Children in Nepal

Situation and Statistics

5th semester
26 November 2015
 Questions
• Who is a child?
• What are the age groups into which child
population is divided into?
• What is the population of Nepal according to
2011 Census?
• What is the percentage of population less
than one year, less than 5 years, 15 years and
18 years?
Answers
 Questions
• Define U5MR, IMR and NMR?
• What are the U5MR, IMR and NMR according
to NDHS’011?
• Define stunting, underweight and wasting
• What are the prevalence rates of stunting,
underweight and wasting in children less than
5 years of age according to NDHS’11?
 Questions
• What are the common illnesses suffered by
children less than five years of age?
• What is the contribution of Neonatal mortality
to U5MR or IMR?
 Pediatrics
• The branch of medical science that deals with
the preventive, promotive and curative
aspects of child health. It aims to help children
to remain healthy, treat them when they are
sick and help them to achieve their potential
for growth and development.
• Origin: Greek words: pediatr: child, iatros:
treatment of
 Child: definition
• According to the UN Convention on the Rights
of the Child, 1989:
A person less than 18 years of unless
described differently under the law of country.
 Who is a child?
• UN CRC: < 18 years
• Nepali legal system: <16 years
• Demographic surveys: <14 years
• Hospital admission policies: 14 years
• “Young human being below the age of full
physical development” – Oxford Concise
English Dictionary
• Full physical development: 19-21 years of age
 Stages in lifecycle
• Neonate: birth to 28 days of life
• Infant: 29 days to 12 months of life
• Toddler: From 13 months to 36 months of life
• Preschool child: from 37 months to 5 years of
age
• School Age child: 6 years to 12 years of life
• Adolescents: From 13 years to 19 years of age
Early: 10-13 yrs, Middle: 14-16 yrs & Late: 17-19 years
• How does a child differ from an adult?
 Characteristics of childhood
• More water content
• Rapid growth and development
• More likely to manifest features of congenital
disorders
• Increased need for nutrients
• More lasting consequences of ill health
• Natural process of growth help healing
• Higher degree of dependence
 Children in Nepal
• Trends in child population
• Health status: mortality and morbidity trends
• Nutritional status
• Coverage with preventive services
 Child population and trends
Age in years 1996 2001 2006 2011
0-4 years 15.6% 15.2% 14.5% 9.7%
5-9 years 13.7% 13.7% 13.5% 15.2%
10-14 years 12.2% 12.2% 12.2% 12.4%
Total % of 41.5% 41.1% 40.2% 37.5%
population
 Mortality rates
• Neonatal mortality rate (number of neonates
dying per thousand live births): 23
• Infant mortality rate (number of deaths in
infancy per thousand live births: 33
• Under five mortality rate (number of children
less than 5 years old dying per thousand live
births): 38
 Children: % population
• Under 5 years old: 9.7%
• 5-9 years old: 15.2%
• Less than 15 years old: 37.5%
 Mortality Trends
Year U5 MR IMR NMR
1996 118 78.5 49.4
2001 91 64.2 38.6
2006 61 48 33
2011 54 46 33
NMICS 2014 38 33 23
Trends in child mortality
 Illnesses
• Acute respiratory infection: 4%
• Fever: 19%
• Diarrhea: 14.3% (2% with blood in stool)
 Morbidity rates: NDHS reports
%age of FHS’96: NDHS’01: NDHS’06: MTR 09:
children with < 3 years <5 years <5 years <5 years
following in
the last 2
weeks
ARI 34% 23% 08% (5.5%) 4%
Fever 39.4% 32% 26% (17%) 19%
Diarrhea 27.5%/6.4% 20.4% 12% (10.5%) 14.3%/ 2% with
with blood in blood in stool:
stool
 Nutritional status
• Underweight (%ge of <5 years old children
with weight less than -2 SD): 30.1
• Stunted: (% of <5 yrs old children with length
or height <- SD): 37.4
• Wasted: (% of <5 yrs old children with weight
for height or length <-2 SD): 11.3
 Trends: General malnutrition
Year of Survey % stunted % under weight % wasted
NNS’75 69.4 69.1 13
NMSS’98 54.1 47.1 6.7
NDHS’01 50.5 48.3 6.6
NDHS’06 49 39 13
NDHS’011 41 28.6 11
MICS 2014 37.4 30.1 11.3
 Micronutrient status
• Vitamin A deficiency is no longer a public
health problem, virtually eliminated
• More than 90% of household consume iodized
salt and IDD is on the way to elimination
• Prevalence of Iron Deficiency Anemia has
been reduced from 78% in 1998 to 48% in
2006
 Challenges
• Slow reduction in Neonatal mortality rates
• High rates of wasting, stunting and
underweight
• Lower rate of Facility based delivery
• Urban centered health facilities
• Still a high prevalence of infectious diseases
• Pockets of unreached population with low
immunization coverage
Thank you!