District Fact Sheet, Banke Health Service Coverage Fact Sheet FY 2071/72 to 2073/074 S.N. Program 2071/72 2072/73 2073/74 District to HMIS section 100 100 100 1:-Reporting Status PHC to District 100 100 100 HP to District 100 100 100 BCG Coverage 106 98 109 DPT3 coverage 97 83 93 2- National Measles 89 77 90 Immunization Program JE 89 71 74 TT2 & 2 + coverage 87 76 95 Growth monitoring coverage as % of <1 yrs children 88 93 60 among new visit Proportion of Malnourished children ( weight/age) 5.6 5.98 4.2 3- Nutrition Program new visit % of Iron distribution for new pregnant women 105 97 100 % of postpartum mother received Iron 52 37 34 Reported incidence of ARI/1000<5 Yrs population 820 636 617 4- ARI control Program Proportion of severe pneumonia among new cases 0.30 0.15 0.134 Incidence of diarrheal /1000<5Yrs population 673 573 515 5- Control of Diarrhoeal % of severe dehydration among new cases 0.10 0.05 0.05 Disease Program % of new diarrheal cases treated by ORS and Zinc 88.20 97.25 96 First antenatal visit as a % of expected live birth 75.20 83.2 75 4 ANC visit as % of antenatal visit ( new) 61.20 48.1 65 6- Safe motherhood % of total delivery conducted by SBA % of live birth 125.60 118.1 100 program ANC 1st visit (any time)as % of live birth 145 107 113 Maternal Mortality Ratio per 100000 live Birth 186 114 138 7-Family Planning Contracepective prevalence rate ( CPR) 41.7 Program 43.7 42.08 Malaria parasite incidence /1000 population 0.04 0.04 0.38 8- Malaria Control 1 Program Slide positivity rate 0.65 0.89 0.84 Case finding rate 87 85 88 9-Tuberculosis Control Sputum conversion Rate 79 83 82 Program Cure rate 77 77 84 Case detection rate /10000 population 22.85 35.08 51.3 10- Leprosy Control Program Prevalence rate/10000 population 1.76 2.76 4.7 11- FCHV Program % of report received from FCHV 90 92 93 Average no of people served by FCHV per month 47 40 38 % of report received from PHC/ORC 90 89 94 12- PHC/ORC Program Average no of people served per clinic per month 32 28 28 Disaster Events 2 5 4 ( fire) 13.Out Break Affected population 51135 8214 600 Management Program Death 15 0 4 14.Curative Services % of OPD new Visit 62.75 53.94 67 Executive Summary A. INTRODUCTION This is the compile report of annual health activities and its achievements for fiscal year 2073/74 of Banke district. The report focuses on the objectives, targets, strategies adopted by the programs and analyses the achievements of the major activities and attempts to highlight trends in the service coverage of the services over the preceding three fiscal years. This report also identifies issues, problems, constraints and suggests actions to be taken by the related health institutions for further improvements. The executive summary highlights the key issues and observations emerging from the analysis of each programme. Detail programme information is available in specific reports following this summary. The information and statistics used in this report are based on the data collected by the Health Management Information System (HMIS) from health institutions across the district. A total of 1 Zonal 2 Hospital, 3 Primary Health Care Centres (PHCCs), 42 Health Posts (HPs) and 2 Sub Health Post (SHPs) reported to HMIS in FY 2073/74. This report also includes service coverage by 148 Primary Health Care/Outreach Clinics (PHC/ORC), 303 Expanded Programme of Immunization (EPI) clinics and 789 Female Community Health Volunteers (FCHVs). A total of five NGO/INGOs and 16 Private Health Institutions (PHI) also reported to HMIS in this year. This implies that 100% of PHCCs, 100% of HPs and SHPs, 94% of PHC/ORCs, 98% of EPI clinics, 94% of FCHVs and 100% of NGO/INGOs reported to HMIS in fiscal year 2073/74. B. CHILD HEALTH IMMUNIZATION National immunization program is the priority 1 (P1) program. The district coverage of BCG is the highest of all antigens indicates that about 109% children have access in immunization services, while DPT‐HepB‐Hib and OPV‐ 3 coverage are more than 93%. The measles/rubella 1 vaccine coverage is 90 % and Td2+ coverage (Td2 and Td2+) coverage is 95%. The JE coverage is 74%. NUTRITION In Banke, the coverage of growth monitoring (GM) is 61% in FY 2073/74. The average number for GM visit marginally increased in the fiscal year 2073/74 i.e. 2.7. The proportion of malnutrition children has decreased to 4.2% in FY 2073/74 from 5.9 % of FY 2072/73. COMMUNITY BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (CB‐IMCI) AND NEWBORN CARE (CB‐NCP) In FY 2073/74 a total of 580 infant of less than 2 months were treated at health facilities. Treated infection cases (PSBI) have been constant (72) in FY 2073/74 as compared to 2072/73. The incidence of diarrhoea per 1,000 under‐five years' children has decreased slightly to 515/1,000 in FY 2073/74 from 573/1,000 of FY 2072/73. In the case of Severe Dehydration, it has also slightly decreased in FY 2073/74 as compared to FY 2072/73. The incidence of ARI Cases has decreased 617/1000 in FY 2073/74 as compared to (636/1000) FY 2072/73. C. FAMILY HEALTH FAMILY PLANNING The contraceptive prevalence rate (CPR) for modern family planning method is 41.7% at district level in fiscal year 2073/74. There is wide variation in CPR at the VDC/Municipality level in the reporting year. SAFE MOTHERHOOD In the fiscal year 2073/74 district level ANC first visit as percentage of expected live birth is 75 percent and 4 ANC visit as percentage of expected live birth is 49 percent. Institutional delivery as percentage of expected live birth is 126 %. It is because of reporting from three referral hospitals. FEMALE COMMUNITY HEALTH VOLUNTEERS There are 789 FCHVs (522 FCHVs at rural and 267 at urban/municipality level). FCHVs have contributed in distribution of 57 percent oral pills and 40 percent of condom. FCHVs distributed 359541 condoms out of 8, 83318 in the FY 2073/74. More than one half of the diarrhea and ARI cases were treated by FCHVs. 3 PRIMARY HEALTH CARE OUTREACH CLINICS Total number of clinics expected to run in a year 1776 (148 PHC/ORC Clinics x 12 times) and clinics have been conducted 94 percent in the reporting year. On an average 28 clients were served per clinic during the fiscal year 2073/74. D. DISEASE CONTROL MALARIA Government of Nepal has set a vision of Malaria free Nepal in 2025. Malaria confirmed cases slightly increased from 24 in fiscal year 2072/73 to 29 in 2073/74. LYMPHATIC FILARIASIS Lymphatic Filariasis (LF) is a public health problem in Banke and completed the recommended seven rounds of MDA in FY 2073/74 with 73% of coverage adopting local innovative activities. TAS done in previous year shows district has revealed that the prevalence of LF infection has not significantly reduced and contributed in preventing disabilities and sufferings due to LF. TUBERCULOSIS In the fiscal year 2073/74, there were registered 965 cases; among them positive proportion was 68% (661). The case finding rate of New PBC TB cases was 88%. Case Notification Rate of new and relapse PBC was 103/1, 00, 000 risk population in the fiscal year 2073/74. Similarly the Treatment Success Rate of new smear positive cases registered in fiscal year of 2073/74 was 86%. LEPROSY During the FY 2073/74 a total number of 288 new leprosy cases were detected including report from mini leprosy elimination campaign and were put under MDT. Total 265 cases were under treatment at the end of the fiscal year 2073/74 which makes the registered prevalence rate of 4.7/10,000 populations at district level. This rate is above the cut‐off point of <1/10,000 population which implies that there still remain a challenge for leprosy elimination in Banke district where as Government of Nepal declared leprosy elimination from Nepal on dated 19 January 2010. Selected innovative and different ways of program implementation Registration of private HFs: Using national guideline DPHO Banke has registered 123 private health institutions by the end of the fiscal year. Following types of private health facilities were registered and have been providing health services: SN Type of HFs Number SN Type of HFs Number 1 15 Bed hospital 13 6 Diagonistic centre 10 2 25 Bed hospital 3 Ultra sound 5 3 Pathology 15 7 X-ray 4 4 4 Polyclinic 8 8 Health clinic 41 5 Dental hospital 6 9 Eye hospital 5 10 Nose Hospital 1 Applied Reaching the Unreached Strategy developed by MoH: MLEC, SMC, MDA additional resource mobilization, from DCC, FID in connection with ODF, I am Healthy and my country is healthy. Attention was paid to provide services to remote areas for example all the positions of human resource was fulfilled and partners' projects activities were implemented in Rapti pari. Control of tobacco, school health program and growth monitoring campaign and my health my country healthy campaign were also implemented in selected areas. Coordination and support: In support and coordination of DPHO established Haemoglobinopathy/Sickle Cell Disease (SCD) center and One Stop Crisis Management Center (OCMC). Further, DPHO procured equipments for Susil Koirala Prakhar cancer hospital, Khajura.