E-Kantipur

KATHMANDU, JAN 24 -

Arzu Rana Deuba, CA member and an advocate for maternal health, is also the chairperson of the Safe Motherhood Network Federation, Nepal. She has been closely working with the Ministry of Health and Population on developing

policies related to maternal health and has been lobbying for making safe motherhood a fundamental right. She spoke to Manish Gautam about Nepal’s progress and challenges on MDGs on child and maternal health and on the role of I/NGOs.

Does our health system adequately support the maternal and child health issues?

I find a lot of improvement although there is still much gap between Nepal and other countries with similar situations. There has been a commendable improvement in the maternal and child health sector. If we see the statistics of the National Demographic and Health Survey of 1996 to 2006 and the preliminary report of 2011, we see considerable reduction in the maternal mortality rate. Though we are on the right track, we still need to do a lot more.

What are the challenges for the government in achieving MDGs?

The number of births attended by the skilled birth attendants (SBAs) is a major problem. The government needs to increase the number to around 6,000; however, we have been able to train less than 600 SBAs a year. The statistics on infant mortality have not improved. It’s very scary since we are not doing enough to save the lives of newborns. Other gaps are on nutrition. Pregnant women don’t have good excess to nutrition. That is the reason why babies die just after birth or are stunted or wasted. Besides, there is a lot of acute respiratory infection among babies in Nepal followed by diarrhoea and pneumonia. So the government needs to address these issues.

Does it mean that the country is unlikely to meet these goals?

Well, the goal on maternal health can be achieved. However, for the government to achieve the goal on child health, it has to pull its shocks up. Still, it can achieve only some of the indicators of 4 and not all. Neonatal death is still very high and shows no sign of decline.

Do you think that a shortage of human resources in the health sector will hinder Nepal in achieving the MDGs?

Human resource is just an issue, but it is vital. So the government should manage

the required human resources in the health sector. There are two things behind human resource crunch. First, when the present health system was designed, our population was half of what it is now. Even those positions created in the early 90s haven’t been fulfiled. Second, the population of the country has doubled and there has been no attempt to review the requirements of the health policy, especially on the human resource part. Human resource crisis is therefore likely to mar the government’s efforts towards achieving the MDGs.

How do you assess the contribution of I/NGOs working in the maternal and child health sectors?

I think the I/NGOs working in this field are doing a very good job. In Nepal, their

partnership with the government is exemplary. Most of them are supporting the

government to deliver services at the grassroots level. The government plans are

formulated well. For instance, the Family Health Division organises an annual planning workshop in which key partners, including all the INGOs and major NGOs in the country are invited. At the end, we have a good and holistic plan. I think this is a good example, which can be emulated in other fields as well.

But it is often criticised that I/NGOs have more administrative cost than programme cost?

The government should have a rule that what percent of the cost of the I/NGOs should go to administration. But the cost has to be realistic. We cannot put the cost so low that we cannot hire experts. However, the cost also should not be so high that nothing is going on the ground. Still we need to review the system. The government needs a closer monitoring mechanism to oversee the activities of I/NGOs. The NGOs should work on a common issue and not on the one where there is money.

What should the government do to address the maternal and child health issues?

We have a policy on safe motherhood, but we want it to be a law. As of now it is just a programme funded by the DIFID and the World Bank. If they stop funding the programme in the future, what will we do? Therefore, safe motherhood services should be governed by a law to ensure concerned women’s access to such services.

Posted on: 2012-01-24 08:54

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