Getting to goals
The government’s goal of bringing down the maternal mortality rate from 539 per 100,000 to 250 and infant mortality rate from 64.2 to 34.4 per 1,000 by 2017 strikes a chord with the prevailing health scenario in the country. The Ministry of Health, though short of target on several goals, has many achievements it can actually be proud of. Polio is being gradually phased out. So has been a range of communicable diseases. Vaccination and awareness programmes are fast catching up. The fight against tuberculosis is being strengthened. However, the record on maternity and childcare is not as impressive as so many others. For example, only 8-10 per cent of pregnant women seek medical help from health institutions, not to mention the huge toll exacted by water-borne diseases, diarrhoea, dysentery, dehydration and so many others related to sanitation and hygiene.
Each year on the World Health Day, the government comes out with a slogan to project a particular health issue. This year’s slogan has been about “making every mother and child count.” It is not as if the government is unaware of its unimpressive outreach to the masses on issues of safe motherhood and childcare. Instead, the Ministry is bogged down with so many health drives, battling paucity of funds, instigating donors and the partner agencies such as the UN and the World Health Organisation to assist it in dealing with different health issues. The infant mortality rate is one of the highest in the region while no less distressing is the record on mortality rate of kids under five which now is alarming at 91 per 1000. Life expectancy is not at all impressive, although that is a significant improvement upon yesteryears. There is no doubt the extent and quality of health services now available in different parts of the country has dramatically improved. But that is still nowhere near the desirable level.
There is a disparity in the extent of health services available for the rich and the poor. As the rich can always avail of services through private means, the same isn’t true for the poor. The government has the explicit burden on its shoulders to extend health services to rural areas. The irony is that many more people die of diseases that are common, curable or even preventable than those which are not. Real effort as the one started in some 19 districts to encourage mothers to come for regular pre-natal and post-partum check up will produce better results. Revolutionary medical techniques have changed the people’s lives in the West. If such techniques are far-fetched for those in rural Nepal, basic healthcare, however, must be within reach of the common man. The government owes that much to the people. Goals alone aren’t enough. They need to be met.