Every day thousands of people enter and exit the capital. Officials at the ministry admit that huge numbers of people in the capital have been left out of health programs. [break]
"We know that a large number of people have been excluded from health programs although we meet the administrative targets." said Taranath Pokhrel, chief of Child Health Division (CHD) under the Department of Health Services (DoHS).
He said the office does not have reliable data on the population living in the capital. MoHP said even the Ministry of Home Affairs is unaware of the exact population of the capital.
The 2011 census shows that only 2.6 million people live in the capital, but several non-governmental organizations (NGOs) claim that the number is about four million.
The discrepancy between government data and the NGOs´ claim is supposed to be accounted for by the floating population.
Ministries always set their targets on the basis of population estimates. "We don´t know who enters the capital and who leaves. So we set targets on the basis of estimates," Pokhrel added.
Expert at DoHS, Dr Shyam Raj Upreti, also admits that the floating population is the main challenge in meeting national health goals. "To meet the national goals we need micro planning, which means planning from the bottom level," stressed Dr Upreti, who is also a former chief of CHD.
He emphasizes collaboration between local NGOs, civil society and government agencies in the planning of health programs. He believes that incompatibility between planning and needs is the hurdle to meeting national health goals.
Earlier, CHD had identified slum settlements as vulnerable from the health perspective. The office had also focused its programs on such areas. Dr Upreti, however, said that alone was not sufficient. He stressed that planning should be from the bottom level and planners should listen to the common man and learn about his needs.
In the ongoing measles-rubella vaccination campaign also, the office has been adopting a special strategy to reach the maximum number of people.
"The same strategy does not work in the capital and so we have been focusing on social mobilization, " CHD chief Pokhrel added.
He said several teams have been deployed in the slum settlements to see if any children there have been deprived of the vaccine.
CHD has also requested local clubs and social organizations for help. Organizations such as Rotary Clubs and Nepal Red Cross Society have been fostering awareness about disease and the importance of vaccination.
Overall coverage of the measles vaccination drive is only 87 percent, according to the ministry. And every year a huge number of people receive no vaccination.
"Unfortunately, the overall coverage of the campaign is also only 87 percent," said Mahendra Prasad Shrestha, chief of District Public Health Office (DPHO) Kathmandu. That means 1.3 million children across the country will escapes immunization, which is a challenge.
Kathmandu DPHO will reorganize immunization programs on Tuesday and Wednesday for people who have been left out.
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