ADB_book_18 April.qxp - Himalayan Document Centre - icimod

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Malnutrition remains a serious obstacleto survival, growth, and development in Nepal.There are different forms of malnutrition. Themost common forms in Nepal are proteinenergymalnutrition, iodine deficiencydisorder, and deficiencies of iron andvitamins. The Nepal Demographic and HealthSurvey conducted in 2001 showed that 51% ofthe sample children (N = 6877) below 5 yearsof age were affected by stunting (short fortheir age), which can be a sign of early chronicunder-nutrition. The survey also found that46% of children below age 5 are underweight(low weight for age). In addition 9% arewasted (thin for their height), an indicator ofacute malnutrition. According to the survey(2001), one important cause of protein energymalnutrition in Nepal is that 30%–50% ofchildren are born with low birth weight(weight below 2.5 kg). Low birth weight alsoleads to an intergenerational cycle ofmalnutrition (DOHS 2003).Table 2.19: Incidence of Diarrhea and Acute Respiratory Infection(ARI) per ‘000 Population Below 5 years of AgeNumber of Diarrhea Number of ARIRegionPatientsPatientsMountain 195 215Hill 167 180Terai 184 277Nepal 177 229ARI = acute respiratory infectionSource: DOHS (2003)Table 2.20: Distribution of Households by Main Fuel Used forCookingCow Dung/ TotalWoodRegionLeaves/ Solid Fuel Kerosene LPG(1)Straw (2) (1+2)Other aFuelMountain 99.7 0 99.7 0 0 0.3Hill 76.8 1.3 78.1 6.5 6.5 2.1Terai 57.0 31.9 88.9 3.6 3.6 2.8Rural 76.7 17.8 94.5 1.6 1.6 2.0Urban 30.6 4.8 35.4 19.9 19.9 3.9Nepal 69.1 15.7 84.8 4.7 8.2 2.3Improvement MeasuresLPG = liquefied petroleum gasa Other fuels include electricity, biogas, coal or charcoal, and other categories.Table 2.22 lists health indicators and their Source: NLSS (2004)status and target by the current Tenth Plan.Increasing the availability of essential health Table 2.21: Malnourished Children Below Age 3 (%)services from 70% to 90% by the end of theRegion Total Normal % MalnourishedTenth Plan (2007) necessitates increasing thenumber of health institutions in rural Hills and Mountain 55,432 45,438 18.0Mountains, given the scattered settlements. Hill 384,582 327,316 14.9The Expanded Programme on ImmunizationTerai 393,948 329,713 16.3is considered one of the most cost-Nepal 833,962 702,467 15.8effective health interventions. The presentSource: DOHS (2003)program covers all 75 districts of the countrywith appropriate interventions to achieve thetargets.The Ministry of Health has developed aTable 2.22: Status and Target of Health -Related Indicators, 2001Second Long Term Health Plan 1997–2017.The aim of this plan is to guide health sectordevelopment in improving the health of thepopulation, particularly those whose healthneeds are not now met. According to the plan,Health IndicatorsAvailability of essential health services (%)Pregnant mother attending four antenatal visits (%)Women of 15–44 age group receivi ng TT vaccines (%)Contraceptive prevalence rate (%)Status70.016.015.039.3Target90.050.050.047.0priority is to be given to health promotion and Use of condoms for safe sex (14 –35 years) (%) 35.0 35.0prevention activities based on primary health Total fertility rate (women of 15 –49 years) 4.1 3.5care principles. It identifies essential healthCrude birth rate per 1,000 34.0 30.0care services that address the most essentialBirth attendance by trained health workers (%) 12.7 18.0health needs of the population.Newborn infant mortality (per 1,000 live births) 39.0 32.0Further, the strategy includes not onlyInfant mortality (per 1,000 live births) 64.0 45.0curative care interventions but also preventivecomponents. The Convention on the Crude mortality rate (per 1,000) 10.0 7.0Rights of the Child states the right of the childto enjoy the highest attainable standard ofhealth and to have access to health services.In this sense integrated management ofchildhood illness has been successful inMaternal mortality rate (per 100,000)Child mortality (below 5 years old) per 1,000 live birthsLife expectancy at birth (years)Total expenditure to total government budget (%)415.091.061.95.2300.072.065.06.5Source: NPC (2002)18 Environment Assessment of Nepal : Emerging Issues and Challenges
Ordinary Dug Well in the Terai RegionB. PradhanImproved Dug Well with Protective CoverB. Pradhanprotecting the rights of children. Today, this approachhas proved to be one of the most successfulstrategies for the survival of children in manycountries.Diarrheal diseases are a major public healthproblem among children under five. The NationalControl of Diarrheal Diseases Programme has beenaccorded high priority by the government andremains an integral part of primary health care.Improvement in diarrheal case management will bea primary strategy for reducing mortality amongchildren under five years of age. Standard diarrheacase management will be provided in healthinstitutes by establishing oral rehydration therapycorners in all health institutions. The main objectiveof the National Control of Diarrheal Diseases Programis to reduce mortality due to diarrhea anddehydration from the current 30,000 deaths per yearto a minimum and to reduce morbidity from 3.3episodes per child per year to a minimum.Rural SanitationRural sanitation refers to access of rural householdsto drinking water sources, drinking water coverage,types of toilet, and wastewater generation.Drinking WaterTable 2.23 shows the proportion of householdshaving access to different sources of drinking waterfor the respective regions as a whole. Most peopleliving in the Mountains and Hills are provided withtap or pipe water, whereas in the Terai tube wells arethe main source of drinking water. The nationalaverage of access to tap water is 53%. Tap water issaid to be safe water. In rural Nepal, most drinkingwater is provided through public taps. Other watersources such as wells, tube wells, water spouts, andrivers are commonly used by the rural poor.A Department of Water Supply and Seweragestudy in 2002 estimated the drinking water access forthe rural population (Table 2.24). By the end of 2007,it is estimated that 92% of the total rural populationwill be covered with improved drinking watersystems provided by different government programs.By 2015, all rural people in the country will haveaccess to a drinking water supply.Toilet AccessThe access of households to toilets in rural and urbanareas is shown in Table 2.25. In 2001, the most recentyear for which reliable statistics are available, 46% ofall households had access to toilets, more in the Hillsand less in the Mountains and Terai. Two types oftoilet facilities—flush and ordinary (pit)—areidentified by the census (CBS 2002b). People usingflush or modern toilets are less vulnerable to healthrisks than those using ordinary toilets. For the countryas a whole, only 23% of households had access tomodern toilets, and 23% had ordinary toilets.Mountain households had the lowest access (7.9%)to modern toilets. Overall some 40% of ruralTable 2.23: Household Accessibility to Drinking Water by Sources, NepalPercent of Total HouseholdsTotalRegionTap/Spout River/ OtherHouseholdsWell Tube WellPipeWater StreamMountain 285,217 72.2 6.24 0.0 17.1 3.4 1.0Hill 1,950,345 72.2 11.99 2.4 10.1 2.0 1.2Terai 1,938,895 30.8 6.48 58.6 1.1 0.6 2.5Nepal 4,174,457 52.9 9.04 28.4 6.4 1.5 1.8Source: CBS (2002b)Chapter 2: Rural Environment, Poverty, and Livelihood19
Page 2 and 3: About the OrganisationsAsian Develo
Page 4 and 5: © 2006 International Centre for In
Page 6 and 7: AcknowledgementsWe would like to ex
Page 8 and 9: PM2.5PAHRSSAARCSACEPSEASO 2TSPUKUND
Page 10 and 11: Chapter 6: Energy Resources 65Intro
Page 12 and 13: List of FiguresFigure 2.1: People a
Page 14 and 15: Table 6.1: Energy Consumption and P
Page 16 and 17: forests are also used for infrastru
Page 18 and 19: as data gathered by different agenc
Page 20 and 21: Table 2.1: Population Growth Rates
Page 22 and 23: mortality rates for rural and urban
Page 24 and 25: Agglomeration village in the centra
Page 26 and 27: soil erosion, and depletion of wate
Page 30 and 31: provision remains inadequate becaus
Page 34 and 35: Table 2.24: Existing and Projected
Page 36 and 37: Table 2.28: Income Poverty Indicato
Page 38 and 39: Table 2.31: Change in Employment St
Page 40 and 41: In 2004, the average annual househo
Page 42 and 43: Mountain areas have the most food i
Page 44 and 45: Schaffner, U. 1987. “Road Constru
Page 46 and 47: Table 3.1: Agricultural Economic De
Page 48 and 49: Table 3.4: Estimated Soil Erosion R
Page 50 and 51: B. PradhanImpacts of land degradati
Page 52 and 53: Carson, B. 1985. “Erosion and Sed
Page 54 and 55: The trend of forest coverage in the
Page 56 and 57: BiodiversityState of BiodiversityNe
Page 58 and 59: The Government has given legal prot
Page 60 and 61: Different ways of maintaining biodi
Page 62 and 63: ———.2004. State of the Enviro
Page 64 and 65: Appendix 4.1: Table continuedMajor
Page 66 and 67: Appendix 4.2: Protected Plant and W
Page 68 and 69: Table A4.2.3: Nepal's Share in Plan
Page 70 and 71: to intense weathering, and percolat
Page 72 and 73: Table 5.5: Water Supply and Water T
Page 74 and 75: Table 5.9: Water Quality of Shallow
Page 76 and 77: species are reported to be endanger
Page 78 and 79: Ministry of Water Resources (MOWR).
Page 80 and 81: Definition, Forms, and UnitsEnergy
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Table 6.5: Hydropower PotentialRive
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Chilime Hydroelectric Project: An E
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load occurs from 6 pm to 9 pm with
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assessment of wind energy and lack
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Review of Dams and Development by t
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IUCNElizabeth Khaka, UNEP-NairobiRu
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therefore reflect the three guiding
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is a seasonal dust storm. Anthropog
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Figure 7.3: Average Air Quality, Ja
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matter, hydrocarbons, and NO x (Nae
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Figure: 7.9: Vehicle Registered in
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Brick Kilnchlorofluorocarbons (HCFC
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Climate ChangeA region’s climate
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Figure 7.14: Mean Annual Precipitat
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Table 7.3: National Ambient Air Qua
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India. Available: http://www.cleana
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———.1999. “Ambient Air Qual
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Appendix 7.1: World Health Organiza
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Table 8.1: Criteria for Urban Statu
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accommodate the rapidly increasing
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managing solid waste. They are part
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In most municipalities, hazardous w
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in worsening public health conditio
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objects of archaeological, historic
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Min BajracharyaB. PradhanVehicles a
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Department of Health Services (DOHS
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Table 9.1 describes the major highl
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the period to up 2017. The document
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earthquakes; and awareness raising
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Sub-regional LinkagesOther developi
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Figure 9.1: The Key Environmental I
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(iv)(v)(vi)plants, and other non-ti
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environmental governance can be bet
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can vary considerably. Both sides h
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Dhungel, D.N., and A.B. Rajbhandari
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Table A9.1.2: Industry-Specific Tol
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. Cultural Heritage8. Convention fo
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Appendix 9.3: Some Prominent Enviro
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Some funding arrangements made by t
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(NARDF 2004) for a period of 1 to 3
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Table 10.2: Annual Income and Expen
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Table 10.4: Users’ Share in Benef
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From Hands Around Everest bookFrom
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Table 10.8: Subsidy Rate for Biogas
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microorganism communities and the n
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subsidies (Mason 1996). All these a
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addressed only part of the problem.
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historical practice of community-ma
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moved or relocated. The fact that s
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Kathmandu Valley and receives a lar
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cooperative ventures provided neith
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further poaching has not been repor
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http://www.pugwash.org/reports/pac/
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United Nations. 2003. World Populat
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how other countries with substantia
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(i) Broad-based and sustainable eco
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Although progress is encouraging, m
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Nepal’s Changing Pattern of Trade
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Table 12.2: Trade/ GDP RatiosFY1981
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Table 12.5: Percentage Share of Maj
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well as other provisions in specifi
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Future Implications for NepalIncrea
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International Trade Forum (ITN). 20
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- Gross domestic product per unit e
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Time Series InformationGenerally tw
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Table 13.1a: Different Datasets Col
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elevant due to its multidisciplinar
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Figure 13.6: Examples of Applicatio
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Judith DobmannThere are many source
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———.2003. Mapping Nepal Censu
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sustainable livelihoods requires an
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and haphazard. Population pressures
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issue. These deficiencies stem from
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population must be assessed. MOEST
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Appendix 14.1: List of Key Environm
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(vii) The EIA report approving agen
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Goal 1: Eradicate extreme poverty a
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Nepal’s Progress Towards the MDGs
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Goal 4: Reduce child mortalityReduc
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