News Summary
- Nepal has secured a promising government after three decades, emphasizing the need to prioritize public health.
- Programs involving midwives are recommended to improve pregnant women’s health through necessary advice and treatments.
- Establishing non-communicable disease prevention centers in primary health centers is suggested to ensure disease control and emergency services.
After more than three decades of despair, Nepal has finally gained a government that instills hope. While the government may set various priorities, I firmly believe that without making public health and the health system the foremost priority, the country’s development will not be possible.
In our society, we often focus on the divide between the rich and the poor. However, what does it really mean to be wealthy? We have long equated prosperity with physical assets such as roads and electricity. Yet, studies of developed nations show that a country’s wealth is largely determined by its education, health, and social systems. Fully developing all three sectors is crucial.
Unless the education system is strong and provides quality education that empowers citizens to be self-reliant and health-conscious, progress cannot be sustained. Social security systems guarantee a dignified and independent life for the citizens, offering economic and mental support when necessary. Employment creation, support for disabled persons and orphans, among others, are essential components of the social system.
Previous research has shown that the absence of social security weakens individuals’ mental and physical health. Rising unemployment and economic challenges have led to increasing depression and suicide rates, which is a serious concern.
Why is long-term thinking necessary?
Technological advancements over the last two decades, especially generative AI, offer a glimpse of transformations expected within the next 30 to 40 years. These changes will also impact public health. Therefore, envisioning healthy citizens and a progressive society with a long-term perspective starting now is imperative. Notably, the rising incidences of non-communicable diseases such as heart disease and diabetes, driven by decreased physical activity and unhealthy diets, point to growing challenges in Nepal. The lifestyle changes observed in very young children are also alarming.
The government must develop long-term plans focused not only on treating patients but also on disease control and health promotion to enhance the health status of future generations.
Health Promotion Plan for Pregnant Women
Healthy mothers and pregnancies are essential for delivering healthy babies. In Nepal, adequate attention has not been given to managing the health of pregnant women. Traditional superstitions and cultural constraints often hinder proper healthcare. Pregnant women should receive primary treatment, health checks, and education at nearby health posts. Treatment must be available when necessary to ensure the health of both the mother and the unborn child.
Any purchase and consumption of intoxicants, tobacco products such as khaini, bidi, and cigarettes by children under 18 should be strictly prohibited. The government must enforce tight regulations on the sale and distribution of these products, allowing sales only through licensed vendors. Creating an environment that encourages children’s participation in physical exercise and sports is essential.
The government should assign at least one midwife per primary healthcare center. Universities across the country need to produce a high number of professionals in midwifery. These health workers can provide advice to pregnant women and continue health monitoring and guidance for children up to two to three years old. Midwives will play an important role in preventing malnutrition and infections and in promoting proper nutrition and vitamin-rich diets.
Ensuring opportunities for children’s play and physical exercise is also the government’s responsibility. Children should have full access not only to education but also to sports. Physical education should be regularly included in school curricula for younger children. Recognizing the importance of sports for physical and mental development, open parks for sports should be constructed in every ward and village.
Additionally, the presence of specialist nurses in schools must be mandatory.
Lifestyle Improvements Are Essential
Children are influenced by their parents and society. If substance abuse and drug use increase among parents and within society, children may also adopt such behaviors. Therefore, positive lifestyle patterns among parents are crucial.
Many individuals engage in little physical exercise and consume excessive amounts of calorie-rich junk food and sugary products. This contributes to rising cases of heart disease and diabetes, increasing the risk of premature death. To combat this, initiatives such as creating safe pedestrian and cycling paths, running gyms, and promoting exercise programs are immediately necessary.
Production of alcoholic substances in rural areas should be commercialized but strictly regulated. Public awareness campaigns and health education must focus on preventing alcohol, smoking, and drug misuse.
With growing habits of junk food and sugary beverages among children, imposing heavy taxes on these products to reduce sales is an effective policy measure. Likewise, enforcing a strict ban on the consumption of intoxicants and tobacco products by individuals under 18 years old is essential.
Establishing Non-Communicable Disease Prevention and Emergency Services at Primary Health Centers
To counter the increasing prevalence of diseases like heart disease, lung conditions, diabetes, and cancer, each primary health center should establish prevention units. These centers would provide health advice and services tailored to healthy individuals, those at risk, and patients already diagnosed with such conditions, focusing on exercise and lifestyle improvements.
Emergency services hold special importance—immediate intervention is critical for complications during childbirth, road accidents, and heart attack cases. Every hospital must ensure emergency services so that people need not travel to Kathmandu and can be saved from premature death.
At least one national-level specialist hospital is necessary in every district. Without such guarantees from the government, patients might be forced to migrate to the capital for treatment again.
Road safety and safe vehicle operation require special training and the construction of secure road infrastructure.
Environmental Health
Lastly, environmental health is paramount. The government should prioritize pollution control and efforts to maintain clean, pollution-free villages and cities. Recycling systems for plastics, paper, glass, and other materials must be implemented to promote green towns and cities. This approach will contribute significantly to controlling pollution-related diseases.
(Prof. Dr. Thapa is a professor and researcher at two universities in Sweden. He serves on the board of the Nepali monitoring organization Niri Nepal and is the vice president of the Society of Nepali Healthcare Professionals in Europe.)
