Key Findings of Nepal Multiple Indicator Cluster Survey 2019:

Background:

The MICS is an international household survey programme developed & supported by UNICEF. MICS is designed to collect estimates of key indicators that are used to assess the situation of children & women & MICS becoming a key source of data on child protection, early childhood education & a major source of data on child health & nutrition.

Since the inception of MICS globally, three rounds survey were carried in Nepal in the year 2010, 2014 & 2019. Nepal MICS 2019 was conducted by the CENTRAL Bureau of Statistic (CBS) from May to November 2019 as a part of sixth round of the global MICS household program, with the technical & financial support from United Nations Children’s Fund (UNICEF) Nepal.

The 2019 NMICS covered a total of 12,800 households and provides a comprehensive picture of women and children across all Nepal’s regions.


1 . Literacy rate:

  • The literacy percentage of women & men age 15-24 years, who are able to read a short simple statement about everyday life is 90.3%, province 2 has recorded the lowest literacy rate i.e. 77.1 % that means, still the more numbers of adolescents in province 2 are behind the bar of getting education.

2. Reproductive & Maternal Health

The total fertility rate of Nepal is 2.0, it means that a Nepali women will have given birth to an average of 2.0 children by the end of her reproductive years.

The percentage of women age 15-49 years who are using contraceptive method (both) declined to 46.7 % & it is less than the data of both MICS 2014 (49.6%)& NDHS 2016(53%).  Hope the concerned public health authorities try their best to improve the situation.

Report showed the declined early child bearing rate i.e. 13.8% but the rate is almost near to double in Karnali province with comparison to National i.e. 24.1%, there is need to implement the effective program in Karnali province, otherwise it will become the hindrance factor for health. As per the report NMICS 2014, early child bearing rate of mid western mountain was 29.7%.

WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. WHO guidelines are specific on the content of antenatal care visits, which include:

  1. Blood pressure measurement
  2. Urine testing for bacteriuria & proteinuria
  3. Blood testing to detect syphilis and severe anemia
  4. Weight/height measurement (optional).
The percentage of women who had four ANC visits increased steadily from 69% in 2016 to 77.8% in 2019 but province 2 recorded the lowest i.e.56.8%.

Among the different findings, there was rise in health facility-based delivery & the use of SBAs. There was 20% increment in institutional delivery with comparison to data of NDHS 2016 & reached 77.5%. the worried part is that, only 62.0 % of delivery were held in health facility of Karnali province & only 67.3% birth assisted by SBAs. 

Karnali province has also recorded the lowest post-natal health check for the mother i.e.49.3, geographical factor isn’t only the reason for this, there is raised the question for different governmental & non-governmental organizations.

 3. Child Mortality

The U5MR, IMR & NMR are declined with comparison to NMICS 2014 & NDHS 2016. During the period of 2014-2019, U5MR is reduced to 28 deaths per 1000 live births, overall, the rate is declined but province 2 & Sudurpaschim province recorded the highest mortality as 40 & 39 respectively.

Simultaneously, Infant mortality rate declined from 33 deaths per 1000 live births in 2014 to 25 per 1000 live births in 2019, comparatively province 5 recorded the highest mortality i.e. 35 deaths per 1000 live births.

Neonatal Mortality rate fell gradually from 23 deaths per thousand live births in 2014 to 16 deaths per thousand live births in 2019 but Sudurpaschim province has accounted 25.

4. Child Health Nutrition & Development

Nepal has made impressive strides in reducing the prevalence of Stunting & Underweight nationally, which fell from 37.4 % & 30.1% in 2014 to 31.5% & 24.3% respectively in 2019. 

Stunting prevalence for children under 5 years does vary by province; Karnali province recorded the highest rate i.e. 47.8 % & Sudurpaschim also accounted for 40.9%. Similarly, Underweight prevalence is also high in Karnali.

The wasting rate reached 12.0% which is slightly more than the rate of 2014 & the maximum wasted rate has recorded in Karnali which is 17.6%.

Although immunization coverage in Nepal has improved over the last five years, 70.2% of children aged 12–23 months had received all basic vaccinations by their first birthday.

5. Water Sanitation & Hygiene

Nepal has made significant progresses in expanding access to water and sanitation over the last few decades,97.1% of households now have access to improved drinking water sources and 94.5% of households are using an improved sanitation facility.

6.  Menstruation & Chhaupadi Practice
  • The total 9.4% of women didn’t participate in social activities that means they were excluded from activities during the time of menstruation, Sudurpaschim province recorded the highest percentage i.e. 40.7 & followed by Karnali province i.e. 18.9%. 
The percentage of women who had to stay in menstrual huts during the time of menstruation was found to be 2.5% but it is highly practiced in Sudurpaschim & Karnali province i.e 17.4 & 10.2% respectively.


Both the child mortality & Maternal mortality is high in Karnali & Sudurpaschim, thus there is need to find out the major reason for addressing the mortality, if the researches will be done effectively with linking the researches with Chhaupadi practice, I thought that this type of bad practice may be the major cause for higher child & maternal mortality.