This Strategy was prepared by the PHD Group for the National Health Education, Information and Communication Centre (NHEICC), MoHP in 2007.
The health policies, plans and programmes since 1950 have contributed to improve the health status of the people. The infant mortality rate was estimated to be 48 per 1000 live births and life expectancy 63.3 in 2006. The National Health Policy 1991, Second Long Term Health Plan (SLTHP) 1997-2017, and Tenth Plan/ Poverty Reduction Strategy Papers (PRSP) have given due importance to ensure better health for all. Efforts have been made to address social in-equality, poverty, exploitation, violence and injustice which contribute to ill health particularly among the poor and marginalized people.
The Ministry of Health and Population has Health Sector Strategy: An Agenda for Reform and Nepal Health Sector Programme – Implementation Plan (NHS-IP) to respond to the health needs of the people. The thrust of the strategy is to ensure equitable access to quality health care by all in line with National Health Policy 1991, SLTHP, Tenth Five-Year Plan, PRSP and the health Millennium Development Goals (MDGs). The Interim Constitution 2007 of Nepal has guaranteed access to health service as one of fundamental rights of the Nepalese citizen.
Following political change in 1990, communication media have expanded quite extensively. About 61% of all households in Nepal possess a radio and about 28% own TV. About 5.5% of all households posses mobile phones. E-mail, internet and pay phone services are also available. Daily and Weekly Newspapers, magazines, booklets, newsletters, etc., are quite extensive at least in cities. These communication materials, however, do not reach the bulk of the population.
In rural areas many types of folk media are in use. They are Sarangi/Gaine, Dohorigeet, Deuda, street drama, Ghantu, Maruni, Lakhe, Nautanki, and Rodi. Various types of religious festivals and gatherings are also used as a means of disseminating information.
Learning from the past, the government initiated the integration of services of vertical projects into the mainstream of the government health service delivery network under which health education programme was expanded from the centre to the periphery with the objective of changing the behaviour of people and health workers and health volunteers.
From the early 1990s, health programmes in Nepal started using communication with a much wider scope. The understanding of communication went through a paradigm shift after integration of the health services particularly Primary Health Care in 1978 for Health For All 2000 which focused on two-way communication or Inter-Personal Communication (IPC). This shift embraced the client-centred approach.
Nepal Health Sector Programme – Implementation Plan (NHS-IP) recognises behaviour change communication (BCC) as one of the means for effective implementation of EHCS. However, for ensuring better health status of the people, it is equally essential to address their health needs, beyond selected EHCS.
In this context, a comprehensive health promotion programme in support of curative, preventive, promotive and rehabilitative services was needed to be made equally available in all ecological regions even if there are several challenges. They should be accessible to all people such as children, adolescents, adults, aged, male and female, the poor and marginalized at all times in appropriate setting through appropriate approach and media.
The objectives of comprehensive strategy for health promotion are therefore to:
Empower people to promote own health adopting supportive behaviour.
The comprehensive strategy for IEC/BCC in health programmes will help achieve:
In order to achieve the outcome indicators of the 20 elements of EHCS as spelled out in the SLTHP and beyond, the key activities identified were:
1 Appropriate treatment of common diseases and injuries
2 Reproductive health services
3 Expanded program of immunization (EPI): Hepatitis B vaccine
4 AIDS and STD control including condom promotion and distribution
5 Leprosy control
6 Tuberculosis control
7 Integrated management of childhood illness (IMCI)
8 Nutritional supplementation, enrichment, nutrition education and rehabilitation
9 Prevention and control of blindness
10 Environmental sanitation
11 School health service
12 VB disease control
13 Oral health services
14 Prevention of deafness
15 Substance abuse including tobacco and alcohol control
16 Mental health problems
17 Accident prevention and rehabilitation
18 Community based rehabilitation
19 Occupational health
20 Emergency preparedness and management
Beyond EHCS include rabies, snake bites, Ayurvedic services, etc.