1. - Dr. Bikas Lamichhane Regional Director, MWRHD, Surkhet
A GLIMPSE OF MID-WESTERN REGION
- Dr. Bikas Lamichhane Regional Director, MWRHD, Surkhet
2070 Mansir 11 ( Nov )

3. BASIC INFORMATIONS Indicator MWR Nepal Population Land Area sq.km.
Land Area sq.km.
42378
147281
Cultivated Land 8%
 18%
Over all Literacy %
64.21
65.94
Per capita Income (PPP US $)
1192
1597
Life Expectancy
57.21
64.1
Districts with HDI Value <0.4 10 15
Population below poverty line
31.68
25.16
Toilet Users Households %
51.41
61.83
ODF Districts 2
 10
Improved Drinking Water user Hhlds %
75.14
85.35
Iodised Salt User %( > 15 PPM)
55.2
72.3
Source : NPHC 2011, HDR, NLSS , NMICS-2010
BASIC INFORMATIONS

4. POPULATION DISTRIBUTION & ACCESS TO HFs
Humla
Population per
Doctor = 31952 9
Mugu
Population per
Nurse = 4648
Jumla
Kalikot
Dolpa
Dailekh
Jajarkot
Rukum
Surkhet
Bardiya
Salyan
Rolpa
Banke
Pyuthan
Dang
Source : NPHC 2011, NLSS

5. PUBLIC HEALTH FACILITIES
Total Public
HFs = 599
Population per HF = 5921
No. of SHP Upgraded to
HP In 2069/70 = 67

6. PRIVATE HEALTH FACILITIES
District
Numbers
Pyuthan 1
Rolpa 2
Rukum
Salyan 4
Dang 14
Banke 18
Bardiya
Surkhet 8
Humla
No. Of Private Institutes
Aproved By RHD till now = 51
HF Type
Numbers
Hospital 25
Polyclinic 8
Lab 6
Dental Hospital/Clinic 4
Clinic/Medical
Nurshing Home 2
Eye Hospital 1
Technical Institute
No. Of Private Institutes Aproved
By RHD in 2069/70 = 17

7. HUMAN RESOURCE SITUATION
Vacant Posts
= 26.85%

8. HUMAN RESOURCE SITUATION

9. HUMAN RESOURCE SITUATION
Doctor Vacant = 62.16%

10. EONC SITES ,BIRTHING CENTERS & SAS
Expected Live Birth per Birthing center in Average= 266
PHCC HP
SHP
Ayurved Hospital
Total 11
168
153 1
350
EONC Sites :
CEONC Sites
BEONC Sites
Total
Govt. Hospitals
Pvt. Hospitals
Hospitals (Govt.)
PHCCs 7 4 10 17 38
Safe Abortion Service Sites :
Number of EONC Sites per 500,000 Population = 7
Government
Other
Total 43 21 64

11. Ambulance Service Situation
Districts
Public
Private/NGO
Total
Registered
Functional
Dang 11 24 35
Banke 2 1 26 25
Surkhet 4 13 17
Bardiya 5 7 12
Pyuthan 3 8 6
Rolpa
Rukum
Dailekh
Jumla
Salyan
Jajarkot
MW Region 34 29 79 77
113
106
* Districts with no functional Ambulance are : Kalikot, Dolpa, Mugu & Humla

12. ACHIEVEMENTS TOWARDS NHSP-II
No. Of HF /5000 Population
% of dist.with at least one public HF providing all CEONC function
% of Healthposts with Birthing Centers
% Of safe abortion Sites
% of HF with at least 5 FP Methods
MWR
0.8 53 61
100 (64)  16
National
0.5 68 79 91 13
Target 2015 1 76
≥80
≥90 60

13. ACHIEVEMENTS TOWARDS NHSP-II
Indicators
2001
2006
2011
Target 2015
MWR
Nepal
TFR
4.6
4.1
3.5
3.1
3.2
2.6
2.5
IMR
72.9 64 97 48 58 46 32
% Stunted< 5 yrs
53.8 51
57.9 49
50.3
40.5 28
% Under weight <5 yrs
52.2 43
43.4 39
36.9
28.8 29
% Wasted < 5 yrs
8.2 11
11.6 13
11.3
10.9 5
Source : NDHS

14. ACHIEVEMENTS TOWARDS NHSP-II
Indicators
2001
2006
2011
Target 2015
MWR
Nepal
% Infant breast fed within 1hrs
65.5 31
32.5 35
46.8
44.5 60
Neonatal mortality rate
40.5 39 57 33 34 16
Unmet need for Family planning
27.8
24.6
26.1 27 18
CPR
35.4 43
44.2
42.8
43.2 67
Source : NDHS

15. ROUTINE IMMUNIZATION COVERAGE :MWR
EPI
ROUTINE IMMUNIZATION COVERAGE :MWR

16. MEASLES COVERAGE
EPI

17. IRON DISTRIBUTION COVERAGE AMONG PREGNANT WOMEN (NEW)
NUTRITION
IRON DISTRIBUTION COVERAGE AMONG PREGNANT WOMEN (NEW)

18. ANTIHELMENTHIC SUPPLEMENTATION COVERAGE AMONG PREG. WOMEN
NUTRITION
ANTIHELMENTHIC SUPPLEMENTATION COVERAGE AMONG PREG. WOMEN

19. VITAMIN A SUPPLEMENTATION COVERAGE AMONG POSTPARTUM MOTHERS
NUTRITION
VITAMIN A SUPPLEMENTATION COVERAGE AMONG POSTPARTUM MOTHERS

20. ANC 4TH VISIT AS % OF EXPECTED PREGNANCY
SAFE MOTHERHOOD 80

21. DELIVERY BY SBA AS % OF EXPECTED PREGNANCY
SAFE MOTHERHOOD

22. DISTRICTS CATEGORIZED BASED ON DELIVERY BY SBA
SAFE MOTHERHOOD
DISTRICTS CATEGORIZED BASED ON DELIVERY BY SBA
<20% delivery
20-40% delivery
40-60% delivery
>60% delivery
FY 2012/2013 (2069/2070)
 1 District
Dolpa (18%)
9 districts
Bardiya (39%) , Kalikot (33%) , Rukum (33%), Humla, Pyuthan (25%), Rolpa (30%), Salyan (29%) , Jajarkot (21%), Jumla (29%)
3 Districts
Dang (45%)
Mugu (40%)
Surkhet (53%)
2 Districts 
Banke (61%)
Dailekh (62%)
FY 2011/2012(2068/2069)
No Districts
10 Districts
Pyuthan (20%), Dolpa (21%)
Rukum (22%), Jajarkot 24%)
Salyan (26%), Rolpa (26%)
Jumla (29%), Humla (32%)
Kalikot (35%), Bardiya (37%)
4 Districts
Dang (43%)
Mugu (47%)
Dailekh (57%)
Surkhet (59%)
1 District
Banke (86%)
(Referral center)
NHSP-II target is 60%
MWRHD Surkhet

23. % OF INSTITUTIONAL DELIVERY AS EXPECTED PREGNANCY
SAFE MOTHERHOOD
% OF INSTITUTIONAL DELIVERY AS EXPECTED PREGNANCY
National 44 %

24. CONTRACEPTIVE PREVALENCE RATE
FAMILY PLANNING
11 Districts CPR Below than National CPR

25. DISTRICTS CATEGORIZED BASED ON CPR
FAMILY PLANNING
<30%
30-40%
40-50%
>50%
2069/2070
Mugu,
Dolpa,Rukum,,
Kalikot, Jajarkot
5 DISTRICTS
Humla, Jumla
Salyan, Dailekh
4 DISTRICTS 
Rolpa, Banke
Dang, Pyuthan
Bardiya
Surkhet
2 DISTRICTS 
2068/2069
Jajarkot
Kalikot
Rukum
3 DISTRICTS
Pyuthan, Rolpa
Dolpa, Humla
Dailekh, Salyan, Mugu
7 DISTRICTS
Banke
Dang
Jumla
3 DISTRICTS 
2067/2068
Rukum, Kalikot
Dolpa, Mugu
Jajarkot, Dailekh
Salyan, Rolpa
Bardiya, Dang
Pyuthan, Jumla, Humla

26. % OF HEALTH POSTS WITH 5 FAMILY PLANNING METHODS
Below 16 (Regional) = 8 Districts

27. PROPORTION OF NEW VSC PROVIDED ( Target vs Achivement)
FAMILY PLANNING
PROPORTION OF NEW VSC PROVIDED ( Target vs Achivement)
Increasing
Decreasing

28. TB
CASE FINDING RATE (%)
MDG Target
Less than 60 – 5 DISTRICTS

29. TREATMENT SUCCESS RATETB
TREATMENT SUCCESS RATE
All Districts above 80%
MDG Target
In Jumla 100% case finding and 100% Treatment Success

30. TOP 10 DISEASES ON THE BASIS OF NUMBER OF PATIENTS% 1
Respiratory Tract Infection (Upper, Lower, Pneumonia)
15.4 2
Skin Diseases (Scabies,Impetigo, abscess,Eczema, Fungal infection)
12.4 3
Diarrhoeal Diseases (Diarrhoea,Dysentry)
9.9 4
Headache (Migraine)
7.3 5
Gastritis (APD)
7.2 6
Intestinal Worms (Abdominal Pain)
7.1 7
Typhoid (Enteric Fever)
4.1 8
Falls/Injuries/Fractures
3.0 9
Conjunctivitis
2.9 10
Oral (Ulcer, mucosa and other related diseases, Dental)
2.8

31. ANNUAL PROGRESS S.N Name of District Number of Activities %Achivement
% Expenditure 1
Banke
180 92 87 2
Bardiya
197 83 74 3
Dailekh
170 95 89 4
Dang
182 98 91 5
Dolpa
134 81 6
Humla
139 99 7
Jajarkot
156 90 8
Jumla
141 94 9
Kalikot
171
100 96 10
Mugu
131 11
Pyuthan
166 85 12
Rolpa
150 86 13
Rukum 14
Salyan
132 15
Surkhet
181
16 
RHD 57
Regional Total
2428
ANNUAL PROGRESS

32. ANNUAL PROGRESS : DISTRICT CATAGORIZATION
>90
80-<90
60-<80
<60
Physical
13 DISTRICTS : Banke, Dailekh, Dang, Dolpa, Humla, Jajarkot, Jumla, Kalikot, Mugu, Pyuthan, Rukum, Salyan, Surkhet, Rolpa
2 DISTRICTS Bardiya, Rolpa
NO DISTRICTS
Financial
9 DISTRICTS Banke, Dang, Jajarkot, Jumla, Kalikot, Mugu, Salyan, Surkhet, Rolpa
5 DISTRICTS : Dailekh, Dolpa, Humla, Pyuthan, Rukum
1 DISTRICT Bardiya
NO DISTRICTS

33. PROGRAMMEWISE ANNUAL PROGRESS IN MWR

34. MAJOR ACTIVITIES CARRIED OUT IN 2069/70
Uterine Prolapse camp conducted in 10 districts (Pyuthan, Rolpa, Rukum, Dang, Salyan, Banke, Bardiya, Surkhet, Dailekh, Kalikot) for 1,588 cases.
DQSA Conducted in 5 districts, shared & feedback given to districts & HFs.
IMCI Training conducted for newly recruited Health workers.
Full immunization VDCs initiated.
New 41 Birthing centers established.

35. MAJOR ACTIVITIES CARRIED OUT IN 2069/70
Measeles Rubela campiagn conducted in 9 districts (Dolpa, Mugu, Humla, Jumla, Kalikot, Dailekh, Jajarkot, Rukum, Salyan)
Internal review surveillance conducted for Vaccine Prevetable Diseases (VPD)
Special TB programmes were conducted for marginalized population & hard to reach area.
Microscopy centers were expanded in Rolpa-2, Dang-1 & Banke-1 districts.

36. MAJOR ACTIVITIES CARRIED OUT IN 2069/70
TB/HMIS orientation programmes were conducted to reduce data variation.
Management Of Community Based Rehabilitation (MCBR) training conducted.
Five Health workers were awarded by RHD for best performance.
Five best performer health workers including FCHV were nominated for national tuberculosis award.
Hydrocele Camp conducted in Banke & Bardiya (60 cases)

37. MAJOR ACTIVITIES CARRIED OUT IN 2069/70
Filariasis Campiagn(MDA) in 10 districts excluding Karnali zone with 72% achievement.
Recruitment of HA (45), Staff Nurse (13) , AHW (59) & ANM (73) as temprory. Total=190
Recruitment of technical assistance staffs on contract (45 persons) .
Scaling up of 67 SHP to HP
Beruju Submitted for regulation (Rs.7400,000 )
Vehicle handed over to DPHO Bardiya.
Regular RHCT Meeting.

38. ISSUES & CHALLANGES
Human resource (27% Vacant) , Retention.
Geographical, Financial, Socio-cultural barriers for proper service accessibility.
Utilization of Services
Quality of Services
Mobile Population
Strange Health-seeking Behavior.
Inadequate/Poor Infrastructure.

39. RHD Surkhet : New Building

40. RHD Surkhet New Building : Seepage in ceiling & wall

41. RHD Surkhet New Building : Seepage in ceiling & wall

42. RHD Surkhet New Building : Seepage in wall

43. RHD Surkhet New Building : Seepage in ceiling & wall

44. MW Regional Hospital : New Building

45. MW Regional Hospital : New Building

46. MW Regional Hospital : New Building Wall

47. MW Regional Hospital : New Building Wall

48. Rapti Sub-Regional Hospital’s Lab: Top Ceiling

49. Rapti Sub-Regional Hospital : Wall

50. Rapti Sub-Regional Hospital : Wall

51. NEED TO FOCUS Special Package of HR retention in Karnali zone.
Rational Incentive Schemes.
Population & topography based resource allocation.
Capacity enhancement of HFOMC for effective coordination with local bodies.
All actors (GoN/NGOs/INGOs/Private) need to focus jointly in rural areas , particularly poor & excluded groups

52. OUR PARTNERS (RHCT) 1. H4L 15.Save the Children 2. KISAN 16.NRCS/CEHP
3. GIZ- HSSP
4. Plan
5. UNFPA
6. UNICEF
7. PSI
8. ADRA
9.FHI 360(SSP)
10.CARE
11. WHO-IPD
12.WFP
13. INF
14.BNMT
15.Save the Children
16.NRCS/CEHP
17.FPAN
18.Nepalguj Medical College
19.NSI
20. MI
21.Western Hospital
22.Kausalya Memorial Hospital
23.United Hospital
24.Susma Koirala MemorialTrust
25. NHSSP
26. Sajhedari

53. THANK YOU