health

Health is the general condition of a person in all aspects. It is also a level of functional and/or metabolic efficiency of an organism, often implicitly human.
At the time of the creation of the World Health Organization (WHO), in 1948, health was defined as being "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity".

Only a handful of publications have focused specifically on the definition of health and its evolution in the first 6 decades. Some of them highlight its lack of operational value and the problem created by use of the word "complete." Others declare the definition, which has not been modified since 1948, "simply a bad one.In 1986, the WHO, in the Ottawa Charter for Health Promotion, said that health is "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities." Classification systems such as the WHO Family of International Classifications (WHO-FIC), which is composed of the International Classification of Functioning, Disability, and Health (ICF) and the International Classification of Diseases (ICD) also define health.
Overall health is achieved through a combination of physical, mental, emotional, and social well-being, which, together is commonly referred to as the Health Triangle.

Health Insurance

The majority of the Indian population is unable to access high quality healthcare provided by private players as a result of high costs. Many are now looking towards insurance companies for providing alternative financing options so that they too may seek better quality healthcare. The opportunity remains huge for insuranace providers entering into the Indian healthcare market since75% of expenditure on healthcare in India is still being met by ‘out-of-pocket’ consumers [28].Even though only 10% of the Indian population today has health insurance coverage, this industry is expected to face tremendous growth over the next few years as a result of several private players that have entered into the market. Health insurance coverage among urban, middle- and upper-class Indians, however, is significantly higher and stands at approximately 50% .

The Insurance Regulatory and Development Authority (IRDA) is the governing body responsible for promoting insurance business and introducing insurance regulations in India .The share of public sector companies in health insurance premiums was 76% and that of private sector companies was 24% for the period 2005-06. Health insurance premiums collected over 2005-06 registered a growth of 35% over the previous year .In 2001 the IRDA introduced provisions for Third Party Administrators (TPAs) to support the administration and management of health insurance products offered by insurance companies. TPAs are facilitators in the coordination process between the health insurance provider and the hospital. Currently there are 27 TPAs registered under the IRDA .

Health insurance has a way of increasing accessibility to quality healthcare delivery especially for private healthcare providers for whom high cost remains a barrier. In order to encourage foreign health insurers to enter the Indian market the government has recently proposed to raise the foreign direct investment (FDI) limit in insurance from 26% to 49% .Increasing health insurance penetration and ensuring affordable premium rates are necessary to drive the health insurance market in India.

Prymari Services

Health care facilities and personnel increased substantially between the early 1950s and early 1980s, but because of fast population growth, the number of licensed medical practitioners per 10,000 individuals had fallen by the late 1980s to three per 10,000 from the 1981 level of four per 10,000. In 1991 there were approximately ten hospital beds per 10,000 individuals. However for comparison, the in China for comparison there are 1.4 doctors per 1000 people.
Primary health centers are the cornerstone of the rural health care system. By 1991, India had about 22,400 primary health centers, 11,200 hospitals, and 27,400 clinics. These facilities are part of a tiered health care system that funnels more difficult cases into urban hospitals while attempting to provide routine medical care to the vast majority in the countryside. Primary health centers and subcenters rely on trained paramedics to meet most of their needs. The main problems affecting the success of primary health centers are the predominance of clinical and curative concerns over the intended emphasis on preventive work and the reluctance of staff to work in rural areas. In addition, the integration of health services with family planning programs often causes the local population to perceive the primary health centers as hostile to their traditional preference for large families. Therefore, primary health centers often play an adversarial role in local efforts to implement national health policies.
According to data provided in 1989 by the Ministry of Health and Family Welfare, the total number of civilian hospitals for all states and union territories combined was 10,157. In 1991 there was a total of 811,000 hospital and health care facilities beds. The geographical distribution of hospitals varied according to local socio-economic conditions. In India's most populous state, Uttar Pradesh, with a 1991 population of more than 139 million, there were 735 hospitals as of 1990. In Kerala, with a 1991 population of 29 million occupying an area only one-seventh the size of Uttar Pradesh, there were 2,053 hospitals.
Although central government has set a goal of health care for all by 2000, hospitals are distributed unevenly. Private studies of India's total number of hospitals in the early 1990s were more conservative than official Indian data, estimating that in 1992 there were 7,300 hospitals. Of this total, nearly 4,000 were owned and managed by central, state, or local governments. Another 2,000, owned and managed by charitable trusts, received partial support from the government, and the remaining 1,300 hospitals, many of which were relatively small facilities, were owned and managed by the private sector. The use of state-of-the-art medical equipment, often imported from Western countries, was primarily limited to urban centers in the early 1990s. A network of regional cancer diagnostic and treatment facilities was being established in the early 1990s in major hospitals that were part of government medical colleges. By 1992 twenty-two such centers were in operation. Most of the 1,300 private hospitals lacked sophisticated medical facilities, although in 1992 approximately 12% possessed state-of-the-art equipment for diagnosis and treatment of all major diseases, including cancer. The fast pace of development of the private medical sector and the burgeoning middle class in the 1990s have led to the emergence of the new concept in India of establishing hospitals and health care facilities on a for-profit basis.
By the late 1980s, there were approximately 128 medical colleges - roughly three times more than in 1950. These medical colleges in 1987 accepted a combined annual class of 14,166 students. Data for 1987 show that there were 320,000 registered medical practitioners and 219,300 registered nurses. Various studies have shown that in both urban and rural areas people preferred to pay and seek the more sophisticated services provided by private physicians rather than use free treatment at public health centers.
Indigenous or traditional medical practitioners continue to practice throughout the country. The two main forms of traditional medicine practised are the ayurvedic system, which deals with mental and spiritual as well as physical well-being, and the unani (or Galenic) herbal medical practice. A vaidya is a practitioner of the ayurvedic tradition, and a hakim is a practitioner of the unani or Greek tradition. These professions are frequently hereditary. A variety of institutions offer training in indigenous medical practice. Only in the late 1970s did official health policy refer to any form of integration between Western-oriented medical personnel and indigenous medical practitioners. In the early 1990s, there were ninety-eight ayurvedic colleges and seventeen unani colleges operating in both the governmental and non-governmental sectors.

Health care in urban India

Behaviors between middle- and upper-class citizens from the four largest metros in India - Delhi, Chennai, Kolkata, and Mumbai - appear to vary widely. In general, those in Chennai appear to be more “westernized” in their attitude towards medical treatment, i.e. they are least likely to cite a chemist/pharmacist or the Internet as the source most frequently used to obtain health-related information, and are most likely to cite allopathy while least likely to cite homeopathy as their preferred system of medical treatment. Those in Kolkata appear to have a strong relationship with their healthcare provider but are generally more traditional in their attitudes towards medical treatment. Those in Delhi are most likely to have a positive view of medical care in India but also tend to be more traditional in their attitudes towards medical treatment. Finally, those in Mumbai are most likely to have a negative view on healthcare in India and also appear to have a weak relationship with their healthcare providers.

Healthcare Infrastructure

The Indian healthcare industry is seen to be growing at a rapid pace and is expected to become a US$280 billion industry by 2022 .The Indian healthcare market is currently estimated at US$35 billion and is expected to reach over US$75 billion by 2012 and US$150 billion by 2017 .According to the Investment Commission of India the healthcare sector has experienced phenomenal growth of 12 percent per annum in the last 4 years .Rising income levels and a growing elderly population are all factors that are driving this growth.In addition, changing demographics, disease profiles and the shift from chronic to lifestyle diseases in the country has led to increased spending on healthcare delivery .Even so, the vast majority of the country suffers from a poor standard of healthcare infrastructure which has not kept up with the growing economy. Despite having centers of excellence in healthcare delivery, these facilities are limited and are inadequate in meeting the current healthcare demands. Most public health facilities lack efficiency, are understaffed and have poorly maintained or outdated medical equipment.
Approximately one million people, mostly women and children, die in India each year due to inadequate healthcare. 700 million people have no access to specialist care and 80% of specialists live in urban areas .In addition to poor infrastructure India faces a shortage of trained medical personal especially in rural areas where access to care is altogether limited.
In order to meet manpower shortages and reach world standards India would require investments of up to $20 billion over the next 5 years .Forty percent of the primary health centers in India are understaffed. According to WHO statistics there are over 250 medical colleges in the modern system of medicine and over 400 in the Indian system of medicine and homeopathy (ISM&H). India produces over 250,000 doctors annually in the modern system of medicine and a similar number of ISM&H practitioners, nurses and para professionals .solutions to the problem of manpower shortage.
India faces a huge need gap in terms of availability of number of hospital beds per 1000 population. With a world average of 3.96 hospital beds per 1000 population India stands just a little over 0.7 hospital beds per 1000 population.Moreover, India faces a shortage of doctors, nurses and paramedics that are needed to propel the growing healthcare industry. India is now looking at establishing academic medical centers (AMCs) for the delivery of higher quality care with leading examples of The Manipal Group & All India Institute of Medical Sciences (AIIMS) already in place.
As incomes rise and the number of available financing options in terms of health insurance policies increase, consumers become more and more engaged in making informed decisions about their health and are well aware of the costs associated with those decisions. In order to remain competitive, healthcare providers are now not only looking at improving operational efficiency but are also looking at ways of enhancing patient experience overall.

Health in India

Healthcare in India is the responsibility of constituent states and territories of India. The Constitution charges every state with "raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties". The National Health Policy was endorsed by the Parliament of India in 1983 and updated in 2002.The art of Health Care in India can be traced back nearly 3500 years. From the early days of Indian history the Aryurvedic tradition of medicine has been practiced. During the rule of Emperor Ashoka Maurya (third century B.C.E.), schools of learning in the healing arts were created. Many valuable herbs and medicinal combinations were created. Even today many of these continue to be used. During his rein there is evidence that Emperor Ashoka was the first leader in world history to attempt to give health care to all of his citizens, thus it was the India of antiquity which was the first state to give it's citizens national health care.
In recent times India has eradicated mass famines, half of children in India are underweight, one of the highest rates in the world and nearly the same rate of Sub-Saharan Africa. Water supply and sanitation in India continue to be a challenged, only one of three Indians has access to improved sanitation facilities such as toilet. India's HIV/AIDS epidemic is a growing threat. Cholera epidemics are not unknown. The maternal mortality in India is the second highest in the world.
Providing healthcare and disease prevention to India’s growing population of more than a billion people becomes challenging in the face of increased competition for resources. 2.47 million people in India are estimated to be HIV positive. India is one of the four countries worldwide where polio has not as yet been successfully eradicated and one third of the world’s tuberculosis cases are in India .

According to the World Health Organization 900,000 Indians die each year from drinking contaminated water and breathing in polluted .As India grapples with these basic issues, new challenges are emerging for example there is a rise in chronic adult diseases such as cardiovascular illnesses and diabetes as a consequence of changing lifestyles .

There are vast disparities in people’s health even among the different states across the country largely attributed to the resource allocation by the state governments where some states have been more successful than others. Better efforts are needed by the local governments to ensure that the health services provided are actually reaching the poor in worst-affected areas.
However, at the same time, India's health care system also includes entities which are world class. The Apollo set of hospitals are considered amougst Asia's most advanced hospitals. Many patients seeking treatment from even from Pakistan have come here. In November 2008, a Pakistani girl was operated on for heart problems. Thus, India's health care system has

Health care in Japan

In the Japanese health care system, healthcare services, including screening examinations for particular diseases at no direct cost to the patient, prenatal care, and infectious disease control, are provided by national and local governments. Payment for personal medical services is offered through a universal health care insurance system that provides relative equality of access, with fees set by a government committee. People without insurance through employers can participate in a national health insurance program administered by local governments. Since 1983[1], all elderly persons have been covered by government-sponsored insurance. Patients are free to select physicians or facilities of their choice.

Public health in China

Since the founding of the People's Republic of China, the goal of healthcare programs has been to provide care to every member of the population and to make maximum use of limited health-care personnel, equipment, and financial resources. The emphasis has been on preventive rather than curative medicine on the premise that preventive medicine is "active" while curative medicine is "passive". The public health system is overseen by the Ministry of Health and the modernization of the system is studied internationally.
Certain political policies led to the starvation of millions during the Great Leap Forward; epidemic disease rebounded during the dislocations of the Cultural Revolution, which seriously harmed public health in China. The effective public health work in controlling epidemic disease during the early years of the PRC and, after reform began in 1978, the dramatic improvements in nutrition greatly improved the health and life expectancy of the Chinese people. The 2000 WHO World Health Report - Health systems: improving performance found that China's health care system before 1980 performed far better than countries at a comparable level of development, since 1980 ranks much lower than comparable countries.The end of the famed "barefoot doctor" system based in the people's communes was abolished in 1981.

The increasing privatization of medicine (private healthcare), often poorly regulated, have made corruption and inefficiency in the delivery of health services serious problems.
China is undertaking a reform on its health care system. The New Rural Co-operative Medical Care System (NRCMCS) is a new 2005 initiative to overhaul the healthcare system, particularly intended to make it more affordable for the rural poor. Under the NRCMCS, the annual cost of medical cover is 50 yuan (US$7) per person. Of that, 20 yuan is paid in by the central government, 20 yuan by the provincial government and a contribution of 10 yuan is made by the patient. As of September 2007, around 80% of the whole rural population of China had signed up (about 685 million people). The system is tiered, depending on the location. If patients go to a small hospital or clinic in their local town, the scheme will cover from 70-80% of their bill. If they go to a county one, the percentage of the cost being covered falls to about 60%. And if they need specialist help in a large modern city hospital, they have to bear most of the cost themselves, the scheme

Health in Amarika

HealthAmerica offers a suite of health plans called HealthAmericaOne®. HealthAmericaOne is designed for PA residents who are looking for individual health insurance (not covered through employer sponsored coverage). HealthAmericaOne is ideal for self-employed individuals, part-time employees, and people in between jobs.
With corporate offices in Pittsburgh and Harrisburg, Pennsylvania, HealthAmerica provides managed health care products and services to over 11,000 employer groups in Pennsylvania and Ohio. HealthAmerica and its affiliates employ over 1,500 people in Pennsylvania.
Today, HealthAmerica and their affiliated health plans insure over 700,000 members in Pennsylvania and Ohio.
HealthAmerica offers one of the state's premier provider networks, with access to over 26,000 providers, 200 hospitals, and hundreds of pharmacies in Pennsylvania and Ohio.

Health in USA

Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is primarily provided by the private sector, with the exception of programs such as Medicare, Medicaid, the Children's Health Insurance Program and the Veterans Health Administration. According to data compiled and published by multiple international pharmaceutical trade groups, the US is the world leader in biomedical research and development as well as the introduction of new biomedical products; pharmaceutical trade organizations also maintain that the high cost of health care in the U.S. has encouraged substantial reinvestment in such research and development.At least 15% of the population is completely uninsured,and a substantial additional portion of the population is "underinsured", or less than fully insured for medical costs they might incur.More money per person is spent on health care in the United States than in any other nation in the world,and a greater percentage of total income in the nation is spent on health care in the U.S. than in any United Nations member state except for East Timor.Medical debt is the principal cause of personal bankruptcy in the United States.Active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, and quality. Many have argued that the system does not deliver equivalent value for the money spent. The US pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy. Currently the U.S. has a higher infant mortality rate than most of the world's industrialized nations.The USA's life expectancy lags 42nd in the world, after most rich nations, lagging last of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th).The USA's life expectancy is ranked 50th in the world after the European Union (40th).The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study.A 2008 report by the Commonwealth Fund ranked the United States last in the quality of health care among the 19 compared countries.According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e. some kind of insurance.The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance.More broadly, the total number of people in the United States, whether insured or uninsured, who die because of lack of medical care was estimated in a 1997 analysis to be nearly 100,000 per year.

Woman health of Nepal

Almost a third of Nepal's population lives on less than a dollar a day, and political turmoil has displaced tens of thousands of people. For Nepalese women, life is particularly difficult. The country has a long record of discrimination and exploitation, and maternal mortality in Nepal has historically been among the highest in Asia. Dr. Sangeeta Mishra is trying to change that. She is a gynecologist from Nepal. She has spent much of the past year as a Fulbright Scholar at Johns Hopkins University.

On "Here and Now" she talks about how women's health issues are addressed in Nepal.Dr. Mishra: "These women they are not coming to the clinics, they don't have access to the hospital, so sitting in the clinic and solving the problem [on a] one-on-one basis, it doesn't work for Nepal."First thing which I realized was a major problem in Nepal was high rate of maternal mortality, and women were dying due to pregnancy-related complications. Women ... are not aware of pregnancy [complications] ... it's just a normal thing and that they can deliver at home and they are not aware of the consequences that pregnancy can bring."So I plan to develop a major educational and awareness generation program for these women, where most of the deaths occur ... to them of the importance of delivering at the hospital, or having a skilled helper at home."

She says around 68 percent of the women deliver in rural areas, and only 16 percent deliver in hospitals, and that delivering at home is a part of the culture: "In the family, mother-in-laws and mothers believe that, because they didn't have any complications and they delivered at home, so they think that their daughters-in-laws and daughters, they should also deliver at home."What these women don't realize is that, they deliver ten kids at home, but how many were alive? Out of ten, you have only four or five kids alive. In this era you cannot deliver ten children and then you have two or three of them alive; you should have two or three kids and all of them should be alive."The low literacy rate in Nepal is also a barrier when it comes to educating the women about health issues. Dr. Mishra says creating messages to transmit on the radio is a good way to get around the literacy problem, as well as utilizing female community health volunteers who go door-to-door.
"Here and Now" is an essential midday news magazine for those who want the latest news and expanded conversation on today's hot-button topics: public affairs, foreign policy, science and technology, the arts and more.

nepal Weater of Health

Nepal is among the least developed countries with a per capita income of around US$200.The population is growing at a rate of 2.1% per year. Nearly 50%of the total population lives below the poverty line. In term of human development Nepal ranked 22nd from the bottom out of 175 countries. It reflects low level of literacy, life expectancy at birth as well as high infant mortality rate and poor access to safe drinking water and sanitation facilities. Although most health indicators have shown significant improvement in recent years, there is a long way to go even to reach South Asian average.
Government spending on health is extremely low in Nepal and accounted for 3.7% of total expenditure and 0.7% of GDP in 1995/96. Government per capita health expenditure was estimated at around US$2.00 on 1994/95.Though health has been identified as basic human need, the above figures reveal the fact that a large segment of population still remains to be denied of many basic health care facilities. Nevertheless, Nepal, as Member State of WHO is committed to provide basic essential health care through primary health care approach. .International and national health organisations are supportive of this goal. For this to happen, His Majesty's Government of Nepal has to continue to strive harder to provide an efficient, cost-effective health service with assurance of quality in care with due attention to the issues of equity, gender sensitivity, human rights and social justice.
Nepal Health Economics Association ( NHEA ) has been established in May,1998 as an independent, non-profit, non-political, professional organization to assist His Majesty's Government towards achievement of its health goal.

Nepal Health Economics assocasion

Nepal is among the least developed countries with a per capita income of around US$200.The population is growing at a rate of 2.1% per year. Nearly 50%of the total population lives below the poverty line. In term of human development Nepal ranked 22nd from the bottom out of 175 countries. It reflects low level of literacy, life expectancy at birth as well as high infant mortality rate and poor access to safe drinking water and sanitation facilities. Although most health indicators have shown significant improvement in recent years, there is a long way to go even to reach South Asian average.
Government spending on health is extremely low in Nepal and accounted for 3.7% of total expenditure and 0.7% of GDP in 1995/96. Government per capita health expenditure was estimated at around US$2.00 on 1994/95.Though health has been identified as basic human need, the above figures reveal the fact that a large segment of population still remains to be denied of many basic health care facilities. Nevertheless, Nepal, as Member State of WHO is committed to provide basic essential health care through primary health care approach. .International and national health organisations are supportive of this goal.

For this to happen, His Majesty's Government of Nepal has to continue to strive harder to provide an efficient, cost-effective health service with assurance of quality in care with due attention to the issues of equity, gender sensitivity, human rights and social justice.
Nepal Health Economics Association ( NHEA ) has been established in May,1998 as an independent, non-profit, non-political, professional organization to assist His Majesty's Government towards achievement of its health goal.

Services of Healthnet Nepal

Services of HealthNet NepalFull Internet access. Users can access a full Internet link to use World Wide Web (WWW), gopher, e-mail, archives and file transfer protocol (FTP). These links can be made over a dial-up modem from a single computer, or a dial-on-demand setup that serves an entire local area network (LAN).Nepal related health information resources. Through our local Intranet, a wide variety of information resources related to health in Nepal can be accessed. These resources include databases, full text journals, health statistics, seminar reports, technical reports and Ph.D. and Masters degree theses.Internet advertising. This is the age of advertising and the Internet is the easiest way to reach millions of people. HealthNet Nepal has its own Web site and it can design and host web pages for its users at very reasonable prices.Consultancy service. HealthNet Nepal provides consultancy service in the use of the Internet, database search, participation in discussion groups and Usenet to get maximum benefit from the information services available through the Internet.Discussion groups and Usenet. The HealthNet Nepal server provides access to the majority of discussion groups related to health. These discussion groups can be accessed without subscribing to them.

Healthnet Nepal

IntroductionHealthNet Nepal is a non-governmental organization (NGO) that serves the Nepalese health community by providing affordable Internet service, access to health information, and technical support for several regional information-sharing initiatives. HealthNet Nepal is housed at the Health Learning Materials Centre (HLMC) of the Institute of Medicine at Tribhuvan University (IOM), and affiliated with the Institutes of Medicine and Engineering. The users of HealthNet Nepal are health workers from several prominent health and medical facilities, university departments, and non-governmental organizations. HealthNet Nepal was established in partnership with SATELLIFE, a non-governmental organization based in Watertown, Massachusetts whose mission is to combat isolation and information poverty among health professionals throughout the developing world.HealthNet Nepal is responsible for introducing many health organizations throughout Nepal to the power of information and communication technology, particularly electronic mail, as a low cost communication medium and a tool for accessing information from various sources such as MEDLINE, discussion groups, and news groups.

Health-Care Facilities

The health-care delivery network in Nepal was poorly developed. Health-care practices in the country could be classified into three major categories: popular folk medical care, which relied on a jhankri (medicine man or shaman); Ayurvedic treatment; and allopathic (modern) medicine. These practices were not necessarily exclusive; most people used all three, depending on the type of illness and the availability of services, sometimes even simultaneously.
Popular folk medicine derived from a large body of commonly held assumptions about magical and supernatural causes of illness. Sickness and death often were attributed to ghosts, demons, and evil spirits, or they were thought to result from the evil eye, planetary influences, or the displeasures of ancestors. Many precautions against these dangers were taken, including the wearing of charms or certain ornaments, the avoidance of certain foods and sights, and the propitiation of ghosts and gods with sacrificial gifts. When illness struck or an epidemic threatened, people went to see a jhankri for treatment. Such pseudomedical practices were ubiquitous; in many parts of Nepal, a jhankri was the only source of medical care available. Nepalese also regularly saw jotishi (Brahman astrologers) for counseling because they believed in planetary influence on their lives, resulting from disalignments of certain planetary signs. Jotishi were commonly relied on even in urban areas, and even by those who were well educated and frequently used modern medicine. And, virtually no arranged marital union was proposed and concluded without first consulting a jotishi.
The Ayurvedic system of medicine was believed to have evolved among the Hindus about 2,000 years ago. It originally was based on the Ayur-Veda (the Veda of Long Life), but a vast literature since has accumulated around this original text. According to the Ayurvedic theory, the body, like the universe, consists of three forces--phlegm, bile, and wind--and physical and spiritual wellbeing rests on maintaining the proper balance among these three internal forces. A harmonious existence between body and mind results. Ayurvedic pharmacopoeia--based on medicinal plants, plant roots, and herbs--remained a major source of medical treatment in Nepal. This school of medical practice also applies the hot-and- cold concept of foods and diets. In the late 1980s, there were nearly 280 practicing Ayurvedic physicians, popularly known as vaidhya, 145 Ayurvedic dispensaries, and a national college of Ayurvedic medicine in Kathmandu.
In 1991 the most commonly used form of medical treatment, especially for major health problems, was modern medicine whenever and wherever accessible. Within the domain of modern medicine, providing public health-care facilities was largely the responsibility of the government. Private facilities also existed in various regions. Modern medical service generally was provided by trained doctors, paramedics, nurses, and other community health workers. The government-operated health-care delivery system consisted of hospitals and health centers, including health posts in rural areas.
Hospitals were located mostly in urban areas and provided a much wider range of medical services than health centers. They were attended by doctors, as well as by nurses, and equipped with basic laboratory facilities. Small health centers and posts in rural areas--most of them staffed by paramedical personnel, health aides, and other minimally trained community health workers--served the needs of the scattered population. Even though these rural facilities were more accessible than urban hospitals, they generally failed to provide necessary services on a regular and consistent basis. The majority of them were barely functional because of such problems as inadequate funding; lack of trained staff; absenteeism; and chronic shortages of equipment, medicines, and vaccines.
Nepal had a total of 123 hospitals, eighteen health centers, and 816 health posts in 1990. There was one hospital bed for every 4,283 persons, an improvement since 1977, when there was one hospital bed for every 6,489 persons. The number of doctors totaled 879 in 1988, or one physician available for about 20,000 people. For the same period, other medical personnel included 601 nurses, 2,062 assistant nurses and midwives, 2,790 senior and assistant auxiliary health workers and health assistants, and 6,808 villagebased health workers.
There was no doubt in the late 1980s that considerable progress had been made in health care, but the available facilities were still inadequate to meet the growing medical needs of the population. The majority of people lacked easy access to modern medical centers, partly because of the absence of such facilities in nearby locations and partly because of the physical barrier posed by the country's rugged terrain. Because there were very few modern means of transportation in rural areas, particularly in the hills and mountains, people had to walk on average about half a day to get to health posts. Such a long walk was not only difficult (especially when the patient needed medical attention), but also meant economic hardship for the majority who rarely could afford to be absent for the whole day from their daily work. As a result, many minor illnesses went untreated, and some of them later developed into major illnesses.
In the early 1990s, Nepal's geographical limitations continued to play a large part in the country's social and economic problems. Moreover, despite twenty-five years of family planning programs, the population growth rate continued to outpace agricultural production and parts of the country continued to be food deficit areas. The educational base was also limited; only one-third of the population was literate. The generally poor health of the population and a lack of adequate health-care facilities also hindered social and economic improvements.

Nastional Health

The national health policy aims at improvement in the health conditions of the people of Nepal through extension of primary health care system to the rural population with a view to provide the benefits of modern medical facilities through trained health care providers; active involvement of private sector and NGOs in health services; and adequate training and community participation.
The strategic analysis of health sector in 1999 resulted in the development of the medium term strategic plan for the 10th five-year health plan (2002-07). This included essential, affordable and accessible health care services, promote a public-private NGO partnership, decentralise the health system and execute particular approaches at all levels, and to improve quality of health care through the public/private/NGO partnership by total quality management of human, financial and physical resources.
Considering the Local Self Governance Act (LSGA) of 1999 and the decentralised health management of the Health Sector Reform Strategy (HSRS), it is anticipated that more resources will be mobilised at the local level to ensure financial sustainability (Ministry of Health, Annual Report 2002/2003).
The Nepal government is committed to bring about tangible changes in the health-sector development process. It aims at providing an equitable, high quality health care system for all the Nepalese during tenth five-year plan (2002-07). The proportion of the government budget allocated to health will increase from the present 5 percent to 6.5 percent in 2006 and 7 percent in 2009 (Nepal health sector programme implementation plan, 2004-09).

Nepal Health Resurch

The Nepal Health Research Council (NHRC) was developed as an example of commitment of Nepal Government (NG) Nepal to promote scientific study and quality research in health in Nepal. It started as Nepal Health Research Committee under the Ministry of Health, chaired by the Secretary of Health in 1982 AD (BS 2039). On 12 April 1991 (29 Chaitra 2047 BS), the committee was developed into the Nepal Health Research Council, a statutory and autonomous body as promulgated by the Nepal Health Research Council Act No. 29 of the year 1991 of NG. With the consent of the Council of Ministers pursuant of Article 129 of the constitution of the government of Nepal, 1990 enacted the NHRC Act.

Determenant of health

The LaLonde report suggests that there are four general determinants of health including human biology, environment, lifestyle, and healthcare services. Thus, health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. A major environmental factor is water quality, especially for the health of infants and children in developing countries.

Studies show that in developed countries, the lack of neighborhood recreational space that includes the natural environment leads to lower levels of neighborhood satisfaction and higher levels of obesity; therefore, lower overall well being.Therefore, the positive psychological benefits of natural space in urban neighborhoods should be taken into account in public policy and land use.

Public Health

Public health is "the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organizations, public and private, communities and individuals." (Winslow, 1920).

It is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). Public health has many sub-fields, but is typically divided into the categories of epidemiology, biostatistics and health services. Environmental, social and behavioral health, and occupational health, are also important fields in public health.
The focus of public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease can be vital to preventing it in others, such as during an outbreak of an infectious disease. Vaccination schedules and distribution of condoms are examples of public health measures