Health

The health system, hygiene, nutrition and sanitation are very underdeveloped in Nepal, especially in rural areas. Health facilities are provided by both the private and public sectors, but both culminate in urban areas and are therefore far removed from much of Nepal’s population. The provision of medical aid is limited, among other things, by inadequate government funding. In 2002, government spending on health matters amounted to approximately US$2.30 per person. Almost 70 % of the cost of medical aid is still paid out of the population’s own pocket. All these factors contribute to the fact that the poor population, isolated from the city centers, has only limited or no access to basic medical care. In addition, the situation is aggravated by a lack of adequate health education. Family planning and pregnancy health are often ignored, which puts women at a significant disadvantage. In addition, people who are not nationals are excluded from social assistance benefits. Research has also shown that traditional beliefs play a strong role in the transmission of diseases. The incidence of diseases is higher in Nepal than in other South Asian countries.

Nutritional status of the Nepalese population
Rapid population growth and an unstable government contribute to an acute food shortage and a high number of malnourished people. Women and children, especially in the hill and mountain regions in the central and western regions, are the most affected. 41 % of children under the age of five have atrophy, a percentage that rises to 60 % in the western mountains. Micronutrient deficiency is widespread, again most affected are women, including most pregnant women, and children under five years of age. In addition, 35 % of women of child-bearing age are anemic. An important factor for a deteriorating nutrient balance are diarrhoeal diseases, aggravated by the lack of sanitary facilities and the still widespread practice of public defecation (44 % have no toilets).

Geographical and infrastructural challenges
Nepal’s hilly and high-alpine terrain and thus its sparsely developed infrastructure are one of the main reasons for the inaccessibility of basic medical care for mountain and hill dwellers. The main means of transport is still the own feet, which can lead to a large delay of treatments, which is particularly critical in emergencies. Apart from that, even if there is a hospital or health post in the area, many of the employees are not sufficiently trained and often lack important medical supplies and tools. Most of Nepal’s health facilities are located in urban areas and projects in rural areas often do not receive sufficient funding.