DoHS/EDCDandWHOEHA,Thissectionhasbeen
committed to enhancing health sector emergency preparedness, and disaster response including
disaster related outbreak management capabilities in close coordination & collaboration with
stakeholdersthroughoutthecountry.
The overall objective of this section is to enhance the capacities of health sector in emergency
preparedness and response by focusing on disaster prevention, mitigation and response through
followingactivities:
1. Expeditingtheprocessofhealthsectorcontingencyplanning
2. Providingtrainingtothehealthworkersinemergencypreparednessanddisasterresponse
3. Strengthening the mechanism for multisectoral coordination and collaboration in relation
tohealthsectordisastermanagement
MajorDisasterEventsinFY2071/72
NepalEarthquake2072(NepalEarthquake2015)
On12thBaishakh2072(25April2015)at11:56localtime,a7.8magnitudeearthquakeasrecorded
byNepalsNationalSeismologicalCentre(NSC),struckBarpakinthehistoricdistrictofGorkha,about
76kmnorthwestofKathmandu.Nepalhadnotfacedanaturalshockofcomparablemagnitudefor
over80years.Thecatastrophicearthquakewasfollowedseveralaftershocks.Fouraftershockswere
greater than magnitude 6.0, including one measuring 7.3 which struck on 29 Baishakh ( 12 May
2015)withtheepicentrenearMountEverest.Thereareover8,885casualtiesand22,302injuries.
It is estimated that the lives of eight million people, almost onethird of the population of Nepal,
have been impacted by these earthquakes. Thirtyone of the countrys 75 districts have been
affected, out of which 14 districts were highly affected declared as crisishit for the purpose of
prioritizingrescuesandreliefoperations;another17neighboringdistrictsarepartiallyaffected.
Jure,SindhupalchowkLandslide
On 17th Shrawan 2071 (02 August 2014) at 4am, a massive landslide occurred in Jure
Sindhupalchowk and the Sunkoshi river has been blocked. The landslide created a 2.5 Km. long
artificial lake that posed a severe risk for flash floods for a number of days until the water slowly
receded. Due to artificial lake formed, the Araniko highway was also blocked. In this landslide, 5
villages (Mankha VDC, Jure Village, Dhuskun, Ramche and Tekanpur) were affected and 24 houses
weresweptdamagedandburiedinthelandslide.Therewere22deaths,122missingandsimilarly
156peoplewereinjured.About434peopleweredisplaced.Similarly,1birthingcenterwaspartially
damaged.
Otherdisasterevents
Series of massive floods and landslides have hit twelve districts in Central, Mid and Far Western
DevelopmentRegionsofNepalinthemonthofAugust,2014.TheworstaffectedwasMidWestern
Region and the Babai River in Bardiya, where the Early Warning System (EWS) was built on the
existinggaugestation,thestationitselfhasbeenwashedawaybyfloodwhichhasresultedin the
wateroverflowingthebanksoftheseriverscausingfloodinginmostofthevillagesofDang,Surkhet,
Banke,Bardiya,andKailali.BesidesthesedistrictssomeoftheotherdistrictslikeRautahat,Kaski,
Dailekh,Sankhuwasava,SindhupalchowkandMahottariwerealsoaffected.
DoHS,
Annual Report 2071/72 (2014/2015)
125
135
DiseaseDisasterManagement
AccordingtothereportreceivedtoEDCDfromdifferentdisasteraffecteddistrictsatotalof2,00,
000thousandspopulationwasaffectedinBardiyafollowedby10,000inDang,20,000inSurkhetand
6,511inBankedistrictrespectively.Thefloodandlandslideshavedamagedinfrastructuresuchas:
roadsconnectingdistrictheadquarterstotheaffectedVDC`s;bridges;healthfacilities;localmarkets;
transport vehicles as well as livestock; crops and daily consumables. Highways, linking Banke to
Bardiya,NepalgunjtoSurkhetandSurkhettoneighboringdistricts,havealsobeenblockeddueto
landslidesandflood.
Thecommunicationnetworkandelectricitysupplyweregreatlyaffectedduetofallenelectricaland
telecommunication poles. Drinking water supply systems have been disrupted in Surkhet valley
whilehandpumpsandsallowwellshavebeencontaminatedinthesouthernplainarea.
Thesummaryofthedisastereventsandtheireffects/impacthasbeensummarizedintablebelow.
MajorDisasterinFY2071/72
SN.
DisasterNature
Noof AffectedDistricts
event
s
Earthquake
Landslides
Floods
FireEvent
Total
Injured/treated
Missing
Death
22,302
8,885
156
10
5
4
53
8,864
6,106
5,300
1,257
272
3
150
0
0
4
6
18
122
5
0
1
0
5
12
91
5
0
0
0
0
0
44
79
90
33
5
2
3
24
15
29
34
14
9
3
0
0
0
0
1
0
14districtshighly
affected
Sindhupalchowk
Sankhuwashava
Jajarkot
Kaski
Taplejung
Banke
Bardiya
Surkhet
Dang
Salyan
Rautahat
Mahottari
Solukhumbu
Khotang
Taplejung
Saptari
Saptari
Source:EDCD,DoHS
MajorDisasterEventsinFY2071/72
DistrictLevelHealthsectorcontingencyplanningworkshop
District level health sector contingency plan has prepared by EDCD with financial and technical
supportofWHO.Inthisfiscalyear,sevendistricts(Rasuwa,Dhading,Kavre,Gorkha,Lamjung,Parbat
andSyangja)havecompletedthehealthsectorcontingencyplan.AtendofFY2071/72,59districts
have completed the health sector contingency planning workshops as shown in table and figure
below.
126
136
DoHS, Annual
Report 2071/72 (2014/2015)
DisasterManagement
Regions
HealthContingencyPlanningWorkshopcompleted(districts
59)
Health Contingency
Planning Workshop
Not Done Yet
(districts16)
Eastern
Region
10districts:
Jhapa,Morang,Sunsari,Saptari,Siraha,Dhankuta,Ilam,
Udayapur,Panchthar,Solukhumbu
6districts:Bhojpur,
Sankhuwashabha,
Tehrathum,
Taplejung,
Okhaldhunga,
Khotang
Central
Region
1district:
18districts:
Kathmandu,Lalitpur,Bhaktapur,Kavre,Dolakha,Rasuwa,Dhading, Sindhupalchowk
Chitwan,Rautahat,Sarlahi,Mahottari,Dhahanusa,Sindhuli,
Ramechhap,Makwanpur,Nuwakot,Bara,Parsa
6districts:Tanahun,
Kaski,
Myagdi,Baglung,
Manang,Mustang
Western
Region
10districts:
Mid
Western
Region
12districts:
3districts:
Banke,Bardiya,Dang,Rolpa,Pyuthan,Surkhet,Jumla,Rukum,
Salyan,Jajarkot,Kalikot,Dailekha
Humla,Mugu,Dolpa
9districts:
None
Lamjung,Rupandehi,Nawalparasi,
Kapilvastu,Gorkha,Parbat,Syangja,Gulmi,Arghakhanchi,Palpa
Far
western
Region
Doti,Achham,
Bajhang,Dadeldhura,Baitadi,Darchula,Bajura,Kailai,Kanchanpur
Health Sector Contigency Planning
60
59
40
20
18
16
10
Nepal
Source: EDCD/DoHS
EDR
Completed
10
1
CDR
12
6
WDR
9
3
MWDR
0
FWDR
Not-Completed
DoHS,
Annual Report 2071/72 (2014/2015)
127
137
DiseaseDisasterManagement
Hospital Emergency/Disaster Preparedness Plan (HEPP) has been prepared in 3 district hospitals:
Makawanpur district Hospital, Parbat district hospital and Dhading district hospital. At the end of
2071/72 28 hospitals (regional /Zonal/district) have prepared Hospital Emergency/Disaster
PreparednessPlan(HEPP).
ListofHospitalswhereHospitalEmergencyPreparednessPlan(HEPP)waspreparedbyEDCD
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
NameofHospital
MahakaliZonalHospitalMahendranagar
SetiZonalHospitalDhading
BheriZonalHospitalNepalgung
RaptiZonalHospitalTulasipur
LumbiniZonalHospital,Butwal
DhaulagiriZonalHospital,Baglung
SagarmathaZonalHospitalRajbiraj
JanakpurZonalHospital,Biratnagar
KoshiZonalHospital,Biratnagar
MechiZonalHospital,Bhadrapur
BirHospital
SurkhetRegionalHospital
GandakiRegionalHospital
NarayanisubregionalHospital,Birgunj
BhaktapurHospital
MakwanpurDistrictHospital
BharatpurHospital
DhankutaDistrictHospital
BardiyaDistrictHospital
GorkhaDistrictHospital
SunsariDistrictHospital
IllamDistrictHospital
AchhamDistrictHospital
NuwakotDistrictHospital
UdaypurDistrictHospital
RaptiSubregionalHospitalGhorahiDang
SindhuliDistrictHospital
GulmiDistrictHospital
ParbatDistrictHospital
DhadingDistrictHospital
DateofPlanPrepared
19112064
19112064
2452069
1832067
29112064
2822066
21012065
2069610
2012065
2112065
25112064
3012065
25112064
30112064
19112064
FY7172
30112064
24112064
2822067
832068
1832068
1692064
2064
2067
662069
2069912
2782070
2332071
FY207172
FY207172
Stockpiling
128
138
Atcentrallevelstockpilingofnecessarydrugsandotheressentialsuppliesincludingsurgical
andTraumakits,rehabilitationequipments.
MoHPandWHOmanagelargescaleInterAgencyEmergencyHealthKit,DiarrhoealDiseases
Kits,stockpiledinKathmandu,BiratnagarandNepalgunj.
AtRegionallevel,allRegionalHealthDirectoratesstockpilenecessarymedicineandlogistics.
Atdistrictlevel,DHOsstockpilemedicinesandlogisticsinadisastercupboard.
DoHS, Annual
Report 2071/72 (2014/2015)
DisasterManagement
GuidingDocumentspublishedbyEDCDareasfollows:
SN
Nameofdocuments
1
Guidelines&ToolsforConductingIntegratedTrainingofRapidResponse
Teams(RRT)onemergencyPreparednessandResponse
2
NepalDistrictLevelContingencyPlanningManual2009/2010
3
StandardOperatingProcedureforDHWG2010(Draft)
4
NonstructuralSafetyinHealthInstitution,2006.
5
Guidelinesforseismicvulnerabilityassessmentofhospitals,2004.
6
PublichealthGuidelinesinEmergency,2004.
7
EmergencyPreparednessandDisasterResponsePlan,2003.
8
EmergencyPreparedness&DisasterManagementforHospitals,2002
PublishedYear
2011
2010
2010
2006
2004
2004
2003
2002
ActivitiesconductedinFY2071/72
CompletedDistrictlevelHealthsectorContingencyPlanning(CP)WorkshopinRamechhap,
Dolakha,NuwakotandSolukhumbudistrictswithsupportofUNFPA.
TraininingtoRRTmembersinRamechhapandDolakhdistrictwithsupportofUNFPA.
Prepared District level Health sector Contingency Plan in Lalitpur and Bhaktapur districts
withsupportofWHOandNepalRedCrossSociety
Workshop on hospital emergency preparedness plan conducted in Sindhuli and Gulmi
districts.
TrainingtoRRTmemberondisasterresposeinArghakhanchiandGorkhadistricts.
Procured25RRTDeploymentKitsandsuppliedtoRRTmembers.
Interaction Programme with stake holders and generalists on prevention from Cold and
Heatwavetodisseminatemassagetoaffectedpeople.
Conductedmeetingofdisasterhealthworkinggroup.
PreparedHealthSectorstrategicPlanforDisasterResponse2071withsupportofWHO.
ConductedRegionalWorkshoptoReviewDistricts'HealthSectorContingencyPlan.
Problem/Constraints
Issues
Healthsectorpreparednessplan
foroutbreaksandemergency
Retrofittingofhospital
Isolationwardathospital
Recommendations
Reviewandimplementhealth
sectoremergency
preparednessplan
Planforretrofittinginmajor
hospitals
Operationalizeisolationward
inselectedhospital
Action
Operationalizehealthsector
emergencypreparedness
plan
Allocatebudgetfor
retrofitting
Allocateresourcesfor
renovationofisolationward
NoprovisionofregularreportingofdisastermanagementactivitiesinHMIS.
Budgetallocationisinadequate.
Healthsectorcontingencyplanningforalldistrictsandyearlyregionallevelreviewmeeting
forreview&updateofcontingencyplanningisnotinpriority.
NoguidelinesfortheprovisionofCommunitylevelRRT
DoHS,
Annual Report 2071/72 (2014/2015)
129
139
DiseaseControl:Surveillance
SURVEILLANCEANDRESEARCH
4.8
4.8.1 Background
Disease surveillance and research section is an integral part of Epidemiology and Disease Control
Division (EDCD). This section came into existence in August 12, 2013 (Shrawan 28, 2070 BS). The
missionofthecommunicablediseasesSurveillanceSectionistoprotectandimprovethehealthof
Nepalesecitizensbytrackingandrespondingtotheoccurrenceofdiseaseinthepopulationacross
the country. The section conducts the surveillance of reportable diseases and is responsible for
collecting,analyzing,interpreting,andreportinginformationforinfectiousdiseases.Thissectionalso
maintainsahighlevelofdataaccuracyandquality,monitorsdiseasetrendsforearlydetectionand
promptresponseincaseofanyoutbreak.Italsoassistsinthedevelopmentofpublichealthpolicies,
programmeplanningandimplementationrelatedtocommunicablediseases.
4.8.2SurveillanceactivitiesoperatedthroughEDCD
EarlyWarningAndReportingSystem(EWARS)
Early Warning Reporting System (EWARS) is a hospitalbased sentinel surveillance system and is
designedtocomplementthecountrysHealthManagementInformationSystem(HMIS)byproviding
timely reporting for the early detection of selected vectorborne, water and food borne diseases
withoutbreakpotential.
Thehospitalbasedreportingprovidestimelysignaloralertandearlydetectionofpossibleoutbreak
due to increased number of cases in the community leading to continuous transmission of the
diseasefortimelyresponse.
TheEWARSmainlyfocusesontheweeklyreportingofnumberofcasesanddeaths(including"zero"
reports) of six priority diseases: three vectorborne diseases Malaria, Kalaazar and Dengue and
threeoutbreakpotentialdiseasesAcuteGastroenteritis(AGE),CholeraandSevereAcuteRespiratory
Infection (SARI). It equally focuses on immediate reporting (to be reported within 24 hours of
diagnosis) of one confirmed case of Cholera, and severe and complicated Malaria and one
suspect/clinicalcaseofDengueaswell as5ormorethan5casesofAGEand SARIfromthesame
geographicallocalityinaoneweekperiod.Basedontheexperiencesofreportedoutbreaksofacute
diarrhoealdiseasesandinfluenzabyseveraldistricts,thesetwodiseasesareincludedforreporting
in EWARS from the year 2005. Likewise, Dengue and DHF case reporting will be required to be
reportedinEWARSduetoitshighpotentialofimpendingepidemics.Othercommunicablediseases
besidesthesesixprioritizeddiseasesalsoneedtobereportedinEWARS,wheneverthenumbersof
casesexceedtheexpectedlevel.
Itwasestablishedin1997firstin8sentinelsitesandexpandedto24sitesin1998,26sitesin2002,
28sitesin2003,40sitesin2008.81sentinelsiteshavebeenidentifiedasEWARSsentinelsitesin
April2015.Itiscurrentlyoperationalin48hospitals(outof81hospitals)throughoutNepal
140
130
Objective
The main objective of EWARS is to strengthen the flow of information on vector borne and other
outbreakproneinfectiousdiseasesfromthedistricts;andtofacilitatepromptoutbreakresponseto
becarriedoutbyRapidResponseTeams(RRTs)atCentral,RegionalandDistrictlevel,whichcanbe
mobilizedatshortnoticetosupportthelocallevels(DHO/DPHO/PHCC/HP)incaseinvestigationand
outbreakcontrolactivities.
In the broader perspective, it also aids on program planning, evaluation, and the formulation of
research hypotheses and to disseminate data/information on infectious diseases through
appropriatefeedbacksystem
Strategies
Monitoranddescribetrendsofinfectiousdiseasesthroughasentinelsurveillancenetwork
ofhospitalsfollowedbypublichealthactionandresearch
Developacomprehensive,computerizeddatabaseofinfectiousdiseasesofpublichealth
importance
ExpansionandstrengthenEarlyWarningandReportingSystem(EWARS)torepresentall75
districtsofNepal
ImplementationofDistrictHealthInformationSystem(DHIS2)platformforEWARS
MajorActivitiesin2071/72
Expansion,sensitizationandstrengthenEWARSsentinelsite
EWARSsentinelsiteshavebeenrecentlyexpandedto48sites.InFY2071/72expansionwasdonein
9newsentinelsites;DistricthospitalGorkha,Lamjungdistrictcommunityhospital,Districthospital
Dhading,DistricthospitalNuwakot,DistricthospitalDolakha,CharikotPHC,Districthospital
Ramechhap,DistricthospitalBaktapurandPatanHospital.33sitesareyettobeoriented.The
orientationwasprovidedtomedicalrecorders,medicaldoctors,staffnurses,labpersonnel,hospital
staff,andstafffromDPHO/DHOwhichalsoserveddualpurposeofstrengtheningthesitesprograms
andcoordinationbetweenthehospitalsanddistrict(public)healthoffices.

141
131
DiseaseControl:Surveillance
EstablishmentofcontrolroomatEDCD
ControlroomhasbeenestablishedundersurveillanceandresearchsectionofEDCDintechnical
supportfromWHO,NHSSPandGIZwiththefollowingobjectives:
Maintainquality,accuracy,timelinessandcompletenessofdatareceivedfromEWARS
sentinelsites.
AnalyzedatareceivedfromEWARSsentinelsites,monitordiseasetrendsandnotifytothe
concernedauthoritiesifanyoutbreakissuspected/predicted.
Conductactivesurveillanceincaseofanyoutbreak.Preparedailysituationupdatereport
andreporttoconcernedauthorities.
Workcloselywithresponsesection.
RegularpublicationofEWARSBulletin
EWARS bulletin is produced every epidemiological week on Sundays and shared to all the medical
recorders, EWARS focal persons, rapid response team members, District Health Offices, Regional
HealthDirectorates,allthedivisionsandcentersofDepartmentofHealthServices,Secretary,MoHP,
ChiefSecretary,andstakeholdersthroughEmail.
WaterQualityMonitoringandSurveillance
EDCDisasecretariatofWaterQualitySurveillanceCommittee.DirectorofEDCDisthecoordinator
ofthecommittee.Thecommitteeisresponsibleforfollowing:
Regularmonitoringofdrinkingwaterqualityfromvarioussourcesanddistributionsites
Regularsurveillanceofwaterbornediseasesandcoordinatewithdifferentstakeholdersfor
qualitysurveillance
Increasecapacityofmanpowerthroughtraining,meeting,andotherprogrammesforthe
surveillanceofwaterqualityofthedistrict
Facilitatetestingofwaterqualityifanywaterbornediseaseepidemicoccursinthewater
distributedintheparticulararea
KeeprecordofdrinkingwaterdistributionsystemofcountryonthebasisofGeographical
InformationSystem(GIS)andprovidefeedbackstotheresponsibleorganization.
MajorActivitiesin2071/72
WaterQualityMonitoringandSurveillancein14earthquakeaffecteddistricts.
WaterQualitysurveillanceinwatersafetyplants(WSP)implementedprojects
Capacitybuildingofcommunitymemberandhealthworkersinwatersafetyplants
implementeddistricts(Tanahu,Kaski,NawalparasiandGulmi)
142
132
Diseasecontrol:Tuberculosis
4.9TUBERCULOSIS
4.9.1 Background
Tuberculosis(TB)remainsasapublichealthprobleminNepal,asitisresponsibleforillhealthamong
thousandsofpeopleeachyear.TBalsoranksasthesixthleadingcauseofdeathinthecountry.During
this reporting year, NTP registered 34,121 TB cases. Among them 15,655 (46%) were new smear
positiveTBcases,2,202(6%)weresmearpositiveretreatmentcases,6,686(20%)weresputumsmear
negativeand8,966(26%)wereextrapulmonaryTBcases.OutoftotalregisteredcasesinNTP,there
were12,300(36%)femaleand21,821(64%)male.AccordingtothelatestWHOdatapublishedinMay
2014,tuberculosisdeathsinNepalreached5,506.Thisis3.5%oftotaldeaths.Theageadjusteddeath
rateis27.80per100,000ofpopulation.ThisranksNepalas43intheworld.
The majority ofTBcasesanddeathsoccuramongmen,theburdenofdiseaseamongwomenseems

significantly lower (2:1). TB mortality is unacceptably high given that most deaths are preventable if
peoplecanaccesstuberculosiscarefordiagnosisandthecorrecttreatmentisprovided.Shortcourse
regimensoffirstlinedrugsthatcancurearound90%ofallcases(Treatmentsuccessratereportedin
2014/15) have been recorded for a decade. National Tuberculosis Program has adopted the global
STOPTBStrategyandMillionDevelopmentGoals(MDGs)asTBcontrolstrategyofthecountry
Tuberculosis (TB), a major public health problem of Nepal infected About 45 percent of the total
population. Every year, about 45,000 people develop active TB, out of them 20,000 have infectious
pulmonarydiseaseandthatareabletospreadthediseasetoothers.TreatmentbyDirectlyObserved
Treatment Short course (DOTS) has reduced the number of deaths. DOTS have successfully been
implemented throughout the country since April 2001. A total of 4244 DOTS treatment centers are
providing TB treatment service. Expansion of this cost effective and highly successful treatment
strategy has proven its efficacy in reducing the mortality and morbidity in Nepal. The NTP has
coordinatedwiththepublicsectors,privatesectors,localgovernmentbodies,I/NGOs,socialworkers,
educational sectors and other sectors of society in order to sustain the present significant results
achievedbyNationalTuberculosisProgram(NTP).
4.9.2NTPGoal,StrategyandTarget
Vision: TuberculosisfreeNepal
Goal: To reduce mortality, morbidity and transmission of tuberculosis until it is no longer a public
healthproblem
Objectives:
TodramaticallyreducetheNationalburdenofTBby2015inlinewiththeMillenniumDevelopment
GoalsandtheStopTBPartnershiptargets
Achieveuniversalaccesstohighqualitydiagnosisandpatientcenteredtreatment
ReducethehumansufferingandsocioeconomicburdenassociatedwithTB
ProtectpoorandvulnerablepopulationsfromTB,TB/HIVandmultidrugresistantTB
Targets:
MDG6,Target8:...haltedby2015andbeguntoreversetheincidence.
TargetslinkedtotheMDGsandendorsedbytheStopTBPartnership:
By2005:detect100%ofnewsputumsmearpositiveTBcasesandcureatleast85%
ofthesecases.
By2015:reduceprevalenceofanddeathduetoTBby50%relativeto1990.
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144
DoHS, DoHS,AnnualReport2071/72(2014/2015)
Annual Report 2071/72 (2014/2015)
By2050:eliminateTBasapublichealthproblem(<1casepermillionpopulation).
ComponentsoftheStopTBstrategy
1.PursuehighqualityDOTSexpansion&enhancement
Politicalcommitmentwithincreasedandsustainedfinancing
Casedetectionthroughqualityassuredbacteriology
Standardizedtreatmentwithsupervisionandpatientsupport
Aneffectivedrugsupplyandmanagementsystem
Monitoringandevaluationsystem,andimpactmeasurement
2.AddressTB/HIV,DRTBandotherchallenges
ImplementcollaborativeTB/HIVactivities
PreventandcontrolmultidrugresistantTB
Addressprisoners,refugeesandotherhighriskgroupsandspecialsituations
3. Contributetohealthsystemstrengthening
Actively participate in efforts to improve systemwide policy, human resources, financing,
management,servicedelivery,andinformationsystems
Shareinnovationsthatstrengthensystems,includingthePracticalApproachtoLungHealth(PAL)
Adaptinnovationsfromotherfields
4.Engageallcareproviders
PublicPublic,andPublicPrivateMix(PPM)approaches
InternationalStandardsforTuberculosisCare(ISTC)
5.EmpowerpeoplewithTB,andcommunities
Advocacy,communicationandsocialmobilization
CommunityparticipationinTBcare
Patients'CharterforTuberculosisCare
6.Enableandpromoteresearch
Programmebasedoperationalresearch
4.9.3 MajorActivitiesfiscalyear2071/72
KeyactivitiesofNTPareasfollows:
Provideeffectivechemotherapytoallpatientsinaccordancewithnationaltreatmentpolicies.
PromoteearlydiagnosisofpeoplewithinfectiouspulmonaryTBbysputumsmearexamination.
Establish a network of microscopy centers and a system of quality control of sputum smear
examination.
Establishtreatmentcentersforevery100,000populationwithintheexistingprimaryhealthcare
system.
Providecontinuousdrugssupplytoalltreatmentcenters.Thisincludessystemsforprocurement,
storage,distribution,monitoringandqualitycontrolofdrugs.
Maintainastandardsystemforrecordingandreporting
Monitor the result of treatment and evaluate progress of the program, by analyzing periodic
treatmentoutcomeincohortsofpatients.
ProvidetrainingtohealthpersonnelinvolvedintheNTP
ExpansionofincomegenerationandskilldevelopmenttrainingactivitiestoneedyDRTBpatients.
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145
Strengthen cooperation between non government organizations (NGOs), bilateral aid agencies
anddonorsinvolvedintheNTP.CoordinateNTPactivitieswithotherprimaryhealthcareactivities,
especiallyleprosyandAIDS/STDprograms.
4.9.4 ProgressandEpidemiologyofTuberculosis
NTPInstitutionalCoverage
Nepal NTP adopted DOTS strategy in 1996 and nationwide coverage was achieved in 2001. All DOTS
sitesarefullyintegratedwithinthegeneralhealthservicesorrunthroughNTPpartnerorganizationsin
publicandprivatesectors.BymidJuly2015atotalof4,244healthinstitutionswereofferingDOTSfor
provisionofDOTSbasedTBcontrolservices
BesidegovernmenthealthinstitutionsseveralNTPpartnersalsoprovideDOTSincluding;privatenursing
homes, polyclinics, factories, I/NGOs health clinics, eye hospitals, prisons, refugee camps, police
hospitals, medical colleges, municipalities, Village Development Committees and District Development
Committees.
EstimationofTBburden
World Health Organization estimates the prevalence of all types of Tuberculosis cases for Nepal at
66,000 (241/100K) while the number of all forms of incidence cases is estimated around 45,000
(163/100K). With the introduction of Directly Observed Treatment Short course (DOTS) number of
deaths has dramatically reduced from 9,712 (51/100K) in 1990 to 20/100K in 2012 (WHO TB Annual
Report 2013). However, the reported deaths among the registered TB cases in the FY 2014/15 were
5506.
Casenotification
NationalTuberculosisProgramreported34,121tuberculosiscasesduringFY2071/72.TheNationalCase
NotificationRate(Allforms)is123/100,000population.BasedontheCNR,thereare13Districtswhich
are considered high burden, 37 districts considered as Medium Burden and 25 districts considered as
Lowburden.MostofthehighburdenDistrictsareincentralregionandMidwestRegion(CNR137for
both region), when looked at
regional level and in terrain belt
(CNR 139) when ecoregion is
considered while mountains region
had the least CNR of 60/100,000.
TheburdenofdiseasecausedbyTB
can be measured in terms of
incidence (defined as the number
of new and relapse cases of TB
arising in a given time period,
usually one year), prevalence
(definedasthenumberofcasesof
TB at a given point in time) and
mortality(definedasthenumberof
deaths caused by TB in a given
time period, usually one year). As,
Prevalence survey is yet to be
carried out, the true prevalence
andprojectedincidenceratesarerathernotdiscussedhere.
135
146
Annual Report 2071/72 (2014/2015)
The pie show the case notifications
composition of TB cases in 2014/15.
Altogether 34,121 cases were notified
during 2014/15. Among them
bacteriologically confirmed pulmonary
cases were 15,655(46%) clinicalcally
confirmedpulmonarycaseswere6305
(18%), extra pulmonary case were
8,518 (25%) and retreatment cases
were 2,914 (9%) just over 30,478
(89.2%) had a new episode of TB and
2941(9%) (Retreatment) had already
been diagnosed with TB but their
treatment was changed to a
retreatment regimen. Among the new
cases (34,121), 64.34% of cases were
pulmonary cases with remaining 25%
asextrapulmonarycases..
Figure4:AllformsofTBcasesRegisteredon2071/72(2014/15)
693
2%
2941
9%
15655
46%
8518
25%
6305
18%
PBCNew
PCDNew
EPNew
Retreatment
Other
TheCaseNotification Rateofnewsmearpositive
cases (CNR/SS+) raised steadily from 1996 till
2001, when nationwide DOTS expansion was
achieved.Outofthe45,00050,000newcases(all
forms) estimated by WHO in the last years, NTP
wasabletonotify120%andsuccessfullytreat85
89% of them. In spite of this sustained good
programme performance the CNR (of both SS+
and all forms) has substantially stagnated. The
percentage of New SS+ notification rate among
new pulmonary cases in 2015 was 52%, lower
thantherecommendedWHOstandardof65%.
RegionalscenarioofCNR
Year
EDR CDR WDR MWDR FWDR NEPAL
Following table how CNR changed over
2011
103 150 109
137
118
127
time in each region. The analysis of
2012
95
149
105
141
119
124
changes in each region requires indepth
2013
105 153 120
146
135
134
investigationinselecteddistrictstoidentify
2014
109 155 123
146
132
136
thecauses.
2015
96 137 115
137
125
123
AgeandSexdistribution
Around7%ofcaseswereregisteredthisyearinchildhoodAgegroupandadultTBwasaround93%
nationally, where Male were nearly 1.8 times reported more than Female. Among the childhood TB
population,mostofthemwere(5%)between514yearsagegroup.Regionaldatashowedthat,Age
distribution for TB significantly varied between the regions. Childhood TB reported was very less in
Easternregion(3%)wherewasitwasreportedhighestinMidwestregion(15%)wherewasTBisadult
populationwashighestintheEasternRegion(97%)andlowestintheMidWesternRegion(85%).Most
oftheregionshadMale:Femalerationnearlysimilar(between1.62isto1).
AnnualtrendsofCNR
136
147
distribution for TB significantly varied between the regions. Childhood TB reported was very less in
Easternregion(3%)wherewasitwasreportedhighestinMidwestregion(15%)wherewasTBisadult
populationwashighestintheEasternRegion(97%)andlowestintheMidWesternRegion(85%).Most
oftheregionshadMale:Femalerationnearlysimilar(between1.62isto1).
The
nation figure for
CNR is somewhat
AnnualtrendsofCNR
stagnantforquitesomeyears.But,itisinFY
136
2071/72
where
thefor
cases
registered
have
The
nation
figure
CNR
is somewhat
significantly reduced (from 37,025 in
stagnantforquitesomeyears.But,itisinFY
previousyearto34,212thisyear).Therateof
2071/72
where the cases registered have
changeisCNRis11%.Thedetailsanalysis
significantly reduced (from 37,025 in
ofthereasonbehindthissignificantchangeis
previousyearto34,212thisyear).Therateof
due process of analysis. While comparing in
changeisCNRis11%.Thedetailsanalysis
regionallevel,Easterandcentralregionhada
ofthereasonbehindthissignificantchangeis
significantreductionincasenotificationsthis
due
process of analysis. While comparing in
yearcomparedtootherregions.Whilecomparinginecoterrainregion,thecasenotificationinTerai
regionallevel,Easterandcentralregionhada
hassignificantlyreducedthisyear.(13%)followedbythemountainandhill.
significantreductionincasenotificationsthis
yearcomparedtootherregions.Whilecomparinginecoterrainregion,thecasenotificationinTerai
hassignificantlyreducedthisyear.(13%)followedbythemountainandhill.
TreatmentOutcome
The trend of Success rates for TB has been higher (90% or more) consistently for last 5 years. The
annual trend Success rates for newer

TreatmentOutcome
Figure7:TreatmentOutcomeTrend
cases(NewandRelapse)isconstantly
The trend of Success rates for TB has been higher (90% or more)
consistently for last 5 years. The
higher trend
than Success
90% but
thefor
trend
of
annual
rates
newer
success
rates
for
the
Retreatment
NewandRelapsecases
Retreatedexcludingrelapse
Figure7:TreatmentOutcomeTrend
cases(NewandRelapse)isconstantly
cases than
(Loss90%
to but
Followup
higher
the trendand
of
Retreatment)
have
been
constantly
91%
90%
success
rates
for
the
Retreatment
NewandRelapsecases
Retreatedexcludingrelapse
90%
90%
92%
lesser but
was stable
around 7085%.
84%
cases
(Loss
to Followup
and
85%
72%
83%
85%
It was this year
where
the
Success
Retreatment)
have
been
constantly
91%
90%
90%
90%
rates for
cases
have
92%
lesser
butthe
wasretreatment
stable around
7085%.
84%
85%
72%
83%
beentothelowestofaround72%.
85%
It was this year where the Success
2067/68
2068/69 2069/70
2070/71 2071/72
rates
for the retreatment cases have
NTP has achieved from the very
beentothelowestofaround72%.
2067/68
2068/69 2069/70
2070/71 2071/72
beginning an excellent treatment
Remarkably, only a
success
NTP
hasrate).
achieved from the very
smallproportion(23%)ofthepatientssuccessfullytreatedisclassifiedasTreatmentCompleted,the
beginning an excellent treatment
rest being Cured; even the percentage of Failure remained
at veryrate).
low levels
over the last
Remarkably,
onlyten
a
success
years.
smallproportion(23%)ofthepatientssuccessfullytreatedisclassifiedasTreatmentCompleted,the
rest
being Cured; even the percentage of Failure remained at very low levels over the last ten
TBpatientshavebeentreatedwith90percenttreatmentsuccessrateaftertheintroductionofDOTsin
years.
1996.ThisratehasbeensustainedsinceDOTSwasintroduced.Treatmentsuccessrateisalmostsame
(around 90%) from FY 2009/10 to 2013/2014. The Treatment success rate of the country has
TBpatientshavebeentreatedwith90percenttreatmentsuccessrateaftertheintroductionofDOTsin
consistentlyachievedandexceededtheglobaltargetoftreatmentsuccess(85%).
1996.ThisratehasbeensustainedsinceDOTSwasintroduced.Treatmentsuccessrateisalmostsame
(around
90%) from FY 2009/10 to 2013/2014. The Treatment success rate of the country has
consistentlyachievedandexceededtheglobaltargetoftreatmentsuccess(85%).
137
148
137
Annual Report 2071/72 (2014/2015)
The treatment success rate for
Figure7:Regionaltreatmentsuccessratetrend
sputum positive cases is almost
constant in all five development
regions.Outoftotalsputumpositive
cases registered in 2070/71, Ninety
one percent cases successfully
completed their treatment course in
2070/71. EDR achieved highest
success rate (93.39%) where FWDR
has achieved lowest success
rate(90.2%) percent treatment
success rate in 2071/72 whereas
westerndevelopmentregiona91.73percent,Midwesternregionhave91.43percentandthecentral
development region have and western have 91.09 percent success rate in the same period. Overall
treatmentsuccessrateremainsatnationallevelwas91.56Thus,caseholdingisquitesatisfactoryand
thisisduetotheeffectivemonitoringandsupervisionofthepatientsbyDOTsprovideraswellasdue
totimelysupplyofadequateandqualitativedrugstothetreatmentcenters.
DuringJuly2013July2014periodatotalof37,025TBpatientswereregisteredfortreatmentinNTP.
TreatmentsuccessrateamongnewsputumsmearpositiveTB cases(15,762)was87%. Thisyearthe
defaulterrateisconstantat3%andsimilarly,failurerateamongnewsmearpositiveis1%.
TreatmentOutcome:SmearPositiveamongpulmonaryTBcasesmidJuly2013midJuly2014
Female
%
Male
%
Total
Registered
Cured
Completed
Died
Defaulted
Failure
TSR
5115
32%
10647
68%
15762
4512
33%
9136
67%
13648
87%
184
30%
428
70%
612
4%
120
24%
373
76%
493
3%
105
25%
322
75%
427
3%
74
35%
136
65%
210
1%
91.8
89.8
91
Thesputumconversionrateattwomonthsin2014was89%forallnewsputumpositive(NSP)cases,
showingageneralhighcompliancewithtreatmentandgoodqualityofantiTBmedicines.Nepalhasnt
yetfosteredthepolicyofretestingallnonconvertersatthreemonths,thusdelayingthediscoveryof
failuresorDRTBtothefifthmonth.
DrugResistantTuberculosis
DrugresistantTB(DRTB) hasbecome great challengetonationalTB control programandisa major
public health concern in Nepal. Innovative approaches and more funding to increase the uptake of
programmatic management of DRTB nationally are urgently required to detect and enroll more
patientsonMDRTBtreatment,andtoimproveoutcomes.
For programmatic and management point of view, Nepal adapted following classification of DR TB:
Multi Drug Resistant TB (MDRTB): the strain of M. tuberculosis is resistant to at least both Isoniazid
andRifampicinandmayormaynotberesistanttootherfirstlineantiTBmedicines.
Extensively Drug Resistant TB (XDRTB): a severe form of MDRTB the strain of M. tuberculosis is
multidrugresistant(MDRTB)andhasalsoresistancetoanyoftheFluoroquinolonesandtoanyoneof
thesecondlineinjectabledrugs.
DoHS,
Annual Report 2071/72 (2014/2015)
138
149
Pre Extensively Drug Resistant TB (Pre XDRTB): the strain of M. tuberculosis is multi drug resistant
(MDRTB) and also resistance to either one of the Fluoroquinolones or any one of the second line
injectabledrugs.
Rifampicin Resistant (RRTB): the strain of M. tuberculosis is resistant to Rifampicin detected using
rapiddiagnosticmethods(phenotypicorgenotypic),withorwithoutresistancetootherantiTBdrugs.
ItincludesanyresistancetoRifampicin,intheformofmonoresistance,multidrugresistance,polydrug
resistanceorextensivedrugresistance.
Burden
TheresultsofthelatestDrugResistanceSurvey(201112)showedthatthelevelsofdrugresistanceTB
aregettinghigher,withnearly9.3%ofnewpatientresistanttoatleastonedrug.AmongallMDRTB
cases, it is low among new cases (2.2%) while among retreatment cases, it is comparatively higher
(15.4%). One of the concerned aspects of drug resistance in Nepal is the high level of resistance to
fluoroquinolones (26.4%), which leads to heavy burden of preXDR and XDRTB among MDRTB
patients(8%ofthecaseswerefoundtobeXDRamongMDRcasesinthesamesurvey).Thisproblemof
drug resistance might be because of over the counter availability and unregulated use of
fluoroquinolones.
CaseFinding
The fundamental principle underlying the case finding strategy in Nepal is the need to ensure
systematicandtimelyscreeningofpatientsthroughactiveandpassivecasefindingmechanism.Along
with this, all of the TB cases should be screened for drug resistance so that prompt initiation of
effectivetreatmentcanbestarted.The,thefollowingtargetgroupsarebeingscreenedforDSTunder
NationalTBControlProgramofNepal:
Retreatmentcases(losttofollowupfailureandrelapse)
InitiallySS+patients(cat.IandII)whoarestillpositiveafterfirstsputumsmearfollowup(i.e.
2monthsforCATIAND3monthsforCATII)orotherpatientsthataredoingpoorlyclinically
(persistentcough,fever,lossofweight,tiredness,etc.)despiteofcontinuingTBtreatment.
HIVPositiveTBPatientsClosecontactsofDRTBcases(RR/MDR/PreXDR&XDR).
SuspectofextrapulmonaryDRTBpatients
Patientsundergoingirregulartreatmentandtreatmentfromprivatesectorwithpoorregimen
The graph shows the distribution of MDRTB case finding from FY 2067/68 to FY 2071/72 by
developmentregionwise.
Looking at the trend of
MDRTB case finding
status,itcanbeobserved
that all of the regions
have been progressing in
case finding. The Central
Development Region has
been identifying highest
cases among all five
regionsanditisthesame
in this year as well
whereas low case finding
was done in Midwestern
139
150
DoHS, Annual
Report 2071/72 (2014/2015)
region.OtherregionslikeEasternRegion,WesternRegionandFarwesternRegionfound58,81and47
casesrespectivelyinthisFY.
The given graph shows MDRTB case finding by registration category from FY 2067/68 to 2071/72.
Thereare6registrationcategoriesinthepolicy.
Theabovegraphshows
that the majority of
MDRTB cases are
diagnosed as failure
after category II and
retreatment cases. DR
TB case are detected
early by MDRTB
investigation among
new TB cases which
was 51 in FY 2070/71
and increased and
reached to 58 cases in
2071/72. In this year,
lessrelapsecaseswere
registeredunderMDRTBcasesi.e.61thoughitwashighinlastFY(84).CategoryITreatment
failurecasesalsoincreasedto131thisyearfrom103lastyears.Losstofollowupcaseswere
alsostagnantforlast2/3years.
ThechartbelowdemonstratestreatmentoutcomeofMDRTBtreatmentcases.
Throughtheabovegraph,we
canseethatthetreatment
successrateofMDRTB
reducedbyalmost5%inthis
yearincomparetolastyear
thoughitwasgrowinginlast
fouryears.Proportionof
patientswhodiedandfailed
intreatmentaresimilarthis
yeari.e.8%whichisnearly
sametothelastyear.
Significantnumberofpatientswerelosttofollowthisyearincomparetolastyearwhichisincreasedto
12%thisyearfrom7.3%lastyear.
DoHS,
Annual Report 2071/72 (2014/2015)
140
151
TB/HIV
ManagementofTB/HIVCoinfection
TheNTPadoptedTB/HIV strategyand policyin2008.CollaborativeTB/HIVactivitiesaim todecrease
the burden of TB and HIV in a population affected by both diseases through effective collaboration
between NTC and NCASC and to provide integrated and comprehensive tuberculosis and HIV
prevention,treatmentandcareserviceasclosetotheclientaspossible.However,theimplementation
of TB/HIV collaborative efforts was not realized up to the expected standard. As part of a remedial
actiontorevitalizeTB/HIVcollaborativeefforts,anumberofstrategicinterventions/approacheswere
devotedtobolstertheTB/HIVcollaboration.
Regarding percentage of TB patients who had an HIV test result recorded in the TB register through
intensifiedcasefindingrevealsthat7%inF/Y2014/15TBpatientsweretestedforHIVandfound175
HIVpositivecases.NTCandNCASCjointlyrevisedthepolicyin2013totestallTBpatientsforHIVand
allHIVpositiveclientsforTBtestateveryvisit.TheprevalenceofHIVisstabilizinginNepal,making
collaborativemeasuresfrombothNationalAIDSandTBControlProgrammemoreimportantnowthan
everbefore.NTPhasconductedseveralsentinelsurveillancessince1994toestablishtheprevalenceof
HIV among TB patients. The latest surveillance (2012) showed HIV prevalence among TB patients at
2.4%, which is remain the same status of 2007 surveillance and TB prevalence among HIV clients at
11.5%.TheGlobalTuberculosisReport2015indicatesthatglobally,51%ofnotifiedTBpatientshada
documentedHIVtestresultin2014,asmallincreasefrom49%in2013.Thenumberofpeopleliving
withHIVwhoweretreatedwithisoniazidpreventivetherapyreached933000in2014,anincreaseof
about60%comparedwith2013.Thetargetfor2016isthat80%ofestimatedHIVpositiveincidentTB
casesreceivetreatmentforbothTBandHIV.
4.9.5 NTPLaboratoryNetwork
Diagnosis and treatment monitoring of
Region
EDR CDR WDR MWDR FWDR Total
tuberculosispatientisreliedonSputum
109
143
82
51
84
469
smearmicroscopyinNTPbecauseofits GoN
NonGoN
18
53
8
29
4
112
low cost and practically easier to
perform. Direct sputum smear Total
127
196
90
80
88
581
microscopy is the choice of TB
diagnostic toolworldwide.Currentlythereare581 microscopy centersdeliveringsputum microscopy
examination throughout the country. Majority of the microscopy centers(469)are established within
governmenthealthfacilities;someareestablishedinnongovernmentalorganizationsaswellasinthe
privatesector.NTPisresponsibleforprovidinglaboratoryreagents,chemicalsandotherequipments
toallthemicroscopycenters.
There are well established networks between the microscopy centers (MCs) at PHC, DHO/DPHO, 5
RTQCCsandthenationallevel(NTC).Microscopycenterssendtheexaminedslidestotheirrespective
regionalTBqualitycontrolcentersviadistricthealthofficeaccordingtoLQASmethod.FiveRegionalTB
quality control centers (RTQCCs) are functioning smoothly with help of skilled and trained quality
control assessors. EQA for sputum microscopy is carried out by BNMT/NATA, Biratnagar for eastern
region, NTC for the national and
AgreementRate
central region. RTC Pokhara for Region
EDR CDR WDR MWDR FWDR Total
western region, Regional Health
Directorate Surkhet for midwestern Agreement
99
99 98.32
98 99.47 98.8
region and NLR, Dhangadhi for Far Rate
westernregion.Theoverallagreementrateisimprovedandmaintainedwithmorethan98%through
FY2014/15
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Annual Report 2071/72 (2014/2015)
GeneXpertMTB/RIF
The Xpert MTB/RIF is a selfcontained and cartridgebased technological platform that integrates
sputum processing, DNA extraction and amplification, TB and MDRTB diagnosis. It has similar
sensitivity to culture, targets Mycobacterium tuberculosis specifically and enables simultaneous
detectionofrifampicinresistanceviarpoBgene.TheXpertMTB/RIFtestisavaluable,highlysensitive,
andspecificnewtoolforearlyTBdetectionandfordeterminingrifampicinresistance.Whileitshould
be noted that monoresistance to rifampicin is found in approximately 5% of rifampicin resistant
strains,ahighproportionofrifampicinresistanceisassociatedwithconcurrentresistancetoisoniazid.
Thus, detecting resistance to rifampicin can be used as a marker for MDRTB with a high level of
accuracy.TheuseofXpertMTB/RIFstartedinNepalfrom2011/2012andmainlythreeorganizations
held the capacity of this technology: IOM (International organization for migration), HERD (Health
ResearchandSocialDevelopmentForum)andNTC(NationalTuberculosisCenter).Currently,thereare
26 Xpert MTB /RIF centers located in different part of the country as listed below. Three more
machineswillbeinstalledshortly.
CultureandDrugSusceptibilityTest(DST)
Culture of Mycobacterium tuberculosis remains the gold standard for both diagnosis and drug
susceptibilitytesting,andalsothemethodofchoicetomonitorDRTBtreatment.Conventionalculture
method using LowensteinJensen (LJ), while cheap and simple have the major disadvantage of being
veryslow.LJculturestake8weeksfornegativeresultandfourtosixweeksafterinitialculturefordrug
susceptibility testing. Both the National TB Reference Laboratories (NRL), NTC and GENETUP, are
providingcultureandDSTservices.TheyarequalityassuredandaccreditedasNRLsbySupranational
TBReferenceLaboratory(SRL)Gauting,Germany.SRLGauting,Germanyissupervisingandmaintaining
regularEQAoftheselaboratories.
NRLatNTCisinprocesstoestablishLiquidCulture(MGIT).TheMGITsystemisbasedonaglasstube
containing7H9broughttogetherwithfluorescencequenchingbasedoxygensensor.Wheninoculated
withMycobacteriumtuberculosis,consumptionofoxygenproducesfluorescencewhenilluminatedby
a UV lamp. The fully automated version can incubate up to 960 samples for Mycobacterium
tuberculosis diagnosis through culture of samples (pulmonary and extrapulmonary) and Drug
Susceptibilitytesting.
areprovidingcultureandDSTservices.BothofthemarebeingqualityassuredandaccreditedasNRLs
by Supranational TB Reference Laboratory (SRL) Gauting, Germany. SRL Gauting, Germany is
supervisingandmaintainingregularEQAoftheselaboratories.
NRLatNTCisinprocesstoestablishLiquidCulture(MGIT).TheMGITsystemisbasedonaglasstube
containing 7H9 broth together with fluorescence quenchingbased oxygen sensor. When inoculated
withMycobacteriumtuberculosis,consumptionofoxygenproducesfluorescencewhenilluminatedby
a UV lamp. The fully automated version can incubate up to 960 samples for Mycobacterium
tuberculosis diagnosis through culture of samples (pulmonary and extrapulmonary) and Drug
Susceptibilitytesting.
142
153
4.9.6 Supervision&MonitoringandLogisticsSystem
Supervision,Monitoring&Evaluation
Supervisionand monitoringiscarriedoutthrough
regularvisitstoalllevelsoftheprogrammeasper
NTP policy. In addition to supervision and
monitoring, quarterly reporting of activities is
carriedoutatPlanning,MonitoringandEvaluation
(PME) workshop at all levels of the programme
whichisheldtrimisterly.
Supervision System & Schedule

Centre
Region, District,
Treatment Centre
Region
District,
Treatment Centre
District
Treatment Centre
Sub Centre
Sub Centre
Four month
Sub Centre
The NTP maintains a regular monitoring

MonitoringandEvaluation
systemwhichincludescasefinding,smear
International
InternationalReview
Annual
conversion, treatment outcome and
programmemanagementreportsfromall
NationalReporting&
National
FourMonthly
PlanningWorkshop
levels of the programme. Data is initially
reported and analyzed by the District

RegionalReporting&
Regional
FourMonthly
PlanningWorkshop
HealthOfficeduringthedistrictreporting
and Planning workshops. District TB and
DistrictReporting&Planning
District
FourMonthly
Workshop
Leprosy Officers (DTLOs) report on
treatment centre and district during the

Treatment
TreatmentCenterReporting
FourMonthly
Regional Planning, Monitoring and
Centre
&PlanningWorkshop
Evaluationworkshops.Finally,RegionalTB
andLeprosyOfficers(RTLOs)reportbydistrictatnationalPMEworkshops.AllofthesePMEworkshops
takeplaceeveryfourmonths,atthebeginningofthenewtrimester.
4.9.7LogisticSupplyManagement
The National Tuberculosis Control
Programme
has
a
logistics
managementsystem.AntiTuberculosis
drugsandotheressentialsaresupplied
quarterly which is based on new cases
notifiedduringquarterandcaseswhich
arestillontreatment.
Eachleveloftheprogrammemaintains
a four months additional buffer stock
to prevent being out of stock. The
buffer stock kept out at regional level
hasbeenincreasedfrom4to6months
in order to guard against shortages
caused by delays in delivery from
national level due to unforeseen
naturalandotherdisturbances.
NTPProcurement,demandandsupplyorganizationalchart
Procurement
Demand
ResponsibleAuthority&Level
GlobalDrug
facilityWHOHQ
WHOSEARO
Supply
WHONepal
NTP/MOHP
RegionalMedicalStore
DistrictHealth/PublicHealthOffice
PrimaryHealthCareCenter
HealthPost
4.9.7PhysicalandFinancialProgressstatus
Physical
Financial
CentralLevel
75.3%
59.3%
DistrictLevel
Physical
Financial
BerujuClearance 61%
95%
92%
Infiscalyear2071/72,NTChad75percentphysicalprogressincentrallevelprogramand95percent
achievement in district level program. Whereas the financial progresses were 59.3 percent in central
143
154
DoHS, Annual
Report 2071/72 (2014/2015)
level and 92 percent in district level program. NTC was in good position regarding to clearance of
financialirregularities.TheBerujuclearancewasaround61percentinthatperiod.
4.9.8Problems/Constraints
KeyConstraint&Challenges
TheNepalNTPhasregularlybeenfacingseveralchallengesandconstraints,whichinfluenceinabilityto
expand and sustain the vision of the Programme. Following are the key challenges and constraints
facedbytheNTPinordertoreachintendedgoalsandtargetsoftheProgramme.
Challenges:
Insufficientincomegenerationprogramforpatientandtheirfamilymembers.
InadequateTBmanagementtrainingtomedicaldoctors
MinimuminterventionsforstrengtheningPPMcomponent
Lackofoperationalresearchregardingincreasingretreatmentcases
LackofpatientfriendlyTBtreatmentservice
Existingcurriersystemforslidenotadequate
InadequateTBIECmaterials
Difficulttocoordinatewithregionalandprovincialhospitals.
Actiontobetaken:
ExpansionofCBDOTProgrammeinthecountry
StrengthenPublicPrivateMixapproach
StrengthentheCommunitySupportSystemProgramme
PlanforoperationalresearchonTB
DevelopanddistributepatientscenteredTBIECmaterials
Pilotpatientfriendlytreatmentcentersinthecountry
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155
Disease Control: Leprosy
4.10 LEPROSY
Vision, mission and program

Vision
To make leprosy free society where there is no new leprosy case and all the needs of existing leprosy
affected persons having been fully met.
Mission
To provide accessible and acceptable cost effective quality leprosy services including rehabilitation and
continue to provide such services as long as and wherever needed.
Goal
Reduce further burden of leprosy and to break channel of transmission of leprosy from person to person
by providing quality service to all affected community.
Objectives
1. To eliminate leprosy (Prevalence Rate below 1 per 10,000 population) and further reduce
disease burden at district level.
2. To reduce disability due to leprosy.
3. To reduce stigma in the community against leprosy.
4. To provide high quality service for all persons affected by leprosy.
5. To integrate leprosy in the integrated health care delivery set-up for provision of quality
services.
Strategies
The national strategy envisions delivering quality leprosy services through greater participation and
meaningful involvement of people affected by leprosy and right based approaches in leprosy services as
follows:
1. Early new case detection and their timely and complete management
2. Quality leprosy services in an integrated setup by qualified health workers
3. Prevention of impairment and disability associated with leprosy
4. Rehabilitation of people affected by leprosy, including medical and community based
rehabilitation
5. Reduce stigma and discrimination through advocacy, social mobilization and IEC activities and
address gender equality and social inclusion
6. Strengthen referral centres for complications management
7. Meaningful involvement of people affected by leprosy in leprosy services and address human
right issues
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156
8. Promote and conduct operational researches/studies

9. Monitoring, supportive supervision including onsite coaching, surveillance and evaluation to
ensure/strengthen quality leprosy services
10. Strengthen partnership, co-operation and coordination with local government, external
development partners, civil society and community based organizations.
Targets
Reduce New Case Detection Rate (NCDR) by 25 % at national level by the end of 2015 in
comparison to 2010
Reduce Prevalence Rate (PR) by 35 % at national level by the end of 2015 in comparison to 2010
Reduce by 35% Grade 2 disability (G2D) amongst newly detected cases per 100,000 population by
the end of 2015 in comparison to 2010
o Additional deformity during treatment <5% by eyes, hands and feet (EHF) score
o 80% health workers are able to recognize and manage /refer reaction/complications
o Promote prevention of disability in leprosy(POD) and Self care
These targets will be revised after midterm evaluation.
Globally WHO has guided to reduce the burden due to Leprosy and Bangkok declaration has committed
to reduce the G2D below 1/1 million and to increase the resources for leprosy, early diagnosis
awareness to reduce stigma and rehabilitation in partnership approach.
Evolution and milestones of leprosy control program in Nepal
Though documented history of organized leprosy services are available scantly, establishment of
Khokana leprosarium is considered the oldest organized leprosy services in Nepal. Some key milestones
of leprosy control activities and programmes are given below.
1960
Leprosy survey by Government of Nepal (GoN) in collaboration with World Health
Organization (WHO).
1966
Pilot project to control leprosy launched with Dapsone monotherapy.
1982
Introduction of Multi Drug Therapy (MDT) in leprosy control program.
1987
Integration of vertically shaped leprosy control program into general basic health
services.
1991
National leprosy elimination goal was set.
1995
Focal persons (TB and Leprosy Assistants-TLAs) for districts & regions appointed.
1996
All 75 districts were brought on MDT
1999/2000- Two rounds of National Leprosy Elimination Campaign (NLEC) were implemented.
2001/02
2008
Intensive efforts made for achieving elimination at national level
2009
Leprosy elimination achieved at national level
2010
Elimination at national level declared
2011
National strategy was introduced
National guidelines was revised
2012-2013
Elimination sustained at national level
2013-2014
Mid Term Evaluation on Strategy 2011-2015
2014-2015
Establishment of Disability Prevention and Rehabilitation Focal Unit
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157
Major Activities Undertaken During FY 2071/72

MDT service delivery
During the FY 2071/72, a total number of 3053 new leprosy patients were detected and were put under
MDT and 2,461 cases were under treatment at the end of this fiscal year. During this fiscal year, 2800
patients completed treatment and were released from treatment (RFT). Secondary and tertiary care
services were provided to the needy and leprosy affected patients through the existing network of
referral centers with support of partners. MDT drugs, which are made available by Novartis Foundation
through WHO and anti-reaction drugs were freely available and the supply remained uninterrupted in
the country throughout the year.
Capacity Building
The Leprosy Control Division (LCD) organized various capacity building activities during this reporting
period. 6 days Medical Officer's course was conducted in Lalgadh Hospital (15 participants) and Far-west
Regional Health Training Centre: Dhangadhi (15 participants). The training was technically supported by
Anandaban Hospital and Lalgadh Hospital. Skin smear training for 18 lab staffs with technical support
from Mid-Western Regional Health Directorate, INF Surkhet, Western Regional Health Directorate
Pokhara and INF-Green Pasture hospital.
District Health Offices/Public Health Offices (DHOs/DPHOs) accomplished 2 days basic leprosy training
(BLT) for 60 health workers in various districts. Moreover, 5 days Comprehensive Leprosy Training (87
participants), 6 days Medical officer course (52 participants), 14 days long Training to MD
Dermatologists (11 participants) and 5 days Complication Management Training to Focal persons (14
participants) were also accomplished in Training centre of The Leprosy Mission Nepal - Anandaban
Hospital.
IEC and advocacy

To enhance community awareness, passive case detection, voluntary case reporting and to reduce
stigma, IEC activities were undertaken on a regular basis using electronic and print medias. During the
year, relevant messages on leprosy were broadcasted using mass media and posters and leaflets were
distributed. Likewise, leprosy messages were disseminated through flex charts which were displayed at
district and health facility service centers. Bulletins (Hamro Sawal) and leprosy handbook for health
care workers were printed and distributed. Likewise, LCD has developed Lok Dohari CDs highlighting
leprosy message in order to distribute in different districts and partner organizations.

World leprosy day celebration
62nd World Leprosy Day was commemorated on 11 Magh 2071 (25 January 2015) by conducting various
activities at national, regional and district levels. The media interaction activity was jointly organized to
commemorate the day by LCD, partners and stakeholders.

Media interaction
On the occasion of the 62nd "World Leprosy Day", a media interaction was organized in the premises of
Department of Health Services, Ministry of Health on 11 Magh 2071 (25 January 2015). Shanta Bahadur
Shrestha, Secretary of Ministry of Health, graced the programme as the chief guest. Dr. Senendra Raj
Upreti, Director General, Department of Health Services chaired the program and Dr. Basu Dev Pandey
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158
Director of Leprosy Control Division, welcomed the dignitaries and facilitated the program. The LCD's
director made a presentation on various aspects of leprosy and its current situation, strategies and
activities conducted and plan to further reduce the disease burden due to leprosy and the role of media
in leprosy control programme. The presentation was followed by interaction with media representatives
and participants.

District and regional review meetings

Regular trimester (in every 4 months) review meetings were held at district and regional level. During
these meetings aggregated data was presented and discussed. Administrative issues were attended too.
Activities that are to be undertaken in the future were presented and the details regarding their
implementation were discussed and agreed upon.
Trimester performance review workshop at central level

Three trimester review workshops were held at LCD to assess the outcome & monitoring of the
program. These meetings were held in the leprosy control division under the chair of the division
director. RTLOs, regional medical store chiefs, regional statistical officers, representatives from and
Health Management Information System (HMIS) section, INGO partners and WHO attended the
workshops. Regional TB-Leprosy Officers (RTLOs) presented and shared the information on leprosy
programme situation, problems and issues in their respective regions and districts. Regional medical
store chiefs also presented the MDT drugs stocks/demands and problems of their respective regions.
Progress made, plans and problems/issues faced by partners were also presented and discussed in the
workshops.
Health management information system (HMIS)

Data generation, compilation, aggregation, and report submission were timely throughout the year.
Consolidated data was received at every 4 months at districts, regions and center. Feedback on vital
issues that had emerged was provided to specific programme area during the review.

Web-Based Leprosy Reporting and Management System (WeBLeRS)
WeBLeRS was developed in 2013 with initiation of LCD and is a system complimentary to HMIS.
WeBLeRs training was provided to the DPHOs, DTLOs and statistic officers/ assistants of central, eastern,
mid-western and far-western development regions to train them in feeding field level information in this
system. This system is based on case-based recording and reporting system of the leprosy patients. The
system is also expected to expedite leprosy reporting process and transmission of official
communication regarding leprosy from central level to regional and district levels and also vice versa.
Early case detection activities (Active Case Detection)

In general population:
Active case detection programme was designed and implemented in 20 VDCs of three high leprosy
burden districts (Nawalparasi, Rupandehi and Kapilvastu). Prior to the search activities, one-day
orientation was conducted to health workers and FCHVs of the concerned VDCs. The search was done
by performing a house-to-house search by FCHVs and other health workers by using a pictorial search
card and other IEC materials. A team consisting of senior and trained leprosy officers/supervisors from
148
159
center, region, district and partners provided technical support to the local health facilities in diagnosing
and managing the identified cases. A total of 34 new cases were identified.

Table 1: Identified cases during active case detection in Nawalparasi, Rupandehi and Kapilvastu
Cases identified
Districts
No of VDCs
MB
PB
Total
Nawalparasi
5
0
3
3
Rupandehi
10
3
0
3
Kapilvastu
5
4
5
9
Total
20
7
8
15
In socially disadvantaged groups:
In Bara and Rautahat districts, socially disadvantaged (Terai dalits) and religions minority communities (3
in each district) were identified and active search was carried out. The ethnic groups in the communities
who were examined were Mushahar, Sadal, Mawlal, Chamar, Chidimana, Das and Rirahato.
Table 2: The summarized findings are shown in the table below:
Districts
Total
No. of
Population
communities
searched
Rautahat
Bara
3
3
Total
21429
21272
42,702
Case Details
Children
Adult
(0-14)
MB PB MB PB
1
1
0
0
1
4
0
0
2
5
0
0
Total Female % of % of % of
cases cases MB G2D Female
2
5
7
2
2
4
50%
20%
29%
0
0
0
100%
40%
57%
Active case detection in urban slums

During this reporting year, active case detection was also done in some slums of major urban
areas/municipalities of Janakpur and Gulariya. The search methodologies was similar to the search done
in the VDCs as mentioned before. The details are given in the table below.

Table 3: Identified cases during active case detection in urban slums

Districts Municipalities
Bara
Banke
Janakpur
Gulariya
Total
Source:LCD, DoHS
Population
searched
1,22,274
6,796
1,29, 070
Suspects
104
50
154
MB
1
2
3
PB
18
9
27
Case Details
Total
Child
19
11
11
4
30
15
Female
11
4
15
Contact examination: Patients their family and neighbours
Contact examination is an index case based approach in which health workers and FCHVs visit every
household of a newly detected leprosy case and their neighbours using the pictorial card. They examine
all household family members and neighbours for any signs and symptoms of leprosy and refer
suspected case of leprosy to nearest health institution for confirmation of diagnosis and treatment
management. During this year, 65176 family members were targeted and examined.

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160
Disease Control:
DiseaseLeprosy
Control: Leprosy
Special contact examination

Special contact examination
Special
examination was
was
conducted
in four
districts
viz., Sarlahi,
Mahottari,
Dhanusha
and
Special contact
contact examination
conducted
in four
districts
viz., Sarlahi,
Mahottari,
Dhanusha
and
Sarlahi
Sarlahi from
from 22
22nd June
June to
to 99th thJuly
July
2015.
2015.
1207
1207
family
family
members
members
were were
examined
examined
out of 23
out
index
of 23
cases,
index cases,
which
the diagnosis
diagnosis
4 new
cases
(1MB
and
3 Similarly,
PB). Similarly,
7240 neighbours
which resulted
resulted in the
of of
4 new
cases
(1MB
and 3
PB).
7240 neighbours
family family
members were examined i.e. 4 members of the neighbours of the each index case, from which 14 new
members were examined i.e. 4 members of the neighbours of the each index case, from which 14 new
cases
iagnosed.
This
special
contact
examination
indicates
that
new
case detection
cases (all
(all PPB)
B) w
were
ere ddiagnosed.
This
special
contact
examination
indicates
that new
case
detection
rate is rate is
high
in in ccommunity
han family.
family.
high
ommunity tthan

Table 4: Special Contact examination of patients and neighbours family members in 4 districts
Table 4: Special Contact examination of patients and neighbours family members in 4 districts
Diagnosed cases
Diagnosed cases
Members
Suspected cases
Members
Suspected cases
Index
Index
examined referred by FCHVs
referred by FCHVs Family Family
examined
Neighbour
Neighbour
Districts
Districts
Grand
Grand
cases
cases
Total
Family
Family Neighbour
Neighbour Family
Family
Neighbour
Neighbour
MB MB
PB S.Total
PB S.Total
MB PB MB
S.Total
PB S.Total
Sarlahi
Sarlahi
Mahottari
Mahottari
Dhanusah
Dhanusah
Siraha
Siraha
4 4
94
35
59
49
237
237
497
497
224
224
295
295
191
191
1207
1207
3260
3260
1417
1417
1899
1899
664
664
7240
7240
20 20
6 6
30 30
12 12
68 68
65 65
34 34
29 29
12 12
140 140
1
0
0
0
1
1
1
0
0
2
0
0
0
3
1
1
2
0
0
2
2
0
0
3
4
0
2
0
0
0
2
0
0
4
0
3 0
2 0
4 0
5 0
14 0
3 3
2 2
4 4
5 5
14 14
Total
5
3
2
2
6
4
5
5
18
14
5
2
6
5
18
Orientation on community based rehabilitation

Orientation on community based rehabilitation
One
One
dday
ay oorientation
rientation pprogram
rogram
for
for
leprosy
leprosy
affected
affected
people
people
and caoncerned
nd concerned
stakeholders
stakeholders
were organized
were organized
in
in
20
districts
hem aaware
ware
United
Nations
Convention
on
the Roights
of Pwersons
with Disabilities
20
districts tto
o m
make
ake tthem
on oUn nited
Nations
Convention
on the
Rights
f Persons
ith Disabilities
(UNCRPD).
(UNCRPD).
Interaction with stakeholders on MCBR for leprosy affected people

Interaction with stakeholders on MCBR for leprosy affected people
Interaction
Interaction programme
programme on
on Medical
Medical
and
and
community
community
based
based
rehabilitation
rehabilitation
(MCBR) (MCBR)
was held
was
in all
held
75 in all 75
districts.
from
major
stakeholders
(Leprosy
affected
other with
people with
districts. The
The representative
representative from
major
stakeholders
(Leprosy
affected
people, people,
other people
disability,
health professionals,
professionals,
representative
of VDCs,
community
local partner
disability, local
local health
representative
of VDCs,
community
leaders, leaders,
local partner
organizations,
isable ppeoples
eoples
organizations)
participated
the program
and discussed
on the issues
organizations, and
nd ddisable
organizations)
participated
the program
and discussed
on the issues
of of
MM
CBR.
CBR.
Interaction on Leprosy with clinical specialists & other practitioners
Interaction on Leprosy with clinical specialists & other practitioners
One
program was
was
conducted
clinical
specialists
and practitioners
other practitioners
in
One day
day interaction
interaction program
conducted
with with
clinical
specialists
and other
in
Janakpurdham:
D
hanusha
(
40
p
articipants),
N
arayangadh:
C
hitwan
(
65
p
articipants),
B
utwal:
R
upandehi
Janakpurdham: hanusha (40 participants), Narayangadh: Chitwan (65 participants), Butwal: Rupandehi
(49
participants),
Nepalgunj:
epalgunj:
Banke
(54
participants)
Dhangadhi:
ailali
(47 participants).
During the
(49
participants), N
Banke
(54
participants)
and aDnd
hangadhi:
Kailali K(47
participants).
During the
interaction
various aspects
aspects
leprosy
its current
situation,
strategies
and activities
interaction program
program various
of of
leprosy
and and
its current
situation,
strategies
and activities
conducted
to reduce the disease burden were discussed. Moreover, the role of clinical specialists and
conducted to reduce the disease burden were discussed. Moreover, the role of clinical specialists and
other
in leprosy
leprosy control
control
programme
leprosy
reduction
activities
were also
other practitioners
practitioners in
programme
and and
leprosy
stigma stigma
reduction
activities
were also
highlighted.
highlighted.
Financial support for Transportation to RFT cases

Financial support for Transportation to RFT cases
LCD
LCD
has
has pprovided
rovided oone
ne tthousand
housand
rupees
rupees
for feor
ach
each
RFT RcFT
ases
cases
to cover
to ctover
he transportation
the transportation
cost after
cost after
completion
completion oof f MDT.
DT.
Recording Reporting Update & Leprosy Case Validation Activities

Recording Reporting Update & Leprosy Case Validation Activities
Recording
Recording reporting
reporting update
update & &
leprosy
leprosy
case
case
validation
validation
activity
activity
was done
was in
done
Jhapa,
in Jhapa,
Dhanusa,
Dhanusa,
Mahottari
Mahottari
and
BBara.
as reclassified
reclassified
from
B PtB
o iP
in Rautahat
nd
one recycle
case
was
and
ara. OOne
ne case
ase wwas
from
MB Mto
n B
Rautahat
and oane
recycle
case was
found
in fBound
ara. in Bara.
DoHS,
2071/72(2014/2015)
(2014/2015)
DoHS,Annual
Annual Report
Report 2071/72
150
150
161
Four over reporting cases were found in Sarlahi district. These results urge programme managers to
continue such update and validation activities in other districts in future too.
Skin camps
This camp is an approach to screen and identify/detect leprosy cases early in areas with high disease
burden and other areas. A team consisting of dermatologists, trained health workers and leprosy focal
persons conducted the camps in the local health facility. FCHVs and other health workers are mobilized
and IEC activities were also done to inform community people about the camp. During this fiscal year,
39 such camps were conducted in various districts.
School health education

This activity targets mainly secondary level school students. The main objective of this activity is to
make students and teachers aware about early signs and symptoms of leprosy, benefits of early
treatment and options of treatment available at treatment facilities. During this FY 105, schools were
given health education against targeted 185 schools.
Publications
During this reporting year, leprosy control division published its annual report 2070/71 (2013/14)
containing the salient features of the current leprosy situation, activities undertaken during previous
year, achievements and obstacles faced by the program.
National operational guideline has been developed and 500 copies printed which were distributed to
the health workers which provides technical as well as programmatic information on leprosy including
disease surveillance, suspecting of leprosy cases etc. In addition, Hamro Sawal, quarterly bulletins of
LCD were also published twice in the months of Magh & Ashad.
Disadvantaged group program
This activity was conducted to increase the access of unreached/marginalized communities (Dalits,
Janajatis and other disadvantaged groups) to leprosy control activities and services. The communities
were educated on stigma reduction and motivation for active participant in leprosy control activities.
One day orientation was done on signs & symptoms to suspect the cases and the participants were
mobilized in the communities to suspect potential cases. During this fiscal year this activity was
conducted in 180 places of different districts. In some places and the community identified suspected
cases and referred them to nearby health institutions for diagnosis & treatment.
Supervision and monitoring
To provide technical guidance to health workers at peripheral health facilities and district health offices,
supervisory visits were undertaken regularly by the staff of LCD, regional health directorate (RHD) and
district health offices (DHO). Apart from the budget made available by GoN for this activity, additional
funds were also provided by WHO, NLR and other supporting partners. Additional technical support
through supervisory visits was also provided by the staff of WHO, NLR, NLT, INF, Anandaban hospital &
other supporting partners.
Involvement of people affected by leprosy in leprosy programmes

The leprosy control division initiated and supported in forming the network of people affected by
leprosy in Nepal at national level. This initiative brought several organizations of people affected by
leprosy together and empowered them to widen their involvement and participation of people affected
by leprosy in various leprosy related programmes and activities. This initiative was highly appreciated by
the people affected with leprosy and the partners working in leprosy in Nepal.
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162
On-site coaching, education and management at local level in leprosy endemic districts
On-site coaching was organized in Rupandehi and Kapilvastu districts. Personnel from SHPs, HPS and
PHC met at Ilaka level to compile and aggregate data, discuss problems faced in the field visits and to
share their experiences. Facilitator from LCD, district regional health directorates and supporting
partners assisted the staff in these meeting.
Coordination meeting with partners

During this fiscal year, the leprosy control division organized/held coordination meetings among the
partners working in leprosy In Nepal. Two such meetings were held in LCD with participation from
partners like WHO, NLR, Leprosy Mission Nepal (LMN), Nepal Leprosy Trust(NLT), International Nepal
Fellowship (INF), BIKASH Nepal, Partnership for New Life(PNL), Nepal Leprosy Fellowship (NLF) Nepal
Leprosy Relief Association (NELRA), Sewa Kendra, Shanti Sewa Griha, Rehabilitation, Empowerment And
Development (READ) Nepal, IDEA Nepal and government institutions.
Surveillance
An initiation has been taken to collect detail information on leprosy cases from low endemic districts. A
surveillance form has been designed and included in new programme guidelines. The districts are
expected to collect detail information about the cases by using the surveillance form which will help
generate socio-demographic and epidemiological information. Further strengthening of this system is
needed to collect timely and quality information in the coming years.
Reporting of relapse cases

Though relapse of leprosy cases after completing a standard and recommended course of treatment is
quite rare, the programme reported 8 laboratory confirmed cases of relapse. Anandaban hospital has
been serving as a sentinel surveillance site of drug resistance in Nepal. Any suspected case of relapse
should be referred to this site for confirmation of the resistance and relapse.
Leprosy Post Exposure Prophylaxis (LPEP) for leprosy contacts
Orientation and capacity building training on Leprosy post exposure prophylaxis to health workers was
conducted in Dhanusa, Parsa, Jhapa, Banke and Morang districts. The LPEP aims to test the feasibility and
effectiveness of a single dose rifampicin as leprosy post-exposure prophylaxis. Rifampicin is given to contacts of
newly diagnosed leprosy patients to decrease their risk of developing leprosy. LPEP programme had been already
initiated in Morang, Jhapa and Parsa districts and this service is planned to be extended in other districts like
Dhanusa, Kapilvastu, etc in the years to come.
The inauguration of LPEP in Morang, Sivsani Jahada VDC, was done by giving first dose of rifampicine by honorable
Secretary Mr. Shanta Bahadur Shrestha from MoH and Dr. Basu Dev Pandey, Director of LCD on Jestha 12, 2072
(May 26. 2015).
Activities supported by different partners

Activities Supported by WHO

MDT drug supply

Technical support for leprosy control programme
Supervision and monitoring
Capacity building activities
Leprosy day observation
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163
Active case detection programme

Community awareness programme
Activities supported by partners (NLR, LMN, NLT, INF etc.)
Following activities were carried out in high endemic districts with the assistance from
supporting partner/s:
Community awareness & participatory program at different level.
Orientation of different community member's
Provision of Primary, secondary and tertiary care through referral centers.
Capacity building activities for government health staff.
Technical support through joint supervision and monitoring.
POID & Rehabilitation service.
Formation of self care and self help groups of people affected by leprosy or people living
with disabilities due to leprosy.

Figure 1:District-wise leprosy prevalence in FY 2071/72 (2014/15)
Prevalence
At the end of the FY 2071/72 (2014/15), there were 2461 leprosy cases receiving MDT in the country,
which makes the registered prevalence rate of 0.89/10,000 populations at national level. This rate is
well below the cut-off point of below 1 case per 10,000 population set by WHO to measure the
elimination of leprosy as public health problem. Thus the national programme has sustained the status
of elimination of leprosy as public health problem achieved at the end of 2009. There is minimal
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164
increase in PR as compared to previous year (i.e. 0.83 in FY 2070/71). Six districts reported zero
prevalence rate.
Region wise, the highest number of leprosy cases under treatment was reported from the central
development region with 956 cases (38.85% of total) followed by eastern development region with 565
(22.96%) cases under treatment. Though far western developmental region reported the least number
(178) and share (7.23%) of total cases under treatment, the registered prevalence rate (RPR) was the
highest in the eastern region (0.94/10,000 population) followed by central region (0.93/10000
population). Region wise registered prevalence rate are shown in the table below.

Table 5: Region-wise distribution of registered cases and prevalence rates (RPR) in FY 2071/72

Regions
MB
345
581
330
242
143
1641
EDR
CDR
WDR
MWDR
FWDR
National
Source:LCD, DoHS
No. of registered prevalence cases at the end of the year

PB
Total
%
PR/ 10,000
220
565
22.96
0.94
375
956
38.85
0.93
95
425
17.27
0.84
95
337
13.69
0.91
35
178
7.23
0.66
820
2461
100
0.89
Figure 2: Region-wise under treatment cases FY 2071/72
Paeents at the End of this Fiscal Year

Eastern
Central
337, 14%
178,
7%
Western
Midwest
Farwest
565, 23%
425, 17%
956, 39%
Nalonal =2461

During this reporting year, 15 districts reported PR more than 1 case per 10,000 population. The number
of districts has decreased than previous year reporting of 16 districts with PR>1. All these 15 districts
are in the Terai regions bordering Bihar and UP states of India. District wise, Dhanusa reported the
highest PR of 2.48/10,000 population after Bardiya, Sarlahi, Jhapa and others. The figure below shows
the district wise PR in endemic districts.
154
165
Figure 3: Districts with PR above 1 per 10,000 population

Dhanusa
Bardiya
Sarlahi
Jhapa
Kapilvastu
Parsa
Banke
Mahonari
Rautahat
Morang
Bara
Rupendehi
Saptahari
Kailali
Sunsari
2.48
2.08
1.98
1.93
1.8
1.79
1.78
1.72
1.47
1.46
1.45
1.34
1.13
1.07
1.02
0
0.5
1.5
2.5
New case detection

Detection of new cases signifies ongoing transmission of leprosy and the rate measured per hundred
thousand populations helps monitoring the progress towards control. 3053 new leprosy cases were
detected during this reporting year (2071/72), which has slightly decrease in number of cases. Region
wise, the highest number was reported from CDR with 1209 cases followed by EDR, WDR, MDR and
FWDR with 807, 447, 364 and 226 new cases respectively.
Figure 4: Region-wise new cases in FY 2071/72
226, 7%
364, 12%
807, 26%
Eastern
447, 15%
Central
Western
1209, 40%
Midwest
Farwest
Naeonal=3053

155
166
The new case detection rate (NCDR) per 100,000 populations for FY 2071/72 was 11.01 nationally,
whereas EDR reported the highest rate among the regions with NCDR 13.43. More than 86 percent of
the new cases were detected from Terai districts alone.
By type, 53.42% of these new cases were Multi Bacillary (MB) and the rest were Pauci Bacillary (PB). This
proportion has constantly remained around fifty percent for the last several years, however MB cases
had slightly increased this year. By region, western region has the highest MB proportion (63.76%)
followed by Mid-western region (62.64%) and the lowest proportion was seen in Central region with
48.06%. Nearly one third (36.03%) of the new cases were female. Female proportion had remained
consistently around thirty percent for the last 5 years (from 2065/66-2071/72). Likewise, children
constituted 7.73% of the total new cases detected in this reporting year which has also increased as
compared to previous fiscal year record (i.e. 6.33%). The increase in child cases signifies ongoing
transmission of leprosy is still prevalent in the community.

Figure 5: Districts which have more than 10 NCDR per 100,000 population FY 2071/72

District wise, nine mountain and hilly districts reported zero new cases during this year. But there are 19
districts which have more than 10 NCDR. Out of them; Dhanusa has the highest NCDR (i.e.
38.66/100,000).

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167
Figure 6: NCDR Trend per 100,000 population 2065/66-2071/72

Table 2: New cases and proportions among new
New Cases
NCDR/
Region
100,000
MB
PB
Total
EDR
399
408
807
13.43
CDR
581
628
1209
11.82
WDR
285
162
447
8.82
MWDR
228
136
364
9.75
FWDR
138
88
226
8.42
National 1631 1422 3053
11.01
Proportion among new cases

Female
Child
G2D
319(39.52%)
61 (7.56%)
47 (5.82%)
366 (30.27%) 128 (10.59%) 48 (3.97%)
222 (49.66%)
15 (3.36%)
8 (1.79%)
143 (39.29%)
25 (6.87%)
14 (3.85%)
50 (22.12%)
7 (3.10%)
18 (7.96%)
1100 (36.03%) 236 (7.73%) 135 (4.42%)
Source:LCD, DoHS
Trend in new case detection and prevalence

Both the new case detection and registered cases have not much changed since last six years. Looking
into the PR trend of last six years, it was suddenly going down in 2066/67 and has consistently
maintained the elimination status since last six years.

Figure 7: Trend in NCDR and PR from 2064/65-2071/72
25
1.42
1.4
19.9
20
PR/10000
1.2
1
0.8
16.7
1.09
0.6
0.77
0.79
11.5
11.2
0.4
157
168
0.82
0.83
12.2
11.9
11.8
0.89
11.01
15
10
5
0.2
0
0.85
NCDR/100000
1.6
PR
64/65
65/66
66/67
67/68
NCDR
68/69
69/70
70/71
71/72
Region wise, Eastern region reported the highest prevalence rate (0.94/10,000 population) followed by
Central, Midwestern, Western and Far Western regions respectively. Three regions (Eastern, Central and
Midwestern) have observed an increase in the trend as compared to the last reporting year however
Western region's PR rate is similar to that of previous year. Six-year trend in registered prevalence rate
by region is given in the table below.
Table 3: Region wise trend in prevalence rate from 2065/66 2070/71
Regions
2066/67
2067/68
2068/69
2069/70
0.92
0.87
0.89
0.90
EDR
0.79
0.82
0.86
0.87
CDR
0.68
0.64
0.70
0.76
WDR
0.48
0.72
0.92
0.80
MWDR
0.88
0.91
0.94
0.81
FWDR
National
0.77
0.79
0.85
0.84
2070/71
0.93
0.80
0.84
0.81
0.73
0.83
2071/72
0.94
0.93
0.84
0.90
0.66
0.89
Source:LCD, DoHS
Relapse cases
The information of relapse of leprosy cases are mentioned in below table. This fiscal year, relapse cases
had reduced as compared to last fiscal year. Anandaban hospital is only one designated sentimental site
for lab confirmation for relapse case.
Table 4: Trend in relapse cases for last three fiscal years
2067/68
2068/69
2069/70
20
25
14
2070/71
11
2071/72
8
Disability
If not detected early and not timely and completely treated, leprosy variably results into disability of
varied degree and type. Thus early detection and timely and complete treatment is very crucial for
prevention of disability due to leprosy. Proportion of Grade II Disability (G2D) among new cases and rate
per hundred thousand populations are major monitoring indicators of early case detection. During this
reporting year, 135 cases of visible disability (G2D) were recorded and its proportion among new cases
was 4.42% nationally and by region it was the highest in Far Western regions (7.96%) and the lowest in
Western region (1.79%).
Figure 8:Region-wise proportion of G2D among new cases in 2071/72
7.96
10.00
5.82
5.00
0.00
3.97
4.42
3.85
1.79
EDR
CDR
WDR
MWDR
FWDR
Nalonal

The G2D proportion among new cases has been fluctuating within 2 to 4 percent since last 6 years and
it has increased this fiscal year as compared to last years report.
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169
Figure 9: Fig 7: Trend in proportion of G2D among new cases from 2066/67 to 2071/72
4.42
3.47
2.72
3.38
3.16
2.89
2068/69
2069/70
2
1
0
2066/67
2067/68
2070/71
2071/72
Child cases
A total of 236 new child cases were diagnosed during the Fiscal Year 2071/72. The proportion of child
cases among new cases is 7.73% for this fiscal year. The trend reflects that child proportion is fluctuating
and has increased this fiscal year as compared to last year.
Figure 10: Trend in child Proportion among new for last 6 years (2066/67-2071/72)
8
7.73
6.71
6.33
6.26
5.19
4.18
4
2
0
2066/67
2067/68
2068/69
2069/70
2070/71
2071/72
Outcome of the registered cases

A total of 2800 (MB=1490 and PB=1310) cases had completed treatment and were released from
treatment. The remaining cases are undergoing treatment. Total transferred out cases were 32, number
of defaulter cases was 38 and other deductions were 146 (other than defaulters and transferred outs),
which include death, double registration, recycle, foreign cases and wrong diagnosis. The number of
patients who restarted MDT in the current year was 73. (See annexes for detail information on district,
regional & national level data for segregated data).
Table 5: Number of cases released from treatment (RFT), by region in 2071/72
Region
EDR
CDR
WDR
MWDR
FWDR
National
MB
391
486
293
208
112
1490
PB
376
570
144
107
113
1310
Total
767
1056
437
315
225
2800
Source:LCD, DoHS

159
170
Table 6: Comparison of leprosy indicators (year-wise from 2066/67 2071/72)

Data/Indicators

New patients
NCDR
UT at the end
RPR/10,000
No. of New child
Child proportion
No of G2D
G2D Proportion
G2D rate/100,000
No of female
Female proportion
RFT
No of defaulters
No of relapse
066/67
067/68
(2009/10) (2010/11)
3157
3142
11.5
11.2
2104
2210
0.77
0.79
212
163
6.71
5.19
86
109
2.72
3.47
0.31
0.39
1030
892
32.6
28.4
3844
2979
25
31
18
20
068/69
(2011/12)
3481
12.2
2430
0.85
218
6.26
110
3.16
0.39
1100
31.6
3190
24
25
069/70
(2012/13)
3253
11.9
2228
0.82
136
4.24
94
2.89
0.35
1004
30.8
3374
43
14
070/71
(2013/14)
3223
11.18
2271
0.83
204
6.33
109
3.38
0.40
1143
35.46
3187
24
11
071/72
(2014/15)
3053
11.01
2461
0.89
236
7.73
135
4.42
0.49
1100
36.03
2800
38
8
Source:LCD, DoHS

Some reasons of decrease in new cases and prevalence
A field verification and validation of records and cases were performed in the current fiscal year. The
retrospective data verification and case validation activity was conducted in endemic districts of terai.

Over holding of cases/RFT due
Recycled cases/double registration
Local address given to cross border cases
Impression
Sustained elimination but overall prevalence has slightly increased as compared to last fiscal
year
15 districts have prevalence above 1 case/10,000 populations which was in 16 districts last year
Increased proportion of Grade 2 Disability
Good coordination exists with partners

Strength, weakness, challenges and way forward
Strength
Commitment from political level Ministers commitment towards Bangkok Declaration for
Leprosy
Trained manpower serving in all health facilities.
Accessible network of public health and services provided by partner organizations.
Free MDT and other services
Regular review meetings
Uninterrupted MDT supply
Good communication and collaboration among supporting partners
Participation of Leprosy affected in the national programme has been improving
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171
Steering, coordination and technical committees are formed in last F/Y and conducting meeting
in regular basis.
Focus has been given to medical & community based rehabilitation (MCBR)
Weaknesses
Low priority to leprosy program at periphery.
Low motivation of health workers
District and regional focal persons are overburdened with TB programme
Very few activities on rehabilitation
Inadequate training and orientation (eg: CLT, BLT, CBR) for health workers, focal persons and
managers
Poor institutional set-up and inadequate human resources at central level

Challenges
To sustain the achievement of elimination at national level and further reduce disease burden
To maintain access/quality of services in low endemic mountain & hilly districts.
To strengthen surveillance, drug supply, logistic, information, and job oriented capacity-building
for general health workers and an efficient referral network.
To assess the magnitude of the disability burden due to leprosy.
To further reduce stigma and discrimination against affected persons and their families.
Information sharing and integration of leprosy services in private sector, including medical
colleges.
Possibility of recycled cases registered in medical colleges, central hospitals & referral centers

Future course of action and opportunities

161
172
Policy related issues to be addressed by MoH.

Implementation of national strategy within ministry and through partners.
Use of/follow national operational guideline as per new strategy.
Intensify IEC activities to raise community awareness on leprosy: early diagnosis and treatment,
prevention of disability, rehabilitation, and social benefits.
Strengthen early case detection activities- focus in some VDCs of high endemic districts.
Establish and strengthen cross notification and information sharing on cross border cases.
Promote community participation in National Leprosy Elimination Program.
Improve access of unreached, marginalized and vulnerable groups to leprosy services.
Strengthen greater and meaningful involvement of people affected by leprosy in leprosy
services and programmes.
Capacity building of health workers for early case detection, management and community based
rehabilitation.
Strengthen functional integration of leprosy services in remaining areas
Use of available resources and infrastructure for other services, eg: lymphatic filariasis,
geriatrics, diabetes and other NTDs & disabilities.
Operational research studies in high endemic districts and pockets on specific issues for quality
services
High time to start chemoprophylaxis and immunoprophylaxis (one, either or both) to protect
the contacts and break the transmission
Vocational education and training and income generation activities to people affected by
leprosy and their families
Ensure resource mobilization, partnership and participation of local government and
collaboration with new partners, institutions and individuals for leprosy services and
rehabilitation
Strengthen capacity of leprosy control division for effective implementation of national policy
and strategies and quality services
Innovative activities for efficient utilization of resources, services and management Efficient use
of health management information system and strengthening e-health
Strengthen surveillance in low endemic districts and areas
Evidence based (laboratory confirmed) reporting of relapse through utilization of available
resource
Address cross border issues
Sustaining the newly initiated program and service e.g. satellite services, interaction with
medical college hospitals, joint monitoring, training & observation in partnership approach with
the Government.
Strengthening of referral hospital (efficiency, quality service in zonal hospitals that were handed
over) & proper referral mechanism.
Web based Leprosy reporting and management system has been developed to support HMIS in
recording and reporting of leprosy patients.
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173
DiseaseControl:HIV/AIDSandSTI
4.11HIV/AIDSandSTI
1.1Background
WiththefirstcaseofHIVidentificationin1988,NepalstarteditspolicyresponsetotheepidemicofHIV
through its firstNational Policy on Acquired Immunity Deficiency Syndrome (AIDS) and Sexually
TransmittedDisease(STD)Control,1995(2052BS).TakingthedynamicnatureoftheepidemicofHIVinto
consideration, Nepal revisited its first national policy on 1995 and endorsed a latest version: National
PolicyonHumanImmunodeficiencyVirus(HIV)andSexuallyTransmittedInfections(STI),2011.Basedon
the latest national policy, the country now is implementing its fourth National HIV/AIDS Strategy (2011
2016).Anewnationalstrategyfor20162021iscurrentlyundertheprocessofformulationwhichwillpave
thewaystoachieveambitiousglobalgoalsof909090.
1.1.2OverviewoftheEpidemic
Starting from a low level epidemic over the period of time; HIV, in Nepal, evolved itself to become a
concentrated epidemic among key affected populations (KAPs), notably with People who Inject Drug
(PWID), Men who have Sex with Men (MSM) and Transgender (TG) People. A review of the latest
epidemiologicaldata,however,indicatesthattheepidemictransmissionofHIVhashaltedinNepal(Error!
Reference source not found.). The trend of new infections is evidently taking a descending trajectory,
reachingitspeakduring 20012002.Theepidemic thatpeakedin2000with almost8,000newcasesina
calendaryearhasdeclinedtoabout1493newHIVinfectionsin2014.Thisdeclineisfurtheraccompanied
bythedecreasing trend of estimated new HIV infections occurring annually in Nepal as shown in Error!
Referencesourcenotfound.1below.
Figure1:EstimatedHIVinfectionsamongadultaged1549years,19852020
0.6
HIVPrevalence
0.5
0.4
0.28
0.3
0.2
0.2
0.1
0.13
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
AdultMale(15+)
AdultFemale(15+)
TotalAdults(15+)
Thisprevalencehasdroppedfrom0.42%(highestlevelprojectedin2004),andisexpectedtomaintaina
plateauat0.2%from2014through2020withcurrentlevelofefforts.Alongwiththat,thenewinfections
have reduced significantly in the last one decade (7,500 in 2003 to 1493 in 2014: about a reduction by
80%).Overall,theepidemicislargelydrivenbysexualtransmissionthataccountsformorethan85%ofthe
totalnewHIVinfections.Makingup5%ofthetotalestimatedpopulationof39.249,thereareabout1,968
childrenagedupto14yearsarelivingwithHIVinNepalin2014,whiletheadultsaged15yearsandabove
accountfor95%.Withanepidemicthathasexistedformorethantwodecades,thereare8,413infections
estimated among population aged 50 years and above (21.4%). By sex, males account for twothirds
(64.8%)oftheinfectionsandtheremainingmorethanonethird(35.2%)ofinfectionsareinfemales,out
of which around 82% are in the reproductive age group of 1549 years (Error! Reference source not
174
163
found.2).Themaletofemalesexratiooftotalinfectioncamedownfrom2.15of2006to0.54fortheyear
2014.
Figure2:EstimatedHIVinfectionsbyageandsexin2014
Figure3:EstimatedHIVinfectionsbyagegroup,2014
20,000
Male
16,818
Female
Number
15,000
10,222
10,000
5,000
6,889
1,013
955
730
1,524
1,099
014years
1524years
2549years
50+years
Figure3:DistributionofHIVinfectionsamongkeyaffectedpopulationsinNepal,19802020
AmongtheKAPsofHIVaged1549,theHIVinfectionsaredistributedasjustifyheterosexualtransmission
isthemajorroutineoftransmissioninthetotalpoolofHIVinfectioninNepal.Thecontributionfromall
bandsofKAPsaresimilarintheperiodofprojection19952020,onlythelevelisvarying.
In 2014, 95% of the total infection

distributed among the population having Figure4:DistributionofpopulationwithHIVinfection
age group 15 years and above. The among15yearsandabovein2014
estimates indicate that 26% of total
FSW
MSW&
1%
infections are distributed among PWID
Client TGSW
3%
6%
(8%),MSWs,TG(3%)andtheirclients(6%),
LowRisk
PWIDs
Males
MSM (8%), and FSWs (1%) (Error!
MSM 8%
(including
8%
Reference source not found.4). These
MLM)
40%
apart, low risk males including MLM
LowRisk
account for 40 %and low risk females
Females
34%
account for 34% of the remaining
N=37,281
infections.The estimated number of annual

Source:NCASC2014
AIDS deaths of all ages is estimated to be

around2,576for2014.
164175
Apart from ministries,a number of District Development Committees (DDCs) have been allocating
resourcesfortheissueofHIVincludingformaintenanceofhumanresourcesofDACCandHIVfocalperson
for many years. Many Village Development Committees (VDCs) particularly of Far West and MidWest
havealsocontributedtheirresourcesforthewellnessoffamiliesaffectedbyHIV.
Civil societies have also played pivotal roles in the national response. Civil societies, through
empowermentofKAPs,havebeenplayinginstrumentalrolesinprevention,treatmentcareandsupportas
wellasbringingaboutchangesinlegalandpolicyenvironmentthroughadvocacy.
ThenationalresponsetoHIVinNepalisequallysupportedbyexternaldevelopmentpartnersbyproviding
asubstantialamountofresourcesrequiredforcombatingHIV.TheGlobalFund,bilateralagencies,namely
United States Agency for International Development (USAID) and GermanysAgency for International
Development (GIZ), UN agencies, pooled fund partners of NHSPII (the World Bank, Department for
International Development (DfID), Australian Agency for International Development (AusAID), Kfw and
AIDSHealthCareFoundation(AHF)throughSectorWideApproach(SWAp)onHIV/AIDSandINGOsarethe
externalsourcesthatarecontributingtothenationalHIVresponse.
2:PolicyEnvironmentandProgressinNationalHIVResponse
2.1Introduction
More than two decades of the HIV epidemic has transpired Nepal to respond with a number of policy
initiatives. These policy responses have come cross cuttingly from the health sector as well as other
developmentsectorsaimingatcreatinganenablingpolicyenvironmentforthecontainmentofHIVaswell
asmitigationoftheepidemic.NotablepolicydevelopmentstakenforguidingthenationalresponsetoHIV
arespelledouthere.
TheNationalPolicyonHIVandSTI,2011
TheNationalPolicyonHIVandSTI,2011accordsHIVandAIDSahighpriorityinthenationaldevelopment
issues. It emphasizes for a multisectoral, decentralized and inclusive response based on three ones
principlethat premises upon: a) One agreed HIV/AIDS Action Framework that provides the basis for
coordinatingtheworkofallpartners,b)OneNationalAIDSCoordinatingAuthority,and;c)Oneagreed
country level Monitoring and Evaluation System. Thus it is through this adherence to the three ones
principle the nation strives to achieve joint effort and partnership between government, non
government,privatesectorandcivilsociety.
TheNationalHealthSectorPlan(NHSPII20102015)
TheNationalHealthSectorPlan(NHSPII20102015)embracesaplantohaltorreversetheHIVprevalence
anditisalsocommittedtoscaleupHIVrelatedinterventionthroughthehealthsectorundertheessential
healthcarepackagewithinthebroaderframeworkofcommunicablediseases.Ithasalsorecognizedthe
needtoscaleupsexualandreproductivehealth(SRH)servicesandintegrateHIVintoSRHservices.
NationalHIV/AIDSStrategy20112016
ThecurrentNationalHIV/AIDSStrategy(20112016),thefourthnationalstrategy,withtheaimofmeeting
thenationalgoalofachievinguniversalaccesstoHIVprevention,and;treatmentcareandsupport,hasset
thethreeobjectives:i)toreduceHIVinfectionsby50%by2016,ii)toreduceHIVrelateddeathsby25%by
2016, and; iii) to reduce new HIV infections in children by 90% by 2016. The current National Strategy
embraces two critical programme strategies: i) HIV prevention and ii) treatment care and support for
infectedandaffected.Apartfromtheseprogrammestrategies,fourmajorcrosscuttingstrategies;namely:
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i)healthsystemstrengthening,ii)legalreformandhumanrights,iii)communitysystemstrengthening;and
iv)strategicinformationhavebeenbuiltintothiscurrentNationalHIV/AIDStoensuretheachievementof
programmatic outcomes. This National Strategy subscribes to the guiding principles of universal access,
rightbasedapproach,meaningfulinvolvementofpeoplelivingwithHIV,andmultisectoralresponse.
TheformulationprocessofnewHIVstrategyfor20162021hasalreadybeeninitiated.
OtherSectoralPlanandPolicies
AnumberofsectoralplansandstrategiessuchasEducationforAll,SchoolSectorReformPlan(20092015)
andNationalYouthPolicyhaveenvisagedtheircomplementaryrolesinaneffectivenationalresponseto
HIV. Several other policies; notably National Policy on HIV in the Workplace (2007) and National Drug
Control Policy (2006) have reinforced the national HIV response working together with that National
Strategy (2011 2016). These apart, enactments of the 2006 Gender Equality Act, and the 2007 Human
Trafficking and Transportation (Control) Act have also yielded reinforcing impacts in the ushering of an
inclusiveenvironmenttoguidethenationalresponsetoHIV.
KeyGuidelinesandDocuments
Withtheaimofeffectiveimplementationofthenationalresponse,anumberofnationalguidelinesalso
havebeenputintooperation.Theseinclude"TheconsolidatedguidelineontreatingandpreventingHIVin
Nepal, 2014" , National Guidelines on Monitoring and Evaluation of HIV Response in Nepal, 2012, and
NationalGuidelinesofCaseManagementofSexuallyTransmittedInfections(STIs)2014.
2.2Policyrelatedactivities/highlightsfromFY071/072
MovingalongthelinesofNationalStrategy(20112016),acoupleofmilestoneactivitieshavebeentaken
in this fiscal yearthat helped ensure the national HIV response is abreast with thelatest scientific
advancementsaswellasfinetunedtothelatestdynamicsofHIVinthecountry.Thesemilestonesare(a),
Nepal HIV Investment Plan (NHIP 20142016) and (b) the Midterm Review of Implementation toward
achievingobjectivesofNationalHIV/AIDSStrategy,(20112016).ThoughtheMidtermReviewofNational
Strategy was not a policy initiative by any means but it fed into NHIP. This apart, following the
recommendation of the Midterm review, aiming at elimination of mother to child transmission, Nepal
takesamajortransformativemeasurethisfiscalyearandadherestoOptionB+forprovidinglifelongART
for all identified pregnant women and breastfeeding mothers with HIV, regardless of CD4 along with
prophylaxistreatmentfortheirinfantsaswell.
NepalHIVInvestmentPlan20142016(NHIP20142016)
Built on the principles of UNAIDS Investment Framework and that of National Strategy 2011 2016, the
Nepal HIV Investment Plan, 20142016 serves as a compelling case for strategic investments in Nepals
response to HIV. With the inclusion of a three year operational plan and budget, NHIP will guide the
implementationofNationalStrategy,20112016fortheperiodof20142016.ThisNHIPaimstoensure
that the resources are concurrent with Nepals HIV program objectives and goals, and contribute to the
effectivenessandefficiencyoftheentirenationalHIVresponse.
OtherKeyGuidelines
NationalguidelinesonamonitoringsystemforHIVDrugResistance(HDR)EarlyWarningIndicators2014
(EWIs) have been prepared and put into operation during the Fiscal Year of 2071/72.Asingle and
comprehensive document of consolidated guidelines encompassing treatment care and support, HIV
testingandconseling(HTC)andPMTCT,ispreparedundertheleadershipofNCASCwithsupportofother
organizationssuchasWorldHealthOrganization(WHO),UNICEFandSaathSaathProject.
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3:HIVTestingandCounselingandSTIManagement
3.1Introduction
Pursuanttoitsgoalofachievinguniversalaccesstoprevention,treatmentcareandsupport,HIVTesting
andCounseling(HTC)hasbeenastrategicfocusinthenationalresponsetoHIVeversinceNepalstartedits
response to HIV. The first ever HTC was started in 1995 with the approach of voluntary ClientInitiated
TestingandCounseling(CITC).MovingfurtherfromitspreviousapproachofvoluntaryCITC,thenational
HIV testing and counseling program has been later widened to include ProviderInitiated Testing and
Counseling (PITC), as well as CITC as crucial components of the nations fight against HIV. With the
expansion of HTC sites across the country, there has been parallel development. National Guidelines on
HTCwasformulatedin2003andupdatedin2007,2009and2011andlaterontheseparateguidelineis
merged as comprehensive guideline on treating and preventing HIV in 2014. Human resources for HTC
havebeentrainedforpublichealthfacilitiesaswellasNGOsrunHTCsites.
Along with HTCs, detection and management of Sexually Transmitted Infections (STIs) has been also a
strategicfocusandintegralpartofthenationalresponsetoHIVeversinceNepalstarteditsresponseto
HIV.Overtheyears,STIclinicshavebeenoperatingacrossthecountrymaintainingtheirlinkagetoKAPson
thebasisoftheNationalSTICaseManagementguidelinewhichwasdevelopedin1995andalsorevisedin
2009and2014.
3.2Keystrategiesandactivities
HIVTestingandCounseling
TheNationalStrategy(20112016)envisionsrapidscalingupoftestingservicesandmobileHTCservicesin
anonduplicatedmannerintargetedlocationsinacosteffectivewaytoensuremaximumutilizationwith
strong referral linkage to higher level for treatment, care and support. The National Strategy further
foreseesthatthepublichealthsystemwillgraduallytakeupHIVtestingandcounselingasintegralpartof
thegovernmenthealthcareserviceby2015.
Pursuant to key actions of the National Strategy, the Government of Nepal is promoting the uptake of
counseling andtesting among KAPs through targeted communications andlinkages between community
outreachandHTC.LikewiseProviderInitiatedTestingandCounseling(PITC)hasbeentakentoSTIclinics,
antenatalClinic(ANC),childbirth,postpartum,FamilyPlanning,andTBservices.Thusinthiscontext,the
nationalresponse,overtheyears,hasseenanexpandingcoverageofHTCwithHTCseveringasanentry
pointto:
Early access to effective medical care (including ARV therapy, treatment of opportunistic
infections(OIs),preventivetherapyfortuberculosisandotherOIandSTIs;
ReductionofmothertochildtransmissionofHIV;
Emotionalcare(individual,coupleandfamily);
Referraltosocialsupportandpeersupport;
Improvedcopingandplanningforthefuture;
NormalisationofHIVinsociety(reductionofstigmaanddiscrimination);
Familyplanningandcontraceptiveservices;and
ManagingTB/HIVcoinfection.
DetectionandManagementofSTI
In the context of detection and management of STI, the standardization of quality STI diagnosis and
treatmentuptohealthpostandsubhealthpostlevelasapartofprimaryhealthcareserviceshasbeena
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Annual Report 2071/72 (2014/2015)
keystrategyinthenationalresponsetoHIV.Thisstrategyfurtherforeseesstandardizationofsyndromic
approachwiththereferralforetiologicaltreatmentwhenneeded.
Strengthening documented linkages (referral of follow up mechanisms) between behavioral change
communication(BCC)servicesandHIVtestingandcounseling,includingstrengtheningoflinkagebetween
HTCandSTIserviceshasbeenoneofkeyactionsinthecontextoftheconcentratedepidemicofNepal.
3.3ProgressandAchievement
HIVTestingandCounseling
Currently there are 235HIV Testing and Counseling sites that include103nongovernment sites and 130
government sites operating in the country also maintaining their forward linkages with KAPs as well as
backwardlinkageswithARTsitesaswellasPMTCTsites.Thetrendofprogrammaticdataofpeoplewho
weretestedandcounseledoverthelastthreeyearsisshowedinTable1
Table1:ServiceStatisticsHIVTestingandCounselingfortheperiodofBS2069/702071/72
Indicators
2069/70
2070/71
2071/72
TotaltestedforHIV
TotalPositivereported
CummulativeHIVreportedcases
272,926
2,411
22,994
297,840
2,228
25,222
2,64,081
1,480
26,702
Source:NCASC
3.4Keychallenges/Issuesandrecommendations
Issues
HugedatagapisfoundinHIVprogram
especiallythereportfromhospitals
(Regional/Subregional,zonalanddistrict)isyet
tobecoveredintheelectronicHMISsystem.
AllHTCsitesunderNGOsettingarenotcovered
byHMISdatabasesystem.Thereportingfrom
theworkingNGOyettobecoveredinthe
electronicHMISsystem.
LowHIVtestingcoverageamongKAPshasbeen
alongstandingchallengeintheresponsetoHIV.
Theproblemoflowcoverageismostprominent
forthereturninglabormigrantsamongallKAPs.
Recommendations
CoordinationbetweenDPHOandhospitalsshould
bestrengthened.
CoordinationbetweenDPHOorHMISandNGO
shouldbestrengthened.AlltheworkingNGOmust
beenlistedinthesystem.Sothat,thetotaltesting
numberscouldbeincorporated.
Effective roll out of Communityled HIV Testing
andTreatmentCompetence(CTTC)approachwith
strong monitoring should be in place.Provide
testing facilities at transit points as well as
destinationsofmigrantpopulation.
Inadequate staff members especially of trained Ensure adequate trained HIV counselors in a
HIV counselors in government setting specially sustainablemannerinallrelevantservicesites.
inPMTCTsite.
Consistently zero counseled and tested in Conductareviewforviabilityofsuchsites.
amongsomeservicesitesovertheyears.
The serive gap among the key population that The service need to be revived to increase the
wassupportedunderpoolfund
testingcoverageamongthekeypopulation.
168179
4:PreventionofMothertoChildTransmission
4.1Introduction
Nepal started its Prevention of Mother to Child Transmission (PMTCT) program in 2005 with setting up
three of sites at: 1) B. P. Koirala Institute of Health Science (BPKIHS), Dharan; 2) Maternity Hospital,
Kathmanduand;3)BheriZonalHospital,Nepalgunj.Movingfurtherinthisdirection,apartfromthefree
provision of maternal ART and prophylaxis for infants, the National Guidelines on PMTCT have been
developedandupdatedperiodically.Humanresourcesespeciallyfrommaternalandchildhealthcarehave
beentrainedinalignmentwithPMTCTservices.Alongwiththatthepreparationandupdatingoftraining
manualshavetakenplace.Thisapart,HIVcounsrelingandscreeninghasbeenincorporatedintomaternal
and child health care in the form of PITC. Tailoring to the needs of HIV infected infants as well as HIV
exposedbabies;counselingandinformationoninfantfeedinghavebeenadjustedaccordingly.
Taking MothertoChild Transmission (MTCT) is a potentially large source of HIV infections in children in
Nepal into consideration, National Strategy, aims at reducing 90% of new infections among children by
2016 compared to the baseline value of 2010. In the cognizance of a very low coverage of PMTCT, the
current National Strategy envisages the PMTCT programme to be integrated and delivered through
ReproductiveHealth(RH)andChildHealthServices.TheNationalStrategyalsoforeseestheintegrationof
PMTCT into RH Programme placing it under the aegis of Family Health Division (FHD). The National
StrategyhasstructuredthePMTCTprogrammearoundthefollowingcomprehensiveandintegratedfour
prongapproach:
PrimarypreventionofHIVtransmission
PreventionofunintendedpregnanciesamongwomenlivingwithHIV
PreventionofHIVtransmissionfromwomenlivingwithHIVtotheirChildren,and
Provision of Treatment, Care and Support for women living with HIV and their children and
families.
Pursuant to the last two elements of the four prong approach, a package with the entailment of the
followingservicesarebeingprovidedtopregnantwomen:
HIVtestingandcounselingduringANC,labouranddeliveryandpostpartum
ProvisionofARVdrugstomothersandinfectedwithHIVinfection
Saferdeliverypractices
Infantfeedinginformation,counselingandsupport,and
Referralstocomprehensivetreatment,careandsocialsupportformothersandfamilieswithHIV
infection.
Withthecollaborationofcommunitybasedorganization,thegovernmentofNepallaunchedCommunity
basedPreventionofMothertoChildrenTransmission(CBPMTCT)programin2009takingPMTCTservices
beyondhospitalsandmakingtheservicesaccessibletopregnantwomenlivinginremoteareas.TheCB
PMTCTprogram,drawingtheleverageofcommunitysupport,hasfoundtohaveincreasedANCcoverage
as well as HTC uptake among pregnant women (UNICEF 2012). CBPMTCT programme have been
implemented in Achham, Kailali, Sunsari, Baitadi and Bajhang districts and later on expanded to other
districts(Dadeldhura,bardiya,SaptariandChitwan)withthesupportofUNICEF.Similarly,withthesupport
of GFATM, the program has been scaled up to Rupandehi, Kapilvastu, Arghkhanchi, Nawalparasi,
Kanchanpur,BankeandDailekh.
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DoHS,
Annual Report 2071/72 (2014/2015)
Apart from CBPMTCT program, adhering to the key actions envisaged by the National Strategy, the
country is scaling up PMTCT service synchronizing with planned ART, HTC /STI, OI services for ensuring
access to continuum of care and ART to pregnant women with HIV. Furthermore, linkages have been
established between PMTCT sites and KAP targeted intervention, Family Planning, SRH and counseling
services.
Pursuanttoitscommitmentofreducing90%ofnewinfectionsamongchildrenby2016comparedtothe
baseline value of 2010, Nepal has scaled up it PMTCT services in recent years. These services are now
offeredat95sitesin45districtsacrossthecountry.AsaresultofthisscaleupofPMTCTsites,thenumber
ofwomenattendingANCandlabourwhoweretestedandreceivedresultshasincreasedovertheyears.
Despitethisrelativeincreaseinuptake,thecoverageforPMTCTislow,andstandsataround32%forthe
year2014.ThethreeyeartrendofservicestatisticsisshowedintheTable2.
Table2:ServiceStatisticsonPMTCTinNepalfortheperiodofBS2069/702071/72
Indicators
2069/70
2070/71
2071/72
PretestCounseled(ANC&Labour)
146,309
166,618
154,588
TestedforHIV(ANC&Labour)
137,561
163,220
135,904
HIVPositivePregnantwomen
153
116
108
TotalDeliveriesbyHIV+vemothers
125
131
88
MothersreceivedprophylaxisandART
125
142
74
Babiesreceivedprophylaxis
199
198
73
(Source:NCASC)
Aimingattheeliminationofmothertochildtransmission,Nepaltakingamajortransformativemeasure
this fiscal year, adheres to Option B+ and embarks for providing lifelong ART for all identified pregnant
womenandbreastfeedingmotherswithHIV,regardlessofCD4alongwithprophylaxistreatmentfortheir
infantsaswell.Therolloutofthelifelongtreatmentaddsthebenefitsoftriplereinforcingeffectivenessto
theHIVresponse:(a)helpimprovematernalhealth(b)preventverticaltransmission;and(c)reducesexual
transmissionofHIVtosexualpartners.
EarlyInfantDiagnosis(EID)
InitiativesforEarlyInfantDiagnosis(EID)ofHIVininfantsandchildrenbelow18monthsofagehavebeen
taken with the goals a) of identifying infants early in order to provide them lifesaving ART; and b) of
facilitating early access to care and treatment in order to reduce morbidity. In this context, a
DeoxyribonucleicAcid(DNA)PolymeraseChainReaction(PCR)testingfacilityhasbeensetupatNational
Public Health Laboratory in Kathmandu.With this, as of end FY 2014/15 there were 4sites where DBS
samplearecollectedwithsupportofNPHLnamlyNPHLitself,BharatpurHospital,LumbiniZonalHospital
and Western Regional Hospital. Likewise, 5 sites are supported by USAIDfunded SSP providing for DBS
samplecollectionsuchasAchhamDistrictHospital,SetiZonalHospital,NSARCBanke,NNSWAKanchanpur
andSACTSKathmandu.Thiswascomplementedbythedevelopmentofatrainingpackageonpreparation
ofDriedBloodSample(DBS).
170181
4.4Keychallenges/Issuesandrecommendations
Issues
InadequatelaboratorypersonnelinPMTCTsites.
InadequatePMTCTsitesasaresultallANC,deliveryand
Postnatal Clinic (PNC) attendees are not getting tested
forHIV.
Reluctancytodelivercasesbecauseoftendencytorefer
thecasestoothercentresduetoinadequateknowledge
regardingPMTCT.
Recommendations
Ensure trained and adequate workforce in a
sustainablemanner
PMTCTsitesshouldbeexpandedtoadequate
number of birthing centresin districts to
capturemoreANCattendees.
Training and awareness program to staff
nurse and medical doctors should be
enhanced.
5:HIVTreatment,CareandSupportServices
5.1Introduction
With a primary aim to reduce mortality among HIVinfected patients, the government, in 2004, started
givingfreeARVdrugsinapublichospitalandthatwasfollowedbythedevelopmentoffirstevernational
guidelinesonARVtreatment.Sincethenawidearrayofactivitieshavebeencarriedoutwiththeaimof
providingTreatmentCareandSupportservicestoPeopleLivingwithHIV(PLHIV).Alongwiththeperiodic
updatingofguidelinesincludingon2012,ARTsiteshavebeensetupincreasinglyacrossthecountry.The
consolidated guideline on treating and preventing HIV, 2014 is endorsed to support the program.This
apart, necessary diagnostic and treatment related infrastructures such as CD4 machines and viral load
machineshavebeensetupindifferentpartsofthecountryforsupplementingARTmanagementprogram.
HumanresourceshavebeentrainedforTreatment,CareandSupportinparallelwiththepreparationand
updating of training guidelines. People Living with HIV have been empowered aiming at enhancing their
supplementary roles in Treatment, Care and Support. And a monitoring system for tracking treatment
adherencehasbeenputinplace.
The present National Strategy has envisaged a comprehensive set of activities for Treatment Care and
Support. Apart from optimizing HIV treatment and care for children, adolescents and adult with the
provision of ART, the National Strategy also includes the following major activities: a) preventing HIV
related illness, b) managing HIV related coinfections, d) providing Community and Home Based Care
(CHBC)forPLHIV,e)provisionofcommunitycarecenterandsocialcareunit;andf)socialprotectionfor
CABA.
With the intention of drawing more people into the bracket of treatment and thereby leveraging the
benefitsoftreatmentasprevention,NHIP(20142016)inalignmentwithUNAIDSTreatment2015and
the WHO HIV Treatment Guidelines, June 2013 (with Update in March 2014), envisages Antiretroviral
TreatmentforallpopulationgroupsthathavebeenidentifiedinNepalasbeingkeyaffected,regardlessof
CD4 count, and for these persons to remain on treatment. In this context, NHIP has further widened
eligibilityforARTenrollmentbasedonWHOTreatmentGuidelines2013andalsohasforeseenascaledup
HIV Testing initiative through a Communityled HIV Testing and Treatment Competence (CTTC)
approach.WiththeoverarchinggoalofreducingtheAIDSrelateddeathsby25%by2016comparedtothe
baselineof2010,theNationalStrategyforeseeskeyactionsthatincludebutnotlimitedto:a)scalingup
ARTservicestotargeteddistrictsandselectedPrimaryHealthcareCenters(PHCs)andteachingHospitals,
b) strengthening national capacity for Adult and Paediatric Treatment, and; c) establish linkages and
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182
integrationamongtheHIVservicesandotherhealthservicesforqualityHIVprevention,treatmentand
monitoringoftreatmentadherence,d)provisionofadherencesupportprogramthroughcommunitybased
organizationsinordertoincreaseuptakeoftheARTandactivitiesliketreatmentliteracyeducationetc.,e)
provide Cotriomoxazole prophylaxis, f) establish and strengthening linkages amongTB center and HTC,
PMTCT and ART sites., g) expand and roll out TB/HIV program. In the context of these key actions, in
addition tothefreeofcosthighlyaffectiveantiretroviraltherapy,HIVinfected patientsareoffered care
package including clinical followup monitoring; nutrition support; and TB screening along with Isoniazid
PreventiveTherapy(IPT).Moreover,thereisacommunityandhomebasedcare(CHBC)componentwhich
includes primary care of PLHIV by trained CHBC workers at homes and community settings aiming for
positiveliving,reducingstigmaanddiscrimination,andsupportingforcontinuityandadherencetoARV.
Bytheendof2014,outof10,407ofthosewhowereonART,therewere8,731retainedinthetreatment
for12monthsandamongthetotaltested(1,198)almost90%(1,086)ofPLHIVwerewiththeirviralload
suppressed (Figure5). The total cumulative number of PLHIV receiving ART by the end of fiscal year
2071/2072has reached the figure of 11,089. Over the years, there have been gradual increases in the
numberofpeopleenrollingthemselvesonARTaswellasreceivingARVs(Table3).Thenumberofpeople
whowereonARThasincreasedfrom8,546of69/70to11,089in071/72.
Out of those who are

currently on ART, 92% are
adults and remaining 8% are
children,
while
male
population makes 51%,
femalepopulation48.7%,and
remaining 0.3% are of third
gender.
Figure5:TreatmentCascadeasoftheendof2014
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
39,249
25,421
10,407
8,731
1,004
Estimated Linkageand
PLHIV Retensionon ViralLoad
Numberof enrollment receivingART ART(12 Suppression
PLHIV
toHIVcare
Months)
Table3:ARTProfileoftheperiodofFY2069/70FY2071/72
Indicators
PeoplelivingwithHIVeverenrolledonART(cumulative)
PeoplewithadvancedHIVinfectionreceivingARVs
(cumulative)
Peoplelosttofollowup(cumulative)
Peoplestoppedtreatment
Totaldeaths(cumulative)
Source:NCASC
DoHS,
Annual Report 2071/72 (2014/2015)
2069/70
11,091
2070/71
12,898
2071/72
14,745
8,546
9,818
11,089
1,055
27
1,463
1,216
30
1,834
1,530
31
2,095
172183
Report from a total of 61 ART sites across 55
Figure6:OutcomesofARTProgrammeinNepal
districts for the fiscal year 2071/72, shows that
1530,11%
14%ofthoseeverregisteredonARTdiedand10%
31,0%
have been lost to followup, while 75% are alive
ontreatment.
2095,14%
TheProgramdata(FY071/72)showedthatofallthe
patientsregisteredonARTduringtheperiod,83.7%
11089,
werestillactivelyonARTafter12monthswhile78
75%
% were still actively on ART after 24 months of
treatment.WiththeaimofsupplementingtheART
CurrentlyonART
Death
management program, 18 CD count machines
Stoppedtreatment
Losttofollowup
across 18 different ART sites are operating along
witheachviralloadtestingmachines.Theseapart,
portable CD4 counting machineshave been placed
in hilly district of western, midwestern and far western districts of Nepal to provide timely CD4 count
service to monitor ARV effectiveness that lead to support PLHIV to sustain quality and comfortable life.
With the purpose of aiding diagnosis of HIV among children below 18 months of age, Deoxyribonucleic
Acid (DNA) Polymerase Chain Reaction (PCR) testing Machine placed at the National Public Health
LaboratoryinKathmandu.
Strong bidirectional referral linkages between Community Care Centers (CCCs), Community HomeBased
Care(CHBC)SystemandARTsitestofacilitatethequalityofARTservices,especiallyinensuringadherence
and follow up of PLHIV on ART and HIVpositive mothers and infected and exposed babies, have played
important roles in enhancing ART coverage as well as maintaining this level of retention to ART. As of
2071/72,atotalof10,640havereceivedCHBCservices(Table4).Inthesamecontext58CCCacrossthe
countryhavebeendeliveringtheirservicestoPLHIV(Table5).
Table4:ServiceStatisticsonCHBCServicesinNepal,asoftheendofFY2071/72
Indicators
Numbers
NumberofPLHIVreceivedCHBCservices
10,640
NumberofPLHIVreferredforARTmanagement
3,706
NumberofPLHIVreferredformanagementofopportunityinfections
2,243
Table5:ServiceStatisticsonCCCServicesinNepalasoftheendofFY2071/72
Indicators
Numbers
NumberofCCCsitesinNepal,
NumberofPLHIVreceivedpsychosocialcounselingsupport
NumberofPLHIVreceivednutritionalsupport
NumberofPLHIVreferredformanagementofopportunityinfections
58
5,916
4,370
2,896
184
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DoHS,
Annual Report 2071/72 (2014/2015)
5Keychallenges/Issuesandrecommendations
Issues
LowaccesstoCD4CountandViral
Loadmachines
Lostordeterioratingmedical
records(RecordingandReporting)
PoorsupplyofOIsmedicinesasperdemand
Inadequatefinancialsupportfortheclients
Inadequatetrainingandstaffsworkinginthe
clinic
PoorMonitoringandSupervisionoftheART
Programs
Recomendation
Thereneedtobereliableandconsistentaccessto
viralloadtestingandCD4count.Evenin
Kathmanduonlyoneviralloadfacilityavailableand
havetothinkaboutexpanding.
Startanelectronicrecordkeepingsystemwith
backupcapability.Inaddition,creatingaclient
codingsystemwouldfacilitateimprovedrecord
keepingandcontinuitywhenclientsare
transferredinortransferredout.
ProvideconsistentsupplyofOIsmedicinesthatare
supposedtobeprovidedaccordingtotheprogram.
ThePLHIVsfacefinancialproblemsbutthereisnot
sufficinetgovernmentsupporttopayformedical
careandtreatment.Sogovernmentthinkstodo
somemechanismforthesupport.
FrequentandupdatedHIVARTrelatedtrainingand
regularmonitoringofthestaffstofollowaccording
tothenationalrecommendedguidelines.Andalso
thereshouldbeenoughstaffsforsmoothrunning
oftheprogram.
regularandfrequentmonitioringandsupervision
toallARTCentersfortheeffectivenessandefficinet
runningoftheprogram(Sitebysitevisit)
DoHS,
Annual Report 2071/72 (2014/2015)
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185
Disease Control: EYE CARE
4.12 Eye Care

4.12.1 Background

In 1999, WHO estimated that there were 45 million blind people and 135 million with low vision globally
based on the population of 1996. It was also assumed that the trend of blindness is going to be doubled
in 20 years if existing trends of increment remain persistent. Therefore, the global initiative of Vision
2020 The Right to Sight was launched in February, 1999 jointly by WHO and IAPB. The Vision 2020
provides the guidelines, targets, and strategies to be taken to reduce the prevalence of blindness in the
developing world, for elimination of avoidable blindness by the year 2020.

Nepal adopted the Vision 2020 initiative same year in September 1999. Prior to 1980, the eye care
service in the country was in very rudimentary stage. For a population of 14 million, there were only
three ophthalmologists outside the national capital Kathmandu, and only 16 hospital beds were
dedicated to eye patients in whole Nepal.

The eye care service took a great leap in the country after the Nepal Blindness Survey (1981) showed
that the magnitude of the problem of blindness prevails as a public health problem. The government eye
care infrastructure and human resource was not capable to cope with the huge magnitude of blindness
revealed. Thus, support from various national and international organizations was solicited in order to
combat the blindness in the country. A geographical sector wide approach was adopted and different
INGOs were delegated the responsibility to develop the eye care service in specified area under the
umbrella of NNJS as a partnership programme. Specific program objectives, based on that survey
results, were established and Nepal began to build the physical and human infrastructure necessary to
address the problem. Primary, secondary and tertiary level eye care facilities dedicated to the
prevention and treatment of eye diseases were established in the areas of the country with greatest
need. The program simultaneously implemented a strategy of training eye care professionals at all levels
to staff the hospitals and clinics as they become operative.

After launching of Vision 2020, the programme became more focused according to the guideline and
target provided by the Vision 2020. The disease focused strategies were adopted and various vertical
programmes for Cataract, Trachoma, Xerophthalmia, Refractive Error and Low Vision were launched.

After a decade of launching of Vision 2020, the situation analysis showed that there have been
significant improvements made by the eye care programme of Nepal. It has been taken as successful
example of NGO run eye care service at international level. The prevalence of blindness has now
reduced to 0.35% from the 0.84% in 1981. (Source: The Epidemiology of Blindness in Nepal 2012). Even
though, the prevalence of blindness has proportionately decreased by more than half compared to the
prevalence of 1981 due to population having doubled, the number of blind remains almost the same.
Now, the definition of blindness is also changing and a visual acuity (VA) of <6/60 is considered as
economic blindness. Due to advancement of technology and greater visual need of the population,
almost all eyes with VA<6/60 due to cataract are advised or patients themselves demand for surgery,
therefore, considering this magnitude, work load for the future eye care programme has to be doubled.
Now, we have been able to clear the back log of blindness among those who easily access the service
and the causes are avoidable. The remaining proportion are either the resistant cases or many of them
are with unavoidable causes and the cohort having prominent barrier to access the services. So, it
indicates that the tough road is ahead and more effective programme implementation is required. Thus,
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186

it shows that a significant improvement has been achieved in terms of blindness reduction in last
decades but still there is a lot more to be done to achieve the national goal of Vision 2020.

A significant development is also seen in terms of infrastructure development in this period; now almost
all the districts have either primary eye care centre or eye hospital. The technology adopted in eye care
practice in the country is regularly updated and of internationally accepted standards. However, most of
the eye hospitals are located either in Terai or in major cities. The service expansion in the far,
inaccessible and remote area is the challenge to be overcome in this second decade of VISION 2020
period.

In terms of human resource development, the number of Ophthalmologists, Ophthalmic Assistants,
Optometrists, Eye Care Managers, Equipment maintenance personnel have satisfactorily increased.
However, its both the inadequate number and inequitable distribution are also the major challenges to
be tackled.

In the disease control component, it seems that several new strategies with definite target with
coherent indicators are to be further refined and a regular monitoring system is to be in place.

In this NGO partnership programme for the last three decades, it has been realized that primary eye
care (PEC) could not be effectively integrated into primary health care (PHC) in spite of the persistent
effort of NGOs.

Different NGOs are rendering eye care service in the country and they are being supported by different
INGOs. So, the working modality is not always uniform. This has sometimes led to duplication of service
in easily accessible areas and unhealthy competition. This will ultimately result in misuse of the scarce
resource whereas large numbers of people are deprived in other remote areas of the country.
Therefore, a proper coordinating body in government is required to facilitate and coordinate the eye
care service providers in the country. The Apex Body for Eye Health was meant to do this; however, due
to lack of executive power in the Apex Body for Eye Health, it has not been very effective in the past.
The coordination is required not only at national level but also a similar mechanism is required at district
level and grassroots level of health care delivery system.

Now Nepal is signatory to Global Eye Health Action Plan endorsed by the Sixty-sixth World Health
Assembly which has opened a new opportunity to make further progress with additional efforts to
prevent visual impairment and strengthen rehabilitation of the blind in communities.

In view of the need to develop/strengthen effective policies to achieve the global target of reduction of
prevalence of avoidable visual impairment by 25% by 2019 from the baseline of 2010, the Apex Body for
Eye Health (ABEH), Ministry of Health (MoH) organized two days workshop in Godavari, Kathmandu
Nepal on 12-13 December 2014 with the support of IAPB. The workshop was held to operationalize the
Global Action Plan in Nepal. Based on the 3 objectives of the Global Action Plan (2014-2019), various
recommendations have been made to Government, WHO and International Partners to
develop/strengthen effective policies to achieve the global target. Now Nepal is moving towards
achieving the goal of Global Action Plan.

Goal and Objectives:
To reduce the overall blindness below 0.2% among the visual acuity <3/60 and <0.4% among the visual
acuity 6/60 by the year 2020.
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187

4.12.2 Outputs for FY 2071/72
With all this opportunities and challenges the service output of the of the eye care services for the fiscal
year 2071/72 are as given below table:

S.N.
Hospital Name
OPD
Surgery
OUTREACH
PECC
School
Screening
Grand
OPD
NNJS/Geta Eye
Hospital,
Dhangadhi
NNJS/Fatehbal Eye
Hospital, Nepalgunj
92,897
32,928
38,757
87035
100,301
318,990
94,669
11,515
13,129
7,492
115,290
NNJS/Chanda Kale
Babu Eye Hospital,
Kapilbastu
NNJS/Lamahi Eye
Hospital,Lamahi
56,005
8,256
56,005
25,940
1,021
25,940
NNJS/Rapti Eye
Hospital, Dang
58,485
2,900
16,962 32,753
7,571
115,771
NNJS/Lumbini Eye
Institute,
Bhairahawa
NNJS/Dr Binod
Neeta Kadel Eye
Hospital
NNJS/Butwal Eye
Hospital,Butwal
179,523
25,807
4,500
8,206
192,229
33,851
1,369
1,742
5,568
41,161
46,858
1,131
24,953
71,811
NNJS/Gulmi Eye
Care Centre, Gulmi
12,256
317
12,256
10
NNJS/Palpa Lions
Lacoul Eye Hospital,
Palpa
NNJS/R.M Kedia
Eye Hospital,
Birgung
NNJS/Gaur Eye
Hospital, Gaur
18,658
518
18,658
78,168
13,438
3,491
12,403
8048
102,110
80,119
10,772
4,589
84,708
NNJS/Bharatpur
Eye Hospital,
Bharatpur
NNJS/Sagarmatha
Choudhary Eye
Hospital, Lahan
85,402
5,172
17,753
12,441
21355
136,951
140,459
42,552
25,838
8,5947
9,907
262,151
2
3
11
12
13
14
177
188

S.N.
Hospital Name
OPD
Surgery
OUTREACH
PECC
School
Screening
Grand
OPD
15
NNJS/Biratnagar
Eye Hospital,
Morang
Mechi Eye Hospital,
Jhapa
Tilganga Institute of
ophthalmology,
Kath
BPKIHS, Dharan
234,001
56,327
25,026
14,321
1,121
274,469
138,376
21,456
13,965
19,506
5,875
177,722
435,655
27,865
435,655
13,382
578
13,382
19
Birat Eye Hospital,

Biratnagar
72,351
16,306
72,351
20
Dristi Eye Hospital,

Jhapa
Nepal Eye Hospital,
Tripureshwor,Kath
mandu
B.P.Koirala Lions
Centre for
Ophthalmic
Studies,
Maharajgunj,Kathm
andu
Kakadvitta Eye
Hospital, Jhapa
6,555
497
6,555
92,317
3,003
92,317
81,591
3,388
17,912
99,503
16,522
1,210
16,522
9,056
76
9,056
12,041
115
12,041
20,254
604
20,254
650
23
650
2,136,041
289,144
208,617
271,898
167,952
2,784,508
16
17
18
21
22
23
24
25
26
27
Dhulikhel Hospital,
Kavre
Nepal Medical
college -Teaching
Hospital,
Maharajgunj
Taparia Eye Care
P.Ltd.
Advance Eyecare &
Phaco Center P.Ltd.
Gwarko, Lalitpur
Total
178
189
Chapter5
5.1
5.CURATIVESERVICES
BACKGROUND
Government of Nepal is committed to improving the health status of rural and urban people by
delivering highquality health services throughout the country. The policy is aimed at providing
promptdiagnosisandtreatment,andreferralofcasesthroughthehealthnetworkfromcommunity
health facilities (PHCC/HP/SHP) to the specialised and central public hospitals. Likewise, diagnostic
services and referral mechanisms at different levels has been established to support early and
correctdiagnosisoftheproblem.
The Interim Constitution of Nepal 2063 has emphasized that every citizen shall have the rights to
basichealthservicesfreeofcostsasprovidedbythelaw.Ultimately,governmentofNepaldecided
to provide essential health care services (emergency and inpatient services) free of charge to
destitute,poor,disabled,seniorcitizens,FCHVs,gendervalianceandothersupto25beddeddistrict
hospitalsandPHCCs(December15,2006)andallcitizensatSubHealthPost(SHP)/HealthPost(HP)
level(8October,2007).
Objectives
Theoverallobjectiveofcurativeservicesistoreducemorbidity,mortalitybyensuringearlydiagnosis
ofthediseasesandprovidingappropriateandprompttreatment.
Strategies
Curativehealthserviceswillbemadeavailableinanintegratedwayintheruralareasthroughsub
healthposts,healthpostsandprimaryhealthcarecenters.
Hospitalswillbeestablishedonthebasisofpopulationdensityandpatientloadensuringatleast
onehospitalineachdistrict.
Zonal and regional hospitals will be established to provide specialized services relating to
pediatrics,gynecology,generalsurgery,generalmedicine,eyecare,dermatology,orthopedicsand
psychiatry.
Thecentralhospitalwillbeequippedwithsophisticateddiagnosticandotherfacilitiestoprovide
specialtyandsuperspecialtyservices.
Specialistcurativecareserviceswillbeextendedtoremoteareas,asandwhenrequired,through
mobileteams
Referral system will be developed through which the rural population will be provided with the
opportunitiestoobtainservicesfrommodernwellequippedhospitals.
Diagnosticservicese.g.laboratory,xray,etc.willbestrengthenedinthehospitals.
Morefrequentoutreachclinics,optionsforrelocatingexistingfacilities
BasiccurativeserviceasacomponentofEHCSwillbeprovidedfreeupto25beddedhospitals.
Promote private medical colleges, hospitals, nursing homes and hospitals run by INGOs / NGOs
andprivatepractitionersascomplementarytopublicfacilities.
DoHS,
Annual Report 2071/72 (2014/2015)
179
191
CURATIVESERVICES
5.2
MajorActivities
Curative health services were provided through the existing health facilities on an outpatient
including emergency where ever available and inpatient basis including Free Health Services as
well.
Inpatient services were provided different level of hospitals including INGOs/NGOs, Private
medicalcollegehospitals,nursinghomes,andprivatehospitalsasperthereportavailable.
Medicalcampswereorganisedindifferentplacesespeciallyintheremotedistricts.
5.3
ReportingStatus:
A total number of383public and private hospitals were listed in Health Management Information
System(HMIS)underDepartmentofHealthServices(DoHS)infiscalyear(FY)2071/72.Outof383
hospitals110(87.7%)publichospitalsand273(79.3%)wereprivatehospitalswerereportedtoHMIS
systeminFY2071/72(Table5.3.1).
Table5.3.1:Hospitalreportingstatus,FY2071/72
No.ofHospital
ReportingStatus
NonPublic
Public
Total
Region
Non
Public Total
Public
N
%
N
%
N
%
EDR
50
21
71
484
80.7
224
88.9
708
83.1
CDR
146
37
183
1280
73.1
329
74.1
1609
73.3
WDR
57
20
77
614
89.8
239
99.6
853
92.3
FWDR
12
14
26
134
93.1
156
92.9
290
92.9
MWDR
8
18
26
85
88.5
209
96.8
294
94.2
National
273
110
383
2597
79.3
1157
87.7
3754
81.7
Source:HMIS,DoHS
Tables5.3.2presentthepublicandprivatehospitalsubmittedtheirtwelvemonthprogressreports
to HMIS system in FY2071/72. Public hospitals were submitted 74.5% and 46.5% from private
hospitals submitted complete fiscal year monthly progress report during this reporting period.
Nationally,privateandpublic hospitalssubmittedonly54.6 percent monthly progressreportfrom
themonthofShrawantoAshartoHMISthisyear.
Table5.3.2:Hospitalreporting12monthsayear,FY2071/72
No.ofHospital
Region
EDR
CDR
WDR
MWDR
FWDR
National
NonPublic
50
146
57
8
12
273
Public
21
37
20
18
14
110
Total
71
183
77
26
26
383
HospitalsReporting12monthsayear
NonPublic
Public
Total
N
%
N
%
N
%
23
46.0 17 81.0
40
56.3
55
37.7 18 48.6
73
39.9
33
57.9 19 95.0
52
67.5
7
87.5 15 83.3
22
84.6
9
75.0 13 92.9
22
84.6
127 46.5 82 74.5
209
54.6
Source:HMIS,DoHS
180
192
DoHS,
Annual Report 2071/72 (2014/2015)
CURATIVESERVICES
Completenessofreports:
Table5.3.3presentcompletenessofreportingfromalllevelofpublichospitalsisassessedinterms
ofreceiptof12monthsreportinFY2071/72.Thestatusofcompletedreportingwas92%ofalllevels
ofpublichospitals.
5.3.3Completereportingfrompublichospitals,FY2071/72
12MonthsReporting
No.ofReports
No.of
TypeofHospital
Expected
Hospital
N
%
Received %
Report
CentralHospital
6
3
50
72
54
75
RegionalHospital
4
3
75
48
36
75
SUBREGIONALHOSPITAL
3
2
67
36
35
97
ZonalHospital
10
7
70
120
95
79
DistrictHospital
52
47
90
624
602
96
GENERALHOSPITAL
23
18
78
276
259
94
National
98
80
82
1176
1081
92
Source:HMIS,DoHS
Table5.3.4presentthereportingstatusofdifferenttypesofhospitalintheFY2071/72.Duringthe
reportingperiod13,hospitalssubmittedmonthlyprogressreportinregularbasisamong35hospitals.
Thecompletionreportingratewas114.2%intheFY2071/72.
Table:5.3.4Statusofcompletereportbytypes,FY2071/72
12Month
No.of
Reporting
TypeofHospital
Hospital
N
%
Community
4
4
100.0
GENERALHOSPITAL(OtherMinistry)
5
1
20.0
SpecializedHospital
3
0
0.0
TeachingHospital(Public)
4
1
25.0
TeachingHospital(NonPublic)
19
7
36.8
National
35
13
37.1
Expected
Reports
48
41
41
41
41
212
TotalReport
Received
N
%
48
100.0
0.0
0
0.0
35
85.4
159 387.8
242 114.2
Source:HMIS,DoHS
Inpatientservices
Inpatientservicesincludeservicesdeliveredthroughinpatientdepartmentsofthepublicandprivate
hospitals. The findings presented in this section should be interpreted with caution because of
limitedreportingcoverageofprivateandpublichospitals.
DoHS,
Annual Report 2071/72 (2014/2015)
181
193
CURATIVESERVICES
BedOccupancy
Bed occupancy rate in higherlevel
government hospitals that submitted
complete reports (12 months a year)
have been assessed here. The highest
100% bed occupancy rate is in Regional
Hospital Surkhet and lowest 8% in SRH
DedeldhurainFY2071/72(Figure5.1).
Figure5.1:Bedoccupancyrateinhigherlevelpublic
hospital,FY2071/72
RHSurkhet
MentalHospital
RHHeatuda
SRHDang
ZHRapti
RHPokhara
MaternityHospital
ZHKoshi
ZHMechi
ZHSeti
ZHDhaulagiri
BirHospital
ZHMahakali
SikrarajTrop.Hospital
SRHParsa
SRHDedeldhura
BhaktapurHospital
KantiChildrenHospital
ZHSagarmatha
ZHZanakpur
ZHLumbini
ZHBheri
Source:HMIS
100
85
81
64
58
54
54
53
41
37
36
35
29
27
20
8
20
Figure 5.2: Bed occupancy for district and district level

hospitals,FY2071/72
DHUdayapur
DHDhadhing
DHPanchthar
DHBhojpur
DHMyagdi
DHPyuthan
DHIlam
DHSalyan
DHDolakha
DHBajhang
DHKhotang
DHDoti
DHRolpa
DHJajarkot
DHDarchula
DHKalikot
DHSindhupalchowk
DHArghakhanchi
DHGulmi
DHRamechhap
DHBardiya
DHTerhathum
DHHumla
DHKapilvastu
DHDailekh
DHAchham
DHSunsari
DHSiraha
DHSyangja
DHMahottari
DHBajura
DHSankuwasabha
DHSolukhumbu
DHNuwakot
DHNawalparasi
RamumaSarakHospital
TikapurHospital
DHTaplejung
ShivrajHospital
DHRauthat
DHBara
DHSindhuli
DHGorkha
DHOkhaldhunga
DHPalpa
KatariHospital
PokhariyaHospital
DHDhankuta
BandipurHospital
DHBaitadi
RampurHospital
DHManang
GokuleshworHospital
BhimHospital
DHParbat
DHMugu
DHMustang
JugbudaHospital
BardibasHospital
DHRukum
DHRasuwa
Methainkot
DHTanahu
ChbandranighapurHospital
MehelkunaHospital
DHDolpa
DulluHospital
BakularHospital
BhardahHospital
DHSarlahi
BharatpurHospital
RangeliHospital
BaghaudaHospital
PipraHospital
MalakhetiHospital
182
194
16
13
13
12
12
11
11
10
10
9
8
8
7
6
6
4
4
3
2
2
0
60
58
58
56
56
54
53
53
51
50
49
49
46
46
46
44
41
41
41
41
41
40
40
39
39
38
38
38
36
34
34
31
31
30
29
25
25
24
24
23
23
23
22
71
68
82
92
100
40
60
80
100
120
Amongthedistrictanddistrict
level hospitals (upgraded),
hundred
percent
Bed
Occupancy Rate found in
District Hospital Udayapur,
Thelowestoccupancyrate3%
observed in District Hospital
Dolpa, followed by District
Hospital Dullu Hospital (2%),
and Bakular Hospital (2%)
respectively(Figure5.2).
DoHS,
Annual Report 2071/72 (2014/2015)
CURATIVESERVICES
AverageLengthofStay(LoS)
Average length of stay among the
higherlevel government hospitals
reported 17 days in Mental Hospital
(Highest) and 1day (lowest) in SRH
Parsa(Figure5.3).
Figure 5.3: Average Length of stay in higherlevel

hospitals,FY2071/72
MentalHospital
BirHospital
MaternityHospital
SukrarajTrop.Hospital
RHPokhara
ZHMechi
ZHKoshi
RHHeatuda
RHSurkhet
SRHDang
ZHMahakali
ZHRapti
ZHDhaulagiri
ZHSeti
SRHDedeldhura
SRHParsa
BhaktapurHospital
ZHSagarmatha
ZHZanakpur
ZHLumbini
ZHBheri
17
8
4
4
3
3
3
3
2
2
2
2
2
2
2
1
Figure 5.4: Average Length of stay in district and district level

hospitalFY2071/72
DHPalpa
DHSindhupalchowk
DHUdayapur
DHMahottari
DHKalikot
DHRamechhap
DHRolpa
DHManang
DHSolukhumbu
DHDhankuta
DHBhojpur
DHKhotang
DHNuwakot
DHDhadhing
DHAchham
DHDailekh
DHIlam
DHBajura
DHDolakha
DHRukum
DHTaplejung
DHDolpa
DHOkhaldhunga
DHPyuthan
Methainkot
BandipurHospital
DHDarchula
DHSalyan
DHJajarkot
DHBajhang
DHPanchthar
DHGulmi
DHDoti
DHSiraha
DHMyagdi
DulluHospital
MehelkunaHospital
DHBaitadi
DHSankuwasabha
DHGorkha
DHHumla
TikapurHospital
DHArghakhanchi
DHKapilvastu
DHSyangja
BakularHospital
DHMustang
DHNawalparasi
DHTerhathum
DHBardiya
BhimHospital
RampurHospital
RamumaSarakHospital
DHRasuwa
ShivrajHospital
DHParbat
DHRauthat
BardibasHospital
DHSunsari
DHBara
DHSindhuli
KatariHospital
PokhariyaHospital
GokuleshworHospital
DHMugu
JugbudaHospital
DHTanahu
BhardahHospital
DHSarlahi
BharatpurHospital
RangeliHospital
BaghaudaHospital
PipraHospital
MalakhetiHospital
Source:HMIS
3
3
3
3
3
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
DoHS,
Annual Report 2071/72 (2014/2015)
4
4
4
10
15
20
Among the district and

district level hospitals,
Average Length of Stay was
found highest in District
Hospital
Palpareported4
days and lowest Bhardah
Hospital(Figure5.4).
183
195
CURATIVESERVICES
HospitalUtilization
Figure5.5:EmergencyWardattendances(higherlevelhospitals),
FY2071/72
Three basic measures of

utilization (Emergency room
attendances,
total
Outpatients and Inpatient
admissions) were shown in
belowfigure.
EmergencyWard
Attendances among the
higherlevel
government
hospitals, with 31,747were
attended in Zonal Hospital
Koshi, which were the
highest
patients
of
attendances among the
other hospitals. Mental
Hospital has the lowest
patientsofattendanceswith
445attendances only (Figure
5.5)
ZHKoshi
BirHospital
ZHSeti
ZHMahakali
SRHDang
RHHeatuda
ZHMechi
MaternityHospital
ZHRapti
SRHDedeldhura
RHSurkhet
RHPokhara
MentalHospital
BhaktapurHospital
ZHSagarmatha
ZHZanakpur
ZHDhaulagiri
ZHLumbini
ZHBheri
SRHParsa
31.747
29.535
25.943
19.187
18.674
17.549
10.755
9.823
6.432
5.618
4.631
2.875
2.678
0.897
0.445
10
Figure5.6:EmergencywardAttendances(districthospitals),FY
2071/72
DHDhadhing
DHBara
DHPanchthar
DHGorkha
DHDhankuta
DHNuwakot
DHIlam
DHUdayapur
DHNawalparasi
DHSindhuli
DHDolakha
DHSunsari
DHSiraha
DHGulmi
DHRauthat
KatariHospital
DHSindhupalchowk
DHBardiya
DHMyagdi
DHSyangja
DHKapilvastu
BhimHospital
DHMahottari
DHPyuthan
DHSankuwasabha
DHBajhang
BakularHospital
DHDarchula
DHTanahu
DHArghakhanchi
DHKhotang
DHDoti
DHParbat
DHDailekh
DHAchham
DHHumla
BardibasHospital
DHTerhathum
DHRamechhap
DHJajarkot
DHRolpa
DHBhojpur
DHTaplejung
BandipurHospital
DHMustang
PipraHospital
DHBajura
DHBaitadi
DHSalyan
PokhariyaHospital
DHKalikot
DHSolukhumbu
DHDolpa
GokuleshworHospital
BaghaudaHospital
DHPalpa
DHRasuwa
Methainkot
DHMugu
DHOkhaldhunga
DHRukum
JugbudaHospital
MehelkunaHospital
ShivrajHospital
RampurHospital
DHManang
BhardahHospital
DulluHospital
TikapurHospital
MalakhetiHospital
RamumaSarakHospital
RangeliHospital
BharatpurHospital
DHSarlahi
Source:HMIS
184
196
9.261
9.047
8.372
7.766
7.174
6.969
6.606
6.496
6.041
5.978
5.842
5.534
5.465
5.418
5.372
5.343
5.006
4.982
4.947
4.893
4.811
4.551
4.201
3.986
3.774
3.722
3.542
3.509
3.502
3.328
3.283
3.153
2.884
2.645
2.387
2.308
2.207
1.955
1.814
1.63
1.585
1.419
1.413
1.351
1.338
1.338
1.318
1.196
1.11
1.063
1.009
0.999
0.98
0.951
0.944
0.869
0.832
0.782
0.607
0.522
0.468
0.352
0.271
0.265
0.075
0.031
10
20
25
30
35
40
T housands
Source:HMIS
15
12
14.441
13.319
13.309
12.479
Among the district and

district level hospitals, with
14,441patients
were
attendedinDistrictHospital
Dhading has reported
highest
patients
of
attendances.
Tikapur
Hospital has the lowest
cases of attendances with
31(Figure5.6).
14
16
18
Thousands
DoHS,
Annual Report 2071/72 (2014/2015)
CURATIVESERVICES
Figure
5.7
present
Outpatient
Attendances
amonghigherlevelofpublic
hospitals; Zonal Hospital
Koshi has the highest
number
of
outpatient
attendances with 139,435.
Kanti Children Hospital has
the lowest cases of
outpatient attendances with
2,926.
Figure 5.7: Outpatient attendances (higher level hospitals), FY

2071/72
ZHKoshi
BirHospital
SRHDang
ZHSeti
ZHMechi
RHSurkhet
ZHRapti
ZHMahakali
SRHDedeldhura
RHHeatuda
MentalHospital
BhaktapurHospital
MaternityHospital
ZHSagarmatha
ZHZanakpur
ZHDhaulagiri
ZHLumbini
ZHBheri
SRHParsa
RHPokhara
139.435
130.848
65.215
42.899
42.203
31.77
30.801
30.649
26.225
14.425
13.039
7.532
2.926
20
40
60
80
100
120
140
160
Thousands
Source:HMIS
Figure5.8:Outpatientattendances(districtanddistrictlevel
hospitals),FY2071/72
DHUdayapur
DHGorkha
DHGulmi
DHDhadhing
DHNawalparasi
DHDhankuta
DHBardiya
KatariHospital
DHTanahu
BaghaudaHospital
DHPyuthan
BakularHospital
DHDoti
DHKhotang
DHKapilvastu
DHSindhupalchowk
DHMahottari
DHSankuwasabha
TikapurHospital
DHRauthat
ShivrajHospital
DHSalyan
PokhariyaHospital
BardibasHospital
DHPanchthar
DHNuwakot
DHBara
DHSindhuli
DHBajura
DHBajhang
DHAchham
DHBhojpur
DHMyagdi
DHIlam
DHParbat
DHJajarkot
DHSiraha
DHDailekh
DHDolakha
DHSyangja
DHTaplejung
MalakhetiHospital
DHBaitadi
DHRamechhap
DHMugu
DHDarchula
GokuleshworHospital
MehelkunaHospital
DHSolukhumbu
JugbudaHospital
DHTerhathum
DHArghakhanchi
DHKalikot
PipraHospital
BhimHospital
DHRolpa
DHOkhaldhunga
RampurHospital
DHPalpa
BhardahHospital
DHRukum
DHDolpa
DHRasuwa
BandipurHospital
DHHumla
Methainkot
DHMustang
RamumaSarakHospital
DHManang
DulluHospital
RangeliHospital
BharatpurHospital
DHSunsari
DHSarlahi
28.135
28.037
26.496
25.366
23.53
23.348
22.814
21.956
21.775
21.459
21.379
21.078
20.693
20.352
18.922
18.78
18.263
18.229
18.118
18.078
18.016
17.77
17.484
17.003
16.873
16.658
16.487
16.21
15.858
15.712
15.49
15.24
14.925
14.844
14.71
14.532
14.269
14.209
13.967
13.334
13.259
13.18
12.852
12.563
11.827
11.745
11.607
10.83
9.907
9.658
9.651
9.288
8.6
8.572
8.267
8.22
8.043
8.041
8.031
7.594
7.34
6.86
6.698
6.486
5.969
5.718
5.695
5.195
3.61
3.461
3.424
Source:HMIS
10
15
20
Thousands
DoHS,
Annual Report 2071/72 (2014/2015)
25
30
Amongdistrictanddistrict
levelhospitals,District
HospitalUdayapurhasthe
highestpatientsof
outpatientattendances
with28,135andDullu
Hospitalhasthelowest
numberofoutpatient
attendanceswith3,424
(Figure5.8)
35
185
197
CURATIVESERVICES
Figure 5.9 present Inpatient
admissions higher level of
public hospitals in fiscal year
2071/72. Maternity Hospital
has recorded the highest
patients
of
Inpatient
Admissions with 21, 047
patients.
Figure 5.9: Inpatient Admissions (higherlevel hospitals), FY

2071/72
MaternityHospital
RHPokhara
ZHKoshi
ZHSeti
SRHParsa
RHSurkhet
BirHospital
SRHDang
ZHMechi
RHHeatuda
ZHMahakali
ZHRapti
ZHDhaulagiri
MentalHospital
SRHDedeldhura
BhaktapurHospital
ZHSagarmatha
ZHZanakpur
ZHLumbini
ZHBheri
21.047
20.511
19.65
15.751
10.796
8.395
7.155
6.549
5.736
5.375
4.312
4.055
3.34
2.503
0.905
0.786
Figure5.10:InpatientAdmissions(districthospitals)FY2071/72
RamumaSarakHospital
DHPanchthar
DHUdayapur
DHSunsari
DHMyagdi
DHPyuthan
DHArghakhanchi
DHNuwakot
DHKapilvastu
DHRauthat
DHBardiya
DHGorkha
DHBara
DHGulmi
DHBajhang
DHIlam
DHNawalparasi
DHBhojpur
TikapurHospital
DHDhadhing
DHSankuwasabha
DHKhotang
DHTerhathum
DHSindhuli
DHSindhupalchowk
DHAchham
BhimHospital
DHDailekh
DHSalyan
DHTaplejung
DHSolukhumbu
DHDoti
DHDolakha
DHJajarkot
PokhariyaHospital
DHDarchula
DHSyangja
DHHumla
DHMahottari
DHSiraha
DHRolpa
DHParbat
DHKalikot
DHBajura
DHRamechhap
DHBaitadi
ShivrajHospital
DHDhankuta
DHOkhaldhunga
DHMugu
JugbudaHospital
RampurHospital
DHTanahu
BandipurHospital
GokuleshworHospital
KatariHospital
DHPalpa
DHMustang
DHRukum
BardibasHospital
DHRasuwa
Methainkot
DHManang
MehelkunaHospital
DHDolpa
DulluHospital
BakularHospital
BhardahHospital
DHSarlahi
RangeliHospital
BaghaudaHospital
BharatpurHospital
PipraHospital
MalakhetiHospital
4.253
4.098
3.909
3.683
3.301
2.881
2.841
2.582
2.522
2.472
2.466
2.326
2.323
2.32
2.32
2.167
2.13
2.073
2
1.989
1.781
1.777
1.729
1.716
1.583
1.531
1.514
1.485
1.43
1.39
1.387
1.371
1.304
1.267
1.267
1.22
1.2
1.191
1.119
1.046
0.984
0.921
0.863
0.852
0.831
0.812
0.753
0.743
0.562
0.535
0.514
0.475
0.39
0.385
0.343
0.338
0.337
0.311
0.294
0.278
0.258
0.235
0.154
0.105
0.098
0.068
0.065
0.052
0.015
Source:HMIS
186
198
10
15
20
25
T housands
Source:HMIS
Among district and district

level hospitals, Ramuma
Sarak Hospital has recorded
the highest number of
Inpatient admissions with
admissions of 4,253 and
Bhardah
Hospital
has
reportedthelowestnumber
of Inpatient admissions
with15cases(Figure5.10)
T housands
DoHS,
Annual Report 2071/72 (2014/2015)
CURATIVESERVICES
Diseaseanalysis
TopTenMorbidity,FY2071/72(Inpatient)
InpatientMorbidity,atotalnumber
of 2,87,616patients were admitted
in hospitals and out of them
Diarrhea and gastroenteritis of
presumed infection was the most
common
reason
for
hospitalization(11,529) followed by
Figure5.11:InpatientTopTenMorbidity,FY2071/72
Diarrhoeaandgastroenteritisofpresumedinfectio
other chronic obstructive pulmonary

disease (8,053) and unspecified acute
lower respiratory infection(7,181)were
the
leading
causes
hospitalization(Figure5.11).
for
11.529
Otherchronicobstructivepulmonarydisease
8.053
Unspecifiedacutelowerrespiratoryinfection
7.181
Otherdisordersofurinarysystem
Typhoidfever
5.514
4.543
Typhoidandparatyphoidfevers
4.229
Essential(primary)hypertension
3.981
Pneumonia,unspecified
3.465
Fever,unspecified
3.393
Gastritisandduodenitis
3.349
Table 5.3.5 presents the age and

0
2
4
6
8
10 12 14
Thousands
sex distribution of discharged
Source:HMIS
inpatients from the hospitals in FY

2071/72. Nearly onethird (26%) of the inpatients were in the age group of 2029 years.
Approximatelyhalfoftheinpatientswerefromtheagegroup1539years(46.4%).Theproportionof
the female (62%) was observed dominant mainly due to delivery was the main reason for
hospitalization
Table5.3.5:InpatientsMorbiditybyAgeandSex,FY2071/72
AgeGroups
Female
%
Male
<28days
8700
1.463
10961
29days<1Yrs
7971
1.34
12410
14Yrs
12738
2.141
16179
514Yrs
20577
3.459
20231
1519Yrs
40138
6.748
15871
2029Yrs
128732
21.64
25643
3039Yrs
45509
7.651
22847
4049Yrs
28902
4.859
25133
5059Yrs
27392
4.605
25881
60+Yrs
48143
8.094
50860
Total
368802
62
226016
Source:HMIS,DoHS
%
1.8
2.1
2.7
3.4
2.7
4.3
3.8
4.2
4.4
8.6
38
Total
19661
20381
28917
40808
56009
154375
68356
54035
53273
99003
594818
%
3.3
3.4
4.9
6.9
9.4
26
11
9.1
9
17
100
Toptenreasons(%)foroutpatientconsultationsinFY2071/72
Figure5.12presentamongthevariousreasonsforOutpatientsconsultationsinFY2071/72,Upper
respiratory tract infection (URTI) is the leading onewith5.7% visitors and is followed by
Gastritis(APD)with5.4%andLowerRespiratoryTractInfection(LRTI)with5%.Headaches,Intestinal
Worms, Presumed noninfectious diarrhea, Typhoid (Enteric Fever) are also among the top ten
reasons for Outpatient Consultations. Amoebic Dysentery is the 10th reason for outpatient
consultations..
DoHS,
Annual Report 2071/72 (2014/2015)
187
199
CURATIVESERVICES
Figure5.12:Toptenreasons(%)foroutpatientconsultations,FY2071/72
Upperrespiratorytractinfection(URTI)
5.7
Gastritis(APD)
5.4
ARI/Lowerrespiratorytractinfection(LRTI)
Headache
4.9
IntestinalWorms
Presumednoninfectiousdiarrhoea
2.9
Typhoid(EntericFever)
2.5
Conjunctivitis
2.5
Scabies
2.4
AmeobicDysentery/Amoebiasis
2.3
0
AirBorneDisease
Figure 5.13 show the Air Borne
Diseases among Inpatients FY
Figure5.13:AirborneDiseasesamongInpatientsFY2071/72
Unspecified acute low er respiratory infection
2071/72. Among patients the
Pneumonia, unspecified
unspecified
acute
lower
respiratory infection patients
were reported highest among
the Air Borne disease with a
total patients of7,181 were
affected and 17 patients were
reported
dead.
Deaths
attributed to Pneumonia,
unspecified organism was
highest (40) among airborne
diseases.
Pneumonia, organism unspecified

Meningitis, unspecified
Respiratory tuberculosis, bacteriologically and hi
Respiratory tuberculosis unspecified, confirmed ba
Bronchopneumonia, unspecified
Acute pharyngitis
Meningitis due to other and unspecified causes
Tuberculosis of lung, confirmed by sputum microsco
Acute bronchiolitis
932
394
18
356
11
306
292
223
202
11
86
64
17
Acute bronchiolitis, unspecified
14
10
Whooping cough
Acute bronchitis
9
7
Lobar pneumonia, unspecified
Whooping cough, unspecified
Tuberculous pleurisy, confirmed bacteriologically
3
2
11
Meningitis due to other specified causes
Tuberculosis of lung, confirmed by unspecified mea
Cerv icofacial actinomycosis
Whooping cough due to Bordetella pertussis
3,465
40
Acute pharyngitis, unspecified
Tinea pedis
7,181
17
2
1
1
Cases
Death
Source: HMIS
188
200
DoHS,
Annual Report 2071/72 (2014/2015)
CURATIVESERVICES
VectorborneDisease
Unspecified
viral
encephalitis patients were
reported highest patients
withthenumberofcasesof
108 and 3 were reported
dead
in
the
FY
2071/72.There were no
reported deaths due other
vectorbornediseasesinthe
FY2071/72(Figure5.14).
Figure5.14:VectorborneDiseasesamongInpatientsFY2071/72
Unspecifiedviralencephalitis
Denguefever[classicaldengue]
Leishmaniasis
Mosquitoborneviralfever,unspecified
Plasmodiumvivaxmalariawithoutcomplication
Othermosquitoborneviralfevers
Plasmodiumfalciparummalaria,unspecified
Plasmodiumvivaxmalaria
Filariasis,unspecified
Denguehaemorrhagicfever
Filariasis
DoHS,
Annual Report 2071/72 (2014/2015)
11,529
16
16
15
6
4,543
4,229
18
Plasmodiumfalciparummalariawithcerebralcompli
53
9
19
236
0
212
1
194
5
186
3
152
0
137
0
90
0
86
0
71
0
58
0
43
0
38
8
36
1
35
0
32
1
21
0
12
0
9
0
8
0
8
0
7
0
6
1
5
0
3
0
2
0
2
0
1
0
1
0
1
0
1
0
20
Typhoidfever
Typhoidandparatyphoidfevers
Volumedepletion
Amoebiasis,unspecified
Shigellosis,unspecified
Shigellosis
ParatyphoidfeverA
Amoebiasis
HepatitisAwithouthepaticcoma
Otheracuteviralhepatitis
Unspecifiedviralhepatitiswithouthepaticcoma
Unspecifiedviralhepatitis
AcutehepatitisA
Intestinalparasitism,unspecified
AcutehepatitisE
Otherprotozoalintestinaldiseases
AcutehepatitisBwithoutdeltaagentandwithout
Cholera
Giardiasis[lambliasis]
AcutegastroenteropathyduetoNorwalkagent
Acuteamoebicdysentery
Helminthiasis,unspecified
Unspecifiedviralhepatitishepaticwithcoma
AcutehepatitisB
HepatitisAwithhepaticcoma
Unspecifiedintestinalparasitism
Paratyphoidfever,unspecified
ShigellosisduetoShigelladysenteriae
Chronicintestinalamoebiasis
Intestinalhelminthiasis,unspecified
Otherintestinalhelminthiases,notelsewhereclas
Othersalmonellainfections
20
Malariaduetosimianplasmodia
Figure5.15:WaterborneDiseasesamongInpatientsFY
2070/71
24
28
25
Plasmodiumfalciparummalaria
Leishmaniasis,unspecified
42
Otherarthropodborneviralfevers,notelsewhere
51
Unspecifiedarthropodborneviralfever
Visceralleishmaniasis
70
Unspecifiedmalaria
108
3
Cases
Death
WaterBorneDiseases
Figure5.15showsthatWaterBorne
Diseases among Inpatients FY
2071/72, Due toDiarrhoea and

Gastroenteritis
of
presumed
Infections was found to be more
thananyotherwaterbornediseases
with number of cases of 11,529and
53were death. Other salmonella
infections had the least number of
cases of 1 and no reported deaths.
Number of patients and deaths of
various other water borne diseases
can be observed in the below
figure..
Cases
Death
189
201
CURATIVESERVICES
Table5.3.6showsthedistributionofCommunicableandNoncommunicableDiseases(OPD)by
national,ecological,anddevelopmentregioninthefiscalyear2071/72.
Communicable
Noncommunicable
Region
Total
N
%
N
%
EASTERN
1,291,009
6.4
2,640,608
13
3,931,617
9.8
23
CENTRAL
2,000,763
4,681,032
6,681,795
6.7
17
WESTERN
1,368,311
3,451,739
4,820,050
4.9
9
MIDWESTERN
1,005,463
1,826,321
2,831,784
3.5
7
FARWESTERN
708,255
1,353,019
2,061,274
31.4
69
NationalTotal
6,373,801
13,952,719
20,326,520
Communicableandnoncommunicabledisease(Inpatient)
Table5.3.7presentofthetotal287,321inpatientnewvisitwerereportedandamong1982patients
were reported death caused by Communicable and Noncommunicable diseases in fiscal year FY
2071/72.ThetotalnumberofcasesofCommunicablediseaseswere43974(15.3%)andnumberof
deaths 395 (20 %) reported in this fiscal year. The total number of243, 347 (84.7 %) patients
reportedonNoncommunicablediseasesandamong1,587(80%)deathsoccurredinthisreporting
period..
5.3.7Communicableandnoncommunicabledisease(Inpatient)FY2071/71
Diseases
Cases
%
Death
Communicable
43,974
15.3
395
Noncommunicable
243,347
84.7
1,587
Total
287,321
100.0
1,982
%
20%
80%
100%
Figure 5.16present Suicide

Figure5.16:SuicideattemptcasesamongInpatientsFY2071/72
attempt cases among Inpatients
475
Toxic effect of unspecified substance
7
in FY 2071/72, during this fiscal
60
Contact with sharp obj ect, undetermined intent
year a total number475 cases
0
werereportedonToxiceffectof
1
Falling, j umping or pushed from a high place, unde
0
unspecified substance and 7
5
Hanging, strangulation and suffocation, undetermin
0
deaths were reported. The
3
Intentional self-poisoning by and exposure to nono
numbers of cases of Contact
0
with
sharp
object,
4
Intentional self-poisoning by and exposure to pest
Cases
0
undetermined intent were60
Death
2
Poisoning by and exposure to pesticides, undetermi
0
with no death. Likewise,
Hangingcasereported5withno
death and intentional self
poisoningharmreported3casesbutnodeathreportedinthisfiscalyear(Figure5.16)
190
202
DoHS,
Annual Report 2071/72 (2014/2015)
CURATIVESERVICES
Road Traffic and Transport
AccidentcasesamongInpatients
FY 2071/72, number of cases of
Motor and nonmotor vehicle
accident were2,610 followed by
Occupantofspecialallterrainor
other motor vehicle 17 and
Occupantofpickuptruckorvan
injured accident 11. Number of
deaths caused by Motor and
nonmotor
vehicleaccident
reported 21 patients (Figure
5.17).
Figure 5.18 shows the Top Ten

MortalityamongInpatientsinFY
2071/72. A total number of 209
numbers of mortality due to
obstructive
Other
Chronic
pulmonary
disease
was
recorded to be the highest. It is
followed by diarrhea and
gastroenteritis of presumed
infection
53,
unspecified
diabetesmellitus47,Pneumonia
(unspecified)
40,
Essential(primary hypertension)
36,othersepticemia36,Chronic
obstructive
pulmonary
disease(unspecified)
33,
Unspecified HIV 29, Chronic
renal failure 28, and Burn and
corrosion,
body
region
unspecified26..(Figure5.18)
Figure5.17:RoadTrafficandTransportAccidentCases
amongInpatientsFY2071/72
2,610
Motorornonmotorvehicleaccident,typeofvehic
21
Animalrideroroccupantofanimaldrawnvehiclei
2
0
Occupant[any]ofpickuptruckorvaninjuredin
11
0
Occupantofspecialallterrainorothermotorveh
17
0
Personinjuredincollisionbetweenothermotorve
1
0
Personinjuredinunspecifiedmotorvehicleaccide
4
0
Personinjuredinunspecifiedmotorvehicleaccide
4
0
Cases
Death
5.18Top10Mortality(Inpatient),FY2071/72
Otherchronicobstructivepulmonarydisease
209
53
Unspecifieddiabetesmellitus
47
Pneumonia,unspecified
40
Essential(primary)hypertension
36
Othersepticaemia
36
Chronicobstructivepulmonarydisease,unspecified
33
Unspecifiedhumanimmunodeficiencyvirus[HIV]dis
29
Chronicrenalfailure
28
Burnandcorrosion,bodyregionunspecified
26
0
Source:HMIS
50
100
150
200
250
5.19SurgeriesinHospitalsFY2070/71,FY2071/72
50
Thousands
Female
Male
40
2071/72.
DoHS,
Annual Report 2071/72 (2014/2015)
18.604
14.873
Plaster
13.704
11.555
EmergencySurgery
22.765
20.347
17.53
20.346
OPDSurgery
Major
10
Minor
21.266
20
39.884
30
Thefollowingfigureshowsboththe
Inpatient and Outpatient Surgeries
in 2071/72. In figure 5.19 present
among Inpatient Surgeries including
majorsurgeriesreportednumberof
39,884 females and 21,266 males
were performed. A total number
17530 female and 20,347male
Minor surgeries were also
performedinFY2071/72.
Among
Outpatient
Surgeries,
20,346female and 22,765 male OPD
surgerieswereperformed.Similarly,
11,555femaleand13,704maleOPD
Plasters were also performed in FY
191
203
CURATIVE SERVICES
Figure 5.20 shows deliveries in hospitals
in FY 2071/72, a total number of 124,295
deliveries took place. Figures also shows
classification of delivery by types were
78% spontaneous, 18% % C/S, and 4 %
Vacuum/Forceps reported.

Among Outpatient Surgeries, 12,750
female and 14,865 male OPD surgeries
were performed. Similarly, 7,504 female
and 9,832 male OPD Plasters were also
performed in FY 2070/71.
Figure 5.20 shows deliveries in hospitals
in FY 2070/71, a total number of 125,273
deliveries took place. Figures also shows
classification of delivery by types were
79.8 normal, 16.2% C/S, 2.7% Vacuum,
0.9% Breech and 0.3% Forceps reported.
5.20 Deliveries in Public-Hospitals FY 2070/71, FY

2070/71
Spontaneous
78.0%
n=124,295
C/S
18.0%
Source: HMIS
Vacuum/Forcep
4.0%
Note: Please see Annexes

5.3.8 Brought Dead and Postmortem done by hospital FY 2071/72

Female
%
Male
Brought Dead
490
40.6
718
Postmortem Done
1562
36.0
2776
Total
2052
37.0
3494
%
59.4
64.0
63.0
Total
1208
4338
5546

Hospital Issues, FY 2071/72
Improvement in infection prevention and waste management practices
Quality of laboratory services at different levels
Overcrowding of referral hospitals
Limited data on causes of deaths and linkages with national reporting system
Low priority in research and poor dissemination practices of research findings
Limited preparedness for major outbreaks and emergencies
Threats of emerging and re-emerging diseases
Retrofitting of hospitals
Unavailability of isolation ward at different hospitals
204
192

DoHS,
Report
DoHS, Annual
Annual R
eport 22071/72
070/71 ((2014/2015)
2013/2014)

Supporting Programmes
6.1 HealthTraining......................................................................................... 207
6.2 HealthEducation,InformationandCommunication..............................216
6.3 LogisticManagement.............................................................................. 223
6.4 PublicHealthLaboratoryServices........................................................... 235
6.5 PersonnelAdministrationManagement..................................................239
6.6 FinancialManagement........................................................................... 243
6.7 Management.......................................................................................... 250
6.8 PrimaryHealthCareRevitalization.......................................................... 257
Monitoring & Evaluation

7.1 Information Systems in Health Sector..................................................... 263
7.2 Progress on M &E.................................................................................... 263
7.3 Monitoring NHSP2 Results Framework Indicators...................................270
205
Chapter6
SupportingPrograms:HealthTraining
SUPPORTINGPROGRAMS
6.1HEALTHTRAINING
1 Introduction
1.1 InstitutionalProfile:
TheNationalHealthTrainingCentre(NHTC),undertheMinistryofHealth(MoH)ispartofanetwork
ofgovernmenthealthtrainingfacilities.TheNHTCoperationalizeitstrainingactivitiesinlinewiththe
2004NationalHealthTrainingStrategy.
The National Health Training Centre (NHTC) is the apex body for the development of human
resources for the health sector. It caters for the training needs of all departments, divisions and
centers of the Ministry of Health. NHTC aims to train health service providers to deliver quality
health care services. To achieve this objective the centre delivers the different training programs
relatedtopublichealth,clinicalandmanagerial.
Inservice training is delivered through a network of National Health Training Programmes, which
providetechnicalaswellasmanagerialtrainingatnational,regional,districtandcommunitylevels.
There are five regional training centers, one sub regional training centre. In addition, there are
differenttriainingsitesatdifferenthospitalsunderNHTCwhichconducttraininglikefamilyplanning,
skilled birth attendance, mid level practicum, safe abortion services, rural USG, anaesthesia
assistance,paediatricnursing,medicolegaletc.Atrainingworkinggroup(TWG)comprisingvarious
supporting partners was formed under the leadership of NHTC with the purpose of ensuring the
efficient running of national health training programs, maintaining the quality of the training and
improvingthecoordinationofalltrainingprovidedunderNHTC.
1.2TrainingNetwork
The National Health Training network includes National Health Training Centre, 5 regional health
training centre, one subregional health training centre, 30 district level training facilities and 14
traininghealthpostsin13district.ThereisateamofDistrictSupervisorshavingGTOTineachdistrict
withonetrainingfocalperson.
Training Network
National Health Training Centre
Dhankuta
RHTC
Pathlaiya
RHTC
Pokhara
RHTC
Surkhet
RHTC
Dhangadi
RHTC
Sapahi
Sub-RHTC
District
Level - 7
District
Level - 8
District
Level - 6
District
Level - 3
District
Level - 3
District
District
District
District
District
HP Level - 2
HP Level - 3
HP Level - 4
DoHS,
Annual Report 2071/72 (2014/2015)
HP Level - 3
HP Level - 2
193
207
1.2Goal
The overall goal of NHTC is to produce/prepare efficient health service providers by means of
trainingtocontributetodeliverqualityhealthcareservicestowardsattainmentofthehighestlevel
ofhealthstatus.
1.3Objectives
ToassesstrainingrequirementsofHealthWorkersandpreparetrainingplansbasedonthe
programsrequirement.
Toplan,implementandtrainhealthworkersasdemandedbyprogramdivision.
To design, develop and refine teaching, learning materials to support implementation of
trainingprograms.
To develop/improve capacity of trainers to deliver quality training at central, regional and
districtlevel.
To support RHDs and DHOs in organizing, implementing and evaluating the training
programs.
To coordinate with all National and International, Governmental and NonGovernmental
Organizationstoavoidduplicationoftrainingandimprovequalityoftraining.
Toorientnewlyrecruitedhealthworkersondifferenthealthprograms.
Tosupervise,monitor,followupandevaluatetrainingprograms.
Toconductoperationalstudiestoimprovetrainingefficiencyandeffectiveness.
ToorganizeInternationalTrainingasperneed.
ToestablishTIMSforthequalityrecordingandreportingsystemsofalltrainingprogramsat
central,regional,district,andcommunitylevels.
1.4Strategies
ThefollowingstrategieshavebeenpursuedtoaddresstheNationalHealthTrainingPrograms;
Assessment,standardizationandaccreditationoftrainingaswellastrainingsites.
Developmentandstandardizationoftrainingpackageasperiodically.
Institutionalcapacitydevelopmentforalllevelstrainingunits.
ConductionofvariousnaturesoftrainingslikePreservice,Inservice,Orientation,Refresher,
longterm,shorttermaspernationalrequired.
Integrationandinstitutionalizationoftrainings.
Capacity development links with professional carrier development regarding to quality
services.
StrengtheningofTIMSaswellasroisteringthetrainingprofile.
2.MajorActivities
2.1 HealthTrainings:NHTCprovidesfollowingarraysoftrainingprograms:
2.1.1 PreserviceTraining(InitialandBasicTraining):
FCHVbasictraining18days(9days+9days)
AHW15months
ANM18months
BiomedicalEquipmentTechnicianTraining(BMET)18months
AnesthesiaAssistantCourse(AAC)6months.
2.1.2 (I) Inservice Training: A wide range of inservice/refresher trainings are designed and
conducted as per the need of different program divisions and centers. Such training
packages are aimed to enhance the skill need for implementing new programs as well as
improving job performance of health workers. NHTC delivers the following Inservice
trainings;UpgradingTraining:
194
208
DoHS,
Annual Report 2071/72 (2014/2015)
ANMP4months
AHWP4months
ANM6months
AHW6months
Sr.AHWs6months
Sr.ANM6months
Supervisorupgradingtraining6months.
(II)SkillBasedCompetencyTraining:
SkilledBirthAttendant(SBA),
AdvancedSkilledBirthAttendant(ASBA),
MedicoLegal,
NonScalpelVasectomy(NSV),
Minilap,
IntrauterineContraceptiveDevice(IUCD),
Implant,
SafeAbortionServices(SAS),
MidLevelPracticum(MLP)etc.
OperationTheatreTechniqueandManagement(OTTM),
Infectionprevention(IP),
ICU/CCU,
PaediatrictNursingTraining,
ASRH
ComprehensiveFamilyPlanning(CoFP)Counseling
Medicolegaletc.
(IV)HealthManagementTraining:
GeneralTrainingofTrainers(GToT),
GenderEquityandSocialInclusion(GESI)Training,
TrainingforPackageDevelopment
HealthTrainingfornonhealthworkerworkinginHealthInstitution.
2.1.3 Orientation Programs: NHTC supports the divisions and centers in developing orientation
packages,preparingapooloftrainersforconductingvariousorientationofshortdurationforhealth
workersandnonhealthworkercategory.
2.1.4 RefresherTraining:Awiderangeofrefreshertrainingsaredesignedandconductedasper
theneedofdifferentprogramdivisionsandcenters.Suchtrainingpackagesareaimedtoenhance
the skill need for implementing new programs as well as improving job performance of health
workers.
2.1.5 Induction Training: NHTC has started the Induction training for the all service groups of
health services officers from this fiscal year. The training is designed for one month (twenty four
workingdays)andhascoveredthewiderangeofdisciplinesofhealthservices.
2.2.Certification
NHTCisresponsibletocertifydifferentnonclinicalandclinicalcompetencybasedtrainingcourses.
NHTCprovidescertificatestotheparticipantsaftercompletingtheaspertrainingcourse.
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2.3TrainingNeedAssessment(TNA)
NHTCisresponsibletoassesstrainingneedduringplanningphase.NHTCidentifiesthegapbetween
expectedandexistingperformanceofthehealthworkersthroughvariousmethods
2.4Planning,Budgeting,ReviewandReportingofthetraining
NHTCdevelopstheannualtrainingprogramplanwithbudgetincludingthesixS/RHTCsanddifferent
training sites and 75 district health training program. The approved annual training program
deliveredtosixS/RHTCsandclinicaltrainingsitesfortheimplementation.Allthecentersandsites
implementthetrainingprogramasperprogram.
2.5Deliveringtrainingandqualityassurance
TheapprovedannualtrainingprogramdeliveredtosixS/RHTCsandsitesfortheimplementation.All
the centers and sites implemented the training program as per training models and guidelines.
QualityImprovement(QI)toolisintroducedmainlyclinicalskillbasedtrainingregardingtoupgrade
it,builtcapacityoftrainingsites,traineesandtrainersforthequalityassuranceoftraining.
2.6AssessmentandAccreditation
NHTCisresponsibletoaccreditdifferentnonclinicalandclinicalcompetencybasedtrainingcourses
like ASBA,SBA, USG, Paediatric Nursing, Medicolegal, MLP, OTTM, Minilap, Vasectomy etc and
trainingsiteslikeParopakarWomenMaternityHospital(PWMH)ThapathaliforComprehensiveRH
training,LamjungCommunityDistrictHospitalforMLP,TUTHforMedicolegaletc.Theinstitutions
shouldbeaccreditedbeforeprovidingsuchtrainingcourses.
2.7
CurriculumDevelopment,ReviewandRevision
NHTCdevelopsthedifferenttypesoftrainingcurriculumbasedontheactualneedsoftheprograms
withclosecollaborationofdivisionsandcenters.NHTChastechnicalworkinggroups(includingwide
rangeofgovernmentandsupportingpartners)toreviewandrevisetheexistingcurriculumandalso
formsthetechnicalgroupsbasedontheneedstoformulatethenewcurriculum.
2.8
CoordinationandCollaborationwithconcernedStakeholders
NHTCcoordinateandcollaboratewiththepartnershipofvariousinstitutionsofMoHPincludingthe
EDPs, NGOs, Private sector and, Medical colleges. Various concerned stakeholders are providing
collaborativesupportstoNHTCinplanningandexecutionoftrainingprograms.
2.9FollowupEnhancementProgram
NHTCconductdifferentskillbasedtrainingforhealthworkers.Similarlyabout9000MO/Nursingstaff
are trained as SBA. For the onsite followup and coaching NHTC started Followup Enhancement
Program for SBA for update the knowledge and skills of Nursing staff with support of different
partners.
2.9
Supervision,Monitoring,FollowupandEvaluation
There is an established mechanism of supervision, monitoring, followup and evaluation of the

trainingactivitiesincoordinationwithrelevantstakeholdersinvolvedintraining.Thesharedefforts
provide feedback to NHTC to assess quality of training programs. NHTC has increased monitoring
andsupervisionoftrainingactivitiestoassuremaintenanceofqualityoftrainingdelivered.
2.10
TrainingPolicyFormulation
TodateNHTCdonothaveadequatepoliciestoaddressthewiderangeoftrainingactivitiesofthe
healthsectorandtheiraccreditation. AlthoughNHTCprovideswiderangeofpublichealth,clinical
andmanagerialtrainingrangingfromdifferentdurationbutthesetrainingsarenotlinkedwiththe
carrierdevelopmentandhealthserviceactandregulation.
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2.11
InstitutionalCapacityDevelopmentforallCentersandSites
FortheinstitutionaldevelopmentoftrainingfunctionNHTCfocuseson;
(a)PhysicalFacility
NHTC reviews existing physical facilities including equipment as per the nature of training
andensuresthesupplyofthesameintrainingsites.
NHTCworkstowardsgradualdevelopmentofphysicalfacilitiesofregionaltrainingcenters,
hospitals,districtleveltrainingfacilities.
In addition NHTC also develops formal alliances with concerned private or non
governmentalinstitutionstomeetthedesiredneedofphysicalfacilityforcateringtrainings
assuringquality.
(b)HealthTrainingProgramDevelopmentandCoordination
NHTC develops the different training programs as per the need of MOHP, DOHS and other
stakeholders. It also facilitates for functional coordination required amongst divisions, centers,
districts and training sites. NHTC has been planning, implementing and managing training need of
various Divisions, Centre of MoHP/DoHS and providing support for quality service improvement in
coordination and collaboration with the partnership of various institutions of MoHP including the
EDPs,NGOs,PrivatesectorandMedicalcolleges.
(c)CapacityBuilding
NHTC makes efforts develop the capacity of different level health workers in different specialized
areas. As part of faculty development and strengthening the capacity of staffs, NHTC has been
providingopportunitiestoparticipateindifferentprogramsorganizedbynationalandinternational
institutions.
(d)SupportingDevelopmentPartnersandtheircontribution:
VarioussupportingpartnersareprovidingcollaborativesupportstoNHTCinplanningandexecution
oftrainingprograms.Thekeyprogramsbeingimplementedwithsuchsupportsareasfollows:
USAID:FamilyPlanning,LogisticTraining,FCHV,qualitymonitoringtoolsinclinicaltraining,
HRSupportforFPtrainingandservicestrengthening.
NSI: SBA, USG, MLP, Anesthesia Assistance Course, BMET, BMEAT, CTS, OTTM, Hospital
Managementtraining.
UNFPA: ASRH, Gender and health, Gender Based Violence, Behavior, HR support for RH
trainingandservicestrengthening.
SavetheChildren:SBAtraining.
SUAHARA:HFOMCtraining.
UNICEF:SBATraining,RuralUltrasound,PediatricNursingtraining,TechnicalAssistance.
IPAS:SASTraining,LongtermFPmethod
PSINepal:FPtraining,MedicalAbortion(MA)training,ClinicalTrainingskillsetc.
(e)TrainingWorkingGroup(TWG)
TrainingWorkingGroup(TWG)hasbeenformedwiththeinvolvementofallthegovernmentaland
EDP supporting partners. This is the high level working group for the quality improvement,
curriculumdevelopmentandaccreditationofdifferenttrainingactivities.
(f)FinancialResources
Annual Program budget is allocated to each RHTC and 75 districts for implementing central and
district level training programs respectively. It is also envisioned to allocate annual grants for
initiating locally organized training based on the number and extent of predefined training needs.
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Fundingprovision,infuture,willbe madeonthebasisofdecentralized planningoftherespective
traininginstitutions.Mechanismwillbeexploredforgenerating/mobilizinglocalresourcesbyeach
traininginstitutions.
2.12DeveloptheTrainingDataBankandstrengtheningtheTIMS
NHTC is trying to update the training information into electronically prepared data bank (Training
management information system). All the training information taken from different training site
undernationalhealthtrainingarebeingupdatedandmadeavailabletoeachparticipant.NHTChas
nowplantoupdatethetrainingmanagementsystematcentrallevelandlinkwithregionalhealth
trainingcentersandotherclinicaltrainingsiteintothisTIMSsoftware.NHTCisalsopreparingthe
trainersroasterondifferentdisciplineandtrainingtypes.
2.13ResearchonTrainingprograms
Atrainingresearchisneededtoidentifyproblemofhealthworkersandconductoperationaswellas
evidence based research on training to explore ways to improve the quality of training. The NHTC
hasplantodevelopthecapacityofthetrainingsiteforreaseach.
3.MajorachievementinFY2071/72
3.1StatusofBudgetAllocationandFinancialProgress
CentralLevel(withregionalandtrainingsites)
TotalallocatedBudget:230,664,000
TotalreleasedandexpensedBudget:178,342
Financialachievement:77.32%
DistrictLevel
TotalallocatedBudget:53,370,000
TotalreleasedandexpensedBudget:49,480,000
Financialachievement:92%
3.2PhysicalProgress:
Thereweredifferenttrainingswith3,548targetsrangesfromfewdaystoyearsanddifferentlevelof
health workers. Among them 3,263 (81%) health workers have completed the targeted trainings
formdifferenttrainingsites.Similarlyatdistrictleveltrainingtotal3645personsweretrainedoutof
4080(about90%).Besidesthetrainingsthecapacitydevelopmentofthetrainingsitesandtrainers,
developmentofthetrainingcurriculumandtrainingmanualswerealsopreparedinthisfiscalyear.
3.3Issuesandrecommendation:
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 issues/problems and opportunities identified during implementation of training activities
notedinrecentregionalreviewmeetingsandNationalReviewmeetingaresummarizedbelow:
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Issues:
Multidoortrainings;
Ownershipoftrainingbytrainingsites
Highworkloadforserviceprovideroftrainingsites(duelresponsibility)
Accreditation,andqualitynotassured;
Trainingsasincentives,notlinkedwithcarrierdevelopment
LowHRcapacityofnationalandregionaltrainingcenter
CapacityofHRinTrainingCenter/structure.
Useoftrainedmanpower/underutilised
HRcapacitydevelopmentplanasperJobDescriptionandservice
Selectionoftraineesforlongandshorttermtraining
TrainingNeedAssessment
Recommendations:
Need based (Based on performance need analysis), Integrated, one door managed,
institutionalizedtrainingwithuptodatetraininginformationandrecords;
Restructure and develop the institutional capacity of the training center to meet the existing
healthtrainingchallenges.
TrainingslinkedwithCarrierdevelopmentsofthehealthworkers.
FulfillmentofacuteshortageHRthroughinitiationandcontinuationofthetraininglikeDiploma
ofBiomedengineeringandanesthesiaassistant.
Capacity Development for skill mixed HR on NCD service delivery through CME (Distance
EducationApproach).
Accreditationandcertificationoftrainingsitesandprogramme
TIMES
PlanforTrainingProgramwithconcerneddivisionanddistricts.
TraineesSelectionNormsdevelopment
4.NewInitiation:
4.1Integrationandinstitutionalizationofhealthtrainings
Healthserviceisalaborintensiveservices,somanynewprinciplesandpracticesaredevelopsfrom
thescientificevidencesandmeantimesomanynewdiseases,newhealthproblemsarealsocoming
up; all these needs the periodic training and updating of the health professionals. To fulfill these
gapsallthedivision,centersanddepartmentsareengagedinthetrainingactivitiesseparatelywith
limited coordination. Fragmented, piecemeal and short duration training has created many more
problems in the health service delivery. Besides the expensive investments in the training
duplication, long absenteeism in the facilities, poor recording and follow up are some observed
lacunaofthetrainingactivitiesinministryofhealthandpopulation.
To minimize all the described problems NHTC has now initiated the integration and
institutionalization of the different training activities, with close collaboration of division and
centers.
4.2Integrationofcrosscuttingandpriorityhealthissuesindifferenthealthtrainings
SixdifferentlongtermtrainingpackagearenowmainstreamedwithGESIandGESIisalsointroduced
in different training curriculum. The emerging issues like Governance, Information communication
technology (ICT), Water sanitation and health (WASH), Climate change and health, and consumer
perspectives in the health is now incorporated in different training activities. The issues of non
communicablediseases,roadtrafficaccident(RTA),andsomenewandemergingdiseasesarealso
incorporatedininductionandupgradingtrainingcurriculum.
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4.3 Initiationandscaleupofdifferentupgradingtrainings
TheHealthserviceact2053andregulation2055hasprovisionoftimeboundupgradingofthelevel
of the health workers, and now the health workers has upgraded 23 level depending upon their
seniority. The VHW became the Sr. AHW and MCHW became the Sr. ANM without any education
qualificationorfurthertraining.The5thlevelhealthworkers(basicallyhealthassistants,staffnurses,
Labtechnicians,Radiographersanddistrictsupervisors)havegottheupgradingoflevelfrom5thto
6thandseventhdependingupontheirsenioritylevel.Thecurrenthealthregulationhasprovisionof
15%adjustmentofupgradedlevelposition.
ThereisprovisionofseniorAHW,SeniorANMandANM,trainingforupgradedhealthworkersand
this year AHW training is restarted and AHWP, ANMP, and supervisor upgraded training is
initiated. Time bound upgrade of position level of the health workers needs the upgraded
knowledgeandskills.
4.5Servicestrengtheningforimprovedtrainingquality
Theclinicaltrainingsneedsadequatenumberofclients/casestodevelopthecompetencylikesNSV,
Minilap,IUCD,Implant,Deliveryetc.TostrengthentheservicesintheinstitutionalclinicsNHTChas
hired family panning consultants and counselors for five different sites. Four family planning
consultant physicians and three nursing counselors were hired for these purposes. Koshi Zonal
hospital, Chetrapti family welfare center, Proshutigriha Maternity hospital clinic, Western regional
Hospital,ICTCNepalgunjandDhangadhiwerefulfilledbythesestaffs.
4.6 Introductionofclinicaltrainings
Toaddresstheincreasingtrendofnoncommunicablediseaseandroadtrafficaccident,fewclinical
training was initiated in this fiscal year with the partnership of different institutions. The primary
trauma care training was initiated with the partnership of Nepal Orthopedic Hospital Jorpati.
Different training manual were also developed in this period with the support of different donors
andexperts.
Morethanthreehundreddoctors,nurses.Alltherelatedtrainingmanualswerealsodevelopedfor
thistraining
4.7IntiationofBlenbedlearningApproach
Due to maximum use and utilization of modern computerized technology, distance learning and
blendedlearningapproachisnowinitiatedonNSVselppacedapproach,IUCDselfpacedapproach
training and Anaesthesia Assistance distance learning cource is started now.This approach help to
savethetime,shortenthedurationofabsentathealthfacilityduetotrainingandresources.
4.8
DevelopmentofdifferenttrainingManualsandRevision:
Different types of training manuals have been developed this year some entirely new and some
adoptedwithrevisiontoaddressthetrainingactivities.NHTChasgotadequatesupportfromEDPs
supportpartnerstoprepareallthesemanualsandneedfulrevision.
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MinilapTrainigPackage
NSVTrainigPackage
IUCDTrainigPackage
PNCTrainigPackage
IPTrainigPackage
NSVselfpacedTrainigPackage
IUCDselfpacedTrainigPackage
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Supporting Programs: Health Training
5 Internal Capacity Development:

5.1 Staff Development
To make the training activities more effective and efficient proper composition of the training
faculties is an important step. NHTC has assessed its capacity with the external evaluation and
suggested for the institutional reform and proper composition. Very limited trainings and workshop
were organized to enhance the capacity of the trainers working under NHTC, RHTC and clinical
training sites.
5.2 Upgrading and Maintenance of Physical Facilities
In the process of upgrading and maintenance of physical facilities, few buildings were renovated for
the residential and training purposes. Few teaching learning materials like laptop, LCD, Desktop
computer, printer, photo copy machine, and models were supplied to strengthen the training sites.
5.3 Improvement of Library
As continuous effort to increase library resources, NHTC has added a large number of books,
periodicals and necessary equipments.
5.4 Major Different Training Sites
SN
Training
Number of
sites
SBA
21
ASBA
Anesthetic
Assistant
Name of training sites

Differentaccrediated Central,Regional and zonal Hospitals
I.
II.
Paropakar maternity Hospital Thapathali

Bharatpur Hospital Chitwan
NAMS Bir Hospital

Dhulikhel Hospital
Amda hospital Damak
FP
15
Different accrediated Hospitals and FPAN clinics
USG
I.
II.
III.
IV.
Medico-legal
I.
II.
Safe Abortion
Service
Paediatric
Nursing
ICU/CCU
On process of site development
10
OT
Management
a) TUTH Teaching Hospitals

b) Bhaaratpur Hospitals
11
Mid-level
Practicum
11
Dhulikhel Hospital
Amda Hospital Damak
Patan Hospital,Lalitpur
Bheri Zonal hospital Nepaljunj
TUTH Teaching Hospital Maharajgunj
BPKIHS Dharan
Differentaccrediated Central, Regional and zonal Hospitals

and FPAN clinic.
I.
II.
Bheri Zonal Hospital

Palpa Mission Hospital
Different hospitals

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2014/2015)
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SupportingPrograms:NationalHealthEducation,InformationandCommunication
6.2 HEALTHEDUCATION,INFORMATIONANDCOMMUNICATION
6.2.1 Background
TheNationalHealthEducation,informationandCommunicationCentre(NHEICC)wasestablishedin
1993 under the Ministry of Health (MoH), Nepal following the New Health Policy, 1991. The MoH
has given structural mandate toward NHEICC in 2002 to provide support for health promotion,
education and communication activities out of the Department of Drug Administration and
Department of Ayurveda. The cabinet of Nepal endorsed "National Health Communication Policy,
2012"whichisthemilestoneforhealthpromotion,educationandcommunicationprogramunder
GoN/MoH. The New Health Policy 2072 (policy no six) focuses on promotion of public health
throughinformation,educationandcommunication.
NHEICC is the government organization responsible for planning, implementation, monitoring and
evaluationofhealthpromotion,educationandcommunicationprogramsofallhealthservicesand
programs within the MoH, Nepal. This centre regulates the health messages and information
produced and disseminated by other organizations such as those in the private sector and non
government sectors. This proceeds in an integrated manner developing, producing and
disseminatingmessagesandmaterialstopromoteandsupporthealthprogramsandservices.
SinceFY2051/52,allofthedistrictsandpublichealthoffices(D/PHO)assembledanorganizational
structureforhealtheducation,informationandcommunicationprograms.Thereishealtheducation
andcommunicationsectionsintheregionalhealthdirectorates,regionaltrainingcentresandhealth
information sections with in the D/PHO. The health education and communication section
implement health promotion, education and communication activities utilizing various media and
methodsbasedontheneedsofthelocalpeopleinthedistrictaswellasthehealthprogramsand
servicesobjectives.Localmediaandlanguagesarepreferredtouseinthedistrictsfordissemination
ofdifferenthealthmessagesandinformationintheirlocalcontextandlanguage.
The Nepal Health Sector Strategy (NHSS) 20152020, addresses the current health challenges, in
addition to providing a roadmap towards universal health coverage of basic health services as
preserved in the constitution of Nepal 2015. This strategy was endorsed by the MoH which has
four major principles including equity in health systems, quality of health services for all, health
system reform and multisectoral collaboration. One of the nine outcomes of the NHSS is to
improvehealthylifestyleandenvironmentthroughahealthpromotionapproachwhichisintended
to achieve the goal of improving the health status of all people through an accountable and
equitable health service delivery system within Nepal. The health promotion is made possible
through a multisectoral approach and collaboration. So,NHEICC intends to implement the
Information, Education and Communication(IEC), Behaviour Change Communication (BCC) and
Health Promotion (HP) programs through a partnership with state(public) and nonstate(private)
sectors.NHSScontinuestoreviewthecurrentmultisectoralapproachesbeingpracticedinareas
suchasWater,Sanitation,Hygiene(WASH)andnutritionandidentifieswaystostrengthenthem.
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Thefollowingkeyareasareimportancetoachievetheprinciplesofhealthpromotion:
1. Promotionofhealthylifestylesandahealthyenvironmentthroughmultisectoralaction
2. Childrenasthestartingpoint
3. Healthfacilitiesasalearningenvironmentforhealthylifestyles
4. Reducingthehighburdenofdeathandinjurythroughimprovedroadsafety
5. Nutrition as a cross cutting issue in collaboration to promote a healthy environment
Establishingmultisectoralresponsestoclimatechange
Innovativeapproachesinhealthpromotion,suchastargetingspecificbehaviours(eg:smoking,
alcoholconsumptionandpromotionofhealthseekingbehaviours)willbestrengthenedand
implementedtoaddressthenoncommunicableconditionssuchasobesity.
NationalHealthCommunicationPolicy,2012
Considering the health communication challenges and needs, the GoN endorsed the "National
Health Communication Policy, 2012" which is a milestone for health promotion, education and
communication programs under the GoN/MoH. It gives high priority of government to health
promotion, education and communication programs in the health sector. The goals, objectives,
policyandstrategyofNationalHealthCommunicationPolicy,2012isasfollows.
Goal
The main goal of the National Health Communication Policy is to sustain healthy life styles of all
citizensby:
promotinghealthservices,programsandhealthybehaviour;
preventingandcontrollingdiseaseand
Increasingaccessibilityandutilizationofhealthservices.
Objectives
TheobjectivesoftheNationalHealthCommunicationpolicyareto:
Mobilize and use modern and traditional communication multimedia and methods in an
extensive and proportionate manner to raise health awareness, knowledge and promote
healthybehaviourofallcitizens.
Strengthen, expand and implement health communication programs at central, regional,
district and community level through clear and strengthened cooperation, coordination
and collaboration among individual, community ,relevant organizations and
communicationmedia.
Generate, collect and mobilize sufficient resources for the effective implementation of
healthcommunicationprogramsatcentral,regional,districtandcommunitylevel.
Prevent unauthorized dissemination and duplication of health related messages or
informationand materials of different issues by maintaining quality, accuracy,
authorization,uniformityandappropriateness.
Enhancecapacityofhealthcommunicationinordertodevelop,produceanddisseminate
quality,accurate,authorized,uniform and appropriate messages or information, materials
andprograms.
Providequalityhealthmessagesorinformationthroughappropriatemediaandmethodto
thecitizens,whohavenoaccesstohealthmessagesorinformation.
increase knowledge, improve skills and promote desired behaviour change on Essential
HealthCareServices(EHCS)andbeyond.
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TocreatedemandforqualityEHCSamongallcastesandethnicgroups,disadvantagedand
hardtoreachpopulations.
advocate for required resources (human and financial) and capacity development for
effective communication programs and interventions to achieve the Nepal Health Sector
Program(NHSP2)goals
increaseaccesstonewinformationandtechnologyregardinghealthprograms.
raiseawarenessamongthepubliconcommunicableandnoncommunicablediseasesand
toencouragealltoseekpreventativemeasures.
intensify and strengthen action against tobacco use, both smoked and smokeless,
excessiveuseofalcohol,unhealthydiets,andphysicalinactivity.
mitigatepublicpanicandrespondtocommunicationneedsduringemergencysituations.
Promoteenvironmentalhealth,hygieneandsanitation.
MajorPolicies
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218
Implementhealthcommunicationprogramsinadecentralizedmanner.
Provide continuity with planning and implementation of communication programs of all
healthservicesandprogramsinanintegratedapproachandthroughaonedoorsystem.
Allocate at least two percentages of the annual MoH budget for managing adequate
financialresourcestoimplementhealthcommunicationrelatedprograms.
Promote participation, coordination and cooperation of relevant organizations and
stakeholdersforeffectiveimplementationofhealthcommunicationprograms.
Use extensively modern and traditional multi media especially mass, interpersonal and
socialcommunicationmediaandmethodstodisseminatehealthmessagesorinformation.
Make arrangements for the dissemination of health messages or information based on
need,approvedstandardsandclassificationthroughallcommunicationmediaandmethods
to intended audiences by direct negotiated agreement in transparent and proportionate
manner.
Disseminate health messages or information in an educative, artistic and entertaining
mannerinlocallanguageandinculturallyacceptedmanner.
Regulate and provide preconsent from GoN for dissemination of health information for
maintainingquality,consistency,accuracy,authorization,uniformity,appropriatenessand
avoidanceofduplicationasperthe"HealthCommunicationPolicy2012".
Make arrangement to encourage the continued dissemination of successful avenues of
healthinformationcommunicationthroughmedia,institutions,healthworkers,journalists
orhealthissuescenteredoncommunicationmedia.
Encourage and facilitate the dissemination of health information through different
communication media and methods in Public Private Partnerships (PPP) under the
corporatesocialresponsibility.
Regulate,controlandbandisseminationofanytypesofmessagesorinformationthatcan
adverselyaffecthumanhealththroughexaggerated,misledorunauthorisedmaterial.
Ensure information is transparent and informative by disseminating through reputable
healthservicesandprograms.Educationaroundtheproperuseofmedicinesandmedical
andservicechargesprovidedtothepeoplebygovernment,nongovernmentandprivate
organizationsisessential.
Make arrangements to ensure health information or materials is easily accessible to
physicallyandmentallydisabledpeopleandseniorcitizens.
Giveprioritytoissuesrelatedtolifestylerelateddiseasesandencouragetheimprovement
oflifestylesviathesimplebehaviourchangescapableofeachindividual.
Ensuregoodgovernanceandmanagementofhealthservicesandinstitutionsofalllevels
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foreffectiveplanningandimplementationofhealthcommunicationprogramsbybuilding
capacityofhealthpromotionandcommunication.
Provide quality health information to all citizens, particularly people living in remote
villages who are geographically disadvantaged, in addition to ethnic, gender, poor and
marginalized populations at an appropriate time and from appropriate media and
methods.
Link health information and programs with services that are socially inclusive, gender
friendlyfactualandappropriatetotheaudience.
Promote and use advanced modern communication technology for dissemination of
healthinformation.
Emphasize quality health promotion and communication by developing and producing
humanresourcesappropriatelyrelatedtohealthpromotionandcommunication.
Develop and use a monitoring and evaluation mechanism for the overall use of health
informationandwiththeviewtoevaluatetheeffectivenessoftheprogram(s).
NationalHealthEducation,InformationandCommunicationCentre(NHEICC)
Program
GOAL
ThegoaloftheNHEICCprogramistocontributetoattainingthenationalhealthprogramgoalsand
objectivesbyprovidingsupportforallhealthservicesandprograms.
OBJECTIVES
ThegeneralobjectiveoftheNHEICCprogramistoraisethehealthawarenessofthepeopleasa
meanstopromotepositivehealthstatusamongallcitizenandtopreventdiseasethroughtheefforts
ofthepeoplethemselvesandthroughfullutilizationofavailableresources.
ThespecificobjectivesoftheIEC/BCCprogramsareto:
Increaseawarenessandknowledgeofthepeopleonhealthissuesandpromote
desiredbehaviourchangeonEHCSandbeyond.
Create demand for quality EHCS among all castes and ethnic groups, disadvantaged
andhardtoreachpopulations.
Advocate for required resources (human and financial) and capacity development for
effectivecommunicationprogramsandinterventionstoachievetheNHSSgoals.
Increaseaccesstonewinformationandtechnologyonhealthprograms.
Increasepositiveattitudestowardshealthcare.
Increasehealthybehaviour.
Increaseparticipationofthepeopleinthehealthinterventionprogramsatalllevelsof
healthservices.
Intensify and strengthen action against tobacco use (in all forms), excessive use of
alcohol,unhealthydietsandphysicalinactivity.
Promoteenvironmentalhealth,hygieneandsanitation.
ControlthetobaccoandalcoholandNonCommunicableDiseases(NCDs)
MajorStrategies:
Healthcommunicationprogramswillbeimplementedthroughhealthstructuresfroma
centralleveltocommunity,districtandregionallevelsinadecentralizedmanner.
Coordinationandcollaborationwillbemadewithlocalbodiesandotherstakeholders
forimplementinghealthcommunicationprogramsinadecentralizedmanner.
Thepolicyofplanningandimplementinghealthrelatedcommunicationprogramsofall
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health services and programs in aone door system and integrated approach will be
implementedthroughtheMoH/NHEICC.
Advocacy,communitymobilizationandbehaviourchangecommunicationprogramswill
be implemented at different levels by formulating health communication strategies of
healthservicesandprogramsinanintegratedmanner.
Health communication programs of different health services and programs will be
integrated while formulating annual programs and the MoH budget will be
implemented through the NHEICC. Budget will be allocated annually according to the
policyfortheimplementationofhealthcommunicationrelatedprograms.
The bodies under the United Nation (UN) and external development partners will be
encouragedandfacilitatedtoinvestinhealthcommunicationprograms.
Certaintaxwillbeleviedonanyservicesorcommoditiesusedbythegeneralpublicand
onbehaviourorcommoditiesthatadverselyaffecthealth.Somepercentageoftaxwill
beutilizedinamanagementfundforthedisseminationofhealthinformationprograms.
The practice of free distribution and use of information related to health will be
discouraged and managed in such a way to ensure accurate information regarding
healthisdisseminatedtothewiderpublic.
Formulation and effectively working health communication coordination committee
comprisingkeystakeholderstoassistintheimplementationofpolicyanddecisions.
Youth,journalists,professionals,institutionsandvariousorganizationswillbemobilized
for the promotion of healthy behaviour, basic health services and programs through
coordinationandcollaborationwiththerelevantministriesandinstitutions.
Modernelectroniccommunicationmediasuchasradio,television,FMradio,websites,
telephone,mobileetcwillalsobeusedtodisseminatehealthmessages.Arrangements
willbemadetoincludehealthmessageswithlinkstoallgovernmentwebsites.
Booklets, pamphlets, posters, diaries,signage, stickers, flipwall charts, brochure , flash
cards, bulletin boards will be produced, published and displayed for effective
dissemination of health message and information. Health messages will also be
displayedthroughvariousmeanssuchastheoutercoverpageoftextbooks,packaging
offooditems,tickets,postallettersandTshirts.
Traditional and local folk art, culture and rituals like Maruni, Rodi, DhanNach,
ShakewaNach, Nautanki, Dohori Geet, Deuda, Ghatu, DhamiJhankri, Gaine, Fine Art,
StreetDrama,PuppetDance,Mikingetc.ofpowerfulfolkcommunicationmediaandits
relatedartswillbeusedappropriatelytodisseminatehealthmessages.
Variouscarnivals,festivals,days,events,exhibitionswillbeorganizedtospreadhealth
messagesandinformationeffectivelythroughouteachcommunity.
Innovative ideas of art especially articles, radio and television program, interaction,
drama, film, songs, dance, fine art, sculpture etc will be encouraged for raising health
awareness. Other sectors will also be encouraged to participate in similar types of
activities.
Interpersonal communication is one of an effective medium in disseminating health
information, but fact checking is crucial in case any messages have been mis
interpreted. Therefore, emphasis will be given to mobilize community people and
groups like local organizations, intellectuals, teachers, students, peer groups, religious
leaders, media, female community health volunteers, consumer groups, mothers
groups,youthandothersocialandprofessionalorganizationsasappropriate.
206
220
DoHS,
Annual Report 2071/72 (2014/2015)
MajorActivities
NHEICCconductedmajorhealthcommunicationactivitiesatalllevelsasfollows:
CentralLevel
Policy,strategy,programdevelopmentandimplementation.
DevelopmentofprogramguidelinesanddirectivesandsupplytoRHD,RHTCandD/PHO.
Development,productionandbroadcastingofshortmessagesthroughradioandtelevision.
Developmentandpublicationofhealthmessagesthroughnewspapers(printedand
electronic).
Development,productionanddistributionofIECmaterialstostakeholdersandRegional
MedicalStores(RMS),D/PHO.
Programorientationtoregionalanddistrictlevelprogrammanagers,involvingakeycontact
personinfiveregions
AdvocacyGlobalHandWashingDay,WorldHealthDayandWorldNoTobaccoDay
Celebrations.
CoordinationTechnicalcommitteemeetings.
Capacitybuildingonhealthpromotion,educationandcommunicationprograms.
Supervision,monitoringandevaluationofhealthpromotion,educationandcommunication
programs.
Tobaccocontrolactivitiesincludingtobaccoproductpictorialhealthwarning
implementation.
Tobaccocontrolstrategicplanpreparationandimplementation.
RegionalorientationtoassistantCDOtoimplementtobaccocontrolactivities.
Conductingenvironmentalhealth,hygieneandsanitationactivities.
Schoolbasedhandwashingwithsoapandwaterprogram
PublicPrivatePartnershipinHandwashingwithsoapprogram.
BroadcastinghealthmessagesthroughRadioandTelevisioninpackage.
RegionalLevel
SupervisionandmonitoringofIECactivities.
Sensitizationprogramforpreventionandcontrolofepidemics.
DistributionofIECmaterialsthroughregionalmedicalstores.
DistrictLevel
StrengthendistrictIECcornerbysupportingelectronicequipment.
Sensitizationprogramforpreventionandcontrolofepidemics.
ProductionofneedbasedIECmaterials.
DistributionofIECmaterialsinhealthfacilities.
ProductionandairingofhealthradioprogramsandmessagesthroughlocalFMradio.
Exhibitiontopromotehealthservicesandprograms.
Publicationofhealthmessagesinprintmedia.
Communityinteractionprogramforhealthservicepromotion.
EstablishmentandmanagementofIECcornerineachhealthfacility.
IECprogramonantitobaccoandnoncommunicablediseasescontrol.
SupervisionandmonitoringofIECactivities
Celebrationofdifferenthealthdays.
Coordinationandcollborationbetweendistrictlevelstakeholder.
DoHS,
Annual Report 2071/72 (2014/2015)
207
221
The physical and financial achievement of the regular IEC/BCC activities carried out by NHEICC
was95.5 percent and 83.9 percent respectively in FY 2069/70. The physical and financial
achievement was 68.9 percent and 57.7 percent respectively during the FY 2070/71 and 85.5
percentagesand78.7percentagesachievementwasin2071/72.
Similarly, the physical and financial achievement on Health Tax FundTobacco control activities
carried out by NHEICC was 96.3 percent and 83.9 percent respectively in FY 2069/70 and 81.4
percentage and 71.6 percentage was in 2070/71 and the physical and financial achievement was
96.1percentand74.7percentrespectivelyduringtheFY2071/72.
Table6.2.5:TrendofPhysicalandFinancialAchievement
Program
RegularIECprogram(%)
IECprogramofTobacco
controlprogram(%)
Source:NHEICC
FY2069/70
Physical
Financial
95.5
83.9
96.3
83.9
FY2070/71
Physical
Financial
68.9
57.7
81.4
71.6
FY2071/72
Physical Financial
85.5
78.7
96.1
74.7
AccordingtoNHSP2,healtheducationandcommunicationisreachingallhealthprograms,aiming
to increase knowledge and improve behaviours regarding key health issues of all castes, ethnic
groups, the disadvantaged, and hardtoreach populations. It also aims to create demand for
qualityessentialhealthservices,therebyimprovingaccess,creatingpublictrustinhealthservices
and ultimately encouraging people to utilize the existing health services and mitigate public fear
andrespondtocommunicationneedsduringemergencysituations.
NDHS 2011 report shows a decrease in TFR, IMR and CBR. The report also shows reduction in
prevalence of anaemia among pregnant women and children. Knowledge of informants about
HIV/AIDShasalsobeincreased.Utilizationratesofavailablehealthserviceshasincreased.Thereis
correlation with these achievements and the impact of health education, information and
communicationprograms.
IssuesandRecommendations
Table 6.2.6 presents the issues discussed during the regional and national reviews and the
recommendationstoovercometheseissues.
Table6.2.6:Issues,recommendationandresponsibility
Issues
Recommendation
LimitedBCCanddemand
Developandimplementdistrict
generationactivitiesfocusingin
specificBCCanddemandgeneration
hardtoreachsubpopulation
activitiesfocusinginhardtoreach
subpopulation
Healtheducationkey
Reviveandreviewofhealth
personnelnotidentified
educationTechnician/
HealthEducationOfficer
Performancegapamong
Capacitybuildingforhealth
healtheducationkey
educationkeypersonnels
personnels
ontheeffective
LimitedfocusonNCD
Provisionofadequate
Responsibility
NHEICC/DoHS
MoH/NHEICC
NHEICC/MoH/NHTC/
RHTC
NHEICC/MoH
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222
DoHS,
Annual Report 2071/72 (2014/2015)
SupportingPrograms:LogisticManagement
6.3
LOGISTICSMANAGEMENT
6.3.1 Background
An efficient management of logistics is crucial for an effective and efficient delivery of health
services as well as ensuring rights of citizen of having quality of health care services. Logistics
Management Division (LMD) has established under the Department of Health Services in 2050/51
(1993),withanetworkofcentralandfiveregionalmedicalstoresaswellasdistrictlevelstores.The
majorfunctionofLMDistoforecast,quantify,procure,storeanddistributehealthcommoditiesfor
thehealthfacilitiesofgovernmentofNepal.Italsoinvolvesrepairandmaintenanceofbiomedical
equipment,instrumentsandthetransportationvehicles.
Inordertosystematizethemanagementoflogistics,theLogisticsManagementInformationSystem
(LMIS) unit was established in LMD in 1994. LMIS Unit collects and analyses quarterly (three
monthly) LMIS reports from all of the health facilities across the country; prepares report and
disseminatesitto:
Forecast annual requirements of commodities for public health program including family
planning, maternal, neonatal and child health, HIV and AIDS commodities, vaccines, and
EssentialDrugs;
Helptoensuredemandandsupplyofdrugs,vaccines,contraceptives,essentialmedicalsupplies
atalllevels;
Quarterlymonitorthenationalpipelineandstocklevelofkeyhealthcommodities.
OverallObjective
To plan and carry out the logistics activities for the uninterrupted supply of essential medicines,
vaccines,contraceptives,equipment,HMIS/LMISformsandalliedcommodities(includingrepairand
maintenance of biomedical equipment) for the efficient delivery of healthcare services from the
healthinstitutionsofgovernmentofNepalinthecountry.
Strategies
Logistics planning for forecasting, quantification, procurement, storage and distribution of
healthcommodities.
IntroduceeffectiveandefficientprocurementmechanismslikeeBidding,eSubmission.
UseofLMISinformationandrealtimedatainthedecisionmaking.
Strengthen physical facilities at the central, regional, subregional and district level for the
storageanddistributionofhealthcommodities.
Promote WebBased Logistics Management Information System and Non
Expendable/ExpendableItemsInventorySysteminCentral,RegionalandDistrictswarehouses.
Repairandmaintenanceofbiomedical,coldchainequipments/instrumentsandtransportation
vehicles.
Capacity building of required human resources on logistics management regarding public
procurement,EbiddingandWebBasedLMIS/onlineIMSatalllevels.
ImplementeffectivePullSystemforyearroundavailabilityofEssentialDrugsandotherhealth
commoditiesatalllevels(Central,Regional,DistrictandHealthFacilities).
Improvementinprocurementandsupplychainofhealthcommodities,workingonprocurement
reformandrestructuringofLogisticsManagementDivisionandDistrictStores.
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223
Plan for the efficient management on forecasting/quantification, procurement, storage,

distribution andtransportationofhealthcommoditiestoallhealthfacilitiesforthedeliveryof
healthcareservicesbasedonLMIS.
Develop tender documents as per public procurement rules and regulations and procure
essential medicines, vaccines, contraceptives, equipment, different forms including HMIS/LMIS
andalliedcommodities.
Store, repack and distribute medicines, vaccines, contraceptives equipment and allied
commodities.
Conduct health logistics management trainings/orientation in collaboration with NHTC up to
regions,districtsandotherstakeholders.
ManagetoprintanddistributeHMIS/LMISforms,stockbooksanddifferentformsrequiredfor
allhealthinstitutions.
Support on implementation and functioning of webbased LMIS, webbased Equipment
InventorySystemandInventoryManagementSystemsoftware.
Managetomaintainthebiomedicalequipment,machineriesandtransportvehicles.
Implement and monitor Pull System for contraceptives, vaccines and essential drugs in the
districts.
Coordinatewithalldevelopmentpartnerssupportinghealthlogisticsmanagement.
Superviseandmonitorthelogisticsactivitiesofallregion(RMS)anddistrictlevels(DPHO/DHO).
Procure,storeanddistributevarioushealthcommoditiesforqualityhealthservices.
ImplementTelemedicineprograminthehillandmountaindistricts.
6.3.3 AnalysisofAchievement
1.
LMISReportingStatus
The trend of total LMIS 120

reportingfromhealthfacilities
96
96 96 94
95
94
is consistently above 95 100
92 89
91
91 91
91
90
90
87
85
85
percent over three years.
75
However,
the
reporting 80
percentagedecreasedto85%
in 2071/72. Analyzing the 60
regionwise
reporting
percentage, there has been 40
sharp decline in Central
20
Region.
The main reason for this
0
decline could be attributed to
National
Eastern
Central
Western MidWestern FarWestern
FY206970
FY207071
FY207172
the massive earthquake of
Baisakh 12, 2072 which hit
mostlyinCentralRegion.
DuetothismostoftheHFsinaffecteddistrictswerecompletelydestroyedandcouldnotsendthe
reports.Besides,thepoliticalsituationaftertheearthquakewasalsonotfavourableresultinginno
reporting from HFs especially from Tarai districts. The LMIS has helped to generate accurate and
reliable feedback reports, thereby contributing to improve logistics functions like budgeting,
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224
quantifying, forecasting, procurement, storage, transportation and distribution of FP, MCH
commodities and essential drugs to be procured by the centre. LMIS has played a key role in
reducing stockout rates and increasing yearround availability of key health commodities through
closemonitoring.Similarly,LMDhasimplementedwebbasedLMISandInventoryreportingsystem.
2.
WebBasedLMISReportingStatus
Webbased LMIS up to the 80

67
district level is in operation 70
57
since 2008. The reporting 60
56
55
53 54
53
51
49
48 51
48
percentage
of
districts 50 48 47 50
45
remained in an around 50
40
percent for the last three
30
23 22
years.Thisnecessitates,tofind
20
out the root cause of non
10
reporting from districts and
strategically plan to overcome 0 National
Eastern
Central
Western MidWestern FarWestern
thisissue.
FY206970 FY207071 FY207172
3.
AvailabilityofKeyHealthCommodities
Figure:NationalStockoutpercentageofHealthCommoditiesatHFs
LMD aims to make year round
availability of key health
commoditieslikeCondom,Oral
Pills, Inj. DMPA, Tab. Iron,
CotrimP, Caps. Vit. A, ORS,
Tab. Zinc sulphate in all health
facilitiesandessentialdrugsfor
free health services. The
stockout
HFs
for
contraceptives, and selected
MCH commodities (Tracer
Drugs) has increased in this FY

2071/72. However, there is a
needtodecreasethestockout
FamilyPlanningCommodities=Condom,InjectableDMPA,IUCD,Implant,andPills
of essential drugs in the health
MCHCommodities=ORS,VitaminA,Cotrim/p,andIronTablets
facilities by the effective
EssentialDrugs=Albendazole,Paracetamol,Chloramphenarimine,Aluminum
implementation of the Pull
Hydroxide,Metronidazole,Chloramphenicol,GammaBenzene,Amoxicillin,
BenzoicAcid.
System.
(DataSource:LMIS(Stockoutinformationisquarterlyaveragebasedonover
90%HealthFacilitiesreportingLMIS)
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225
6.3.4 MajorLogisticsActivitiestoStrengthenHealthCareServices
a.
Procurement
LMDcontinuedandaddedmorecommoditiesinthemultiyearprocurement.Condom,Injectable,
ORS, Iron Tablets, Essential Drugs are now being procured through multiyear mechanism. Multi
yearmechanismsaveseveryyearbiddingandevaluationtimefortender.LMDalsocompletedthe
LICB (limited international competitive bidding) process in coordination with World Bank in the
procurementofImplants,whichresultsinprocuringdirectlyfromthemanufacturerinmuchlower
cost.
Adistrictwisebreakdownlistofessentialdrugsandquantitiestobeprocuredatthedistrictlevel,
basedonconsensusforecastwasdevelopedbyPHCRDandLMD.Thelistandbudgetwassenttoall
districtsbythePrimaryHealthCareRevitalizationDivision(PHCRD).Similarly,onthedevelopmentof
ebidding software, the terms of reference/guidelines was finalized and sent to prospective e
biddersfortheirreviewandfeedback.
Providing of training on public procurement for the Region and District level personnel with the
financialsupportofUKAID/NHSSPandtechnicalsupportofGoN/PPMO.Completionofthetraining
inFY2071/72in3 Region(Eastern,CentralandFarWestern),restof2Region(Westernand Mid
Western)willbecoverinFY2072/73.
b.
ConsensusForecastMeeting,2015
Everyyear,theworkinggroupforecastsforcomingthreetofive yearperiodwithperiodicreview.
The group consists of representation from various divisions under DoHS/MoH, districts, social
marketing organizations and EDPs. This year the workshop convened on March 1819, 2015 with
participation from public sector, social marketing sector and EDPs. The main purpose of the
workshopisoutlinedbelow:
Toestimatethecommodityneedsandassessstockstatusofincountrysupplypipelinesoasto
identifyandcorrectsupplyimbalance.
To provide data on specific commodity requirements and plan for government budget
allocations.
Tosupporttheestimationofcommodityprocurementcost.
Toinformdonorsaboutfundingrequirementsandadvocateforcommodityprocurement.
ToensuregovernmentscommitmentforCitizensRightinprovidinghealthcareservice.
The workshop developed a consensus on forecasting of Essential drugs, FP commodities, MNCH

commodities, vaccines, syringes and HIV& AIDS commodities. The forecast was based on scientific
data, which included demographic data, consumption pattern, morbidity issues and some special
programmaticconsiderations.
The workshop was highly successful in addressing issues of forecast and quantification of health
commodities with some important recommendations from the participants. The workshop also
incorporated other factors effecting forecasting and quantification i.e. nonprescribed drugs,
replacingdrugs,fastmovingdrugsandduplication.Recently,MoHhasupdatedfreeessentialdrugs
listandforecastingoftheseitemswerecarriedoutbyPHCRD.Thesuccessofconsensusforecastisa
milestoneinlogisticsmanagement,butthereisalwaysroomforcontinuousimprovement.
Subsequently, LMD organized a Quantification workshop in March 26, 2015 in which a total 403
items quantified and out of which, 188 items quantified to procure for upcoming fiscal year
2072/073(2015/2016)bypublicsectorthatwasdecided.
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226
Similarly, National Level Consolidated Annual Procurement Plan (CAPP) organized by DoHS in
collaborationwithallconcerneddivisionandcentreinAugust1314,2015withtechnicalassistance
andfinancialsupportfromUSAID/NepalHealthForLifeLogistics/LifelineNepal.LMDsProcurement
UnittookaleadrolepreparedCAPPinwhichallrequirementsaregroupedintoGoods,Consulting
Services,DrugPackage1andDrugPackage2.
c.
QuarterlyNationalPipelineReviewMeetings
LogisticsManagementDivision(LMD)startedpipelinemonitoringofFPcommoditiessince1997/98.
ItnowcoversFP,MNCH,EPIVaccines,Syringes,selectedEssentialDrugsandHIV/AIDScommodities
as well. National pipeline reports are now used to monitor the availability of the stock at service
deliverypoints(SDPs)andtomonitortheprocurementstatusofkeyhealthcommodities,including
antiretroviral(ARVs).
Ineachquarter,anationalpipelinemeetingtakesplaceattheLMDtoreview,monitor,andevaluate
the procurement, shipment, distribution, transportation and stock status of family planning and
otherhealthcommodities.
LMD with the support from Health for Life (H4L) Logistics conducted quarterly National Pipeline
StatusReviewmeetings.ThemeetingwasparticipatedbyProgramDivisionsofDoHS,ExternalDonor
Partners and stakeholders like Social Marketing agency and FPAN. In the meetings shipment
schedules, shipment status (planned, ordered and received), actual consumption and monthsof
stockinhandof32healthcommoditieswerediscussed.
d.
StrengthenStorageCapacity
Idealstorageconditionsforessentialdrugsandcommoditiesarerequiredtodeliverqualityhealth
servicestoservicedeliverysitesinordertoensureoptimalhealthserviceutilizationbyconsumers.
In the course of implementing the Logistics System Improvement Plan (LSIP) of Ministry of Health
andPopulation(MoH)jointlydevelopedbyMoH,amassivecleanupanddejunkingactivitieswere
carriedoutacrossthecountryduringtheperiodof199497.Thiseffortresultedinfreeingstorage
spaceandgeneratingrevenueforthegovernment(fromdejunkingandauctioning),whichrevealed
that numerous districts seriously lacked ideal storage space for handling health and other allied
commoditiesincludingvaccines.
TheMoHandLMDcommissionedanassessmentin1999toidentifythecurrentstorageconditions
andspaceneededatdistrictlevel.TheassessmentwascarriedoutwithsupportfromJSIResearch&
TrainingInstituteandUSAID.Thestudyrevealedthat58of75districtshadimmediatestorageneeds
(noneofthedistrictshadidealcoldstoragefacilities)andall75wouldrequirenewstores.Spacewas
inadequateandsecuritywaspoor.49outof75districtshadstoreroomsscatteredintwoormore
roomswithnonespecificallydesignedforstorageandmanywereinrentedbuildings.Mostofthe
storeroomswerefilledwithunusablecommoditiesandjunk.Everyyearhugequantitiesofdrugsand
otherhealthcommoditieswentmissing,damagedorhadtobedestroyed.
DoHS/LMDteamwasvisitedCentralWareHousePathalaiyaand5RegionalMedicalStoresincluding
DistrictMedicalStoresatsametimetoobserveanddiscussrealwarehouseproblemsandsolution.
e.
CapacityBuildinginLogisticsManagement
NewIntervention
In an effort to decentralize logistics decision making at the peripheral level health facilities and
transferoftechnologybelowdistrictlevel,LMDwithsupportfromH4LLogisticspilotedwebbased
LMISinperipherallevelHealthFacilities(HFs)ofJumla,ArghakhanchiandBardiya.Thisisaneffortto
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227
help districts with real time information on stock status of key health commodities and other
essential drugs at peripheral level HFs and can make evidence based logistics decision by making
commodities available uninterruptedly and ultimately contributing to increase health services
utilizationbythehardtoreachpopulation.
Inthisreportingperiod,asapartofimplementingwebbasedLMISuptotheperipherallevelHFs,
traininginArghakhanchiandBardiyawasconducted.Priortothetrainingthefollowingpreparatory
activitieswerecarriedout:
1. CurriculumDevelopmentandTrainingofTrainers
2. SoftwareModification
3. ProcurementofComputersandAccessories
Accordingly,aspartofimplementationtrainingwasconductedinallthreepiloteddistrictsin2015.A
total of 111 laptops, printers and CDMA data devises were distributed to all HFs of Bardiya,
ArghakhanchiandJumla.
Thefacilitybasedreportingstatusof3
piloteddistrictsisshownintheFigure
1. The reporting status of
ArghakhanchiandBardiyaisabove50
percent. However, the reporting
percentage of Jumla is not that
encouraging and it remained around
25 percent. Though LMD is providing
remote assistance through Team
Viewer, poor net connectivity and HF
personnel not being user friendly in
IT,thereportingstatusisstillfarfrom
par. However, it is expected that the
reportingpercentagewillbeimproved
incomingmonths.
RealTimeInventoryManagementSystem(IMS)
TheWebBasedLMISwasintroducedin2008replacedthequarterlypaperbasedreportingsystem
tomonthly,howeveritdidnotprovidetherealtimeinformationneededtomakeaneffectivesupply
chaindecisionmaking.Realizingtheneedofrealtimeinformationonheathcommodities,LMDtook
an initiative to make real time inventory management system up to the district level with
customizationofalreadyinuseIMSsoftware.ThesystemisadaptedfromtheUSAIDsupportedIMS
system with support from UNICEF/Lifeline Nepal. This is being online system, gives realtime
informationofstockstatusofhealthcommoditiesofcentral,regionalanddistrictstores.Thisallows
tomakesupplychaindecisionmaking.PlanistoimplementthisnewsystemfromnextFY.
ManualRevisionandPullSystemTraining
LMDandNationalHealthTrainingCenter(NHTC)withsupportfromH4LLconductedainJanuary16,
2015 to revise pull system training manuals. In the revision process data quality chapter was
introduced to improve recording and reporting and reducing data error. The manuals were yet to
revisesince2009.
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228
LMDandNHTCorganizedaPullSystemTrainingfor14districtstorekeepersespeciallyfocusingon
data quality in March 2527, 2015. Nepalgunj. The pull system training was new for almost all
participants. Importantly, newly introduced chapter Data Quality in which participants has to
performindividualexercisewasveryeffectiveandparticipantsshowedtheirkeeninterest.
Similarly, LMD and NHTC with support from H4LL organized a facility level pull system training for
theHFsofKalikotinJuly.ThetrainingwasrequestedbyKalikotDHOasthereweremanynewstaff
whodonothaveideaonhealthlogisticsandmanytrainedstaffsweretransferred.Themainaimof
thetrainingwastoimproveknowledge,skillandattitudeofthestorekeepersofhealthfacilitiesso
as to ensure the availability of adequate supply of medicine and health commodities in health
facilitiesviapullsystemtoprovideeffectivehealthcareservice.
LMISToolsRevision
LMIS revision subcommittee was formed under LWG and organized three meetings to revise the
LMISformsthathavenotbeenrevisedsince20years.ThesubcommitteerevisedtheLMISforms
accordinglyaddingnewdrugsandremovingredundantoneswitheightdigituniquecodesforeach
items.
Table1:RevisedinLMISFormsandNumberofItems
TypeofForms
OriginalNumberof
drugsandsupplies
Revisionandaddednew
drugs
Newcode
Assigned
DistrictStore
208
232
95
DistrictHospital
PHC
HP
208
208
169
232
193
132
95
NGO
6
5
RecommendationfromLMISrevisionsubcommitteeinpresenceofDirectorGeneral(DG):
Toimplementbimonthlyreportingsystemfromperipheralhealthfacilitiesuptocentreleveli.e.
HP,PHC,DistrictHospital,DHO/DPHO,RMS,andCentre.
Incaseof HIV&AIDS commoditiesreporting Regional,ZonalandReferralHospitalneedtobe
includedinthesystem.
TovalidateLMISdatawithmorbiditydataofHMISreporting.
Feedback mechanisms need to be strengthened and need to plan quality assurance annual
surveytoimprovethedataquality.
LMISdataprocessingsystemshouldberevisedaccordinglysuchasIMSsoftware.
LogisticsRegionalReviewMeeting
LogisticsManagementDivision(LMD)carriedoutRegionalLogisticsReviewMeetinginallregionsof
thecountrytoaddresstheproblemsandissuesfacedbythedistrictsinsupplychainmanagementof
healthcommoditiestoservetheendusers.Thecurrentlogisticschallengesandissuesarediscussed
with district health officers in the meetings. Likewise, this is an opportunity to share districts
experience last mile in supply chain and issues/challenges in supply chain management and how
theydealt.Similarly,inthisforumLMDcansharetheprogressstatus,logisticsindicatorsandcoming
yearsactivitiesaswell.
TheobjectivesoftheLogisticsregionalReviewWorkshopwasto:
Share districts experience in supply chain management of health commodities to the
peripherallevelHFs
Experiencesharinginissuesandchallengesinlogisticsmanagement
Progress,achievements/accomplishmentsandupcomingyearsprogramfromthecenter
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229
During the regional logistics workshop districts present on the prescribed format provided by
LogisticsManagementDivision(LMD)whichcoversthefollowingareas:
1. Progressstatus(Anusuchi2)
2. HealthFacilitywiseestimatedtransportation
3. TotalcommoditiesdistributedinFYyear2071/72
4. EstimatedrequiredquantityofcommoditiesforFY2071/72
5. QuarterlyLMIS/MonthlyWebbasedLMISreportingstatus
6. Situationofbiomedicalinstrumentsandequipments
7. Statusofrepairandmaintenanceofbiomedicalequipments
8. EstimatedtransportationcostfromdistricttoperipherallevelHFs
9. Transportationfacilityandtheirconditions
10. Majorissuesandchallenges
Theworkshophasrecommendedthefollowingactionstoalleviatetheabovementionedproblems
andconstraints.
LMD will forward the problem to concern ministries and planning commission for the
additionalrequiredtransportationbudgetindistrict.
Strengthen supply system with coordination to center stores, regional medical stores and
districtstores.
LMDwillcoordinatewithManagementDivisiononmakingstoragespacesandsuggestedto
districtstosendestimatetoMD.
BudgetshouldbeallocateincontractforComputerAssistanttotheregion/districts.
Budgetshouldbeallocateinlogisticsorientationprogramfornewlyappointedstaffstothe
districts.
LMD along with supporting partners will provide necessary support for auctioning and
disposal.
HIV/AIDSLogistics
LMDconductedanassessmentontheHIVandAIDScommodities(ARVDrugsandHIVtestkits)and
essentiallogisticssystemstodetermineverticallymanagementofARVsupplychainsystemcanbe
integratedwiththegeneralhealthlogisticssystem.Aspertherecommendation,theintegrationof
HIV and AIDS logistics into mainstream logistics was endorsed by MoH in June 2012. As a part of
integrationprocess,HIVandAIDScommoditieswereincludedinNationalConsensusForecastsince
November2011.IntegrationofHIVandAIDSLogisticssystemcameintoeffectmainstreamlogistics
fromJuly2012withassumingtheresponsibilitiesofstorageandtransportation/distributionofHIV
andAIDScommoditiestotheservicedeliverysites.
DisposalofUnusableHealthEquipmentandCommodities:ABestPractice
Unusableand/orexpired health commoditiesarea majorproblemforNepalshealthsystem.Safe
storage conditions for essential drugs and commodities are required to deliver quality health
servicestoservicedeliverysites.Inaddition,dejunkingofunusablecommoditieshelpsclearthe
wayforusablecommodities.Forexample,amajordejunkingdrivein199497freedupmorethan
125,000 square feet of free space and generated 25 million Nepali Rupees (NRs.) for the
GovernmentofNepalstreasury.
USAIDs H4L Logistics project is engaged in several actions to disposal of unused, unwanted or
expireditems.Theseactivitiesincludetheprovisionoftechnicalsupportinauctioningofunusable
commoditiesfortheDistrictHealthOffices(DHO)inArghakhanchi,Surkhet(DasarathpurPHC)and
Banke district in MaySeptember 2015. This generated more than NRs. 78,000 for the national
treasury and freed approximately 450 square feet of space which could now be used to store
valuablelifesavingdrugs.
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TelemedicineProgram
Nepal Government Ministry of Health & Population is committed to provide quality health to the
ruralpopulationwithspecialattentiontothevulnerablecommunity.Telemedicinehasbeenchosen
asoneofthemostimportantmeanstoachieveit.
LMDinitiatedandimplementedRuralTelemedicineprogramin30hillandmountaindistricts1.The
trainingonTelemedicineforthesedistrictshasalsobeencompleted.
6.3.5IssuesandActionTaken
Issuesraisedandactiontaken:
Issues
ActionTaken
Insufficient
budget
for LMD has requested to concern
transportationaspertariff
ministriesfortransportationbudget
No vehicle for transportation of Double Cab PickUp has been
medicines, equipments and procured and distributed in 18
materials
Districts
and
planning
for
continuation.
Not updated webbased LMIS LMD will provide budget for web
and inventory management based LMIS operation human
system as regular due to HR resource
issue
Lack of training/orientation LMD will provide budget for
program regarding logistics and orientation on logistics and LMIS for
LMISfornewlyappointedstaffs newlyappointedstaffsinthedistricts
Expansion of store space and
clearing of not repair and not
used
equipments/materials
fromstore
Clearanceofnotrepair/notused
equipments/materials
from
districtandhealthfacility.
Responsibility
MoH/DoHS/LMD
MoH/DoHS/LMD
DoHS/LMD
DoHS/LMD
LMD will plan for expansion of store

space with the coordination of
managementdivision
DoHS/MD/LMD
LMD will act auctioning and disposal

according to guideline with the
coordination
of
external
developmentpartners.
DoHS/LMD/EDPs
6.3.6Issues/Challenges&ProgressinProcurementReform
IssuesandChallenges:
SomeprogressinprocurementandSupplyChainmanagementandreformagenda.
StockoutSituationofDrugsandcommoditiesandRemedytoresolve.
ManagingProcurementandsupplyinpostearthquickandembargo.
Inadequateskilledandtrainedtechnicalhumanresourcesforprocurementandquality
assurance.
SupplyChain(WarehousecapacityandPUSH/PULLmechanism,realtimeLMIS)toaddress
theissueofoverstock.
PriceVariation/lotmanyissues?
Governanceandtransparencythroughegovernance(procurement/bidding/Esubmission)
Achham, Bajhang, Bajura, Darchula, Dolpa, Gorkha, Humla, Jajarkot, Jumla, Kalikot, Khotang, Manang, Mugu, Mustang,
Okhaldhunga, Pyuthan, Rasuwa, Rolpa, Rukum, Sankhuwasabha, Sindhuli, Sindhupalchowk, Dolakha, Solukhumbu,
Taplejung, Baitadi, Doti, Dadeldhura, Dailekh and Salyan
217
231
JointAttempt:
MoHandPartnersrealizedonProcurementreformandcommittedonagenda.
ProcurementReformStrategyandRoadmapagreed.
Seriesofmeetingandworkshoporganized.
KeystakeholdersfromthePartnersParticipated.
Recommendations:
ElevateLMDwithinMoHstructureandgiveitfullauthoritytooverseeprocurementinthe
healthsector,
createpositionforprofessionalprocurementexpertswithclearToRfortherestructured
LMD,and
clearlydefinethescopeofworkofLMD.
SN Output
Activities
Progress
1
Concept Note for Restructuring of
Approved by MoH on 23
LMD along with Procurement
April2015
ReformActionPlan
2
218
232
Health
sector
procurement
Processes/Procedure strengthened
(drugs, equipment and health
commodities).
Develop and approve

standard specification
Drug
PilotingCentralbidding
and payment local
ordering and delivery
(inoneRegion
Implementing the Plan
as per the
E
tendering/submission
as per the
E
Specification Prepared
with consultation and
endorsed by MOH and
uploaded
in
LMD
website. Few needs
Revisit.
Specifications for 1060
alreadyprepared
QA completed (Crown
Agent) Need to discuss
with user group and
makemorecompetitive.
Specification for cold
Chain
Equipment
Prepared endorsed and
uploadedinWebsite.
AdoptedPQforVaccine
Cold chain Equipment
Specification prepared
andendorsedbyMOH
FP commodities except
DMPA is PQ and DMPA
is WHO GMP as per
decision made from
MOH
as
per
the
E
as
per
the
E
alreadyinplace
Health
sector
procurement Piloting Central bidding Draft Standard Bid
documentprepared
Processes/Procedure strengthened and payment local
(drugs, equipment and health ordering and delivery (in
oneRegion.
commodities).
Health
sector
procurement Define list and volume Yettobefinalized
Processes/Procedure strengthened drugs&equipmenttobe
(drugs, equipment and health procured at different
levels.
commodities).
Health
sector
procurement ImplementingthePlanas Executed
the
E
Processes/Procedure strengthened per
(drugs, equipment and health tendering/submission
commodities).
Capacity (Org/HR/IT/
enhanced
Finance) Make arrangement of Not yet Managed and

revolving funds for
notPossiblebyFinancial
health
sector
RulesandRegulation
procurement
O&M Survey completed

and Structure defined
Procurement
of
additionalstaffadjusted
professional dedicated
with in MOH staffing
staffoutsourced.
and post which exists.
Capacity enhancement
No additional Post can
andtraining.
beputlikeProcurement
consultant
Procurement Training
forEDR,CDR,andFWDR
completed.
E bidding Training for
LMD completed. Non
fromEDPforLMD
Procurement Training
for EDR,CDR ,FWDR
completed.
E bidding Training for
LMD completed. Non
fromEDPforLMD
Supply Chain (Infra/ Systems) made Expansion of current NoProgressmadeyet
regionalstores.
effectivelyfunctional.
Supply Chain (Infra/ Systems) made Real
time/Live Logistic working group
operation
of
LMIS at
has completed Draft
effectivelyfunctional.
districtlevelmonthly
LMISreportingFormat
(Paperless system at Web Based LMIS Soft
ware
revised
and
districtlevel)
Piloted in Central
Medical
Store
Pathalaiya
219
233
MajorActionsCarriedoutbyLMDinFY2071/72:
CapacitybuildingonPPAandPPRin3regions.
ContractManagementsoftwareinPlace
Rapidhumanitarianresponseduringearthquakeinsupplyanddistributionofemergency
medicinesandequipments.
Planahead:
TrainingonpublicprocurementRulesandRegulation
TrainingonEsubmission
TrainingonInternet/WebbasedLMIS
ExpansionofRealtimeWebBasedLMISSoftwareinRegionalstore.
Regional/Districtlevelforecasting
EstablishLWGatregionallevel
AtdistrictlevelNoPaperbasedInventoryonlycomputerized.DecisionmadeatDoHSandletter
alreadysent
ProgressinProcurement:
Reviewofalldocuments,Qualificationcriteria'sandPPA/PPR
PreBidMeetingpracticedintroducedandissuesresolvedforbidfloated.
ComputerizedContractManagementSystemintroduced.
InitiatedConsolidatedAnnualandMasterProcurementPlan
Situationofoverstockandexpirymanagedleadingtostockout.
Multiyearcontracting(2Year)toensurecommoditysecurity
CurrentIssues:
PPAandPPRandBiddocumentneedstobereviewedtoaddressissueswhichisnothealth
Procurementfriendly.
WhywedontanalyzeandWhatistherealcauseofdelayedProcurementandsupplychain
andstockout.
220
234
SupportingPrograms:PublicHealthLaboratoryServices
6.4 PublicHealthLaboratoryServices
6.4.1INTRODUCTIONANDBACKGROUND
Under curative services, the Health policy aims to provide diagnostic laboratory services in all the
hospitals from central to the periphery. In accordance with National Health Policy 2071 and National
HealthLaboratoryPolicy2069,theNationalPublicHealthLaboratory(NPHL)hasbeenidentifiedasthe
centralandspecialisednationalreferralpublichealthlaboratoryforthecountryandregulatorybodyto
licence the public and private labs. Besides, NPHL is a focal point for Blood Safety. In this regards,
NationalBureauofBloodTransfusionService(NBBTS)hasbeenestablishedatNPHL.
NHSP II (20102015) envisages Public Health Laboratory Service strengthening at all levels. In this
regards, National Public Health Laboratory (NPHL) has been designated as nodal institute for Policy,
guidelines and over all framework for capacity building&development in laboratory sector. Attention
will be given to strengthen laboratory procedure and communication between national, regional and
district levels and strengthening the systems ensuring the availability of essential equipment and
logistics.Italsogivescommitmenttonewrecruitmentofstaffaswellastrainingofexistingstaff.
HistoryoflaboratoryservicesinNepalisnearlyhalfcenturyoldandaclinicallabwasfirstestablishedat
Bir Hospital. At present there are central hospital based laboratories8, Regional hospital based
laboratory3, sub regional hospital based laboratory3, Zonal hospital based laboratories10, District
hospitalbasedlaboratories62,DistrictlevelHospitalBased16andPHCCbasedlevellaboratories204.
In the private sector there are above1500 laboratories. All these laboratories require significant
strengthening with respect to quality assurance, human resource recruitment, competency,
developmentofservicerangeandphysicalinfrastructure.
Quality service of laboratory is important issue. NPHLconducts external quality assurance scheme on
differentdisciplineoflabservicesanddevelopqualitycontrolsamples.
EveryyearNepalisatthreatofoutbreakofnewemergingandreemergingdiseases.In2009,therewas
apandemicofInfluenzaA,H1N1&Pdm,in2013,MersCoronavirusoutbreakoccurredinMiddleEastand
H7N9inChina,in2015,EbolainAfricaandin2016ZikaVirusinSouthAfricaandsouthAmerica.AsNPHL
is responsible for outbreak investigation of diseases, National Influenza Centre (NIC) has been
establishedinApril,2010andBioSafetyLevel3LabinJanuary2015fordiagnosisofemergingandre
emerginginfectiousdiseases.NICfunctionsthroughtheNationalInfluenzaSurveillanceNetwork(NISN)
locatedatdifferentregions.Inpublichealth,NPHLhascapacitytodiagnosedifferenttypesofinfluenza;
InfluenzaA(H1H3,H1N1,H7,H5),InfluenzaB,otherviruslikeRSV,Hanta,Ebola,CCHF,KFD,Dengue,
Chickengyunya,Zika,leptospira,scrubtyphus,HIVViralLoad&EID,HCVViralLoad&Genotyping,etc.
MajorchallengeofHealthLaboratoryserviceisshortageofhumanresource.Thereisnoadequatepost
microbiologist/virologistwhoseroleisverycrucialfordiagnosisofinfectiousdisease.Labservicecannot
befunctionalwithoutuseofbiomedicalequipments.Repair,maintenanceofcalibrationofequipmentis
veryessentialtoprovidequalitylaboratoryserviceforwhichitneedsadequatenumberofbiomedical
engineers. Other laboratory staffs like pathologist, medical technologist and biochemist are not
adequateateachhealthfacility.Thepostforeachcategoryshouldbeincreasedaspertheworkload.
NationalBureauforBloodTransfusionServicebasedatNPHLhasbeenformedastheNationalauthority
forbloodsafetyonbehalfofMoHforeffectiveimplementationofNationalBloodProgram(NBP).The
missionstatementofNBPistoensuresafe,adequateandtimelysupplyofbloodandbloodproductto
meet the transfusionrequirementofthepeopleofNepalinandequitableandaffordablemannerfor
221
235
whichNBPisworkingondevelopment/revisionofpolicy,guidelines,protocols,SOPsasperneed.NPHL
also serves as National Reference laboratory for TTIs screening for BTS. As a reference lab, its
responsibility is to evaluate the testing kits for TTIs to perform conformational test and to send
proficiencypanelstoallBTSCsunderNationalQualityAssuranceScheme(NEQAS)inBTS.Otherquality
related responsibilities are to conduct training of BTSCs staffs, carry out supervision & monitoring of
differentBTSCsasperneedandsupplyofqualityequipmentonneedbasisandsetsofBTSCequipment
tofivenewlyestablishedBTSCstotheremotedistricteveryyear.
OBJECTIVES
To affirm government commitment and support for the organization and management of
efficient,costeffectiveandsustainablehealthlaboratoryservices.
Tostrengthenlaboratoryservicesforsupportingdiagnosis,treatment,surveillance,prevention
andcontrolofdiseases.
Toestablishnationalstandardsforlaboratoryqualitysystems.
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.
6.4.2MAJORACTIVITIES
A. Routineandspecializeddiagnosticservice
B. Publichealthrelatedactivities
o Laboratorybasedsurveillance(AES/JE,Measles/Rubella,AMR,Influenza)
o HIVReferenceUnit
o NationalInfluenzaCentre
o BSL3laboratory
o OutbreakInvestigation
C. Trainingandworkshops
D. Logisticsprocurementandsupply
E. Laboratoryrefurbishment
F. SupervisionandMonitoring
G. NationalExternalQualityAssuranceScheme(Haematology,Biochemistry,GramStain,
microbiology,AMRonselectedbacterialpathogensandTTIs)
Majorachievement
Routineandspecializeddiagnosticfacilities
NPHL is providing the routine and specialized laboratory service at affordable prices. The major
objective is to provide the routine and specialised diagnostic facilities at reasonable price on timely
manner.
222
236
ThefollowingfigurerepresentsthepastyearlaboratoryperformanceindifferentdepartmentofNPHL
Biochemistry
120000
100000
Haematology
29000
100460
75813
80000
75034
28000
27045
27000
60000
25519
26000
40000
20000
25000
24000
2069/70
12000
11500
11000
10500
10000
9500
9000
28520
11728
2070/71
2071/72
2069/70
Parasitology
10136
2070/71
10200
10000
9800
9600
9400
9200
9000
8800
10101
2069/70
2071/72
10000
9896
2070/71
2071/72
Virology
12998
11851
10126
9366
Endocrionology
15000
2071/72
Immunology
11165
2069/70
2070/71
18769
20000
15000
12252
14576
10000
5000
5000
0
0
2069/70
2070/71
2069/70
2071/72
HistologyCytology
10000
6000
3388
4000
6088
6027
2069/70
2070/71
4000
2000
2000
0
2069/70
7473
8000
5804
6000
2071/72
Microbiology
8696
8000
2070/71
2070/71
2071/72
2071/72
223
237
Publichealthrelatedactivities
Laboratorybasedsurveillanceactivities
Beyondtheroutinediagnostic,NPHLisalsoconductingthelaboratorysurveillanceactivitiesonvarious
disease pathogens. These activities include Measles/Rubella surveillance, Japanese encephalitis
surveillance, Influenza surveillance and Antimicrobial resistance surveillance. The major objective of
theseprogrammesistofindouttheburdenofrelateddiseasesandprovidebackgroundinformationfor
theformulationofstrategytocontrolthesediseasesinthecount
Belowarethesamplesanalysedontherelatedactivities.
798
736
574
Salmonella ShigellaSPP
SPP
V.Cholerae
069/070
2
1
0
36
21
7
4
7
0
8
6
6
250
179
205
642
1600
1400
1200
1000
800
600
400
200
0
1203
1475
AMRSurveillance(DistributionofIsolates)
S.
H.Influenzae
N.
Preumoniae
Gonorrhoea
070/071
ESBLE.Coli
071/072
LabBasedSurveillance
1400
1200
1306
1209
1124
1000
800
600
634
472
439 439 456
304 304
400
402 402
200
0
069/070
AES/JE
070/071
Measles
Rubella
2071/072
Dengue
NationalExternalQualityAssuranceScheme(NEQAS)
Toensurethetestingqualityandaccesstheexistingstatus,NPHLisconductingtheNEQASprogramasa
part of External quality assurance. NPHL dispatch the laboratory samples of different parameters to
variouslabsthroughoutthecountryandreceivesthetestresultfromthoselabswhereasinsomeNPHL
receivesthetestedsample(HIVDBS).Onthebasisoftheir,testresult,NPHLcompilesthereportand
sendfeedbacktoindividuallaboratories.Thisalsohelpstoaccessthetestingcapabilityoflabpersonnel.
Thetestingparameterrangesfrombiochemicaltest,malariaslideandotherslikeDBSEQASwhereHIV
testingqualityismonitoredandTTIscreening,PTforbloodtransfusionservicecentres.
224
238
SupportingPrograms:PersonnelAdministrationManagement
6.5 PERSONNELADMINISTRATIONMANAGEMENT
6.5.1 Background
Human resource being the living and key resource is pivotal of the health service delivery system.
Human resource management includes the human resource planning, motivation, utilization,
training and development activities of the employees. Promotion, transfers of staffs and special
training provisions are also key activities of human resource management in health system.
Organizationisbasicallyallabouthumanproperplacementandutilizationofemployeesiscrucialfor
effectiveimplementationoftheprogramandqualityhealthservicedeliverytopeople.
UndertheDepartmentofHealthServicesthePersonnelAdministrationSection(PAS)isresponsible
tooperateroutineandprogramadministrativefunction.Themajorfunctionsofthesectioninclude
upgradinghealthinstitutions,transferofhealthworkers,levelupgradingofhealthworkersupto7th
level,capacitybuildingaswellasinternalmanagementofhumanresourcesofpersonnel.
Objectives
Themainobjectiveofthesectionistomobilize humanresourcetodeliver qualityhealthservices.
Thespecificobjectivesinclude:
Transferandmanageallthepostupto7thlevelaccordingtothegovernmentpolicyandact.
Placementofhealthstaffsatthesanctionedpostinallthehealthinstitutions;
Managehumanresourcesatthedifferentlevels;
Takedisciplinaryactionaccordingtotheprofessionallaw;
Manageandupdatepersonnelinformationofalllevelsandinstitutionsunderthedepartment.
Performthetasksaccordingtoprevailinglaws,rulesandregulations;
Mange the posting and transfer of medical officers who had completed their study in
governmentscholarships;
ExecutetheO&Msurveyasneededtoestablishandextendthestructureofhealthinstitutions/
organizationsinandundertheDepartmentofHealthServices;and
ConductingtheactivitiesasperthedirectiongivenbyMinistryofHealth&Population.
RecommendtoMoHPforapprovalofspecialleave&educationleaveasperrequestofhealth
workers.
6.5.2 Majoractivities
DistributionofHealthWorkForce
Ministry of Health and Population (MoHP) has more than 30,000 employees of them more than
24,000 are technical personnel and 6,300 are administrative staff. Department of Health Services
(DoHS)hasabout24,000workforceincludingallfivedevelopmentregion'shealthfacilitiesandof
them 196 post (technical and administrative) for all divisions and sections under the DoHS.
Sanctionedandfulfilledpostbytypeshasgivenintables(Table:6.5.2and6.5.3).
Transfer
Accordingtotransferschedulementainedinhealthserviceregulation,2055andMoHPpolicy,DoHS
is responsible for transfer of the health workforce up to the 7th level. As requirement of health
organizationanddemandedbyhealthworkers.
DoHS,
Annual Report 2071/72 (2014/2015)
239
225
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.DoHSworkstomaintaintheprofessionaldisciplinewithinitsemployees.
LevelUpgrading
Following a set of criteria DoHS manages upgrading of its employees up to the 7th level two
times(ShrawanandMagh)ayearasmentionedinregulation.
Leave
DoHS approves different types of leaves such as house leave, sick leave, delivery leave and other
leavesasperrequestmadebyhealthworkersunderandwithinthedepartment.DoHSrecommends
toMoHPforapprovalofspecialleaveandeductionleavewhichareforwardedthroughconcerned
healthfacilitiesandregionalhealthdirectorateasrequestmadebyemployeesupto7thlevelunder
thedepartment,accordingtoNepalHealthAct&Law.
RetirementandResignation
DoHS manages the retirement of the staff after their information of retirement provided by
DepartmentofCivilPersonnelRecords.Approvalofresignationofthestaffabove6thlevelismade
through the Ministry as the reference from their concerning office with verification and clearance
provided.
Newinitiation
Duringthereportingyearfollowingnewinitiationshasbeenimplemented.
Filetrackingsystem.
DigitalattendancewithinDoHS.
Calenderofoperation(onlineactionplan)ofdivisionsanddepartment.
Table6.5.1TypeofworkforcedistributionsatDepartmentofHealthServices,FY2071/72
SN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
240
226
Post
DirectorGeneral
DeputyDirectorGeneral
Director
Director
Sr./HealthAdministrator
Sr.ComputerOfficer
Sr./CommunityNursingAdministrator
Sr./PublicHealthAdministrator
Chief/DeputyChiefMedicalOfficer
Sr./ConsultantDermatologist
Sr./ConsultantGynae Obst.
Director/DeputyDirectorSr.Demographer
UnderSecretary
UnderSecretary(Finance)
SectionOfficer
AccountOfficer
LegalOfficer
Pharmacis
Sr.PublicHealthOfficer
MedicalOfficer
Grade/Level
12th
11th
11th (PHA)
11th (PHA/HI)
9/10th
GazettedII
9/10th
9/10th
9/10th
9/10th
9/10th
GazettedII
GazettedII
GazettedII
GazettedIII
GazettedIII
GazettedIII
7/8th
7/8th
8th
Sanctioned
1
1
5
1
6
1
2
8
1
1
1
4
3
1
12
6
1
2
9
3
Fulfilled
1
1
5
1
6
1
0
8
1
0
1
3
3
1
12
6
1
2
4
3
DoHS,
Annual Report 2071/72 (2014/2015)
SN
21
22
23
24
25
26
27
28
29
30
Post
ElectricalEngineer
Sr./CommunityNursingOfficer
Sr.NursingOfficer
Entomologist
ComputerProgrammer
StatisticsOfficerDemographer
VeterinaryDoctor
ComputerOfficer
MechanicalEngineer
ComputerOperator
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
NayabSubba
Accountant
HealthAssistant/PublicHealthInspector
VectorControlAssistant
EntomologistAssistant
LabTechnician
ImmunizationSupervisor
MedicalRecorderAssistant
TB/LeprosyAssistant
StoreKeeper(Tech)
PublicHealthNurse/
Kharidar
AccountantAssistant
ColdChainAssistant
LabAssistant
MalariaAssistant
Typist
HeavyVehicleDriver
LightVehicleDriver
OfficeAssistant(Peon)
Sweeper
Grade/Level
GazettedIII
7/8th
7/8th
7/8th
GazettedIII
GazettedIII
GazettedIII
GazettedIII
GazettedIII
NonGazettedI
Sanctioned
2
1
1
1
1
5
2
6
1
6
Fulfilled
1
0
0
0
1
5
2
6
1
6
NonGazettedI
NonGazettedI
5/6th
5/6th
5/6th
5/6th
5/6th
5/7th
5/8th
NonGazettedI
5/6th
NonGazettedII
NonGazettedII
4/5th
4/5th
4/5th
Asoftypingspeed
NotClassified
NotClassified
NotClassified
NotClassified
12
6
18
2
1
1
2
1
1
1
1
3
1
4
2
3
4
2
6
28
2
12
6
18
2
1
1
2
1
1
1
1
3
1
4
2
1
4
2
6
27
2
196
175
Total
Source:PersonnelAdministrationSection,DoHS
Table6.5.2:WorkforceofunderRegionalHealthDirectorate,fiscalyear2070/71
WorkforceofEasternRegionalHealthDirectorate,Dhankuta
Designation
Doctors
PHO
Districtsupervisors
HA/SAHW/PHI
StaffNurse/PHN
AHW/SAHW
ANM/SANM
LabPersonnel
Sanctioned
Fulfilled
Vacant
%ofvacant
100
16
65
10
35
38
125
410
136
2053
1315
108
112
227
87
1562
988
89
35
6
13
183
49
491
327
19
DoHS,
Annual Report 2071/72 (2014/2015)
10
45
36
24
25
17
241
227
Admin/Finance
175
133
42
24
OtherTechnician(RG,DRA)
25
555
5018
14
553
3799
11
2
1219
44
Other(Driver,OA)
Total
0.3
24
WorkforceofCentralRegionalHealthDirectorate,Hetauda
Organization
Sanctioned
Fulfilled
Region&District
6283
5012
Hospital
679
529
GrandTotal
6962
5541
Vacant
1567
171
1738
Extra
296
12
308
WorkforceofWesternRegionalHealthDirectorate,Pokhara
Designation
Sanctioned
Fulfilled
Doctors
250
132
Paramedics
2098
1410
Nursingstaff
1352
1041
Total
3700
2583
Vacant
118
688
311
1117
%ofVacant
47%
33%
23%
30%
WorkforceofMidwesternRegionalHealthDirectorate,Surkhet
Designation
Sanctioned
Fulfilled
148
56
Doctors
929
763
Nursingstaff
1564
1139
SAHW/HA/AHW
80
56
LabStaff
191
60
OthersHealthStaff
771
620
Admin&OthersStaff
3683
2694
Total
Vacant
92
166
425
24
131
151
989
%ofVacant
62
18
27
30
69
20
27
WorkforceofFarwesternRegionalHealthDirectorate,Dipayal
Designation
Sanctioned
Fulfilled
Doctors
77
36
Paramedics
1131
852
Nursingstaff
607
489
Total
1815
1377
Vacant
41
279
118
438
%ofVacant
53%
25%
19%
24%
Source:AdministrativerecordsofallRHDs
ActiontobeTaken
Responsibilities
Inadequatetrainingof
administrativestaff
UnclearJobDescription
Provideappropriatetraining
DoHS/MoHP
Developjobdescriptionand
implement
RHD/DoHS/
MoHP
Performanceappraisal
systemwasnotfunctioning
properly
NoRegistrationofhealth
institution
Noapprovesalaryreport
Performanceappraisalsystem
shouldbetieupwithupgrading
andpromotion
Institutionalized/registered
Facilitateprocess
DoHS/RHD/
MoHP
Nopersonneldatabase
ManageHPIS(HealthPersonnel
DatabaseSystem
Deadline
Within3
months
After
approved
fromMoHP
Asper
schedule
DoHS/RHD
Within6
months
D/PHO, District Within6
Treasury
months
ControlOffice
DoHS/RHD
within1yr
242
228
DoHS,
Annual Report 2071/72 (2014/2015)
SupportingPrograms:FinancialManagement
6.6
FINANCIALMANAGEMENT
6.6.1 Background
An effective financial support system is imperative for efficient management of health services.
Preparation of the annual budget, timely disbursement of funds, accounting, reporting, and
auditing are the main financial management functions that are necessary to support the
implementationofhealthprograms.TheFinanceSectionoftheDoHSisthefocalpointforfinancial
management for all programs under the DoHS. All health institutions have their own Finance
Section,exceptPHCs,HPsandSHPs.
Objectives
Toprovidesupporttoallprogramsdivisions/centresduringannualbudgetpreparation
Toobtainanddisburseprogrambudgets
Tokeepbooksofaccountsandcollectfinancialreportsfromallinstitutions
Toprepareandsubmitfinancialreports
Tofacilitateinternalandexternalauditing
Toprovidefinancialconsultation
Targets
The main target of financial management is to achieve 100% expenditure of all budgets in
accordancewithprogramworkplanswithinaspecifiedtimeasperfinancialrulesandregulations
ofgovernmentandtomaintaintherecordingandreportingsystemaccuratelyandtimely.
6.6.2 AnalysisofAchievementsbyMajorActivities
Out of total National Budget of Rs. 6,18,10,00,00,000 a sum of Rs. 33,51,71,02,000 (5.42%) was
allocatedforthehealthsectorduringthefiscalyear2071/72.Ofthetotalhealthsectorbudget,Rs.
23,47,29,63,597(70.03%)wasallocatedfortheexecutionofprogramsundertheDepartmentof
HealthServicesNetwork(Table6.6.1).
Table6.6.1:HealthBudgetunderDoHS,FY2071/72
National Budget
Health Budget
Health Budget under DoHS
Total
Recurrent
Capital
618,100,000,000
33,517,102,000
23,472,963,597
398,951,195,000
29,006,652,000
19,539,715,000
64.54
86.54
83.24
219,148,805,000
4,510,450,000
3,933,248,597
35.46
13.46
16.76
Source:FinanceSection,DoHS
Table6.6.2:AllocationofBudgetbySource,FY2071/72
Health Budget
under DoHS
Total
HMG
Donor
23,472,963,597
12,539,259,000
51.52
10,933,704,597
48.47
DoHS,AnnualReport2071/72
229
243
Table6.6.3: RegularProgramRecurrentBudget,ReleasesandExpenditurebyProgramme
Activities,FY2071/72
Programme Budget
Total Budget (in Rs.)
Budget
Code No
3700123
3700133
3700143
3700213
3700233
Department of
Health
Regional Health
Directorates
District Health
Offices
Health Training
Centres
Expenditure (in Rs.)
Amount
Amount
Amount
% (a)
% (b)
117,546,000
1.64
121,770,493
1.63
121,770,493
100
1.63
75,984,000
1.06
70,151,850
0.94
70,151,850
100
0.94
6,095,352,000
84.80
6,407,675,042
86.02
6,407,675,042
100
86.02
45,278,000
0.63
44,261,313
0.59
44,261,313
100
0.59
854,150,000
11.88
804,953,232
10.81
804,953,232
100
10.81
7,188,310,000
100
7,448,811,930
100
7,448,811,930
100
100
Districts Hospitals
Total
Release Budget (in Rs.)
Table6.6.4:CentralLevelRecurrentBudgetAllocationbySourceandProgramactivities,FY
2071/72
ProgrammeBudgetHeading
TotalBudgetAllocationbySource
Budget
CodeNo
Gon
Donor
Total
3701133
TuberculosisControl
Programmes
122,642,000
5.28
843150000
17.56
965,792,000
17.56
3701143
NationalAidsControl
38,381,000
1.65
889,346,000
18.53
927,727,000
18.5
3701153
FP/MCHProgrammes
16,646,000
0.72
314,883,000
6.56
331,529,000
6.6
3701163
IntregretedCHDProgramme
702,116,000
30.23
1,576,416,000
32.84
2,278,532,000
32.8
3701193
EpidemiologyProgramme
181,209,000
7.80
370,240,000
7.71
551,449,000
7.7
3701203
LeprosyControlProgramme
18,590,000
0.80
11,150,000
0.23
29,740,000
0.2
3701213
IndentProcurement
33,749,000
1.45
292,540,000
6.09
326,289,000
6.1
3701223
HospitalConstruction
/ManagementInformation
System
782,918,000
33.71
167,477,000
3.49
950,395,000
3.5
3701233
NHEICC
43,701,000
1.88
127,185,000
2.65
170,886,000
2.6
3701263
HealthLaboratoryServices
48,597,000
2.09
49,250,000
1.03
97,847,000
1.0
3701363
PHCRD
14,399,000
0.62
147,750,000
3.08
162,149,000
3.1
3701383
PreimryHealthRDAvain
112,700,000
4.85
0.00
112,700,000
0.0
3701243
NationalHealthTrainingCentre
206,666,000
8.90
10,800,000
0.22
217,466,000
0.2
2,322,314,000
100.00
4,800,187,000
100.00
7,122,501,000
100
Total
230
244
Table6.6.5:CentralLevelRecurrentBudgetReleasedbySourcebyProgram,FY2071/72
Budget
CodeNo
3701133
ProgrammesBudget
Heading
TuberculosisControl
Programmes
Gon
111,371,002.37
6.16
ReleasedBudgetBySource
Donor
%
32.3
412037130.66
7
26.8
341885245.82
6
120671937.62
9.48
Total
523,408,133
16.99
11.9
3
4.13
12.5
6
3701143
NationalAidsControl
25,598,211.56
1.42
3701153
FP/MCHProgrammes
IntregretedCHD
Programme
Epidemiology
Programme
LeprosyControl
Programme
IndentProcurement
/Management
InformationSystem
NHEICC
HealthLaboratory
Services
PHCRD
PreimryHealthAvain
NationalHealth
TrainingCentre
Total
6,521,222
0.36
355,867,017.79
19.69
31,128,349
2.45
386,995,367
158,949,812
8.79
32,737,467.42
2.57
191,687,279
6.22
10,035,493
0.56
4,341,991
0.34
14,377,484
0.47
19,286,903.02
1.07
92,557,995.18
7.27
111,844,898
3.63
773,243,958
42.78
41,129,740
3.23
814,373,698
26.4
4
39,591,487.20
2.19
54,730,386.21
4.30
94,321,873
3.06
95,298,613.70
5.27
46,824,911.61
3.68
142,123,525
4.61
3,426,105
86,221,786.51
0.19
4.77
86,782,350.57
0
6.82
0.00
90,208,456
86,221,787
2.93
2.80
122,006,441.50
6.75
8,071,048
0.63
130,077,490
4.22
1,807,418,054
100.00
1,272,898,553.090
100
3,080,316,607
100
3701163
3701193
3701203
3701213
3701223
3701233
3701263
3701363
3701383
3701243
367,483,457
127,193,160
Table6.6.6:CentralLevelRecurrentBudgetExpenditurebySourceandProgram,FY2071/72
Budget
CodeNo
3701133
3701143
3701153
3701163
3701193
3701203
3701213
3701223
3701233
3701263
3701363
3701383
3701243
ProgrammesBudget
Heading
TuberculosisControl
Programmes
NationalAidsControl
FP/MCHProgrammes
IntregretedCHD
Programme
LeprosyControl
Programme
IndentProcurement
/Management
InformationSystem
NHEICC
HealthLaboratory
Services
PHCRDAvian
PreimryHealthRD
NationalHealthTraining
Centre
Total
ExpenditureBudgetbySource
Donor
%
Gon
Total
%(a)
111,371,002.37
6.16
412037130.66
32.37
523,408,133
16.99
25,598,211.56
6,521,222
1.42
0.36
341885245.82
120671937.62
26.86
9.48
367,483,457
127,193,160
11.93
4.13
355,867,017.79
19.69
31,128,349
2.45
386,995,367
12.56
158,949,812
8.79
32,737,467.42
2.57
191,687,279
6.22
10,035,493
0.56
4,341,991
0.34
14,377,484
0.47
19,286,903.02
1.07
92,557,995.18
7.27
111,844,898
3.63
773,243,958
42.78
41,129,740
3.23
814,373,698
26.44
39,591,487.20
2.19
54,730,386.21
4.30
94,321,873
3.06
95,298,613.70
5.27
46,824,911.61
3.68
142,123,525
4.61
3,426,105
86,221,786.51
0.19
4.77
86,782,350.57
0
6.82
0.00
90,208,456
86,221,787
2.93
2.80
122,006,441.50
6.75
8,071,048
0.63
130,077,490
4.22
1,807,418,054
100.00
1,272,898,553
100
3,080,316,607
100
231
245
Table6.6.7:CentralLevelCapitalBudgetAllocationbySourcebyProgram,FY2071/72
Budget
CodeNo
ProgrammeBudget
Heading
Gon
Donor
Total
3701134
TuberculosisControl
Programmes
155,274,000
53.37
134,254,000
13.38
289,528,000
22.37
3701144
NationalAidsControl
5,250,000
1.80
523,000
0.05
5773000
0.45
3701154
FP/MCHProgrammes
IntregetedChildHealth
Programme
Epidemiology
Programme
IndentProcurement
/Management
InformationSystem
NHEICCCenter
HealthLaboratory
Services
Centre
LeprosyDivisionControl
26,300,000
9.04
85,283,000
8.50
111583000
8.62
39,906,000
13.72
75,656,000
7.54
115562000
8.93
10,600,000
3.64
7,480,000
0.75
18080000
1.40
0.00
612,300,000
61.03
612300000
47.31
5,811,000
2.00
1,000,000
0.10
6811000
0.53
1,070,000
0.37
0.00
1070000
0.08
37,400,000
12.85
82,900,000
8.26
120300000
9.30
9,348,000
3.21
3,850,000
0.38
13198000
1.02
150,000
0.00
0.01
290,959,000
100
1,003,246,000
100
150000
1,294,205,00
0
3701164
3701194
3701214
3701224
3701234
3701264
3708034
3701204
Total
100
Table6.6.8:CentralLevelCapitalBudgetReleasedbySourcebyProgram,FY2071/72
Budget
CodeNo
ProgrammesBudget
Heading
ReleasedBudgetbySource
Gon
Donor
Total
37,073,264
29.68
68,362,669
9.05
105435933
11.99
3701144
TuberculosisControl
Programmes
NationalAidsControl
3,420,340.00
2.74
0.00
3420340
0.39
3701154
FP/MCHProgrammes
0.00
63,579,282.68
8.42
63579283
7.23
24,818,962.73
19.87
22,695,462.52
3.00
47514425
5.40
2,742,800
2.20
399,398
0.05
3142198
0.36
21,000,000
16.81
528,892,173
70.03
549892173
62.51
3,754,067
3.01
0.00
3754067
0.43
1,045,635
0.84
0.00
1045635
0.12
21,614,630.12
17.30
69,734,847.65
9.23
91349478
10.38
8,952,268
7.17
1,594,892
0.21
10547160
1.20
490,412
0.39
0.00
490412
0.06
124,912,379
100
755,258,725
100
879,680,692
100
3701134
3701164
3701194
3701214
3701224
3701234
3701264
3708034
3701204
IntregetedChild
HealthProgramme
Epidemiology
Programme
IndentProcurement
/Management
InformationSystem
NHEICCCenter
HealthLaboratory
Services
NationalHealth
TrainingCentre
LeprosyDivision
Control
Total
232
246
Table6.6.9:CentralLevelCapitalBudgetExpenditurebySourcebyProgram,FY2071/72
BudgetCode
No
3701134
3701144
3701154
3701164
3701194
3701214
3701224
3701234
3701264
3708034
3701204
ProgrammesBudgetHeading
TuberculosisControl
Programmes
NationalAidsControl
FP/MCHProgrammes
IntregetedChildHealth
Programme
IndentProcurement
/ManagementInformation
System
NHEICCCenter
HealthLaboratoryServices
NationalHealthTrainingCentre
LeprosyDivisionControl
Total
ExpenditureBudgetbySource
Donor
%
Gon
Total
%(a)
37,073,264
29.80
68,362,669
9.05
105435933
11.99
3,420,340.00
0
2.75
0.00
0
63,579,282.68
0.00
8.42
3420340
63579283
0.39
7.23
24,818,962.73
19.95
22,695,462.52
3.00
47514425
5.40
2,742,800
21,000,000
2.20
16.88
399,398
528,892,173
0.05
70.03
3142198
549892173
0.36
62.51
3,754,067
3.02
0.00
3754067
0.43
1,045,635
21,614,630.12
8,952,268
490,412
124,421,967
0.84
17.37
7.20
0.39
100
0
69,734,847.65
1,594,892
0
755,258,725
0.00
9.23
0.21
0.00
100
1045635
91349478
10547160
490412
879,680,692
0.12
10.38
1.20
0.06
100
Table6.6.10:DistrictLevelRecurrentBudgetAllocationbySourceandProgram,FY2071/72
BudgetCode
No
3708063
3708023
3708033
3708043
ProgrammesBudget
Heading
TBControlProgrammes
NHEICC
Centre
IntegratedHealthServices
Total
Donor
%
Total
67244000
2.21
164,191,000
99,820,000
3.28
121,955,000
Gon
96,947,000
22,135,000
%
4.44
1.01
%
3.14
2.33
39,330,000
1.80
11,040,000
0.36
50,370,000
0.96
2,024,115,000
2,182,527,000
92.74
100
2,868,273,000
3,046,377,000
94.15
100
4,892,388,000
5,228,904,000
93.56
100
Table6.6.11:DistrictLevelRecurrentBudgetReleasedbySourceandProgram,FY2071/72
BudgetCode
No
ProgrammeBudget
Heading
3708063
TBControlProgrammes
3708023
NHEICC
3708033
3708043
Centre
IntegratedHealth
Services
Total
ReleasedBudgetbySource
Donor
%
Gon
Total
80,058,316.50
3.79
36113714
1.72
116,172,031
2.76
19,282,774
0.91
83,263,350.75
3.96
102,546,125
2.43
19,845,657.25
0.94
203,000
0.01
20,048,657
0.48
1,991,639,762.65
94.35
1,983,022,022.58
94.31
3,974,661,785
94.33
2,110,826,510.40
100
2,102,602,087
100
4,213,428,598
100
Table6.6.12:DistrictLevelRecurrentBudgetExpenditurebySourceandProgram,FY2071/72
Budget
Code No
3708063
3708023
3701243
3708043
Programme Budget
Heading
TB Control
Programmes
NHEICC
National Health
Training Centre
Integrated Health
Services
Total
Gon
Expenditure Budget by Source

%
Donor
%
Total
% (a)
80,058,316.50
3.79
36113714
1.72
116,172,031
2.76
19,282,774
0.91
83,263,350.75
3.96
102,546,125
2.43
19,845,657.25
0.94
203,000
0.01
20,048,657
0.48
1,991,639,762.65
94.35
1,983,022,022.58
94.31
3,974,661,785
94.33
2,110,826,510.40
100
2,102,602,087.33
100
4,213,428,597.73
100
233
247
Table6.6.13:DistrictLevelCapitalBudgetAllocationbySourceandProgram,FY2071/72
BudgetCode
No
3708024
3708044
3708064
3708034
Programme
BudgetHeading
NHEICC
IntegratedHealth
Services
TBControl
Programmes
NHTC
Total
%
Donor
%
Total
0.70
0
0.00
3,900,000
%
0.15
549,671,000
99.01
2,082,627,597
99.94
2,632,298,597
99.74
1,578,000
0.28
1,267,000
0.06
2,845,000
0.11
2,000,000
555,149,000
0.36
100
0
2,083,894,597
0.00
100
2,000,000
2,639,043,597
0.08
100
Gon
3,900,000
Table6.6.14:DistrictLevelCapitalBudgetReleasedbySourceandProgram,FY2071/72
Budget Code No
3708024
3708044
3708064
3708024
Programme Budget Heading

NHEICC
Integrated Health Services
TB Control Programmes
NHTC
Total
Gon
3,758,617.41
442,451,323.99
1,282,718
1,399,398
447,492,659.40
%
0.84
98.87
0.29
0.31
100
Released Budget by Source

Donor
%
0
0.00
1,592,651,640.70
99.98
352,082
0.02
0
0.00
1,593,003,722.70
100
Total
3,758,617
2,035,102,965
1,634,800
1,399,398
2,040,496,382
%
0.18
99.74
0.08
0.07
100
Table6.6.15:DistrictLevelCapitalBudgetExpenditurebySourceandProgram,FY2071/72
Budget
Code No
3708024
3708044
3708064
3708024
Programme Budget
Heading
NHEICC
Integrated Health
Services
TB Control
Programmes
NHTC
Total
Expenditure Budget by Source

Donor
%
0
0.00
Gon
3,758,617.41
%
0.84
Total
3,758,617
%
0.00
442,451,323.99
98.87
1,592,651,640.70
99.98
2,035,102,965
99.98
1,282,718
0.29
352,082
0.02
1,634,800
0.02
1,399,398
447,492,659.40
0.31
100.00
0
1,593,003,722.70
0.00
100.00
1,399,398
2,040,496,382.10
0.00
100.00
Table6.6.17:CumulativeFinancialIrregularitiesupto2071/72
Irregularitytoberegularized
Irregularityclearance
4,32,08,93
1,95,76,36
Table6.6.18:IrregularityClearanceStatusofLastThreeYears
F/Y
2071/72
2070/71
2069/70
234
248
TotalIrregularityAmount
4,32,08,93
3,05,34,59
2,45,87,63
(RSs.In,000)
Percent
45.31
IrregularityClearance
1,95,76,36
1,19,53,63
90,19,61
(Rs.InLakh)
Clearance%
45.31
39.15
36.68
Problems/constraints
Difficultyinfinancialreporting
proceduresand
reimbursementfromdonors
duetothelackoftrained
manpowerandphysical
facilities
Delayinbudgetdisbursement
duetoprogramsnotbeing
approvedontime
Actiontobetaken
Provideinternalandexternaltrainingin
financeasappropriate
Responsibility
MoF,MoH
Timelyactionsmustbetakenforthe
approvalofdevelopmentprograms.
Nonreleaseofcommitted
donorbudget
PlansofActionandworkplanagreements
mustbesignedbeforebudgetallocation,
anddonorsshouldreleasebudgetasper
theircommitment.
Accountstaffsshouldbethoroughly
orientedonbookkeepingandreporting
formatsusedbyofdifferentdonors
Providecomputerstodistrictlevel
financesectionandprovidecomputer
trainingforthem
DoHS(especially
PlanningDivision
andconcerned
programdivisions
andcentres),MoH
NPC
MoF,MoH,Donors
Difficultyinkeepingbooksof
accountsandreporting
accordingtothediffering
formatsofthedifferentEDPs
supportingthesameprogram
MoF,MoHand
donors
235
249
SupportingPrograms:Management
6.7
MANAGEMENT
6.7.1 Background
General management of Department of Health Services is assigned to Management Division.

OperatingManual(Procedure),2068(thirdedition)forDepartmentofHealthServicesdescribesthe
responsibility of this division in information management, planning, coordination, supervision,
monitoringandevaluationofthehealthprograms.Thedivisionisalsoresponsibleformonitoringthe
deliveryofqualityhealthservicesthroughalltypesofhealthinstitutions.Furthermore,itmonitors
the building construction and maintenance of public health institutions and provides supports for
maintenance of medical equipment. More activities are assigned to this division as directed by
NHSP, policies and plans that include mental health, oral health, health care waste management,
health facility upgrading / renewals, nursing program and treatment facilities to impoverished
NepaleseCitizensfromthelisteddiseases.
Objectives
The Management Division has major objective to support health programs and DoHS in overall to
accomplishtheirservicedeliveryfunctionswhichincludeinmajorto;
facilitate and coordinate among concerned program divisions and centres to prepare
annual plan, programs and make necessary arrangements to get approval from National
PlanningCommission(NPC)andMinistryofFinance(MoF)
make necessary arrangements for preparation and compilation of annual budget and
programsoftheRegionalHealthDirectoratesandDistrictsPublic/HealthOffices
monitorprogramimplementationstatusandcarryoutperiodicperformancereviews
supportqualityimprovementinthehealthsector
manageHealthManagementInformationSystem(HMIS)
manage and Coordinate for construction and maintenance of buildings and other
infrastructuresofPublicHealthInstitutions
processforapprovalofestablishmentofprivateandnongovernmenthealthinstitutions
processforapprovalofnewpublichealthinstitutionsandtheirupgrades
makearrangementsforcapacitybuildingofhumanresourcesinpublichealth
supportinInfoTecharearelatedtohealthinformation,disseminationandmanagement
providetreatmentfacilitiesforimpoverishedNepalesecitizensforlisteddisease.
Strategies
To achieve the overall and specific objectives, management division adopts following major
strategies.
Make necessary arrangements to collect and analyze health information and use it to
supportplanning,monitoring,andevaluation(PME)ofhealthprograms
Strengthen Bottomup planning process from community to the central level by optimum
useofavailableresourcesincludinghealthserviceinformation
Conduct and expand regular periodic performance reviews and use outcomes for
improvementdowntocommunitylevel
Strengthenandguidethemonitoring/supervisionsystemateachlevel
EstablishcentraldatabanklinkingHMISwithHURDIS,LMIS,Finance,Surveys/Censusesand
othersourcesofinformation
Expandcomputerizedinformationsystematalllevels
Monitoringofhealthservicesprovidedbystateownedandnonstatehealthinstitutions
Develop and implement construction, repair and maintenance plan for public health
facilities
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Capacity development of health workers as well as Management Committees in close
collaborationwithNHTCandconcernedagencies
Conduct Human Resource Development programs for improvement in quality of health
services
RoutinemanagementofHealthServiceInformationroundtheyear
Orientationonqualityhealthservicedelivery
Upgradinghealthfacilitiesasperplanandpolicies
Initiate processing for approval of establishment of private and nongovernment health
institutionswithinthe51to200bedcapacity
Process for approval and renewal of private and nongovernmental health facilities on the
basisofgivenservicestandards
Developandimplementintegratedsupervisionandmonitoringplan
Establish and develop required infrastructure, human resource and guidelines to conduct
otherdesignatedandnonroutineworksassignedtoMD
OrganizationalArrangement
Thedivisionhassixsections,threeunitsandoneUpacharKoshforoverallmanagementoffunctions
andservicedeliveryasdirectedbyoperatingmanual,citizencharterandplanandpolicydocuments
ofhealthsystem.
1. HealthManagementInformationSection
2. Budget&PlanningSection
3. ProgramMonitoringandEvaluationSection
4. HealthFacilities&QualityAssuranceSection
5 InformationTechnology(IT)Section
6. NursingServiceDevelopmentSection
7. OralHealthUnit
8. PAMUnit
9. MentalHealthUnit
10. ImpoverishedCitizensServiceUnit
11. ENTUnit(proposed)
Thespecificfunctionsofsectionsandunitsareasfollows:
1. HealthManagementInformationSection(HMIS)
ThissectionmanageshealthserviceinformationfromcommunitytotheDoHSthroughpredefined
processandprocedure.Thissystemisalmost21yearsoldrobustandwellsetthatprovidebasefor
planning,monitoringandevaluationofhealthsystematalllevels.ThemajorfunctionsoftheHMIS
are;
To collect and manage the health service delivery information from all levels of health
servicedeliveryoutletsincludingservicesatthecommunitiesbyFCHVsandcommunitylevel
healthworkers
ToimproveOnlinedataentrymechanisminalldistrictsandhospitals.
Toverify,process,analyzethecollecteddataandoperatedatabank
Toprovidefeedbacksonachievements,coverage,continuityandqualityofhealthservicesto
programdivisions/centres,RHDs,hospitalsanddistrictpublic/healthoffices
Todrawindicatorsandrelevantinformationandsupporttotheprogrammanagement
Todisseminatehealthinformationthroughefficientmethodsandtechnologies
TopublishacomprehensiveAnnualReportofDepartmentofHealthServices
TodevelopcompetenthumanresourceforHealthInformationManagementSystem
TosupportforconductingNationalPerformanceReviewofhealthprogramsandsupportto
regional,districtandbelowlevelreviews
Toimprovetheinformationmanagementsystemusingmoderninformationtechnology.
ToupdatetheHMIStoolsasperneedofprogrammedivisions/centres.
DoHS,
Annual Report 2071/72 (2014/2015)
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251
ToupdateGeoInformationofhealthfacilities
2. Programming,Budgeting,BuildingConstructionandMaintenance Section
ThissectionismainlyresponsibleforintegratedplanningofDoHSandprovidingtechnicalsupports
in the planning process of District Public Health and Health Offices as well as Regional Health
Directorates. The annual program and budgeting is prepared in collaboration with respective
divisions, RHDs, DPHOs and DHOs. The section performs following activities to satisfy related
objectives.
Facilitatesplanning,programmingandbudgetingatcentral,regionalanddistrictlevel
Make process for approval of annual programs and budget of health programs of DoHS,
RegionsanddistrictsfromNPCandMoF
Supportandfacilitatebottomupplanningprocess
Supportthemaintenanceofbiomedicalequipment
Support the construction, repair and maintenance of infrastructure of public health
institutions
3. ProgramMonitoring&EvaluationSection
Thissectionisassignedwithresponsibilityofmonitoringhealthprogramsandservicesperformedby
DoHS,RHDs,DPHOs,DHOSandhealthinstitutionsunderDoHSthatincludes;
Monitoring, supervision and evaluation the preventive, curative and promotive health
programs
Conducting integrated supervision in collaboration with Divisions, Centres and Regional
HealthDirectorates
Monitoringhealthcareservicedeliverywithspecialfocusonessentialhealthcareservicesin
stateandnonstatesector
SupportingDPHOsandDHOstostrengthenLocalHealthFacilityManagementCommittee
Strengthenhealthcarewastemanagementactivitiesinhospitals,PHCCsandHPs
SupporttoGOsandNGOsonHealthCareWasteManagement(HCWM)ativities.
4. HealthFacilities&QualityAssuranceSection
This section mainly performs the activities for health facilities under the DoHS to improve and
maintaining the quality of health services as well as supporting establishment and operating of
healthfacilities.Toachievetheobjectiveitperformsfollowingactivities.
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 &
serviceprotocolincoordinationwithprogrammonitoringandevaluationsection
Conductstudies&researchactivitiestoimprovequalityofhealthcare
ToprocessprovidingapprovalforopeningnewhospitalsunderNGO/privatesectorincluding
nursinghomesof51to200bedsandtheirrenewal.
ProvidesuggestionsduringRegistrationProcessforNGOs
5. NursingServiceDevelopmentSection
Thisunitsupportcapacitybuildingofnursingstaffsandcoordinationofactivitiesrelatedtonursing
servicesthatmainlyinclude;
supportcapacitydevelopmentprogramsandactivitiesfornursingprofessionals
supportnursingleadershipandmotivationalprograms
Coordinateprogramsandactivitiesforimprovementinnursingservices.
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6.
OralHealth Unit
Managementdivisionsupportoralhealthservicesthroughthisunitbyconductingactivitieson;
Capacitybuildingofhealthworkers
PreparationanddistributionofIEC/BCCmaterialsfororalhealthcareincollaborationwith
NHEICC
Coordinate with stakeholders and national focal point for expanding and improving the
services
7.InformationTechnology(IT)Section
This unit support in info Tech area related to health information, dissimination and management
mainlyincludesfollowing:
Disseminationofinformationrelatedtohealth.
SupportinITinfrastructure,planninganddevelopment.
SupportinNetworkcommunicationrelatedareas.
Supportinehealthandmhealthprogrammsandactivities.
ITrelatedsurveysandsupportinginguidelinesandpoliymaking.
8.ImpoverishedCitizensServiceUnit
TheoverallobjectiveofImpoverishedCitizensServiceProgramistomanagetreatmentfacilitiesfor
impoverishedNepalesecitizensforlisteddiseases.Thespecificobjectivesoftheprogramare;
ToprovidebudgetuptoonelakhperpatientthroughnotifiedHospitalforfreeMedication
& treatment to very severe disease as Cancer, Heart, Head/Spinal injuries, Alzaimers/
ParkinsonsandSickleCellAnaemiddisease.
Toprovidemedicationcostuptoonelakhforpostrenaltransplantcases.
Toprovidefreedialysisservicesupto104sessions(foroneyear)perpatient.
ToproviderenaltransplantationcostuptoTwoLakhperkidneypatient.
Toprovidefinancialsupportandtreatmentforveryimportantnationalpersonstoo.
9.PAMUnit
RoleandresponsibilityofPAMunit
IdentifystatusofHFbuildingsandmedicalequipments
Recommendforconstructionandmaintenanceofhealthfacilitybuilding.
Maintenanceofmedicalequipmentswasinoperationsince3yearsinFarwestandMidwest
regionwithcooperationofKFWandfoundsuccessful
RolloutoutsourcingofMCnationwide.
ContractedBiomedicalEngineerforPAMunit.
ManagementDivisionconductstheactivitiesrelatedtomentalhealthprogrammeandproposedfor
ENTactivities.
6.7.2 Majoractivities
Management division conducts some major activities related to regular and assigned functions to
enhance and improve the program and activities. The following activities are major innovations
thosehavebeenconductedonregularoradhocbesidesitsregularfunctions.
a)GeographicInformationSystem(GIS)
GIShasbeeninceptedandintheprocessofinstitutionalizeinthehealthsystem.Thisisguidedby
NHSP, Periodic Development Plans, Health Sector Information SystemNational Strategy (HSISNS)
andInformation,CommunicationandTechnologyPolicyoftheGovernmentofNepal.Thisadoption
is also reinforced by ehealth, Health GIS and need for integration of information systems. Health
DoHS,
Annual Report 2071/72 (2014/2015)
239
253
Facility Mapping Survey (HFMS) has been carried out in 75 districts with technical and financial
support from WHO. The completion of this survey is expected to result in geographic feature
embeddedplanning,monitoringandevaluationinthehealthsystem.
b)PerformanceBasedManagementSystem(PBMS)
This is aimed at reward mechanism for best performers at the district level. Ranking of health
facilities and health workers are done with a set of performance indicators. Districts select health
facilitiesandhealthworkerssortingtheirrankandhonouredwithgifts.Fifteendistrictsareselected
andprovidedwithrequiredbudgetandguidelineforPBMSconduction.
c)HealthCareWasteManagement(HCWM)
Solid Waste Management Act2011 provides legal basis for health care waste management.
Management division has been providing orientation and onsite coaching for health facilities.
Hospitalswereprovidedbudgetfordifferentmaterials(e.g.coloredbuckets,autoclaveetc)forthe
propermanagementofhealthcarewaste.Healthcarewastemanagementguidelineshavealready
beendevelopedanddistributed.
d)HealthInfrastructureInformationSystem(HIIS)
HIIS is started to have complete scenario on infrastructure of all the public health facilities. This
information system is expected to provide basis for decision making on building construction and
maintenance as well as for resource allocation. The system is in the process of completion. The
systemaimstoregularlyupdatetheinformation.
e)BuildingConstructionandMaintenance
Managementdivisionmakesprocessforconstructionofbuildingandotherinfrastructureofhealth
facilities. Public health facility construction and maintenance work is assigned to Management
Division and Department of Urban Development and Building Construction (DUDBC). All the
maintenancewithinpremisesofDoHSandconstructionandmaintenanceworksinthedistrictsand
regions costing less than one million is disbursed through Management Division. All other
constructionworkscostingmorethanonemillionisdonethroughDUDBC.Acommitteeisformedin
theMoHPtomonitortheconstructionandmaintenanceworks(Table6.7.1).
Table6.7.1:SummaryofbuildingconstructionbyDUDBC(FY2061/0622071/72)
TotalnumberofHealthFacilitis(HFs)
Underconstruction
Nearcompletion
Completed/handedover
BudgetallocatedtoDUDBC(in'000)inFY2071/72
Expenditure(in'000)inFY2071/72
1,554
465
154
935
2,21,00,00,000
1,80,95,68,000(82%)
Table6.7.2:BuildingConstructionScenariointhethreeconsecutiveyears
Typesofthehealthfacility
2068/69
2069/70
2070/71
HealthpostwithBirthingCenter
Doctor'sQuarter
Staffquarter
PHCC
Birthingcenter
Districthealthstore
BEOCbuilding
CEOCbuilding
Publichealthofficebuilding
Districthospitalbuilding
RegionalHospitalbuilding
240
254
80
15
10
10
25
10
10
0
10
0
0
0
0
0
0
0
0
0
0
0
115
20
25
5
12
2
1
1
10
4
2071/72
200
7
20
3
6
1
Typesofthehealthfacility
2068/69
2069/70
2070/71
2071/72
15bededHospitalbuilding
ZonalHospitalbuilding
3
2
f)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
upgradationisgiveninTable6.7.3.
Table6.7.3:StatusofHealthFacilitiesupGradation
Year
2065/66
2065/66
2066/67
2067/68
2068/69
HFType
SHPtoHP
HealthfacilitytoHospital
SHPtoHP
HPtoPHC
HPtoPHC;PHCtoHospital
SHPtoPHCtoHospital
SHP/HP/PHCtoHospital
SHP/HPtoPHCC
SHP/HP/PHCCtoHospital
SHPtoHP
2069/70
2069/70
2070/71
2071/72
2071/72
NewlyestablishedPHCC1
HPtoPHCC2
HPtoHospital15beded4
HPtoHospitals(25beded)1
PHCCtoHospital(15beded)2
15bededHospital50beded3
15bededHospitalto51beded1
HFNumber
478
6
522
10
25
20
6
5
10
2,205
Status
Approved,Implementing
O&Misgoingon
O&Mgoingon
O&Mgoingon
O&Mgoingon
O&Mgoingon
O&Mgoingon
ApprovedImplementation
g)ApprovaltoPrivateHealthFacilities
ManagementDivisionprocessesdocumentsforapprovaltoprivatehealthfacilities.
6.7.3MajoractivitiescarriedoutinFY2071/72
Followingarethemajoractivitiesconductedbymanagementdivisionmentionedintheannualwork
planandbudgetoffiscalyear.
Conductionof21thNationalAnnualPerformanceReviewMeeting,2071/72
ConductionofHMIStrainingfornewlyrecruitedhealthworkersthroughoutthecountry
ArrangementsforprintingandsupplyofHMISrecordingandreportingtools
WebbasedonlinereportingsystemofHMISisbeingcontinued
Preparation,printinganddistributionofAnnualReportofFY2070/71(2013/14)ofDoHS
UpdateofofHealthGISinformation
ConstructionofHospitals,PHCs,HPs,birthingcentres,storebuilding,staffquarters,birthing
unitsisbeingcontinued
ElectricitysupplyandfurnitureprocurementfornewlyconstructedHFs.
Dentalcaretrainingtohealthworkers
ConductionofRegionallevelplanningworkshops
Orientationandtrainingonhealhcarewastemanagemen
CapacitybuildingprogramsforhealthworkersinOralHealth
PerformanceBasedMonitoringSystemrelatedactivitiescontinued
DoHS,
Annual Report 2071/72 (2014/2015)
241
255
MentalHealthTrainingiscontinued
OrientationandtrainingonhealhcarewastemanagementtoDHOs/DPHOsstaffs
ImpoverishedCitizens,FY2071/72
Head/spinal
injuries
Alzaimer/
Parkinsons
SickleCell
Anaemia
55
0
165
25
4
6
6
0
0
48
43
24
0
0
0
0
0
260
47
42
16
45
10
13
15
40
52
26
64
0
1
0
118
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
238
4
0
0
0
0
0
0
0
0
0
0
78
515
1303
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
165
3
0
0
0
0
0
132
0
20
65
86
0
0
1258
895
120
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
49
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
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
23
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1006
195
238
1900
2744
52
39
Transplant
Cancer
BirHospital,Kathmandu
MaternityHospital,Kathmandu
HumanOrganTransplantHospital,Bhaktapur
WesternRegionalHospsital,Pokhara
NarayaniSubregionalHospital,Parsa
JanakpurZonalHospital,Janakpur
KoshiZonalHospital,Biratnagar
CivilHospital,Kathmandu
SetiZonalHospital,Kailali
TUTHHospital,Kathmandu
PatanHospital,Lalitpur
BPKISH,Dharan
MonmohanCardioCenter,Kath
GangalalHeartCenter,Kathmandu
BPCancerHospital,Bharatpur
BhaktapurCancerHospital,Bhaktapur
CancercareNepal,Lalitpur,Jawalakhel
KidneytreatmentCentre,Kathmandu
ChitwanMedicalCollege,Chitwan
CollegeofMedicalSciences,Bharatpur
GandakiMedicalCollege,Pokhara
ManipalMedicalCollege,Pokhara
B&BHospital,Lalitpur
GoldenHospital,Biratnagar
UniversalCol.ofMedicalSciencesBhairahawa
NepalgunjMedicalcollage,Banke
ArogyaHospital,Lalitpur
NationalDialyasisCentre,Lalitpur
NepalMedicalCollege,JorpatiKathmandu
Impoverished
Citizens
Service
Unit.
ManagementDivision,DoHS,TekuKathmandu
Total
Source:MD/DoHS
Heart
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
NameofHealthInstitution
Dialysis
SN
PostRenal
Treatment
TypesofFreeTreatmentServices
Kidney
Management Division had 37 activities in the fiscal year2071/72, out of which major are listed in
Annex1.Overallphysicalandfinancialprogressscenarioisasgivenbelowtable.
Physicalachievement
Financialachievement(in000)
TotalActivities
:37
TotalBudgetallocated
:957,206
Activitiesconducted
:33
Totalbudgetreceived
:909,500
Activitiesnotdoneandcause
BudgetnorreceivedfromPartners:47,706
BudgetnotreceivedfromPartners :2
TotalExpenditure(throughMD):817,648
Activitiesnotconducted
:2
Financialprogress:86%
PhysicalProgress
:92%
(ofthereceivedbudget)
(DUBBCbudgetnotinclude)
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SupportingPrograms:PrimaryHealthCareRevitalization
6.8PRIMARYHEALTHCAREREVITALIZATION
6.8.1Background
PHC is a strategic movement for the achievement of Optimum health for all. PHC needs to be
expandedthroughoutthecountryforachivingtheuniversalhealthcoverage(UHC).PHCisregarded
asacosteffectiveapproachanditsprinciplesinsocialjustice,equity,humanrights,universalaccess
tohealthservices,communityinvolvementandprioritytothemostvulnerableandunderprivileged.
PHChasworkedsinceitsimplementation36yearsago,thereisnounequivocalanswereitherway
andthematterisstillopenfordiscussion.However,fewpositivebenefitsbroughtaboutbyPHCe.g.
changeslikeincreasedlifeexpectancy,reductioninchildandinfantmortality,increasedcoveragefor
endemicdiseases,increasedrecognitionofhealthasahumanright,etc.thatcouldbeattributedto
the36yearsofimplementingPHC.Next,therearesomegrowingareasofconcernthatthePHChas
to address; inequitable access to healthcare services, attaining universal coverage, and rapid
privatizationofhealthcareweresomeareasfeltPHCapproachisyettotackle.
In Nepal, PHC has a long history that was reinforced by the Declaration at Alma Ata. It was
mainstreamed in 1991 National Health Policy endorsing PHC as a major service component. Thus,
theNationalHealthPolicy1991wasaturningpointindeliveryofprimaryhealthcareservicesinthe
rural areas of Nepal. The most important contribution of the Policy is that it helped to increase
access to health services to majority of people in Nepal by establishing a total of 4,020 health
institutions spread throughout the country. Health Posts (HP) deliver health services at VDC level.
PrimaryHealthCareCenters(PHCC)with3bedsareestablishedineachelectoralconstituency.
TheSecondLongTermHealthPlan(19972017)ofNepalhasalsoreflectedPHCasEssentialHealth
Care Services (EHCS), and Nepal Health Sector ProgramII (NHSPII, 20102015) has set three
objectivesintheresultframeworkregardingtoEHCS.
ToincreaseaccesstoandutilizationofqualityEHCS.
To reduce cultural and economic barriers to accessing health care services and harmful
culturalpracticesinpartnershipwithnonstateactors.
ToimprovethehealthsystemtoachieveuniversalcoverageofEHCS.
The NHSPII puts a major emphasis on an increased coverage and quality EHCS with a special
attention to improve access to the poor, vulnerable and disadvantaged groups. The rationale is to
revitalizethePHCprogramstomeettheNHSPIIobjectivesandtargetasbelow:
Assure availability of basic health services to all Nepalese citizens as addressed by the
InterimConstitutionofNepal.
Assurequalityhealthservices.
AssureeasyaccessofhealthservicestoallNepalesecitizens.
Implementhealthinsurancethroughhealthcooperatives.
Monitoring,supervisionandevaluationoffreehealthcareservicesforthedevelopmentof
futureplanningandstrategies.
ManageurbanPHCservicestotheurbanvulnerableanddeprivedcitizens.
Implement environmental and sanitation programs for the creation of healthful
environment.
The concern of the poor and marginalized people both in urban and rural areas has been in high
priority in government programs. In order to materialize the constitutional commitment (Interim
DoHS,
Annual Report 2071/72 (2014/2015)
243
257
Constitution, 2007) of fundamental right of basic free health care, MoH introduced a policy of
providing Free Health Care Services to the population in a phased manner to enhance access to
primary health care services for every citizen with special consideration for the poor/ultrapoor,
destitute,disabled,seniorcitizensandFemaleCommunityHealthVolunteers(FCHV).Subsequently,
in 2009 (Jestha 2065), Ministry of Health (MoH) established a new division (Primary Health Care
Revitalization Division) under the Department of Health Services. The PHCRD is envisaged to
revitalize PHC services in Nepal by addressing the unaddressed and unmet issues of PHC. The
Divisioncarriesoutthefollowingprograms:
NationalFreeHealthServices
Urbanhealthprogram
Communityhealthinsuranceprogram.
Ruralcommunityhealth,basichealthandmodelhealthyvillageprogram.
Equityandaccessprogram.
Socialauditprogram.
Preventionandcontrolofnoncommunicablediseases
It is expected to make inroads into translating the constitutionally stipulated fundamental right of
basicfreehealthcareintopracticebyaddressingthedisparitiesinhealthservicedeliveryandhealth
outcomesandpromotingequitablehealthservices.
Vision:ThevisionistocontributeinimprovingthehealthstatusofNepalipopulation,especiallyof
thepoorandexcluded.Itwillsupportthenationtopovertyreductionthroughprovisionofequitable
andaccessiblehealthcareservices.
Goal:Toreducemorbidityandmortalityespeciallyofpoor,marginalizedandvulnerablepeopleby
securingtherightofthecitizenstoqualityessentialhealthservices.
Objectives
IncreasedaccesstoandutilizationofqualityEssentialhealthcareservicesbyensuring
availabilityofEssentialDruginbothUrbanandRuralHealthFacilitiesthroughouttheYear
ToProvideQualitativeEssentialhealthcareservicestotheMunicipalPopulationthrough
UrbanHealthClinic
Minimizingeconomical,culturalandgeographicalbarriers
Carryouturbanandenvironmentalhealthprogram.
DefineBasicHealthCarePackage
Strategy
Supportestablishingofurbanhealthcenters.
ContinueCommunityHealthinsuranceprogram.
Providefreehealthcareservicespackages.
OrganizeHealthcampsinruralandhardtoreacharea.
Equityandaccess.
CarryoutSocialauditofHealthfacilities.
EstablishmodelhealthyvillagesandCommunityHealthUnit.
PromoterationaluseofdrugusingStandardTreatmentProtocol.
Preventionandcontrolofnoncommunicablediseases.
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SpecificObjectivesandStrategiesasperthematicfocusesoftheDivisionareasbelow:
6.8.2Majoractivitiesaccomplished
Thefollowingactivitieswerecarriedoutinthefiscalyear2071/72
Planning&ProcurementofFreeEssentialMedicine
OPDRegistrationFeeDistrictHospital/PHCC/HP
PrintingandDistributionofOPDTicket&ReportingForm
ReferralProgramforTargetGroup
DressIncentiveforFCHVs
ReviewProgramofFCHV
FundofUrbanHealthCentre
FCHVsDaycelebration
UrbanHealthMonitoringCommitteeMeeting
UrbanHealthCenterestablishment
Ruralcommunityhealth,basichealthandmodelhealthyvillageprogram.
ReviseandPrintingofProgramNirdesika
Integratedpublichealthprogram
Communityhealthunitestablishment
Healthcamps
CommunityHealthInsurance(6HFsTikapur,Chandranigahpur,KatariHospital,Lamahi,Damkauli
,MangalbarePHCCsin6Districts)
SpecialProgramsinDAGVDCs
SocialAudit
ENTTrainingin DistrictHospital
DevelopMaterialandOrientationonNCD(Dibetes,HTNandMentalDisease)
MonitoringandSupervision
6.8.3AnalysisofAchievement
Itisestimatedthatabout78peopleinNepalutilizedpublichealthservicesin2071/72.Amongthe
totalreportedmorbiditycases(21,930,433),92.3percentageofpopulationwerefoundutilizingfree
healthcareservices(Table1).Thisinformationshowsthatremarkablechunkofpeopleutilizethefree
healthcareservices.
Table6.8.1:Utilizationstatusoffreehealthcareservices,FY2071/72
SN
Indicators
Number of Persons utilizing health services among Total

Populatrion(NoofregisteredMorbiditycases)
Number of Persons Utilizing free health OPD services
amongregisteredMorbiditycases
Number of Persons utilizing free health emergency
servicesamongTotalMorbidity
Number of Persons utilizing free health indoor services
amongTotalMorbidity
Referralcasesamongtotalnumberofutilizingfreehealth
servicesamongTotalMorbidity
2
3
4
5
Achievement
(Number)
(Percentage)
21,900,869
78.3
20,242,908
92.3
988,817
4.9
669,144
3.3
29,564
0.14
Source:HMIS
DoHS,
Annual Report 2071/72 (2014/2015)
245
259
Thefreehealthcareservicesprovidedtothetargetgroupsareasbelow:
The total OPD patients served by the hospitals were 198,864; emergency patients were 31,075
indoorpatientswere50,926andreferralcaseswere1,612.ThusthetotalnumberofTargetgroup's
patientsutilizingfreehealthservicesware282,477.
Table6.8.2:Hospitalfreehealthcareserviceutilizationstatusbytargetedgroups,FY2071/72
Servicetargetgroup
OPD
Emergency
Indoor
Refer
Poor/Ultrapoordestitute
104,535
15,870
30,006
725
Helpless/Distitute
18,899
3,082
5,328
456
Disable
3,985
1,055
1,637
221
Seniorcitizen
66,142
10,512
13,523
448
FCHV
5,103
556
432
162
Total
198,864
31,075
50,926
1,612
Source:HMIS
6.8.4PhysicalandFinancialProgressbybudgetsubtitle,FY2071/72
Level
DistrictLevel(DHO/DPHO/
Hospital/PHCC
BudgetSubTitle
370138
PhysicalProgress
94.40
FinancialProgress
26.65
370804
370136
370138
37.77
62.79
84.56
53.64
54.38
29.96
CentralLevel
Source::PHCRD
PHCRD central level in FY 2071/72 Physical Progress was 73.7 percent and financial progress was
42.2,FinacialachievementisverylowascomparedtoPhysicalexpenditurebecauseofmanagerial
problems.(Figure1)
Figure1:Physicalandfinancialprogress,FY2071/72(Centrallevel)
80
73.7
60
42.2
40
20
0
Physical
Financial
Source::PHCRD
Figure2:Physicalandfinancialprogress,FY2071/72{DistrictLevel)
70
66.05
60
50
40.1
40
30
20
10
0
Physical
Finacial
Source:PHCRD
246
260
DoHS,
Annual Report 2071/72 (2014/2015)
InDistrictlevel,financialandphysicalachievementseemsapproximatelyequal.PHCRDcentrallevel
inFY2071/72PhysicalProgresswas66.05percentandfinancialprogresswas40.1percent(Figure2)
6.8.5IssuesandRecommendations:
Issues
Increasebudgetfordrug
procurementindistrictlevel.
Essentialdruglistforfreehealth
programislimited
Urbanhealthcenterbuilding
constructionnotcompletedin
manyMunicipalities.
PoorcoordinationbetweenD/PHO
andMunicipalityandNoHealth
IndicatorsinMCPMofMOFLD
Recommendation
Inaverageincreasedasperneed
fordrugprocurementindistrict
level
IncreasedEssentialdruglistfor
freehealthprogram
Adequatebudgettobeallocated
byPHCRDandMunicipalities.
Temporaryurbanhealthcenters
staffs
Socialauditprogramonlyin
limiteddistricts
PHCRD/
DoHS/MoH/MoFALD/Muni
cipalities
JointeffortofMunicipalitiesand PHCRD/
D/PHO
cipalities
IncreaseNumberofDistrictsand PHCRD/MoH/
budgettobeincreasedinyearly DoHS/LocalGovernance
basis.
IncreaseNumberofdistrictsand PHCRD/MoH/DoHS
budget.
Lackofbudgetformonitoringin
RegionandDistrict
NoReviewProgramforPHCRD
ProvisionOfBudgetfor
Supervisionandmonitorning
ProvisionOfBudgetforReview
HighdemandofUHC
MoredemandofIntegrated
CommunityHealthUnits
ImplementationofUrbanHealth
policyandcollaborative
Framework.
Developedpolicietomakeurban
healthcenterstaffsparmanent.
Responsibility
PHCRD/
DoHS/MoH/MoFALD
PHCRD/DoHS/MoH
PHCRD/
cipalities
PHCRD/
cipalities
PHCRD/MoH/DoHS
PHCRD/MoH/DoHS
DoHS,
Annual Report 2071/72 (2014/2015)
247
261
Chapter7
Monitoring and Evaluation
MONITORINGANDEVALUATION
7.1 Information Systems in Health Sector
SourcesofhealthsectorinformationinNepalincludeManagementInformationSystems(MIS),disease
surveillance, vital registration, census, sentinel reporting, surveys, rapid assessments, and research
(Figure 7.1). ThereareelevenMISslocatedwithinthehealthsector:HealthManagementInformation
System(HMIS);LogisticalManagementInformationSystem(LMIS);FinancialManagementInformation
System (FMIS); Health Infrastructure Information System (HIIS); Human Resource Information System
(HuRIS); Training Information Management System (TIMS); WebBased Leprosy Reporting and
Management System (WeBLeRS); Ayurveda Reporting System (ARS); and Drug Information Network
(DIN).MinistryofHealth(MoH)isworkingtowardsdevelopingunifiedcodesforthehealthfacilitiesand
creatinganenvironmentthatallowsinteroperabilitybetweentheseinformationsystems.
Figure7.1:Healthinformationsystems
HMIS
Routine
Information
Systems
DIN
HuRIS
ARS
Vital
Registration
Health
Sector
Information
Disease
Surveillance
WebLeRS
HIIS
Routine
Informatio
nSystems
TABUCS
Population
based
Information
TMIS
LMIS
PLAMAH
S
FMIS
7.2 Progress on M &E

There has been incremental progress on health sector monitoring and evaluation during the NHSP2
period.NHSP2sResultsFrameworkwasdevelopedinthesecondyearofNHSP2tomonitorprogress
againsttheframeworkindicators.TherevisionofHMIStoaddressdataneeds,particularlydisaggregated
data,ofNHSP2,programmedivisionsandcentres;theharmonizationofhealthfacilityandpopulation
based surveys; the annual monitoring of NHSP2s Results Framework indicators during DoHS/MoH
annualreviewsandjointannualreviews(JAR)aresomeofthemainM&EprogressmadebyMoHduring
this period. Considerable data is produced through management information systems (MISs), studies
andsurveys.NHSP2utilizedallsourcesofinformationlikeMISs,diseasesurveillance,census,sentinel
reporting,surveys,rapidassessments,andresearchtomonitoritsprogress.
248
263

The revised HMIS has adopted DHIS2, a free open source public health analytical tool (software),
developed byUniversity ofOslo,recommendedbyWHOandbeing used in about45 countriesacross
theglobe.TheMoHisintheprocessofitsrolloutfromthisfiscalyear.TheEarlyWarningandReporting
System(EWARS)underEpidemiologyandDiseaseControlDivision(EDCD)hasalsoadoptedDHIS2andis
readytorolloutinthesentinelsites.
Despite strong realization of importance of building interoperability among the major information
systemsexistinginthehealthsectortherehasnotbeenafunctionallinkagebetweenthemyet.Asafirst
steptowardsthisMinistryhasdevelopeduniquecodeforallhealthinstitutionsandisintheprocessof
endorsementandrollout.OncetheuniquecodeisrolledoutandDHIS2isfunctionalthiswillcreatea
platformforinteroperabilityofinformationsystems.
During2012/13MinistryofHealthdevelopedCountryAccountabilityRoadmapNepal(CARN)adopting
Commission on Information and Accountability (COIA) framework. Ministry is working on the seven
thematic areas namely Civil Registration and Vital Statistics; Monitoring of results; Maternal Death
Surveillance and Response; eHealth and innovation; Monitoring for resources; Review and planning;
andAdvocacyandoutreach.
Themajorongoingstrategicactivitiesinclude:
CRVS strengthening activities in 10 collaborative districts Solukhumbu, Sunsari,
Sindhupalchowk,Chitwan,Lamjung,Rupandehi,Banke,Jumla,KailaliandBaitadi.
Establishment of cause of death data system implementing medical certificate of death and
verbalautopsyforcommunitydeaths.
Pilot test of the complete package of the maternal and perinatal death surveillance and
responsesystem
Improvingqualityofcare
Nationalehealthstrategy(20152020)
Advocacywithparliamentarians,civilsocietyandjournalists.
DoHShasdevelopedaprototypeofanelectronichospitalmedicalrecordsystemandisintheprocessof
being tested in western regional hospital, Pokhara. Similarly, different ehealth initiatives have been
initiatedfromgovernmentandnongovernmentsectorsandbeingtestedatsmallscaleindifferentparts
of the country. For instance, Bayalpata hospital in Achham district has been using electronic medical
record system trying to move from paperbased to complete electronic (paperless) system. Electronic
ImmunizationReportingSystemhasbeeninitiatedinallhealthfacilitiesinKanchanpurdistrict.Learning
fromtheseinitiatives,theMinistryisplanningtoinitiateelectronicreportingfromhealthfacilitiesinthe
14earthquakeaffecteddistrictsinthefirstphaseandgraduallyscaleupacrossthecountry.
Table 2 below presents a synopsis of the national level population and health facility based surveys,
reviewsandassessmentsdoneduringtheNHSP2period.
249
264

Table7.1:Nationallevelsurveys,studiesandassessmentsdoneduringNHSP2period
Survey
Year
By
Populationbased
surveys
NepalDemographicHealth
Survey(NDHS)
A.
Remarks
2011
Ministry
of Crosssectionalsurveytoassessaccessand
Health/USAID
utilization of health services and health
outcomes. It is done in every five years'
timeinterval.Firstroundwasdonein1996
and the other series in 2001, 2006 and
2011. The fifth round of NDHS (2016) is
underway.
Nepal Adolescents and 2010/11 Ministry
of The survey is a nationally representative
YouthSurvey
Health
household survey on Adolescent and
Youth (NAYS) conducted to generate
adolescent and youth specific data in
Nepal
Nepal Living Standard 2011 Central Bureau The survey in 2011 is the third series, the
Survey(NLSS)
of
first series was done in 1995/96 and the
Statistics/World secondin2003/04.
Bank
HouseholdSurvey
2012 Ministry
of The study is a nationally representative
Health/NHSSP
crosssectionalsurveyconductedtocollect
information on all women in the selected
clusters who had delivered in a
government institution in the last 12
months
Further analysis of NDHS 2013 Ministry
of ProvidefurtheranalysisofNDHS2011data
2011on:
Health
and on key areas that are very important to
Impact
of
male
partner
assess progress and gaps, and ascertain
migration
on
organizations
determinants,inhighprioritypublichealth
contraceptive
use,
programmes that the ministry is
unmet need and
implementing. The work was carried out
fertilityinNepal
by technical professionals from the
Maternal and child
ministry and partner organizations who
health in Nepal: The
aredirectlyworkinginthegivenarea.
effects
of
caste,
ethnicity and regional
identity
Sexual
and
reproductive health of
adolescents and youth
in Nepal: Trends and
Determinants
Trends
and
determinants
of
neonatal mortality in
Nepal
250
265

Survey
Year
Women's
empowerment
and
spousal violence in
relation to health
outcomesinNepal
Non
Communicable
Diseases Risk Factors:
STEPSSurveyNepal
Nepal Multiple Indicator
Cluster Survey (NMICS):
KeyFindingsandTables
2013
NHRC/WHO
2014
Central Bureau The report is a part of the global MICS

of
programme and contains detailed
Statistics/UNICEF information on demographic, social,
economicandculturalcharacteristics.
Population
TRac study evaluating LLIN use among
Service
general population and children under 5
International
yearsofagein31Malariariskdistricts
Nepal
NepalMinistryof It is the further analysis study undertaken
Health,NewERA, as part of the followup of Nepal
and
ICF Demographic and Health Survey, 2011
International.
(NDHS) and provides data on fertility,
familyplanning,maternalandchildhealth,
nutrition,andHIV/AIDS
Malaria TRac Study in 31

Malariariskdistricts
2013
Women's Empowerment
and Spousal Violence in
Relation
to
Health
Outcomes in Nepal:
Further Analysis of the
2011 Nepal Demographic
andHealthSurvey.
National
Micronutrient
StatusSurvey
2013
2015
/16
(on
going)
Health facility based

surveys
ServiceTrackingSurvey
2011
2012
251
266
By
Remarks
Cross sectional study to determine the

burdenofriskfactorsforNCDsinNepal
Ministry
of Thesurveywillassessmicronutrientstatus
Health/
Child among representative populations in
HealthDivision
Nepal, including specifically the status of
vitaminsAandB12,iron,folicacid,iodine,
zinc and the condition of anemia among
vulnerablepopulationsinthecountry.The
survey will also collect information on
anthropometry,
infectious
diseases
(malaria, STH, H. pylori, visceral
leishmaniasis), blood disorders, and
markersofinflammation.Additionally,the
surveywillprovideinformationonpriority
process and outcome indicators for
nationalsupplementationandfortification
interventions, and other key nutrition
interventionsinthecountry.
Ministry
of ItisthefirststudydonetosupportNHSP2
Health/NHSSP
toreceivefacilitybasedinformationin169
health facilities across the 13 selected
districts
Ministry
of STS 2012 is the second health facility

Survey
Year
By
Health/NHSSP
2013
Ministry
of
Health/NHSSP
Facility Based Assessment

for Reproductive Health
CommoditiesandServices
2012
United Nations
Population Fund
(UNFPA)
Facility Based Assessment

for Reproductive Health
CommoditiesandServices
2013
United Nations
Population Fund
(UNFPA)
Responding to Increased
Demand for Institutional
Childbirths at Referral
Hospitals
in
Nepal:
Situational Analysis and
EmergingOptions
Results from Assessing
BirthingCentersinNepal
2013
Family
Health
Division/NHSSP
2014
Nepal Health
Survey
Facility
2015
Family
Health
Division, Ministry
ofHealth
Ministry
of
Health
Voices
from
the
Community: Access to
Health Services, A Rapid
Participatory Ethnographic
Evaluation and Research
(RapidPEER)Study,Nepal.
Evaluation of Health
Facility
Management
StrengtheningProgramme
2012
2012
Remarks
surveyconductedin198healthfacilitiesin
selected 13 districts to monitor the
progressofNHSP2
STS2013isthethirdhealthfacilitysurvey
conducted in 224 health facilities in 13
districts. In 2015 the STSs have been
harmonized with theNepalHealthFacility
Survey(NHFS).
Itassessestheavailabilityandstockoutof
RH commodities as well as provision of
quality Family Planning (FP) services. This
survey has been harmonized with the
NHFS2015.
Itassessestheavailabilityandstockoutof
RH commodities as well as provision of
quality Family Planning (FP) services. This
survey has been harmonized with the
NHFS2015.
Assesses the factors contributing to
overcrowdinginreferralhospitalsinNepal
and provides recommendations to
overcometheemergingchallenges.
Assesses the situation of birthing centres

inNepal
Assessesserviceavailability,readinessand
quality of health services. Harmonizes
STSs, UNFPA supported health facility
survey,SARA(WHO)andSPA(USAID).And
also harmonizes resources from USAID,
DFID/NHSSP,WHOandUNFPA.MoHplans
to conduct this survey in every five years
withapossiblyofaminisurveyinbetween
twosurveys.
Nepal
Health The study provides understanding of the
SectorSupport
sociocultural, economic, and institutional
Programme.
barriers to accessing health services
experiencedbypoorandexcludedwomen
andmeninNepal
Ministry
of The study measures the effectiveness of
Health and theHFMSPimplementedin13districts
Nepal
Family
Health
252
267

Survey
Assessing
Biomedical
Waste
Management
Practices among Health
CareInstitutionsofNepal.
Surveillances
Early
Warning
and
ReportingSystem(EWARS)
Year
2013
On
going
Maternal and Perinatal

Death Surveillance and
Response(MPDSR)
On
going
Others
Rapid Assessment of the
Demand Side Financing
Schemes:Aamaand4ANC
Programmes(7thRound)
Unit Cost Analysis of the
Health
Facility
Reimbursement
made
under
the
Aama
Programme
Scoping Study on Burden
2014
253
268
By
Remarks
Programme
Nepal
Health
Research
Council, Ministry
ofHealth.
Epidemiology
and
Disease
ControlDivision
EWARS is currently operational in 48

hospitals (out of 81 sites) throughout
Nepal. It reports weekly on number of
casesanddeaths(including"zero"reports)
of
six
epidemic
potential
diseases/syndromesMalaria, Kalaazar,
Dengue, Acute Gastroenteritis (AGE),
Cholera and Severe Acute Respiratory
Infection (SARI). The reporting also
includes immediate reporting (to be
reported within 24 hours of diagnosis) of
one confirmed case of Cholera, Kalaazar
severe and complicated Malaria and one
suspect/clinicalcaseofDengueaswellas5
or more cases of AGE and SARI from the
same geographical locality in one week
period. The EWARS has now adopted
DHIS2 platform and customization has
been completed. The system is under
testinganditwillberolledoutsoon.
Family
Health Maternal and Perinatal Death Review
Division
(MPDR)beingimplementedin42hospitals
got continuity and will be continued next
year. Family Health Division has initiated
theprocessofmovefromMPDRtoMPDSR
infivedistrictsin2014/15.Thetargetisto
review and respond all institutional
maternaldeathsby2020,asguidedbythe
NHSS201520.
Ministry
of RapidAssessmentistheseventhinaseries
Health/NHSSP
that is monitoring the implementation of
theAamaProgramme
2015
Ministry
of The study is done to assess the adequacy
Health/NHSSP
of the current rate of reimbursement
undertheAamaProgrammeinbothpublic
andprivatefacilities
2014
Ministry
of It assesses existing data sources and


Survey
Year
of Disease Survey for

Nepal
National Health Account

(NHA)
2000
2012
Mapping the Human

Resource Functions across
theMinistryofHealthand
Other
Government
Ministries, Departments
andAgencies
Human Resources for
Health Nepal Country
Profile
2013
Readiness
of
Comprehensive Obstetric
and Neonatal Emergency
CareinNepal
2011
2013
By
Remarks
Health, NHRC, evidence available for the country. It

IHME,
identifies opportunities to refine country
NHSSP/DFID
level burden of disease estimates for
Nepal; and assesses the feasibility of
estimating burden of disease at the
subnational level for Nepal in the near
future.
Ministry
of Determinesthefinancialburdenonprivate
Health
households in the form of outofpocket
expenditure, kind of services being
purchased, and the level of catastrophic
spending. Nepal has completed three
rounds of NHA; First round covers 2000
2006;Secondround20062009;andThird
round 20092012. Fourth round (2012to
date).
Ministry
of The study is carried out to support
Health
strategies and activities in the Human
Resources for Health (HRH) Strategic Plan
(201115)
Ministry
of
HealthandNepal
Health Research
Council
National Health
Sector Support
Programmeand
Ministry
of
Health
TBPrevalenceSurvey
The study is an Human Resources for

Healthassessmentofthehealthworkforce
to enable the development of a HRH
profile
The study is conducted to explore the
context in which district level hospitals
operate and the contributing factors that
affect their readiness to provide
Comprehensive Emergency Obstetric and
NewbornCare(CEONC)services.
Aims to estimate the prevalence of TB in
Nepal
2015on National
going Tuberculosis
Center
Strategic Review of Equity 2012 Ministry
of The review was consultative and contains
andAccess
Health
stakeholders views on the progress and
Programme
challengesofimplementingEAP
BudgetAnalysis
2013 Ministryof
The report presents analysis of the given
Health
and budgets and actual expenditure for the
Population
givenfiscalyear
BudgetAnalysis
2012 Ministryof
The report presents analysis of the given
Health
and budgets and actual expenditure for the
Population
givenfiscalyear
254
269
7.3 Monitoring NHSP2 Results Framework Indicators
This section assesses the performance of the NHSP2 in terms of progress from baseline 2010
towards achieving the targets set for 2015 in the results framework. The main sources of
information for monitoring the progress are Health Management Information System (HMIS),
Census2011,NepalDemographicandHealthSurvey(NDHS)2011,MultipleIndicatorClusterSurvey,
2014(MICS,2014),ServiceTrackingSurveys(STSs)andadministrativerecordsfromtheMinistryof
Health. For some indicators there are no data sources for 2014. Hence, some achievements could
notbecomparedwiththetargets.
Goal
Improvedhealthandnutritionalstatusofpeople,especiallythepoorandexcluded
Code
G1
Indicators
Data
TotalFertilityRate(perwoman)
3
G2
G3
G4
G5
G6
G7
G8
G9
Adolescent Fertility Rate (women aged

1519 years, per 1,000 women in that
agegroup)
UnderfiveMortalityRate(per1,000live
births)
55
Infant Mortality Rate (per 1,000 live

births)
44
Neonatal Mortality Rate (per 1,000 live

births)
33
98
Baseline
Source
2.3
2.6
[NMICS
[NDHS,2011]
2014]
71
81
[NMICS
NDHS2,2006
[NDHS2011]
2014]
38
54
[NMICS
NHSP2,2010
[NDHS2011]
2014]
33
46
[NMICS
NHSP2,2010
[NDHS2011]
2014]
23
33
NDHS2006
[NMICS
[NDHS2011]
2014]
NHSP2,2010
281
190
NHSP2,2010
Maternal Mortality Ratio (per 100,000

250
livebirths)
HIV prevalence among men and women 0.12 EPP/Spectrum
aged 1524 years (per 100,000 M=0.2, modeling,
population)
F=0.05 2010
Malaria annual parasite incidence rate 0.16
HMIS
2010/11
(per1,000populationinoneyear)
%ofchildrenunderfiveyearsofagewho 49.3
NDHS2006
arestunted
G10 %ofchildrenunderfiveyearsofagewho
areunderweight
34
NHSP2,2010
G11 %ofchildrenunderfiveyearsofagewho
arewasted
13
NDHS2006
14.3
NDHS2006
G12 %oflowbirthweightbabies
270
255
Achieved
2011
2014
NA
0.16
[HMIS]
44
[NDHS2011]
29
[NDHS2011]
10.9
[NDHS2011]
12.4
[NDHS2011]
NA
Target
2015
2.5
70
38
32
16
134
0.06
Halt&
0.15
[HMIS] reverse
37.4
[NMICS
28
2014]
30.1
[NMICS
29
2014]
11.3
5
[NMICS
2014]
24.2
12
[NMICS
2014]

%ofinfantsbreastfedwithinone
hourofbirth
%ofinfantsexclusivelybreastfed
for05months
%ofoneyearoldchildren
immunizedagainstmeasles
%ofchildrenaged659months
whohavereceivedvitaminA
supplements
%ofchildrenaged659months
sufferingfromanaemia
%ofhouseholdsusing
adequatelyiodisedsalt
ContraceptivePrevalenceRate
(CPR)modernmethods(%)
%ofpregnantwomenattending
atleastfourantenatalcare(ANC)
visits
%ofpregnantwomenreceiving
Iron/FolicAcid(IFA)tabletsor
syrupduringlastpregnancy
%ofdeliveriesconductedbya
SkilledBirthAttendant(SBA)
P1
P2
P3
P6
P7
P8
P10
256
Baseline
26.2
[HMIS2010]
59
[HMIS2010]
57
[HMIS2010]
44
[HMIS2010]
80
[NDHS2011]
48
[NDHS2006]
90
[HMIS2010]
86
[HMIS2010]
53
[NDHS2006]
35
[NDHS2006]
P9
P5
P4
Indicator
Code
39
[HMIS]
68
[HMIS]
57
[HMIS]
46.2
[NDHS,
2011]
80
[NDHS,
2011]
43
[HMIS]
101
[HMIS]
65.9
[NDHS
2011]
86
[HMIS]
48.5
[HHS]
2068/69
2012
41
[HMIS]
75
[HMIS]
56
[HMIS]
46.2
[NDHS,
2011]
80
[NDHS,
2011]
45
[HMIS]
97
[HMIS]
88
[HMIS]
NA
NA
Achievement
2069/70
2013
43
[HMIS]
72
[HMIS]
59
[HMIS]
46.2
[NDHS,
2011]
81.5
[NMICS
2014]
45
[HMIS]
142
[HMIS]
48.7
[NMICS
2014]
56.9
[NMICS
2014]
88
[HMIS]
2070/71
2014
33
[HMIS]
73
[HMIS]
57
[HMIS]
46.2
[NDHS,
2011]
80
[NDHS,
2011]
44
[HMIS]
106
[HMIS]
88
[HMIS}
69.6
[NDHS}
44.5
[NDHS}
2067/68
2011
51
[HMIS]
52
[HMIS]
52
[HMIS]
43
[HMIS]
[NMICS
2014]
46.2
[NDHS,
2011]
170
[HMIS]
48.7
[NMICS
2014]
56.9
[NMICS
2014]
85
[HMIS]
2071/72
2015
60
90
80
67
88
43
90
90
60
60
2015
Target
Remarks
271
HMISreports 180daysupplyof
IFAtopregnantwoman
Calculatedonthebasisof%of4
ANCasper1ANCvisit
Formarriedwomenof
reproductiveage(MWRA)
NDHSdatareflectchildrenbornin
last two yrs. HHS data reflect
childrenborninlastoneyear
Increasedutilizationofhealthservices,andimprovedhealthandnutritionalbehaviourofthepeople,especiallybythepoorandexcluded
Purpose:
272
257
P14
P13
P12
P11
Code
Obstetricdirectcasefatalityrate
% of women who had three

postnatal checkups as per
protocol (1st within 24 hours of
delivery, 2nd within 72 hours of
delivery,and3rdwithin7daysof
delivery, as % of expected live
births)
% of Women Of Reproductive
Age (WRA) (1549) with
complications
from
safe
abortions(surgicalandmedical)
Prevalence rate of leprosy per
10,000population
Indicator
NA
NA
0.82
[HMIS]
5.7
[HMIS]
4.5
[HMIS]
0.85
[HMIS]
50
[HMIS]
Achievement
2069/70
2013
51
[HMIS]
2068/69
2012
0.09
[HMIS]
0.83
[HMIS]
5
[HMIS]
44
[HMIS]
2070/71
2014
2071/72
2015
0.89
[HMIS]
0.09
[HMIS,20
14]
0.79
[HMIS]
0.77
[HMIS2010]
0.17
4.8
[HMIS]
4.9
[HMIS2010]
NA
51
[HMIS]
2067/68
2011
49
[HMIS2010]
Baseline
Datafortheyear2010,2011,
2012and2013representsPNCof
st
1 visitandonly2014datahasfor
3PNCvisit
Remarks
Haltand
reverse
Totalinstitutionalmaternaldeaths
<1
reported/totalinstitutional
deliveriesx100
<2
50
2015
Target
% of deliveries by caesarean section

(CS)
Tuberculosis treatment success rates
(%)
% of eligible adults and children
currently
receiving
antiretroviral
therapy(ART)
Metneedforemergencyobstetriccare
(%)
% population living within 30 minutes

traveltimetoahealthpost(HP)orsub
healthpost(SHP)
% of population utilising outpatient
services at SHPs, HPs, primary health
care centres (PHCCs) and district
hospitals
% of population utilizing inpatient
servicesatdistricthospitals(alllevelsof
hospitals)
% of population utilizing emergency
servicesatdistricthospitals(alllevelsof
hospitals)
Indicator
258
OC1.8
OC1.7
OC1.6
OC1.5
OC1.4
OC1.3
OC1.2
OC1.1
Code
NA
NA
3.9
HHS
90
[HMIS]
15.9
[HMIS]
NA
1.3
[HMIS]
90
[HMIS]
24
[HMIS]
17
[HMIS]
7.8
[HMIS]
90
[HMIS]
21.8
[HMIS]
21.8
[HMIS]
73
[HMIS]
2071/72
2015
8.6
[NMICS]
90
[HMIS]
23
[HMIS]
17
[HMIS]
9
[HMIS]
79
[HMIS]
2070/71
2014
NA
90
23
[HMIS]
4.6
[NDHS]
2.7
[HMIS]
2.4
[HMIS]
9
[HMIS]
76
[HMIS]
76
[HMIS]
9.5
[HMIS]
47.2
[HHS2012]
Achievement
2069/70
2013
47.2
[HHS
2012]
2068/69
2012
9.1
[HMIS]
70
[HMIS]
70
[HMIS]
9.1
[HMIS,
2011]
16.4
[HMIS,
2010]
23
[EOC
monitoring]
4.6
[NDHS]
90
[HMIS]
61.8
[NLSS]
2067/68
2011
61.8
[NLSS]
Baseline
Data
2011
OUTCOME 1:Increased and equitable access to quality essential health careservices
80
90
4.5
49
80
2015
Targets
273
NDHS data = for last 5

years,HHS=forlastyr.
Remarks
%ofinstitutionaldeliveries
%ofwomenwhoreceived
contraceptivesaftersafeabortion
(surgicalandmedical)
%ofclientssatisfiedwiththeirhealth
careprovideratpublicfacilities
Tuberculosiscasedetectionrate
OC2.4
OC2.5
OC2.7
OC2.6
Unmetneedforfamilyplanning(%)
OC2.3
274
259
%ofchildrenunderfivewith
diarrhoeatreatedwithzincandoral
rehydrationsalts(ORS)
%ofchildrenunderfivewith
pneumoniawhoreceivedantibiotics
OC2.1
OC2.2
Indicator
68.4
[NHSP2,
2010]
76
[HMIS,
2010]
25
[NDHS,
2006]
18
[NDHS,
2006]
NA
47.7
[HMIS,
2010]
27.5
[HMIS,
2010]
Baseline
2011
73
[HMIS]
91.3
[STS]2012
33
[HMIS]
36.5
[HHS]
27
[NDHS]
79
[HMIS]
26.9
[HHS]
2068/69
2012
78
[HMIS]
89
[STS2013]
29.5
[HMIS]
45.3
[HMIS]
27
[NDHS]
42.1
[HMIS]
97
[HMIS]
Achievement
2069/70
2013
83
[HMIS]
89
[STS2013]
24.3
[HMIS]
50
[HMIS]
27
[NDHS]
41
[HMIS]
96.4
[HMIS]
2070/71
2014
73
[HMIS]
96
[STS2011]
41
[HMIS]
35.3
[NDHS]
27
[NDHS]
35.1
[NDHS]
87.8
[HMIS]
FY2067/68
2011
85
80
60
40
18
50
40
2015
Targets
NDHS data for last 5

years. HHS and HMIS
dataforlastyr.
Remarks
83
[HMIS]
60.0
[HMIS]
52
[HMIS]
27
[NDHS]
93.1
[HMIS]
2071/72
2015
Improved health systems to achieve universal coverage of essential health care services
Code
Outcome 2:
%ofPWIDreportingtheuseof
sterileinjectingequipmentthelast
timetheyinjected
%ofhouseholdswithhandwashing
facilitieswithsoapandwater
nearby^thelatrine
260
OC3.4
OC3.3
NA
NA
53
(IBBS
2010)
MLMs
PWID
MSM
18.4
[HHS
2012]
NA
NA
NA
NA
NA
18.4
[HHS
2012]
NA
NA
NA
NA
NA
83
[PSI2013]
Achieved
2069/70
2013
72.5
[NMICS
2014]
NA
NA
NA
NA
NA
83
[PSI2013]
2070/71
2014
47.8
[NDHS]
95.3
[IBBS]
NA
46.5
(IBBS)
NA
NA
82.6
(IBBS)
37.8
(IBBS
2009)
75.3
(IBBS
2009)
10.4
[HHS]
2068/69
2012
67.8
[PSI2011]
FY2067/68
2011
67.8
[PSI
2011]
Baseline
2011
Malesexworkers(MSWs)
%ofchildrenunderfiveinhighrisk
areaswhosleptunderaLonglasting
InsecticidetreatedBedNet(LLIN)
thepreviousnight
%ofkeypopulationsathigherrisk
(FSWs,MSWs,MSMs,PWID,MLMs)
reportingtheuseofcondomatlast
sex
Femalesexworkers(FSWs)
OC3.1
OC3.2
Indicator
Increasedadoptionofhealthypractices
Code
Outcome3:
72.5
[NMICS
2014]
NA
NA
NA
NA
NA
2071/72
2015
85
95
80
80
80
80
85
80
2015
Target
275
NMICS:
Households
with a specific place for
hand washing where
waterandsoaporother
cleansing agent are
present
Remarks
Other Departments
8.1 DrugAdministration............................................................................... 279
8.2 Ayurveda.................................................................................................. 284
8.3 Homeopathic.......................................................................................... 289
277
278
Chapter8
DEPARTMENTOFDRUGADMINISTRATION
8.1 DEPARTMENTOFDRUGADMINISTRATION
1.BACKGROUND
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.
To implement and fulfill the aim of Drug Act 1978 and various regulations under it Government of
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.
1. RegulationonConstitutionofDrugConsultativeCouncilandDrugAdvisoryCommittee,(2037
BS).
2. DrugRegistrationRegulation,(2038BS).
3. DrugStandardRegulation(2043BS).
4. EnquiryandInspectionRegulation(2040BS).
5. CodesonDrugProduction(2041BS).
DrugDonationguidelineshavebeenimplementedforthequalityassuranceofdonatedmedicines.
2.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
controllingtheproduction,marketing,distribution,sale,exportimport,storageanduseofmedicines.
3.STRATEGIES
Selectionofessentialmedicinetopromoterationaluseofmedicines.
Establishmentofregionalofficesatallfiveregionsforeffectivedecentralization.
StrengtheningofNationalMedicinesLaboratory(NML)asanIndependentMedicineControl
Laboratory.
Medicineregistrationbasedonscientificfacts.
Promotionofrationaluseofmedicines.
Development of an efficient drug information system to disseminate the relevant
information.
Encouragement to promote and establish pharmaceutical industries to achieve selfreliance
intheproductionofessentialmedicines.
DoHS,
Annual Report 2071/72 (2014/2015)
279
261
Effectiveinspectiontoensurethequalityofmarketedmedicines.
Preventmisuseofantibiotictocombatantimicrobialresistance.
StrengthennationalindustrytocomplywithWHOGoodManufacturingPractices(GMP)
4. DIVISION AND BRANCH OFFICES OF DEPARTMENT OF DRUG ADMINISTRATION AND THEIR

FUNCTIONS
DivisionofDepartmentofDrugAdministration(DDA)
RegistrationDivision
ImportandExportSection:
To register the foreign drug manufacturing company and products in a scientific
mannerforimport.
Toissuetherecommendationletterforimport/exportofmedicines
Torenewtherecommendationletterforimportexport.
IndustrySection;
Toissuerecommendationletterfortheestablishmentofpharmaceuticalindustryand
issueProductManufacturingLicenseandrenewthem.
Checkandapprovethepharmaceuticalmanufacturingplantlayout.
Evaluatethenewproductsandissuemarketingpermissionforthesaleanddistribution.
Issueletterofrecommendationfortheimportofrawmaterialsandrenewthem.
PharmacyRegistrationSection:
Toregisterandissueregistrationcertificatestoopenretail/wholesalepharmacyoutletsand
renewthem.
Issueandrenewcertificatesforpersonsauthorizedtosalemedicines.
Updatetherecordofpharmacies
ManagementDivision
TrainingandDrugInformationSection:
Conducttherefreshertrainingtomedicinesellers.
Disseminateinformationaboutmedicinesparticularlysideeffects,contraindication,drug
Interactionandstorageconditionandothernecessaryinformationregardingmedicines.
PublishDrugBulletinofNepal(DBN)anddistributetohealthinstitutions,industries,medical
doctors,healthpersonnel's,pharmacistsandothersconcernedpersonandinstitutions.
ReviseNationalListofEssentialMedicinesandNepaleseNationalFormularyperiodically.
Recommendforimportofnarcotic,psychotropic,precursorssubstancesandliaisewh
InternationalNarcoticControlBoard.
ConductactivitiesrelatedtoPharmacovigillanceandAdverseDrugMonitoringReporting.
Planningsection
PrepareyearlyplanningforactivitiesconductbyDDAandregionaloffice.
Coordinate with Ministry, other department and other government and non government
organizationforconductingactivitiesandsubmitthereporttoMOH.
Collect,prepareandforwardmonthly,quarterlyandyearlyreport.
Administrationsection
Managementofhumanresources(recruitment,posting,promotion,transferetc)
PerformProcurementrelatedactivities
Monitoringandevaluationofregionalofficesactivities.
280
262
DoHS,
Annual Report 2071/72 (2014/2015)
InspectionDivision
Inspectdrugindustries,wholesaleandretailpharmaciesregularly.
TakelegalandadministrativeactiononcasesofnoncomplianceaspertheprovisionofDrug
ActanditsRegulations.
Regulatesalesanddistributionofpsychotropicandnarcoticdrugs.
CoordinateGoodManufacturingPracticeAuditwithinandoutsidethecountry.
Industryinspectionsection
Inspectionofpharmaceuticalindustryasperyearlyplan.
Takeactionfornoncompliancerelatedtodrugact2035.
Lawsection
Preparenecessarydocumentforregisteringthecaseoncourtagainstpharmacyandindustry.
Givelegalsuggestiontodepartment.
Import/exportsection
Inspection for the effective implementation of Drug act 2035 and other regulations under
DrugAct.
Auditsection
WHOGMPcertificationandRecertificationrelatedactivities.
BranchOffices:
DDA has its branch offices at Biratnagar, Birgunj and Nepalgunj. These offices carry out the
responsibilityofinspectionaswellasPharmacyregistrationandrenewal
NationalMedicinesLaboratory(NML)
NationalMedicinesLaboratoryistheprincipalbodyofGovernmentofNepalfortestingandanalysis
ofdrugs.Ithasvarioussectionslikechemicalanalysis,microbiology,pharmacologyandinstrumental
analysis.ThemainfunctionsofNMLareto:
TestandanalyzethequalityofmedicinesasempoweredaccordingtotheDrugAct1978.
IssueLotReleaseCertificateforvaccines.
DevelopSecondaryReferenceStandardandmakeavailabletothepharmaceuticalindustries
andlaboratories.
ConducttrainingonGoodLaboratoryPractices.
AuditlaboratoriesofNepalesepharmaceuticalindustries.
ANALYSISOFACHIEVEMENTSBYMAJORACTIVITIES
ActivitiescarriedoutinFY2071/72(20142015)
Majoractivities
1. Awarenessontherationaluseofmedicinesbydifferentmedia.
2. RegularpublicationofDrugBulletinofNepal(DBN).
DoHS,
Annual Report 2071/72 (2014/2015)
281
263
3. Audit/inspection of domestic drugindustriesforWHO GoodManufacturingPractice(GMP)
compliance.
4. Inspectionofretail&wholesalepharmaciesforcomplianceofregulatoryframework.
5. Postmarketingqualityanalysisofdrugsavailableinmarket.
6. InspectionofForeignManufacturersbeforeregistrationfortheimportationpurposes.
7. Conductingexaminationofveterinarydrugsellerstraining.
8. Premarketingdruganalysisformarketingauthorization/Approval
9. AuditofdomesticmanufacturerlaboratoryforcomplianceofGoodLaboratoryPractice(GLP)
10. Takelegalandadministrativeactionforviolationofregulatorystandards.
11. Recallofmedicinefrommarketthosefailedtoqualitystandard.
12. Controlthemaximumretailprice(MRP)ofmedicines.
TargetVsAchievement,FY2071/72
S Activities
.
N
1 Druginformationtothe
publicbydifferentmedia
2 PublicationofDrugBulletinofNepal
3 Conductingexaminationofveterinarydrugsellerstrai
ning
4 Inspectionofdomestic
PharmaceuticalIndustries
5 Inspectiontodrugretailers&wholesalers
6 DrugsampleAnalysis
7 AuditofPharmaceutical
AnalyticalLaboratories
8 InspectionofForeign
Companies
Unit
Targe
t
Achievemen
t
Numbe
r
Issue
Numbe
r
Numbe
r
Numbe
r
Numbe
r
Numbe
r
Times
60
58
96.7
3
1
3
1
100
100
100
48
48
2900
3072
1000
802
105.9
3
80.2
24
24
100
100
Otheractivities
S.N
Activities
1
Registrationofnewforeignpharmaceuticalindustry
2
Registrationofnewmedicine(import)
3
Renewofimportlicense
4
Issueofmarketinglicense
5
Issueofproductlicense
6
Importlicenseforrawmaterialfordomesticindustry
7
Approvaloflayoutofindustry
8
Registrationofnewpharmacy
9
Renewofpharmacy
10
Renewofprofessionallicense
11
Deregistrationofpharmacy
12
Recallofmedicinefrommarketduetoinferiorquality
282
264
Achievement
9
438
4344
443
653
1104
13
1250
8927
2251
378
23
DoHS,
Annual Report 2071/72 (2014/2015)
FinancialallocationandExpenditure
Budgetinthousands(000)
S.N Budgetheading
Budgetallocation
Budgetexpenditure
Capitalbudget
64,510
59,581
92.4
Recurrentbudget
55,053
47,167
85.67
Totalbudget
119,563
106,748
89.28
Revenue
Totalrevenue:42,116,562.00
Challenges
Regulatorynoncompliancecomesunderlegalframeworkandtakinglegalactiontothem.
Lackingmechanism(legalandorganizationalforregulationofHTP.
InformationManagement,TransparencyandlackingofdynamicandResponsiveInformation
system
Illegalimportofmedicineduetoopenborderand,SSFFCsregulationandcontrol.
Lackingofresources(human,Technology)
Regionalharmonizationanduniformity,MRHandSRAcollaboration.
Pharmacovigilance,postmarketingsurveillance
Medicinepriceregulationandtransparency
Goodgovernanceandaccountability
DoHS,
Annual Report 2071/72 (2014/2015)
283
265
DepartmentofAyurveda
8.2 AYURVEDA
8.2.1 Background
Ayurvedaisthemostancientmedicalsystembasedontheherbal,mineralsandanimalproducts.At
presentAyurvedahealthservicesarebeingdeliveredthroughtwoAyurvedaHospitals(one100+18
cabin bedded at Naradevi, Kathmandu & other 30 beds Bijauri, Dang), 14 Zonal Ayurveda
Aushadhalayas, 61 District Ayurveda Health centers and 305 Ayurveda Aushadhalayas in the
country. Ayurveda and Alternative Medicine unit in the Ministry of Health and Populations (MoH)
formulates policies and guidelines for the traditional medical system. Department of Ayurveda
(DoA),oneofthethreedepartmentswithintheMinistryofHealthandPopulation,wasestablished
in2038B.S.
OrganizationofDepartmentofAyurveda:
Planning,
Monitoring
&
Coordination
Division
Planning,
Monitoring
&Statistic
Section
Medicine&
Logistic
Managemen
tDivision
Logistic&
Management
Section
Ayurveda&
Alternative
Medicine
Section
Drug,
Research&
Training
Division
Research&
Training
Section
Administrativ
eSection
Financial
Admin.
Section
MedicinePlant
Drug&Quality
ControlSection
Altogether 1907 posts have been sanctioned within the Department of Ayurveda. Of which 999
postsaretechnical,101areadministrativeand807postsaresupportinglevel(officeassistance).
TheratiosbetweenpopulationandAyurvedainstitutionareasfollows:
PopulationperHospital:13.3million.
PopulationperDistrictAyurvedaHealthCenters:0.354million;and
PopulationperAyurvedaDispensaries:0.087million.
Objectives
266
284
Toexpandanddevelopfunctional,physicalAyurvedahealthinfrastructure;
ToimproveaqualitycontrolmechanismforAyurvedahealthservicesthroughoutthe
country;
Todevelopandmanagetherequiredhumanresources;
Tomobilizetheadequateresourcesformedicinalplants;
Topromotecommunityparticipationinthemanagementofthehealthfacility&utilization
of
localherbs;
Toprocure,storeanddistributetheAyurvedamedicine&otheralliedmaterials;
DoHS, Annual
Report 2071/72 (2014/2015)
Topromotehealthstatus&sustainabledevelopmentofAyurvedasystemusinglocally
available
medicinalplants;
Topromotepositiveattitudestowardshealthcare&awarenessofhealthissues;
Strategies
Providepreventive,promotive&curativehealthservicesintheruralareas;
Establishment&developmentofAyurvedainstitutions;
Strengthen&expandtheAyurvedahealthservices;
Developskilledmanpowerrequiredforvarioushealthfacilities;
Strengtheningofmonitoring&supervisionactivities;
Developmentofinformation,education&communicationcenterintheDepartment;
DevelopIntersectoredcoordinationwithEducationMinistry,Forestry,localdevelopment
sector&otherNGO's&INGO's;
EstablishmentofregionalAyurvedaHospitals&AyurvedaDispensaries;
Strengthening&expansionofresearch&trainingcenterofinternationallevel;
National&Internationalleveltrainingforthecapacitydevelopmentofitshumanresources
MajorActivities
Centrallevel
Procurement&paymentofessentialAyurvedadrugs&transportationtodistricts.
FreehealthcampsconductedonShivaratrifestival&fivedistrictsoutsideKathmandu
Annualperformancereviewmeeting.
Panchakarma&YogaToTProgrammeforAyurvedaphysician
RefresherTrainingoforientationtothedistrictofficechief
OrientationTrainingofJanapadoddhyawmsmanagementtoAyurvedaphysician&Kaviraj
Panchakarma,yog&statisticstrainingtoKaviraj&Vaidhyas.
Districtlevel
Constructionoftwentyofficebuildingspartiallycompleted.
Ayurvedamedicine,Firstaidandsurgicalequipmentssuppliedtoallhealthfacilities.
Repairedexistingbuildingsandcompoundwallsindistrictandlocallevels.
AyurvedamedicinepreparationwerecontinuedatruralAyurvedaPharmacyanddistrict.
AyurvedaHealthCenterutilizingthelocallyavailablemedicinalherbsandsuppliedto
Ayurveda
institutionintheregions.
PromotivePanchakarma/Rasayan/Yogaprogrammeforolderpopulation
Awarenessprogramformedicinalplants
Programforlactatingmother(Distributionofgalactogoguemedicine).
ConductionoffreeAyurvedahealthcampsin75districts.
Conductionoftraditionalhealerstraining(districtwise)
Construction,Maintenance&repairofAyurvedicinstitution
AyurvedahealtheducationforSchoolstudents
SupervisionandmonitoringofAyurvedainstitution
Conductionofruraloutreachclinic
DoHS,
Annual Report 2071/72 (2014/2015)
267
285
BasedonthetreatmentreportofdifferentAyurvedainstitutionsfollowingdiseaseswereclassified
BasedonthetreatmentreportofdifferentAyurvedainstitutionsfollowingdiseaseswereclassified
astoptendiseases:
astoptendiseases:
Amlapitta(Gastritis)
Amlapitta(Gastritis)
Udarrog(Abdominaldiseases)
Udarrog(Abdominaldiseases)
SwasanBikar(Respiratorydiseases)
SwasanBikar(Respiratorydiseases)
Vatavyadhi(Arthritis,RheumaticArthritisetc.diseases)
Vatavyadhi(Arthritis,RheumaticArthritisetc.diseases)
Jwar(Pyrexia)
Jwar(Pyrexia)
Balrog(Pediatricdiseases)
Balrog(Pediatricdiseases)
Karna,Nasa,Mukha,Danta&Kantharog(ENT,Oral,Dentaldiseases)
Karna,Nasa,Mukha,Danta&Kantharog(ENT,Oral,Dentaldiseases)
Strirog(Gynecologicaldiseases)
Strirog(Gynecologicaldiseases)
Brana(Wound,Abscess)
Brana(Wound,Abscess)
Atisar/Grahani(Diarrheadiseases)
Atisar/Grahani(Diarrheadiseases)
Tableshowsthenumberofpeopleservedatvariousregionsandzonesbysexin2071/72.The
Tableshowsthenumberofpeopleservedatvariousregionsandzonesbysexin2071/72.The
highestnumberofpeoplewereservedinwesternregionwhereastheleastnumberofpeoplewere
highestnumberofpeoplewereservedinwesternregionwhereastheleastnumberofpeoplewere
servedinmidwesternregion.
servedinmidwesternregion.
ServiceStatisticsforfiscalyear2071/72
ServiceStatisticsforfiscalyear2071/72
S.S.
N
N
11
Particular
Particular
OPDservice
OPDservice
EDR
EDR
CDR
CDR
WDR MWDR
MWDR FWDR
FWDRHospitals
Hospitals
DoA*TotqlTotql
WDR
DoA*
11496
11496
168814 202716
202716 267833
267833 118005
118005
31270 0
168814
31270
7 7
Eldercitizen
Eldercitizen
5289
6171 10203
10203
5289
6171
22 programmed
programmed
Lactating
Lactating
mother
2790
3786
3965
mother
2790
3786
3965
33
programme
programme
snehan\
snehan\
4245
2801
3554
4245
2801
3554
swedan
44 swedan
FreeHealth
FreeHealth
10429
10429 18053
18053 8840
8840
Camp
55 Camp
Rural
Rural
outreach
13444
outreach
13444 16618
16618 20351
20351
66
clinic
clinic
Total
Total
205011
205011 250145
250145 314796
314796
**FreehealthcampconductbyDoA
**FreehealthcampconductbyDoA
268
268
286
0903605
903605
3558 3284
3284
3558
0 0
0 28505
28505
2318 2344
2344
2318
0 0
0 15203
15203
3338
3338
0 0
0 13980
13980
42 42
10229
10229 6384
6384
0 0 32183218
57153
57153
10790
10790 6962
6962
0 0
0 68165
68165
148238
148238 133983
133983 31270
31270 32183218
1086611
1086611
DoHS,DoHS,AnnualReport2071/72(2014/2015)
Annual
Report 2071/72 (2014/2015)
7.2.4Problems/Constraints
Noprovisionforhigherstudyfor
BAMSAyurvedadoctors
Lackofexpertsandinadequate
qualifiedmanpower.
Inadequatefinancialsupportfor
districtlevelAyurvedainstitutionto
conductmonitoringsupervision&
publicityprogram.
Poorstorage&dispensing
techniquesofmedicinesincurative
aspectsofAyurvedainstitutions.
Lackofintersectorcoordination.
Lackofcommunitybasedprogram
forpublicityofAyurveda.
Lackofworkshop,training&
seminaronplanningforAyurveda.
Lackofappropriaterecording&
reportingsystem.
Inadequatestaffingunder
DepartmentofAyurveda.
FormalJustificationaboutthe
successfultreatmentofcertain
incurablediseasewithAyurveda
therapyclaimedbypractitioners.
Actionstobetaken
EstablishPGinstitutioninNepal
RecognitionofBAMScourseofNepal
byforeigncountry(India)
ProductionofQualifiedAyurvedic
manpower(BAMS,MD)
AllocatesufficientBudget
Responsibility
MoH
MOE
MOFA
DOA
MoH
MOE
MoH
MOE
Providegoodfurniture&dispensing
materials
Trainingonstorage&dispensing.
Coordinationwithrelated
ministries,
NGO's&INGO's
Increasequalifiedmanpower.
Increasemanpowerproduction.
Allocatebudget.
DOA
MoH
MOE
DOA
MoH
MOE
Allocatenecessarybudget,develop
longtermpolicy&planonAyurveda
Establishstatisticssectionunder
departmentofAyurvedawith
sufficientbudget.
Trainemployeeonrecording&
reporting.
Recruitment&placementasper
need.
Goalformation.
Allocatebudget.
DOA
MoH
MOE
DOA
MoH
MOE
DOA
MoH
MOE
MOGA
PSC
DOA
MoH
MOE
ProgramsProposedfor2072/73
OtherPrograms:Ayurvedvibhagh(3701293/4)
Procurement&paymentofessentialAyurvedadrugs&transportationtodistricts.
ProcurementofPhotocopy,Fax,Scanner,computerforZonalAyurvedaAushadhalaya&
DistrictAyurvedahealthcentre.
EstablishmentofpatientrecordingreportingnetworkingsystemsoftwareamongAyurveda
institutions.
Procurementofofficefurnitureforcentre.
EstablishmentofRegionalAyurvedaHospitalatDhangadi&Jhapa
StrengtheningprogramofNaturopathy,Yoga,Homeopathy,Unani,Aamchietc.
Purvakarma,Naturopathy&YogaHealthcamp.
DoHS,
Annual Report 2071/72 (2014/2015)
269
287
TotalQualityManagement&GESITrainingtoAyurvedaPhysician.
TranslationoftraditionalbooksofAmchi&otherAlternativemedicine.
QualitymonitoringofdifferentAyurvedicproductionsinNepalesemarket.
MonitoringofservicesprovidedbyprivateAyurveda&Alternativetherapies.
Procurementofbooksandmagazine.
Panchakarma&YogatrainingforKaviraj&Vaidya.
Annualreviewmeetingineachdistrictandcenter.
Revision,evaluation,monitoringandupdateofAyurvedichealthpolicyanddevelopmentof
codeofethics.
Freehealthcamps.
PreparationofAyurvedapharmacopeias.
Evaluationandmonitoring.
AyurvedaSewakaryakarm(3708093/4)
270
288
ConnectionofInternetatZonalAyurvedaAushadhalay&DistrictAyurvedahealthcentre.
Powder(Churna)medicineproductioninZAD&DAHC.
Strengtheningofherbalgarden.
Workshopanddiscussionwithlocaltraditionalhealers.
Preparationofinformativebooks,pamphlets&brochurerelatedtoAyurveda.
SchoolAyurvedahealthprogram.
ConstructionofcompoundwallinAyurvedicinstitutions.
Buildingconstructionof28Ayurvedicinstitutions.
PromotivePanchakarma/Rasayan/Yogaprogrammeforolderpopulation
Awarenessprogramformedicinalplants
Programforlactatingmother(Distributionofgalactogoguemedicine).
Observationtour.
Skilldevelopmenttraining.
AwarenessprogramonEpidemicdiseases&commonlyusedmedicinalplants.
Procurementoftreatmentequipment
Ayurvedamessagedevelopment&publications
Procurement of vechicle for ayurveda institutions, Ambulance for the central & regional
Ayurvedahospital&motorcycleforzonalayurvedaaushadhalay&districtayurvedahealth
centres.
DoHS, Annual
Report 2071/72 (2014/2015)
Homoeopathic Services
8.3HomoeopathicServices
BACKGROUND
Dr.SamuelHahnemanofGermanyhaddiscoveredHomoepathicsystembeforetwocentury.Thisis
basedonthefixedprincipalsof"SimiliaSimilibusCurantur".Medicineisprovidedonhealthyhuman
beingandsymptomsarerecordedinMateriaMedica.Medicineisprescribedonthebasisofsignand
symptomobtainedfrompatients.
PashupatiHomoeopathicHospital'sistheonlyonehospitalprovidinghomoeopathicservicestothe
people of Nepal in the public sector. The homoeopathic system is economic, easy and effective
havingnosideeffectaswell.ThehospitalprovidesOPD&IPDservicestothepatientsandsixbeds
areavailableforIndoorpatientsalongwithmealfreeofcost.Thehospitalisprocessingforupgrade
fromsixtotwentyfivebeds.
SUMMARYOFACHIEVEMENT
Homoeopathicsystemisgainingpopularmodeoftreatment.Hospitalrecordshowsthat,thenumber
of patient is increasing day by day. Many rejected cases by other system of medicine and surgical
caseshavebeentreatedsuccessfully.Atotalnumberof73,736patientswerevisitsfortreatmentin
thefiscalyear2071/72.
DescriptionofPatientsVisitedinHospital,FY2071/72
GeneralMedicine
Skin
E.N.T.
Eye
Dental
Gyn/Obs.
Other
Particular
Numberofpatients
40,545
18,786
3,389
1,203
1,409
1,312
7,092
Totalpatients
73,736
SummaryofFinancialAllocationandExpenditure
Regular
FiscalYear
BudgetinRs
2071/72(2014/2015)
1,03,07,100
Development
BudgetinRs
2,23,800
Total
BudgetinRs
10,963,000
CONSTRAINTS
Duetolimitedbudgetitishardtomanagethemedicineforincreasingnumberofpatients.
NotenoughhumanresourcesfortheeverincreasingnumberofpatientsinHospitalbasicallythe
Doctors,Technicalpersonnel(IT)andothersupportingstaffsduetolackofbudget.
DuetounavailabilityofPathologicalLaboratoryandXrayMachine,patientshavetogooutside
forpathologicalfindings.

289
271
Homoeopathic Services
HumanresourceespeciallytheDoctor,Technicalstaffandothersupportingstaffdonothave
anyopportunitytoexposethemselvesforhigherstudies,attendinginthetrainingandseminars.
CONCLUSION
TheHomoeopathicHospitalisprovidingservicetooutdoorpatientaswellasindoorpatientfreeof
cost.Homoeopathicsystemistobedeveloped.PeoplealloveroftheNepalarenotgettingservice
ofthisHospitalwhoisfarawayfromKathmanduvalley.Soitshouldbedevelopedtoprovideservice
to5developmentregionsofNepalgradually.
290
272
Development Partners
9.1 Multilateral Partners................................................................................ 294
9.2 Bilateral Partners..................................................................................... 295
9.3 International Non-Governmental Organisations.....................................297
9.4 National Non-Governmental Organisations.............................................299
291
Chapter9
DevelopmentPartners
DEVELOPMENTPARTNERS
The outcomes discussed in the previous chapters are the results of combined efforts of Ministry of
Health and development partners (multilateral, bilateral and international organizations 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 these
organizations and their contact details to help the readers find more details about them and their
programs.
PooledFunding
WorldBank,UKsDepartmentforInternationalDevelopment(DFID),GovernmentofAustralia,German
DevelopmentCooperationthroughKfWandGAVIAlliancehavebeenprovidingpooledfundtosupport
MoHP/GoN via SectorWide Approach (SWAp). The pool funding supports the governments five year
NHSP2 (2010/20112014/2015) to achieve its three objectives: (i) increase access to and utilization of
quality essential health services (ii) reduce cultural and economic barriers to accessing health care
services and harmful cultural practices in partnership with nonstate actors and (iii) improve health
systems to achieve universal coverage of essential health care services. The current support is a
continuationofthepreviousHealthSWAp(NepalHealthSectorProgram2004/20052009/2010).
ThecoverageisnationwideandinalignmentwiththeNHSP2.Theareasofsupportincludetheoverall
sector governance, child health, population and reproductive health, health system performance,
genderequalityandsocialinclusion,HIV/AIDSandnutrition.
FortheNHSP2,thedisbursementsfromthepooledfundingpartnerstillFY2014/2015wereasfollows:
World Bank: USD 119.6million disbursed for the NHSP 2 till date (out of total committed USD
129.15million)
DFID: GBP 77 million (USD 123 million) disbursed to NHSP2 till FY 2014/2015 (out of a total
commitment of GBP 72.5 million (USD 116 million). Of this, in FY 2014/2015 DFID disbursed
25.65million(USD41million)underpooledfundarrangementandearmarkedfinancialaidfor
familyplanning,and3.3million(USD5.3million)asaTechnicalAssistance.
German Development Cooperation: KfW under German Financial Cooperation committed for
fouryearsstartingfrom201112asumofEuro10millionthroughinthePoolFund.UnderNHSP
II Pool Fund arrangement, the cumulative till date amounts to Euro 9.13 million. Additionally
about Euro 450,000 was disbursed through the ongoing Sector Program Health and Family
Planning.
GAVI: During fiscal year 2013/2014 GAVI disbursed $ 4,996,135. With this the GAVI grant of
$14.54 million is fully disbursed. GAVI has made a further commitment of $36.54 million
towardsNHSP3foritsduration2015to2020.
Apart from the fully flexible pooled funding to the GoN in support of NHSP2, some pooled funding
partnersalsosupportedotheractivitieswhichhavebeenpresentedinthetablebelowwhichalsoshows
contributionsfromothernonpooledpartners.
273
293
294
274
UNICEF
UNFPA
Healthintervention
districts:
MNCHandHIV:National
withfocuson15priority
districts
Emergency22affected
districts
Nutritionintervention
NationalProgramme
withfocuson18priority
districts:Saptari,Sarlahi,
Rautahat,Mahottari,
Sunsari,Dang,Rukum,
Rolpa,Pyuthan,
Arghakhanchi,
Kapilvastu,Dadeldhura,
Baitadi,Bajura,Bajhang,
Sindhuli,Udayapurand
Achham
HumanitarianResponsein
14mostaffecteddistricts:
Gorakha,Dhagding,
Nuwakot,Rasuwa,
Kathmandu,Bhaktapur,
Lalitpur,Makwanpur,
Okaldhunga,Kavre,
Sindhupalchowk,Dolakha,
Ramechhap,andSindhuli
Geographicalcoverage
Officeaddress:
UNICEFNepal,UNHouse,Pulchowk,
Lalitpur
Tel:5523200
Fax:5527280
Officeaddress:
UNFPANepal
Jhamsikhel,Lalitpur.
Tel:+97715523880
Fax:+97715523985
Email:registrynp@unfpa.org
Web:
http://countryoffice.unfpa.org/nepal
Contactdetails
AllocatedBudget:
(includingallocation
duringemergency)
Health:
USD12,081,769
Nutrition:
USD17,030,157
Expenditure:(including
Healthsectorbudget
for2014/2015
AllocatedBudget:
USD3,615,000
Expenditure:
USD3,240,000
GPRHCS
(HQfundforRH
commodities)
USD2,584,000
ASRH,FP,SMPincludingmidwiferyandRHmorbidities,
HIV/AIDs&STI,Emergencypreparednessandresponsein
healthsector,FPcommoditiesandessentialRHmedicinesto
MoH,IPPF/FPAN,PSIandMSI
Establishandstrengthenfourclinicaltrainingsites(Seti
Zonal,WesternRegional,BheriZonalandMaternityHospital)
ascomprehensivetrainingsiteforRHrelatedtrainings(FP,RH
morbidities,SBA,healthresponsetoGBV)
EstablishB.P.KoiralaInstituteofHealthSciences,Dharanas
obstetricfistulatrainingsite
StrengthencapacityofHWsregardingidentification,
treatment,collectionofevidence,recording,reportingand
referralofGBVsurvivorsandclinicalmanagementofrape
DeliveryofSRHservices,withaspecialprogrammefor
adolescents,andtopreventandrespondtoGBVin14most
affecteddistricts,includingpsychosocialcounselingservices
ConductofmobileRHcampsin14mostEQaffecteddistricts
EstablishmentofFFSin14EQaffecteddistricts
DeliveryofdignitykitstoEQaffectedwomenandgirlsinall
14affecteddistricts
Provisionoflifesavingreproductivehealthequipmentand
supplies(RHKits)
Establishmentoftransitionhomefortemporaryshelterfor
pregnant,postpartummotherandadolescentgirlsandtheir
newborns
Setupofmaternityunitswithequipmentsupportatpartiallyor
totallydamagedhealthfacilities.
Health
Childhealth
Maternalandnewbornhealth
HIV/AIDS(PMTCTandPediatricHIV)
AdolescentHealth
HealthSystemStrengthening
Nutrition
Majorprogramfocus
MULTILATERALORGANIZATIONS
Organization
9.1
DevelopmentPartnersContributingtoHealthSectorinNepal
DevelopmentPartners
SupporttoScaleupMSNP,
MIYCFlinkedwithMultipleMicronutrients(MNP)
MIYCFLinkedwithChildCashGrantinKarnali
NationalMicronutrientProgramme(VitA,IDDandIFA)
IntegratedManagementofAcuteMalnutritionIMAM
NutritioninEmergency
275
Mi/Farwest
Nationwide
districts:
CMAM11districts
MNIYCF15districts
Emergency14districts
MSNP16districts
VitAnationalwith611
focusingonpriority15
districts
IDD2districts
AdolescentIFA15priority
districts
National
Expenditure
Euro3,346,089
AllocatedBudget:
Euro3,346,089
Contactdetails
Email:nepal
enquiries@dfid.gov.uk
Web:https://www.gov.uk/gover
nment/world/nepal
GIZSanepa,HealthSector
SupportProgramme
Tel:5013088
Fax:5013078
Email:Paul.Rueckert@giz.de
Fax:+97715000179
Telephone:+97715542980
OfficeAddress:Ekantakuna,
Lalitpur,POBox106,Nepal
Contactdetails
DrJosVandelaer
WHOCountryOfficeNepal
UNHouse,
Pulchowk,Lalitpur
Email:
vandelaerjo@who.int
Email:kathmandu@unicef.org
Web:
http://www.unicef.org/nepal
Healthsectorbudget
for2014/2015
Allocated:
18.65millionfinancial
aidand4million
technicalassistance
Expenditure:
25,650,000financial
aidand4,055,157
technicalassistance
Onbudget
$1,556,671
Offbudget
$3,083,008
(includesEQresponse)
Healthsectorbudget
for2014/2015
expenditureduring
emergency)
Health:
USD12,102,133
Nutrition
USD10,920,993
HSSP:
ImprovingQualityofmedicalcare,esp.for
pregnant women and newborn, access to
health Services for young people,
implementation for national health
DeutscheGesellschaft
FrInternationaleZusammenarbeit
(GIZ)
Majorprogramfocus
Health system strengthening, including

health policy and planning, financing,
procurement and infrastructure, essential
health care services, family planning,
public financial management, gender
equity and social inclusion, and
monitoringevaluationandresearch
Organization
BILATERALORGANIZATIONS
HIV/AIDS, TB, Malaria, NTD, Vaccine Preventable diseases, Non

Communicablediseases,MentalHealth,Nutrition,MaternalChild
health, Gender, Adolescent health, Geriatric health,
Environmentalhealth,Healthpoliciesandstrategicplans,Health
services,DrugsandDiagnostic,Epidemicpandemicandresponse,
outbreakandmanagement,Emergencyhealth,Foodsafety
Majorprogramfocus
DepartmentforInternational
Development(DFID)
9.2
WHONepal
Organization
DevelopmentPartners
295
296
276
USAID
KfWDevelopmentBank
Organization
Nationwide
Nationwide
HIV/AIDS
Water
OfficeAddress:USAIDc/o
AmericanEmbassy
Maharajgunj,Kathmandu
Tel:4007285
Email:dsinclair@usaid.gov
Web:www.usaid.gov/nepal
KfWOfficeSanepa,
Tel:5523228
Fax:5535693
Email:Shanker.Pandey@kfw.de
Web:kfw.de
Web:GIZ.de
Contactdetails
AllocatedBudget:
Euro148,509
Expenditure
Euro148,509
AllocatedBudget:
Euro2.5m.
Expenditure
Euro0
AllocatedBudget:
$14,400,000
Expenditure:
$7,944,810
AllocatedBudget:
$14,400,000
Expenditure:
$14,922,547
AllocatedBudget:
$8,000,000
Expenditure:
$5,569,980
AllocatedBudget:
$3,000,000
Expenditure:
$2,861,527
AllocatedBudget:
$1,500,000
Expenditure:
$1,111,414
Healthsectorbudget
for2014/2015
Nationwide
Nutrition
Nationwide
Nationwide
Country
Country
FamilyPlanning&ReproductiveHealth
Sector Program Health and Family

Planning
Nepal Health Sector Program NHSPII

(PoolFunding
MaternalNewbornandChildHealth
insurance
system,
improving
access/quality/medical/psychosocial
services for injecting drug users and
Decentralization
Majorprogramfocus
DevelopmentPartners
Organization
Majorprogramfocus
INTERNATIONALNONGOVERNMENTORGANIZATIONS
Micronutrient
277
TheMicronutrient
HelenKellerInternational
supplementation
and
20districts
AllocatedBudget:
UttardhokaMarg,424/2,
Officeaddress:
Baluwatar,Kathmandu
Tel:014423237
Fax:014420931
Email:lkhanal@np.jsi.com
Web:www.jsi.com
AllocatedBudget:NRs.
62.7million
Expenditure:NRs.54.9
million
Allocated:
Rs71,064,120
Expenditure:
70,966,954
Budget:
Nrs.151,155,770
Expenditure:
Nrs.155,237,135
Officeaddress:304SuryaBikramGyawali
Marg,Baneswor,Kathmandu
Tel:4115636
Fax:4115515
Email:kumudkafle@gmail.com
Web:www.inrudnepal.org.np
Dholahiti
Tel:+97715572157
shovakhark@tlmnepal.org
OfficeAddress:Kupodole,Lalitpur
Telephone:015524459
Fax:015521618
Email:ipasnepal.ipas.org
Web:www.ipas.org
P.OBox:3752
GreenBlock,Ward#10
Chakupat,Patan,Lalitpur,Nepal.
Tel:5260247,5260837,
Fax:5260459
Email:ddavis@hki.org
Web:www.hki.org
Contactdetails
AllocatedBudget:
MoH/DoHS
Healthsectorbudgetfor
2014/2015
AllocatedBudget:
NRs.397,820,446
Expense:
NRs.378,689,682
food
41districts
Suaaharaproject:Improvethenutritionalstatus
ofwomenandchildren
EssentialNutritionAction,
HomesteadFoodProduction(HFP),
SABAL:districts6
Socialmobilizationandgovernance
ARCH:3districtsSPRING:
SABALproject
3districts
Researchandadvocacyonhealthand
PoSHAN:10districts
nutrition
4districts
Emergencyresponseinhealthandnutrition:
InternationalNetworkfor
Differentdistricts
Monitoringprescribingpracticesand
RationalUseofDrugs
availabilityoffreedrugsatPHCoutletsto
(INRUD,Nepal)
improverationaluseofmedicines/Standard
TreatmentProtocoladherence.
Provides technical support to DoHS/MOHP to
thesetactivitiessince200910.
TheLeprosyMissionNepal IntegratedcomprehensiveLeprosyProgramin
15districtofCentral
CentralDevelopmentRegion
developmentRegion
(excluding:Sarlahi,
Dhanusha,Mahottari&
Sindhuli)
IPAS
Goal:
19districts.
Expandedinselected
Toimproveandadvancewomenssexualand
PHCCsandHPsof5
reproductivehealthandrightsinNepal
districts
Abortionservices
Purpose:
availablein22
Toenhancetheabilityandrightsofwomen,
hospitals
includingyoungwomen,toobtain
comprehensiveabortioncareandprevent
unwantedpregnancy
JSIResearch&Training
Chlorhexidinecordcare
Nationwide
Institute,Inc.
9.3
DevelopmentPartners
297
298
ImprovingtheHealthCareServiceDelivery
278
Programdistricts
Mugu
AllocatedBudget:
USD4,500,000
Expenditure:
ApproxUSD186,555.84
AllocatedBudget:
USD5,000,000
Expenditure:
ApproxUSD258,210
AllocatedBudget:
USD8,4000,000
Expenditure:
ApproxUSD1,354,721
AllocatedBudget:
USD5,500,000
Expenditure:
ApproxUSD722,932
AllocatedBudget:
Rs.65,465,712
Expenditure:
Rs.51,974,910
AllocatedBudget:
NRs:55,863,444
Expenditure:
NRs:33063684
Tel:5535580,5535560
Fax:5536431
Email:Sherbahadur.rana@plan
international.org
Web:www.planinternational.org/Nepal
Officeaddress:Sanepa
Telephone:5261858/5261860/5260718
Email:nepal@koica.go.kr
2ndFloor,Lazimpat
Telephone:014001083;
Fax:014001084
Email:minepal@micronutrient.org
Web:www.micronutrient.org
Dr.NastuSharma
POBox3764,HouseNo.496,DharaMarg,
Maharajgunj,Kathmandu,Nepal
Telephone:+97714416191/4417547
Email:nsharma@oneheartworld
wide.org,ohwnepal@oneheartworld
wide.org
Web:www.oneheartworldwide.org
Officeaddress:Sanepa
Telephone:5541401
Contactdetails
2014/2015
NPR24,291,440
Expenditure:
NPR2,2247,825
1)Strengtheningbirthingcentres
(construction&renovationofbirthingrooms,
SBAtraining,medicalequipmentandfurniture
support,awarenessraisingsafemotherhood)
2)Behaviouralchangecommunicationsessions
amongpregnantwomengroups
3)Communitybasedintegratedmanagementof
newbornandchildhoodillnessprogrammes
4)Childhooddisabilityservices
5)Emergencymedical&surgicaltreatmentto
sponsoredchildren&theirsiblings.
6)EmergencyresponseduringEarthquakehit
Tikapur
KOICA:Postdisaster
HealthServicesRecovery
PrograminNuwakot
District
KOICA:HealthServices
ImprovementinTikapur
PlanInternationalNepal
Nuwakot
KOICA:Improvementof
MaternalandChildHealth
CareinMugu
Kailali
HealthInsurance
KOICA:NationalHealth
InsuranceSupportProject
(NHISP)
5districts:Baglung,Dolpa,
Dhading,Sindupalchwok
andBhojpur
Maternalandneonatalhealth
OneHeartWorldWide
Nepal(OHW)
fortification
Majorprogramfocus
Initiative(MI)
Organization
DevelopmentPartners
formaternal,newborn&childhealth.
- Familyplanningandsafeabortion
- Childheath(earthquakeresponse)
- Safewatertreatment(earthquakeresponse)
Integration of Hygiene Promotion in Routine
ImmunizationProgram
Majorprogramfocus
41districts(Suaahara)
75districts(National
VitaminAProgram)
3districts(Policyand
ScienceofHealth,
AgricultureandNutrition
{PoSHAN}Community
Studies)
3districts(MarketAccess&
WaterTechnologyfor
Women)
6districts(Anukulan)
6districts(SABAL)
1district(HNARA
PROGRAM)
Maternalandchildnutrition
Multisectoraltrainingtohealthworkers,
FCHVsandothers
PromotionandadvocacyofNationalVitaminA
Program
Researchandsurveys
Budgetforhealthsectorfor
2014/2015
Suaahara
Budget:NRS.122,868,620
Expenditure:NRS.94,003,886
NationalVitaminAProgram
PoSHANCommunityStudies
MA&WTforWomen
BRACEDProgramme,
Anukulan
Expenditure:NRS.512,532
SABAL
Expenditure:NRS.552,698
HNARAProgram
AllocatedBudget:
NRs.36,262,959
Expenditure:
NRs.28,476,138
AllocatedBudget:
NPR36,001,500
Expenditure:
NPR4,953,901.82
2014/2015
42districts:
- ThroughPrivate
Sector:30districts
- ThroughPublicSector:
12districts
14mostearthquake
affecteddistricts
6districts
Jajarkot,Bardiya,
NawalparasiandMyagdi
Majorprogramfocus
279
DoHS, Annual
Report 2071/72 (2014/2015)
NepaliTechnical
AssistanceGroup
(NTAG)
Organization
9.4 NonGovernmentalOrganizations
WaterAidinNepal(WAN)
PopulationServices
International/Nepal
(PSI/Nepal)
Organization
Officeaddress:
Maitighar,Kathmandu,Nepal
GPOBox7518
Tel:97714224884/4220736
Fax:97714221133
Email:nvatag@mail.com.np
/deepakntag@mos.com.np
Web:http://www.ntagnepal.org
Contactdetails
Officeaddress:KrishnaGalli
Pulchowk,Lalitpur
Tel:97715553190
Fax:97715550619
Email:nbobin@psi.org
Web:
www.psi.org
JMRoad10,PabitraTole
Nakkhipot14,Lalitpur
Phone:
5574210/5572864/5572420/5573365
Email:wateraidnepal@wateraid.org
Web:www.wateraid.org/np
Contactdetails
DevelopmentPartners
299
300
SushmaKoirala
MemorialHospital
280
CRSCompany
b. TrainingonRH
c. SocialmarketingofFeminyl,Jodi,Mariprist
d. StrengthentheFPservicesdeliverysystemof
DoHS/MoHPtoincreasevoluntaryuseof
familyplanningservicesbyincreasing
accessibilityandavailabilityofhighquality
comprehensivefamilyplanningservicesto
thehardtoreach,disadvantaged,migrants
andadolescentpopulationtoachieve
universalcoverageinthedistrictsand
increasedistrictlevelCYPthroughSIFPO2
e. To contribute to and establish social
franchise of private sector nurses to deliver
SRHR, mainly FP services to deliver FP
services in remote areas through DANIDA
Project
PlasticandReconstructiveSurgery,Gynecology
andOrthopedicservices
Maternalchildhealth
Familyplanning
HIV/AIDSprevention
MajorActivities:
SafeAbortionServices(SAS)
Familyplanningstaticandoutreachservices
(fullrangeofFPmethods)
AdolescentSexualandReproductiveHealth
(ASRH)
Training:
AnesthesiaAssistant,SkilledBirthAttendant,
BiomedEquipTech,MidlevelPracticum,Follow
upProgram
RuralInstitutionSupport:
RuralStaffSupport
HospitalManagement
Advocacy:Research,Newsletters&Lobbying
a. SexualandReproductiveHealth
Majorprogramfocus
SunauloParivar
Nepal,an
implementing
partnerofMarie
Stopes
International
NickSimons
Institute(NSI)
Organization
Budget
NotAvailable
Expenditure:
ShankarapurMinicipality8,
Salambutar
Tel:014450826,
Fax:014450725
Email:skm@wlink.com.np
Web:www.nepalhospital.de
TokhaRoad,MahadevTaar,
Gongabu,Kathmandu,Nepal
P.O.Box.842,Phone:4362097,
4362098
OfficeAddress:Baluwatar,
Kathmandu
Telephone:014419376
Fax:014420416
Email:cd@msinepal.org.np
suveckshya@msinepal.org.np
Web:http://www.msinepal.org.np
AllocatedBudget:
Rs.28Crores(approx.)
Expenditure:
Rs.27Crores(approx.)
Budget
Rs.45,887,000
Expenditure:
Rs.53,174,924
NSIOfficeCenter
Sanepa,Lalitpur
Box8975,EPC1813
Kathmandu,Nepal
Ph.97715551978
Fax5544179
nsi@nsi.edu.np
www.nsi.edu.np
Contactdetails
AllocatedBudget:
Rs.256,896,468
Expenditure:
Rs.218,030,701
2014/2015
CRSSocialMarketingcovers
all75districts
NationalMinistryofHealth
StaticCenters:36
11districts
4districts(DANIDA)
25
districts
(STERI
Outreach)
6districts(LARCOutreach)
45districts
RSSP:11districts
HMSP:18districts
Trainingsites:16districts
Participants:75districts
DevelopmentPartners
- Comprehensivesalesandmarketingactivities
usingsocialmarketingtoolsandtechniques
- Openingofcondomoutletsathighwaysand
hotzonestomakecondomaccessibletoMost
atRiskPopulations(MARPs).
- ExpansionofSanginiFranchisingOutletsto
provideservicesofSanginiTinMahineySui
(Depo)throughcertifiedpharmacies.
- ImplementationofRemoteAreaInitiative
(RAI)
- ImplementationofBCCactivities
- ProvidingserviceofLARCs(IUCDandJadelle)
- PartnershipwithMicronutrientInitiative
CanadaonORSwithZinc.
Majorprogramfocus
281
Organization
2014/2015
Rs.200,000,000
Expenditure:(MIproject)
Rs.3,600,000
Fax:4362099
Email:crs.org.np/webmail
Web:www.crs.org.np
Contactdetails
DevelopmentPartners
301
302
EmergencyPreparednessResponse
RHresponseandpreparednessProjectfor
disasterandcrisisaffectedpopulation
HamroSawalHamroSahabhagita(Our
ConcernsOurParticipation)
CommunityEmpowermentforHealth
PromotionProject(CEHP)
HIVandBCCProject
EmergencyHealthProject
NRCSShreeJanakiEyeHospital
Partners:FredHollowsFoundation,Austrilia
andTilgangaInstituteofOphthamology(TIO),
Kathmandu
CentralBloodTransfusionServices
FirstAidandRoadSafety
Majorprogramfocus
4districts
67districts
4districts
JanakpurZone
4districts
1district
5districts
6districts
3districts
15districts
282
NepalRedCrossSociety,
HealthServiceDepartmetn
RedCrossMarga.Kalimati,
Kathmandu
Tel:4270650,4272761,4279425
Fax:014271915
Email:
nrcs@nrcs.org
mona.aryal@nrcs.org
sabin.adhikari@nrcs.org
bksedain@gmail.com
info@nrcscehp.org,
cehp@nrcscehp.org
manoj.thokar@nrcs.org
cbts@nrcs.org
krishna.ghimire@nrcs.org
Web:
http://www.nrcs.org
www.nrcscehp.org
Contactdetails
2014/2015
Allocated:
Rs57,478,058
Expenditure:
Rs37,318,533
Allocated:
Rs7,086,225
Expenditure:
Rs6,314,313
Allocated:
Rs49,239,200
Expenditure:
Rs48,050,000
Allocated:
Rs20,000,000
Expenditure:
Rs16,902,374
Allocated:
Rs5,760,300
Expenditure:
Rs5,700,000
Allocated:
Rs5,430,075
Expenditure:
Rs5,280,000
Allocated:
Rs54,695,000
Expenditure:
Rs36,614,143
Allocated:
Rs11,527,079
Expenditure:
Rs11,500,826
Allocated:
Rs60,600,000
Expenditure:
Rs55,400,000
Allocated:Rs35,278,344
Expenditure:Rs23,984,764
Source:RespectiveEDPs,INGOsandNGOsNote:=*=Informationnotreceivedforthe FY2071/72(2014/2015)
NepalRedCross
Society(NRCS)
Organization
DevelopmentPartners
Annexes
ANNEX 1
ACTIVITIES CARRIED OUT IN FY 2071/72
ANNEX 2
TARGET FOR FY 2072/73
ANNEX 3
HEALTH SERVICES (Target Population, Raw/Analysed Data)
303
Annex 1: Major Activities Carried out in FY 2071/72

ANNEX 1 Major activities carried out in FY 2071/72

SN
Activities
Health Workers training of Immunization Training g
1
Center( 3days 3 batch 36 HWs)
Immunization Training to private and NGO sectors
2
Health Workers ( 10 batch 200 person)
Health workers training on immunization
3
Advocacy and on Immunization Act
4
New vaccine Introduction training and orientation
6
Full Immunization Initiation Orientation workshop( 2
7
batch 20 district
Full immunization declaration manual preparation
9
Appreciative Inquiry workshop in 20 district
10
New vaccination PCV,IPVMRSD and HPV introduction
11
Interaction workshop with health professionals
New vaccine introduction training workshop(region&
12
district)
New vaccination PCV,IPVMRSD and HPV introduction
13
Interaction workshop Regional level workshop-5
Financial sustainability and Immunization fund
14
advocacy with parliamentarians
Media people interaction on immunization
15
Fund raising on Immunization Fund
16
AEFI management and treatment support
17
Immunization
programme Resource tracking and
18
analysis 8 district
SNIDs in 27 district
19
IEC/BCC materials production and distribution for
20
new vaccines
Immunization card availability and utilization study
21
Electrical Immunization Registration System in 3
22
district
Source: CHD
Unit
person
Targets
36
Achieve.
36
%
100
person
100
100
100
person
Time
Times
Times
200
1
3
2
200
1
3
2
100
100
100
100
Times
Times
Times
1
2
2
1
2
2
100
100
100
Times
100
Times
100
Times
100
Times
Times
Times
Times
3
1
3
3
3
1
3
3
100
100
100
100
Times
Times
1
2
1
2
100
100
Times
Times
1
3
1
2
100
66
CHILD HEALTH: NUTRITION

SN
Activities
1
Implementation of Pilot Program on Adolescent Anaemia and
Under Nutrition Control - 3 Districts (Siraha, Kapilvastu and
Pyuthan)
2
School Health & Nutrition Programme (Continuation in 3 Districts:
Siraha, Kapilbastu, Pyuthan and Expansion on 3 Districts: Rolpa,
Dhanusha, and Saptari)
3
Regional Level Review (2 Days) of School Health and Nutrition (Soil
Transmitted Helminthic Programme) (Eastern and Western)
4
Orientation Training Programme on Maternal & Child Health
Nutrition Programme (6 Districts: Karnali Zone and Solukhumbu)
5
Workshop on Inter-personal Communication and Community
Involvement for Implementation of Integrated Nutrition
Programme (SUAAHARA Programme)
6
Programme Implementation of Multi-Sectoral Nutrition Plan
(SUAAHARA: 22 Districts) and Formation and Strengthening of
Nutrition and Food Security Steering Committee at VDC Level
DoHS,
2071/72 (2014/2015)
(2014/2015)
DoHS, Annual
Annual Report
Report 2071/72
Unit
Time
Target
1
%
100
Times
100
Times
100
Time
50
Times
100
Times
100
305
283

SN
7
8
9
10
11
Activities
Iodized Salt Social Marketing Campaign, 2014 (Dadeldhura and
Baitadi)
Midline Survey on Effectiveness of IYCF-MNP
Establish Nutrition Surveillance System in 4 New Districts and
Continue Technical and Financial Support in 2 Last Year Districts
Training Program on Maternal, Infant and Young Child Nutrition
(MIYCN) Training Package and Basic Nutrition Package at Central
Level MToT and DTOT in 5 Districts
National Micro-Nutrient Survey (2071-73)
12
Implementation of Multi-Sectoral Nutrition Plan (Districts: 6)
Source: CHD
CHILD HEALTH: CB-IMCI/NCP
SN
Program/Activities
1.
Procurement of ARI Sound Timer
Procurement of Equipment (Bag and Mask, Thermometer,
Delee Suction, Tubular Weight Spring Balance) for CBIMNCI
2.
Program
Construction and Renovation of Health Institutions
3.
for Newborn Care (34)
Follow up and Supervision of CB-IMNCI Program
4.
(UNICEF)
Assessment and Feedback of Child Health Program
5.
(Bajura, Baitadi, Rolpa and Udayapur)
Carryout CBIMNCI Program(40 Districts) (GoNDistricts
Okhaldhunga ,Dhanusha, Sindhupalchowk, Tanahu,
Kaski, Syngja, Rukum, Dailekh, Surkhet, Jajarkot,
6.
Achham&Doti)
7.
Carryout CHXP rogram
CB-IMNCI Training to untrained and newly
8.
r ecruited FCHVs (H4L District)
9.
Workshop on CB-IMNCI Package Development
CB-IMNCI ToT (5 batches) GoN, UNICEF,
10.
WHO
11.
Printing of CB-IMNCI Training Materials
ProgressAnalysisandImprovementProgramtobeimple
mentedattheprioritizeddistrictsforChildHealthandNew
12.
borncare(140VDCsofH4L)
MToTon CBIMNCI Package SUAHARA (2 batches
40 persons) and H4L( 2 batches 40 Persons)
Unit
Times
Target
2
%
100
Time
Time
1
1
100
0
Time
100
Times
Times
Going
on
100
Unit
Pcs
Time
Targets
16,000
1
Achieve.
16,000
1
%
100
100
Sites
34
34
100
Time
100
District
33.3
District
40
District
Times
12
3
12
3
100
100
Times
Times
3
5
3
5
100
100
Times
100
VDCs
100
VDCs
140
150
(SUAA
HARA
100
and
H44L
(50)
Times
100
13.
Feet Measurement and Management Program of the
14.
Child who get birth at home low weight2 districts
Source: CHD
SN
Activities
1
Family Planning (FP) current users
2
VSC expected new acceptors
3
IUCD expected new acceptors
306
284
Unit
Couple
Couple
Couple
Targets
2,775,000
50,000
45,000
Achieve
2527380
30728
32429
%
91.73
61.45
72.06
DoHS,
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)

4
5
6
7
8
9
10
Implant expected new acceptors

Micro-planning in low CPR districts
Family Planning Supervisors conference
FP integration with EPI clinic
Pre VSC meeting with FCHVs in low
performing districts
Conduct Satellite clinics for long acting
methods
Family Health: Safe motherhood program

SN
Activities
1
24 hours CEOC Services
2
Recruitment of Staff nurse
3
Recruitment of ANM
4
Rural Utlrasound program
5
Free Blood Transfusion services for Aama
program
6
4th ANC
7
Transportation incentive and Free Delivery
services
8
Nano Jhola for Birthing Centre
9
Fistula/UP Screening
10
UP Surgery
Family Health: FCHV /ASRH/PHC-ORC
SN
Activities
1
Knowledge update to FCHVs on LARC
2
Committee formation to respond FCHV
demands
3
Initiated to distribute RIM and SIM for 20
thousand FCHVs in coordination with NTC
5
ASRH program orientations to District Health
Managers program districts
Source: FHD
Couple
District
District
Time
District
District
55,000
16
25
1
4
53
61343
16
25
1
1
53
111.53
100
100
100
25
100
District
75
75
100
Unit
Place
Number
Number
District
Targets
41
81
1629
10
Achieve.
38
77
1517
10
%
92.68
95.06
93.12
100
5000
3200
64
225000
82689
36.75
Pint
Number
Number
Set
Person
Person
375000
309220
82.45
210000
45600
4500
117088
37306
1003
55.75
81.81
22.28
Unit
District
Times
Targets
27000
1
Achieve.
17280
1
%
64
100
persons
20,000
20000
100
districts
100
Unit
Annual
Target
Achieve
times
100
piece
100
piece
piece
Epidemic disease control

SN
Activity

Purchase furniture and fixtures for malaria
1
control programme
Procure Ambulance for mobile health team (
2
road accident management)
3
Purchase of Ambulance for TIA Health Desk
Procurement of dengue and chickungunya
test, PCR machine, ELISA Reader, Platelet
4
Segregation Machine.
Procurement & installation of temperature &
5
humidity measurement equipment( 150 HI)
Procurement of server, scanner,
Teleconference set & install aircondition/Mobile set for SMS reporting and
6
other (Thru WHO)
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(2014/2015)
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Annual Report
Report 2071/72
307
285

Procurement of 4WD Vehicle thru WHO use
7
for malaria Program
Development of Treatment Protocol Out
8
Break Management
Orientation training for district/community
RRT members and health workers on
9
epidemic control and management
Procure drugs and equipment for control of
10
epidemic diseases
Supervision, Monitoring & Evaluation
11
expenses during Outbreaks
Activities for the effective implementation of
IHR 2005 and Integrated Disease Surveillance
12
System
Procurement of furniture for control of
13
Ebola,Swain flu and etc
Field programme of Health workers to
14
controlEbola,Swain flu and etc
Orientation to health worker on
15
Ebola,Swinflue,and bird flue
16
orientation for Health worker on EBOLA
Malaria control
17
Human Resource Cost at Central Office
Basic and Refresher training in malaria
18
microscopy
Capacity strengthening of VBDRTC in Malaria
19
Training and Research
Printing and dissemination of
SoPs,Treatment and prevention algorithm,
Publication of malaria annual report and
20
other training Materials
Quality control of malaria slide in centre&
Monitoring to ensure the quality of the blood
21
slide examined in the districts
RRT Mobilization for outbreak /emergency
preparedness, prevention, control and
22
management
Technical support from WHO on IHR, IDSS,
outbreak investigation, Water safety plan
23
and control
Technical support through WHO in malaria
24
control programme
Technical assistance from WHO in malaria
25
control
In country program related capacity building
trainings (Malariology, vector identification
26
and bionomics, etc)
Implement the plan, including international
trainings for key staffs (Masters in medical
entomology, program management,
malariology, malaria elimination,
entomology, surveillance, M & E, etc),
Programme representation International
27
Level
308
286
piece
times
100
times
11
times
100
times
100
times
67
times
times
67
times
times
times
100
person
75
50
67
person
100
times
50
times
12
times
100
times
100
times
33
times
times
person
DoHS,
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)

28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
Annual Health Facilities Survey

Survey on malaria microscopy services to
establish baseline on adherence to standard
operating procedures & Internal competency
assessment workshop in malaria microscopy
Implement advocacy, social mobilization and
behavior change communication (BCC)
strategy and Develop specific materials print,
audio and video
Hoarding boards to be placed at hospital
campound,in major boarder crossings
Malariometric Survey and Entomological
Survey
Monitoring efficacy of first line anti-malarial
medicines and Monitoring vector
susceptibility to insecticides, in malaria risk
districts
Develop advocacy materials and flip chart for
FCHV and Printing National Malaria diagnosis
tretment guideline, manual and Training plan
(thru WHO)
Capacity building Orientation on GR ,
mapping and GPS/GPRS & orientation for
Web-based system
Update micro-stratification ,Orientation to
key staff on foci investigation and rapid
response team at national and district level
Cross-border meeting to exchange
information and develop joint operational
plan
Conduct annual national review meetings
and Strengthen partnership with other
national institutions
Distribution of LLINs in targeted area of
districts every year and conduct BCC on
usage of LLINs.
Strengthen Malaria Technical Working Group
(TWG) and Programme representation
National Level
Supportive supervision and monitoring of
malaria microscopists
Technical Review of EWARS sentinel sites
focal persons
Emergency focal spraying in vector borne
epidemic area
Vector surveillance for Malaria,Kalaazar,Dengue ,L.Fileria& JE
Celebration of World Malaria Day
Purchase of Insecticide for Malaria Indoor
residual spraying
Procure medicines and diagnostic materials
for malaria control
Procurement of LLIN
Distribution of LLIN in high and moderate risk
VDCs Freight, Insurance and Shipping cost
DoHS,
2071/72 (2014/2015)
(2014/2015)
DoHS, Annual
Annual Report
Report 2071/72
times
times
times
times
times
100
times
50
times
person
33
person
times
times
50
times
times
times
person
50
times
times
12
times
100
piece
100
times
100
piece
472747
472747
100
piece
472747
472747
100
309
287

Monitoring and Supervision - EDCD/PMU-at
50
all level - MoH/RHSD/DoHS
Kala-azar control
Orientation to multi-sectoral/stake holders
51
on IVM
Technical support by WHO in kala-azar
52
elimination and Dengue controlprogramme
53
kala-zar case base surveillance
Case validation in new kala-zaremerging
54
district
Purchasing medicines and medical goods for
55
Kala-azar control
Purchase of Insecticide for IRS in Kala-azar
56
affected districts
Transportation cost support for Kalaazar
57
patients
Natural disaster management
orientation to RRT for RH promotion in
emergency and natural disaster and prepare
58
district level contingency planning
Technical support from WHO in disaster
59
management programme
Emergency planning workshop to the
60
hospital /PHC
Lymphatic filariasis elimination
LF follow-up survey in 10 LF MDA conducted
61
districts
62
Interaction with professional organizations
Monitoring and supervision of MDA
63
campaign
Technical & financial support by WHO in
64
filaria elimination campaign
Technical & financial support by DFID/CNTD
65
in LF elimination program
RTI financial and technical support on LF
66
elimination
Surveillance activities in 20 MDA stopped
67
districts
Management of LF morbidity, MDA
orientation, SAE management and
conduction of hydrocele operation
68
camps(center & hospitals)
IEC activities for Mass Drug Administration
(MDA) campaign in Filaria elimination
69
programme
MDA Planning Workshop, Review and
70
publication of annual reports
Zoonotic disease control
Procurement of chemicals, Equipment and
operational costs to produce ARV Tissues
71
culture vaccine.
72
celebrate world Rabies day
Development, printing & dissemination of IEC
73
materials on Zoonoses
310
288
times
67
times
times
100
times
times
100
times
100
times
person
150
14
times
33
times
100
times
67
times
times
100
times
100
times
100
times
times
100
times
times
100
times
100
times
50
times
100
times
100
times
100
DoHS,
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)

Technical support by WHO in zoonotic
disease control
Orientation training to the MO and
Paramedical staffs on rational use of ARV and
75
poisonous snakebite case management
Study & research for production of inj .ASVS
76
in Nepal
77
Procurement of ASVS for districts
Procurement of ARV (Cell culture vaccine) for
78
approx 50000 persons.
Dengue control
Orientation/interaction with stakeholders on
79
dengue disease control
emergency management for dengue
80
outbreak control
Orientation for MO and paramedical staffs
81
and journalists on dengue and chickungunea
Public awareness activities on dengue and
82
chickun control
Mobilization of team during dengue and
chickungunea outbreak & vector search and
83
destroy campaign to control dengue
epidemics
Development of search and destroy guide
84
line for dengue and chickungunea control
Multi-sectoral interaction on dengue and
85
chickungunea control
Procurement of dengue and chickungunya
86
diagnostic test kits
87
Health worker recruitment
88
Staff Hiring for Ariport
89
payment of Health working in EDCD
90
Printing of Materials
Source: EDCD
74
Tuberculosis:
SN
Activities
1.
Anti-TB medicines for 6- 8 month regimen
2.
Procurement of second line anti-TB
medicines (MDR + XDR patients)
3.
First LIne drug Procurement
4.
National PME Workshop
5.
Establishment MDR Hostels in five places
6.
Establish hostel accommodation at regional
level
7.
National TB conference including MDR - TB
national seminar and DTLO seminar at
national level
8.
Nutrition support to Retreatment Patients
9.
DOTS training for medical Officer
10.
DHO/PHO workshop at regional review
11.
Nutrition grant to Retreatment Patients
12.
PPM/ISTC orientation in medical colleges
(medical colleges including private and public
sectors)
DoHS,
2071/72 (2014/2015)
(2014/2015)
DoHS, Annual
Annual Report
Report 2071/72
times
person
375
350
93
times
piece
30000
30000
100
times
300000
50000
17
times
times
times
67
times
times
times
times
33
times
times
times
times
times
69
4
7
1
0
0
0
0
0
0
0
0
Unit
Times
Times
Targets
1
Achieve.
1
%
100
450
450
100
Times
Times
Place
Place
1
3
5
1
3
3
100
100
60
60
100
2800
6
5
400
1500
6
5
51
100
100
22
21
21
100
Times
Persons
Package
Times
persons
Times
311
289

SN
13.
Activities
Provide training to medical practitioners
(PMPs) including private and public sector on
PPM and ISTC (2 days)
14.
Procurement of TB drugs in emergency
15.
TB Modular training
16.
National workshops to align NTP monitoring
system with HMIS reporting system
17.
Procurement of MIcroscope
18.
DOTS workshop at District level
19.
Regional Monitoring & Evaluation Workshop
(DOTS) for each region
20.
Supervision from region to district/Treatment
Centers- DOTS, Lab-(QC, Culture, MC), MDR,
TB HIV, PPM, PAL, ACSM
21.
Supervision from center to region and district
22.
Supervision from National to region/district/
Treatment Centers- DOTS, Lab-(QC, Culture,
MC) MDR, TB HIV, PPM, PAL, ACSM
23.
Conditional contribution to DR Home
Bandipur for MDR/XDR
24.
Conditional Grand to Kalimati Chest Hospital
Source: NTC
Unit
Times
Targets
Achieve.
100
Times
Package
Times
3
20
3
20
100
100
100
Pieces
Times
Times
40
200
40
200
100
100
100
100
60
60
30
30
100
100
100
100
1
1
1
1
100
100
Times
Times
Times
Times
Times
Leprosy:
SN
Activity
1.
Furniture for meeting and resource room
2.
Photocopy machine
3.
Laptop computer (region)
4.
Establishment of museum at KhokanaAarogya
Ashram and construction of a residential building for
10-15 family
5.
Publication of quarterly bulletin and other supportive
materials for health care workers (production,
printing & distribution) (times)
6.
Supportive review meeting at 17 leprosy service
centres
7.
Update review meeting on WeBLeRS reporting system
among DHO/DPHOs, RTLOs, DTLOs (5 regions)
8.
Review meeting on planning & procurement of
chemoprophylaxis
9.
Review meeting on planning of chemoprophylaxis
among doctors, managers and health care workers
10.
MCBR study, Resource Center for WeBLeRS and
implementation
11.
MCBR study, WeBLeRS, Book, Resource &counselling
service
12.
POID follow up, research and surveillance
13.
Planning and preparation for establishment of
museum and construction of residential building for
people with disability due to leprosy and elderly
people
14.
Onsite coaching, education and management at local
level in leprosy endemic districts
15.
In collaboration with supporting partners, providing
312
290
Unit
Piece
Piece
Piece
Times
Target
1
1
2
3
Achieve
1
1
2
0
%
100%
100%
100%
0
Times
66.66%
Times
20
20
100%
Times
80%
100%
100%
Times
0%
Times
0%
Times
Times
3
2
0
0
0%
0%
Times
100%
Times
0%
Times
Times
DoHS,
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)

SN
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.
Activity
financial support to hospital for free health services
for poor leprosy affected people
In collaboration with supporting partners, income
generation programme, occupational training &
scholarship to leprosy affected people and their
family members
Operational study in leprosy endemic districts
Chemoprophylaxis training/workshop for doctors,
health care workers & health managers
Procurement and distribution of supportive
appliances for leprosy related disability and
complications (5 regions)
Travel allowances for the treatment of complications
& disability of leprosy patients (Rs. 1000/patient)
Monitoring, supervision and quality check at district
level stores from regional medical stores
Programme supervision, monitoring and on site
coaching
Programme supervision & monitoring for central &
regional level
Quarterly review meeting at central level (Annual,
first & second)
Quarterly review meeting at regional level (Annual,
first & second)
Quarterly review meeting with stakeholders, Steering
committee, coordination committee and technical
committee
Capacity building of referral centres and handing over
to zonal hospital and others
MDT transportation and management (times)
Annual report & program activity guidelines
Disability Study with Partners , NFDN & Other
stakeholders
WeBLeRS Strengthening, Upgrading & Annual
Maintenance
Active case detection in urban slums (Place)
Updating district recording & reporting system by
case validation & verification
World Leprosy Day celebration at central/regional
level
Active Case Detection & special programme at district
level
Leprosy Handbook for health care workers
Implementation of day care service centre for elderly
and leprosy affected people at KhokanaAarogya
Ashram
Procurement of drugs for complication management
in KhokanaAarogya Ashram & others
Supervision
In collaboration with Leprosy Affected Society
/Network and other partner organizations, Income
generation and vocational training
Grant to Nepal Leprosy Elimination Association and
other partner organizations in order to provide living
DoHS,
2071/72 (2014/2015)
(2014/2015)
DoHS, Annual
Annual Report
Report 2071/72
Unit
Target
Achieve
Times
100%
Times
Times
3
3
3
3
100%
100%
Times
80%
Persons
2100
1796
86%
Times
15
12
80%
Times
25
100%
Times
39
39
100%
Times
66.66%
Times
15
15
100%
Times
100%
Times
100%
Times
Times
Times
3
2
2
3
2
2
100%
100%
100%
Times
Times
Times
2
3
2
3
100%
100%
Times
100%
Place
100%
Pieces
Times
17000
3
17000
0
100%
0
Times
Times
Times
15
2
15
0
100%
0
Times
100%
313
291

SN
Activity
allowances for elderly and leprosy affected people in
KhokanaAarogya Ashram
Source: LCS
Unit
HIV/AIDS and STI

SN
Activities
1 Scale up of 9 new ART Sites (from 52 to 61 sites
Scale up of 12 CB-PMTCT Districts (4 to 16
districts)
3 Started 7 Integrated Bio-Behavioral Surveillance
(IBBS) Survey among 4 Key Populations ( MSM,
FSWs,PWIDs and MLMs)
4 Conducted training on HTC, CMT, PMTCT, STI
and S&D Reduction to health workers
5 Continued Targeted Interventions for HIV with
NGOs in Nepal
Source: NCASC
2
Unit
Site
Districts
Components
Person
Time
Health Training (central level)

SN
Program/Activities
1
Upgrading and Basic Training
1.1
Supervisor Upgrading Training
1.2
Sr. AHW
1.3
Sr. ANM
1.4
AHW
1.5
ANM
1.6
AHW-P
1.7
ANM-P
2
Induction and Health management
2.1
Induction Training for Health Officer
2.2
Data analysis and management training
2.3
Orientation about health & health system for non
health workers
2.4
TABUCS training for account section staff
3
Reproductive Health related training
3.1
Safe abortion service training for SN
3.2
Safe abortion service training for SN
3.3
Follow up Enhancement Program
3.4
ASRH training
3.5
SBA Training (Nursing Staff and MO)
3.6
ASBA training for MO
3.7
NSV
3.8
Minilap
3.9
Implant
3.10
IUCD
3.11
PPIUCD
3.12
COFP Counseling
3.13
MISP
3.14
Hiring of FP consultant
1.15
Hiring of FP councilor
4
Clinical Training
4.1
Medico Legal Training
4.2
Primary Trauma Care Training
4.3
Paediatric Nursing Training
292
314
Target
Achieve
Targets
9
Achievement
9
%
100
12
12
100
100
200
160
80
100
Unit
Target
Achievement
Person
Person
Person
Person
Person
Person
Person
75
180
60
30
30
60
60
46
186
52
28
30
58
55
61
103
87
93
100
97
92
Person
Person
Person
150
18
200
120
19
196
80
106
98
Person
100
90
90
Person
Person
times
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
100
100
5
220
825
20
60
40
270
100
40
288
60
6
6
100
102
2
220
934
20
38
24
256
15
13
311
60
6
6
100
102
40
100
113
100
63
60
95
15
33
108
100
100
100
Person
Person
Person
90
50
40
43
41
10
48
82
25
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,

SN
4.4
4.5
4.6
4.7
5
5.1
5.2
5.3
5.4
6
6.1
6.2
6.3
6.4
6.5
7
7.1
7.2
7.3
Program/Activities
Palliative Care Training
Burn Care Training
Anaesthesia Assistant Training
OTTM
Training of Trainers
CTS
TOT on ASRH
GTOT (General Training of Trainers)
TOT on High Altitude Sickness
Others
Biomedical Equipment Technical Assistant training
Mental Health Training
Training on Package Development for RHTCs/NHTC
staff
Lab Users Maintenance Training
X-ray Users maintenance training
Package Development
Video Preparation of FP counseling
Package Development of Long and Short Training
(FP)
Package revision of long and short term training
program(IP,FP)
Health Training (central level)

SN
Program/Activities
1
District training site strengthening and upgrade
2
High altitude sickness training for HW of 15 hilly district
3
Infection Prevention Training at district level
4
FCHV Basic Training
5
Clinical management training on GBV of 18 district HW
6
ASRH training at district level
7
Basic training for HFOMC member at 3 district
8
Refresher training for HFOMC member
Source: NHTC
Unit
Person
Person
Person
Person
Target
20
20
6
40
Achievement
0
0
6
29
%
0
0
100
73
Person
Person
Person
Person
32
20
20
40
16
41
0
40
50
205
0
100
Person
Person
person
24
250
20
24
0
20
100
0
100
Person
Person
12
12
10
10
83
83
times
times
1
2
1
2
100
100
times
50
Unit
district
person
person
person
person
person
person
person
Target
10
150
1500
2000
90
160
48
140
Achieve
10
150
1200
1850
60
160
45
140
%
100
100
80
92
66
100
93
100
HEALTH EDUCATION INFORMATION AND COMMUNICATION

S.N.
Activities
Audio/ video message production

IEC materials - flip wall chart, health diary, printing
of GBV and IEC/BCC programs on prevention and
control of TB, HIV/AIDs, Leprosy, IMCI, Epidemics,
Thyroid diseases, ENT, health hazards from arsenic
and mercury, NTD, NCD and alcohol, tobacco, GBV,
and Free health services, FP, EPI, Nutrition, nASHR,
Ayurveda, hand washing, care of the disabled and
rational usage of drugs.
Health message airing through TV
Health message airing through Radio
Community level interaction programs
on HPE programs
3
4
5
DoHS,
2071/72 (2014/2015)
(2014/2015)
DoHS, Annual
Annual Report
Report 2071/72
Unit
Target
Achieve
Nos
Nos
823
485444
323
543165
39
112
3453
4280
100022
104
242
100
Nos
Nos
Nos
3312
1763
100080
315
293

S.N.
Activities
Unit
Nos
Nos
Nos
Stakeholder orientation on FTCT/MPOWER

6
7
HP and BCC orientation Programs
8
Health Days celebration
Source: NHEICC
Logistics Management:
SN
Activities
1.
Construction of New Warehouse in Teku and
Pathalaiya
2.
Procurement of Pick-Up for Drug transportation
3.
Procurement and payment of Biomedical, Cold Chain,
Machinery Equipment
4.
Training on Web-Based LMIS, Inventory System and
Internal Mailing System
5.
Training on Cold Chain Maintenance and Vaccine
Management
6.
Training on Web Based Vaccine Distribution
7.
Training on Basic Logistics, E-Bidding
8.
Preparation of Tender Documents, Bidding
Publications, Third Party Insurance etc
9.
Quality Control of Drugs and Equipments
10.
Maintenance of Biomedical, Cold Chain Equipments,
Machinery and Vehicles
11.
Printing of LMIS Forms and Stock Book
12.
EVM Evaluation
13.
Vaccine Management and GSM Survey
14.
National Forecasting and Pipeline Meeting
15.
Essential Drugs, Vaccines, Equipment transportation
16.
Essential Drugs, Vaccines, Equipment Repacking
17.
Procurement of Medicines
18
Integrated Supervision, Monitoring and Evaluation
19
Telemedicine Training Program
20
Conversation Recording Software Development for
Hello Syasthey Program
21
Conversation Recording Software Development for
Telemedicine Program
22
Payment of internet, v-sat, ADSL for Telemedicine
Program
23.
Contract staffs for operation of LMIS (District
Program)
24.
Essential Drugs, Vaccines, Equipment Repacking and
transportation (District Program)
25.
Maintenance of equipment, vehicle (District Program)
26.
Supervision and Monitoring (District Program)
Source: LMD
National Public Health Laboratory
SN Activities
1
Continuation on construction of new building
Procurement of Furniture and fixture for newly
2
constructing building
Establishment of Bactology service at hospitals with the
3
support of separate room and Human resource form
316
294
Target
Achieve
23
5
5
23
5
5
100
100
100
Unit
Building
Target
2
Achieve
0
%
0
Piece
Times
18
3
18
3
100
100
Number
150
150
100
Times
100
Times
Number
Times
2
200
3
1
100
3
50
50
100
Times
Number
60
225
60
225
100
100
Number
Times
Times
Times
Times
Times
Times
Times
Number
Times
300
1
1
5
300
300
3
36
90
1
300
1
1
5
300
300
2
12
90
0
100
100
100
100
100
100
66
33
100
0
Times
Times
100
Number
80
60
75
Number
225
225
100
Times
Times
3
225
3
225
100
100
Targets
1
Achieve
1
1
%
14
100
20
100
Unit
Building
time
site
1
20
DoHS,
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)

SN
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
Activities
related hospitals
Procurement of equipments for establishment of One
Regional Laboratory
Establishment of Laboratory at Healthpost level with the
support of VDCs for infrastructure and Human resource
Procurement of Analyzer for Biochemistry service in
districts
Procurement of equipment for operational of BSL III lab
Procurement of Gama Radiation Chamber and other
equipments for blood transfusion service and zonal
hospitals
Expansion of Blood transfusion services at remote five
district
Preparation of laboratory software for uniformity in
billing and reporting at 34 district hospitals
Construction emergency exit in newly constructing
building
Construction of compound wall in laboratory building
Construction of shed for waste management
Consultancy service for laboratory software, Cold room,
equipment and computer maintenance
Hiring of Microbiologist and Biomedical Engineer on
service contact basis
Organization and Management survey of regional, zonal,
district and PHC level laboratory
Hiring of watchman, sweeper and gardener on service
contact basis
Hiring of plumber, electrician and driver on service
contact basis
Application training on operation of hematology analyzer
machine to regional and zonal hospital laboratory staff
On the job training for newly appointed lab technician
and lab assistant
Operational of National Bureau of Blood Transfusion
service
Scholarship scheme to study bachelor programme for Lab
technician working for government service
Continuation of quality control programme in different
laboratories and BTSCs throughout the country
Consultancy service for preparation of National guideline
on health laboratory
Office operational of National Bureau of Blood
Transfusion
Procurement of kits, chemical and reagents for National
Influenza Center
Procurement of reagents, kits and chemical for
emergency diseases diagnosis
Procurement of kits and chemical for endocrinology test
Procurement of kits, chemicals and reagents for regular
and specialized laboratory test
Procurement of kits and chemicals for HIV/ AIDS testing
Procurement of yellow fever vaccine
Monitoring and evaluation of government hospital
laboratories, private hospital laboratories and blood
DoHS,
2071/72 (2014/2015)
(2014/2015)
DoHS, Annual
Annual Report
Report 2071/72
Unit
site
site
site
site
site
site
site
site
site
site
time
person
time
person
person
person
person
time
person
time
time
time
time
time
time
kit
kit
pcs
site
Targets
1
50
24
1
1
5
34
1
1
1
1
6
4
6
3
14
25
1
6
2
1
1
1
1
1
20000
1000
1600
40
Achieve
100
50
100
24
100
1
1
100
64
100
34
100
100
1
1
1
100
100
100
99
100
100
100
14
100
25
100
100
100
100
100
62
100
100
1
20000
100
97
1000
1600
40
100
100
96
317
295

SN
Activities
banks
Source: NPHL
Management
SN
Activities
Procurement of Dental Chair for Zonal and District level
1
Hospital
2 Printing of HMIS R/R & monitoring tools
3 Upgrading of HMIS Software
Training/Folloupon health care waste management
4
programme
5 Revision/update and printing of program guidelines
6 Data Management Training
7 National annual review workshop
8 Services for impoverished citizens through listed Hospital
9 O & M Survey of 25 bed hospitals
10 Integrated supervision
11 Preparation and Printing of Job Description
Preparation and Printing of DoHS Annual Report FY
12
2070/71
13 Oral health basic training for health workers
Source: MD
Unit
Targets
Achieve
Unit
Targets
Achieve
set
15
15
100
Times
Times
1
1
1
1
100
100
Times
12
100
Times
Times
Times
Times
Inst
Times
Times
1
2
1
3
45
150
1
1
2
1
3
45
150
1
100
100
100
100
100
100
100
Times
100
Times
100
Unit
Times
District
Targets
3
45
Achieve
2
45
%
66.6
100
Times
100
Times
Times
Times
Times
Times
Region
8
2
1
1
1
5
1
0
1
1
1
1
12.5
0
100
100
100
20
Times
60
60
100
HFs
Times
6
140
6
60
100
42.8
Primary Health Care Revitalization

SN
1
2
3
4
5
6
7
8
9
10
11
12
Activities
Procurement & Planning of Free Essential Medicine
Social audit conduction
Environment health promotion program for Department
of Health Services
Training on Ear problem for district health workers.
Impact Study of Free Health Service
Revised and Printing Program Guideline Nirdesika
FCHV day celebration
Orietation on Social Audit
Development, Printing materials and Orientation on NCD
Rural community health, basic health and model healthy
village program.
Continuation of Community Health Insurance Activities
Monitoring and Supervision
Source: PHCRD
318
296
DoHS,
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
Annex 2: Program Targets for FY 2072/73


SN
Activities
1
Introductory Appreciative Inquiry Approach (AIA) Workshop to Ensure
Fully Immunized VDC (20 Districts)
2
Introductory Workshop on Fully Immunized Program (2 Batch from 20
Districts: LDO, PHA, Kho. Su.)
3
Information Dissemination from TV and FM to Introduce New Vaccine
4
Availability and Utility of Immunization Card at Home
5
Regional Level Review and Planning Workshop for New Vaccine (PCV, IPV,
MR 2nd Doze, HPV) (5 Regions, 75 Districts and Central Medical Store)
6
Strengthening and Establishment of Immunization Training Centre for
Immunization Training
7
Immunization Training for Health Workers (200 Personnel)
8
Training Orientation Programme on Newly Introduced Vaccines (District
and Region)
9
Introduction of Hygiene Promotion in Routine Immunization Programme
(4 Districts: Jajarkot, Myagdi, Bardiya, and Nawalparasi)
10
National Polio immunization Campaign (27 Districts)
11
Piloting Programme on Electronic Registration of Immunization Services
(3 Districts)
12
Study on Identification of Low Immunization Coverage
13
Analysis of Central and District Level Financial Source and Expenditure of
Immunization Programme (8 Districts)
14
Development of Immunization Programme Related Educational and
Information Materials (Print and Electronic Media)
15
Study on Identification of Risky Areas for Typhoid, Cholera and HepatitisB)
16
Internal Observation Tour of Immunization-related Health Workers (4
Group: 25 Persons/ Group)
17
Operation Cost for Demonstration Project of HPV Immunization for 15
Thousand Girls (10 Years) (2 Districts)
18
Printing of Immunization Service Related Materials (Immunization
Monitoring Chart, Temperature Monitoring Chart, Jinsi Control Lazer,
Vaccine Batch Card, Full Immunization Card, etc.)
Source: CHD
Child Health: Nutrition Program

SN
Activities
1
National Micronutrient Status Survey
2
MTOT for Maternal, Infant and Young Child Nutrition (MAYAN) Program
Basic and Refresher Training
3
MTOT on Adolescent Girl Iron Folic Acid Supplementation Program
4
Basic Training on Maternal, Infant, and Young Child Nutrition (MAYAN)
Program
5
Refresher Training on Maternal, Infant, and Young Child Nutrition
(MAYAN) Program
6
Pilot Program of Integrated Management of Acute Malnutrition in 2
districts (
7
Feasibility Study on Rice Fortification ( in coordination with Nepal Food
Corporation)
8
Revision and updating of Training Package of Nutrition in Emergency
9
Continuation of Integrated Management of Acute Malnutrition (IMAM)
Program (14 districts)

DoHS,
(2014/2015)
Unit
Times
Target
2
Times
Times
Time
Batch
3
1
5
Time
Times
Time
10
1
Time
Time
Times
1
3
Times
Times
3
3
Time
Time
Time
Time
Time
Unit
Times
Times
Target
1
1
Times
Districts
1
9
Districts
Districts
Times
Times
Districts
1
14
297
319

SN
10
Activities
Iodized Salt Social Marketing Campaign Program in Dadeldhura and
Baitadi districts
11
Adolescent Girls Iron Folic Acid Supplementation Program
12
Scaling-up of Vitamin A Supplementation (VAS) to the children aged 6-11
months
13
Iodized Salt Social Mobilization Program
14
Multi-Sector Nutrition Program (continuation and scaling up)
15
School Health and Nutrition Program (refresher training)
16
Implementation of Nutrition Surveillance System
17
Management of Malnutrition in Nutrition Rehabilitation Centers
18
Infant and Young Child Feeding (IYCF) Program integrated with MNP
(continuation and review)
Source: CHD
Child health: CB-IMCI and NCP
SN
Activity
1 Procurement of ARI Sound Timer (4,000 Units)
2 Procurement of Equipment and Tools for CB-IMNCI Program
3 Service Operation and Maintenance of Health Facilities for Newborn Care
(10 Hospitals and Medical College, Cooperation with Academy)
4 Service Operation and Maintenance of Health Facilities for Newborn Care
(10 Hospitals and Medical College, Co-operation with Academy)
5 Equipment Support to 10 Hospitals for Special Newborn Unit and
Stabilization Unit
6 Equipment Support to 2 Central and 3 Regional Hospitals for Establishing
NICU 3 Additional Hospitals (Kanti, Prasuti, Western, Mid-Western,
Chitwan, Lumbini, Koshi and Seti)
7 Development and Printing of CB-IMNCI Training Materials (Guidelines,
Handbook, Chart, Flex, etc.)
8 Free Transportation and Treatment Cost for Diseased New-born (Program
Implemented Districts and Hospitals)
9 Capacity Development Training of Health Workers and Service Provision
for SNCU, Stabilization Unit and New-born Corner Services (10 Batch)
10 Trainers Training Program on CB-IMNCI (1 Batch) and Update of CB-IMNCI
Package including CB-IMNCI
11 Evaluation of CB-IMNCI Program and Expansion of CB-IMNCI Program
12 Trainers Training Program on CB-IMNCI(1 Batch)
13 Development of Medical Standard for Child Health
14 Printing of Child Health Related Materials (Medical Standard, Poster, Job
Aid, Forms, Quality Improvement Guideline, etc.) (H4L)
15 Workshop on Development Guideline for Medical Standard for Health
Facility and District Hospitals and Remote Area for Child Health (H4L)
16 Workshop on Development of Training Approach and Process and
Guideline for Training and Coaching Sites and Institutional Strengthening
of Health Training Centres for CB-IMNCI Training (H4L)
17 Review and Plan Formulation Workshop of Child Health Program
(Including Quality of CB-IMNCI Training and Coaching Sites) (H4L)
18 Development and Printing of CB-IMNCI Training Materials (Guidelines,
298
320
Unit
Districts
Target
2
Districts
Districts
5
15
Districts
Districts
Districts
Districts
Hospitals
Districts
15
16
Unit
4000
Time
10
Hospitals
10
Hospitals
10
Hospitals
5 Hospitals
Targets
1
1
1
Time
Time
10 Batch
1 Batch
Districts
1 Batch
Time
Time
1
1
1
1
Time
Time
Time
Time
6
18
15
1
1
1
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,

SN
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
Activity
Program Implementation of Navi Program (3 Districts: Kathmandu, Jhapa
and Bhaktapur)
Program Implementation of Navi Program (Central, Regional and Zonal
Hospital and Medical Colleges)
Equity and Access Program for Promotion of New-born and Children
Especially Effective Intervention to Backward Community for e.g. Solving
of Shortage for Antibiotics, ORS, and Zinc (9 Districts: Karnali Zone and 1
Districts from Each Region)
Contract Service 3 Persons (for Technical Support on Clinical and
Community Part of CB-IMNCI Program in Centre: Public Health, Clinical
Nurse and Doctor)
Training to 200 Doctors and Nurses on Level II Package for Special
Newborn Care Unit and Stabilization Unit
Clinical Mentorship in Special Newborn Care Unit and Stabilization Unit in
20 Hospitals Including BPKIHS, IOM and PAHS
Orientation to the 40 Hospitals and Pediatricians on Neonatal Clinical
Protocol
Development and Printing of CB-IMNCI Training Materials (Guidelines,
Learning Visit (International) for Program Managers, Health Workers,
Focal Points from Districts and Centre
Program Exposure Internal Visit of FCHVs, CB-IMNCI Focal Person, Health
Workers and District Managers
Study and Dissemination of Out of Pocket Payment for Management of
Sick Newborn and Children in Level II and III Hospitals
Strengthening/initiation of postnatal visits through Outreach Clinics and
Immunization Clinics
Study on Service Availability, Readiness and Quality of Newborn Care in 28
Hospitals
Initiation of Remote Area Program for Increasing Access and Coverage of
CB-IMNCI Interventions in Remote and Hard to Reach Communities
Guideline for Free Care for Sick Newborn in Level II and III Hospitals
Development of Neonatal and Pediatric Clinical Protocol and Health
Facility Based Newborn Care Training Package for Level II and III Health
Facility
Emergency Treatment of Childhood Disability and Support
Strengthening and Opening Program of Childhood Illness
Supervision of SNCU and Stabilization Unit on Implementation on SOP and

CB-IMNCI
38 Monitoring and Supervision of CB-IMNCI Program (Health for Life)
39 Monitoring and Supervision of CB-IMNCI Program
Source: CHD
37
Family Health: Safe motherhood program

SN
Activities
1
24 hours CEOC Services
2
Free Treatment for Neonate
3
Recruitment of ANM

DoHS,
(2014/2015)
Unit
Districts
Targets
3
Hospitals/C
olleges
Districts
Persons
Persons
Hospitals
Hospitals
Time
Time
Time
Time
Time
Hospitals
Time
Time
Time
2
1
Time
3
3
Time
Time
Time
3
3
Unit
Place
person
Number
Targets
50
30000
1588
299
321

4
5
6
7
8
9
10
Rural Utlrasound program

Free Blood Transfusion services for Aama program
4th ANC
Transportation incentive and Free Delivery services
Nano Jhola for Birthing Centre
Fistula/UP Screening
UP Surgery
District
Pint
Number
Number
Set
Place
Person

SN
Activities
1
Family Planning (FP) current users
2
VSC expected new acceptors
3
IUCD expected new acceptors
4
Implant expected new acceptors
5
Micro-planning in low CPR districts
6
7
Family Planning Supervisors conference
8
FP integration with EPI clinic
9
Pre VSC meeting with FCHVs in low performing districts
10
Conduct Satellite clinics for long acting methods
Unit
Couple
Couple
Couple
Couple
District
District
Time
District
District
District
10
3500
112000
382771
210000
400
2000
Targets
2,775,000
36608
30000
30000
17
10
1
3
55
75
Family Health: FCHV /ASRH/PHC-ORC

SN
1
Dress Allowance for FCHV
2
Review Program for FCHV
3
AFS center's strengthen
4
AFS center's continuity
Source: FHD
Activities
Unit
Person
District
Place
Place
Targets
47000
75
82
175

Unit
Annual
Target
times
piece
piece
1
2
1
piece
piece
piece
piece
2
1
times
times
Procure drugs and equipment for control of epidemic diseases
times
Supervision, Monitoring & Evaluation expenses during Outbreaks

Activities for the effective implementation of IHR 2005 and Integrated Disease
Surveillance System
Procurement of furniture for control of Ebola,Swain flu and etc
times
SN
Activity

1
2
3
Purchase furniture and fixtures for malaria control programme

Procure Ambulance for mobile health team ( road accident management)
Purchase of Ambulance for TIA Health Desk
Procurement of dengue and chickungunya test, PCR machine, ELISA Reader,
4
Platelet Segregation Machine.
Procurement & installation of temperature & humidity measurement
5
equipment( 150 HI)
Procurement of server, scanner, Teleconference set & install air6
condition/Mobile set for SMS reporting and other (Thru WHO)
7
Procurement of 4WD Vehicle thru WHO use for malaria Program
8
Development of Treatment Protocol Out Break Management
Orientation training for district/community RRT members and health workers on
9
epidemic control and management
10
11
12
13
300
322
times
times
3
3
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,

SN
14
15
16
Activity
Field programme of Health workers to contoleEbola,Swain flu and etc
Orientation to health worker on Ebola,Swinflue,and bird flue
Orientation for Health worker on EBOLA
Malaria control
17 Human Resouce Cost at Central Office
18 Basic and Refresher training in malaria microscopy
19 Capacity strengthening of VBDRTC in Malaria Training and Research
Printing and dissemination of SoPs,Treatment and prevention algorithm,
20 Publication of malaria annual report and other training Materials
Quality control of malaria slide in centre& Monitoring to ensure the quality of
21 the blood slide examined in the districts
RRT Mobilization for outbreak /emergency preparedness, prevention, control
22 and management
Technical support from WHO on IHR, IDSS, outbreak investigation, Water safety
23 plan and control
24 Technical support through WHO in malaria control programme
25 Technical assisstancy from WHO in malaria control
In country program related capacity building trainings (Malariology, vector
26 identification and bionomics, etc)
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
Implement the plan, including international trainings for key staffs (Masters in
medical entomology, program management, malariology, malaria elimination,
entomology, surveillance, M & E, etc), Programme representation International
Level
Annual Health Facilities Survey
Survey on malaria microscopy services to establish baseline on adherence to
standard operating procedures & Internal competency assessment workshop in
malaria microscopy
Implement advocacy, social mobilization and behavior change communication
(BCC) strategy and Develop specific materials print, audio and video
Hoarding boards to be placed at hospital compounding major border crossings
Malariometric Survey and Entomological Survey
Monitoring efficacy of first line anti-malarial medicines and Monitoring vector
susceptibility to insecticides, in malaria risk districts
Develop advocacy materials and flip chart for FCHV and Printing National Malaria
diagnosis treatment guideline, manual and Training plan (thru WHO)
Capacity building Orientation on GR , mapping and GPS/GPRS & orientation for
Web-based system
Update micro-stratification ,Orientation to key staff on foci investigation and
rapid response team at national and district level
Cross-border meeting to exchange information and develop joint operational
plan
Conduct annual national review meetings and Strengthen partnership with other
national institutions
Distribution of LLINs in targated area of districts every year and conduct BCC on
usage of LLINs.
Strengthen Malaria Technical Working Group (TWG) and Programme
representation National Level
Supportive supervision and monitoring of malaria microscopists
Technical Review of EWARS sentinel sites focal persons
Emergency focal spraying in vector borne epidemic area

DoHS,
(2014/2015)
Unit
times
times
times
times
person
person
times
times
times
times
times
times
times
person
times
times
Annual
Target
3
3
1
3
75
1
2
12
4
3
3
3
1
3
1
2
times
times
times
times
3
1
1
2
times
person
person
times
2
1
times
times
times
times
person
times
2
1
3
3
2
2
301
323

SN
Activity
Unit
44
45
Vector surveillance for Malaria,Kala-azar,Dengue,L.Fileria& JE

Celebration of World Malaria Day
46
Purchase of Insecticide for Malaria Indoor residual spraying
47
48
Procure medicines and diagnostic materials for malaria control

Procurement of LLIN
Distribution of LLIN in high and moderate risk VDCs Freight, Insurnce and
49 Shipping cost
50 Monitoring and Supervision - EDCD/PMU-at all level - MoH/RHSD/DoHS
Kala-azar control
51
52
53
Orientation to multi-sectoral/stake holders on IVM

Technical support by WHO in kala-azar elimination and Dengue
controlprogramme
kala-zar case base surveillance
54
55
Case validation in new kala-zaremmerging district

Purchasing medicines and medical goods for Kala-azar control
56 Purchase of Insecticide for IRS in Kala-azar affected districts

57 Transportation cost support for Kalaazar patients
Natural disaster management
orientation to RRT for RH promotion in emergency and natural disaster and
58 prepare district level contingency planning
59 Technical support from WHO in disaster management programme
60 Emergency planning workshop to the hospital /PHC
Lymphatic filariasis elimination
61
62
63
LF follow-up survey in 10 LF MDA conducted districts

Interaction with professional organizations
Monitoring and supervision of MDA campaign
64
65
66
Technical & financial support by WHO in filaria elimination campaign

Technical & financial support by DFID/CNTD in LF elimination program
RTI financial and technical support on LF elimination
67
Surveillance activities in 20 MDA stopped districts

Management of LF morbidity, MDA orientation, SAE management and
68 conduction of hydrocele operation camps(center & hospitals)
IEC activities for Mass Drug Administration (MDA) campaign in Filaria elimination
69 programme
70 MDA Planning Workshop, Review and publication of annual reports
Zoonotic disease control
Procurement of chemicals, Equipment and operational costs to produce ARV
71 Tissues culture vaccine.
72 celebrate world Rabies day
73 Development, printing & dissemination of IEC materials on Zoonoses
74 Technical support by WHO in zoonotic disease control
Orientation training to the MO and Paaramedical staffs on rational use of ARV
75 and poisonous snakebite case management
76 Study & research for production of inj .ASVS in Nepal
77 Procurement of ASVS for districts
78
302
324
Procurement of ARV (Cell culture vaccine) for approx 50000 persons.
times
times
times
times
Annual
Target
12
1
1
piece
1
472747
piece
times
472747
3
times
times
times
times
times
times
person
times
3
3
3
1
1
150
3
times
times
2
3
times
times
times
times
times
times
times
times
times
times
times
1
3
2
2
1
3
2
2
2
times
times
times
1
1
1
3
person
times
piece
375
1
30000
times
300000
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,

SN
Activity
Unit
Annual
Target
Dengue control
79
Orientation/interaction with stakeholders on dengue disease control
times
80
emergency management for dengue outbreak control

Orientation for MO and paramedical staffs and journalists on dengue and
chickungunea
Public awareness activities on dengue and chickun control
Mobbilization of team during dengue and chickungunea outbreak & vector
search and destroy campaign to control dengue epidemics
Development of search and destroy guide line for dengue and chickungunea
control
times
times
times
times
81
82
83
84
85
Multi-sectoral interaction on dengue and chickungunea control
86
Procurement of dengue and chickungunya diagnostic test kits
87 Health worker recruitment

88 Staff Hiring for Airport
89 Payment of Health working in EDCD
90 Printing of Materials
Source: EDCD
Tuberculosis
SN
Activities
1
Procure cartridge for existing gene-xpert machine for
2
Procure gene-expert machine to expand in new districts/health facilities
3
Mapping TB diagnostic centers with GIS
4
Basic Modular Training for Z-N microscopy
5
Procurement of Microscopy
6
Procurement of MDR anti-TB drugs
7
Care and support to MDR patients (nutritious food, transport and
accommodation cost assistance @ NRs 2500/month)
8
Nutritional allowance to retreatment patients, NRs 1000/month
9
Procure Microscopes to expand DOTS centre innon state health sector
(private, community..etc)
10
Procure digital X-ray film
11
Basic clinical management training in TB to medical officers
12
Basic TB Modular Training to health worker
13
Refresher TB Modular Training to health worker
14
National PME workshop
15
Regional PME Workshop
16
Onsite data verification program (OSDV).
17
Training for E-TB Master Register
18
Trimester DR PME workshop
19
Compare the effectiveness of Community-based DOTS, Family-based DOTS
and Institutional DOTS
20
contraction of Chest Hospital
21
conditional grant to Kalimati Chest Hospital-NATA
22
TB Management Training in Banglore, India
23
Procure van intalled with xpert machine and x-ray machine to increase TB
case finding in hard to reach population
24
TB Management Training to new DTLOs
25
Procure of Anti-TB medicines

DoHS,
(2014/2015)
times
times
times
times
times
times
times
2
1
3
1
69
4
7
1
Unit
Pieces
Pieces
Times
Person
Pieces
Times
Targets
39,350
3
1
16
65
1
Person
Person
808
100
place
Pieces
Times
Person
Person
Times
Times
Times
Times
Times
20
10,000
11
80
54
3
18
5
1
12
Times
Times
Person
1
1
12
10
Pieces
Times
Times
2
1
1
303
325

SN
26
Activities
Mobilize health facility helper/FCHV/Mothers group/cured TB patients to
follow up the initial/prime defaulter
27
Microscopic camp Conduction
28
Contact tracing to Family members in the beginning and end of treatment
duration.
29
Broadcast radio messages from national and local radio networks
30
commemorate world TB Day
31
Provide Nutritional and travel support to all retreatment PBC TB patients. NRS
750/month
32
Basic TB Modular Training to health worker
Source: NTC
Leprosy
SN
Activities
1. 1
Reconstructive surgery camp
2. 2
World Leprosy Day celebration at central level
3. 3
Printing of Program implementation guidelines
4. 4
Coordination with other stakeholders from Disability Focal Unit
5. 5
Post disaster data collection and treatment
6. 6
MDT transportation and management (times)
7. 7
Procurement and distribution of supportive appliances for leprosy affected
person for disability prevention and complications mgmt
8. 8
Travel allowances for the treatment of complications & disability of leprosy
patients (Rs. 1000/patient)
9. 9
Quarterly review meeting at regional level (Annual, first & second)
10. 10
Onsite coaching, education and management at local level in leprosy endemic
districts
11. 11
Programme supervision & monitoring for central & regional level
12. 12
Annual report printing
13. 13
Support to the referral centres to provide other special treatment services for
the leprosy affected
14. 14
Upgrading, establishing and extending POID clinic
15. 15
Contact examination of neighbours and community people of new leprosy
cases
16. 16
Operational study regarding disability and consumption of drugs
17. 17
Active Case Detection
18. 18
Active case detection in urban slums (Place)
19. 19
Capacity building program regarding leprosy to new health care workers,
doctors (20 people in each batch)
20. 20
Special activity(POID, rehabilitation and discrimination reduction) in local level
towards leprosy free society as put forward in Bangkok Declaration
21. 21
Case Validation
22. 22
Campaign in high leprosy endemic districts (40 places of Saptari, Siraha,
Dhanusa, Mahottari, Sarlahi, Rautahat, Kapilvastu, Nawalparasi, Banke and
Kailali)
23. 23
One day leprosy training to medical officers
24. 24
Technical support, monitoring and supervision
25. 25
Survey and need assessment of disability and injury post disaster
26. 26
Quarterly review meeting (Central Level)
27. 27
Chemorophylaxis drugs procurement
28. 28
Procurement of drugs for leprosy complication management
29. 29
Monitoring and Supervision
30. 30
Grant to leprosy affected persons of Khokana&PokharaAarogyaAshram
Source: LCS
304
326
Unit
Targets
Person
Times
660
228
Person
Times
Times
14,343
260
75
Person
Person
2600
80
Unit
Times
Times
N/A
Persons
Persons
Times
Persons
Target
2
1
1
3
3
3
2
Times
1500
Times
Persons
15
2
Times
Times
Persons
48
1
3
Persons
Times
10
900
Times
Times
Times
Times
2
2
2
2
N/A
Times
Times
15
2
Times
Times
Times
Times
---Times
Person
N/A
1
9
2
3
2
1
15
6
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,

HIV/AIDS
SN
Activities
1
Scale up of services sites throughout the nation
ACMT,CMT,PMTCT ,EWI all ART SITE
2
Capacity building
3
GARPR report preparation
4
Size Estimation of key population
5
IBBS Study
6
Patient tracking system -with a unique identifier
7
HIV Strategy 2016-2021
8
Data Quality Assurance
9
Frequent monitoring visit/on site coaching to SDPs
10
Equipment- computer, Internet at ART sites
11
Strengthening HMIS system- customization of DHIS2
Source: NCASC
National Public Health Laboratory
S.N.
Activities
1.
Continuation on construction of new building
2.
Procurement of Furniture and Fixture for newly constructing building
3.
Procurement of electrolyte, biochemistry analyzer machine for district
hospital
4.
Procurement of equipment for operational of BSL III Lab
5.
Procurement of equipment for specialized microbiology research
6.
Procurement of equipment of establishment of health post level
laboratory
7.
Procurement equipment for the establishment of Regional Public Health
Laboratory
8.
Procurement of cell counter machine for zonal hospital
9.
Procurement of equipment for BTS expansion in 5 remote districts
10. Procurement of component separation machine for BTS service
expansion
11. Procurement of semi-automated blood grouping machine for regional
BTS
12. Installation of Air-conditioner in newly constructing building
13. Procurement of equipment of laboratory operational
14. Procurement of equipment for laboratory service continuation in PHCs
15. Operational of bio-safety and bio-security programme
16. RCC construction in laboratory compound
17. Construction of -20 cold room for storage of quality control samples
18. Library management
19. Installation of electricity transformer
20. Two weeks orientation Training to newly appointed Lab Assistant and
Lab Technician
21. Continuation on quality control programme for laboratory and BTSCs
22. EQAS training to technical staffs
23. Scholarship scheme to study bachelor programme for Lab technician
working for government service
24. Operational of safe blood programme
25. Application training on Biochemistry analyser and cell counter
26. Organization and management survey for NBBTS and BSL- 3 lab
27. Procurement of kits and chemicals for HIV testing
28. Procurement of yellow fever vaccine
29. Procurement of kit chemicals for endocrinology test

DoHS,
(2014/2015)
Unit
Time
Targets
3
Person
Time
Time
Time
Time
Time
Time
Time
Place
Time
50
1
1
2
1
1
1
12
10
1
Unit
Building
time
set
Target
1
1
set
set
set
1
1
set
set
set
set
set
25
35
1
20
5
1
1
set
time
set
time
time
time
time
time
Persons
20
2
12
1
1
1
1
1
time
Persons
Persons
3
2
time
persons
time
kit
vaccine
time
1
20
1
12000
1200
1
30
305
327

30. Procurement of kit chemicals for operational of national influenza center
31. Monitoring and supervision of government and private laboratories
Soruce: NPHL
Health Training:Central Level
SN
Program/Activities
1
Upgrading and Basic Training
1.1
Supervisor Upgrading Training
1.2
Sr. AHW
1.3
Sr. ANM
1.4
AHW
1.5
ANM
1.6
AHW-P
1.7
ANM-P
2
Induction and Health management
2.1
Induction Training for Health Officer
2.2
TABUCS and LMBIS training
3
Clinical Skill based training
3.1
Safe abortion service training for SN and MO
3.2
Follow up Enhancement Program
3.3
ASRH training
3.4
SBA Training (Nursing Staff and MO)
3.5
ASBA training for MO
3.6
NSV
3.7
Minilap
3.8
Implant
3.9
IUCD
3.10
PPIUCD
3.11
NSV self pacedtraining
3.12
IUCD self paced training
3.13
COFP Counseling
3.14
Hiring of FP consultant
1.15
Hiring of FP councilor
3.16
Medico Legal Training
3.17
Paediatric Nursing Training
3.18
Palliative Care Training
3.19
3.20
3.21
3.22
4
4.1
4.2
4.3
5
5.1
5.2
5.3
6
6.1
6.2
306
328
OTTM
MISP Training at regional level
ICU/NICU management Training (level 2)
ICU/NICU management Training (level 3)
Training of Trainers
TOT on ASRH
TOT on MISP
Orientation/TOT on IP whole site for trainers
Others
Biomedical Equipment Technical Assistant training
Mental Health Training
X-ray Users maintenance training
Package Development
Package Development of Long and Short Training (Upgrading, Burn
Care,High Altitude Sickness)
Package
printing
of
long
and
short
term
training
program(upgrading,IP,PNC,FCHV,CoFP/counseling,SBA)
time
time
3
3
Unit
Target
Person
Person
Person
Person
Person
Person
Person
75
180
60
30
30
60
60
Person
Person
150
100
Person
District
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
Person
100
3
340
522
10
60
60
500
80
30
40
20
240
4
6
80
40
20
Person
person
person
person
30
125
200
30
Person
Person
Person
20
20
100
Person
district
Person
24
3
12
times
times
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,

Health Training: District Level
SN
Program/Activities
1
District training site strengthening and upgrade
2
Infection Prevention whole site training at 15 districts
3
FCHV Basic Training
4
ASRH training at 3 districts
Soruce: NHTC
Health Education Information and Communication
SN
Activities
1
Audio/ video message production
2
IEC materials - flip wall chart, health diary, printing on GBV and IEC/BCC
programs regarding prevention and control of TB, HIV/AIDs, Leprosy,
IMCI, Epidemics, Thyroid diseases, ENT, health hazards from arsenic and
mercury, NTD, NCD and tobacco and its products, harmful consumption
of alcohol, tobacco, GBV, and Free health services, FP, EPI, Nutrition,
ASHR, Ayurveda, hand washing, disabled friendly, rational usage of
drugs.
3
Health message airing through TV
4
Health message airing through Radio
5
Video show in the Shaja bus
6
HP and BCC orientation Programs
7
Capacity building program for IEC focal person representing from district
and Region for the effective implementation of IEC activities
Source: NHEICC
Logistics Management
SN
Activities
1.
Construction of New Warehouse in Teku and Pathalaiya
2.
Procurement of Back-up Generator/UPS for 300 MA X-Ray Machine
3.
Procurement and payment of Biomedical, Cold Chain, Machinery
Equipment for new established Health Facilities
4.
Procurement of Biomedical, Cold Chain spare parts
5.
Procurement of essential materials for disaster management
6.
Procurement and supply of Cold Chain Equipments for 24
earthquake affected districts(Commodities Grant)
7.
Training on Web-Based LMIS, Inventory System and Internal Mailing
System
8.
Training on Cold Chain repair and Maintenance for Mechanical
Engineers and Refrigerator Technicians
9.
Quality Control of Drugs and Equipments
10.
Maintenance of Biomedical, Cold Chain Equipments, Machinery and
Vehicles
11.
Fuels for Generators to save vaccines
12.
Preparation of Tender Documents, Bidding Publications, Third Party
Insurance etc
13.
Web-site updates and Web-based LMIS repair and maintenance
14.
Printing of LMIS Forms and Stock Book
15.
Repacking and Transportation Essential Drugs, Vaccines, Equipment
16.
Procurement of Essential Medicines for Buffer Stock
17.
Supervision and Monitoring
18
Team Mobilization for Cold Chain Equipment Assessment, Inventory,
Auctioning and preparation of replacement plan
19
Payment of internet and monitoring of Telemedicine Program
20
Receive and supply of Xithromax for trachoma control
DoHS, Annual
Annual Report
Report 2071/72
DoHS,
2071/72 (2014/2015)
(2014/2015)
Unit
Target
district
HF
Persons
persons
10
250
500
160
Unit
Nos
Nos
Targets
500
500000
Nos
Nos
Nos
Nos
No
3500
2000
2000
5
100
Unit
Building
Piece
Times
Target
2
18
3
Times
Time
Time
2
1
1
Number
150
Times
Times
Number
60
300
Times
Times
5
3
Time
Time
Times
Times
Times
Times
1
1
450
3
50
3
Times
Time
3
1
307
329

program(Commodities Grant)
21
Contract staffs for operation of LMIS (District Program)
22
Essential Drugs, Vaccines, Equipment Repacking and transportation
(District Program)
23.
Orientation on Pull System, LMIS for Newly Appointed personnel in
the districts (District Program)
24.
Supervision and Monitoring (District Program)
25.
Construction of New Warehouse in Teku and Pathalaiya
26.
Procurement of Back-up Generator/UPS for 300 MA X-Ray Machine
Source: LMD
Management
SN
Activities
1 Procurement of Motorbikes for Regions/Districts
2 Computer Assistant on contract service
Health care waste management, onsite coaching and preparation of
3
job description health workers
4 HMIS Training to newly recruited HWs -75 Districts
5 Hospital Equipment maintenance program expansion in 5 regions
6 Dental chair procurement
7 Procurement of dental kits
8 Water tank construction in DoHS complex
9 Web site hosting, upgrade and firewall in DoHS
10 AI Training
11 Community base mental health training
12 HMIS Training Manual Update
13 Revision/update and printing of program guidelines
14 Commission on Information and Accountability related activities
16 Printing of HMIS , R/R Tools, Monitoring Sheet
17 HMIS Training for Central and Private Hospitals Staff
18 Oral health basic training for health workers
19 Oral health school programme
20 Services for impoverished citizens in community level
28 Software update and purchase of health information
29 Printing of DoHS Annual Report
31 Integrated supervision
Source: MD
Primary Health Care Revitalization
SN
Activities
1
Urban Health Clinic
2
Establishment of community Health Unit
3
Model Village Health Activities
4
TOT on Standard Treatment Protocol
5
Training of STP
6
Social Audits
7
Health Campaign (with specialized services)
8
Integrated Public Health Campaign
Source: PHCRD
308
330
Number
Number
80
225
Districts
49
Times
Building
Piece
225
2
18
Unit
Number
District
Times
Targets
60
53
2
District
Region
Times
set
Number
Times
Times
Times
Times
Times
Times
Times
Times
Times
Times
Times
Times
piece
Times
Times
Times
75
5
10
70
1
1
2
3
1
1
1
1
1
1
24
4
8
5
1
1
300
Unit
HFs
District
VDC
Region
District
40 District
Region
district
Targets
129
33+67
20
5
20
40 (752 H. Unit)
5
40
DoHS,Annual
AnnualReport
Report2071/72
2071/72(2014/2015)
(2014/2015)
DoHS,
Estimated Target Population Fiscal Year 2071/72 (2014/2015)

DC
District
NEPAL
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Eastern Region
17 Dhanusha
18 Mahottari
19 Sarlahi
20 Sindhuli
21 Ramechhap
22 Dolakha
23 Sindhupalchok
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 Region
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 Region
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 Region
67 Bajura
68 Bajhang
69 Achham
70 Doti
71 Kailali
72 Kanchanpur
73 Dadeldhura
74 Baitadi
75 Darchula
Far western Region
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Total
Population
27,723,373
128,499
193,593
298,346
855,600
1,014,212
819,591
166,393
101,209
157,480
172,098
104,496
148,812
193,385
331,436
664,906
660,594
6,010,650
786,266
656,037
813,977
300,853
203,966
186,160
289,780
389,550
505,490
327,907
1,916,667
280,878
43,885
342,210
436,089
741,598
737,985
641,848
623,832
10,224,978
260,509
168,652
331,292
273,925
527,439
6,399
12,625
112,439
146,962
273,614
269,573
255,969
675,379
950,288
607,225
198,559
5,070,849
231,756
228,507
215,151
252,691
587,924
533,874
446,466
375,170
273,636
179,786
38,607
114,289
143,984
58,123
53,580
3,733,544
141,652
203,713
266,763
211,276
839,390
479,952
147,731
255,775
137,100
2,683,352
Population of 011 months
608,802
2,857
4,135
5,825
18,215
21,860
17,530
3,572
2,147
3,381
3,825
2,280
3,332
4,282
7,332
14,314
14,887
129,774
17,363
14,985
18,545
6,774
4,285
3,997
6,126
8,006
9,898
6,596
37,749
5,869
957
7,459
9,428
16,963
16,656
14,372
12,798
218,826
5,733
3,661
7,051
5,850
10,874
126
256
2,595
3,278
6,202
6,072
5,602
14,353
20,395
13,835
4,549
110,432
5,659
5,550
5,001
5,889
12,927
11,712
9,789
8,663
6,740
4,529
951
2,834
3,776
1,542
1,389
86,951
3,536
5,035
6,703
5,395
18,410
10,650
3,545
6,256
3,289
62,819
Female
Women of
Married Women of
Expected
Adolescent
Population of Population of 24-35 Population of 36-47 Population of 48- Population of 0-4
Expected Live
population of 15- Reproductive of Reproductive age 15- Pregnancies of 15- Population of 10-19
12-23 months
months
months
59 months
years
birth
44 years
15-49 years
49 years
49 years
years
576,324
2,701
3,924
5,599
17,175
20,627
16,650
3,371
2,049
3,251
3,611
2,159
3,101
4,063
6,940
13,809
14,182
123,212
16,497
14,307
17,738
6,407
4,017
3,741
5,747
7,493
9,366
6,167
35,811
5,510
893
6,993
8,918
16,342
16,058
13,910
12,030
207,945
5,296
3,401
6,646
5,472
10,245
116
244
2,413
3,036
5,809
5,689
5,253
13,572
19,378
13,169
4,253
103,992
5,305
5,194
4,737
5,546
12,239
11,182
9,184
8,187
6,358
4,298
891
2,676
3,546
1,426
1,283
82,052
3,332
4,765
6,295
5,018
17,441
10,033
3,315
5,846
3,078
59,123
555,246
2,620
3,801
5,484
16,464
19,781
16,056
3,251
1,991
3,168
3,467
2,086
2,956
3,933
6,694
13,515
13,744
119,011
15,960
13,871
17,211
6,183
3,852
3,587
5,529
7,183
9,008
5,879
34,467
5,295
851
6,693
8,592
15,958
15,688
13,628
11,533
200,968
5,022
3,238
6,384
5,239
9,828
113
227
2,294
2,892
5,559
5,448
5,029
13,080
18,720
12,740
4,061
99,874
5,064
4,958
4,568
5,327
11,789
10,838
8,779
7,870
6,091
4,130
857
2,565
3,367
1,350
1,220
78,773
3,191
4,575
6,011
4,756
16,804
9,628
3,159
5,557
2,939
56,620
542,989
2,571
3,742
5,442
16,033
19,262
15,727
3,173
1,956
3,127
3,383
2,047
2,876
3,864
6,555
13,380
13,507
116,645
15,684
13,629
16,894
6,060
3,776
3,494
5,421
7,026
8,803
5,703
33,640
5,184
828
6,528
8,413
15,751
15,492
13,462
11,249
197,037
4,856
3,141
6,246
5,104
9,579
110
221
2,221
2,801
5,397
5,311
4,903
12,806
18,354
12,481
3,942
97,473
4,911
4,811
4,477
5,194
11,523
10,641
8,544
7,680
5,914
4,018
837
2,486
3,252
1,290
1,165
76,743
3,097
4,461
5,821
4,590
16,441
9,395
3,062
5,377
2,847
55,091
536,699
2,531
3,716
5,426
15,829
19,012
15,580
3,132
1,937
3,105
3,328
2,012
2,830
3,805
6,497
13,333
13,381
115,454
15,580
13,515
16,735
6,008
3,742
3,451
5,357
6,953
8,701
5,620
33,247
5,120
816
6,449
8,325
15,633
15,402
13,367
11,146
195,167
4,763
3,077
6,191
5,041
9,475
103
211
2,174
2,745
5,301
5,228
4,835
12,696
18,202
12,329
3,883
96,254
4,834
4,721
4,431
5,125
11,423
10,564
8,447
7,566
5,783
3,941
808
2,428
3,155
1,250
1,123
75,599
3,031
4,382
5,699
4,463
16,303
9,303
3,005
5,254
2,785
54,225
2,820,060
13,280
19,318
27,776
83,716
100,542
81,543
16,499
10,080
16,032
17,614
10,584
15,095
19,947
34,018
68,351
69,701
604,096
81,084
70,307
87,123
31,432
19,672
18,270
28,180
36,661
45,776
29,965
174,914
26,978
4,345
34,122
43,676
80,647
79,296
68,739
58,756
1,019,943
25,670
16,518
32,518
26,706
50,001
568
1,159
11,697
14,752
28,268
27,748
25,622
66,507
95,049
64,554
20,688
508,025
25,773
25,234
23,214
27,081
59,901
54,937
44,743
39,966
30,886
20,916
4,344
12,989
17,096
6,858
6,180
400,118
16,187
23,218
30,529
24,222
85,399
49,009
16,086
28,290
14,938
287,878
7,143,666
33,202
51,137
78,117
230,281
265,297
213,848
44,568
27,034
40,639
44,399
26,379
38,946
49,805
88,098
167,704
168,287
1,567,741
194,205
161,685
195,508
76,963
53,615
48,806
73,978
101,659
129,317
83,988
485,963
72,773
10,862
90,032
110,948
174,673
175,734
150,351
166,401
2,557,461
71,258
45,712
92,589
76,996
139,769
1,369
3,025
30,196
40,522
76,632
75,877
71,629
181,491
245,153
150,115
55,858
1,358,191
64,233
61,028
56,272
65,617
157,937
135,709
118,417
96,952
68,069
43,517
9,377
27,666
33,951
13,617
12,611
964,973
34,511
50,928
67,951
56,463
217,990
127,681
38,550
66,312
34,914
695,300
7,812,882
36,404
56,108
85,615
252,066
290,638
233,706
48,924
29,668
44,589
48,834
28,979
42,786
54,731
96,328
183,845
184,410
1,717,631
212,859
177,350
214,064
84,217
58,941
53,684
81,225
111,450
141,233
91,649
528,739
79,817
11,933
98,675
121,389
190,946
192,151
164,437
181,951
2,796,710
78,395
50,290
101,429
84,552
152,666
1,503
3,326
33,156
44,502
83,885
83,238
78,474
198,368
267,588
163,933
61,291
1,486,596
70,235
66,702
61,497
71,592
172,215
147,884
129,190
105,640
74,358
47,498
10,261
30,214
37,126
14,841
13,830
1,053,083
37,766
55,722
74,274
61,696
237,463
139,155
42,085
72,479
38,222
758,862
5,922,174
27,595
42,525
64,896
191,066
220,300
177,153
37,085
22,489
33,795
37,015
21,966
32,434
41,483
73,014
139,355
139,789
1,301,960
161,350
134,434
162,261
63,836
44,678
40,690
61,570
84,480
107,056
69,470
400,781
60,501
9,045
74,796
92,011
144,740
145,653
124,642
137,918
2,119,912
59,423
38,116
76,882
64,089
115,724
1,140
2,520
25,133
33,733
63,585
63,094
59,484
150,363
202,831
124,266
46,461
1,126,844
53,240
50,559
46,614
54,266
130,540
112,095
97,929
80,077
56,363
36,004
7,776
22,900
28,142
11,249
10,485
798,239
28,629
42,240
56,299
46,764
179,997
105,478
31,899
54,942
28,971
575,219
724,839
3,451
4,957
6,958
21,563
25,903
20,757
4,279
2,585
4,051
4,613
2,739
4,030
5,209
8,720
17,091
17,728
154,634
20,651
17,806
22,028
8,088
5,150
4,798
7,357
9,607
11,748
7,814
44,611
7,032
1,152
8,888
11,202
20,185
19,802
17,112
15,157
260,188
6,890
4,413
8,396
7,006
12,893
164
334
3,135
3,958
7,413
7,302
6,711
17,054
24,180
16,457
5,441
131,747
6,766
6,629
5,985
7,016
15,305
13,888
11,599
10,292
8,051
5,390
1,168
3,397
4,510
1,865
1,680
103,541
4,220
6,006
8,031
6,434
21,788
12,589
4,220
7,481
3,960
74,729
6,366,442
30,195
45,542
68,395
192,033
229,343
186,765
37,991
23,395
36,378
40,080
24,333
35,100
45,873
77,981
149,844
149,491
1,372,739
179,224
148,030
185,105
71,101
48,659
43,644
66,978
90,904
111,658
73,070
426,592
65,573
10,094
79,881
100,989
167,572
167,224
144,062
143,223
2,323,583
60,725
38,687
76,967
63,801
120,636
1,351
2,634
25,691
34,163
63,528
63,238
59,813
156,177
219,691
140,015
46,149
1,173,266
54,227
53,216
50,651
59,824
137,540
123,788
104,968
87,218
64,204
41,707
8,615
26,240
33,208
13,170
11,939
870,515
32,776
47,349
62,416
48,463
197,054
112,955
34,512
59,291
31,523
626,339
614,666
2,927
4,202
5,900
18,287
21,967
17,602
3,629
2,192
3,435
3,913
2,325
3,416
4,416
7,397
14,490
15,035
131,133
17,510
15,099
18,682
6,858
4,368
4,070
6,235
8,146
9,960
6,625
37,830
5,963
977
7,537
9,501
17,119
16,792
14,511
12,856
220,639
5,840
3,743
7,119
5,943
10,937
139
283
2,658
3,356
6,287
6,192
5,690
14,460
20,506
13,956
4,612
111,721
5,739
5,619
5,075
5,950
12,980
11,777
9,835
8,728
6,829
4,570
991
2,881
3,825
1,581
1,425
87,805
3,577
5,094
6,808
5,455
18,478
10,675
3,578
6,344
3,359
63,368
331
Eestimated Population, FY 2072/73 (2015/2016)

DC
DISTRICT
National
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
TAPLEJUNG
PANCHTHAR
ILLAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TEHRATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
DHANUSHA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOWK
KAVREPALANCHOWK
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKAWANPUR
RAUTAHAT
BARA
PARSA
CHITWAN
GORKHA
LAMJUNG
TANAHUN
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKHA
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
BAJURA
BAJHANG
AACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHULA
332
Total
Population
Under 1
year
6 to 59
months
0 to 23
months
0 to 35
months
1 to 2 yrs
(12 to 23
months)
0 to 59
months
28624299 660629 2628869 1276859 1859181 616229 2959177

129767
195460
303880
882251
1044071
854308
168449
101371
157480
167077
104053
150492
187605
341412
683473
678504
808607
678004
845921
305800
206827
187401
292475
395151
531402
343894
2041388
284169
44463
347755
446207
781366
773382
670249
651092
257325
170651
337847
267464
549288
6422
12327
112330
148083
278259
266635
254203
695484
993886
631159
201055
237212
233033
221163
260990
611384
561497
459535
391813
283805
187950
40157
118895
150679
60615
55719
147526
211653
276198
213473
881031
499079
152222
260744
140299
2990
4500
7013
20315
24085
19714
3876
2332
3629
3851
2402
3463
4322
7855
15781
15646
18700
15658
19588
7051
4758
4311
6746
9116
12317
7972
47389
6552
1027
8005
10308
18112
17926
15559
15016
5905
3919
7748
6130
12678
151
286
2582
3398
6378
6106
5830
16011
22950
14597
4603
5434
5354
5090
6014
14075
12978
10593
9042
6556
4349
929
2753
3490
1405
1292
3408
4881
6363
4898
20333
11493
3505
6003
3235
11902
17911
27907
80859
95846
78452
15427
9281
14442
15323
9559
13782
17195
31267
62792
62265
74398
62304
77925
28060
18938
17160
26843
36275
48999
31712
188498
26074
4086
31861
41013
72051
71307
61884
59759
23507
15604
30846
24403
50452
597
1138
10275
13529
25394
24312
23208
63727
91326
58074
18333
21640
21315
20259
23934
56024
51641
42153
35984
26088
17302
3698
10951
13885
5587
5135
13562
19426
25325
19497
80920
45745
13950
23891
12875
5780
8698
13555
39267
46551
38103
7492
4506
7014
7443
4643
6693
8353
15183
30500
30241
36141
30263
37858
13628
9196
8334
13038
17619
23805
15407
91585
12664
1985
15472
19922
35004
34644
30069
29023
11415
7576
14976
11849
24504
291
553
4990
6569
12329
11804
11269
30947
44357
28210
8900
10505
10350
9838
11624
27205
25084
20474
17477
12672
8405
1796
5320
6745
2715
2495
6588
9435
12299
9467
39302
22215
6775
11603
6253
8416
12665
19736
57178
67783
55481
10909
6562
10212
10838
6760
9745
12162
22109
44409
44034
52621
44064
55119
19844
13392
12135
18984
25654
34659
22431
133340
18440
2890
22530
29007
50964
50439
43777
42260
16621
11033
21809
17254
35680
423
805
7266
9566
17954
17189
16410
45064
64587
41074
12960
15299
15071
14325
16926
39615
36523
29811
25448
18450
12238
2615
7746
9821
3953
3633
9592
13738
17909
13786
57226
32348
9865
16895
9105
2790
4197
6542
18952
22467
18389
3616
2175
3385
3592
2241
3230
4031
7328
14719
14595
17441
14605
18269
6577
4438
4022
6292
8503
11488
7435
44196
6112
958
7468
9614
16892
16717
14510
14007
5509
3657
7228
5719
11826
140
266
2408
3171
5951
5698
5439
14937
21408
13614
4296
5071
4996
4748
5610
13130
12106
9881
8435
6115
4056
867
2568
3255
1310
1204
3179
4554
5936
4569
18968
10722
3270
5599
3018
13397
20161
31414
91016
107888
88309
17365
10446
16257
17248
10760
15513
19357
35195
70683
70088
83748
70133
87720
31585
21317
19316
30216
40833
55157
35698
212192
29350
4599
35864
46166
81106
80270
69663
67267
26460
17564
34719
27468
56791
672
1281
11566
15229
28583
27365
26123
71732
102801
65372
20635
24357
23992
22804
26941
63061
58130
47450
40504
29365
19476
4162
12328
15629
6290
5781
15266
21866
28507
21946
91087
51492
15702
26892
14493
Adolescent
Married
population
Female
1 to 4 years
(10 to 19
pop 15 to
years)
49 years
6300914
28537
42957
66893
193907
229749
188034
37004
22263
34632
36751
22910
33061
41247
74997
150493
149272
178237
149310
186623
67275
45429
41162
64356
86958
117316
75924
451119
62514
9792
76419
98283
172500
170731
148114
143246
56430
37445
74046
58601
120915
1429
2726
24656
32472
60969
58393
55722
152832
218851
139120
44026
51956
51143
48591
57389
134351
123720
101066
86242
62511
41444
8857
26229
33249
13382
12298
32497
46566
60723
46803
193935
109694
33455
57300
30866
Female
Expected
Pop 15-49
Pregnancies
years
2298547 6217423 8202399

10406
15661
24401
70701
83804
68596
13489
8115
12627
13397
8358
12050
15034
27339
54902
54442
65048
54475
68131
24534
16559
15004
23470
31717
42840
27726
164803
22798
3572
27859
35859
62994
62344
54105
52251
20554
13644
26972
21338
44113
521
994
8984
11831
22205
21259
20293
55722
79851
50775
16031
18922
18638
17714
20927
48986
45152
36857
31462
22809
15128
3233
9575
12140
4884
4489
11858
16985
22143
17049
70754
39999
12197
20889
11257
28777
43934
66039
197554
228288
185807
38152
23081
34949
37014
22539
34080
41981
77315
147649
149103
170833
145976
175355
67317
46978
42579
64149
86423
108420
70093
407219
62581
9585
78251
95763
159402
157996
133936
142768
60400
39544
79914
63889
119111
1123
2470
25875
34701
66179
64179
60145
156271
214193
133255
48368
56760
53740
49894
57908
137286
119317
101572
85143
60842
39386
8388
24680
31093
12373
11472
31577
46423
61516
50218
191137
111613
34124
58603
30855
37965
57960
87122
260625
301171
245128
50332
30449
46106
48831
29735
44960
55384
101999
194787
196705
225373
192580
231339
88809
61976
56172
84629
114015
143035
92471
537228
82561
12646
103233
126337
210292
208438
176696
188348
79683
52168
105427
84286
157138
1482
3259
34136
45780
87307
84669
79347
206163
282577
175798
63810
74881
70897
65823
76396
181116
157411
134000
112326
80266
51960
11065
32560
41019
16323
15135
41659
61244
81155
66250
252159
147247
45018
77313
40706
Expected
live birth
751490
637263
3478
5310
7982
23878
27592
22458
4611
2790
4225
4474
2724
4119
5074
9345
17847
18021
20648
17644
21195
8137
5679
5146
7754
10446
13105
8472
49218
7564
1159
9459
11574
19266
19096
16188
17255
7302
4780
9659
7723
14397
136
299
3128
4195
7999
7758
7270
18888
25888
16106
5847
6861
6495
6030
7000
16593
14422
12277
10291
7353
4761
1014
2983
3758
1495
1387
3816
5611
7435
6070
23101
13490
4124
7084
3729
2950
4503
6769
20248
23398
19044
3911
2366
3582
3794
2310
3493
4303
7925
15134
15282
17510
14962
17973
6900
4816
4364
6575
8859
11112
7184
41737
6415
983
8021
9815
16338
16194
13728
14632
6192
4054
8191
6549
12208
115
254
2652
3557
6783
6579
6165
16017
21953
13658
4958
5818
5508
5114
5936
14071
12229
10411
8727
6236
4037
860
2530
3187
1268
1176
3236
4758
6305
5147
19590
11440
3497
6007
3162
Reporting Status
PUBLIC
Code
HOSPITAL
Name
PRIMARY HEALTH CENTRE
HEALTH POST
URBAN HEALTH CENTRE
No of HF
Exp. Rep.
Received
Rep.
Service
No of HF
Exp. Rep.
Received
Rep.
Service
No of HF
Exp. Rep.
Received
Rep.
Service
No of HF
Exp. Rep.
Received
Rep.
Service
National
116
1392
1204
3378904
202
2424
2408
2036702
3804
45648
45229
16169530
153
1836
1340
553551
EASTERN
21
252
225
617430
49
588
587
486985
863
10356
10327
3394361
22
264
135
51290
1 TAPLEJUNG
12
12
30468
24
24
7402
50
600
600
106765
2 PANCHTHAR
12
12
30182
24
24
12377
40
480
479
117404
12
3 ILAM
12
12
28759
48
48
21067
44
528
523
118662
12
12
7511
4 JHAPA
12
12
56223
72
72
103531
44
528
528
338618
72
5 MORANG
24
21
189838
84
84
95709
60
720
719
414612
36
12
17314
6 SUNSARI
24
13
35414
60
60
61816
47
564
564
353630
7 DHANKUTA
12
12
40323
24
24
13299
35
420
419
109316
24
24
7622
8 TERHATHUM
12
12
18737
24
24
8079
29
348
348
79763
9 SANKHUWASABHA
12
12
23250
24
24
14208
36
432
432
125418
24
22
3079
10 BHOJPUR
12
13
16341
36
36
13886
60
720
720
142165
11 SOLUKHUMBU
12
10
19450
24
23
15037
32
384
378
98516
12 OKHALDHUNGA
12
12
9867
12
12
4090
54
648
648
183086
13 KHOTANG
12
12
25670
24
24
9583
73
876
876
174543
14 UDAYAPUR
24
24
63393
12
12
17824
44
528
528
163271
48
48
10511
15 SAPTARI
24
12
8385
48
48
41292
111
1332
1332
448009
12
16 SIRAHA
24
24
21130
48
48
47785
104
1248
1233
420583
24
17
5253
314730
CENTRAL
41
492
351
1358487
70
840
830
676205
1167
14004
13815
4781682
67
804
671
17 DHANUSA
12
60
60
42725
98
1176
1173
385837
12
12
5434
18 MAHOTTARI
24
21
27503
60
59
65958
70
840
810
347678
24
2932
19 SARLAHI
12
1450
60
53
55244
94
1128
993
415456
20 SINDHULI
12
12
38712
48
48
22964
51
612
609
132306
24
19
3011
21 RAMECHHAP
36
24
17899
36
36
19683
52
624
624
169887
48
22 DOLAKHA
12
12
34099
24
24
28576
52
624
622
155904
84
23
3571
23 SINDHUPALCHOK
12
12
46291
36
36
47884
75
900
900
205601
24 KAVRE
12
11
7091
48
48
25540
89
1068
1068
338719
36
36
17251
25 LALITPUR
24
24
348448
48
46
39132
38
456
456
183095
60
60
40402
26 BHAKTAPUR
36
11
149
24
24
20492
19
228
228
112846
36
36
72883
27 KATHMANDU
12
144
93
574638
96
96
59846
58
696
696
274983
28
336
335
113643
28 NUWAKOT
12
12
25915
36
36
20723
64
768
768
151810
24
24
4767
29 RASUWA
12
12
7686
12
12
8231
17
204
200
44056
30 DHADING
12
12
43463
24
24
41481
49
588
587
277144
31 MAKWANPUR
12
12
61488
48
48
52038
40
480
480
182514
32 RAUTAHAT
24
24
36088
48
48
28751
92
1104
1104
340710
33 BARA
12
11
14231
60
60
33257
94
1128
1125
375012
34 PARSA
24
23
14770
36
36
18434
79
948
948
322835
48
48
19079
35 CHITAWAN
48
24
58566
36
36
45246
36
432
424
365289
72
71
31757
22
264
263
505052
40
480
475
401604
842
10104
10026
3334050
30
360
259
79521
36 GORKHA
12
12
41965
36
36
24796
66
792
792
222652
36
36
5398
37 LAMJUNG
12
12
57119
24
24
9114
58
696
695
132568
38 TANAHU
24
24
78825
24
24
14815
46
552
540
134912
24
24
3692
39 SYANGJA
12
12
36334
36
35
57990
65
780
778
184941
36
34
5404
40 KASKI
24
24
16398
36
36
19581
45
540
545
144836
96
84
38720
41 MANANG
12
12
6017
13
156
156
8863
42 MUSTANG
12
12
7737
12
12
3832
15
180
180
20180
43 MYAGDI
12
12
29351
12
12
9746
39
468
468
96987
44 PARBAT
12
12
18494
24
24
12371
52
624
624
144521
45 BAGLUNG
12
12
36
36
31394
58
696
696
229651
24
46 GULMI
12
12
35714
48
44
28014
76
912
858
281062
47 PALPA
24
24
48121
24
24
15636
62
744
744
207360
48
12
2882
48 NAWALPARASI
12
12
48621
60
60
68954
71
852
851
410270
49 RUPANDEHI
24
24
6522
60
60
60546
64
768
765
540548
84
59
18599
50 KAPILBASTU
36
35
57129
24
24
26676
73
876
868
448356
12
10
4826
51 ARGHAKHANCHI
12
12
16705
24
24
18139
39
468
466
126343
MID WESTERN
18
216
209
492803
27
324
324
284414
556
6672
6554
2792406
12
144
130
33995
52 PYUTHAN
12
12
43395
24
24
24158
46
552
552
207476
53 ROLPA
12
12
16269
24
24
18203
49
588
587
168053
54 RUKUM
12
12
36430
24
24
8126
41
492
492
144267
55 SALYAN
12
12
20170
24
24
14815
45
540
539
212612
56 DANG
24
24
125600
36
36
51797
36
432
432
337895
72
72
14023
57 BANKE
12
11
36
36
38409
44
528
528
384896
58 BARDIYA
12
12
28700
36
36
46105
30
360
360
353650
24
24
6659
59 SURKHET
24
24
62921
36
36
43901
47
564
564
326890
36
24
10901
60 DAILEKH
24
24
42374
24
24
14404
56
672
672
203388
12
10
2412
61 JAJARKOT
12
12
6746
24
24
9804
32
384
384
129412
62 DOLPA
12
22018
23
276
184
24625
63 JUMLA
12
11
24758
12
12
4891
29
348
340
78972
64 KALIKOT
12
12
18361
12
12
5724
28
336
336
101545
65 MUGU
12
12
13294
12
12
4077
24
288
275
44506
66 HUMLA
12
12
31767
26
312
309
74219
14
168
156
405132
16
192
192
187494
376
4512
4507
1867031
22
264
145
74015
67 BAJURA
12
12
17283
12
12
23148
26
312
312
153802
68 BAJHANG
12
12
17175
24
24
23850
45
540
540
166432
24
69 ACHHAM
12
12
33241
24
24
13390
72
864
859
274735
70 DOTI
24
12
24759
24
24
7317
49
588
588
184413
24
24
7800
71 KAILALI
36
36
102908
48
48
56398
37
444
444
411690
72
72
27591
72 KANCHANPUR
12
12
72735
36
36
45120
18
216
216
238822
108
13
33388
73 DADELDHURA
24
24
56927
24
288
288
126782
12
12
3277
74 BAITADI
12
12
27577
24
24
18271
65
780
780
193212
24
24
1959
75 DARCHAULA
24
24
52527
40
480
480
117143
WESTERN
FAR WESTERN
333
Reporting Status
Code
COMMUNITY HEALTH UNIT
Name
Non-Public Health Institutions
OTHER HEALTH FACILITY
No of HF
Exp. Rep.
Received Rep.
Service
No of HF
Exp. Rep.
Received Rep.
Service
No of HF
Exp. Rep.
Received Rep.
Service
National
92
1104
352
67326
51
612
390
160726
1257
15084
7247
5422128
EASTERN
25
300
119
22163
11
132
56
11040
137
1644
778
580206
1 TAPLEJUNG
48
11
401
36
28
5348
2 PANCHTHAR
48
18
2313
48
3 ILAM
24
19
7746
12
12
5160
36
17
12361
4 JHAPA
24
12
27
324
177
198348
5 MORANG
36
36
36
432
211
236428
6 SUNSARI
12
12
19
228
64
40042
7 DHANKUTA
12
878
12
4754
108
87
12653
8 TERHATHUM
9 SANKHUWASABHA
84
52
9334
60
45
17685
2543
10 BHOJPUR
12
12
24
21
11 SOLUKHUMBU
24
15
1491
12
1126
36
22
5877
12 OKHALDHUNGA
36
35
28311
13 KHOTANG
12
12
265
14 UDAYAPUR
72
34
2073
15 SAPTARI
12
84
16 SIRAHA
12
108
25
18272
CENTRAL
24
288
116
18539
21
252
187
87663
871
10452
4680
2834165
17 DHANUSA
12
10
17
204
29
54028
18 MAHOTTARI
12
10
2768
24
108
21
1247
19 SARLAHI
12
10
120
20 SINDHULI
12
12
3246
13
156
78
13711
21 RAMECHHAP
84
48
41
23980
22 DOLAKHA
48
10
120
63
7580
23 SINDHUPALCHOK
12
12
1519
108
67
18410
24 KAVRE
36
27
5154
12
12
1726
27
324
224
298004
25 LALITPUR
12
12
12
12
1819
67
804
425
439051
26 BHAKTAPUR
24
24
4005
24
24
25091
38
456
257
164023
27 KATHMANDU
48
46
9759
523
6276
2849
1591061
28 NUWAKOT
24
24
1891
12
12
6452
10
120
107
41028
29 RASUWA
24
12
30 DHADING
12
12
6287
15
180
69
34103
31 MAKWANPUR
12
12
16869
12
144
89
8065
32 RAUTAHAT
96
12
621
33 BARA
12
81
10
120
22
5705
34 PARSA
12
12
36
432
105
1899
35 CHITAWAN
24
19
4721
12
10
14814
53
636
221
131649
WESTERN
1372820
25
300
80
9165
14
168
90
51515
153
1836
1129
36 GORKHA
12
12
1041
60
52
3626
108
92
40785
37 LAMJUNG
48
20
2353
17
204
51
12778
38 TANAHU
36
36
4228
23
276
276
143433
39 SYANGJA
24
48
47
30462
40 KASKI
24
15
36156
22
264
209
306919
41 MANANG
24
42 MUSTANG
43 MYAGDI
72
12
646
12
11
4001
44 PARBAT
12
48
25
947
45 BAGLUNG
12
2086
60
1609
46 GULMI
60
115
47 PALPA
84
12
1543
12
12
9001
48
48
483335
48 NAWALPARASI
24
13
156
139
90717
49 RUPANDEHI
24
36
432
164
254779
50 KAPILBASTU
12
72
29
51 ARGHAKHANCHI
24
24
2940
MID WESTERN
10
120
14
10065
48
46
10508
70
840
426
330066
52 PYUTHAN
36
36
676
53 ROLPA
48
54 RUKUM
36
23
30403
55 SALYAN
56 DANG
12
144
82
14838
57 BANKE
12
12
3026
12
144
50
201185
58 BARDIYA
12
12
9718
12
12
72
57
19230
59 SURKHET
48
12
12
4043
12
144
120
54804
60 DAILEKH
12
347
96
45
3172
61 JAJARKOT
62 DOLPA
63 JUMLA
12
10
3439
108
472
64 KALIKOT
65 MUGU
48
66 HUMLA
12
11
5286
304871
FAR WESTERN
96
23
7394
12
11
26
312
234
67 BAJURA
68 BAJHANG
12
12
11
3505
69 ACHHAM
12
12
124708
70 DOTI
12
692
36
22
8847
71 KAILALI
24
16
6702
12
11
13
156
114
138477
72 KANCHANPUR
36
36
15
1169
73 DADELDHURA
48
48
28165
74 BAITADI
12
12
12
75 DARCHAULA
334
Raw Data:Service Status (Sheet 1 of 2)
District
Code
District Name
Total number of Client Served from Health Facility
Received
Reports
New Clients Served

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
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
12978
2198
12
16
17
218
303
63
483
41
48
25
28
41
12
57
12
822
5936
110
170
412
41
57
59
13
243
331
66
2940
956
223
35
55
27
13
47
138
1839
45
57
160
46
360
14
12
20
19
79
21
48
276
321
320
41
2169
25
13
14
76
594
21
281
73
249
331
8
330
119
12
23
836
17
23
44
456
150
26
35
60
25
Male
12823131
2517865
71021
77737
92495
364817
438995
230206
85085
46160
89277
85162
76164
102475
106195
119892
257190
274994
4190961
256533
224798
246693
107804
124438
116680
161316
271388
296151
157289
795783
124771
29940
190486
139901
229793
218696
191670
306831
2742120
165715
95744
171869
148279
243325
5794
11291
71571
83282
147577
190683
292700
318996
442415
270065
82814
1985193
151382
105434
130035
134497
272184
244954
257855
256076
148031
78481
20467
50429
66511
29689
39168
1386992
97051
106597
197954
112727
373839
193214
100066
121690
83854
9546122
1878129
56841
57142
62331
291514
325156
168073
60460
35470
65296
62191
49452
70455
82840
86881
199718
204309
3359718
218227
187117
214628
79304
81265
79394
114857
189486
185214
108134
785463
93082
24778
127993
89589
189425
180361
173328
238073
1950240
113455
70226
124709
105951
185870
6496
11397
46909
59524
97663
123071
216045
210251
314172
207295
57206
1345719
98931
68767
83486
78535
170208
182614
161984
155672
102040
59406
17749
46065
53478
26689
40095
1012316
84567
87807
144651
78185
246678
125102
78242
94715
72369
Total Clients Served

Total
22369253
4395994
127862
134879
154826
656331
764151
398279
145545
81630
154573
147353
125616
172930
189035
206773
456908
479303
7550679
474760
411915
461321
187108
205703
196074
276173
460874
481365
265423
1581246
217853
54718
318479
229490
419218
399057
364998
544904
4692360
279170
165970
296578
254230
429195
12290
22688
118480
142806
245240
313754
508745
529247
756587
477360
140020
3330912
250313
174201
213521
213032
442392
427568
419839
411748
250071
137887
38216
96494
119989
56378
79263
2399308
181618
194404
342605
190912
620517
318316
178308
216405
156223
Female
15516359
2893802
82211
87948
120430
362846
521128
278992
118904
59938
110163
102160
83204
134286
117030
143096
281769
289697
5427468
261996
241604
252046
120655
138477
133503
185396
417142
586697
221335
1296376
144754
32557
240183
185419
217049
229378
198521
324380
3286365
195528
119303
215011
179899
297580
6470
15369
80636
102045
159456
205212
437292
377031
500033
301391
94109
2313978
164788
122656
130297
155813
319999
350592
281445
313574
155519
81285
23841
57265
68811
32091
56002
1594746
101923
113046
257777
135982
419244
229730
113311
135428
88305
Male
11296556
2095250
66359
61019
72464
297735
381993
201473
58867
43996
77004
70697
56711
87532
89489
100162
215652
214097
4204806
226028
198837
220104
86000
86570
87519
129801
260554
385051
153209
1122115
97850
26436
145869
118006
182433
185589
176997
315838
2274966
129512
85275
149394
128278
205505
8139
14795
54375
70770
105193
133715
308608
234564
352309
228703
65831
1582121
106024
77662
86099
90369
197441
283432
179031
183303
107175
62369
21692
51711
55403
28842
51568
1139413
90897
93303
182020
93080
270349
140359
88849
104240
76316
Total
26812915
4989052
148570
148967
192894
660581
903121
480465
177771
103934
187167
172857
139915
221818
206519
243258
497421
503794
9632274
488024
440441
472150
206655
225047
221022
315197
677696
971748
374544
2418491
242604
58993
386052
303425
399482
414967
375518
640218
5561331
325040
204578
364405
308177
503085
14609
30164
135011
172815
264649
338927
745900
611595
852342
530094
159940
3896099
270812
200318
216396
246182
517440
634024
460476
496877
262694
143654
45533
108976
124214
60933
107570
2734159
192820
206349
439797
229062
689593
370089
202160
239668
164621
335
Raw Data:Service Status (Sheet 2 of 2)
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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
336
Received
Reports
53681
11782
675
525
637
739
852
668
570
380
549
782
454
694
924
636
1392
1305
17000
1284
936
1048
778
713
698
1032
1195
762
584
1209
979
223
680
631
1169
1208
1172
699
12077
1044
759
924
904
877
159
195
506
685
744
916
876
974
1045
966
503
7634
625
622
549
575
646
643
485
779
777
420
191
364
359
288
311
5188
336
564
931
666
672
291
372
852
504
Outreach Clinics
EPI Clinics
Total No. of Total No. of Reports Service Provided to

clinics
Received
Total Patients
12912
2917
189
152
186
173
269
162
106
64
109
199
79
169
228
151
402
279
4118
394
302
305
193
139
143
256
314
216
45
137
176
44
193
158
429
292
274
108
2520
240
176
164
195
167
10
20
85
105
133
216
187
201
259
278
84
1899
155
181
125
161
131
145
158
150
191
99
70
103
66
83
81
1458
64
128
229
214
200
77
74
322
150
124747
30722
1937
1590
2089
1730
2853
1805
1041
672
1090
2162
779
1879
2428
1625
4386
2656
33866
3183
2997
1673
1596
1506
1548
1920
3338
1081
469
1400
1586
432
1822
1541
2958
2302
1546
968
26923
2511
1997
1750
2086
1919
90
158
916
1052
1525
2341
2212
2203
2546
2849
768
17669
1379
1810
1217
1583
1361
1577
1744
1623
1876
918
201
862
562
391
565
15567
612
1197
2643
1695
2213
862
841
3830
1674
2570986
597824
27076
32421
42941
59074
90042
45004
16347
10274
15747
29021
11400
22003
26861
31426
90438
47749
685202
71437
96101
40242
22279
20170
22556
35281
57108
12455
8225
31952
22990
6557
40035
35463
62946
50004
26455
22946
508007
47674
29203
26871
32696
47539
879
1551
14669
13357
33519
35480
39064
45419
56674
65071
18341
391326
20352
26703
23310
31463
44475
50237
50679
33353
36015
22293
2942
19692
12455
7214
10143
388627
22179
28690
83368
35300
76486
18004
21048
72909
30643
Clinic
FCHV
Sessions
Planned (No) Conducted (No) Planned (No) Conducted (No)
16397
3709
179
216
189
246
334
277
139
116
203
196
103
168
230
201
454
458
5120
525
368
435
206
179
164
251
320
127
73
208
214
57
221
219
440
494
394
225
3284
258
196
217
236
191
20
32
111
159
169
318
239
315
267
375
181
2518
250
204
161
224
200
275
199
184
244
131
73
95
108
89
81
1766
122
142
265
248
275
142
99
332
141
180542
41941
2098
2290
2204
3021
3660
3185
1500
1284
2224
2304
1078
1896
2623
2285
5283
5006
53951
5244
4153
3940
2127
2050
1830
2528
3721
1089
723
2277
2419
573
2369
2362
4488
5686
4053
2319
37378
2715
2306
2529
2709
2233
151
249
1256
1774
1957
3534
2841
3760
3161
4287
1916
27156
2967
2225
1784
2388
2363
3153
2318
2154
2655
1436
383
893
1216
653
568
20116
1199
1582
2827
2763
3429
1693
1042
3974
1607
13694
3226
174
187
188
226
200
189
127
110
205
181
100
124
230
149
453
383
4467
337
223
267
199
176
145
175
364
306
180
308
219
53
5
199
277
487
368
179
2963
258
67
227
239
168
19
32
108
160
179
198
292
347
161
327
181
1955
12
174
161
211
218
300
199
193
58
78
41
79
108
42
81
1083
0
147
185
184
246
106
71
2
142
142464
34222
1986
1911
2159
2252
2422
1932
1308
1230
2235
1979
769
1272
1902
1577
5240
4048
42699
3020
2282
1749
1789
2071
1731
1585
3691
1917
1599
3297
2140
520
67
2028
2632
5103
3584
1894
32045
2702
668
2634
2730
2074
117
222
1144
1737
1863
1828
3576
3979
1754
3378
1639
20103
42
1514
1464
2175
2580
3399
1935
2246
1088
915
190
641
1156
221
537
13395
11
1590
2442
2045
2608
1229
1030
864
1576
Service Provided
3669699
859712
19240
33032
36346
130955
138252
109294
24789
14000
26825
22265
10023
15647
24602
42671
109199
102572
1128888
123979
117235
114636
39487
22413
19175
28362
40789
17732
19642
93756
26709
5631
45311
50149
102341
104818
81864
74859
709964
30276
19997
41077
39790
73196
250
854
14697
20126
36027
38979
47272
100541
120810
98794
27278
570053
39592
30892
28319
35027
101798
91591
62845
52912
41650
25292
4610
14839
22659
10488
7539
401082
21848
28179
42555
36081
116205
72221
21542
43161
19290
Total No. of
FCHV)
49677
10842
834
393
1063
612
753
1186
350
392
325
570
279
697
898
442
1065
983
14246
936
673
1347
495
750
1226
666
963
493
279
1235
1111
245
445
440
902
885
712
443
11014
621
652
466
651
1053
119
144
361
500
950
987
615
713
1327
1012
843
7708
432
441
396
414
875
788
832
986
744
263
200
574
295
225
243
5867
261
423
901
625
1239
766
452
831
369
Total No. of
Reports Received
520548
110543
8320
3834
9831
6034
7678
11079
3537
4160
3117
6301
2839
7317
9226
4487
11952
10831
142376
9354
7365
11558
4816
7854
11347
6636
10708
4234
2754
12383
8825
2494
4759
4616
11856
9623
6961
4233
126789
6669
7371
4768
6972
10824
962
877
4094
5390
11197
20413
7319
8400
13518
10398
7617
76791
4888
4662
3673
4755
8985
8554
9022
9777
8355
2519
802
4226
3132
1505
1936
64049
2843
4565
10390
6630
12220
8355
4886
9820
4340
Service Provided to
Total Patients
12910940
2893630
35471
82299
101030
338159
452840
417985
100161
45385
73205
96005
39373
175031
57898
100607
537960
240221
2992879
249519
323903
214666
85627
142798
88123
112621
214057
71574
47908
238713
52702
38840
122941
223925
222595
239102
109038
194227
2378689
112530
101446
84530
132649
246453
2835
2549
64526
82870
191350
154106
159661
384188
348469
174807
135720
2197430
128194
101404
49957
142446
270830
387749
483867
188248
241990
59568
2665
43962
75006
7932
13612
2448312
133370
108004
346211
140720
706109
485579
159322
298235
70762
District/
HF 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
Analyzed Data:Reporting Status

Reporting Status (%)
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received Reports
53586
11782
675
525
637
739
852
668
570
380
549
782
454
694
924
636
1392
1305
16982
1284
928
1048
778
713
698
1027
1192
762
584
1209
979
223
680
631
1169
1208
1172
697
12045
1032
759
924
904
877
159
195
506
685
744
916
876
963
1036
966
503
7614
624
622
549
575
646
625
484
779
777
420
191
364
359
288
311
5163
336
564
918
666
660
291
372
852
504
Averge no. of People Sevrved
PHCORC
EPIC
FCHV
ORC (Per Clinic)
EPIC (Per Clinic)
80.53
87.77
85.41
87.17
93.59
83.33
88.38
92.85
81.84
87.5
83.33
90.54
82.17
92.65
88.74
89.68
90.92
79.33
68.56
67.32
82.7
45.71
68.91
90.29
90.21
62.93
88.59
41.71
86.85
85.16
75.09
81.82
78.67
81.28
57.46
65.7
47.02
74.69
89.03
87.19
94.55
88.92
89.15
95.76
75
65.83
89.8
83.49
95.55
90.32
98.57
91.33
81.92
85.4
76.19
77.54
74.14
83.33
81.13
81.94
86.58
90.63
91.98
90.17
81.85
77.27
23.93
69.74
70.96
39.26
58.13
89.09
79.69
77.93
96.99
66
92.21
93.29
94.71
99.12
93
91.98
94.23
97.67
88.35
97.18
102.34
91.32
95.82
89.93
92.24
91.3
97.96
87.22
94.05
95.04
94.73
96.97
91.08
87.84
83.24
94.04
75.48
86.04
95.44
92.99
84.54
96.9
71.46
82.53
91.23
94.2
83.77
89.33
89.88
85
95.92
85.72
85.89
94.85
87.69
98.04
97.12
95.66
97.43
62.92
64.84
94.29
92.98
96.5
92.61
99.06
99.47
98.66
95.27
88.21
89.87
98.9
90.89
92.34
88.84
98.46
95.55
97.07
97.55
90.68
91.35
43.72
78.33
93.83
61.14
58.44
97.05
81.9
92.84
104.33
92.84
103.91
99.35
87.71
99.65
94.98
87.17
84.97
83.13
81.3
77.07
82.16
84.97
77.85
84.21
88.44
79.92
92.12
84.8
87.48
85.62
84.6
93.52
91.82
83.28
83.28
91.2
71.5
81.08
87.27
77.13
83.03
92.66
71.57
82.26
83.56
66.19
84.83
89.12
87.42
109.53
90.61
81.47
79.63
95.93
89.49
94.21
85.26
89.25
85.66
67.37
50.75
94.51
89.83
98.22
172.35
99.17
98.18
84.89
85.62
75.3
82.41
94.29
84.82
77.29
95.71
81.21
92.23
90.36
82.63
93.58
79.82
33.42
61.35
88.47
55.74
66.39
90.41
90.77
89.93
92.37
88.4
82.19
90.89
90.08
98.48
98.01
20.61
19.46
13.98
20.39
20.56
34.15
31.56
24.93
15.7
15.29
14.45
13.42
14.63
11.71
11.06
19.34
20.62
17.98
20.23
22.44
32.07
24.05
13.96
13.39
14.57
18.38
17.11
11.52
17.54
22.82
14.5
15.18
21.97
23.01
21.28
21.72
17.11
23.7
18.87
18.99
14.62
15.35
15.67
24.77
9.77
9.82
16.01
12.7
21.98
15.16
17.66
20.62
22.26
22.84
23.88
22.15
14.76
14.75
19.15
19.88
32.68
31.86
29.06
20.55
19.2
24.28
14.64
22.84
22.16
18.45
17.95
24.97
36.24
23.97
31.55
20.83
34.56
20.89
25.03
19.04
18.31
20.33
20.5
9.17
14.42
16.49
43.35
37.77
34.32
16.53
10.9
12.06
9.66
9.3
8.25
9.38
18.67
20.67
20.49
20.92
23.64
28.23
29.1
18.56
10.93
10.48
11.22
10.96
16.28
27.17
41.18
11.04
9.83
19.13
21.23
22.8
18.43
20.2
32.28
18.99
11.15
8.67
16.24
14.69
32.78
1.66
3.43
11.7
11.34
18.41
11.03
16.64
26.74
38.22
23.05
14.24
20.99
13.34
13.88
15.87
14.67
43.08
29.05
27.11
24.56
15.69
17.61
12.04
16.62
18.63
16.06
13.27
19.95
18.22
17.81
15.11
13.06
33.89
42.66
20.67
10.87
12
FCHV (reporting
Period)
24.83
26.18
4.26
21.47
10.28
56.04
58.98
37.73
28.32
10.91
23.49
15.24
13.87
23.92
6.28
22.42
45.01
22.18
21.02
26.68
43.98
18.57
17.78
18.18
7.77
16.97
19.99
16.9
17.4
19.28
5.97
15.57
25.83
48.51
18.77
24.85
15.66
45.88
18.76
16.87
13.76
17.73
19.03
22.77
2.95
2.91
15.76
15.37
17.09
7.55
21.81
45.74
25.78
16.81
17.82
28.84
26.23
21.7
13.6
29.96
30.14
49.21
53.63
19.25
28.96
23.65
3.32
10.4
23.95
5.27
7.03
38.2
46.91
23.66
33.19
21.22
57.78
58.12
32.61
30.37
16.3
337
338
555866
125422
2998
4330
5138
17910
21360
16756
3321
2114
3407
3648
1892
2684
4248
6997
14105
14514
190242
20822
14440
15434
6402
3244
3225
4760
6856
7288
5176
25864
5188
896
6458
8064
16278
15925
12684
11238
100675
4856
3316
5978
5587
9159
56
184
2349
2853
5687
5867
5226
12917
19455
13157
4028
82932
6124
5676
4923
5591
12906
11220
8052
7860
6611
4653
700
2385
3296
1633
1302
56595
3034
4715
6793
5479
15511
8869
3260
5963
2971
550434
123968
2934
4301
5389
18141
20893
16627
3193
2080
3275
3629
1788
2611
4169
6944
14103
13891
186662
19294
14147
14832
5507
3373
3181
4842
7044
7222
5191
26614
5136
878
6489
8062
15783
15620
12954
10493
101033
4743
3350
6083
5856
9213
60
173
2388
2862
5777
5938
5193
13051
19775
12721
3850
82370
6094
5724
4923
5658
12672
11374
7974
7988
6429
4518
687
2318
3278
1501
1232
56401
3168
4790
6654
5356
15448
8758
3260
6036
2931
95352
29648
822
1474
1292
3825
5183
4204
1068
452
1032
774
365
650
1085
1479
3639
2304
2662
251
700
477
45
0
31
0
0
0
0
0
0
0
0
39
803
230
0
86
62526
3139
1890
3947
3912
6606
35
99
1573
2426
3462
5230
2000
7989
10880
6297
3041
349
0
0
239
0
0
0
0
0
0
0
56
54
0
0
0
167
59
30
29
0
0
49
0
0
0
65469
19202
442
1043
742
2755
4083
2579
664
284
452
420
311
359
756
960
2165
1187
1134
94
419
77
3
0
23
0
0
0
0
0
0
0
0
0
396
95
0
27
44979
1915
1043
2690
2610
5328
26
103
948
1770
2524
3658
1528
5979
8462
4344
2051
115
0
0
74
0
0
0
0
0
0
0
16
25
0
0
0
39
12
15
12
0
0
0
0
0
0
32891
10792
285
520
53
0
3695
1734
358
62
194
79
219
176
476
420
1515
1006
3160
488
1304
300
4
0
24
7
0
0
0
0
0
0
0
400
419
91
0
123
18526
739
377
904
1292
2082
8
34
353
856
1148
1128
29
1795
4906
2240
635
246
0
0
158
0
0
0
0
0
0
0
22
50
6
10
0
167
95
35
37
0
0
0
0
0
0
359604
76831
1000
2943
4483
7649
14552
10583
2191
1445
3808
2405
647
1754
2279
3859
9584
7649
115352
7404
7682
7755
3205
2384
2212
3959
5767
4643
4294
18249
3836
732
4386
5984
4081
10208
9891
8680
76578
3362
2670
4356
3720
5739
18
106
2311
3035
4664
4740
6392
10158
14869
7609
2829
54413
4406
1744
2580
4184
11001
5186
7072
5927
4587
2287
36
1419
2409
712
863
36430
1157
2458
4586
2881
11094
7576
1686
3320
1672
44068
11660
396
578
632
2848
1795
1324
54
46
265
90
92
134
288
499
1391
1228
18171
1812
1930
2201
762
144
527
101
0
2375
349
742
660
12
318
319
1967
1094
1630
1228
5587
266
131
82
100
677
3
10
0
98
48
313
96
668
1650
1199
246
4473
673
437
343
0
0
248
3
573
454
712
181
238
296
250
65
4177
230
1003
681
468
1493
7
19
209
67
517349
117145
2545
3789
5047
17001
19808
15812
3169
1864
3259
3380
1809
2629
3837
6894
13665
12637
171684
15423
13458
13022
5125
3402
3287
4764
6722
6913
5205
27424
4565
831
6159
7654
13141
14069
10276
10244
96417
4754
3210
5769
5315
8754
54
151
2302
2490
5393
5290
5126
12685
19566
11749
3809
78942
5733
5618
4734
5461
13060
10396
7930
7307
5955
4315
601
2281
2922
1431
1198
53161
2845
4538
6519
4710
14560
8229
3170
5736
2854
28965
5815
133
300
102
934
1019
831
22
50
1080
145
88
50
95
246
495
225
9080
813
396
1010
373
41
43
34
0
677
679
1550
120
0
252
220
1153
606
799
314
5214
689
51
180
317
323
2
4
51
269
347
514
79
630
964
517
277
3815
285
603
231
51
0
575
0
560
154
205
58
158
255
480
200
5041
305
328
308
654
2725
141
96
308
176
302291
70632
0
0
0
14448
17476
12776
0
0
0
0
4
0
0
5924
10641
9363
122407
10816
10648
9882
3232
0
0
0
6056
6898
4549
22023
0
0
5133
6537
8582
10567
8293
9191
51390
0
0
0
0
8093
0
0
0
0
0
51
4770
11708
18350
8418
0
36669
0
0
0
0
11937
9982
7761
6979
0
0
6
4
0
0
0
21193
0
0
1
0
13442
7750
0
0
0
323839
69806
1865
2165
4261
14120
6060
8253
2491
1009
1673
1917
1188
1586
3424
3336
8790
7668
126726
10264
12361
9791
2907
2458
1741
2223
7711
6028
3114
20973
2830
727
2733
5692
12495
7282
7034
8362
48888
2992
2204
3474
1744
4356
28
99
1183
742
4183
2550
1660
6078
10847
4824
1924
47063
2691
2331
2568
2321
10335
6203
4645
4270
3068
2635
561
1288
2510
832
805
31356
1473
3113
2347
4391
8777
5369
1509
2896
1481
292762
66578
1641
2173
4370
13204
7767
7855
2336
1185
1604
1713
1100
1498
2856
3017
8028
6231
104959
9184
11686
8816
2300
2157
1742
2148
5562
4990
2726
16089
2152
370
3597
4841
7848
6163
5042
7546
53080
3178
2273
3222
2856
4360
28
102
1187
1219
3533
3300
1687
6498
9315
7957
2365
42924
2878
2633
2105
2650
10289
5587
4096
3881
2477
2097
322
971
1751
596
591
25221
1211
2182
2068
3174
7430
4265
1161
2611
1119
229438
56022
811
2036
1059
4557
13001
7391
292
765
1318
1379
694
1026
1025
3072
7463
10133
61841
11211
3417
9637
2090
377
1141
1550
0
650
180
124
1604
0
3440
1463
9373
9003
5226
1355
56172
1578
986
1745
3114
3942
9
46
1314
1446
1872
3357
2611
6537
14151
11998
1466
28906
2495
1960
1722
2468
0
6558
3762
3961
2576
1018
139
1223
645
201
178
26497
1491
1604
4328
1024
6811
4304
1876
3526
1533
TT 2 &
TT 2+
3rd Dose
569585
129535
2936
4290
5249
18705
21747
17320
3216
2260
3303
3708
1867
2792
4352
7517
14399
15874
194759
21586
14555
16729
5851
3249
3280
4983
7043
7754
4964
26145
5499
861
6582
8342
17814
15677
13447
10398
103165
4906
3392
6188
5710
9234
45
155
2480
2913
5843
5932
5368
12893
19833
13991
4282
84784
6245
5751
5215
5689
12971
11599
8163
7997
6724
4829
740
2457
3445
1621
1338
57342
3195
4911
6920
5680
15420
8923
3304
6053
2936
TT 2+
2nd
Dose
552289
123991
2844
4297
5181
18165
20903
16627
3193
2080
3303
3633
1810
2669
4269
7023
14103
13891
188397
19738
14301
15024
5592
3404
3214
4862
7044
7218
5201
26674
5170
878
6489
8083
16032
16313
12749
10411
100867
4751
3350
6083
5844
9213
61
173
2388
2870
5786
5917
5193
13051
19505
12736
3946
82507
6094
5740
4948
5658
12672
11374
7992
7988
6429
4511
682
2360
3293
1535
1231
56527
3202
4788
6757
5356
15448
8749
3260
6036
2931
TT 2
1st Dose
555333
125535
2915
4333
5201
17961
21360
16756
3321
2114
3393
3655
1897
2694
4241
7075
14105
14514
189355
20814
14817
15867
5552
3267
3232
4795
6847
7260
5176
25864
5230
896
6448
8059
16614
15492
12706
10419
100707
4856
3316
5978
5658
9159
56
184
2349
2865
5685
5833
5226
12917
19429
13168
4028
83137
6124
5693
5075
5591
12906
11220
8062
7860
6611
4653
703
2422
3302
1612
1303
56599
3075
4711
6795
5479
15511
8834
3260
5963
2971
TT Pregnant Women
TT 1
3rd Dose
570453
129592
2961
4297
5261
18649
21747
17320
3216
2196
3307
3711
1876
2828
4350
7600
14399
15874
195383
21463
14577
16773
6039
3327
3285
4990
7023
7754
4967
26145
5408
861
6582
8372
18530
15915
13081
10291
103227
4905
3392
6190
5712
9234
47
155
2480
2998
5830
5926
5368
12893
19812
14006
4279
84849
6245
5770
5150
5689
12971
11599
8169
7997
6724
4826
741
2471
3523
1636
1338
57402
3219
4933
6948
5680
15420
8909
3304
6053
2936
Measles/Rubella
Japnese Encephalitis
2nd
Dose
67
68
69
70
71
72
73
74
75
1st Dose
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
3rd Dose
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
2nd
Dose
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
1st Dose
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
IPV
PCV
2nd
Dose
571420
128555
2861
4010
5251
18370
23375
16605
3200
2032
3307
3572
1822
2824
4002
7486
14436
15402
197697
20101
14086
15358
5853
3098
3112
4099
7103
12054
3620
33437
4826
842
5946
7679
16896
15307
12041
12239
103030
4451
3173
5369
4677
11867
28
133
2372
2435
5660
5069
6714
11663
23214
12585
3620
85890
6080
5625
5253
5603
13290
12358
7935
8686
6627
4809
761
2404
3521
1662
1276
56248
3308
4933
6550
5647
15305
9066
3309
5239
2891
Polio
1st Dose
51725
11603
672
534
616
640
899
688
570
361
501
763
446
698
911
607
1392
1305
16341
1230
892
1040
645
677
658
899
1249
688
390
1513
955
223
630
596
1163
1184
1076
633
11388
902
749
578
827
868
168
204
492
685
743
915
829
931
1072
928
497
7275
576
573
523
575
637
621
452
668
741
420
177
360
360
271
321
5118
336
576
908
679
614
277
372
852
504
DPT-Hep B-Hib
3 doze completion of DPTHepB-Hib & OPV after 1

year
BCG
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
HF Code
District/HF Name
Received Reports
Raw Data:Immunization (Sheet 1 of 2)
522200
122600
2452
4209
5429
17761
20768
15246
2628
1950
2922
3092
1794
2524
3881
6089
15491
16364
166800
20395
15103
18453
4390
2534
2883
3698
5562
5640
2906
16213
3756
370
7037
6304
17221
15166
10268
8901
109252
4756
3259
4967
5970
8302
37
148
2501
2665
5405
6657
4298
13035
23466
19955
3831
71830
5373
4593
3827
5118
10289
12145
7858
7842
5053
3115
461
2194
2396
797
769
51718
2702
3786
6396
4198
14241
8569
3037
6137
2652
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
Vaccine Received in Doses
Distric/HF Name
Received
Reports
HF Code
Raw Data:Immunization (Sheet 2 of 2)
BCG
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
51725
11603
672
534
616
640
899
688
570
361
501
763
446
698
911
607
1392
1305
16341
1230
892
1040
645
677
658
899
1249
688
390
1513
955
223
630
596
1163
1184
1076
633
11388
902
749
578
827
868
168
204
492
685
743
915
829
931
1072
928
497
7275
576
573
523
575
637
621
452
668
741
420
177
360
360
271
321
5118
336
576
908
679
614
277
372
852
504
2753797
626626
24770
32390
36050
48696
64737
56038
22028
18440
35699
32230
15129
27919
36510
38110
72080
65800
842665
70300
55969
42106
29762
32726
27947
37470
68125
21254
20300
115638
38004
9820
47790
36592
43730
59602
40370
45160
591825
40320
36854
42070
44630
56960
391
2390
17780
21818
32060
42480
59500
57700
56437
53245
27190
431231
43030
35645
27143
36500
46040
49800
40120
40960
43701
22559
3706
10306
18351
7570
5800
261450
17320
24140
35578
29819
49740
31160
16100
38553
19040
DPT-Hep B-Hib
2296956
525069
15501
18025
23280
65747
76897
65156
14199
11160
15680
17960
10893
17739
27500
30032
61700
53600
753849
75328
51663
58455
26758
17560
16188
24520
32805
18381
18642
108389
23707
4720
30280
34313
60770
59928
50022
41420
445299
23616
18261
30060
27750
44890
850
1850
10110
15428
24266
28734
31960
53260
65328
50466
18470
341959
29075
24045
21176
24540
45530
42055
30916
32480
31354
18020
3821
10979
15128
6990
5850
230780
13801
20502
27082
26120
56257
33450
12795
27603
13170
Vaccine Expenditure in Doses
Polio
PCV
IPV
Measles
JE
TT
BCG
2331268
530150
15631
18830
22730
65558
76600
64957
14260
11210
15504
17832
10751
18691
27500
30506
64530
55060
765469
80741
50988
58789
26738
17870
17202
24600
32621
18615
19373
109464
23663
4930
30440
35263
61030
59790
51008
42344
455563
24016
18930
30780
28980
45010
820
1890
10300
15893
24238
29589
33170
53640
66998
51549
19760
346582
29335
24936
21637
25170
45880
42140
31630
32910
31696
18156
3836
10719
15697
7000
5840
233504
13680
20540
27320
26410
58721
32200
12920
28573
13140
255624
79769
2720
3950
2859
10071
15026
10589
2484
1388
2399
1718
1684
2129
3342
3937
9863
5610
14482
2259
3763
1508
603
0
465
300
350
1067
0
0
0
0
0
559
1973
680
150
805
157221
7636
4754
9901
10270
19252
106
429
3107
6372
8638
12222
6419
19530
25583
15712
7290
2228
0
0
1260
0
0
0
60
0
90
0
306
312
0
180
20
1924
510
150
530
0
0
640
20
74
0
916720
189495
3882
10131
14101
10969
23390
19984
6389
5544
13557
8514
2417
9643
11146
9214
24664
15950
268710
15760
15819
13179
9533
8050
9293
13243
22121
8911
8372
33532
15932
3260
13805
13843
7398
22643
15179
18837
222497
13314
12360
15662
13231
15810
140
694
5968
9444
11314
22391
26235
25780
21073
18136
10945
143300
14975
5225
7803
14710
22030
12686
16057
13940
14532
6041
176
3352
8103
1760
1910
92718
3414
3880
13026
9559
20662
17228
4430
15219
5300
1631196
362873
12578
19380
20684
32217
36759
36760
12050
9160
17432
16417
8025
11795
20943
23134
46499
39040
512046
39381
37747
32198
19947
16390
15251
21059
33958
16280
14855
64520
22008
5070
24940
23370
30094
43667
25446
25865
348197
23130
18360
23215
23729
27560
460
1280
9084
12549
18021
28439
31205
37500
38007
37881
17777
246520
24595
21222
16267
19430
27900
28495
23345
18340
23068
13920
2596
7704
11268
4920
3450
161560
11010
14430
21430
17610
30860
17100
10680
27570
10870
575404
122246
0
0
0
21354
26204
22324
0
40
0
0
0
10
0
12628
22216
17470
240426
19649
19632
17780
8690
0
10
0
18873
7923
8691
41417
0
0
13931
14295
15636
20564
15204
18131
111828
0
0
0
0
19350
10
0
0
0
0
582
20888
24930
27458
18610
0
64426
0
0
0
0
18250
17618
13950
14550
0
0
6
32
0
20
0
36478
0
40
0
0
21327
15111
0
0
0
1439184
362178
8863
10840
15140
39955
77326
36989
9055
7530
8308
10194
7480
9347
20400
17845
48696
34210
462199
49269
36865
40729
17501
10940
10432
12906
19151
6959
8079
66138
12115
3260
18051
19854
40473
32901
29948
26628
265906
14950
12150
19520
17039
16990
325
1240
6292
8652
14227
18524
18250
30390
39500
37094
10763
210746
18885
12545
12930
14580
25580
25748
18070
18550
24181
11575
2546
7033
11451
3822
3250
138155
9070
13719
15442
16657
31375
18239
6721
17602
9330
2513400
584669
23481
28833
36024
45824
56199
49621
20608
18380
27339
30041
14140
26619
36510
35278
71882
63890
766882
68993
54444
41359
26996
31986
26589
30252
50416
30710
19735
84636
37882
9700
46550
33696
41173
53824
38873
39068
501469
36870
27292
42070
37068
40620
390
1730
17320
17760
30391
34671
38000
51220
50791
50204
25072
414425
41670
32293
26552
37180
44220
47260
37165
38820
42733
21406
3646
10103
18261
7316
5800
245955
17300
23489
35065
27827
45660
27850
14600
35164
19000
DPT-Hep B-Hib
2157100
501974
14922
16620
23043
62399
69174
61311
13706
11160
14102
16929
10451
17311
27500
29142
61674
52530
715384
73676
51045
57881
24884
17400
15798
21101
28605
24799
17537
88308
23338
4690
29480
32414
58732
60206
49755
35735
397826
22102
15229
30060
25120
34190
850
1720
9982
13013
23478
25125
23890
46960
60718
47911
17478
326993
28705
21741
20878
24360
43570
39345
27632
30790
30901
17057
3821
10385
15020
6938
5850
214923
13736
20206
26592
25209
50344
28257
11428
26031
13120
Polio
PCV
2183673
507334
14780
17498
22513
62052
69805
61023
13850
11210
14118
16833
10416
18311
27500
29491
64504
53430
719626
74243
50378
58096
25118
17660
16747
21399
29370
27060
17616
89492
22909
4900
29800
33349
59089
55763
49746
36891
408305
22471
15834
30790
26657
34820
820
1760
10170
13327
22934
25840
25330
47820
62349
48980
18403
331381
28845
21958
20668
24940
43790
39580
28599
31280
31336
17372
3836
10770
15659
6908
5840
217027
13594
20264
27102
24642
51644
28040
11558
27083
13100
238195
78520
2694
3940
2947
9716
13467
9934
2308
1395
2175
1725
3725
2105
3343
3722
9875
5449
15722
2309
3992
1398
493
30
445
230
200
1797
0
30
0
0
30
546
1940
1040
260
982
140023
6865
3854
9897
9288
15790
126
378
3032
5417
8153
10579
4271
16932
23885
14950
6606
2257
0
0
1269
0
0
0
50
0
90
0
336
312
0
180
20
1673
530
150
570
0
150
180
0
93
0
IPV
Measles
JE
TT
843068 1498756 513340 1289329

177672 340012 114468 304509
3588
12011
0
8596
9278
17503
1
9825
13930
20218
0
14871
10251
30354 20080
36981
20993
32313 23078
32219
18234
33338 20432
34225
6021
11235
0
8559
5504
9160
40
7530
10963
14081
0
7583
7672
15255
10
9513
2339
7504
20
6908
9068
11139
20
8916
11126
20932
0
20400
8666
21393 11848
16573
24629
46436 22189
48630
15410
37140 16750
33180
250689 471353 220191 424208
15733
37965 19040
45132
15306
36689 19056
35684
13291
31616 17561
40109
8681
17980
7730
15738
7850
15920
0
10744
8918
14481
60
10075
11106
17450
0
11117
18016
27657 15620
20075
10238
18831 10978
14312
7178
13319
7638
6793
29704
50407 31746
44475
15819
21236
0
10499
3240
5020
0
3220
13557
24485 13486
17209
12571
21777 13140
17783
6959
28934 14752
38545
20768
39961 18902
30278
14946
24982 15347
29459
16808
22643 15135
22961
190389 300930 88417 234386
12222
21204
0
14133
9676
13999
0
10303
15662
23215
0
19520
11136
20158
0
14354
11430
19860 13875
15030
150
450
10
315
534
1082
0
1105
5868
8844
0
6282
7832
10394
20
6863
10665
17056
0
13333
18231
23418
542
15653
19625
22305 11965
12730
21630
32710 20555
25630
19401
34618 24565
34916
16590
35230 16885
34047
9737
16387
0
10172
138823 235150 59334 199462
14645
24065
0
18235
5126
19304
0
11303
7833
15916
0
12615
14570
19220
0
14510
21130
26550 17040
24220
12040
26480 16367
23213
14560
21437 12419
15917
13370
17360 13460
17600
14720
22760
0
23782
5901
13164
0
10573
176
2606
6
2536
2979
6833
2
6567
8103
11200
0
11425
1760
4815
40
3720
1910
3440
0
3246
85495 151311 30930 126764
3414
10940
0
9047
3829
14162
40
13468
12721
20868
0
15150
8687
16703
0
14849
18735
28393 18737
26950
15424
14981 12153
15435
3847
9400
0
5894
13538
25024
0
16711
5300
10840
0
9260
339
Analyzed Data:Immunization (Sheet 1 of 2)

% of children 12-23 months
immunized
Coverage (% of children under one year immunized)

District
Code
District Name
Received
Reports
DPT-HepB-Hib
BCG
1st Dose
01
02
03
04
05
06
07
08
09
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
340
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
46389
10533
509
488
509
586
685
631
570
363
552
770
328
623
724
563
1392
1240
13955
1017
731
891
651
615
587
735
1291
540
279
1014
969
223
609
554
699
1058
1030
462
10534
905
740
756
721
696
148
195
471
685
690
807
776
885
902
767
390
6446
576
362
358
561
624
582
415
670
693
419
60
334
348
167
277
4921
333
480
866
655
620
263
351
849
504
93.9
99.1
100.1
97.0
90.2
100.9
106.9
94.7
89.6
94.6
97.8
93.4
79.9
84.8
93.5
102.1
100.9
103.5
90.2
115.8
94.0
82.8
86.4
72.3
72.6
66.9
88.7
121.8
54.9
88.6
82.2
88.0
79.7
81.5
99.6
91.9
83.8
95.6
93.3
76.6
86.7
76.2
81.1
109.1
23.0
52.0
91.4
74.3
91.3
83.5
119.9
81.3
113.8
91.0
79.6
99.1
107.4
101.4
105.0
95.1
102.8
105.5
81.1
103.7
98.3
106.2
80.0
83.9
93.3
107.8
91.9
89.5
93.6
98.0
97.7
104.7
83.1
85.1
93.3
83.7
87.9
93.7
99.9
103.6
103.9
90.3
102.4
99.5
98.8
90.0
102.3
97.8
97.0
82.3
84.9
101.6
103.7
100.6
106.6
89.2
123.6
97.3
90.4
89.2
77.6
76.7
81.5
87.7
78.3
75.3
69.3
92.2
90.0
88.2
88.8
109.2
95.6
91.0
80.4
93.5
84.4
92.7
87.8
99.0
84.9
38.5
60.6
95.6
91.5
94.0
97.6
95.8
89.8
97.1
101.2
94.1
97.9
110.4
104.0
103.0
96.6
100.3
99.0
83.5
95.5
99.8
106.6
77.9
86.3
93.3
106.1
96.3
91.4
91.0
98.0
103.7
105.3
83.8
83.7
93.2
96.8
89.3
2nd dose
91.2
96.7
102.0
104.8
89.3
98.6
97.7
95.6
93.0
98.5
100.4
95.6
83.2
80.9
99.0
96.5
98.5
97.5
86.4
119.9
98.9
85.6
82.0
76.2
75.4
78.3
85.5
73.4
78.5
68.5
89.1
93.6
86.5
85.5
97.9
93.0
88.4
81.4
91.2
83.5
90.6
84.8
98.1
84.2
45.9
71.9
90.5
87.4
91.7
96.1
93.3
90.0
95.3
95.2
88.6
95.9
108.2
102.6
101.5
94.9
99.8
95.8
82.4
93.8
98.1
102.7
73.9
84.6
87.5
104.5
93.8
90.1
87.0
93.6
101.4
101.6
84.3
83.0
92.0
95.3
90.3
Polio
3rd dose
90.7
95.5
99.5
103.9
88.9
99.7
95.6
94.9
89.4
96.9
97.7
95.0
79.4
80.1
99.7
95.8
98.5
93.3
86.0
113.7
95.4
81.0
82.6
79.4
75.0
79.4
88.0
72.9
78.9
70.7
88.1
91.8
87.0
85.7
94.5
97.9
88.7
81.4
91.3
81.7
91.5
86.3
101.3
84.7
50.0
67.6
92.0
87.6
93.3
97.5
92.7
90.9
95.6
92.1
86.7
95.2
107.7
103.4
98.9
96.1
98.0
97.1
81.6
95.4
95.4
99.6
71.7
82.5
87.2
99.6
88.6
90.0
90.6
95.1
100.8
99.3
83.9
82.2
92.0
96.5
89.1
1st Dose
93.6
99.8
102.8
103.8
90.1
102.7
99.5
98.8
90.0
105.3
97.7
96.9
81.9
83.8
101.6
102.5
100.6
106.6
88.9
124.3
97.1
90.2
86.4
75.8
76.6
81.3
88.0
78.3
75.3
69.3
93.7
90.0
88.2
88.5
105.0
94.1
93.6
81.3
93.4
84.4
92.7
87.8
99.0
84.9
36.9
60.6
95.6
88.9
94.2
97.7
95.8
89.8
97.2
101.1
94.1
97.8
110.4
103.6
104.3
96.6
100.3
99.0
83.4
95.5
99.8
106.6
77.8
85.8
91.2
105.1
96.3
91.3
90.4
97.5
103.2
105.3
83.8
83.8
93.2
96.8
89.3
2nd dose
91.3
96.7
104.9
104.7
88.2
98.3
97.7
95.6
93.0
98.5
100.8
95.4
83.0
80.6
99.2
95.4
98.5
97.5
86.8
119.9
96.4
83.2
94.5
75.7
75.3
77.7
85.6
73.6
78.5
68.5
88.4
93.6
86.6
85.5
96.0
95.6
88.3
87.8
91.2
83.5
90.6
84.8
96.9
84.2
45.9
71.9
90.5
87.0
91.7
96.6
93.3
90.0
95.4
95.1
88.6
95.7
108.2
102.3
98.4
94.9
99.8
95.8
82.3
93.8
98.1
102.7
73.6
83.3
87.3
105.9
93.7
90.1
85.8
93.6
101.3
101.6
84.3
83.3
92.0
95.3
90.3
PCV
3rd dose
90.4
95.5
102.7
104.0
92.5
99.6
95.6
94.9
89.4
96.9
96.9
94.9
78.4
78.4
97.4
94.7
98.5
93.3
85.2
111.1
94.4
80.0
81.3
78.7
74.3
79.0
88.0
73.0
78.7
70.5
87.5
91.8
87.0
85.5
93.0
93.8
90.1
82.0
91.5
81.6
91.5
86.3
101.5
84.7
49.2
67.6
92.0
87.3
93.2
97.8
92.7
90.9
97.0
92.0
84.6
95.0
107.7
103.1
98.4
96.1
98.0
97.1
81.5
95.4
95.4
99.8
72.2
81.0
86.8
97.3
88.7
89.8
89.6
95.1
99.3
99.3
83.9
82.2
92.0
96.5
89.1
1st Dose
15.7
22.9
28.8
35.7
22.2
21.0
23.7
24.0
29.9
21.1
30.5
20.2
16.0
19.5
25.3
20.2
25.4
15.5
1.2
1.5
4.7
2.6
0.7
0.0
0.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.4
4.7
1.4
0.0
0.7
56.6
54.0
51.6
56.0
67.8
60.8
28.7
38.7
60.6
74.0
55.8
86.1
35.7
55.7
53.4
45.5
66.9
0.4
0.0
0.0
4.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
5.9
1.9
0.0
0.0
0.0
0.3
1.7
0.6
0.4
0.0
0.0
0.5
0.0
0.0
0.0
2nd dose
10.8
14.8
15.5
25.2
12.7
15.1
18.7
14.7
18.6
13.2
13.4
11.0
13.6
10.8
17.7
13.1
15.1
8.0
0.5
0.5
2.8
0.4
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.3
0.6
0.0
0.2
40.7
32.9
28.5
38.2
45.2
49.0
21.3
40.2
36.5
54.0
40.7
60.2
27.3
41.7
41.5
31.4
45.1
0.1
0.0
0.0
1.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.7
0.9
0.0
0.0
0.0
0.1
0.3
0.3
0.2
0.0
0.0
0.0
0.0
0.0
0.0
IPV
Measles/Rubella
(Polio)
(9-11 months)
3rd dose
5.4
8.3
10.0
12.6
0.9
0.0
16.9
9.9
10.0
2.9
5.7
2.1
9.6
5.3
11.1
5.7
10.6
6.8
1.4
2.8
8.7
1.6
0.1
0.0
0.6
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
4.2
2.5
0.6
0.0
1.0
16.8
12.7
10.3
12.8
22.4
19.2
6.6
13.3
13.6
26.1
18.5
18.6
0.5
12.5
24.1
16.2
14.0
0.3
0.0
0.0
3.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.3
1.7
0.2
0.7
0.0
0.3
2.7
0.7
0.6
0.0
0.0
0.0
0.0
0.0
0.0
1st Dose
59.1
59.2
35.0
71.2
77.0
42.0
66.6
60.4
61.3
67.3
112.6
62.9
28.4
52.6
53.2
52.6
67.0
51.4
52.6
42.6
51.3
41.8
47.3
55.6
51.6
64.6
72.0
46.9
65.1
48.3
65.4
76.5
58.8
63.5
24.1
61.3
68.8
67.8
69.4
57.8
72.9
61.8
64.5
52.8
14.8
41.4
89.1
92.6
75.2
78.1
114.1
70.8
72.9
55.0
62.2
62.8
77.9
31.4
51.6
71.1
85.1
44.3
72.2
70.8
68.1
50.5
3.8
49.5
63.8
46.2
62.1
58.0
32.7
48.8
68.4
53.4
60.3
71.1
47.6
53.1
50.8
85.0
90.3
89.1
91.6
86.6
93.3
90.6
90.2
88.7
86.8
96.4
88.4
79.3
78.9
89.6
94.0
95.5
84.9
78.4
88.8
89.8
70.2
75.7
79.4
76.7
77.8
84.0
69.8
78.9
72.7
77.8
86.8
82.6
81.2
77.5
84.5
71.5
80.0
87.3
81.8
87.7
81.8
92.1
80.5
44.3
59.0
88.7
76.0
87.0
87.1
91.5
88.4
95.9
84.9
83.7
91.1
101.3
101.2
94.7
92.7
101.0
88.8
81.0
87.2
88.4
95.3
63.2
79.6
77.4
92.8
86.3
84.6
80.5
90.1
97.3
87.3
79.1
77.3
89.4
91.7
86.8
Japanese
Encephalitis
% of children under one year

fully immunized as per NIP
schedule
2nd Dose
5.0
4.7
4.9
7.7
1.8
5.4
4.9
5.0
0.7
2.4
33.2
4.0
4.1
1.6
2.3
3.5
3.6
1.6
4.4
4.9
2.8
5.7
5.8
1.0
1.1
0.6
0.0
7.2
11.0
4.3
2.2
0.0
3.6
2.5
7.1
3.8
5.7
2.6
5.0
12.8
1.5
2.7
5.9
3.2
1.8
1.6
2.1
8.9
6.0
9.0
1.5
4.6
5.0
3.9
6.5
4.7
5.4
11.6
4.9
0.9
0.0
5.1
0.0
7.1
2.4
4.8
6.5
5.8
7.2
33.7
15.6
8.5
9.2
6.9
4.9
13.0
15.6
1.4
2.9
5.3
5.7
52.5
57.3
0.0
0.0
0.0
84.1
84.7
76.7
0.0
0.0
0.0
0.0
0.2
0.0
0.0
85.4
77.1
66.0
58.8
65.6
74.4
55.7
50.4
0.0
0.0
0.0
80.8
73.7
73.8
61.5
0.0
0.0
73.4
73.3
52.5
65.8
59.6
76.4
49.4
0.0
0.0
0.0
0.0
79.0
0.0
0.0
0.0
0.0
0.0
0.9
90.8
86.3
94.7
63.9
0.0
44.8
0.0
0.0
0.0
0.0
97.5
89.3
84.5
88.2
0.0
0.0
0.7
0.2
0.0
0.0
0.0
35.9
0.0
0.0
0.0
0.0
77.1
77.3
0.0
0.0
0.0
73.4
84.6
58.8
99.2
74.6
90.2
56.9
84.1
98.7
86.8
98.1
86.9
72.0
67.4
83.4
123.1
79.8
107.8
59.1
63.8
85.1
61.6
73.7
75.2
69.7
55.9
76.0
47.1
36.6
37.1
74.2
90.1
72.2
70.4
50.5
94.5
35.0
46.0
68.8
76.9
86.2
73.9
68.7
47.6
61.5
48.4
67.7
52.9
68.5
76.6
83.4
90.6
70.2
47.1
65.0
83.0
101.0
76.3
93.0
102.9
79.1
86.8
68.6
83.9
92.7
95.1
32.7
41.5
83.5
124.0
0.0
94.5
93.0
77.8
98.9
103.9
77.1
125.1
129.8
89.1
69.1
Analyzed Data:Immunization (Sheet 2 of 2)
Dropout Rate
District
Code
01
02
03
04
05
06
07
08
09
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
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
51718
11603
672
534
616
640
899
688
570
361
501
763
446
698
911
607
1392
1305
16341
1230
892
1040
645
677
658
899
1249
688
390
1513
955
223
630
596
1163
1184
1076
633
11388
902
749
578
827
868
168
204
492
685
743
915
829
931
1072
928
497
7268
576
573
528
575
637
621
452
668
741
420
177
348
360
271
321
5118
336
576
908
679
614
277
372
852
504
DPT-HepB-Hib 1
vs 3
3.2
4.3
4.0
0.0
1.5
2.6
3.9
4.0
0.7
5.3
0.1
2.1
3.5
5.6
1.9
7.6
2.1
12.5
3.6
8.0
1.9
10.4
7.4
-2.3
2.2
2.6
-0.3
6.9
-4.7
-2.0
4.4
-2.0
1.4
3.5
13.5
-2.5
2.5
-1.2
2.3
3.1
1.2
1.7
-2.3
0.2
-29.8
-11.6
3.7
4.3
0.8
0.2
3.3
-1.2
1.6
9.1
7.8
2.8
2.4
0.5
3.9
0.5
2.3
1.9
2.2
0.1
4.4
6.5
8.0
4.4
6.5
6.2
8.0
1.5
0.5
2.9
2.8
5.7
-0.2
1.8
1.3
0.3
0.2
WASTAGE RATE
DPT-HepB-Hib1 vs
measles/rubella 1
BCG
9.3
9.6
14.1
11.8
4.1
8.8
8.9
8.7
1.5
15.1
1.5
8.9
3.6
7.0
11.8
9.3
5.1
20.4
12.1
28.1
7.7
22.4
15.1
-2.3
-0.1
4.5
4.3
10.9
-4.8
-4.9
15.6
3.5
6.4
8.6
29.1
11.6
21.4
0.5
6.6
3.1
5.4
6.8
7.0
5.2
-14.9
2.6
7.2
16.9
7.5
10.7
4.5
1.6
1.2
16.1
11.0
7.0
8.2
2.6
8.1
4.0
-0.7
10.4
2.9
8.6
11.4
10.6
18.9
7.7
17.1
12.5
10.5
7.4
11.6
8.0
6.2
17.1
5.6
7.6
4.1
5.2
2.8
DPT-Hep B-Hib
77.3
78.0
87.8
86.1
85.4
59.9
58.4
66.5
84.5
88.9
87.9
88.1
87.1
89.4
89.0
78.8
79.9
75.9
74.2
70.9
74.1
62.9
78.3
90.3
88.3
86.5
85.9
60.8
81.7
60.5
87.3
91.3
87.2
77.2
59.0
71.6
69.0
68.7
79.5
87.9
88.4
87.2
87.4
70.8
92.8
92.3
86.3
86.3
81.4
85.4
82.3
77.2
54.3
74.9
85.6
79.3
85.4
82.6
80.2
84.9
70.0
73.9
78.7
77.6
84.5
77.5
79.1
75.9
80.7
77.3
78.0
77.1
80.9
79.0
81.3
79.7
66.5
67.5
77.3
85.1
84.8
22.2
24.5
41.6
22.2
32.1
12.2
7.5
17.3
29.0
42.7
29.1
35.0
46.6
52.7
53.2
25.5
30.9
15.7
19.9
15.8
14.4
17.7
31.0
42.5
38.4
30.6
26.9
10.4
12.5
10.9
32.3
43.8
33.8
24.4
12.9
20.7
22.6
12.9
23.4
34.3
34.0
39.3
31.5
19.3
80.7
70.2
27.7
32.9
26.3
29.7
33.9
17.3
3.3
16.7
29.9
23.4
35.7
20.9
27.3
30.5
11.5
13.1
12.3
22.6
36.0
18.0
44.4
29.2
32.6
31.1
33.8
20.7
30.9
28.6
22.9
34.5
7.9
6.3
14.0
30.7
32.6
Polio
(OPV)
23.3
25.3
40.0
26.2
29.9
11.8
8.3
16.9
29.8
42.4
29.3
34.7
46.8
55.8
53.6
27.2
34.0
17.1
20.6
16.9
14.4
19.1
29.3
44.1
42.2
31.8
28.7
17.7
13.0
12.2
30.9
46.2
34.5
26.6
15.6
15.3
21.4
12.9
25.3
35.5
36.5
40.7
35.7
20.7
80.4
70.9
29.0
35.3
24.5
31.4
37.7
18.7
5.3
18.6
33.9
24.5
36.0
21.9
27.1
32.1
12.0
13.6
15.4
23.8
36.9
19.4
44.6
32.9
36.0
31.2
33.7
21.5
30.9
28.9
24.9
33.0
10.2
5.3
15.0
33.4
32.5
PCV
18.7
24.0
42.5
22.9
29.2
32.3
3.8
14.3
9.5
42.8
22.9
26.2
76.0
43.7
30.7
23.2
25.9
17.5
55.8
63.9
39.3
38.9
89.5
100.0
82.5
97.0
100.0
100.0
0.0
100.0
0.0
0.0
100.0
19.6
16.6
60.0
100.0
76.0
10.0
15.6
14.1
23.8
15.9
11.2
45.2
37.6
5.2
6.7
12.5
5.3
16.7
6.9
-1.5
13.8
13.3
68.6
0.0
0.0
62.9
0.0
0.0
0.0
100.0
0.0
100.0
0.0
72.0
59.0
0.0
94.4
100.0
77.7
68.7
46.7
86.3
0.0
100.0
72.8
0.0
100.0
0.0
Polio
Measles
(IPV)
57.3
56.8
72.1
68.3
67.8
25.4
30.7
42.0
63.6
73.8
65.3
68.7
72.3
80.7
79.5
55.5
61.1
50.4
54.0
52.9
49.8
41.7
63.1
69.6
75.2
64.4
68.0
54.7
40.2
38.6
75.8
77.4
67.7
52.4
41.4
50.9
33.8
48.4
59.8
72.5
72.4
72.2
66.6
49.8
88.0
80.2
60.6
61.3
56.3
74.0
67.4
53.0
23.4
54.1
71.0
60.8
69.9
66.0
67.1
71.3
47.9
56.9
51.4
55.7
68.8
61.2
79.6
51.8
70.3
59.6
54.8
57.4
66.1
35.8
64.0
66.8
40.8
50.9
56.2
75.5
68.5
63.6
63.8
77.7
76.6
74.5
40.9
35.6
50.1
71.6
79.1
69.2
76.9
74.7
76.0
81.2
66.6
69.5
65.4
61.7
57.2
62.2
55.6
69.4
78.4
77.0
72.5
75.7
59.7
55.8
42.5
77.9
83.5
73.8
63.8
50.6
63.3
55.7
53.4
66.2
74.3
76.7
74.4
72.1
54.3
87.6
85.7
73.4
73.5
66.4
75.2
76.7
59.3
40.7
65.2
75.1
64.8
75.0
67.8
68.8
71.3
50.8
58.6
63.0
54.7
73.2
65.7
74.7
63.7
71.6
60.3
59.4
61.5
71.2
65.6
67.3
67.9
39.1
44.1
65.3
75.9
72.1
JE
41.1
38.3
0.0
100.0
0.0
28.1
24.3
37.5
0.0
100.0
0.0
100.0
80.0
100.0
0.0
50.0
52.0
44.1
44.4
43.2
44.1
43.7
58.2
0.0
100.0
0.0
61.2
37.2
40.4
30.6
0.0
0.0
61.9
50.3
41.8
44.1
46.0
39.3
41.9
0.0
0.0
0.0
0.0
41.7
100.0
0.0
0.0
100.0
0.0
90.6
60.1
43.0
25.3
50.2
0.0
38.2
0.0
0.0
0.0
0.0
30.0
39.0
37.5
48.2
0.0
0.0
0.0
-100.0
0.0
100.0
0.0
31.5
0.0
100.0
0.0
0.0
28.3
36.2
0.0
0.0
0.0
TD
34.4
36.8
49.8
35.1
34.8
13.8
16.7
31.3
40.2
60.7
39.4
47.4
56.8
53.9
64.2
43.1
50.1
27.6
30.8
32.1
23.0
29.6
53.6
53.5
54.1
46.7
33.9
18.5
11.4
16.4
37.3
65.9
43.2
32.5
22.9
25.9
41.3
24.8
32.5
45.2
47.0
56.8
46.3
15.8
79.4
77.7
41.4
50.4
28.1
41.2
53.2
25.4
1.7
27.2
43.4
40.4
55.8
38.7
49.3
48.7
14.9
21.0
21.5
31.2
65.9
45.6
59.7
46.6
57.1
56.2
51.5
34.5
53.9
48.8
42.3
42.2
14.6
9.7
22.9
46.0
55.4
341
Raw Data:Nutrition (Sheet 1 of 8)
Nutritional status of registered children (New)

District
Code
District Name
Received
Reports
0-11 M
Normal
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
342
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50339
11393
667
493
590
599
814
665
570
371
516
759
433
702
901
611
1392
1310
15450
1207
875
1011
657
670
661
889
1217
614
333
983
955
223
634
582
1160
1140
1061
578
11273
943
746
628
829
786
167
204
486
685
741
907
842
908
987
920
494
7143
581
559
519
574
625
586
426
646
736
419
164
357
356
282
313
5080
336
569
905
665
602
276
371
852
504
589759
127262
4019
4197
6059
17980
20516
12472
3479
2059
3990
4485
3298
4062
4618
8192
17092
10744
172793
11417
16939
14793
5426
3880
3669
7831
5536
10006
5692
16969
6031
1030
6185
9956
9895
16463
10953
10122
131952
7299
5800
7653
5379
8900
78
401
3012
3273
9362
8010
6476
16589
31161
12857
5702
90167
6246
5200
6209
6345
15718
9741
8374
8368
6402
4859
1262
5111
2820
1574
1938
67585
2209
7102
8358
5337
15162
7020
2680
15621
4096
Moderate
12868
1409
59
16
21
63
149
184
23
19
31
33
34
30
51
129
239
328
3650
131
514
251
58
16
65
290
75
603
76
80
91
6
145
67
291
544
182
165
1676
14
65
47
31
45
0
2
7
31
37
40
256
246
206
595
54
3917
118
54
189
151
807
372
241
113
161
371
6
625
353
129
227
2216
319
132
176
399
281
204
51
553
101
12-23 M
Severe
3939
441
45
0
22
2
27
133
8
2
9
46
18
10
4
17
70
28
1433
12
100
36
6
5
0
25
31
735
15
64
5
1
10
25
100
89
47
127
309
5
9
28
2
9
0
0
27
6
2
3
48
4
11
149
6
1187
51
20
133
17
173
98
98
32
32
70
4
184
203
57
15
569
79
28
65
71
61
170
1
87
7
Total
Normal
606566
129112
4123
4213
6102
18045
20692
12789
3510
2080
4030
4564
3350
4102
4673
8338
17401
11100
177876
11560
17553
15080
5490
3901
3734
8146
5642
11344
5783
17113
6127
1037
6340
10048
10286
17096
11182
10414
133937
7318
5874
7728
5412
8954
78
403
3046
3310
9401
8053
6780
16839
31378
13601
5762
95271
6415
5274
6531
6513
16698
10211
8713
8513
6595
5300
1272
5920
3376
1760
2180
70370
2607
7262
8599
5807
15504
7394
2732
16261
4204
307237
57230
1960
1468
1860
6686
7472
5832
894
666
1633
2177
1662
2672
3072
3590
11010
4576
94674
9593
13536
12306
2762
1635
1130
2493
4704
1228
1879
9577
2490
710
2077
3314
9892
7388
6067
1893
73129
3768
3082
2426
3467
4126
26
196
2131
1465
5591
4415
2855
6800
23474
6699
2608
47467
3620
1830
1617
4224
4765
4122
5200
5900
2342
2909
489
3921
2186
2312
2030
34737
1518
3559
3133
3729
3766
4295
729
11183
2825
Moderate
11156
1321
5
10
33
96
171
135
32
10
13
72
25
14
56
80
345
224
2945
196
552
384
72
22
9
129
66
33
12
125
84
11
135
77
282
533
130
93
1262
16
124
45
25
103
2
2
21
17
28
56
32
98
157
497
39
3185
75
25
127
170
242
261
146
134
63
288
11
766
328
294
255
2443
281
118
445
355
179
494
5
468
98
Total
Severe
2762
492
0
10
7
1
81
95
8
2
10
59
2
47
12
16
110
32
648
33
115
61
9
10
1
52
30
5
1
23
6
4
8
9
28
105
9
139
249
7
16
2
2
1
0
2
2
1
0
0
2
1
4
205
4
868
19
23
21
16
65
99
59
22
4
139
2
157
150
81
11
505
53
2
56
88
14
203
1
84
4
Total
321155
59043
1965
1488
1900
6783
7724
6062
934
678
1656
2308
1689
2733
3140
3686
11465
4832
98267
9822
14203
12751
2843
1667
1140
2674
4800
1266
1892
9725
2580
725
2220
3400
10202
8026
6206
2125
74640
3791
3222
2473
3494
4230
28
200
2154
1483
5619
4471
2889
6899
23635
7401
2651
51520
3714
1878
1765
4410
5072
4482
5405
6056
2409
3336
502
4844
2664
2687
2296
37685
1852
3679
3634
4172
3959
4992
735
11735
2927
Normal
896996
184492
5979
5665
7919
24666
27988
18304
4373
2725
5623
6662
4960
6734
7690
11782
28102
15320
267467
21010
30475
27099
8188
5515
4799
10324
10240
11234
7571
26546
8521
1740
8262
13270
19787
23851
17020
12015
205081
11067
8882
10079
8846
13026
104
597
5143
4738
14953
12425
9331
23389
54635
19556
8310
137634
9866
7030
7826
10569
20483
13863
13574
14268
8744
7768
1751
9032
5006
3886
3968
102322
3727
10661
11491
9066
18928
11315
3409
26804
6921
Moderate
24024
2730
64
26
54
159
320
319
55
29
44
105
59
44
107
209
584
552
6595
327
1066
635
130
38
74
419
141
636
88
205
175
17
280
144
573
1077
312
258
2938
30
189
92
56
148
2
4
28
48
65
96
288
344
363
1092
93
7102
193
79
316
321
1049
633
387
247
224
659
17
1391
681
423
482
4659
600
250
621
754
460
698
56
1021
199
Severe
6701
933
45
10
29
3
108
228
16
4
19
105
20
57
16
33
180
60
2081
45
215
97
15
15
1
77
61
740
16
87
11
5
18
34
128
194
56
266
558
12
25
30
4
10
0
2
29
7
2
3
50
5
15
354
10
2055
70
43
154
33
238
197
157
54
36
209
6
341
353
138
26
1074
132
30
121
159
75
373
2
171
11
Total
927721
188155
6088
5701
8002
24828
28416
18851
4444
2758
5686
6872
5039
6835
7813
12024
28866
15932
276143
21382
31756
27831
8333
5568
4874
10820
10442
12610
7675
26838
8707
1762
8560
13448
20488
25122
17388
12539
208577
11109
9096
10201
8906
13184
106
603
5200
4793
15020
12524
9669
23738
55013
21002
8413
146791
10129
7152
8296
10923
21770
14693
14118
14569
9004
8636
1774
10764
6040
4447
4476
108055
4459
10941
12233
9979
19463
12386
3467
27996
7131
Nutritional status of registered children (Repeated)

District
Code
District Name
Received
Reports
0-11 M
Normal
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50339
11393
667
493
590
599
814
665
570
371
516
759
433
702
901
611
1392
1310
15450
1207
875
1011
657
670
661
889
1217
614
333
983
955
223
634
582
1160
1140
1061
578
11273
943
746
628
829
786
167
204
486
685
741
907
842
908
987
920
494
7143
581
559
519
574
625
586
426
646
736
419
164
357
356
282
313
5080
336
569
905
665
602
276
371
852
504
909327
228268
8946
5517
11967
28362
42212
21930
9453
4887
7165
12566
8021
8525
8406
14006
25643
10662
229331
8352
14834
6815
8339
7171
10792
12537
14767
10002
7899
38652
7349
1848
17478
23114
3937
14697
4049
16699
235692
14260
11550
15855
21885
26017
172
539
8969
8798
19637
20130
20134
29019
16840
10674
11213
98552
10976
7199
7249
6288
10606
10009
14126
8084
10152
4769
184
5023
1574
1876
437
117484
1542
11509
27293
5411
25162
7062
21124
10184
8197
Moderate
12062
1925
36
17
89
172
390
60
21
21
5
162
109
69
76
199
248
251
2744
41
205
254
40
36
93
115
123
33
19
85
70
19
456
155
139
268
113
480
1569
15
109
181
25
68
3
2
39
165
38
107
72
280
39
358
68
2890
125
47
189
123
252
495
244
69
169
228
1
643
144
91
70
2934
253
195
711
350
400
157
477
208
183
12-23 M
Severe
Total
3353
692
5
6
94
5
155
2
1
3
5
27
198
57
25
38
26
45
641
23
5
20
24
14
2
37
28
65
5
62
0
7
117
47
40
51
10
84
262
4
5
33
0
31
0
6
12
3
2
17
12
7
0
122
8
1086
10
50
39
44
156
99
62
2
191
35
0
192
43
133
30
672
45
46
179
87
104
83
90
26
12
924742
230885
8987
5540
12150
28539
42757
21992
9475
4911
7175
12755
8328
8651
8507
14243
25917
10958
232716
8416
15044
7089
8403
7221
10887
12689
14918
10100
7923
38799
7419
1874
18051
23316
4116
15016
4172
17263
237523
14279
11664
16069
21910
26116
175
547
9020
8966
19677
20254
20218
29306
16879
11154
11289
102528
11111
7296
7477
6455
11014
10603
14432
8155
10512
5032
185
5858
1761
2100
537
121090
1840
11750
28183
5848
25666
7302
21691
10418
8392
Normal
467874
123506
4818
2552
3654
17857
16743
9853
2862
2070
2853
4881
12785
5073
5166
6718
18505
7116
101058
6571
13671
5385
3518
1920
3056
3371
9241
4405
1901
8500
2076
626
9838
5907
3774
7837
3010
6451
93507
5741
5834
3343
6702
8021
112
317
3450
2722
7843
9549
8971
10506
11145
6518
2733
60929
3675
3915
2243
4671
5242
6005
10927
6312
4973
3413
103
4866
1388
2860
336
88874
1501
5606
28715
4821
10632
1921
21087
8018
6573
Moderate
14018
2535
29
84
31
125
139
325
57
48
11
112
315
12
157
222
536
332
2622
151
241
101
68
34
70
214
194
92
7
106
108
13
310
182
137
280
125
189
1652
20
191
130
70
315
0
2
25
44
61
176
62
143
50
330
33
3664
91
128
112
219
268
382
262
108
282
253
2
1153
161
196
47
3545
177
204
1160
255
481
69
778
306
115
Total
Severe
2917
595
12
3
48
0
111
22
1
0
14
62
110
8
24
32
75
73
663
74
52
20
15
9
10
128
41
19
1
71
14
2
61
11
18
38
1
78
220
2
44
37
6
6
0
2
16
1
4
0
6
7
2
65
22
802
61
60
22
35
35
86
64
29
16
43
0
249
77
17
8
637
37
15
190
16
86
73
147
67
6
Total
Normal
484809
126636
4859
2639
3733
17982
16993
10200
2920
2118
2878
5055
13210
5093
5347
6972
19116
7521
104343
6796
13964
5506
3601
1963
3136
3713
9476
4516
1909
8677
2198
641
10209
6100
3929
8155
3136
6718
95379
5763
6069
3510
6778
8342
112
321
3491
2767
7908
9725
9039
10656
11197
6913
2788
65395
3827
4103
2377
4925
5545
6473
11253
6449
5271
3709
105
6268
1626
3073
391
93056
1715
5825
30065
5092
11199
2063
22012
8391
6694
1377201
351774
13764
8069
15621
46219
58955
31783
12315
6957
10018
17447
20806
13598
13572
20724
44148
17778
330389
14923
28505
12200
11857
9091
13848
15908
24008
14407
9800
47152
9425
2474
27316
29021
7711
22534
7059
23150
329199
20001
17384
19198
28587
34038
284
856
12419
11520
27480
29679
29105
39525
27985
17192
13946
159481
14651
11114
9492
10959
15848
16014
25053
14396
15125
8182
287
9889
2962
4736
773
206358
3043
17115
56008
10232
35794
8983
42211
18202
14770
Moderate
26080
4460
65
101
120
297
529
385
78
69
16
274
424
81
233
421
784
583
5366
192
446
355
108
70
163
329
317
125
26
191
178
32
766
337
276
548
238
669
3221
35
300
311
95
383
3
4
64
209
99
283
134
423
89
688
101
6554
216
175
301
342
520
877
506
177
451
481
3
1796
305
287
117
6479
430
399
1871
605
881
226
1255
514
298
Severe
6270
1287
17
9
142
5
266
24
2
3
19
89
308
65
49
70
101
118
1304
97
57
40
39
23
12
165
69
84
6
133
14
9
178
58
58
89
11
162
482
6
49
70
6
37
0
8
28
4
6
17
18
14
2
187
30
1888
71
110
61
79
191
185
126
31
207
78
0
441
120
150
38
1309
82
61
369
103
190
156
237
93
18
Total
1409551
357521
13846
8179
15883
46521
59750
32192
12395
7029
10053
17810
21538
13744
13854
21215
45033
18479
337059
15212
29008
12595
12004
9184
14023
16402
24394
14616
9832
47476
9617
2515
28260
29416
8045
23171
7308
23981
332902
20042
17733
19579
28688
34458
287
868
12511
11733
27585
29979
29257
39962
28076
18067
14077
167923
14938
11399
9854
11380
16559
17076
25685
14604
15783
8741
290
12126
3387
5173
928
214146
3555
17575
58248
10940
36865
9365
43703
18809
15086
343
Pregnant women receiving

District
Code
District Name
Iron tablets at first time
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
344
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50339
11393
667
493
590
599
814
665
570
371
516
759
433
702
901
611
1392
1310
15450
1207
875
1011
657
670
661
889
1217
614
333
983
955
223
634
582
1160
1140
1061
578
11273
943
746
628
829
786
167
204
486
685
741
907
842
908
987
920
494
7143
581
559
519
574
625
586
426
646
736
419
164
357
356
282
313
5080
336
569
905
665
602
276
371
852
504
502240
120054
2493
3479
3406
16944
22888
15106
2906
1789
2862
3352
2183
2560
4210
6485
16478
12913
147852
15638
15838
15693
5359
2809
2888
3698
4127
10367
2989
5161
5546
766
5653
6940
14634
12381
9585
7780
103950
4400
3165
5539
4834
10671
55
154
2122
1915
5625
5669
7384
13244
23682
12403
3088
75633
5318
3689
4592
5375
10283
12107
8231
7870
4650
3686
495
2716
3377
1854
1390
54751
2751
4722
7717
4677
12539
8293
3073
8363
2616
180 iron tablets
319073
72703
1478
1969
2252
8764
13705
10206
1655
721
1760
1804
1505
1667
2582
3707
12306
6622
86424
5371
9838
8550
2556
1911
1986
2174
2006
9167
733
3645
3134
371
4654
4037
10099
7194
4948
4050
76185
2748
3229
2630
3676
8638
25
41
1833
1556
3593
4478
3761
9476
18779
9575
2147
45593
2423
2184
3040
2943
7113
6196
5883
4914
2952
1828
285
2565
1390
1062
815
38168
1654
2602
5079
3672
9714
4810
3219
5662
1756
< 5 yrs Children receiving
PP mother receiving
Received
Reports
De-worming tablets
464201
105396
2461
3428
3380
12390
16213
13355
2858
1749
2840
3085
2048
2443
3631
5865
16346
13304
134325
13408
14056
14615
5144
2757
2925
3266
3980
10024
1967
4920
3985
761
5554
6649
13123
11683
8358
7150
99544
4319
2931
5400
4439
11784
56
139
2101
1910
5575
5675
7377
12992
19977
11747
3122
74275
5206
3970
4747
5477
9972
11462
8294
7701
4573
3494
519
2327
3363
1782
1388
50661
2713
4682
7304
4228
12489
8216
3068
5501
2460
45 iron tablets
Vitamin A cap.
303414
62233
1455
2220
1957
7237
7707
7130
1546
870
1515
2473
1361
2244
2990
4508
9742
7278
83801
7002
9649
10417
2896
1823
2439
2242
1910
9082
1341
2486
1993
291
3206
2145
9239
7637
5744
2259
67620
2807
2138
2131
2643
12383
20
82
1774
1066
3532
3916
6788
6892
10239
9378
1831
51299
4290
2327
2673
4083
7968
6065
5632
6262
3946
2353
284
1429
2168
973
846
38461
2036
3352
5651
3459
7527
5400
2939
5934
2163
301547
60979
1450
2204
2297
7546
7069
7386
1665
877
1387
2139
1354
2194
2514
4375
9440
7082
85350
6672
9338
10642
3055
1863
2207
1705
1797
9107
1340
2972
1991
321
3250
3869
9472
7646
5878
2225
64930
2789
2147
2182
2588
12374
20
79
1701
1035
3681
3872
6790
6079
9904
7891
1798
53504
4354
2573
2693
4056
7958
8222
5032
6697
4225
2044
286
1417
2186
915
846
36784
2038
3381
5754
3437
7575
5364
2874
4219
2142
(Bi-annual)
Vitamin A
6-11M
12-59M
535276
106560
2116
3332
4559
13514
16895
9340
1786
2331
3441
4645
2422
3300
6246
5659
13565
13409
177808
12675
12555
22127
7990
4156
4335
3452
6615
3875
2802
13576
6808
886
5516
8825
21144
18632
12365
9474
93940
5098
2412
6675
5834
4654
61
203
2620
1650
5067
6368
5187
13357
16301
15148
3305
98017
6916
5794
6832
9552
13112
12130
8686
9313
8843
5348
961
1912
5060
2779
779
58951
5794
5182
9275
4799
11244
9620
3372
6369
3296
3574154
737574
14240
23288
33636
98582
118155
71696
12874
15717
18233
26394
17915
23604
41501
32820
102844
86075
1180965
78472
94954
134485
50050
28914
24853
25559
51449
36669
25959
106901
44967
6428
41728
68993
92224
112925
82883
72552
651942
31556
16420
53619
41746
35650
427
1473
16704
11920
32183
43191
39407
98450
114654
89714
24828
608902
44297
33235
37544
44739
76608
87520
68246
69077
49703
27578
5320
10442
35121
14619
4853
394771
34221
35844
54109
27587
83767
72258
22699
42885
21401
Students received Deworming tablet
Deworming tablet
3494686
719958
13893
21286
34533
99516
117664
68430
11077
14471
18278
24733
17430
21365
41501
34721
101911
79149
1190674
78394
91462
135653
48747
29047
24052
23471
52011
35996
25426
105677
45024
6545
42957
69358
99758
108447
84561
84088
637267
29482
15883
54262
41948
26561
402
1534
18662
12153
31797
43270
39431
98952
112791
86016
24123
571740
31174
32392
37533
31827
77156
81869
61969
67701
49840
27772
6806
12374
33787
14646
4894
375047
35233
37159
43994
28691
86846
60635
18325
42192
21972
Girls
838380
140210
5888
42
3077
4172
1848
211
180
289
30870
2185
28167
952
58697
412
2070
1150
206951
3468
3556
4020
15694
24350
6807
19740
39041
11661
185
1545
4419
1277
26044
9433
8252
4259
4686
18514
284169
47139
97
10934
11266
511
26
195
110
72
971
23412
67722
68648
48656
2629
1781
141469
2115
1175
24927
3424
4
29907
585
1364
698
1439
1415
13745
58437
1561
673
65581
12217
10506
1025
2506
508
40
13062
791
24926
Boys
797794
130808
5462
36
1860
3616
1427
195
103
346
29346
2462
26476
948
55208
427
1951
945
188584
3198
2389
4064
12914
21290
5790
17220
33471
10969
129
1515
3622
1242
24731
10099
9576
2366
6384
17615
283366
43167
104
9093
9599
1556
26
209
99
67
872
22326
68844
73098
50142
2452
1712
132794
1965
490
22940
3146
3
28559
683
1260
717
1337
978
12255
56176
1809
476
62242
11651
10233
152
2410
342
30
12814
588
24022
Admission
Children at End of Last Month

District
Code
District Name
Received
Reports
<6 months
Female
Male
New
6-59 months
Total
152 158 310
Female
Male
Total
Total
Female
National Total
50339
EASTERN
11393
10
1 TAPLEJUNG
667
2 PANCHTHAR
493
3 ILAM
590
4 JHAPA
599
13
5 MORANG
814
6 SUNSARI
665
7 DHANKUTA
570
8 TERHATHUM
371
9 SANKHUWASABHA
Male
<6 months
Total
Female
7047 5577 12624
7199 5735 12934
2267 1539
2273 1543
Total
96 109 205
Female
Male
Total
Total
Female
<6 months
Male
Total
Female
Male
6-59 months
Total
Female
Male
2698 2148 4846
2794 2257 5051
17
82
517 367 884
519 368 887
Total
Total
81 163
Female
Male
Total
91
89
180
3816
11
16
11
16
18
31
14
19
33
12
16
28
14
17
31
516
10 BHOJPUR
759
11 SOLUKHUMBU
433
12 OKHALDHUNGA
702
49
49
98
49
49
98
30
22
52
30
22
52
13 KHOTANG
901
14 UDAYAPUR
611
15 SAPTARI
1392
2205 1472
3677
2210 1475
3685
464 324 788
16 SIRAHA
1310
15450
284 282
566
182 117 299
11
12
1207
32
46
78
35
46
81
875
19 SARLAHI
1011
233 224
457
233 224
457
141
87 228
142
87 229
20 SINDHULI
657
21 RAMECHHAP
670
22 DOLAKHA
661
23 SINDHUPALCHOK
889
1217
25 LALITPUR
614
13
13
26 BHAKTAPUR
333
15
22
15
23
27 KATHMANDU
983
28 NUWAKOT
955
29 RASUWA
223
30 DHADING
634
31 MAKWANPUR
582
32 RAUTAHAT
1160
33 BARA
1140
34 PARSA
1061
578
WESTERN
11273
11
17
1107 1240
2347
1113 1251
2364
609 487 1096
10
14
10
14
36 GORKHA
943
37 LAMJUNG
746
38 TANAHU
628
39 SYANGJA
829
40 KASKI
786
41 MANANG
167
42 MUSTANG
204
43 MYAGDI
486
44 PARBAT
685
51
74
125
51
74
125
13
19
13
19
45 BAGLUNG
741
46 GULMI
907
47 PALPA
842
48 NAWALPARASI
908
49 RUPANDEHI
987
50 KAPILBASTU
920
11
17
1056 1166
2222
1062 1177
2239
603 474 1077
10
14
10
14
53 100
54
61
115
CENTRAL
17 DHANUSA
18 MAHOTTARI
24 KAVRE
35 CHITAWAN
51 ARGHAKHANCHI
494
MID WESTERN
7143
118 131 249
3806
Male
Re-admission
6-59 months
279 279
558
1816 1335
3151
1934 1466
3400
75
87 162
464 324 788

0
179 114 293
609 486 1095
603 473 1076

0
724 673 1397
799 760 1559
15
47
52 PYUTHAN
581
53 ROLPA
559
54 RUKUM
519
57
73 146
219
130 230
360
40
59
99
90 167 257
55 SALYAN
574
56 DANG
625
57 BANKE
586
58 BARDIYA
426
918 619
1537
918 624
1542
309 234 543
10
10
59 SURKHET
646
33
41
74
36
47
83
10
58
60 DAILEKH
736
11
61 JAJARKOT
419
140
82
222
141
83
224
92
62 DOLPA
164
63 JUMLA
357
31
20
51
295 218
513
326 238
564
14
86
64 KALIKOT
356
65 MUGU
282
26
15
41
66 HUMLA
84 141
357 229
586
0
2762
627
15
11
26
313
5080
17
26
67 BAJURA
336
68 BAJHANG
569
69 ACHHAM
905
452 389
841
70 DOTI
665
71 KAILALI
602
72 KANCHANPUR
276
17
1126 795
1921
73 DADELDHURA
371
74 BAITADI
852
75 DARCHAULA
504
FAR WESTERN
1578 1184
383 244
0
50 108 158
309 234 543
76 134
0
11
60 152
79 173
25
24
49
29
27
56
144 135 279
15
21
36
18
26
44
58 150
92
73 159
94
129 124 253

0
4
0
0
2788
16
17
33
459 390
849
1135 803
1938
12
15
27
669 508 1177
229 176 405
440 332 772
81 144
1595 1193
63
685 525 1210
21
12
33
22
12
34
233 178 411
10
14
11
15
452 347 799
11
19
11
19
345
Discharge
Transfer In
District Code
District Name
Received
Reports
<6 months
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
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
346
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50339
11393
667
493
590
599
814
665
570
371
516
759
433
702
901
611
1392
1310
15450
1207
875
1011
657
670
661
889
1217
614
333
983
955
223
634
582
1160
1140
1061
578
11273
943
746
628
829
786
167
204
486
685
741
907
842
908
987
920
494
7143
581
559
519
574
625
586
426
646
736
419
164
357
356
282
313
5080
336
569
905
665
602
276
371
852
504
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
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
0
Re-covered
6-59 months
Male
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
63
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
20
0
0
13
0
0
3
1
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
19
0
0
0
0
0
0
1
0
0
5
0
5
0
8
0
19
0
0
10
0
0
9
0
0
0
Male
55
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
8
0
0
2
0
0
2
2
0
2
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
21
0
0
0
0
0
0
7
0
0
6
0
2
0
6
0
19
0
0
12
0
0
7
0
0
0
Total
Female
66
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
20
0
0
13
0
0
3
1
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
22
0
0
0
0
0
0
1
0
0
5
0
5
0
11
0
19
0
0
10
0
0
9
0
0
0
<6 months
Male
55
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
8
0
0
2
0
0
2
2
0
2
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
21
0
0
0
0
0
0
7
0
0
6
0
2
0
6
0
19
0
0
12
0
0
7
0
0
0
Female
74
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
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
56
0
0
23
0
0
0
0
2
0
0
0
16
0
15
0
15
0
0
3
0
0
12
0
0
0
6-59 months
Male
51
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
2
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
34
0
0
17
0
0
0
0
6
0
0
0
4
0
7
0
13
0
0
0
0
0
13
0
0
0
Female
2555
802
0
0
11
8
0
0
0
0
0
0
0
20
0
0
763
0
107
8
0
97
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
387
0
0
0
0
0
0
0
0
1
0
0
0
0
0
386
0
688
0
0
21
0
0
0
344
38
0
66
0
140
0
79
0
571
0
0
200
0
0
371
0
0
0
Male
1963
580
0
0
5
20
0
0
0
0
0
0
0
25
0
0
530
0
95
10
0
83
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
312
0
0
0
0
0
0
0
0
7
0
0
0
0
0
305
0
533
0
0
51
0
0
0
251
51
0
33
0
74
0
73
0
443
0
0
188
0
0
255
0
0
0
Death
Total
Female
2629
803
0
0
11
8
0
0
0
0
0
0
0
20
0
0
764
0
109
8
0
98
2
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
387
0
0
0
0
0
0
0
0
1
0
0
0
0
0
386
0
744
0
0
44
0
0
0
344
40
0
66
0
156
0
94
0
586
0
0
203
0
0
383
0
0
0
<6 months
Male
2014
582
0
0
5
21
0
0
0
0
0
0
0
25
0
0
531
0
97
10
0
83
3
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
312
0
0
0
0
0
0
0
0
7
0
0
0
0
0
305
0
567
0
0
68
0
0
0
251
57
0
33
0
78
0
80
0
456
0
0
188
0
0
268
0
0
0
Female
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
De-faulter
6-59 months
Male
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
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
7
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
4
0
0
2
0
0
2
0
0
0
Total
Male
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
5
0
0
0
0
0
0
0
0
0
1
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
Female
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
7
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
4
0
0
2
0
0
2
0
0
0
<6 months
Male
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
5
0
0
0
0
0
0
0
0
0
1
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
Female
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
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
1
0
6
0
0
0
2
0
0
2
0
0
0
0
0
0
6-59 months
Male
4
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
0
0
0
0
0
0
0
0
0
0
3
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
Female
386
77
0
0
0
0
0
0
0
0
0
0
0
6
0
0
71
0
52
3
0
48
0
0
0
0
0
1
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
109
0
84
0
0
0
0
0
0
7
1
0
12
0
18
0
46
0
64
0
0
31
0
0
33
0
0
0
Total
Male
337
45
0
0
0
0
0
0
0
0
0
0
0
1
0
0
44
0
33
3
0
29
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
143
0
0
0
0
0
0
0
0
0
0
0
0
0
0
143
0
77
0
0
0
0
0
0
3
7
0
9
0
20
0
38
0
39
0
0
28
0
0
11
0
0
0
Female
395
77
0
0
0
0
0
0
0
0
0
0
0
6
0
0
71
0
52
3
0
48
0
0
0
0
0
1
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
109
0
91
0
0
0
0
0
0
7
1
0
13
0
24
0
46
0
66
0
0
33
0
0
33
0
0
0
Male
341
45
0
0
0
0
0
0
0
0
0
0
0
1
0
0
44
0
34
3
0
29
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
143
0
0
0
0
0
0
0
0
0
0
0
0
0
0
143
0
80
0
0
0
0
0
0
3
7
0
9
0
23
0
38
0
39
0
0
28
0
0
11
0
0
0
Discharge
District
Code
District Name
Not Improved
<6 months
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
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
27
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
0
0
0
0
0
0
0
0
0
0
24
0
0
3
0
0
0
0
1
0
0
0
9
0
11
0
2
0
0
1
0
0
1
0
0
0
6-59 months
Male
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
17
0
0
4
0
0
0
3
0
0
0
0
5
0
5
0
0
0
0
0
0
0
0
0
0
0
Female
Male
189 155
27 26
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
25 25
0
0
18 14
0
1
0
0
18 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
34 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
34 32
0
0
62 55
0
0
0
0
0
2
0
0
0
0
0
0
6
5
1
4
0
0
9
7
0
0
14 11
0
0
32 26
0
0
48 28
0
0
0
0
10
6
0
0
0
0
38 22
0
0
0
0
0
0
Transfer Out
Refer to Hospital
Total
Female
<6 months
Male
216 172
27 26
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
25 25
0
0
19 14
0
1
0
0
18 13
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
34 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
34 32
0
0
86 72
0
0
0
0
3
6
0
0
0
0
0
0
6
8
2
4
0
0
9
7
0
0
23 16
0
0
43 31
0
0
50 28
0
0
0
0
11
6
0
0
0
0
39 22
0
0
0
0
0
0
Female
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
0
0
0
0
0
0
0
0
0
0
3
0
0
2
0
0
0
0
1
0
6-59 months
Male
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
2
0
0
2
0
0
0
0
0
0
Female
59
18
0
0
0
2
0
0
0
0
0
0
0
2
0
0
14
0
4
1
0
0
2
0
1
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
2
0
11
0
0
0
0
0
0
6
0
0
1
0
1
0
3
0
24
0
0
18
0
0
6
0
0
0
Male
50
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
5
3
0
0
1
0
0
0
0
1
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
13
0
0
1
0
0
0
6
0
0
2
0
3
0
1
0
17
0
0
16
0
0
1
0
0
0
Total
Female
62
18
0
0
0
2
0
0
0
0
0
0
0
2
0
0
14
0
4
1
0
0
2
0
1
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
2
0
11
0
0
0
0
0
0
6
0
0
1
0
1
0
3
0
27
0
0
20
0
0
6
0
1
0
<6 months
Male
52
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
5
3
0
0
1
0
0
0
0
1
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
13
0
0
1
0
0
0
6
0
0
2
0
3
0
1
0
19
0
0
18
0
0
1
0
0
0
Female
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
0
0
0
0
0
0
0
0
0
0
3
0
0
3
0
0
0
0
0
0
6-59 months
Male
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
18
5
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
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
3
0
0
0
0
0
0
0
9
0
0
9
0
0
0
0
0
0
Male
34
9
0
0
0
0
0
0
0
0
0
0
0
7
0
0
2
0
1
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
0
0
1
0
3
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
20
0
0
20
0
0
0
0
0
0
Children at End of This Month

Total
Female
21
5
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
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
3
0
0
0
0
0
0
0
12
0
0
12
0
0
0
0
0
0
<6 months
Male
34
9
0
0
0
0
0
0
0
0
0
0
0
7
0
0
2
0
1
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
0
0
1
0
3
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
20
0
0
20
0
0
0
0
0
0
Female
Male
131 158
4
3
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
3
1
0
0
3
2
0
0
0
0
1
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
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
1
0
0
110 143
0
0
0
0
56 108
0
0
0
0
0
0
0
3
4
5
7
4
0
0
0
0
15
9
0
0
28 14
0
0
14
9
0
0
0
0
7
0
0
0
0
0
7
9
0
0
0
0
0
0
6-59 months
Female
6362
1823
0
0
0
12
0
0
0
0
0
0
0
49
0
0
1762
0
248
33
0
194
1
0
5
0
0
6
3
0
0
0
0
0
1
0
0
5
1237
0
0
0
0
0
0
0
0
57
0
0
0
0
0
1180
0
1591
0
0
99
0
0
0
839
49
0
138
0
211
0
255
0
1463
0
0
436
0
0
1027
0
0
0
Male
5198
1228
0
0
0
18
0
0
0
0
0
0
0
46
0
0
1164
0
213
39
0
159
0
0
3
0
0
6
2
0
0
0
0
0
0
0
0
4
1224
0
0
0
0
0
0
0
0
79
0
0
0
0
0
1145
0
1399
0
0
196
0
0
0
585
53
0
95
0
223
0
247
0
1134
0
0
353
0
0
781
0
0
0
Total
Female
6493
1827
0
0
0
13
0
0
0
0
0
0
0
49
0
0
1765
0
251
33
0
195
3
0
5
0
0
6
3
0
0
0
0
0
1
0
0
5
1237
0
0
0
0
0
0
0
0
57
0
0
0
0
0
1180
0
1701
0
0
155
0
0
0
839
53
7
138
0
226
0
283
0
1477
0
0
443
0
0
1034
0
0
0
Male
5356
1231
0
0
0
20
0
0
0
0
0
0
0
46
0
0
1165
0
215
39
0
159
2
0
3
0
0
6
2
0
0
0
0
0
0
0
0
4
1225
0
0
0
0
0
0
0
0
79
0
0
0
0
0
1146
0
1542
0
0
304
0
0
0
588
58
4
95
0
232
0
261
0
1143
0
0
353
0
0
790
0
0
0
347
IYCF and Baal Vita Community Promotion Programme

District
Code
District Name
First Time
Received
Reports
11-Jun
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
348
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
49434
11214
660
514
580
577
807
617
570
371
476
764
416
699
902
571
1392
1298
15084
1217
874
1019
645
671
641
864
1175
551
273
856
955
223
619
565
1160
1167
1053
556
10993
876
741
572
819
740
164
193
475
685
735
908
794
920
964
907
500
7076
575
594
513
567
625
556
404
630
734
419
164
357
356
268
314
5067
336
575
905
667
590
266
372
852
504
Second Time
FCHV
63711
14083
0
0
0
0
7021
4518
0
0
1752
8
0
784
0
0
0
0
7019
46
0
42
448
52
531
642
0
275
92
0
79
416
0
3867
0
34
495
0
17560
2684
0
0
0
0
0
0
0
0
0
0
2723
0
6071
6082
0
16487
0
0
1461
0
6883
0
7991
0
70
39
0
35
0
8
0
8562
0
0
6126
0
14
5
2376
41
0
17-Dec
45417
11101
0
0
0
0
5684
3363
0
0
1278
0
0
776
0
0
0
0
5438
50
0
38
550
39
651
696
0
272
56
0
46
223
0
2124
0
39
654
0
13572
2225
0
0
0
0
0
0
0
0
0
0
1036
0
5206
5105
0
9358
0
7
1130
0
3830
0
4293
0
12
43
0
41
0
2
0
5948
0
0
4553
0
8
6
1353
28
0
HF
18-23
31767
7367
0
0
0
0
3368
2548
0
0
554
0
0
897
0
0
0
0
4682
43
0
36
613
50
1083
611
0
486
63
0
312
217
0
706
0
40
422
0
9963
1239
0
0
0
0
0
0
0
0
0
0
380
0
3736
4608
0
6555
0
7
1338
0
1910
0
3225
0
10
30
0
28
0
7
0
3200
0
0
2453
0
3
4
700
40
0
11-Jun
11112
2850
0
0
0
0
1097
1032
0
0
657
9
15
33
0
7
0
0
1914
31
0
51
15
0
0
32
0
5
0
0
7
243
0
1343
0
49
138
0
3214
842
0
0
0
0
0
0
0
0
0
0
501
0
546
1325
0
2412
0
0
437
0
1698
0
162
0
12
80
9
13
0
1
0
722
0
0
533
0
10
33
139
7
0
17-Dec
7196
1833
0
0
0
0
671
863
0
0
230
3
35
31
0
0
0
0
1561
41
0
43
12
0
0
24
0
23
0
0
8
132
0
1100
0
38
140
0
1917
471
0
0
0
0
0
0
0
0
0
0
229
0
300
917
0
1456
0
0
293
0
1022
0
42
0
17
49
0
25
0
8
0
429
0
0
295
0
9
15
105
5
0
Third Time
FCHV
18-23
4392
946
0
0
0
0
338
433
0
0
131
2
25
17
0
0
0
0
1037
43
0
44
17
0
0
25
0
11
0
0
50
69
0
667
0
26
85
0
1364
236
0
0
0
0
0
0
0
0
0
0
70
0
204
854
0
846
0
0
252
0
504
0
20
0
14
26
0
17
0
13
0
199
0
0
135
0
3
7
44
10
0
17-Dec
17512
2834
0
0
0
0
1566
1012
0
0
256
0
0
0
0
0
0
0
662
25
0
41
29
0
19
40
0
80
0
0
2
93
0
286
0
25
22
0
4431
815
0
0
0
0
0
0
0
0
0
0
726
0
1148
1742
0
5704
0
7
328
3
1945
0
3358
0
9
46
0
6
0
2
0
3881
0
0
2759
0
0
0
1122
0
0
HF
18-23
8596
1308
0
0
0
0
630
565
0
0
113
0
0
0
0
0
0
0
685
12
0
38
18
0
17
323
0
71
0
0
0
47
0
116
0
23
20
0
1895
531
0
0
0
0
0
0
0
0
0
0
170
0
595
599
0
3060
0
7
232
0
810
0
1969
0
5
25
0
7
0
5
0
1648
0
0
1292
0
0
1
355
0
0
17-Dec
3703
1033
0
0
0
0
428
412
0
0
191
0
0
0
0
2
0
0
297
26
0
48
6
0
0
16
0
3
0
0
0
49
0
109
0
6
34
0
1215
179
0
0
0
0
0
0
0
0
0
0
95
0
216
725
0
898
0
0
181
0
573
0
74
0
7
50
0
6
0
7
0
260
0
0
191
0
0
7
53
9
0
18-23
2434
510
0
0
0
0
197
274
0
0
39
0
0
0
0
0
0
0
175
24
0
46
4
0
0
11
0
2
0
2
1
11
0
52
0
1
21
0
780
106
0
0
0
0
0
0
0
0
0
0
16
0
67
591
0
799
0
0
139
0
344
0
270
0
9
28
0
8
0
1
0
170
0
0
154
0
0
0
13
3
0
FCHV
HF
18-23
18-23
6966
1385
0
0
0
0
671
590
0
0
124
0
0
0
0
0
0
0
262
5
0
40
0
0
0
18
0
0
0
0
0
31
0
130
0
20
18
0
2480
450
0
0
0
0
0
0
0
0
0
0
301
0
418
1311
0
1331
0
0
212
0
730
0
367
0
5
15
0
2
0
0
0
1508
0
0
1013
0
0
2
486
7
0
2409
599
0
0
0
0
192
307
0
0
94
0
0
0
0
6
0
0
193
21
0
51
0
0
0
9
0
0
0
0
0
32
0
45
0
3
32
0
939
125
0
0
0
0
0
0
0
0
0
0
40
0
93
681
0
466
0
0
124
0
289
0
28
0
2
14
0
7
0
2
0
212
0
0
160
0
0
0
50
2
0
Infant & Young Child Feeding

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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
49434
11214
660
514
580
577
807
617
570
371
476
764
416
699
902
571
1392
1298
15084
1217
874
1019
645
671
641
864
1175
551
273
856
955
223
619
565
1160
1167
1053
556
10993
876
741
572
819
740
164
193
475
685
735
908
794
920
964
907
500
7076
575
594
513
567
625
556
404
630
734
419
164
357
356
268
314
5067
336
575
905
667
590
266
372
852
504
Excl. breast
feeding
86656
15107
0
0
225
25
4576
973
1089
0
1777
0
0
1521
1163
1054
2633
71
11600
427
95
293
494
2
566
1062
0
291
292
2724
1265
679
0
2797
0
134
327
152
16630
4460
405
0
0
165
9
84
0
95
81
67
2856
247
3502
3946
713
25243
0
0
994
352
5923
18
10252
0
4478
616
157
613
1493
347
0
18076
0
0
9942
51
244
976
2459
3860
544
Timely introduction of
Complementary
feeding
IMAM Program (FCHV)
Fortified Flour Distribution
MUAC Screening
(Children 6-23 months)

Antnatal
Female
Postnatal
Green (Normal)
Yellow (Moderate Acute

Malnutrition)
781801
259468
241
16
200
538
634
1942
1735
4
890
47
129
101771
0
677
149898
746
71588
1565
3310
16562
7001
3909
6521
11085
2823
1888
2209
887
1543
51
0
9383
1826
574
183
268
69516
9180
45
154
0
107
0
1
48
398
113
0
0
0
187
59250
33
143369
0
68
0
259
4611
2457
104799
3262
614
18776
118
5149
8
3248
0
237860
105
2
156443
672
2200
76280
130
1428
600
35297
8365
34
0
1
187
75
174
19
3
26
0
30
1316
0
93
6205
202
3684
67
439
974
227
138
208
509
36
122
35
4
63
12
0
429
337
24
2
58
4563
247
0
8
0
7
0
0
0
7
120
0
0
0
7
4164
3
8155
0
1
0
7
825
252
2796
668
79
1950
22
1020
0
535
0
10530
14
1
6057
345
164
3489
0
454
6
Male
83870 10997 25174

14439 2784 2473
0
0
0
0
0
0
215
0
0
39
0
0
4393
301
36
804
306
102
1135
0
0
0
0
0
1504
0
0
0
0
0
0 1826 2090
1882
29
26
1210
0
0
1270
106
2
1903
216
217
84
0
0
10903
262
115
359
47
4
35
0
0
270
0
0
514
5
0
0
0
0
747
0
0
1374
28
26
0
0
0
243
0
0
221
0
0
2579
15
0
974
0
0
878
5
4
0
0
0
2009
133
66
0
0
0
174
0
0
350
29
15
176
0
0
16667
403
233
4161
0
0
431
0
0
0
0
0
0
0
0
144
0
0
0
0
0
108
11
10
0
0
0
102
0
0
81
0
0
74
0
0
2672
0
0
240
0
0
3473
86
70
4445
306
153
736
0
0
23660 6692 22106
0
0
0
0
0
0
1164
0
0
346
0
0
6545
0
0
60
0
0
9913 1089
214
0
0
0
1874
22
27
708
108
0
115
9
10
794
0 16707
1431
9
7
710 5455 5141
0
0
0
18201
856
247
0
0
0
0
0
0
10104
628
216
44
0
0
298
0
0
1053
50
0
2063
143
4
4096
32
25
543
3
2
3376
848
0
0
0
0
0
0
0
0
0
5
683
0
0
0
160
0
23
0
16
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
2505
0
0
0
0
0
0
0
0
0
0
0
0
0
2505
0
0
0
0
0
0
0
0
0
0
0
2096
593
0
0
0
0
0
0
0
0
1
5
504
0
0
0
83
0
17
0
12
0
0
0
0
0
0
2
0
3
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
1484
0
0
0
0
0
0
0
0
0
0
0
275
0
1209
0
0
0
0
0
0
0
0
0
0
0
HH visit and Monitoring
Red (Severe Acute

Malnutrition)
4107
645
0
0
0
0
2
7
0
0
1
1
4
77
0
10
512
31
445
2
31
118
19
17
22
61
6
6
23
0
14
0
0
91
15
0
0
20
771
16
0
0
0
2
0
0
0
0
0
0
0
0
0
753
0
1337
0
0
0
1
100
111
264
54
5
237
1
206
0
358
0
909
0
0
536
9
8
350
1
5
0
Oedema
162
11
0
0
0
0
0
1
0
0
0
0
1
0
0
1
6
2
32
0
2
15
0
0
0
3
0
7
0
0
0
0
0
2
2
0
0
1
19
0
0
0
0
0
0
0
0
0
1
0
0
0
0
18
0
81
0
0
0
0
9
1
2
8
2
11
0
18
0
30
0
19
0
0
4
1
5
9
0
0
0
Red: Cured child after Red: Stagnating or

treatment
decreasing weight
23648
410
0
0
3
0
1
20
0
0
1
1
2
25
0
9
330
18
82
4
22
24
3
1
3
11
0
0
0
0
0
0
0
7
7
0
0
0
164
3
0
0
0
1
0
0
0
0
1
0
0
0
0
159
0
496
0
0
0
0
16
27
126
1
0
137
3
110
0
76
0
22496
0
0
22401
9
0
84
0
2
0
331
75
0
0
0
0
1
1
0
0
0
0
0
8
0
9
51
5
27
0
5
2
1
0
1
10
0
0
0
0
3
0
0
4
0
0
1
0
29
1
0
0
0
0
0
0
0
0
0
0
0
0
0
28
0
114
0
0
0
0
9
2
28
0
8
15
0
38
0
14
0
86
0
0
41
3
0
38
0
4
0
Red: Absent of
defaulting
266
63
0
0
0
0
1
0
0
0
0
0
0
9
0
5
44
4
27
4
4
4
1
2
1
7
0
0
0
0
0
0
0
1
0
0
3
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
72
0
0
0
0
12
1
14
0
1
15
2
20
0
7
0
74
1
0
26
2
8
32
1
4
0
349
Analyzed Data:Nutrition (Sheet 1 of 1)
GROWTH MONITORING
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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
350
Received
Reports
49422
11214
660
514
580
577
807
617
570
371
476
764
416
699
902
571
1392
1298
15084
1217
874
1019
645
671
641
864
1175
551
273
856
955
223
619
565
1160
1167
1053
556
10993
876
741
572
819
740
164
193
475
685
735
908
794
920
964
907
500
7064
575
594
513
567
625
556
404
630
734
419
164
345
356
268
314
5067
336
575
905
667
590
266
372
852
504
% of children aged 0-12

% of newborns with low
months registered for
birth weight (<2.5kg)
growth monitoring
8.87
8.1
2.94
3.3
2.97
3.45
17.09
5.42
4.01
2.27
5.57
2.44
7.04
5.6
3.65
4.89
3.33
19.36
7.71
2.33
6.34
5.75
3.23
3.44
5.25
5.02
3.54
9.42
16.76
31.55
6.62
2.91
5.85
3.01
6.24
7.74
5.7
7.92
9.46
6.59
6.37
8.93
7.13
9.62
25
4.65
6.81
4.83
2.67
3.95
14.87
7.65
13.56
7.41
8.2
11.39
4.03
43.12
10.35
6.11
9.59
13.52
11.62
9.78
6.26
7.22
8.12
9.16
6.3
9.87
8.76
8.91
6.39
6.58
8.32
7.07
10.23
10.1
15.06
7.76
5.75
96.86
98.06
140.67
101.5
104.02
98.71
93.85
71.15
97.4
95.9
118.01
117.25
144.65
121.91
107.85
111.73
119.41
72.17
78.86
65.75
113.04
79.77
80.1
90.55
85.64
127.83
69.15
101.09
86.29
44.95
102.76
107.63
82.92
105.6
58.33
98.84
76.21
79.09
119.49
127.32
158.43
108.54
91.95
81.85
63.93
156.64
116.07
99.85
150.95
131.92
115.6
115.58
152.79
92.93
125.35
103.99
110.37
93.69
124.16
107.74
121.59
83.17
85.54
99.9
94.99
107.29
132.7
178.65
74.68
102.08
139.52
107.59
62.47
141.05
124.69
98.92
82.36
65.92
75.6
249.7
124.54
Average number of
visits among children
aged 0-24 months
registered for growth
monitoring
2.51
2.89
3.28
2.42
2.98
2.87
3.1
2.7
3.78
3.53
2.77
3.58
5.22
3.01
2.75
2.75
2.54
2.14
2.22
1.7
1.91
1.45
2.43
2.64
3.86
2.5
3.32
2.21
2.28
2.77
2.09
2.42
4.27
3.18
1.39
1.91
1.42
2.91
2.59
2.8
2.93
2.91
4.21
3.59
3.71
2.44
3.41
3.44
2.83
3.38
4.02
2.68
1.51
1.85
2.67
2.13
2.47
2.58
2.19
2.02
1.76
2.14
2.81
2
2.73
1.99
1.16
2.02
1.57
2.13
1.2
2.95
1.78
2.59
5.67
2.08
2.87
1.76
13.38
1.66
3.1
MICRO-NUTRIENTS AND ANTIHELMINTHICS
% of children aged 0- 6
% of children aged 0-24 % of children aged 0-24
%ofchildrenaged68
months registered for
months registered for months registered for
months registered for % of children aged 6-59
growth monitoring, who
growth monitoring who growth monitoring who
growth monitoring who months, who received
were exclusively
were underweight
were underweight
received solid, semi- Vitamin A supplements
breastfed for the first
(New Visits)
(Repeat Visits)
solid or soft foods
six months
3.31
1.95
1.79
0.63
1.04
0.65
1.51
2.9
1.6
1.2
1.11
3.06
1.57
1.48
1.57
2.01
2.65
3.84
3.14
1.74
4.03
2.63
1.74
0.95
1.54
4.58
1.93
10.91
1.36
1.09
2.14
1.25
3.48
1.32
3.42
5.06
2.12
4.18
1.68
0.38
2.35
1.2
0.67
1.2
1.89
1
1.1
1.15
0.45
0.79
3.5
1.47
0.69
6.89
1.22
6.24
2.6
1.71
5.67
3.24
5.91
5.65
3.85
2.07
2.89
10.05
1.3
16.17
17.12
12.62
11.35
5.31
16.42
2.56
6.07
9.15
2.75
8.65
1.67
4.26
2.94
2.29
1.61
0.59
1.34
1.65
0.65
1.33
1.27
0.65
1.02
0.35
2.04
3.4
1.06
2.04
2.31
1.97
3.79
1.98
1.9
1.73
3.14
1.22
1.01
1.25
3.01
1.58
1.43
0.33
0.68
2
1.63
3.34
1.34
4.15
2.75
3.41
3.47
1.11
0.2
1.97
1.95
0.35
1.22
1.05
1.38
0.74
1.82
0.38
1
0.52
1.09
0.32
4.84
0.93
5.03
1.92
2.5
3.67
3.7
4.29
6.22
2.46
1.42
4.17
6.4
1.03
18.7
12.55
8.45
16.7
3.64
14.4
2.62
3.85
6.47
2.91
4.08
3.41
3.23
2.09
28.45
23.36
0
0
7.77
0.27
41.93
11.12
61.35
0
105.52
0
0
92.24
54.78
28.84
36.83
0.96
10.62
4.93
1.27
3.17
14.64
0.09
26.59
34.88
0
5.89
8.87
14.44
43.35
143.25
0
59.45
0
1.61
4.56
2.38
30.24
156.49
22.3
0
0
3.04
15.79
67.74
0
5.85
2.62
2.22
102.73
3.45
34.39
57.17
31.49
57.03
0
0
28.16
12.01
91.77
0.31
209.78
0
133.39
27.3
33.33
42.12
79.46
45.36
0
57.72
0
0
298.11
1.9
2.65
18.35
139.16
123.92
33.31
27.53
22.32
0
0
7.42
0.43
40.25
9.19
63.94
0
89.31
0
0
114.13
56.99
34.75
26.62
1.13
9.98
4.15
0.47
2.92
15.23
0
35.09
45.12
0
4.92
6.71
13.67
33.38
185.23
0
42.7
0
2.1
4.88
2.75
30.3
146
23.73
0
0
2.66
0
87.1
0
6.28
2.62
2.45
96.12
3.35
34.11
64.4
32.51
53.41
0
0
32.97
11.8
101.41
1.03
202.84
0
55.82
31.38
24.42
53.48
76.16
92.81
0
58.12
0
0
302.97
1.64
3.24
19.79
116.75
131.49
33.25
163.35
156.49
137.85
154.21
153.52
150.22
150.68
111.33
99.57
200.24
151.06
197.46
215.18
200.09
267.88
126.73
190.2
159.73
148.98
125.84
171.11
201.12
206.86
188.49
166.87
115.42
177.67
99.28
107.83
77.2
215.19
188.94
155.38
199.68
157.04
185.31
154.7
156.64
164.65
160.62
128.09
207.87
199.94
90.41
97.99
161.93
185.65
103.37
147.93
200.38
195.23
188.4
154.31
181.89
152.7
199.31
223.08
173.68
225.44
224.82
167.87
202.99
193.02
227.61
212.67
176.45
162.17
104.13
264.05
285.54
102.49
176.85
277.42
198.09
233.08
150.37
124.68
187.41
182.07
195.65
185.62
% of children aged 1259 months who

received
antihelminthics
158.1
151.79
133.29
140.2
157.32
151.93
149.54
106.9
85.69
182.42
144.48
179.37
209.9
181.63
264.93
130.11
188.59
144.4
148.43
123.03
165.33
197.81
197.69
188.78
156.83
106.43
181.51
100.33
108.8
77.04
213.29
193.18
161.11
202.52
156.65
173.13
155.54
182.97
160.29
147.88
123.54
213.07
201.13
67.88
93.06
169.88
205.03
105.92
144.1
199.62
196.96
189.73
151.09
169.59
149.47
183.69
154.99
164.56
218.01
150.18
164.25
189.4
177.29
223.88
206.41
169.48
200.59
119.23
253.66
275.51
102.15
166.64
278.5
204.36
184.65
152.39
129.64
158.07
146.12
191.49
188.62
% of children aged 6-23 % of children aged 6-23

months, who received months who received
1st dose of Baal Vita
monthly food
(MNP)
supplements
18.58
20.28
0
0
0
0
57.58
50.17
0
0
93.01
0.4
2.27
53.05
0
0.07
0
0
6.81
1.01
0
0.94
16.88
2.28
36.71
23
0
7.48
2.23
0
5.93
94.48
0
71.89
0
0.93
9.16
0
29.85
94.11
0
0
0
0
0
0
0
0
0
0
61.16
0
54.29
93.98
0
29.88
0
0.18
79.11
0
84.69
0
111.69
0
1.39
4.06
0.66
3.88
0
1.77
0
21.03
0
0
145.87
0
0.18
0.46
92.62
1.46
0
0.34
0.23
0
0
0
0
0.09
0.13
0
0
0
0
9.87
0.1
0
0.08
0.17
0
0.01
0.02
0
0
0
0
0
0.05
0
0
0
0
0
0.05
0
0.12
0
0
0.02
0
0.03
0
0
0
0
0
0
0.47
0
0
0
0
0
0
0.04
0.19
0
1.9
0
0
0
0
0
0
0.77
0
0.04
0.14
0.12
32.85
0.02
40.08
0
0.1
0
0
0.73
0
0
0.03
0.24
0.05
0.01
Raw Data:CBIMCI (Sheet 1 of 11)
Health Facility (< 2 months Children)

Classification
District Code
District Name
Received Reports
Total cases
28days
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
29-59
days
PSBI
28
days
29-59
days
LBI
28days
Hypothermia
29-59
days
28
days
50230 27881 37735 4693 3300 12384 19195 410

11415 5654 8907 780 647 3083 5080 78
672
180
661
5
16
162
464
3
527
113
169
30
19
64
104
2
596
53
75
6
10
39
49
3
604
548 1320
46
72
332
921
9
813 1173
924 310 147
435
473
6
615
755 1193
82
59
363
472
5
568
365
320
32
28
124
128
0
384
136
223
20
20
91
163
5
524
271
310
40
30
101
112
8
771
298
360
19
28
186
175
6
438
199
515
6
26
115
230
7
701
222
333
28
18
130
220
4
901
341
755
20
34
201
422 11
606
386
501
91
60
319
310
6
1392
337
845
18
48
251
627
2
1303
277
403
27
32
170
210
1
15334 5960 9213 732 649 2772 5360 92
1235
154
336
13
26
75
171
4
889
470
837 136
85
227
602
3
1031
190
557
13
18
136
424
0
666
341
232
47
41
92
147
7
681
186
254
13
12
106
155
1
672
158
174
6
12
88
105
1
898
119
322
9
11
91
259
6
1184
314
364
25
30
130
144
1
557
115
193
11
8
44
68
1
267
39
394
0
0
25
355
0
871
689
625
21
11
35
140
2
955
144
287
21
14
96
226
7
223
48
96
5
2
10
33
0
647
406
422
67
76
165
250
7
577
317
587
47
32
159
268
2
1164
813 1154
81
76
345
740 22
1179
487
376
42
40
181
171 16
1063
289 1010 105
75
425
719 10
575
681
993
70
80
342
383
2
11301 3972 5972 429 495 1756 2665 49
964
207
256
14
3
103
121
2
750
418
185
7
10
41
51
2
621
250
167
21
23
87
60
4
828
160
772
6
3
76
303
0
798
103
74
3
2
65
49
1
168
1
0
0
0
0
0
0
204
7
19
0
1
3
6
0
491
252
220
27
26
75
152
2
685
130
127
22
10
57
43
0
738
305
520
54
68
175
306
3
910
247
411
28
39
159
279 10
821
641 1053 121 118
152
129 11
918
637
427
75
46
340
233
6
998
151
377
15
16
84
142
3
920
392 1181
33 109
289
693
3
487
71
183
3
21
50
98
2
7127 7590 7047 1741 899 2718 3365 92
573
259
352
45
37
150
234
5
525
337
306
60
46
94
141
3
536
263
285
60
48
127
153 12
573
552
443 176 110
156
170
0
628 1524
996 196
88
318
319
5
564
532
474
80
67
222
220
3
434 1680
777 649 157
555
271
1
636
758
830 102
75
312
379
6
737
511
317 177
58
198
157
1
419
388
554
73
58
163
302 18
179
132
241
26
29
63
158 12
359
117
415
33
28
39
186
2
360
278
288
48
48
121
132
6
282
53
154
9
18
35
67 10
322
206
615
7
32
165
476
8
5053 4705 6596 1011 610 2055 2725 99
336
262
544
63
39
144
417
2
565
342
414
92
55
179
217
8
904
820 1103 145 123
418
627 13
668
296
390
56
54
105
219
8
585 1624 2628 311
88
608
644 16
268
511
377 118
51
292
187
2
371
519
489 144 115
174
185 47
852
261
458
60
59
99
129
3
504
70
193
22
26
36
100
0
29-59
days
Treatment
Jaundice
28
days
660 1916
112 346
14
9
3
1
1
3
12
75
2
37
4
39
10
17
0
18
7
23
12
8
5
15
10
27
13
36
5
25
3
5
11
8
136 432
4
8
5
10
10
6
5
24
2
20
2
11
4
14
0
13
4
19
0
6
29
17
0
15
1
3
12
96
1
50
26
33
9
12
9
16
13
59
121 499
7
41
1
26
4
73
0
35
4
32
0
0
0
0
0
67
3
10
3
42
17
50
12
63
6
35
30
5
33
13
1
7
133 463
1
14
1
11
18
37
1
40
28 112
3
15
0
75
19 100
2
14
23
18
18
8
0
9
1
3
7
2
11
5
158 176
8
5
7
7
24
29
1
10
56
76
3
21
52
15
2
12
5
1
29-59
days
Low weight/
Feeding Prob.
28days
29-59
days
Cotrim Paediatrics
28days
29-59
days
Refer
Gentamycin
1st doze
853 1730 2548 11268 17529 5349

205 313 572 2532 4859 908
12
7
16
174
542
11
1
8
7
48
79
13
3
18
4
24
27
5
50
58 165
144
493
27
4
46
26
641
549 452
18
24
40
412
845 118
8
26
43
114
115
18
17
6
17
50
133
7
8
12
6
68
100
20
5
14
23
92
143
9
33
21
65
88
215
37
0
18
25
70
138
13
9
21
38
125
435
23
31
9
25
184
258 100
5
11
59
207
643
23
1
14
13
91
144
32
241 326 560 1927 3873 755
6
5
60
35
169
18
15
20
10
362
650 152
48
7
18
91
357
84
5
16
14
77
123
31
3
4
5
53
56
6
2
10
20
38
68
3
9
2
2
65
152
9
2
13
8
99
124
25
4
8
2
10
55
0
2
0
0
3
63
0
36
20
59
19
124
0
2
5
14
12
38
8
1
2
2
6
17
3
28
44
28
97
204
40
19
25
33
107
227
18
15
66 151
317
692 181
18
38
34
99
163
38
17
7
35
138
258
88
9
34
65
299
333
51
182 301 372 1207 2170 275
16
14
6
40
82
18
9
6
2
24
22
2
14
18
22
30
41
6
3
2
4
46
125
4
5
4
11
18
28
0
0
0
0
0
0
0
0
2
0
2
26
2
14
8
13
82
100
14
0
9
5
19
36
10
45
23
26
102
217
39
24
24
45
63
115
21
20
67
36
94
140
17
10
38
38
200
144
41
2
5
20
74
141
9
19
62 136
361
726
68
1
19
8
52
227
24
161 429 600 3544 3917 2263
1
15
8
96
139
50
7
13
17
112
174
43
12
35
30
116
153
35
8
31
27
272
239 249
35
38
79
375
366 228
7
23
25
255
219 133
8
43
33 1068
420 787
39
23
41
276
316 185
3
21
11
344
172 165
2
54
85
184
366 106
25
39
30
46
159
15
3
13
25
74
466
98
4
33
42
104
128
74
1
15
69
52
105
17
6
33
78
170
495
78
64 361 444 2058 2710 1148
2
21
38
189
510 225
1
70
65
230
252 166
7
85 105
301
599 194
4
31
63
196
239 100
18
47
49
450
423 189
8
40
39
244
177
83
19
37
34
273
268 126
4
21
21
154
165
46
1
9
30
21
77
19
Compl.
doze
5419
841
11
26
1
20
425
134
23
8
44
9
26
13
24
41
13
23
965
36
208
141
41
7
2
9
22
1
0
0
7
2
43
27
196
75
99
49
302
1
2
0
3
1
0
1
18
5
40
81
13
37
1
88
11
2151
31
55
58
233
187
113
756
129
197
101
18
97
105
14
57
1160
235
141
181
96
149
86
127
113
32
Other antibiotic
Death
Follow-up
28
days
7565 1206
1929 342
122
4
46
9
35
3
549 123
54
37
107
33
52
11
77
4
92
13
122
9
63
10
86
14
217
17
79
22
84
12
144
21
2269 274
58
7
61
19
42
12
84
33
153
5
60
6
84
2
62
11
14
5
190
1
294
25
86
9
22
2
176
28
231
19
131
49
69
14
220
4
232
23
1111 212
96
15
26
3
51
25
59
6
12
17
0
0
8
1
41
9
58
10
112
16
183
26
30
18
202
31
70
12
131
22
32
1
1250 196
103
19
68
14
85
8
49
19
122
30
41
13
120
15
238
27
51
12
157
23
39
6
86
5
56
4
30
0
5
1
1006 182
35
5
67
11
213
22
62
9
220
53
127
26
211
29
49
17
22
10
29-59
days
913 19033
255 4766
4
276
7
74
3
45
88
553
24
855
27
770
5
208
2
76
11
105
4
157
8
129
5
167
18
347
18
261
15
572
16
171
241 4797
7
218
32
652
20
301
20
170
1
58
5
114
7
135
9
112
10
50
7
217
15
70
2
52
1
19
29
316
8
169
43
924
8
227
6
277
11
716
162 2091
8
118
2
33
8
59
4
88
5
45
0
0
0
15
4
143
5
86
11
311
28
163
12
91
23
223
9
97
39
551
4
68
104 4092
17
97
10
126
5
110
4
348
12
424
11
231
5 1044
11
465
1
296
13
258
7
100
5
265
1
156
1
45
1
127
151 3287
4
481
6
251
48
709
11
168
33
641
13
199
22
533
9
204
5
101
28days
169
20
3
0
2
1
1
5
1
0
2
0
0
3
1
1
0
0
23
1
2
2
4
1
1
2
0
0
0
0
2
0
2
2
2
0
0
2
14
0
1
0
1
0
0
0
3
2
1
0
4
0
0
2
0
65
3
3
2
7
5
4
6
3
9
8
7
1
7
0
0
47
6
2
5
10
6
1
5
9
3
29-59
days
51
5
0
0
2
0
2
0
0
0
0
0
0
0
0
1
0
0
9
0
0
2
3
0
0
2
1
1
0
0
0
0
0
0
0
0
0
0
7
2
0
0
0
0
0
0
0
0
0
0
4
0
0
0
1
19
0
0
0
0
0
1
1
0
7
2
6
0
2
0
0
11
0
0
0
1
4
0
1
5
0
351
PHCORC (< 2 months Children)

Classification
District
Code
District Name
Received
Reports
Total cases
28days
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
352
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
29-59
days
50230 4219 9444

11415 1137 2548
672 140 362
527
13
63
596
7
15
604
96 234
813 182 264
615 164 356
568
19
57
384
12
14
524
20
56
771
40
50
438
56 139
701
21
37
901 191 384
606
50 118
1392 104 324
1303
22
75
15334 1236 2669
1235 453 481
889 144 448
1031
44 110
666
14
36
681
3
48
672
7
23
898
10 140
1184
38
39
557
9
4
267
1
0
871
11
33
955
44 126
223
6
15
647
23 110
577
41 136
1164 285 692
1179
49
95
1063
25
87
575
29
46
11301 368 817
964
26
69
750
9
12
621
33
48
828
12
60
798
31
37
168
0
0
204
3
9
491
7
15
685
7
28
738
23
47
910
11
16
821
25
30
918
28
25
998
31
91
920 111 254
487
11
76
7127 946 1817
573
10
39
525
35 153
536
73
53
573
44
90
628
42
52
564
34
51
434 275 234
636
75 165
737 119 294
419
98 218
179
31
88
359
30 142
360
21
49
282
19
31
322
40 158
5053 532 1593
336
51 276
565
80 157
904 131 353
668 162 439
585
53 125
268
5
26
371
6
29
852
44 168
504
0
20
PSBI
28days
478
123
0
1
0
3
74
30
0
0
1
0
2
3
5
2
1
1
97
12
10
14
4
0
0
0
1
0
0
0
2
2
0
0
42
3
2
5
18
1
0
0
0
3
0
0
2
0
2
2
0
0
0
8
0
182
0
4
3
2
4
3
108
3
20
11
7
4
2
11
0
58
4
12
5
23
6
2
0
6
0
LBI
29-59
days
28days
Treatment
Hypothermia
29-59
days
615 2936 5468

132 576 1595
3
99 274
0
6
25
1
3
6
2
41
85
30
66 108
29 103 245
1
16
31
0
10
12
5
5
15
3
15
29
21
18
92
4
7
25
14
81 238
8
24
97
8
73 279
3
9
34
155 1175 1570
39 283 262
15
94 288
18
19
54
2
7
34
0
0
6
1
2
11
1
12
83
2
17
19
0
0
2
0
0
0
1
7
19
10
20
94
0
0
10
2
12
62
3
29
70
43 616 433
17
16
60
0
21
40
1
20
23
31 210 421
0
10
11
0
3
2
0
9
18
0
2
23
0
34
29
0
0
0
0
3
3
2
1
4
6
1
3
4
9
37
0
5
15
2
9
15
1
19
16
2
16
32
12
79 156
2
10
57
218 463 1068
0
0
32
2
8
45
4
16
19
12
28
79
1
34
37
7
24
36
31 150 193
18
32 113
75
52 126
25
47 107
15
19
75
2
8
21
4
5
33
14
12
15
8
28 137
79 512 814
4 223 268
9
46 136
21 109 144
28
75 131
5
26
59
0
4
19
1
7
15
9
22
35
2
0
7
28days
156
8
0
0
0
0
0
0
0
0
1
4
1
0
2
0
0
0
34
0
9
4
0
0
0
0
0
0
0
0
2
0
0
1
16
0
0
2
8
1
0
0
0
0
0
0
0
1
0
0
0
0
0
6
0
88
0
0
0
0
0
2
0
0
52
10
7
0
3
13
1
18
0
2
6
3
0
0
0
3
4
29-59
days
228
24
2
0
0
3
1
0
4
0
2
2
1
4
4
1
0
0
96
3
27
14
1
0
0
0
0
0
0
8
4
0
2
2
28
1
0
6
15
0
0
0
0
2
0
1
0
0
0
0
2
0
0
10
0
44
0
0
4
0
0
2
1
11
1
10
8
0
1
6
0
49
0
1
12
28
1
0
0
7
0
Jaundice
28days
267
53
3
0
1
27
1
3
0
0
2
0
4
0
9
0
3
0
71
0
8
5
1
0
1
1
0
1
1
2
10
0
8
5
22
1
0
5
55
12
0
6
3
2
0
1
0
0
5
4
8
7
1
6
0
75
9
0
8
0
15
4
7
7
5
4
6
0
0
5
5
13
0
4
3
0
4
0
0
2
0
Cotrim Paediatrics
29-59
days
28days
29-59
days
306 2425 6074

43 615 1799
4
99 346
0
4
19
2
2
11
14
18
70
1 112 102
1 121 358
0
18
38
0
9
14
0
5
32
0
22
35
14
10 120
0
13
23
1
89 259
5
19
87
1
67 254
0
7
31
143 553 1558
0 101 200
6 123 351
71
31
52
0
5
27
0
0
20
2
1
10
0
2 104
1
10
25
0
0
0
0
0
0
0
5
16
2
12
67
0
11
4
3
16
65
8
26 107
30 163 408
17
17
47
1
6
27
2
24
28
39 222 469
6
3
28
0
0
3
5
11
47
0
5
38
1
10
21
0
0
0
0
2
3
0
3
1
0
2
23
11
8
31
0
0
4
1
6
15
2
15
15
4
17
18
9
81 149
0
59
73
57 663 1319
6
2
29
0
11
70
7
16
30
0
30
82
14
34
39
3
30
42
4 246 214
5
36
82
0
88 217
3
50 159
13
14
62
0
15
80
0
5
35
1
23
42
1
63 136
24 372 929
0
47 293
3
61 136
1 108 185
11
90 144
6
21
49
0
5
18
1
7
30
2
31
67
0
2
7
Gentamycin
1st doze
712
162
9
7
0
3
89
35
0
0
1
0
11
2
3
1
1
0
156
21
41
9
7
0
0
0
0
0
0
0
2
0
0
1
54
5
10
6
35
1
0
0
0
0
0
0
0
0
1
0
0
2
0
9
22
295
1
8
5
10
4
4
128
3
90
11
7
9
2
3
10
64
24
10
8
14
2
0
1
5
0
Compl.
doze
690
133
7
0
0
1
101
14
0
0
0
0
7
0
3
0
0
0
211
24
51
10
12
0
0
0
0
1
0
0
3
0
1
0
82
3
17
7
23
0
0
0
0
0
0
0
0
0
2
0
0
1
0
17
3
269
0
1
3
13
3
7
116
0
86
22
7
6
0
1
4
54
12
6
7
19
1
1
0
8
0
Refer
Death
Follow-up
28days
660
134
8
2
1
37
6
43
0
0
2
1
12
1
3
4
10
4
308
206
24
12
5
0
1
1
6
1
1
1
7
0
3
4
30
1
3
2
99
11
0
4
0
8
0
0
1
0
3
49
2
2
8
11
0
78
5
9
0
1
2
1
22
9
3
15
6
0
3
0
2
41
1
6
14
9
7
0
0
4
0
29-59
days
562
145
5
2
2
39
3
42
1
0
1
1
17
2
13
9
5
3
188
30
27
8
0
0
6
8
6
1
0
4
35
0
8
5
49
1
0
0
53
4
0
1
0
2
0
0
0
0
5
0
1
1
17
22
0
75
2
5
0
0
0
0
13
10
3
33
0
2
5
1
1
101
1
6
52
17
1
9
9
6
0
28days
4072
1152
156
16
5
32
146
247
29
8
4
12
56
8
157
62
198
16
1238
250
285
40
25
10
4
9
8
7
0
4
63
2
33
38
377
21
25
37
317
17
2
31
15
13
0
1
0
13
18
2
12
12
4
155
22
714
19
26
2
45
59
26
187
91
100
62
42
20
10
5
20
651
240
41
199
97
18
2
7
45
2
94
45
41
0
0
2
1
0
0
0
0
0
1
0
0
0
0
0
8
0
2
1
0
0
0
1
0
0
0
1
0
0
0
2
0
1
0
0
3
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
16
0
0
0
0
0
0
0
1
1
5
6
2
1
0
0
22
0
0
2
4
4
1
0
8
3
29-59 days
24
5
1
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
9
0
0
0
0
0
0
1
0
0
0
6
2
0
0
0
10
0
0
0
0
0
0
0
4
6

Health Facility (2 - 59 months Children)
Classification
District
Code
District Name
Received
Reports
ARI
Total
No pneumonia
Diarrhoea
Pneumonia
Sev Pneu/ very

severe disease
No Dehydration
Some Dehydration
Malaria
Severe
Dehydration
Dysentery
Very Severe
Febrile disease
Nonfalciparum
Falciparum
Measeles
Ear infection
Other fever
Anaemia
Other
National Total
50230 1722561
498640
251029
7358
290374
72767
2623
60624
537
6615
6224
6964
6554
326684
EASTERN
11415
394167
121170
65738
1560
52700
20125
521
9478
99
1994
1586
306
24315
30988
670
968
69093
1 TAPLEJUNG
672
11534
3324
2470
48
1407
911
255
12
41
18
752
1003
1464
2 PANCHTHAR
527
15557
5301
3461
87
1458
827
47
204
15
48
638
1074
50
2262
3 ILAM
596
14862
3787
2975
58
991
426
28
118
13
16
105
17
484
1251
20
146
1321
4 JHAPA
604
34817
12722
6631
89
6598
1579
1075
690
199
66
3196
1671
25
51
3877
5 MORANG
813
43910
13743
6858
141
5064
1147
54
804
72
1064
142
20
2462
1799
32
71
10063
6 SUNSARI
615
37170
11029
7285
190
5325
2117
37
905
86
47
2230
3438
64
146
6633
7 DHANKUTA
568
14149
5875
2823
13
1729
95
284
29
538
1012
16
2857
8 TERHATHUM
384
11093
3506
2106
21
942
608
157
26
12
613
1139
19
31
2517
9 SANKHUWASABHA
524
16588
4022
3804
108
2209
310
13
183
85
782
1508
20
20
3544
10 BHOJPUR
771
19332
5838
2448
97
2076
709
24
338
19
175
12
961
1812
35
90
4029
11 SOLUKHUMBU
438
14037
5412
2262
108
2161
786
79
359
55
696
569
27
62
2079
12 OKHALDHUNGA
701
23062
6980
3778
69
2196
1206
29
399
138
966
1685
31
4319
13 KHOTANG
901
21280
6293
4314
162
2694
2041
38
924
127
27
1481
1689
21
32
2867
14 UDAYAPUR
606
19423
5001
3184
136
3087
966
28
634
34
104
13
1377
1983
40
12
4978
15 SAPTARI
1392
43807
13096
3401
19
7713
3057
69
1542
65
202
20
3456
4590
245
25
7799
16 SIRAHA
1303
53546
15241
7938
214
7050
3340
54
1297
55
24
24
3683
4765
76
207
8484
15334
464401
123284
73644
1970
84756
21868
827
16853
304
3225
1316
432
32052
42936
1113
1898
84044
1235
38446
12348
5394
163
8186
1665
31
1336
100
480
81
51
3603
1251
42
143
4979
889
37601
11357
6310
59
6102
2645
60
1548
87
2383
28
34
3569
2159
100
230
7807
19 SARLAHI
1031
39607
11494
6264
157
8644
2238
98
1778
59
33
3101
3925
127
131
5742
20 SINDHULI
666
12201
2913
2995
108
1764
760
47
348
50
20
35
765
1218
21
33
1979
21 RAMECHHAP
681
16199
5521
3057
43
2165
178
240
10
35
633
1754
38
67
2990
22 DOLAKHA
672
17325
6210
3084
62
3337
843
18
946
13
12
623
1329
14
2071
23 SINDHUPALCHOK
898
18159
5299
3163
62
2584
1365
32
665
95
12
794
2132
63
18
2666
1184
25641
8000
4029
67
4239
772
498
22
43
926
2451
42
42
5763
25 LALITPUR
557
18608
6003
3385
64
3082
283
316
19
34
540
598
26
31
3674
26 BHAKTAPUR
267
7918
2337
888
1329
127
302
41
301
968
2009
27 KATHMANDU
871
18809
5011
2457
42
3738
551
14
572
16
111
22
1028
1859
29
26
3949
28 NUWAKOT
955
14090
3957
1979
30
3495
538
578
98
11
789
1445
30
76
1789
29 RASUWA
223
4775
1574
719
19
1015
116
109
190
432
11
12
707
30 DHADING
647
26772
6788
5555
268
4602
1132
119
1529
178
1354
2574
80
109
7554
CENTRAL
17 DHANUSA
18 MAHOTTARI
24 KAVRE
31 MAKWANPUR
1179 104189 172805
Severe
malnutrition
577
19169
4638
3186
108
2904
1136
27
530
27
67
12
1028
1775
45
31
3479
32 RAUTAHAT
1164
44047
8410
5852
179
9232
3376
175
2290
10
32
161
76
4633
5769
105
186
5660
33 BARA
1179
36772
8397
4329
269
8163
1503
54
1275
35
107
70
17
3032
5324
190
409
7004
34 PARSA
1063
31412
5904
4389
202
6229
2262
106
985
25
48
236
16
3254
3148
49
193
5815
575
36850
7123
6609
63
3946
378
14
1008
12
24
1889
2825
94
155
8407
WESTERN
11301
320472
95107
36828
713
51365
8129
209
10441
50
319
1240
80
16821
35352
1065
933
64576
36 GORKHA
964
23168
5953
3356
24
2959
774
938
30
1151
3048
30
11
4630
37 LAMJUNG
750
14504
3658
1889
10
1749
135
136
14
24
441
3010
23
3685
38 TANAHU
621
12613
3543
1934
17
1276
624
16
135
146
596
1449
36
39
2801
39 SYANGJA
828
13741
5231
1628
23
2423
400
176
19
779
1215
21
1835
40 KASKI
798
13709
5375
1638
15
1804
196
217
12
28
532
1415
28
2340
41 MANANG
168
556
233
103
136
10
13
53
92
42 MUSTANG
204
2529
998
319
368
78
68
10
74
170
784
43 MYAGDI
491
14578
5118
1501
139
2655
225
262
13
59
592
2053
41
25
2461
44 PARBAT
685
10621
3492
2673
24
1105
118
178
30
382
1642
1963
45 BAGLUNG
738
22243
9124
3288
78
2679
752
12
868
178
1152
2101
24
60
3580
46 GULMI
910
25904
8683
2189
40
3799
346
15
799
13
74
1412
3909
16
48
5057
47 PALPA
821
27726
5788
2920
44
3098
906
43
277
29
72
1028
2597
59
174
6026
48 NAWALPARASI
918
40570
11540
4963
74
6475
163
40
911
40
132
11
1871
3905
86
114
10693
49 RUPANDEHI
998
44611
11332
3451
8585
934
2341
26
20
2915
2766
11
75
11419
50 KAPILBASTU
920
41844
11502
3363
184
10565
2076
49
2717
151
338
3136
4633
668
265
5173
51 ARGHAKHANCHI
487
11555
3537
1613
33
1689
392
415
42
80
747
1386
45
61
2037
61488
35 CHITAWAN
7127
302059
84726
45411
1802
55056
13081
619
13035
42
632
1038
187
18751
30832
2289
1297
52 PYUTHAN
MID WESTERN
573
24022
5848
3736
49
4010
731
35
760
19
1245
2906
32
14
5631
53 ROLPA
525
16636
4081
3487
53
3448
906
11
696
75
26
963
1697
55
73
3115
54 RUKUM
536
17017
4531
3316
181
3447
806
21
594
16
46
879
1889
97
17
2977
55 SALYAN
573
18591
5474
3504
116
4051
767
54
792
53
88
14
1145
3672
101
23
3499
56 DANG
628
40618
11123
5103
203
6332
764
32
1905
286
55
32
2334
3704
115
251
10542
57 BANKE
564
32824
8537
4689
121
6832
897
47
1244
116
17
33
2589
2184
261
231
8533
58 BARDIYA
434
35999
11900
5108
131
4479
587
55
1169
81
101
19
1684
2648
311
219
8307
59 SURKHET
636
36725
10598
4260
93
6862
902
18
1879
24
110
2640
3872
69
88
7173
60 DAILEKH
737
22651
6411
3318
251
3567
1723
22
480
31
131
1143
3076
24
136
4456
61 JAJARKOT
419
18673
5171
1992
166
4068
1058
81
842
235
17
1234
2037
369
55
3123
62 DOLPA
179
2387
873
463
20
495
264
25
217
33
187
108
13
54
63 JUMLA
359
7520
2316
1881
86
1628
783
37
407
518
194
122
23
643
64 KALIKOT
360
13495
3245
2187
135
2880
1321
45
714
25
853
2178
255
107
2464
65 MUGU
282
5323
1404
1062
69
931
500
76
502
10
29
22
455
265
405
24
401
66 HUMLA
322
9578
3214
1305
128
2026
1072
60
834
67
882
402
60
28
570
47483
5053
241462
74353
29408
1313
46497
9564
447
10817
42
445
1044
174
12250
32697
1827
1458
67 BAJURA
FAR WESTERN
336
21970
5564
3197
107
5157
1787
66
1505
36
13
1212
2857
124
64
2587
68 BAJHANG
565
18905
5798
3624
164
4510
1777
45
1035
30
957
1635
37
27
2043
69 ACHHAM
904
51553
17359
3902
174
12650
1279
63
1985
45
251
43
2701
7697
723
584
12482
70 DOTI
668
18912
5402
2472
158
4386
1240
65
971
44
82
1468
3216
51
56
3038
71 KAILALI
585
48163
17656
3408
237
6778
793
85
1731
26
175
177
89
2314
5256
152
552
11152
72 KANCHANPUR
268
27591
7811
3889
144
4129
521
23
1361
27
1215
2270
532
72
7079
73 DADELDHURA
371
15874
4915
2304
170
2873
205
38
542
52
156
778
3621
27
2164
74 BAITADI
852
26496
6830
4244
100
4466
1402
26
1112
96
230
1119
4255
153
41
4641
75 DARCHAULA
504
11998
3018
2368
59
1548
560
36
575
12
24
55
18
486
1890
46
35
2297
353
Health Facility (2 - 59 months Children)

Treatment
District
Code
District Name
Refer
Received
Reports
Cotrim Paediatrics
Other antibiotics
IV Fluid
ORS and Zinc
ORS Only
Anti-helminthes
Death
Expenditure
Follow-up
Vitamin A
ARI
Diarrhoea
Others
ARI
Others
ORS (Pkt)
Zinc
(tab)
National Total
50230
405716
260777
9081
356275
69702
54078
17640
2575
1170
203
65
315
698426
3455212
EASTERN
11415
98921
58049
1605
68225
16765
10444
2043
749
206
854
48605
121
26
42
143445
676680
1 TAPLEJUNG
672
3813
1747
2212
233
380
133
15
2231
4636
22332
2 PANCHTHAR
527
3741
2676
91
2183
249
173
21
13
21
1680
4267
22449
3 ILAM
596
2955
1907
99
1225
286
165
46
11
37
1943
3221
13267
4 JHAPA
604
10262
5465
206
6929
2065
2051
279
172
77
226
4943
15509
77112
5 MORANG
813
9278
4517
52
5794
1254
1075
25
55
54
3951
31
13066
66378
6 SUNSARI
615
10862
4868
221
6140
2189
962
135
110
23
76
5683
11616
55233
7 DHANKUTA
568
3525
2368
1680
144
167
18
12
12
1847
3686
19061
8 TERHATHUM
384
2910
2137
39
1460
176
356
20
27
864
30
3116
14493
9 SANKHUWASABHA
524
3062
2992
47
2330
197
378
30
49
73
1635
5082
23053
10 BHOJPUR
771
4863
3586
78
2600
631
755
353
47
13
60
1641
5418
25862
11 SOLUKHUMBU
438
3532
1843
168
2484
1010
465
187
45
15
54
1449
6495
22594
12 OKHALDHUNGA
701
8386
4108
68
3143
948
297
14
10
13
2758
62
18
5829
31113
13 KHOTANG
901
7180
3668
123
4895
1489
599
367
72
23
68
4245
9219
43896
14 UDAYAPUR
606
4773
2120
35
3487
408
383
41
20
25
1942
8768
37199
1392
8579
6006
57
11012
2739
927
257
28
15
58
5588
23696
102622
15 SAPTARI
16 SIRAHA
4584 185359
Diarrhoea
1303
11200
8041
320
10651
2747
1311
117
86
43
6205
19821
100016
15334
111258
67899
3032
104014
22434
18591
6444
680
422
1550
53629
23
13
118
204776
990650
1235
9256
4591
168
9499
2050
1998
277
27
11
131
4831
19668
95201
889
12846
4829
342
8673
4005
1997
212
15
71
127
5895
18
19076
81200
19 SARLAHI
1031
10680
3845
194
11339
2871
1267
342
69
98
189
5188
17
18336
98870
20 SINDHULI
666
3466
2062
75
2357
387
352
96
31
11
35
1775
5139
22773
21 RAMECHHAP
681
3304
2898
82
2289
118
188
15
25
1273
4586
23403
22 DOLAKHA
672
4777
1811
98
4689
890
359
236
23
23
1775
10427
41454
23 SINDHUPALCHOK
898
4039
2820
48
4114
1230
233
47
20
22
21
1591
7401
33692
1184
5217
3616
48
4953
273
384
189
19
10
60
1982
9999
50287
25 LALITPUR
557
3026
2441
133
3183
114
223
50
32
76
1577
6974
32351
26 BHAKTAPUR
267
1556
1617
12
1509
305
181
20
16
30
602
3349
14281
27 KATHMANDU
871
2973
2756
37
3892
895
878
471
24
35
66
2667
8991
37982
28 NUWAKOT
955
1183
2641
100
3760
481
343
112
11
50
1190
14
7044
31158
29 RASUWA
223
490
716
15
1121
50
64
16
426
2420
11250
30 DHADING
647
6246
4923
277
5644
984
954
190
111
21
162
4831
18
11820
53811
31 MAKWANPUR
577
4538
3867
80
3860
697
1017
770
35
13
80
1581
7950
37228
32 RAUTAHAT
1164
12703
4140
342
12695
3315
2886
743
142
210
8494
21630
123910
33 BARA
1179
9441
6179
618
9058
1401
2517
1787
51
58
120
3515
16502
89971
34 PARSA
1063
7484
4909
223
6889
2051
2046
734
22
27
58
1994
13053
65733
575
8033
7238
140
4490
317
704
137
27
84
2442
10411
46095
WESTERN
11301
68418
47311
1038
59753
8846
5725
1899
335
173
644
28698
64
113134
563959
36 GORKHA
964
5694
5121
21
3996
702
407
50
10
11
36
2873
8752
36681
37 LAMJUNG
750
1934
1993
24
1905
172
75
12
21
893
3040
17334
38 TANAHU
621
2520
2034
24
1847
168
251
11
33
652
3788
17849
39 SYANGJA
828
3153
1825
40
2793
304
187
41
21
14
51
1203
4896
26897
40 KASKI
798
2074
1548
26
1867
305
97
14
30
14
28
898
3977
18427
41 MANANG
168
120
75
125
30
133
257
998
42 MUSTANG
204
521
458
362
65
17
14
285
788
3216
43 MYAGDI
491
2879
1841
3017
572
113
19
25
21
1967
5685
29073
44 PARBAT
685
2561
1993
34
1455
161
40
21
11
1071
15
2450
12870
45 BAGLUNG
738
4225
3523
156
3753
560
383
153
24
49
3729
7999
37770
46 GULMI
910
5096
3162
50
4266
510
760
591
58
2979
7995
40151
47 PALPA
821
5178
2970
259
3518
398
126
22
30
18
57
1624
18
5599
30464
48 NAWALPARASI
918
4921
7922
87
6494
640
606
64
26
47
92
2311
15
11435
67900
49 RUPANDEHI
998
10038
5403
76
9698
887
600
55
18
69
2891
18968
90245
50 KAPILBASTU
920
13992
5129
173
12359
3019
1839
822
71
44
73
3983
22973
113060
CENTRAL
17 DHANUSA
18 MAHOTTARI
24 KAVRE
35 CHITAWAN
51 ARGHAKHANCHI
487
3512
2314
63
2298
353
221
34
35
14
31
1206
4532
21024
MID WESTERN
7127
69912
51191
1978
67415
9504
11157
4623
422
199
919
26743
27
16
66
133493
678089
52 PYUTHAN
573
5234
4239
30
5506
152
341
197
48
15
18
1146
8187
54970
53 ROLPA
525
4319
2726
309
4462
1018
379
152
22
21
36
1559
9127
38653
54 RUKUM
536
4212
2594
10
3971
319
450
187
57
1104
8696
39201
55 SALYAN
573
4452
2770
94
4800
206
378
152
51
66
1844
9249
48280
56 DANG
628
10062
7760
546
7146
569
1278
202
55
74
146
2765
14651
72841
57 BANKE
564
7284
4851
163
7271
1094
1197
729
18
156
2260
14638
74715
58 BARDIYA
434
7332
6232
88
5735
741
663
217
47
20
64
4121
11539
54064
59 SURKHET
636
7508
9304
59
7346
270
1515
137
50
66
3601
13728
76028
60 DAILEKH
737
5375
3300
142
4644
819
252
103
15
102
1815
12
8304
53877
61 JAJARKOT
419
4224
2863
133
5461
1716
1327
1114
51
17
79
2310
11340
50601
62 DOLPA
179
680
179
35
606
160
623
456
11
397
1568
6279
63 JUMLA
359
2198
680
45
2225
835
544
183
21
1016
4407
22112
64 KALIKOT
360
3395
2543
187
4140
425
825
361
25
11
61
1310
30
8725
43435
65 MUGU
282
1198
683
75
1477
562
732
275
16
729
3562
15403
66 HUMLA
322
2439
467
62
2625
618
653
158
12
27
766
5772
27630
5053
57207
36327
1428
56868
12153
8161
2631
389
170
617
27684
24
25
103578
545834
67 BAJURA
FAR WESTERN
336
5541
2857
94
8458
3418
596
174
6083
10240
64100
68 BAJHANG
565
5139
1495
30
6071
1905
883
131
19
32
2326
11132
55945
69 ACHHAM
904
9469
7755
316
14030
2383
2023
885
119
69
139
5760
28548
135211
70 DOTI
668
4957
3089
113
5294
1382
587
290
54
32
27
1567
7981
51294
71 KAILALI
585
9850
7574
506
7377
1209
1281
86
51
27
279
3298
13332
74006
72 KANCHANPUR
268
8181
5071
90
4534
442
1225
391
27
30
2079
8285
45443
73 DADELDHURA
371
3474
3399
126
3216
531
674
570
58
15
11
1665
8145
39798
74 BAITADI
852
7483
3470
100
5787
700
669
82
28
59
3166
11583
58308
75 DARCHAULA
504
3113
1617
53
2101
183
223
22
27
36
1740
4332
21729
354
PHC-ORC (2 - 59 months Children)

Classification
District
Code
District Name
Received
Reports
ARI
Total
No pneumonia
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50230
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7127
573
525
536
573
628
564
434
636
737
419
179
359
360
282
322
5053
336
565
904
668
585
268
371
852
504
341263
85818
6658
3710
3912
9921
7581
7428
2031
1192
1560
3940
2337
3980
6040
3194
12670
9664
99700
14449
13244
7507
3315
1462
3353
3175
4854
1904
486
2597
3626
631
4601
3058
11809
9099
7335
3195
51159
4911
1573
2120
3949
2001
33
177
1468
1085
4541
3828
1696
4046
10110
8196
1425
50459
3136
4067
3157
4310
3359
3843
4668
5859
4197
4611
361
2474
2594
1029
2794
54127
3943
5549
15667
6697
5187
1669
3200
8259
3956
143338
35936
2393
1439
1735
4820
3608
2541
951
513
669
1647
968
1603
2343
1201
5507
3998
43425
6991
6933
3986
1584
717
1565
1246
2094
672
217
953
1506
244
1878
1058
4130
3534
3244
873
21501
1854
700
1089
1987
906
26
45
708
555
2041
1785
581
1372
3616
3693
543
20610
1158
1744
1223
1890
1303
1529
1798
2487
1897
1911
189
1031
842
396
1212
21866
1393
2598
6137
2493
2495
593
870
3571
1716
Pneumonia
45779
14396
1139
706
766
1559
1586
2154
351
186
198
432
239
699
1268
428
986
1699
13240
1738
1813
862
699
213
417
508
589
131
50
211
345
41
664
374
2156
785
1267
377
4857
686
166
257
323
211
1
36
88
240
543
374
232
377
452
638
233
7549
609
601
538
682
515
800
507
810
524
387
56
665
304
210
341
5737
914
814
925
692
749
108
291
867
377
Diarrhoea
Sev Pneu/ very
severe disease
1093
341
17
2
23
10
22
46
14
0
5
14
99
12
16
5
17
39
285
42
9
21
4
4
1
17
7
2
0
1
6
0
36
6
53
58
8
10
68
4
3
0
7
3
0
0
3
0
14
5
0
3
0
14
12
210
3
6
15
11
32
8
15
11
15
51
6
8
4
13
12
189
22
22
27
35
70
2
4
2
5
No Dehydration
92735
20999
1392
720
978
3059
2544
1491
561
228
244
780
425
665
1257
632
3748
2275
29670
5048
3481
2486
791
341
936
762
1346
567
176
880
921
226
1327
998
3415
2941
2240
788
13279
915
326
517
981
446
10
48
364
182
968
806
280
1255
3085
2797
299
14118
834
1123
853
1415
778
1240
905
1871
1378
1427
86
585
572
314
737
14669
1020
1476
4355
1738
1465
607
925
2183
900
Some Dehydration
24202
8334
733
420
314
767
460
1342
32
126
69
226
190
427
587
354
1251
1036
7582
779
1206
487
297
46
162
313
351
58
0
137
185
29
374
229
1457
533
835
104
2194
235
73
139
81
108
0
5
22
14
203
104
38
15
462
614
81
3450
143
289
182
412
201
183
168
222
369
281
23
332
207
132
306
2642
339
444
357
470
182
55
82
443
270
Severe Dehydration
610
127
4
7
14
2
5
11
0
0
1
20
10
5
12
16
14
6
186
18
42
18
0
0
0
4
13
0
0
3
9
0
11
8
47
13
0
0
59
7
2
7
1
16
0
0
0
0
16
1
0
2
0
4
3
182
1
11
0
2
0
8
1
2
28
29
68
9
0
15
8
56
9
9
8
8
0
0
0
18
4
Dysentery
6274
983
119
8
19
67
32
61
21
2
3
40
49
25
231
55
160
91
1503
149
213
104
24
10
93
83
86
13
2
29
104
11
86
45
255
93
51
52
1112
95
6
14
15
22
1
3
11
6
222
58
12
31
176
400
40
1446
24
62
71
236
100
65
22
168
49
229
28
49
99
50
194
1230
150
209
312
147
70
9
42
158
133
Other fever
20204
3954
544
162
223
507
158
167
74
47
106
233
131
195
333
147
418
509
5159
349
605
353
195
81
150
270
237
86
2
112
190
66
286
239
816
508
334
280
2967
471
159
102
101
137
4
6
104
63
227
233
99
181
460
516
104
3655
177
196
152
491
286
220
625
357
293
462
12
24
191
56
113
4469
195
447
1519
509
334
158
317
695
295
Severe malnutrition
923
179
8
2
0
7
41
0
0
0
8
32
21
0
7
9
33
11
291
3
33
14
7
0
4
78
9
6
0
1
2
1
12
10
44
24
14
29
107
5
0
3
0
8
0
0
3
1
3
1
3
1
0
79
0
198
0
11
9
9
12
14
9
20
23
40
6
8
4
24
9
148
24
7
38
27
14
6
0
28
4
Anaemia
807
104
1
22
2
17
3
10
0
1
0
3
5
0
2
1
24
13
278
7
14
22
11
1
0
39
0
1
0
4
0
1
11
9
35
70
29
24
124
5
8
1
6
0
0
0
0
0
0
2
2
3
16
81
0
144
5
6
3
4
19
15
17
8
8
14
6
6
18
9
6
157
0
24
56
14
16
16
6
23
2
Other
26796
6148
491
240
118
536
511
317
163
109
215
411
221
369
341
393
1069
644
7536
705
825
666
237
87
202
222
286
78
15
343
297
33
296
284
1204
1187
309
260
5088
452
117
222
140
185
0
23
112
62
329
348
315
750
1629
295
109
3992
336
297
282
297
404
142
745
786
122
276
8
39
149
24
85
4032
269
571
1354
263
191
64
332
662
326
355
PHC-ORC (2 - 59 months Children)

Treatment
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
356
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
50230
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7127
573
525
536
573
628
564
434
636
737
419
179
359
360
282
322
5053
336
565
904
668
585
268
371
852
504
Cotrim
Paediatrics
60192
18840
1742
864
939
1876
1438
2067
518
251
312
864
464
847
2288
614
1403
2353
14786
1553
2096
852
695
268
567
814
751
130
57
233
447
36
778
613
2387
989
1106
414
8066
1083
206
350
631
320
8
50
139
272
908
580
373
333
914
1430
469
9844
711
681
613
959
780
755
640
962
772
1090
91
585
441
229
535
8656
1043
1034
1735
1082
1283
306
406
1339
428
ORS and Zinc
106667
25991
1706
1012
1300
3158
2373
2862
408
331
275
1006
611
859
1820
866
4372
3032
34072
4848
4404
2588
1100
342
1106
1111
1781
568
144
1068
1058
241
1544
1079
4760
3156
2212
962
13997
1152
416
591
1071
456
6
103
320
218
1109
917
325
1208
3185
2544
376
15817
1005
1329
871
1892
837
1204
986
1826
1601
1595
89
786
741
296
759
16790
1386
1793
4752
2041
1519
523
1045
2600
1131
ORS Only
28377
7064
257
128
223
631
487
1049
178
39
17
280
293
377
595
212
1283
1015
9631
1359
1953
823
270
24
328
567
149
101
34
345
194
15
333
315
1282
797
651
91
3374
249
45
106
127
181
0
20
52
34
316
192
31
150
758
1021
92
3751
73
508
138
140
208
219
196
124
378
896
26
309
108
113
315
4557
810
884
872
660
444
208
74
360
245
Refer
Antihelminthes
10395
2083
364
29
62
341
107
164
4
23
51
44
65
50
172
136
228
243
3996
605
762
338
79
7
41
62
35
5
0
18
126
2
154
215
789
333
227
198
1302
98
11
34
71
39
0
2
8
32
125
128
13
78
280
337
46
1768
34
192
53
28
119
55
115
174
65
397
36
50
124
85
241
1246
95
349
359
193
58
15
23
97
57
Vitamin A
2737
458
46
17
17
110
33
40
1
2
5
9
7
1
59
4
54
53
1182
211
149
133
29
2
8
91
15
31
1
11
17
2
47
67
210
64
36
58
402
27
2
6
17
4
0
0
2
2
44
30
13
7
30
216
2
389
34
45
15
19
27
15
21
18
25
81
7
5
24
18
35
306
10
118
94
32
18
1
4
21
8
Death
Expenditure
Follow-up
ARI
1635
474
29
4
24
199
7
83
1
3
3
22
23
4
24
10
23
15
393
98
43
28
15
0
12
40
7
14
0
9
33
0
34
8
42
9
1
0
213
13
2
9
2
14
0
0
2
10
5
8
0
3
41
89
15
317
2
17
0
17
0
22
1
11
37
93
66
10
17
12
12
238
4
52
26
38
18
15
8
11
66
Diarrhoea
Others
1237 1284
291 287
14
12
0
9
19
40
66
35
0
14
128
23
0
0
0
3
1
13
11
3
6
74
0
9
20
19
3
1
16
23
7
9
329 390
19
94
68
61
85
43
5
8
0
0
5
13
17
5
15
3
10
10
0
0
13
4
7
2
0
0
38
92
7
11
17
12
23
17
0
4
0
11
198 245
17
8
2
0
20
45
3
27
10
4
0
0
0
0
1
1
7
0
1
0
0
18
0
2
8
2
57
55
70
32
2
51
209 200
1
10
9
11
0
0
3
8
5
0
8
1
2
39
10
32
12
19
115
49
0
6
17
5
12
14
6
2
9
4
210 162
2
3
45
37
37
33
25
52
22
25
10
0
1
2
9
10
59
0
ARI
28354
8804
761
424
433
897
581
1214
170
56
51
180
130
429
781
328
1358
1011
9167
929
1158
531
330
116
262
108
369
127
64
371
341
15
536
244
1836
703
1043
84
3329
400
63
58
183
83
11
23
42
94
443
356
33
250
378
800
112
3437
246
225
66
233
254
323
380
455
285
451
38
140
110
118
113
3617
611
291
1102
341
315
81
169
462
245
134
106
0
6
1
0
4
0
0
20
0
0
1
0
0
0
70
4
13
0
1
4
0
0
0
2
0
0
0
0
1
0
0
0
5
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
10
0
0
0
0
0
0
0
0
2
1
6
1
0
0
0
3
0
0
0
0
1
1
0
0
1
Diarrhoea
15
0
0
0
0
0
0
0
0
0
0
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
2
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
8
0
0
0
0
0
0
0
0
0
0
6
2
0
0
0
2
0
0
1
0
0
0
0
0
1
Others
41
7
0
0
2
0
0
0
0
0
0
0
0
0
1
1
0
3
16
0
5
9
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
11
0
0
0
0
0
0
0
0
0
2
6
2
1
0
0
5
0
1
2
0
0
0
0
2
0
ORS (Pkt)
191075
48771
3558
1848
2312
6077
4412
5202
822
690
491
1675
1486
1432
3457
1454
8752
5103
56996
8669
7326
4041
1838
608
2389
1759
3082
893
293
2108
1980
461
2964
1986
6669
4370
4022
1538
28579
2583
739
1640
1625
1029
15
97
640
346
2744
1574
556
1881
7272
5083
755
28261
1393
2821
1510
2770
1897
2227
1255
3026
2347
3282
190
1430
1474
801
1838
28468
2070
3316
8336
3369
3063
995
1517
3909
1893
Zinc
(tab)
1003001
244372
17077
10900
11116
31794
24541
19512
4523
3360
2782
8794
5035
8908
14858
8826
43484
28862
314452
48435
35676
24314
9450
3557
9322
7938
17070
4427
1420
8134
10269
2410
15684
10604
43024
31029
23306
8383
134474
11258
3611
5460
10090
4814
70
600
3410
1842
12580
8695
3196
11980
30529
23929
2410
153665
10050
12155
8340
19242
9275
10844
9293
18979
15224
14068
846
7040
7447
3280
7582
156038
11882
15405
45843
17865
14792
6108
9890
23861
10392
FCHV
District
Code
District Name
Received
Reports
Below 2 months
28Days
2 - 59 months
Treated with cotrim & refered to

HF
Sick baby
29-59 Days
28Days
Total cases of ARI
29-59 Days
No pneumonia
cases
Treated with
cotrim
Total cases of
diarrhoea
Death
Treated with ORS Treated with ORS ORS expenditure Zinc expenditure
28Days 29-59 Days
only
& Zinc
(packet)
(tablet)
2-59
months
National Total
49434
20565
50285
11041
27687
1209706
984678
276737
930109
346187
852680
1410652
7351904
1602
152
371
EASTERN
11214
3765
11051
2791
7864
294941
220714
76919
187834
74369
162263
280620
1482991
243
24
90
1 TAPLEJUNG
660
133
552
181
501
6626
4586
2699
3806
909
3257
6560
30897
2 PANCHTHAR
514
39
230
20
74
10039
8073
2006
6467
1333
6370
10758
61065
12
3 ILAM
580
46
375
27
172
12463
10715
2759
8225
4145
7424
13968
58586
16
4 JHAPA
577
356
1115
233
1412
37926
26884
12269
21029
7029
20215
36565
182976
18
5 MORANG
807
375
1385
355
893
40939
28472
11429
22206
6797
19191
30770
193572
42
63
6 SUNSARI
617
855
1281
733
1144
34381
21148
8337
23985
12896
18195
33535
162792
20
7 DHANKUTA
570
108
349
80
212
9569
7817
2601
6050
1913
5312
7624
50620
8 TERHATHUM
371
134
289
165
315
8203
7056
1198
5273
1459
4046
7624
38737
11
9 SANKHUWASABHA
476
88
485
65
188
7737
6073
2503
3962
1399
4206
6052
35831
10 BHOJPUR
764
322
1084
90
528
13531
11236
4285
8743
4275
7657
12299
62701
15
11 SOLUKHUMBU
416
192
640
172
507
5967
4796
2264
4675
3399
4363
9042
27836
14
12 OKHALDHUNGA
699
140
435
133
316
22074
18801
6554
12305
5844
9279
16388
86175
14
13 KHOTANG
902
177
508
141
601
11286
7150
5148
7137
2421
5854
12371
53553
15
14 UDAYAPUR
571
246
874
181
419
13201
10628
3814
10158
2472
9692
14900
96587
28
1392
449
925
165
354
29435
21762
1856
22780
9353
17076
31845
160661
15 SAPTARI
16 SIRAHA
1298
105
524
50
228
31564
25517
7197
21033
8725
20126
30319
180402
14
15084
3574
11556
2064
5107
309066
252446
58148
239746
95428
227188
367476
1855857
295
33
88
1217
170
729
125
250
29472
24591
4557
18467
4789
20452
26698
157507
12
874
437
1230
440
724
22456
18441
4749
15124
7743
14856
24749
111786
22
19 SARLAHI
1019
456
1516
188
511
30114
25978
4519
17131
8191
15661
23977
141346
40
20 SINDHULI
645
79
270
47
175
15092
10896
4853
10101
2722
13048
14507
82924
27
21 RAMECHHAP
671
58
311
20
174
14964
13462
2101
13383
4416
11364
21786
105835
22 DOLAKHA
641
53
459
62
236
12931
11508
2359
11180
4609
13755
18965
88721
23 SINDHUPALCHOK
864
80
229
45
247
9614
9593
1749
9265
6237
5321
13301
44436
20
35
CENTRAL
17 DHANUSA
18 MAHOTTARI
24 KAVRE
1175
202
271
96
122
17333
16239
1850
15160
3329
14870
25529
131237
18
25 LALITPUR
551
22
111
29
7139
6366
288
6217
2534
6257
9626
45132
26 BHAKTAPUR
273
64
136
11
58
2774
3085
115
4075
1963
3094
11501
29298
27 KATHMANDU
856
149
412
25
157
17034
16394
843
18597
11034
12152
29261
98758
28 NUWAKOT
955
60
265
22
141
6708
6328
735
5032
1148
4781
8610
42545
29 RASUWA
223
21
170
12
32
2637
2473
205
3598
644
3032
5249
30320
10
30 DHADING
619
208
663
118
328
12222
9902
3052
11512
2400
10814
16822
97461
31 MAKWANPUR
565
329
1125
205
436
19520
16335
5148
18308
11562
16441
24492
142479
36
32 RAUTAHAT
1160
324
898
136
418
18232
14703
5422
15651
5475
15631
21271
144244
35
33 BARA
1167
230
889
90
273
30626
21417
6190
21789
8240
20538
29087
151003
16
34 PARSA
1053
182
682
169
311
23932
12404
4994
12580
4808
12137
19255
107833
556
450
1190
252
485
16266
12331
4419
12576
3584
12984
22790
102992
24
WESTERN
10993
2319
6338
884
3038
185283
164040
29453
135253
46859
121075
221368
1029164
179
11
23
36 GORKHA
876
86
326
30
124
12371
9860
2572
6281
1711
5519
11246
53937
37 LAMJUNG
741
21
205
15
49
10050
9373
953
6444
1589
6160
8358
59783
38 TANAHU
572
92
349
85
204
8179
6518
1726
6757
2210
5966
11093
53952
39 SYANGJA
819
142
421
32
125
16141
14755
2020
7815
1456
7609
12711
75594
40 KASKI
740
451
860
36
227
18756
17617
1813
14225
6339
11691
23649
90747
41 MANANG
164
158
144
38
224
106
282
418
1522
42 MUSTANG
193
29
11
315
336
67
365
123
374
711
2980
43 MYAGDI
475
127
209
12
102
5590
4981
951
4997
1756
4883
10566
39955
10
44 PARBAT
685
25
225
47
10708
9772
1656
4842
1511
4312
7755
41898
45 BAGLUNG
735
196
725
189
721
15785
13375
3810
8829
4314
9204
17691
65607
46 GULMI
908
95
292
28
125
17434
14952
2783
8453
3307
7689
14080
64978
41
47 PALPA
794
91
318
54
144
11151
8693
2780
7337
1338
7141
12548
67404
14
48 NAWALPARASI
920
413
882
161
339
19838
17607
2975
18949
3565
17968
24971
163335
49 RUPANDEHI
964
262
483
64
224
21142
19475
2056
22584
8822
20626
38636
147895
50 KAPILBASTU
907
235
786
129
443
8216
7701
1678
10892
5205
8026
16776
69509
41
51 ARGHAKHANCHI
500
81
221
41
149
9449
8881
1575
6259
3507
3625
10159
30068
23
MID WESTERN
35 CHITAWAN
7076
4230
10841
2998
6235
223478
173828
67864
189956
61241
186607
301930
1603959
419
51
100
52 PYUTHAN
575
69
467
67
215
17201
12647
5404
11363
1997
10742
13140
106474
32
53 ROLPA
594
113
472
60
383
14899
12165
5440
14570
15487
13813
21916
112975
23
54 RUKUM
513
115
264
46
129
5344
3707
1637
4934
770
4164
7627
41230
12
55 SALYAN
567
139
752
123
453
17386
13744
4776
13350
1372
12535
18715
122353
53
26
56 DANG
625
793
1425
564
879
22845
18093
7350
20212
6013
23850
31337
170850
34
57 BANKE
556
398
1537
296
781
27149
20806
7669
25312
7335
23495
61070
208705
49
58 BARDIYA
404
1008
1246
751
816
31735
25683
6940
23275
6040
22509
29308
197825
49
59 SURKHET
630
414
744
230
393
25214
19097
6117
23239
3525
19663
36610
185485
26
60 DAILEKH
734
241
774
160
471
28359
24535
9741
27367
9467
28572
38744
224439
42
13
61 JAJARKOT
419
350
905
220
545
5962
5050
2337
4897
2628
4857
9542
41057
26
62 DOLPA
164
53
146
12
92
704
517
364
388
173
504
1192
3890
63 JUMLA
357
242
1148
151
393
11694
7470
5287
8198
4691
10579
12510
73349
36
13
64 KALIKOT
356
175
536
188
318
10183
7170
3149
9724
788
8966
13888
93304
30
65 MUGU
268
18
112
28
65
1690
907
783
1171
231
869
2246
8583
66 HUMLA
314
102
313
102
302
3113
2237
870
1956
724
1489
4085
13440
5067
6677
10499
2304
5443
196938
173650
44353
177320
68290
155547
239258
1379933
466
33
70
67 BAJURA
336
259
800
245
710
17818
12662
8325
10205
6265
10057
14687
88316
32
68 BAJHANG
575
296
775
252
523
16049
12475
5113
12022
6453
10697
17580
85150
36
69 ACHHAM
905
440
901
196
481
29893
28731
5767
23291
8662
22719
35533
187209
47
11
70 DOTI
667
366
940
263
504
14970
12991
3905
13902
6092
12986
20270
118954
57
13
71 KAILALI
590
4576
3866
778
2010
38032
36635
8479
45984
21589
30717
51320
299433
149
72 KANCHANPUR
266
404
1382
299
616
27072
22752
4448
30324
9345
28142
42777
241036
22
73 DADELDHURA
372
168
540
108
207
11646
10198
1814
11571
1560
11087
14412
107574
34
74 BAITADI
852
165
1019
160
353
31737
27969
5267
23994
6166
21229
33101
205045
64
13
75 DARCHAULA
504
276
39
9721
9237
1235
6027
2158
7913
9578
47216
25
11
FAR WESTERN
357
Classification
District
Code
District Name
ARI
Received
Reports
No pneumonia
HF
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
358
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50230
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7127
573
525
536
573
628
564
434
636
737
419
179
359
360
282
322
5053
336
565
904
668
585
268
371
852
504
498640
121170
3324
5301
3787
12722
13743
11029
5875
3506
4022
5838
5412
6980
6293
5001
13096
15241
123284
12348
11357
11494
2913
5521
6210
5299
8000
6003
2337
5011
3957
1574
6788
4638
8410
8397
5904
7123
95107
5953
3658
3543
5231
5375
233
998
5118
3492
9124
8683
5788
11540
11332
11502
3537
84726
5848
4081
4531
5474
11123
8537
11900
10598
6411
5171
873
2316
3245
1404
3214
74353
5564
5798
17359
5402
17656
7811
4915
6830
3018
PHCORC
143338
35936
2393
1439
1735
4820
3608
2541
951
513
669
1647
968
1603
2343
1201
5507
3998
43425
6991
6933
3986
1584
717
1565
1246
2094
672
217
953
1506
244
1878
1058
4130
3534
3244
873
21501
1854
700
1089
1987
906
26
45
708
555
2041
1785
581
1372
3616
3693
543
20610
1158
1744
1223
1890
1303
1529
1798
2487
1897
1911
189
1031
842
396
1212
21866
1393
2598
6137
2493
2495
593
870
3571
1716
FCHV
984678
220714
4586
8073
10715
26884
28472
21148
7817
7056
6073
11236
4796
18801
7150
10628
21762
25517
252446
24591
18441
25978
10896
13462
11508
9593
16239
6366
3085
16394
6328
2473
9902
16335
14703
21417
12404
12331
164040
9860
9373
6518
14755
17617
144
336
4981
9772
13375
14952
8693
17607
19475
7701
8881
173828
12647
12165
3707
13744
18093
20806
25683
19097
24535
5050
517
7470
7170
907
2237
173650
12662
12475
28731
12991
36635
22752
10198
27969
9237
Pneumonia
Total
1626656
377820
10303
14813
16237
44426
45823
34718
14643
11075
10764
18721
11176
27384
15786
16830
40365
44756
419155
43930
36731
41458
15393
19700
19283
16138
26333
13041
5639
22358
11791
4291
18568
22031
27243
33348
21552
20327
280648
17667
13731
11150
21973
23898
403
1379
10807
13819
24540
25420
15062
30519
34423
22896
12961
279164
19653
17990
9461
21108
30519
30872
39381
32182
32843
12132
1579
10817
11257
2707
6663
269869
19619
20871
52227
20886
56786
31156
15983
38370
13971
HF
251029
65738
2470
3461
2975
6631
6858
7285
2823
2106
3804
2448
2262
3778
4314
3184
3401
7938
73644
5394
6310
6264
2995
3057
3084
3163
4029
3385
888
2457
1979
719
5555
3186
5852
4329
4389
6609
36828
3356
1889
1934
1628
1638
103
319
1501
2673
3288
2189
2920
4963
3451
3363
1613
45411
3736
3487
3316
3504
5103
4689
5108
4260
3318
1992
463
1881
2187
1062
1305
29408
3197
3624
3902
2472
3408
3889
2304
4244
2368
PHCORC
45779
14396
1139
706
766
1559
1586
2154
351
186
198
432
239
699
1268
428
986
1699
13240
1738
1813
862
699
213
417
508
589
131
50
211
345
41
664
374
2156
785
1267
377
4857
686
166
257
323
211
1
36
88
240
543
374
232
377
452
638
233
7549
609
601
538
682
515
800
507
810
524
387
56
665
304
210
341
5737
914
814
925
692
749
108
291
867
377
Sev Pneu/ very severe disease

FCHV
Total
276737
76919
2699
2006
2759
12269
11429
8337
2601
1198
2503
4285
2264
6554
5148
3814
1856
7197
58148
4557
4749
4519
4853
2101
2359
1749
1850
288
115
843
735
205
3052
5148
5422
6190
4994
4419
29453
2572
953
1726
2020
1813
38
67
951
1656
3810
2783
2780
2975
2056
1678
1575
67864
5404
5440
1637
4776
7350
7669
6940
6117
9741
2337
364
5287
3149
783
870
44353
8325
5113
5767
3905
8479
4448
1814
5267
1235
573545
157053
6308
6173
6500
20459
19873
17776
5775
3490
6505
7165
4765
11031
10730
7426
6243
16834
145032
11689
12872
11645
8547
5371
5860
5420
6468
3804
1053
3511
3059
965
9271
8708
13430
11304
10650
11405
71138
6614
3008
3917
3971
3662
142
422
2540
4569
7641
5346
5932
8315
5959
5679
3421
120824
9749
9528
5491
8962
12968
13158
12555
11187
13583
4716
883
7833
5640
2055
2516
79498
12436
9551
10594
7069
12636
8445
4409
10378
3980
HF
PHCORC
7358
1560
48
87
58
89
141
190
13
21
108
97
108
69
162
136
19
214
1970
163
59
157
108
43
62
62
67
64
5
42
30
19
268
108
179
269
202
63
713
24
10
17
23
15
1
2
139
24
78
40
44
74
5
184
33
1802
49
53
181
116
203
121
131
93
251
166
20
86
135
69
128
1313
107
164
174
158
237
144
170
100
59
1093
341
17
2
23
10
22
46
14
0
5
14
99
12
16
5
17
39
285
42
9
21
4
4
1
17
7
2
0
1
6
0
36
6
53
58
8
10
68
4
3
0
7
3
0
0
3
0
14
5
0
3
0
14
12
210
3
6
15
11
32
8
15
11
15
51
6
8
4
13
12
189
22
22
27
35
70
2
4
2
5
Total
Total
8451
1901
65
89
81
99
163
236
27
21
113
111
207
81
178
141
36
253
2255
205
68
178
112
47
63
79
74
66
5
43
36
19
304
114
232
327
210
73
781
28
13
17
30
18
1
2
142
24
92
45
44
77
5
198
45
2012
52
59
196
127
235
129
146
104
266
217
26
94
139
82
140
1502
129
186
201
193
307
146
174
102
64
2208652
536774
16676
21075
22818
64984
65859
52730
20445
14586
17382
25997
16148
38496
26694
24397
46644
61843
566442
55824
49671
53281
24052
25118
25206
21637
32875
16911
6697
25912
14886
5275
28143
30853
40905
44979
32412
31805
352567
24309
16752
15084
25974
27578
546
1803
13489
18412
32273
30811
21038
38911
40387
28773
16427
402000
29454
27577
15148
30197
43722
44159
52082
43473
46692
17065
2488
18744
17036
4844
9319
350869
32184
30608
63022
28148
69729
39747
20566
48850
18015
Classification
District
Code
District Name
Diarrhoea
Received
Reports
No Dehydration
HF
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50230
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7127
573
525
536
573
628
564
434
636
737
419
179
359
360
282
322
5053
336
565
904
668
585
268
371
852
504
290374
52700
1407
1458
991
6598
5064
5325
1729
942
2209
2076
2161
2196
2694
3087
7713
7050
84756
8186
6102
8644
1764
2165
3337
2584
4239
3082
1329
3738
3495
1015
4602
2904
9232
8163
6229
3946
51365
2959
1749
1276
2423
1804
136
368
2655
1105
2679
3799
3098
6475
8585
10565
1689
55056
4010
3448
3447
4051
6332
6832
4479
6862
3567
4068
495
1628
2880
931
2026
46497
5157
4510
12650
4386
6778
4129
2873
4466
1548
PHCORC
92735
20999
1392
720
978
3059
2544
1491
561
228
244
780
425
665
1257
632
3748
2275
29670
5048
3481
2486
791
341
936
762
1346
567
176
880
921
226
1327
998
3415
2941
2240
788
13279
915
326
517
981
446
10
48
364
182
968
806
280
1255
3085
2797
299
14118
834
1123
853
1415
778
1240
905
1871
1378
1427
86
585
572
314
737
14669
1020
1476
4355
1738
1465
607
925
2183
900
Some Dehydration
Total
383109
73699
2799
2178
1969
9657
7608
6816
2290
1170
2453
2856
2586
2861
3951
3719
11461
9325
114426
13234
9583
11130
2555
2506
4273
3346
5585
3649
1505
4618
4416
1241
5929
3902
12647
11104
8469
4734
64644
3874
2075
1793
3404
2250
146
416
3019
1287
3647
4605
3378
7730
11670
13362
1988
69174
4844
4571
4300
5466
7110
8072
5384
8733
4945
5495
581
2213
3452
1245
2763
61166
6177
5986
17005
6124
8243
4736
3798
6649
2448
HF
72767
20125
911
827
426
1579
1147
2117
95
608
310
709
786
1206
2041
966
3057
3340
21868
1665
2645
2238
760
178
843
1365
772
283
127
551
538
116
1132
1136
3376
1503
2262
378
8129
774
135
624
400
196
10
78
225
118
752
346
906
163
934
2076
392
13081
731
906
806
767
764
897
587
902
1723
1058
264
783
1321
500
1072
9564
1787
1777
1279
1240
793
521
205
1402
560
PHCORC
24202
8334
733
420
314
767
460
1342
32
126
69
226
190
427
587
354
1251
1036
7582
779
1206
487
297
46
162
313
351
58
0
137
185
29
374
229
1457
533
835
104
2194
235
73
139
81
108
0
5
22
14
203
104
38
15
462
614
81
3450
143
289
182
412
201
183
168
222
369
281
23
332
207
132
306
2642
339
444
357
470
182
55
82
443
270
Severe Dehydration
Total
96969
28459
1644
1247
740
2346
1607
3459
127
734
379
935
976
1633
2628
1320
4308
4376
29450
2444
3851
2725
1057
224
1005
1678
1123
341
127
688
723
145
1506
1365
4833
2036
3097
482
10323
1009
208
763
481
304
10
83
247
132
955
450
944
178
1396
2690
473
16531
874
1195
988
1179
965
1080
755
1124
2092
1339
287
1115
1528
632
1378
12206
2126
2221
1636
1710
975
576
287
1845
830
HF
2623
521
9
47
28
7
54
37
0
5
13
24
79
29
38
28
69
54
827
31
60
98
47
6
18
32
8
4
5
14
8
1
119
27
175
54
106
14
209
3
4
16
1
4
0
0
8
4
12
15
43
40
2
49
8
619
35
11
21
54
32
47
55
18
22
81
25
37
45
76
60
447
66
45
63
65
85
23
38
26
36
PHCORC
610
127
4
7
14
2
5
11
0
0
1
20
10
5
12
16
14
6
186
18
42
18
0
0
0
4
13
0
0
3
9
0
11
8
47
13
0
0
59
7
2
7
1
16
0
0
0
0
16
1
0
2
0
4
3
182
1
11
0
2
0
8
1
2
28
29
68
9
0
15
8
56
9
9
8
8
0
0
0
18
4
Total cases of
diarrhoea
Dysentery
Total
3233
648
13
54
42
9
59
48
0
5
14
44
89
34
50
44
83
60
1013
49
102
116
47
6
18
36
21
4
5
17
17
1
130
35
222
67
106
14
268
10
6
23
2
20
0
0
8
4
28
16
43
42
2
53
11
801
36
22
21
56
32
55
56
20
50
110
93
46
45
91
68
503
75
54
71
73
85
23
38
44
40
HF
60624
9478
255
204
118
1075
804
905
284
157
183
338
359
399
924
634
1542
1297
16853
1336
1548
1778
348
240
946
665
498
316
302
572
578
109
1529
530
2290
1275
985
1008
10441
938
136
135
176
217
3
68
262
178
868
799
277
911
2341
2717
415
13035
760
696
594
792
1905
1244
1169
1879
480
842
217
407
714
502
834
10817
1505
1035
1985
971
1731
1361
542
1112
575
PHCORC
6274
983
119
8
19
67
32
61
21
2
3
40
49
25
231
55
160
91
1503
149
213
104
24
10
93
83
86
13
2
29
104
11
86
45
255
93
51
52
1112
95
6
14
15
22
1
3
11
6
222
58
12
31
176
400
40
1446
24
62
71
236
100
65
22
168
49
229
28
49
99
50
194
1230
150
209
312
147
70
9
42
158
133
Total
66898
10461
374
212
137
1142
836
966
305
159
186
378
408
424
1155
689
1702
1388
18356
1485
1761
1882
372
250
1039
748
584
329
304
601
682
120
1615
575
2545
1368
1036
1060
11553
1033
142
149
191
239
4
71
273
184
1090
857
289
942
2517
3117
455
14481
784
758
665
1028
2005
1309
1191
2047
529
1071
245
456
813
552
1028
12047
1655
1244
2297
1118
1801
1370
584
1270
708
Total
FCHV
930109
187834
3806
6467
8225
21029
22206
23985
6050
5273
3962
8743
4675
12305
7137
10158
22780
21033
239746
18467
15124
17131
10101
13383
11180
9265
15160
6217
4075
18597
5032
3598
11512
18308
15651
21789
12580
12576
135253
6281
6444
6757
7815
14225
224
365
4997
4842
8829
8453
7337
18949
22584
10892
6259
189956
11363
14570
4934
13350
20212
25312
23275
23239
27367
4897
388
8198
9724
1171
1956
177320
10205
12022
23291
13902
45984
30324
11571
23994
6027
1548851
313766
9295
10458
11777
36475
34400
35423
9301
7443
7169
13510
8969
17495
15591
16208
42831
37421
425079
39948
32696
34983
14626
16664
18289
15522
23468
11049
6192
25264
11606
5302
21645
24954
37856
38772
26693
19550
233126
12887
9128
9863
12793
17376
394
978
8886
6617
15314
15083
12233
29081
40792
32297
9404
301611
18592
21950
11579
22082
30901
36885
31398
36812
35992
14058
1657
12281
15927
3873
7624
275269
20919
22559
48298
24195
58371
37581
17121
35542
10683
359
Treatment
ARI
District Code
District Name
Received
Reports
Diarrhoea
Other
antibiotics
Cotrim Paediatrics
IV Fluid
ORS and Zinc
ORS Only
Total
HF
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
360
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50230
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7127
573
525
536
573
628
564
434
636
737
419
179
359
360
282
322
5053
336
565
904
668
585
268
371
852
504
405716
98921
3813
3741
2955
10262
9278
10862
3525
2910
3062
4863
3532
8386
7180
4773
8579
11200
111258
9256
12846
10680
3466
3304
4777
4039
5217
3026
1556
2973
1183
490
6246
4538
12703
9441
7484
8033
68418
5694
1934
2520
3153
2074
120
521
2879
2561
4225
5096
5178
4921
10038
13992
3512
69912
5234
4319
4212
4452
10062
7284
7332
7508
5375
4224
680
2198
3395
1198
2439
57207
5541
5139
9469
4957
9850
8181
3474
7483
3113
PHCORC
FCHV
Total
60192 276737 742645

18840 76919 194680
1742 2699 8254
864 2006 6611
939 2759 6653
1876 12269 24407
1438 11429 22145
2067 8337 21266
518 2601 6644
251 1198 4359
312 2503 5877
864 4285 10012
464 2264 6260
847 6554 15787
2288 5148 14616
614 3814 9201
1403 1856 11838
2353 7197 20750
14786 58148 184192
1553 4557 15366
2096 4749 19691
852 4519 16051
695 4853 9014
268 2101 5673
567 2359 7703
814 1749 6602
751 1850 7818
130
288 3444
57
115 1728
233
843 4049
447
735 2365
36
205
731
778 3052 10076
613 5148 10299
2387 5422 20512
989 6190 16620
1106 4994 13584
414 4419 12866
8066 29453 105937
1083 2572 9349
206
953 3093
350 1726 4596
631 2020 5804
320 1813 4207
8
38
166
50
67
638
139
951 3969
272 1656 4489
908 3810 8943
580 2783 8459
373 2780 8331
333 2975 8229
914 2056 13008
1430 1678 17100
469 1575 5556
9844 67864 147620
711 5404 11349
681 5440 10440
613 1637 6462
959 4776 10187
780 7350 18192
755 7669 15708
640 6940 14912
962 6117 14587
772 9741 15888
1090 2337 7651
91
364 1135
585 5287 8070
441 3149 6985
229
783 2210
535
870 3844
8656 44353 110216
1043 8325 14909
1034 5113 11286
1735 5767 16971
1082 3905 9944
1283 8479 19612
306 4448 12935
406 1814 5694
1339 5267 14089
428 1235 4776
HF
260777
58049
1747
2676
1907
5465
4517
4868
2368
2137
2992
3586
1843
4108
3668
2120
6006
8041
67899
4591
4829
3845
2062
2898
1811
2820
3616
2441
1617
2756
2641
716
4923
3867
4140
6179
4909
7238
47311
5121
1993
2034
1825
1548
75
458
1841
1993
3523
3162
2970
7922
5403
5129
2314
51191
4239
2726
2594
2770
7760
4851
6232
9304
3300
2863
179
680
2543
683
467
36327
2857
1495
7755
3089
7574
5071
3399
3470
1617
Total
HF
1003422
252729
10001
9287
8560
29872
26662
26134
9012
6496
8869
13598
8103
19895
18284
11321
17844
28791
252091
19957
24520
19896
11076
8571
9514
9422
11434
5885
3345
6805
5006
1447
14999
14166
24652
22799
18493
20104
153248
14470
5086
6630
7629
5755
241
1096
5810
6482
12466
11621
11301
16151
18411
22229
7870
198811
15588
13166
9056
12957
25952
20559
21144
23891
19188
10514
1314
8750
9528
2893
4311
146543
17766
12781
24726
13033
27186
18006
9093
17559
6393
9081
1605
1
91
99
206
52
221
0
39
47
78
168
68
123
35
57
320
3032
168
342
194
75
82
98
48
48
133
12
37
100
15
277
80
342
618
223
140
1038
21
24
24
40
26
0
5
0
34
156
50
259
87
76
173
63
1978
30
309
10
94
546
163
88
59
142
133
35
45
187
75
62
1428
94
30
316
113
506
90
126
100
53
HF
356275
68225
2212
2183
1225
6929
5794
6140
1680
1460
2330
2600
2484
3143
4895
3487
11012
10651
104014
9499
8673
11339
2357
2289
4689
4114
4953
3183
1509
3892
3760
1121
5644
3860
12695
9058
6889
4490
59753
3996
1905
1847
2793
1867
125
362
3017
1455
3753
4266
3518
6494
9698
12359
2298
67415
5506
4462
3971
4800
7146
7271
5735
7346
4644
5461
606
2225
4140
1477
2625
56868
8458
6071
14030
5294
7377
4534
3216
5787
2101
PHCORC
106667
25991
1706
1012
1300
3158
2373
2862
408
331
275
1006
611
859
1820
866
4372
3032
34072
4848
4404
2588
1100
342
1106
1111
1781
568
144
1068
1058
241
1544
1079
4760
3156
2212
962
13997
1152
416
591
1071
456
6
103
320
218
1109
917
325
1208
3185
2544
376
15817
1005
1329
871
1892
837
1204
986
1826
1601
1595
89
786
741
296
759
16790
1386
1793
4752
2041
1519
523
1045
2600
1131
FCHV
Total
HF
852680
162263
3257
6370
7424
20215
19191
18195
5312
4046
4206
7657
4363
9279
5854
9692
17076
20126
227188
20452
14856
15661
13048
11364
13755
5321
14870
6257
3094
12152
4781
3032
10814
16441
15631
20538
12137
12984
121075
5519
6160
5966
7609
11691
282
374
4883
4312
9204
7689
7141
17968
20626
8026
3625
186607
10742
13813
4164
12535
23850
23495
22509
19663
28572
4857
504
10579
8966
869
1489
155547
10057
10697
22719
12986
30717
28142
11087
21229
7913
1315622
256479
7175
9565
9949
30302
27358
27197
7400
5837
6811
11263
7458
13281
12569
14045
32460
33809
365274
34799
27933
29588
16505
13995
19550
10546
21604
10008
4747
17112
9599
4394
18002
21380
33086
32752
21238
18436
194825
10667
8481
8404
11473
14014
413
839
8220
5985
14066
12872
10984
25670
33509
22929
6299
269839
17253
19604
9006
19227
31833
31970
29230
28835
34817
11913
1199
13590
13847
2642
4873
229205
19901
18561
41501
20321
39613
33199
15348
29616
11145
69702
16765
233
249
286
2065
1254
2189
144
176
197
631
1010
948
1489
408
2739
2747
22434
2050
4005
2871
387
118
890
1230
273
114
305
895
481
50
984
697
3315
1401
2051
317
8846
702
172
168
304
305
30
65
572
161
560
510
398
640
887
3019
353
9504
152
1018
319
206
569
1094
741
270
819
1716
160
835
425
562
618
12153
3418
1905
2383
1382
1209
442
531
700
183
PHCORC
28377
7064
257
128
223
631
487
1049
178
39
17
280
293
377
595
212
1283
1015
9631
1359
1953
823
270
24
328
567
149
101
34
345
194
15
333
315
1282
797
651
91
3374
249
45
106
127
181
0
20
52
34
316
192
31
150
758
1021
92
3751
73
508
138
140
208
219
196
124
378
896
26
309
108
113
315
4557
810
884
872
660
444
208
74
360
245
FCHV
Total
1410652
280620
6560
10758
13968
36565
30770
33535
7624
7624
6052
12299
9042
16388
12371
14900
31845
30319
367476
26698
24749
23977
14507
21786
18965
13301
25529
9626
11501
29261
8610
5249
16822
24492
21271
29087
19255
22790
221368
11246
8358
11093
12711
23649
418
711
10566
7755
17691
14080
12548
24971
38636
16776
10159
301930
13140
21916
7627
18715
31337
61070
29308
36610
38744
9542
1192
12510
13888
2246
4085
239258
14687
17580
35533
20270
51320
42777
14412
33101
9578
1508731
304449
7050
11135
14477
39261
32511
36773
7946
7839
6266
13210
10345
17713
14455
15520
35867
34081
399541
30107
30707
27671
15164
21928
20183
15098
25951
9841
11840
30501
9285
5314
18139
25504
25868
31285
21957
23198
233588
12197
8575
11367
13142
24135
448
796
11190
7950
18567
14782
12977
25761
40281
20816
10604
315185
13365
23442
8084
19061
32114
62383
30245
37004
39941
12154
1378
13654
14421
2921
5018
255968
18915
20369
38788
22312
52973
43427
15017
34161
10006
2824353
560928
14225
20700
24426
69563
59869
63970
15346
13676
13077
24473
17803
30994
27024
29565
68327
67890
764815
64906
58640
57259
31669
35923
39733
25644
47555
19849
16587
47613
18884
9708
36141
46884
58954
64037
43195
41634
428413
22864
17056
19771
24615
38149
861
1635
19410
13935
32633
27654
23961
51431
73790
43745
16903
585024
30618
43046
17090
38288
63947
94353
59475
65839
74758
24067
2577
27244
28268
5563
9891
485173
38816
38930
80289
42633
92586
76626
30365
63777
21151
Death
District Code
District Name
Received
Reports
28Days
HF
PHC ORC
National Total
50230
169
EASTERN
Expenditure
29-59 Days
FCHV
Total
HF
94 1602 1865
PHC ORC
51
2-59 months
FCHV
ARI
Total
HF
Diarrhoea
PHC ORC
HF
Other
PHC ORC
24
152
227
203
134
65
Zinc
ORS (Pkt)
HF
PHC ORC
15
315
41
FCHV
Total
HF
371 1144 698426
FCHV
Total
HF
PHCORC
FCHV
Total
191075 1410652 2300153 3455212 1003001 7351904 11810117
11415
20
45
243
308
24
34
121
106
26
42
90
48771
280620
472836
676680
1 TAPLEJUNG
672
41
51
4636
3558
6560
14754
22332
17077
30897
70306
2 PANCHTHAR
527
12
12
4267
1848
10758
16873
22449
10900
61065
94414
3 ILAM
596
16
18
13
3221
2312
13968
19501
13267
11116
58586
82969
4 JHAPA
604
18
21
15509
6077
36565
58151
77112
31794
182976
291882
5 MORANG
813
42
44
11
31
63
104
13066
4412
30770
48248
66378
24541
193572
284491
6 SUNSARI
615
20
25
11616
5202
33535
50353
55233
19512
162792
237537
7 DHANKUTA
568
3686
822
7624
12132
19061
4523
50620
74204
8 TERHATHUM
384
11
11
30
20
50
3116
690
7624
11430
14493
3360
38737
56590
9 SANKHUWASABHA
524
11
5082
491
6052
11625
23053
2782
35831
61666
10 BHOJPUR
771
15
15
5418
1675
12299
19392
25862
8794
62701
97357
11 SOLUKHUMBU
438
14
15
6495
1486
9042
17023
22594
5035
27836
55465
12 OKHALDHUNGA
701
14
17
62
18
83
5829
1432
16388
23649
31113
8908
86175
126196
13 KHOTANG
901
15
16
9219
3457
12371
25047
43896
14858
53553
112307
14 UDAYAPUR
606
28
29
8768
1454
14900
25122
37199
8826
96587
142612
15 SAPTARI
1392
70
70
23696
8752
31845
64293
102622
43484
160661
306767
16 SIRAHA
1303
14
14
17
19821
5103
30319
55243
100016
28862
180402
309280
15334
23
295
326
33
42
23
13
13
118
16
88
274 204776
56996
367476
629248
990650
314452 1855857
3160959
1235
12
13
19668
8669
26698
55035
95201
48435
157507
301143
889
22
26
18
35
19076
7326
24749
51151
81200
35676
111786
228662
19 SARLAHI
1031
40
43
17
51
18336
4041
23977
46354
98870
24314
141346
264530
20 SINDHULI
666
27
31
13
5139
1838
14507
21484
22773
9450
82924
115147
21 RAMECHHAP
681
10
4586
608
21786
26980
23403
3557
105835
132795
22 DOLAKHA
672
10427
2389
18965
31781
41454
9322
88721
139497
23 SINDHUPALCHOK
898
20
23
35
45
7401
1759
13301
22461
33692
7938
44436
86066
1184
18
18
9999
3082
25529
38610
50287
17070
131237
198594
25 LALITPUR
557
6974
893
9626
17493
32351
4427
45132
81910
26 BHAKTAPUR
267
3349
293
11501
15143
14281
1420
29298
44999
27 KATHMANDU
871
8991
2108
29261
40360
37982
8134
98758
144874
28 NUWAKOT
955
14
19
7044
1980
8610
17634
31158
10269
42545
83972
29 RASUWA
223
10
16
2420
461
5249
8130
11250
2410
30320
43980
30 DHADING
647
10
18
23
11820
2964
16822
31606
53811
15684
97461
166956
31 MAKWANPUR
577
36
40
7950
1986
24492
34428
37228
10604
142479
190311
32 RAUTAHAT
1164
35
37
17
21630
6669
21271
49570
123910
43024
144244
311178
33 BARA
1179
16
17
10
16502
4370
29087
49959
89971
31029
151003
272003
34 PARSA
1063
13053
4022
19255
36330
65733
23306
107833
196872
575
24
26
10411
1538
22790
34739
46095
8383
102992
157470
WESTERN
11301
14
179
196
11
18
64
23
102 113134
28579
221368
363081
563959
134474 1029164
1727597
36 GORKHA
964
10
8752
2583
11246
22581
36681
11258
53937
101876
37 LAMJUNG
750
3040
739
8358
12137
17334
3611
59783
80728
38 TANAHU
621
3788
1640
11093
16521
17849
5460
53952
77261
39 SYANGJA
828
11
4896
1625
12711
19232
26897
10090
75594
112581
40 KASKI
798
3977
1029
23649
28655
18427
4814
90747
113988
41 MANANG
168
257
15
418
690
998
70
1522
2590
42 MUSTANG
204
788
97
711
1596
3216
600
2980
6796
43 MYAGDI
491
10
13
5685
640
10566
16891
29073
3410
39955
72438
44 PARBAT
685
15
16
2450
346
7755
10551
12870
1842
41898
56610
45 BAGLUNG
738
10
7999
2744
17691
28434
37770
12580
65607
115957
46 GULMI
910
41
41
7995
1574
14080
23649
40151
8695
64978
113824
47 PALPA
821
14
18
18
26
5599
556
12548
18703
30464
3196
67404
101064
48 NAWALPARASI
918
15
16
11435
1881
24971
38287
67900
11980
163335
243215
49 RUPANDEHI
998
18968
7272
38636
64876
90245
30529
147895
268669
50 KAPILBASTU
920
41
45
22973
5083
16776
44832
113060
23929
69509
206498
51 ARGHAKHANCHI
487
23
23
4532
755
10159
15446
21024
2410
30068
53502
MID WESTERN
7127
65
16
419
500
19
51
79
27
10
16
66
11
100
238 133493
28261
301930
463684
678089
153665 1603959
2435713
52 PYUTHAN
573
32
35
8187
1393
13140
22720
54970
10050
106474
171494
53 ROLPA
525
23
26
9127
2821
21916
33864
38653
12155
112975
163783
54 RUKUM
536
12
14
10
8696
1510
7627
17833
39201
8340
41230
88771
55 SALYAN
573
53
60
26
27
9249
2770
18715
30734
48280
19242
122353
189875
56 DANG
628
34
39
14651
1897
31337
47885
72841
9275
170850
252966
57 BANKE
564
49
53
10
14638
2227
61070
77935
74715
10844
208705
294264
58 BARDIYA
434
49
55
11539
1255
29308
42102
54064
9293
197825
261182
59 SURKHET
636
26
30
13728
3026
36610
53364
76028
18979
185485
280492
60 DAILEKH
737
42
52
10
12
13
30
8304
2347
38744
49395
53877
15224
224439
293540
61 JAJARKOT
419
26
39
21
11340
3282
9542
24164
50601
14068
41057
105726
62 DOLPA
179
15
13
42
1568
190
1192
2950
6279
846
3890
11015
63 JUMLA
359
36
39
11
13
22
4407
1430
12510
18347
22112
7040
73349
102501
64 KALIKOT
360
30
38
30
38
8725
1474
13888
24087
43435
7447
93304
144186
65 MUGU
282
15
3562
801
2246
6609
15403
3280
8583
27266
66 HUMLA
322
5772
1838
4085
11695
27630
7582
13440
48652
5053
47
22
466
535
11
10
33
54
24
25
70
138 103578
28468
239258
371304
545834
156038 1379933
2081805
67 BAJURA
336
32
38
10240
2070
14687
26997
64100
11882
88316
164298
68 BAJHANG
565
36
38
13
11132
3316
17580
32028
55945
15405
85150
156500
69 ACHHAM
904
47
54
11
22
28548
8336
35533
72417
135211
45843
187209
368263
70 DOTI
668
10
57
71
13
23
7981
3369
20270
31620
51294
17865
118954
188113
71 KAILALI
585
149
159
11
22
13332
3063
51320
67715
74006
14792
299433
388231
72 KANCHANPUR
268
22
24
8285
995
42777
52057
45443
6108
241036
292587
73 DADELDHURA
371
34
39
8145
1517
14412
24074
39798
9890
107574
157262
74 BAITADI
852
64
81
10
13
24
11583
3909
33101
48593
58308
23861
205045
287214
75 DARCHAULA
504
25
31
11
23
4332
1893
9578
15803
21729
10392
47216
79337
CENTRAL
17 DHANUSA
18 MAHOTTARI
24 KAVRE
35 CHITAWAN
FAR WESTERN
392 143445
PHCORC
(tab)
244372 1482991
2404043
361
Analyzed Data:CBIMCI (Sheet 1 of 3)
CHILDREN UNDER FIVE YEARS: DIARRHOEA
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
362
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received Reports
50218
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7115
573
525
536
573
628
564
434
636
737
419
179
347
360
282
322
5053
336
565
904
668
585
268
371
852
504
Diarrhoea incidence rate among

children under five years
501.09
481.12
622.14
514.86
395.16
394.68
313.1
420.74
513.18
712.5
424.65
714.09
786.66
1115.14
690.13
448.03
565.2
499.19
376.62
421.71
407.64
356.99
437.77
819.39
839.76
508.34
597.07
223.06
190.62
136.75
377.64
1147.3
559.08
540.57
413.57
441.33
352.81
303.05
414.34
435.29
528.7
287.1
438.18
335.97
684.68
745.47
707.1
424.69
476.12
487.39
456.72
404.45
375.09
418.21
422.03
692.45
664.14
806.77
441.24
740.41
472.76
628.34
658.65
857.57
1115.52
566.12
310.54
865.19
862.72
457.71
997.57
872.57
1148.02
873.59
1375.84
900.38
647.4
727.6
975.63
1149.95
625.59
% of children under five years

with diarrhea suffering from
dehydration (facility, outreach
and community)
20.74
28.31
37.19
37.4
28.43
19.61
17.96
33.97
5.25
38.71
13.81
25.53
29.17
36.82
40.4
26.83
27.7
32.24
21.03
15.85
29.2
20.33
30.17
8.41
19.32
33.87
17
8.64
8.06
13.24
14.35
10.53
21.63
26.41
28.56
15.92
27.44
9.48
14.08
20.83
9.35
30.48
12.43
12.59
6.41
16.63
7.79
9.56
21.23
9.19
22.61
2.77
10.7
17.03
19.58
20.06
15.82
21.03
19.01
18.43
12.3
12.33
13.09
11.58
30.22
20.87
39.54
35.45
31.3
36.74
34.35
17.2
26.27
27.54
9.12
22.55
11.39
11.23
7.88
22.12
26.22
% of children under five

years with diarrhea
suffering from dysentery
(blood in stool)
12.16
9.24
7.74
5.74
4.74
8.68
8.27
8.56
11.2
7.69
6.13
8.97
10.05
8.56
14.84
11.94
9.7
9.16
11.24
8.63
11.51
11.87
9.23
8.37
16.4
12.88
7.99
7.61
15.66
10.15
11.68
7.96
17.59
9.78
12.57
9.39
8.15
16.85
13.31
17.43
5.84
5.46
4.68
8.5
2.5
12.46
7.7
11.45
19.06
14.46
6.21
10.59
16.15
16.22
15.54
14.34
11.99
11.58
11.13
13.3
19.83
12.45
16.13
17.17
6.95
13.36
20.32
11.84
13.93
21.9
19.63
14.02
16.5
13.09
10.93
12.39
16.22
20.43
12.41
12.95
17.59

% of children under five years
Diarrhoea mortality rate
years with diarrhea treated
with diarrhea treated with years with diarrhoea treated among children under
with ORS only (facility,
zinc and ORS
with IV fluid
five years (per 1,000)
outreach and community)
31.43
33.79
16.93
17.19
42.4
29.43
27.12
47.03
26.4
23.31
23.69
41.23
56.47
42.59
32.73
20.29
34.62
35.89
33.15
23.97
47.81
38.21
24.56
28.28
35.37
56.08
17.14
26.92
40.3
51.31
17.89
14.22
19.48
53.26
30.2
29.83
30.97
22.42
28.07
23.82
20.68
26.61
16.13
40.63
35.79
24.07
28.78
27.23
38.56
29.64
15.1
16.19
29.36
34.24
45.26
26.94
12.98
83.57
11.98
8.57
23.98
25.05
23.67
11.83
30.95
44.25
26.61
50.98
8.96
28.86
26.88
33.84
56.47
45.57
28.37
37.3
42.04
28.03
13.8
22.21
27.67
93.05
88.25
86.84
96.17
90.64
91.71
86.91
79.27
87.4
81.27
100.04
89.55
89.57
78.9
91.3
92.15
84.02
97.17
94.97
101.77
97.46
95.13
119.95
86.82
118.66
73.62
98.7
98.01
83.11
71.54
94.22
88.14
94.36
90.55
99.2
93.59
87.57
103.54
92.56
95.46
97.11
90.02
98.04
83.42
108.68
97.11
99.38
95.53
104.51
95.18
93.86
95.43
93.99
84.93
72.15
97.43
100.79
96.3
87.92
95.89
112.41
92.62
99.19
87.07
101.05
100.61
88.88
113.71
93.88
84.17
79.04
91.25
107.09
91.51
98.8
93.18
71.65
93.1
97.8
91.04
119.26
0.64
0.55
0.01
0.91
0.9
0.62
0.17
0.64
0
0.54
0.69
0.62
2.02
0.4
0.89
0.23
0.15
0.92
0.79
0.49
1.19
0.62
0.55
0.51
0.59
0.34
0.22
1.3
0.21
0.15
0.98
0.3
1.45
0.34
1.03
1.77
0.92
0.79
0.49
0.19
0.27
0.26
0.34
0.15
0
0.58
0
0.54
1.16
0.37
2.21
0.32
0.21
0.64
0.72
0.72
0.18
1.52
0.1
0.47
1.93
0.47
0.3
0.18
0.41
1.12
2.59
0.4
1.27
2.39
1.01
0.57
0.51
0.15
0.75
0.52
0.92
0.25
0.8
0.31
0.57
0.03
0.04
0
0
0
0
0.02
0
0
0
0
0
0.47
1.19
0
0.03
0
0
0.02
0
0.1
0.07
0
0
0
0
0
0
0
0
0.04
0
0
0
0.01
0
0.01
0
0.01
0
0
0
0
0
0
0
0
0
0
0.04
0
0
0
0.02
0.05
0.06
0
0.04
0.04
0
0
0
0
0
0
0.1
2.99
0.38
0.06
0.15
0
0.04
0
0
0.07
0
0.06
0
0
0.04
0.2
Diarrhoea case fatality rate

among children under five
years (per 1,000)
0.15
0.31
0
0
0
0
0.28
0
0
0
0
0
1.48
4.7
0
0.21
0
0
0.1
0
0.39
0.47
0
0
0
0
0
0
0
0
0.22
0
0
0
0.07
0
0.1
0
0.01
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.4
0.2
0
0.2
0.21
0
0
0
0
0
0
0.33
6.99
1.1
0.2
0.5
0
0.13
0
0
0.06
0
0.53
0
0
0.14
0.74
CHILDREN UNDER FIVE YEARS: ARI
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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
50218
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7115
573
525
536
573
628
564
434
636
737
419
179
347
360
282
322
5053
336
565
904
668
585
268
371
852
504
ARI incidence rate

among children
under five years (per
1,000)
764.72
884.1
1206.1
1088.88
785.1
761.59
665.36
706.69
1187.71
1441.96
1031.87
1362.95
1422.43
2332.89
1287.51
680.7
767.52
870.76
553.14
692.47
696.05
607.16
744.31
1246.39
1237
706.49
876.11
380.02
209.28
146.98
538.62
1204.6
803.32
661.46
483.74
605.3
566.58
533.07
677.85
944.6
997.46
461.87
948.85
538.07
940.54
1479.72
1123.96
1199.3
1092.15
1099.54
808.52
573.88
420.81
427.7
745.36
961.41
1109.84
985.61
652.54
1073.19
686.53
779.67
1144.18
1125.78
1320.18
747.75
532
1329.97
988.54
706.33
1508.9
1145.64
1792.49
1252
1913.49
1082.57
733.58
808.4
1255.75
1673.77
1155.71
Incidence of
pneumonia among
children under five
years (per 1,000)
188.01
258.67
430.27
322.08
200.53
230.91
209.6
280.93
300.2
343.25
360.47
300.1
366.5
518.78
496.11
185.96
176.97
228.65
142.72
150.68
173.61
131.31
254.58
244.97
254.18
133.82
157.82
95.14
21.09
19.16
101.56
217.03
259.16
157.04
145.93
184.75
253.04
187.11
125.41
256.37
166.18
118.98
126.08
60.12
214.41
289.91
200.05
262.54
224.03
183.44
220.67
115
58.65
73.02
118.86
262.12
347.3
272.69
244.98
293.75
177.04
217.72
264.02
292.39
256.82
167.72
168.51
521.13
330.08
311.61
430.74
208.2
580.47
353.09
202.76
220.3
68.63
172.68
262.15
317.46
220.44
% of children under % of children under % of children under

% of multiple illness
% of children under
% of children under % of children under
ARI mortality rate ARI case fatality
five years with
five years with
five years with
% of children 6-59 classification cases five years enrolled in
five years with ARI
five years with
among children
rate among
pneumonia
pneumonia
pneumonia
reported in CBmonths treated
CBIMCI programme
suffering
pneumonia, who counselled for home counselled for home counselled for home under five years children under five
IMCI
with Vitamin A
pneumonia
received antibiotics
(per 1,000)
years (per 1,000)
care management
care management
care management
(facility)
(outreach)
(community)
24.59
29.26
35.67
29.58
25.54
30.32
31.5
39.75
25.28
23.8
34.93
22.02
25.77
22.24
38.53
27.32
23.06
26.26
25.8
21.76
24.94
21.63
34.2
19.65
20.55
18.94
18.01
25.03
10.08
13.03
18.86
18.02
32.26
23.74
30.17
30.52
44.66
35.1
18.5
27.14
16.66
25.76
13.29
11.17
22.8
19.59
17.8
21.89
20.51
16.68
27.29
20.04
13.94
17.07
15.95
27.26
31.29
27.67
37.54
27.37
25.79
27.92
23.07
25.97
19.45
22.43
31.67
39.18
33.39
44.12
28.55
18.17
32.38
28.2
10.6
20.35
9.36
21.36
20.88
18.97
19.07
189.23
161.73
175.03
149.26
153.68
154.53
126.52
114.08
181.95
187.75
153.47
257.25
208.89
254.05
184.76
178.96
147.52
180.66
172.95
163.34
200.88
173.92
138.42
177.86
190.78
249.85
197.61
135.13
529.27
203.07
182.7
153.45
169.61
206.53
209.47
155.62
106.32
182.86
240.54
219.88
185.28
171.36
226.58
191.45
202.52
326.19
248.29
167.36
196.84
228.31
199.88
211.18
330.24
471.55
320.05
190.08
174.15
191.34
159.24
162.88
244.71
171.88
178.99
211.59
241.91
299.71
179.51
127.35
168.85
135.38
161.95
244.5
189.08
155.9
399.45
244.25
463.85
212.76
215.63
195.51
194.14
35.09
35.29
36.47
42.07
31.27
30.49
31.01
32.11
44.45
38.75
47.96
34.92
51.69
30.75
41.93
35.93
31.48
38.54
35.21
31.89
36.22
33.87
25.71
35.16
38.55
42.81
37.66
54.33
51.51
29.21
41.06
44.17
46.01
27.46
37.02
27.07
26.95
44.04
38.52
38.49
33.73
36.58
27.16
26.12
64.56
76.91
51.4
34.98
40.46
35.77
42.25
43.43
36.97
54.51
33.61
34.36
33.68
30.64
53
31.29
39.95
31.16
33.48
34.39
24.48
46.86
58.68
23.63
32.94
52.33
49.83
31.86
30.56
32.98
36.69
30.63
34
29.89
36.58
23.6
31.54
8.82
9.49
22.16
10.21
11.57
10.02
7.8
8.23
6.72
4.81
5.27
8.72
8.67
6.57
14.12
7.06
12.41
9.45
10.08
15.62
17.89
9.2
9.78
3.81
8.17
8.9
8.38
4.63
4.26
4.53
12.78
5.45
9.4
4.98
16.25
9.12
11.6
4.02
7.67
10.49
5.27
8.96
9.14
4.16
5.17
4.72
6.08
4.49
8.42
7.09
3.92
4.59
10.17
15.74
5.11
7.4
6.19
9.45
11.72
8.89
4.5
5.46
4.53
7.61
5.97
15.02
10.86
9.85
6.8
12.78
16.78
8.43
8.03
11.81
12.14
12.28
5.29
1.77
5.77
9.38
12.15
56.09
55.22
41.37
47.73
57.15
59.49
61.2
59.66
48.83
56.44
46.77
56.36
39.63
62.68
43.95
57.01
56.11
52.01
54.71
52.49
45.89
56.93
64.51
61.03
53.28
48.29
53.96
41.04
44.24
66.26
46.16
50.38
44.59
67.57
46.73
63.81
61.45
51.93
53.81
51.02
61
54.46
63.7
69.71
30.27
18.37
42.52
60.52
51.13
57.14
53.83
51.98
52.86
29.76
61.28
58.24
60.13
59.91
35.28
59.82
55.55
63.38
61.99
58
69.55
38.12
30.46
66.52
60.25
34.89
33.38
59.71
61.41
55.21
51.17
57.09
60.71
68.33
57.65
67.02
56.31
0.12
0.38
0.08
0.47
0.22
0
0.08
0.01
0
4.96
0.19
0
0.09
4.11
0.2
0.06
1.02
0.14
0.04
0
0.06
0.15
0.06
0.05
0.05
0.07
0
0.04
0
0
0.04
0
0.09
0
0.07
0
0.01
0
0.02
0
0
0.03
0
0
0
0
0.17
0
0
0
0.2
0
0
0.02
0.05
0.09
0
0.08
0.04
0
0
0
0
0
0.16
0.1
3.45
0.15
0.06
1.17
0.16
0.09
0
0.17
0.07
0.04
0.01
0.02
0.19
0.25
0.54
0.27
0.64
0.17
0.34
0.73
0
0.19
0.05
0
5.33
0.38
0
0
5.73
0.37
0.24
0
0.26
0.12
0
0.17
0.5
0.33
0.12
0.11
0
0
0.21
0
0
0
0
0.24
0
0.07
0
0.1
0
0.06
0
0
0.18
0
0
0
0
0.3
0
0
0
0.57
0
0
0
0
0.2
0
0.26
0.12
0
0
0
0
0
0.3
0.14
6.64
0.24
0.18
3.16
0.22
0.23
0
0.42
0.09
0.12
0
0
0.41
0.63
1.29
0.7
0.38
1.12
0.12
0.18
0.37
0.03
0.19
0.12
0.22
0.21
2.25
1.98
0.1
2.06
0.14
0.42
0.19
0.71
0.38
0.34
0.44
0.34
0.09
1.35
0.19
0.58
0.12
0.07
0.3
0.47
0.41
0.62
1.98
1.03
2.52
1.19
0.26
0.42
0.22
0.08
0.04
0.17
0.03
0
0.29
0.18
0.06
0.61
2.39
0.1
0.11
0.06
1.43
0.18
1.3
0.86
0.68
0.95
0.63
0.38
1.48
0.54
0.4
0.37
5.97
11.77
1.58
2.37
4.51
2.88
1.03
1.21
0.63
3.25
1.35
0.11
0.89
3.98
0.33
0.17
113.85
109.06
107.43
105.25
91.52
114.96
105.43
114.51
114.09
114.29
108.19
104.42
107.44
101.67
112.64
118.44
111.73
106.82
113.84
107.54
121.5
120.44
116.59
113.21
113.22
115.38
112.57
98.69
116.05
111.82
111.96
110.82
125.59
108.09
117.18
120.41
114.39
95.27
110.29
109.31
120.4
111.4
105.23
108.7
125.47
118.55
116.05
122.93
114.12
114.44
92.52
109.61
103.33
117.08
114.75
118.16
114.93
119.4
119.13
141.74
113.93
116.48
108.79
115.55
121.26
118.46
122.63
116.4
130.4
120.29
113.75
120.96
121.39
122.46
125.97
125.98
114.97
112.65
127.65
119.75
118.66
61.08
65.26
86.88
80.54
53.52
41.6
43.68
45.59
85.76
110.1
103.52
109.79
132.69
152.81
106.74
57.11
64.09
76.82
45.48
47.42
53.49
45.46
38.84
82.35
88.31
64.46
69.94
40.65
26.42
10.75
52.25
109.9
78.48
43.89
54.64
46.39
45.71
62.72
63.09
90.26
87.82
38.8
51.45
27.42
100.18
218.21
124.65
72
78.7
93.39
108.25
61.01
46.94
64.82
55.86
75.68
93.23
65.94
73.36
68.65
67.82
59.75
80.46
95.12
73.34
89.36
55.23
55.07
78.97
77.76
155.11
83.91
135.74
81.46
168.91
78.11
56.42
56.3
98.97
93.67
80.32
363
COMMUNITY BASED NEONATAL CARE PROGRAMME (CB-NCP)

% of newborns
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
364
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
50218
11415
672
527
596
604
813
615
568
384
524
771
438
701
901
606
1392
1303
15334
1235
889
1031
666
681
672
898
1184
557
267
871
955
223
647
577
1164
1179
1063
575
11301
964
750
621
828
798
168
204
491
685
738
910
821
918
998
920
487
7115
573
525
536
573
628
564
434
636
737
419
179
347
360
282
322
5053
336
565
904
668
585
268
371
852
504
% of infants
who had skin-to-skin

who had chlorhexidine
who initiated
contact immediately after
ointment applied
breastfeeding within an
birth
immediately after birth
hour of birth
71.64
63.22
81.11
65.3
62.26
68.04
39.66
44.91
76
72.22
64.75
48.86
70.99
72.27
85.49
80.54
70.83
70.33
79.07
79.25
80.59
88.7
75.32
80.15
73.08
54.48
57.34
62.26
40.47
49.67
120.52
70.57
65.53
39.02
85.1
99.18
70.22
39.41
70.89
78.39
70.88
70.49
73.14
43.76
80
52.63
81.83
57.36
77.89
84.74
58.87
65.6
45.9
83.3
59.69
62.43
52.26
3.31
37.44
71.58
64.12
66.06
60.04
61.5
75.58
75.24
85.71
91.27
87.56
60.36
70.02
76.09
84.81
75.91
97.21
74.99
75.51
56.27
55.29
71.06
80.18
61.19
50.05
74.76
62.94
5.76
2.01
66.61
64.83
70.36
94.09
84.45
78.4
2.47
8.34
93.28
82.56
86.96
3.82
64.12
17.17
91.83
91.5
25.88
5.47
8.8
5.34
271.8
0.42
1.35
3.42
120.15
47.01
6.65
42.06
91.01
79.42
78.27
105.1
56.05
9.55
96.46
80.77
3.01
0.9
0
1.16
106.25
1.42
110.36
1.71
85.37
90.91
60.34
86.13
74.15
64.74
52.74
88.16
0.49
85.73
89.87
94.04
94.23
0.07
85.43
3.88
73.72
87.63
0.73
3.07
65.69
75.46
83.42
90.46
3.28
94.18
83.27
88.4
83.36
87.49
75.38
84.82
76.19
97.27
90.79
77.22
82.1
54.07
54.35
79.66
86.49
80.16
86.87
81.14
85.88
96.1
102.2
75.11
82.25
89.13
87.9
90.23
94.39
94.97
96.39
95.27
79.51
70.2
69.35
54.09
78.41
146.64
81.43
86.94
63.46
97.91
85.86
81.56
70.29
87.25
93.56
90.7
79.19
99.03
141.01
100
94.74
101.99
81.98
100.73
103.48
78.59
73.31
57.36
88.73
75.24
81.2
82.72
85.11
63.59
81.65
70.07
70.92
61.44
76.3
84.29
91.78
100.46
114.62
95.58
85.23
93.15
89.15
88.34
92.19
110.56
86.03
90.4
72.3
69.06
78.83
100.56
aged 0-2 months with

possible severe bacterial
infection (PSBI)

PSBI receiving a first
dose of Gentamycin
11.46
9.22
1.79
13.97
11.33
5.6
22.06
8.1
8.02
10.39
11.57
6.68
6.05
8.65
4.37
15.26
4.66
8.11
8.56
6.32
12.95
6.99
15.09
5.09
5.25
3.55
7.68
5.92
0
2.43
7.82
5.45
15.09
7.59
8.22
10.13
12.9
8.92
8.74
3.23
2.72
8.84
0.9
3.27
0
2.63
11.54
13.01
14.3
10.07
13.78
10.92
5.08
8.36
7.62
17.48
12.42
13.48
17.06
26.57
11.06
14.39
31.86
10.83
26.59
13.28
15.65
9.57
16.04
20.23
4.61
13.09
9.71
16.92
12.21
12.51
9.26
18.61
24.93
14.39
17.67
66.71
63.61
83.33
40
29.41
24.39
96.43
76.5
29.51
17.5
27.63
18
87.27
28.3
35.62
62.73
32
50.79
55.79
43.33
78.46
147.62
40.43
24
15.79
42.86
43.1
0
0
0
21.28
33.33
27.59
23.17
97.11
42.16
53.85
36.54
31.86
105.56
11.76
13.64
44.44
0
0
200
24.56
26.32
31.25
30.43
7.05
35.25
27.27
47.53
176.92
84.14
62.2
45.54
34.78
86.33
80.28
87.26
96.83
94.95
77.27
70.06
28.57
159.7
74.51
38.46
187.23
68.94
226.36
104.76
68.71
70.81
46.59
48.54
48.85
38.06
38

PSBI receiving a complete
dose of Gentamycin
67.24
57.91
75
52
5.88
17.07
93.76
74
37.7
20
57.89
18
60
24.53
36.99
25.47
17.33
36.51
72.01
66.67
105.28
239.68
56.38
28
10.53
42.86
37.93
10.53
0
0
21.28
22.22
30.34
32.93
114.88
76.47
63.74
35.9
33.4
5.56
11.76
0
33.33
12.5
0
100
31.58
13.16
32.81
117.39
5.39
31.15
3.03
64.81
53.85
79.61
37.8
50
53.04
82
65.74
76.43
92.28
65.15
85.76
73.65
32.47
153.73
102.94
28.85
129.79
69.06
224.55
87.5
63.95
71.43
36.59
50.88
48.85
90.3
64

localized bacterial
infection (LBI)
11.46
9.22
1.79
13.97
11.33
5.6
22.06
8.1
8.02
10.39
11.57
6.68
6.05
8.65
4.37
15.26
4.66
8.11
8.56
6.32
12.95
6.99
15.09
5.09
5.25
3.55
7.68
5.92
0
2.43
7.82
5.45
15.09
7.59
8.22
10.13
12.9
8.92
8.74
3.23
2.72
8.84
0.9
3.27
0
2.63
11.54
13.01
14.3
10.07
13.78
10.92
5.08
8.36
7.62
17.48
12.42
13.48
17.06
26.57
11.06
14.39
31.86
10.83
26.59
13.28
15.65
9.57
16.04
20.23
4.61
13.09
9.71
16.92
12.21
12.51
9.26
18.61
24.93
14.39
17.67

hypothermia
1.83
1.22
1.41
1.4
2.67
1.09
0.35
0.36
1.84
1.3
2.74
3.21
1.54
2.94
1.8
1.14
0.31
1.54
1.88
0.77
2.32
3.11
2.09
0.61
0.83
1.69
0.13
1.56
0
2.87
2.16
0.61
2.19
0.56
3.13
2.58
1.35
1.32
1.73
1.79
0.48
1.61
0
2.86
0
2.63
0.4
1.37
0.67
3.94
1.43
1.07
5.08
2.68
0.88
2.05
0.91
0.48
5.04
0.09
1.26
0.92
0.07
1.97
4.51
4.85
9.15
0.29
1.73
14.01
1.96
2.41
0.88
1.81
2.29
3.11
1.65
0.54
9.49
1.61
3.18

low weight for age
5.4
4.85
1.71
4.19
14.67
10.15
2.83
2.59
9.07
5.97
2.74
4.95
9.46
7.01
3.53
3.22
4.35
3.47
4.64
4.56
1.58
2.77
4.82
1.83
8.29
0.68
2.78
3.12
0
5.82
3.16
2.42
7.49
5.37
7.37
7.15
2.98
5.66
6.05
3.58
1.28
8.03
0.6
6.12
0
5.26
4.25
4.79
5.47
10.07
5.89
6.8
3.85
10.22
7.92
5.92
3.48
3.61
9.64
5.14
4.48
4.4
2.56
3.5
2.58
11.05
14.02
5.43
11.79
32.68
10.89
6
5.21
13.6
7.89
7.3
2.17
8.6
6.81
4.51
13.78
Raw Data:FAMILY PLANNING (Sheet 1 of 3)
New Acceptors
District
Code
District Name
Temporary Methods
Received
Reports
Condom
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
53147
11682
663
532
620
648
892
711
571
380
537
768
448
707
890
611
1393
1311
17012
1267
911
1028
727
680
676
1001
1320
682
475
1675
953
228
655
603
1168
1200
1096
667
11814
991
753
790
865
849
168
204
497
685
766
916
849
970
1053
957
501
7462
612
616
533
574
633
623
496
686
757
419
177
373
359
282
322
5177
336
575
905
690
653
290
372
852
504
207819
33523
916
1742
1391
3130
4049
3430
1414
1179
1150
1547
1060
976
1560
1220
4582
4175
46585
3669
3446
2756
1804
1906
1648
1265
2914
1680
1159
3369
1553
621
2773
1727
4007
3783
2772
3732
41612
2229
1786
1579
2126
2959
205
378
1403
946
2539
3605
3467
5180
7264
3871
2076
45036
4425
4559
1608
2920
6477
6896
5058
4467
3822
858
265
1261
1755
288
377
41063
2177
3268
3212
5757
10357
7014
2577
5276
1425
Pills
<20 Years
10779
2074
160
76
115
265
156
240
125
34
79
84
115
107
183
195
77
63
3560
140
122
476
103
39
69
97
210
102
38
726
333
24
249
365
89
53
167
158
1835
126
26
217
54
177
3
5
159
25
126
283
90
97
114
277
56
2503
137
121
266
76
235
102
143
323
333
299
33
113
70
89
163
807
74
24
56
60
217
221
10
96
49
=gt;20 Years
101098
21973
1105
1006
1189
2766
2091
2076
756
439
644
939
810
919
1357
1057
2896
1923
28854
2363
1560
2056
1453
374
890
780
1429
2010
730
4038
1027
151
1837
2340
1568
1280
1301
1667
21384
1542
504
1344
850
1925
51
142
652
499
1544
1608
793
1575
4968
2634
753
16694
1600
861
1690
930
1486
1746
1185
1650
1923
1212
385
461
562
363
640
12193
791
707
1592
1326
2389
1933
471
2026
958
Depo
Total
111877
24047
1265
1082
1304
3031
2247
2316
881
473
723
1023
925
1026
1540
1252
2973
1986
32414
2503
1682
2532
1556
413
959
877
1639
2112
768
4764
1360
175
2086
2705
1657
1333
1468
1825
23219
1668
530
1561
904
2102
54
147
811
524
1670
1891
883
1672
5082
2911
809
19197
1737
982
1956
1006
1721
1848
1328
1973
2256
1511
418
574
632
452
803
13000
865
731
1648
1386
2606
2154
481
2122
1007
<20 Years
23963
4615
296
239
249
437
442
386
197
104
262
220
462
285
164
599
132
141
7047
309
198
634
243
160
246
331
417
392
275
926
533
81
500
703
86
224
290
499
4973
276
96
322
54
248
1
19
175
74
2482
152
171
362
202
240
99
5882
312
613
585
341
659
440
637
620
499
547
69
169
100
67
224
1446
119
74
191
113
506
250
38
61
94
=gt;20 Years
231346
57573
2264
2584
3350
5318
5554
4612
2213
1054
2013
1910
2672
2221
2417
3288
5248
10855
68744
5953
3508
3707
2763
1523
3059
3072
3990
3696
3538
8357
2956
728
4578
4721
2762
3398
2936
3499
37705
3055
1268
2093
990
2752
57
261
1290
686
2048
2541
1514
3453
8687
5643
1367
39494
2422
2878
4206
2097
3918
4831
4341
3348
3628
2914
396
985
1708
791
1031
27830
1836
1939
3597
2707
6190
4242
1842
3283
2194
IUCD
Total
255309
62188
2560
2823
3599
5755
5996
4998
2410
1158
2275
2130
3134
2506
2581
3887
5380
10996
75791
6262
3706
4341
3006
1683
3305
3403
4407
4088
3813
9283
3489
809
5078
5424
2848
3622
3226
3998
42678
3331
1364
2415
1044
3000
58
280
1465
760
4530
2693
1685
3815
8889
5883
1466
45376
2734
3491
4791
2438
4577
5271
4978
3968
4127
3461
465
1154
1808
858
1255
29276
1955
2013
3788
2820
6696
4492
1880
3344
2288
<20 Years
2083
408
17
0
8
22
23
40
4
1
5
124
1
3
1
145
3
11
722
27
4
22
7
4
3
4
46
9
4
311
24
2
14
22
8
96
3
112
245
1
15
28
5
24
0
0
33
12
18
4
22
7
23
52
1
415
3
15
2
31
64
50
151
42
30
11
2
8
0
0
6
293
3
33
42
152
28
28
0
1
6
=gt;20 Years
30346
5803
136
76
459
295
1296
1270
340
45
138
48
48
22
52
381
163
1034
10600
610
656
168
340
192
90
231
1059
497
272
1858
584
8
229
690
848
873
510
885
4862
46
89
674
121
563
0
9
270
352
413
89
181
665
794
472
124
4905
70
162
49
264
1413
779
876
306
523
236
12
177
38
0
0
4176
152
104
175
765
1442
1189
166
135
48
Implant
Total
32429
6211
153
76
467
317
1319
1310
344
46
143
172
49
25
53
526
166
1045
11322
637
660
190
347
196
93
235
1105
506
276
2169
608
10
243
712
856
969
513
997
5107
47
104
702
126
587
0
9
303
364
431
93
203
672
817
524
125
5320
73
177
51
295
1477
829
1027
348
553
247
14
185
38
0
6
4469
155
137
217
917
1470
1217
166
136
54
<20 Years
2717
255
12
4
36
37
25
60
14
2
14
13
2
0
3
33
0
0
926
9
5
23
6
19
4
21
96
34
8
392
147
0
35
63
2
4
12
46
698
4
4
49
2
56
1
1
3
8
3
1
52
9
28
454
23
647
17
42
5
29
233
33
71
81
49
45
0
33
8
1
0
191
4
20
7
39
78
24
1
15
3
=gt;20 Years
58626
9556
172
397
2143
1033
1463
664
373
111
337
356
165
220
239
265
341
1277
20838
209
58
272
660
871
295
3649
5468
1039
432
2004
767
142
1108
1842
196
431
561
834
10352
327
88
430
120
1568
50
67
178
154
308
56
367
810
3342
2133
354
11287
579
674
291
1101
2688
1366
1030
1024
872
777
15
478
279
67
46
6593
401
457
572
451
2037
1212
361
977
125
Total
61343
9811
184
401
2179
1070
1488
724
387
113
351
369
167
220
242
298
341
1277
21764
218
63
295
666
890
299
3670
5564
1073
440
2396
914
142
1143
1905
198
435
573
880
11050
331
92
479
122
1624
51
68
181
162
311
57
419
819
3370
2587
377
11934
596
716
296
1130
2921
1399
1101
1105
921
822
15
511
287
68
46
6784
405
477
579
490
2115
1236
362
992
128
Total (Temporary
Methods)
668777
135780
5078
6124
8940
13303
15099
12778
5436
2969
4642
5241
5335
4753
5976
7183
13442
19479
187876
13289
9557
10114
7379
5088
6304
9450
15629
9459
6456
21981
7924
1757
11323
12473
9566
10142
8552
11432
123666
7606
3876
6736
4322
10272
368
882
4163
2756
9481
8339
6657
12158
25422
15776
4853
126863
9565
9925
8702
7789
17173
16243
13492
11861
11679
6899
1177
3685
4520
1666
2487
94592
5557
6626
9444
11370
23244
16113
5466
11870
4902
365
New Acceptors
Distribution
Sterilization
District
Code
District Name
Received
Reports
Public
Institutions
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
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
366
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
53147
11682
663
532
620
648
892
711
571
380
537
768
448
707
890
611
1393
1311
17012
1267
911
1028
727
680
676
1001
1320
682
475
1675
953
228
655
603
1168
1200
1096
667
11814
991
753
790
865
849
168
204
497
685
766
916
849
970
1053
957
501
7462
612
616
533
574
633
623
496
686
757
419
177
373
359
282
322
5177
336
575
905
690
653
290
372
852
504
Male
Non-Public
Camp
Female
Institutions
Male
2695 1443 12007 4592

259
71 4408
92
2
7
0
5
0
0
0
0
0
0
0
0
88
0
576
15
49
18 1079
0
8
0 1112
0
0
0
0
0
0
0
0
9
0
0
0
0
1
4
0
0
0
0
0
6
0
1
0
20
14
28
0
0
16
13
104
18
78
0
738
17
3
0
799
2
1206 653 2424 1248
114
0
102
0
82
0
162
0
102
7
943
2
13 100
264 441
0
0
8
38
3
4
56
42
0
0
29 154
0
0
31
55
9
51
0
0
12
5
0
0
206 254
21
43
10
2
105 189
0
0
17
40
14 114
0 176
0
22
0
14
72
0
261
0
563
7
383
6
0
0
42
0
6
87
0
48
558 235 2191 696
13
21
16
33
15
7
11
64
0
17
65
94
0
0
45
14
160
94
119 136
0
0
0
0
0
0
3
4
6
15
26
46
0
24
0
18
12
12
139 150
10
10
4
2
20
14
36
42
22
1
891
58
292
20
590
11
8
0
221
0
0
0
25
24
294 299 1330 1724
120
21
83
21
0
0
8
65
0
0
0 116
0
0
0 149
18
14
18
1
98
95
167
15
0
0
855
34
47
53
199 228
9
42
0 243
0
21
0 127
0
0
0
44
0
26
0 288
2
27
0 151
0
0
0
96
0
0
0 146
378 185 1654 832
0
0
157 176
114
48
22 111
0
0
46
60
10
12
104 183
183
92
670
25
59
17
251
31
0
12
66
51
12
4
259
89
0
0
79 106
Female
Male
6669 1418
3168 119
0
0
0
0
0
0
2097
44
976
25
70
36
0
0
0
0
0
0
0
0
0
0
16
14
0
0
0
0
0
0
9
0
2857 708
377
1
3
0
37
0
0
0
0
0
0
0
0
0
42 143
20 311
43
59
272
99
0
2
0
0
0
0
14
39
4
0
1
0
2042
30
2
24
335 523
0
0
0
0
0
0
16
1
64
29
0
0
0
0
0
0
0
0
2
0
0
0
165
18
37
10
51 465
0
0
0
0
62
31
0
0
0
0
0
0
0
0
19
0
43
2
0
0
0
29
0
0
0
0
0
0
0
0
0
0
0
0
0
0
247
37
0
0
0
0
0
0
0
0
247
36
0
1
0
0
0
0
0
0
Camp
Female
1507
817
0
0
0
219
34
0
0
0
0
0
0
0
0
16
0
548
207
0
25
65
0
0
0
0
38
0
0
0
0
0
0
0
7
64
8
0
153
0
0
0
0
29
0
0
0
0
0
0
5
10
10
99
0
329
0
0
0
0
282
47
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
Total Strerilization
Total All Methods
Condom
Pills
Depo
IUCD
Implant
Male
397
2
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
312
0
0
0
0
0
0
0
8
28
0
0
0
0
0
195
0
6
0
75
45
0
0
0
0
33
0
0
0
0
0
0
2
8
0
2
0
21
0
0
0
0
13
8
0
0
0
0
0
0
0
0
0
17
0
0
0
2
8
1
0
0
6
30728
8936
14
0
0
3039
2181
1228
0
9
0
5
6
51
42
167
833
1361
9615
594
272
1156
818
46
105
183
317
419
119
895
308
57
304
284
344
1030
2122
242
4736
83
97
176
76
664
0
7
93
42
315
26
302
1037
1439
330
49
4090
245
73
116
149
365
475
889
556
294
148
44
314
180
96
146
3351
333
295
106
311
1261
361
129
364
191
699505 31172810 1595108

144716 5028450 444954
5092
137390
11205
6124
261275
19804
8940
208612
33464
16342
469536
67225
17280
607403
55929
14006
514508
52778
5436
212170
17768
2978
176808
6138
4642
172548
7390
5246
232102
19345
5341
159069
9919
4804
146432
14061
6018
233994
13282
7350
182981
19776
14275
687364
65046
20840
626258
31824
197491 6987727 394942
13883
550422
24376
9829
516854
27667
11270
413411
28239
8197
270668
23502
5134
285955
8434
6409
247229
9319
9633
189739
13510
15946
437132
22867
9878
251955
16176
6575
173807
13457
22876
505371
70112
8232
232951
8528
1814
93125
2037
11627
416014
27648
12757
259087
19395
9910
600993
19218
11172
567444
22454
10674
415749
12588
11674
559821
25415
128402 6241850 284010
7689
334356
14094
3973
267834
9616
6912
236899
14163
4398
318887
19172
10936
443860
21947
368
30712
513
889
56747
1026
4256
210427
5504
2798
141861
6033
9796
380893
13655
8365
540753
22298
6959
520048
37270
13195
777019
34658
26861 1089528
43849
16106
580587
31845
4902
311439
8367
130953 6755371 247177
9810
663744
26742
9998
683830
9686
8818
241142
12476
7938
438066
14524
17538
971485
38442
16718 1034390
40723
14381
758674
28334
12417
670062
27813
11973
573269
18870
7047
128699
9469
1221
39811
2816
3999
189208
3436
4700
263264
7206
1762
43173
2130
2633
56554
4510
97943 6159412 224025
5890
326601
8492
6921
490196
5821
9550
481784
15153
11681
863528
16103
24505 1553619
93767
16474 1052064
49310
5595
386513
4942
12234
791352
22391
5093
213755
8046
1336607
374260
10534
18633
30115
48603
45587
39268
16348
6555
11991
17193
16247
15326
12060
17608
39132
29060
428861
25251
25902
16142
17799
15136
14818
24524
29233
22804
21984
72409
15958
3260
28870
26564
12204
21997
16972
17034
183004
15266
6858
9975
7342
12871
347
1161
4442
4057
7281
10596
11827
21536
36020
28345
5080
214682
14680
15340
14422
16354
31032
31046
24685
22532
14918
11486
2075
3443
6327
2586
3756
135800
6361
7234
12828
10046
40782
29851
7267
13345
8086
38277
6703
175
195
678
367
1306
1551
363
47
156
86
68
74
20
410
166
1041
13232
625
608
626
384
211
99
275
996
436
309
2215
294
10
1060
736
769
936
550
2093
7163
77
138
1377
397
883
0
11
129
350
214
82
696
852
1106
557
294
6401
73
181
113
274
1203
945
2087
348
609
341
40
134
51
2
0
4778
46
116
236
1130
1932
801
172
250
95
77133
11240
243
522
1996
1805
1696
1031
357
120
507
465
208
259
157
265
341
1268
23512
323
172
610
1098
915
305
3597
4076
1093
443
2308
869
142
1191
2161
271
440
799
2699
12764
437
104
1201
143
1945
57
102
201
205
317
103
673
836
3044
2560
836
13488
601
1600
392
1150
2804
1391
1060
1105
957
1331
15
544
424
68
46
16129
381
580
968
985
10309
942
505
1336
123

Current Users
District
Code
District Name
Condom
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
53147
11682
663
532
620
648
892
711
571
380
537
768
448
707
890
611
1393
1311
17012
1267
911
1028
727
680
676
1001
1320
682
475
1675
953
228
655
603
1168
1200
1096
667
11814
991
753
790
865
849
168
204
497
685
766
916
849
970
1053
957
501
7462
612
616
533
574
633
623
496
686
757
419
177
373
359
282
322
5177
336
575
905
690
653
290
372
852
504
Defaulter
Temporary Methods
Received
Reports
Pills
Depo
IUCD
Strerilization
Implant
207819 179010 409679 154316 165048

33523 52570 128309 31493 28189
916
1266
4766
1077
532
1742
1964
4874
952
1665
1391
5172 10221
1220
3016
3130
6180 12236
3395
3535
4049
6033 16259
9948
5272
3430
6272 11862
4936
3025
1414
2943
4967
1267
1368
1179
499
1636
437
569
1150
718
3516
421
959
1547
2018
4945
276
798
1060
1067
4752
104
700
976
1611
5209
427
1444
1560
2314
6553
275
844
1220
1848
5031
610
393
4582
6622 14702
859
623
4175
6043 16780
5289
3446
46585 44652 129421 64071 57455
3669
2519
6743
1609
541
3446
2908
7421
1442
251
2756
3644
6079
1395
1407
1804
2523
5072
1374
2159
1906
725
3658
1300
2335
1648
808
3918
383
992
1265
1297
6731
1982
4709
2914
2541
8727
4731 12402
1680
1883
9938
5112
3735
1159
1095
4797
3275
1440
3369
9310 22137 21133 12980
1553
671
4061
1918
1269
621
214
1108
63
538
2773
2812
8492
3286
3336
1727
2880
8301
2598
3617
4007
1596
3421
1982
83
3783
2374
8825
3440
1695
2772
1417
4836
1700
2027
3732
3435
5156
5348
1939
41612 31158 50700 21779 23874
2229
1319
4154
428
947
1786
855
1927
269
238
1579
1364
2918
3396
1217
2126
1793
1820
805
292
2959
2720
3999
3850
3370
205
51
97
0
73
378
98
282
212
273
1403
502
1172
1309
1444
946
625
1044
546
174
2539
1509
1909
1514
1030
3605
1734
2868
58
38
3467
7919
4217
2364
1791
5180
3091
6219
3258
2623
7264
3864
9111
1994
5608
3871
2961
7598
1161
3322
2076
753
1365
615
1434
45036 29704 63396 27700 37908
4425
2685
4270
684
1747
4559
1096
4115
943
5196
1608
1566
4324
235
696
2920
1433
4791
1871
2906
6477
9774 12440
8453
6519
6896
3743
7844
3876
4322
5058
2328
6848
6098
4418
4467
2703
5921
2752
3521
3822
1473
3272
1672
4308
858
906
3814
622
2208
265
232
845
0
0
1261
325
1000
155
825
1755
772
2173
264
921
288
194
674
70
191
377
474
1065
5
130
41063 20926 37853
9273 17622
2177
721
1724
153
500
3268
624
2222
141
1271
3212
1458
4144
583
1442
5757
1563
3056
1458
1305
10357
7865 11965
3601
5585
7014
5424
6299
2181
3036
2577
565
2501
411
858
5276
1996
3915
561
3271
1425
710
2027
184
354
Total (Temporary
Methods)
Female
Male
1115872 1052571 358937

274084 315261 41463
8557
4
1871
11197
353
1680
21020
6374
1745
28476
57966
8454
41561
90068
4915
29525
40946
3043
11959
1651
1786
4320
134
1655
6764
84
2581
9584
127
2507
7683
167
791
9667
328
2360
11546
216
2459
9102
4189
3968
27388
57487
570
35733
55167
1078
342184 461940 149726
15081
76342
1546
15468
51951
439
15281
65908
2475
12932
5011
4606
9924
189
3240
7749
3043
4414
15984
1968
7136
31315
9201
8616
22348
9136 18746
11766
7958
3608
68929
30796 18789
9472
7048
7273
2544
673
1832
20699
1607
9487
19123
3658 27151
11089
59966
703
20117
40249
1890
12752
75052
2851
19610
12184 24924
169123 131025 72499
9077
5762
5996
5075
2093
5768
10474
6019
6980
6836
8834
3921
16898
11130 12377
426
16
173
1243
250
299
5830
996
2928
3335
1002
3960
8501
3514
5965
8303
5657
3531
19758
8430
5208
20371
31051
7863
27841
29886
2923
18913
13735
1637
6243
2650
2970
203744
76403 62816
13811
2242
2800
15909
107
3395
8429
202
3081
13921
750
5530
43663
19465
3763
26681
16356
5984
24750
26205
2896
19364
10468 12110
14547
86
6546
8408
199
3656
1342
11
874
3566
213
5889
5885
22
2749
1417
27
1858
2051
50
1685
126737
67942 32433
5275
510
3345
7526
316
4617
10839
443
3080
13139
688
3670
39373
43224
4543
23954
19612
3881
6912
1197
3046
15019
1513
3685
4700
439
2566
Total Sterilization
Total all
Methods
Postpartum FP Acceptors
(Within 48 Hours of Delivery)
Pills
Depo
IUCD
Implant
1411508 2527380 126463 308376 11768 20270

356724 630808 33047 81541 2477 3392
1875
10432
948
1494
71
18
2033
13230
2072
7151
5
691
8119
29139
2864
6744
559
452
66420
94896
4834
7905
360
410
94983 136544
3074
8019
273
516
43989
73514
3453 11039
211
226
3437
15396
1357
3763
28
154
1789
6109
709
1743
40
111
2665
9429
1080
3719
91
167
2634
12218
1462
3314
96
22
958
8641
1333
3717
7
29
2688
12355
1777
4302
14
78
2675
14221
2057
3465
14
0
8157
17259
1789
4745
445
68
58057
85445
2304
4997
168
75
56245
91978
1934
5424
95
375
611666 953850 35949 96893 3887 7069
77888
92969
1131
3440
17
5
52390
67858
1883
3920
328 1132
68383
83664
7376
6743
513
260
9617
22549
1426
2946
7
86
3429
13353
556
2708
39
212
7457
15206
989
3846
19
45
9104
25088
994
4144
69
640
17817
49132
1403
5568
889
669
27882
50230
1434
5011
195
367
11566
23332
1436
8860
57
100
49585 118514
6378 17229
764 1314
14321
23793
1534
6075
119
341
2505
5049
227
807
0
54
11094
31793
1713
4695
391
763
30809
49932
1836
5480
11
237
60669
71758
921
2127
9
2
42139
62256
1214
3755
104
27
77903
90655
1613
5391
232
585
37108
56718
1885
4148
124
230
203524 372647 25068 44352 2978 2947
11758
20835
1377
3823
120
87
7861
12936
1107
2234
82
5
12999
23473
1498
2732
227
254
12755
19591
1163
1363
19
8
23507
40405
5413
8774
196
193
189
615
75
133
0
6
549
1792
210
429
5
22
3924
9754
766
1444
42
68
4962
8297
472
778
10
1
9479
17980
1079
1319
46
74
9188
17491
1915
2725
52
22
13638
33396
2199
3322
79
187
38914
59285
1744
4313
481
207
32809
60650
2412
4558
125
419
15372
34285
3068
5434 1441 1247
5620
11863
570
971
53
147
139219 342963 21242 54423 1273 3451
5042
18853
2057
2888
29
115
3502
19411
1178
3809
131
570
3283
11712
2088
5666
0
90
6280
20201
1369
4565
208
411
23228
66891
2929
6254
238
438
22340
49021
2894
8546
147
511
29101
53851
1298
3490
150
203
22578
41942
2028
4784
97
367
6632
21179
1830
5006
48
186
3855
12263
1143
3919
43
134
885
2227
168
500
7
0
6102
9668
520
1207
171
114
2771
8656
743
1504
1
149
1885
3302
208
611
1
7
1735
3786
789
1674
2
156
100375 227112 11157 31167 1153 3411
3855
9130
905
2324
212
437
4933
12459
688
2527
38
527
3523
14362
1181
3453
152
167
4358
17497
2062
4786
256
213
47767
87140
2804
6683
283 1247
23493
47447
973
5006
85
400
4243
11155
455
1821
21
40
5198
20217
1280
2596
70
319
3005
7705
809
1971
36
61
IUCD
296
10
7
0
2
0
0
0
0
0
0
0
0
1
0
0
0
0
164
0
15
17
0
0
0
0
21
0
0
69
0
0
0
0
0
0
0
42
64
1
7
0
1
4
0
0
18
0
0
0
2
0
31
0
0
43
0
1
0
2
0
0
0
39
1
0
0
0
0
0
0
15
0
0
1
0
7
3
2
2
0
Implant
421
8
3
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
82
0
8
5
38
1
2
1
10
4
0
0
0
0
0
13
0
0
0
0
153
0
0
0
1
13
0
0
0
0
0
0
98
0
41
0
0
36
4
0
3
3
0
5
1
0
16
4
0
0
0
0
0
142
0
63
18
27
0
0
0
0
34
Tubectomy
840
249
0
0
0
32
209
0
0
0
0
0
0
8
0
0
0
0
67
0
8
0
0
0
3
0
2
3
4
47
0
0
0
0
0
0
0
0
278
2
0
0
0
155
0
0
0
0
0
0
74
0
47
0
0
25
20
0
0
0
0
0
0
0
4
0
0
0
1
0
0
221
0
129
6
0
81
3
0
2
0
367
Analyzed Data:Family Planning (Sheet 1 of 2)
Temporay Method
District
Code
District Name
New Acceptors as % of MWRA
Received
Reports
Condom
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
368
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
53135
11682
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
663
3.51
2.57
3.32
4.1
2.14
1.64
1.84
1.94
3.81
5.24
3.4
4.18
4.83
3.01
3.76
1.67
3.29
2.99
2.19
2.27
2.56
1.7
2.83
4.27
3.81
2.05
3.45
1.57
1.67
0.84
2.57
6.86
3.71
1.88
2.77
2.6
2.22
2.71
3.69
3.7
4.68
2.05
3.36
2.56
18.66
15.01
5.58
2.8
3.99
5.71
5.83
3.45
3.58
3.11
4.47
5.66
8.31
9.02
3.45
5.38
4.96
6.15
5.16
5.76
6.78
2.38
3.41
5.38
6.24
2.56
3.6
7.14
7.61
7.74
5.71
12.31
5.75
6.65
8.08
9.6
4.92
Pills
1.89
1.85
4.58
2.54
2.01
1.59
1.02
1.31
2.38
2.1
2.14
2.76
4.21
3.16
3.71
1.71
2.13
1.42
1.53
1.55
1.25
1.56
2.44
0.92
2.22
1.42
1.94
1.97
1.11
1.19
2.25
1.93
2.79
2.94
1.14
0.92
1.18
1.32
2.06
2.77
1.39
2.03
1.43
1.82
4.92
5.83
3.23
1.55
2.63
3
1.48
1.11
2.51
2.34
1.74
2.41
3.26
1.94
4.2
1.85
1.32
1.65
1.36
2.54
4
4.2
5.38
2.49
2.25
4.02
7.66
2.26
3.02
1.73
2.93
2.96
1.45
2.04
1.51
3.86
3.48
Depo
4.31
4.78
9.28
6.64
5.55
3.01
2.72
2.82
6.5
5.15
6.73
5.75
14.27
7.73
6.22
5.32
3.86
7.87
3.57
3.88
2.76
2.68
4.71
3.77
7.65
5.53
5.22
3.82
5.49
2.32
5.77
8.94
6.79
5.89
1.97
2.49
2.59
2.9
3.79
5.52
3.58
3.14
1.65
2.59
5.29
11.11
5.83
2.25
7.12
4.27
2.83
2.54
4.38
4.73
3.16
5.7
5.14
6.9
10.28
4.49
3.51
4.7
5.08
5.12
7.32
9.61
5.98
4.93
6.42
7.63
11.97
5.09
6.83
4.77
6.73
6.03
3.72
4.26
5.89
6.09
7.9
IUCD
0.55
0.48
0.55
0.18
0.72
0.17
0.6
0.74
0.93
0.2
0.42
0.46
0.22
0.08
0.13
0.72
0.12
0.75
0.53
0.39
0.49
0.12
0.54
0.44
0.22
0.38
1.31
0.47
0.4
0.54
1
0.11
0.32
0.77
0.59
0.67
0.41
0.72
0.45
0.08
0.27
0.91
0.2
0.51
0
0.36
1.21
1.08
0.68
0.15
0.34
0.45
0.4
0.42
0.27
0.67
0.14
0.35
0.11
0.54
1.13
0.74
1.05
0.45
0.98
0.69
0.18
0.81
0.14
0
0.06
0.78
0.54
0.32
0.39
1.96
0.82
1.15
0.52
0.25
0.19
Current Users as % of MWRA

Implant
1.04
0.75
0.67
0.94
3.36
0.56
0.68
0.41
1.04
0.5
1.04
1
0.76
0.68
0.58
0.41
0.24
0.91
1.03
0.14
0.05
0.18
1.04
1.99
0.69
5.96
6.59
1
0.63
0.6
1.51
1.57
1.53
2.07
0.14
0.3
0.46
0.64
0.98
0.55
0.24
0.62
0.19
1.4
4.65
2.7
0.72
0.48
0.49
0.09
0.7
0.54
1.66
2.08
0.81
1.5
1.12
1.42
0.64
2.08
2.24
1.25
1.12
1.42
1.63
2.28
0.19
2.23
1.02
0.6
0.44
1.18
1.41
1.13
1.03
1.05
1.18
1.17
1.13
1.81
0.44
Total
11.29
10.43
18.4
14.4
13.78
6.96
6.85
7.21
14.66
13.2
13.74
14.16
24.29
14.66
14.41
9.84
9.65
13.93
8.85
8.24
7.11
6.23
11.56
11.39
14.59
15.35
18.5
8.84
9.29
5.48
13.1
19.42
15.14
13.56
6.61
6.96
6.86
8.29
10.97
12.61
10.17
8.76
6.84
8.88
33.52
35.01
16.56
8.17
14.91
13.22
11.19
8.09
12.53
12.7
10.45
15.94
17.97
19.63
18.67
14.35
13.16
14.49
13.78
15.29
20.72
19.16
15.14
15.84
16.06
14.81
23.72
16.44
19.41
15.69
16.77
24.31
12.91
15.28
17.13
21.6
16.92
Condom
3.51
2.57
3.32
4.1
2.14
1.64
1.84
1.94
3.81
5.24
3.4
4.18
4.83
3.01
3.76
1.67
3.29
2.99
2.19
2.27
2.56
1.7
2.83
4.27
3.81
2.05
3.45
1.57
1.67
0.84
2.57
6.86
3.71
1.88
2.77
2.6
2.22
2.71
3.69
3.7
4.68
2.05
3.36
2.56
18.66
15.01
5.58
2.8
3.99
5.71
5.83
3.45
3.58
3.11
4.47
5.66
8.31
9.02
3.45
5.38
4.96
6.15
5.16
5.76
6.78
2.38
3.41
5.38
6.24
2.56
3.6
7.14
7.61
7.74
5.71
12.31
5.75
6.65
8.08
9.6
4.92
Pills
3.02
4.04
4.59
4.62
7.97
3.23
2.74
3.54
7.94
2.22
2.12
5.45
4.86
4.97
5.58
2.53
4.75
4.32
2.1
1.56
2.16
2.25
3.95
1.62
1.87
2.11
3.01
1.76
1.58
2.32
1.11
2.37
3.76
3.13
1.1
1.63
1.14
2.49
2.77
2.19
2.24
1.77
2.84
2.35
4.65
3.89
2
1.85
2.37
2.75
13.31
2.06
1.91
2.38
1.62
3.73
5.04
2.17
3.36
2.64
7.49
3.34
2.38
3.49
2.61
2.52
2.98
1.41
2.74
1.72
4.52
3.64
2.52
1.48
2.59
3.34
4.37
5.14
1.77
3.63
2.45
Depo
6.92
9.86
17.27
11.46
15.75
6.4
7.38
6.7
13.39
7.27
10.4
13.36
21.63
16.06
15.8
6.89
10.55
12
6.1
4.18
5.52
3.75
7.95
8.19
9.07
10.93
10.33
9.28
6.91
5.52
6.71
12.25
11.35
9.02
2.36
6.06
3.88
3.74
4.5
6.89
5.06
3.8
2.88
3.46
8.84
11.19
4.66
3.09
3
4.55
7.09
4.14
4.49
6.11
2.94
7.96
8.02
8.14
9.28
8.83
9.53
7
6.99
7.63
5.81
10.59
10.87
4.29
7.72
5.99
10.16
6.58
6.02
5.26
7.36
6.53
6.65
5.97
7.84
7.13
7
IUCD
2.61
2.42
3.9
2.24
1.88
1.78
4.52
2.79
3.42
1.94
1.25
0.75
0.47
1.32
0.66
0.84
0.62
3.78
3.02
1
1.07
0.86
2.15
2.91
0.89
3.22
5.6
4.78
4.71
5.27
3.17
0.7
4.39
2.82
1.37
2.36
1.36
3.88
1.93
0.71
0.71
4.42
1.27
3.33
0
8.41
5.21
1.62
2.38
0.09
3.97
2.17
0.98
0.93
1.32
3.48
1.28
1.87
0.5
3.45
6.48
3.46
6.23
3.55
2.97
1.73
0
0.68
0.94
0.62
0.05
1.61
0.53
0.33
1.04
3.12
2
2.07
1.29
1.02
0.64
CPR
Implant
2.79
2.17
1.93
3.92
4.65
1.85
2.39
1.71
3.69
2.53
2.84
2.16
3.19
4.45
2.03
0.54
0.45
2.47
2.71
0.34
0.19
0.87
3.38
5.23
2.3
7.65
14.68
3.49
2.07
3.24
2.1
5.95
4.46
3.93
0.06
1.16
1.63
1.41
2.12
1.57
0.62
1.58
0.46
2.91
6.65
10.83
5.75
0.52
1.62
0.06
3.01
1.74
2.76
2.67
3.09
4.76
3.28
10.28
1.49
5.36
4.99
3.86
4.51
4.54
7.64
6.13
0
3.6
3.27
1.7
1.24
3.06
1.75
3.01
2.56
2.79
3.1
2.88
2.69
5.95
1.22
Total
18.84
21.05
31.01
26.33
32.39
14.9
18.87
16.67
32.25
19.21
20.02
25.89
34.98
29.81
27.83
12.47
19.65
25.56
16.12
9.35
11.51
9.42
20.26
22.21
17.93
25.96
37.07
20.87
16.94
17.2
15.66
28.12
27.67
20.78
7.66
13.81
10.23
14.22
15.01
15.05
13.31
13.62
10.82
14.6
38.81
49.34
23.2
9.89
13.37
13.16
33.22
13.55
13.73
15.22
13.44
25.6
25.94
31.47
18.08
25.65
33.45
23.8
25.27
24.97
25.81
23.35
17.26
15.35
20.91
12.6
19.56
22.03
18.43
17.82
19.25
28.1
21.87
22.71
21.67
27.34
16.22
42.68
48.45
37.8
31.11
44.9
49.67
61.98
41.5
41.52
27.16
27.9
33.01
39.34
38.09
34.28
23.64
61.31
65.8
44.94
57.62
50.48
51.56
35.32
29.89
35.19
40.75
58.16
46.92
33.59
29.57
39.33
55.82
42.51
54.27
49.58
42.74
72.73
41.12
33.07
34.55
33.94
30.53
31
34.92
56.04
71.12
38.81
24.6
28.28
27.72
56.14
39.43
29.9
27.59
25.53
43.09
35.41
38.39
25.12
37.23
51.24
43.73
54.99
54.08
37.58
34.06
28.64
42
30.76
29.35
36.11
39.48
31.89
29.5
25.51
37.42
48.41
44.98
34.97
36.8
26.6
% of postpartum
mothers using a
modern FP method
(implant, IUCD)
0.21
0.03
0.79
0
0.12
0
0
0
0
0
0
0
0
0.33
0
0
0
0
0.23
0
0.34
0.28
2
0.07
0.15
0.08
0.54
0.05
0
0.26
0
0
0
0.39
0
0
0
0.27
0.31
0.04
0.37
0
0.13
0.12
0
0
1.15
0
0
0
1.83
0
0.3
0
0
0.13
0.14
0.04
0.12
0.17
0
0.03
0.02
0.58
0.34
0.25
0
0
0
0
0
0.36
0
1.87
0.37
0.66
0.05
0.05
0.08
0.05
1.83
Analyzed Data:Family Planning (Sheet 2 of 2)
Permanent Method
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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
53135
11682
663
532
620
648
892
711
571
380
537
768
448
707
890
611
1393
1311
17012
1267
911
1028
727
680
676
1001
1320
682
475
1675
953
228
655
603
1168
1200
1096
667
11814
991
753
790
865
849
168
204
497
685
766
916
849
970
1053
957
501
7450
612
616
533
574
633
623
496
686
757
419
177
361
359
282
322
5177
336
575
905
690
653
290
372
852
504
New Acceptors as % of Current Users as % of

MWRA
MWRA
0.5
0.7
0.1
0.0
0.0
1.6
1.0
0.7
0.0
0.0
0.0
0.0
0.0
0.2
0.1
0.2
0.6
1.0
0.5
0.4
0.2
0.7
1.3
0.1
0.2
0.3
0.4
0.4
0.2
0.2
0.5
0.6
0.4
0.3
0.2
0.7
1.7
0.2
0.4
0.1
0.3
0.2
0.1
0.6
0.0
0.3
0.4
0.1
0.5
0.0
0.5
0.7
0.7
0.3
0.1
0.5
0.5
0.1
0.3
0.3
0.3
0.4
0.9
0.7
0.5
0.4
0.6
1.4
0.6
0.9
1.4
0.6
1.2
0.7
0.2
0.7
0.7
0.3
0.4
0.7
0.7
23.8
27.4
6.8
4.8
12.5
34.8
43.1
24.8
9.3
8.0
7.9
7.1
4.4
8.3
6.5
11.2
41.7
40.2
28.8
48.3
39.0
42.1
15.1
7.7
17.3
14.8
21.1
26.0
16.7
12.4
23.7
27.7
14.8
33.5
41.9
28.9
62.5
26.9
18.1
19.5
20.6
16.9
20.2
20.3
17.2
21.8
15.6
14.7
14.9
14.6
22.9
25.9
16.2
12.4
12.1
17.5
9.5
6.9
7.0
11.6
17.8
19.9
29.7
29.1
11.8
10.7
11.4
26.7
9.9
16.8
16.6
17.5
13.5
11.7
6.3
9.3
26.5
22.3
13.3
9.5
10.4
% of VSC new Cases

Female
74.5
96.8
14.3
0.0
0.0
98.1
98.0
96.9
0.0
0.0
0.0
20.0
0.0
31.4
33.3
81.4
98.0
99.9
69.6
99.8
100.0
99.2
33.9
17.4
56.2
15.9
35.0
6.9
46.2
55.8
37.3
29.8
4.6
4.9
100.0
98.2
98.6
3.3
68.4
34.9
26.8
36.9
80.3
56.0
0.0
42.9
34.4
0.0
48.6
53.9
74.8
92.6
65.5
99.4
51.0
49.3
82.9
11.0
0.0
0.0
92.3
74.7
96.2
44.2
3.1
0.0
0.0
0.0
1.1
0.0
0.0
68.0
47.2
46.1
43.4
36.7
87.2
86.2
51.2
74.5
41.4
Target Vs Achievement
Proportion of VSC new acceptors at
Male
25.6
3.2
85.7
0.0
0.0
1.9
2.0
3.1
0.0
100.0
0.0
80.0
100.0
68.6
66.7
18.6
2.0
0.2
30.4
0.2
0.0
0.8
66.1
82.6
43.8
84.2
65.0
93.1
53.8
44.3
62.7
70.2
95.4
95.1
0.0
1.8
1.4
96.7
31.7
65.1
73.2
63.1
19.7
44.0
0.0
57.1
65.6
100.0
51.4
46.2
25.2
7.4
34.5
0.6
49.0
50.7
17.1
89.0
100.0
100.0
7.7
25.3
3.8
55.8
96.9
100.0
100.0
100.0
98.9
100.0
100.0
32.0
52.9
53.9
56.6
63.3
12.8
13.9
48.8
25.6
58.6
HF
39.8
40.5
64.3
0.0
0.0
73.4
49.0
9.3
0.0
0.0
0.0
100.0
0.0
60.8
100.0
17.4
9.4
0.9
56.4
82.8
31.3
12.6
13.8
0.0
6.7
0.0
58.4
93.3
100.0
92.9
4.6
0.0
42.1
26.4
22.1
55.4
97.6
49.2
34.9
41.0
22.7
9.7
22.4
52.3
0.0
0.0
22.6
57.1
8.3
76.9
71.9
6.8
57.5
2.4
0.0
16.8
57.6
0.0
0.0
0.0
14.0
50.1
0.0
23.2
17.4
14.2
0.0
8.3
16.1
0.0
0.0
25.3
0.0
54.9
0.0
7.1
44.3
21.3
9.3
4.4
0.0
Camp
60.2
59.5
35.7
0.0
0.0
26.7
51.0
90.7
0.0
100.0
0.0
0.0
100.0
39.2
0.0
82.6
90.6
99.1
43.6
17.2
68.8
87.4
86.2
100.0
93.3
100.0
41.6
6.7
0.0
7.2
95.5
100.0
57.9
73.6
77.9
44.6
2.4
50.8
65.1
59.0
77.3
90.3
77.6
47.7
0.0
100.0
77.4
42.9
91.8
23.1
28.2
93.3
42.5
97.6
100.0
83.2
42.5
100.0
100.0
100.0
86.0
49.9
100.0
76.8
82.7
85.8
100.0
91.7
83.9
100.0
100.0
74.7
100.0
45.1
100.0
92.9
55.8
78.7
90.7
95.6
100.0
Proportion of VSC provided by

Public
67.5
54.1
100.0
0.0
0.0
22.3
52.5
91.2
0.0
100.0
0.0
100.0
100.0
41.2
100.0
90.4
100.0
59.1
57.5
36.4
89.7
91.2
100.0
100.0
100.0
100.0
27.1
14.3
14.3
58.6
99.4
100.0
100.0
12.7
96.8
93.1
2.0
58.3
77.7
100.0
100.0
100.0
77.6
76.7
0.0
100.0
100.0
100.0
99.4
100.0
37.1
93.7
63.5
69.4
100.0
89.2
100.0
100.0
100.0
100.0
14.0
79.0
100.0
94.8
100.0
100.0
100.0
100.0
100.0
100.0
100.0
91.0
100.0
100.0
100.0
99.4
76.9
99.2
100.0
100.0
96.9
as % of Current Users
as % of VSC new Cases
NGO
32.5
46.0
0.0
0.0
0.0
77.7
47.5
8.8
0.0
0.0
0.0
0.0
0.0
58.8
0.0
9.6
0.0
40.9
42.5
63.6
10.3
8.8
0.0
0.0
0.0
0.0
72.9
85.7
85.7
41.5
0.7
0.0
0.0
87.3
3.2
6.9
98.0
41.7
22.3
0.0
0.0
0.0
22.4
23.3
0.0
0.0
0.0
0.0
0.6
0.0
62.9
6.3
36.6
30.6
0.0
10.8
0.0
0.0
0.0
0.0
86.0
21.1
0.0
5.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
9.0
0.0
0.0
0.0
0.6
23.1
0.8
0.0
0.0
3.1
92.7
91.3
94.8
73.5
78.8
86.3
91.6
94.3
85.5
76.4
72.5
76.4
78.6
95.0
83.7
69.0
100.5
112.2
92.9
94.9
89.3
93.0
90.2
78.6
89.5
96.5
98.3
77.3
75.3
79.5
85.0
101.0
75.7
832.2
90.8
98.8
92.5
91.5
87.5
94.7
80.9
83.8
78.4
80.8
61.5
89.6
88.7
59.2
85.6
79.5
123.7
92.6
89.2
87.9
74.2
94.7
89.8
84.4
78.1
96.2
111.5
94.3
92.9
97.5
105.9
61.3
74.3
96.2
96.2
110.1
94.7
102.8
101.5
113.3
89.8
125.0
102.5
98.9
93.0
112.3
96.3
61.3
63.6
28.0
0.0
0.0
101.3
72.7
49.1
0.0
18.0
0.0
5.0
12.0
51.0
84.0
55.7
41.7
54.4
48.8
19.8
20.9
46.2
409.0
46.0
52.5
91.5
158.5
83.8
79.3
49.7
154.0
57.0
60.8
40.6
9.8
79.2
108.8
18.6
79.6
27.7
48.5
88.0
50.7
94.9
0.0
14.0
62.0
42.0
157.5
13.0
100.7
69.1
110.7
66.0
49.0
69.3
245.0
48.7
116.0
74.5
30.4
47.5
88.9
69.5
98.0
49.3
88.0
104.7
120.0
96.0
97.3
73.7
333.0
147.5
53.0
155.5
63.1
32.8
43.0
121.3
127.3
369
Raw Data:SAFEMOTHERHOOD (Sheet 1 of 5)
Antenatal Checkup
District
Code
District Name
Received
Reports
First ANC Visit (any time)

< 20 Years
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
370
51886
11652
661
534
622
693
903
694
570
363
525
758
429
697
895
606
1392
1310
16143
1222
864
989
668
671
648
871
1222
670
366
1456
953
223
643
595
1169
1170
1092
651
11593
974
745
724
828
858
164
204
490
685
756
910
821
956
1037
944
497
7303
589
620
505
570
630
633
454
679
744
419
164
372
359
254
311
5195
336
571
908
679
684
289
372
852
504
122009
25730
656
707
778
4102
5277
3011
599
426
842
764
489
686
1008
1459
2173
2753
38384
3874
2759
3812
1273
742
602
869
2362
1022
743
4470
1136
177
1496
1623
3247
3179
2152
2846
22184
1071
987
1981
1355
2944
5
31
652
507
1685
1188
1930
2493
3389
1152
814
24172
1464
1319
2217
2062
3461
2777
2073
2682
1785
1376
184
1060
741
644
327
11539
654
1308
1445
1638
2987
1670
513
836
488
20Years
468581
105672
1840
2587
3401
16022
22644
10979
2737
1383
2257
2284
2068
1932
3387
4827
15347
11977
158010
13069
12144
11790
4122
2312
2371
3045
8128
10410
3915
25202
3380
712
4197
6237
14039
11755
10573
10609
100278
3897
2945
4260
4782
13757
53
138
1655
1419
4706
4436
5323
11744
25338
13297
2528
59994
3772
2802
3727
3325
7582
11980
6812
5632
3936
2369
468
1900
2935
1466
1288
44627
2261
4125
6286
5041
11107
7618
2000
4266
1923
Delivery Services
First ANC visit as per protocol

Total
590590
131402
2496
3294
4179
20124
27921
13990
3336
1809
3099
3048
2557
2618
4395
6286
17520
14730
196394
16943
14903
15602
5395
3054
2973
3914
10490
11432
4658
29672
4516
889
5693
7860
17286
14934
12725
13455
122462
4968
3932
6241
6137
16701
58
169
2307
1926
6391
5624
7253
14237
28727
14449
3342
84166
5236
4121
5944
5387
11043
14757
8885
8314
5721
3745
652
2960
3676
2110
1615
56166
2915
5433
7731
6679
14094
9288
2513
5102
2411
< 20 Years
84617
17111
360
596
599
2810
2605
2251
368
326
603
536
259
489
644
1120
1543
2002
25073
1467
1745
2681
791
475
448
593
1563
436
394
4542
720
114
1322
1148
2141
1775
779
1939
15885
872
634
1054
896
1942
3
24
474
507
1148
970
1563
2038
2503
629
628
17783
1068
979
1848
1541
2947
1592
1746
2360
1395
836
51
667
390
220
143
8765
428
711
1055
784
2786
1313
493
776
419
20Years
360773
76286
1511
2574
2657
11705
11795
8824
1963
1113
1672
1734
1695
1585
2579
3945
12490
8444
128912
7158
8703
7653
2746
1781
1937
2109
4824
3223
2894
43623
2436
441
3981
4746
9033
8573
5483
7568
76247
3041
2220
2716
3245
9735
39
90
1509
1491
3433
3741
4413
10140
18032
10233
2169
43617
2534
2181
2220
2500
6800
7267
5869
5023
3188
1413
252
1398
1640
656
676
35711
1671
2548
4934
3157
9969
5560
2138
4027
1707
Total
445390
93397
1871
3170
3256
14515
14400
11075
2331
1439
2275
2270
1954
2074
3223
5065
14033
10446
153985
8625
10448
10334
3537
2256
2385
2702
6387
3659
3288
48165
3156
555
5303
5894
11174
10348
6262
9507
92132
3913
2854
3770
4141
11677
42
114
1983
1998
4581
4711
5976
12178
20535
10862
2797
61400
3602
3160
4068
4041
9747
8859
7615
7383
4583
2249
303
2065
2030
876
819
44476
2099
3259
5989
3941
12755
6873
2631
4803
2126
Four ANC visits as per protocol

< 20 Years
20Years
Total
Skilled Birth Attendants (SBA)

Facility
Home
Total
Non-SBA health workers

Facility
Home
Total
Total
Facility
Home
Total
53261 265669 318930 303621 11134 314755 15640 18784 34424 319261 29918 349179
9651 56281 65932 62521 1316 63837 1653 3237 4890 64174 4553 68727
184
1173 1357
726
14
740
175 350 525
901 364 1265
369
1758 2127
1980
16
1996
26
59
85 2006
75 2081
382
2149 2531
1444
68
1512
26
98 124 1470 166 1636
1898
7410 9308 12620
32 12652
17
61
78 12637
93 12730
1622
9389 11011 18777
281 19058
351
41 392 19128 322 19450
1190
6658 7848
5159
34
5193
31
78 109 5190 112 5302
163
1628 1791
595
18
613
30 150 180
625 168
793
140
619
759
545
7
552
22
92 114
567
99
666
432
1274 1706
1763
28
1791
27
14
41 1790
42 1832
280
1103 1383
732
53
785
297 119 416 1029 172 1201
123
1162 1285
566
86
652
30 189 219
596 275
871
285
1127 1412
1599
54
1653
104
87 191 1703 141 1844
324
2015 2339
729
6
735
208 973 1181
937 979 1916
660
2769 3429
3178
47
3225
135 210 345 3313 257 3570
803 10657 11460
4602
424
5026
136 540 676 4738 964 5702
796
5390 6186
7506
148
7654
38 176 214 7544 324 7868
17394 81642 99036 87250 6730 93980 3022 11071 14093 90272 17801 108073
775
3609 4384
959 1268
2227
91 1203 1294 1050 2471 3521
891
6630 7521
2597 1029
3626
621 2457 3078 3218 3486 6704
1580
5109 6689
4801 1275
6076
259 1545 1804 5060 2820 7880
282
1346 1628
1482
114
1596
166 136 302 1648 250 1898
222
1456 1678
1249
65
1314
77 133 210 1326 198 1524
258
1570 1828
955
114
1069
126 155 281 1081 269 1350
291
1349 1640
1025
66
1091
41 163 204 1066 229 1295
901
3090 3991
5638
31
5669
18
20
38 5656
51 5707
595
8595 9190
8096
16
8112
9
13
22 8105
29 8134
258
1776 2034
1523
2
1525
30
5
35 1553
7 1560
5677 18180 23857 26008
36 26044
13
3
16 26021
39 26060
435
1836 2271
1987
75
2062
30
85 115 2017 160 2177
50
347
397
218
14
232
24
16
40
242
30
272
849
3089 3938
3130
15
3145
100
8 108 3230
23 3253
623
2827 3450
3165
22
3187
123
14 137 3288
36 3324
1195
6672 7867
4398 1499
5897
259 3274 3533 4657 4773 9430
937
6541 7478
2337
319
2656
458 999 1457 2795 1318 4113
313
2770 3083
2363
748
3111
464 831 1295 2827 1579 4406
1262
4850 6112 15319
22 15341
113
11 124 15432
33 15465
10181 66203 76384 64520 1930 66450
687 2862 3549 65207 4792 69999
373
2107 2480
1858
97
1955
145 142 287 2003 239 2242
606
2409 3015
1718
49
1767
72
49 121 1790
98 1888
570
2065 2635
1515
30
1545
20
35
55 1535
65 1600
466
2526 2992
1404
73
1477
15
68
83 1419 141 1560
1316
8640 9956 13979
89 14068
19
22
41 13998 111 14109
0
11
11
7
0
7
2
1
3
9
1
10
8
25
33
54
5
59
5
6
11
59
11
70
244
1530 1774
1257
85
1342
14 206 220 1271 291 1562
375
1379 1754
843
35
878
11
6
17
854
41
895
765
3234 3999
2629
241
2870
75 248 323 2704 489 3193
519
3048 3567
2104
91
2195
45 428 473 2149 519 2668
909
2908 3817
5359
48
5407
9
42
51 5368
90 5458
1332
8539 9871
4558
56
4614
53
83 136 4611 139 4750
2016 18333 20349 23548
14 23562
178 100 278 23726 114 23840
319
7798 8117
2409
903
3312
24 1356 1380 2433 2259 4692
363
1651 2014
1278
114
1392
0
70
70 1278 184 1462
10674 32162 42836 52395
593 52988 5238 777 6015 57633 1370 59003
639
1838 2477
2688
24
2712
66
61 127 2754
85 2839
669
1716 2385
2172
23
2195
441
10 451 2613
33 2646
491
947 1438
1769
37
1806
344
78 422 2113 115 2228
857
1772 2629
2860
25
2885
58
16
74 2918
41 2959
2064
6901 8965
8303
11
8314
388
12 400 8691
23 8714
906
4512 5418 14791
1 14792
7
0
7 14798
1 14799
1157
4309 5466
5631
2
5633
39
2
41 5670
4 5674
1925
3827 5752
5441
0
5441 1320
19 1339 6761
19 6780
878
2620 3498
2933
20
2953 1960
29 1989 4893
49 4942
462
882 1344
1058
105
1163
317 146 463 1375 251 1626
15
166
181
101
95
196
6
61
67
107 156
263
255
918 1173
1447
68
1515
28
95 123 1475 163 1638
174
1072 1246
1903
59
1962
233
20 253 2136
79 2215
94
337
431
574
58
632
9 162 171
583 220
803
88
345
433
724
65
789
22
66
88
746 131
877
5361 29381 34742 36935
565 37500 5040 837 5877 41975 1402 43377
199
1098 1297
1775
54
1829
212
58 270 1987 112 2099
381
1983 2364
2861
125
2986
242 148 390 3103 273 3376
637
4387 5024
3894
102
3996
669 431 1100 4563 533 5096
458
2504 2962
3852
101
3953
121
21 142 3973 122 4095
1691
7881 9572 12117
55 12172 2311
48 2359 14428 103 14531
980
4491 5471
6039
2
6041
26
0
26 6065
2 6067
335
2063 2398
2195
12
2207
305
7 312 2500
19 2519
448
3591 4039
2525
60
2585 1093
63 1156 3618 123 3741
232
1383 1615
1677
54
1731
61
61 122 1738 115 1853

Type of Delivery
District
Code
District Name
Received
Reports
Spontaneous
Cephalic
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
51886
11652
661
534
622
693
903
694
570
363
525
758
429
697
895
606
1392
1310
16143
1222
864
989
668
671
648
871
1222
670
366
1456
953
223
643
595
1169
1170
1092
651
11593
974
745
724
828
858
164
204
490
685
756
910
821
956
1037
944
497
7303
589
620
505
570
630
633
454
679
744
419
164
372
359
254
311
5195
336
571
908
679
684
289
372
852
504
274151
52528
1196
1796
1308
7633
13278
5105
761
662
1656
1048
708
1606
1556
3028
4092
7095
75830
2505
4129
6090
1789
1464
1212
1188
3759
4986
1198
15517
1844
257
3163
2892
6893
3171
3631
10142
56113
2076
1641
1549
1535
10038
8
61
1467
897
2586
2516
4276
4461
17834
3802
1366
50871
2625
2533
1836
2707
7573
11286
5203
5877
4680
1354
138
1341
2055
791
872
38809
2113
2914
4630
3753
11903
5921
2373
3490
1712
Shoulder
604
115
1
2
3
16
7
0
2
3
0
8
0
6
2
3
60
2
167
4
9
37
9
2
1
0
20
1
0
9
9
1
5
26
7
1
9
17
67
8
0
0
0
11
0
0
0
0
1
5
1
2
12
20
7
186
6
10
8
8
84
21
1
8
14
12
0
12
2
0
0
69
1
6
8
13
12
5
19
5
0
Vacuum/Forcep
Breech
3935
534
12
34
17
64
12
17
8
10
43
13
5
24
15
21
80
159
1172
57
265
292
18
25
23
19
13
24
3
11
26
7
33
33
95
109
26
93
655
24
20
9
10
86
0
1
14
7
27
30
30
55
275
55
12
924
49
47
66
60
88
219
99
91
51
48
36
22
38
7
3
650
42
53
64
88
218
78
31
52
24
Cephalic
8895
1823
41
44
87
462
375
216
13
6
59
35
20
37
6
75
0
347
2550
42
76
168
9
23
12
16
268
130
68
730
171
0
44
3
106
76
38
570
1639
40
63
8
14
284
1
0
80
6
22
40
80
105
826
23
47
2057
29
10
154
62
312
1130
53
217
33
17
5
25
10
0
0
826
7
55
49
59
534
29
35
38
20
Shoulder
C/S
Breech
77
15
0
0
0
3
0
0
0
0
0
4
0
1
7
0
0
0
14
0
3
5
0
0
0
0
0
0
0
0
0
0
1
0
0
2
0
3
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
41
0
0
2
1
38
0
0
0
0
0
0
0
0
0
0
6
0
0
1
1
0
0
4
0
0
Cephalic
209
89
0
0
0
0
87
0
1
0
0
0
0
0
0
1
0
0
18
0
0
6
0
0
0
0
0
0
1
3
0
0
1
4
1
0
2
0
57
0
0
0
0
32
0
0
0
0
0
2
19
1
0
0
3
40
0
0
5
2
30
0
0
0
0
0
0
2
1
0
0
5
0
0
0
3
2
0
0
0
0
46163
13372
16
192
218
6592
5293
71
7
4
83
35
53
78
84
276
29
341
18530
39
85
24
29
18
55
16
946
4086
315
8836
103
6
49
237
39
60
114
3473
9203
49
70
1
0
3770
0
0
24
3
65
72
817
120
4175
15
22
3484
96
13
87
33
446
2080
66
573
13
0
2
49
26
0
0
1574
13
52
121
52
1260
23
22
31
0
Total
Shoulder
279
12
0
0
0
2
0
0
0
0
1
0
1
2
3
0
0
3
34
0
1
10
0
0
0
0
2
0
1
3
3
0
0
0
0
0
0
14
102
1
0
0
0
78
0
0
0
0
0
0
15
1
7
0
0
97
3
0
1
0
67
10
0
0
0
0
0
7
9
0
0
34
0
4
16
1
12
0
1
0
0
Breech
1510
371
0
0
4
310
4
3
1
0
4
2
0
13
2
0
0
28
472
0
1
1
1
0
0
1
0
4
1
353
16
0
0
0
0
0
0
94
454
1
9
0
0
284
0
0
0
0
0
10
83
5
62
0
0
131
14
0
6
6
28
59
1
0
0
0
0
12
4
1
0
82
0
4
25
11
39
0
2
1
0
Cephalic
329209
67723
1253
2032
1613
14687
18946
5392
781
672
1798
1118
781
1721
1646
3379
4121
7783
96910
2586
4290
6282
1827
1505
1279
1220
4973
9202
1581
25083
2118
263
3256
3132
7038
3307
3783
14185
66955
2165
1774
1558
1549
14092
9
61
1571
906
2673
2628
5173
4686
22835
3840
1435
56412
2750
2556
2077
2802
8331
14496
5322
6667
4726
1371
145
1415
2091
791
872
41209
2133
3021
4800
3864
13697
5973
2430
3559
1732
Shoulder
960
142
1
2
3
21
7
0
2
3
1
12
1
9
12
3
60
5
215
4
13
52
9
2
1
0
22
1
1
12
12
1
6
26
7
3
9
34
170
10
0
0
0
89
0
0
0
0
1
5
16
3
19
20
7
324
9
10
11
9
189
31
1
8
14
12
0
19
11
0
0
109
1
10
25
15
24
5
24
5
0
Breech
5654
994
12
34
21
374
103
20
10
10
47
15
5
37
17
22
80
187
1662
57
266
299
19
25
23
20
13
28
5
367
42
7
34
37
96
109
28
187
1166
25
29
9
10
402
0
1
14
7
27
42
132
61
337
55
15
1095
63
47
77
68
146
278
100
91
51
48
36
36
43
8
3
737
42
57
89
102
259
78
33
53
24
Total
335823
68859
1266
2068
1637
15082
19056
5412
793
685
1846
1145
787
1767
1675
3404
4261
7975
98787
2647
4569
6633
1855
1532
1303
1240
5008
9231
1587
25462
2172
271
3296
3195
7141
3419
3820
14406
68291
2200
1803
1567
1559
14583
9
62
1585
913
2701
2675
5321
4750
23191
3915
1457
57831
2822
2613
2165
2879
8666
14805
5423
6766
4791
1431
181
1470
2145
799
875
42055
2176
3088
4914
3981
13980
6056
2487
3617
1756
371
No. of Mother
District
Code
District Name
Received
Reports
No. of Life Births
Multiple
Single
Twin
Triplet
National Total
51886 310602 1752
EASTERN
11652 63407
Female
Twin
Male
Female
114 312468 142155 146471
390
31
63828
Birth weight
Multiple
Single
Total
26769 27161
Total
Triplet
Male
Female
Male
Female
Normal(2.5kg)
Male
1247 1001
63
37 143465
279 191
5 27054
Total
Total No
147509 290974 270555

27357
54411 53611
Asphyxia
4300
Low (2 to < 2.5 kg)

Defect
Total No
169 26880
Asphyxia
No of still births
Very low (< 2 kg)

Defect
Total No
Asphyxia
Defect
Fresh
1665
35
9010
421
59 3006
8 421
547
28
5663
670
1790
85
CHX applied
in cord
Macerated
1929 195080
Blood transfusion
No.
Units
3528
6657
1717
285
30524
1036
1 TAPLEJUNG
661
1264
10
1280
657
615
665
621
1286
1206
23
44
11
1017
2 PANCHTHAR
534
2046
10
2057
939
1078
10
949
1084
2033
2003
24
61
26
24
12
1426
36
77
3 ILAM
622
1565
13
1585
750
762
758
765
1523
1432
47
10
26
33
10
15
4 JHAPA
693
8817
38
12
8867
4445
4270
37
22
4482
4292
8774 13179
110
315
565
98
21
46
41
201
323
5 MORANG
903 18558
197
18756
5511
5408
91
62
5604
5471
11075
9090
21
2316
658
0 164
101
9367
384
768
6 SUNSARI
694
5348
5351
2584
2547
2592
2549
5141
4974
37
438
19
50
12
4438
10
14
7 DHANKUTA
570
790
793
358
428
362
430
792
724
15
56
12
499
8 TERHATHUM
363
646
649
309
345
313
345
658
597
12
20
644
12
9 SANKHUWASABHA
525
1804
1810
900
757
18
918
761
1679
1737
33
90
32
15
15
1734
10 BHOJPUR
758
1181
1181
535
572
537
576
1113
1044
34
10
993
33
11 SOLUKHUMBU
429
846
848
395
426
396
429
825
763
56
14
14
10
12
12 OKHALDHUNGA
697
1809
18
1830
886
903
18
11
905
915
1820
1708
23
104
30
14
18
151
34
25
13 KHOTANG
895
1952
11
1963
1000
960
11
1007
971
1978
1773
16
116
11
19
1895
10
14 UDAYAPUR
606
3656
15
3671
1490
1458
1499
1463
2962
3062
59
166
67
25
2678
15 SAPTARI
1392
5281
14
5295
2509
2637
10
2515
2647
5162
5210
109
297
12
76
20
5591
16 SIRAHA
1310
7844
48
7892
3501
3995
51
43
3552
4038
7590
5109
40
1503
47
694
51
11
47
41
291
442
16143 85321
345 223
18
5 42104
41700
83804 75207
6 1098
1837
CENTRAL
505
32
85858
638
49
6610
153
2751
67
439
53726
573
1222
2895
14
2913
1338
1256
12
1350
1260
2610
2783
12
104
49
15
317
19
18 MAHOTTARI
864
5975
13
5989
2684
2834
18
10
2702
2844
5546
5803
134
281
15
158
90
18
5973
14
19 SARLAHI
989
6946
78
7024
3432
3486
66
14
3498
3500
6998
6641
142
610
48
147
17
62
34
6768
20 SINDHULI
668
1976
1985
958
960
961
963
1924
1853
36
86
30
16
18
880
21 RAMECHHAP
671
1523
13
1536
696
762
705
769
1474
1399
21
63
23
17
49
22 DOLAKHA
648
1390
1396
682
703
690
710
1400
1285
12
78
43
40
141
10
18
17 DHANUSA
23 SINDHUPALCHOK
41741 41472
871
1255
1258
639
640
641
644
1285
1129
105
29
18
97
1222
4727
21
4748
1480
1211
10
1483
1221
2704
1161
17
42
18
68
11
5675
44
96
25 LALITPUR
670
9057
79
9139
4363
4444
70
60
4440
4506
8946 13161
617
778
30
85
41
13
20
26 BHAKTAPUR
366
1218
1224
509
612
512
620
1132
84
37
10
122
27 KATHMANDU
24 KAVRE
362
1456
8803
85
8894
5455
5510
62
22
5520
5534
11054
5723
26
2061
14
895
52
43
216
178
843
28 NUWAKOT
953
2125
14
2139
996
888
1001
895
1896
1894
12
149
26
13
14
2304
21
47
29 RASUWA
223
271
272
122
149
122
149
271
258
144
30 DHADING
643
3212
12
3224
1441
1660
12
1453
1668
3121
2957
50
190
34
18
11
245
16
31 MAKWANPUR
595
3240
11
3251
1468
1723
1472
1731
3203
2308
26
132
16
1 428
12
2037
13
28
32 RAUTAHAT
1169
8066
41
8109
4228
4024
20
20
4249
4045
8294
8230
33
18
810
14
163
59
22
7671
33 BARA
1170
3901
19
3927
1832
1924
10
1842
1928
3770
3821
39
230
13
44
72
3662
34 PARSA
1092
3926
12
3938
1888
1805
11
1899
1812
3711
3820
16
134
31
11
21
3714
651 14815
68
14892
7530
6881
34
20
7564
6901
14465 10619
50
826
31
227
25
80
124
13792
266
609
11593 64685
30665
59581 56047
11 506
35 CHITAWAN
339
26
65050
8 28916
1849
12
6357
536
2253
118
439
37402
1029
1557
36 GORKHA
WESTERN
974
2240
2245
1167
1057
1173
1059
2232
2018
168
47
16
269
10
19
37 LAMJUNG
745
1831
1836
884
927
885
933
1818
1719
44
112
31
15
16
1858
42
81
38 TANAHU
724
1574
1578
736
823
738
826
1564
1410
132
15
1469
39 SYANGJA
828
1556
1560
655
835
657
835
1492
1388
132
12
35
11
40 KASKI
858 13240
98
10
13348
6428
7312
78
84
6506
7396
13902 12098
12
1124
1041
14
7 193
67
872
114
119
41 MANANG
164
12
42 MUSTANG
204
67
68
26
35
28
35
63
64
43 MYAGDI
490
1519
1527
636
670
640
673
1313
1259
25
86
14
15
1519
10
18
44 PARBAT
685
906
907
446
451
448
451
899
834
52
45 BAGLUNG
756
2370
2376
887
1053
891
1058
1949
2032
19
41
15
11
15
2927
16
19
46 GULMI
910
2596
10
2613
1177
1290
1184
1299
2483
2303
16
121
27
19
12
47 PALPA
821
4742
43
4787
2355
2558
23
22
2379
2586
4965
4560
63
699
14
305
12
77
50
4851
445
444
956
4698
25
4724
2198
2337
10
2208
2346
4554
4198
36
385
112
37
29
4499
67
179
1037 21681
118
21801
8171
8368
77
85
8252
8455
16707 17076
1559
2631
472
486
65
76
214
13798
317
671
0
48 NAWALPARASI
49 RUPANDEHI
28683 30427
225 230
50 KAPILBASTU
944
4191
13
4204
2198
1958
2204
1960
4164
3793
23
531
74
16
4076
51 ARGHAKHANCHI
497
1467
1469
711
749
715
749
1464
1288
33
139
41
1257
7303 55130
294
55429
195 179
23
14 26032
27063
53095 47668
676
52
4693
179
14
1312
100
20 596
425
38816
638
1093
14
MID WESTERN
25814 26870
52 PYUTHAN
589
2793
21
2814
1336
1410
18
19
1355
1429
2784
2611
19
140
36
30
18
2195
16
53 ROLPA
620
2615
18
2633
1266
1337
10
1276
1343
2619
2510
24
102
21
21
2573
54 RUKUM
505
2087
18
2105
1151
903
17
1156
920
2076
1797
47
230
67
22
10
13
105
55 SALYAN
570
2852
17
2870
1420
1422
14
20
1437
1442
2879
2674
67
201
64
10
10
25
2705
11
59
56 DANG
630
8714
28
8742
4225
4263
4229
4271
8500
7859
105
642
21
335
13
55
59
8574
220
149
57 BANKE
633 11903
83
11986
4878
5339
47
27
4925
5366
10291
8521
70
11
1467
64
301
39
3 177
127
10531
213
396
58 BARDIYA
454
5601
30
5631
2609
2883
45
24
2655
2907
5562
4689
151
586
34
132
16
47
61
5579
12
22
59 SURKHET
679
6700
31
6732
3018
3495
27
16
3045
3511
6556
5917
39
541
11
109
66
53
60 DAILEKH
744
4768
21
4789
2309
2395
14
2318
2409
4727
4431
58
283
12
111
55
37
4521
30
210
61 JAJARKOT
419
1512
1520
780
746
793
750
1543
1486
40
128
46
14
27
62 DOLPA
164
225
228
101
111
102
120
222
236
12
174
63 JUMLA
372
1569
1577
838
695
14
853
712
1565
1477
24
115
28
47
21
1379
112
124
64 KALIKOT
359
2120
2129
1037
1075
1040
1084
2124
1967
26
104
44
17
19
65 MUGU
254
795
797
380
388
382
391
773
693
78
11
14
41
66 HUMLA
311
876
876
466
408
466
408
874
800
64
509
5195 42059
224
20
42303
203 178
5 19359
20724
40083 38022
590
28
3557
127
904
51
14 385
341
34612
252
453
FAR WESTERN
19148 20541
67 BAJURA
336
2046
15
2062
1028
1002
12
10
1044
1012
2056
1834
40
153
14
21
20
25
1874
68 BAJHANG
571
3076
23
3099
1517
1525
16
1525
1541
3066
2942
87
230
20
58
36
31
3041
13
69 ACHHAM
908
4922
33
4956
2369
2473
49
54
2420
2528
4948
4415
34
304
117
2 126
27
80
42
69
70 DOTI
679
3946
32
15
3993
1923
1960
19
11
1942
1971
3913
3633
52
231
11
65
28
21
3912
24
14
71 KAILALI
684 14194
50
14244
6418
7117
64
45
6482
7162
13644 12771
166
1278
35
320
17
85
144
12150
119
255
72 KANCHANPUR
289
5977
30
6010
2678
3129
15
22
2695
3155
5850
5407
49
526
17
130
11
14
53
5879
33
65
73 DADELDHURA
372
2491
11
2502
1099
1201
15
1114
1204
2318
2116
67
407
109
12
2484
12
24
74 BAITADI
852
3650
21
3671
1227
1281
14
13
1241
1294
2535
3309
71
304
12
51
40
18
3494
15
13
75 DARCHAULA
504
1757
1766
889
853
896
857
1753
1595
24
124
33
24
13
1698
372

Obstetric Complications
District
Code
District Name
Received
Reports
Ectopic
pregnancy
(O00)
Abortion
complication
(O08)
Preg.-induced
hypertension
(O13)
Severe/ Preeclampsia
(O14)
Hyper-mesis
gravidarum
(O21.0)
Eclampsia
(O15)
Ante- partum
haemorrhage
(O46)
Maternal Deaths
Prolonged
labour (O63)
Obstructed
Labor (O64O66)
Post partum
Ruptured
Retained
Pueperal Other complihaemorrhage
uterus (S37.6)
placenta (O73) sepsis (O85) cations (O75)
(O72)
Antepartum
Intrapartum
Transport Incentive
Postpartum
Eligible
ANC Incentive
Received
National Total
51886
1094
6211
1916
612
1008
4328
1102
5309
3923
172
4194
3233
927
4931
78
42
61 718840
EASTERN
11652
102
1040
147
119
131
395
68
697
557
14
895
725
80
645
5 134934
1 TAPLEJUNG
661
16
2 PANCHTHAR
534
139
12
30
153
113
47
113
56
3 ILAM
622
100
28
14
31
4 JHAPA
693
35
317
40
27
20
122
19
32
95
86
291
5 MORANG
903
39
247
21
40
65
239
230
99
81
22
200
6 SUNSARI
694
21
77
104
7 DHANKUTA
570
18
11
8 TERHATHUM
363
13
18
9 SANKHUWASABHA
Eligible
Received
610162 203046
175732
129248
39039
44773
842
835
369
365
2053
2043
999
950
2331
3251
1221
1504
5949
5911
473
391
2 33453
33727
6951
7246
0 19940
11434
9215
7680
286
120
122
33
500
455
266
226
838
525
16
33
13
12
27
1414
1206
994
10 BHOJPUR
758
13
10
1884
1827
695
668
11 SOLUKHUMBU
429
10
12
24
1984
4991
236
5119
12 OKHALDHUNGA
697
51
14
38
108
34
33
14
1 15031
17659
5313
9201
13 KHOTANG
895
40
18
21
981
964
624
608
14 UDAYAPUR
606
15
60
23
51
3618
2367
673
623
1392
21
29
10
10
121
37
26
31
1 12506
10323
7229
5757
15 SAPTARI
16 SIRAHA
CENTRAL
17 DHANUSA
1310
53
48
54
50
130
10
42
17
340
69
0 32162
32135
3659
3564
16143
319
1636
776
211
92
2008
442
806
701
16
878
696
406
841
71
20
23 231910
204667
65484
52047
1222
32
15
13
435
378
41
18 MAHOTTARI
864
15
66
17
5477
4941
660
399
19 SARLAHI
989
58
58
86
34
65
0 84618
90207
28255
27274
20 SINDHULI
668
10
47
14
55
72
1570
1563
427
326
21 RAMECHHAP
671
48
35
26
15
1262
1176
791
731
22 DOLAKHA
648
11
14
13
12
15
10
887
754
344
312
23 SINDHUPALCHOK
871
19
11
13
192
8367
6800
1557
1546
1222
26
77
20
38
109
31
85
73
9286
9292
1072
985
670
72
30
229
961
138
16
183
11
228
61
1 37420
34616
13953
11742
24 KAVRE
25 LALITPUR
26 BHAKTAPUR
366
11
81
18
55
23
15
39
278
195
18
27 KATHMANDU
1456
131
618
339
40
11
716
86
54
33
100
55
22
181
0 32742
30359
3763
2915
28 NUWAKOT
953
79
12
28
55
10
20
6111
2060
1173
946
29 RASUWA
223
231
185
162
122
30 DHADING
643
51
10
99
15
14
54
70
3171
2919
1826
1684
31 MAKWANPUR
595
30
12
220
36
56
41
12
0 17767
2788
5639
401
32 RAUTAHAT
1169
12
84
17
39
28
16
43
21
8621
574
260
33 BARA
1170
36
12
30
3923
1341
2367
631
34 PARSA
1092
11
3882
2765
653
384
13
35 CHITAWAN
9184
651
75
613
82
119
48
155
75
255
294
119
92
55
158
5299
3707
2209
1380
WESTERN
11593
448
1770
878
114
621
1788
318
2371
1523
57
1440
642
287
1998
7 142490
114262
29319
27697
36 GORKHA
974
140
25
148
181
31
19
33
1878
1625
913
747
37 LAMJUNG
745
11
81
13
48
28
44
16
40
1631
1573
869
768
38 TANAHU
724
13
43
19
25
26
1196
1272
335
328
39 SYANGJA
828
25
15
57
14
30
1412
1412
441
422
40 KASKI
858
363
680
404
38
516
1064
145
166
132
33
308
255
139
994
1 17678
13633
645
638
41 MANANG
164
42 MUSTANG
204
6052
1537
37
26
43 MYAGDI
490
18
12
1137
1144
713
758
44 PARBAT
685
819
761
509
422
45 BAGLUNG
756
13
0 32573
9543
929
558
46 GULMI
910
14
38
28
1 51428
55286
7947
9856
47 PALPA
821
16
111
14
15
22
17
38
54
270
93
48
20
200
5003
4985
2093
2086
48 NAWALPARASI
20
11
956
124
10
78
69
119
59
13
41
4521
4514
3093
2498
49 RUPANDEHI
1037
55
547
423
49
58
553
113
1674
795
17
750
81
85
608
0 13852
13696
9945
7904
50 KAPILBASTU
944
78
56
11
16
25
2168
2072
340
211
51 ARGHAKHANCHI
497
10
14
20
21
1139
1206
508
475
MID WESTERN
21 161758
7303
93
1221
82
117
132
116
200
1111
939
12
510
727
78
1295
10
124982
41598
27912
52 PYUTHAN
589
35
39
23
50
75
108
2694
2476
1226
1094
53 ROLPA
620
34
38
34
10
32
14
26
52
16
2598
2090
1219
1069
54 RUKUM
505
93
10
67
42
32
82
1 21324
21263
1942
645
55 SALYAN
570
22
22
15
25
36
8622
7997
1201
963
56 DANG
630
244
14
227
75
102
144
19
51
7759
7598
4964
4634
57 BANKE
633
83
382
28
88
93
20
97
546
675
134
89
21
1071
9 10234
9191
1384
714
58 BARDIYA
454
155
10
11
13
53
16
52
56
32
25
25
5490
5012
3556
2975
59 SURKHET
679
28
30
24
6954
6954
2481
4183
60 DAILEKH
744
71
10
32
40
45
0 36279
3775
10467
861
61 JAJARKOT
419
36
20
16
35
10
1 43120
50901
10706
9138
62 DOLPA
164
0 12105
4582
1273
813
63 JUMLA
372
68
14
20
18
16
29
1224
999
259
157
64 KALIKOT
359
29
16
13
67
2058
1460
767
556
65 MUGU
254
22
16
583
387
147
107
66 HUMLA
311
714
297
5195
132
544
33
51
32
21
74
324
203
73
471
443
76
152
5 47748
37003
27606
23303
67 BAJURA
336
51
15
11
38
21
11
1002
1945
477
902
68 BAJHANG
571
27
14
26
39
1 13044
2510
1630
1087
69 ACHHAM
908
128
11
25
31
29
31
27
4195
4090
4171
4050
70 DOTI
679
59
55
40
29
56
10
3780
3710
2344
2029
71 KAILALI
684
111
127
23
39
13
12
14
98
67
68
216
145
19
90
1 13328
12659
9939
7668
72 KANCHANPUR
289
19
61
37
35
29
5971
5874
5194
3880
73 DADELDHURA
372
20
18
19
2451
2291
1961
1876
74 BAITADI
852
41
34
60
84
11
2240
2190
1265
1207
75 DARCHAULA
504
15
72
22
20
19
1737
1734
625
604
FAR WESTERN
373
PNC Visit
District
Code
District Name
Received
Reports
Within 24 hour
Safe Abortion Service (No of women)
3 PNC visit as
per protocol
Medical
< 20 years
Post Abortion FP methods
Surgical
20Years
< 20
years
Total
20Years
Total
Total
Medical
< 20 years 20Years
Short
term
Total
Long
term
Post Abortion Care (PAC)
Surgical
Short
term
Total
Long
term
Total
Total
This facility
Short term Long term
National Total
51886
294268
122574
5541
EASTERN
11652
65317
22743
1009
7861
8870
839
5514
6353
1 TAPLEJUNG
661
1067
414
91
96
26
252
278
31
343
374
81
88
146
25
171
227
32
2 PANCHTHAR
534
1985
552
172
1246
1418
176
1246
1422
821
80
901
822
3 ILAM
622
1589
306
84
698
782
33
312
345
117
1010
1127
456
81
537
171
61
232
4 JHAPA
693
11290
3643
243
1762
2005
325
912
1237
568
2674
3242
1536 101
1637
403
60
5 MORANG
903
18913
4981
260
1110
1370
167
1043
1210
427
2153
2580
994 253
1247
152
6 SUNSARI
694
5274
1691
87
1303
1390
176
2002
2178
263
3305
3568
1200 147
1347
7 DHANKUTA
570
809
357
59
654
713
16
201
217
75
855
930
432
41
473
76
8 TERHATHUM
363
628
19
29
33
30
34
9 SANKHUWASABHA
525
1801
743
58
449
507
61
454
515
139
10 BHOJPUR
758
937
428
20
22
20
25
11 SOLUKHUMBU
429
690
591
11
18
94
103
20
101
121
12 OKHALDHUNGA
697
1820
1054
18
19
22
13 KHOTANG
895
1809
1000
58
66
59
63
12
14 UDAYAPUR
606
3563
716
23
74
97
76
79
1392
5416
4923
33
574
607
274
292
11
46
57
15 SAPTARI
16 SIRAHA
CENTRAL
17 DHANUSA
1310
7726
1325
18
16143
64622
44746
2301
Total
Medical
34274 39815 6489 32307 38796 12030 66581 78611 25110 3942 29052 12747 5076 17823 37857 9018 46875
10339 12640 2524 11378 13902
Others
Surgical
3723
6132
1762
1125
1265
229
259
13
16
80
902
70
16
627
142
769
103
125
463
1939
161
2100
322
236
114
75
227
1146
328
1474
21
313
85
1624 208
1832
2824
355
3179
486
357
55
131
508
96
604
27
27
22
29
23
30
139
180
42
222
319
42
361
27
15
59
63
59
12
71
23
10
12
17
21
21
35
117
129
55
26
150
176
36
42
19
27
46
55
33
88
11
14
33
575
608
452 111
563
455
111
566
28
10
29
320
349
223
10
233
15
16
5355 11175 3049 14224
806
1701
570
1848 13375 15223
4825 21717 26542
6446 848
221
7294
10
231
7651 1218
8869
2809 570
3524 1831
3379
9255 1418 10673
1222
3091
2503
59
382
441
55
252
307
114
634
748
324
34
358
214
55
269
538
89
627
13
41
18 MAHOTTARI
864
5938
5018
10
15
12
18
19 SARLAHI
989
7482
4888
31
33
36
38
24
27
30
33
20 SINDHULI
668
1733
484
16
16
20
23
36
39
11
14
21 RAMECHHAP
671
1448
362
14
148
162
20
84
104
34
232
266
41
43
10
17
51
60
22 DOLAKHA
648
1336
727
180
185
67
74
12
247
259
186
28
214
14
17
200
31
231
31
48
23 SINDHUPALCHOK
871
1322
319
15
118
133
15
15
15
133
148
86
87
11
14
97
101
16
1222
3464
1128
160
845
1005
111
276
387
271
1121
1392
537 112
649
152
58
210
689
170
859
10
27
670
7891
3419
78
1560
1638
23
951
974
101
2511
2612
737 192
929
159 225
384
896
417
1313
18
33
16
26 BHAKTAPUR
366
1548
359
30
451
481
19
19
30
470
500
266
49
315
69
36
27 KATHMANDU
1456
3902
2695
1497
3523
5020 1961
6776
8737
5717 1854
7571
462
656
458
28 NUWAKOT
953
2333
1141
91
139
230
86
110
196
177
249
426
169
36
205
42
46
211
40
251
71
29 RASUWA
223
267
129
30 DHADING
643
3210
1197
66
568
634
26
299
325
92
867
959
226
48
274
75
11
86
301
59
360
16
22
199
24 KAVRE
25 LALITPUR
31 MAKWANPUR
3458 10299 13757
41
298
3350 498
257
3848
17
2367 1356
3723
595
1447
271
22
345
367
79
707
786
101
1052
1153
36
235
273
33
306
472
69
541
63
95
32 RAUTAHAT
1169
7123
5865
33
373
406
11
14
36
384
420
221 101
322
12
227
107
334
18
33 BARA
1170
4099
2863
24
254
278
26
254
280
187
39
226
188
41
229
11
34 PARSA
1092
3624
1499
13
278
291
109
1319
1428
122
1597
1719
190
28
218
27
27
190
55
245
44
619
651
3364
9879
182
1147
1329
35
439
474
217
1586
1803
926
22
948
166
24
190
1092
46
1138
36
56
WESTERN
11593
65302
22589
1163
6246 1181
7427
2867 1688
4555
9113 2869 11982
1051
1229
488
36 GORKHA
974
2265
892
51
372
423
33
274
307
84
646
730
207
53
260
42
36
78
249
89
338
78
33
37 LAMJUNG
745
1893
1144
68
38 TANAHU
724
1618
358
189
601
790
252
899
1151
441
1500
1941
400
77
477
359 207
566
759
284
1043
53
21
39 SYANGJA
828
1525
735
14
250
264
17
125
142
31
375
406
49
54
31
76
85
15
21
40 KASKI
858
12216
3983
232
1859
2091
304
3422
3726
536
5281
5817
1684 433
2117
283 134
417
1967
567
2534
196
423
189
41 MANANG
164
42 MUSTANG
204
59
29
11
16
13
18
43 MYAGDI
490
1523
721
97
931
1028
12
116
128
109
1047
1156
721 109
830
58
18
76
779
127
906
46
19
44 PARBAT
685
802
324
50
497
547
79
298
377
129
795
924
222
64
286
143 116
259
365
180
545
12
10
45 BAGLUNG
756
3032
944
45
805
850
28
78
106
73
883
956
596
38
634
20
27
616
45
661
52
46 GULMI
910
2939
1713
41
45
68
74
10
109
119
12
19
12
19
23
47 PALPA
821
5112
979
111
116
54
802
856
59
913
972
112
20
132
368 371
739
480
391
871
73
58
36
15
35 CHITAWAN
48 NAWALPARASI
8934 10097 1454
9289 10743
2617 18223 20840
27
956
4667
837
111
1006
1117
52
296
348
163
1302
1465
725 143
868
58
156
823
201
1024
53
101
49 RUPANDEHI
1037
22074
6928
188
1403
1591
378
1806
2184
566
3209
3775
914 118
1032
818 260
1078
1732
378
2110
282
341
50 KAPILBASTU
944
4364
2763
152
881
1033
230
885
1115
382
1766
2148
588 116
704
573 417
990
1161
533
1694
56
157
215
184
218
227
29
382
411
3861 1372
2382
3754
2007
5608
7615
51 ARGHAKHANCHI
497
1208
239
20
164
MID WESTERN
7303
57849
15586
635
3226
52 PYUTHAN
589
2829
271
51
59
32
370
402
40
421
461
12
19
141
53 ROLPA
620
2606
772
13
86
99
50
53
16
136
152
34
38
11
54 RUKUM
505
2145
516
34
39
17
17
51
56
37
37
55 SALYAN
570
2716
661
40
48
11
90
101
19
130
149
56 DANG
630
8631
1519
212
435
647 1126
571
1697
1338
1006
2344
271
59
330
57 BANKE
633
14777
3159
28
489
517
25
98
123
53
587
640
380
26
406
45
58 BARDIYA
454
5675
1608
108
117
15
161
176
24
269
293
31
38
142
59 SURKHET
679
6713
2006
190
1105
1295
104
657
761
294
1762
2056
323 120
443
60 DAILEKH
744
4737
2060
27
98
125
15
192
207
42
290
332
43
41
84
91
61 JAJARKOT
419
1514
769
71
73
18
19
89
92
57
59
62 DOLPA
164
205
132
63 JUMLA
372
1617
698
84
420
504
30
36
66
114
456
570
618
85
64 KALIKOT
359
2139
930
41
285
326
47
50
44
332
376
219
65 MUGU
254
671
156
75
82
79
88
66 HUMLA
311
874
329
5195
41178
16910
433
3914
4347
300
3744
4044
733
7658
8391
67 BAJURA
336
1901
681
43
50
46
53
16
68 BAJHANG
571
3157
1144
303
311
305
313
49
52
83
69 ACHHAM
908
5201
4001
50
290
340
32
241
273
82
531
613
141
149
171
70 DOTI
679
3982
1293
78
78
445
450
523
528
68
71
256
71 KAILALI
684
12916
5387
258
1730
1988
192
1256
1448
450
2986
3436
1235 201
1436
72 KANCHANPUR
289
6001
897
68
1257
1325
38
370
408
106
1627
1733
825
66
891
163
73 DADELDHURA
372
2640
2337
44
280
324
443
448
49
723
772
182
34
216
356
74 BAITADI
852
3589
766
13
274
287
363
370
20
637
657
79
25
104
85
75 DARCHAULA
504
1791
404
280
286
280
286
148
150
226
FAR WESTERN
374
30
2032 353
25
2385
98
48
119
96
53
149
65
13
1428 580
71
2008
3460
933
4393
336
1160
355
50
191
153
57
210
24
15
45
53
34
26
17
17
54
54
25
60
749 298
1047
1020
357
1377
528
60
20
65
425
46
471
18
165
142
34
176
173
41
214
19
165
175 128
303
498
248
746
34
16
130
29
120
134
70
204
64
16
19
60
18
78
22
20
703
23
23
641
85
726
23
54
221
12
13
231
234
98
17
19
19
26
26
19
40
2735 342
3077
2119 407
2526
4854
749
5603
405
777
120
16
24
24
17
48
86
132
138
103
35
26
197
312
34
346
91
54
30
286
324
33
357
21
56
763 257
1020
1998
458
2456
149
214
56
172
988
75
1063
79
110
56
412
538
90
628
28
67
91
164
31
195
12
47
20
246
374
22
396
78
Analyzed Data:Safe Motherhood (Sheet 1 of 2)
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
50369
11393
667
493
590
599
814
665
570
371
516
759
433
702
901
611
1392
1310
15453
1207
875
1011
657
670
661
890
1219
614
333
983
955
223
634
582
1160
1140
1061
578
11287
948
746
628
829
786
167
204
486
685
741
907
842
908
996
920
494
7143
581
559
519
574
625
598
426
646
736
419
164
345
356
282
313
5093
336
569
906
665
614
276
371
852
504
96.1
100.2
85.3
78.4
70.8
110.1
127.1
79.5
91.9
82.5
90.2
77.9
110.0
76.6
99.5
85.0
120.9
98.0
88.9
96.8
98.7
83.5
78.7
69.9
68.2
62.8
128.8
114.8
70.3
78.4
75.7
91.0
75.5
82.7
101.0
88.9
87.7
104.7
109.6
83.9
105.1
87.7
104.7
152.7
43.6
59.7
86.8
57.4
101.7
90.8
127.5
98.5
140.0
103.5
72.5
96.4
91.2
73.3
121.1
90.5
85.1
125.3
90.3
98.5
83.8
82.0
65.8
102.0
96.1
133.5
113.3
88.6
81.5
106.7
113.6
122.4
76.3
87.0
70.2
80.4
71.8
51.9
50.3
46.4
50.6
42.9
50.9
50.1
44.6
49.4
34.6
49.7
35.3
55.3
41.3
53.0
46.4
79.1
41.1
44.8
25.0
49.8
35.8
23.7
38.4
42.0
26.3
49.0
92.3
30.7
63.1
38.1
40.6
52.3
36.3
46.0
44.5
21.3
47.5
68.4
41.9
80.6
37.0
51.1
91.0
8.3
11.7
66.7
52.3
63.6
57.6
67.1
68.3
99.2
58.2
43.7
49.1
43.2
42.5
31.3
44.2
69.1
46.0
55.6
68.1
51.2
29.4
18.3
40.1
32.6
27.3
30.4
54.8
36.3
46.4
73.8
54.3
51.8
51.3
67.0
63.7
48.1
51.9
55.4
50.5
46.9
38.2
47.9
62.4
58.0
45.6
32.9
51.2
46.1
64.7
48.8
58.5
50.1
84.9
44.0
39.1
30.7
65.2
45.8
37.3
43.8
45.6
34.9
24.6
92.0
11.1
9.6
52.6
38.0
61.8
42.5
59.0
42.8
34.1
31.5
68.2
46.6
86.3
36.9
62.7
79.0
18.8
14.5
69.0
46.4
57.2
72.3
66.1
65.5
91.5
68.6
46.6
52.1
42.2
38.9
59.9
49.5
54.8
52.8
59.8
58.2
43.2
40.0
28.8
88.4
36.3
67.2
57.2
60.3
46.2
51.1
74.7
67.3
52.6
45.1
90.0
89.3
52.3
75.6
80.4
84.1
81.6
57.3
67.8
73.8
75.9
78.8
79.8
82.7
78.8
88.1
71.5
82.2
79.3
112.8
88.5
60.8
76.6
93.1
78.2
75.0
63.1
67.1
52.4
48.9
100.6
29.7
13.0
66.8
77.9
73.7
70.0
76.7
69.6
57.6
55.6
89.1
73.1
78.3
75.9
75.7
107.7
42.1
49.1
79.0
56.9
88.7
91.7
129.7
89.9
97.4
84.2
67.7
85.1
90.7
70.7
93.5
92.1
76.8
99.7
84.3
91.2
66.7
76.5
52.4
80.1
87.9
112.7
97.4
80.0
75.9
91.9
107.4
77.5
67.6
77.0
85.8
86.7
73.2
52.0
48.9
30.8
47.7
24.9
69.1
87.1
29.5
17.2
25.9
52.1
26.3
25.6
49.9
21.2
44.8
32.7
50.2
40.9
6.0
21.3
27.1
24.0
30.4
24.8
17.1
69.4
81.4
23.4
68.8
33.8
24.8
42.9
34.6
27.2
16.6
19.5
120.0
58.4
33.8
47.8
21.6
24.2
128.0
6.8
20.9
47.8
25.5
43.0
34.7
94.3
31.9
115.7
17.4
27.7
66.1
48.0
46.5
45.5
49.0
67.0
125.7
57.7
80.1
71.7
30.1
10.8
51.2
55.8
36.9
52.4
66.2
55.6
60.9
67.0
72.8
78.1
56.8
69.9
57.0
51.7
51.2
48.7
25.3
47.5
25.6
69.2
86.8
29.5
16.9
25.2
52.1
20.1
28.0
48.4
16.6
43.6
34.7
50.9
42.5
12.7
24.0
32.5
23.3
30.1
24.5
17.5
69.6
81.5
23.0
68.8
34.6
23.8
41.7
33.5
34.5
15.8
21.4
119.3
59.5
33.0
47.2
21.7
25.2
128.6
5.3
20.9
50.5
26.2
45.7
35.5
95.0
31.9
114.9
23.7
30.2
60.8
47.3
39.1
39.5
48.5
64.1
125.6
57.3
64.5
43.2
25.5
19.8
52.6
51.3
40.0
55.4
59.2
51.1
58.6
58.7
72.5
65.9
56.6
61.7
40.8
51.5
5.6
3.7
17.9
2.0
2.1
0.4
1.8
0.6
5.0
5.2
1.2
10.6
9.4
5.6
26.7
4.7
4.7
1.4
6.4
7.4
20.4
9.7
4.4
4.8
6.5
3.3
0.5
0.2
0.5
0.0
1.9
4.1
1.4
1.4
20.6
8.7
8.9
1.0
3.2
4.9
3.2
0.8
1.4
0.4
2.3
3.9
8.3
0.5
5.1
7.6
0.9
0.9
1.4
9.9
1.5
6.9
2.2
8.0
8.3
1.2
3.1
0.1
0.4
15.9
29.1
10.1
6.8
4.3
6.6
10.8
6.2
9.3
7.6
7.7
16.2
2.6
12.8
0.2
8.7
18.2
3.6
99.8
77.0
19.1
155.5
136.5
114.1
154.6
17.5
22.5
25.8
51.9
26.1
42.5
89.5
30.4
34.5
25.6
89.0
78.6
6.1
23.2
13.4
36.4
36.2
80.3
64.9
63.6
176.4
41.8
146.2
61.0
27.9
62.8
50.6
24.3
8.2
2.8
426.5
194.1
97.2
129.6
25.9
60.2
682.5
20.0
52.6
30.6
5.0
37.9
41.3
223.7
52.0
457.6
35.3
19.5
80.3
58.7
43.7
102.3
31.5
73.5
215.3
68.9
46.3
43.6
62.3
12.7
87.5
60.8
43.0
26.6
81.9
65.3
80.4
76.1
62.8
69.8
160.9
32.1
57.3
60.0
42.1
28.0
5.2
108.4
22.9
40.1
39.4
8.6
9.1
14.6
24.4
8.9
18.4
60.9
14.9
16.8
13.9
36.4
29.6
3.0
5.5
9.1
21.0
22.3
16.3
28.5
39.4
130.3
26.6
42.1
25.1
13.6
29.3
29.5
11.3
3.8
1.2
111.1
85.0
67.2
54.1
13.1
19.0
318.4
6.7
23.7
15.4
3.0
6.4
11.7
108.1
24.7
188.6
9.9
11.1
50.6
40.9
31.0
48.2
14.8
45.6
188.8
30.8
7.8
21.1
20.0
4.0
41.0
24.9
25.5
8.9
27.6
30.2
18.2
30.0
33.5
37.6
13.2
14.1
26.1
33.3
1102.0
68.0
0.0
5.0
3.0
19.0
6.0
0.0
2.0
1.0
4.0
0.0
1.0
8.0
1.0
5.0
3.0
10.0
442.0
15.0
5.0
8.0
6.0
1.0
5.0
6.0
38.0
138.0
2.0
86.0
7.0
0.0
5.0
4.0
39.0
2.0
0.0
75.0
318.0
4.0
2.0
3.0
2.0
145.0
0.0
0.0
1.0
1.0
0.0
0.0
38.0
7.0
113.0
1.0
1.0
200.0
8.0
10.0
10.0
6.0
14.0
97.0
16.0
2.0
10.0
6.0
0.0
14.0
4.0
1.0
2.0
74.0
15.0
7.0
11.0
9.0
14.0
5.0
6.0
3.0
4.0
1094.0
102.0
0.0
4.0
0.0
35.0
39.0
0.0
0.0
0.0
0.0
1.0
0.0
2.0
0.0
0.0
21.0
0.0
319.0
0.0
0.0
0.0
0.0
0.0
2.0
0.0
26.0
72.0
11.0
131.0
1.0
0.0
0.0
0.0
0.0
0.0
1.0
75.0
448.0
1.0
11.0
0.0
0.0
363.0
0.0
0.0
0.0
0.0
0.0
1.0
16.0
1.0
55.0
0.0
0.0
93.0
1.0
0.0
2.0
0.0
0.0
83.0
2.0
0.0
0.0
0.0
0.0
4.0
1.0
0.0
0.0
132.0
0.0
2.0
4.0
0.0
111.0
0.0
0.0
0.0
15.0
5309.0
697.0
3.0
153.0
28.0
32.0
239.0
21.0
18.0
7.0
33.0
5.0
10.0
38.0
7.0
60.0
1.0
42.0
806.0
0.0
15.0
58.0
47.0
48.0
14.0
11.0
109.0
5.0
1.0
54.0
12.0
4.0
99.0
7.0
28.0
36.0
3.0
255.0
2371.0
148.0
48.0
43.0
57.0
166.0
1.0
5.0
9.0
0.0
11.0
7.0
54.0
78.0
1674.0
56.0
14.0
1111.0
39.0
32.0
67.0
22.0
227.0
546.0
52.0
30.0
32.0
20.0
1.0
20.0
16.0
5.0
2.0
324.0
11.0
14.0
25.0
55.0
98.0
61.0
4.0
34.0
22.0
172.0
14.0
0.0
1.0
0.0
1.0
3.0
0.0
0.0
0.0
0.0
4.0
0.0
5.0
0.0
0.0
0.0
0.0
16.0
0.0
1.0
0.0
0.0
0.0
0.0
0.0
0.0
1.0
0.0
5.0
0.0
0.0
0.0
1.0
5.0
0.0
0.0
3.0
57.0
0.0
1.0
0.0
0.0
33.0
0.0
0.0
0.0
0.0
0.0
1.0
5.0
0.0
17.0
0.0
0.0
12.0
0.0
0.0
1.0
0.0
1.0
9.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.0
73.0
0.0
0.0
1.0
2.0
68.0
0.0
0.0
2.0
0.0
Number of women treated

for pre-eclampsia

for ruptured uterus

for prolonged/ obstructed
labor

for ectopic pregnancy

for haemorrhage
% of women with a direct

obstetric complication who
were treated at a EONC
(basic or comprehensive)
site]
Met need for emergency

obstetric care
MATERNAL COMPLICATIONS
% of births attended by a
health worker other than
SBA
% of births attended by a
skilled birth attendant
(SBA)
% of institutional deliveries
% of pregnant women who

received anthelmintics
Received
Reports
DELIVERY
% of women who received a

180 day supply of iron folic
acid during pregnancy
District Name

had four ANC checkups as
per protocol
District
Code

had at least one ANC
checkup
ANTEPARTUM
612.0
119.0
2.0
12.0
2.0
27.0
6.0
0.0
0.0
0.0
2.0
2.0
0.0
2.0
2.0
5.0
3.0
54.0
211.0
0.0
2.0
0.0
1.0
1.0
6.0
1.0
20.0
5.0
7.0
40.0
1.0
0.0
3.0
0.0
4.0
0.0
1.0
119.0
114.0
4.0
1.0
1.0
0.0
38.0
0.0
0.0
1.0
0.0
0.0
0.0
15.0
3.0
49.0
2.0
0.0
117.0
2.0
1.0
9.0
1.0
3.0
88.0
11.0
1.0
0.0
0.0
0.0
1.0
0.0
0.0
0.0
51.0
6.0
0.0
2.0
0.0
39.0
2.0
0.0
0.0
2.0
375
Analyzed Data:Safe Motherhood (Sheet 2 of 2)
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
376
50369
11393
667
493
590
599
814
665
570
371
516
759
433
702
901
611
1392
1310
15453
1207
875
1011
657
670
661
890
1219
614
333
983
955
223
634
582
1160
1140
1061
578
11287
948
746
628
829
786
167
204
486
685
741
907
842
908
996
920
494
7143
581
559
519
574
625
598
426
646
736
419
164
345
356
282
313
5093
336
569
906
665
614
276
371
852
504
83.0
77.2
95.5
88.6
81.1
51.1
69.8
94.6
97.2
98.5
92.0
93.4
90.6
92.6
93.9
89.7
99.3
91.0
78.1
96.9
96.4
96.8
97.9
97.3
94.9
97.3
75.7
54.3
75.7
61.0
86.5
97.8
97.1
92.4
98.0
96.0
96.0
71.2
83.2
95.8
92.1
99.4
99.1
69.5
88.9
100.0
93.4
99.0
96.8
95.4
80.9
95.1
78.1
99.0
95.1
89.9
95.0
99.1
88.9
96.4
89.4
77.9
97.8
88.3
99.0
98.8
96.1
93.5
97.7
99.9
100.0
94.0
99.1
96.3
95.7
96.8
86.8
99.1
97.4
98.1
98.9
2.7
2.8
3.2
2.1
5.3
3.1
2.4
4.0
1.8
0.9
3.2
3.4
2.5
2.2
0.8
2.2
0.0
4.4
2.6
1.6
1.7
2.7
0.5
1.5
0.9
1.3
5.4
1.4
4.4
2.9
7.9
0.0
1.4
0.2
1.5
2.3
1.1
4.0
2.5
1.9
3.5
0.5
0.9
2.2
11.1
0.0
5.1
0.7
0.8
1.6
1.9
2.2
3.6
0.6
3.4
3.7
1.0
0.4
7.0
2.3
4.4
7.6
1.0
3.2
0.7
1.2
2.8
1.8
0.5
0.0
0.0
2.0
0.3
1.8
1.0
1.6
3.8
0.5
1.6
1.1
1.1
14.3
20.0
1.3
9.3
13.6
45.8
27.8
1.4
1.0
0.6
4.8
3.2
6.9
5.3
5.3
8.1
0.7
4.7
19.3
1.5
1.9
0.5
1.6
1.2
4.2
1.4
18.9
44.3
20.0
36.1
5.6
2.2
1.5
7.4
0.6
1.8
3.0
24.9
14.3
2.3
4.4
0.1
0.0
28.3
0.0
0.0
1.5
0.3
2.4
3.1
17.2
2.7
18.3
0.4
1.5
6.4
4.0
0.5
4.2
1.4
6.2
14.5
1.2
8.5
0.3
0.0
1.1
4.6
1.8
0.1
0.0
4.0
0.6
1.9
3.3
1.6
9.4
0.4
1.0
0.9
0.0
47.9
49.8
36.5
47.2
26.9
61.7
86.1
30.0
22.3
28.7
52.4
24.0
29.7
53.3
41.0
48.2
37.4
51.4
29.3
17.7
39.3
40.1
25.3
33.2
30.7
21.2
42.5
79.2
23.4
10.3
39.1
27.3
42.6
15.2
41.6
24.4
25.0
26.2
58.5
38.3
50.6
22.7
26.0
111.7
3.8
20.9
57.3
23.9
48.2
47.5
89.8
32.3
107.6
31.3
26.2
66.1
49.3
46.4
42.3
45.7
66.5
125.5
57.7
79.5
69.4
33.1
20.7
56.1
55.9
42.4
61.3
65.0
53.2
62.0
76.4
73.0
69.9
56.2
73.8
56.6
53.3
19.9
17.3
14.1
13.1
5.2
19.9
22.7
9.6
9.8
0.9
21.6
10.9
25.4
30.9
22.6
9.7
34.0
8.8
20.3
14.3
33.2
26.2
7.1
8.3
16.7
5.1
13.9
34.3
5.4
7.1
19.1
13.2
15.9
2.9
34.3
17.1
10.3
76.8
20.2
15.1
30.6
5.0
12.5
36.4
0.0
10.3
27.1
9.7
15.0
27.7
17.2
5.8
33.8
19.8
5.2
17.8
4.7
13.7
10.2
11.1
11.7
26.8
16.4
23.8
30.2
16.8
13.3
24.2
24.3
9.9
23.1
26.7
19.0
22.5
58.8
23.7
29.2
8.4
65.3
12.1
12.0
49.4
47.5
49.7
52.8
33.2
39.6
35.1
40.5
42.6
39.7
44.1
63.2
58.5
65.7
67.7
60.9
67.2
48.4
37.9
40.0
63.9
55.8
42.2
41.7
56.0
36.0
23.5
91.2
20.2
6.6
33.4
29.8
42.5
22.6
54.0
45.5
39.6
17.6
60.5
47.5
57.1
29.9
45.1
113.2
15.0
29.0
66.7
31.8
56.2
63.2
119.3
47.7
49.9
67.2
39.7
58.6
74.8
41.4
52.7
68.6
61.4
51.6
57.3
74.2
57.7
51.5
28.7
49.3
56.7
61.5
59.4
60.7
56.9
65.8
83.2
63.4
40.7
50.6
82.1
93.5
64.4
49.1
46.5
49.5
52.5
38.9
41.3
32.2
42.0
45.9
40.0
40.4
54.7
58.2
64.2
56.9
59.2
65.2
47.1
38.6
38.1
61.9
57.0
44.6
42.7
50.7
27.4
22.1
91.4
20.2
7.9
33.4
32.9
43.1
40.7
55.3
45.5
40.5
17.3
58.1
47.2
57.4
30.7
44.2
113.1
15.0
27.9
64.0
30.8
58.6
62.5
119.3
42.0
48.3
56.5
39.0
61.1
75.9
45.8
53.1
68.2
61.3
69.8
51.2
79.3
61.8
44.7
28.9
48.9
57.2
57.9
59.4
58.1
57.0
66.4
84.7
63.0
41.0
50.3
80.3
66.5
63.8
1008.0
131.0
1.0
2.0
1.0
20.0
40.0
1.0
0.0
1.0
0.0
2.0
1.0
0.0
0.0
6.0
6.0
50.0
92.0
1.0
1.0
3.0
0.0
0.0
1.0
0.0
4.0
7.0
0.0
11.0
4.0
0.0
1.0
1.0
6.0
2.0
2.0
48.0
621.0
4.0
5.0
0.0
3.0
516.0
0.0
0.0
2.0
1.0
0.0
0.0
22.0
9.0
58.0
1.0
0.0
132.0
5.0
4.0
1.0
3.0
5.0
93.0
13.0
3.0
4.0
0.0
0.0
1.0
0.0
0.0
0.0
32.0
0.0
2.0
3.0
5.0
13.0
5.0
1.0
1.0
2.0
3233.0
725.0
6.0
113.0
31.0
86.0
81.0
104.0
11.0
18.0
27.0
13.0
24.0
33.0
21.0
51.0
37.0
69.0
696.0
0.0
17.0
86.0
72.0
26.0
15.0
13.0
73.0
11.0
15.0
55.0
55.0
5.0
54.0
56.0
21.0
30.0
0.0
92.0
642.0
19.0
16.0
26.0
30.0
255.0
0.0
2.0
12.0
6.0
13.0
38.0
48.0
59.0
81.0
16.0
21.0
727.0
75.0
52.0
82.0
36.0
144.0
89.0
25.0
24.0
45.0
35.0
1.0
29.0
67.0
16.0
7.0
443.0
21.0
39.0
31.0
56.0
145.0
29.0
19.0
84.0
19.0
927.0
80.0
1.0
6.0
3.0
5.0
22.0
0.0
1.0
2.0
8.0
1.0
0.0
3.0
2.0
0.0
26.0
0.0
406.0
2.0
1.0
1.0
2.0
0.0
10.0
9.0
4.0
228.0
7.0
22.0
10.0
0.0
6.0
41.0
6.0
2.0
0.0
55.0
287.0
7.0
9.0
0.0
5.0
139.0
0.0
0.0
1.0
0.0
2.0
4.0
20.0
13.0
85.0
2.0
0.0
78.0
6.0
1.0
4.0
0.0
19.0
21.0
4.0
0.0
3.0
10.0
0.0
3.0
5.0
2.0
0.0
76.0
5.0
4.0
27.0
7.0
19.0
4.0
5.0
3.0
2.0
6211.0
1040.0
16.0
139.0
100.0
317.0
247.0
1.0
7.0
1.0
16.0
6.0
2.0
51.0
40.0
15.0
29.0
53.0
1636.0
9.0
6.0
1.0
10.0
7.0
2.0
8.0
77.0
30.0
81.0
618.0
79.0
0.0
51.0
30.0
12.0
0.0
2.0
613.0
1770.0
140.0
81.0
13.0
25.0
680.0
0.0
0.0
18.0
0.0
6.0
8.0
111.0
124.0
547.0
7.0
10.0
1221.0
35.0
34.0
93.0
22.0
244.0
382.0
155.0
28.0
71.0
36.0
2.0
68.0
29.0
22.0
0.0
544.0
51.0
27.0
128.0
59.0
127.0
19.0
20.0
41.0
72.0
3.8
6.7
2.7
3.7
0.8
6.4
7.5
2.2
0.0
3.5
2.6
21.7
4.7
7.4
3.5
1.8
0.4
14.5
2.2
1.9
0.0
0.8
0.0
0.0
1.9
0.0
5.7
0.5
2.4
2.1
3.9
0.0
1.1
1.8
0.5
0.5
0.0
3.2
3.2
1.2
5.8
0.0
0.2
1.0
0.0
5.0
8.3
0.0
4.5
0.3
23.3
5.9
2.3
0.0
3.7
6.1
3.2
0.5
1.7
3.9
15.4
5.6
1.2
0.0
6.7
0.0
21.1
29.6
1.2
1.0
0.0
3.2
0.0
1.1
5.4
4.7
6.2
1.3
6.9
2.8
0.0
6657.0
1717.0
4.0
77.0
15.0
323.0
768.0
14.0
0.0
12.0
8.0
2.0
12.0
25.0
10.0
4.0
1.0
442.0
1837.0
19.0
14.0
1.0
0.0
0.0
18.0
2.0
96.0
20.0
122.0
843.0
47.0
0.0
16.0
28.0
2.0
0.0
0.0
609.0
1557.0
19.0
81.0
0.0
0.0
119.0
0.0
0.0
18.0
0.0
19.0
2.0
444.0
179.0
671.0
0.0
5.0
1093.0
14.0
4.0
105.0
59.0
149.0
396.0
22.0
0.0
210.0
0.0
1.0
124.0
7.0
2.0
0.0
453.0
0.0
13.0
69.0
14.0
255.0
65.0
24.0
13.0
0.0
% of births by caesarean
section
Number of blood units used

for treating obstetric
complications
% of women treated for an

obstetric complication who
received a blood transfusion

for abortion complications

for puerperal sepsis

for retained placenta

for eclampsia
% of postpartum women
who received Vitamin A
supplementation
MATERNAL COMPLICATIONS
who received a 45 day
supply of iron folic acid (IFA)
% of women who had three

postnatal check-ups as per
protocol
who received a PNC checkup
within 24 hours of delivery
Received
Reports
POSTPARTUM
% of deliveries by caesarean
section
District Name
% of assisted (vacuum or
forceps) deliveries
District
Code
% of normal deliveries
DELIVERY
7.8
10.5
0.6
4.6
3.8
37.8
24.1
0.4
0.2
0.2
2.6
1.0
2.3
2.7
2.0
3.7
0.2
2.5
8.6
0.2
0.6
0.2
0.4
0.4
1.3
0.3
11.6
41.1
4.8
24.3
2.1
0.6
0.7
2.5
0.2
0.4
0.8
27.9
8.7
0.9
2.1
0.0
0.0
37.8
0.0
0.0
0.9
0.1
1.0
1.3
16.1
0.9
20.7
0.1
0.5
4.3
2.0
0.2
1.9
0.7
4.2
18.3
0.7
6.8
0.2
0.0
0.2
2.4
1.0
0.1
0.0
2.7
0.4
1.2
2.4
1.2
7.1
0.2
0.7
0.5
0.0
Raw Data:PHCORC (Sheet 1 of 2)
Growth Monitoring
District
Code
District Name
0-11 month
Received Reports General treatment

Normal
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
47397
10908
662
505
566
576
801
619
569
348
413
752
389
681
841
537
1392
1257
14045
1152
826
819
528
655
607
771
1113
487
248
781
954
223
594
558
1072
1074
1041
542
10756
855
741
543
784
766
165
193
439
685
729
899
754
883
967
891
462
6680
483
535
502
521
629
552
400
591
699
417
124
360
358
196
313
5008
336
538
896
664
581
266
372
851
504
754413
147699
8431
9375
12498
10239
24351
6530
5102
3233
5333
10458
4805
12988
8017
6558
11018
8763
191129
8867
8833
8630
7679
9652
12659
10772
29177
8955
4464
13875
13353
4156
12462
10458
6605
8458
5677
6397
229070
26226
15944
32131
11751
18554
703
1090
6268
7721
17397
12777
17860
15580
19974
9943
15151
77281
7934
7854
4707
7481
5804
5970
5382
9153
5507
5267
642
2580
3408
2148
3444
109234
9479
11876
23149
7940
10892
7613
11740
18097
8448
Low
Very Low
537871 10069 11084

117453 1250 1433
4768
19
95
5332
31
24
8488
22
260
14978
109
201
20797
147
344
3895
60
10
2974
17
12
2076
7
19
3460
15
12
4895
46
38
1014
10
104
2728
14
38
5569
39
77
9031
136
33
17296
255
55
10152
323
111
121854 1984 2731
9643
155
277
16152
349
657
5260
161
33
3284
23
63
2961
29
38
2968
12
81
7622
113
62
8891
51
91
1659
3
58
867
0
50
5513
4
12
4167
45
27
787
7
3
8332
128
147
10032
92
16
7955
207
56
15781
471
595
3156
28
287
6824
106
178
96523
992 1405
5998
12
9
5281
61
10
5701
15
4
6636
6
73
11764
73
205
44
0
0
199
0
4
2501
9
122
2061
7
6
3585
26
155
7666
66
31
6522
38
46
12192
132
256
14589
122
53
10069
396
137
1715
29
294
102596 3202 2597
6254
133
18
6226
92
163
7234
256
153
7267
128
157
17330
357
141
10907
424
246
15966
226
359
6175
40
97
10593
160
455
4953
198
128
427
3
15
5901
758
216
1395
212
186
878
93
253
1090
122
10
99445 2641 2918
1766
205
124
6630
170
33
19171
418 1027
7403
316
241
26553
518
773
3218
51
68
8326
228
44
18975
562
256
7403
173
352
12-23 month
Total
559024
120136
4882
5387
8770
15288
21288
3965
3003
2102
3487
4979
1128
2780
5685
9200
17606
10586
126569
10075
17158
5454
3370
3028
3061
7797
9033
1720
917
5529
4239
797
8607
10140
8218
16847
3471
7108
98920
6019
5352
5720
6715
12042
44
203
2632
2074
3766
7763
6606
12580
14764
10602
2038
108395
6405
6481
7643
7552
17828
11577
16551
6312
11208
5279
445
6875
1793
1224
1222
105004
2095
6833
20616
7960
27844
3337
8598
19793
7928
Normal
357220
74593
4038
2332
3402
7864
11526
3423
2274
1160
1746
3503
1183
2204
4208
4573
14146
7011
77575
8648
13260
5473
1862
1538
1813
2895
5752
828
580
2560
2204
393
5933
3689
7008
6770
3606
2763
62934
4750
4276
2378
4532
5139
50
192
1483
1330
4344
5398
4330
5580
10221
7562
1369
64218
2295
4089
3158
4955
7069
6090
10639
4729
5765
3985
360
6730
1577
1330
1447
77900
1564
5530
21664
6802
11477
1682
8038
14766
6377
Low
10554
1400
51
20
16
60
247
111
9
14
8
101
59
17
57
95
252
283
1864
197
410
109
20
4
4
134
60
5
10
12
40
3
110
70
212
354
40
70
877
6
28
15
5
60
0
2
29
6
45
36
47
71
88
417
22
3571
34
97
194
201
308
237
286
38
127
240
5
1363
274
81
86
2842
175
201
556
410
322
24
444
557
153
Very Low
4299
415
14
2
49
15
129
32
4
3
3
12
25
2
13
8
55
49
1737
202
369
38
17
8
56
40
3
13
0
18
25
1
0
14
96
634
147
56
471
1
6
18
16
19
0
0
60
1
87
16
14
100
20
95
18
1092
3
22
29
26
61
99
156
45
41
67
13
385
116
22
7
584
29
11
65
127
110
6
91
87
58
Antenatal
checkup
Postnatal
checkup
Deworming
Tablets
Total
372073
76408
4103
2354
3467
7939
11902
3566
2287
1177
1757
3616
1267
2223
4278
4676
14453
7343
81176
9047
14039
5620
1899
1550
1873
3069
5815
846
590
2590
2269
397
6043
3773
7316
7758
3793
2889
64282
4757
4310
2411
4553
5218
50
194
1572
1337
4476
5450
4391
5751
10329
8074
1409
68881
2332
4208
3381
5182
7438
6426
11081
4812
5933
4292
378
8478
1967
1433
1540
81326
1768
5742
22285
7339
11909
1712
8573
15410
6588
258979
62486
1801
1912
2714
5448
9872
8982
1165
510
1060
1502
483
734
1867
3141
14423
6872
79583
13028
17490
5432
2290
1004
1406
1522
2468
449
196
1141
1489
556
2347
3487
9750
7631
5262
2635
49655
2473
1914
2363
2238
3397
9
30
1172
798
1900
4175
2998
6976
8738
9206
1268
41608
2014
1677
1440
1949
6556
9969
6881
3653
1750
2158
213
1876
571
375
526
25647
1125
1952
4155
1904
6717
1747
1335
5163
1549
56917
12535
851
269
778
1329
1651
853
227
98
116
443
188
181
880
425
3200
1046
24251
3516
5425
2477
461
160
439
608
292
177
97
425
611
28
639
333
4345
2147
1595
476
9975
723
218
292
353
463
1
20
191
101
640
619
154
612
1893
3593
102
5115
200
228
276
300
234
404
486
543
319
759
141
566
202
210
247
5041
331
560
1319
325
917
205
229
579
576
105145
24749
1441
776
1012
2642
3027
2872
385
211
641
579
551
248
1344
1085
5118
2817
37726
6553
8530
2749
995
263
683
716
821
204
158
678
955
218
890
1850
4895
3326
2220
1022
17106
940
496
850
783
1014
15
22
299
217
968
1064
759
1548
3256
4445
430
16444
698
630
716
673
2598
2761
2415
1354
626
1456
257
747
441
326
746
9120
714
1219
1776
978
1946
530
342
1136
479
Timely
Exclusive breast introduction of
Comple-mentary
feeding
feeding
229986
42866
1828
2281
2253
3256
8373
1739
1245
658
1595
1672
788
1175
2386
2168
8918
2531
48974
4912
8544
3282
1063
805
1009
2013
2718
369
60
2400
1284
322
3145
3749
3953
4525
2538
2283
41040
3836
1831
2048
3239
4266
12
56
1278
929
1854
3871
1811
3607
5858
6004
540
49068
1721
2605
1273
3808
9430
6453
9323
2422
4802
2137
162
2021
1707
776
428
48038
1418
2396
11067
3341
14036
2069
1457
9935
2319
232775
41674
1965
1960
2126
3264
6630
1552
1526
654
1407
1698
899
1441
2664
2733
8949
2206
46932
4468
7439
3361
936
902
1284
2001
2694
431
184
2559
1529
343
3771
2722
3820
4096
2320
2072
41700
3802
2407
1804
3352
4060
8
65
1475
902
2144
4080
1777
3533
5648
6082
561
51359
1758
2793
1171
3909
10445
5513
9999
2579
4605
2241
186
2783
1892
1076
409
51110
1614
2627
12943
4057
13301
1941
1575
10563
2489
377
Raw Data:PHCORC (Sheet 2 of 2)

Analyzed Data:PHCORC
FP Method
Iron tablet distribution

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
378
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received
Reports
New
pregnant
47397 124207
10908 30836
662
993
505
755
566
1211
576
2624
801
5384
619
4102
569
408
348
260
413
542
752
806
389
1371
681
255
841
1147
537
1344
1392
6116
1257
3518
14045 44442
1152
8132
826
9887
819
3666
528
1148
655
299
607
575
771
956
1113
867
487
305
248
109
781
637
954
1126
223
230
594
1360
558
1424
1072
6413
1074
3706
1041
2606
542
996
10756 19534
855
1119
741
565
543
1261
784
1089
766
1185
165
5
193
17
439
412
685
242
729
796
899
1141
754
861
883
1934
967
3465
891
4942
462
500
6680 17911
483
882
535
780
502
978
521
754
629
3335
552
3095
400
1937
591
1548
699
1023
417
1394
124
143
360
1049
358
294
196
261
313
438
5008 11484
336
568
538
1099
896
2587
664
833
581
1999
266
1199
372
446
851
2206
504
547
Vitamin A for
post partum
Repeated
238468
58301
1417
1455
2500
4761
8432
9364
974
453
783
1733
471
686
1657
2647
13303
7665
70098
11506
16411
5318
1643
1112
1386
1421
2177
347
206
1059
1077
382
1822
2389
8535
7036
4317
1954
44217
2484
1874
3098
2309
3268
66
22
1097
741
1545
4518
2278
5602
6626
7577
1112
40595
1993
1869
1168
1650
12667
7648
4872
2775
2010
1687
85
1144
419
292
316
25257
1141
1702
4594
1328
5930
1312
1165
5945
2140
Post partum
59914
13550
787
265
772
1525
2056
871
255
103
111
461
352
132
927
431
3037
1465
25334
3634
5513
2522
489
180
467
656
277
177
99
784
709
33
651
440
4303
2266
1746
388
10209
838
255
750
404
481
5
6
140
91
559
558
168
693
1877
3250
134
5484
396
225
304
248
431
348
662
548
367
756
114
546
175
114
250
5337
467
548
1393
320
824
185
129
858
613
Condoms
Piece
Pills
No
70019 2991785 127261

15567 686452 40595
947
34731
2125
233
53005
2179
1047
33476
5121
1912
47091
4264
1970
75414
7187
619
45289
2013
364
16823
682
470
14839
451
128
8091
483
1025
40968
1454
354
10411
621
291
17764
994
1126
40404
1498
434
17149
1505
2898 138008
7595
1749
92989
2423
28124 823805 37859
4269
85917
3276
5011 107290
8001
2555
42469
2012
838
24208
1391
279
20414
489
509
23674
1161
586
17214
1815
225
48853
2008
333
10735
723
84
7404
548
537
37083
1486
846
48284
1281
35
6675
147
764
46197
2955
450
22020
1070
4084 129612
3981
3804
67008
1823
2086
53252
2913
829
25496
779
11489 550162 21217
686
31208
1363
308
22798
725
390
20976
987
466
38973
2531
783
39417
1794
2
760
8
3
2021
26
145
11583
456
70
9139
297
614
45760
1454
643
55027
1434
379
27606
981
939
34537
1382
1590
79961
4343
3451 102043
2922
1020
28353
514
8659 516219 16186
356
63634
2391
445
69851
847
506
15303
837
250
37549
826
1846
50041
1773
219
44942
932
421
49995
1839
1589
54772
1568
951
33971
772
732
22635
2038
102
4747
240
560
31030
543
221
20603
515
126
6155
327
335
10991
738
6180 415147 11404
327
27087
937
464
38582
821
1749
85391
1760
698
37906
968
989
61903
3168
132
27636
383
66
18757
583
826
91251
1838
929
26634
946
Depo
Cycle
Defaulter
tracing (TB)
Blood slide
collection
Mother's
group attend
No
164707
56127
3649
3961
8537
5906
9115
2767
1135
755
990
2140
1035
1596
2315
1750
7840
2636
48598
3197
9213
2200
2519
756
1805
3310
3071
1363
888
3014
1935
235
4449
2375
3775
1571
1736
1186
26810
2283
1111
1515
2691
2131
26
50
695
395
1800
1408
1263
1594
5210
4056
582
21337
2685
1275
1246
1008
3298
1123
2463
1798
1012
2468
347
585
550
293
1186
11835
964
794
1545
762
3713
658
671
1442
1286
214370
68574
3601
6539
10580
5511
11240
3333
3116
733
2216
3798
1144
2808
1483
3921
6211
2340
73724
2219
7454
2718
2773
3364
2777
7244
7788
2437
1075
4739
4683
441
6793
8470
2335
2110
1447
2857
21965
3338
1126
2344
1174
1960
14
44
448
318
783
1671
2081
1251
3406
1446
561
32867
2312
1881
2357
3340
5534
2487
4521
3437
1622
3615
101
502
474
170
514
17240
1039
868
1694
1015
6801
1798
1066
1978
981
3233
1044
44
11
129
217
159
90
22
5
0
72
20
16
47
12
111
89
1046
59
155
90
20
11
14
35
14
63
0
62
61
1
43
56
168
101
69
24
524
110
12
14
53
43
0
4
17
2
34
7
28
70
27
91
12
372
20
57
9
4
47
19
35
54
15
44
0
24
1
5
38
247
20
36
37
18
35
8
10
34
49
4488
1201
1
7
61
115
269
236
132
2
0
79
0
3
5
0
236
55
2014
12
181
16
23
0
3
2
121
362
0
0
9
0
0
119
477
624
57
8
447
11
40
3
0
37
0
0
18
0
20
26
28
22
190
52
0
673
7
12
11
34
163
155
28
239
0
10
0
9
5
0
0
153
1
14
12
5
14
10
1
81
15
184103
48730
2337
1391
3051
3408
4086
4441
1244
605
2039
2702
734
2746
2537
1328
9028
7053
54363
5226
5636
3012
1714
2109
3018
2253
4190
1573
612
4174
3129
967
2430
1661
4439
4412
2733
1075
36997
2991
2669
1662
3348
3342
49
194
753
770
2688
4397
1463
2127
4220
4473
1851
23523
1538
1417
1520
1218
1893
3675
2360
3332
2458
1105
183
1505
612
238
469
20490
1011
1786
4278
1731
2174
708
1743
5181
1878
% of planned
primary health
care (PHC)
outreach clinics
conducted
80.5
87.8
85.4
87.2
93.6
83.3
88.4
92.9
81.8
87.5
83.3
90.5
82.2
92.7
88.7
89.7
90.9
79.3
68.5
67.3
82.7
45.7
68.9
90.3
90.2
62.5
88.6
41.7
86.9
85.2
75.1
81.8
78.7
81.3
57.5
65.7
47.0
74.7
89.0
87.2
94.6
88.9
89.2
95.8
75.0
65.8
89.8
83.5
95.6
90.3
98.6
91.3
81.9
85.4
76.2
77.6
74.1
83.3
81.1
81.9
86.6
90.6
92.0
90.2
81.9
77.3
23.9
70.6
71.0
39.3
58.1
89.0
79.7
77.9
96.2
66.0
92.2
93.3
94.7
99.1
93.0
Average number % of women who

of clients served
received ANC
per PHC outreach check-up at PHC
clinic
outreach clinic
20.6
19.5
14.0
20.4
20.6
34.2
31.6
24.9
15.7
15.3
14.5
13.4
14.6
11.7
11.1
19.3
20.6
18.0
20.2
22.4
32.1
24.1
14.0
13.4
14.6
18.4
17.1
11.5
17.5
22.8
14.5
15.2
22.0
23.0
21.3
21.7
17.1
23.7
18.9
19.0
14.6
15.4
15.7
24.8
9.8
9.8
16.0
12.7
22.0
15.2
17.7
20.6
22.3
22.8
23.9
22.2
14.8
14.8
19.2
19.9
32.7
31.9
29.1
20.6
19.2
24.3
14.6
23.0
22.2
18.5
18.0
25.0
36.2
24.0
31.5
20.8
34.6
20.9
25.0
19.0
18.3
44.8
48.7
57.0
47.3
51.7
36.9
47.3
53.4
39.4
40.2
38.3
52.1
27.3
34.2
44.4
47.8
55.7
52.6
44.6
74.8
69.9
44.8
58.5
37.4
43.5
48.1
38.2
4.7
8.8
4.6
39.6
58.3
37.3
50.3
55.3
50.5
63.1
30.1
39.4
49.9
38.8
47.3
42.8
25.4
45.0
47.6
39.8
31.3
32.2
53.9
44.0
41.4
30.0
53.1
38.6
49.2
44.9
41.3
47.6
42.6
42.2
64.8
55.7
38.8
33.4
61.6
54.1
61.9
31.4
46.5
54.9
42.5
46.5
45.2
45.3
39.1
41.2
24.2
35.8
56.1
49.0
Raw Data:FCHV (Sheet 1 of 2)
Home Delivery (Person)

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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received Reports
49451
11214
660
514
580
577
807
617
570
371
476
764
416
699
902
571
1392
1298
15086
1217
874
1019
645
671
641
864
1177
551
273
856
955
223
619
565
1160
1167
1053
556
10999
876
741
572
819
740
164
193
475
685
735
908
794
920
970
907
500
7083
575
594
508
567
625
568
404
630
734
419
164
357
356
268
314
5069
336
575
906
667
591
266
372
852
504
Mother's group
meeting held (Times)
702823
103614
5886
3754
7730
5627
7523
9293
3372
3595
2612
6498
2578
7600
8278
4250
12139
12879
350286
21108
7732
10053
8514
7187
9750
5959
10080
109865
2235
11966
8602
2428
5026
6392
9751
11156
99000
3482
111852
6230
7112
4157
6716
10557
825
492
3580
4377
10878
10364
9794
8331
11426
9314
7699
69905
4690
4816
3428
4269
7946
7370
7706
10069
7994
2338
283
4055
2865
728
1348
67166
2711
4327
9901
5789
16935
8944
5089
9617
3853
Visits to pregnant
women (Person)
Iron tab. distributed to

preg. Women (Person)
1137219
237836
3730
6420
6899
24743
32885
37198
6413
3421
4817
8768
3809
8034
7596
11548
37011
34544
325766
32529
35819
30027
10889
7493
6430
10514
13082
5137
3450
12762
5136
2602
10666
14713
34203
35582
37837
16895
195602
9662
6776
7860
11589
13286
112
226
5310
6623
11432
12301
12266
33175
32846
22482
9656
186722
12158
9259
5679
13439
25065
32076
29950
16021
19561
5373
662
6119
8298
1508
1554
191293
12101
14836
25260
19443
43598
25600
12141
27397
10917
932945
185499
2016
3183
10573
22429
27939
27838
2344
545
2215
4691
2491
4164
6080
9366
36712
22913
252334
27760
31862
27436
10220
5556
8666
4869
10153
990
2640
8732
3886
1432
5354
13354
27014
32604
17083
12723
153661
4690
9291
5388
13462
8918
29
128
4123
4693
9749
13694
8840
23880
16035
22082
8659
175433
9674
8837
4424
11231
37133
18786
30006
13037
17162
9462
510
6174
6108
1430
1459
166018
10752
12383
17500
19401
45164
16017
6115
29391
9295
Ensure mesoprostol
taken (Tablet)
117477
31979
1416
448
1609
8086
1496
5415
15
29
163
335
437
20
1118
1293
4808
5291
55523
4559
9401
16712
665
240
351
4117
2465
59
267
265
140
162
69
7454
2251
4486
1518
342
14292
215
524
551
2795
39
0
2
679
647
240
1547
27
1
1102
5380
543
9995
62
875
246
1671
1191
1207
0
297
626
798
233
1554
851
214
170
5688
475
849
635
1170
1366
101
141
84
867
Live birth
182023
40584
1027
1248
1203
3107
5883
5231
1229
918
746
1713
986
963
2433
2595
6823
4479
70458
7729
9764
9662
2366
1164
1185
1586
1151
310
257
755
1087
350
850
3065
12759
7881
6568
1969
26637
1180
570
1230
1236
946
5
19
754
516
2478
2156
1471
2477
2791
7007
1801
26423
1858
2323
1170
2442
2773
3711
1141
1878
3100
1874
217
1330
1584
555
467
17921
1527
2304
2908
1983
2291
2282
973
2225
1428
Still birth
3194
594
20
34
33
45
81
51
17
15
13
43
21
20
41
53
52
55
1048
75
164
133
51
14
9
44
15
11
2
13
25
4
6
38
143
142
93
66
452
26
7
51
25
32
0
1
18
28
47
23
28
45
0
98
23
654
21
43
22
50
45
155
24
36
89
62
6
32
46
13
10
446
37
40
46
44
78
74
48
48
31
Birth asphyxia
management
2729
374
27
8
8
30
25
82
13
15
9
36
11
5
33
17
11
44
1300
152
342
113
14
17
16
8
3
0
3
2
33
17
2
56
162
203
148
9
293
10
1
41
8
1
0
1
19
13
65
15
13
27
0
69
10
521
4
27
6
26
45
57
3
79
34
57
7
52
95
17
12
241
28
23
17
14
68
39
20
22
10
Skin to skin contact

after birth
130394
25659
833
815
749
2114
2333
2349
934
663
483
837
700
696
2080
2090
4833
3150
55713
6125
7869
8570
1782
933
866
864
660
193
104
375
1310
247
557
1196
10858
7816
4612
776
18882
925
404
867
904
414
4
10
617
296
1930
1827
866
1625
1281
5837
1075
16496
971
77
438
1748
1778
2449
685
1155
2343
1410
186
1207
1387
335
327
13644
1295
1749
2835
1487
1730
1284
538
1581
1145
Chlorhexidine
applied in cord
104678
20343
689
675
122
329
2587
2494
923
806
466
1196
35
83
2147
2185
5197
409
45672
1514
8726
8842
242
96
87
55
772
21
10
107
1488
147
23
285
12317
5849
4546
545
14560
57
488
782
83
57
0
1
726
14
2112
79
1155
2021
71
5747
1167
13135
255
1796
17
1908
1859
2583
591
0
2249
110
171
1203
25
0
368
10968
1075
1965
174
1656
1722
1498
521
1658
699
379
Raw Data:FCHV (Sheet 1 of 2)
Analyzed Data:FCHV
Home Delivery (Person)
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
380
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received Reports Breast feeding < 1

hour of birth
49451
11214
660
514
580
577
807
617
570
371
476
764
416
699
902
571
1392
1298
15086
1217
874
1019
645
671
641
864
1177
551
273
856
955
223
619
565
1160
1167
1053
556
10999
876
741
572
819
740
164
193
475
685
735
908
794
920
970
907
500
7083
575
594
508
567
625
568
404
630
734
419
164
357
356
268
314
5069
336
575
906
667
591
266
372
852
504
154402
30921
999
1133
929
2551
3181
2843
979
794
598
1488
800
827
2338
2652
5125
3684
62800
6794
8810
9120
2247
1122
1129
1261
808
215
139
592
1594
285
739
1945
12492
6767
5357
1384
23240
1104
517
974
1224
1334
5
18
769
423
2496
2231
1156
1816
1601
6217
1355
21456
1537
1977
744
1994
1943
2627
701
1433
2613
1720
218
1527
1514
473
435
15985
1349
2124
3223
1706
2071
1650
672
1754
1436
Low birth
weight
5919
482
9
17
13
98
38
47
11
7
19
30
42
22
24
40
25
40
1501
58
167
187
22
3
9
7
17
2
3
18
27
4
4
13
286
385
267
22
612
6
5
77
26
67
0
1
29
8
26
16
35
41
0
217
58
2782
9
1949
35
55
80
66
38
151
62
65
15
95
79
38
45
542
41
65
99
61
46
136
20
69
5
Visits to newborn & postpartum mothers

Very low birth
weight
24hrsofbirth 3rd day of birth 7rd day of birth
2294
303
9
6
10
67
56
45
2
2
4
3
16
1
7
15
15
45
1084
37
408
37
2
2
6
2
7
3
0
2
7
3
8
5
112
268
170
5
200
4
7
25
6
13
0
0
15
1
40
18
7
11
0
23
30
328
2
65
5
9
56
52
5
25
40
16
8
30
6
5
4
379
11
11
124
61
60
51
7
33
21
142131
29251
929
1035
737
2293
4588
3209
919
720
549
1149
618
715
1981
2184
4267
3358
56904
6133
8272
8631
1677
996
1054
871
684
144
102
464
796
294
650
1470
12297
6355
5025
989
19862
905
407
621
967
592
5
16
730
373
2228
2121
859
1715
1028
5931
1364
19631
1266
1608
561
1687
1746
2514
824
1737
2418
1512
205
1395
1313
418
427
16483
1352
1931
3108
1878
2862
1982
603
1768
999
202948
59868
762
999
533
2406
8503
5434
22457
716
590
1055
646
745
1581
2643
7715
3083
65761
6594
10842
9495
1612
1146
964
870
1478
120
136
475
701
211
568
1172
12452
7482
5983
3460
29027
929
655
661
1282
984
5
14
1982
364
2378
2186
1990
5774
937
6919
1967
26775
1052
1393
481
2404
4738
4455
3169
1260
3357
1116
216
1366
1100
299
369
21517
1395
2135
3238
2164
3565
2858
1306
3801
1055
181396
41133
669
886
576
3094
10151
5343
1274
703
596
1071
719
728
1623
2560
7812
3328
64728
5221
10729
9610
1234
881
946
916
1594
135
162
527
605
194
518
1116
12915
7657
6170
3598
28524
881
677
823
1317
827
3
18
828
339
2482
2129
2257
5853
914
6999
2177
26135
893
1097
369
2450
4984
4524
3236
1236
3255
1112
218
1326
858
219
358
20876
1367
2187
3131
2032
3689
2908
1318
3202
1042
Distribution of
Postpartum
Vitamin A
Condoms
distribution
(Piece)
273577 10512449
63243 1798657
1175
39308
1255
69402
5121
61429
8815
174721
11317
211834
7932
213332
1339
48460
741
36777
774
33808
1360
92941
1038
17523
1261
47751
2801
66119
2565
62591
8591
331234
7158
291427
109337 2415172
11790
190042
10596
241966
10789
201692
2626
72085
1242
89636
1619
67116
2017
35431
1278
105499
826
39115
670
29708
4585
128324
1578
55709
437
32352
2470
100049
2934
90510
12966
338394
29947
329817
6843
166422
4124
101305
45798 1814586
1604
69561
1099
72881
1292
51313
3293
96674
4061
144077
6
2459
19
4876
3993
57069
794
54131
3371
151827
3453
167081
1636
88427
6143
261265
5359
238314
7653
208379
2022
146252
27903 2011841
2295
174108
106
166757
1543
31109
2380
119691
2609
250069
6541
313481
1414
357788
1841
226906
2661
203046
1830
32489
211
6203
1534
46754
1942
57049
546
9062
450
17329
27296 2472193
1520
81501
2190
91619
3411
196894
2244
142676
9105 1030264
2383
431822
903
70357
3729
360268
1811
66792
Pills distribution
(Cycle)
866881
246404
4342
8904
11838
43128
37222
37538
7918
2352
4449
11619
2495
8734
5864
16752
22063
21186
199614
10444
21618
18638
11221
5783
6211
5228
8978
5059
4710
16795
4002
1132
10392
20917
14643
11481
6012
16350
148647
7126
4533
6527
11512
10830
104
123
4466
4421
9716
9705
9511
21526
29753
12697
6097
139981
11130
8004
5225
8432
23494
23947
17384
14994
10592
4684
821
3402
4604
1176
2092
132235
7926
5560
6424
4909
61722
28630
1991
10903
4170
Number of
Female
Community
Health Volunteers
(FCHVs)
% of mothers
group meetings
held
49659
10842
834
393
1063
612
753
1186
350
392
325
570
279
697
898
442
1065
983
14246
936
673
1347
495
750
1226
666
963
493
279
1235
1111
245
445
440
902
885
712
443
11014
621
652
466
651
1053
119
144
361
500
950
987
615
713
1327
1012
843
7690
432
441
396
414
875
788
832
986
744
263
200
556
295
225
243
5867
261
423
901
625
1239
766
452
831
369
135.0
93.7
70.8
97.9
78.6
93.3
98.0
83.9
95.3
86.4
83.8
103.1
90.8
103.9
89.7
94.7
101.6
118.9
246.0
225.7
105.0
87.0
176.8
91.5
85.9
89.8
94.1
2594.8
81.2
96.6
97.5
97.4
105.6
138.5
82.3
115.9
1422.2
82.3
88.2
93.4
96.5
87.2
96.3
97.5
85.8
56.1
87.5
81.2
97.2
50.8
133.8
99.2
84.5
89.6
101.1
91.1
96.0
103.3
93.3
89.8
88.4
86.2
85.4
103.0
95.7
92.8
35.3
97.0
91.5
48.4
69.6
104.9
95.4
94.8
95.3
87.3
138.6
107.1
104.2
97.9
88.8
Raw Data:Malaria (Sheet 1 of 4)

Blood Slide Collection
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
District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
ACD
PCD
15297
3493
0
10
93
1650
568
188
203
0
31
0
0
0
0
406
335
9
5682
905
167
317
178
5
0
54
39
318
0
0
24
0
54
1576
738
1118
61
128
962
155
90
7
187
130
0
0
0
31
0
19
74
264
0
2
3
2891
1
61
5
2
549
0
649
1624
0
0
0
0
0
0
0
2269
6
2
441
58
360
949
312
141
0
86080
17404
0
750
2520
2995
5103
837
179
5
1
307
0
82
0
869
1693
2063
15195
2839
3998
630
464
79
0
30
544
161
0
0
143
0
234
1085
1585
2262
233
908
18047
339
527
210
485
1755
0
0
304
15
50
354
1027
5399
6429
1074
79
11341
503
246
0
62
1576
3405
3590
1439
435
85
0
0
0
0
0
24093
0
12
449
236
9827
12461
415
693
0
Examined
Total
Micros-copy
only
101377
20897
0
760
2613
4645
5671
1025
382
5
32
307
0
82
0
1275
2028
2072
20877
3744
4165
947
642
84
0
84
583
479
0
0
167
0
288
2661
2323
3380
294
1036
19009
494
617
217
672
1885
0
0
304
46
50
373
1101
5663
6429
1076
82
14232
504
307
5
64
2125
3405
4239
3063
435
85
0
0
0
0
0
26362
6
14
890
294
10187
13410
727
834
0
69991
13735
0
619
2641
3033
3886
119
316
0
21
307
0
0
0
1121
574
1098
12584
2516
3596
462
129
84
0
32
417
610
0
10
112
0
61
1309
1044
1156
27
1019
14969
96
568
102
0
1602
0
0
277
100
32
210
896
3583
6429
1074
0
8298
44
307
5
9
333
515
3713
2848
431
85
0
0
8
0
0
20405
0
14
622
231
6547
11825
398
768
0
RDT Only
39127
7330
0
91
30
1509
1120
645
116
2
10
0
0
82
0
329
1621
1775
7108
1206
659
280
586
7
0
30
257
76
0
10
30
0
209
224
5
392
249
2888
14429
440
8
30
672
283
0
0
27
41
0
0
45
1865
9067
1719
232
5320
529
0
0
2
1271
1978
935
598
7
0
0
0
0
0
0
4940
8
14
420
70
3632
649
66
81
0
Positive
Both (M+R)
18740
4952
0
12
60
58
1485
410
287
0
5
0
0
0
0
838
961
836
6892
3535
524
449
41
17
0
12
229
0
0
10
56
0
8
668
447
714
90
92
790
52
0
51
143
0
0
0
0
120
0
51
9
211
8
0
145
3291
43
307
0
0
521
912
1200
215
8
85
0
0
0
0
0
2815
0
14
650
238
8
936
263
706
0
Micros-copy
only
649
71
0
0
2
42
4
8
1
0
0
2
0
0
0
3
0
9
210
13
95
36
0
1
0
0
0
0
0
1
0
0
5
4
36
14
0
5
78
2
0
0
0
19
0
0
0
0
1
5
3
14
16
18
0
84
5
0
0
0
2
3
28
46
0
0
0
0
0
0
0
206
0
0
5
3
147
41
3
7
0
RDT Only
651
139
0
30
0
16
8
9
0
0
0
0
0
0
0
2
19
55
77
11
25
0
2
0
0
13
0
0
0
1
0
0
0
0
0
0
0
25
208
3
0
0
1
1
0
0
0
0
0
0
2
27
91
82
1
60
33
0
0
0
0
7
0
20
0
0
0
0
0
0
0
167
2
2
12
2
120
11
0
18
0
Treatment
Both (M+R)
121
12
0
0
0
0
0
0
0
0
0
0
0
0
5
0
7
13
0
4
0
1
5
0
0
1
0
0
1
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
33
5
0
0
0
7
12
0
9
0
0
0
0
0
0
0
63
0
2
10
1
1
35
11
3
0
Total
1349
180
0
1
2
58
11
17
1
0
0
2
0
1
0
5
19
63
241
24
80
36
3
3
0
0
1
2
0
10
0
0
0
1
36
14
0
31
289
5
0
0
1
20
0
0
0
0
0
5
5
41
107
100
5
206
43
0
0
29
9
22
28
75
0
0
0
0
0
0
0
433
4
1
27
5
268
85
14
29
0
Pregnant
12
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
2
1
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
1
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
6
1
0
1
0
3
1
0
0
0
381
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
382
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
22
8
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
2
1
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
1
0
0
10
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
10 186 352
2 31 47
0
0
0
0
0
0
0
0
0
0
1 14
0
1
3
1
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
1
0
7
3
1 21 25
2 30 42
1
1 12
0 15 15
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
1
0
0
0
0
0
0
0
0
0
0
0
0
1
4
6
0
5
4
0
0
0
0
5
2
1 33 78
0
1
1
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
1
3 10
0 16 35
0 12 25
0
0
1
1 20 64
0
8 14
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
1 12
1
9 37
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4 72 121
0
0
1
0
0
0
0
4
7
0
1
0
2 36 83
2 14 18
0
1
4
0 16
8
0
0
0
570
88
0
0
0
15
10
2
0
1
0
0
0
0
0
1
10
49
75
14
30
0
1
1
0
0
0
0
0
1
0
0
0
0
12
9
0
7
113
2
0
0
1
2
0
0
0
0
0
0
4
14
52
37
1
95
32
0
0
0
0
2
13
47
1
0
0
0
0
0
0
199
1
0
13
1
121
34
5
24
0
5Years
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
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
5
1
0
1
0
1
2
0
0
0
8
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
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
4
2
0
0
0
0
0
0
1
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
62 418
10 43
0
0
0
0
1
1
6 22
0
3
1
5
1
0
0
0
0
0
0
2
0
0
0
1
0
0
0
2
0
0
1
7
16 49
0
5
0
4
14 17
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
0
0
0
0
1 18
3 106
0
0
0
0
0
0
0
0
1 11
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0 20
1 25
1 49
0
0
5 63
5
6
0
0
0
0
0
0
0
8
0 16
0 10
0 17
0
6
0
0
0
0
0
0
0
0
0
0
0
0
28 157
1
1
1
1
4
6
2
2
16 93
3 43
1
8
0
3
0
0
496
53
0
0
2
28
3
6
1
0
0
2
0
1
0
2
0
8
70
5
4
36
1
0
0
0
1
0
0
0
0
0
0
0
4
0
0
19
110
0
0
0
0
12
0
0
0
0
0
1
0
21
26
50
0
72
13
0
0
0
8
16
10
18
7
0
0
0
0
0
0
191
3
2
11
4
110
48
9
4
0
< 5 Years
5Years
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
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
1
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
36
5
0
0
0
1
0
1
0
0
0
0
0
0
0
0
2
1
4
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
21
2
0
0
0
1
0
0
0
0
0
0
0
3
12
3
0
3
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
3
0
0
0
0
37
11
0
0
0
4
0
0
0
1
0
0
0
0
0
0
2
4
3
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
10
0
0
0
0
0
0
0
0
0
0
0
1
0
7
2
0
8
6
0
0
0
0
0
0
2
0
0
0
0
0
0
0
5
0
0
0
0
4
1
0
0
0
77
16
0
0
0
5
0
1
0
1
0
0
0
0
0
0
4
5
8
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
0
0
31
2
0
0
0
1
0
0
0
0
0
0
1
3
19
5
0
14
12
0
0
0
0
0
0
2
0
0
0
0
0
0
0
8
0
0
0
0
7
1
0
0
0
< 5 Years
5Years
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
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
20
3
0
0
0
1
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
4
0
0
0
0
1
0
0
0
0
0
1
0
0
1
0
1
9
7
0
0
0
0
0
2
0
0
0
0
0
0
0
0
4
0
0
2
0
2
0
0
0
0
86 109
13 17
0
0
0
0
0
0
4
6
3
3
5
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
7
9
0
1
0
0
2
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
1
1
0
0
0
0
4
4
26 30
0
0
0
0
0
0
0
0
4
5
0
0
0
0
0
0
1
1
0
0
3
4
0
0
3
3
7
8
5
5
3
4
17 26
8 15
0
0
0
0
0
0
1
1
3
3
3
5
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23 27
0
0
0
0
1
3
0
0
16 18
5
5
0
0
1
1
0
0
Indigenous
< 5 Years
5Years
2
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
3
0
0
0
1
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
0
0
0
0
1
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
18
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
4
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
5
0
0
0
0
5
0
0
0
0
24
8
0
0
0
1
0
0
0
0
0
0
0
0
0
0
5
2
6
3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
3
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
5
0
0
0
0
5
0
0
0
0
Imported
< 5 Years
F
5Years
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
19
0
18
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
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
42
3
0
0
0
2
0
1
0
0
0
0
0
0
0
0
0
0
28
2
24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
4
1
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
3
0
0
0
0
0
1
0
2
0
0
0
0
0
0
0
4
0
0
0
0
3
1
0
0
0
Total
Imported
< 5 Years
Plasmodium Mixed (P-MIX)
Imported
Total
indigenous
5Years
Indigenous
Total
Imported
< 5 Years
Plasmodium Falciparum (PF)
Imported
Total
indigenous
Indigenous
Total
Imported
District Name
Total
indigenous
Plasmodium Vivax (PV)

District Code
64
4
0
0
0
3
0
1
0
0
0
0
0
0
0
0
0
0
47
2
42
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
4
1
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
4
0
0
0
0
0
1
0
3
0
0
0
0
0
0
0
5
0
0
0
0
4
1
0
0
0
RawData:Malaria(Sheet3of4)
Noofmalariacases
District
Code
DistrictName
NationalTotal
EASTERN
1 TAPLEJUNG
2 PANCHTHAR
3 ILAM
4 JHAPA
5 MORANG
6 SUNSARI
7 DHANKUTA
8 TERHATHUM
9 SANKHUWASABHA
Suspected/Probable
ConfirmedUncomplicated
Treatmentofmalaria
ProbableSevere
ConfirmedSevere
Suspected/Probable
ConfirmedUncomplicated
ConfirmedSevere
ProbableSevere
<5Years
5Years
<5Years
5Years
<5Years
5Years
<5Years
5Years
<5Years
5Years
<5Years
5Years
<5Years
5Years
<5Years
393 348 2292 2482

56 47 546 578
0
0
0
0
0
0
4
45
0
0
0
23
3
0
32 465 899
2 68 112
0
0
0
2
2
0
2
2
0
15
5
0
57
38
0
3
0
0
6
0
0
49
2
0
0
0
1
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
13
12
33 264 279
0
0
0
0
0
0
1
6
5
14
11
0
0
0
0
4
0
7
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
0
0
0
0
0
0
0
0
0
0
0
1
1
9
1
13
5
66 288 250 1580 1716

5 20 13 188 202
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
16
0
7
0
1
0
0
0
0
0
9
1
28
4
0
34 377 821
5 51 98
0
0
0
5Years
4
2
0
4
3
0
52
16
0
79
21
0
0
0
0
0
0
0
13
2
0
41
8
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
13
53
0
70
0
2
0
3
1
6
5
14
11
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
8
5
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10 BHOJPUR
11 SOLUKHUMBU
0
0
0
0
4
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
0
0
0
0
0
0
0
2
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
2
0
12 OKHALDHUNGA
13 KHOTANG
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
1
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
14 UDAYAPUR
15 SAPTARI
0
7
0
0
0
6 266 259
0
1
0
0
0
29
2
31
0
2
0
2
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 122 111
0
0
0
0
0
14
3
16
0
2
0
3
0
15
0
18
0
0
0
0
0
2
0
3
0
0
2
3
249 220 1129 1265
2
14
1 24 37
20 241 232
0
0
0
0
0
6
0
9
0
3
0
6
0
45
0
0
0
2
3
50 198 176 809 907
2
18
1 23 36
20 169 189
0
2
0
1
1
36
1
42
0
0
0
0
0
9
0
16
16 SIRAHA
CENTRAL
17 DHANUSA
18 MAHOTTARI
19 SARLAHI
20 SINDHULI
21 RAMECHHAP
60 279 318
176 140 555 598

1
3 92 138
66
14
0
4
0
4
0
44
0
49
3
0
0
15 200 178
0 12 13
0
0
0
0
3
0
5
0
2
0
4
0
38
3
0
0
0
0
2
1
3
1
0
0
0
0
0
1
0
0
12
0
8
1
30 233 273
36 153 135 422 437

8
1
3 37 66
17
0
0
1
39
4
0
4
0
37
0
41
3
0
0
15
16 120 127
0
7
3
0
0
0
0
19
3
20
5
0
0
0
0
9
0
5
0
0
0
0
0
6
0
8
1
0
0
0
0
0
0
0
3
0
0
13
13
0
8
1
22 DOLAKHA
23 SINDHUPALCHOK
24 KAVRE
0
0
1
0
1
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
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
25 LALITPUR
26 BHAKTAPUR
0
0
0
0
3
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
3
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
27 KATHMANDU
28 NUWAKOT
29 RASUWA
0
0
0
0
0
0
2
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
1
0
0
30 DHADING
31 MAKWANPUR
32 RAUTAHAT
33 BARA
34 PARSA
35 CHITAWAN
WESTERN
0
0
0
0
1
1
7
0
6
7
0
1
0
6 67 68
2 66 60
2
0
2
2 12 11
6 392 411
0
0
0
0
0
0
1
0
0
2
0
0
0
2
0
0
0
0
2
3
2
2
0
0
7 24
41 141
0
0
0
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
1
0
0
0
0
1
0
5
0 13 14
0
0
0
3 43 50
0 20 19
0
0
2
0
0
0
3 384 398
0
0
1
0
0
0
1
0
0
1
0
0
0
2
0
0
0
0
3
3
6
8
0
0
7 24
38 136
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
2
36 GORKHA
37 LAMJUNG
38 TANAHU
39 SYANGJA
40 KASKI
41 MANANG
42 MUSTANG
1
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
1
0
13
0
0
13
0
8
0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
1
0
0
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
13
0
0
4
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
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 MYAGDI
44 PARBAT
45 BAGLUNG
46 GULMI
47 PALPA
48 NAWALPARASI
0
0
0
0
1
1
0
0
0
0
1
2
0
0
0
0
2
25
0
1
0
1
5
40
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
6
0
0
0
3
3
33
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
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
4
24
0
1
0
1
7
39
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
6
0
0
0
3
3
33
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
3 342 330
0
0
0
0
0
0
75 200 192
0
0
0
0
0
0
0
0
0
7 19 21
68 180 170
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 25 36
0
2
3
0
0
2
0
4 10
0
8
8
0
0
1
0
0
0
0
0
0
0 11 12
0
0
0
1
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
4
1
0
0
0
1
2
0
0
0
0
0
0
5
2
0
0
1
0
0
0
2
0
0
0
0
0
0
0
3
0
0
0
0
2
1
0
0
0
30 76
1
1
1
4
31 143
11 19
0
0
0
0
4
5
0
8
2 20
3 25
11 62
0
4
0
0
0
0
0
0
0
0
0
0
0
0
84 271
1
0
0
1
1
9
0
1
53 184
19 56
2 12
8
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
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
9
0
0
0
0
8
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
2
0
0
0
2
0
0
0
0
0
0
0
0
5
0
0
0
0
1
0
0
0
4
0
0
0
0
0
0
5
0
0
0
0
1
2
0
2
0
4
0
0
61
0
0
0
8
53
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
2
0
0
1
0
3 342 330
0
0
0
0
0
3
58 183 176
0
0
0
0
0
0
0
0
0
5
6
8
53 176 167
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 16 33
0
0
0
0
0
2
0
1
8
0
4
3
0
1 12
0
2
0
0
0
0
0
8
8
0
0
0
1
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
4
1
0
0
0
1
2
0
0
0
0
0
0
5
2
0
0
1
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
1
1
0
0
0
30 76
0
0
1
1
31 144
11 19
0
0
0
0
4
6
0
8
2 20
3 25
11 62
0
4
0
0
0
0
0
0
0
0
0
0
0
0
88 254
1
0
0
1
1
6
1
1
57 174
18 54
2 12
8
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
4
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
12
0
0
1
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
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
13
1
0
0
0
49 RUPANDEHI
50 KAPILBASTU
51 ARGHAKHANCHI
MIDWESTERN
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
FARWESTERN
67 BAJURA
68 BAJHANG
69 ACHHAM
70 DOTI
71 KAILALI
72 KANCHANPUR
73 DADELDHURA
74 BAITADI
75 DARCHAULA
4
0
0
78
0
0
0
9
69
0
0
0
0
0
0
0
0
0
0
3
2
0
1
0
0
0
0
0
0
383

Died
District Code
Probable
District Name
< 5 Years
F
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
384
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Confirmed Malaria PV
5Years
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 Years
M
43
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
41
0
41
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
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
42
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
38
0
34
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
3
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
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
Confirmed Malaria PF
5Years
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 Years
M
2
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
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
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
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
5Years
M
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
among new
Disability
Grade 2
New Child
Positive
Smear
Tested
Total child
Total
deduction
Patients at
the End of
this fiscal
year
Other
Deduction
Defaulter
RFT
61
27
24
103
308
91
128
513
1641
2
544
1644
0
171
3285
2
1490
Panchthar
Ilam
116
113
230
100
13
113
117
25
12
31
Morang
98
84
188
90
105
83
19
59
18
17
27
Sunsari
50
58
108
58
58
50
25
11
18
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
12
29
41
23
23
18
Saptari
29
41
88
40
41
47
22
Siraha
45
361
59
399
0
2
0
14
0
15
104
0
3
0
5
25
47
90
14
791
65
391
446
345
7
48
11
132
6
51
7
29
2
41
19
125
Dhanusha
65
116
181
86
96
85
22
79
46
22
26
Mahottari
65
62
128
67
67
61
13
41
16
17
Sarlahi
77
88
168
79
83
85
24
36
16
15
34
Sindhuli
10
Ramechhap
Dolkha
Sindhupal chok
Kavre
Lalitpur
Bhaktapur
Kathmandu
34
45
37
Nuwakot
Rasuwa
Dhading
Makawanpur
19
10
29
21
Rautahat
70
76
147
74
74
73
23
Bara
67
71
140
61
65
75
15
Parsa
62
55
117
38
42
75
11
Chitawan
36
46
85
38
43
42
13
10
18
485
11
581
4
1
0
5
0
22
1
1094
16
486
4
7
0
9
0
11
4
513
8
581
8
92
1
176
2
91
2
40
0
48
0
142
0
Jhapa
Gorkha
Lamjung
10
17
12
12
Tanahun
15
16
31
13
15
16
12
10
Syangja
15
13
28
12
12
16
13
Kaski
27
28
56
30
31
25
28
14
Manang
Mustang
Myagdi
14
Parbat
Baglung
0
0
Gulmi
10
21
14
14
Palpa
13
11
24
16
16
Nawalparasi
66
26
92
31
38
54
Rupandehi
100
84
193
95
102
91
15
11
Kapilbastu
42
71
120
42
47
73
10
337
6
285
0
0
2
16
1
11
19
649
6
293
0
1
0
5
0
20
6
319
13
330
0
11
1
67
1
58
0
7
Arghakhanchi
3
9
0
9
3
53
47
6
152
Rolpa
10
10
21
13
Rukum
26
17
43
15
25
18
17
15
Salyan
15
11
31
14
14
17
Dang
26
14
41
24
25
16
Banke
65
57
126
62
68
58
31
26
23
Bardiya
37
Surkhet
Pyuthan
45
84
34
36
48
30
16
17
19
32
51
16
19
32
Dailekh
16
23
10
13
12
Jajarkot
11
18
14
14
Dolpa
Jumla
16
10
Kalikot
Mugu
Humla
232
228
475
208
10
14
233
242
15
119
79
11
14
70
Bajura
Bajhang
Achham
21
18
39
15
18
21
14
11
Mid-West
67
68
69
70
71
72
73
74
75
Transfer Out
Total
44
Western
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
Transfer In
Central
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
Re-starter
1631
Eastern
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Relapse
1541
Taplejung
National
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
MB Cases
New Patients
Districts
Patients at
the end of
previous
year
District Codes
Raw Data: Leprosy (Sheet 1 of 3)
10
Kailali
61
54
121
55
60
61
14
10
Kanchanpur
19
36
61
24
34
27
14
Dadeldhura
Baitadi
10
17
10
Darchula
Far-West
126
138
276
112
11
133
143
50
29
17
24
Doti
385
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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
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
Transfer Out
RFT
Total
Transfer In
Re-starter
730
1422
28
12
2192
1310
14
43
1372
820
224
333
15
145
587
Panchthar
Ilam
Jhapa
54
83
137
87
89
48
14
30
Morang
57
132
191
121
126
65
35
74
12
64
Sunsari
21
71
92
57
58
34
11
13
32
Dhankuta
Terhathum
Sankhuwasabha
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
12
15
20
46
71
30
13
43
28
24
Saptari
32
59
12
103
66
66
37
11
43
190
408
19
617
376
18
397
220
61
115
32
194
Dhanusha
73
188
264
148
154
110
66
52
50
97
Mahottari
67
106
173
116
121
52
19
66
11
35
Sarlahi
54
122
178
99
102
76
16
29
10
36
Sindhuli
Ramechhap
Dolkha
Sindhupal chok
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
38
57
95
59
59
36
10
24
Bara
32
53
87
54
55
32
16
Parsa
36
59
95
55
55
40
12
Chitawan
Central Region
Total
Gorkha
14
28
43
25
25
18
324
0
628
0
0
0
3
0
7
0
962
0
570
0
4
0
5
0
8
0
587
0
375
0
129
0
157
0
6
0
88
0
0
0
224
0
Lamjung
Tanahun
Syangja
Kaski
11
10
10
Manang
Mustang
Myagdi
Parbat
Baglung
0
0
Gulmi
Palpa
Nawalparasi
17
12
29
11
16
13
Rupandehi
28
61
89
50
53
36
Kapilbastu
28
70
101
62
65
36
Arghakhanchi
Western
2
82
1
162
0
0
1
3
0
3
4
250
2
144
0
0
0
2
0
9
2
155
2
95
0
8
0
9
0
0
0
8
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
35
63
100
62
63
Bardiya
24
56
80
33
Surkhet
Dailekh
Jajarkot
Dolpa
Jumla
Kalikot
Mugu
Humla
67
136
Bajura
Bajhang
Achham
Doti
Siraha
0
0
0
8
0
0
0
24
32
1
70
37
18
37
35
45
11
22
27
206
107
111
95
20
43
14
73
00
Kailali
45
74
119
84
89
30
25
Kanchanpur
22
13
37
28
32
Dadeldhura
Baitadi
Darchula
Far West
67
88
157
113
122
35
26
Mid Western
67
68
69
70
71
72
73
74
75
Relapse
National
Taplejung
Eastern
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
New Patients
Districts
Patients at the
end of
previous year
District Codes
PB Cases
386

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
Transfer Out
RFT
Total
Transfer In
Re-starter
Relapse
New Patients
Districts
Patients at
the end of
previous year
District Codes
Total Leporsy Cases (MB + PB)
National
1 Taplejung
2271
3053
72
73
5477
2800
32
38
146
3016
2461
395
877
323
236
135
1100
2 Panchthar
3 Ilam
4 Jhapa
170
196
367
187
15
202
165
16
39
12
14
61
5 Morang
155
216
379
211
231
148
54
133
19
19
20
91
6 Sunsari
71
129
200
115
116
84
20
38
16
11
50
7 Dhankuta
8 Terhathum
9 Sankhuwasabha
10 Bhojpur
11 Solukhumbu
12 Okhaldhunga
13 Khotang
11
14 Udayapur
15
41
56
32
32
24
15 Saptari
49
87
14
159
70
14
84
75
46
16 Siraha
77
118
12
207
131
25
156
51
15
22
10
62
551
807
33
15
1408
767
65
843
565
109
247
53
61
47
319
17 Dhanusha
138
304
445
234
12
250
195
88
131
50
59
22
123
18 Mahottari
132
168
301
183
188
113
32
107
16
15
52
19 Sarlahi
131
210
346
178
185
161
40
65
17
25
70
20 Sindhuli
19
10
21 Ramechhap
22 Dolkha
23 Sindhupal chok
24 Kavre
25 Lalitpur
11
26 Bhaktapur
27 Kathmandu
38
51
11
11
40
28 Nuwakot
29 Rasuwa
30 Dhading
24
11
35
13
13
22
108
133
242
133
133
109
17
12
47
33 Bara
99
124
227
115
120
107
31
34 Parsa
98
114
212
93
97
115
23
11
35 Chitawan
50
74
128
63
68
60
16
16
25
Eastern
31 Makawanpur
32 Rautahat
Central Region Total
809
1209
29
2056
1056
11
14
19
1100
956
221
333
97
128
48
366
36 Gorkha
11
16
37 Lamjung
11
20
14
14
38 Tanahun
17
18
35
15
17
18
12
10
39 Syangja
15
14
29
12
12
17
13
40 Kaski
27
37
67
40
41
26
37
14
10
41 Manang
42 Mustang
43 Myagdi
15
44 Parbat
45 Baglung
11
46 Gulmi
10
21
14
14
47 Palpa
14
14
28
19
19
48 Nawalparasi
83
38
121
42
54
67
17
49 Rupandehi
128
145
282
145
155
127
15
11
77
50 Kapilbastu
70
141
221
104
112
109
79
51 Arghakhanchi
12
23
15
419
447
19
14
899
437
29
474
425
19
76
58
15
222
Western
52 Pyuthan
11
53 Rolpa
10
12
23
15
54 Rukum
26
17
43
15
25
18
17
15
55 Salyan
18
16
39
19
20
19
56 Dang
27
18
46
25
26
20
12
57 Banke
100
120
226
124
131
95
17
49
33
10
60
58 Bardiya
61
101
164
67
71
93
14
52
16
12
44
59 Surkhet
21
37
58
20
23
35
11
60 Dailekh
17
25
10
11
14
12
61 Jajarkot
11
18
14
14
62 Dolpa
63 Jumla
16
10
64 Kalikot
65 Mugu
66 Humla
299
364
681
315
10
18
344
337
35
162
86
25
14
143
67 Bajura
68 Bajhang
69 Achham
21
19
40
16
19
21
14
11
10
2
35
Mid West
70 Doti
71 Kailali
106
128
240
139
149
91
11
19
72 Kanchanpur
41
49
98
52
10
66
32
18
73 Dadeldhura
74 Baitadi
10
17
10
75 Darchula
Far West
193
226
433
225
15
255
178
11
59
29
18
50
387
Raw Data:Tuberculosis
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
388
Districts
National Total
Eastern
Taplejung
Panchthar
Ilam
Jhapa
Morang
Sunsari
Dhankuta
Terhathum
Sankhuwasava
Bhojpur
Solukhumbu
Okhaldhunga
Khotang
Udayapur
Saptari
Siraha
Central
Dhanusha
Mahottari
Sarlahi
Sindhuli
Ramechhap
Dolakha
Sindhupalchok
Kavre
Lalitpur
Bhaktapur
Kathmandu
Nuwakot
Rasuwa
Dhading
Makawanpur
Rautahat
Bara
Parsa
Chitwan
Western
Gorkha
Lamjung
Tanahu
Syangja
Kaski
Manang
Mustang
Myagdi
Parbat
Baglung
Gulmi
Palpa
Nawalparasi
Rupandehi
Kapilvastu
Arghakhanchi
Mid-western
Pyuthan
Rolpa
Rukum
Salyan
Dang
Banke
Bardiya
Surkhet
Dailekh
Jajarkot
Dolpa
Humla
Kalikot
Mugu
Jumla
Far-western
Bajura
Bajhang
Achham
Doti
Kailali
Kanchanpur
Dadeldhura
Baitadi
Darchula
Total notified
34121
5749
50
83
130
1310
1210
1031
81
51
85
64
68
81
74
287
519
625
14017
833
1007
1223
335
216
107
238
364
728
607
3305
232
39
283
584
893
1044
975
1004
5894
201
118
314
303
473
5
4
68
108
169
364
397
935
1441
665
320
5104
258
292
260
267
1188
889
671
703
203
126
19
12
105
29
82
3357
132
145
187
194
1304
864
176
218
137
New and
Relapse
New treatment
excluding
relapse
New and previous treatment history unknown

PBC
PCD
EP
Relapse
PBC
33199
795
15731
6387
8583
5603
50
82
127
1284
1165
989
81
51
84
63
68
74
74
284
517
610
13641
811
999
1187
329
210
106
230
353
698
593
3194
229
39
282
578
866
1007
955
975
5730
193
116
303
302
451
5
4
68
102
169
337
388
909
1410
645
318
4970
253
291
259
261
1173
848
632
681
201
125
19
12
105
28
82
124
0
1
3
18
36
39
0
0
1
0
0
6
0
3
2
15
329
19
8
31
6
5
1
4
11
24
13
97
3
0
1
3
19
37
20
27
130
8
2
10
1
17
0
0
0
5
0
5
8
24
29
20
1
123
5
1
1
6
14
33
39
20
2
1
0
0
0
1
0
3095
22
50
77
749
627
568
45
32
41
34
40
30
33
150
230
367
6074
440
502
612
200
83
33
104
138
254
228
1067
113
18
128
323
382
541
471
437
2758
107
57
157
140
213
2
1
40
43
68
155
146
474
615
426
114
2144
122
135
93
98
491
476
355
157
75
48
2
6
45
10
31
855
10
9
17
142
155
76
8
14
11
3
2
10
6
65
210
117
2748
175
384
313
68
64
13
30
56
108
56
383
32
4
41
116
285
199
238
183
1045
27
11
44
44
33
0
0
4
15
37
59
61
145
387
101
68
1100
52
47
82
65
339
144
119
169
28
24
5
2
4
6
14
1313
16
18
30
299
290
286
23
4
31
24
24
27
32
51
60
98
3762
144
93
152
34
45
52
78
123
277
254
1495
56
12
86
91
158
192
184
236
1477
42
41
70
86
178
3
3
18
29
50
99
149
206
314
83
105
1359
58
88
67
76
244
167
108
305
93
43
11
4
50
12
33
3255
89
1660
639
672
130
140
181
190
1269
832
169
208
136
1
5
6
4
32
24
7
9
1
77
75
117
123
597
419
71
101
80
15
25
18
27
269
173
30
43
39
30
30
29
24
305
141
59
42
12
PCD
2202
313
2
5
3
83
90
58
4
1
1
2
2
5
2
13
17
25
893
44
20
101
27
16
6
18
27
54
43
179
25
4
22
43
38
73
55
98
394
15
5
30
22
24
0
0
6
10
14
21
24
81
82
35
25
334
19
17
16
20
91
54
50
42
5
9
1
0
6
0
4
268
8
10
16
16
92
95
7
19
5
EP
131
10
0
0
0
8
0
0
0
0
0
0
0
2
0
0
0
0
65
4
0
7
0
1
1
0
3
2
6
15
2
0
1
3
3
2
6
9
25
0
0
0
4
0
0
0
0
1
0
2
3
2
10
0
3
18
1
2
0
0
7
3
0
5
0
0
0
0
0
0
0
13
0
0
0
0
5
4
1
3
0
165
17
0
0
0
3
3
1
1
0
0
0
0
0
1
5
0
3
99
4
0
2
0
1
1
0
6
3
6
55
1
1
4
2
0
0
1
12
31
2
2
2
6
3
0
0
0
4
0
1
5
1
2
0
3
15
1
2
1
2
1
4
0
3
0
1
0
0
0
0
0
3
0
0
1
0
1
0
1
0
0
Raw Data:OPD (Sheet 1 of 2)
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
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
11385113
2184869
58725
59688
72911
279231
381772
193391
71389
45409
83305
83445
64249
97248
103679
123742
228947
237738
3627545
241677
221916
225132
83010
112300
112938
146234
308321
181418
150607
549936
126092
28096
154049
111575
223554
193254
166564
290872
2742255
160197
98712
120624
159954
378365
6223
13212
70133
86455
135161
175459
238012
272163
497232
254349
76004
1661089
134135
73326
97936
117343
185926
192628
211906
250832
127852
78702
21580
45283
50398
23976
49266
1169355
85776
94100
175230
111390
298248
154576
88633
98208
63194
8857795 20242908 2081568 1659344 3740912

1730675 3915544 404776 320085 724861
49883 108608 10686
9409 20095
46833 106521
6820
5582 12402
55269 128180 13660
9995 23655
241966 521197 50407 45837 96244
297696 679468 85743 62671 148414
148017 341408 40506 31917 72423
56987 128376 15121 12120 27241
37205
82614
2902
2479
5381
92712
18450
886
880
533
3532
2101
1337
883
299
23011
4486
2
25
174
328
1201
587
72
9
2784573
551099
16119
11395
10629
69558
78781
45558
14356
9836
8769
827
1
18
8
193
286
84
2
1
133651
20000
925
452
621
4316
4192
976
822
281
3305033
686971
19397
20413
24782
110490
109593
61766
21122
14352
62116
65560
49066
68775
83168
94807
188235
185092
2982468
213351
191900
197990
67018
77512
80887
111721
238729
128117
109343
485338
89886
23783
113578
78960
198859
165247
156634
253615
2078209
112739
77095
89381
100525
362403
7239
13528
50948
62215
90133
116679
174330
194794
371661
199466
55073
1179989
88498
51519
68784
75415
121132
142395
149414
158695
93410
61119
18684
40600
42526
22142
45656
886454
75361
79626
134794
80281
197946
110567
71343
79246
57290
902
1177
636
961
959
1510
1280
574
31790
839
1599
1497
954
1010
1002
1126
3770
2197
984
5195
1182
159
1646
986
838
1097
941
4768
18617
1007
671
1035
768
2345
2
202
383
641
1020
1050
1771
2424
2956
1623
719
13774
2039
833
433
686
2763
768
2232
2231
805
376
12
208
233
135
20
10081
831
664
968
779
3003
1854
1078
535
369
26
104
47
15
193
138
973
592
10670
1697
3182
1036
581
22
103
50
45
352
45
356
12
0
135
135
1043
1016
608
252
3215
35
78
16
111
78
0
0
0
3
68
48
92
516
1793
225
152
2536
71
98
11
169
503
208
357
522
9
9
0
566
10
3
0
2104
504
24
121
36
1112
174
52
81
0
17702
17394
13374
17267
28739
29287
91018
80086
980262
99822
93088
96563
24942
18066
24926
38757
52638
27110
18729
80052
45349
6820
37478
22586
88369
74633
58371
71963
534125
30576
18234
21974
25711
55314
1966
1980
11002
12169
27333
38924
28050
59949
91142
90604
19197
445162
29365
20709
25869
31628
46546
52188
51357
58655
39890
19508
9499
16956
14655
8475
19862
273925
25333
29915
41009
27017
62186
33482
22378
19243
13362
5
0
9
8
6
21
54
131
5348
3976
90
147
6
3
11
47
85
18
5
250
23
1
11
3
116
85
114
357
1734
23
8
8
6
403
0
2
3
2
9
10
129
237
788
94
12
498
7
120
42
5
26
69
76
31
94
10
0
2
10
6
0
362
6
7
41
19
229
19
33
7
1
872
574
497
291
861
1429
1385
1506
34571
1598
1967
2192
1037
587
541
1461
1553
3771
727
6609
2108
103
1544
1857
1902
835
1210
2969
27754
1406
434
1808
1759
3488
48
52
341
423
1085
1039
1992
3398
5452
4376
653
30636
1082
1173
1379
1857
2861
2647
6315
5628
1076
2073
523
855
1197
431
1539
20690
696
1556
2939
1073
8645
2470
1694
1145
472
20044
26386
19385
28820
32168
31461
63909
82883
927230
71666
65762
67161
19757
30794
33900
44954
83727
46724
32604
106869
31454
9852
48760
31633
42881
40868
27353
90511
780518
51200
26176
31488
48670
100793
1798
4334
23454
35129
56133
59028
52116
81220
119728
64386
24865
513381
34614
19597
31777
34681
55110
59664
63334
71648
46126
28849
4274
21960
19118
7520
15109
396933
23895
35319
65054
34568
81367
60165
35224
34583
26758
145421
149005
113315
166023
186847
218549
417182
422830
6610013
455028
413816
423122
150028
189812
193825
257955
547050
309535
259950
1035274
215978
51879
267627
190535
422413
358501
323198
544487
4820464
272936
175807
210005
260479
740768
13462
26740
121081
148670
225294
292138
412342
466957
868893
453815
131077
2841078
222633
124845
166720
192758
307058
335023
361320
409527
221262
139821
40264
85883
92924
46118
94922
2055809
161137
173726
310024
191671
496194
265143
159976
177454
120484
16736
6289
19371
25997
32378
16974
30282
30904
694750
34107
58545
35227
10850
6580
7921
25062
26756
102554
26888
108141
8956
4169
16530
24083
65043
35939
33364
64035
452043
15883
21543
9391
18694
92761
1641
2391
11274
13706
11955
34052
54197
29196
88382
31176
15801
279789
21382
9961
25241
13256
27903
41426
33815
30841
16007
24056
6404
17977
5070
3253
3197
250210
12929
29687
38919
30848
64937
18836
16715
25712
11627
12190
4386
14066
18473
26805
12837
26400
24918
572548
31139
49640
31111
8702
4268
5831
18151
20294
75147
20549
91542
7674
4129
11781
17423
56916
30774
33249
54228
372659
11459
14702
7311
14082
109802
1683
2080
8028
9402
7757
22539
41033
19783
64438
25424
13136
204579
14622
6917
16805
8076
18755
33240
24412
15847
12674
18965
5912
17119
5022
2973
3240
189473
10468
27029
28783
21149
41534
15221
13618
21746
9925
28926
10675
33437
44470
59183
29811
56682
55822
1267298
65246
108185
66338
19552
10848
13752
43213
47050
177701
47437
199683
16630
8298
28311
41506
121959
66713
66613
118263
824702
27342
36245
16702
32776
202563
3324
4471
19302
23108
19712
56591
95230
48979
152820
56600
28937
484368
36004
16878
42046
21332
46658
74666
58227
46688
28681
43021
12316
35096
10092
6226
6437
439683
23397
56716
67702
51997
106471
34057
30333
47458
21552
J. Oral Health
Related
Problems
I. Ear, Nose and

Throat Infection
H. Skin Diseases
G. Nutritional &
Metabolic
Disorder
F. Other
Infected
Diseases
HIV/STI
E.
D. Other
Communi-cable
Diseases
C. Communicable,
Water/Food
Borne
B. Communicable, Vector
Borne
OPD Morbidity by Broad Classifcation
Total
Male
Female
Total
Male
Female
1
2
3
4
5
6
7
8
OPD repeated Visits
District Name
A. Communicable, Immunizable
OPD New Visits

District Code
385765 2530056 1497389

74239 476269 355537
1194
11527
14897
1265
12934
13973
1498
12640
16344
8102
57077
51264
23189
66336
42951
8549
47383
26228
986
12438
17852
785
9964
13557
918080
147552
5864
3369
6470
23457
18604
15080
5093
2723
1385
1700
1093
1189
1239
2071
10222
9772
129989
9386
8134
11043
1692
2071
1607
2310
12963
5978
3545
25373
2381
1025
3740
2051
10041
8197
5804
12648
109911
3586
4455
3936
4474
28012
213
232
921
3406
3621
5976
10787
8846
18241
11347
1858
42676
1946
1166
2945
2117
5273
5994
8712
6891
1703
1420
172
1708
1126
783
720
28950
1497
1909
4288
1587
11416
3655
1694
1399
1505
6530
5015
5165
5766
7784
7521
13797
15314
383600
16529
15208
16318
6399
9393
10701
7820
38913
13323
28424
111952
10792
1617
9021
8452
15641
12116
11402
39579
230341
10901
10088
12632
8530
71854
567
890
4746
5152
9056
8924
17561
12154
35509
17553
4224
94539
5131
3134
5925
7219
8097
10412
10617
18284
5769
4932
1650
3858
3072
2064
4375
62048
4207
8158
7511
6389
9434
6805
5260
8123
6161
12345
18176
10886
15850
21494
29488
69641
68090
883595
105379
63386
71156
19028
19412
15556
20643
63482
23141
17243
87789
21962
4762
30231
21024
78775
69449
79717
71460
529044
24460
18889
20750
23780
48293
896
1829
12221
13898
20996
29527
38125
59001
125603
75936
14840
413064
29460
19715
19022
25040
46704
70283
66016
50774
27816
21855
4352
8237
8568
5826
9396
228084
16239
16576
35730
16204
63975
38136
14581
16250
10393
14279
19765
11666
16590
22071
21641
28291
24168
493316
24913
22827
26894
14241
19196
15372
20766
46429
23890
18367
89094
17113
3564
19709
16185
25700
17209
20534
51313
361687
22334
13140
17095
22982
51628
1482
2853
9691
16817
19971
23536
27614
29283
62891
31020
9350
178575
14605
8785
10335
12981
20642
18364
24812
27269
10531
7554
2332
5649
6237
2456
6023
108274
6235
8018
14962
9914
31211
13290
7744
10864
6036
389
Raw Data:OPD (Sheet 2 of 2)
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
390
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
760281
250748
5216
4235
4090
46538
116035
9336
5449
2945
3614
5746
3810
4949
6577
6299
11947
13962
204014
11717
11252
12675
4442
6612
7543
7340
24895
10701
4924
21925
8060
2330
8811
6793
11609
12672
10953
18760
167579
7150
7202
5537
5903
23752
537
779
5562
4658
4907
5942
14225
30974
31125
16067
3259
79402
4881
3784
3238
4862
8377
13296
11112
9676
5363
3397
1653
2573
2404
1831
2955
58538
4235
3968
6530
6702
19079
7480
3039
4065
3440
49098
8913
95
161
911
1754
3576
243
67
36
128
95
82
99
63
190
230
1183
15383
76
397
119
149
84
426
335
222
887
88
5629
242
24
331
270
407
111
33
5553
17398
130
351
125
352
5714
2
11
42
10
292
267
890
473
8158
533
48
2746
118
111
303
128
301
115
417
460
160
254
11
134
177
19
38
4658
137
455
347
182
790
2350
78
255
64
279040
40559
1077
1294
1202
6933
10009
2062
895
645
2326
1264
1253
1918
2084
2990
1468
3139
87703
1508
2381
2211
1971
3095
2966
2588
9930
5797
7601
21682
3425
466
4124
2360
2503
1217
859
11019
85420
4641
2309
3835
2996
18357
76
313
1569
1557
2828
3536
8323
4748
22784
5426
2122
38255
2913
1658
3229
3106
3868
2036
4090
6714
2579
2812
705
1616
1413
363
1153
27103
2354
1816
3565
2282
7274
3690
2503
2232
1387
202746
20259
383
196
288
2493
11572
367
375
88
431
241
461
1076
195
1183
308
602
69496
399
471
166
416
514
577
557
7340
10405
3070
28654
1155
70
1037
1317
418
210
286
12434
98498
1621
1737
1486
13239
25087
10
66
299
356
1391
1436
17744
1305
31111
792
818
7788
1379
447
837
509
1255
160
801
896
487
259
258
332
126
42
0
6705
119
637
1446
373
2641
359
953
90
87
15247
1211
11
3
7
180
428
26
11
1
9
3
33
11
3
2
170
313
3552
2
0
12
4
29
21
2
177
1084
16
1538
20
1
15
72
28
24
6
501
9766
13
3
34
33
8247
1
2
2
3
14
35
680
12
683
4
0
451
3
3
73
4
2
6
7
282
19
40
9
0
3
0
0
267
4
29
101
10
83
11
23
5
1
733883
113164
2840
2411
3783
16756
27558
7416
3186
2104
3574
3707
4891
4484
3666
6571
9853
10364
253196
12280
10705
10638
3818
6067
5641
8509
21389
14836
12932
72010
9002
961
8583
5890
7769
6114
9842
26210
226884
10575
7596
11919
21265
58317
461
1038
2581
5828
8998
10744
21725
17260
32720
10614
5243
75310
5737
2035
4795
4878
9642
7221
10465
10666
5292
2779
999
3560
3661
1019
2561
65329
5640
3486
9623
5332
13828
8045
7254
8246
3875
3318840
620498
18129
19258
20680
76080
75110
68475
21315
13630
24824
23340
18809
33795
31857
34521
68524
72151
1072777
57192
75542
87505
33062
38367
33715
48681
66762
40761
41167
124166
32986
8425
47294
35007
90819
73637
65483
72206
740780
47485
37799
36371
39309
81379
3228
4030
20830
25952
31789
49299
50857
79583
123728
88340
20801
488752
36819
18827
32226
45178
45728
52622
50929
54301
41022
28256
12133
17382
19293
10548
23488
396033
43313
38879
64783
40590
85400
36203
32615
32491
21759
1329948
191930
5186
6182
7329
18004
27088
17045
7686
4983
11763
6851
7622
10521
7198
11931
24152
18389
478393
15453
13671
15970
6097
13913
16237
26982
60513
26462
23405
107269
13491
5475
25484
12602
14623
18492
14475
47779
371035
30033
12598
20145
20990
54592
1013
3067
10197
11482
16581
26168
36349
31413
66313
20860
9234
154759
15195
7914
9792
9342
20645
16831
21532
19584
12869
4675
1085
4590
5318
1411
3976
133831
8186
11128
19258
12178
34278
17207
9319
13706
8571
243488
30864
776
328
549
7438
11740
1156
460
492
1479
1209
466
822
925
1287
832
905
94643
1011
1603
1105
1373
809
1104
990
17161
7007
3328
25178
1816
92
2086
642
4913
669
1243
22513
78184
2004
1139
2008
1672
30294
10
197
1333
558
1709
1473
11065
2851
18926
2076
869
18953
1003
573
2208
766
2110
1114
2733
2596
1682
2252
324
710
614
179
89
20844
825
1437
3585
1370
8483
875
2872
1030
367
Not mentioned
above and
other
S. Surgical
Problems
R. Orthopaedic
Problems
Q. Other
Diseases &
Injuries
P.
Cardiovascular
& Respiratory
Related
Problems
O. Malignancy
N. Mental
Health related
problems
M. Gynae
Problems
L. Obstetrics
Compli-cations
District Name
K. Eye
Problems
OPD Morbidity by Broad Classifcation

District
Code
1716269
309007
6586
7413
16295
23945
48011
26830
15291
5731
22936
16095
12646
21664
22688
28051
17696
17129
522481
19811
21120
19928
9640
20192
21569
23220
35417
45093
42971
110939
14102
5869
17184
20706
21131
19851
12595
41143
430918
23604
13551
17633
18420
73068
1122
4775
16161
10490
17273
24889
72114
39754
74482
10820
12762
241388
35818
13313
13930
7372
25376
20232
25132
60953
17518
8192
203
1904
5251
2830
3364
212475
16332
10580
27635
24853
55665
27945
10776
22777
15912
Analyzed Data:OPD (Sheet 1 of 3)
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
District Name
Received Reports
% of new OPD Visits

of Total Population
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
12965
2198
12
16
17
218
303
63
483
41
48
25
28
41
12
57
12
822
5936
110
170
412
41
57
59
13
243
331
66
2940
956
223
35
55
27
13
47
138
1839
45
57
160
46
360
14
12
20
19
79
21
48
276
321
320
41
2158
25
13
14
76
594
21
281
73
249
331
8
319
119
12
23
834
17
12
44
456
157
26
37
60
25
73.0
65.1
84.5
55.0
43.0
60.9
67.0
41.7
77.2
81.6
92.3
86.6
108.4
111.6
96.6
65.9
62.7
64.0
64.6
57.9
63.1
52.0
49.9
93.1
97.9
89.0
140.4
61.2
79.3
54.0
76.9
118.2
78.2
43.7
57.0
48.6
50.4
87.3
95.1
103.1
104.2
63.4
96.5
140.5
219.5
211.8
107.7
101.2
82.3
108.4
161.1
69.1
91.4
74.7
66.0
76.3
96.1
54.6
77.5
76.3
52.2
62.8
80.9
112.7
80.9
77.8
104.3
73.4
64.5
79.4
177.2
76.5
113.8
83.7
116.2
90.7
59.1
55.2
108.3
69.4
87.9
Proportion by sex among total OPD Visit

Female
Average OPD Visits
Male
56.2
55.8
54.1
56.0
56.9
53.6
56.2
56.7
55.6
55.0
57.3
56.0
56.7
58.6
55.5
56.6
54.9
56.2
54.9
53.1
53.6
53.2
55.3
59.2
58.3
56.7
56.4
58.6
57.9
53.1
58.4
54.2
57.6
58.6
52.9
53.9
51.5
53.4
56.9
58.7
56.2
57.4
61.4
51.1
46.2
49.4
57.9
58.2
60.0
60.1
57.7
58.3
57.2
56.1
58.0
58.5
60.3
58.7
58.7
60.9
60.6
57.5
58.7
61.3
57.8
56.3
53.6
52.7
54.2
52.0
51.9
56.9
53.2
54.1
56.5
58.1
60.1
58.3
55.4
55.3
52.5
Female
43.8
44.2
45.9
44.0
43.1
46.4
43.8
43.4
44.4
45.0
42.7
44.0
43.3
41.4
44.5
43.4
45.1
43.8
45.1
46.9
46.4
46.8
44.7
40.8
41.7
43.3
43.6
41.4
42.1
46.9
41.6
45.8
42.4
41.4
47.1
46.1
48.5
46.6
43.1
41.3
43.9
42.6
38.6
48.9
53.8
50.6
42.1
41.9
40.0
39.9
42.3
41.7
42.8
44.0
42.0
41.5
39.8
41.3
41.3
39.1
39.5
42.5
41.4
38.8
42.2
43.7
46.4
47.3
45.8
48.0
48.1
43.1
46.8
45.9
43.5
41.9
39.9
41.7
44.6
44.7
47.6
Male
1.2
1.2
1.2
1.1
1.2
1.2
1.2
1.2
1.2
1.1
1.2
1.1
1.3
1.3
1.3
1.1
1.1
1.1
1.2
1.1
1.3
1.2
1.1
1.1
1.1
1.2
1.1
1.6
1.2
1.2
1.1
1.2
1.1
1.2
1.3
1.2
1.2
1.2
1.2
1.1
1.2
1.1
1.1
1.3
1.3
1.2
1.2
1.2
1.1
1.2
1.2
1.1
1.2
1.1
1.2
1.2
1.2
1.1
1.3
1.1
1.2
1.2
1.2
1.1
1.1
1.3
1.3
1.4
1.1
1.1
1.1
1.2
1.2
1.3
1.2
1.3
1.2
1.1
1.2
1.3
1.2
Total
1.2
1.2
1.2
1.1
1.2
1.2
1.2
1.2
1.2
1.1
1.2
1.1
1.3
1.3
1.3
1.1
1.1
1.1
1.2
1.2
1.3
1.2
1.1
1.1
1.1
1.2
1.1
1.6
1.2
1.2
1.1
1.2
1.1
1.2
1.3
1.2
1.2
1.2
1.2
1.1
1.2
1.1
1.1
1.3
1.2
1.2
1.2
1.2
1.1
1.2
1.2
1.1
1.2
1.1
1.2
1.2
1.2
1.1
1.2
1.1
1.2
1.2
1.2
1.1
1.1
1.3
1.3
1.4
1.1
1.1
1.1
1.2
1.1
1.3
1.2
1.3
1.2
1.1
1.2
1.3
1.2
1.2
1.2
1.2
1.1
1.2
1.2
1.2
1.2
1.2
1.1
1.2
1.1
1.3
1.3
1.3
1.1
1.1
1.1
1.2
1.1
1.3
1.2
1.1
1.1
1.1
1.2
1.1
1.6
1.2
1.2
1.1
1.2
1.1
1.2
1.3
1.2
1.2
1.2
1.2
1.1
1.2
1.1
1.1
1.3
1.3
1.2
1.2
1.2
1.1
1.2
1.2
1.1
1.2
1.1
1.2
1.2
1.2
1.1
1.3
1.1
1.2
1.2
1.2
1.1
1.1
1.3
1.3
1.4
1.1
1.1
1.1
1.2
1.2
1.3
1.2
1.3
1.2
1.1
1.2
1.3
1.2
391
% of OPD Morbidity by Broad Classifcation

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
District Name
Received Reports
Eye Problems
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
392
54843
11774
673
515
593
703
967
614
570
382
584
788
424
702
923
624
1392
1320
18759
1231
910
1038
733
713
749
980
1380
763
510
3192
977
223
646
571
1158
1169
1064
752
11885
994
805
839
888
847
163
204
506
685
740
889
843
1014
1039
911
518
7263
597
540
544
567
629
569
478
702
741
419
179
347
350
286
315
5162
336
575
914
664
671
274
372
852
504
2.7
4.2
4.1
2.2
1.4
5.4
11.4
1.1
3.3
2.9
2.3
3.3
3.7
3.3
3.4
1.9
1.8
2.1
2.0
1.5
1.7
1.6
1.5
3.2
3.8
2.5
6.4
2.1
1.5
1.1
2.9
5.3
2.6
1.6
1.6
1.7
1.7
3.0
3.3
2.7
4.3
1.7
2.2
4.5
8.8
6.2
5.0
3.2
1.8
2.2
5.6
4.6
3.3
2.7
1.6
2.1
2.1
1.7
1.5
1.9
1.4
2.5
2.5
2.7
2.0
1.9
4.3
2.2
1.7
3.2
5.5
2.2
3.0
1.9
2.5
3.2
2.3
1.6
2.1
1.6
2.5
Obstetrics
Complications
0.2
0.2
0.1
0.1
0.3
0.2
0.4
0.0
0.0
0.0
0.1
0.1
0.1
0.1
0.0
0.1
0.0
0.2
0.2
0.0
0.1
0.0
0.1
0.0
0.2
0.1
0.1
0.2
0.0
0.3
0.1
0.1
0.1
0.1
0.1
0.0
0.0
0.9
0.3
0.1
0.2
0.0
0.1
1.1
0.0
0.1
0.0
0.0
0.1
0.1
0.4
0.1
0.9
0.1
0.0
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0.1
0.1
0.1
0.1
0.0
0.1
0.1
0.0
0.1
0.2
0.1
0.2
0.1
0.1
0.1
0.5
0.1
0.1
0.1
Gynae Problems
1.0
0.7
0.8
0.7
0.4
0.8
1.0
0.3
0.5
0.6
1.5
0.7
1.2
1.3
1.1
0.9
0.2
0.5
0.9
0.2
0.4
0.3
0.7
1.5
1.5
0.9
2.6
1.2
2.3
1.1
1.2
1.1
1.2
0.5
0.3
0.2
0.1
1.8
1.7
1.8
1.4
1.2
1.1
3.5
1.2
2.5
1.4
1.1
1.0
1.3
3.3
0.7
2.4
0.9
1.1
1.0
1.3
0.7
1.5
1.2
0.7
0.4
0.9
1.9
0.9
1.6
1.8
1.4
1.0
0.6
2.2
1.0
1.7
0.8
1.3
1.1
0.9
0.8
1.7
0.9
1.0
Mental Health related

problems
0.7
0.3
0.3
0.1
0.1
0.3
1.1
0.0
0.2
0.1
0.3
0.1
0.4
0.7
0.1
0.4
0.1
0.1
0.7
0.1
0.1
0.0
0.1
0.3
0.3
0.2
1.9
2.1
0.9
1.5
0.4
0.2
0.3
0.3
0.1
0.0
0.0
2.0
1.9
0.6
1.0
0.5
4.9
4.8
0.2
0.5
0.3
0.2
0.5
0.5
6.9
0.2
3.3
0.1
0.4
0.2
0.6
0.2
0.4
0.2
0.2
0.0
0.2
0.3
0.2
0.1
0.7
0.3
0.1
0.1
0.0
0.3
0.1
0.3
0.5
0.2
0.3
0.1
0.7
0.0
0.1
Cardiovascular &
Respiratory Related
Problems
Malignancy
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
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.2
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.2
0.0
0.0
0.0
0.0
1.6
0.0
0.0
0.0
0.0
0.0
0.0
0.3
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
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
2.7
1.9
2.2
1.3
1.3
2.0
2.7
0.9
1.9
2.1
2.3
2.2
4.7
3.0
1.9
2.0
1.5
1.6
2.5
1.6
1.6
1.3
1.3
3.0
2.9
2.9
5.5
2.9
3.9
3.8
3.2
2.2
2.5
1.4
1.1
0.8
1.5
4.2
4.5
4.0
4.5
3.6
7.9
11.1
7.5
8.2
2.3
4.0
3.3
4.0
8.5
2.6
3.4
1.8
2.6
2.0
2.5
0.9
2.2
1.9
1.6
1.4
2.3
2.9
1.9
1.6
2.6
3.1
2.5
1.8
4.8
2.4
4.0
1.7
3.6
2.5
1.7
1.7
4.9
3.2
2.8
Other Diseases &

Injuries
12.0
10.3
14.1
10.0
6.9
8.9
7.4
8.4
12.8
13.5
15.8
13.6
18.0
22.7
16.5
10.4
10.3
10.9
10.5
7.3
11.5
10.8
11.0
18.8
17.0
16.8
17.1
8.1
12.6
6.5
11.7
19.2
13.8
8.0
12.3
10.0
10.2
11.6
14.6
17.9
22.4
11.0
14.6
15.4
52.6
31.9
18.5
17.7
11.6
18.3
19.9
11.8
13.0
14.6
10.5
13.1
15.9
8.2
15.0
17.9
7.8
9.9
11.4
14.9
15.0
15.7
31.4
14.9
13.4
18.2
43.8
14.7
30.6
18.4
24.3
19.2
10.2
7.5
22.1
12.7
15.9
Orthopaedic Problems
4.8
3.2
4.0
3.2
2.5
2.1
2.7
2.1
4.6
4.9
7.5
4.0
7.3
7.1
3.7
3.6
3.6
2.8
4.7
2.0
2.1
2.0
2.0
6.8
8.2
9.3
15.5
5.2
7.1
5.6
4.8
12.5
7.5
2.9
2.0
2.5
2.3
7.7
7.3
11.4
7.5
6.1
7.8
10.4
16.5
24.3
9.1
7.8
6.1
9.7
14.2
4.7
7.0
3.4
4.7
4.2
6.6
3.5
4.6
3.7
3.5
3.2
4.8
5.4
4.7
2.6
2.8
3.9
3.7
2.4
7.4
5.0
5.8
5.2
7.2
5.8
4.1
3.6
6.3
5.4
6.3
Surgical Problems
0.9
0.5
0.6
0.2
0.2
0.9
1.2
0.1
0.3
0.5
0.9
0.7
0.5
0.6
0.5
0.4
0.1
0.1
0.9
0.1
0.2
0.1
0.5
0.4
0.6
0.3
4.4
1.4
1.0
1.3
0.7
0.2
0.6
0.2
0.7
0.1
0.2
3.6
1.5
0.8
0.7
0.6
0.6
5.7
0.2
1.6
1.2
0.4
0.6
0.6
4.3
0.4
2.0
0.3
0.4
0.5
0.4
0.3
1.0
0.3
0.4
0.2
0.6
0.7
0.6
1.3
0.8
0.6
0.4
0.3
0.2
0.8
0.6
0.6
1.3
0.7
1.0
0.2
1.9
0.4
0.3
Not mentioned above

and other
6.2
5.1
5.1
3.8
5.5
2.8
4.7
3.3
9.2
5.7
14.6
9.4
12.1
14.6
11.7
8.5
2.7
2.6
5.1
2.5
3.2
2.5
3.2
9.9
10.9
8.0
9.1
8.9
13.1
5.8
5.0
13.4
5.0
4.8
2.9
2.7
2.0
6.6
8.5
8.9
8.0
5.3
6.8
13.9
18.3
37.8
14.4
7.1
6.3
9.2
28.2
5.9
7.8
1.8
6.4
6.5
15.5
5.8
6.5
2.9
4.3
3.8
5.6
16.8
6.4
4.6
0.5
1.5
3.7
4.9
6.3
7.9
11.5
5.2
10.4
11.8
6.6
5.8
7.3
8.9
11.6
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
% of OPD Morbidity by Broad Classifcation

District Name
National Total
EASTERN
TAPLEJUNG
PANCHTHAR
ILAM
JHAPA
MORANG
SUNSARI
DHANKUTA
TERHATHUM
SANKHUWASABHA
BHOJPUR
SOLUKHUMBU
OKHALDHUNGA
KHOTANG
UDAYAPUR
SAPTARI
SIRAHA
CENTRAL
DHANUSA
MAHOTTARI
SARLAHI
SINDHULI
RAMECHHAP
DOLAKHA
SINDHUPALCHOK
KAVRE
LALITPUR
BHAKTAPUR
KATHMANDU
NUWAKOT
RASUWA
DHADING
MAKWANPUR
RAUTAHAT
BARA
PARSA
CHITAWAN
WESTERN
GORKHA
LAMJUNG
TANAHU
SYANGJA
KASKI
MANANG
MUSTANG
MYAGDI
PARBAT
BAGLUNG
GULMI
PALPA
NAWALPARASI
RUPANDEHI
KAPILBASTU
ARGHAKHANCHI
MID WESTERN
PYUTHAN
ROLPA
RUKUM
SALYAN
DANG
BANKE
BARDIYA
SURKHET
DAILEKH
JAJARKOT
DOLPA
JUMLA
KALIKOT
MUGU
HUMLA
FAR WESTERN
BAJURA
BAJHANG
ACHHAM
DOTI
KAILALI
KANCHANPUR
DADELDHURA
BAITADI
DARCHAULA
Received Reports
54843
11774
673
515
593
703
967
614
570
382
584
788
424
702
923
624
1392
1320
18759
1231
910
1038
733
713
749
980
1380
763
510
3192
977
223
646
571
1158
1169
1064
752
11885
994
805
839
888
847
163
204
506
685
740
889
843
1014
1039
911
518
7263
597
540
544
567
629
569
478
702
741
419
179
347
350
286
315
5162
336
575
914
664
671
274
372
852
504
Communicable,
Immunizable
0.3
0.3
0.7
0.5
0.2
0.4
0.2
0.2
0.5
0.3
0.6
0.7
0.6
0.7
0.5
0.5
0.2
0.1
0.3
0.1
0.2
0.2
0.3
0.5
0.5
0.4
1.0
0.4
0.3
0.3
0.4
0.4
0.5
0.2
0.1
0.2
0.2
0.8
0.4
0.4
0.4
0.3
0.3
0.4
0.0
1.6
0.3
0.4
0.4
0.4
0.7
0.4
0.3
0.3
0.4
0.4
0.9
0.4
0.2
0.3
0.5
0.1
0.5
0.6
0.3
0.2
0.0
0.2
0.2
0.2
0.0
0.4
0.6
0.3
0.4
0.4
0.4
0.4
0.7
0.2
0.3
Communicable,
Vector Borne
Communicable,
Other Communicable
Water/Food Borne
Diseases
0.1
0.1
0.0
0.0
0.1
0.0
0.1
0.1
0.0
0.0
0.0
0.1
0.0
0.0
0.1
0.0
0.2
0.1
0.1
0.2
0.5
0.1
0.2
0.0
0.1
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.1
0.1
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
0.1
0.2
0.0
0.1
0.1
0.0
0.0
0.0
0.1
0.1
0.0
0.1
0.1
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.1
0.4
0.0
0.1
0.0
0.1
0.0
0.0
0.0
0.0
10.0
9.2
12.5
5.9
3.6
8.1
7.8
5.6
8.6
9.7
11.2
10.1
12.8
11.6
14.9
8.8
13.7
12.1
9.6
12.7
14.2
11.9
8.3
8.9
12.6
13.4
13.5
5.4
5.7
4.2
16.2
15.5
11.0
5.2
11.9
10.1
9.1
11.5
10.5
11.6
10.8
6.6
9.5
10.5
32.1
15.7
9.8
8.3
10.0
14.4
11.0
8.9
9.6
14.9
9.7
12.0
12.7
9.1
12.0
12.5
7.9
9.8
11.5
16.1
14.6
10.9
24.6
14.6
10.2
14.6
37.1
10.2
17.9
14.2
15.4
12.8
7.4
7.0
15.2
7.5
9.8
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
0.1
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
0.1
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.1
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
Other Infected
Diseases
HIV/STI
0.5
0.3
0.7
0.2
0.2
0.5
0.4
0.1
0.5
0.3
0.6
0.3
0.5
0.2
0.5
0.4
0.2
0.2
0.3
0.2
0.3
0.3
0.3
0.3
0.3
0.5
0.4
0.8
0.2
0.3
0.8
0.2
0.5
0.4
0.3
0.1
0.2
0.5
0.6
0.5
0.3
0.6
0.7
0.7
0.8
0.4
0.3
0.3
0.4
0.4
0.8
0.5
0.6
0.7
0.3
0.8
0.5
0.5
0.6
0.7
0.5
0.5
1.4
1.6
0.4
1.2
1.4
0.8
0.8
0.7
2.9
0.8
0.5
0.7
1.1
0.5
1.0
0.5
1.2
0.5
0.3
11.9
11.4
15.1
10.5
8.3
12.9
10.8
7.5
12.7
14.2
12.7
15.3
18.6
19.4
16.6
9.5
9.6
12.6
9.1
9.1
10.0
8.3
6.6
15.1
17.1
15.5
21.5
9.2
9.9
5.6
11.2
22.5
14.3
7.3
5.8
5.5
4.3
14.5
15.4
19.4
15.5
9.5
18.0
19.1
29.3
34.3
20.9
23.9
20.5
21.9
20.4
12.0
12.6
10.6
12.5
13.8
14.9
8.6
14.8
13.7
9.4
11.2
14.2
19.7
16.9
16.1
11.1
18.7
13.3
12.9
28.2
14.8
16.9
16.9
24.4
16.4
9.7
12.5
23.8
13.5
19.5
Nutritional &
Metabolic Disorder
1.4
1.2
0.9
0.7
0.5
1.0
2.3
1.0
0.6
0.8
0.9
1.0
1.1
0.8
0.6
0.6
1.5
1.5
1.3
1.2
1.2
1.4
0.6
1.0
0.8
0.8
3.3
1.2
1.1
1.3
0.9
2.3
1.1
0.5
1.4
1.1
0.9
2.0
2.2
1.4
2.6
1.2
1.7
5.3
3.5
1.8
0.8
2.3
1.3
2.2
4.2
1.3
1.9
1.9
0.9
1.2
0.8
0.5
1.4
0.8
0.9
1.1
2.0
1.9
0.6
0.8
0.5
1.5
0.8
1.4
1.3
1.1
1.1
0.9
1.6
0.8
1.4
0.8
1.2
0.6
1.1
Skin Diseases
9.1
7.9
9.0
6.7
4.2
6.7
6.5
5.8
7.5
9.8
7.8
10.6
10.4
10.7
11.1
8.9
10.5
10.3
8.6
13.4
9.7
8.7
6.3
9.5
7.9
7.1
16.3
4.6
5.3
4.6
7.8
10.9
8.8
4.8
10.6
9.4
12.4
11.5
10.4
9.2
11.2
6.3
8.8
9.2
14.6
14.5
10.9
9.5
7.7
11.0
14.9
8.7
13.2
12.5
7.5
11.1
12.7
8.6
8.8
9.9
7.9
13.2
14.8
14.0
10.2
12.2
11.3
7.1
6.0
10.0
17.5
8.5
11.5
8.1
13.4
7.7
7.6
8.0
9.9
6.4
7.6
Ear, Nose and Throat Oral Health Related

Infection
Problems
5.4
5.9
11.6
7.2
5.5
6.0
4.2
3.2
10.7
13.4
9.1
11.5
11.2
11.2
11.4
6.5
4.3
3.7
4.8
3.2
3.5
3.3
4.7
9.4
7.8
7.2
11.9
4.7
5.6
4.7
6.1
8.1
5.8
3.7
3.5
2.3
3.2
8.2
7.1
8.4
7.8
5.2
8.5
9.8
24.2
22.6
8.6
11.4
7.3
8.7
10.8
4.3
6.6
5.1
4.7
4.8
6.3
3.8
4.8
5.1
3.5
3.4
5.6
7.5
3.9
4.2
6.0
4.9
4.3
4.2
11.2
4.0
4.4
3.9
5.6
4.7
3.7
2.8
5.2
4.3
4.4
3.3
2.5
4.6
1.7
2.2
2.7
1.8
1.8
3.1
2.7
4.2
2.9
4.9
3.9
4.0
2.3
2.1
2.3
3.8
2.1
2.3
2.0
2.1
4.6
5.4
2.7
10.0
2.6
8.7
5.8
3.8
3.7
2.6
1.9
2.1
1.6
1.8
6.3
4.5
4.1
6.0
3.8
3.2
13.6
9.3
7.1
4.2
3.5
3.3
3.3
6.9
1.8
3.7
2.9
2.1
2.5
2.2
1.4
2.8
2.9
1.4
2.0
2.4
5.0
2.1
2.7
4.3
3.4
2.1
3.6
8.2
2.3
3.0
4.0
2.8
3.0
1.1
1.4
3.6
3.2
4.5
393
Raw Data:HOSPITAL (Sheet 1 of 24)

Outpatient Services
20 - 59 Years
Female
Male
Female
Male
Female
28 1390
3215
1169
1157
1261 1266
1692 1277
1861
1508
4016
2622
4233
2961
693
554
829
774
7570
5610
8184 6509
15
30 4098
9013
1717
2237
1717 2237
1554 1383
1554
1383
5582
3097
5582
3097
614
689
614
689
9467
7406
9467 7406
DISTRICT HOSPITAL, ILAM
12
25
25 2167
5333
889
1082
896 1196
1177
927
1189
949
5653
3000
5792
3027
952
1030 1006
1086
8671
6039
8883 6258
MECHI ZONAL HOSPITAL, JHAPA
12
50
114 5736 16956
4013
5283
4273 5555
3084 2643
4131
3237
14727
8517 15072
8966
1876
2060 2034
2200 23700 18503 25510 19958
KOSHI ZONAL HOSPITAL, MORANG
12
250
300 19650 57554
6208
8190
7096 9486 13605 22020 18518 17924
49929 34260 59316 39549
2550
2673 3007
3195 72292 67143 87937 70154
RANGELI HOSPITAL, MORANG
15
15
BPKIHS, DHARAN,SUNSARI
733
DISTRICT HOSPITAL, SUNSARI
12
25
25 3683
3608
2816 2873
3598
5010
2771
2797
600
696
DISTRICT HOSPITAL, DHANKUTA
12
50
27
743
2126
2720
3420
DISTRICT HOSPITAL, TERHATHUM

DISTRICT HOSPITAL,
SANKHUWASABHA
DISTRICT HOSPITAL, BHOJPUR
12
0 1729
2859
759
823
1090 1405
12
15
25 1781
3433
1589
1829
12
15
22 2073
5662
1331
1363
DISTRICT HOSPITAL, SOLUKHUMBU
10
15
29 1387
3981
749
12
32
46 4216 17879
12
15
15
562
1296
12
15
23 1777
KATARI HOSPITAL, UDAYPUR
12
15
DISTRICT HOSPITAL, UDAYAPUR
12
50
BHARADAH HOSPITAL,SAPTARI
RAM UMA SMARAK
HOSPITAL,LAHAN, SIRAHA
DISTRICT HOSPIAL, SIRAHA
12
15
12
50
50 4253
12
15
15 1046
BARDIBAS HOSPITAL, MAHOTTARI

DISTRICT HOSPITAL,
JALESWOR,MAHOTTARI
MALANGAWA DISTRICT HOSPITAL,
SARLAHI
DISTRICT HOSPITAL, SINDHULI
12
15
10
25
12
50
19 1716
30
1876
2353
DISTRICT HOSPITAL, RAMECHHAP
12
15
15
831
2513
615
495
617
1886 1338
2283
1588
2660
1831
3039
2086
JIRI DISTRICT HOSPITAL, DOLAKHA

DISTRICT HOSPITAL,
SINDHUPALCHOWK
METHINKOT HOSPITAL,KAVRE
MENTAL HOSPITAL,
LALITPUR,LALITPUR
PATAN HOSPITAL,LALITPUR
12
15
15 1304
3092
1166
1033
1601 1195
1524 1205
1668
1381
4000
2591
4404
2842
12
15
33 1583
5848
1847
1576
2023 2369
1247 1114
1414
1261
5450
4250
5367
4245
1633
1663 1799
11
15
15
154
353
460
475
472
492
669
408
694
434
2145
750
2288
827
393
395
463
470
3667
2028
12
50
50
905 15519
33
53
89
139
361
405
1242
1424
2958
3185 10825 11415
280
257
905
762
3632
3900 13061 13740
12
411
411 14877 76157
5643
6114 5342 10892
9115
41024 23043 113220 39462
4252
BHAKTAPUR HOSPITAL ,BHAKTAPUR
BIR HOSPITAL, KATHMANDU

BIRENDRA ARMY
HOSPITAL,KATHMANDU
CENTRAL JAIL
HOSPITAL,KATHMANDU
CIVIL SERVICES
HOSPITAL,KATHMANDU
KANTI CHILDREN
HOSPITAL,KATHMANDU
MATERNITY
HOSPITAL,KATHMANDU
NEPAL POLICE
HOSPITAL,KATHMANDU
SUKRARAJ TROPICAL
HOSPITAL,KATHMANDU
DISTRICT TRISULI HOSPITAL,
NUWAKOT
DISTRICT HOSPITAL , RASUWA
371
OKHALDHUNGA COMMUNITY
HOSPITAL,OKHALDHUNGA
RUMJATAR HOSPITAL,
OKHALDHUNGA
DISTRICT HOSPITAL, KHOTANG
Total Clients
Served
9785 11376
7369
3750
535
305
1305
1072
102
982
2608
1831
2880
2302
789
785
881
1606 1854
1538 1233
1552
1246
5845
3602
5891
3646
1252
1331 1363
1111 1007
1111
1007
4805
3200
4805
3200
1165
943
854
715
8412
6513
8101 6285
876
1527 1111
1100
892
1253
1036
3459
1950
4193
2331
341
291
761
668
5649
4009
7734 5146
1297
1638
1707 2044
1262
792
1644
1067
5371
2611
9101
3975
843
814 1913
1690
8773
5855 14365 8776
793
774
976
668
1085
760
2410
1278
2653
1432
680
462
771
561
4859
3182
4573
1623
1536
1992 1865
3082 3035
3462
3128
5503
4092
5799
4201
797
684
892
789 11005
9347 12145 9983
22
3485
3802
3336 3724
2136 1641
2184
1640
5602
3424
5608
3396
900
966
909
937 12123
9833 12037 9697
32 3909 14335
2678
2953
2901 3125
3092 2890
3154
3044
5819
3854
5451
3823
3887
729
770
829
851
689
691
751
792
1643
1760
1810
1910
466
592
519
658
3527
3813
6185
238
387
41
10
320
319
1138
876
151
181
1847
1763
2207
1199
1223
1247 1249
2161 2032
2344
2231
2544
2294
2681
2552
1284
1472 1225
1509
7188
7021
278
284
1369
1010
1346 1034
2046 1728
1845
1596
5126
4091
5123
3475
848
785
888
845
9389
7614
9202 6950
25 1119
3524
387
464
1650 2028
279
396
5232
5921
844
1034
1094
1487
274
352
8363
9900
1539 1981
338
142
199
1884 2358
801
6900 35589 23956
446 7155 57082
1551
2846
2155 3773
866
1341 1277
2962 3791
92 13249 10099
Male
New Clients
Served
Male
Total Clients
Served
Male
Male
Female
Male
Sanctioned
New Clients
Served
125
881
5022
1367 10224
4266
987
831
5886 5570
8005 10326 8113
5391 3607
3070 15476 12659 15297 13062

3909 4211
41
10
7497 7541
1367 1294
1367
1294
4421
2740
4419
2744
974
833
974
833
8638
7220
1866
1136 2001
1273
7027
4800
8124 5564
1049
766 1221
922
7739
5595
8894 6340
6058 10831
9070 14961
40939 52548 69047 77402
7196
0
111808
18
13
22
16
207
969
249
1033
12
132
132 7828
2667
3167
4568
5138 7482
1501
1425
1501 1426
1501
415 21047 82354
0 34374
0 34374
3020 5338
5698
9419
1911
2983
1356 1121
1551 1149
1551
1149
5469
3755
5469
3955
1215
1052 1215
12
12
12
15
15
258
358
500
585
12
15
15 1989
5022
2381
2920
HEATUDA HOSPITAL, MAKWANPUR 12

CHANDRANIGAHAPUR HOSPTIAL,
12
RAUTAHAT
12
GAUR HOSPITAL, RAUTAHAT
15
KALAIYA DISTRICT HOSPITAL, BARA
11
100
100 2503
9773
1206
2195
0 2582
6643
1356
1111
601
384
530
410
2030
1980
2119
2036
265
2358 1798
521
2661
2078
9071
3973 10516
4397
1563
3933 20875
6377 14275 14877 58171 49479 110601 87742
221
274
1302 1803
1425
0 11835 19935
1052
9591
230
3316
1506 15373
1501 1426
7067
9591 7277
3170
3429 3277
9993 17743 11279
1680
1230
4117 2732
1604 1248
4554
4860
3329
2173
9771
8046
1119
656 2275
1638
7732
5307 20717 17276
123
1816
1717
2183 1935
1966 1826
2347
1987
3755
3044
4227
3299
1115
971 1273
1210
8652
7558 10030 8431
25
25 2472
2604
1293
1181
845
799
1950 1812
1068
1033
5467
4885
3427
3038
781
709
399
394
9491
8587
50
25 2323
1681
719
901
41
69
2463 2680
97
107
3880
4286
180
320
743
815
54
44
7805
8682
372
540
0 10796
12
15
15 1267
342
2212
2620
1044 1265
1721 1619
728
807
4720
2750
3355
2244
895
947
344
414
9548
7936
BAGHAUDA HOSPTIAL,CHITAWAN 12
BHARATPUR SAMUDAYIK HOSPITAL
8
,CHITAWAN
BAKULAHAR HOSPITAL,CHITAWAN 11
15
2299
1749
2383 1871
2765 2367
85
887
137
119
15
15
52
91
1016
831
AANPPIPAL HOSPITAL,GORKHA
12
15
46 1607
5025
707
850
1379 1524
DISTRICT HOSPITAL, GORKHA
12
50
50 2326
4455
2035
2198
2235 2357
394
0 5375 14760
506
2763 3298
2931 17941
235
NARAYANI SUB REGIONAL

HOSPITAL,PARSA
POKHARIYA HOSPITAL,PARSA
0
2567
10
1956 1019
80
6496
244
43033 31468 82134 54071
8879 12215 15672 55744 75104 92487
315
0
311
3428 13519 10159 57033 38713 173220 82692
15
2395 15003
3917 2223
2643 17259
8603 10603 9477
15
9054 11312
5475 7066
1602 10177
8644 7229
12
DISTRICT HOSPITAL, DHADING
Total Clients
Served
133
854
1855 1857
New Clients
Served
1035
882
309
Total Clients
Served
827
217
New Clients
Served
Female
Male
15
12
Total Clients
Served
Female
Male
12
DISTRICT HOSPITAL, PANCHATHAR
New Clients
Served
Female
Female
DISTRICT HOSPITAL, TAPLEJUNG
Hospital Name
Operational
Female
Total
Male
60Years
Female
10 - 19 Years
Total Inpatient
Service Days
Number of
Beds
0 - 9 Years
Total Patients
Admitted
Received Reports
Hospital Service
351
433
1381 1188
2910
2557
5419
4195
5822
4778
1528
140
985
787
128
115
993
723
137
1220 1261
1581
1713
7894
5420
9877
6945
1913
215
664
1137 1745
119
789
1523 2570
515
1298
938
2732
1192
5710
2261
1002
733 2072
2936 3212
3235
2603
8852
4665
9501
5019
2359
1780 2562
1307 12011
749
617
5739 5264
5471 4730
9448 12860 10513

493
3118 2692
2389 12043
9035 15409 12235
1541
3290 10459 6264
5105
1974 16182 11855 17533 11953
2265
8031
12
10
10
160
202
12
25
15 1200
2116
801
1077
12
500
325 20511 64507
12
15
105
211
214
282
289
12
15
15
311
531
274
347
332
403
MYAGDI DISTRICT HOSPITAL,MYAGDI
12
15
27 3301
6730
1381
1730
1536 2106
12
15
26
921
1013
935
1113
922 1085
1667 1398
12
50
50 3340
6636
12
50
30 2320
5079
1877
2219
2135 2428
RAMPUR HOSPITAL,PALPA
12
15
15
475
696
540
668
808 1122
701
DISTRICT HOSPITAL, PALPA

PRITHIV CHANDRA HOSPITAL,
NAWALPARASI
LUMBINI ZONAL HOSPITAL,
RUPANDEHI
BHIM HOSPITAL, RUPANDEHI
SHIVRAJ HOSPITAL, BAHADURGANJ,
KAPILBASTU
PIPARA HOSPITAL,KAPILBASTU
337
1282
306
384
306
461
12
25
29 2130
3619
1524
1647
12
12
25
12
15
11
15
PRITHIV BIR HOSPITAL, KAPILBASTU 12

DISTRICT HOSPITAL,
ARGHAKHANCHI
DISTRICT HOSPITAL, PYUTHAN
276
2797
DISTRICT HOSPITAL, SYANGJA

WESTERN REGIONAL HOSPITAL,
POKHARA,KASKI
DISTRICT HOSPITAL, MANANG
MUSTANG DISTRICT
HOSPITAL,MUSTANG
PARBAT DISTRICT HOSPITAL,
PARBAT
DHAULAGIRI ZONAL
HOSPITAL,BAGLUNG
TAMGHAS HOSPITAL, GULMI
229
2093 1808
Male
Female
Male
1637 1791
5181 17087
1884
1095 1428
384
2139 2436
289
7219
3071
1646 3346
2416
987
451
3888 11795
4991
1665
817
361
1579 2084
252
373
326
394
264
492
346
63
1158 1041
1424
1142
4633
1925
5782
2086
1457
158
196
251
273
1030
1503
1498
2943
56
503
556
609
683
1478
1759
1722
2048
1353 1059
1535
1209
5527
2101
6583
2454
1600
1322
3763
3380
3559
3199
536
85
Male
1377
10454
591
Female
1334
2507
600
517
Total Clients
Served
Male
164
Female
390
3328
509
2096 1862
Male
19
New Clients
Served
Female
15
855
Total Clients
Served
Male
12
654
New Clients
Served
Female
823
Total
Total Clients
Served
Male
3353 4744
607
60Years
New Clients
Served
Female
3089
882
Total Clients
Served
Male
2367
385
New Clients
Served
Female
Female
1156
15
Total Clients
Served
Male
Male
52 4144
15
New Clients
Served
Female
Female
50
12
Operational
12
306
Outpatient Services
20 - 59 Years
10 - 19 Years
Total Inpatient
Service Days
0 - 9 Years
Total Patients
Admitted
LAMJUNG COMMUNITY
HOSPITAL,LAMJUNG
BANDIPUR HOSPITAL, TANAHU
DAMAULI DISTRICT HOSPITAL,
TANAHU
DAHAL HOSPITAL, TANAHU
Sanctioned
Hospital Name
Received Reports
Hospital Service
Number of
Beds
3128 17988 11778 27114 17598

505
3459
1978 13123
2510
4206 2938
8652 18313 11025
104
135
906
803
1198 1083
1167 1599
1247
8049
5210
9900 5903
93
89
121
1455
2006
2120 3626
146
132
189
166
2401
2794
2852 3300
958
735 1108
879
9219
5625 10762 6648
1200
1076 1109
992
7565
6967
2951 1768
3249
1957
9595
2568 10756
3222
3282
534
1274
818
3242
1266
4907
2024
526
554
448
461
448
2607
2028
2607
2028
633
727
2086 1500
2595
1746
9734
4585 11712
4901
1211
2236 3560
7190 6598
0
2429 17705
8791 19700 10036
766
1050
5009
3022
7755 5014
633
727
4007
3587
4007 3587
1243 1383
1423 14555
8975 17829 10506
58 1514
2284
285
553
98
148
710
759
177
209
2988
1871
376
375
466
588
71
86
4449
3771
722
818
753
865
1092
1109
3309 4218
713
704
15
30 2522
4485
1440
1436
12
15
30 2841
5087
691
803
12
15
30 2881
6604
1792
2287
1222 1266
875
862
1440 1436
813
961
1868 2380
4095
4601
3547
3346
4072
3830
583
812
694
920
8531
9485 10083 10617
563
947
691
3046
1197
4096
1663
632
631
802
845
5172
3095
1890 1071
1775
1019
7772
3876
7772
3876
648
789
648
789 11750
625
743
781
531
933
648
3062
1461
3550
1727
632
2306 1579
795
2402
1673
7604
3401
9114
3608
1240
1170 1346
769
5180
1278 12942
6720 4061
7172 11635 7120

3420
6039 4105
8437 14730 8939
DISTRICT HOSPITAL, ROLPA
12
15
15
984
2909
770
880
803
931
827
553
875
555
3160
1289
3379
1360
310
254
382
287
5067
2976
5439 3133
DISTRICT HOSPITAL, RUKUM
15
25
294
694
549
540
673
619
577
390
718
528
2575
1471
2818
1694
473
285
571
419
4174
2686
4780 3260
DISTRICT HOSPITAL, SALYAN

RAPTI SUB REGIONAL
HOSPITAL,DANG
RAPTI ZONAL HOSPITAL,DANG
12
15
15 1430
8210
2506
8801
492
587
524 12506
12
100
12
50
BHERI ZONAL HOSPITAL, BANKE
11
200
DISTRICT HOSPITAL, BARDIYA

MID WESTERN REGIONAL
HOSPITAL, SURKHET
MEHELKUNA HOSPITAL,SURKHET
12
3157
1080
1239
1119 1283
2669 1027
2874
1063
2581
547
63 6549 14674
7149
7629
7921 7929
8512 5798
8512
4686
22781 11374 21881 11374
1033
939 1033
929 39475 25740 39347 24918
40 4055
3375 4668
3032 1684
2226 2609
2401 18819 11830 23037 13192
8521
2935
4055
50
25 2466
4001
1364
1128
12
50
50 8395 19481
1814
2468
2476 3400
98
195
982
1164
1079 1302
DULLU HOSPITAL,DAILEKH
65
131
367
400
DISTRICT HOSPITAL, DAILEKH
12
15
25 1485
3733
1277
1389
DISTRICT HOSPITAL, JAGARKOT
12
15
15 1267
2791
1228
1582
DISTRICT HOSPITAL, DOLPA

KARNALI ACADEMY OF HEALTH
SCIENCE,JUMLA
15
68
157
523
359
11
300
100 1670
933
909
150
15
1427 1193
368
401
1290 1401
3790
1986
10505
4137
2347
1223 1056
1275
1103
8836
7824
8907
7900
792
591
837
640 12215 10599 12446 10836
2789 2125
4040
2885
12857
7084
2159
1447 4003
2547 19619 11182 30431 15916
1209
564
1528
597
4082
957
4707
1084
573
376
661
463
6846
3061
7975 3446
406
243
405
244
1325
396
1369
402
145
142
146
145
2243
1181
2288 1192
1578
3865 13263
5264 13381 5451
5142 19912
901
1605
905
5612
1959
5394
2001
694
557
711
590
9161
4806
9000 4897
472
690
1886 1526
583
518
4481
2677
1202
699
469
420
141
133
8064
6205
2398 2040
863
691
1368 1056
1996
1708
1680
1452
2202
2422
91
169
121
174
3662
3036
5182 4995
1104 1085
1665 1714
1935
1953
3237
3016
3715
3465
827
773 4221
3724
6662
6412 10975 10227
1250
11
15
863
2663
434
468
925
1209
901
2861
1832
2861
1832
426
376
426
376
4971
3601
4930 3637
DISTRICT HOSPITAL, MUGU

SIMIKOT DISTRICT HOSPITAL,
HUMLA
DISTRICT HOSPITAL, BAJURA
12
535
261
1418
1475
1431 1478
1177 1049
1219
1054
3364
2297
3390
2316
499
466
545
525
6458
5287
6585 5373
12
0 1191
2247
373
360
1881 1803
1027
896
5305
4334
1510
1254
7275
5583
161
137 1388
1045
3071
2647 15849 12765
12
15
15
852
2096
1197
1716
1197 1716
1903 2805
1916
2833
3983
3302
4008
3362
385
421
396
442
7468
8244
7517 8353
DISTRICT HOSPITAL, BAJHANG
12
15
25 2320
5104
1640
1606
1314 1306
2215 1963
1631
1537
3644
2785
3177
2345
908
729
748
566
8407
7083
6870 5754
DISTRICT HOSPITAL, ACHHAM
12
15
26 1531
3849
1519
2366
1576 2492
1993 1523
2034
1583
5073
1879
5069
1969
610
277
696
339
9195
6045
9375 6383
DISTRICT HOSPITAL, DOTI
12
15
15 1371
2928
1239
1258
1352 1275
2769 1955
2807
1983
7395
3996
7643
4073
1219
862 1242
SETI ZONAL HOSPITAL, KAILALI
12
125
2244 1397
MALAKHETI HOSPITAL,KAILALI
12
15
TIKAPUR HOSPITAL, KAILALI

MAHAKALI ZONAL
HOSPITAL,KANCHANPUR
DADELDHURA SUB REGIONAL
HOSPITAL
JOGBUDA HOSPITAL,DADELDHURA
12
DISTRICT HOSPITAL, BAITADI

GOKULESHWOR
HOSPITAL,DARCHAULA
DISTRICT HOSPITAL, DARCHULA
225 15751 30561
434
528
875 12622
8071 13044 8206
2633
3997
1376 2440
3009 3190
1543
1773
16558
9004
9815
5292
2264
1274
1515
1406 1554
1638 1133
1773
1196
4818
1223
5564
2132
796
455
831
577
8526
4326
9574 5459
15
32 2000
3679
1916
1249
961
275
181
5919
3963
1126
709
1522
1054
293
256 10891
7227
2023 1350
12
100
91 4312
9471
2946
2552
3312 2876
3325 2818
3759
3165
5642
4440
6282
4945
2560
1942 2908
2189 14473 11752 16261 13175
12
100
50
786
1399
1493
1473
1975 2020
1542 1513
2077
2236
3277
3050
3928
3715
1057
1020 1403
12
15
15
514
305
934
898
1846 1351
1342
928
2457
1219
1531
704
517
12
15
33
812
1604
1210
1167
1238 1201
1230 1038
1272
1086
3470
2550
3591
2630
12
15
343
313
906
1095
986 1122
1349 1276
1395
1335
3345
1938
3318
1963
12
15
15 1220
2713
1151
1306
1224 1433
1087 1249
1224
1365
3082
3329
3329
3526
194
329
800
204
747
1534
1404 24464 18435 14131 10909
1409
7369
7056
9383 9380
332
279
5754
3897
4005 2658
969
929 1058
1041
6879
5684
7159 5958
450
471
492
6050
4780
6170 4912
6093
6017 6594
429
471
209
240
270
5514
PUBLIC HOSPITAL TOTAL
1170 4701 5446 267874 704296 133760 152786 176657 182814 177317 171145 205503 184242
617980 423697 797846 504219 107400 99422
174494
130887
1036457
847050 1354500
1002162
NON-PUBLIC HOSPITAL TOTAL
2303 12555 11908 372316 1007913 132215 151054 175654 205642 168644 157107 221161 204794
664143 477513 1060262 685920 181804 165602
258738
273708
1146806
951276 1715815
1370064
TOTAL
PUBLIC HOSPITAL %
NON-PUBLIC HOSPITAL %
3473 17256 17354 640190 1712209 265975 303840 352311 388456 345961 328252 426664 389036 1282123 901210 1858108 1190139 289204 265024 433232 404595 2183263 1798326 3070315 2372226
34
66
27
73
31
69
42
58
41
59
50
50
50
50
50
50
47
53
51
49
52
48
48
52
47
53
48
52
47
53
43
57
42
58
37
63
38
62
40
60
32
68
47
53
47
53
44
56
42
58
395
Raw Data: Hospital Services

Hospital Name
DISTRICT HOSPITAL, ILAM,ILAM
0 - 9 Years
Female Male
10 - 19 Years
Female Male
Emergency Services
20 - 59 Years
60Years
Female Male Female Male
Total
Female Male
191
2297
875
1195
138
1823
1215
1868
172
1104
743
645
151
807
849
768
308
3410
1932
2476
312
3868
2040
2456
267
0
316
624
275
0
402
723
938
6811
3866
4940
876
6498
4506
5815
359
260
679
1456
1666
576
752
748
3456
3040

493
422
1976
1876
2294
2200
4763
4498
326
359
263
259
495
447
241
255
1325
1320
DISTRICT HOSPITAL, SANKHUWASABHA
656
649
493
504
713
736
500
560
2362
2449
95
132
100
122
265
367
61
54
521
675
OKHALDHUNGA COMMUNITY HOSPITAL,OKHALDHUNGA
158
261
304
137
777
355
257
235
1496
988
RUMJATAR HOSPITAL, OKHALDHUNGA
102
161
71
82
188
154
48
63
409
460
395
447
299
313
880
694
247
267
1821
1721
777
854
555
449
1495
1080
177
147
3004
2530
841
916
891
996
1091
1094
1011
926
3834
3932
24
46
72
86
13
12
117
148
SAGARMATHA ZONAL HOSPIAL,SAPTARI
RAM UMA SMARAK HOSPITAL,LAHAN, SIRAHA
479
499
853
1027
1164
1058
452
509
2948
3093

JANAKPUR ZONAL HOSPITAL, DHANUSHA
231
193
373
270
760
552
267
238
1631
1253
DISTRICT HOSPITAL, JALESWOR,MAHOTTARI
177
201
459
389
1489
1596
296
340
2421
2526
MALANGAWA DISTRICT HOSPITAL, SARLAHI
701
855
705
752
1730
1528
391
307
3527
3442
287
379
194
182
595
370
199
181
1275
1112
DISTRICT HOSPITAL, SINDHUPALCHOWK

537
668
74
483
558
69
431
1000
106
380
863
66
1148
1481
316
1602
1148
177
448
484
69
436
404
74
2564
3633
565
2901
2973
386
MENTAL HOSPITAL, LALITPUR,LALITPUR

196
231
203
242
2857
4387
2257
2590
13737
8350
3240
2649
22091
17976
353
828
1044
3262
5749
14183
1849
2267
8995
20540
BIRENDRA ARMY HOSPITAL,KATHMANDU
CENTRAL JAIL HOSPITAL,KATHMANDU
66
354
12
89
86
453
CIVIL SERVICES HOSPITAL,KATHMANDU
462
859
1068
1454
10136
4969
3110
1642
14776
8924
KANTI CHILDREN HOSPITAL,KATHMANDU
430
467
430
467
3747
291
5785
9823
122
221
233
306
510
871
183
232
1048
1630
4267
MATERNITY HOSPITAL,KATHMANDU
NEPAL POLICE HOSPITAL,KATHMANDU
SUKRARAJ TROPICAL HOSPITAL,KATHMANDU
DISTRICT TRISULI HOSPITAL, NUWAKOT
1018
921
968
1039
1901
1381
893
926
4780
39
69
71
151
210
359
29
52
349
631
2681
2172
1178
2404
2768
1694
878
666
7505
6936
HEATUDA HOSPITAL, MAKWANPUR
7876
1835
1355
2203
2153
4503
3538
1132
830
9673
CHANDRANIGAHAPUR HOSPTIAL, RAUTAHAT
127
138
76
68
96
121
77
79
376
406
454
426
700
644
1537
1398
334
349
3025
2817
558
807
2083
2553
2435
3762
511
610
5587
7732
608
577
67
86
675
663
531
NARAYANI SUB REGIONAL HOSPITAL,PARSA

BAGHAUDA HOSPTIAL,CHITAWAN
78
81
92
87
218
257
90
106
478
BHARATPUR SAMUDAYIK HOSPITAL ,CHITAWAN
105
48
81
65
63
78
98
53
347
244
BAKULAHAR HOSPITAL,CHITAWAN
532
511
244
210
1166
1020
292
226
2234
1967
LAMJUNG COMMUNITY HOSPITAL,LAMJUNG
396
46
64
89
54
214
60
65
61
414
239
1082
1555
1102
1159
3047
2481
1055
998
6286
6193
753
1088
555
675
1937
1825
525
578
3770
4166
Hospital Name
0 - 9 Years
Female Male
10 - 19 Years
Female Male
Emergency Services
20 - 59 Years
60Years
Female Male Female Male
Total
Female Male
139
228
161
281
364
282
95
80
759
871
DAMAULI DISTRICT HOSPITAL, TANAHU
230
326
352
425
1088
932
224
197
1894
1880

WESTERN REGIONAL HOSPITAL, POKHARA,KASKI
36
52
46
50
62
48
35
32
179
182
263
395
480
536
1438
1608
296
327
2477
2866
1325
1550
1325
1550
43
45
13
38
113
98
173
MUSTANG DISTRICT HOSPITAL,MUSTANG
163
178
141
142
367
504
44
46
715
870
342
462
500
555
1241
1288
315
669
2398
2974
PARBAT DISTRICT HOSPITAL, PARBAT
235
249
393
402
907
796
261
259
1796
1706
423
573
604
510
1757
1148
518
445
3302
2676
145
DHAULAGIRI ZONAL HOSPITAL,BAGLUNG

15
18
62
41
106
61
24
25
207
57
103
33
99
77
353
62
215
229
770
382
390
666
631
2369
1664
539
533
3956
3218
PRITHIV CHANDRA HOSPITAL, NAWALPARASI

LUMBINI ZONAL HOSPITAL, RUPANDEHI
181
296
350
568
1389
1811
155
232
2075
2907
SHIVRAJ HOSPITAL, BAHADURGANJ, KAPILBASTU
15
27
56
71
131
124
12
32
214
254
82
68
197
169
372
459
40
32
691
728
PRITHIV BIR HOSPITAL, KAPILBASTU
232
324
483
151
1651
1062
409
694
2775
2231
DISTRICT HOSPITAL, ARGHAKHANCHI
311
362
334
308
990
670
412
335
2047
1675
379
508
525
321
1636
1014
267
243
2807
2086
191
266
203
191
615
535
87
119
1096
1111
94
71
93
63
227
166
72
46
486
346
97
155
149
84
395
247
154
57
795
543
1205
1853
2510
1870
5954
4534
378
370
10047
8627
421
581
603
533
1821
1442
528
503
3373
3059
628
532
560
460
1339
1111
424
364
2951
2467
MID WESTERN REGIONAL HOSPITAL, SURKHET
197
363
373
352
1358
1092
455
441
2383
2248
42
48
75
39
163
94
38
23
318
204
27
14
45
30
268
358
404
322
867
583
273
253
1812
1516
278
406
268
191
531
496
70
68
1147
1161
72
94
120
157
237
353
30
47
459
651
KARNALI ACADEMY OF HEALTH SCIENCE,JUMLA
523
442
441
311
864
642
146
187
1974
1582
109
178
145
150
318
308
48
62
620
698
98
93
87
83
246
221
74
42
505
439
SIMIKOT DISTRICT HOSPITAL, HUMLA
173
150
580
464
821
611
189
165
1763
1390
121
203
169
185
317
313
52
53
659
754
311
617
453
548
1296
937
199
190
2259
2292
358
493
331
255
1022
576
138
110
1849
1434
356
345
382
318
953
684
246
225
1937
1572
2036
4590
1897
2503
6259
6083
1118
1457
11310
14633
10
10
15
16
1973
1789
2411
2369
3750
3970
1490
1435
9624
9563
471
482
686
686
1119
1062
504
608
2780
2838
48
59
118
73
129
110
38
32
333
274
121
145
115
133
360
285
96
96
692
659
GOKULESHWOR HOSPITAL,DARCHAULA
101
142
120
145
237
202
57
59
515
548
644
558
426
477
810
864
104
103
1984
2002
43789
48524
44423
48426
124944
112586
41697
34925
254853
244461
36857
46665
33393
37875
108682
101372
53668
39668
232600
225580
TOTAL
80646
95189
77816
86301
233626
213958
95365
74593
487453
470041
54
46
51
49
57
43
56
44
53
47
53
47
44
56
47
53
52
48
52
48
RAPTI SUB REGIONAL HOSPITAL,DANG

MAHAKALI ZONAL HOSPITAL,KANCHANPUR

DADELDHURA SUB REGIONAL HOSPITAL
PUBLIC HOSPITAL %
397


398
924
2699
3587
8372
0
0
2557
2928
1549
4780
1066
4939
575
2619
662
4358
0
2724
2539
222
2852
0
2907
594
2492
2795
36
0
60904
0
27887
0
1259
48156
0
1841
0
4472
4151
728
9617
14575
0
1506
3108
17530
208
0
4146
770
1690
3801
11696
741
0
894
167
1998
2890
6229
0
0
559
1659
1051
2783
1454
3132
235
2695
0
5168
0
0
0
0
628
0
862
107
539
1359
0
0
0
0
4378
0
0
35732
0
40657
0
801
2078
0
3476
3969
0
0
0
4840
0
0
6605
365
984
1745
2920
89
0
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
2261
0
0
2496
0
0
0
0
0
0
246
0
0
0
0
0
0
0
153
17
0
0
193
0
0
0
0
0
0
6
285
0
0
0
0
0
72
0
0
25
0
0
0
0
0
0
0
0
0
14
0
0
0
1
0
687
0
179
0
0
0
0
0
0
0
33
0
0
0
0
0
0
323
0
0
0
0
0
0
431
0
0
0
1073
3278
0
0
0
204
92
430
113
884
81
850
10
238
0
0
89
0
0
0
10
50
51
156
4
0
6667
0
7385
0
0
22607
0
40
0
225
248
16
451
613
1
0
0
1418
0
0
603
114
105
416
430
31
0
62
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3688
0
2
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
2651
0
2871
0
0
4669
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
267
0
0
1586
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Nuclear Medicine
Colonoscopy
Endoscopy
Magnetic Resonance
Imaging (MRI)
Computed
Tomographic (CT)
Scan
Trademill
Electrocardiogram
(ECG)
Electro Encephalo
Gram (EEG)
Echocardiogram
(Echo)
Ultrasonogram
(USG)
Hospital Name
X-ray
Diagnostic Services
0
0
0
0
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
0
0
1454
0
1574
0
0
2046
0
0
0
0
0
0
0
0
0
0
0
115
0
0
58
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
195
0
325
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
0
0
354
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2510
1586
0
51387 23396 5376
80
14
0
770
465
0
3419
1478
0
2278
1108
0
3740
3147
0
5506
2940
0
1086
0
0
2071
358
0
3736
2826
0
0
0
0
1817
0
0
183
0
0
0
0
0
649
3441
0
1283
1413
3
4984
2207
0
2171
502
0
593
665
0
997
1718
0
13847
5635
0
5930
3898
0
0
0
0
2325
1514
0
8741
6557
0
473
0
0
0
140
0
2743
3240
0
852
532
0
909
160
0
6294
2967
0
206
559
200
652
269
0
67
278
0
1099
492
0
4063
3252
0
1801
429
6
1839
3868
0
18650
3576
0
0
0
0
1978
1834
0
7496
1606
0
3745
4972
0
163
0
0
2269
2090
6
72
0
0
1649
810
0
0
0
0
0
0
0
455579 239128 10957
1206020 648931 60968
1661599 888059 71925
TOTAL
27
27
15
PUBLIC HOSPITAL %
73
73
85
0
90
0
0
7521
0
0
0
0
0
20
0
50
569
0
0
285
0
0
948
0
0
322
0
0
4
0
68
232
0
0
230
0
0
0
0
0
0
0
0
0
0
0
0
0
0
126
0
0
20
0
0
37
0
0
5
0
0
18
0
3
138
0
0
1488
0
31
249
0
0
0
0
0
0
0
13
56
0
16
6
0
0
0
0
0
92
0
0
66
0
5
20
0
0
472
0
320
0
0
0
0
0
0
0
0
0
0
0
0
27
0
2
6
0
0
162
0
0
2190
0
0
0
0
0
0
0
0
739
0
0
238
0
0
9
0
0
43
0
0
22
0
0
136
0
0
0
0
0
0
0
2558 65637 3697
12498 243591 10052
15056 309228 13749
17
21
27
83
79
73
0
312
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10503
65124
75627
14
86
0
0
0
0 1254 183
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
0
0
0
0
0
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
35
0
0
0
0
0
0
0
0
0
0
0
104
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
88
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
198
0
0
0
0
0
81
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
1873 7106 739
12336 56426 6060
14209 63532 6799
13
11
11
87
89
89
Nuclear Medicine
Colonoscopy
Endoscopy
Magnetic Resonance
Imaging (MRI)
Computed
Tomographic (CT)
Scan
Trademill
Electrocardiogram
(ECG)
Electro Encephalo
Gram (EEG)
Echocardiogram
(Echo)
Ultrasonogram
(USG)
X-ray
Hospital Name
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
354
2314
2668
13
87
399
Free Service Received by Impoverished Citizens

Heart
Hospital Name
F
OKHALDHUNGA COMMUNITY
400
Kidney
M
Free Dialiasis
Cancer
F
Spinal and
Head Injury
F
M
Alzheimer/
Parkinson
F
M
Total
F
11
5
0
0
0
0
18
0
0
1
0
13
7
0
0
0
0
15
0
0
1
0
1
2
0
0
0
0
3
0
0
0
0
3
3
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
20
0
0
0
0
0
0
0
0
0
0
25
0
0
0
0
0
21
0
0
0
0
27
0
0
6
0
1
21
0
0
0
0
26
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
2
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
14
28
0
0
0
0
68
0
0
7
0
19
32
0
0
0
0
72
0
0
1
0
119
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
0
79
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
0
0
0
87
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
6
3
0
0
0
7
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
1
0
0
0
0
6
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
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
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
6
0
0
0
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
446
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
7
0
0
0
0
0
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
541
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
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
7
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
1
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
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
136
0
0
0
0
0
0
0
45
0
0
0
0
0
0
0
0
79
0
0
0
0
0
0
446
0
30
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
2
0
0
0
107
0
0
0
0
0
0
0
50
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
541
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
3
0
0
0
Heart
Hospital Name
F
Kidney
M
Free Dialiasis
Spinal and
Head Injury
Cancer
F
Alzheimer/
Parkinson
F
Total

0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
33
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
137
0
0
0
0
0
0
0
0
0
0
0
0
175
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
1
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
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
170
0
0
0
11
0
0
0
0
0
0
0
0
228
0
1
0
8
0
0
0
0
0
0
0
10
18
24
38
42
68
12
12

192
192
25
25

10
10

474
197
63
95
169
214
625
698
11
19
1342
1223
1705
297
167
314
1304
2433
261
163
115
117
11
3552
3324
TOTAL
2179
494
230
409
1473
2647
886
861
126
136
18
17
4894
4547
401
Referrals
402
99
0
0
0
0
0
0
2
0
0
21
0
0
85
0
33
0
0
0
0
0
70
0
0
13
0
81
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
142
0
14
0
6
22
0
0
2
0
11
115
0
0
0
0
0
0
44
46
24
0
11
0
0
166
0
162
0
0
0
0
3
28
0
0
61
0
25
79
15
0
0
0
0
175
0
0
0
0
0
33
0
0
0
42
15
85
0
25
152
0
0
4
17
108
0
0
0
0
45
52
13
0
18
0
0
105
0
177
0
0
0
0
4
34
0
0
58
0
19
35
19
0
0
0
0
2299
0
0
0
0
0
27
0
0
0
46
13
49
0
0
143
0
0
1
13
117
44
0
65
0
0
35
105
36
109
0
8
0
36
75
0
30
0
0
0
0
11
33
0
0
39
274
81
16
0
0
0
0
0
18
0
0
0
0
0
64
3
0
12
27
488
80
0
155
156
2
0
0
75
41
43
0
63
0
0
13
141
37
141
0
14
0
20
61
0
34
0
0
0
0
13
32
0
0
32
201
72
11
0
0
0
0
0
55
0
0
0
0
0
76
9
0
13
31
455
81
0
20
170
2
0
0
94
72
1292
0
0
0
0
0
0
0
0
192
1713
580
20
0
2522
0
0
0
0
116
0
0
0
0
0
0
0
0
0
0
0
0
1492
0
0
0
0
0
0
0
0
9
0
0
2094
0
0
0
3635
0
10
2243
0
2038
76
911
0
853
0
0
0
0
0
337
285
0
2694
44
0
879
0
0
0
0
190
0
0
0
0
0
2418
0
0
0
75
0
0
24385
0
0
0
0
426
0
0
0
99
0
0
3078
0
0
0
12340
21659
0
4276
0
427
2766
88
22
47
0
0
0
48
33
0
36
154
74
45
49
4
60
0
0
0
0
219
0
0
0
49
0
33
66
0
0
0
0
0
0
0
3
2160
0
0
0
0
0
0
54
0
0
0
43
50
0
32
115
24
42
No. of Clients
Served
No. of session
conduct
Completely
Partially
92
108
55
208
0
0
31
26
44
112
43
74
2
93
20
0
0
0
24
14
0
11
9
0
79
38
47
19
3
16
0
0
0
0
27
0
0
0
0
58
40
2
96
113
5
7
7
0
0
0
0
0
20
49
110
No. Patients
Male
95
176
110
332
0
0
330
31
94
93
32
44
0
125
24
0
0
0
174
42
0
5
40
0
149
55
60
20
28
14
0
0
0
0
9
0
0
14
0
39
62
6
157
238
6
110
38
0
37
0
0
0
14
151
111
Emergency
Female
Male
91
0
Inpatient
Male

Male
Female
144
0
0
0
0
0
0
0
1
0
0
21
0
0
101
0
22
0
0
0
0
0
58
0
0
19
0
109
0
0
0
0
2
0
0
0
0
457
0
0
5
0
0
15
147
0
26
0
0
19
0
0
3
2
13
Female
Outpatient
Hospital Name
Female
Referral In

No. of Patients Immunization

Exempted
Services
Referred Out
2696
789
0
4452
0
0
0
1905
833
0
386
1136
74
2028
3048
0
1438
0
0
0
0
1966
0
0
0
678
0
666
674
0
0
0
0
0
0
0
1447
26714
0
0
0
0
0
0
5246
0
0
0
1232
1241
0
1612
300
1509
2696
Referrals
7
0
0
16
0
0
64
28
26
9
0
18
0
69
0
38
3
0
0
157
0
0
24
175
0
0
0
0
0
5
1
91
5
0
0
7
0
0
0
0
72
17
0
0
9
32
123
0
0
13
0
2173
10687
12860
5
20
30
29
0
0
0
0
0
9
5
0
8
51
53
70
0
5
7
9
0
2
5
1
75
67
70
26
49
120
150
84
16
31
30
68
16
0
0
153
0
162
111
120
28
57
61
45
0
12
13
12
76
134
129
119
0
0
0
0
20
0
0
41
4
33
30
26
0
0
0
0
0
0
0
198
137
31
31
270
0
0
0
107
0
0
8
47
9
40
27
37
30
0
0
46
0
0
0
136
0
0
0
26
0
0
0
0
0
0
0
32
0
0
0
35
5
12
8
2
0
1
1
4
70
8
12
87
6
37
46
60
5
5
9
7
0
0
0
20
0
7
4
16
0
5
3
54
0
26
27
0
0
0
0
30
0
94
105
50
29
117
127
47
19
16
18
24
0
0
0
99
0
0
0
0
0
0
0
13
1
0
0
111
132
56
47
29
0
0
0
3
0
98
97
29
12
28
25
27
0
45
57
63
1353 2764 4724 5577
7582 21703 21662 4795
8935 24467 26386 10372
17
10
23
0
0
55
0
0
0
0
78
13
0
10
6
63
0
0
31
57
77
232
152
57
13
0
1 2923 11863
0
0
2
5
0
451
5
41
28
23
0 7505
11
73
163
230
0
0
21
39
151
137
0
0
20
78
0
0
0
0
0
44
138
157
580 13213
141
25
43
35
774 2792
66
2
0
2
0
0
0
29
151
169 1379 1170
133
0
0
0
0
0
0
11
0
0
0
0
18
21
23
6
0 5979
0
0
0
0
0
0
42
39
100
121
0
0
20
153
224
221
0
0
4
66
1
5
0
0
0
13
13
2
0 2763
0
17
10
4
80
0
0
10
12
11
0
0
0
124
0
0
0
0
48
44
39
81
0
0
189
0
0
0
0
0
0
18
0
0
0
0
0
14
0
0
0
0
302
1
4
7
137
253
4
0
0
0
84
133
25
55
70
72
502 7780
14
34
13
21
0 2199
48
8
12
15
0 14680
24
14
8
7
2
10
0
25
9
10 5208 9012
61
47
0
0
404
959
2
0
34
13
0 24294
0
17
0
0
0
0
0
93
92
95 1112 3399
16
33
61
91
0
639
156
39
9
14
0
0
11
39
0
0
0
0
109
0
0
0
0 7550
30
8
0
0
0
0
0
102
175
246
0 4963
96
35
69
72
0 1513
16
5
0
0
0
0
30
12
61
57
0
115
30
22
32
35
11
84
45
43
34
49
0
0
0
3256 3976 4126 31523 201691 5412
4889 7926 9247 295326 156236 9637
8145 11902 13373 326849 357927 15049
No. of Clients
Served
No. of session
conduct
Partially
Completely
No. Patients
Male
Emergency
Female
Inpatient
Male
Male
Male
Female

TOTAL
Female
Outpatient
Female
Referral In
Hospital Name
No. of Patients Immunization

Exempted
Services
Referred Out
1700
2063
0
3218
0
10
181
2168
934
0
3499
2429
0
2868
0
1430
0
1236
2224
0
0
0
105
0
8591
13152
0
0
2848
101
320
617
847
140
0
1631
27
0
0
242
1088
344
6748
1791
0
21522
977
1000
544
459
0
151820
87762
239582
403

404
186
0
790
0
1
0
0
2377
536
919
1000
0
7
1089
156
8337
0
0
0
58
0
1
0
0
0
417
3080
0
0
9
0
0
0
0
0
0
0
0
0
0
0
114
3063
0
256
0
0
0
676
0
0
0
0
1450
1303
9
0
18
0
4
0
0
27
26
4
2
0
1
95
81
296
0
0
0
15
0
1
0
0
0
12
134
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
219
0
748
0
0
0
43
0
0
3
0
0
8
0
0
0
0
0
0
141
2
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
0
266
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
20
0
0
4
0
0
9
177
0
0
0
1566
0
0
0
147
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
236
3181
0
120
0
0
0
0
0
0
0
0
152
0
9949 107 1157

0
0
0
853
0
0
0
0
0
66
3 25
0
0
0
141
0
0
2691 78
0
649 20 10
1194 30
5
1027
0
0
2256 267
4
19 11
0
1340
0
0
3052 315 230
10908 16 10
0
0
0
0
0
0
0
0
0
515 13
4
0
0
0
4
1
2
0
0
0
0
0
0
0
0
0
826 110
3
8966 1158
0
0
0
0
0
0
0
258 44 24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 209 72
0
0
0
0
0
0
0
0
0
448 14
0
27990 256 127
0
0
0
1891 47 17
0
0
0
0
0
0
0
0
0
719
0
0
0
0
0
0
0
0
3
0
0
0
0
0
1619 50
4
1388 73
0
0
0
0
0
0
0
0
6
6
0
0
5
1
0
58
10
0
0
0
1
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
102
0
0
0
0
66
0
4
0
0
0
0
0
0
0
0
4
3
126
0
0
0
0
0
0
132
131
170
97
0
2
170
8
217
0
0
0
9
0
0
0
0
0
236
380
0
0
0
0
0
0
0
0
0
0
53
0
0
0
5
221
0
27
0
0
0
14
0
0
0
0
296
89
0
0
0
0
4
0
0
1
5
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
30
0
9
0
0
0
0
0
0
0
0
0
0
Gender Based
Voilence
FCHV
Sr. Citizens > 60

Years
Disabled
Helpless/
Destitute
Ultra Poor/
Poor
Total
Others
Gender Based
Voilence
FCHV
Sr. Citizens > 60

Years
Disabled
13
0
13
0
3
0
0
95
8
8
0
65
2
24
84
103
0
0
0
23
0
0
0
0
0
5
86
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
635
0
31
0
0
0
0
0
0
0
0
15
13
0
0
0
0
0
0
34
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
17
0
0
0
0
38
0
0
0
0
0
0
0
0
0
0
0
0
Total
161 9580
0
0
26
0
0
0
3 35
0
0
0
0
183
3
44 35
227 36
0
0
2014
0
9
0
95 37
2499 232
455 151
0
0
0
0
0
0
165 107
0
0
1
1
0
0
0
0
0
0
380
0
5662
4
0
0
0
0
119 130
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
61 31
19118 1508
0
0
630 106
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
60
4
Inpatients
Others

Helpless/
Destitute
Hospital Name
Ultra Poor/
Poor
Outpatients
0
0
0
0
3
0
0
0
0
192
0
25
0
0
0
47
0
0
0
21
0
0
0
0
0
122
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
412
0
17
0
0
0
0
0
0
0
0
41
922
1390
0
0
0
35
0
34
217
172
397
97
301
14
170
612
301
0
0
0
48
0
3
0
0
0
477
1540
0
0
68
0
0
0
0
0
0
0
462
0
0
0
28
1150
0
121
0
0
0
14
0
0
0
0
395
1087



TOTAL
4876
0
0
0
55
0
0
0
4246 109
0
0
1399
0
0
0
0
0
0
0
1238 192
0
0
31 23
86 12
0
0
470 300
5979
0
0
0
0
0
0
0
211
4
592 155
10
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
48
8
4140 183
7 1790
15136 560
0
0
5798 858
0
0
0
0
0
0
0
0
2045 599
85 52
2974 316
1460
0
0
0
817 689
0
0
0
0
89 32
27
0
367 52
11
0
0
0
347
0
0
0
0
0
253
0
18
8
0
61
0
0
0
0
24
6
2
0
0
0
0
0
0
0
55
32
12
146
0
130
0
0
0
0
229
89
249
5
0
32
0
0
60
0
7
84098 17938 3003
20333 947 967
104431 18885 3970
902 25
0
0
0
0
0
0
1750 37
0
0
304
0
0
0
0
0
0
0
5804 596
0 1670
1508 16
109
6
0
0
287 46
0
0
0
0
0
0
0
0
918 15
509
7
30
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
129 17
1756 52
80
5
149 127
0
0
721 30
0
0
0
0
0
0
0
0
892 150
1319
3
1800 114
317 63
0
0
1010 28
0
0
0
0
538 49
26
0
265
9
46948 4818
19069 278
66017 5096
0
0
0
0
32
0
0
0
0
68
0
0
0
5
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
1
0
0
8
0
0
0
0
5
32
29
5
0
4
0
0
0
0
0
616
271
887
0
0
0
0
0
0
3399
0
0
0
3159
0
0
25
0
167
0
0
0
0
70
0
0
0
0
0
0
0
0
0
0
328
0
0
0
15
0
0
0
0
293
0
881
0
0
0
0
0
12
972
0
5814 261
0
0 95
0
0
0
0
0
55
0
0
0
0
0
4
0
0
1
6521 15491 1446 523 2434
0
6
0
0
0
5102 100
0
0 26
0
0
0
0
0
0
0
0
0
0
68
0
0
0
0
11242 10
0
0 258
1670
0
0
0
0
1596
7 10
2 95
251 144 44
7 67
0
0
0
0
0
1331
0
0
0 37
5979 57
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 10
1244 193
2
7 358
1269 649
0
0 139
46
2
0
0 18
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 18
0
0 25
0
0
0
0
0
0
0
0
0
0
257 32
3
6 22
6491 413 306
2 225
1895
0 158
0
3
16118 42 11 10
4
0
0
0
0
0
7560 737 44
4 85
0 70
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4213 576 111 18 90
1580 22 15 44 111
6363 3192 356 268 2008
1850
0
0
0
0
0 78
1
0 10
2580 112 93
3 142
0
0
0
0
0
0
3
0
0
1
780
0
0
0 28
1025
6
0
0
5
700 354
0
0 119
14951 172372 25401 4294 1164 8802
121010 162875 4588 1031 470 4698
135961 335247 29989 5325 1634 13500
0
0
0
0
58
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
10
4
0
2
0
4
0
0
0
0
2
0
123
0
0
2
0
1
0
0
0
270
162
432
0
0
0
0
10
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
25
0
0
83
0
0
0
0
0
218
159
377
Total
Others
Gender Based
Voilence
FCHV
Sr. Citizens > 60

Years
Disabled
Helpless/
Destitute
Ultra Poor/
Poor
Total
Others
Inpatients
Gender Based
Voilence
FCHV
Sr. Citizens > 60

Years
Disabled
Helpless/
Destitute
Hospital Name
Ultra Poor/
Poor
Outpatients
0
0
0
0
0
0
136
0
0
0
265
0
0
1115
0
3800
0
0
0
0
35
0
0
0
0
0
0
0
0
0
0
498
0
0
0
0
0
0
0
0
94
0
1048
0
210
0
0
0
41
15
0
9068
356
0
0
5
19962
6
262
0
0
0
533
0
114
1384
0
3837
57
0
0
10
596
788
20
0
0
0
0
43
0
0
73
1451
161
69
0
874
73
0
0
0
891
192
7020
0
299
435
0
5
69
26
473
49217
18592 29700
27660 78917
405
406
0
0 1037
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3 1792
0
0 194
0 24 256
0
0 93
0
0
0
0
0
0
0
0 355
0
0 678
0 298 1448
0
0
0
0
0
0
0
0
0
0
4 16
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
1 115 737
5
0 3904
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
86 630 2954
0
0
0
0
0 48
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
34 131
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1
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
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
40
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
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
49
0
0
0
0
0
0
0
2
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
12
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
0
0
0
0
0
0
0
0
0
0
Total
Others
Gender Based
Voilence
FCHV
Sr. Citizens > 60

Years
Disabled
Reffer in
Ultra Poor/
Poor
Helpless/
Destitute
Total
Others
FCHV
103 808
2 120
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
436
0 102 1249
2
53 30
6 101
4
137 17
4 68
6
0
0
0 93
0
0
0
0
0
0
0
0
0
0
0
14
5
6 316 14
318 125 100 128
7
17 13 31 1080
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
1
0
6
0
0
0
0
0
0
2
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
250
3
6 354
8
2968 27 11 872 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
0
0
0
0
0
0
28
0
2 22
0
732 301 167 873 165
0
0
0
0
0
25
6
6
5
6
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
0
0
0
0
Gender Based
Voilence
Sr. Citizens > 60

Years
Disabled
Hospital Name
Ultra Poor/
Poor
Helpless/
Destitute
Emergency
0 214
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
3
0
3
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
0
0
0
0
0
0
0
0
0
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
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
185
0
8
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
4
4
0
0
2
0
0
0
0
0
0
10
0
0
0
0
0
0
0
311
191
502
54
70
0
0
0
0
0
0
876
0
0
0
102
0
0
107
0
288
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
191
0
112
0
0
0
0
13
43
0
2939
6175
9114
Gender Based
Voilence
FCHV
Disabled
Sr. Citizens > 60

Years
Ultra Poor/
Poor
Helpless/
Destitute
Total
Others
FCHV
Gender Based
Voilence
Sr. Citizens > 60

Years
0
0 14
0
0
8 65
0
0
1 175
0
0
0
0
0
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
31 13 617
2
0
0
0
0
108 10 71
0
76 22 111
4
0
0
0
0
214 44 295 29
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3 56
0
100
5 156
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
11
5 428
2
310
1 11
0
93 53 52 39
0
0
0
0
26 10 79
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
184 80 129 20
20 19 303
0
39 32 201 15
0
0
0
0
0
0
0
0
85
4 207
3
0
0
0
0
24 13 168 22
0
0
9
0
1
0 201
1
14479 2660 767 8712 394
1350 415 286 1767 162
15829 3075 1053 10479 556
78
4
0
0
3
0
0
147
0
0
0
0
0
0
1429
4
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
135
0
0
0
0
0
0
0
0
0
0
0
0
0
1207 41
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
1008
0
0
0
0
0
0
0
0
0
0
0
0
0
322
0
0
0
0
0
0
771 32 14
2 13
2
1
0
0
0
0
0
0
0
1326 51 48 11 85
9
0
158
0
0
0
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
0
0
0
0
0
0
453
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2447 107
7
0
4
0
0
326
0
1
0
0
0
0
1110
0
0
0
0
0
0
0
0
0
0
0
0
0
1027
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
0
0
0
0
0
0
0
0
1736 32
0
0
7
0
0
383
0
3
2
0
0
0
768
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
861
0
0
0
0
0
0
0
0
0
0
0
0
0
296
0
0
0
0
0
0
92
0
0
0
0
0
0
515
0
0
0
0
0
0
30262 368 205
30 192 12
1
10346 353 251 191 292 150 151
40608 721 456 221 484 162 152
Total
10
4
1253
0
0
4
135
0
264
0
0
0
243
0
133
266
0
448
158
0
0
0
20
181
0
0
0
0
0
0
0
0
0
1993
0
873
0
904
0
0
0
0
1132
41
359
0
0
562
0
56
40
312
Reffer in
Others

TOTAL
Disabled
Hospital Name
Ultra Poor/
Poor
Helpless/
Destitute
Emergency
12
0
0
0
0
0
0
0
91
0
0
0
0
0
0
63
0
192
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
28
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
8
0
422
3443
3865
19
0
6
0
0
0
0
0
143
0
0
0
0
0
0
127
0
396
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
146
1
0
0
5
0
0
0
0
52
5
0
0
0
0
0
0
8
0
1230
4831
6061
407
408
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
0
0
0
0
0
0
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
36
379
0
0
0
0
0
0
9
59
155
4
15
0
33
12
6
0
0
0
0
0
6
0
0
0
0
582
0
0
14
0
0
0
0
0
0
0
0
0
0
0
1
8
0
7
0
0
0
0
0
0
0
0
246
475
0
26
0
6
0
0
697
138
421
0
2296
20
109
3147
488
0
0
0
183
0
5
0
0
0
740
10085
0
0
171
0
0
0
0
0
0
0
209
0
0
0
103
20114
0
744
0
0
0
9
0
0
0
0
204
11912
0
0
0
60
0
0
3
92
61
0
4
0
42
587
174
0
0
0
112
0
6
0
0
0
6
31
0
0
160
0
0
0
0
0
0
0
72
0
0
0
31
1936
0
129
0
0
0
0
0
0
0
0
7
Gender Based
Voilence
554
0
790
0
1
0
0
3767
789
1189
1194
0
9
1608
292
9643
0
0
0
73
0
4
0
0
0
1007
4621
0
0
9
0
0
0
0
0
0
0
53
0
0
0
142
4157
0
301
0
0
0
699
0
0
0
0
1831
13
0
0 12969
0
0
0
0
18
0
6
853
0
0
0
0
8
0 23
101
0
0
0
0
0 175
0
175
30
2
7 4709
38
0
0 1081
10
0 309 2002
2 16
9 1221
0
0 202 2572
1
0
0
33
109
0
0 1898
89
0
0 4357
306
0 1911 12666
0
0
0
0
0
0
0
0
0
0
0
0
15
0 172
579
0
0
0
0
1
0
0
18
0
0
0
0
0
0
0
0
0
0
0
0
20
3 249 2040
157
5
0 14996
0
0
0
0
0
0
0
0
0
0
0
340
0
0
0
0
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 17
0
462
0
0
0
0
0
0
0
0
0
0
0
0
5
0 245
529
414 390 4223 32102
0
0
0
0
763
0 140 2134
0
0
0
0
0
0
0
0
0
0
0
0
43
0
0
751
0
0
0
0
0
0
0
0
3
0
0
3
0
0
0
0
0
0 295 2357
Total
15
0
13
0
3
0
0
203
24
12
0
70
3
30
242
144
0
0
0
24
0
2
0
0
0
15
97
0
0
0
0
0
0
0
0
0
0
102
0
0
0
3
868
0
57
0
0
0
0
0
0
0
0
20
Others
Ultra Poor/
Poor
Helpless/
Destitute
Total
Others
Gender Based
Voilence
Sr. Citizens
FCHV
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
FCHV

0 73
0
0
0
0
0
0
0
0
0
0
0
0
0
9
4 19
0 32
0
4
0
0
0
0
0 33
0
0
0
6
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
0 289
0
0
0
0
0
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 68
Sr. Citizens
70 236
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18 16
27
3
0
0
15
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
293
0
0
0
0
0
8
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
8
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
140
1
Total
Disabled

Disabled
Hospital Name
Ultra Poor/
Poor
Helpless/
Destitute
Reffer out


TOTAL
145
6408
0
55
25
4
0
0
0
0
1555
1
0
0
0
0
226
0
141
184
0
562
0
0
0
0
7
255
2
0
0
0
0
0
0
0
11
519
2273
679
0
929
0
0
0
0
895
90
711
0
1
867
0
0
57
0
53
24
12
0
0
0
19872
870
6
0
1868
0
0
0
0
0
0
0
1502
267
0
0
172
30
652
57
0
0
969
116
6207
0
0
0
0
0
0
0
448
34
1429
11
12
2
0
0
0
0
0
0
0
0
18
0
0
0
0
0
80
61
6838
39
9
13
16078
217
0
0
7463
144
70
0
0
0
0
0
0
0
3805
327
152
154
6527
549
1460
5
78
0
1491
39
0
0
3
0
148
73
73
0
1279
7
125732 25447 4998
26990 2841 2096
152722 28288 7094
1457
1176
0
0
2
4184
0
461
0
0
0
6732
0
1674
370
0
704
0
0
0
10
1332
813
51
0
0
0
0
25
0
0
151
2429
96
214
0
892
3
0
2
0
1125
1734
4009
317
10
1359
0
1
735
40
620
0
0
0
0
0
42
0
0
0
0
68
0
0
0
201
0
8
0
0
0
0
3
6
0
0
0
0
0
0
0
0
0
7
5
0
0
10
0
0
0
0
5
32
64
5
0
87
0
0
0
0
0
1151
925
2076
Total
Others
FCHV
8
25
0
0
0
95
0
0
0
0
0
598
1670
16
14
0
84
0
0
0
0
15
12
2
0
0
0
0
0
0
0
27
58
5
170
0
40
0
0
0
0
172
3
252
63
0
33
0
1
71
0
10
65461 5498
26060 902
91521 6400
Gender Based
Voilence
Sr. Citizens
8
16
0
0
116
0
1
287
0
0
0
68
0
1
422
0
159
13
0
0
0
24
16
12
0
0
0
0
0
0
0
0
237
18
61
0
27
0
0
22
0
37
5
2
0
0
0
0
0
12
10
281
3391
2346
5737
Disabled
0
0
0
0
98
0
0
170
0
0
0
0
0
0
167
0
159
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
24
0
0
0
0
0
0
20
0
9
0
0
0
0
0
0
0
7
10
0
805
1064
1869
Ultra Poor/
Poor
Helpless/
Destitute
FCHV
Gender Based
Voilence
Sr. Citizens
8
0
0
0
0
0
14
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
64
0
0 53
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
3
1 53
0
0
0
0
0
0
0
0
1
0
0
0
0
0
124 38 18 70
0
5
0
0
0
0
0
0
0
0
0
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
24
0
0
0
0
0
7
0
0
9
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
185 12
0 16
0
0
2 14
0
2
0
0
27 15
8
9
2
0
0
0
0
0
0
0
20
1
0
6
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
20
1
0
7
0
0
4
0
0
1
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
3
1
0
1
0
0
0
0
0
0
0
0
246
0
0 35
0
0
1386 350 34 807
4
5
366 197 182 234 150 153
1752 547 216 1041 154 158
Total
Total
Others

Disabled
Hospital Name
Ultra Poor/
Poor
Helpless/
Destitute
Reffer out
992
0
0
0
98
0
0
4672
0
0
0
3526
0
0
1477
0
4606
0
0
0
0
110
0
24
0
0
0
0
0
0
0
0
882
0
0
0
15
0
0
20
0
600
0
2041
0
210
0
0
0
73
1048
0
2630
7621
0
55
125
26618
7
7001
0
0
68
12851
1670
2033
2955
0
7049
6207
0
0
10
1949
2526
93
0
0
0
0
43
0
0
330
10772
2401
17358
0
9493
73
0
22
0
6929
2165
14153
1850
299
3876
0
5
1157
1161
1969
28185 256472
150284 210098
178469 466570
409

<28 days
Hospital Name
Recovered
F






410
15 12
6
8
9
7
37 60
1
2
0
0
1
3
1
2
1
5
2
7
60 33
26 46
1
2
8
6
0
0
56 49
0
0
0
0
5
2
4
7
0
0
16 13
0
0
0
0
11
6
4
2
2
0
4
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
11 10
0
0
10 10
61 101
6
4
0
0
0
0
38 46
0
0
0
0
0
0
0
0
10 12
10
7
Not
Improved
Referral
M
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
3
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
F
0
0
0
0
0
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
0
1
0
0
0
0
0
0
0
0
0
0
4
9
16
0
0
0
0
0
2
0
1
0
0
0
7
0
0
1
0
0
4
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
7
1
0
0
1
0
0
0
0
0
4
M
0
4
6
29
0
0
1
2
2
1
0
0
1
2
0
3
0
0
2
0
0
1
0
0
1
3
1
0
1
0
0
0
0
0
0
0
0
0
0
0
2
0
4
6
2
0
0
0
0
0
0
0
0
0
Lama
Absconded Dead <48 hrs Dead >48 hrs
M
0
0
0
6
0
0
0
0
0
0
0
1
0
8
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
1
0
1
0
0
0
0
0
0
0
0
F
0
0
0
8
1
0
1
0
0
1
0
0
0
9
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
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
10
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
M
0
0
0
0
0
0
0
0
1
0
0
1
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
1
0
0
0
0
0
0
0
0
0
0
F
1
1
0
0
1
0
0
0
1
0
1
8
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
0
0
0
1
0
0
0
0
0
0
0
0
0
1
M
0
0
0
2
0
0
0
0
2
0
0
5
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
1
0
1
0
0
0
0
0
0
0
0
0
1
0
F
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
2
0
0
0
0
0
0
0
0
0
0
M
0
0
1
0
0
0
0
0
0
0
0
2
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
3
0
0
0
0
0
0
0
0
0
0
Total
M
16
11
18
59
2
0
1
1
2
4
61
37
1
52
0
70
0
0
6
4
0
22
0
0
13
4
3
4
0
0
0
0
0
0
0
0
0
0
0
0
11
0
12
72
7
1
0
39
0
0
0
0
10
15
12
12
14
99
3
0
5
4
10
9
33
54
3
56
0
60
0
0
4
7
0
16
0
0
7
5
1
5
1
0
0
0
0
0
0
0
0
0
0
0
13
0
15
112
7
0
0
46
0
0
0
0
13
8
All
Total
28
23
32
158
5
0
6
5
12
13
94
91
4
108
0
130
0
0
10
11
0
38
0
0
20
9
4
9
1
0
0
0
0
0
0
0
0
0
0
0
24
0
27
184
14
1
0
85
0
0
0
0
23
23
<28 days
Hospital Name





TOTAL
Recovered
46
0
2
0
1
206
0
0
295
3
17
10
3
0
0
0
0
0
0
1
5
14
1
3
9
110
2
255
22
1368
0
0
2
55
0
9
2
0
0
1
2
11
3
251
0
31
5
2
1
1
0
4
3169
4313
7482
46
0
2
0
1
322
1
0
286
2
14
5
3
0
3
0
0
0
0
9
5
24
2
6
22
122
5
410
20
1663
0
1
4
80
0
6
0
3
0
1
10
9
7
305
0
34
12
2
1
2
0
7
3924
5320
9244
Not
Improved
Referral
Lama
0
0
8
8
3
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
7
8
2
3
5
3
0
0
0
0
0
0
0
0
1
0
0
0
1
0
9
6
0
4
0
0
2
0
0
0
0
0
3
3
0
0
0
0
2
1
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
0
1
0
0
2
7
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
3
0
0
0
0
4
0
0
1
0
1 46 50
3
2
0
0
0
1
0
0
0
0
4 13 13 23
0
0
2
1
0
4
0
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
7
0
0
0
0
2
1
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
1
3
0
0
0
1
1
1
0
2
0
0
0
2
1
1
0
0
7
2
4
3
0
0
0
0
0
0
0
0
3
0
0
0
0
0
2
4
1
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
14 17 168 199 52 83
73 125 116 184 264 304
87 142 284 383 316 387
F
0
0
0
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
2
0
0
0
0
0
0
0
0
19
17
36
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
5
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
2
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
0
0
0
1
1
1
4
5
0
0
0
7 17 30
1
0
1
1
2
5
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
1
1
1
4
0
0
1
0
1
0
3
1
1
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
29 62 86
21 155 240
50 217 326
0
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
4
8
0
0
2
3
0
0
0
0
0
0
0
1
0
0
0
2
1
1
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
24 42
69 99
93 141
Total
F
57
0
2
0
1
226
0
1
305
5
20
13
3
0
3
0
0
0
0
2
7
15
1
4
14
163
2
299
24
1372
0
0
3
58
0
9
3
0
0
1
4
12
5
265
0
34
8
2
1
1
0
5
3508
5007
8515
All
Total
60
117
0
0
2
4
0
0
2
3
344
570
1
1
0
1
297
602
2
7
17
37
6
19
3
6
0
0
3
6
0
0
0
0
0
0
0
0
14
16
13
20
24
39
2
3
10
14
24
38
181
344
6
8
491
790
27
51
1676 3048
0
0
1
1
12
15
83
141
0
0
8
17
3
6
3
3
0
0
2
3
19
23
15
27
10
15
314
579
0
0
38
72
17
25
2
4
3
4
3
4
1
1
7
12
4380 7888
6293 11300
10673 19188
411

29 days - <1 Yrs
Hospital Name
Recovered Not Improved
F






412
51 52
106 141
19 36
118 233
3
5
0
0
47 83
19 43
45 56
39 78
14 20
78 137
10 21
22 36
0
0
67 83
0
0
0
0
17 22
10 14
0
0
15 17
3
7
0
0
17 30
14 10
17 20
33 38
0
0
0
0
0
0
0
0
5 15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31 37
3
6
41 63
65 180
5
5
0
0
2
4
108 135
0
0
0
0
0
0
0
0
30 43
37 73
M
0
0
F
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
6
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
Referral
0
0
0
0
0
0
0
0
1
0
0
0
6
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
3
9
10
6
4
3
12 23
0
0
0
0
2
2
1
0
2
3
10 13
0
1
3
1
0
0
4
7
0
0
7 13
0
0
0
0
0
2
0
4
0
0
0
1
0
0
0
0
4
9
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
1
5
0
0
11 13
8
7
0
0
0
0
0
0
1
3
0
0
0
0
0
0
0
0
0
1
3
4
Lama
0
0
0
1
8
2
0
1
0
0
1
0
0
0
0
0
7
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
1
0
0
1
0
0
0
0
0
0
5
3
12
2
0
0
1
0
1
1
1
0
0
0
11
0
0
3
1
0
0
0
0
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
4
2
0
0
0
0
0
0
0
0
0
0
M
0
1
F
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
0
1
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
M
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
F
0
1
0
1
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
1
0
0
0
0
0
1
M
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
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
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
5
0
0
0
0
0
0
0
0
1
0
Total
All
Total
54
117
24
139
5
0
50
20
47
50
14
86
10
26
0
87
0
0
17
10
0
15
3
0
26
14
19
34
0
0
0
0
5
0
0
0
0
0
0
0
33
3
55
79
5
0
4
110
0
0
0
0
30
46
61 115
149 266
44 68
268 407
7 12
0
0
85 135
44 64
59 106
93 143
23 37
141 227
21 31
43 69
0
0
113 200
0
0
0
0
28 45
19 29
0
0
21 36
7 10
0
0
42 68
11 25
21 40
39 73
0
0
0
0
0
0
0
0
15 20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
44 77
6
9
81 136
195 274
5 10
0
0
5
9
138 248
0
0
0
0
0
0
0
0
45 75
77 123
29 days - <1 Yrs

Hospital Name
Recovered Not Improved
F




TOTAL
50 95
1
2
4
2
0
0
6
7
268 413
0
0
4
0
68 98
34 13
66 91
38 62
1
6
1
1
8 13
0
0
0
2
1
3
0
0
18 42
63 108
44 101
31 39
9 17
20 27
96 134
13 23
39 91
17 27
19 56
1
0
0
1
27 40
29 42
3
3
34 48
19 36
5 16
13 30
15 12
13 31
43 59
18 22
356 625
0
0
26 30
27 55
24 27
16 21
4 10
3
8
13 23
2699 4355
3942 6154
6641 10509
F
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
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
13
40
53
M
1
0
0
0
0
6
0
0
0
0
0
3
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
29
39
68
Referral
5
5
1
0
0
1
0
0
0
0
0
1
0
0
0
1
4
7
1
1
5 10
4
6
1
0
0
0
0
1
0
0
0
0
0
0
0
0
6
9
24 26
7
5
3
2
1
4
1
0
6 16
0
3
3
1
0
2
2
2
0
0
0
0
5
6
3
1
0
0
0
1
0
0
0
0
0
0
0
1
3
5
3
1
0
2
1
2
0
0
0
1
2
4
0
3
0
2
1
1
0
1
1
2
180 267
126 172
306 439
Lama
5
0
0
0
0
0
0
0
2
1
1
2
0
1
0
0
1
0
0
7
1
3
1
0
2
0
1
1
3
1
0
0
0
0
0
3
0
2
0
0
0
9
3
6
0
0
3
1
0
2
1
0
97
177
274
6
0
0
0
0
2
0
0
5
0
0
6
0
0
0
0
0
0
0
8
4
2
1
0
1
0
0
11
7
5
0
0
4
0
0
2
0
0
0
0
3
2
2
5
0
0
4
0
2
2
2
0
134
244
378
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
4
0
0
0
0
1
2
0
1
0
0
0
0
0
0
0
6
0
0
0
0
0
1
1
0
28
9
37
M
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
11
2
0
0
0
3
1
0
2
0
0
0
0
2
2
0
18
0
1
0
0
0
0
0
0
55
13
68
F
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
1
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
36
48
M
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
10
45
55
F
0
0
0
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
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
10
14
24
Total
All
Total
0 60 107 167
0
2
2
4
0
5
3
8
0
0
0
0
0
6
7 13
0 270 422 692
0
0
0
0
0
4
1
5
0 75 111 186
0 36 14 50
0 72 101 173
0 45 78 123
0
2
6
8
0
2
1
3
0
8 14 22
0
0
0
0
0
1
2
3
0
1
3
4
0
0
0
0
0 35 61 96
0 88 148 236
0 54 110 164
3 36 45 81
0 10 21 31
0 25 28 53
0 102 150 252
0 14 26 40
0 48 115 163
0 21 38 59
0 23 63 86
0
1
0
1
0
0
1
1
0 34 53 87
0 34 44 78
0
3
3
6
1 42 55 97
0 19 36 55
0
7 16 23
0 13 30 43
0 15 13 28
0 17 42 59
0 55 64 119
0 21 27 48
0 370 650 1020
0
0
0
0
0 26 32 58
0 32 63 95
0 25 30 55
0 16 25 41
2
8 15 23
0
5 11 16
0 14 25 39
12 3039 4862 7901
23 4344 6690 11034
35 7383 11552 18935
413

Hospital Name






PABAN HOSPITAL PVT.LTD.,CHITAWAN

414
Recovered
F
72
134
34
235
11
0
88
49
81
61
31
113
16
57
0
79
0
0
20
17
0
15
3
0
33
15
32
0
44
0
0
0
14
0
0
0
0
2
0
3
57
5
45
174
12
0
4
173
0
0
0
0
5
57
39
M
69
194
52
309
17
0
134
65
72
78
25
176
23
85
0
118
0
0
31
28
0
12
9
0
40
22
46
0
54
0
0
0
25
0
0
0
0
0
0
2
58
2
93
232
5
1
13
219
0
0
0
0
4
81
57
Not
Improved
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
2
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
M
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
7
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
1 - 4 Yrs
Referral
1
6
3
4
0
0
6
1
0
3
2
2
0
12
0
5
0
0
1
0
0
1
0
0
7
4
3
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
13
0
0
2
1
0
0
0
0
0
1
7
M
2
3
4
16
0
0
7
1
5
8
5
5
1
8
0
10
0
0
0
0
0
3
0
0
9
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
6
1
0
0
0
0
0
0
0
0
2
6
Lama
1
0
2
11
1
0
4
1
0
3
0
2
0
0
0
8
0
0
0
2
0
0
0
0
7
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
1
0
4
2
0
0
1
3
0
0
0
0
0
4
3
2
0
4
19
1
0
1
0
0
1
1
0
1
0
0
10
0
0
1
4
0
0
0
0
13
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
2
6
0
0
0
3
0
0
0
0
0
4
3
0
2
0
0
0
0
1
0
0
2
0
0
0
0
0
0
0
0
1
1
0
0
0
0
1
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
1
0
0
0
1
0
0
0
0
2
0
1
0
0
1
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
1
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
2
0
0
0
0
0
0
0
M
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
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
3
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
16
0
0
0
0
0
0
0
0
0
0
0
M
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
8
0
0
0
0
0
0
0
0
0
0
0
Total
F
74
142
39
250
15
0
99
51
82
69
34
117
16
69
0
100
0
0
22
20
0
18
3
0
48
19
36
1
45
0
0
0
16
0
0
0
0
2
0
3
58
5
51
205
12
0
7
179
0
0
0
0
5
62
50
M
73
197
60
345
21
0
142
66
79
88
33
183
25
94
0
145
0
0
32
32
0
16
9
0
64
28
46
0
54
0
0
0
26
0
0
0
0
0
0
2
58
2
99
253
6
1
13
222
0
0
0
0
4
87
66
All
Total
147
339
99
595
36
0
241
117
161
157
67
300
41
163
0
245
0
0
54
52
0
34
12
0
112
47
82
1
99
0
0
0
42
0
0
0
0
2
0
5
116
7
150
458
18
1
20
401
0
0
0
0
9
149
116
Hospital Name





TOTAL
Recovered
F
101
5
15
0
6
395
2
2
85
41
108
66
16
3
7
0
5
2
0
28
97
74
25
46
13
106
14
82
23
50
2
0
37
56
1
46
25
8
47
20
39
68
20
1213
0
27
78
15
7
11
2
24
4921
6008
10929
M
121
6
11
0
16
624
1
10
144
50
156
105
12
7
12
0
15
10
0
30
121
93
62
32
27
160
12
168
40
78
2
0
48
74
5
64
37
27
52
27
88
61
29
198
0
52
123
29
14
25
14
50
5524
8242
13766
Not
Improved
M
0
0
0
1
2
0
0
0
0
0
0
6
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
5
5
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
21 27
65 80
86 107
1 - 4 Yrs
Referral
M
0
2
0
0
0
0
0
0
3
1
0
0
0
0
0
2
4
9
1
4
8 10
3
4
4
3
0
0
6
4
0
0
0
2
0
9
0
0
1
4
17 18
5
7
1
2
0
3
1
0
8 10
0
4
6 10
1
0
4
1
0
0
0
0
4
8
2
1
0
0
0
2
0
5
2
3
0
0
2
2
2
1
3
4
0
0
11
1
0
0
0
1
3
6
0
3
0
1
0
1
0
1
0
5
188 262
125 163
313 425
Lama
M
6
6
0
0
0
0
0
0
0
0
3
0
0
0
0
0
6
5
1
0
0
0
5
6
0
0
0
0
0
0
0
0
0
2
0
0
0
0
6
8
1
0
2
2
1
0
0
0
0
0
3
1
4
2
5
9
3
4
1
3
0
0
0
0
1
4
0
3
0
0
2
3
0
0
1
4
0
0
0
1
2
2
4
2
3
1
6
4
0
0
0
0
14 11
2
0
1
2
2
3
0
5
0
0
146 169
211 279
357 448
1
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
1
7
0
0
0
0
2
3
0
0
2
0
0
0
2
0
0
9
0
0
2
0
2
1
0
0
45
20
65
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
1
0
0
1
2
1
1
0
0
1
0
15
1
1
0
0
3
3
0
0
0
1
0
0
3
0
0
2
0
0
6
0
0
0
1
11
64
11
75
M
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
1 0
0 0
1 0
0 0
0 0
0 0
0 1
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 0
0 1
0 1
0 0
0 0
0 0
0 0
1 0
0 0
0 0
0 0
0 0
0 1
9 9
14 19
23 28
Total
All
Total
M
F
M
0 0 108 129 237
0 0
5
7
12
0 0
17 11
28
0 0
0
0
0
0 0
9 17
26
0 0 400 630 1030
0 0
2
1
3
0 0
2 12
14
0 1
96 160 256
0 0
43 54
97
0 0 116 166 282
0 0
74 117 191
0 0
20 15
35
0 0
3
7
10
0 0
13 16
29
0 0
0
0
0
0 0
5 20
25
0 0
2 19
21
0 0
0
0
0
0 0
38 43
81
0 0 120 146 266
0 0
82 103 185
0 0
27 65
92
0 0
46 35
81
0 0
14 27
41
0 0 117 173 290
0 0
19 18
37
2 0 103 205 308
0 0
27 45
72
0 0
55 83 138
0 0
2
2
4
0 0
0
0
0
0 0
44 64 108
0 0
61 81 142
0 0
1
5
6
0 0
48 69 117
0 0
27 43
70
0 1
11 36
47
0 0
47 52
99
0 0
22 30
52
0 0
45 95 140
0 0
76 69 145
0 0
23 30
53
1 0 1241 205 1446
0 0
0
0
0
0 0
27 53
80
0 0
98 146 244
0 0
17 32
49
0 0
10 17
27
0 0
14 29
43
0 0
2 21
23
0 0
24 67
91
23 13 5353 6068 11421
4 6 6447 8800 15247
27 19 11800 14868 26668
415
5 - 14 Yrs
Hospital Name






416
Recovered
F
112
124
44
170
14
0
35
31
77
67
47
131
25
81
0
72
0
0
47
22
0
17
27
0
44
24
55
3
49
1
0
0
85
0
0
0
0
220
0
32
63
4
73
186
24
4
5
215
0
0
0
0
11
66
58
M
99
155
44
232
13
0
34
36
70
71
42
234
34
82
0
80
0
0
47
29
0
16
24
0
54
22
42
0
59
0
0
0
167
0
0
0
0
0
0
44
63
2
57
217
13
5
9
244
0
0
0
0
5
100
86
Not
Improved
M
0
0
0
0
0
0
6
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
2
0
0
0
0
0
0
0
0
0
0
Referral
F
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
4
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
2
0
9
15
2
10
1
0
2
0
2
7
4
6
0
12
0
17
0
0
7
0
0
0
0
0
9
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
5
1
8
19
2
1
1
0
0
0
0
0
0
3
3
M
16
18
2
10
0
0
1
1
6
7
5
8
0
12
0
8
0
0
3
1
0
0
2
0
11
5
4
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
12
19
1
0
2
3
0
0
0
0
0
3
9
Lama
4
1
2
17
1
0
0
0
0
0
1
1
0
0
0
5
0
0
7
3
0
0
0
0
9
1
0
0
0
0
0
0
0
0
0
0
0
5
0
0
1
0
4
6
0
0
6
1
0
0
0
0
0
2
7
Dead <48
hrs
Absconded
4
1
3
20
1
0
0
1
0
2
4
3
0
0
0
7
0
0
1
4
0
0
0
0
9
1
0
0
1
0
0
0
5
0
0
0
0
0
0
0
0
0
7
7
0
1
1
2
0
0
0
0
0
4
8
M
0
1
0
0
0
0
0
0
1
2
1
0
0
0
0
0
0
0
5
2
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
1
0
0
0
0
0
0
0
F
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
2
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
1
0
0
0
0
0
0
2
Dead >48
hrs
M
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
F
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
12
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
1
0
0
0
0
0
0
0
0
2
0
11
0
0
0
0
0
0
0
0
0
0
0
M
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
0
0
0
0
0
0
0
0
1
0
0
0
13
0
0
0
0
0
0
0
0
0
1
0
Total
F
125
141
48
197
28
0
43
31
80
76
54
139
25
93
0
96
0
0
66
27
0
17
27
0
63
27
57
3
49
1
0
0
88
0
0
0
0
225
0
32
69
7
85
224
28
5
14
217
0
0
0
0
11
71
68
M
119
175
49
262
26
0
35
38
76
80
51
247
34
95
0
100
0
0
53
36
0
16
26
0
76
28
47
0
62
0
0
0
174
0
0
0
0
0
0
45
64
2
76
260
15
6
13
250
0
0
0
0
5
110
105
All
Total
244
316
97
459
54
0
78
69
156
156
105
386
59
188
0
196
0
0
119
63
0
33
53
0
139
55
104
3
111
1
0
0
262
0
0
0
0
225
0
77
133
9
161
484
43
11
27
467
0
0
0
0
16
181
173
5 - 14 Yrs
Hospital Name
Recovered
Lama
Dead <48
hrs
Dead >48
hrs
Total
All
Total
417



TOTAL
F
M
F
0
2 14
5
1
1
2
0
2
4
0
0
0
0
0
0
0
1
4
0
4
0
1
1
0
0
0
0
0
2
2
2
0
9 11
4
0
1
2
0
0
5
7
0
5
9
7
7
0
3
4
0
0
0
2
0
1
1
3
1
0
0
0
0
0
1
3
4
0
6
0
0
0
0
0
0
0
7
5
4
0 15 18
0
1
8 11
2
0
4
5
1
0
7
2
2
0
3
0
0
0
8
7
2
0
2
1
0
0 11 22 18
0
1
0
0
0
1
1
1
0
0
0
0
0
0
0
0
1
4
3
0
0
3
6
1
0
0
0
0
0
0
2
1
0
0
4
0
0
2 12
5
0
0
0
0
0
2
5
0
0 10 23
3
0
4
2
4
0
5
5
1
0 47
3 28
0
0
0
0
1
1
1
6
1
3
8
5
0
0
3
2
0
0
2
0
0
4
3
0
0
0
1
2
0
3
3
0
30 340 375 192
95 197 222 217
125 537 597 409
Absconded
M
F
M
F
M
F
M
F
M
10
0
0
0
0
0
0 163 201
364
0
0
0
0
0
0
0 12 15
27
1
0
1
0
0
0
0 39 38
77
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0 19 37
56
3
0
0
0
0
0
0 444 701 1145
0
0
0
0
0
0
0
2
3
5
2
0
0
0
0
0
0 18 14
32
6
1
1
0
0
0
0 77 126
203
0
0
0
0
0
0
0 54 62
116
0
0
0
0
0
0
0 92 133
225
4
1
0
0
0
0
0 97 107
204
0
0
0
0
0
0
0 31 16
47
0
0
0
0
0
0
0 13
8
21
2
1
0
0
0
0
0 22 29
51
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0 90 120
210
0
0
0
0
0
0
0 12 16
28
0
0
0
0
0
0
0
0
0
0
6
2
1
0
0
0
0 39 67
106
0
2
0
0
0
0
0 98 99
197
3
0
0
0
0
0
0 95 102
197
1
0
2
0
0
0
0 27 31
58
1
0
0
0
0
0
0 42 47
89
2
0
0
0
0
0
0 50 21
71
2
0
0
0
0
0
0 65 109
174
3
1
0
0
0
0
0 20 10
30
16
5 14
1
1
1
1 243 364
607
1
0
0
0
0
0
0 26 57
83
2
0
1
0
0
0
0 56 104
160
0
0
0
0
0
0
0 10
8
18
0
0
0
0
0
0
0
0
0
0
3
2
2
0
0
0
0 44 50
94
0
2
1
0
0
0
0 73 76
149
0
0
0
0
0
0
0
6
4
10
2
3
0
1
0
0
0 45 73
118
0
0
0
0
1
0
1 34 63
97
4
1
0
1
0
0
0 29 38
67
0
0
0
0
0
0
0 70 65
135
0
1
0
0
0
0
0 33 33
66
5
0
8
1
0
1
0 96 191
287
2
0
0
0
0
0
0 44 52
96
2
0
1
0
0
0
0 36 51
87
3 33
6
1
1
0
1 5934 429 6363
0
0
0
0
0
0
0
0
0
0
7
2
2
0
0
0
0 47 33
80
16
2
5
1
1
0
0 73 120
193
0
0
0
0
0
0
0 28 34
62
1
0
0
0
0
0
0
9 17
26
1
0
0
0
0
0
0
8 13
21
4
0
0
0
0
0
0
8 20
28
2
0
1
0
0
0
0 46 67
113
217 78 62
7
5 29 30 11151 6811 17962
273 15 23 20 24 14 8 8225 11814 20039
490 93 85 27 29 43 38 19376 18625 38001

M
F
177
0
12
0
34
0
0
0
32
0
693
6
3
0
10
0
108
0
60
0
126
0
91
2
12
0
6
2
23
0
0
0
111
0
16
0
0
0
55
0
81
1
87
0
23
0
44
0
19
1
100
0
6
0
310
0
56
0
100
0
8
0
0
0
41
2
69
0
4
0
69
0
57
0
22
0
65
0
28
0
155
0
48
0
43
0
415
0
0
0
22
0
89
0
31
0
14
0
9
0
15
0
61
0
10479 6092 26
7683 11169 79
18162 17261 105
Referral
F
156
11
35
0
18
437
2
14
63
53
87
78
28
11
19
0
85
6
0
26
80
85
22
33
46
55
17
207
25
54
10
0
36
67
6
40
34
20
70
30
81
36
30
5825
0
38
62
26
9
4
6
43
Not
Improved
15 - 19 Yrs
Hospital Name


418
Recovered
F
193
367
260
391
47
0
145
93
108
182
83
349
37
161
89
64
0
0
530
93
0
19
147
0
169
42
107
74
29
44
0
0
165
0
0
0
0
3909
0
102
230
13
180
415
14
236
146
333
0
0
0
0
13
107
220
130
68
16
73
6
0
25
11
60
45
31
96
18
41
0
60
0
0
23
15
0
18
7
0
28
17
30
24
0
40
0
0
283
0
4
0
0
0
0
118
50
1
32
86
10
1
5
363
0
0
0
0
8
51
27
Not
Improved
F
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
1
0
Referral
F
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
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
26
7
38
3
0
46
4
14
13
6
1
0
12
0
6
0
0
55
6
0
1
7
0
11
2
1
5
7
0
0
0
0
0
0
0
0
3
0
0
5
3
8
34
1
19
1
8
0
0
0
0
0
5
27
12
7
3
6
0
0
1
0
3
5
3
4
1
6
0
10
0
0
1
1
0
2
0
0
4
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
6
0
2
11
0
1
0
21
0
0
0
0
0
2
2
Lama
F
8
1
9
18
0
0
2
0
2
0
0
2
1
0
0
5
0
0
42
2
0
0
0
0
10
0
0
1
0
1
0
0
1
0
0
0
0
62
0
0
3
0
2
4
0
17
1
9
0
0
0
0
0
2
7
Dead within Dead after

48 hrs
48 hrs
Absconded
5
0
2
14
0
0
1
0
1
1
0
3
0
0
0
8
0
0
1
1
0
0
0
0
7
0
0
0
0
2
0
0
2
0
0
0
0
1
0
0
1
0
4
3
0
3
1
11
0
0
0
0
0
1
1
0
1
0
1
0
0
0
0
0
1
1
1
0
0
0
0
0
0
16
3
0
0
0
0
2
0
0
1
0
0
0
0
0
0
0
0
0
4
0
0
0
0
1
0
0
4
1
1
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
3
0
0
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
1
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
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
4
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
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
35
0
0
0
0
0
0
0
0
0
0
0
Total
F
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
4
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
208
395
276
448
51
0
193
97
124
196
90
354
38
173
89
75
0
0
643
104
0
21
154
0
195
44
109
81
36
45
0
0
168
0
0
0
0
3978
0
102
238
16
191
488
16
277
149
352
0
0
0
0
13
115
255
All
Total
148 356
76 471
21 297
93 541
8
59
0
0
27 220
11 108
64 188
51 247
34 124
105 459
19
57
47 220
0
89
82 157
0
0
0
0
25 668
19 123
0
0
20
41
7 161
0
0
40 235
17
61
30 139
25 106
1
37
43
88
0
0
0
0
296 464
0
0
4
4
0
0
0
0
1 3979
0
0
118 220
57 295
1
17
38 229
110 598
10
26
5 282
6 155
400 752
0
0
0
0
0
0
0
0
8
21
54 169
31 286
15 - 19 Yrs
Hospital Name
Recovered
F
LAMJUNG COMMUNITY HOSPITAL,LAMJUNG 306

23
106
0
137
WESTERN REGIONAL HOSPITAL, POKHARA,KASKI 1526
2
14
192
97
302
257
86
21
PRITHIV CHANDRA HOSPITAL, NAWALPARASI 223
0
335
25
0
105
164
396
77
117
271
911
8
1087
247
MID WESTERN REGIONAL HOSPITAL, SURKHET 901
6
29
171
122
14
KARNALI ACADEMY OF HEALTH SCIENCE,JUMLA 20
78
63
111
79
155
125
19
297
0
275
MAHAKALI ZONAL HOSPITAL,KANCHANPUR 222
115
58
58
33
141
19840
15550
35390
TOTAL
Not
Improved
F
Referral
F
Lama
F
98
0
0 25
8 34
5
1
3
0
0
9
2
1
0
0
15
0
0 17
1
4
0
4
0
0
0
0
0
0
0
0
18
0
0 10
3
1
0
2
381
0
2
0
0
2
2
2
3
0
0
0
0
0
1
0
3
0
1
3
1
0
0
0
50
0
0 13
2
6
7
3
45
0
0
5
1
2
1
0
42
0
0 18
6
2
1
0
20
3
2 19
5
2
2
0
21
0
0
6
2
0
0
0
2
0
0
0
0
0
1
0
9
1
0
9
4
5
0
1
0
0
0
0
0
0
0
0
119
0
0 16
2
6
9
0
44
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
19
0
0 14
3
2
3
2
41
3
0 48
9
4
1
2
20
0
0 11
2
3
0
0
8
0
0
6
2
5
0
0
24
0
0
7
0
3
0
0
11
1
0
8
1
6
0
3
34
0
0 20
7
8
0
7
1
0
0
2
0
1
1
0
183
1
0 19 13 15
5
6
20
0
0
3
1 10
2
0
29
0
0
3
2 10
0
0
7
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
19
0
0 10
5
3
2
2
22
0
0 18
1
1
0
4
3
0
0
0
0
0
0
0
16
0
0
1
0
0
3
1
22
0
0
2
1
0
1
0
16
0
0
2
3
0
1
0
82
0
0
0
0
0
0
0
15
0
0
3
1
0
0
0
53
0
0
0
1
4
2
2
19
0
0
4
1
1
0
0
17
0
0
1
0
0
1
0
574
0
0
3
3
2
2
3
0
0
0
0
0
0
0
0
33
0
0
4
0
0
0
0
42
0
0 10
8 11
3
1
17
0
0
2
3
0
1
0
16
0
0
1
0
0
0
0
3
0
1
4
1
2
0
2
5
0
0
0
0
3
4
0
27
0
0
4
1
1
0
0
4062 18 12 746 214 364 130 87
9274 109 87 238 169 313 230 15
13336 127 99 984 383 677 360 102

48 hrs
48 hrs
Absconded
M
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
4
0
3
0
1
0
0
0
1
0
0
0
0
0
1
0
0
0
7
0
0
1
0
1
1
2
0
36
18
54
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
2
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
7
18
25
Total
F
0
0
0 366 111
0
0
0 33
5
0
0
0 131 16
0
0
0
0
0
0
0
0 150 21
0
2
0 1532 385
0
0
0
2
4
0
0
0 17
5
0
0
0 214 60
0
0
0 104 47
0
0
0 322 49
0
0
0 281 29
0
0
0 92 23
0
0
0 21
3
0
0
0 239 13
0
0
0
0
0
1
0
0 357 131
0
0
0 25 48
0
0
0
0
0
0
0
0 123 25
0
0
0 221 51
0
0
0 411 22
0
0
0 88 10
0
0
0 127 24
0
0
0 289 12
0
0
0 948 45
0
0
0 11
2
1
2
0 1130 205
0
0
0 260 23
0
2
0 916 32
0
0
0
6
7
0
0
0 30
0
0
0
0 186 26
0
0
0 145 24
0
0
0 14
3
1
0
0 22 20
0
0
0 80 24
0
0
0 65 20
0
0
0 111 82
0
0
0 82 17
0
0
0 162 56
0
0
0 130 20
0
0
0 20 18
1
0
0 305 587
0
0
0
0
0
0
0
0 279 33
0
0
0 244 54
0
0
0 117 21
0
0
0 59 17
0
0
0 66
6
0
0
0 36 11
0
0
0 146 28
11 42 14 21104 4479
16 23 13 16266 9807
27 65 27 37370 14286
All
Total
477
38
147
0
171
1917
6
22
274
151
371
310
115
24
252
0
488
73
0
148
272
433
98
151
301
993
13
1335
283
948
13
30
212
169
17
42
104
85
193
99
218
150
38
892
0
312
298
138
76
72
47
174
25583
26073
51656
419
20 - 29 Yrs
Hospital Name
Recovered
F

470 164
1180 103
847 36
1189 174
134
9
0
0
748 43
237 13
246 73
PRITHIV CHANDRA HOSPITAL, NAWALPARASI 468 40
214 37
OKHALDHUNGA COMMUNITY HOSPITAL,OKHALDHUNGA 807
98
82 50
368 105
317
0
107 67
0
0
0
0
RAM UMA SMARAK HOSPITAL,LAHAN, SIRAHA 1981 23
495 13
0
0
19 18
DISTRICT HOSPITAL, JALESWOR,MAHOTTARI 673
8
0
0
411 33
145 29
195 44
228 51
74
1
98 108
0
0
0
0
434 508
0
0
11 41
0
0
0
0
14580
0
0
0
SUKRARAJ TROPICAL HOSPITAL,KATHMANDU 262 236
738 141
43 12
527 25
1975 142
CHANDRANIGAHAPUR HOSPTIAL, RAUTAHAT 22 24
1478
6
2310
1
NARAYANI SUB REGIONAL HOSPITAL,PARSA 482 507
0
0
0
0
0
0
0
0
23
7
218 56
420
Not
Improved
F
1
0
0
0
0
0
0
0
0
0
1
3
0
0
0
3
0
0
1
0
0
0
0
0
10
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
Referral
F
0 42
0 47
0 45
0 126
0 11
0
0
0 220
0 12
0 37
0 17
0
9
2
5
0
0
0 22
0
0
4
9
0
0
0
0
1 125
0 26
0
0
0
0
0 29
0
0
1 50
0 10
1
7
0 21
4 16
1
7
0
0
0
0
4
0
0
0
0
4
0
0
0
0
0
7
0
0
0
0
0 18
0
4
0 25
0 70
0
2
0 72
0 18
0
3
0
0
0
0
0
0
0
0
0
0
0
5
Lama
F
Absconded
9 13
16
8
7 11
17 71
0
1
0
0
2
9
3
2
1
2
14
1
6
7
6
8
0
0
9
0
0
0
5
7
0
0
0
0
1 104
1
7
0
0
1
0
1
1
0
0
8 31
2
1
0
0
3
0
0
1
6 12
0
0
0
0
0
4
0
0
5
0
0
0
0
0
1 117
0
0
0
0
13
2
1
0
1 22
6 12
1
0
1 131
1 15
7
6
0
0
0
0
0
0
0
0
0
0
4
7
6
0
0
20
1
0
1
0
0
2
3
1
0
0
0
7
0
0
0
3
0
0
0
0
3
1
1
0
0
18
0
0
10
0
0
0
0
0
0
0
2
0
2
3
0
5
2
9
0
0
0
0
0
3
2
3
2
1
0
0
9
0
1
1
3
2
0
0
0
0
0
0
50
3
0
0
0
0
8
0
0
1
0
6
0
0
0
0
0
0
0
8
0
0
0
0
0
3
0
14
21
0
0
0
0
0
0
0

48 hrs
48 hrs
F
0
0
1
2
0
0
1
0
0
0
0
1
0
0
0
2
0
0
0
1
0
0
0
0
0
0
0
1
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
3
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
1
0
0
5
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
1
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
2
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2 13
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0 160
0
0
0
0
0
0
0
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
4
0
4
0
0
0
0
5
1
0
0
18
0
0
0
0
0
0
0
0
0
0
Total
F
528
1238
905
1387
147
0
986
251
286
487
234
829
82
390
317
126
0
0
2261
533
0
19
703
0
511
156
202
250
91
124
0
0
463
0
15
0
0
179
119
44
214
10
0
47
16
74
56
46
110
50
114
0
85
0
0
25
18
0
19
9
0
45
32
46
55
5
142
0
0
528
0
50
0
0
1
0
241
157
13
28
172
25
12
4
526
0
0
0
0
7
63
14712
0
263
758
47
574
2220
24
1702
2364
491
0
0
0
0
23
230
All
Total
707
1357
949
1601
157
0
1033
267
360
543
280
939
132
504
317
211
0
0
2286
551
0
38
712
0
556
188
248
305
96
266
0
0
991
0
65
0
0
14713
0
504
915
60
602
2392
49
1714
2368
1017
0
0
0
0
30
293
20 - 29 Yrs
Hospital Name
Recovered
F



TOTAL
Not
Improved
F
681
972
70
253
0
355
6801
11
35
555
291
1171
729
126
31
1225
0
1544
124
0
1146
615
921
180
174
479
2704
13
3424
965
2523
13
61
366
194
13
59
198
177
203
233
480
344
47
1056
0
1101
1210
640
201
273
69
409
Referral
F
Lama
F
Absconded
F

48 hrs
48 hrs
F
21
0
0 74
2 21
7
1
0
0
0
0
0
114
0
0 24 10 45
9
0
2
0
0
0
0
11
0
0 14
1
2
0
0
0
0
0
0
0
11
5
0 24
2
4
2
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
0 35
3
3
1
0
0
0
0
0
0
1032
1
5
0
0
6
3
2
0
6
3
4
3
4
0
0
1
2
0
0
0
0
0
0
0
0
12
0
1
6 10
1
0
0
0
0
0
0
0
43
0
1 27
6 15
2
0
1
0
0
0
0
79
0
0 24
3
1
0
0
0
0
0
0
0
45
0
0 57
6
2
1
0
0
0
1
0
0
35
3
1 55
2 23
2
0
0
0
0
0
0
46
2
0 11
5
0
0
0
0
0
0
0
0
13
0
0
3
0
1
0
0
0
0
0
0
0
12
7
1 58
0 14
0
2
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
173
0
0 87
4 34 17
4
1
1
1
0
1
46
0
0
8 10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
36
0
0 115
3 66
3
33
0
2
0
0
0
49
3
0 104 10 10
0
0
0
0
0
0
0
30
3
0 26
5
4
0
0
0
0
0
0
0
27
0
0 19
1
8
2
2
1
0
0
0
1
29
0
0
7
3
0
2
0
0
0
0
0
0
9
0
0 27
0
2
0
1
0
0
0
0
0
48
0
0 41
7 19
3
7
4
1
0
1
0
6
1
0
1
1
3
1
0
0
0
0
0
0
321
0
2 93 29 33 23
12
2
2
0
0
2
50
0
0 18
4 47
2
0
0
0
0
0
0
57
0
0 13
1 13
0
3
1
0
0
0
1
4
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
23
0
0 27
7 12
3
11
0
0
0
0
0
50
0
0 16 10
0
1
2
3
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
46
0
0
0
1
0
1
0
2
0
0
0
0
29
0
0
0
2
0
0
0
0
1
0
0
0
32
0
0
7
6
6
3
1
0
1
0
1
0
57
0
0
0
0
0
0
0
0
0
0
0
0
27
0
0
9
4
0
1
0
0
1
0
0
0
45
1
1 13 12
2
0
7
3
0
0
0
0
30
4
0 10
4
2
5
0
0
0
0
0
0
35
0
0
4
6
3
0
1
1
0
0
0
0
331
1
0
8
3 10
5
10
7
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
35
1
0 21
2
0
0
0
0
0
0
0
0
51
0
0 33 10 28 10
7
4
0
0
0
0
23
0
0 22
7
5
0
0
0
0
0
0
0
10
0
0
5
2
1
0
2
0
0
0
0
0
12
1
2 18
4
5
2
4
1
0
0
0
0
5
0
0
5
0
4
1
0
1
0
0
0
0
37
0
0 40
5
0
1
0
1
0
0
0
0
69831 6145 64
32 2292 365 1055 210 249 60 26 10 187 42
49086 15887 214 146 471 264 824 424 41
16 61 47 42 78
118917 22032 278 178 2763 629 1879 634 290
76 87 57 229 120
Total
F
All
Total
777
1041
86
287
0
393
6820
12
42
597
316
1230
810
139
35
1307
0
1670
132
0
1362
732
954
209
181
509
2773
18
3564
1030
2552
13
64
416
212
13
59
199
193
203
243
503
360
55
1087
0
1123
1278
667
209
301
78
449
30
135
12
16
0
21
1046
6
23
53
82
53
40
51
13
13
0
197
56
0
42
59
35
32
34
9
62
8
379
56
60
4
0
33
64
5
50
31
41
57
32
61
39
42
348
0
37
75
30
12
21
7
44
73704 6864
807
1176
98
303
0
414
7866
18
65
650
398
1283
850
190
48
1320
0
1867
188
0
1404
791
989
241
215
518
2835
26
3943
1086
2612
17
64
449
276
18
109
230
234
260
275
564
399
97
1435
0
1160
1353
697
221
322
85
493
80568
50739 16862 67601
124443 23726 148169
421
30 - 39 Yrs
Hospital Name
Recovered
F

211
333
210
338
423
0
199
77
95
130
76
43
109
33
86
0
0
RAM UMA SMARAK HOSPITAL,LAHAN, SIRAHA 288
110
0
18
90
0
86
49
85
99
11
82
0
0
406
0
6
0
0
3174
0
301
334
20
121
405
14
194
141
435
0
0
0
0
21
68
422
116
83
19
138
7
0
28
13
61
43
32
83
23
25
0
62
0
0
19
12
0
15
14
0
11
13
38
35
3
84
0
0
490
0
36
0
0
0
0
257
113
16
25
96
17
6
5
499
0
0
0
0
3
39
Not
Improved
F
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
1
0
0
3
0
0
0
0
0
0
0
1
0
0
0
2
0
0
1
0
0
1
0
0
1
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
Referral
Lama
Absconded
13
21
20
43
1
0
38
2
9
9
2
4
0
15
0
6
0
0
18
6
0
1
3
0
21
12
4
4
1
1
0
0
1
0
2
0
0
3
0
0
7
1
11
18
0
18
5
3
0
0
0
0
0
3
15
8
3
21
0
0
2
3
5
11
5
8
1
7
0
7
0
0
5
2
0
2
0
0
3
1
2
1
1
3
0
0
0
0
3
0
0
0
0
0
6
0
3
12
0
2
1
5
0
0
0
0
0
2
5
3
6
44
3
0
3
1
1
3
5
2
0
0
0
4
0
0
22
3
0
0
0
0
7
2
0
0
0
11
0
0
7
0
0
0
0
42
0
0
2
0
7
3
0
26
10
7
0
0
0
0
0
2
10
0
2
22
2
0
0
1
0
0
5
5
0
0
0
3
0
0
1
0
0
0
0
0
4
2
1
0
0
12
0
0
10
0
0
0
0
0
0
0
1
0
2
2
0
0
1
10
0
0
0
0
0
3
1
0
0
1
0
0
3
0
1
0
0
0
0
0
0
0
0
0
4
1
0
0
1
0
2
0
0
1
0
3
0
0
0
0
0
0
0
4
0
0
1
0
0
1
0
7
5
2
0
0
0
0
0
0

48 hrs
48 hrs
F
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
1
1
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
1
0
0
0
0
0
0
0
0
0
1
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
1
0
0
4
0
0
0
0
1
0
0
0
0
0
0
0
0
1
4
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
1
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
4
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
7
0
0
0
0
1
0
8
0
0
0
44
0
0
0
1
0
0
0
0
0
0
1
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
14
0
5
0
0
0
0
7
0
0
0
10
0
0
0
1
0
0
0
0
0
0
Total
F
230
357
236
431
428
0
243
80
106
142
83
230
43
124
33
100
0
0
332
120
0
19
94
0
119
63
89
104
12
98
0
0
431
0
8
0
0
3225
0
309
344
21
139
471
14
247
162
452
0
0
0
0
21
73
All
Total
144 374
91 448
24 260
188 619
10 438
0
0
31 274
17
97
66 172
55 197
42 125
98 328
24
67
32 156
0
33
76 176
0
0
0
0
26 358
14 134
0
0
18
37
14 108
0
0
19 138
16
79
43 132
37 141
4
16
108 206
0
0
0
0
524 955
0
0
44
52
0
0
0
0
0 3225
0
0
264 573
120 464
16
37
30 169
122 593
17
31
8 255
8 170
517 969
0
0
0
0
0
0
0
0
3
24
44 117
30 - 39 Yrs
Hospital Name
TOTAL
Recovered
F
143
295
19
34
0
62
1690
5
13
107
85
191
128
55
24
120
0
379
189
0
319
137
201
57
53
63
481
11
887
143
430
6
9
101
80
5
33
55
43
119
83
186
150
43
453
0
116
205
183
34
35
14
48
17255
23177
40432
31
100
21
8
0
18
456
10
8
34
53
54
33
30
8
7
0
105
22
0
21
35
32
22
14
4
61
6
304
76
38
6
0
22
34
0
32
14
13
65
27
54
22
28
352
0
26
51
19
7
8
4
27
Not
Improved
F
0
0
0
2
0
0
3
0
0
1
0
0
0
0
0
3
0
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
Referral
F
Lama
F
Absconded
F

48 hrs
48 hrs
F
Total
F
0 13 5
4
1
0
0
0
0
0
0 160 37
0 11 7 25
3
0
3
0
1
0
1 331 115
0
0 1
0
0
0
0
0
0
0
0 19 22
0
9 1
1
0
0
0
0
0
0
0 46
9
0
0 0
0
0
0
0
0
0
0
0
0
0
0
4 2
1
1
0
1
0
0
0
0 67 22
0
0 1
0
1
1
0
3
1
2
2 1699 461
0
0 2
0
0
0
0
0
0
0
0
5 12
1
5 4
0
3
0
0
0
0
0
0 18 16
0
7 5
6
4
2
0
0
0
0
0 123 43
0
3 3
1
1
0
0
0
0
0
0 89 57
0 18 7
1
0
0
1
0
0
0
0 210 62
0 10 2
0
1
0
0
0
0
0
0 138 36
0
8 3
0
0
0
0
0
0
0
0 63 33
0
2 0
0
2
0
0
0
0
0
0 26 10
0
7 0
0
0
0
0
0
0
0
0 130
7
0
0 0
0
0
0
0
0
0
0
0
0
0
0 13 6 12
7
0
0
2
0
0
1 406 119
0
8 0
0
0
0
0
0
0
0
0 197 22
0
0 0
0
0
0
0
0
0
0
0
0
0
0 31 2 17
4
9
1
0
0
0
1 376 29
2 17 10
3
1
0
1
0
0
0
0 158 49
0 12 6
7
1
0
0
0
1
0
0 220 40
0 10 1
2
0
3
2
0
0
0
0 72 25
0
6 2
0
2
0
0
0
0
0
0 59 18
0
5 2
1
0
0
0
0
0
0
0 69
6
0 17 7 10
2
1
3
0
1
0
0 509 74
0
3 2
0
1
0
0
0
0
0
0 14
9
3 46 39 20 16 12 11
2
5
1
1 971 379
0
2 1 15
1
0
0
1
0
0
0 161 78
0
2 1
4
1
1
0
0
0
0
1 437 41
0
0 0
0
0
0
0
0
0
0
0
6
6
0
1 0
0
0
0
0
0
0
0
0 10
0
0
9 3
2
0
0
0
1
0
0
0 114 25
0
5 1
1
0
0
1
0
0
0
0 86 36
0
0 0
0
0
0
0
0
0
0
0
5
0
0
1 2
1
1
0
0
0
0
0
1 35 36
0
2 2
1
0
0
0
0
0
0
1 58 17
0
6 6
3
0
0
0
1
0
0
0 53 19
0
0 0
0
0
0
0
0
0
0
0 119 65
0
4 5
1
1
0
0
0
1
0
0 88 34
0
3 6 16
1
1
4
1
0
1
0 208 65
0
7 5
6
0
0
0
0
0
0
0 163 27
0
4 6
4
2
0
0
0
2
0
0 51 38
2
7 9
3
3
5
3
2
4
2
4 472 377
0
0 0
0
0
0
0
0
0
0
0
0
0
0
1 2
0
0
0
0
0
0
0
0 117 28
0
7 11 11
9
2
6
0
0
1
0 226 77
0
5 3
2
0
0
0
0
0
0
0 190 22
0
3 1
0
0
1
0
0
0
0
0 38
8
0
4 3
4 10
0
0
1
0
0
0 44 21
0
2 0
3
3
1
0
0
0
0
0 20
7
0
5 8
3
1
1
1
0
0
0
0 58 37
4885 30 19 658 330 417 173 77 54 27 33 73 52 18537 5546
14611 165 164 310 261 499 363 28
16 55 65 43 60 24277 15540
19496 195 183 968 591 916 536 105
70 82 98 116 112 42814 21086
All
Total
197
446
41
55
0
89
2160
17
34
166
146
272
174
96
36
137
0
525
219
0
405
207
260
97
77
75
583
23
1350
239
478
12
10
139
122
5
71
75
72
184
122
273
190
89
849
0
145
303
212
46
65
27
95
24083
39817
63900
423
40 - 49 Yrs
Hospital Name

424
Recovered
F
110
143
58
120
11
0
36
28
67
34
48
148
33
62
2
76
0
0
53
27
0
19
12
0
36
38
55
81
6
81
0
0
415
0
7
0
0
526
0
216
184
8
60
156
16
14
30
362
0
0
0
0
13
68
M
76
100
25
163
7
0
27
11
43
25
27
104
17
42
2
73
0
0
41
10
0
20
14
0
15
20
33
53
3
66
0
0
610
0
20
0
0
0
0
232
92
7
25
87
14
9
5
381
0
0
0
0
19
54
Not
Improved
F
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
1
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
Referral
Lama
M F M F M
0 14 10 0 2
0 16 9 1 0
0 8 2 6 1
3 26 16 37 30
0 0 0 2 2
0 0 0 0 0
0 6 0 2 1
0 4 3 0 0
0 9 4 0 0
0 18 10 1 0
1 3 6 3 1
3 7 10 0 3
0 0 0 0 0
0 8 11 0 0
0 0 0 0 0
7 9 4 3 7
0 0 0 0 0
0 0 0 0 0
2 6 4 5 1
0 2 5 3 0
0 0 0 0 0
0 3 2 0 0
0 0 0 0 0
0 0 0 0 0
0 13 10 8 5
0 5 4 1 0
0 5 1 0 0
0 5 4 0 0
0 2 0 0 0
0 0 0 8 8
0 0 0 0 0
0 0 0 0 0
8 0 0 10 8
0 0 0 0 0
0 1 2 0 0
0 0 0 0 0
0 0 0 0 0
0 4 1 5 0
0 0 0 0 0
0 0 0 0 0
0 1 4 0 0
0 1 0 0 0
0 3 6 5 0
0 15 6 2 1
0 0 0 0 0
0 0 0 6 5
0 3 0 5 1
0 2 5 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 5 6 3 3
Absconded
M
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
2
1
0
0
0
1
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
2
1
0
0
0
0
0
0
Dead <48 Dead >48

hrs
hrs
F
1
1
1
0
0
0
0
0
0
0
1
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
2
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
3
0
0
0
0
0
0
0
4
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
1
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
M F M
1 0 0
1 0 0
0 0 0
3 3 1
0 0 1
0 0 0
0 0 0
1 0 0
0 0 0
0 0 0
1 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
0 0 0
0 0 0
0 0 0
1 0 1
0 0 1
0 0 0
1 0 1
0 0 0
0 0 0
0 0 0
0 0 0
13 14 18
0 0 0
0 0 4
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 1 0
0 0 0
3 20 14
0 0 0
0 0 0
0 0 0
5 3 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 1 0
Total
F
124
161
72
189
13
0
44
32
76
53
54
162
33
70
2
89
0
0
69
32
0
22
12
0
59
45
63
86
8
91
0
0
451
0
8
0
0
536
0
216
187
10
68
193
16
22
40
375
0
0
0
0
13
77
All
Total
M
90 214
111 272
29 101
216 405
10
23
0
0
28
72
15
47
47 123
35
88
37
91
123 285
17
50
53 123
2
4
92 181
0
0
0
0
48 117
15
47
0
0
22
44
14
26
0
0
32
91
25
70
34
97
60 146
3
11
76 167
0
0
0
0
657 1108
0
0
26
34
0
0
0
0
1 537
0
0
237 453
96 283
7
17
31
99
111 304
14
30
14
36
7
47
399 774
0
0
0
0
0
0
0
0
19
32
63 140
40 - 49 Yrs
Hospital Name
TOTAL
Recovered
Not
Improved
F
60
129
11
18
0
33
491
5
3
43
57
73
55
27
20
26
0
126
12
0
33
85
75
22
29
21
136
12
366
38
111
6
2
70
40
1
24
29
34
76
38
125
59
38
370
0
18
88
57
13
14
9
46
6623
M
F
30
0
82
0
12
0
7
0
0
0
28
0
394
1
3
0
10
0
21
0
71
0
55
0
26
1
21
0
16
0
7
0
0
0
73
5
16
0
0
0
18
0
31
3
40
0
20
0
17
0
8
0
74
1
3
0
335
7
65
0
45
0
10
0
0
0
28
2
34
0
1
0
33
0
19
0
12
0
43
0
15
0
48
0
34
1
32
0
496
0
0
0
42
0
50
0
23
0
8
0
6
0
8
0
34
0
5000 40
18825 16975 150
25448 21975 190
M
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
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
30
149
179
Referral
Lama
Absconded
M F M
F
8 5 6 4
1
10 9 12 12
3
2 1 2 0
0
1 2 1 0
0
0 0 0 0
0
2 2 2 1
0
2 1 2 6
3
0 2 0 0
0
4 6 1 0
0
5 7 4 4
4
1 4 0 1
0
5 9 1 1
0
1 1 6 4
1
8 6 0 0
0
1 0 0 1
0
2 1 1 0
1
0 0 0 0
0
6 1 10 8
0
0 2 0 0
0
0 0 0 0
0
9 3 2 2
3
17 9 3 4
1
10 5 2 3
0
6 1 0 2
2
2 1 1 1
0
7 1 3 1
0
5 6 5 7
2
0 0 1 1
1
44 37 17 10
6
4 2 3 1
0
0 0 1 0
0
0 0 0 0
0
0 0 0 0
0
11 2 0 0
1
4 3 1 0
0
0 0 0 0
0
1 1 2 1
1
2 0 0 0
0
6 2 2 0
1
0 0 0 0
0
5 3 0 0
1
8 3 2 1
4
6 4 2 5
0
3 2 2 2
0
4 3 5
4
6
0 0 0 0
0
2 1 1 0
0
10 5 6 6
4
1 1 1 0
0
0 0 0 0
0
1 1 1 1
0
0 1 4 1
0
8 3 0 0
0
424 294 235 176 59
248 247 377 374 21
672 541 612 550 80
Dead <48 Dead >48

hrs
hrs
F M F
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 3 4 3
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 2 1 0
0 0 0 0
0 0 0 0
2 0 1 1
1 0 0 0
0 0 0 0
5 0 0 0
0 1 0 0
0 0 0 0
0 0 0 1
0 0 0 0
10 0 2 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 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
1 1 0 0
2 0 2 0
1 0 1 0
0 0 1 1
16 0 0 0
0 0 0 0
0 0 0 0
4 2 1 0
1 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 2 0
59 27 47 49
16 85 129 59
75 112 176 108
Total
M
F
0
75
0 154
0
15
0
20
0
0
0
37
1 505
0
5
0
8
0
57
0
58
0
79
0
64
0
35
0
21
1
30
0
0
1 149
0
12
0
0
0
48
0 109
0
87
0
30
0
33
0
31
0 150
0
14
2 440
0
45
1 112
0
6
0
2
0
85
0
45
0
1
0
28
0
31
0
44
0
76
0
45
0 139
1
68
0
44
0 385
0
0
0
21
0 110
0
59
0
13
0
16
0
13
0
54
56 7457
68 19765
124 27222
M
40
103
13
11
0
31
408
5
17
32
76
65
32
27
17
9
0
84
18
0
26
45
48
29
19
10
87
4
396
68
46
10
0
32
38
1
35
19
14
43
19
58
46
37
519
0
43
66
25
8
8
10
39
All
Total
115
257
28
31
0
68
913
10
25
89
134
144
96
62
38
39
0
233
30
0
74
154
135
59
52
41
237
18
836
113
158
16
2
117
83
2
63
50
58
119
64
197
114
81
904
0
64
176
84
21
24
23
93
5662 13119
17958 37723
23620 50842
425
50 - 59 Yrs
Hospital Name
Recovered
F
89
157
46
114
10
0
37
22
71
PRITHIV CHANDRA HOSPITAL, NAWALPARASI 43
34
37
36
2
83
0
0
RAM UMA SMARAK HOSPITAL,LAHAN, SIRAHA 52
61
0
21
DISTRICT HOSPITAL, JALESWOR,MAHOTTARI 8
0
27
19
59
82
3
36
0
0
321
0
4
0
0
200
0
SUKRARAJ TROPICAL HOSPITAL,KATHMANDU 149
154
11
54
120
CHANDRANIGAHAPUR HOSPTIAL, RAUTAHAT 17
3
18
NARAYANI SUB REGIONAL HOSPITAL,PARSA 257
0
0
0
0
6
61
56
LAMJUNG COMMUNITY HOSPITAL,LAMJUNG 128
426
Not
Improved
Referral
Lama
Absconde
Dead <48 hrs Dead >48 hrs
d
Total
87
70
18
127
10
0
33
17
42
32
30
113
29
37
1
89
0
0
38
27
0
17
10
0
20
23
31
51
0
30
0
0
542
0
18
0
0
0
0
199
87
11
42
66
19
2
7
297
0
0
0
0
11
45
48
81
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
3
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
2
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
1
0
0
0
0
1
0
0
4
0
0
0
3
0
0
0
0
0
1
0
0
1
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
9
8
6
15
0
0
3
2
4
11
5
4
0
9
0
7
0
0
4
1
0
3
0
0
8
6
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
2
11
7
0
0
1
2
0
0
0
0
0
1
5
9
8
13
2
29
2
0
4
6
3
10
7
6
1
7
0
6
0
0
2
3
0
5
0
0
7
0
1
3
0
0
0
0
0
0
6
0
0
0
0
0
2
0
5
8
0
0
2
0
0
0
0
0
0
3
4
12
3
0
1
34
3
0
0
0
1
0
3
5
2
2
0
7
0
0
3
4
0
0
0
0
7
0
0
1
0
0
0
0
9
0
0
0
0
0
0
0
2
0
3
1
0
0
8
2
0
0
0
0
0
5
3
7
1
0
2
23
0
0
0
0
0
0
0
1
0
0
0
6
0
0
1
3
0
0
0
0
5
1
0
1
0
1
0
0
15
0
0
0
0
0
0
0
2
0
1
2
0
1
2
1
0
0
0
0
0
5
2
7
1
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
0
0
0
0
1
0
0
1
0
2
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
3
1
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
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
2
0
0
1
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
7
0
0
0
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
0
3
0
0
0
1
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
2
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
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
1
0
0
0
0
1
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
10
0
0
0
2
0
0
0
0
0
1
0
0
0
0
0
1
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
18
0
2
0
0
0
0
2
0
0
0
6
0
0
0
5
0
0
0
0
0
0
0
1
102
167
53
165
13
0
40
24
77
54
42
129
39
47
2
100
0
0
60
69
0
24
10
0
44
25
60
89
3
38
0
0
349
0
4
0
0
200
0
150
158
13
68
139
17
3
30
266
0
0
0
0
6
68
65
148
96
83
22
182
12
0
37
23
46
43
38
127
30
44
1
105
0
0
41
34
0
23
10
0
33
25
33
57
0
31
0
0
605
0
26
0
0
0
0
201
91
11
48
85
19
3
12
305
0
0
0
0
11
53
54
103
All
Total
198
250
75
347
25
0
77
47
123
97
80
256
69
91
3
205
0
0
101
103
0
47
20
0
77
50
93
146
3
69
0
0
954
0
30
0
0
200
0
351
249
24
116
224
36
6
42
571
0
0
0
0
17
121
119
251
50 - 59 Yrs
Hospital Name
Recovered
F
Not
Improved
Referral
Lama
Total
0 0
0 0
0 0
0 0
1 0
0 0
0 0
1 0
0 0
0 0
0 0
0 0
0 0
0 1
0 0
2 1
0 0
0 0
1 1
0 0
0 0
1 1
0 0
0 0
1 0
0 0
7 2
0 0
1 0
0 0
0 0
2 0
0 1
0 0
0 0
0 0
2 0
0 0
0 0
1 0
0 0
2 0
5 1
0 0
0 0
1 3
0 0
0 0
1 0
0 0
0 0
47 18
0
0
0
0
4
0
0
0
0
0
1
0
0
0
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
0
1
1
0
0
0
0
0
0
0
0
34
0
0
0
0
7
0
0
0
0
0
1
0
0
0
0
3
0
0
3
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
4
0
0
5
0
0
0
0
0
53
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
1
0
0
0
0
0
29
0
14
0
7
0
0
0
45
8 395
0
3
0
8
0
56
0
58
0
61
0
58
0
20
0
14
0
28
0
0
0
87
0
4
0
0
0
33
0 133
0
62
0
27
0
28
0
14
0 123
0
4
0 342
0
32
0
64
0
2
0
0
0
51
0
20
0
0
0
27
0
16
1
27
0
50
0
32
2
84
0
36
0
39
4 347
0
0
0
14
1
77
0
51
0
13
0
11
0
12
0
25
52 5712

TOTAL
18576 17872 251 250 325 388 471 431 14 14 114 171 82 119 19833 19245 39078
23692 22336 278 299 599 728 656 589 61 32 148 224 111 171 25545 24379 49924

14
16
0
26
412
11
12
62
52
48
43
14
28
18
0
83
0
0
24
68
44
32
17
8
95
7
309
67
45
1
0
29
41
0
25
16
18
52
14
54
22
45
340
0
26
78
67
6
7
4
27
5134
All
Total
11
10
0 0
1
4
11
1 2
2
0
0
0 0
0
39
24
2 1
4
381 383 2 8
1
3
10
0 0
0
5
4
0 0
3
46
50
0 0
4
55
51
0 0
2
56
39
0 0
4
51
33
0 2
3
18
14
0 0
2
10
20
1 1
3
27
16
0 0
1
0
0
0 0
0
77
70
0 0
2
4
0
0 0
0
0
0
0 0
0
20
17
0 0
7
112 44
1 2 18
54
38
0 0
7
20
27
0 1
5
25
15
0 0
3
12
7
0 0
1
106 80
0 0
8
3
3
0 0
0
306 260 4 1 14
26
65
0 0
3
60
44
0 0
3
2
1
0 0
0
0
0
0 0
0
36
24
4 0
7
19
36
0 0
1
0
0
0 0
0
26
23
0 0
1
16
11
0 0
0
23
14
0 0
0
50
52
0 0
0
27
10
0 0
5
75
29
0 2
7
31
19
1 1
3
33
38
0 0
1
338 326 0 0
2
0
0
0 0
0
13
22
0 3
1
64
53
0 0
3
47
65
0 0
0
12
5
0 0
0
9
6
0 0
1
8
3
0 0
2
22
22
0 0
2
5116 4464 27 49 274
3 2
1
3 0
0
0 0
0
0 0
1
2 3
4
1 0
0
8 0
0
6 5
6
1 1
0
9 1
0
4 3
3
0 0
0
5 0
2
1 0
0
0 0
0
6 5
3
0 0
0
0 0
0
2 5
1
17 2
5
4 1
2
3 1
0
2 0
0
0 1
1
11 8
4
0 1
4
31 6 14
2 3
0
0 0
1
0 0
0
0 0
0
3 2
2
4 0
0
0 0
0
2 0
0
4 0
1
2 2
1
0 0
0
4 0
0
18 0
2
2 1
0
4 2
3
1 1
4
0 0
0
1 0
0
8 8
8
1 4
1
1 1
0
0 0
1
1 2
0
4 1
1
340 185 158
Absconde
d
28
23
0
71
807
14
20
118
110
109
101
34
42
46
0
170
4
0
57
201
106
59
45
22
218
11
651
99
109
3
0
80
61
0
52
32
45
102
46
138
58
84
687
0
40
155
118
19
18
16
52
10846
427
60 + Yrs
Hospital Name







428
Recovered
127
179
101
183
35
0
51
108
131
89
55
205
69
90
0
141
0
0
76
46
0
11
9
0
67
121
120
229
5
12
0
0
650
0
1
0
0
88
0
191
257
16
149
261
11
9
21
225
0
0
0
0
15
136
172
279
121
135
55
278
19
0
47
82
97
87
62
227
59
95
2
137
0
0
63
53
0
16
13
0
57
90
111
159
4
21
0
0
2837
0
13
0
0
0
0
146
164
12
101
227
8
12
25
247
0
0
0
0
12
155
124
207
Not
Improved
Referral
M
0
0
0
0
0
0
0
1
1
0
0
10
0
0
0
5
0
0
0
0
0
0
0
0
0
0
2
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
1
2
0
0
F
0
0
0
7
0
0
0
0
1
1
1
7
0
0
0
6
0
0
1
0
0
2
0
0
1
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15 17
23 24
9
10
36 48
1
1
0
0
3
9
6 12
20 15
31 33
5 10
10 19
1
1
34 14
0
0
5 11
0
0
0
0
4
8
6
2
0
0
3
5
0
0
0
0
27 13
14 19
4 11
14 14
1
0
1
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
1
0
0
0
0
0
7
7
0
1
11 16
42 23
0
0
0
2
1
1
5
7
0
0
0
0
0
0
0
0
0
0
10 10
23 20
23 37
Lama
2
1
5
0
5
60
2
0
3
2
0
4
3
13
0
2
0
5
0
0
1
4
0
0
1
0
18
3
1
4
0
2
0
0
27
0
0
0
0
0
0
0
2
0
11
7
0
3
9
0
0
0
0
0
0
10
18
29
6
60
2
0
0
0
0
1
3
4
0
1
0
3
0
0
2
4
0
0
0
0
14
2
0
1
0
3
0
0
28
0
0
0
0
0
0
0
1
0
5
2
0
4
6
1
0
0
0
0
0
8
9
37
M
0
0
F
0
0
0
0
0
0
0
1
0
3
2
1
0
0
0
0
0
0
3
1
0
0
0
0
4
0
0
3
0
0
0
0
1
0
0
0
0
0
0
0
2
0
1
2
0
0
7
0
0
0
0
0
0
0
2
1
M
0
0
0
0
0
0
0
0
0
3
1
1
0
0
0
0
0
0
1
0
0
0
0
0
6
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
2
0
0
0
0
0
0
0
1
0
5
0
0
1
1
0
1
1
3
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
21
0
1
0
0
0
0
0
1
0
1
1
0
1
0
12
0
0
0
0
0
2
1
3
F
1
0
1
3
0
0
2
0
0
1
2
7
0
1
0
0
0
0
0
0
0
0
0
0
1
5
0
0
0
0
0
0
24
0
0
0
0
0
0
0
0
0
0
2
0
1
0
15
0
0
0
0
0
3
2
3
M
1
0
0
3
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
40
0
1
0
0
0
0
2
0
0
0
20
0
0
0
3
0
0
0
0
0
1
0
0
Total
All
Total
0 145 144 289

0 203 159 362
1 117 73 190
3 287 399 686
0 38 22
60
0
0
0
0
0 58 58 116
0 119 94 213
0 152 113 265
0 128 126 254
0 66 79 145
5 246 270 516
0 70 60 130
0 128 111 239
0
0
2
2
0 156 157 313
0
0
0
0
0
0
0
0
0 84 75 159
0 57 59 116
0
0
0
0
0 14 23
37
0 10 13
23
0
0
0
0
0 116 92 208
0 139 116 255
0 127 122 249
2 253 178 431
0
6
4
10
0 15 24
39
0
0
0
0
0
0
0
0
41 753 2943 3696
0
0
0
0
1
4 16
20
0
0
0
0
0
0
0
0
0 89
0
89
0
0
0
0
4 193 150 343
1 269 173 442
0 16 14
30
0 173 122 295
20 333 278 611
0 11
8
19
0 13 19
32
0 38 34
72
12 245 282 527
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 16 12
28
2 161 178 339
1 216 157 373
2 335 286 621
60 + Yrs
Hospital Name




TOTAL
Recovered
45
20
0
82
838
4
8
132
89
199
118
15
37
43
0
85
2
0
47
224
142
78
35
19
242
21
493
38
147
8
0
104
67
2
53
12
39
32
24
108
106
56
675
0
36
151
86
11
14
6
57
9464
29
18
0
47
759
4
9
100
78
160
84
19
55
25
0
123
2
0
36
156
130
59
32
25
195
19
532
84
117
10
0
98
49
2
46
15
27
33
35
119
46
78
638
0
55
141
82
8
14
9
51
Not
Improved
Referral
Lama
2
1
7
5
1
5
0
0
0
7
3
3
1
0
0
0
0
0
0
0
0
0
0
8 11
1
3
0
5 12
0
0 14 16
0
0
0
0
0
0
0
0
0
0
8
7
0
0
0
2
1 22 19 12 10
3
0
0
3
6
2
0
0
0
0 31 24
9
0
0
1
3 18 16 10
7
0
0
0
2
6
0
0
0
0 12 18
8
3
2
0
0
1
5
4
1
0
1
0
0
0
0
0
0
0
0
0 12
8 17 15
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
7
4
1
1
2
1 46 36
7
8
2
0
0 20 18
5
9
0
0
2
5
6
5
4
3
0
0
7
1
0
0
0
0
0 31
2
2
0
0
1
1 29 23 15 12
3
0
1
3
4
5
3
0
8
8 69 69 18 28
9
0
0
1
2
6
7
1
0
1
6
4
2
2
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
7 10
2
6
1
0
0
4
4
0
1
0
0
0
0
0
0
0
0
0
0
2
2
6
3
0
0
0
1
2
1
1
0
0
0
1
8
0
4
1
0
0
0
0
0
0
0
2
0
4
7
1
2
1
0
0
7 25
7
9
1
0
2
6 11
2
2
0
0
0
4 11
1 10
1
0
0
5
5
3
5
7
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
5 15 16 14
1
0
0
4
3
1
2
1
0
0
1
0
0
0
0
0
0
1
2
3
4
0
0
0
1
1
2
1
0
2
0
4 10
3
3
0
10712 68
87 804 810 440 407 78
32459 33757 370 364 535 586 1016 979
37
41923 44469 438 451 1339 1396 1456 1386 115
Total
All
Total
0
1
0
1
0 57 40
97
0
0
0
0
0 30 22
52
0
0
0
0
0
0
0
0
0
0
1
0
0 91 62 153
0 14 17 23 17 894 821 1715
0
0
0
0
0
4
4
8
0
0
1
0
0 16 17
33
2
0
0
1
1 172 133 305
0
0
7
3
0 97 91 188
0
1
0
1
1 241 185 426
0
1
0
1
0 149 110 259
0
0
0
0
0 17 25
42
2
1
0
0
0 59 79 138
0
0
0
0
0 50 30
80
0
0
0
0
0
0
0
0
1
2
3
0
0 118 150 268
0
0
0
0
0
2
2
4
0
0
0
0
0
0
0
0
0
2
2
0
0 61 46 107
0
4
2
0
1 285 204 489
0
1
2
2
0 170 159 329
3
1
1
2
2 94 77 171
0
0
0
0
0 42 33
75
1
0
0
0
0 52 28
80
1
2
3
2
0 294 235 529
1
0
0
0
0 29 28
57
11
6
9
3
5 606 662 1268
0
0
2
0
0 46 95 141
1
3
1
1
1 162 127 289
0
0
0
0
0
8 10
18
0
0
0
0
0
0
0
0
3
1
0
0
1 117 118 235
0
0
0
0
0 71 54 125
0
0
0
0
0
2
2
4
0
0
0
1
0 62 51 113
2
0
0
1
1 15 21
36
0
0
0
0
2 41 41
82
0
0
0
0
0 32 33
65
1
0
0
0
0 32 45
77
6
0
1
0
1 123 161 284
0
0
0
0
3 114 64 178
0
0
2
0
1 62 102 164
9
2
4
4
3 696 664 1360
0
0
0
0
0
0
0
0
0
1
0
0
0 42 55
97
4
4
5
0
0 177 179 356
1
0
0
0
0 92 88 180
0
0
0
0
0 12
8
20
0
0
1
0
0 18 21
39
0
0
0
0
0
9 11
20
3
0
0
0
0 66 67 133
73 107 137 122 135 11083 12361 23444
25 325 414 326 424 35068 36549 71617
98 432 551 448 559 46151 48910 95061
429

Total
Hospital Name









430
Recovered
F
1450
2729
1628
2895
689
0
1387
665
922
1115
662
2195
353
994
443
831
0
0
3069
885
0
170
972
0
901
471
751
899
131
354
0
0
2495
0
29
0
0
22699
0
1256
2059
123
1260
3818
141
1938
2677
2628
0
0
0
0
107
821
1476
M
926
1057
308
1787
95
0
457
293
579
506
339
1314
276
554
5
818
0
0
309
208
0
162
106
0
294
248
443
481
11
349
0
0
5477
0
132
0
0
0
0
1234
815
69
473
1434
119
42
74
2938
0
0
0
0
69
636
504
Not Improved
F
1
0
0
0
0
0
6
1
2
0
1
19
0
0
0
35
0
0
3
0
0
5
0
0
17
0
7
0
0
0
0
0
42
0
0
0
0
0
0
1
0
0
0
0
3
11
0
0
0
0
0
0
1
3
0
M
1
0
2
14
0
0
0
0
2
2
2
21
0
0
0
44
0
0
5
0
0
10
0
0
6
0
2
0
4
1
0
0
46
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
0
0
2
0
Referral
F
113
176
113
326
17
0
326
32
97
121
36
43
1
128
0
78
0
0
221
47
0
16
39
0
151
55
22
58
27
9
0
0
1
0
8
0
0
18
0
0
44
12
91
233
6
110
32
26
0
0
0
0
0
33
167
M
98
108
42
215
3
0
29
31
47
112
48
67
6
83
0
77
0
0
28
19
0
22
3
0
75
38
17
31
3
9
0
0
0
0
18
0
0
2
0
0
46
2
66
104
5
6
7
51
0
0
0
0
0
33
57
Lama
F
M
36 35
15
2
43 23
306 228
15 12
0
0
24
5
6
3
6
1
13
9
22 18
34 21
3
1
12 10
0
0
55 68
0
0
0
0
184 11
28 20
0
0
0
0
2
0
0
0
100 61
8
9
1
3
6
3
2
0
34 44
0
0
0
0
59 79
0
0
0
0
0
0
0
0
231
1
0
0
0
0
14
9
0
0
61 27
39 29
0
0
184 19
56 14
32 41
0
0
0
0
0
0
0
0
0
0
35 31
74 36
Absconded
F
4
10
4
4
0
0
13
1
3
9
7
5
0
10
0
0
0
0
82
14
0
0
1
0
24
1
0
10
0
12
0
0
1
0
0
0
0
17
0
0
6
0
3
10
0
25
42
6
0
0
0
0
0
0
7
M
1
3
2
4
0
0
2
0
3
5
3
5
0
12
0
6
0
0
4
5
0
0
0
0
11
1
1
6
0
21
0
0
0
0
0
0
0
0
0
0
0
0
1
19
0
0
7
11
0
0
0
0
0
0
5
F
1
2
0
11
1
0
1
1
1
1
3
25
0
14
0
0
0
0
1
0
0
0
1
0
0
0
1
3
0
3
0
0
41
0
1
0
0
1
0
0
2
0
1
2
0
2
1
25
0
0
0
0
0
2
3
M
4
2
1
12
0
0
2
1
2
2
6
20
0
15
0
2
0
0
0
1
0
0
0
0
2
6
2
3
0
0
0
0
67
0
0
0
0
0
0
0
1
0
1
7
0
1
0
24
0
0
0
0
0
4
2
Total
All
Total
M
F
M
1
1 1606 1066 2672
0
0 2932 1172 4104
0
2 1788 380 2168
10
6 3552 2266 5818
18 19 740 129 869
0
0
0
0
0
0
0 1757 495 2252
0
0 706 328 1034
1
0 1032 634 1666
0
0 1259 636 1895
1
0 732 416 1148
8 10 2329 1458 3787
0
0 357 283 640
14 15 1172 689 1861
0
0 443
5 448
0
0 999 1015 2014
0
0
0
0
0
0
0
0
0
0
0
0 3560 357 3917
2
0 976 253 1229
0
0
0
0
0
0
0 191 194 385
1
0 1016 109 1125
0
0
0
0
0
1
1 1194 450 1644
1
1 536 303 839
0
0 782 468 1250
2
3 978 527 1505
0
0 160
18 178
0
0 412 424 836
0
0
0
0
0
0
0
0
0
0
85 99 2724 5768 8492
0
0
0
0
0
1 16
39 166 205
0
0
0
0
0
0
0
0
0
0
1
0 22967
3 22970
0
0
0
0
0
11 24 1268 1258 2526
0
2 2125 873 2998
3
0 138
72 210
0
0 1416 568 1984
322 105 4424 1698 6122
0
0 150 126 276
0
0 2270
68 2338
0
0 2808 102 2910
9 20 2726 3085 5811
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 108
69 177
3
4 897 710 1607
0
1 1727 605 2332
Total
Hospital Name
Recovered
LAMJUNG COMMUNITY HOSPITAL,LAMJUNG 2462 1121






196
491
0
739
13033
34
98
1586
805
2270
1530
375
158
1698
0
2636
365
0
1743
1582
2006
513
524
953
4947
114
7146
1544
5663
54
101
950
729
45
344
468
412
721
550
1264
973
307
10834
0
1681
2112
1195
362
423
150
807
106
119
0
208
5457
39
66
934
502
782
494
184
128
127
0
791
159
0
283
671
595
289
230
159
1008
84
2914
503
2227
48
2
347
490
23
383
240
182
479
197
632
347
329
4260
0
351
667
318
104
95
71
339
149331 55099
179615 139257
328946 194356
TOTAL
Not Improved
Referral
M
F
0
1 117
2
3
35
10
4
64
0
0
0
2
1
67
27
53
5
0
0
1
0
3
32
5
2 104
0
0
43
0
0 154
11
17 124
2
0
45
3
13
27
11
3
90
0
0
0
5
0 137
0
0
22
0
0
0
0
0 198
19
17 308
3
1 107
1
4
59
0
0
41
2
0
88
2
2 188
1
1
11
23
15 309
0
0
35
0
1
34
0
0
0
0
0
5
12
3
85
0
0
58
0
0
0
0
0
6
0
2
7
0
0
26
0
0
0
2
0
34
1
5
54
7
5
47
0
0
22
3
2
95
0
0
0
6
4
33
0
1
78
0
0
34
0
0
10
1
3
34
0
0
10
3
0
68
321 332 6071
1516 1499 2691
1837 1831 8762
Lama
M
F
M
112 171 101
15
8
6
13
13
4
0
0
0
27
8
8
9
36 40
7
0
1
41
4
5
78
60 53
25
9
3
91
17
3
48
59 35
29
0
0
15
5
8
18
22
2
0
0
0
32
89 67
25
0
0
0
0
0
41 113 37
160
31 24
63
29 22
23
24 10
21
6
6
6
17
6
144
73 33
16
16 16
264 146 155
15
90 29
14
33 16
0
0
0
0
0
0
54
22 24
32
4
5
0
0
0
13
15 16
21
2
3
42
21 17
0
0
0
32
2
5
97
36 25
35
31 20
38
20 24
32
68 38
0
0
0
9
7
7
79 103 82
27
18
4
11
3
5
16
19 24
6
21 22
41
8
8
3447 3183 1857
2656 4369 3901
6103 7552 5758
Absconded
F
7
0
6
0
2
9
0
0
15
0
0
2
0
0
6
0
8
0
0
56
7
0
11
0
4
21
3
74
1
8
0
0
22
13
0
6
2
6
0
3
18
0
4
86
0
2
20
1
5
9
2
1
767
217
984
M
F
M
F
5
6
6
0
0
1
0
1
4
0
0
0
0
0
0
0
1
0
1
0
0
37
37
38
0
0
0
0
1
0
1
0
7
0
1
2
0
0
7
3
1
1
1
1
3
2
1
1
0
0
0
0
2
1
0
0
1
3
0
0
0
0
0
0
4
8
9
0
0
0
0
0
0
0
0
0
8
6
7
1
6
4
3
0
1
3
5
2
15
1
1
2
1
1
0
0
1
3
1
0
14
9
10
4
1
0
0
0
86
34
52
14
4
2
3
0
6
5
6
6
0
0
0
0
0
0
0
0
12
3
1
0
11
1
2
0
0
0
0
0
4
4
2
2
2
1
1
2
1
4
0
1
0
0
0
0
3
2
2
0
29
5
10
3
3
0
3
0
2
2
6
1
72
8
16
8
0
0
0
0
3
1
3
0
33
8
12
2
2
0
0
0
1
0
0
0
2
1
2
0
4
0
0
0
17
0
3
0
510 317 401 588
173 883 1170 676
683 1200 1571 1264
M
4
0
0
0
0
34
0
0
2
0
1
0
0
0
1
0
3
0
0
1
1
0
6
0
0
0
0
19
0
7
0
0
1
1
0
4
4
4
0
0
4
5
1
13
0
1
1
0
0
2
0
0
448
898
Total
F
2763
243
584
0
818
13185
35
134
1772
860
2443
1729
422
194
1830
0
2883
387
0
2117
1951
2150
611
572
1067
5244
145
7746
1672
5749
54
106
1094
805
45
377
482
470
721
593
1381
1058
356
11102
0
1730
2323
1248
380
487
183
887
M
1350
130
144
0
246
5630
47
117
1077
537
879
598
213
166
152
0
906
184
0
377
882
687
348
258
173
1211
118
3505
554
2277
48
2
442
541
23
422
273
246
479
239
802
418
400
4433
0
378
875
351
121
144
103
408
160578 62094
All
Total
4113
373
728
0
1064
18815
82
251
2849
1397
3322
2327
635
360
1982
0
3789
571
0
2494
2833
2837
959
830
1240
6455
263
11251
2226
8026
102
108
1536
1346
68
799
755
716
1200
832
2183
1476
756
15535
0
2108
3198
1599
501
631
286
1295
222672
189967 149554 339521
1346 350545 211648
562193
431

Hospital Name






432
22 - 27
Gastational Weeks
37 - 41
28 - 36
42
Total
Grand
Grand
Grand
Grand
Grand
Primi Multi
Primi Multi
Primi Multi
Primi Multi
Primi Multi
Multi
Multi
Multi
Multi
Multi
0
0
0
4
0
0
0
1
0
0
0
5
0
0
0
0
0
0
0
6
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
9
3
0
0
0
0
0
0
232
2
0
0
2
0
0
0
0
0
0
0
0
0
0
1
1
1
0
1
0
0
0
0
0
8
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
7
2
0
0
0
0
0
0
227
1
0
0
2
0
0
0
0
1
0
0
0
0
0
1
0
3
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
6
0
0
0
0
0
0
0
78
6
0
0
0
0
16
31
0
44
0
0
0
7
16
9
9
14
0
2
7
0
0
0
0
64
0
0
12
0
0
0
6
2
4
0
0
0
0
0
0
0
0
0
0
0
29
0
1
0
0
0
0
0
133
10
0
0
0
8
8
10
0
38
0
0
0
4
6
2
12
8
0
1
9
0
0
0
0
84
0
0
26
0
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
20
3
3
0
0
0
0
0
220
8
0
0
1
3
0
1
0
1
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
43
0
0
12
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
0
0
0
0
0
0
0
91
1
0
0
0
1
124
626
499
512
0
0
0
148
124
177
114
401
19
106
177
0
0
0
0
0
0
0
86
0
51
58
75
112
38
0
0
0
0
0
0
0
0
0
0
0
528
0
343
0
0
705
0
0
127
79
0
0
14
100
54
278
257
454
0
0
0
123
46
96
74
179
19
48
244
0
0
0
0
0
0
0
318
0
1
34
52
68
40
0
0
0
0
0
0
0
0
0
0
0
579
1
257
0
0
853
0
0
147
68
0
0
7
56
0
28
27
1 168
89
1
8
43
24
2 700 312
11
11
0
0
0 499 257
11
8
13
17
1 573 509
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
8
2
0 164 129
6
3
7
4
2 147
56
5
12 110
42
12 296 141
25
2
8
4
1 131
91
3
83
67
18
9 487 206 105
1
2
1
2
21
20
3
27
8
7
1 116
57
28
2
1
5
0 185 258
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
70
92
47
0
0
0
0
0
0
0
0
0
0
0
0
0
0
76
34 239 110 132 583 198
0
0
0
0
0
0
0
0
0
0
0
51
1
0
7
1
3
0
59
37
8
10
4
6
0
86
60
10
8
2
1
0 116
70
8
4
0
0
0
42
41
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 4453 4255 1620 4453 4255 1620
0
0
0
0
0
0
0
0
0
0
0
0
0
0
99
43
45
16 609 651 138
0
0
0
0
3
6
0
12
1
1
0 345 261
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
932
0
0
0 705 853 932
0
0
0
0
0
0
0
0
0
0
0
0
0
0
79
25
11
8 517 605 256
29
4
1
0
95
78
36
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
0
20
11
0
13
2
7
2 110
66
16
Hospital Name
22 - 27
Primi Multi





TOTAL
5
2
3
1
0
0
0
0
0
0
0
0
5
10
0
0
0
0
14
7
2
0
1
3
2
0
1
1
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
1
13
0
0
0
0
0
0
0
7
4
0
0
0
1
2
1
0
0
0
0
1
0
1
0
2
0
0
0
0
0
3
0
0
0
1
1
0
0
0
0
74
71
3
1
0
0
1
0
4
1
2
0
22
13
437 374
1090 729
1527 1103
Gastational Weeks
37 - 41
28 - 36
42
Total
Grand
Grand
Grand
Grand
Grand
Primi Multi
Primi Multi
Primi Multi
Primi Multi
Multi
Multi
Multi
Multi
Multi
1
23
21
1
21
17
0
1
2
0
0
0
0
0
0
0
11
12
4
78
72
0
0
0
0
11
6
0
44
35
0
4
3
0
23
59
0
19
14
0
3
5
0
1
0
1 112
86
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
20
10
2
57
30
0
2
3
0
4
0
0
16
6
7 796 496
0
0
0
0
0
0
0
87
46
2
84
58
0
0
0
0
2
1
1
20
8
0
2
2
0
0
0
0
3
2
0
5
3
0
8
4
0
0
0
0
1
2
3
20
15
1
16
9
0
38
23
0
0
0
0
0
0
0
4
1
1
49
32
0
0
0
0
3
1
0
11
12
0
6
4
3
15
11
127 2028 1572
181 2189 1649
308 4217 3221
1
5
0
0
0
1
14
0
0
8
0
2
0
0
0
47
0
0
0
0
0
1
4
2
1
2
58
0
0
12
10
0
1
4
1
0
0
1
0
0
0
2
4
0
0
0
0
15
0
0
1
1
0
376
416
792
301
471
23
0
0
111
4256
1
8
299
83
569
385
85
5
358
0
0
282
0
0
262
585
76
87
310
841
0
0
478
1195
0
34
175
45
0
88
82
82
38
82
213
122
248
0
29
153
587
0
74
143
82
195
18762
12196
30958
298
11
33
28
1
428
36
19
23
1
29
0
1
0
0
0
0
0
0
0
0
0
0
0
0
236
15
3
2
0
3829 311
81
59
13
5
1
0
0
0
4
0
2
0
0
241
63
3
6
0
97
2
13
9
0
581
25
16
16
3
344
14
27
24
1
77
2
1
0
0
4
0
0
1
0
330 152
68
6
4
0
0
0
0
0
0
0
0
0
0
245
29
0
0
0
0
0
0
0
0
0
0
0
0
0
201
49
8
7
1
399
19
52
41
1
36
13
12
10
2
37
22
7
1
2
198
29
23
12
4
572
73 105
42
14
0
0
0
0
0
0
0
0
0
0
250 112
0
0
0
1192 221 167 164
35
0
0
0
0
0
45
9
1
3
2
143
25
13
12
2
75
1
3
3
0
0
0
11
9
4
95
11
25
22
11
86
23
15
15
5
93
18
17
4
2
88
20
0
0
0
153
12
0
0
0
185
48
16
10
3
121
68
5
11
3
177
55
19
12
3
0
0
0
0
0
19
0
2
0
0
136
29
7
6
0
516
89
26
28
9
0
0
0
0
0
91
22
3
4
5
119
14
14
11
0
79
17
7
6
1
178
16
36
25
2
16331 3108 5701 5326 1920
10020 1906 806 811 316
26351 5014 6507 6137 2236
362
514
25
0
0
125
4420
1
21
360
102
609
433
90
6
540
0
0
282
0
0
290
694
91
98
349
1755
0
0
565
1453
0
37
210
50
11
117
103
109
38
83
252
143
306
0
31
238
665
0
81
172
97
268
26928
16281
43209
349
14
469
43
31
0
0
0
0
0
250
16
3970 342
5
1
10
0
289
71
109
2
659
30
382
15
83
2
5
0
424 204
0
0
0
0
245
29
0
0
0
0
218
52
472
26
49
17
38
25
217
35
1110 152
0
0
0
0
296 124
1418 268
0
0
50
12
164
32
80
2
9
4
119
22
104
29
101
20
88
20
155
12
210
56
141
76
213
58
0
0
19
0
214
29
577 114
0
0
96
27
143
15
89
19
227
21
23603 5531
13209 2819
36812 8350
433

22 - 27
28 - 36
Maternal Age (Yrs)

37 - 41
42
Total
< 20 20 - 34 35
< 20 20 - 34 35
< 20 20 - 34 35
< 20 20 - 34 35
< 20 20 - 34 35
Hospital Name
0
0


DISTRICT HOSPITAL,
SOLUKHUMBU
OKHALDHUNGA
COMMUNITY
434
0
0
0
4
1
0
0
0
0
172 1264
1
0
38
77
22
65
0
1
3
5
0
0
44 153
2
3
0
0
0
0
0
0
376 1816
0
0
0
0
0
0
0
0
0
0
51 222
0
0
0
1
5
16
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
11
2
6
0
0
314 1623
0
0
0
0
28 410
0
0
119 567
7
29
0
0
0
0
1
3
0
0
3
5
3
2
0
0
0
0
0
0
159
0
6
4
0
1
0
6
0
0
0
0
2
0
0
0
0
0
53
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
225
0
0
26
0
45
0
0
0
0
0
0
0
24
0
0
23
0
0
0
2
1
1
5
8
0
0
10
0
0
0
0
0
0
0
16
0
0
0
3
0
2
0
0
0
0
0
0
0
0
0
0
0
18
0
1
0
0
0
0
0
47
3
0
0
1
3
13
12
16
0
0
57
0
0
0
7
0
1
16
18
0
1
39
0
0
0
0
0
0
0
61
0
0
0
4
6
2
0
0
0
0
0
0
0
0
0
0
0
89
0
3
0
0
0
0
0
173
11
0
0
0
9
30
25
3
0
0
2
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
0
0
0
10
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
21
0
0
0
0
0
0
0
25
0
0
0
0
0
1
7
12 127 24
9 34
201 778 41
0
0
154 588 25
0
0
179 761 35
6 24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
45 177 11 15 37
19 62
4
0
0
84 162 17 17 76
38 147
6
1 11
172 429 24 29 56
6 32
0
0
3
10 55
1
2
5
94 261 19
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9 16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
82 420 62 37 208
0
0
0
0
0
14 75
0
0
0
21 76
3
0
3
22 104 12
0
8
42 115
8
0
2
22 59
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 1188 7108
0
0
0
0
0
0
0
0
0
0
237 803 88 28 44
0
0
0
0
0
121 442 11
7
2
0
0
0
0
0
0
0
0
0
0
228 1448 113
0
0
17 471 30 66 1389
0
0
0
0
0
64 121 33
6 29
28 119
2 14
1
0
0
0
0
0
0
0
0
0
0
6 14
1
1
4
42 127
0
0 11
138 458 14 16 48
196 710 29
5 32
10 45
0 201
0 154
1 212
0
0
0
0
0 172
3 63
0 58
13 124
0 44
6 212
0
6
0 56
1 106
0
0
0
0
0
0
0 385
0
0
0
0
0
0
27 135
0
0
0 65
0 21
0 25
0 47
0 24
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
472 1188
0
0
0
0
16 295
0
2
0 129
0 314
0
0
0 228
45 111
0
0
7 236
0 52
0
0
0
0
0
9
0 45
0 170
2 216
177 37
778 41
588 25
843 38
0
0
0
0
1264 159
221 15
139 10
304 34
175
6
508 34
35
0
214
7
304 20
0
0
0
0
0
0
1832
2
0
0
0
0
0
0
689 99
0
0
297 53
79
4
117 12
139
8
62
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7108 472
0
0
0
0
947 131
6
0
447 11
1623 225
0
0
1448 113
2270 101
0
0
890 110
160
2
0
0
0
0
21
1
147
0
541 15
769 38
Hospital Name

TOTAL
22 - 27
28 - 36
Maternal Age (Yrs)

37 - 41
42
Total
< 20 20 - 34 35
< 20 20 - 34 35
< 20 20 - 34 35
< 20 20 - 34 35
< 20 20 - 34 35
0
0
0
1
2
0 11 39
2
1
0
0 13 41
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
8 15
0 93 266
6
2
2
0 103 283
6
5
23
2 42 95 10 1173 6296 190 37 198 21 1257 6612 223
0
0
0
0
1
0
0 31
1
0
0
0
0 32
1
0
0
0
1 14
2
3 10
0
0
2
0
4 26
2
0
0
0 30 27
5 166 481 23
0
1
0 196 509 28
1
0
0
2
2
0 48 136
1
7 15
0 58 153
1
1
0
0 18 22
1 219 959 19
7 29
1 245 1010 21
1
1
0 10 24
0 164 566 14
9 40
2 184 631 16
1
0
0
3
1
1 56 175 15
0
0
0 60 176 16
0
0
0
1
0
0
2
7
0
0
0
0
3
7
0
1
4
0 43 197 13 114 698 12
5 24
0 163 923 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
0 495 61
0
0
0
0 495 61
0
0
0
0
0
0
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
35
3 18 16
2 60 393
5
3
8
0 96 452 10
0
1
1 25 63
3 276 642 27 28 65
1 329 771 32
0
1
0
1
5
0 38 100
5
2
5
0 41 111
5
0
0
0
4
2
0 59 82
4
5
4
1 68 88
5
0
1
0
5 13
0 192 330
5 16 23
0 213 367
5
3
11
0 372 959 91 348 1002 88 30 98 15 753 2070 194
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 37 109
1 149 748 12
0
0
0 186 857 13
6
7
0 56 92
4 583 1969 56 101 256
9 746 2324 69
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
1
0 25 61
3
1
4
0 29 67
3
2
2
0 14 16
0 105 224
9
9 15
1 130 257 10
0
0
0
2
1
1 35 88
0
2
2
1 39 91
2
10
14
0
0
0
0
0
0
0
0
0
0 10 14
0
1
0
1
3
3
0 45 145
6 19 40
4 68 188 11
1
0
0
3
4
1 54 119
8
6 19
3 64 142 12
1
1
0
5
7
0 39 129 12
8 12
1 53 149 13
0
0
0
0
0
0 25 109
5
0
0
0 25 109
5
0
0
0
0
0
0 38 148
9
0
0
0 38 148
9
1
2
2 10 18
2 100 316 34 11 18
0 122 354 38
3
25
0
8 13
3 40 221 24
2
8
2 53 267 29
4
45
1 12 54
1 78 322 28
1 29
4 95 450 34
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
45
1
0
0
0
0
0
0
0
0
0 11 45
1
80 388 11
0
0
0
0
0
0
0
0
0 80 388 11
0
4
0 20 71
2 125 1045 23
9 52
2 154 1172 27
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
39
3 11 24
0 26 87
2
0
0
0 52 150
5
18 109
4
3 10
0 29 118
7
2 11
1 52 248 12
6
3
0
8 11
0 39 122
8
7
3
0 60 139
8
0
1
7
6 17
0 73 291
5 17 32
1 96 341 13
1394 7044 569 954 2461 214 6921 28000 1320 1785 10117 663 11054 47622 2766
1138 4384 554 626 2140 346 3574 15818 1123 344 1007 104 5682 23349 2127
2532 11428 1123 1580 4601 560 10495 43818 2443 2129 11124 767 16736 70971 4893
435

Hospital Name
1st Trimester
Medical
Surgical
Total
Medical
Surgical
< 20 20 < 20 20 < 20 20 < 20 20 < 20 20

Years Years Years Years Years Years Years Years Years Years

2nd Trimester
Medical
Surgical
< 20
Years
20
Years
24
201
29
24
34
309
38
40
347
140
49
11
144
230
2
60
31
31
22
24
22
24
85
31
21
85
52
29
29
85
85
49
42
49
42
10
13
46
10
13
46
11
17
69
11
17
69
11
11
84
13
84
13
59
59
29
29
12
285
12
285
13
26
49
13
26
49
95
103
42
84
31
81
45
179
33
184
14
14
108
13
108
13
19
16
13
19
16
13
22
22
38
79
64
38
79
64
67
40
67
40
436
Hospital Name
1st Trimester
Medical
Surgical
2nd Trimester
Medical
Surgical
Total
Medical
Surgical
< 20 20 < 20 20 < 20 20 < 20 20 < 20 20

Years Years Years Years Years Years Years Years Years Years
< 20
Years
20
Years
27
27
0
1
24
37
24
37
111
84
111
84
15
182
11
87
13
15
19
195
11
102
50
291
12
65
50
298
12
68

40
27
40
27
14
279
32
14
288
32
5
13
15
25
30
25
30
19
67
19
67
91
30
91
30
32
32
20
134
21
135
107
16
107
16
60
60
23
43
15
38
49
14
14
29
72
16
45
73
35
17
12
52
50
74
11
58
85
32
78
32
78
36
11
115
16
42
14
131
19
19
34
16
216
34
18
216
77
77
16
93
11
27
93
11
17
34
13
30
43
12
44
12
44
254
254
13
166
17
13
183
400
400
56
52
323
290
52
51
56
52
375
341
82
82
14
90
14
91
35
52
12
47
52
12
61
12
61
41
294
41
299

0
405
0
3188
10
627
236
3921
25
102
0
220
0
109
0
553
25
507
0
3408
10
736
236
4474
437
1663
466
2378
22
80
35
132
459
1743
501
2510
TOTAL
842
4851
1093
6299
124
300
144
685
966
5151
1237
6984
437

Hospital Name
Hospital Death
Early
Neonatal
F
M
Late Neonatal Maternal Post-operative*

F
(All)
Brought Dead
Other
F
Postmortem
Done
F
M
12
19

1
0
2
0
0
0
0
0
0
0
0
0
0
0
1
0
2
2
11
0
24
0
30
32
43
52
265
20
15
164
29
34
20
31
106
22
21
10
21
24
15
11
16
20
57
112
24
29
18
36
23
15
0
0
114
148
19
22
38
42
20
24
29
12
10
21
41
71
17
11
38
36
28
16
34
65
135
438
Hospital Name
Hospital Death
Late Neonatal Maternal Post-operative*
Early
Neonatal
F
M
(All)
Brought Dead
Other
F
Postmortem
Done
F
M
13
10
11
16
14
13
218
66
79
83
7
42
29
15
31
48
28
10
8
65
43
59
107
0
112
10
13
58
19
41
20
44
49
53
19
12
21
25
23
55
53
87
17
28
34
63
39
4
16
19
20
15
14
179
18
33
92
11
16
57
11
20
32
0
81
0
88
0
44
0
66
0
17
0
0
0
5
0
362
0
494
0
190
0
292
15
1421
15
2492

121
191
42
53
14
15
18
603
730
300
425
129
265
TOTAL
202
279
86
119
31
15
23
965
1224
490
717
1550
2757
439




440
11
189
200
438
0
0
0
7
2
24
4
124
0
53
0
0
0
0
0
0
0
0
17
0
0
0
67
15
0
0
0
0
0
0
0
0
0
3952
0
0
79
0
17
293
0
24
16
667
0
0
0
0
81
12
0
0
8
140
0
0
0
0
0
0
11
63
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
58
0
0
0
125
61
0
0
0
70
2
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
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
387
51
328
0
0
0
49
35
141
66
377
13
49
36
0
0
0
0
0
0
0
14
0
0
182
122
33
0
0
0
0
0
0
0
0
0
0
0
0
9
4
0
0
0
0
0
203
0
0
0
0
35
239
0
0
64
88
0
15
64 168
0
0
0
0
0
0
26
14
0
11
26
29
0
31
0 187
0
3
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
19
0
0
65
0
58
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 1585
0
0
0
0
0
26
0
2
0
0
0
96
0
0
0
14
0
19
0 412
0
9
0
0
0
0
0
0
0 204
0
36
0
0
14
195
0
0
0
0
13
31
37
249
2
0
4
0
0
0
0
0
0
0
14
0
0
0
65
60
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
110
0
1
0
822
9
0
0
0
229
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
4
0
10
1
0
0
0
0
27
179
20
59
2
45
7
0
0
0
0
0
0
0
18
0
0
191
99
513
0
0
0
0
0
0
0
0
0
0
0
0
0
16
940
0
0
28
0
0
0
0
0
0
0
12
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
5
0
0
0
0
0
0
0
0
0
0
0
22
127
89
0
0
0
19
37
161
88
37
42
1
4
15
3
0
0
0
59
0
0
16
0
0
126
113
483
0
0
0
0
0
0
0
0
0
0
0
0
36
1
608
0
0
0
0
0
0
0
0
0
44
177
Male
Post Op
Infection
Male
Female
1
0
5
0
0
0
0
0
21
92
6
36
2
23
10
0
0
0
0
0
0
0
13
0
0
160
102
681
0
0
0
0
0
0
0
0
0
0
0
0
0
16
823
0
0
39
0
0
0
0
0
0
0
9
Female
Plaster
Emergency
Post Op
Infection
Male
Post Op
Infection
Male
Female
0
225
23
333
0
0
0
67
29
153
33
342
7
27
23
0
0
0
0
0
0
0
9
0
0
204
121
21
0
0
0
0
0
0
0
0
0
0
0
0
8
10
0
0
0
0
0
97
0
0
0
0
43
222
Female
Minor Surgeries
Inpatients
Outpatients
Post Op
Infection
Male
Hospital Name
Female
Major Surgeries
25
233
111
0
0
0
16
46
201
117
57
48
4
9
14
7
0
0
0
68
0
0
33
0
0
131
154
360
0
0
0
0
0
0
0
0
0
0
0
0
52
6
739
0
0
0
0
0
0
0
0
0
74
219



TOTAL
195 120
0
0
0
0
0
0
0
0
2463 475
0
0
0
0
18
4
0
0
3
0
37
0
0
0
0
0
79
3
0
0
0
0
0
0
0
0
42
26
0
0
113
3
0
0
17
0
16
0
504 103
0
0
0
0
26
0
858 190
0
0
12
10
62
1
0
0
0
0
44
36
34
14
1
0
0
0
0
0
28
14
32
0
73
33
897 156
0
0
0
0
45
0
6
0
0
0
26
0
0
0
0
0
11923 1751
26613 18206
38536 19957
0 124 100
6
3
5
0
0
0
0
0
0
0
0
0
0 730 947
0
9
18
0
0
0
8
44
40
0
12
0
0
3
0
0 111
58
0
0
0
0
2
3
0
28
2
0
0
0
0
0
0
0
0
0
0
0
0
0
49
19
0
37
22
0
3
20
0
0
0
15
6
4
0
62
52
0 760 885
0
0
0
0
0
0
0
2 182
0 216 234
0
0
0
0
1
0
0
0
0
0
22
22
0
9
11
0
10
16
0
46
40
0
0
0
0
23
20
0
0
0
0
56
38
0
11
14
0
32
29
0 509 602
0
0
0
0
0
0
0
3
0
0
35
38
0
0
0
0
8
7
43
7
10
0
0
0
271 6060 5307
185 11107 14639
456 17167 19946
Male
Post Op
Infection
Male
Female
0 229 364
0
23
50
0
0
0
0
2
14
0
0
0
0
89
93
0
33
48
0
0
0
35 208 268
0
22
34
0
0
0
0 285 254
0
4
6
0
0
1
0
89 124
0
0
0
0
0
0
0
2
0
0
0
0
0 543 360
0 121 183
0
23
33
0
0
0
0
8
8
0 287 337
0
0
0
0
0
0
0
0
0
0
1
1
0
2
4
0
0
0
0
1
2
0
51
60
0
25
29
0
45
49
0 429 647
0
0
0
0
0
0
0
33
23
0
0
0
0
0
2
0
20
16
0
0
0
0
70
78
0
0
0
0
0
0
0
0
0
0 246 290
0
0
0
0
62
47
0
12
11
0
0
0
35 5004 5607
48 6381 7918
83 11385 13525
Female
Plaster
Emergency
Post Op
Infection
Male
Female
Post Op
Infection
Male
12 192 184
0
32
39
0
0
0
0
9
9
0 360 519
0 282 365
0 736 1082
0
0
0
0 647 788
0
8
12
3
46
36
0 113 133
0
26
36
0
60
69
0 125 141
0
0
0
0
0
0
0
0
0
0
0
0
6
4
8
0
3
8
1 634 623
0
0
0
0
19
5
0
60
72
0
0
0
0
0
0
0
0
0
1
0
0
0 263 261
0
0
0
0
10
6
0
12
15
0 129 136
0
36
46
2
0
0
2
4
4
0
0
0
0
16
11
0
0
0
1
0
2
0
12
75
0
33
27
0
0
0
0
0
0
0
0
0
0
13
16
0
74
66
0
0
0
0
96
90
0
11
44
0
0
0
31 6062 7301
398 13468 14952
429 19530 22253
Minor Surgeries
Inpatients
Outpatients
Female
Post Op
Infection
Male
Hospital Name
Female
Major Surgeries
0 198 186
0
17
29
0
0
0
0
6
17
0
66
87
0 162 184
0
0
2
0
1
10
0 150 172
0
19
19
0
0
0
0 235 310
0
72
85
0
33
39
0
89 110
0
0
0
0
0
0
0
0
17
0
0
0
0
17
22
0
21
16
0 524 556
0
7
2
0
29
39
0
15
26
0 198 233
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
4
0 134 143
0
17
16
0
61
59
0 109 172
0
39
36
0
0
2
0
13
8
0
0
0
0 147 189
0
80 111
0
18
11
0 110 156
0
0
0
0
0
0
0
43
60
3 237 325
0
4
7
0 113 109
0
0
0
0
0
0
12 5295 6293
4 9035 11812
16 14330 18105
441
Inpatients Morbidity
ICD
Code
Diseases
National
28
Days
2978 3882
A00
Cholera
A01.0
Typhoid fever
A01
A01.1
A01.4
A02
A03
A03.0
A03.9
A05.9
A06
A06.0
A06.1
A06.9
A07
A07.1
A08
A08.1
A09
A15
A15.0
A15.3
A15.6
A15.9
A16
A16.0
A16.1
A16.2
A16.3
A16.5
A16.7
A16.9
A18
A18.3
A18.4
A19
A19.9
A27
A27.9
A30
A30.9
A31.0
A35
A36
A36.9
A37
A37.0
A37.9
A38
A39
A39.9
A40
A41
442
Typhoid and paratyphoid fevers

Paratyphoid fever A
Paratyphoid fever, unspecified

Other salmonella infections
Shigellosis
Shigellosis due to Shigella dysenteriae

Shigellosis, unspecified
Bacterial foodborne intoxication, unspecified

Amoebiasis
Acute amoebic dysentery
Chronic intestinal amoebiasis

Amoebiasis, unspecified
Other protozoal intestinal diseases

Giardiasis [lambliasis]
Viral and other specified intestinal infections

Acute gastroenteropathy due to Norwalk
agent
Diarrhoea and gastroenteritis of presumed
infectious origin
Respiratory tuberculosis, bacteriologically
and histologically confirmed
Tuberculosis of lung, confirmed by sputum
microscopy with or without culture
Tuberculosis of lung, confirmed by
unspecified means
Tuberculous pleurisy, confirmed
bacteriologically and histologically
Respiratory tuberculosis unspecified,

confirmed bacteriologically and histologically
Respiratory tuberculosis, not confirmed
bacteriologically or histologically
Tuberculosis of lung, bacteriologically and
histologically negative
Tuberculosis of lung, bacteriological and
histological examination not done
Tuberculosis of lung, without mention of

bacteriological or histological confirmation
Tuberculosis of intrathoracic lymph nodes,
without mention of bacteriological or
histological confirmation
Tuberculous pleurisy, without mention of

bacteriological or histological confirmation
Primary respiratory tuberculosis without

mention of bacteriological or histological
confirmation
Respiratory tuberculosis unspecified, without
mention of bacteriological or histological
confirmation
Tuberculosis of other organs
Tuberculosis of intestines, peritoneum and
mesenteric glands
29 Days-1
Yr
3319
0
21
52
0
0
1
0
0
0
0
0
0
1
0
0
0
5
0
0
0
0
0
0
30-39
Years
40-49
Years
50-59
Years
60
Years
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
22
10
13
12
11
0
0
0
0
0
0
16
5
0
0
10
9
1
0
2
0
0
19
10
5
0
0
0
0
0
10
0
1
0
2
0
0
0
4
0
0
0
0
0
1
2
0
0
0
0
0
1
2
0
0
0
1
0
1
8
0
0
0
4
0
2
1
0
0
8
2
0
1
5
0
0
0
2
1
0
4
1
0
4
2
12
4
0
0
7
1
1
0
0
0
0
0
0
1
10
14
2
1
0
0
0
1
0
0
0
0
0
10
2
0
0
14
0
0
6
8
2
0
0
10
0
16
5
0
20
6
5836
123
38
2
2
89
14
186
94
92
212
82
101
36
3
1
15
6
5
194
8
1
35
12
5693 11529
0
0
0
2
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
31
86
11
356
22
233
48
111
49
152
4543
11
17
2177
13
37
73
M
1079
10
137
23
79
2366
65
23
4229
72
13
21
1899
29
13
2330
105
22
Total
93634 287321 903
35
22
11
38
20
18
42
22
22
43
145
161
306
5
0
0
14
0
0
17
0
0
14
0
0
11
0
0
20
0
0
13
0
1
11
1
0
24
0
0
24
1
0
59
1
1
99
2
0
153
1
2
252
10
12
13
17
55
52
32
52
47
60
35
70 109 127
305
395
700
11
Miliary tuberculosis, unspecified
Other septicaemia
16
Streptococcal septicaemia
Meningococcal infection, unspecified
531 1029 911 1378 533 683 399 374 878 500 740 451 575 373 438 345 802 523
Meningococcal infection
10
14
11
Scarlet fever
12
Whooping cough, unspecified
10
Whooping cough due to Bordetella pertussis
12
12
10
12
10
16
10
12
12
12
10
19
14
24
14
Whooping cough
Tuberculosis of skin and subcutaneous tissue
Diphtheria, unspecified
31
Diphtheria
29
Other tetanus
30
Pulmonary mycobacterial infection
10
25
Leprosy, unspecified
16
Leprosy [Hansen's disease]
20
Leptospirosis, unspecified
16
Leptospirosis
12
Miliary tuberculosis
12
20
11
11
10
4
0
11
11
40 121 180 354 485 320 313 541 413 340 257 249 178 202 154 199 152
75 156 217 355 400 288 219 514 329 323 214 239 171 182 116 212 137
22
Total
Deaths
Total
5762 5660 8495 7481 10285 22229 6257 83165 11456 24715 10264 15487 10257 10365 9455 18288 17521 193687
21
20-29
Years
11
0
0
15-19
Years
12
37
05-14
Years
29
38
01-04
Years
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
2
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
1
0
4
0
0
0
1
5
0
0
0
0
0
1
0
0
0
2
1
1
0
0
0
3
6
0
0
0
0
0
1
0
0
1
1
0
0
0
0
0
0
1
0
0
0
0
2
0
1
0
0
1
0
1
0
1
0
2
12
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
6
0
0
0
0
0
0
0
0
0
1
0
0
1
1
1
1
6
15
14
26
18
21
28
19
22
28
46
177
210
387
20
24
0
0
0
0
0
0
2
1
0
1
0
0
0
1
0
0
3
0
0
0
0
1
0
1
0
0
1
0
0
0
1
0
0
5
Page 112 of 149
0
0
1
0
0
0
0
0
0
0
0
0
0
2
0
0
10
1
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
4
1
0
0
1
0
0
0
0
0
0
0
0
0
3
0
0
8
1
0
0
0
0
0
6
0
0
0
0
0
0
1
0
0
5
0
0
0
0
0
0
2
0
0
0
0
0
11
0
0
0
0
0
1
0
0
7
0
0
0
0
0
1
0
0
5
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
6
1
0
0
0
1
0
3
0
0
0
0
0
0
0
0
0
10
0
1
0
1
1
0
1
0
0
2
2
0
1
1
2
1
1
12
6
0
2
6
1
21
7
1
4
7
2
12
13
35
48
0
0
0
0
0
6
0
0
23
0
0
0
0
0
1
3
0
4
0
17
15
74
0
0
0
2
0
0
0
0
0
0
2
0
0
0
0
0
0
1
0
6
0
0
10
1
1
1
1
0
0
0
0
22
73
147
21
15
1
6
1
8
0
0
0
0
ICD
Code
Diseases
A41.0
Septicaemia due to Staphylococcus aureus
A41.9
Septicaemia, unspecified
A41.8
A42.2
A44
Other specified septicaemia

Cervicofacial actinomycosis
A48.1
Bartonellosis
Other bacterial diseases, not elsewhere
classified
Legionnaires' disease
A49.9
Bacterial infection, unspecified
A48
A49
A49.0
A50
A50.9
A51
A52.3
A54
Bacterial infection of unspecified site

Staphylococcal infection, unspecified
Congenital syphilis
Congenital syphilis, unspecified

Early syphilis
Neurosyphilis, unspecified
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
17
20
20
20
28
10
10
10
10
13
16
110
124
234
16
11
0
0
0
0
0
0
1
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
1
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
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
1
0
0
0
0
1
1
1
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
4
0
0
0
1
1
0
0
0
2
7
1
0
1
1
A58
Granuloma inguinale
0
0
A64
A69
A82
A82.9
A83.0
A85.8
A86
A87
A89
A90
A91
A92
A92.9
Anogenital herpesviral infection, unspecified

Unspecified sexually transmitted disease
Other spirochaetal infections
Rabies
Rabies, unspecified
Japanese encephalitis
Other specified viral encephalitis

Unspecified viral encephalitis
Viral meningitis
Unspecified viral infection of central nervous
system
Dengue fever [classical dengue]
Dengue haemorrhagic fever
Other mosquito-borne viral fevers
0
0
0
0
0
0
0
1
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
10
14
6
0
0
0
0
0
17
0
0
0
1
0
3
1
0
11
14
0
0
1
1
0
0
0
0
0
0
0
0
0
0
14
23
33
22
24
17
0
0
0
1
5
0
0
1
1
0
3
0
1
1
0
0
2
0
0
1
0
0
4
0
0
0
0
0
2
0
1
1
0
0
3
0
4
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
2
0
1
0
4
0
0
0
5
0
0
0
28
12
B00.0
Eczema herpeticum
0
0
11
22
23
11
26
13
29
13
11
12
11
12
13
A99
B00
B00.9
B01
B01.8
B01.9
B02
B02.9
B03
B05
B05.9
B07
B09
B15
B15.0
B15.9
B16
Unspecified viral haemorrhagic fever
Herpesviral [herpes simplex] infections

Herpesviral infection, unspecified
Varicella [chickenpox]
Varicella with other complications

Varicella without complication
Zoster [herpes zoster]
Zoster without complication

Smallpox
Measles
Measles without complication
Viral warts
Unspecified viral infection characterized by
skin and mucous membrane lesions
Acute hepatitis A
Hepatitis A with hepatic coma
Hepatitis A without hepatic coma
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
1
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
1
0
0
0
0
0
0
0
1
0
1
0
0
0
1
0
0
0
0
0
0
0
4
1
4
2
0
1
0
0
1
0
0
3
0
4
2
0
0
0
3
0
0
0
3
0
5
1
2
0
2
1
1
0
0
9
0
1
0
0
0
0
0
1
1
0
3
0
3
1
2
0
0
0
0
0
0
5
0
3
3
0
0
0
0
1
0
0
2
0
2
4
0
0
0
0
1
0
0
1
0
2
3
0
0
0
2
2
0
0
1
0
0
1
2
0
0
0
0
0
0
0
0
0
1
0
0
20
13
B19.0
Unspecified viral hepatitis hepatic with coma
0
0
0
0
0
0
2
0
3
0
6
0
9
0
2
1
7
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
3
0
15
0
4
2
7
Page 113 of 149
2
7
11
2
0
19
0
1
4
2
16
B17
B26
5
0
0
14
14
41
47
90
0
2
0
2
0
0
3
2
0
229
2
0
3
1
5
1
14
8
1
2
3
5
13
0
1
1
5
27
8
2
3
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23
43
42
10
20
3
1
48
90
0
0
0
0
0
1
11
21
32
10
26
36
12
34
88
15
6
4
102
36
127
15
B24
18
21
HIV disease resulting in unspecified infectious

or parasitic disease
Unspecified human immunodeficiency virus
[HIV] disease
Mumps
15
13
B20.9
10
33
B20
24
19
Human immunodeficiency virus [HIV] disease

resulting in infectious and parasitic diseases
12
14
B19.9
Unspecified viral hepatitis without hepatic

coma
Unspecified viral hepatitis
B19
Acute hepatitis E
B17.2
Acute hepatitis B
Acute hepatitis B without delta-agent and
without hepatic coma
Other acute viral hepatitis
B16.9
21
12
70
12
41
29
A94
Mosquito-borne viral fever, unspecified

Other arthropod-borne viral fevers, not
elsewhere classified
Unspecified arthropod-borne viral fever
A93
10
10
108
59
49
12
298
128
170
15
88
17
14
A60.9
Chlamydial lymphogranuloma (venereum)
A54.3
A55
Gonococcal infection
Gonococcal infection of lower genitourinary
tract with periurethral and accessory gland
abscess
Gonococcal infection of eye
A54.1
Total
Deaths
Total
0
0
5
2
0
2
3
0
15
7
0
0
4
1
0
9
2
1
7
37
2
2
2
8
28
24
31
31
124
12
58
34
40
42
271
24
86
58
71
73
395
36
0
0
0
0
1
0
12
0
0
0
0
0
0
17
443
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
B26.9
Mumps without complication
B35.3
Tinea pedis
B30.9
B34
B36
B37
B42.9
B43
B44.9
B46
B48.8
B49
B50
B50.0
B50.9
B51
Viral conjunctivitis, unspecified
Viral infection of unspecified site

Other superficial mycoses
Candidiasis
Sporotrichosis, unspecified
Chromomycosis and phaeomycotic abscess

Aspergillosis, unspecified
Zygomycosis
Other specified mycoses (Adiaspiromycosis)

Unspecified mycosis (Fungaemia NOS)
Plasmodium falciparum malaria

Plasmodium falciparum malaria with cerebral
complications
Plasmodium falciparum malaria, unspecified
B53.1
Plasmodium vivax malaria

Plasmodium vivax malaria without
complication
Malaria due to simian plasmodia
B55.0
Visceral leishmaniasis
B51.9
B54
B55
B55.9
B67
B67.8
B67.9
B69
B69.0
B69.9
B71
B71.0
B74
B74.9
B76
B77
B77.9
Unspecified malaria
Leishmaniasis
Leishmaniasis, unspecified
Echinococcosis
Echinococcosis, unspecified, of liver
Echinococcosis, other and unspecified

Cysticercosis
Cysticercosis of central nervous system

Cysticercosis, unspecified
Other cestode infections
Hymenolepiasis
Filariasis
Filariasis, unspecified
Hookworm diseases
Ascariasis
B82
Ascariasis, unspecified
Other intestinal helminthiases, not elsewhere
classified
Unspecified intestinal parasitism
B83.9
Helminthiasis, unspecified
B81
B82.0
B82.9
B86
B87.1
B88.9
B90
B90.2
B90.9
B94
B97.4
B99
C00.9
C02
C02.0
C02.3
C02.9
C03
C05.1
C05.9
Intestinal helminthiasis, unspecified

Intestinal parasitism, unspecified
Scabies
Wound myiasis
Infestation, unspecified
Sequelae of tuberculosis
Sequelae of tuberculosis of bones and joints
Sequelae of respiratory and unspecified

tuberculosis
Sequelae of other and unspecified infectious
and parasitic diseases
Respiratory syncytial virus as the cause of
diseases classified to other chapters
Other and unspecified infectious diseases
Lip, unspecified
Malignant neoplasm of other and unspecified
parts of tongue
Dorsal surface of tongue
Anterior two-thirds of tongue, part
unspecified
Tongue, unspecified
Malignant neoplasm of gum
Soft palate
C06.0
Palate, unspecified
Malignant neoplasm of other and unspecified
parts of mouth
Cheek mucosa
C08.0
Submandibular gland
C06
C06.1
C06.9
C09
C09.9
C10.4
444
Vestibule of mouth
Mouth, unspecified
Malignant neoplasm of tonsil

Tonsil, unspecified
Branchial cleft
0
2
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
0
0
0
0
0
4
0
1
0
0
0
1
0
0
0
0
0
0
0
12
34
63
97
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
1
1
5
0
1
0
1
0
1
0
1
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
3
0
4
0
1
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
1
0
4
M
0
1
0
1
0
0
0
0
1
1
2
0
1
0
0
0
0
0
0
1
0
1
M
0
0
1
0
0
0
0
0
1
1
1
0
2
0
0
0
0
0
0
1
0
1
Total
Deaths
Total
14
60
Years
50-59
Years
19
40-49
Years
30-39
Years
11
0
0
20-29
Years
11
15-19
Years
5
0
05-14
Years
M
1
1
0
1
0
0
0
0
1
0
0
0
1
0
0
1
0
0
0
2
1
1
M
1
21
2
6
0
0
1
0
3
4
Total
0
26
0
3
1
1
0
2
5
3
47
2
9
1
1
1
2
8
7
12
16
M
0
0
0
0
0
0
0
0
0
0
0
13
20
10
15
25
20
31
51
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
3
0
0
0
3
0
0
0
0
0
3
4
0
0
0
0
6
0
4
1
0
0
0
0
0
0
2
2
1
0
0
1
1
1
1
0
0
0
0
0
0
0
3
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
5
2
0
0
1
0
4
0
1
0
0
0
0
0
0
1
3
0
1
1
0
0
2
0
0
0
0
0
0
0
0
1
9
8
3
1
0
0
1
1
1
0
0
0
0
0
0
0
2
3
0
1
0
1
3
1
0
1
0
0
1
0
0
0
4
4
0
1
0
0
1
0
0
0
0
1
1
0
0
0
4
4
0
1
0
0
1
0
0
0
0
0
0
0
1
0
5
2
0
1
0
0
1
0
0
0
0
1
0
0
0
0
3
2
1
0
0
0
0
0
1
0
0
0
0
0
0
0
3
6
0
0
0
0
1
0
0
0
0
0
0
0
2
0
1
1
0
0
0
3
1
0
1
1
0
0
1
1
0
0
3
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
3
2
0
0
0
0
0
0
0
1
0
3
0
0
0
0
0
0
0
0
6
0
3
0
5
11
14
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
2
1
0
0
0
0
0
0
0
0
2
4
0
0
1
0
0
0
0
0
2
4
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
2
1
0
1
0
3
0
0
0
1
0
0
0
1
0
3
0
0
0
5
0
0
0
0
0
0
0
0
0
1
2
0
1
0
0
0
0
0
0
1
0
0
0
1
0
2
0
0
0
1
1
0
0
1
1
0
0
0
0
1
2
0
0
0
1
0
0
0
1
1
10
27
12
15
16
12
0
0
1
6
0
0
2
1
1
1
2
1
20
7
1
5
28
3
0
0
5
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
10
3
1
0
3
1
1
0
3
3
3
1
4
2
33
1
4
1
0
0
0
0
0
0
0
0
0
0
0
0
16
42
38
22
26
16
59
1
6
2
0
2
0
0
0
0
0
0
6
1
0
1
0
0
11
26
20
46
12
12
0
0
0
0
0
0
0
0
0
1
0
1
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
1
0
0
2
1
0
3
0
0
3
1
0
4
1
1
2
1
0
0
0
0
0
0
0
0
11
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
3
0
0
0
0
2
0
0
1
0
5
0
0
0
0
2
0
0
0
0
1
0
0
0
0
2
0
Page 114 of 149
0
0
0
7
0
0
0
0
6
0
1
0
0
5
0
0
0
0
8
0
1
0
0
8
0
0
0
3
9
0
1
0
0
4
1
0
0
1
2
0
0
0
0
3
0
2
0
3
1
3
1
0
36
0
7
33
1
1
7
69
0
0
0
0
0
0
1
0
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
C10.9
Oropharynx, unspecified
C14
Malignant neoplasm of other and ill-defined

sites in the lip, oral cavity and pharynx
C15
Malignant neoplasm of oesophagus
13
10
30
40
C11.9
C13.9
C14.0
C15.9
C16
C16.3
C16.4
C16.9
C17.0
C18
C18.1
C18.9
C19
C20
Nasopharynx, unspecified
Hypopharynx, unspecified
Pharynx, unspecified
Oesophagus, unspecified
Malignant neoplasm of stomach

Pyloric antrum
Pylorus
Stomach, unspecified
Duodenum
Malignant neoplasm of colon

Appendix
Colon, unspecified
Malignant neoplasm of rectosigmoid junction
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
2
0
0
0
0
0
0
1
0
0
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
1
0
0
0
0
1
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
C22.0
C22.9
Liver, unspecified
0
0
C22.2
C23
C25
C25.4
C25.9
C31.0
C32.0
C32.3
C32.9
C34
C34.1
C34.9
C39.0
C41.4
C41.9
C44
C44.0
C44.9
C47.0
Hepatoblastoma
Malignant neoplasm of gallbladder

Malignant neoplasm of pancreas
Endocrine pancreas
Pancreas, unspecified
Maxillary sinus
Glottis
Laryngeal cartilage
Larynx, unspecified
Malignant neoplasm of bronchus and lung

Upper lobe, bronchus or lung
Bronchus or lung, unspecified
Upper respiratory tract, part unspecified

Pelvic bones, sacrum and coccyx
Bone and articular cartilage, unspecified

Other malignant neoplasms of skin
Skin of lip
Malignant neoplasm of skin, unspecified
C49.5
Peripheral nerves of head, face and neck

Peripheral nerves of upper limb, including
shoulder
Peritoneum, unspecified
Malignant neoplasm of other connective and
soft tissue
Connective and soft tissue of head, face and
neck
Connective and soft tissue of pelvis
C50.6
Axillary tail of breast
C47.1
C48.2
C49
C49.0
C49.9
C50
C50.9
C51.9
C53
C53.8
C53.9
C54.1
C54.2
Connective and soft tissue, unspecified

Malignant neoplasm of breast
Breast, unspecified
Vulva, unspecified
Malignant neoplasm of cervix uteri

Overlapping lesion of cervix uteri
Cervix uteri, unspecified
Endometrium
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
2
0
1
0
0
0
0
8
0
0
0
0
0
0
0
0
1
0
0
1
2
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
1
0
0
0
0
0
0
1
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
10
4
0
2
0
1
0
3
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
3
0
0
0
0
8
0
2
1
0
0
0
0
0
0
0
0
1
0
0
3
10
0
0
0
0
0
0
6
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
0
4
0
7
3
0
1
0
0
0
0
0
0
0
0
0
0
2
0
0
0
1
0
0
0
0
0
4
4
0
3
0
0
0
0
4
0
0
0
0
0
0
0
13
1
0
0
0
0
0
0
1
0
0
0
0
1
3
2
0
2
33
1
0
9
13
3
8
7
46
4
8
103
11
14
25
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
42 164 207
21
19
34
5
1
0
0
1
0
0
6
0
0
1
0
1
0
14
0
0
0
0
0
1
1
1
1
0
1
0
0
2
1
2
232
299
23
25
51
17
1
1
1
0
1
0
44
1
3
1
3
531
0
0
0
0
0
0
0
0
1
0
1
1
1
1
1
1
0
0
0
0
2
2
0
44
10
115
48
64
27
67
23
36
21
32
17
30
14
16
4
6
72
120
30
23
69
14
51
20
49
8
1
10
39
2
1
10
15
38
33
58
23
18
29
42
8
5
29
10
157
21
1
0
15
88
12
19
10
69
2
2
58
30
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
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
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
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Penis, unspecified
C60.9
Ureteric orifice
47
21
C67.6
11
20
C67
10
C64
Scrotum
Malignant neoplasm of kidney, except renal
pelvis
Malignant neoplasm of bladder
13
C63.2
Epididymis
C56
C63.0
Malignant neoplasm of testis
C62
Malignant neoplasm of prostate
C61
Prepuce
C60.0
Uterine adnexa, unspecified
C57.4
Myometrium
Malignant neoplasm of uterus, part
unspecified
Malignant neoplasm of ovary
C55
Intrahepatic bile duct carcinoma
C22.1
Malignant neoplasm of rectum

Malignant neoplasm of liver and intrahepatic
bile ducts
Liver cell carcinoma
C22
0
0
0
0
0
0
0
0
1
0
8
0
1
0
0
0
0
30
0
1
0
0
0
0
0
74
8
0
5
0
0
51
0
3
0
0
0
0
0
24
20
13
4
0
4
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
0
0
0
0
9
0
0
0
0
0
0
93
0
0
11
0
2
22
34
17
8
1
0
1
0
0
0
0
93
0
0
0
0
0
0
0
0
1
0
27
0
0
15
43
1
7
1
0
0
0
0
0
0
0
0
0
33
0
0
57
12
1
0
1
0
Page 115 of 149
0
0
0
55
14
1
0
0
0
0
15
167
163
29
1
0
0
0
3
2
19
15
14
124
19
0
2
55
23
419
163
0
3
12
124
155
19
1
0
411
0
0
24
0
0
22
11
16
11
0 143
0
4
47
0
0
7
2
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
35
445
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
C67.9
Bladder, unspecified
C69.9
Eye, unspecified
C68.1
C68.9
C70.0
C70.9
C71
C71.1
C71.2
C71.3
C71.4
C71.7
C71.9
C72.0
C73
Paraurethral gland
Urinary organ, unspecified

Cerebral meninges
Meninges, unspecified
Malignant neoplasm of brain

Frontal lobe
Temporal lobe
Parietal lobe
Occipital lobe
Brain stem
Brain, unspecified
C76.0
Spinal cord
Malignant neoplasm of thyroid gland
Malignant neoplasm of other and ill-defined
sites
Head, face and neck
C76.3
Pelvis
C76
C76.1
C76.2
C76.4
C76.5
C77
C77.0
C77.3
C77.4
C77.9
C78.8
C79
C79.5
C79.8
C80
C81
C81.9
C84.3
C85
C85.9
Thorax
Abdomen
Upper limb
Lower limb
Secondary and unspecified malignant
neoplasm of lymph nodes
Lymph nodes of head, face and neck
Axillary and upper limb lymph nodes
Inguinal and lower limb lymph nodes
Lymph node, unspecified

Secondary malignant neoplasm of other and
unspecified digestive organs
Secondary malignant neoplasm of other sites

Secondary malignant neoplasm of bone and
bone marrow
Secondary malignant neoplasm of other
specified sites
Malignant neoplasm without specification of
site
Hodgkin's disease
Hodgkin's disease, unspecified
Lymphoepithelioid lymphoma
Other and unspecified types of non-Hodgkin's
lymphoma
Non-Hodgkin's lymphoma, unspecified type
C90.0
Multiple myeloma and malignant plasma cell

neoplasms
Multiple myeloma
C92.0
Acute myeloid leukaemia
C90
C91.1
C92
C92.1
C92.3
C95
C95.0
C95.9
D00.0
D01.2
D01.9
D02.2
D02.4
D04.8
D04.9
D05
D06.9
D07.0
D07.2
D07.5
Chronic lymphocytic leukaemia

Myeloid leukaemia
Chronic myeloid leukaemia

Myeloid sarcoma
Leukaemia of unspecified cell type
Acute leukaemia of unspecified cell type

Leukaemia, unspecified
Lip, oral cavity and pharynx

Rectum
Digestive organ, unspecified

Bronchus and lung
Respiratory system, unspecified

Skin of other sites
Skin, unspecified
Carcinoma in situ of breast

Cervix, unspecified
Endometrium
Vagina
D09.7
Prostate
Carcinoma in situ of other and unspecified
sites
Carcinoma in situ of other specified sites
D10.9
Pharynx, unspecified
D09
D09.9
D10.4
D11.0
D12.5
446
Carcinoma in situ, unspecified

Tonsil
Parotid gland
Sigmoid colon
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
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
1
0
0
0
1
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
1
0
0
0
1
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
1
0
0
0
1
0
0
2
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
1
0
0
1
0
0
1
1
0
0
0
1
0
0
0
0
1
0
3
0
3
0
0
2
0
0
1
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
2
0
5
0
2
0
0
0
2
1
0
0
0
1
0
4
0
0
0
1
0
9
15
15
Total
12
1
2
M
3
13
2
0
Total
Deaths
Total
1
0
1
0
1
1
0
2
1
6
0
1
0
5
0
0
0
1
6
1
5
1
19
20
1
0
26
1
1
0
0
0
0
0
0
0
0
1
11
3
4
0
8
1
9
3
4
1
14
2
28
0
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
1
0
0
0
0
1
0
1
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
1
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
1
0
0
1
1
1
3
3
1
0
0
4
2
1
3
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
7
2
9
0
0
3
0
3
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
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
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
4
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
52
43
46
15
14
11
18
12
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
2
0
0
0
0
0
1
0
2
0
1
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
0
0
0
0
10
15
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
1
0
0
32
0
0
0
0
0
0
0
0
19
0
0
0
2
2
1
1
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
1
16
0
0
0
2
1
0
2
0
11
0
0
0
0
0
0
0
1
1
21
63 151 134
0
0
0
0
0
2
0
1
0
0
1
1
1
42
48
18
20
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
1
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
1
3
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
4
0
0
2
0
0
0
0
0
0
0
0
0
0
5
0
0
0
1
0
0
2
2
0
0
0
0
0
1
0
0
1
0
0
5
2
2
0
0
1
1
0
1
78
0
1
2
2
0
1
1
0
2
0
0
0
0
4
0
0
2
3
45
13
19
0
0
7
2
33
12
14
15
11
580
290
290
33
26
10
5
5
26
0
0
0
0
0
0
0
0
10
1
1
0
0
2
0
1
1
1
1
1
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
78
0
0
1
2
2
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
2
0
2
0
1
0
0
1
1
0
0
0
0
0
0
Page 116 of 149
0
1
0
0
0
0
0
0
1
0
1
0
0
2
1
0
1
0
1
0
0
1
0
0
0
0
1
0
0
0
1
0
3
0
0
0
3
0
0
0
6
4
3
2
3
4
2
0
9
8
5
2
0
0
0
0
0
0
0
0
ICD
Code
D12.6
D13.4
D14
D16
D16.9
D17
Diseases
Colon, unspecified
Liver
Benign neoplasm of middle ear and
respiratory system
Benign neoplasm of bone and articular
cartilage
Bone and articular cartilage, unspecified
Benign lipomatous neoplasm
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
14
22
14
28
42
D18
Haemangioma and lymphangioma, any site
D22.9
D24
D25
D25.1
D25.9
D26.0
D26.9
D27
D29
D29.1
D29.2
D29.9
D30
D30.2
D30.9
D31.6
D31.9
D32.9
D33.0
D36.0
D39.0
D39.2
D41.1
D41.2
D41.4
D41.9
Melanocytic naevi, unspecified

Benign neoplasm of breast
Leiomyoma of uterus
Intramural leiomyoma of uterus
Leiomyoma of uterus, unspecified

Cervix uteri
Uterus, unspecified
Benign neoplasm of ovary
Benign neoplasm of male genital organs

Prostate
Testis
Male genital organ, unspecified
Benign neoplasm of urinary organs

Ureter

Orbit, unspecified
Eye, unspecified
Meninges, unspecified
Brain, supratentorial
Lymph nodes
Uterus
Placenta
Renal pelvis
Ureter
Bladder
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
1
0
0
0
0
0
0
2
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
5
1
2
0
3
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
2
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
2
0
0
3
0
1
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
5
1
0
0
0
0
0
1
0
0
0
1
1
0
5
1
0
3
1
0
5
0
0
1
0
0
0
2
0
1
0
5
4
0
33
0
0
0
0
0
0
0
1
0
1
0
0
1
0
0
0
0
1
2
0
28
0
0
0
0
0
0
0
0
0
0
4
0
3
0
1
0
2
0
3
0
0
0
0
2
1
1
0
2
28
0 111
0
56
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
1
1
0
8
0
0
1
1
0
2
1
0
0
1
0
0
0
0
0
0
0
7
0
18
0
0
0
0
0
0
0
0
0
3
3
0
0
0
0
2
2
0
34
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
0
0
0
1
1
2
0
12
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
1
1
0
0
0
0
0
0
1
40
21
19
Lymphangioma, any site
D18.1
Haemangioma, any site
Total
D18.0
D17.0
Benign lipomatous neoplasm, unspecified
Benign lipomatous neoplasm of skin and

subcutaneous tissue of head, face and neck
D17.9
Total
Deaths
Total
0
0
1
3
0
33
169
0
0
0
0
7
2
0
1
1
0
0
0
1
1
1
0
44
2
1
136
0
0
0
0
0
1
1
0
0
3
7
0
18
0
0
0
0
1
1
4
1
1
2
1
5
1
0
0
0
0
0
0
0
0
34
169
0
0
0
0
7
2
1
1
1
1
1
1
1
4
44
2
1
136
7
2
1
1
1
2
2
1
1
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
13
2
0
0
18
10
4
0
8
1
0
0
0
0
D43
Neoplasm of uncertain or unknown behaviour

of brain and central nervous system
D44.4
Craniopharyngeal duct
D44.0
D46
D48.4
D48.6
D48.9
D50
D50.9
D53
D55
D55.1
D55.9
D56
D56.9
D57
D57.0
D57.1
D57.8
D58
D58.9
Thyroid gland
Myelodysplastic syndromes
Peritoneum
Breast
Neoplasm of uncertain or unknown
behaviour, unspecified
Iron deficiency anaemia
Iron deficiency anaemia, unspecified

Other nutritional anaemias
Anaemia due to enzyme disorders

Anaemia due to other disorders of glutathione
metabolism
Anaemia due to enzyme disorder, unspecified
Thalassaemia
Thalassaemia, unspecified
Sickle-cell disorders
Sickle-cell anaemia with crisis
Sickle-cell anaemia without crisis

Other sickle-cell disorders
Other hereditary haemolytic anaemias
Hereditary haemolytic anaemia, unspecified
D61
Acquired pure red cell aplasia

[erythroblastopenia]
Other aplastic anaemias
D64.9
Anaemia, unspecified
D60
D61.9
D64
D66
Aplastic anaemia, unspecified

Other anaemias
Hereditary factor VIII deficiency
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
1
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
0
0
0
1
0
0
2
0
1
1
0
1
1
1
2
0
0
0
0
0
0
0
0
17
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
1
0
0
1
1
0
0
0
0
1
0
0
3
0
0
0
0
0
2
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
8
0
2
6
1
0
14
1
2
0
0
0
0
15
29
16
14
13
44
47
91
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
13
0
0
0
0
0
11
0
0
16
3
0
0
0
0
21
1
0
1
1
0
0
0
4
0
0
0
0
0
3
5
0
0
0
1
0
0
6
0
1
0
0
0
0
1
2
0
0
0
4
0
14
16
28
31
18
14
0
44
41
67
44
60 114
43
7
60
50 183
24 108
2
Page 117 of 149
0
0
6
0
0
0
0
0
0
1
3
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
49 109
47 101
4
51 121
53
0
83
80
58
1
81
53
64 149 162
53 110 115
0
31
16
1
0
0
1
22
15
857
591
0
37
13
0
1
1
1
34
20
588
469
16
68
29
1
1
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
35
56
1445
1060
16
0
7
4
0
0
3
2
0
447
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
D69
Purpura and other haemorrhagic conditions
D69.3
Idiopathic thrombocytopenic purpura
16
24
D69.0
D69.6
D69.9
D70
D73.1
D73.3
D76.1
Allergic purpura
Thrombocytopenia, unspecified
Haemorrhagic condition, unspecified

Agranulocytosis
Hypersplenism
Abscess of spleen
E03.5
Haemophagocytic lymphohistiocytosis
Immunodeficiency associated with other
major defects
Wiskott-Aldrich syndrome
Immunodeficiency associated with major
defect, unspecified
Other hypothyroidism
Hypothyroidism due to medicaments and
other exogenous substances
Myxoedema coma
E04.1
Nontoxic single thyroid nodule
D82
D82.0
D82.9
E03
E03.2
E03.9
E04
E04.2
E04.9
E05.9
E06.3
E06.9
E07
E10
E11
E14
E16
E16.0
E16.1
E16.2
E20
E27.8
E28
E28.2
E28.9
E29
E32
E40
Hypothyroidism, unspecified
Other nontoxic goitre
Nontoxic multinodular goitre

Nontoxic goitre, unspecified
Thyrotoxicosis, unspecified
Autoimmune thyroiditis
Thyroiditis, unspecified
Other disorders of thyroid
Insulin-dependent diabetes mellitus
Non-insulin-dependent diabetes mellitus
Unspecified diabetes mellitus

Other disorders of pancreatic internal
secretion
Drug-induced hypoglycaemia without coma

Other hypoglycaemia
Hypoglycaemia, unspecified
Hypoparathyroidism
Other specified disorders of adrenal gland

Ovarian dysfunction
Polycystic ovarian syndrome
Ovarian dysfunction, unspecified

Testicular dysfunction
Diseases of thymus
0
0
0
0
0
0
0
0
0
0
0
0
0
0
E77
E77.8
E78.5
Other disorders of glycoprotein metabolism
1
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
2
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
2
0
1
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
1
0
0
0
0
0
0
1
1
0
0
0
0
0
1
0
0
0
0
1
5
1
0
1
1
0
4
0
1
1
0
1
9
1
1
2
1
0
0
0
0
0
0
0
0
0
0
0
0
12
21
23
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
1
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
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
2
0
0
0
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
46 171
1
0
0
0
1
0
0
0
0
0
0
1
1
1
11
E71
Ascorbic acid deficiency
E64
E54
Other vitamin deficiencies

Sequelae of malnutrition and other
nutritional deficiencies
Disorders of branched-chain amino-acid
metabolism and fatty-acid metabolism
Disorders of glycoprotein metabolism
E56
Deficiency of other B group vitamins
E46
E53
Vitamin A deficiency
E50
Kwashiorkor
Unspecified severe protein-energy
malnutrition
Unspecified protein-energy malnutrition
E43
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
1
2
1
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
6
0
0
0
0
0
2
3
7
1
0
0
0
0
0
1
0
0
0
0
0
0
0
6
1
1
14
0
0
0
0
0
2
0
0
0
0
0
1
0
4
1
0
23
0
0
0
0
0
2
0
0
0
0
1
0
0
0
0
4
0
1
2
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
1
1
2
1
0
0
1
0
0
1
0
0
20
21
26
11
0
1
0
74
0
0
2
0
15
17
0
0
1
0
0
0
0
2
13
14
23
33
92 210 249 247 295 552 574

0
3
0
0
0
0
0
3
1
9
0
0
22
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
3
0
0
7
0
0
0
1
1
0
0
0
0
0
0
0
0
0
5
0
1
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
2
0
0
0
88
57
10
10
30
1
1
4
9
160
106
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
3
26
24
38
1
0
2
50
29
0
3
0
69
0
1
0
3
1
1
1
2
0
0
0
0
18
418
38
153
13
265
28
1
0
19
2415
1268
69
1147
49
72
17
12
10
19
20
28
13
14
10
0
0
41
0
1
37
12
20
0
92
0
3
16
0
0
0
0
0
E83
E84.9
Cystic fibrosis, unspecified
0
0
E84
E86
E87
E87.1
E87.3
E87.5
E87.6
E87.8
E88.0
E88.2
448
Cystic fibrosis
Volume depletion
Other disorders of fluid, electrolyte and acidbase balance
Hypo-osmolality and hyponatraemia
Alkalosis
Hyperkalaemia
Hypokalaemia
Other disorders of electrolyte and fluid
balance, not elsewhere classified
Disorders of plasma-protein metabolism, not
Lipomatosis, not elsewhere classified
0
2
0
0
0
0
39
16
25
23
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
13
12
12
15
12
11
0
0
0
0
1
0
0
0
0
0
3
0
0
3
0
0
1
0
0
8
1
1
9
0
0
1
0
0
8
0
0
10
0
0
0
0
1
0
2
0
0
1
1
0
1
0
0
0
0
5
0
0
Page 118 of 149
0
0
10
0
0
0
0
236
0
0
121
0
0
115
0
0
Disorders of calcium metabolism
E83.5
Hyperlipidaemia, unspecified
Hyperuricaemia without signs of
inflammatory arthritis and tophaceous
disease
Disorders of mineral metabolism
E79.0
0
0
0
0
0
0
0
15
0
0
0
0
17
8
3
0
0
0
0
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
E88.9
Metabolic disorder, unspecified
F03
Unspecified dementia
Delirium, not induced by alcohol and other
psychoactive substances
Delirium, unspecified
10
14
10
24
27 175
34
82
176
757
933
F00*
F05
F05.9
F07.1
F10
F10.0
F10.1
F10.2
F10.3
F10.5
F10.7
F10.9
F12
F14
F19
F20
F20.9
F23
Dementia in Alzheimer's disease ( G30.-+ )
Postencephalitic syndrome
Mental and behavioural disorders due to use
of alcohol
of alcohol - Acute intoxication
of alcohol - Harmful use
of alcohol - Dependence syndrome
of alcohol - Withdrawal state
of alcohol - Psychotic disorder
of alcohol - Residual and late-onset psychotic
disorder
of alcohol - Unspecified mental and
behavioural disorder
of cannabinoids
of cocaine
Mental and behavioural disorders due to
multiple drug use and use of other
psychoactive substances
Schizophrenia
Schizophrenia, unspecified
F25
Acute and transient psychotic disorders

Acute and transient psychotic disorder,
unspecified
Schizoaffective disorders
F30
Manic episode
F23.9
F28
F29
F30.1
F30.2
F30.9
F31
F32
F32.0
F32.8
F32.9
F33
F39
F40
F41
F41.0
F41.1
F41.9
F42
F43
F43.8
F44
F44.5
Other nonorganic psychotic disorders

Unspecified nonorganic psychosis
Mania without psychotic symptoms

Mania with psychotic symptoms
Manic episode, unspecified
Bipolar affective disorder
Depressive episode
Mild depressive episode
Other depressive episodes
Depressive episode, unspecified

Recurrent depressive disorder
Unspecified mood [affective] disorder

Phobic anxiety disorders
Other anxiety disorders
Panic disorder [episodic paroxysmal anxiety]

Generalized anxiety disorder
Anxiety disorder, unspecified
Obsessive-compulsive disorder
Reaction to severe stress, and adjustment
disorders
Other reactions to severe stress
Dissociative [conversion] disorders
F45
Dissociative convulsions
Dissociative [conversion] disorder,
unspecified
Somatoform disorders
F48.9
Neurotic disorder, unspecified
F44.9
F45.2
F48
F50
F50.5
F51
F51.3
F52
F53
F53.1
Hypochondriacal disorder
Other neurotic disorders
Eating disorders
Vomiting associated with other psychological
disturbances
Nonorganic sleep disorders
Sleepwalking [somnambulism]
Sexual dysfunction, not caused by organic
disorder or disease
Mental and behavioural disorders associated

with the puerperium, not elsewhere classified
Severe mental and behavioural disorders
associated with the puerperium, not
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
11
60
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
20
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
0
0
1
1
0
0
0
1
0
0
1
0
38 209
0
17
0
2
0
18
0
0
0
2
0
0
0
0
0
59 217
0
33
0
2
0
16
0
0
0
0
0
0
0
22
0
1
0
11
0
1
2
0
130
12
15
0
0
1
0
0
0
1
0
0
0
0
0
50
2
5
12
19
58
18
24
16
23
11
67
129
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
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
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
1
0
2
0
1
0
0
2
0
1
0
1
3
0
0
0
0
1
0
7
0
0
0
0
1
9
0
0
0
7
0
0
19
0
1
23
1
0
22
0
0
11
0
0
0
0
14
0
0
0
3
0
0
0
2
0
0
0
4
0
0
0
4
0
0
14
17
0
1
13
11
0
0
2
0
0
1
3
0
16
0
0
0
1
1
7
2
0
49
0
4
1
6
1
3
1
0
5
24
10
0
1
0
4
1
1
0
0
3
0
0
1
0
0
0
4
0
12
39
39
15
10
20
34
3
2
16
22
34
67
39
1
1
31
15
17
0
0
34
23
32
1
0
36
33
0
0
13
16
0
0
63
0
0
3
5
0
12
0
4
0
2
2
13
0
2
0
2
0
19
2
5
1
2
3
0
1
0
0
6
0
0
1
1
12
0
0
0
1
0
1
0
0
0
0
20
0
3
0
1
5
0
2
0
0
0
1
0
0
0
8
0
0
33
12
0
9
238
9
0
3
0
4
0
0
0
0
0
4
0
0
1
1
0
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
3
4
0
0
0
2
3
1
3
0
0
0
25
18
14
255
334
96
22
2
0
72
20
12
183
11
15
54
18
22
36
10
12
207
236
89
15
147
107
26
100
31
24
57
13
344
155
189
13
12
140
20
13
61
28
0
0
28
41
196
42
38
40
26
53
79
11
0
0
14
22
19
19
11
57
0
0
104
26
11
12
3
1
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
1
0
0
0
7
1
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
10
10
Page 119 of 149
449
ICD
Code
Diseases
F60
Abuse of non-dependence-producing
substances
Specific personality disorders
F79
Unspecified mental retardation
F55
F73
F78
F99
G00
G00.9
Profound mental retardation

Other mental retardation
Mental disorder, not otherwise specified
Bacterial meningitis, not elsewhere classified
G03.8
Bacterial meningitis, unspecified

Meningitis in bacterial diseases classified
elsewhere
Meningitis due to other and unspecified
causes
Meningitis due to other specified causes
G04
Encephalitis, myelitis and encephalomyelitis
G01*
G03
G03.9
G04.0
Meningitis, unspecified
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
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
1
0
0
3
0
3
0
0
0
0
0
0
0
4
0
0
0
0
0
1
0
1
0
0
2
2
0
0
0
0
7
0
0
0
1
1
4
4
0
0
1
0
2
1
1
0
0
0
0
0
2
0
0
0
0
0
0
18
12
21
19
23
18
15
15
11
11
49
42
34
11
38
12
10
20
28
6
1
12
12
33
29
14
16
0
11
2
1
23
12
57
14
196
198
394
20
202
37
100
102
23
19
23
6
1
10
0
G06.0
28
22
50
G20
Parkinson's disease
0
0
G24.9
G35
Extradural and subdural abscess, unspecified

Dystonia, unspecified
G40.9
Multiple sclerosis
Other demyelinating diseases of central
nervous system
Epilepsy
Localization-related (focal)(partial)
symptomatic epilepsy and epileptic
syndromes with simple partial seizures
Special epileptic syndromes
Grand mal seizures, unspecified (with or
without petit mal)
Epilepsy, unspecified
G43.9
Migraine, unspecified
G37
G40
G40.1
G40.5
G40.6
G41
G43
G44
G44.1
G44.2
Status epilepticus
Migraine
Other headache syndromes
Vascular headache, not elsewhere classified
G47
Tension-type headache
Transient cerebral ischaemic attacks and
related syndromes
Multiple and bilateral precerebral artery
syndromes
Transient cerebral ischaemic attack,
unspecified
Sleep disorders
G54.1
Lumbosacral plexus disorders
G45
G45.2
G45.9
G51
G51.0
G56
G58
G58.8
Facial nerve disorders

Bell's palsy
Mononeuropathies of upper limb

Other mononeuropathies
0
0
0
0
0
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
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
3
0
0
2
0
0
0
0
4
0
0
1
2
0
0
0
2
0
0
4
0
4
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
1
0
0
11
0
1
16
0
0
0
0
1
0
8
0
0
3
1
0
0
0
3
0
0
7
0
0
1
0
6
0
0
3
0
1
0
0
5
0
0
7
2
2
0
1
2
0
0
2
0
0
0
0
1
0
0
5
0
0
0
0
1
2
0
0
0
0
0
0
1
0
0
3
0
1
0
0
3
0
0
0
7
0
1
2
0
1
0
7
1
1
0
0
0
11
0
1
31
2
0
60
2
1
10
54
44
0
0
29
G06.2
Acute disseminated encephalitis

Encephalitis, myelitis and encephalomyelitis,
unspecified
Intracranial abscess and granuloma
G04.9
2
8
1
3
1
0
5
9
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
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
2
0
0
0
0
1
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
2
0
0
0
0
0
1
1
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
1
0
0
0
1
0
0
0
0
1
3
0
1
1
1
3
2
3
0
0
0
4
5
3
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
G61
G62.1
Alcoholic polyneuropathy
0
0
G62
G62.8
G62.9
G72
G80
G80.9
G81
G81.1
G81.9
G82
G82.0
G82.2
G83
G83.3
G83.9
G91
G91.9
450
Other polyneuropathies
Other specified polyneuropathies

Polyneuropathy, unspecified
Other myopathies
Cerebral palsy
Cerebral palsy, unspecified

Hemiplegia
Spastic hemiplegia
Hemiplegia, unspecified
Paraplegia and tetraplegia

Flaccid paraplegia
Paraplegia, unspecified
Other paralytic syndromes

Monoplegia, unspecified
Paralytic syndrome, unspecified

Hydrocephalus
Hydrocephalus, unspecified
0
0
0
0
0
0
0
0
0
0
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
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
4
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
1
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
1
0
1
0
1
0
0
3
2
1
0
0
1
0
0
0
1
0
0
1
0
1
4
0
1
2
1
2
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
Page 120 of 149
1
0
0
0
0
0
1
0
0
1
1
0
1
0
0
0
1
1
1
0
0
0
0
0
0
0
0
2
0
0
1
0
0
0
1
2
0
0
0
0
0
0
0
3
0
0
0
0
1
0
1
1
0
0
0
0
0
1
1
0
0
1
0
1
1
0
1
5
0
0
0
1
1
0
0
0
0
0
0
0
1
0
0
0
0
0
11
0
4
0
0
0
0
0
1
0
0
2
0
1
0
1
0
1
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
9
0
0
0
0
0
4
0
0
2
0
2
1
1
3
1
9
2
1
0
0
1
7
1
9
4
1
2
1
10
15
16
24
39
63
0
4
0
0
0
1
0
0
0
0
5
0
2
0
1
1
0
0
12
1
1
2
1
0
2
0
3
4
0
3
0
1
0
1
2
22
2
14
36
12
16
7
3
8
6
10
3
6
13
17
14
19
Guillain-Barr syndrome
G61.0
Other specified mononeuropathies

Neuropathy in association with hereditary
ataxia
Inflammatory polyneuropathy
G60.2
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
3
0
1
0
0
0
0
0
0
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
G93
Other disorders of brain
G93.8
Other specified disorders of brain
G93.4
G93.5
G93.9
G95.1
G95.2
Encephalopathy, unspecified
Compression of brain
Disorder of brain, unspecified

Vascular myelopathies
H00.1
Cord compression, unspecified

Other disorders of nervous system, not
Hordeolum and other deep inflammation of
eyelid
Chalazion
H10
Conjunctivitis
G98
H00.0
H02
H04
H10.0
H10.3
H10.9
H11
H11.0
H15.0
H26
H26.1
H26.9
H40
H50
H51
H52.1
H53.5
H57
H60
H60.0
H60.9
H61.2
H65.2
H65.3
H66
H66.0
Other disorders of eyelid
Disorders of lacrimal system

Mucopurulent conjunctivitis
Acute conjunctivitis, unspecified

Conjunctivitis, unspecified
Other disorders of conjunctiva

Pterygium
Scleritis
Other cataract
Traumatic cataract
Cataract, unspecified
Glaucoma
Other strabismus
Other disorders of binocular movement

Myopia
Colour vision deficiencies
Other disorders of eye and adnexa

Otitis externa
Abscess of external ear
Otitis externa, unspecified

Impacted cerumen
Chronic serous otitis media
Chronic mucoid otitis media
Suppurative and unspecified otitis media
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
1
0
0
1
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
2
0
0
0
0
0
1
2
0
0
0
0
0
0
0
1
0
1
0
0
0
0
2
0
0
0
0
2
0
0
0
0
5
0
0
3
1
7
2
0
6
0
9
1
0
1
2
1
17
17
44
23
67
10
65
58
123
0
0
0
0
0
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
1
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5
0
0
2
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
1
1
6
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
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
6
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
8
1
0
8
0
0
0
1
1
0
0
0
0
2
12
1
0
1
0
0
0
0
2
0
0
0
0
5
2
0
1
0
0
0
0
1
2
0
1
0
0
0
0
12
12
26
11
0
1
0
0
1
0
0
0
0
0
1
1
2
0
0
0
0
0
0
1
0
0
0
15
27
31
0
0
4
4
0
0
0
2
12
10
15
68
21
55
13
61
19
31
0
0
0
0
0
0
0
1
0
0
0
4
0
2
0
5
0
0
0
14
95
3
0
1
0
0
0
0
0
0
5
1
0
0
4
17
0
0
8
0
1
0
0
3
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
0
0
1
4
0
0
3
0
0
0
0
0
1
0
0
0
0
3
0
0
0
0
1
0
0
0
1
0
23
15
14
0
0
0
0
0
0
1
0
5
0
0
0
0
0
0
1
0
6
0
0
0
0
0
0
0
1
0
81
3
1
0
1
1
0
3
2
0
4
49
51
415
1764
1
1
1
0
1
5
0
2
1
45
1
170
2
1
2
1
1
8
2
2
5
94
105
123
228
26
15
16
126
113
239
H70
Mastoiditis and related conditions
0
0
H70.9
H74.4
H74.9
H81.4
H91.9
Mastoiditis, unspecified
Polyp of middle ear

Disorder of middle ear and mastoid,
unspecified
Vertigo of central origin
I01
Hearing loss, unspecified

Other disorders of ear, not elsewhere
classified
Tinnitus
Rheumatic fever without mention of heart
involvement
Rheumatic fever with heart involvement
I01.2
Acute rheumatic myocarditis
H93
H93.1
I00
I01.0
I01.1
I01.8
I02
I02.0
I05
I06
I09
I09.0
I09.9
I10
I11
I12
I13.9
I15
I15.1
Acute rheumatic pericarditis
Acute rheumatic endocarditis
Other acute rheumatic heart disease

Rheumatic chorea
Rheumatic chorea with heart involvement

Rheumatic mitral valve diseases
Rheumatic aortic valve diseases
Other rheumatic heart diseases
Rheumatic myocarditis
Rheumatic heart disease, unspecified

Essential (primary) hypertension
Hypertensive heart disease
Hypertensive renal disease

Hypertensive heart and renal disease,
unspecified
Secondary hypertension
Hypertension secondary to other renal
disorders
0
0
0
0
1
1
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
1
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
1
1
0
0
2
0
0
0
2
0
0
0
0
0
17
0
3
1
0
1
14
1
1
2
2
0
31
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
900
89
0
0
38
864
45
20
25
28
17
23
71
66
213
11
11
202
23
89 105 199 196 531 542
10
22
12
8
1
12
33
55
0
0
11
12
1
0
15
Otitis media, unspecified
Suppurative otitis media, unspecified
H66.9
0
0
0
0
0
0
14
H66.3
H66.4
Acute suppurative otitis media

Chronic tubotympanic suppurative otitis
media
Other chronic suppurative otitis media
H66.1
0
0
0
0
0
0
11
18
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
1
0
0
5
0
0
0
0
0
0
0
0
0
0
1
3
0
0
1
0
0
0
1
0
0
0
0
0
0
0
5
0
2
2
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
1
1
0
0
0
0
2
1
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
13
11
0
0
0
0
0
6
0
0
0
6
1
0
0
1
0
0
0
0
1
0
0
1
3
0
0
0
0
0
0
0
19
15
15
89
0
1
0
0
0
1
0
0
15
0
0
0
3
0
0
0
0
0
0
0
7
0
6
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
5
0
0
0
0
0
0
4
4
0
0
0
0
0
0
0
2
0
0
0
0
0
1
1
1
0
0
0
0
0
0
0
4
0
2
0
0
0
0
16
20
Page 121 of 149
0
0
0
2
6
1
1
1
0
0
1
1
1
2
6
0
0
0
0
0
0
0
19
2
11
0
63
26
37
2
33
30
1
24
0
96
56
61
0
0
0
0
0
0
0
21
32
14
18
26
10
10
3981
1892
2089
16
63 132 182 582 315 378 375 882 923
11
182
72
13
110
10
15
14
0
1
0
0
1
2
0
1
0
0
0
451
ICD
Code
Diseases
I15.9
Hypertension secondary to endocrine

disorders
Secondary hypertension, unspecified
I20.9
Angina pectoris, unspecified
I15.2
I20
I20.0
I21
I21.9
I22
I24
I24.0
I24.9
I25
I25.1
I25.4
I25.5
I25.9
I26
I27
I27.8
I27.9
I30
I30.0
I30.9
I31
I31.3
I31.9
I33.9
I37.9
I38
I40
I40.0
I41*
I42
I42.0
I42.6
I42.9
I44
I44.7
I45
I45.9
I46
I46.1
I46.9
I47.1
I48
I49
Angina pectoris
Unstable angina
Acute myocardial infarction
Acute myocardial infarction, unspecified

Subsequent myocardial infarction
Other acute ischaemic heart diseases

Coronary thrombosis not resulting in
myocardial infarction
Acute ischaemic heart disease, unspecified

Chronic ischaemic heart disease
Atherosclerotic heart disease
Coronary artery aneurysm
Ischaemic cardiomyopathy
Chronic ischaemic heart disease, unspecified

Pulmonary embolism
Other pulmonary heart diseases
Other specified pulmonary heart diseases

Pulmonary heart disease, unspecified
Acute pericarditis
Acute nonspecific idiopathic pericarditis

Acute pericarditis, unspecified
Other diseases of pericardium
Pericardial effusion (noninflammatory)

Disease of pericardium, unspecified
Acute endocarditis, unspecified
Pulmonary valve disorder, unspecified

Endocarditis, valve unspecified
Acute myocarditis
Infective myocarditis
Myocarditis in diseases classified elsewhere

Cardiomyopathy
Dilated cardiomyopathy
Alcoholic cardiomyopathy
Cardiomyopathy, unspecified
Atrioventricular and left bundle-branch block

Left bundle-branch block, unspecified
Other conduction disorders
Conduction disorder, unspecified

Cardiac arrest
Sudden cardiac death, so described

Cardiac arrest, unspecified
Supraventricular tachycardia
Atrial fibrillation and flutter
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
12
12
24
14
17
24
26
64
56
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
1
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
1
0
0
1
0
0
1
1
0
1
0
0
3
0
2
0
0
0
0
2
0
1
0
1
1
3
4
0
5
0
1
1
1
4
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
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
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
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
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
1
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
1
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
1
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
1
0
0
3
1
0
1
1
0
0
1
2
0
2
0
0
0
0
1
0
0
0
2
0
0
0
0
1
2
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
1
0
0
0
0
0
1
0
1
1
0
0
0
0
3
0
1
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
2
1
1
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
I50.1
Left ventricular failure
I60.9
I61.5
Intracerebral haemorrhage, intraventricular
I61
I61.9
452
Intracerebral haemorrhage
Intracerebral haemorrhage, unspecified
0
1
0
1
0
4
0
1
0
0
0
1
0
2
0
0
0
1
0
2
5
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
1
0
0
0
0
0
0
0
0
0
0
0
4
I60.1
6
0
10
2
0
0
1
1
1
0
1
0
2
0
0
2
2
0
0
1
0
0
1
0
1
0
0
3
0
2
0
0
0
1
0
1
0
0
1
0
0
0
0
0
1
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
5
11
11
3
3
1
0
1
0
0
2
1
0
0
0
1
0
1
0
0
0
0
1
0
2
0
0
8
0
2
0
2
0
0
0
0
0
15
1
8
2
1
9
Page 122 of 149
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
1
6
3
3
3
4
19
1
5
11
2
1
1
1
0
0
0
0
0
0
0
0
0
11
8
1
1
2
0
0
2
4
3
3
13
1
5
6
1
1
8
7
6
6
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
12
12
23
12
1
2
0
2
0
0
1
0
2
2
1
0
8
2
0
2
0
3
0
0
4
2
2
1
10
1
5
6
0
1
9
8
1
2
8
93
66
54
52
2
0
0
14
3
4
0
11
113
101
19
4
0
12
62
81
175
182
12
36
51
165
10
17
93
72
29
76
47
25
33
0
0
18
10
13
0
0
0
0
56
37
25
2
6
17
10
12
12
10
11
42
18
24
20
15
4
7
10
49
10
50
182
17
24
86
1
5
180
10
96
30
74
106
25
37
46
10
22
17
67
20
11
12
10
14
12
12
17
12
I60
I50
I52*
Heart disease, unspecified

Other heart disorders in diseases classified
elsewhere
Subarachnoid haemorrhage
Subarachnoid haemorrhage from middle
cerebral artery
Subarachnoid haemorrhage, unspecified
I51.9
Cardiomegaly
Cardiovascular disease, unspecified
I51.7
I51.6
I51.4
Total
I51.3
I51.0
I51
Heart failure, unspecified

Complications and ill-defined descriptions of
heart disease
Cardiac septal defect, acquired
Intracardiac thrombosis, not elsewhere
classified
Myocarditis, unspecified
I50.9
Congestive heart failure
Total
Deaths
Total
I50.0
60
Years
Other cardiac arrhythmias

Other and unspecified premature
depolarization
Heart failure
I49.4
50-59
Years
8
1
1
6
5
1
0
7
12
19
20
87
1
2
2
1
0
9
10
16
23
34
57
13
13
26
22
28
31
41
72
0
0
0
0
0
0
1
2
0
0
1
0
0
2
0
0
3
1
1
5
1
1
0
0
0
0
0
0
0
0
ICD
Code
I62
I62.0
I62.9
I63
I63.8
Diseases
Other nontraumatic intracranial haemorrhage
Subdural haemorrhage (acute)(nontraumatic)
Intracranial haemorrhage (nontraumatic),
unspecified
Cerebral infarction
I67
Other cerebral infarction

Stroke, not specified as haemorrhage or
infarction
Occlusion and stenosis of unspecified
precerebral artery
Other cerebrovascular diseases
I70.9
Generalized and unspecified atherosclerosis
I64
I65.9
I67.2
I67.9
Cerebral atherosclerosis
Cerebrovascular disease, unspecified
I72.0
Aortic aneurysm of unspecified site, without

mention of rupture
Aneurysm of carotid artery
I73
Other peripheral vascular diseases
I71.9
I72.1
I72.9
I73.1
I73.9
I74.9
I77.6
I80
I80.2
I80.8
Aneurysm of artery of upper extremity

Aneurysm of unspecified site
Thromboangiitis obliterans [Buerger]
Peripheral vascular disease, unspecified

Embolism and thrombosis of unspecified
artery
Arteritis, unspecified
Phlebitis and thrombophlebitis

Phlebitis and thrombophlebitis of other deep
vessels of lower extremities
Phlebitis and thrombophlebitis of other sites
I81
Phlebitis and thrombophlebitis of unspecified

site
Portal vein thrombosis
I82.9
Embolism and thrombosis of unspecified vein
I80.9
I82
I82.2
Other venous embolism and thrombosis

Embolism and thrombosis of vena cava
I86
Varicose veins of lower extremities without

ulcer or inflammation
Haemorrhoids
Unspecified haemorrhoids without
complication
Varicose veins of other sites
I86.8
Varicose veins of other specified sites
I83.9
I84
I84.9
I86.1
I86.3
I88
I88.0
I88.1
I88.9
I89
I89.0
I89.1
I95.9
Scrotal varices
Vulval varices
Nonspecific lymphadenitis
Nonspecific mesenteric lymphadenitis
Chronic lymphadenitis, except mesenteric

Nonspecific lymphadenitis, unspecified
Other noninfective disorders of lymphatic
vessels and lymph nodes
Lymphoedema, not elsewhere classified
Lymphangitis
J00
Hypotension, unspecified
Other and unspecified disorders of circulatory
system
Acute nasopharyngitis (common cold)
J01.9
Acute sinusitis, unspecified
I99
J01
J01.4
J02
J02.9
J03
J03.0
J03.9
J04
J04.0
J04.2
J05
J05.0
J05.1
J06
J06.9
Acute sinusitis
Acute pansinusitis
Acute pharyngitis
Acute pharyngitis, unspecified

Acute tonsillitis
Streptococcal tonsillitis
Acute tonsillitis, unspecified
Acute laryngitis and tracheitis

Acute laryngitis
Acute laryngotracheitis
Acute obstructive laryngitis [croup] and
epiglottitis
Acute obstructive laryngitis [croup]
Acute epiglottitis
Acute upper respiratory infections of multiple
and unspecified sites
Acute upper respiratory infection, unspecified
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
F
M
1
Total
2
10
12
22
M
0
0
0
15
22
28
40
37
83
78
161
10
15
26
16
40
98 113
144
192
336
12
13
0
0
1
3
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
1
0
0
0
0
0
0
0
1
1
3
0
2
0
1
1
3
0
3
0
1
4
3
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
1
1
0
0
0
0
0
1
0
0
0
1
0
0
1
2
1
1
0
0
0
0
0
1
0
0
1
1
0
0
0
2
0
0
1
2
1
0
1
6
2
2
2
3
2
3
0
0
0
0
0
0
10
12
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
2
0
0
5
0
0
4
0
1
17
0
0
7
0
2
6
0
0
2
1
0
13
0
0
2
0
0
2
2
0
1
1
0
1
2
0
19
0
0
2
3
46
4
3
65
0
0
0
0
0
0
24
42
35
53
23
42
13
46
22
49
128
248
376
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
1
2
3
0
0
0
1
0
0
0
1
3
1
5
0
1
0
0
0
1
1
1
1
0
0
0
1
0
0
1
0
3
0
0
0
0
0
0
0
0
0
0
1
1
2
0
1
0
0
0
0
0
0
0
0
1
0
0
1
1
0
0
0
0
8
1
0
0
0
0
2
0
0
0
0
1
0
0
0
1
10
0
0
1
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
0
0
0
0
0
3
1
0
0
0
0
0
0
0
1
20
0
1
0
28
4
0
1
20
4
4
1
3
5
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
0
1
0
0
0
0
0
0
1
0
1
0
0
0
0
0
10
10
12
23
19
12
37
29
14
13
0
6
2
0
1
0
23
8
0
1
43
12
2
0
92 119 102
28
28
12
0
0
0
0
0
0
0
0
74
56 107 118 143 100 116
0
2
0
5
0
1
73 185 126
17
46
35
0
0
2
0
0
0
0
89
22
5
0
0
0
0
9
3
0
2
13
51
22
17
0
0
10
0
0
67
6
0
0
25
4
3
0
0
48 138
72
73
55
67
54
72
0
0
0
7
0
0
0
1
1
1
0
2
0
0
0
1
0
0
4
0
0
0
3
1
2
0
0
1
0
0
1
0
0
13
591
131
13
1
0
3
6
0
0
17
252
483
1074
16
121
4
1
1
5
1
0
0
0
0
56 118 106
823
763
1586
0
1
223
18
105
13
118
23
0
14
6
0
0
5
10
1
2
0
2
0
5
0
1
20
0
0
0
0
0
1
0
0
0
0
0
0
13
0
0
0
0
11
0
0
0
0
48
11
31
0
0
0
0
0
0
0
0
0
0
Page 123 of 149
453
ICD
Code
Diseases
J12.1
Influenza due to other identified influenza

virus
Influenza, virus not identified
Influenza with other respiratory
manifestations, virus not identified
Respiratory syncytial virus pneumonia
J14
Pneumonia due to Haemophilus influenzae
J10
J11
J11.1
J13
J15
J15.3
J15.4
J15.9
Pneumonia due to Streptococcus pneumoniae

Bacterial pneumonia, not elsewhere classified
Pneumonia due to streptococcus, group B
Pneumonia due to other streptococci
28
Days
29 Days-1
Yr
M
0
M
0
01-04
Years
05-14
Years
M
0
15-19
Years
M
0
20-29
Years
M
0
30-39
Years
M
0
40-49
Years
M
0
50-59
Years
M
1
16
24
20
10
29
23
170
143
313
13
18
10
46
16
37
37 101
30
65
31
42
43
47
213
495
708
33
41
183 222 118 181

0
36
0
35
0
4
0
0
8
1
36 125
11
10
0
3
2
67
52
63
49
J31.0
Vasomotor rhinitis
Chronic rhinitis, nasopharyngitis and
pharyngitis
Chronic rhinitis
J32.4
Chronic pansinusitis
J31
J32
J32.2
J32.9
J33
J33.0
J33.9
J34
J34.2
J34.8
J35
J35.0
J35.3
J36
J37
Chronic sinusitis
Chronic ethmoidal sinusitis
Chronic sinusitis, unspecified

Nasal polyp
Polyp of nasal cavity
Nasal polyp, unspecified
Other disorders of nose and nasal sinuses
Deviated nasal septum

Other specified disorders of nose and nasal
sinuses
Chronic diseases of tonsils and adenoids
Chronic tonsillitis
Hypertrophy of tonsils with hypertrophy of
adenoids
Peritonsillar abscess
J38.2
Chronic laryngitis and laryngotracheitis

Diseases of vocal cords and larynx, not
Nodules of vocal cords
J39.0
Retropharyngeal and parapharyngeal abscess
J38
J39
J39.2
J39.3
J39.8
J39.9
J40
J41
J42
J43
J43.9
J44
J44.0
J44.1
J44.8
J44.9
J45
J45.0
J45.9
454
Other diseases of upper respiratory tract
Other diseases of pharynx

Upper respiratory tract hypersensitivity
reaction, site unspecified
Other specified diseases of upper respiratory
tract
Disease of upper respiratory tract,
unspecified
Bronchitis, not specified as acute or chronic
Simple and mucopurulent chronic bronchitis

Unspecified chronic bronchitis
Emphysema
Emphysema, unspecified
Other chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease with
acute lower respiratory infection
Chronic obstructive pulmonary disease with
acute exacerbation, unspecified
Other specified chronic obstructive
pulmonary disease
Chronic obstructive pulmonary disease,
unspecified
Asthma
Predominantly allergic asthma
Asthma, unspecified
62
85
0
0
78
12
0
14
1
12
2
16
1
35
0
1
1
0
38
0
0
1
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
1
0
1
0
0
0
1
0
0
2
0
1
0
10
4
3
14
2
0
0
3
1
4
2
6
4
0
1
2
1
4
0
4
1
0
5
0
8
0
4
2
0
4
0
5
4
11
32
45
0
0
12
7
0
0
6
1
0
10
0
3
10
27
4
0
0
4
0
3
1
4
0
0
6
0
7
2
13
2
0
0
4
0
2
3
3
3
0
1
7
0
1
0
0
0
0
3
0
0
2
10
129
2
6
28
63
17
26
10
0
0
0
0
0
0
0
0
12
23
0
0
0
2
0
0
0
1
1
0
0
0
0
0
1
0
0
0
1
4
0
0
4
0
3
1
2
1
5
0
5
2
0
0
3
0
0
0
7
1
0
0
2
0
0
0
1
0
0
0
3
0
0
0
2
0
0
0
2
0
0
0
14
14
18
36
13
40
14
11
26
15
17
188 393 107 194

0
0
0
0
1
0
0
1
18
13
36
1
0
0
3
0
1
0
0
0
11
0
4
0
0
1
16
0
5
0
0
2
40
0
9
52
0
1
1
77
0
0
0
12
0
0
0
9
0
0
1
32
0
0
0
23
0
3
1
2
0
58
16
96
0
3
25
0
9
0
2
50
0
8
0
5
14
0
7
0
2
19
0
7
Page 124 of 149
0
0
10
62
1
13
0
0
4
22
0
12
4
0
22
66
0
25
0
0
10
10
11
22
18
20
1
0
0
0
2
0
0
0
2
0
0
0
5
0
535
3
12
27
0
7
25
0
55
74
0
18
24
11
47
35 104
40
0
8
57
20
16 114
94
44 226 233
0
56 145
96
82 436 426
2
17
21
18
149
5
637
463
1
119
0
0
1
0
271
820
1355
296
312
3462
10
4591
47 281 227 742 452 3371 2637
10
32
10
44
12
52
24
44
28
17
51
10
143
11
128
14
12
33
10
21
0
28
0
1
0
0
0
2
0
2
2
0
53
189
1
2
32
121
1
2
68
1
0
34
0
0
29
0
5
21
27
11
57
24
27
33
0
1
0
0
64
0
0
36
18
0
0
7181
0
0
292
3871
0
0
163
59
3310
0
0
10
13
3465
2108
1357
13
77 107 173 193
932
518
932
414
0
0
518
11
0
0
414
29
30
10
0
0
0
0
11
0
0
1
0
0
0
0
0
0
0
668 1109 849 1127 371 498 127 128 222 164 189 149 216 152 199 132 407 327
0
3
46
68
64
37
32
21
22
99 168
412 834 332 540
87
48
Pneumonia, unspecified
J18.9
Vasomotor and allergic rhinitis
J30.0
15
10
J30
25
Unspecified acute lower respiratory infection
22
J22
31
Acute bronchiolitis, unspecified
M
1
11
J21.9
45
15
Acute bronchiolitis
Total
28
21
J21
M
17
19
35
Acute bronchitis
16
36
J20
13
183 222 118 181
Lobar pneumonia, unspecified
11
41
J18.1
33
Bronchopneumonia, unspecified
J18
J18.0
M
5
Total
Deaths
Total
Bacterial pneumonia, unspecified

Pneumonia due to other infectious organisms,
not elsewhere classified
Pneumonia, organism unspecified
J16
60
Years
115
2
20
0
1
0
8053 110
264
608
0
0
1
99
8
7
566
1203
15
18
365
90
828
209
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
J46
Status asthmaticus
J64
Unspecified pneumoconiosis
J47
J63.0
J65
J66
J66.8
J67.7
J68.0
J68.2
J68.3
J69.0
J80
J81
Bronchiectasis
Aluminosis (of lung)
Pneumoconiosis associated with tuberculosis

Airway disease due to specific organic dust
Airway disease due to other specific organic

dusts
Air-conditioner and humidifier lung
Bronchitis and pneumonitis due to chemicals,
gases, fumes and vapours
Upper respiratory inflammation due to
chemicals, gases, fumes and vapours, not
Other acute and subacute respiratory
conditions due to chemicals, gases, fumes and
vapours
Pneumonitis due to food and vomit
Adult respiratory distress syndrome
J84.9
Pulmonary oedema
Pulmonary eosinophilia, not elsewhere
classified
Other interstitial pulmonary diseases
Other interstitial pulmonary diseases with
fibrosis
Interstitial pulmonary disease, unspecified
J85.3
Abscess of mediastinum
J82
J84
J84.1
J85.1
J85.2
J86
J86.0
J86.9
J90
Abscess of lung with pneumonia
Abscess of lung without pneumonia

Pyothorax
Pyothorax with fistula
Pyothorax without fistula
0
0
0
0
0
0
0
1
0
0
0
0
1
0
1
0
0
0
1
0
0
0
J98.1
J98.8
J98.9
K01
K02
K02.0
K02.9
K03.5
K04
K04.8
K05
K06
K07.0
K08
K08.8
K08.9
K09
K09.0
Pulmonary collapse
Other specified respiratory disorders

Respiratory disorder, unspecified
Embedded and impacted teeth
Dental caries
Caries limited to enamel
Dental caries, unspecified

Ankylosis of teeth
Diseases of pulp and periapical tissues

Radicular cyst
Gingivitis and periodontal diseases

Other disorders of gingiva and edentulous
alveolar ridge
Major anomalies of jaw size
Other disorders of teeth and supporting
structures
Other specified disorders of teeth and
supporting structures
Disorder of teeth and supporting structures,
unspecified
Cysts of oral region, not elsewhere classified
11
0
0
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
1
2
1
0
0
2
0
0
1
0
14
20
34
0
0
4
6
3
0
7
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
5
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
1
0
1
4
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
2
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
1
1
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
2
1
0
0
0
0
0
0
0
2
0
2
0
0
1
0
0
0
2
0
1
0
0
0
0
1
0
1
0
0
0
0
0
0
0
31
20
0
0
0
0
0
1
0
8
0
4
0
0
2
1
0
0
0
0
3
0
0
0
0
0
0
0
0
1
0
2
0
0
5
0
1
0
1
0
2
1
0
0
0
1
0
1
0
0
0
0
0
3
0
0
6
0
1
0
3
1
2
0
0
2
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
1
0
0
1
0
1
1
1
1
0
1
0
0
0
1
0
0
0
0
0
0
0
49
31
37
32
39
20
30
1
0
16
2
0
0
0
0
0
0
1
0
2
0
0
1
0
0
1
4
0
1
3
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
3
0
0
0
0
2
0
0
0
0
2
0
0
0
3
0
2
4
1
0
0
0
0
0
0
4
0
0
0
0
2
1
1
0
2
0
0
3
1
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
3
0
3
5
0
0
2
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
0
0
0
4
0
1
0
1
4
0
0
0
4
0
0
3
4
0
2
0
0
1
0
0
0
0
0
0
1
0
0
0
2
0
1
0
0
1
0
0
0
2
0
1
3
0
0
0
0
4
0
0
0
1
0
1
0
0
0
0
0
0
0
79
1
0
53
10
29
1
1
1
0
1
0
0
0
2
0
0
0
0
1
0
0
0
0
0
1
3
0
0
1
0
1
0
1
3
1
0
0
0
2
0
0
0
3
0
1
1
0
1
3
5
1
4
208
1
1
1
6
0
2
0
8
277
2
2
1
7
3
7
1
1
0
2
0
2
0
2
3
2
2
2
16
22
1
0
0
1
9
1
20
1
3
4
2
4
38
2
1
2
2
21
11
11
0
1
0
0
1
0
0
0
0
2
0
0
0
1
1
0
0
0
36
14
17
22
0
2
0
19
13
485
45
15
33
12
12
2
3
32
0
0
0
0
0
0
0
19
0
0
0
2
0
16
10
26
16
21
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
3
0
1
0
0
0
4
2
2
0
1
0
6
0
1
1
0
0
1
0
1
0
0
0
1
0
K11.2
Sialoadenitis
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
1
0
0
0
0
11
0
0
0
0
3
1
0
1
0
5
0
0
0
0
3
0
0
0
1
1
0
0
0
0
0
Page 125 of 149
0
3
1
0
3
0
1
0
0
0
0
0
0
0
3
0
0
0
0
1
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
3
1
0
0
0
0
K10
2
1
0
0
0
1
10
3
1
13
0
23
3
0
0
1
2
1
30
1
0
10
27
14
13
Stomatitis and related lesions
K12
Mucocele of salivary gland
K11.6
Fistula of salivary gland
K11.4
24
Diseases of salivary glands
K11
20
Giant cell granuloma, central
16
K10.1
11
Developmental odontogenic cysts

Other cysts of oral region, not elsewhere
classified
Other diseases of jaws
K09.8
5
4
Other respiratory disorders
Other pleural conditions
J98
J94
Respiratory failure, unspecified
13
J96.9
Acute respiratory failure
J96.0
Respiratory failure, not elsewhere classified
J96
Other specified pleural conditions
J92
J94.8
Haemothorax
J94.2
Pneumothorax, unspecified
J93.9
Pneumothorax
J93
Pleural effusion, not elsewhere classified

Pleural effusion in conditions classified
elsewhere
Pleural plaque
J91*
10
3
3
1
40
0
0
0
0
0
0
0
0
0
0
0
0
455
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
K12.1
Other forms of stomatitis
K13.0
K14
Diseases of lips
Leukoplakia and other disturbances of oral
epithelium, including tongue
Diseases of tongue
K22
Other diseases of oesophagus
0
0
K12.2
K13
K13.2
K20
K21
K22.0
K22.1
K22.2
K25
K26
K27
K29
K29.0
K29.1
K29.4
K29.7
K29.8
K29.9
K30
K31
K31.0
K31.1
K31.2
K31.3
K31.5
K31.8
K31.9
K35
K35.0
K35.1
K35.9
K36
K37
K38
K38.1
K38.3
K40
Cellulitis and abscess of mouth
Other diseases of lip and oral mucosa
Oesophagitis
Gastro-oesophageal reflux disease

Achalasia of cardia
Ulcer of oesophagus
Oesophageal obstruction
Gastric ulcer
Duodenal ulcer
Peptic ulcer, site unspecified

Gastritis and duodenitis
Acute haemorrhagic gastritis

Other acute gastritis
Chronic atrophic gastritis

Gastritis, unspecified
Duodenitis
Gastroduodenitis, unspecified
Dyspepsia
Other diseases of stomach and duodenum

Acute dilatation of stomach
Adult hypertrophic pyloric stenosis
Hourglass stricture and stenosis of stomach

Pylorospasm, not elsewhere classified
Obstruction of duodenum
Other specified diseases of stomach and
duodenum
Disease of stomach and duodenum,
unspecified
Acute appendicitis
Acute appendicitis with generalized
peritonitis
Acute appendicitis with peritoneal abscess

Acute appendicitis, unspecified
Other appendicitis
Unspecified appendicitis
Other diseases of appendix

Appendicular concretions
Fistula of appendix
K50
Inguinal hernia
Bilateral inguinal hernia, with obstruction,
without gangrene
Unilateral or unspecified inguinal hernia,
without obstruction or gangrene
Femoral hernia
Unilateral or unspecified femoral hernia,
without obstruction or gangrene
Umbilical hernia
Umbilical hernia without obstruction or
gangrene
Ventral hernia
Ventral hernia with obstruction, without
gangrene
Ventral hernia without obstruction or
gangrene
Diaphragmatic hernia
Unspecified abdominal hernia
Unspecified abdominal hernia with
obstruction, without gangrene
Unspecified abdominal hernia without
obstruction or gangrene
Crohn's disease [regional enteritis]
K51.1
Ulcerative (chronic) ileocolitis
K40.0
K40.9
K41
K41.9
K42
K42.9
K43
K43.0
K43.9
K44
K46
K46.0
K46.9
K50.9
K51
K51.9
K52
K52.0
K52.9
K56
456
Crohn's disease, unspecified

Ulcerative colitis
Ulcerative colitis, unspecified
Other noninfective gastroenteritis and colitis

Gastroenteritis and colitis due to radiation
Noninfective gastroenteritis and colitis,

unspecified
Paralytic ileus and intestinal obstruction
without hernia
0
0
0
0
0
0
1
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
6
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
4
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
1
0
1
0
0
0
5
1
0
0
0
0
0
0
0
3
0
1
0
1
0
1
0
0
0
0
0
29
4
0
0
0
2
3
0
0
0
3
0
2
0
0
0
0
0
1
18
0
0
3
0
1
7
9
70
20
0
0
12
0
0
0
0
0
0
0
0
2
1
3
0
0
0
0
0
0
0
2
0
0
0
0
0
0
1
2
0
1
0
0
0
0
0
0
0
0
0
0
0
4
3
0
0
0
1
6
18
63 249
1
1
2
0
0
0
1
0
0
0
0
0
0
0
0
1
0
3
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
1
0
0
0
0
2
1
6
0
0
0
4
0
1
2
3
0
0
0
2
0
0
4
0
1
1
0
0
1
0
1
3
0
1
0
0
0
0
1
0
0
1
3
0
1
1
1
0
0
0
1
2
0
0
0
6
0
0
4
1
3
0
0
0
5
1
0
0
4
22
29
17
24
19
35
29
29
22
10
22
42
21
49
21
32
14
51
31
99 446 222 356 213 341 213 282 182 340 218
2
0
1
0
2
0
6
1
1
0
2
1
11
0
0
0
0
0
0
0
2
0
2
0
4
0
1
0
0
0
1
2
0
0
0
9
0
0
0
0
0
0
2
1
1
0
4
0
1
0
2
0
10
0
0
0
1
0
0
0
1
2
0
1
0
2
1
2
0
0
0
1
2
1
0
4
0
1
0
8
0
2
0
4
1
10
10
10
1
0
0
0
14
0
0
0
0
0
0
0
1
1
0
2
5
0
1
0
25
10
35
4
1
2
13
154
252
9
0
0
3
15
38
21
30
41
46
34
32
14
23
17
13
12
14
16
10
11
88
12
20
13
78
10
73
15
30
0
0
5
2
0
0
0
1
0
0
2
0
0
0
0
0
1
0
0
0
0
0
0
0
0
84 129 169 137 228 257 148 141 241 109

3
0
15
0
1
0
5
0
2
0
4
0
3
0
3
0
5
0
2
0
71
33
8
1
3
0
65
36
13 152
0
987
20
0
0
1
0
1
0
3
1
9
0
9
0
44
0
19
0
74
0
11
0
28
0
20
0
78
0
26
0
88
0
0
35 111
0
24
0
97
0
0
25 137
0
173
0
0
0
0
1
0
1
1
0
0
0
0
1
0
2
0
0
0
0
0
2
0
29
1
0
2
0
0
2
0
27
0
0
0
0
0
5
0
0
0
0
0
3
1
0
4
0
34 100
1
0
0
0
0
0
0
0
4
0
50
0
0
0
1
3
0
0
6
0
42
6
0
0
0
0
0
0
0
0
0
0
0
12
1
0
0
0
0
1
0
0
0
0
3
0
23
Page 126 of 149
1
0
0
0
0
0
0
0
0
2
1
30
6
0
3
0
1
0
0
0
0
0
5
0
33
11
2
0
2
0
0
0
1
0
0
0
0
19
9
2
3
1
0
0
0
0
0
0
1
1
24
6
1
3
0
4
0
0
0
0
3
0
16
4
0
0
0
1
3
0
14
7
0
0
1
0
0
0
0
0
0
4
0
10
0
2
0
0
0
0
0
0
0
3
0
10
13
0
2
0
1
0
0
0
0
6
0
21
18
0
0
0
1
1
5
0
0
0
0
0
0
0
60
119
0
1
0
0
0
0
10
14
1
667
1
840
0
0
0
1
11
14
15
0
1
0
0
3
8
1
2
27
31
13
222
288
17
3
0
332
40
183
1874
30
29
887
45
213
746
648
98
17
54
65
47
50
187
145
54
59
12
16
1635
94
875
760
23
38
27
23
45
44
42
11
40
68
14
15
13
26
58
375
31
276
14
123
25
36 118 266 154 103 206 202 126 117
122
16
12
3349
1243
2106
39
55
8
0
23
12
3
0
3
4
14
24
45
9
5
22
80
48
65
20
9
1
2
58
510
113
0
0
0
0
0
0
0
0
0
0
0
0
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
K56.0
Paralytic ileus
K56.4
Other impaction of intestine
K56.1
K56.3
K56.5
K56.6
K57
K57.1
K57.9
K58
K59
K59.0
K60
K60.2
K60.3
K60.4
K60.5
K61
K61.0
K61.1
K61.3
K62
K62.0
K62.1
K62.3
K62.4
K62.5
K63.1
K63.2
K65
K65.9
K66
K66.0
K70
K70.1
K70.3
K70.4
K70.9
K72
K72.9
K73
K74
K74.1
K74.2
K74.6
K75
K75.0
K75.9
K76
K76.6
K76.7
K76.9
K80
K80.0
K80.2
K80.3
K80.4
Intussusception
Gallstone ileus
Intestinal adhesions [bands] with obstruction

Other and unspecified intestinal obstruction
Diverticular disease of intestine

Diverticular disease of small intestine without
perforation or abscess
Diverticular disease of intestine, part
unspecified, without perforation or abscess
Irritable bowel syndrome
Other functional intestinal disorders

Constipation
Fissure and fistula of anal and rectal regions

Anal fissure, unspecified
Anal fistula
Rectal fistula
Anorectal fistula
Abscess of anal and rectal regions

Anal abscess
Rectal abscess
Ischiorectal abscess
Other diseases of anus and rectum

Anal polyp
Rectal polyp
Rectal prolapse
Stenosis of anus and rectum
Haemorrhage of anus and rectum
Perforation of intestine (nontraumatic)

Fistula of intestine
Peritonitis
Peritonitis, unspecified
Other disorders of peritoneum

Peritoneal adhesions
Alcoholic liver disease

Alcoholic hepatitis
Alcoholic cirrhosis of liver

Alcoholic hepatic failure
Alcoholic liver disease, unspecified
Hepatic failure, not elsewhere classified

Hepatic failure, unspecified
Chronic hepatitis, not elsewhere classified

Fibrosis and cirrhosis of liver
Hepatic sclerosis
Hepatic fibrosis with hepatic sclerosis
Other and unspecified cirrhosis of liver

Other inflammatory liver diseases
Abscess of liver
Inflammatory liver disease, unspecified

Other diseases of liver
Portal hypertension
Hepatorenal syndrome
Liver disease, unspecified
Cholelithiasis
Calculus of gallbladder with acute
cholecystitis
Calculus of gallbladder without cholecystitis

Calculus of bile duct with cholangitis
1
1
0
0
0
1
0
0
1
0
2
0
0
0
0
4
0
1
0
0
2
0
0
0
0
1
0
1
2
0
0
0
0
1
0
1
1
1
4
0
0
0
0
1
0
0
0
0
2
1
0
0
0
5
0
0
0
0
3
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
3
0
1
0
1
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
1
0
1
2
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
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
1
0
0
0
0
0
0
0
1
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
2
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
2
0
0
0
1
0
0
0
2
0
0
0
2
0
0
0
0
0
4
0
0
0
0
0
0
1
0
0
0
0
1
0
0
1
6
0
0
0
0
0
0
1
1
4
1
0
0
0
1
4
2
1
0
0
0
0
0
0
0
0
1
2
1
0
0
10
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
1
0
0
0
0
0
0
0
0
0
4
0
14
11
1
0
2
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
1
1
0
0
0
0
1
0
0
1
0
0
2
4
4
4
6
1
0
0
0
0
0
0
0
1
0
0
3
1
1
2
0
0
1
0
0
2
4
6
4
2
1
0
0
5
0
0
2
9
0
0
0
15
0
0
2
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
1
0
3
2
0
0
0
9
2
0
0
0
13
1
3
0
0
0
6
Page 127 of 149
6
7
3
6
4
18
0
0
0
32
2
2
1
5
0
0
3
2
2
0
1
0
1
1
0
0
0
0
2
0
1
1
8
9
9
38 118
1
2
1
5
3
0
28
10
50
0
1
3
0
0
0
7
0
0
0
9
6
0
0
4
0
10
7
1
13
11
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
2
0
0
0
0
0
0
1
0
0
0
1
1
0
2
1
0
3
5
2
8
39 153
0
3
0
2
1
1
2
2
2
0
0
0
3
0
0
0
0
3
6
0
1
0
0
3
4
1
4
19
40
34
82
116
1
3
0
0
1
1
0
0
1
0
0
1
0
2
0
0
1
2
1
2
30
30
45
39
11
12
15
21
208
4
0
5
1
7
1
19
2
26
37
17
36
20
60
61
159
220
15
13
13
49
62
15
11
10
93
93
0
0
9
1
1
0
0
0
22
16
0
0
7
3
7
0
0
0
0
0
0
0
26
17
10
11
3
0
0
11
1
0
7
2
0
0
69
24
60
47
65
27
69
48
2
8
2
21
0
1
0
25
38
0
0
2
0
11
0
0
1
31
92
0
0
9
4
15
0
0
0
23
44
0
0
4
1
9
0
1
1
24
87
0
0
7
2
24
1
0
1
31
45
1
0
1
1
1
0
0
1
21
0
1
65
23
1
0
0
0
0
0
0
0
0
0
168
13
40
14
29
11
40
49
28
40
12
15
35 117
604
462
142
93
37
17
39
55
59
30
30
0
0
45
17
23
11
25
22
87 409 156 378 152 339 141 284 155
10
61
24
20
24
33
37
10
8 168
42
13
22
12
Cholecystitis, unspecified
K81.9
19
14
65
15
13
13
19
18
1
0
10
14
11
20
4
1
10
25
24
1 112
76
11
20
21
27 340
36
0
20
16
10
15
10
Acute pancreatitis
K80.8
K85
Obstruction of bile duct
K83.1
Cholangitis
89
52
13
37
11
M
0
11
11
K83.0
Other diseases of biliary tract
10
K83
Disease of gallbladder, unspecified
K82.9
Acute cholecystitis
K81.0
Cholecystitis
K81
Calculus of bile duct with cholecystitis

Calculus of bile duct without cholangitis or
cholecystitis
Other cholelithiasis
K80.5
Total
Deaths
Total
0
0
0
0
3
0
0
0
0
0
0
0
0
53
76
2
1
57
125
186
3
1
2
0
0
0
0
0
19
2
0
0
0
0
4
3
0
0
0
0
2
1
2
1
0
0
11
11
348
184
532
1796
590
0
2
43
15
97
1
3
1
155
182
160
26
95
19
11
735
2531
174
764
1
0
15
7
58
0
0
171
133
22
36
0
1
5
326
0
0
0
0
0
0
0
0
457
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
K85.0
Idiopathic acute pancreatitis
K86.2
Cyst of pancreas
K85.1
K86
K90
K90.3
K91.0
K91.3
K91.4
K92
K92.0
K92.2
K92.9
L00
L01
L01.0
L02
Biliary acute pancreatitis
Other diseases of pancreas

Intestinal malabsorption
Pancreatic steatorrhoea
Vomiting following gastrointestinal surgery

Postoperative intestinal obstruction
Colostomy and enterostomy malfunction

Other diseases of digestive system
Haematemesis
Gastrointestinal haemorrhage, unspecified

Disease of digestive system, unspecified
Staphylococcal scalded skin syndrome
Impetigo
Impetigo [any organism] [any site]
Cutaneous abscess, furuncle and carbuncle
L03
Cutaneous abscess, furuncle and carbuncle of

face
neck
trunk
buttock
limb
other sites
Cutaneous abscess, furuncle and carbuncle,
unspecified
Cellulitis
L03.2
Cellulitis of face
L02.0
L02.1
L02.2
L02.3
L02.4
L02.8
L02.9
L03.0
L03.1
L03.8
L03.9
L04
L04.0
L04.1
L04.9
L05
L05.9
Cellulitis of finger and toe
Cellulitis of other parts of limb

Cellulitis of other sites
Cellulitis, unspecified
Acute lymphadenitis
Acute lymphadenitis of face, head and neck

Acute lymphadenitis of trunk
Acute lymphadenitis, unspecified

Pilonidal cyst
L10
Pilonidal cyst without abscess

Other local infections of skin and
subcutaneous tissue
Pyoderma
Local infection of skin and subcutaneous
tissue, unspecified
Pemphigus
L20
Atopic dermatitis
L08
L08.0
L08.9
L10.9
L13.9
L21.9
L23.9
L26
L27
L30
L30.3
L30.9
L40
L40.1
L40.3
L40.9
L43
L44
L50
L50.9
L51
L51.1
L52
L53
L53.9
L60
L60.2
L70
L70.0
458
Pemphigus, unspecified
Bullous disorder, unspecified
Seborrhoeic dermatitis, unspecified
Allergic contact dermatitis, unspecified cause

Exfoliative dermatitis
Dermatitis due to substances taken internally

Other dermatitis
Infective dermatitis
Dermatitis, unspecified
Psoriasis
Generalized pustular psoriasis
Pustulosis palmaris et plantaris
Psoriasis, unspecified
Lichen planus
Other papulosquamous disorders
Urticaria
Urticaria, unspecified
Erythema multiforme
Bullous erythema multiforme
Erythema nodosum
Other erythematous conditions
Erythematous condition, unspecified
Nail disorders
Onychogryphosis
Acne
Acne vulgaris
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
2
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
2
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
0
0
1
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
1
0
0
0
0
0
0
0
3
5
10
24
49
68
2
0
0
0
0
0
8
0
0
1
0
0
10
0
0
0
0
2
18
0
1
0
3
3
28
0
3
2
0
2
0
0
0
1
0
0
0
1
0
1
0
0
4
5
0
0
0
0
0
0
0
1
0
2
0
0
2
3
87 116
41
58
0
2
4
0
2
0
1
5
0
5
0
0
0
0
0
0
0
1
1
1
0
0
0
2
69
19
0
0
2
0
0
1
0
0
0
0
0
0
0
1
3
0
0
0
0
0
0
2
0
0
0
0
0
0
3
0
0
0
0
0
0
4
0
0
0
0
0
0
5
0
0
0
0
0
0
4
0
0
0
0
0
0
3
3
0
0
0
0
0
3
4
0
0
0
0
0
3
1
0
0
0
0
Total
Deaths
Total
0
0
4
0
0
1
16
4
0
1
1
4
33
8
1
1
1
5
15
14
18
21
18
20
11
32
18
57
82
148
230
20
14
22
13
30
31
95
126
0
0
0
3
1
0
2
0
1
1
58 113
19
54
0
0
4
2
0
0
1
3
0
5
1
1
0
1
1
1
0
0
2
2
1
1
0
1
0
1
1
3
1
0
0
4
0
0
0
2
1
1
1
4
0
1
0
4
1
0
0
11
2
0
12
5
20
29
587
1130
17
1
1
5
1
1
31
0
0
4
0
3
19
0
1
1
0
0
29
1
0
2
0
1
27
0
1
2
1
3
13
0
2
1
0
0
20
0
1
2
0
2
27
0
0
1
0
2
36
2
1
0
0
2
242
3
8
16
3
17
245
5
21
17
487
37
34
30
32
44
23
34
37
41
207
263
470
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
1
1
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
17
0
3
6
0
0
0
0
0
27
0
0
1
0
0
0
1
0
0
0
0
1
0
1
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
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
4
0
3
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5
1
0
0
0
3
1
1
2
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
3
0
8
0
0
0
0
5
0
6
7
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
6
0
8
0
0
0
0
4
1
11
9
0
0
0
0
1
0
0
0
0
1
1
2
3
0
9
14
0
0
0
0
15
1
0
2
0
0
24
0
0
3
2
0
0
1
3
0
1
0
6
2
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
3
0
9
0
0
0
0
11
1
10
8
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
9
0
20
0
1
0
0
13
1
21
10
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
2
0
4
0
0
0
0
7
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
4
0
0
0
0
6
1
2
0
0
0
0
0
0
0
0
0
0
Page 128 of 149
12
11
8
2
0
0
0
1
2
26
0
0
0
0
0
0
2
1
0
0
0
11
0
0
0
0
0
12
0
1
0
0
13
0
7
0
0
0
1
0
0
15
0
5
0
0
0
0
0
0
14
1
8
4
0
0
0
1
0
22
5
0
0
9
1
1
0
0
0
0
24
0
0
0
26
2
4
0
105
0
0
0
0
3
0
13
0
0
0
1
10
0
3
1
0
0
0
0
2
1
0
0
3
0
0
0
1
0
0
3
0
5
0
0
0
0
12
1
4
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
7
1
0
0
0
9
0
3
2
0
0
0
3
1
0
0
0
0
0
0
0
0
0
0
1
0
4
0
0
0
0
9
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
6
0
3
0
0
0
0
6
0
7
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
3
0
9
0
0
0
0
6
0
3
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
6
0
0
0
0
7
0
3
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
5
2
0
0
0
6
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
5
0
8
1
0
0
0
6
0
4
1
1
0
1
0
0
0
0
0
0
0
0
0
0
1
0
6
0
12
4
0
0
0
10
0
2
1
0
0
1
0
1
0
0
0
0
26
1
4
2
2
173
34
1
6
6
2
278
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
17
13
21
1
0
1
0
1
31
1
61
2
0
1
1
62
1
38
24
1
0
1
4
3
1
1
0
3
32
116
65
51
23
11
543
26
60
27
48
36
37
28
38
26
61
22
0
63
32
0
67
21
0
60
15
0
95
13
0
3
0
3
0
2
0
11
13
16
23
1
0
15
17
11
3
0
Total
0
1
0
1
0
35
0
72
7
1
0
0
69
5
45
23
0
1
3
0
4
0
0
1
1
1
1
1
1
1
66
1
133
9
1
1
1
131
6
83
47
1
1
4
4
7
1
1
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
0
0
0
ICD
Code
Diseases
L72.1
Follicular cysts of skin and subcutaneous

tissue
Trichilemmal cyst
L81.1
Chloasma
L72
L80
L81
L81.5
L82
L84
L85.3
L88
L89
L90.0
L90.5
L91
L91.0
L92
L92.2
L92.8
L92.9
L93.0
L95
L95.9
L97
Vitiligo
Other disorders of pigmentation
Leukoderma, not elsewhere classified

Seborrhoeic keratosis
Corns and callosities
Xerosis cutis
Pyoderma gangrenosum
Decubitus ulcer
Lichen sclerosus et atrophicus
Scar conditions and fibrosis of skin

Hypertrophic disorders of skin
Keloid scar
Granulomatous disorders of skin and
subcutaneous tissue
Granuloma faciale [eosinophilic granuloma of
skin]
Other granulomatous disorders of skin and
subcutaneous tissue
Granulomatous disorder of skin and
subcutaneous tissue, unspecified
Discoid lupus erythematosus
Vasculitis limited to skin, not elsewhere
classified
Vasculitis limited to skin, unspecified
Ulcer of lower limb, not elsewhere classified
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
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
1
2
0
0
0
0
1
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
2
1
1
0
3
0
0
0
0
0
0
0
1
0
3
0
0
6
0
3
0
0
1
0
0
3
0
4
0
0
8
0
0
0
0
0
0
0
2
1
2
0
0
6
0
2
0
0
0
0
0
2
0
3
0
0
2
0
0
0
0
0
0
0
4
0
0
0
0
8
0
0
0
2
0
0
0
3
0
0
0
0
5
0
0
0
0
0
0
0
4
0
0
0
0
1
0
0
0
2
0
0
1
0
1
0
0
0
7
1
0
0
0
0
0
0
3
0
0
0
0
2
0
0
1
0
1
0
0
1
0
0
0
0
Total
Deaths
Total
F
M
7
Total
30
32
0
1
4
0
1
0
4
0
0
0
0
1
1
4
2
0
1
1
1
4
1
1
0
18
3
8
1
10
62
2
5
2
8
3
1
1
27
0
0
0
1
0
0
0
0
1
0
1
1
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
1
0
1
0
0
0
0
0
1
0
1
1
2
1
13
10
24
28
15
22
22
16
14
17
12
39
125
145
270
0
0
11
17
L98.4
Chronic ulcer of skin, not elsewhere classified
M06.9
M08.0
M08.1
M10
M10.9
M13
M13.0
M13.1
M13.9
M15
M15.9
M17
M17.0
M17.4
M17.9
M19
M19.9
M20.0
M21.3
M23
M24
M24.5
M25
M25.2
M25.4
M25.5
M25.9
M30
M32
M32.9
M33.0
M34.9
M35
M36*
Other rheumatoid arthritis
Rheumatoid arthritis, unspecified

Juvenile rheumatoid arthritis
Juvenile ankylosing spondylitis

Gout
Gout, unspecified
Other arthritis
Polyarthritis, unspecified
Monoarthritis, not elsewhere classified

Arthritis, unspecified
Polyarthrosis
Polyarthrosis, unspecified
Gonarthrosis [arthrosis of knee]

Primary gonarthrosis, bilateral
Other secondary gonarthrosis, bilateral

Gonarthrosis, unspecified
Other arthrosis
Arthrosis, unspecified
Deformity of finger(s)
Wrist or foot drop (acquired)
Internal derangement of knee
Other specific joint derangements

Contracture of joint
Other joint disorders, not elsewhere classified

Flail joint
Effusion of joint
Pain in joint
Joint disorder, unspecified
Polyarteritis nodosa and related conditions

Systemic lupus erythematosus
Systemic lupus erythematosus, unspecified

Juvenile dermatomyositis
Systemic sclerosis, unspecified

Other systemic involvement of connective
tissue
Systemic disorders of connective tissue in
diseases classified elsewhere
13
49
23
72
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
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
1
0
0
1
0
0
0
5
0
1
2
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
0
6
1
0
0
0
0
6
0
0
2
0
0
1
0
0
0
0
1
4
0
0
0
0
0
0
0
0
2
0
0
0
1
0
4
0
1
8
1
0
0
0
0
0
0
1
3
0
0
0
0
0
1
1
0
8
0
0
0
0
0
1
0
0
0
0
0
23
0
0
0
0
3
0
0
0
1
0
0
0
0
0
1
29
5
1
0
0
1
0
1
1
1
6
1
1
1
27
46
14
18
32
32
30
39
40
46
45
32
63
38
261
256
517
10
16
14
11
61
37
98
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
1
0
0
0
0
0
1
0
2
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
2
0
0
0
0
2
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
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
1
1
6
6
0
7
2
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
8
7
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
1
1
0
1
0
0
0
3
0
8
3
0
2
2
0
0
0
0
0
0
1
0
0
0
0
2
0
0
0
0
0
0
2
0
0
0
1
0
0
0
0
0
7
1
1
0
0
0
0
0
0
0
12
6
0
0
0
0
0
1
6
0
2
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
2
0
6
4
0
0
0
0
1
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
2
0
0
5
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
10
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
11
2
0
0
0
1
0
0
3
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
1
1
1
0
1
21
0
0
1
0
0
0
0
0
3
7
1
0
0
3
6
3
1
0
3
0
0
1
0
1
1
4
1
1
1
1
0
0
2
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
1
1
1
4
2
1
9
2
1
1
7
8
4
1
1
8
0
0
70
28
30
42
24
6
3
21
16
16
0
0
M06
Seropositive rheumatoid arthritis
M05
Reactive arthropathies
M02
Pyogenic arthritis, unspecified
M00.9
M00
Other specified disorders of skin and

subcutaneous tissue
Pyogenic arthritis
L98.8
13
Other disorders of skin and subcutaneous

tissue, not elsewhere classified
Pyogenic granuloma
L98
L98.0
23
0
47
0
0
0
0
0
0
0
0
0
0
0
0
10
0
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Page 129 of 149
459
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
M41.9
Scoliosis, unspecified
M43.1
Spondylolisthesis
M43
M43.0
M43.6
M45
M46
M46.4
M47
M47.8
M47.9
M48
M50
M50.9
M51
Other deforming dorsopathies

Spondylolysis
Torticollis
Ankylosing spondylitis
Other inflammatory spondylopathies

Discitis, unspecified
Spondylosis
Other spondylosis
Spondylosis, unspecified
Other spondylopathies
Cervical disc disorders
Cervical disc disorder, unspecified
M51.9
Other intervertebral disc disorders

Other specified intervertebral disc
displacement
Other specified intervertebral disc
degeneration
Intervertebral disc disorder, unspecified
M54
Dorsalgia
M51.2
M51.3
M53
M54.2
M54.3
M54.4
M54.5
M54.9
M60
M60.0
M60.1
Other dorsopathies, not elsewhere classified

Cervicalgia
Sciatica
Lumbago with sciatica

Low back pain
Dorsalgia, unspecified
Myositis
Infective myositis
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
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
1
1
3
0
0
0
1
0
0
0
0
0
0
0
0
6
0
0
0
1
1
0
2
0
0
0
3
2
8
0
0
0
2
0
0
0
0
0
1
1
1
5
0
0
0
2
0
1
0
0
0
0
5
3
4
0
0
0
0
0
0
1
0
1
0
0
0
5
0
0
0
2
0
0
0
0
0
0
1
3
4
0
2
0
1
0
0
0
0
0
0
0
0
8
0
1
0
0
0
0
0
0
1
0
1
2
1
1
1
0
0
0
0
2
1
0
0
0
1
0
6
1
1
2
0
1
0
11
0
2
11
20
1
3
1
1
4
1
0
0
0
0
0
0
10
0
0
1
1
1
1
1
1
2
1
0
0
0
0
0
0
0
0
0
0
12
26
12
46
28
23
51
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
2
0
1
0
2
0
0
0
0
5
0
1
0
3
0
0
0
2
5
2
2
0
2
0
0
0
0
3
3
2
1
0
0
0
0
1
2
0
1
0
1
1
0
0
0
5
1
0
1
17
1
0
6
0
1
0
0
1
1
0
0
33
8
0
3
1
0
0
0
5
0
0
0
0
9
0
0
0
10
0
0
0
1
22
14
26
10
11
0
3
8
0
0
28
37
65
0
0
2
0
2
2
4
2
0
0
0
0
0
0
0
0
0
0
104
39
143
13
15
0
3
0
M60.9
M62.8
Other specified disorders of muscle
0
0
M62.1
M65
M65.3
M65.4
M65.9
M66
M66.5
M67
M67.0
M67.4
M67.9
Other rupture of muscle (nontraumatic)

Synovitis and tenosynovitis
Trigger finger
Radial styloid tenosynovitis [de Quervain]

Synovitis and tenosynovitis, unspecified
Spontaneous rupture of synovium and tendon

Spontaneous rupture of unspecified tendon
Other disorders of synovium and tendon
Short Achilles tendon (acquired)
Ganglion
Disorder of synovium and tendon, unspecified
M70.1
Soft tissue disorders related to use, overuse

and pressure
Bursitis of hand
M71.0
Abscess of bursa
M70
M70.2
M70.7
M71.2
M72
M72.2
M72.6
M72.9
M75
M75.0
M75.5
M75.9
M76.4
M77.1
M77.3
M77.5
Olecranon bursitis
Other bursitis of hip
Synovial cyst of popliteal space [Baker]

Fibroblastic disorders
Plantar fascial fibromatosis

Necrotizing fasciitis
Fibroblastic disorder, unspecified

Shoulder lesions
Adhesive capsulitis of shoulder

Bursitis of shoulder
Shoulder lesion, unspecified
Tibial collateral bursitis [Pellegrini-Stieda]

Lateral epicondylitis
Calcaneal spur
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
3
0
0
0
0
0
0
1
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
1
1
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
2
0
1
2
1
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
1
1
0
3
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
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
5
1
0
3
0
1
1
0
1
4
1
0
6
1
1
7
1
1
13
18
2
0
1
2
0
0
1
0
1
1
2
1
1
3
1
145
64
81
11
15
14
18
16
Other disorders of muscle
M62
Interstitial myositis
Foreign body granuloma of soft tissue, not
Myositis, unspecified
M60.2
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
2
0
0
0
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
0
0
0
0
1
0
0
0
1
2
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
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
1
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
1
0
0
3
0
0
0
0
0
2
2
0
0
1
1
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
1
1
0
1
1
0
0
3
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
3
0
1
0
0
1
0
0
0
0
0
1
2
7
4
1
0
2
2
1
0
1
0
0
0
0
0
1
1
2
0
0
0
0
0
0
10
4
0
4
2
1
1
6
1
1
1
1
6
4
2
1
7
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
M79.1
37
M79.6
Pain in limb
0
0
M79.3
M79.7
M79.8
M79.9
M80
460
Panniculitis, unspecified
Fibromyalgia
Other specified soft tissue disorders

Soft tissue disorder, unspecified
Osteoporosiswithpathologicalfracture
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
2
3
0
0
0
0
0
1
0
0
0
0
0
1
0
Page 130 of 149
0
8
0
1
9
0
0
1
0
1
6
0
0
4
0
0
15
0
3
0
0
7
0
0
2
1
0
10
0
3
0
0
12
0
0
0
0
0
3
0
1
1
0
0
11
0
0
0
0
7
0
2
0
0
1
2
1
14
10
24
45
42
87
0
0
0
1
1
1
0
3
0
1
4
1
14
23
11
Neuralgia and neuritis, unspecified
M79.2
Other enthesopathy of foot

Other soft tissue disorders, not elsewhere
classified
Myalgia
M79
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
ICD
Code
Diseases
M80.5
Idiopathic osteoporosis with pathological

fracture
M81.9
Osteoporosis, unspecified
M80.8
M84
M84.0
M84.9
M85
M86
M86.1
M86.6
M86.8
M86.9
M87.9
M89.9
M91
M95
M95.0
M
0
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
M
0
Disorders of continuity of bone
Malunion of fracture
Disorder of continuity of bone, unspecified
Other disorders of bone density and structure

Osteomyelitis
Other acute osteomyelitis
Other chronic osteomyelitis

Other osteomyelitis
Osteomyelitis, unspecified
Osteonecrosis, unspecified
Disorder of bone, unspecified
Juvenile osteochondrosis of hip and pelvis
Other osteochondropathies
Other specified osteochondropathies

Other disorders of cartilage
Other acquired deformities of

musculoskeletal system and connective tissue
Acute nephritic syndrome
Acute nephritic syndrome - Unspecified
Nephrotic syndrome
Nephrotic syndrome - Unspecified
Unspecified nephritic syndrome - Unspecified
N15.9
Renal tubulo-interstitial disease, unspecified
N18.8
N18.9
N19
N20
N20.0
N20.1
N20.2
N20.9
N21
N21.0
N21.1
N21.9
N22*
N23
N25
N25.9
N26
N13.3
N18
Glomerular disorders in diseases classified

elsewhere
Acute tubulo-interstitial nephritis
Tubulo-interstitial nephritis, not specified as
acute or chronic
Obstructive and reflux uropathy
Hydronephrosis with ureteropelvic junction
obstruction
Hydronephrosis with ureteral stricture, not
Hydronephrosis with renal and ureteral
calculous obstruction
Other and unspecified hydronephrosis
N17.9
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
0
0
0
0
0
Pyonephrosis
Other renal tubulo-interstitial diseases
Acute renal failure
Acute renal failure with tubular necrosis

Acute renal failure, unspecified
Chronic renal failure
Other chronic renal failure
Chronic renal failure, unspecified

Unspecified renal failure
Calculus of kidney and ureter

Calculus of kidney
Calculus of ureter
Calculus of kidney with calculus of ureter

Urinary calculus, unspecified
Calculus of lower urinary tract

Calculus in bladder
Calculus in urethra
Calculus of lower urinary tract, unspecified
Calculus of urinary tract in diseases classified

elsewhere
Unspecified renal colic
Disorders resulting from impaired renal
tubular function
Disorder resulting from impaired renal
tubular function, unspecified
Unspecified contracted kidney
0
0
2
0
0
0
12
0
0
0
2
0
2
6
0
0
0
7
0
0
1
1
0
0
0
3
1
0
0
3
0
0
0
0
0
0
2
2
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Unspecified nephritic syndrome
N17.0
N05
N17
N03
N13.6
N15
N13.2
N13.1
N13.0
N13
N12
Total
N10
Recurrent and persistent haematuria

Recurrent and persistent haematuria - Minor
glomerular abnormality
Chronic nephritic syndrome
N08*
N05.9
N04.9
N04
N02.0
N02
N00.9
Acquired deformity of nose
N00
Total
Deaths
Total
Osteochondropathy, unspecified
M94
05-14
Years
M93.9
M93.8
01-04
Years
M92
M93
29 Days-1
Yr
Other osteoporosis with pathological fracture
Juvenile osteochondrosis of head of femur

[Legg-Calv-Perthes]
Other juvenile osteochondrosis
M91.1
28
Days
0
0
0
0
0
0
1
0
0
2
0
0
1
1
0
0
0
0
0
0
0
0
0
2
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
1
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
1
3
0
0
1
0
1
0
0
0
2
0
0
2
0
0
2
0
0
0
0
2
0
0
0
0
31
1
2
5
0
5
2
0
18
0
16
0
0
0
0
0
0
0
0
1
3
1
0
0
0
1
2
0
0
0
0
0
2
0
0
0
1
0
0
2
0
3
2
0
0
1
1
0
3
1
4
2
0
0
8
0
0
4
2
0
0
0
0
1
1
2
0
0
0
0
1
1
0
2
0
17
0
0
0
1
18
1
1
0
0
0
18
1
1
0
0
11
23
15
22
15
26
0
0
15
0
6
3
1
0
0
0
Page 131 of 149
3
1
73
10
0
82
87 104
0
3
29
3
1
11
0
46
26
1
0
12
19
1
0
47
0
0
41
0
0
4
2
37
1
0
3
5
29
0
0
9
1
25
76
0
1
0
0
0
0
15
1
10
0
1
1
1
11
1
0
0
1
9
1
0
0
7
7
0
0
3
0
2
0
31
7
0
3
1
2
1
27
1
0
48
12
0
3
7
4
0
0
0
0
1
45
0
2
0
0
0
1
4
1
337
7
32
8
1
0
0
1
14
7
159
12
1
1
2
71
111
265
467
435
6
11
59
27
13
0
110
1
1
15
0
0
105
42
10
92
25
40
1
57
128
73
471
202
0
12
23
265
21
13
206
16
3
25
16
25
19
92
13
20
139
18
10
25
14
13
7
346
57
19
157
35
14
18
83 111
16
114
63
189
45
22
20
91
18
10
0
3
50
8
2
20
29
29
10
4
0
1
16
6
1
28
32
29
83 130
32
57
23
1
25
11
15
29
15
326
14
190
136
15
34
10
0
1
14
18
14
27
11
24
23
36
0
10
0
2
0
17
0
3
19
22
19
28
46
13
4
46
2
3
28
23
23
11
23
15
10
16
18
26
17
20
17
18
62
26
36
13
0
0
26
18
66
29
19
7
0
41
24
17
13
380
233
0
0
147
0
1
40
0
0
27
0
0
0
0
14
0
0
26
19
26
22
38
17
39
28
28
16
33
16
1
0
0
0
2
0
0
1
1
21
772
197
17
201
0
0
0
0
1
0
0
41
18
91
20
269
0
0
0
0
0
0
0
0
13
17
461
ICD
Code
Diseases
N28.1
Other disorders of kidney and ureter, not

Cyst of kidney, acquired
N30
Cystitis
N28
N28.9
N30.0
N30.2
N30.9
Disorder of kidney and ureter, unspecified

Acute cystitis
Other chronic cystitis
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
30
23
53
26
15
41
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
5
0
0
5
1
0
6
1
0
1
2
0
0
0
0
2
2
0
5
0
0
9
1
0
3
0
0
3
0
0
2
0
0
2
0
0
3
1
0
2
0
0
4
0
N34
Urethritis and urethral syndrome
N34.3
N35
N35.0
N35.9
N36
N36.0
N36.3
N36.8
N36.9
N37*
N39
N39.0
N39.8
N39.9
N40
N41
N41.0
N41.1
N41.2
N41.3
N41.9
N42
N42.9
N43
N43.2
N43.3
N43.4
N44
N45
N45.9
N46
N47
N48
N48.1
N49
N49.2
N50
Urethral syndrome, unspecified

Urethral stricture
Post-traumatic urethral stricture

Urethral stricture, unspecified
Other disorders of urethra
Urethral fistula
Prolapsed urethral mucosa
Other specified disorders of urethra
Urethral disorder, unspecified

Urethral disorders in diseases classified
elsewhere
Other disorders of urinary system
Urinary tract infection, site not specified
Other specified disorders of urinary system

Disorder of urinary system, unspecified
Hyperplasia of prostate
Inflammatory diseases of prostate

Acute prostatitis
Chronic prostatitis
Abscess of prostate
Prostatocystitis
Inflammatory disease of prostate, unspecified

Other disorders of prostate
Disorder of prostate, unspecified

Hydrocele and spermatocele
Other hydrocele
Hydrocele, unspecified
Spermatocele
Torsion of testis
Orchitis and epididymitis

Orchitis, epididymitis and epididymo-orchitis
without abscess
Male infertility
Redundant prepuce, phimosis and
paraphimosis
Other disorders of penis
Balanoposthitis
Inflammatory disorders of male genital
organs, not elsewhere classified
Inflammatory disorders of scrotum
N60.0
Other disorders of male genital organs

Other specified disorders of male genital
organs
Disorders of male genital organs in diseases
classified elsewhere
Solitary cyst of breast
N60.3
Fibrosclerosis of breast
N50.8
N51*
N60.1
N60.2
N60.4
N61
N62
N63
N64
N64.4
N64.5
N70
N71
N71.0
N71.9
N72
462
Diffuse cystic mastopathy

Fibroadenosis of breast
Mammary duct ectasia
Inflammatory disorders of breast

Hypertrophy of breast
Unspecified lump in breast

Other disorders of breast
Mastodynia
Other signs and symptoms in breast

Salpingitis and oophoritis
Inflammatory disease of uterus, except cervix

Acute inflammatory disease of uterus
Inflammatory disease of uterus, unspecified

Inflammatory disease of cervix uteri
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
0
0
55
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
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
35
61
0
2
0
0
0
0
0
0
1
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
1
2
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
44
0
0
0
0
0
7
0
4
22
76
77 113 116 146
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
1
0
0
4
0
4
2
0
0
0
1
0
1
0
0
3
0
0
3
0
0
0
1
1
1
0
1
6
0
2
4
0
0
0
0
0
0
0
0
1
0
3
0
0
1
0
0
0
0
0
0
7
1
2
1
0
0
0
2
0
1
0
0
3
0
0
1
0
0
0
0
0
0
0
0
3
0
2
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
1
0
0
0
43
0
0
0
0
2
6
0
8
1
0
0
0
0
0
0
0
0
76 491 111 202

0
0
1
0
0
0
0
0
0
0
29
0
0
0
0
0
1
0
5
3
0
0
0
0
0
0
0
0
0
0
0 100
18
0
0
0
0
0
2
0
0
0
70
0
0
0
12
0
13
81 172
0
10
0
0
0
0
0
0
0
0
0
0
0
0
81
0
0
0
0
24
0
8
0
0
0
0
1
0
0
0
0
0
92
21
34
27
0
0
0
19
0
13
2
0
0
0
0
0
0
0
0
0
87
1
0
3
1
0
0
44
0
0
0
0
14
0
3
0
1
25
6
11
0
9
0
0
1
0
0
1
0
24
66
13
0
5
33
40
10
18
0
3
0
2
0
1
15
3
2
1
4
5514
0
0
475
96
1
59
8
254
1
1
96
59
0
0
0
0
0
0
0
0
0
0
0
0
254
0
0
10
10
21
21
0
0
1
0
0
0
0
0
0
0
10
0
0
475
421
421
26
26
13
0
0
2539
902
200
200
14
12
1585
1637
3929
11
18
10
0 284
10
0 144
53
12
28
87 297 236
78 130
69 140 119 219 196 487 114 1136 216 704 210 450 197 332 150 403 310
Urethral abscess
N34.0
Bladder disorder, unspecified
N32.9
Total
Vesicointestinal fistula
N32.0
N32.1
Cystitis, unspecified
Neuromuscular dysfunction of bladder,
unspecified
Bladder-neck obstruction
N31.9
Total
Deaths
Total
0
0
1
23
23
25
34
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
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
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
2
0
3
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
54
12
0
0
0
0
0
0
0
0
0
24
5
0
0
1
0
0
0
0
0
0
0
0
0
2
0
0 147
0
84
0
0
0
0
0
0
0
Page 132 of 149
34
14
1
0
0
1
1
0
0
0
0
1
0
0
1
18
0
0
0
0
0
0
0
0
0
17
0
1
0
0
0
1
2
0
0
0
0
0
0
0
0
0
0
9
0
17
0
0
0
0
0
0
0
2
2
0
0
1
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
2
1
1
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
3
2
1
1
2
0
0
0
0
3
0
0
0
0
0
1
1
1
240
57
0
0
0
0
0
0
0
0
0
148
24
1
1
1
1
5
8
0
0
0
2
1
1
1
0
0
0
0
0
0
0
0
240
57
0
0
0
0
0
0
0
0
0
148
24
1
1
1
5
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
ICD
Code
N73
N73.0
Diseases
Other female pelvic inflammatory diseases
N75
Acute parametritis and pelvic cellulitis

Female pelvic inflammatory disease,
unspecified
Diseases of Bartholin's gland
N76
Other inflammation of vagina and vulva
N73.9
N75.0
N75.1
N76.0
N80
N80.0
N80.1
N80.9
N81
N81.1
N81.2
N81.4
N81.6
N81.8
N81.9
N82
N83
N83.0
N83.2
N83.4
N83.8
N83.9
Cyst of Bartholin's gland
Abscess of Bartholin's gland

Acute vaginitis
Endometriosis
Endometriosis of uterus
Endometriosis of ovary
Endometriosis, unspecified
Female genital prolapse
Cystocele
Incomplete uterovaginal prolapse
Uterovaginal prolapse, unspecified

Rectocele
Other female genital prolapse
Female genital prolapse, unspecified
Fistulae involving female genital tract

Noninflammatory disorders of ovary,
fallopian tube and broad ligament
Follicular cyst of ovary
Other and unspecified ovarian cysts

Prolapse and hernia of ovary and fallopian
tube
Other noninflammatory disorders of ovary,
fallopian tube and broad ligament
Noninflammatory disorder of ovary, fallopian

tube and broad ligament, unspecified
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
53
20-29
Years
16
35
35
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
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
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
1
0
0
2
0
6
0
0
0
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
N84.9
Polyp of female genital tract, unspecified

Other noninflammatory disorders of uterus,
except cervix
Endometrial glandular hyperplasia
N85
N85.0
N85.1
N85.2
N85.7
Endometrial adenomatous hyperplasia

Hypertrophy of uterus
N86
Haematometra
Other specified noninflammatory disorders of
uterus
Erosionandectropionofcervixuteri
N89
Other noninflammatory disorders of vagina
N85.8
N88.2
N89.6
N89.8
N89.9
N90
N90.0
N90.7
N90.8
N91
N91.1
N91.2
Stricture and stenosis of cervix uteri
Tighthymenalring
vagina
Noninflammatory disorder of vagina,
unspecified
Other noninflammatory disorders of vulva
and perineum
Mild vulvar dysplasia
Vulvar cyst
vulva and perineum
Absent, scanty and rare menstruation
Secondary amenorrhoea
N92.2
Amenorrhoea, unspecified
Excessive, frequent and irregular
menstruation
Excessive and frequent menstruation with
regular cycle
Excessive menstruation at puberty
N93
Other abnormal uterine and vaginal bleeding
N92
N92.0
N92.6
N93.0
N93.8
N93.9
N94
Irregular menstruation, unspecified
Postcoital and contact bleeding

Other specified abnormal uterine and vaginal
bleeding
Abnormal uterine and vaginal bleeding,
unspecified
Pain and other conditions associated with
female genital organs and menstrual cycle
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
19
19
14
14
1
1
0
0
5
0
1
0
0
0
27
31
16
Polyp of cervix uteri
Polyp of corpus uteri
Polyp of female genital tract
N84.1
N84
N84.0
51
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
65
25
17
10
0
14
0
0
0
0
0
0
0
0
4
4
5
1
26
24
31
32
27
0
10
0
0
0
0
0
0
0
0
0
0
0
0
4
12
4
7
51
0
0
0
0
0
0
0
0
0
0
0
27
0
0
0
0
14
7
2
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
0
0
0
0
0
1
2
0
0
0
0
1
1
0
0
0
1
2
3
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
0
0
0
88
3
1
1
0
0
0
0
0
0
0
0
0
0
38
0
0
0
0
11
31
17
10
110
149
101
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
27
0
0
145
21
0
0
1
4
3
10
98
27
21
12
145
0
0
0
0
10
17
101
31
11
149
11
110
88
38
10
98
10
97
17
0
0
M
0
F
0
Total
457
M
0
F
457
M
0
5
0
F
21
0
0
M
0
0
1
F
32
0
0
M
0
0
0
Total
Deaths
Total
58
0
0
60
Years
0
0
50-59
Years
0 146
0
0
40-49
Years
0 144
0
0
30-39
Years
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
1
0
2
0
0
0
0
0
1
0
4
6
0
0
0
0
0
0
0
1
34
14
0
0
0
0
0
0
0
0
9
2
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
1
1
54
22
0
0
0
0
0
1
1
54
22
0
0
0
0
41
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
2
0
1
6
0
1
6
14
83
1
18
0
8
91
72
13
28
0 315
0
13
53
34
50
13
0 213
31
39
0 199
0
10
31
0
0
0
8
19
0 107
0
17
23
0
0
0
2
6
83
45
2
5
0
0
0
0
0
0
5
0
49
235
18
120
13
44
141
31
235
49
248
920
0
1
0
0
0
0
44
141
120
920
248
31
N94.5
Secondary dysmenorrhoea
N94.8
Other specified conditions associated with

female genital organs and menstrual cycle
N94.6
Dysmenorrhoea, unspecified
Page 133 of 149
463
ICD
Code
N95
N95.0
N97
N97.9
N98.8
N99
N99.4
O00
O00.0
O00.2
O00.8
O00.9
O01
O01.9
O02
O02.0
O02.1
O03
O03.0
O03.4
O03.9
O04
O04.3
O04.8
O05
O06
O06.0
O06.3
O06.4
O06.5
O06.8
O06.9
O07
O07.0
O07.4
O08
O08.3
O08.9
O10
O10.9
O12
Diseases
Menopausal and other perimenopausal
disorders
Postmenopausal bleeding
Female infertility
Female infertility, unspecified

Other complications associated with artificial
fertilization
Postprocedural disorders of genitourinary
system, not elsewhere classified
28
Days
29 Days-1
Yr
M
0
M
0
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
M
0
M
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
Abdominal pregnancy
Hydatidiform mole
Hydatidiform mole, unspecified
Other abnormal products of conception
Blighted ovum and nonhydatidiform mole

Missed abortion
Spontaneous abortion
Spontaneous abortion - Incomplete,
complicated by genital tract and pelvic
infection
Spontaneous abortion - Incomplete, without
complication
Spontaneous abortion - Complete or
unspecified, without complication
Medical abortion
Medical abortion - Incomplete, with other and
unspecified complications
Medical abortion - Complete or unspecified,
with other and unspecified complications
Other abortion
Unspecified abortion
Unspecified abortion - Incomplete,
complicated by genital tract and pelvic
infection
Unspecified abortion - Incomplete, with other
and unspecified complications
Unspecified abortion - Incomplete, without
complication
Unspecified abortion - Complete or
unspecified, complicated by genital tract and
pelvic infection
unspecified, with other and unspecified
complications
unspecified, without complication
Failed attempted abortion
Failed medical abortion, complicated by
genital tract and pelvic infection
Failed medical abortion, without complication

Complications following abortion and ectopic
and molar pregnancy
Shock following abortion and ectopic and
molar pregnancy
Complication following abortion and ectopic
and molar pregnancy, unspecified
Pre-existing hypertension complicating
pregnancy, childbirth and the puerperium
Unspecified pre-existing hypertension
complicating pregnancy, childbirth and the
puerperium
Gestational [pregnancy-induced] oedema and

proteinuria without hypertension
Ectopic pregnancy, unspecified
Other ectopic pregnancy
Ovarian pregnancy
Postprocedural pelvic peritoneal adhesions

Ectopic pregnancy
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
2
1
0
0
11
31
11
11
16
0
0
11
0
0
10
0
1
9
1
12
0 102
0
97
79
0
0
39
90
0 103
0
18
11
57
11
0
0
68
0 103
0
0
0
0
1
1
54
180
50
37
43
27
3
4
0
0
0
0
0
0
0
4
3
7
10
0
0
0
0
0
1
7
8
1
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
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
155
54
168
131
171
0
0
134
10
180
1
1
3
134
131
171
0
0
109
109
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0 114
237
237
0 413
58
0
2444
2
2444
0 125
19
19
118
118
13
23
10
80
25
20
0
0
0
0
0
0
0
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
0 136
0
0
0
10
0 645
0
0
4
1
0 264
0
0
0
0
46
0
0
0
0
0
3
0
0
0
0
0
1
0
0
20
1
1096
0
0
20
1
193
834
193
834
32
0 1801
31
28
0
0
0
0
0
0
22
0
0
0
0
78
0 195
0
0
0 494
0
0
0 118
0 169
13
25
61
10
54
168
155
22
112
22
112
54
0
0
34
34
Total
14
29
0
0
Total
Deaths
Total
13
23
1096
22
50
21
94
94
O14.1
Gestational [pregnancy-induced]
hypertension with significant proteinuria
Severe pre-eclampsia
0
0
O15.0
Eclampsia in pregnancy
O13
O14
O14.9
O15
O15.1
O15.2
O15.9
O16
O20
464
Gestational [pregnancy-induced]
hypertension without significant proteinuria
Pre-eclampsia, unspecified
Eclampsia
Eclampsia in labour
Eclampsia in the puerperium
Eclampsia, unspecified as to time period

Unspecified maternal hypertension
Haemorrhage in early pregnancy
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
1
0
0
10
10
0
0
0
0
0
Page 134 of 149
25
3
3
5
30
0
0
0
0
0
0
0
6
4
0
1
0
1
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
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
21
18
0
0
0
0
0
42
8
3
6
52
21
18
0
0
0
0
0
42
2
8
3
6
52
0
0
0
0
0
0
0
0
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
O20.0
Threatened abortion
12
O21
Excessive vomiting in pregnancy
45
O20.9
O21.0
O21.1
O21.9
O23
Haemorrhage in early pregnancy, unspecified

Mild hyperemesis gravidarum
Hyperemesis gravidarum with metabolic
disturbance
Vomiting of pregnancy, unspecified
Infections of genitourinary tract in pregnancy
O26.2
Infections of other parts of urinary tract in

pregnancy
Unspecified infection of urinary tract in
pregnancy
Other and unspecified genitourinary tract
infection in pregnancy
Pregnancy care of habitual aborter
O29
Complicationsofanaesthesiaduringpregnancy
O23.3
O23.4
O23.9
O26.9
O30
O30.1
O31
O32
O32.1
O32.2
O33
O33.1
O34
O34.1
O34.2
O36
O36.4
O36.9
O40
O41
O41.0
O42
O42.9
O43
O43.9
O44
O44.1
O46
O46.9
O47
Pregnancy-related condition, unspecified
O62.2
O63
O63.9
O64
O64.9
O65
O65.1
O66
O66.9
O68
O68.1
O68.9
O70
O70.2
O71
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
20
M
6
M
0
M
0
457
38
26
8
0
0
0
2
0
0
0
30
2
0
13
457
38
50
11
20
11
15
234
20
15
1
3
Complications specific to multiple gestation
Triplet pregnancy
Maternal care for known or suspected

malpresentation of fetus
Maternal care for breech presentation
Maternal care for transverse and oblique lie

disproportion
Maternal care for disproportion due to
generally contracted pelvis
abnormality of pelvic organs
Maternal care for tumour of corpus uteri
Maternal care due to uterine scar from
previous surgery
Maternal care for other known or suspected
fetal problems
Maternal care for intrauterine death
Maternalcareforfetalproblem,unspecified
Polyhydramnios
Other disorders of amniotic fluid and
membranes
Oligohydramnios
Premature rupture of membranes
Premature rupture of membranes,
unspecified
Placental disorders
Placental disorder, unspecified
Placenta praevia
Placenta praevia with haemorrhage

Antepartum haemorrhage, not elsewhere
classified
Antepartum haemorrhage, unspecified
Prolonged pregnancy
Preterm labour
Abnormalities of forces of labour

Other uterine inertia
Long labour
Long labour, unspecified

Obstructed labour due to malposition and
malpresentation of fetus
Obstructed labour due to malposition and
malpresentation, unspecified
Obstructed labour due to maternal pelvic
abnormality
Obstructed labour due to generally contracted
pelvis
Other obstructed labour
Obstructed labour, unspecified
Labour and delivery complicated by fetal
stress [distress]
Labour and delivery complicated by
meconium in amniotic fluid
Labour and delivery complicated by fetal
stress, unspecified
Perineal laceration during delivery
Third degree perineal laceration during
delivery
Other obstetric trauma
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
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
1
0
22
38
0
0
0
0
0
0
55
26
12
81
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
4
0
1
0
0
0
0 231
56
13
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
25
21
0
0
0
0
0
0
0
0
0
0
965
19
29
149
12
58
471
471
46
46
15
0
0
11
58
66
12
117
117
0
0
0 336
34
109
319
319
14
149
29
12
19
100
965
0
0
0
0
0
0
23
109
81
13
2
12
188
100
14
23
0
0
0
188
81
13
2
79
14
64
87
39
0
0
22
3
0
0
0
0
0
0
0
0
0
13
23
0 662
58
0
0
0
0
44
12
47
20
0
0
0 213
0
0
0
0
0
23
0
0
0
0
0
0
75
2
0
0
0
0
0
15
0
1
0
0
0
16
49
10
1
0
0
0
16
15
3
0
48
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
38
23
0
0
0
0
0
0
M
0
234
99
50
Total
0
0
0
M
99
29
Total
Deaths
Total
60
0 185
0
17
0 339
17
60
Years
Failed induction of labour
O62
64
50-59
Years
O61
O60
40-49
Years
O47.9
O48
30-39
Years
Multiple gestation
False labour
False labour at or after 37 completed weeks of
gestation
False labour, unspecified
O47.1
20-29
Years
15
Page 135 of 149
465
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
O71.5
Other obstetric injury to pelvic organs
O72
Postpartum haemorrhage
76
O71.7
O71.9
O72.0
O72.1
Obstetric haematoma of pelvis

Obstetric trauma, unspecified
Third-stage haemorrhage
Other immediate postpartum haemorrhage
O82
Delayed and secondary postpartum

haemorrhage
Retained placenta and membranes, without
haemorrhage
Retained placenta without haemorrhage
Other complications of labour and delivery,
Pyrexia during labour, not elsewhere
classified
Vaginal delivery following previous caesarean
section
Complication of labour and delivery,
unspecified
Single spontaneous delivery
Spontaneous vertex delivery
Single spontaneous delivery, unspecified
Single delivery by forceps and vacuum
extractor
Low forceps delivery
Mid-cavity forceps with rotation
Vacuum extractor delivery
Delivery by combination of forceps and
vacuum extractor
Single delivery by caesarean section
O82.1
Delivery by emergency caesarean section
O72.2
O73
O73.0
O75
O75.2
O75.7
O75.9
O80
O80.0
O80.9
O81
O81.0
O81.2
O81.4
O81.5
O82.0
O82.2
O82.9
O83
O83.0
O83.1
O83.4
O83.8
O83.9
O84
O84.0
O84.8
O84.9
O85
O86
O86.0
O86.4
O88
O88.1
O89
O89.9
O92.4
O99
O99.5
P01
P03.8
Delivery by elective caesarean section

Delivery by caesarean hysterectomy
Delivery by caesarean section, unspecified

Other assisted single delivery
Breech extraction
Other assisted breech delivery
Destructive operation for delivery
Other specified assisted single delivery

Assisted single delivery, unspecified
Multiple delivery
Multiple delivery, all spontaneous

Other multiple delivery
Multiple delivery, unspecified

Puerperal sepsis
Other puerperal infections
Infection of obstetric surgical wound
Pyrexia of unknown origin following delivery
Obstetric embolism
Amniotic fluid embolism
Complications of anaesthesia during the
puerperium
Complication of anaesthesia during the
puerperium, unspecified
Hypogalactia
Other maternal diseases classifiable
elsewhere but complicating pregnancy,
childbirth and the puerperium
Diseases of the respiratory system
complicating pregnancy, childbirth and the
puerperium
Fetus and newborn affected by maternal
complications of pregnancy
Fetus and newborn affected by other

specified complications of labour and delivery
P07.0
Disorders related to short gestation and low

birth weight, not elsewhere classified
Extremely low birth weight
P07.3
Other preterm infants
P07
P07.1
P07.2
P08.0
Other low birth weight

Extremeimmaturity
P20
Exceptionally large baby

Intracranial laceration and haemorrhage due
to birth injury
Intrauterine hypoxia
P21.9
Birth asphyxia, unspecified
P10
P20.9
P21
P22
P22.0
466
0
0
0
0
0
0
0
0
0
0
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
1
91
33
0 233
0
0
0
0
0
0
0
0
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
15
0 137
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
3
1
0
2
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
44
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
17
0
0
0
0
41
1
0
0
0
Total
0 217
58
360
360
0
0
0 140
38
82
11
63
0 359
0 816
0
0
0
19433
24887
0 588
0 103
0 137
0 2890
0
2
0 3733
0
0
0
19
0
0
72
15
0 212
0
0
0 137
0 849
0
0
3
0
0
0
0
0
0
0
0
5
0
2
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
2
494
6110
0
0
0
1
0
0
0
1
0 3161
0 633
31
0 103
6
0 130
0
17
65
0
0
0
0
14
4
2
35
0
0
0
0
0
58
7
5
2
1
22
0
0
0
0
0
0
56
0
1
5
0
0
10
0
0
0
0
0
11
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
6
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
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
54
28
0 299
71
0 251
45
791
0
0
0
1
2
494
6110
48
92
9
5
2
1
0
0
0
0
0
0
0
0
0
0
34
4361
0
1
0
0
172
19
77
233
15
4
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
3
48
319
87
19
109
172
0 27684
0
7
0 33737
77
213
15
11
34
34
233
4361
0
0
791
1205
0
0
0
56
109
0 27684
0
7
0 33737
563
213
11
34
1205
56
563
78
10
0
0
0
21
26
9
12
0
0
21
0 534
Total
Deaths
Total
60
Years
0 4016
0
0
50-59
Years
0 1164
0
0
0
0
85
40-49
Years
0
1
0
2
0 331
0
0
0
0
0
0
30-39
Years
0
0
0
0
0
0
0 5136
0
0
0 4969
0
0
0
20-29
Years
92
9
5
2
1
0
0
0
0
87
0
0
0
0
319
457
457
81
53
52
53
52
105
18
21
18
21
39
6
5
6
0
12
7
2
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
6
5
6
12
18
10
1
4
12
2
1
8
1
3
0
0
0
Intrauterine hypoxia, unspecified
12
22
12
22
34
Respiratory distress of newborn
Birth asphyxia
Respiratory distress syndrome of newborn
85
44
1
81
66
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Page 136 of 149
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
44
1
81
166
66
110
0
1
1
0
0
0
4
2
0
0
ICD
Code
Diseases
P22.1
Transient tachypnoea of newborn
P24.0
Neonatal aspiration of meconium
P23
P24
P24.8
P24.9
P27.0
P36
P36.0
P36.1
P36.2
P36.3
P36.8
P36.9
P37
P37.9
P38
P39
P39.3
P39.9
P50
P58
P58.2
P58.4
Congenital pneumonia
Neonatal aspiration syndromes
Other neonatal aspiration syndromes
Neonatal aspiration syndrome, unspecified

Wilson-Mikitysyndrome
Bacterial sepsis of newborn, unspecified

Other congenital infectious and parasitic
diseases
Congenital infectious and parasitic disease,
unspecified
Omphalitis of newborn with or without mild
haemorrhage
Other infections specific to the perinatal
period
Neonatal urinary tract infection
Infection specific to the perinatal period,
unspecified
Fetalbloodloss
Neonatal jaundice due to other excessive
haemolysis
Neonatal jaundice due to infection
Neonatal jaundice due to drugs or toxins

transmitted from mother or given to newborn
P71.2
P76.9
Intestinalobstructionofnewborn,unspecified
P59.0
P59.9
P61.9
P74.1
P76.0
P78.0
P78.9
P80.9
P81.0
P81.9
P92
P92.0
P93
P95
P96
Q01.9
Q04.9
Q05
Q07
Q14
Q18.1
Q21.1
Q24
Q24.8
Q25
Q27.3
Q33
Q33.0
Q35
Q35.9
Q36
Q36.0
29 Days-1
Yr
M
1
1
Dehydration of newborn
Meconium plug syndrome
Perinatalintestinalperforation
Perinatal digestive system disorder,
unspecified
Hypothermia of newborn, unspecified
Environmental hyperthermia of newborn

Disturbance of temperature regulation of
newborn, unspecified
Feedingproblemsofnewborn
Vomiting in newborn
Reactions and intoxications due to drugs
administered to fetus and newborn
Fetal death of unspecified cause
Other conditions originating in the perinatal
period
Encephalocele, unspecified
Congenital malformation of brain, unspecified
Spina bifida
Other congenital malformations of nervous
system
Congenital malformations of posterior
segment of eye
Preauricular sinus and cyst
Atrial septal defect
Other congenital malformations of heart

Other specified congenital malformations of
heart
Congenital malformations of great arteries
Peripheral arteriovenous malformation
Congenital malformations of lung
Congenital cystic lung
Cleft palate
Cleft palate, unspecified

Cleft lip
Cleft lip, bilateral
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
1
1
424 493
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
362
1
1
1
561
923
211
326
537
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
493
21
424
48
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1
26
917
1
6
80
113
193
64
86
64
86
150
20
28
26
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
20
28
48
0
0
26
0
31
57
1
0
0
0
0
0
10
80 113
11
127
79
M
0
46
Total
1
31
M
1
15
79
48
Total
Deaths
Total
4
0
15-19
Years
31
05-14
Years
15
01-04
Years
Bacterial sepsis of newborn

362 561
Sepsis of newborn due to streptococcus,
211 326
group B
Sepsis of newborn due to other and
5 21
unspecified streptococci
Sepsis of newborn due to Staphylococcus
0
2
aureus
Sepsisofnewbornduetootherandunspecifiedst
0
2
aphylococci
Other bacterial sepsis of newborn
2
2
Neonatal jaundice from other and unspecified

causes
Neonatal jaundice associated with preterm
delivery
Neonatal jaundice, unspecified
Perinatal haematological disorder,
unspecified
Neonatal hypomagnesaemia
P59
28
Days
2
0
0
0
0
0
0
0
0
0
18
16
18
16
34
3
0
1
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1
1
0
2
0
3
3
1
0
0
0
0
0
0
0
7
0
1
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
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
5
2
0
0
0
5
16
0
1
0
0
9
14
0
0
0
0
0
0
7
0
0
1
6
0
0
4
0
0
0
2
0
0
2
0
0
0
1
0
0
0
0
0
Page 137 of 149
0
1
0
0
3
0
0
0
2
0
0
4
0
1
0
0
0
0
0
0
0
0
2
1
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
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
1
0
0
0
0
0
5
12
30
27
1
5
0
1
13
17
0
0
0
0
0
0
14
57
0
0
0
0
467
ICD
Code
Diseases
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
Q36.9
Cleft lip, unilateral
14
21
29
50
Q37.8
Unspecified cleft palate with bilateral cleft lip
Q37
Q37.3
Cleft palate with cleft lip
Cleft soft palate with unilateral cleft lip
Q40.0
Unspecified cleft palate with unilateral cleft

lip
Other congenital malformations of tongue,
mouth and pharynx
Other congenital malformations of upper
alimentary tract
Congenital hypertrophic pyloric stenosis
Q43.5
Ectopic anus
Q37.9
Q38
Q40
Q43.1
Q43.4
Q44.4
Q44.6
Hirschsprung's disease
Duplication of intestine
Choledochal cyst
Q53
Cystic disease of liver

Other congenital malformations of female
genitalia
Imperforate hymen
female genitalia
Undescended testicle
Q54
Hypospadias
Q52
Q52.3
Q52.8
Q53.1
Q53.9
Q54.1
Q54.3
Undescended testicle, unilateral
Undescended testicle, unspecified

Hypospadias, penile
Q62.0
Hypospadias, perineal
Other congenital malformations of male
genital organs
Other congenital malformations of testis and
scrotum
male genital organs
Renal agenesis and other reduction defects of
kidney
Congenital hydronephrosis
Q64.0
Epispadias
Q55
Q55.2
Q55.8
Q60
Q62.6
Q63.2
Q65.5
Q66
Malposition of ureter
Ectopic kidney
Congenital subluxation of hip, unspecified
Q69
Congenital deformities of feet

Other congenital deformities of skull, face and
jaw
Other specified congenital musculoskeletal
deformities
Polydactyly
Q71.5
Longitudinal reduction defect of ulna
Q67.4
Q68.8
Q69.0
Q70.0
Q73
Q74
Q79.3
Q79.9
Q80
Q82
Q85.0
Q89
Q89.2
Q89.9
Q90
Q96
Accessory finger(s)
Fused fingers
Reduction defects of unspecified limb
Other congenital malformations of limb(s)
Gastroschisis
Congenital malformation of musculoskeletal
system, unspecified
Congenital ichthyosis
Other congenital malformations of skin
Neurofibromatosis (nonmalignant)
Other congenital malformations, not
Congenital malformations of other endocrine
glands
Congenital malformation, unspecified
Down's syndrome
R00
Turner's syndrome
Other chromosome abnormalities, not
Abnormalities of heart beat
R00.2
Palpitations
Q99
R00.0
R00.1
R01
R02
R04
R04.0
R04.2
R05
R06
R06.4
R06.5
R06.6
468
Tachycardia, unspecified
Bradycardia, unspecified
Cardiac murmurs and other cardiac sounds

Gangrene, not elsewhere classified
Haemorrhage from respiratory passages
Epistaxis
Haemoptysis
Cough
Abnormalities of breathing
Hyperventilation
Mouth breathing
Hiccough
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
1
0
0
0
0
1
1
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
1
0
2
1
0
1
2
2
1
3
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
2
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
2
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
2
1
0
0
0
0
0
0
0
0
0
0
0
5
0
1
0
0
9
1
0
4
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
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
1
0
0
0
5
0
0
0
0
0
3
0
0
0
1
0
0
0
9
0
3
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
2
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
0
0
0
0
3
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
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
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
61 105
0
0
0
0
0
1
0
23
20
21
30
14
13
24
16
14
12
0
0
0
14
0
0
0
0
0
0
5
1
0
0
8
1
2
1
23
11
11
31
31
2
4
1
3
6
2
4
1
1
144
189
333
1
0
0
1
1
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
12
19
7
1
0
0
20
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
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
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
1
0
0
0
0
0
0
0
0
3
1
0
1
1
0
0
2
1
1
3
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
1
0
0
0
0
0
0
0
0
0
0
1
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
1
2
1
0
0
0
1
2
1
0
0
0
0
0
0
0
0
1
3
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
1
5
0
5
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
3
1
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
14
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
3
0
0
0
1
0
0
0
0
0
0
7
1
0
1
0
0
0
0
0
0
0
2
3
2
2
0
1
0
0
0
0
1
0
0
5
1
1
0
2
2
10
1
0
0
0
0
Page 138 of 149
3
0
0
1
0
1
1
0
1
6
9
3
1
0
0
0
0
0
0
0
0
0
0
0
5
3
15
9
4
0
0
0
0
0
0
0
1
6
0
0
0
9
7
0
0
0
0
5
0
1
0
5
9
0
0
0
14
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
17
12
41
61
10
1
9
32
22
9
12
17
4
9
9
4
1
0
0
0
10
7
0
0
0
1
70
18
2
1
1
0
2
4
1
50
93
65
135
27
0
0
1
45
23
1
1
1
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
ICD
Code
Diseases
R07
Other and unspecified abnormalities of

breathing
Pain in throat and chest
R07.2
Precordial pain
R06.8
R07.0
R07.1
R07.3
R07.4
Pain in throat
Chest pain on breathing

Other chest pain
28
Days
29 Days-1
Yr
01-04
Years
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
R19
R19.0
R21
R22
R22.1
R22.2
R22.3
R22.4
R22.7
R22.9
R23.0
R23.4
R23.8
R25.2
R29
R29.6
R29.8
R30
R31
R32
R33
R34
R39
R40
R41
R41.0
R42
R44
R49
R50
R50.2
R50.9
R51
R52
R52.9
R53
R55
R56
R56.0
R56.8
R57
R57.0
R57.1
Rash and other nonspecific skin eruption
Localized swelling, mass and lump of skin and

subcutaneous tissue
Localized swelling, mass and lump, neck
Localized swelling, mass and lump, trunk
Localized swelling, mass and lump, upper
limb
Localized swelling, mass and lump, lower limb

Localized swelling, mass and lump, multiple
sites
Localized swelling, mass and lump,
unspecified
Cyanosis
Changes in skin texture
Other and unspecified skin changes
Cramp and spasm
Other symptoms and signs involving the
nervous and musculoskeletal systems
Tendency to fall, not elsewhere classified
Other and unspecified symptoms and signs
involving the nervous and musculoskeletal
systems
Pain associated with micturition
Unspecified haematuria
Unspecified urinary incontinence
Retention of urine
Anuria and oliguria
urinary system
Somnolence, stupor and coma
Other symptoms and signs involving
cognitive functions and awareness
Disorientation, unspecified
Dizziness and giddiness
Other symptoms and signs involving general
sensations and perceptions
Voice disturbances
Fever of other and unknown origin
Drug-induced fever
Fever, unspecified
Headache
Pain, not elsewhere classified
Pain, unspecified
Malaise and fatigue
Syncope and collapse
Convulsions, not elsewhere classified
Febrile convulsions
Other and unspecified convulsions
Shock, not elsewhere classified
Cardiogenic shock
Hypovolaemic shock
3
3
0
1
0
1
0
2
3
110
11
14
13
14
0
0
0
0
0
0
0
0
0
3
0
0
1
0
2
4
0
0
0
1
0
0
0
2
65 111
1
0
0
1
2304
15
16
40
3
13
29
15
384
202
586
0
0
0
0
0
0
27
0
0
0
0
17
0
0
0
0
20
0
2
0
0
14
0
0
0
0
27
0
2
0
1
14
0
0
0
0
14
0
0
0
0
18
0
0
1
1
11
0
0
1
0
14
0
0
16
1
0
32
0
0
1
0
6
1
0
15
3
0
14
1
0
0
0
9
1
0
19
2
0
15
19
34
32
29
23
43
23
15
20
29
22
16
24
31
23
13
4
12
4
17
2
31
2
14
3
13
2
18
5
869
70
41
1435
21
19
0
0
78
50
18
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
1
0
0
1
0
0
1
0
0
2
0
0
3
0
0
2
0
0
7
0
0
3
0
0
4
0
0
6
0
0
2
0
2
23
20
182
1
4
18
2
1
250
74
7
133
315
16
37
20
70
0
0
41
94 100
96
25
90 476 176 247 137 151
53
37
30
11
0
0
51 122 159 182
26
12
0
0
14
0
0
12
26
11
15
M
0
42
53
30
Total
0
30
M
1
23
Ascites
digestive system and abdomen
Intra-abdominal and pelvic swelling, mass
and lump
R18
Flatulence and related conditions
R17
R14
R16.2
14
22
0
0
16
R16.0
R16.1
R16
Faecal incontinence
Hepatomegaly and splenomegaly, not
Hepatomegaly, not elsewhere classified
Splenomegaly, not elsewhere classified
Hepatomegaly with splenomegaly, not
Unspecified jaundice
R15
Total
Deaths
Total
R10.4
Dysphagia
60
Years
Pelvic and perineal pain

Pain localized to other parts of lower
abdomen
Other and unspecified abdominal pain
30
17
14
Acute abdomen
50-59
Years
R13
Nausea and vomiting
Abdominal and pelvic pain
R11
R10
R10.3
14
R10.2
Other specified symptoms and signs involving

the circulatory and respiratory systems
Pain localized to upper abdomen
40-49
Years
R10.1
30-39
Years
R09.0
R10.0
20-29
Years
R09.8
15-19
Years
Chest pain, unspecified

circulatory and respiratory systems
Asphyxia
R09
05-14
Years
1
0
2
2
0
71
86
160
45
53
7
1
235
9
4
9
2
485
16
0
0
0
0
0
0
0
6
24
21
23
30
10
0
0
0
18
1
2
25
0
0
43
1
2
0
1
0
0
0
2
0
0
0
0
1
0
2
0
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
1
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
1
0
0
3
2
2
1
6
1
2
1
9
3
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
12
0
28
1
2
0
0
0
0
1
1
0
0
0
0
0
1
0
0
0
0
0
0
0
14
0
22
0
3
0
0
0
0
4
6
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
1
0
1
0
0
0
1
0
0
0
0
2
0
0
0
0
0
0
1
0
2
0
0
1
1
0
0
0
0
1
0
0
0
2
0
3
0
1
0
1
0
0
11
0
0
3
0
10
0
0
0
0
6
0
0
1
0
17
0
0
0
0
16
1
0
10
1
9
1
8
0
0
2
0
4
0
0
0
10
0
0
1
0
6
0
2
0
3
0
0
1
0
1
0
1
0
8
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
44 79 132 172 182 235 115 98 251 165 136 117 118 73 77
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
66 109 145 223 205 277 167 166 330 190 217 149 528 125 116
0
2
3
3 32 37 37 33 109 55 51 30 60 33 30
2
3 11
9 24 25 16
8 81 34 84 40 96 51 51
0
2 19 27 23 29 19 11 82 30 71 30 52 34 44
0
0
0
0
2
2
4
4 12
9 12
7 12 10
7
0
0
0
0
2
0
2
2
0
0
4
0
0
0
1
10 17 55 70 50 45
4
5 16 24 24 15 14 12
3
19 37 84 132 35 30
8
2
4
3
2
1
2
3
1
9 19 45 78 37 32 11 23 34 37 17 31 21 22
8
0
0
1
0
1
1
0
1
0
1
4
0
0
4
3
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
1
Page 139 of 149
0
0
1
9
0
0
1
0
14
0
1
6
0
51
0
1
5
0
51
0
1
13
1
93
1
2
18
1
144
1
0
5
0
10
2
4
0
4
0
6
1
49
2
37
3
86
0
0
1
79 95 84
0
0
0
90 127 113
27 48 37
33 26 15
27 23 24
7
9
9
1
3
0
8
6
6
0
1
0
14 28 33
4
1
5
1
1
2
0
0
0
0
1162
0
1929
371
393
333
58
12
182
157
211
10
2
2
2
1116
1
1464
257
221
214
48
3
202
212
295
16
3
0
2
2278
1
3393
628
614
547
106
15
384
369
506
26
5
2
0
0
0
0
0
0
0
0
0
0
4
0
1
1
0
0
0
0
0
2
1
2
1
0
0
0
0
0
0
0
0
0
0
0
4
0
2
2
0
0
0
0
2
1
0
2
2
0
469
ICD
Code
R57.9
R58
R59
R59.1
R60
R60.1
R60.9
R61
R61.9
R63
R64
R68.8
R69
R71
R73
R79
R80
R82.3
R89
R90.0
R99
S00
S00.0
S00.4
S00.9
S01
S01.0
S02
S02.0
S02.1
S02.2
S02.4
S02.6
S02.9
S03
S04.5
S05
S06
S06.4
S06.5
S07.0
S07.8
S09
S09.0
S09.9
S12
S12.2
S12.8
S12.9
S13.1
S14.5
S17.9
S19.7
S20
S20.8
S22
S22.0
S22.3
S22.4
S22.9
S27
S27.9
S30
S30.2
S30.9
S31
S31.0
S31.1
S31.4
S32
S32.0
S32.5
S32.7
S32.8
S34.1
S36.0
470
Diseases
Shock, unspecified
Haemorrhage, not elsewhere classified
Enlarged lymph nodes
Generalized enlarged lymph nodes
Oedema, not elsewhere classified
Generalized oedema
Oedema, unspecified
Hyperhidrosis
Hyperhidrosis, unspecified
Symptoms and signs concerning food and
fluid intake
Cachexia
Other specified general symptoms and signs

Unknown and unspecified causes of
morbidity
Abnormality of red blood cells
Elevated blood glucose level
Other abnormal findings of blood chemistry

Isolated proteinuria
Haemoglobinuria
Abnormal findings in specimens from other
organs, systems and tissues
Intracranial space-occupying lesion
Other ill-defined and unspecified causes of
mortality
Superficial injury of head
Superficial injury of scalp
Superficial injury of ear
Superficial injury of head, part unspecified
Open wound of head

Open wound of scalp
Fracture of skull and facial bones
Fracture of vault of skull
Fracture of base of skull
Fracture of nasal bones
Fracture of malar and maxillary bones
Fracture of mandible
Fracture of skull and facial bones, part
unspecified
Dislocation, sprain and strain of joints and
ligaments of head
Injury of facial nerve
Injury of eye and orbit
Intracranial injury
Epidural haemorrhage
Traumatic subdural haemorrhage
Crushing injury of face
Crushing injury of other parts of head
Other and unspecified injuries of head
Injury of blood vessels of head, not elsewhere
classified
Unspecified injury of head
Fracture of neck
Fracture of other specified cervical vertebra
Fracture of other parts of neck
Fracture of neck, part unspecified
Dislocation of cervical vertebra
Injury of cervical sympathetic nerves
Crushing injury of neck, part unspecified
Multiple injuries of neck
Superficial injury of thorax
Superficial injury of other and unspecified
parts of thorax
Fracture of rib(s), sternum and thoracic spine
Fracture of thoracic vertebra

Fracture of rib
Multiple fractures of ribs
Fracture of bony thorax, part unspecified
Injury of other and unspecified intrathoracic
organs
Injury of unspecified intrathoracic organ
Superficial injury of abdomen, lower back and
pelvis
Contusion of external genital organs
Superficial injury of abdomen, lower back and
pelvis, part unspecified
Open wound of abdomen, lower back and
pelvis
Open wound of lower back and pelvis
Open wound of abdominal wall
Open wound of vagina and vulva
Fracture of lumbar spine and pelvis
Fracture of lumbar vertebra
Fracture of pubis
Multiple fractures of lumbar spine and pelvis
Fracture of other and unspecified parts of
lumbar spine and pelvis
Other injury of lumbar spinal cord
Injury of spleen
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
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
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
1
2
0
0
0
1
1
0
2
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
1
1
1
1
1
0
0
1
6
2
1
8
0
2
0
0
0
0
1
0
0
0
1
0
1
0
6
3
0
2
0
0
2
0
0
3
3
0
1
0
0
0
0
1
0
1
1
0
1
1
0
0
1
10
4
0
2
0
0
0
0
0
1
2
0
1
0
2
0
0
1
4
1
0
0
0
1
0
0
1
2
5
0
1
1
1
0
0
0
8
3
1
0
3
2
0
0
3
16
19
2
13
3
8
2
0
2
26
14
2
6
4
5
0
1
5
42
33
4
19
7
13
2
1
2
1
1
0
0
0
1
0
0
2
2
0
0
0
0
0
0
0
9460 25212
88
92
834 947
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
2
0
0
0
1
1
0
0
0
1
0
0
0
0
1
1
0
1
0
0
6
4
0
0
1
0
2
0
1
0
1
0
0
1
0
1
0
0
0
0
0
1
2
0
0
0
1
0
1
0
0
0
0
0
1
0
1
0
7
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
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
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
2
0
1
0
0
0
0
0
0
0
139 311 342 561 643 798 1565 822 5817 1257 2397 1086 1489 1165 1149 1025 1377 1488 15752
0
0
0
0
0
0
0
0
11
1
0
0
1
1
0
0
2
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
12
15
0
1
12
5
0
0
0
0
2
1
3
1
1
0
0
1
0
0
3
0
0
4
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
1
1
2
16
13
19
13
26
0
0
0
1
0
0
0
2
0
0
0
3
9
0
0
0
1
0
0
0
3
0
3
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
0
1
0
2
0
2
0
0
5
0
0
0
0
1
0
0
0
7
0
0
10
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
1
0
3
19
22
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
0
4
2
4
2
11
3
0
0
0
0
82
1
1
0
0
0
0
0
0
2
3
3
1
1
12
1
15
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
4
3
8
5
121
119
240
0
0
0
0
2
0
0
0
0
2
0
0
1
1
1
0
1
4
0
5
0
3
49
1
1
1
2
2
1
0
8
1
10
1
2
1
5
0
0
9
5
32
33
0
0
3
1
7
0
0
0
0
2
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
0
0
0
2
0
0
0
2
0
0
1
0
0
0
2
1
0
0
0
1
1
0
3
0
0
2
2
0
0
0
1
1
0
4
1
2
0
0
6
0
0
1
0
0
0
0
10
0
0
0
1
1
0
0
1
0
0
7
1
0
0
1
9
1
0
2
5
2
0
0
8
0
0
2
1
1
0
0
4
0
0
4
2
1
0
0
13
0
0
2
0
1
0
0
7
0
0
4
3
4
0
0
5
0
0
4
1
2
0
0
10
0
0
4
4
5
0
0
12
0
0
6
1
3
0
0
16
0
1
4
2
7
0
0
14
2
0
24
7
7
0
1
59
3
1
22
18
25
1
0
62
5
1
46
25
32
1
1
121
9
0
0
0
0
0
2
0
3
2
9
3
7
12
27
20
10
7
16
3
16
4
45
2
17
8
33
4
13
7
18
5
11
8
19
15
15
18
15
22
101
66
184
74
285
140
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
1
1
0
0
0
1
1
0
1
0
0
1
0
0
0
0
0
0
0
0
2
0
7
0
0
3
0
1
0
2
0
0
2
0
2
0
3
0
0
1
0
4
0
2
1
1
2
0
4
0
1
0
0
1
0
7
0
1
1
0
1
0
3
0
1
0
0
0
0
7
0
3
0
0
0
0
7
0
2
0
0
1
0
2
0
2
0
0
0
0
15
0
15
0
0
7
0
21
1
11
2
1
6
1
34
1
26
2
1
13
1
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
0
0
0
0
0
0
0
0
0
0
0
0
0
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
2
0
1
0
0
2
0
0
0
1
3
0
0
0
0
1
0
0
2
0
6
1
0
0
0
5
2
0
0
0
2
0
1
3
0
2
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
1
0
0
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
0
1
0
0
0
0
0
Page 140 of 149
1
0
0
0
0
1
1
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
1
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
2
0
2
0
0
0
1
1
0
0
0
0
1
0
2
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
1
1
2
0
0
0
0
1
0
1
0
0
2
1
0
0
1
0
0
0
0
1
0
0
3
0
1
0
0
0
1
0
0
5
1
0
0
0
0
2
0
0
1
1
1
6
1
8
10
0
1
0
2
0
1
10
1
2
1
19
6
3
1
0
0
0
0
8
0
0
0
1
28
8
2
0
14
7
0
10
1
14
1
2
1
0
2
1
2
0
0
2
0
4
5
0
0
0
4
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
12
1
3
2
1
1
18
2
11
0
0
0
0
0
0
0
0
0
0
0
0
18
0
3
0
2
3
1
0
0
0
0
0
0
ICD
Code
S37
S37.3
S37.8
S38.0
S39
S39.9
S42
S42.0
S42.1
S42.2
S42.3
S42.4
S42.9
Diseases
Injury of urinary and pelvic organs
Injury of urethra
Injury of other pelvic organs
Crushing injury of external genital organs
Other and unspecified injuries of abdomen,
lower back and pelvis
Unspecified injury of abdomen, lower back
and pelvis
Fracture of shoulder and upper arm
Fracture of clavicle
Fracture of scapula
Fracture of upper end of humerus
Fracture of shaft of humerus
Fracture of lower end of humerus
Fracture of shoulder girdle, part unspecified
S50
S50.9
S51.9
S52
S52.0
S52.1
S52.2
S52.3

ligaments of shoulder girdle
Dislocation of shoulder joint
Dislocation of acromioclavicular joint
Injury of median nerve at upper arm level
Injury of blood vessels at shoulder and upper
arm level
Injury of unspecified blood vessel at shoulder
and upper arm level
Other and unspecified injuries of shoulder
and upper arm
Superficial injury of forearm
Superficial injury of forearm, unspecified
Open wound of forearm, part unspecified
Fracture of forearm
Fracture of upper end of ulna
Fracture of upper end of radius
Fracture of shaft of ulna
Fracture of shaft of radius
S52.5
Fracture of lower end of radius
S43
S43.0
S43.1
S44.1
S45
S45.9
S49
S52.4
S52.6
S52.7
S52.8
S52.9
S53
S53.1
S53.2
S54
S56
S59
S59.7
S59.9
S60
S60.9
S61
S61.8
S61.9
S62
S62.3
S62.5
S62.6
S62.7
S62.8
S63
S64
S64.7
S66
S67
S67.0
Fracture of shafts of both ulna and radius
Fracture of lower end of both ulna and radius
Multiple fractures of forearm

Fracture of other parts of forearm
Fracture of forearm, part unspecified
ligaments of elbow
Dislocation of elbow, unspecified
Traumatic rupture of radial collateral
ligament
Injury of nerves at forearm level
Injury of muscle and tendon at forearm level
Other and unspecified injuries of forearm

Multiple injuries of forearm
Unspecified injury of forearm
Superficial injury of wrist and hand
Superficial injury of wrist and hand,
unspecified
Open wound of wrist and hand
Open wound of other parts of wrist and hand
Open wound of wrist and hand part, part

unspecified
Fracture at wrist and hand level
Fracture of other metacarpal bone
Fracture of thumb
Fracture of other finger
Multiple fractures of fingers
Fracture of other and unspecified parts of
wrist and hand
ligaments at wrist and hand level
Injury of nerves at wrist and hand level
Injury of multiple nerves at wrist and hand
level
Injury of muscle and tendon at wrist and hand
level
Crushing injury of wrist and hand
Crushing injury of thumb and other finger(s)
S69.9
Crushing injury of other and unspecified parts

of wrist and hand
Traumatic amputation of wrist and hand
Traumatic amputation of other single finger
(complete)(partial)
Traumatic amputation of wrist and hand,
level unspecified
Other and unspecified injuries of wrist and
hand
Unspecified injury of wrist and hand
S71
S71.1
S72
S72.0
Open wound of hip and thigh

Open wound of thigh
Fracture of femur
Fracture of neck of femur
S67.8
S68
S68.1
S68.9
S69
S70.9
Superficial injury of hip and thigh, unspecified
28
Days
29 Days-1
Yr
M
0
0
0
0
0
0
0
0
M
0
0
0
0
0
0
0
0
01-04
Years
05-14
Years
M
0
0
0
0
0
0
0
0
15-19
Years
M
0
0
0
0
0
0
0
0
20-29
Years
M
0
0
1
0
0
0
0
0
30-39
Years
M
0
0
0
1
0
0
0
0
40-49
Years
M
0
0
0
0
2
0
0
0
50-59
Years
M
0
0
0
0
0
1
0
0
60
Years
M
0
0
0
0
0
0
0
0
M
0
0
0
0
0
1
0
0
M
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
4
1
0
0
7
1
6
0
0
0
8
2
15
0
0
0
60
4
60
1
0
0
55
5
5
1
0
0
8
0
5
0
0
0
6
0
7
3
0
0
6
0
12
2
0
1
13
0
5
1
2
0
4
1
8
2
0
0
9
0
8
1
0
0
4
0
12
5
0
0
7
0
5
1
0
1
4
1
11
2
1
0
5
1
3
1
1
0
10
0
6
1
0
0
4
1
52
9
3
1
103
7
Total
Deaths
Total
Total
2
2
0
0
M
0
0
0
0
0
0
0
0
121
13
1
1
107
9
173
22
4
2
210
16
1
0
0
0
0
0
0
0
0
0
0
0
10
13
19
2
2
1
1
14
31
22
50
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
17
1
0
1
0
0
0
0
55
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
1
0
1
0
0
83 155
5
8
0
1
10 17
0
0
1
0
0
0
1
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
19
0
0
0
0
0
0
0
21
3
1
2
0
0
1
0
14
1
0
3
0
0
3
2
233
16
2
33
2
1
2
9
388
18
4
31
0
1
5
11
621
34
6
64
2
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
1
0
0
2
2
0
0
0
7
17
4
6
19
1
10
12
4
8
14
4
6
13
1
8
19
4
5
13
2
9
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
10
2
1
19
0
8
11
20
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
3
0
0
0
0
2
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
1
0
0
0
1
0
0
3
7
15
107
63
24
63
88
39
170
151
10
11
0
0
1
0
0
0
0
0
2
10
2
5
7
4
0
0
0
0
0
0
0
0
0
0
0
0
1
4
6
1
2
4
1
0
3
0
0
0
0
0
1
4
1
1
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
1
0
0
0
0
1
0
0
0
0
3
5
1
0
0
10
0
1
0
1
1
0
0
0
0
5
1
0
0
0
10
17
13
16
25
0
3
0
0
0
2
1
0
1
0
3
1
0
0
0
2
1
0
0
0
1
0
0
0
0
2
0
0
0
0
0
0
1
2
0
0
0
10
17
1
0
0
0
33
5
1
2
1
3
43
22
2
2
1
30
3
1
4
1
0
1
0
0
0
0
0
0
0
10
0
0
1
0
1
7
0
0
0
0
0
0
0
1
10
0
1
0
29
1
0
6
1
0
0
0
0
0
0
36
1
2
2
0
0
0
0
0
1
1
27
2
1
6
0
0
51
4
2
2
1
0
0
1
36
2
0
3
0
0
1
2
1
1
1
0
0
0
25
3
0
2
0
1
1
0
0
0
4
46
4
1
2
0
0
0
0
0
1
1
19
0
0
6
1
1
0
0
0
0
0
27
2
0
4
0
0
0
0
0
0
0
11
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
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
10
0
0
0
0
0
13
0
0
0
0
0
0
14
2
0
0
0
0
0
28
0
1
0
0
0
0
9
0
0
2
0
0
0
16
0
Page 141 of 149
0
0
0
1
0
9
0
0
2
0
0
0
17
0
0
1
0
0
0
3
1
0
1
0
0
0
20
2
0
0
0
0
0
13
0
0
1
0
0
0
16
0
0
0
1
0
0
16
1
0
0
0
0
0
11
2
0
0
0
1
0
30
5
0
0
0
0
1
37
1
1
1
1
2
0
106
9
0
6
0
0
1
158
5
1
7
1
2
1
264
14
0
0
0
0
0
0
0
0
0
0
0
1
1
0
471
ICD
Code
S72.1
S72.3
S72.4
S72.7
S72.8
S72.9
Diseases
S73.0
S77.2
Pertrochanteric fracture
Fracture of shaft of femur
Fracture of lower end of femur
Multiple fractures of femur
Fractures of other parts of femur
Fracture of femur, part unspecified
Dislocation, sprain and strain of joint and
ligaments of hip
Dislocation of hip
Crushing injury of hip with thigh
S79.9
S80
S80.9
S81
S81.0
Unspecified injury of hip and thigh

Superficial injury of lower leg
Superficial injury of lower leg, unspecified
Open wound of lower leg
Open wound of knee
S73
S79
S81.9
S82
S82.0
S82.1
S82.2
S82.3
S82.4
S82.5
S82.6
S82.7
S82.8
S82.9
Other and specified injuries of hip and thigh
Open wound of lower leg, part unspecified
S83.0
S83.1
S83.2
S83.7
S84
S84.1
Fracture of lower leg, including ankle

Fracture of patella
Fracture of upper end of tibia
Fracture of shaft of tibia
Fracture of lower end of tibia
Fracture of fibula alone
Fracture of medial malleolus
Fracture of lateral malleolus
Multiple fractures of lower leg
Fractures of other parts of lower leg
Fracture of lower leg, part unspecified
ligaments of knee
Dislocation of patella
Dislocation of knee
Tear of meniscus, current
Injury to multiple structures of knee
Injury of nerves at lower leg level
Injury of peroneal nerve at lower leg level
S88.0
Traumatic amputation at knee level
S83
S86
S89
S89.9
S90
S90.0
S91
S91.0
S91.1
S91.3
S92
S92.0
S92.1
S92.3
S92.5
S92.7
S92.9
S93
S93.0
S93.4
S93.6
S95.9
S96
S97.8
S98
S98.4
S99
S99.9
T00.0
T00.3
T02
T02.2
T02.7
T03
T03.9
T04
T05.9
Injury of muscle and tendon at lower leg level

Other and unspecified injuries of lower leg
Unspecified injury of lower leg
Superficial injury of ankle and foot
Contusion of ankle
Open wound of ankle and foot
Open wound of ankle
Open wound of toe(s) without damage to nail
Open wound of other parts of foot

Fracture of foot, except ankle
Fracture of calcaneus
Fracture of talus
Fracture of metatarsal bone
Fracture of other toe
Multiple fractures of foot
Fracture of foot, unspecified
ligaments at ankle and foot level
Dislocation of ankle joint
Sprain and strain of ankle
Sprain and strain of other and unspecified
parts of foot
Injury of unspecified blood vessel at ankle
and foot level
Injury of muscle and tendon at ankle and foot
level
Crushing injury of other parts of ankle and
foot
Traumatic amputation of ankle and foot
Traumatic amputation of foot, level
unspecified
Other and unspecified injuries of ankle and
foot
Unspecified injury of ankle and foot
Superficial injuries involving head with neck
Superficial injuries involving multiple regions

of lower limb(s)
Fractures involving multiple body regions
Fractures involving multiple regions of one

upper limb
Fractures involving thorax with lower back
and pelvis with limb(s)
Dislocations, sprains and strains involving
multiple body regions
Multiple dislocations, sprains and strains,
unspecified
Crushing injuries involving multiple body
regions
Multiple traumatic amputations, unspecified
28
Days
29 Days-1
Yr
M
0
0
0
0
0
0
0
0
0
0
0
0
M
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
1
32
0
0
0
1
0
0
0
2
0
0
01-04
Years
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
1
0
0
0
0
0
0
0
0
0
0
0
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
0
2
0
0
0
0
6
1
1
1
25
0
1
0
0
0
12
0
4
2
0
0
70
0
0
0
0
0
35
0
2
0
0
0
20
0
1
0
0
0
45
0
1
2
7
1
0
1
0
2
2
17 136
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
1
1
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
1
0
0
0
0
2
0
0
1
36
29
0
8
4
0
0
0
0
0
4
6
M
0
0
0
0
0
9
14
0
3
2
0
0
0
0
2
0
2
8
0
1
2
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
60
Years
0
0
0
0
0
0
0
0
50-59
Years
0
5
5
0
0
83
0
0
0
0
0
0
40-49
Years
0
0
0
0
0
0
30-39
Years
0
4
0
1
0
18
2
0
0
0
0
0
0
0
0
0
0
20-29
Years
15-19
Years
0
1
1
0
0
5
0
0
0
0
0
05-14
Years
0
0
0
0
0
0
0
5
0
0
0
2
0
1
0
1
3
1
0
2
0
0
1
3
2
1
2
0
0
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
2
0
0
3
0
0
0
2
0
0
2
0
0
0
2
1
0
3
0
0
0
1
1
0
0
1
0
0
0
1
0
0
0
0
0
25
10
3
5
352
1
40
11
4
8
652
1
0
2
1
2
1
4
2
0
1
0
1
0
0
0
1
0
3
7
2
0
9
Total
M
0
1
0
0
1
0
0
0
0
0
0
1
0
0
0
0
1
2
7
2
1
1
5
14
4
1
0
0
0
0
0
0
0
0
0
0
10
19
28
3
8
13
0
3
0
0
0
2
20
27
1
8
7
1
6
0
0
0
7
15
27
12
8
11
2
0
1
0
2
5
25
27
5
4
6
1
0
0
0
0
3
16
67
12
8
19
0
5
0
0
0
8
26
19
5
3
7
0
1
0
0
0
6
17
27
7
8
5
1
3
0
0
0
3
9
20
3
5
8
0
1
0
0
0
1
4
35
7
2
6
0
1
0
0
0
1
7
130
20
29
46
3
8
0
0
2
26
72
238
42
47
63
4
13
1
2
3
26
100
368
62
76
109
7
21
1
2
5
52
172
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
5
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
1
1
1
2
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
9
2
1
1
1
2
0
1
0
0
1
2
9
3
1
1
0
0
0
0
0
0
0
0
0
0
0
0
1
15
1
1
3
300
18
6
6
10
1
0
0
0
0
7
17
0
1
0
0
0
0
0
0
0
0
0
0
2
0
1
1
94
15
1
4
3
0
1
0
2
1
3
6
3
0
0
6
0
0
0
0
0
2
1
Total
Deaths
Total
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
6
0
1
0
0
0
0
0
0
1
0
1
0
0
0
0
0
4
1
0
2
0
0
0
0
0
0
0
0
0
1
1
0
1
4
0
0
1
2
2
1
0
0
0
0
0
0
0
0
0
0
2
1
0
3
0
0
2
0
0
0
1
0
0
0
0
0
0
8
0
0
2
0
0
3
0
1
0
1
0
0
0
0
1
0
2
0
0
5
0
0
1
0
0
1
0
0
0
1
1
0
0
5
1
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
0
1
0
0
1
1
0
1
0
0
0
0
2
1
0
1
0
0
1
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
2
1
1
1
1
0
0
0
2
0
0
2
3
0
1
3
3
0
2
1
3
4
1
1
3
3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
1
0
0
0
15
3
0
13
0
0
4
1
32
3
2
7
6
2
6
1
47
6
2
20
6
2
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
2
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
3
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
1
0
2
0
0
0
4
1
3
1
7
0
0
0
0
15
21
36
57
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
1
0
0
2
0
0
2
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
1
2
4
0
0
4
1
2
8
0
0
0
0
0
0
Page 142 of 149
472
ICD
Code
Diseases
T10
T12
Other injuries involving multiple body

regions, not elsewhere classified
Injuries of brain and cranial nerves with
injuries of nerves and spinal cord at neck
level
Injuries of nerves and spinal cord involving
other multiple body regions
Fracture of spine, level unspecified
Other injuries of spine and trunk, level
unspecified
Open wound of trunk, level unspecified
Injury of spinal cord, level unspecified
Injury of unspecified nerve, spinal nerve root
and plexus of trunk
Fracture of upper limb, level unspecified
Fracture of lower limb, level unspecified
T14
Injury of unspecified body region
T06
T06.0
T06.1
T08
T09
T09.1
T09.3
T09.4
T13
T14.0
T14.1
T14.2
T14.3
T14.4
T14.6
T14.7
T14.9
T15
T15.9
T16
T17
T17.1
T17.2
T18
T18.1
T18.2
T18.3
T18.4
T19
T19.8
T19.9
T20
T20.0
T20.1
T21
T21.0
T21.1
T21.4
T22
T22.0
T22.1
T22.2
T22.3
T23.0
T23.1
T23.2
T24
T24.1
T24.4
T25
T25.0
T25.1
T26
T29
T29.0
T30
T30.0
T30.2
T30.3
Other injuries of lower limb, level unspecified

Superficial injury of unspecified body region
Open wound of unspecified body region
Fracture of unspecified body region
Dislocation, sprain and strain of unspecified
body region
Injury of nerve(s) of unspecified body region
Injury of muscles and tendons of unspecified

body region
Crushing injury and traumatic amputation of
unspecified body region
Injury, unspecified
Foreign body on external eye
Foreign body on external eye, part
unspecified
Foreign body in ear
Foreign body in respiratory tract
Foreign body in nostril
Foreign body in pharynx
Foreign body in alimentary tract
Foreign body in oesophagus
Foreign body in stomach
Foreign body in small intestine
Foreign body in colon
Foreign body in genitourinary tract
Foreign body in other and multiple parts of
genitourinary tract
Foreign body in genitourinary tract, part
unspecified
Burn and corrosion of head and neck
Burn of unspecified degree of head and neck
Burn of first degree of head and neck

Burn and corrosion of trunk
Burn of unspecified degree of trunk
Burn of first degree of trunk
Corrosion of unspecified degree of trunk
Burn and corrosion of shoulder and upper
limb, except wrist and hand
Burn of unspecified degree of shoulder and
upper limb, except wrist and hand
Burn of first degree of shoulder and upper
Burn of second degree of shoulder and upper
Burn of third degree of shoulder and upper
Burn of unspecified degree of wrist and hand

Burn of first degree of wrist and hand
Burn of second degree of wrist and hand
Burn and corrosion of hip and lower limb,
except ankle and foot
Burn of first degree of hip and lower limb,
except ankle and foot
Corrosion of unspecified degree of hip and
lower limb, except ankle and foot
Burn and corrosion of ankle and foot
Burn of unspecified degree of ankle and foot

Burn of first degree of ankle and foot
Burn and corrosion confined to eye and
adnexa
Burns and corrosions of multiple body
regions
Burns of multiple regions, unspecified degree

Burn and corrosion, body region unspecified
Burn of unspecified body region, unspecified

degree
Burn of second degree, body region
unspecified
Burn of third degree, body region unspecified
28
Days
29 Days-1
Yr
M
0
0
0
0
0
0
M
1
0
0
1
0
0
01-04
Years
05-14
Years
M
2
15-19
Years
M
3
0
0
3
0
0
20-29
Years
M
2
0
0
2
0
0
30-39
Years
M
3
0
0
2
0
0
40-49
Years
M
2
0
0
4
0
0
50-59
Years
M
4
0
0
5
0
0
60
Years
M
6
1
0
2
1
0
M
2
0
0
Total
Deaths
Total
3
0
1
M
25
1
0
Total
24
1
1
49
2
1
M
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
1
0
3
0
5
0
2
0
2
0
1
0
2
0
2
0
1
1
3
0
11
1
12
1
23
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
1
2
0
3
1
1
1
3
0
4
0
3
1
4
0
1
1
5
0
4
0
17
1
14
6
31
7
0
0
4
0
15
33 157 251 547 1042 346 617 649 1032 569 888 502 685 431 540 680 599
3900
5693
9593
13
18
0
0
0
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
1
0
0
1
2
0
0
0
0
0
0
0
2
1
0
0
2
0
0
0
4
0
0
0
3
5
20
8
68
5
11
10
32
32
19
7
48
8
24
5
14
2
5
10
20
10
1
0
0
1
1
0
0
3
7
7
36 1234
6
0
0
0
1
0
6
10
1
0
22
4
1
32
0
0
0
1
0
0
0
1
11
43
74
1365
60
327
134
1692
42
15
15
18
8
40
19
5
32
29
7
12
19
5
54
4
3
5
8
4
7
26
39
65
83
115
198
22
20
0
0
1
0
3
0
3
0
5
0
6
2
19
1
8
1
7
1
5
0
9
2
16
1
8
1
19
2
18
0
16
0
13
1
10
0
24
0
24
0
106
6
108
6
214
12
1
0
1
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
1
0
1
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
1
1
1
0
0
0
0
0
0
2
1
2
2
0
0
0
0
0
0
4
3
0
2
1
0
0
0
0
1
3
0
0
0
0
3
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
1
1
0
1
0
0
0
0
0
2
2
1
1
1
0
0
0
0
0
0
0
0
3
0
0
0
0
0
1
0
0
0
0
1
1
1
0
0
0
0
2
2
1
0
0
0
1
0
1
0
0
0
0
1
0
0
1
0
0
0
0
0
1
4
0
0
0
0
1
0
0
0
2
2
0
0
0
0
0
0
1
1
0
2
0
0
0
0
2
0
1
1
1
3
0
1
1
0
0
2
7
6
5
13
0
0
1
0
9
7
5
6
5
9
1
2
2
1
5
9
12
12
10
22
1
2
3
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
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
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
1
0
0
1
0
0
0
2
2
0
0
0
2
0
0
0
0
1
0
0
0
0
0
0
0
0
1
2
1
0
2
0
0
1
0
0
0
0
0
0
2
0
0
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
1
1
6
3
1
6
0
2
2
0
7
1
8
5
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
1
0
0
0
0
2
0
1
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
0
2
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
1
1
1
0
0
0
0
0
0
0
0
1
0
0
1
0
3
3
0
0
1
8
1
1
1
1
11
4
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
1
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
1
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
1
0
0
0
0
0
1
0
0
0
0
0
2
1
1
1
4
0
0
0
6
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
17
22
0
0
0
0
1
12
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
1
0
0
1
1
1
0
0
0
0
80 101
51
66
39
23
54
44
51
31
31
22
29
19
40
19
393
350
743
17
48
62
43
0
40
0
20
0
33
0
Page 143 of 149
57
0
58
0
41
0
32 223
0
21
0
23
18
0
30
0
13
0
493
1
290
0
783
18
0
0
8
0
473
ICD
Code
T31
T31.0
T31.1
T31.2
T31.3
T31.4
T31.5
T31.6
T35.0
T35.3
T36
T37.1
T39
T39.0
T39.9
T40
T43
T44
T44.1
T44.9
T45
T49
T49.0
T50
T50.0
T50.9
T51.9
T52
T52.0
T52.9
T54
T54.9
T56.6
T57.1
T59.2
T60
T60.0
T60.2
T60.4
T60.9
Diseases
Burns classified according to extent of body
surface involved
Burns involving less than 10% of body
surface
Burns involving 10-19% of body surface
Superficial frostbite involving multiple body
regions
Unspecified frostbite of thorax, abdomen,
lower back and pelvis
Poisoning by systemic antibiotics
Antimycobacterial drugs
Poisoning by nonopioid analgesics,
antipyretics and antirheumatics
Salicylates
Nonopioid analgesic, antipyretic and
antirheumatic, unspecified
Poisoning by narcotics and psychodysleptics
[hallucinogens]
Poisoning by psychotropic drugs, not
Poisoning by drugs primarily affecting the
autonomic nervous system
Other parasympathomimetics [cholinergics]
Other and unspecified drugs primarily

affecting the autonomic nervous system
Poisoning by primarily systemic and
haematological agents, not elsewhere
classified
Poisoning by topical agents primarily
affecting skin and mucous membrane and by
ophthalmological, otorhinolaryngological and
dental drugs
Local antifungal, anti-infective and antiinflammatory drugs, not elsewhere classified
Poisoning by diuretics and other and

unspecified drugs, medicaments and
biological substances
Mineralocorticoids and their antagonists
Other and unspecified drugs, medicaments
and biological substances
Alcohol, unspecified
Toxic effect of organic solvents
Petroleum products
Organic solvent, unspecified
Toxic effect of corrosive substances
Corrosive substance, unspecified
Tin and its compounds
Phosphorus and its compounds
Formaldehyde
Toxic effect of pesticides
Organophosphate and carbamate insecticides
T62.0
T62.1
T62.2
Other insecticides
Rodenticides
Pesticide, unspecified
Toxic effect of other noxious substances eaten
as food
Ingested mushrooms
Ingested berries
Other ingested (parts of) plant(s)
T63
Toxic effect of contact with venomous animals
T62
T62.9
T63.0
T63.2
T63.3
Noxious substance eaten as food, unspecified
T65.9
T66
T67
T68
T69
Snake venom
Venom of scorpion
Venom of spider
Toxic effect of contact with unspecified
venomous animal
Toxic effect of aflatoxin and other mycotoxin
food contaminants
Toxic effect of other and unspecified
substances
Toxic effect of unspecified substance
Unspecified effects of radiation
Effects of heat and light
Hypothermia
Other effects of reduced temperature
T70.1
T71
T74
T75
T75.0
T75.1
T75.4
Sinus barotrauma
Asphyxiation
Maltreatment syndromes
Effects of other external causes
Effects of lightning
Drowning and nonfatal submersion
Effects of electric current
T63.9
T64
T65
T70
474
Effects of air pressure and water pressure
28
Days
29 Days-1
Yr
M
0
M
0
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
M
1
M
0
M
0
M
0
M
0
M
0
M
0
M
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
2
0
1
0
0
0
2
1
1
0
0
1
1
0
0
0
0
0
0
1
0
0
0
0
0
3
1
2
0
0
0
1
0
0
0
0
3
2
3
0
0
0
1
0
3
0
0
0
0
3
0
0
0
1
1
2
0
0
0
0
0
4
1
1
1
0
0
1
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
M
2
8
14
6
3
1
1
0
0
0
0
0
1
1
0
19
0
2
0
0
0
0
0
9
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
1
0
0
2
0
1
0
0
0
1
3
0
0
4
1
0
0
3
8
1
0
2
4
0
0
3
1
0
0
4
1
0
1
4
1
0
0
6
1
0
0
2
0
0
0
5
2
0
0
42
42
59
1
1
0
0
0
1
0
1
0
0
0
1
1
0
0
1
0
0
0
0
0
0
11
12
20
11
3
1
2
32
1
84
4
0
10
57
4
6
5
0
0
1
14
61
0
0
Total
0
0
Total
Deaths
Total
24
5
2
71
155
58
117
10
0
0
0
0
0
0
0
1
13
21
19
40
13
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
0
0
0
0
0
3
0
1
0
0
0
0
0
0
0
4
2
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
0
0
0
1
0
0
0
0
0
1
0
2
0
3
0
0
0
0
0
25
0
0
0
1
0
0
0
0
0
5
0
0
1
6
0
0
0
0
1
27
0
0
0
4
0
2
0
0
0
16
0
1
0
1
0
0
0
0
0
24
1
0
0
0
0
2
0
0
0
8
0
0
0
2
0
0
0
0
0
23
1
0
0
0
0
0
1
0
0
19
0
0
0
0
0
1
0
0
0
2
0
0
0
1
0
0
0
0
0
4
0
1
0
0
0
0
0
1
0
2
0
0
0
0
1
0
0
0
0
1
0
9
1
14
0
1
0
1
1
105
2
6
2
7
1
4
1
0
0
54
2
15
3
21
1
5
1
1
1
159
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
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
1
2
1
0
0
0
0
0
0
0
0
0
0
1
0
1
3
0
0
1
0
0
1
0
0
0
0
0
1
0
1
0
0
0
1
0
3
4
1
1
6
1
4
10
0
0
0
0
0
0
1
2
1
0
0
0
0
0
0
10
17
0
0
0
0
1
0
0
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
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
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
10
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
12
1
4
0
0
0
0
18
0
2
0
0
0
0
6
0
4
0
0
1
0
59
7
0
0
0
3
15
2
0
0
2
15
1
0
0
0
13
0
1
0
0
58
3
0
0
1
1
0
0
0
0
0
0
0
0
0
0
1
1
1
0
0
0
2
0
0
1
0
0
0
0
0
0
1
0
0
0
0
2
0
2
12
0
0
0
0
16
31
0
0
0
0
20
0
0
0
0
0
0
1
5
1
0
0
11
1
0
17 103
32 118
0
0
0
3
0
0
0
2
2
0
0
0
1
2
0
1
56
0
2
0
3
0
0
3
0
0
0
5
5
0
1
0
0
37
16
0
0
0
0
0
44
0
0
0
2
0
0
5
0
0
1
0
25
14
20
1
0
0
0
0
14
61
0
0
0
2
41
2
0
0
0
28
1
0
0
0
21
3
1
0
0
21
0
0
0
0
0
1
0
2
2
0
10
0
1
0
0
0
0
1
0
0
0
5
1
0
4
0
1
0
0
2
0
2
0
1
0
0
0
0
3
57
20
28
12
11
0
0
0
0
0
0
4
0
0
24
0
0
0
2
2
1
1
0
0
4
8
0
0
0
0
13
0
0
0
1
0
0
1
51
36
87
105
57
162
0
0
0
0
0
0
0
0
0
18
17
35
0
0
0
0
0
0
0
0
0
0
0
3
1
0
0
13
0
1
1
27
2
1
261
1
1
0
15
0
1
131
42
2
2
392
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
15
0
0
0
0
11
0
0
0
0
285
9
4
1
6
190
3
1
0
4
475
12
5
1
10
2
0
0
0
0
5
0
0
0
0
0
1
0
0
0
0
1
0
0
1
2
1
0
0
0
0
0
1
0
0
0
1
4
1
9
5
0
10
0
3
0
9
6
1
21
1
7
1
18
11
1
31
0
0
0
0
0
0
0
0
1
0
0
0
0
0
13
13
105
137
242
Page 144 of 149
ICD
Code
T78
T78.2
T78.4
T78.9
T79
T79.0
T79.2
T79.3
T79.7
T79.9
T80.5
T81
T81.1
T81.2
T81.4
T81.9
T82
T83.1
T85.7
T86.8
T88
T88.7
T90
U89
V04
V12
V20.0
V29.2
V39
V59.9
V80
V86
V87.1
V89
V89.0
V89.2
V99
W14
W16
W19
W39
W49
W52
W54
W57
W59
W69
W70
W74
W87
X04
X17
Diseases
Adverse effects, not elsewhere classified
Anaphylactic shock, unspecified

Allergy, unspecified
Adverse effect, unspecified
Certain early complications of trauma, not
Air embolism (traumatic)
Traumatic secondary and recurrent
haemorrhage
Post-traumatic wound infection, not
Traumatic subcutaneous emphysema
Unspecified early complication of trauma
Anaphylactic shock due to serum
Complications of procedures, not elsewhere
classified
Shock during or resulting from a procedure,
Accidental puncture and laceration during a

procedure, not elsewhere classified
Infection following a procedure, not

Unspecified complication of procedure
Complications of cardiac and vascular
prosthetic devices, implants and grafts
Mechanical complication of other urinary
devices and implants
Infection and inflammatory reaction due to
other internal prosthetic devices, implants
and grafts
Failure and rejection of other transplanted
organs and tissues
Other complications of surgical and medical
care, not elsewhere classified
Unspecified adverse effect of drug or
medicament
Sequelae of injuries of head
Agent resistant to other and unspecified
antibiotics
Pedestrian injured in collision with heavy
transport vehicle or bus
Pedal cyclist injured in collision with two- or
three-wheeled motor vehicle
Motorcycle rider injured in collision with
pedestrian or animal - Driver injured in
nontraffic accident
Unspecified motorcycle rider injured in
collision with other and unspecified motor
vehicles in nontraffic accident
Occupant of three-wheeled motor vehicle
injured in other and unspecified transport
accidents
Occupant [any] of pick-up truck or van
injured in unspecified traffic accident
Animal-rider or occupant of animal-drawn
vehicle injured in transport accident
Occupant of special all-terrain or other motor

vehicle designed primarily for off-road use,
injured in transport accident
Person injured in collision between other
motor vehicle and two- or three-wheeled
motor vehicle (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
Unspecified transport accident
Fall from tree
Diving or jumping into water causing injury
other than drowning or submersion
Unspecified fall
Discharge of firework
Exposure to other and unspecified inanimate
mechanical forces
Crushed, pushed or stepped on by crowd or
human stampede
Bitten or struck by dog
Bitten or stung by nonvenomous insect and
other nonvenomous arthropods
Bitten or crushed by other reptiles
Drowning and submersion while in natural
water
Drowning and submersion following fall into
natural water
Unspecified drowning and submersion
Exposure to unspecified electric current
Exposure to ignition of highly flammable
material
Contact with hot engines, machinery and
tools
28
Days
29 Days-1
Yr
01-04
Years
05-14
Years
15-19
Years
20-29
Years
30-39
Years
40-49
Years
50-59
Years
60
Years
Total
Deaths
Total
Total
17
11
28
16
21
20
14
11
15
70
79
149
0
0
0
0
0
0
0
1
0
0
1
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
2
0
0
0
0
0
0
0
1
1
1
0
1
0
0
0
0
0
0
0
0
3
0
1
7
1
1
13
1
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
4
0
0
5
0
1
0
4
0
0
0
2
0
0
0
2
0
0
1
3
0
1
0
2
0
0
0
1
0
0
1
0
0
0
0
3
1
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
16
1
2
1
13
0
1
11
20
0
6
0
3
29
1
3
31
42
61
19
22
30
11
14
29
50
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
9
1
0
7
0
11
0
5
0
0
7
0
0
5
0
0
9
0
1
5
0
0
6
0
0
4
0
0
6
1
16
2
0
1
1
80
66
90
10
17
12
13
13
16
18
26
17
16
15
14
10
13
89
101
190
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
1
0
0
1
0
0
0
0
0
0
38
2
52
0
0
0
3
1
0
0
0
0
0
0
0
0
0
11
12
17
2
0
2
1
0
1
4
0
2
0
5
0
0
1
2
0
2
0
0
0
1
1
2
0
3
2
3
1
12
5
19
2
31
7
0
0
1
0
0
0
0
0
0
0
3
0
2
0
17
65
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
3
67
27
0
225
1
276
0
501
1
0
0
0
0
1
0
0
0
13
21
10
0
0
78
0
0
0
25
17
15
11
14
0
2
0
0
0
1
0
0
17
79
74
0
0
0
0
68 221 133 136

0
0
Page 145 of 149
0
1
0
0
0
0
82
0
0
1
13
61
98
0
0
0
0
100
30
103
59
0
0
37
14
46
0
1
11
77
0
0
54
1
0
0
751
0
1
1
203
529
1280
0
4
0
0
33
0
19
25
0
23
0
17
34
0
32
0
0
0
43
0
0
0
42
1
53
0
2610
23
0
33
0
1705
26
0
44
0
905
34
0
97 135
15
0
82 113
11
0
1
0
76 163 125 251 218 505 171 288 115 184
2
0
2
0
1
0
1
5
0
0
0
0
0
0
0
0
475
ICD
Code
Diseases
Y42.4
Y57.9
Contact with other and unspecified heat and

hot substances
Victim of earthquake
Accidental poisoning by and exposure to
antiepileptic, sedative-hypnotic,
antiparkinsonism and psychotropic drugs, not
other and unspecified drugs, medicaments
and biological substances
pesticides
Unspecified privation
Intentional self-poisoning by and exposure to
nonopioid analgesics, antipyretics and
antirheumatics
Intentional self-poisoning by and exposure to
pesticides
Assault by bodily force
Sexual assault by bodily force
Neglect and abandonment
Assault by unspecified means
Poisoning by and exposure to pesticides,
undetermined intent
Hanging, strangulation and suffocation,
undetermined intent
Contact with sharp object, undetermined
intent
Falling, jumping or pushed from a high place,
undetermined intent
Oral contraceptives
Drug or medicament, unspecified
Y63.2
Overdose of radiation given during therapy
X19
X34
X41
X44
X48
X57
X60
X68
Y04
Y05
Y06
Y09
Y18
Y20
Y28
Y30
Y58.6
Y83.6
Y84.4
Y89
Z03.0
Pertussis vaccine, including combinations

with a pertussis component
Z30.9
Z32
Z32.0
Z32.1
Z33
Z34
Removal of other organ (partial) (total)

Aspiration of fluid
Sequelae of other external causes
Observation for suspected tuberculosis
Observation for suspected myocardial
infarction
Carrier of infectious disease
Contraceptive management
Surveillance of (intrauterine) contraceptive
device
Contraceptive management, unspecified
Pregnancy examination and test
Pregnancy, not (yet) confirmed
Pregnancy confirmed
Pregnant state, incidental
Supervision of normal pregnancy
Z35
Z37
Z37.9
Z38.1
Supervision of high-risk pregnancy

Outcomeofdelivery
Outcome of delivery, unspecified
Singleton, born outside hospital
Z03.4
Z22
Z30
Z30.5
Z34.9
Z38.2
Supervision of normal pregnancy, unspecified
Singleton, unspecified as to place of birth
Z47
Other plastic surgery for unacceptable

cosmetic appearance
Routine and ritual circumcision
Ear piercing
Follow-up care involving plastic surgery of
lower extremity
Follow-up care involving plastic surgery,
unspecified
Other orthopaedic follow-up care
Z48.9
Z51
Z51.1
Z52.4
Z41.1
Z41.2
Z41.3
Z42.4
Z42.9
Z47.0
Z51.3
Z64
Z73
Z73.3
Z90.5
Z91
Z93.2
Z93.3
Z94
Z94.0
476
28
Days
29 Days-1
Yr
M
0
M
0
01-04
Years
05-14
Years
M
0
15-19
Years
M
0
20-29
Years
M
0
30-39
Years
M
0
40-49
Years
M
0
50-59
Years
M
0
60
Years
M
0
M
0
M
0
Total
1
M
0
11
23
14
13
10
21
100
45
145
10
27
16
43
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
10
0
0
2
15
0
0
0
29
1
0
2
0
0
0
0
0
0
0
1
0
0
0
0
0
2
0
0
0
0
0
2
0
0
5
0
0
3
0
0
0
0
2
0
0
0
1
0
0
48 114 115 106 112

0
0
0
0
0
0
0
0
0
0
1
7
1
2
6
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
1
3
4
0
0
0
1
3
0
0
0
0
70
0
0
2
59
0
0
1
39
0
1
2
35
0
0
0
24
0
5
0
33
0
0
2
393
1
6
17
419
0
0
11
812
1
6
28
0
0
0
0
1
0
0
0
0
7
0
0
4
0
0
5
1
1
4
0
0
3
0
31
29
60
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
1
1
0
1
1
0
0
0
0
0
3
0
0
0
3
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
1
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
0
0
0
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
50
0
0
25
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
12
0
0
0
0
0
0
2
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
2
0
0
0
1
1
5
2
2
0
0
0
0
0
0
0
0
2
3
2
0
4
3
0
0
0
0
0
3
1
0
1
35
0
0
0
7
0
0
0
0
0
1
0 185
0
0
0
0
0
0
1
2
0
1
0
57
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
0
0
0
0
0
0
1
12
1
1
2
281
0
0
0
0
0
0
1
12
1
1
2
281
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
7
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
67
17
50
2
0
25
53
0
67
42
103
2
0
0
0
0
0
0
0
0
10
23
0 185
48
0
0
1
0
55
265
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
1
0
0
0
0
0
0
Surgical follow-up care, unspecified

Other medical care
Chemotherapy session for neoplasm
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
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
3
0
Kidney donor
Problems related to certain psychosocial
circumstances
Problems related to life-management
difficulty
Stress, not elsewhere classified
Acquired absence of kidney
Personal history of risk-factors, not elsewhere
classified
Ileostomy status
Colostomy status
Transplanted organ and tissue status
Kidney transplant status
0
0
0
0
0
1
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
9
3
3
0
1
0
0
0
4
1
1
1
0
0
0
0
2
0
0
Blood transfusion without reported diagnosis
Follow-up care involving removal of fracture

plate and other internal fixation device
Total
Deaths
Total
0
0
0
0
0
11
0
0
0
0
1
0
0
0
0
11
0
0
0
0
Page 146 of 149
3
2
3
0
0
28
0
0
1
0
0
0
3
0
0
2
2
0
0
1
0
3
1
0
0
1
0
1
2
0
1
1
0
2
0
0
11
0
5
3
2
5
3
0
0
0
0
0
0
2
0
0
0
11
56
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
1
0
0
0
13
0
0
0
0
0
1
2
1
0
0
15
0
0
2
1
18
18
1
0
12
265
17
0
0
0
0
10
0
1
1
0
1
1
35
17
37
93
1
0
0
1
1
0
1
1
1
1
2
1
0
0
0
0
0
0
0
0
0
0
0
0
Number of Beds
Sanctioned
Operational
Hospital Name
MANMOHAN MEMORIAL COMMUNITY HOSPITAL
THAMEL ,KATHMANDU
MEDI CARE NATIONAL HOSPITAL PVT
LTD,KATHMANDU
MENLHA NURSING HOME (CIWEC HOSPITAL
PVT),KATHMANDU
Number of Beds
Received
Reports
Hospital Name
Received
Reports
NON-PUBLIC HOSPITAL REPORTING STATUS

Sanctioned
Operational
11
100
100
12
100
100
11
15
15
KANKAI HOSPITAL PVT LTD,JHAPA
N/A
N/A
MANMOHAN MEMORIAL COMMUNITY REGIONAL

HOSPITAL, JHAPA
100
100
MECHI EYE CARE HOSPITAL,JHAPA
15
15
ANJALI HOSPITAL, JHAPA
15
15
NATIONAL DENTAL HOSPITAL,KATHMANDU
N/A
N/A
MEDICA HOSPITAL, JHAPA
25
25
NEPAL BEIJING FRIENDSHIP

HOSPITAL,KATHMANDU
N/A
N/A
SHANKAR HOSPITAL
15
15
NEPAL KOREA SKIN HOSPITAL,KATHMANDU
10
N/A
N/A
OM SHAI PATHIVARA HOSPITAL,JHAPA
12
100
100
NEPAL SKIN HOSPITAL,KATHMANDU
10
N/A
N/A
KANCHANJANGHA HOSPITAL,JHAPA
10
100
100
NOBEL HOSPITAL & RESEARCH

CENTER,KATHMANDU
12
100
100
PURNA TUNGA BIRTA CITY HOSPITAL
25
25
NORVIC INTERNATIONAL HOSPITAL ,KATHMANDU
11
N/A
125
AMDA HOSPITAL DAMAK,JHAPA
75
100
OM HOSPITAL & RESEARCH CENTER ,KATHMANDU
10
172
N/A
DAMAK HOSPITAL & RESEARCH CENTRE,JHAPA
N/A
N/A
OMNI CARE HOSPITAL & RESEARCH

CENTER,KATHMANDU
11
15
15
LIFE LINE HOSPITAL PVT LTD,JHAPA
100
100
PEOPLE'S GENERAL HOSPITAL,KATHMANDU
15
N/A
NAMASTE HEALTH CARE & RESEARCH CENTRE,JHAPA
N/A
N/A
RASTRIYA NAMUNA DENTAL

HOSPITAL,KATHMANDU
12
N/A
N/A
OM INTERNATIONAL MECHI HOSPITAL PVT LTD,JHAPA
11
N/A
N/A
SAHID MEMORIAL HOSPITAL ,KATHMANDU
12
100
100
MARIGOLD HOSPITAL, JHAPA
15
15
SHIVA JYOTI HOSPITAL,KATHMANDU
12
50
50
BELBARI COMMUNITY NOBEL HOSPITAL,MORANG
10
15
N/A
SIRDI SATYA SAI DENTAL HOSPITAL PVT

LTD,KATHMANDU
N/A
N/A
ABADH NARAYAN MEMORIAL HOSPITAL,MORANG
12
15
15
SWASTIK DENTAL HOSPITAL,KATHMANDU
11
N/A
N/A
BIRATNAGAR EYE HOSPITAL,MORANG
12
15
15
TEACHING HOSPITAL, KATHMANDU
10
N/A
N/A
BIRATNAGAR HOSPITAL,MORANG
12
100
100
UNIVERSAL DENTAL HOSPITAL,KATHMANDU
12
N/A
N/A
GREEN CROSS HOSPITAL,MORANG
12
15
49
VAYODHA HOSPITAL,KATHMANDU
12
50
50
SHREE HOSPITAL,MORANGB
12
15
15
VENUS INTERNATIONAL HOSPITAL,KATHMANDU
12
50
50
LIFE GUARD HOSPITAL,MORANG
12
50
50
VIBHOR HOSPITAL,KATHMANDU
125
125
MORANG COOPERATIVE HOSPITAL,MORANG
12
50
50
YETI HOSPITAL PVT.LTD,KATHMANDU
12
55
55
NEURO CARDIO MULTISPECIALITY HOSPITAL PVT.

LTD.,MORANG
11
100
100
Swacan International Hospital , Kathmandu
12
25
25
NOBEL MEDICAL COLLEGE,MORANG
N/A
N/A
Golfutar Eye Hospital , Kathmandu
12
N/A
N/A
GOLDEN HOSPITAL,MORANG
12
50
50
ENT Care Center Nepal Pvt. Ltd , Kathmandu
11
N/A
N/A
BIRATNAGAR CITY HOSPITAL,MORANG
12
15
15
Siddhi Binayak Hospital, Kathmandu
12
20
20
100
N/A
11
55
55
Kantipur General Hospital , Basundhara,

Kathmandu
VINAYAK HOSPITAL & MATERNITY HOME PVT.LTD,
KATHMANDU
RAMLAL GOLCHHA EYE HOSPITAL,MORANG
12
100
100
SURACHHA PRASUTI HOSPITAL,MORANG
15
15
HAMRO HOSPITAL,MORANG
12
100
100
KRITIPUR HOSPITAL (NGO),KATHMANDU
12
15
15
RK CHILDREN HOSPITAL,MORANG
12
15
15
NATIONAL INSTITUTE OF NEUROLOGICAL & ALLIED

SCIENCES ,KATHMANDU
11
100
100
NATIONAL KIDNEY HOSPITAL,MORANG
12
15
15
BAGESWARI HOSPITAL,KATHMANDU
11
15
15
TR HOSPITAL ITHARI, SUNSARI
15
15
SUVEKCHYA INTERNATIONAL HOSPITAL

,KATHMANDU
12
55
55
COMMUNITY HOSPITAL ITHARI, SUNSARI
10
15
15
OM SAMAJ HOSPITAL ,KATHMANDU
55
MODEL HOSPITAL, DHANKUTA
12
N/A
N/A
NUWAKOT HOSPITA Pvt.Ltd.L,NUWAKOT
15
GOPAL BHAGAT MEMORIAL

HOSPITAL,SANKHUWASABHA
12
15
N/A
PANCHAKANYA COMMUNITY
HOSPITAL,NUWAKOT
12
N/A
N/A
HARISIDDHI HOSPITAL,SANKHUWASABHA
12
15
15
Galchi Hospital Pvt.Ltd., Dhading
11
15
15
SIDDHI KALI HOSPITAL,BHOJPUR
11
N/A
N/A
SHAHID MEMORIAL HOSPITAL ,DHADING
10
50
50
PASANG LHAMU HOSPITAL,SOLUKHUMBU
N/A
N/A
AASHA HOSPITAL,CHITAWAN
N/A
N/A
SURYODAYA HOSPITAL,UDAYAPUR
12
15
15
ALIVE HOSPITAL & TRUMA CENTER,CHITAWAN
N/A
N/A
ASTHA HOSPITAL KATARI, UDAYAPUR
10
15
15
CHITWAN HOSPITAL ,CHITAWAN
55
55
JASMIN HOSPITAL KATARI, UDAYAPUR
10
15
15
CHITWAN MEDICAL COLLEGE ,CHITAWAN
750
750
AJAY DENTAL HOSPITAL,SIRAHA
N/A
N/A
COLLEGE OF MEDICAL SCIENCE ,CHITAWAN
750
750
FUL KUMARI MAHATO MEMORIAL HOSPITAL,SIRAHA
50
50
MANKAMANA HOSPITAL,CHITAWAN
N/A
N/A
DHANUSHA HRC ,DHANUSA
N/A
N/A
NARAYANI SAMUDAYIK HOSPITAL ,CHITAWAN
280
20
SHREE RAM HOSPITAL, SARLAHI
N/A
N/A
NATIONAL CITY HOSPITAL ,CHITAWAN
55
55
477
Number of Beds
Received
Reports
Received
Reports
Number of Beds
Sanctioned
MODERN APPOLO HOSPITAL, SINDHULI
24
24
OM HOSPITAL ,CHITAWAN
N/A
N/A
SARAHA COMMUNITY HOSPITAL,RAMECHHAP
12
15
OSIS MEDICAL COLLEGE TEACHING HOSPITAL &

RESEARCH CENTER,CHITAWAN
N/A
N/A
TAMAKOSHI COOPERATIVE HOSPITAL ,RAMECHHAP
12
15
N/A
SANTI HOSPITAL ,CHITAWAN
11
55
40
BHIMESHWOR DENTAL HOSPITAL,DOLAKHA
N/A
N/A
SAPTAGANDAKI HOSPITAL,CHITAWAN
15
15
CHCHHO ROLPA HOSPITAL ,DOLAKHA
12
55
55
Niko chitwan Hospital, Chitwan
24
24
DOLAKHA CUMMUNITY HOSPITTAL ,DOLAKHA
11
15
15
AAMA-BAA HOSPITAL & RESEARCH

CENTRE,GORKHA
12
15
10
Hospital Name
Sanctioned
Operational
Hospital Name
Operational
GAURISANKAR HOSPITAL ,DOLAKHA
15
15
Model Hospital, Lamjung
N/A
N/A
12
15
15
Karmada Hospital, Lamjung
N/A
N/A
BANEPA HOSPITAL,KAVRE
12
15
15
Namuna Community Hospital, Lamjung
N/A
N/A
KRISHNA PRASAD HOSPITAL, BANEPA,KAVRE
12
N/A
N/A
LAXMI HOSPITAL, DUMRE,TANAHU
12
55
55
SATYA SAI HOSPITAL,KAVRE
12
15
N/A
NATIONAL APPOLO HOSPITAL,TANAHU
11
15
25
SCHEER MEMORIAL HOSPITAL ,KAVRE
12
150
150
RATNAHARI MEMORIAL HOSPITAL, TANAHU
12
15
15
DHULIKHEL HOSPITAL ,KAVRE
12
375
375
BYASNAGAR HOSPITAL, TANAHU
12
15
DCWC HOSPITAL,KAVRE
12
15
N/A
NE-KORYO HOSPITAL, TANAHU
12
18
BHAIRAB HOSPITAL,KAVRE
10
N/A
N/A
SETI GANGA COMMUNITY HOSPITAL,TANAHU
12
15
15
SUMERU HOSPITAL
12
100
100
TANAHUN SEWA HOSPITAL,TANAHU
10
25
25
KIST MEDICAL COLLEGE,LALITPUR
12
N/A
N/A
FULBARI HOSPITAL, TANAHU
12
15
15
ALKA HOSPITAL,LALITPUR
12
100
100
Gandaki Gramin Samudayik Hospital, Syanjha
11
15
15
B & B HOSPITAL,LALITPUR
12
100
224
Galyang Community Hospital,SYANGJA
11
15
GLOBAL HOSPITAL,LALITPUR
12
55
55
KALIKA COMMUNITY HOSPITAL PUTALIBAZAR

MUNICIPALITY,SYANGJA
12
100
20
LALIGURAS HOSPITAL,LALITPUR
12
N/A
N/A
SHAHID MEMORIAL COMMUNITY HOSPITAL
11
N/A
N/A
MIDAT HOSPITAL,LALITPUR
12
15
25
FEWACITY HOSPITAL & RESEARCH CENTRE,KASKI
11
100
105
PUNARJEEVAN HOSPITAL,LALITPUR
12
N/A
N/A
FISHTAIL HOSPITAL & RESEARCH CENTRE,KASKI
11
100
100
STAR HOSPITAL,LALITPUR
12
50
50
GREEN PASTURE HOSPITAL,KASKI
11
80
80
Ganeshman Singh Memorial Hospital, Lalitpur
10
100
100
MANIPAL TEACHING HOSPITAL,KASKI
11
750
750
Sumaru City Hospital, Lalitpur
10
25
25
METROCITY HOSPITAL & RESEARCH CENTRE,KASKI
50
50
NIDAN HOSPITAL, LALITPUR
20
20
MODEL HOSPITAL,KASKI
N/A
15
ANANDABAN LEPROSY HOSPITAL,LALITPUR
N/A
N/A
OM HOSPITAL & RESEARCH CENTRE,KASKI
11
25
50
Nobel Hospital, Lalitpur
N/A
N/A
POKHARA HOSPITAL & RESEARCH CENTRE,KASKI
25
25
DR. IWAMURA HOSPITAL ,BHAKTAPUR
12
N/A
N/A
GANDAKI MEDICAL COLLEGE, POKHARA
542
542
SIDDHI MEMORIAL HOSPITAL,BHAKTAPUR
12
50
50
MATRI SHISHU MITERI HOSPITAL
20
20
KATHMANDU MEDICAL COLLEGE DUWAKOT,BHAKTAPUR
120
120
NAMASTE HOSPITAL & REASEARCH CENTRE
55
33
MADHYAPUR HOSPITAL,BHAKTAPUR
12
51
51
SAHARA HOSPITAL
11
55
55
NAGARIK HOSPITAL ,BHAKTAPUR
12
100
100
KASKI SEWA HOSPITAL & RESEARCH CENTRE
100
100
SUMMIT HOSPITAL, LOKANTHALI
51
51
CHARAK MEMORIAL HOSPITAL & RESEARCH

CENTRE
10
22
50
PEOPLES LIFE CARE HOSPITAL ,KATHMANDU
11
15
N/A
BENI HOSPITAL & RESEARCH CENTRE,MYAGDI
N/A
N/A
SUSMA KOIRALA MEMORIAL HOSPITAL ,KATHMANDU
12
46
46
RESHUNGA PRIVATE HOSPITAL,GULMI
N/A
N/A
12
15
15
LUMBINI MEDICAL COLLEGE,PALPA
600
535
N/A
N/A
UNITED MISSION HOSPITAL, PALPA
12
165
169
200
165
MID POINT COMMUNITY HOSPITAL,NAWALPARASI
10
55
52
12
N/A
N/A
12
N/A
51
51
MANMOHAN MEMORIAL COMMUNITY

HOSPITAL,PHARPING ,KATHMANDU
B.P SMRITI COMMUNITY COOPERATIVE
HOSPITAL,KATHMANDU
GRANDE INTERNATIONAL HOSPITAL PVT,KATHMANDU
GREEN CITY HOSPITAL,KATHMANDU
12
100
100
Saheed Smriti Community Hospital, Daunnedevi,

Nawalparasi
GANDHI TULSI MEMORIAL HOSPITAL,KATHMANDU
10
N/A
Sahaj Community Hospital, Gaidakot, Nawalparasi
CHINESS DENTAL HOSPITAL,KATHMANDU
N/A
N/A
KALIGANDAKI HOSPITAL,NAWALPARASI
51
NEPAL APANGA SANGHA ORTHOPEDIC

HOSPITAL,KATHMANDU
12
100
100
Devchuli Hospital, Kawasoti, Nawalparasi
12
15
NEPAL MEDICAL COLLEGE,KATHMANDU
12
N/A
N/A
DR. BINOD KANDEL EYE HOSPITAL,NAWALPARASI
12
N/A
N/A
SHANKARAPUR HOSPITAL,KATHMANDU
12
55
55
SHECHAIN CLINIC AND HOSPITAL,KATHMANDU
12
478
Ramnagar Community Hospital, Ramnagar,

Nawalparasi
AMDA HOSPITAL BUTAWAL
MUNICIPALITY,RUPANDEHI
10
15
15
12
100
N/A
Received
Reports
Number of Beds
Received
Reports
Number of Beds
Sanctioned
Sanctioned
STUPA COMMUNITY HOSPITAL ,KATHMANDU
12
55
55
BUTWAL HOSPITAL PVT. LTD.,RUPANDEHI
N/A
N/A
AADHARBHUT PARSUTI HOSPITAL,KATHMANDU
12
15
15
Crimson Hospital, Rupendehi
12
50
50
10
N/A
N/A
Hospital Name
Operational
Hospital Name
Operational
ADVANCE ORAL DENTAL HOSPITAL,KATHMANDU
11
N/A
N/A
Lumbini Hospital and Technical College,

Rupendehi
ALL NEPAL HOSPITAL PVT LTD ,KATHMANDU
11
20
20
Lumbini city Hospital, Rupendehi
N/A
N/A
ANNAPURNA NEUROLOGICAL HOSPITAL,KATHMANDU
12
55
51
Devdaha Medical College, Rupendehi
10
N/A
N/A
10
N/A
N/A
BHAROSA HOSPITAL PVT LTD ,KATHMANDU
11
55
15
BINAYAK HOSPITAL KATHMANDU METROPOLITAN

CITY,KATHMANDU
UNIVERSAL COLLEGE OF MEDICAL SCIENCE

(UCMS),RUPANDEHI
12
55
55
Siddhartha City Hopsital, Rupendehi
12
50
N/A
BIRAJ DENTAL HOSPITAL ,KATHMANDU
12
N/A
N/A
Bhairahawa Hospital Pvt. Ltd., Rupendehi
N/A
N/A
12
15
BLUE CROSS HOSPITAL PVT LTD ,KATHMANDU
10
25
25
ARGHAKHANCHI HOSPITAL PVT.LTD.,

ARGHAKHANCHI
BUDDHA DENTAL HOSPITAL,KATHMANDU
12
12
12
SWORGADWARI LIFECARE HOSPITAL,PYUTHAN
12
15
N/A
CHIRAYU NATIONAL HEALTH & RESEARCH CENTER PVT

LTD,KATHMANDU
N/A
N/A
CHAURJAHARI HOSPITAL,RUKUM
10
40
40
EVEREST HOSPITAL,KATHMANDU
25
25
CHINARI HOSPITAL, GHORAHI, DANG
12
15
15
GRACE HOSPITAL,KATHMANDU
N/A
N/A
GHORAHI HOSPITAL PVT.LTD., DANG
12
25
HAMRO SAHAYATRI HOSPITAL PVT LTD,KATHMANDU
N/A
N/A
NEPALGUNJ MEDICAL COLLEGE,BANKE
256
256
HAMS HOSPITAL ,KATHMANDU
12
50
50
WESTERN HOSPITAL & RESEARCH CENTER,BANKE
12
60
60
HELPING HANDS COMMUNITY HOSPITAL ,KATHMANDU
100
100
SURKHET HOSPITAL PVT.LTD., SURKHET
12
N/A
N/A
HIMAL DENTAL HOSPITAL & INST. OF DENTAL

SCIENCE,KATHMANDU
N/A
N/A
AMISHA HOSPITAL PVT. LTD,BAJHANG
11
15
15
HIMAL DENTAL HOSPITAL CHABHIL KATHMANDU
N/A
N/A
BAYALPATA HOSPITAL (NYAYA HEALTH),ACHHAM
11
15
25
HIMAL HOSPITAL PVT LTD,KATHMANDU
50
50
SUJANG HOSPITAL,DOTI
12
50
50
KANTIPUR DENTAL COLLEGE, TEACHING HOSPITAL &

RESEA,KATHMANDU
12
N/A
150
LAL RATNA HOSPITAL,KAILALI
12
14
KANTIPUR HOSPITAL ,KATHMANDU
15
15
GHODA GHODI HOSPITAL,KAILALI
12
15
KATHMANDU ENT HOSPITAL,KATHMANDU
12
15
15
CP HOSPITAL DHANGADHI, KAILALI
12
25
15
KATHMANDU HOSPITAL,KATHMANDU
50
50
NAWA JEEWAN HOSPITAL,KAILALI
12
50
50
KATHMANDU MEDICAL COLLEGE KATHMANDU

METROPOLITAN CITY,KATHMANDU
10
750
750
KAILALI HOSPITAL, DHANGADHI, KAILALI
12
15
14
KATHMANDU MODEL HOSPITAL ,KATHMANDU
11
N/A
N/A
COMMUNITY HOSPITAL ATTARIYA, KAILALI
N/A
N/A
LAV KUSH DENTAL HOSPITAL,KATHMANDU
N/A
N/A
PADMA HOSPITAL,KAILALI
12
50
50
LIONS EYE HOSPITAL,KATHMANDU
N/A
N/A
GETA EYE HOSPITAL, KAILALI
N/A
N/A
MAHENDRANARAYAN NIDHI MEMORIYAL

HOSPITAL,KATHMANDU
12
100
100
API HOSPITAL
12
25
25
RAMECHHAP COMMUNITY HOSPITAL ,RAMECHHAP
N/A
N/A
KHUNDE HOSPITAL,SOLUKHUMBU
16
16
479
480

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Annual

Department of Health Services

National Health Policy 2071 i-xv

Executive Summary xvi-xxiv

Chapter 6: SUPPORTING PROGRAMS -------------------------------------------------------------------------------------------------- 207-262

6.1 Health Training --------------------------------------------------------------------------------------------------------------------- 207

Department of Health Services

National Health Policy-2071

National Health Policy- 2071

National Health Policy-2071

4. Issues and Challenges

National Health Policy-2071

National Health Policy-2071

There is a need for urgently addressing regional disparity in health indicators.

5. Need for new policy, guiding principles and vision

People will be participated in every kind and level of health services.

All health services, provided by government or organized differently through a network of

Flow of health services will be made fully accountable.

National Health Policy-2071

To establish an effective and accountable health system with required medicines,

To promote peoples participation in extending health services. For this, promote

To make available in an effective manner the quality health services, established as a

To aim at becoming self-sufficient in quality medicine and medical equipment through

To promote public health by giving high priority to education, information, and

To reduce prevalence of malnutrition through promotion and usage of quality healthy

To ensure availability of quality health services through competent and accountable

To ensure professional and quality service standard by making health related

To mainstreaming health in every policy of state by reinforcing collaboration with health-

National Health Policy-2071

1. Following strategies (related to policy 1) will be adopted to make available in an effective

As Nepal is the signatory of international convention on Rights of Persons with

Impartial service will be delivered on the basis of equality by strengthening programs

Current situation of managing infectious diseases will be modified and implemented

National Health Policy-2071

Blood transfusion service will be made systematic in coordination with non-government

At least one-village-one-health-institution will be established in the distance of 30

Establishment of referral hospitals on various subjects of medicines including dental and

National Health Policy-2071

Development of international standard referral laboratory will be done by increasing

Country being signatory to International treaty, agreements and commitments including

Minimum integrated national curriculum will be implemented to produce human

Regional and zonal hospitals are included in specialization course provided by

Brain drain of human resources is discouraged by taking effective measures such as

National Health Policy-2071

Capacity of female community health volunteers will be developed with necessary

Ayurveda will be developed gradually. Development and reformation will be done by

Development and expansion of appropriate structure will be done gradually for

Emphasis is given for production and commercialization by ensuring quality of herbal

4. Following strategies (related to policy 4) will be adopted to aim at becoming self-sufficient in

Supplied to private and government sector, manufactured either within country or

5. Following strategies (related to policy 5) will be adopted to utilize in policy formulation,

Current organizational, institutional and procedural state of affair of Nepal health

National Health Policy-2071

Encouragement will be done to include health in research of other sectors.

Health researcher and scientist will be encouraged to do research in various subjects of

Universities related to health and governmental and nongovernmental educational

National health information system will be developed to provide information of works

Governmental and nongovernmental sectors will be mobilized to disseminate user

Arrangement will be done to provide all kinds of information of health service